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This chapter presents an overview of the nature, assessment, and treatment of obsessive-compulsive and related disorders (OCRD), including obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), hair-pulling disorder (HPD), and skin-picking disorder (SPD). Specifically, we review the DSM-V diagnostic criteria, epidemiology and impact, clinical features and course, and etiological insights for each of these disorders in turn. Next, we discuss key points to consider when making a differential diagnosis with disorders outside the OCRD category. From there, we turn to a discussion of the assessment and treatment of these disorders using pharmacological, cognitive-behavioral, and neuromodulation interventions. Future directions in the research on OCRDs then follows.
We present a framework for predicting the interactions between motion at a single scale and the underlying stress fluctuations in wall turbulence, derived from approximations to the Navier–Stokes equations. The dynamical equations for an isolated scale and stress fluctuations at the same scale are obtained from a decomposition of the governing equations and formulated in terms of a transfer function between them. This transfer function is closely related to the direct correlation coefficient of Duvvuri & McKeon (J. Fluid Mech., vol. 767, 2015, R4), and approximately to the amplitude modulation coefficient described in Mathis et al. (J. Fluid Mech., vol. 628, 2009, pp. 311–337), by consideration of interactions between triadically consistent scales. In light of the agreement between analysis and observations, the modelling approach is extended to make predictions concerning the relationship between very-large motions and small-scale stress in the logarithmic region of the mean velocity. Consistent with experiments, the model predicts that the zero-crossing height of the amplitude modulation statistic coincides with the wall-normal location of the very large-scale peak in the one-dimensional premultiplied spectrum of streamwise velocity fluctuations, the critical layer location for the very large-scale motion. Implications of fixed phase relationships between small-scale stresses and larger isolated scales for closure schemes are briefly discussed.
The influence of repetitive transcranial magnetic stimulation (rTMS) on mood in healthy people is uncertain, as former studies show divergent results. Previous studies in healthy volunteers focused exclusively on the immediate effect of a single session of rTMS on mood.
Aims
The aim of this study was to analyse the influence on mood of a series of 9 High Frequency (HF) rTMS stimulations of the left dorsolateral prefrontal cortex (DLPFC).
Methods
44 young healthy male volunteers were randomly assigned to receive 9 sessions of active HF-rTMS (n = 22) or sham rTMS (n = 22) over the left DLPFC. Each session in the active group consisted of 15 trains of 25 Hz starting with 100% of motor threshold. Sham stimulation was performed following the same protocol, but using a sham coil. The variables of interest were the Beck Depression Inventory (BDI) and Visual Analogue Scales (VAS) which quantified “mood”, “enjoyment” and “energy”.
Results
We found a significant reduction of the BDI score in the active group (GLM, p < 0.001) whereas no significant changes of the BDI score were caused by sham stimulation (GLM, p = 0.109). We did not find significant differences caused by active or sham stimulation in VAS scales except for the VAS labelled lively/gloomy immediately after stimulation. The active group was found to be more “gloomy” (p = 0.001).
Conclusions
Our data support the hypothesis that a 9-day long series of HF-rTMS of the left DLPFC improves mood, analysed by BDI in healthy young men.
Psychotic and psychotic-like experiences (PLEs) are frequently found in the general population when assessed with self-report questionnaires. It is not clear how these assessments can help to predict the future development of mental disorders. The degree of certainty in appraisal or the experience-related distress may add prognostic power of clinical PLE assessments. This study was designed to provide baseline data of PLEs in a representative sample, which will be monitored for the future development.
Methods
We studied the frequency of PLEs in a representative sample of 4483 participants of the German population recruited through the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH). Participants were asked if they had had psychotic or psychosis-like experiences over their lifetime. We used the psychosis section of the Composite International Diagnostic Interview (CIDI), the Launay-Slade Hallucination Scale (LSHS) and the Peter's Delusion Inventory (PDI).
Preliminary Results
33.3% of the participants endorsed at least one item of the CIDI psychosis scale, 68.8% of the PDI and 49.0% of the LSHS. In the PDI assessments, conspiracy-related delusional experiences were most often experienced as distressing, while religious beliefs were experienced less distressing, but with high levels of conviction.
Discussion
Our findings show frequent endorsement of lifetime psychotic or psychotic-like experiences in the general population in self-report questionnaires with varying degrees of distress and conviction. This provides the needed baseline assessment for follow-up studies observing the development of mental disorders with a view to determine the predictive values of these tests.
