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The Royal College of Psychiatrists’ Parliamentary Scholar Scheme gives higher trainees in psychiatry the opportunity to spend 1 day a week in the House of Lords working alongside a peer with an interest in health. This article describes the work of the House of Lords and Parliament using examples from the experiences of 2017–2018 scholars and outlines ways doctors can get more involved in policy and politics.
Childhood-onset attention-deficit hyperactivity disorder (ADHD) in adults is clinically heterogeneous and commonly presents with different patterns of cognitive deficits. It is unclear if this clinical heterogeneity expresses a dimensional or categorical difference in ADHD.
We first studied differences in functional connectivity in multi-echo resting-state functional magnetic resonance imaging (rs-fMRI) acquired from 80 medication-naïve adults with ADHD and 123 matched healthy controls. We then used canonical correlation analysis (CCA) to identify latent relationships between symptoms and patterns of altered functional connectivity (dimensional biotype) in patients. Clustering methods were implemented to test if the individual associations between resting-state brain connectivity and symptoms reflected a non-overlapping categorical biotype.
Adults with ADHD showed stronger functional connectivity compared to healthy controls, predominantly between the default-mode, cingulo-opercular and subcortical networks. CCA identified a single mode of brain–symptom co-variation, corresponding to an ADHD dimensional biotype. This dimensional biotype is characterized by a unique combination of altered connectivity correlating with symptoms of hyperactivity-impulsivity, inattention, and intelligence. Clustering analyses did not support the existence of distinct categorical biotypes of adult ADHD.
Overall, our data advance a novel finding that the reduced functional segregation between default-mode and cognitive control networks supports a clinically important dimensional biotype of childhood-onset adult ADHD. Despite the heterogeneity of its presentation, our work suggests that childhood-onset adult ADHD is a single disorder characterized by dimensional brain–symptom mediators.
We examined associations between specific self-regulatory mechanisms and externalizing behavior patterns from ages 2 to 15 (N = 443). The relation between multiple self-regulatory indicators across multiple domains (i.e., physiological, attentional, emotional, and behavioral) at age 2 and at age 5 and group membership in four distinct externalizing trajectories was examined. By examining each of these self-regulatory processes in combination with one another, and therefore accounting for their shared variance, we aimed to better understand which specific self-regulatory skills were associated most strongly with externalizing behavioral patterns. Findings suggest that behavioral inhibitory control and emotion regulation are particularly important in distinguishing between children who show normative declines in externalizing behaviors across early childhood and those who demonstrate high levels through adolescence.
Skin is the parchment upon which identity is written; class, race, ethnicity, and gender are all legible upon the human surface. Removing skin tears away identity, and leaves a blank slate upon whichlaw, punishment, sanctity, or monstrosity can be inscribed; whether as an act of penal brutality, as a comic device, or as a sign of spiritual sacrifice, it leaves a lasting impression about the qualities and nature of humanity. Flaying often functioned as an imaginative resource for medieval and early modern artists and writers, even though it seems to have been rarely practiced in reality. From images of Saint Bartholomew holding his skin in his arms, to scenes of execution in Havelok the Dane, to laws that prescribed it as a punishment for treason, this volume explores the ideaand the reality of skin removal - flaying - in the Middle Ages. It interrogates the connection between reality and imagination in depictions of literal skin removal, rather than figurative or theoretical interpretations of flaying, and offers a multilayered view of medieval and early modern perceptions of flaying and its representations in European culture. Its two parts consider practice and representation, capturing the evolution of flaying as both an idea and a practice in the premodern world.
Larissa Tracy is Associate Professor, Longwood University.
Contributors: Frederika Bain, Peter Dent, Kelly DeVries, Valerie Gramling, Perry Neil Harrison, Jack Hartnell, Emily Leverett, Michael Livingston, Sherry C.M. Lindquist, Asa Mittman, Mary Rambaran-Olm, William Sayers, Christina Sciacca, Susan Small, Larissa Tracy, Renée Ward
The development of attention has been strongly linked to the regulation of emotion and behavior and has therefore been of particular interest to researchers aiming to better understand precursors to behavioral maladjustment. In the current paper, we utilize a developmental psychopathology and neural plasticity framework to highlight the importance of both intrinsic (i.e., infant neural functioning) and extrinsic (i.e., caregiver behavior) factors for the development of attentional control across the first year. We begin by highlighting the importance of attention for children's emotion regulation abilities and mental health. We then review the development of attention behavior and underscore the importance of neural development and caregiver behavior for shaping attentional control. Finally, we posit that neural activation associated with the development of the executive attention network may be one mechanism through which maternal caregiving behavior influences the development of infants’ attentional control and subsequent emotion regulation abilities known to be influential to childhood psychopathology.
It is very gratifying for a researcher/practitioner to discover that her personal experience bears out the results of her own previous study. I enjoyed this fortunate circumstance recently when I wrote my first novel some years after completing a dissertation and later writing a popular trade book about successful writers and their writing processes (Perry, 1996, 1999).
My writing research consisted of interviews with a convenience sample of 76 regularly publishing writers (40 novelists and 36 poets; 43 males, 33 females). Participants included both best-selling novelists such as Jonathan and Faye Kellerman, Sue Grafton, Michael Connelly, T. Coraghessan Boyle, and Ursula LeGuin, and Pulitzer Prize, MacArthur Foundation Award, and American Book Award winning literary authors and poets such as Jane Smiley, Robert Olen Butler, Donald Hall, Octavia Butler, Philip Levine, and Mark Strand. (All attributed but uncited quotes in this article are from interviews I personally conducted [Perry, 1996, 1999].) I also read hundreds of accounts of and interviews with writers and have continued to do so.
So many of the creative writers with whom I spoke enjoyed writing so much that I decided to try it myself. I had been an independent writer of nonfiction books and articles for magazines and newspapers for the previous two decades. I wondered whether it would be possible for a writer who had until then been so scrupulous about truthfulness to make things up.