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Psychotic experiences are reported by 5–10% of young people, although only a minority persist and develop into psychotic disorders. It is unclear what characteristics differentiate those with transient psychotic experiences from those with persistent psychotic experiences that are more likely to be of clinical relevance.
To investigate how longitudinal profiles of psychotic experiences, created from assessments at three different time points, are influenced by early life and co-occurring factors.
Using data from 8045 individuals from a birth cohort study, longitudinal profiles of psychotic experiences based on semi-structured interviews conducted at 12, 18 and 24 years were defined. Environmental, cognitive, psychopathological and genetic determinants of these profiles were investigated, along with concurrent changes in psychopathology and cognition.
Following multiple imputations, the distribution of longitudinal profiles of psychotic experiences was none (65.7%), transient (24.1%), low-frequency persistent (8.4%) and high-frequency persistent (1.7%). Individuals with high-frequency persistent psychotic experiences were more likely to report traumatic experiences, other psychopathology, a more externalised locus of control, reduced emotional stability and conscientious personality traits in childhood, compared with those with transient psychotic experiences. These characteristics also differed between those who had any psychotic experiences and those who did not.
These findings indicate that the same risk factors are associated with incidence as with persistence of psychotic experiences. Thus, it might be that the severity of exposure, rather than the presence of specific disease-modifying factors, is most likely to determine whether psychotic experiences are transient or persist, and potentially develop into a clinical disorder over time.
Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression.
Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs.
Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations.
Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature.
Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.
A history of childhood adversity is associated with psychotic disorder, with an increase in risk according to the number of exposures. However, it is not known why only some exposed individuals go on to develop psychosis. One possibility is pre-existing polygenic vulnerability. Here, we investigated, in the largest sample of first-episode psychosis (FEP) cases to date, whether childhood adversity and high polygenic risk scores for schizophrenia (SZ-PRS) combine synergistically to increase the risk of psychosis, over and above the effect of each alone.
We assigned a schizophrenia-polygenic risk score (SZ-PRS), calculated from the Psychiatric Genomics Consortium (PGC2), to all participants in a sample of 384 FEP patients and 690 controls from the case–control component of the EU-GEI study. Only participants of European ancestry were included in the study. A history of childhood adversity was collected using the Childhood Trauma Questionnaire (CTQ). Synergistic effects were estimated using the interaction contrast ratio (ICR) [odds ratio (OR)exposure and PRS − ORexposure − ORPRS + 1] with adjustment for potential confounders.
There was some evidence that the combined effect of childhood adversities and polygenic risk was greater than the sum of each alone, as indicated by an ICR greater than zero [i.e. ICR 1.28, 95% confidence interval (CI) −1.29 to 3.85]. Examining subtypes of childhood adversities, the strongest synergetic effect was observed for physical abuse (ICR 6.25, 95% CI −6.25 to 20.88).
Our findings suggest possible synergistic effects of genetic liability and childhood adversity experiences in the onset of FEP, but larger samples are needed to increase precision of estimates.
In times of democratic backsliding and electorally successful populist leaders, it becomes relevant to identify which actors could function as gatekeepers of institutional and policy change. Would civil servants be willing to act as veto players by refusing to implement policies that undermine democratic institutions? We provide preliminary answers to this question based on a set of survey experiments conducted with Brazilian bureaucrats. Using the triad “working, shirking, and sabotage” (Brehm and Gates 1999), our results confirm that civil servants are willing to shirk and sabotage if assigned to implement policies that are perceived to restrict democratic rights, such as the freedoms of press and expression. Furthermore, we demonstrate how different individual characteristics affect the bureaucrats’ intention to behave in these situations.
Populism challenges our democracies. And populists in governments attempt to transform public administration systems in manifold illiberal ways. This chapter outlines an analytical frame for systematic comparative research on determining how populists attempt to convert public bureaucracies, what are their motivations, and what are their chances of succeeding. It bridges different strands of scholarship that have remained rather insulated so far. It complements the debate on system transformation and democracy systematically with administrative aspects. The chapter thus offers a path to integrate public administration scholarship in system transformation research by eliciting the role of bureaucracies in reform projects of populist governments.
The complex relationship between populist governments and their bureaucratic apparatus constituted the center of the theoretical and empirical analyses of this book. The concluding chapter synthesises the comparative insights form the chapters and assesses the validity of the theoretical claims of the introduction. It warns that populists in government are not condemned to fail. Populism may well get entrenched in individual political systems. Public administration has a warden role: namely, identifying threats to liberal society and our democratic systems.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
Archaeology is often defined as the study of the past through material culture. As we enter the Anthropocene, however, the two parts of this definition increasingly diverge. In the Anthropocene the archaeological record ceases to be observed from a distance, but is something we exist within. It is not an assemblage of material culture, but a hyperobject of vast temporal and geographical scope, in which ecofacts increase in prominence and the role of artefacts recedes. This article examines the archaeological record as a hyperobject and argues for an expanded definition of archaeology for the future past. It argues for a shift from the study of objects towards a broader archaeology that includes immaterial Anthropocene culture.
Liberal democracy is at risk. Its hallmark institutions – political pluralism, separation of powers, and rule of law—are coming under pressure, as authoritarian sentiment is growing around the globe. While liberal-democratic backsliding features prominently in social science scholarship, especially the branches concerned with political parties and political behavior, public administration research lags behind. However, without considering illiberal approaches towards the executive, efforts of actual and aspiring authoritarians remain only partly understood. State bureaucracies are, after all, important instruments of power. This timely and important volume addresses the administrative implications of liberal-democratic backsliding. It studies public administrations as objects and subjects in the context of illiberal dynamics. For this purpose, the volume brings together an international group of scholars to analyze authoritarian tendencies in several countries. The contributions combine theoretical with empirical work, providing the first comparative perspective on an overlooked aspect of one of the most important contemporary political trends.