There is absence knowledge about the effects of lactation trimester and parity on eating behavior, production and efficiency of dairy cows. Objective of this study was to identify and characterize in 340 dairy cows, the 20% high efficient (HE), 20% low efficient (LE) and 60% mid efficient (ME) cows according to their individual residual feed intake (RFI) values, within and between lactation trimesters and between 1st and 2nd parities. Efficiency effect within each lactation trimester, was exhibited in daily dry matter intake (DMI), eating rate and meal size, that were the highest in LE cows, moderate in the ME cows and lowest in the HE group. Daily eating time, meal frequency, yields of milk and energy-corrected milk (ECM) and BW were similar in the three efficiency groups within each trimester. The lower efficiency of the LE cows in each trimester attributes to their larger metabolic energy intake, heat production and energy losses. In subgroup of 52 multiparous cows examined along their 1st and 2nd trimesters, milk and ECM production, DMI, eating behavior and efficiency traits were similar with high Pearson’s correlation (r=0.78 to 0.89) between trimesters. In another subgroup of 42 multiparous cows measured at their 2nd and 3rd trimesters, milk and ECM yield, DMI and eating time were reduced (P<0.01) at the 3rd trimester, but eating rate, meal frequency and meal size remained similar with high Pearson’s correlation (r=0.74 to 0.88) between trimesters. In subgroup of 26 cows measured in 1st and 2nd parities, DMI, BW, milk and ECM yield, and ECM/DMI increased in the 2nd lactation, but eating behavior and RFI traits were similar in both parities. These findings encourage accurate prediction of DMI based on a model that includes eating behavior parameters, together with individual measurement of ECM production. This can be further used to identify HE cows in commercial herd, a step necessary for potential genetic selection program aimed to improve herd efficiency.
With the loss of methyl bromide (MeBr) and high prices of alternatives, tomato growers are applying lower fumigant rates or adopting a reduced system. Without the broad-spectrum control provided by the complete fumigant system, a fallow weed program might be needed to avoid an increase in pest pressure with consecutive years of application of the reduced-fumigant system. Nutsedges are among the pests of interest due to their fast reproduction by underground structures and ability to spread and quickly infest a field. Field trials were conducted between February and December of 2011 in Balm, FL, to evaluate the impacts of fallow treatments, fumigants, and halosulfuron on nutsedge control. The trial design was a split–split plot with main, sub-, and subsubplots being fallow, fumigant, and herbicide treatment, respectively. Fallow treatments were spaced evenly throughout the fallow season and consisted of sequential combinations of cultivation (C) and/or glyphosate (G) applied at 2.24 kg ae ha−1; including: C, CC, G, GG, CG, GC, GCG, and NO (nontreated control). Fumigant treatments included a reduced-fumigant system of 1,3-dichloropropene plus chloropicrin 40:60 (1,3-D + pic) at 281 kg ha−1, a complete fumigant system of dimethyl disulfide plus chloropicrin 79:21 (DMDS + pic) at 545 kg ha−1, and no fumigant (NoFum). Herbicide treatments were either two POST applications of halosulfuron at 39 g ai ha−1 (Hal) or no halosulfuron (NoHal). In general, the fallow weed treatment GCG was the most effective in reducing nutsedge shoot emergence through the plastic mulch. When the reduced-fumigant system 1,3-D + pic was combined with GCG fallow treatment and halosulfuron (GCG:1,3-D + pic:Hal), no differences were found between this combination and the complete fumigant system DMDS + pic with halosulfuron and combined with CC, G, GG, CG, GC or GCG. This study shows the importance of adding a fallow weed program and halosulfuron to either a reduced or complete fumigation system to minimize the reproduction and growth of nutsedges.
As the amount of methyl bromide approved for use in Florida strawberry diminishes, growers are faced with a forced transition to alternative fumigants. Many of these methyl bromide alternatives have been associated with reductions in weed control, requiring additional but complementary measures. POST herbicide options for annual strawberry are limited, resulting in significant portions of the strawberry acreage in Florida being hand-weeded when troublesome weeds escape conventional control methods. Strawberry has shown acceptable tolerance to clopyralid in other areas and production systems; however, its integration into the Florida production system and ramifications of applications during fruiting warrants further research. Eight trials were conducted, with three common strawberry cultivars grown in West Central Florida subjected to POST spray and drip-tape-injected applications of clopyralid. Formation of new strawberry leaves was not affected by clopyralid application, except for a reduction in new leaves of the cultivar ‘Strawberry Festival' at the highest rate of application of 261 g ae ha−1 in comparison with the nontreated control. Strawberry leaf malformation was best explained by an exponential growth equation, whereas marketable yield followed the trend of a Weibull peak. At the maximum labeled rate (66 g ha−1), leaf malformation was less than 5% for all cultivars tested, and marketable yield was estimated at 104% of the nontreated control.
