Objective:
Alcohol use disorder and social anxiety disorder are interconnected disorders that commonly co-occur. We report the first trial to assess whether integrated treatment for social anxiety ...and alcohol use disorder comorbidity improves outcomes relative to standard alcohol-focussed treatment.
Method:
Participants were recruited to a randomised controlled trial, and randomly allocated to one of two treatments, Integrated (n = 61) or Control (alcohol-focussed; n = 56). Assessment and treatment session were conducted at two sites in Sydney, Australia. Inclusion criteria were as follows: (1) clinical diagnosis of social anxiety disorder and (2) Diagnosis or sub-clinical symptoms of alcohol use disorder. Diagnoses were determined according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). All participants (n = 117) received 10 sessions of cognitive behavioural treatment and motivational enhancement. The Integrated treatment simultaneously targeted social anxiety disorder, alcohol use disorder and the connections between these disorders. The Control treatment focussed on alcohol use disorder only. Outcomes were assessed at 6-month follow-up, with interim assessments at post-treatment and 3 months. Primary outcomes were social anxiety disorder severity (composite Social Phobia Scale and Social Interaction Anxiety Scale), alcohol use disorder severity (standard drinks per day and Severity of Alcohol Dependence Questionnaire) and quality of life (Short-Form Health survey) was assessed to capture the combined impairment of social anxiety and alcohol use disorder comorbidity.
Results:
At 6-month follow-up, both conditions showed significant reductions in social anxiety and alcohol use disorder symptoms, and improved quality of life. There was no evidence of between-condition differences for alcohol outcomes, with mean consumption reduced by 5.0 (0.8) and 5.8 (1.0) drinks per day following Alcohol and Integrated treatments, respectively. Integrated treatment achieved greater improvements in social anxiety symptoms (mean difference = −14.9, 95% confidence interval = −28.1, −1.6, d = 0.60) and quality of life (mean difference = 7.6, 95% confidence interval = 1.2, 14.0, d = 0.80) relative to alcohol-focused treatment.
Conclusion:
These results suggest that integrated social anxiety and alcohol use disorder treatment enhances quality of life and social anxiety disorder symptom improvement, but not alcohol outcomes, compared to treatment focussed on alcohol use disorder alone.
Objective
To assess whether baclofen‐treated alcohol dependent participants show different subjective and psychophysiological responses to appetitive cues during an alcohol cue reactivity task ...compared to placebo, and whether these responses are associated with prospective drinking outcomes.
Methods
Forty‐two alcohol dependent participants (placebo: n = 12, low‐dose baclofen 30 mg/day n = 18, high‐dose baclofen 75 mg/day: n = 12) completed an alcohol cue reactivity task, whereby water and alcohol beverage cues were presented, with subsequent recovery periods, and subjective alcohol craving and psychophysiological indices (skin conductance; cardiovascular measures: heart rate, high‐frequency heart rate variability) were recorded.
Results
High‐dose baclofen‐treated participants showed both overall cue reactivity to water and alcohol cues and greater recovery effects during recovery periods, revealed by high‐frequency heart rate variability, when compared to low‐dose‐ and placebo‐treated participants. There were no medication effects on subjective craving. In high‐dose baclofen participants only, there was a predictive effect of lower baseline heart rate variability and fewer post‐test percentage of heavy drinking days.
Conclusion
There was a dose‐specific rescuing effect of high‐dose baclofen on the dynamic modulation of cardiovascular responses to eliciting cues. Investigation of treatment responses using psychophysiological techniques may elucidate baclofen's mechanisms of action, and identify subgroups amenable to treatment.
Chromosome-level assemblies are indispensable for accurate gene prediction, synteny assessment, and understanding higher-order genome architecture. Reference and draft genomes of key helminth species ...have been published, but little is yet known about the biology of their chromosomes. Here, we present the complete genome of the tapeworm Hymenolepis microstoma, providing a reference quality, end-to-end assembly that represents the first fully assembled genome of a spiralian/lophotrochozoan, revealing new insights into chromosome evolution.
