The network approach to psychopathology posits that mental disorders can be conceptualized and studied as causal systems of mutually reinforcing symptoms. This approach, first posited in 2008, has ...grown substantially over the past decade and is now a full-fledged area of psychiatric research. In this article, we provide an overview and critical analysis of 363 articles produced in the first decade of this research program, with a focus on key theoretical, methodological, and empirical contributions. In addition, we turn our attention to the next decade of the network approach and propose critical avenues for future research in each of these domains. We argue that this program of research will be best served by working toward two overarching aims: (a) the identification of robust empirical phenomena and (b) the development of formal theories that can explain those phenomena. We recommend specific steps forward within this broad framework and argue that these steps are necessary if the network approach is to develop into a progressive program of research capable of producing a cumulative body of knowledge about how specific mental disorders operate as causal systems.
We report the final measurement of the neutrino oscillation parameters Δm322 and sin2 θ23 using all data from the MINOS and MINOS+ experiments. These data were collected using a total exposure of ...23.76 × 1020 protons on target producing νμ and νμ beams and 60.75 kt yr exposure to atmospheric neutrinos. The measurement of the disappearance of νμ and the appearance of νe events between the Near and Far detectors yields ... and ... at 68% C.L. for normal (inverted) hierarchy. (ProQuest: ... denotes formulae omited.).
Background:Biliary tract infection is a common cause of bacteraemia and is associated with high morbidity and mortality. Few papers describe blood culture isolates, underlying structural ...abnormalities and clinical outcomes in patients with bacteraemia.Aims:To determine the proportion of bacteraemias caused by biliary tract infection and to describe patient demographics, underlying structural abnormalities and clinical outcomes in patients with bacteraemia.Design:Prospective cohort study.Methods:Biliary tract infection that caused bacteraemia was defined as a compatible clinical syndrome and a blood culture isolate consistent with ascending cholangitis. Patients aged 16 years and over were included in the study. From June 2003 to May 2005, demographic and clinical data were collected prospectively on all adult patients with bacteraemia. Radiological and endoscopic retrograde cholangiopancreatography findings were collected retrospectively.Results:In 49 patients, the biliary tract was the site of infection for 39/592 (6.6%) community-acquired and 19/466 (4.1%) hospital-acquired episodes of bacteraemia. Three patients had mixed bacteraemias, and four had recurrent bacteraemia. The proportion of patients presenting with a structural abnormality was 34/49 (69%), and, of these structural abnormalities, 18/34 (53%) were pre-existing or newly diagnosed malignancies. Gram-negative organisms caused 55/58 (95%) episodes of bacteraemia. The most common Gram-negative organisms were Escherichia coli (34/55; 62%) and Klebsiella pneumoniae (14/55; 26%). Of the E coli isolates, 6/34 (18%) were extended spectrum β-lactamase producers or multiply drug resistant. Thirty-day mortality was 7/49 (14%). There was no difference in time taken to administer an effective antibiotic to survivors and non-survivors (0.86 vs 1.05 days, respectively, p = 0.92). Of the seven who died, four died from septic shock within 48 h of admission caused by “susceptible” Gram-negative organisms. Two others died from disseminated malignancy.Conclusions:The proportion of bacteraemias caused by biliary tract infection was 5.5%. The most common infecting organisms were E coli and K pneumoniae. There was a strong association with choledocholithiasis and malignancies, both pre-existing and newly diagnosed. Death was uncommon but when it occurred was often caused by septic shock within 48 h of presentation.
BackgroundCognitive–behavioural theories of panic disorder posit that panic attacks arise from a positive feedback loop between arousal-related bodily sensations and perceived threat. In a recently ...developed computational model formalising these theories of panic attacks, it was observed that the response to a simulated perturbation to arousal provided a strong indicator of vulnerability to panic attacks and panic disorder. In this review, we evaluate whether this observation is borne out in the empirical literature that has examined responses to biological challenge (eg, CO2 inhalation) and their relation to subsequent panic attacks and panic disorder.MethodWe searched PubMed, Web of Science and PsycINFO using keywords denoting provocation agents (eg, sodium lactate) and procedures (eg, infusion) combined with keywords relevant to panic disorder (eg, panic). Articles were eligible if they used response to a biological challenge paradigm to prospectively predict panic attacks or panic disorder.ResultsWe identified four eligible studies. Pooled effect sizes suggest that there is biological challenge response has a moderate prospective association with subsequent panic attacks, but no prospective relationship with panic disorder.ConclusionsThese findings provide support for the prediction derived from cognitive–behavioural theories and some preliminary evidence that response to a biological challenge may have clinical utility as a marker of vulnerability to panic attacks pending further research and development.Trial registration number135908.
