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Levels of Analysis in Psychopathology draws research from psychiatry, philosophy, and psychology to explore the variety of explanatory approaches for understanding the nature of psychiatric disorders both in practice and research. The fields of psychiatry and clinical psychology incorporates many useful explanatory approaches and this book integrates this range of perspectives and makes suggestions about how to advance etiologic theories, classification, and treatment. The editors have brought together leading thinkers who have been widely published and are well-respected in their area of expertise, including several developers of the Diagnostic and Statistical Manual of Mental Disorders and authors of the US National Institute of Mental Health's Research Domain Criteria Project (RDoC). Each main chapter has a commentary provided by one of the other authors and an introduction written by one of the editors to create an accessible, interdisciplinary dialog.
Some of the greatest successes in infectious disease control rest on empirically grounded models of human and livestock infections. In contrast, disease control in wildlife has not always been as successful. Timely translation of knowledge into proposed management actions remains a challenge in several wildlife disease systems, one of which is pneumonia management in bighorn sheep throughout the North American West. Although pneumonia was recognised as a major impediment to bighorn sheep conservation >80 years ago, a series of challenges stymied the management decision-making process. Despite past obstacles, recent advances from long-term, intensive studies of marked individual sheep have motivated new interest in research-driven strategies for disease management in this system. The system provides an unusual opportunity to study an emerging pathogen disproportionately impacting immature animals through infections that originate from asymptomatically infected adult hosts. We tell the story of bighorn sheep pneumonia, emphasising the obstacles that historically hindered decision-making, the biological or logistical constraints underlying each decision point, and the particular empirical insights that clarified each constraint.
In the days that followed his first fight, having seen bodies ripped apart by bullets and shells, Virginian Cornelius Bell prayed every night for God to keep him from returning to the battlefield. “No never again do I wish to pass through what I did last Monday evening and night.” Wherever he turned, he saw men “suffering the agonies of death.” That night, when the musketry turned to desultory skirmishing, Bell felt great sympathy for the “dead & dying enemy,” “Each & every one of whom” he wrote to his wife, “was some ones darling son, brother or husband. And there they lay cold in death, their bodies stripped of the few old clothes they had on & every indignity that could be heaped upon them was.” Some of the wounded were still clinging to life, their naked bodies shaking in the final spasms of life as Bell watched in horror. When the Shenandoah Valley farmer turned Confederate soldier thought about the desecration of the dead, he was sickened by the hypocrisy of his comrades whom “I suppose in the estimation of some [think] this was all right.” Bell could just imagine his fellow soldiers saying the following words as if memorized in their youth. “The Yanks are a God forsaken people & we are his delight.
Impairments of contextual processing and theory of mind (ToM) have both been offered as accounts of the deviant language characterising formal thought disorder (FTD) in schizophrenia. This study investigated these processes in patients' dialogue. We predicted that FTD patients would show a decrement in linguistic alignment, associated with impaired ToM in dialogue.
Speech samples were elicited via participation in an interactive computer-based task and a semi-structured interview to assess contextual processing abilities and ToM skills in dialogue, respectively, and from an interactive card-sorting task to measure syntactic alignment. Degree of alignment in dialogue and the syntactic task, and evidence of ToM in (i) dialogue and (ii) a traditional ToM task were compared across schizophrenia patients with FTD (n = 21), non-FTD patients (n = 22) and healthy controls (n = 21).
FTD patients showed less alignment than the other two groups in dialogue, and than healthy controls on the syntactic task. FTD patients showed poorer performance on the ToM task than the other two groups, but only compared to the healthy controls in dialogue. The FTD group's degree of alignment in dialogue was correlated with ToM performance in dialogue but not with the traditional ToM task or with syntactic alignment.
In dialogue, FTD patients demonstrate an impairment in employing available contextual information to facilitate their own subsequent production, which is associated with a ToM deficit. These findings indicate that a contextual processing deficit impacts on exploiting representations via the production system impoverishing the ability to make predictions about upcoming utterances in dialogue.
This study analyses the interplay between classical acoustic modes and intrinsic thermoacoustic (ITA) modes in a simple thermoacoustic system. The analysis is performed using a frequency-domain low-order network model as well as a time-domain spatially discretised model. Anti-correlated modal sensitivities are found to arise due to a pairwise interplay between acoustic and ITA modes. The magnitude of the sensitivities increases as the interplay between the modes grows stronger. The results show a global behaviour of the modes linked to the presence of exceptional points in the spectrum. The time-domain analysis results in a delay-differential equation and allows the investigation of non-normal behaviour and its consequences. Pseudospectral analysis reveals that energy amplification is crucially linked to an interplay between acoustic and ITA modes. While higher non-orthogonality between two modes is correlated with peaks in modal sensitivity, transient energy growth does not necessarily involve the most sensitive modes. In particular, growth estimates based on the Kreiss constant demonstrate that transient amplification relies critically on the proximity of the non-normal modes to the imaginary axis. The time scale for transient amplification is identified as the flame time delay, which is further corroborated by determining the optimal initial conditions responsible for the bulk of the non-modal energy growth. The flame is identified as an active and dominant contributor to energy gain. The frequency of the optimal perturbation matches the acoustic time scale, once more confirming an interplay between acoustic and ITA structures. Flame-based amplification factors of two to five are found, which are significant when feeding into the acoustic dynamics and eventually triggering nonlinear limit-cycle behaviour.