One in 5 PN are ejected from common envelope binary interactions but Kepler results are already showing this proportion to be larger. Their properties, such as abundances can be starkly different from those of the general population, so they should be considered separately when using PN as chemical or population probes. Unfortunately post-common envelope PN cannot be discerned using only their morphologies, but this will change once we couple our new common envelope simulations with PN formation models.
Provision and need for mental health services among military personnel are a major concern across nations. Two recent comparisons suggest higher rates of mental disorders in US and UK military personnel compared with civilians. However, these findings may not apply to other nations. Previous studies have focused on the overall effects of military service rather than the separate effects of military service and deployment. This study compared German military personnel with and without a history of deployment to sociodemographically matched civilians regarding prevalence and severity of 12-month DSM-IV mental disorders.
Method.
1439 deployed soldiers (DS), 779 never deployed soldiers (NS) and 1023 civilians were assessed with an adapted version of the Munich Composite International Diagnostic interview across the same timeframe. Data were weighted using propensity score methodology to assure comparability of the three samples.
Results.
Compared with adjusted civilians, the prevalence of any 12-month disorder was lower in NS (OR: 0.7, 95% CI: 0.5–0.99) and did not differ in DS. Significant differences between military personnel and civilians regarding prevalence and severity of individual diagnoses were only apparent for alcohol (DS: OR: 0.3, 95% CI: 0.1–0.6; NS: OR: 0.2, 95% CI: 0.1–0.6) and nicotine dependence (DS: OR: 0.5, 95% CI: 0.3–0.6; NS: OR: 0.5, 95% CI: 0.3–0.7) with lower values in both military samples. Elevated rates of panic/agoraphobia (OR: 2.7, 95% CI: 1.4–5.3) and posttraumatic stress disorder (OR: 3.2, 95% CI: 1.3–8.0) were observed in DS with high combat exposure compared with civilians.
Conclusions.
Rates and severity of mental disorders in the German military are comparable with civilians for internalising and lower for substance use disorders. A higher risk of some disorders is reduced to DS with high combat exposure. This finding has implications for mental health service provision and the need for targeted interventions. Differences to previous US and UK studies that suggest an overall higher prevalence in military personnel might result from divergent study methods, deployment characteristics, military structures and occupational factors. Some of these factors might yield valuable targets to improve military mental health.
Background: Obsessive beliefs account for substantial (but not all) obsessive-compulsive (OC) symptoms. Intolerance of internal experiences (IIE), which encompasses the constructs of experiential avoidance (EA) and distress tolerance (DT), refers to difficulty managing unwanted thoughts, emotions, and other internal states, and might add to current explanatory models. Although IIE appears to be conceptually relevant to obsessive-compulsive (OC) symptoms, scant research has examined this relationship empirically. Aim: The present study examined the relative contributions of EA and DT as predictors of OC symptom dimensions. Method: A nonclinical sample (n = 496) completed self-report questionnaires measuring general distress, EA, DT and OC symptom dimensions. Results: All variables of interest were significantly (all ps ≤ .001) correlated with one another, such that higher general distress, higher EA, and lower DT were associated with greater OC symptom severity for all symptom dimensions; however, only EA independently predicted obsessional symptoms, but not other OC symptom dimensions. Conclusions: One's willingness to endure (i.e. EA), rather than their ability to tolerate (i.e. DT) unpleasant internal experiences best predicts obsessional symptoms (i.e. obsessing) above and beyond general distress. Potential implications for understanding, assessing, and treating OC symptoms are discussed.
The number of studies on electronic self-monitoring in affective disorder and other psychiatric disorders is increasing and indicates high patient acceptance and adherence. Nevertheless, the effect of electronic self-monitoring in patients with bipolar disorder has never been investigated in a randomized controlled trial (RCT). The objective of this trial was to investigate in a RCT whether the use of daily electronic self-monitoring using smartphones reduces depressive and manic symptoms in patients with bipolar disorder.