Long-read sequencing and optical mapping data were added to previous short-read data enabling complete re-assembly into six chromosomes, consistent with karyology. Small genome size (169 Mb) and lack of haploid variation (1 SNP/3.2 Mb) contributed to exceptionally high contiguity with only 85 gaps remaining in regions of low complexity sequence. Resolution of repeat regions reveals novel gene expansions, micro-exon genes, and spliced leader trans-splicing, and illuminates the landscape of transposable elements, explaining observed length differences in sister chromatids. Syntenic comparison with other parasitic flatworms shows conserved ancestral linkage groups indicating that the H. microstoma karyotype evolved through fusion events. Strikingly, the assembly reveals that the chromosomes terminate in centromeric arrays, indicating that these motifs play a role not only in segregation, but also in protecting the linear integrity and full lengths of chromosomes.
Despite strong conservation of canonical telomeres, our results show that they can be substituted by more complex, species-specific sequences, as represented by centromeres. The assembly provides a robust platform for investigations that require complete genome representation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a ...manifestation of underlying dimensions of psychopathology (or "spectra"). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.
Objectives
This study sought to identify the temporal order in which mindfulness facets develop during Mindfulness-Based Stress Reduction (MBSR) and the effect of early changes on later changes in ...these facets and their relation to changes in depression, anxiety, and stress.
Methods
This longitudinal study of 147 adults participating in a MBSR program examined relationships between components of mindfulness, self-compassion and measures of depression, anxiety, and stress. Self-report measures were administered pre-course, mid-course, end-of-course, and 3-months post-course.
Results
Initial improvements in decentering, non-reactivity, and self-compassion were observed early in the MBSR course (
p
-values < 0.05), followed by later changes in observing, acting with awareness, and nonjudging. Bivariate latent growth curve modelling suggested changes in the mindfulness components of decentering and nonreactivity coincided with decreases in anxiety and stress (
p
-values < 0.05). However, in a path analysis, changes in self-compassion appeared to uniquely contribute to changes in depression and anxiety, over and above the effects of other mindfulness components (
p
-values < 0.05). These changes in self-compassion were associated with simultaneous and precursory change in non-reactivity and non-judgment.
Conclusions
These findings elucidate the possible temporal order of change in mindfulness facets through MBSR. Self-compassion may be a prominent mechanism of change in the MBSR program, along with non-reactivity and decentering. However, additional longitudinal research is needed with alternate model specifications to confirm the proximal role of self-compassion in longitudinal symptom change. Results are tempered by a relatively short period of longitudinal observation with a possible nonresponse bias.
Preregistration
Because the trial was conceived prior to 2009, pre-registration was not possible. However, the trial was registered on anzctr.org.au after data collection and analysis. Title: “Mechanisms of mindfulness: A longitudinal observational study of the effects of mindfulness-based stress reduction (MBSR) on depression, anxiety, and stress among participants in a MBSR program”, Identifier: ACTRN12623000485639.
Neurocognitive deficits are common among youth with mental disorders, and patterns of aberrant brain function generally cross diagnostic boundaries. This study investigated associations between ...functional neurocircuitry and broad transdiagnostic psychopathology dimensions in the critical preadolescent period when psychopathology is emerging.
Participants were 9- to 10-year-olds from the Adolescent Brain Cognitive Development Study. Factor scores of general psychopathology, externalizing, internalizing, and thought disorder dimensions were calculated from a higher-order model of psychopathology using confirmatory factor analysis (N = 11,721) and entered as explanatory variables into linear mixed models to examine associations with resting-state functional connectivity (n = 9074) and neural activation during the emotional n-back task (n = 6146) when covarying for sex, race/ethnicity, parental education, and cognitive function.