Humanity’s future will be shaped by the portfolio of capital assets we inherit and choose to pass on to our descendants, and by the balance we strike between the portfolio and the size of our population. So it makes sense to include population on the list of a society’s assets and build an overarching study of our relationship with our descendants and with nature by dividing assets into three categories: produced capital (buildings, roads, ports, machines, instruments), human capital (population, health, education, knowledge and skills) and natural capital (biodiversity, ecosystems, subsoil resources). In this Introduction we offer a perspective on the chapters that follow by summarising salient aspects of humanity’s troubled relationship with the biosphere.
Metabolic syndrome (MetS) is associated with reduced life expectancy in patients with affective disorders, however, whether MetS also plays a role before the onset of affective disorder is unknown. We aimed to investigate whether MetS, inflammatory markers or oxidative stress act as risk factors for affective disorders, and whether MetS is associated with increased inflammation and oxidative stress.
We conducted a high-risk study including 204 monozygotic (MZ) twins with unipolar or bipolar disorder in remission or partial remission (affected), their unaffected co-twins (high-risk) and twins with no personal or family history of affective disorder (low-risk). Metabolic Syndrome was ascertained according to the International Diabetes Federation (IDF) criteria. Inflammatory markers and markers of oxidative stress were analyzed from fasting blood and urine samples, respectively.
The affected and the high-risk group had a significantly higher prevalence of MetS compared to the low-risk group (20% v. 15% v. 2.5%, p = 0.0006), even after adjusting for sex, age, smoking and alcohol consumption. No differences in inflammatory and oxidative markers were seen between the three groups. Further, MetS was associated with alterations in inflammatory markers, and oxidative stress was modestly correlated with inflammation.
Metabolic syndrome is associated with low-grade inflammation and may act as a risk factor and a trait marker for affective disorders. If confirmed in longitudinal studies, this suggests the importance of early intervention and preventive approaches targeted towards unhealthy lifestyle factors that may contribute to later psychopathology.
The purpose of this study was to examine sex differences in neuropsychological functioning after sports-related concussion using several approaches to assess cognition: mean performance, number of impaired scores, and intraindividual variability (IIV).
In the study, 152 concussed college athletes were administered a battery of neuropsychological tests, on average, 10 days post-concussion (SD = 12.75; Mdn = 4 days; Range = 0–72 days). Mean performance was evaluated across 18 individual neuropsychological variables, and the total number of impaired test scores (>1.5 SD below the mean) was calculated for each athlete. Two measures of IIV were also computed: an intraindividual standard deviation (ISD) score and a maximum discrepancy (MD) score.
Analyses of covariance revealed that, compared with males, females had significantly more impaired scores and showed greater variability on both IIV indices (ISD and MD scores) after adjusting for time since injury and post-concussive symptoms. In contrast, no significant effects of sex were found when examining mean neuropsychological performance.
Although females and males demonstrated similar mean performance following concussion, females exhibited a greater level of cognitive impairment and larger inconsistencies in cognitive performance than males. These results suggest that evaluating cognitive indices beyond mean neuropsychological scores may provide valuable information when determining the extent of post-concussion cognitive dysfunction. (JINS, 2019, 00, 1–7)
North-west Atlantic rocky intertidal shores contain few species that are affected by sharp environmental gradients. As a result, these communities have been widely used as a model experimental system. Earlier studies focussed on how average differences in ecological processes can be driven by environmental differences. More recently, there is an emphasis on how variability in recruitment and ecological interactions can shape communities. In this chapter, we explore how these two distinctly different conceptual approaches – average effects versus variability in effects – have affected the course of ecological research. Our review touches on how phylogeographic history, large-scale variability in ecological processes and small-scale indirect interactions have contributed to the generation and maintenance of community patterns. We argue that human activities, including harvesting, introducing non-native species, eutrophication and climate change, are likely to increase the variability of ecological processes. We conclude that variability of ecological processes and human activities vary on a scale much larger or longer than a typical experiment. Future studies should explicitly incorporate scales that capture the role of variability on the resilience of coastal ecosystems.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
In the process of researching this chapter, the first author spent a crisp December day touring London’s major bookshops in an attempt to discover what recent books on health might have to say about leadership and what those on leadership might have to say about health. It was a pleasant way to spend a day, but, as a research exercise, it was something of a failure. Of the books on health, not a single one had an index entry for leadership and most restricted their coverage of the topic to general discussions of team and patient management as aspects of effective healthcare. Conversely, very few of the books on leadership had much to say about health, although the biographies of influential leaders (e.g. Obama, Gillard, Thatcher) typically included significant sections devoted to the biographee’s policy on health (e.g. democratisation, rationalisation, privatisation).