Method
A total of 78 patients with bipolar disorder according to ICD-10 criteria, aged 18–60 years, and with 17-item Hamilton Depression Rating Scale (HAMD-17) and Young Mania Rating Scale (YMRS) scores ≤17 were randomized to the use of a smartphone for daily self-monitoring including a clinical feedback loop (the intervention group) or to the use of a smartphone for normal communicative purposes (the control group) for 6 months. The primary outcomes were differences in depressive and manic symptoms measured using HAMD-17 and YMRS, respectively, between the intervention and control groups.
Results
Intention-to-treat analyses using linear mixed models showed no significant effects of daily self-monitoring using smartphones on depressive as well as manic symptoms. There was a tendency towards more sustained depressive symptoms in the intervention group (B = 2.02, 95% confidence interval −0.13 to 4.17, p = 0.066). Sub-group analysis among patients without mixed symptoms and patients with presence of depressive and manic symptoms showed significantly more depressive symptoms and fewer manic symptoms during the trial period in the intervention group.
Conclusions
These results highlight that electronic self-monitoring, although intuitive and appealing, needs critical consideration and further clarification before it is implemented as a clinical tool.
Adequate Zn and Mg intakes may be beneficial for the prevention and treatment of mental health problems, such as depression, anxiety and attention-deficit hyperactivity disorder. We aimed to investigate the prospective association between dietary intakes of Zn and Mg and internalising and externalising behaviour problems in a population-based cohort of adolescents.
Design
Prospective analysis (general linear mixed models) of dietary intakes of Zn and Mg assessed using a validated FFQ and mental health symptoms assessed using the Youth Self-Report (YSR), adjusting for sex, physical activity, family income, supplement status, dietary misreporting, BMI, family functioning and energy intake.
Setting
Western Australian Pregnancy Cohort (Raine) Study.
Subjects
Adolescents (n 684) at the 14- and 17-year follow-ups.
Results
Higher dietary intake of Mg (per sd increase) was significantly associated with reduced externalising behaviours (β=−1·45; 95 % CI −2·40, −0·50; P=0·003). There was a trend towards reduced externalising behaviours with higher Zn intake (per sd increase; β=−0·73; 95 % CI −1·57, 0·10; P=0·085).
Conclusions
The study shows an association between higher dietary Mg intake and reduced externalising behaviour problems in adolescents. We observed a similar trend, although not statistically significant, for Zn intake. Randomised controlled trials are necessary to determine any benefit of micronutrient supplementation in the prevention and treatment of mental health problems in adolescents.
Despite the importance of skeletal growth during adolescence, there is limited research reporting vitamin D status and its predictors in adolescents. Using prospective data from the Western Australian Pregnancy Cohort (Raine) Study, we investigated vitamin D status and predictors of serum 25-hydroxyvitamin D (25(OH)D) concentrations in adolescents. Serum 25(OH)D concentrations were measured in the same participants at 14 and 17 years (n 1045 at both time points). The percentage of adolescents with serum 25(OH)D concentrations < 50, 50–74·9 and ≥ 75 nmol/l was reported year-round and by month of blood collection. We examined the predictors of serum 25(OH)D concentrations, including sex, race, month of blood collection, physical activity, BMI, family income, and Ca and vitamin D intakes (n 919 at 14 years; n 570 at 17 years), using a general linear mixed model. At 14 years, 31 % of adolescents had serum 25(OH)D concentrations between 50 and 74·9 nmol/l and a further 4 % had concentrations < 50 nmol/l. At 17 years, 40 % of adolescents had serum 25(OH)D concentrations between 50 and 74·9 nmol/l and 12 % had concentrations < 50 nmol/l. Caucasian ethnicity, being sampled at the end of summer, exercising more, having a lower BMI, a higher Ca intake and a higher family income were significantly associated with higher serum 25(OH)D concentrations. The proportion of adolescents with serum 25(OH)D concentrations < 50 nmol/l was low in this Western Australian cohort. There is a need for international consensus on defining adequate vitamin D status in order to determine whether strategies to increase vitamin D status in adolescents are warranted.
Recent Hα surveys such as SHS and IPHAS have improved the completeness of the Galactic planetary nebula (PN) census. We now know of ∼3000 PNe in the Galaxy, but this is far short of most estimates, typically ~25 000 or more for the total population. The size of the Galactic PN population is required to derive an accurate estimate of the chemical enrichment rates of nitrogen, carbon, and helium. In addition, a high PN count (>20 000) is strong evidence that most main-sequence stars of mass 1–8 M⊙ will go through a PN phase, while a low count (<10 000) argues that special conditions (e.g. close binary interactions) are required to form a PN. We describe a technique for finding hundreds more PNe using the existing data collections of the digital sky surveys, thereby improving the census of Galactic PNe.