All dimensions of psychopathology were commonly characterized by hypoconnectivity within the dorsal attention and retrosplenial-temporal networks, hyperconnectivity between the frontoparietal and ventral attention networks and between the dorsal attention network and amygdala, and hypoactivation of the caudal middle frontal gyrus. Externalizing pathology was uniquely associated with hyperconnectivity between the salience and ventral attention networks and hyperactivation of the cingulate and striatum. Internalizing pathology was uniquely characterized by hypoconnectivity between the default mode and cingulo-opercular networks. Connectivity between the cingulo-opercular network and putamen was uniquely higher for internalizing pathology and lower for thought disorder pathology.
These findings provide novel evidence that broad psychopathology dimensions are characterized by common and dissociable patterns, particularly for externalizing pathology, of functional connectivity and task-evoked activation throughout neurocognitive networks in preadolescence.
Although dependence on alcohol appears to be a reliable unitary construct, abuse has not found a similar level of support as a separate construct. This paper describes a confirmatory factor analysis ...of the DSM-IV alcohol abuse and dependence criteria in a general population sample.
Data from alcohol drinkers (
n
=
7746) were obtained from a cross-sectional study of a large, representative sample of the Australian general population. One- and two-factor solutions for the DSM-IV criteria for abuse and dependence (assessed by CIDI-Auto) were compared using confirmatory factor analysis.
Approximately 74% of Australians had used alcohol 12 or more times in the past year and 19% met at least one DSM-IV alcohol abuse or dependence criterion. Overall 6% met criteria for an alcohol use disorder (1.9% abuse, 4.1% dependence). More men than women met criteria for an alcohol use disorder and the prevalence of alcohol use disorders decreased with increasing age. Both one- and two-factor solutions from the confirmatory factor analyses provided an adequate fit to the data for the overall sample. The correlation between the abuse and dependence factors in the two-factor model was extremely high (0.95).
Alcohol abuse and dependence criteria were most parsimoniously described by a single continuous construct incorporating all eleven abuse and dependence criteria.
Measures of body dysmorphic disorder symptoms have received little psychometric evaluation in adolescent samples. This study aimed to examine cross-sex measurement invariance in the Body Image ...Questionnaire–Child and Adolescent version (BIQ-C) to establish whether observed sex differences in total scores may be meaningful or due to differences in measurement properties. A sample of 3,057 Australian high school students completed the initial screening item of the measure (63.2% male, Mage = 14.58 years, SD = 1.37, range = 12-18 years). Of these participants, 1,512 (49.5%) reported appearance concerns and thus completed the full measure. Partial scalar measurement invariance was established among a revised two-factor, 9-item version of the BIQ-C (BIQ-C-9). Females reported significantly greater latent factor variance, higher BIQ-C-9 total and factor scores, and higher scores on most individual BIQ-C-9 items. The measure can be used with caution to compare body dysmorphic disorder symptoms between male and female adolescents, though sex-specific cutoff scores should be used.
ABSTRACT
Aims To apply item response mixture modelling (IRMM) to investigate the viability of the dimensional and categorical approaches to conceptualizing alcohol and cannabis use disorders.
Design ... A cross‐sectional survey assessing substance use and DSM‐IV substance use disorders.
Setting and participants A household survey of a nationally representative sample of 10 641 Australia adults (aged 18 years or older).
Measurements Trained survey interviewers administered a structured interview based on the Composite International Diagnostic Interview (CIDI).
Findings Of the 10 641 Australian adults interviewed, 7746 had drunk alcohol in the past 12 months and 722 had used cannabis. There was no improvement in fit for categorical latent class nor mixture models combining continuous and categorical parameters compared to continuous factor analysis models. The results indicated that both alcohol and cannabis problems can be considered as dimensional, with those with the disorder arrayed along a dimension of severity.
Conclusions A single factor accounts for more variance in the DSM‐IV alcohol and cannabis use criteria than latent class or mixture models, so the disorders can be explained most effectively by a dimensional score.
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