Maternal pre-pregnancy obesity has been linked with an increased risk for negative emotionality and inattentiveness in offspring in early childhood. The aim of this study was to examine the association between maternal pre-pregnancy body mass index (BMI) and the development of affective problems (dysthymic disorder, major depressive disorder) throughout childhood and adolescence. In the Western Australian Pregnancy Cohort (Raine) Study, 2900 women provided data on their pre-pregnancy weight, and height measurements were taken at 18 weeks of gestation. BMI was calculated and categorized using standardized methods. Live-born children (n = 2868) were followed up at ages 5, 8, 10, 14 and 17 years using the Diagnostic and Statistical Manual of Mental Disorders-oriented scales of the Child Behavior Checklist (CBCL/4–18). Longitudinal models were applied to assess the relationships between maternal pre-pregnancy BMI and affective problems from age 5 through 17. There was a higher risk of affective problems between the ages of 5 and 17 years among children of women who were overweight and obese compared with the offspring of women in the healthy pre-pregnancy weight range (BMI 18.5–24.99) after adjustment for confounders, including paternal BMI. Maternal pre-pregnancy overweight and obesity may be implicated in the development of affective problems, including depression, in their offspring later in life.
Archaeological work preceding a housing development revealed mid-Devensian (MIS 3) deposits preserved in a geological fault, a graben feature, on an interfluve plateau. Rare evidence for Early Upper Palaeolithic open-air occupation was characterised by a scant lithic signature of the Lincombian-Ranisian-Jerzmanowician (LRJ) leaf-point techno-complex of the North European plain. The lithics included a complete leaf-point, another broken example with traces of impact damage, and knapping debitage indicating leaf-point maintenance. The site also preserved good evidence for an open-air hyaena den with abundant faunal remains. Discrete bone clusters were present, some of which probably represent meat caches for hyaena cubs in the burrows and scrapes of a maternity den. It is suggested that the hominins targeted the den site to forage the stored food. Their occupation is associated with a group of spirally-fractured wild horse bones thought to be the result of marrow extraction by humans, and these have been dated to 44,290–42,440 calibrated years before present (44.3–42.5 kyr cal bp), comparable to the date range of continental LRJ sites. The early date of the LRJ techno-complex corresponds with that of the oldest Neanderthals in northern Europe, but possibly overlaps with the recently reported early dates for anatomically modern humans. However, it is concluded that the oldest Early Upper Palaeolithic technology in northern Europe was the product of final Neanderthals.
The zero-pressure-gradient turbulent boundary layer over a flat plate was perturbed by a temporally oscillating, spatial impulse of roughness, and the downstream response of the flow field was interrogated by hot-wire anemometry and particle-image velocimetry. The key features common to impulsively perturbed boundary layers, as identified in Jacobi & McKeon (J. Fluid Mech., 2011), were investigated, and the unique contributions of the dynamic perturbation were isolated by contrast with an appropriately matched static impulse of roughness. In addition, the dynamic perturbation was decomposed into separable large-scale and small-scale structural effects, which in turn were associated with the organized wave and roughness impulse aspects of the perturbation. A phase-locked velocity decomposition of the entire downstream flow field revealed strongly coherent modes of fluctuating velocity, with distinct mode shapes for the streamwise and wall-normal velocity components. Following the analysis of McKeon & Sharma (J. Fluid Mech., vol. 658, 2010, pp. 336–382), the roughness perturbation was treated as a forcing of the Navier–Stokes equation and a linearized analysis employing a modified Orr–Sommerfeld operator was performed. The experimentally ascertained wavespeed of the input disturbance was used to solve for the most amplified singular mode of the Orr–Sommerfeld resolvent. These calculated modes were then compared with the streamwise and wall-normal velocity fluctuations. The discrepancies between the calculated Orr–Sommerfeld resolvent modes and those experimentally observed by phase-locked averaging of the velocity field were postulated to result from the violation of the parallel flow assumption of Orr–Sommerfeld analysis, as well as certain non-equilibrium effects of the roughness. Additionally, some difficulties previously observed using a quasi-laminar eigenmode analysis were also observed under the resolvent approach; however, the resolvent analysis was shown to provide reasonably accurate predictions of velocity fluctuations for the forced Orr–Sommerfeld problem over a portion of the boundary layer, with potential applications to designing efficient flow control strategies. The combined experimental and analytical effort provides a new opportunity to examine the non-equilibrium and forcing effects in a dynamically perturbed flow.