Aliment Pharmacol Ther 2010; 32: 645–654
Summary
Background While there is evidence of ethnic variation in the prevalence of gastro‐oesophageal reflux disease (GERD) symptoms, few population‐based ...studies examine GERD symptom prevalence amongst the growing Hispanic minority in the US as well as Asians in the West.
Aim To examine the prevalence, awareness and care patterns for GERD across different ethnic groups.
Methods A population‐based, cross‐sectional survey was fielded in English, Chinese and Spanish that assessed self‐reported GERD prevalence, awareness and care patterns in four ethnic groups (Caucasian, African American, Asian, Hispanic).
Results A total of 1172 subjects were included for analysis: 34.6% experienced GERD symptoms at least monthly, 26.2% at least weekly and 8.2% at least daily. Statistically significant differences in raw prevalence rates between racial groups were found: 50% of Hispanics experienced heartburn at least monthly, compared with 37% of Caucasians, 31% of African Americans and 20% of Asians (P > 0.0001). Significant differences in knowledge and care‐seeking patterns by ethnicity were also observed.
Conclusions This study confirms the high prevalence of GERD symptoms in the US and introduces Hispanics as the ethnicity with the highest prevalence rate. Asians in the US have higher rates of symptoms than in the Far East. These data demonstrate a need for culturally appropriate education about GERD symptoms and treatment.
•Shame and guilt are positively correlated with post-loss psychopathology.•Shame predicts post-loss psychopathology when guilt is in the low to medium range.•Guilt predicts post-loss psychopathology ...when shame is in the low range.
Self-blame following bereavement has been implicated in the development of post-loss psychopathology. However, prior studies have not distinguished between the emotions of shame versus guilt. This study examined the cross-sectional associations among bereavement-related shame, bereavement-related guilt, and two mental disorders that commonly arise after bereavement: complicated grief and depression. In addition, exploratory analyses examined the associations between bereavement-related pride and post-loss psychopathology.
Participants included 92 bereaved adults who experienced the death of a family member at least one year prior to the study. Participants completed self-report measures of complicated grief symptoms, depression symptoms, shame, guilt, and pride.
Shame and guilt were positively correlated with complicated grief and depression symptoms. When controlling for their shared variance, only shame remained a significant predictor of post-loss psychopathology. Follow-up analyses indicated that the effect of guilt on psychopathology depended on the level of shame, and vice versa. At low shame, guilt predicted psychopathology; however guilt did not predict psychopathology at moderate to high shame. At low to moderate guilt, shame predicted psychopathology; however shame did not predict psychopathology at high guilt. Pride negatively predicted depression symptoms, but not complicated grief symptoms, when we controlled for shame and guilt.
Limitations include the cross-sectional design and modest sample size.
Our analyses identify shame as the more pathogenic moral emotion for bereaved adults. However, whereas guilt in the absence of shame is often considered adaptive, we found that guilt predicted greater psychological distress at low levels of shame in this sample.
87Sr/86Sr ratios of ground waters in the Bighorn and Laramie basins' carbonate and carbonate‐cemented aquifer systems, Wyoming, United States, reflect the distinctive strontium isotope signatures of ...the minerals in their respective aquifers. Well water samples from the Madison Aquifer (Bighorn Basin) have strontium isotopic ratios that match their carbonate host rocks. Casper Aquifer ground waters (Laramie Basin) have strontium isotopic ratios that differ from the bulk host rock; however, stepwise leaching of Casper Sandstone indicates that most of the strontium in Casper Aquifer ground waters is acquired from preferential dissolution of carbonate cement. Strontium isotope data from both Bighorn and Laramie basins, along with dye tracing experiments in the Bighorn Basin and tritium data from the Laramie Basin, suggest that waters in carbonate or carbonate‐cemented aquifers acquire their strontium isotope composition very quickly—on the order of decades.
Strontium isotopes were also used successfully to verify previously identified mixed Redbeds‐Casper ground waters in the Laramie Basin. The strontium isotopic compositions of ground waters near Precambrian outcrops also suggest previously unrecognized mixing between Casper and Precambrian aquifers. These results demonstrate the utility of strontium isotopic ratio data in identifying ground water sources and aquifer interactions.
Mobile sensing is a ubiquitous and useful tool to make inferences about individuals' mental health based on physiology and behavior patterns. Along with sensing features directly associated with ...mental health, it can be valuable to detect different features of social contexts to learn about social interaction patterns over time and across different environments. This can provide insight into diverse communities' academic, work and social lives, and their social networks. We posit that passively detecting social contexts can be particularly useful for social anxiety research, as it may ultimately help identify changes in social anxiety status and patterns of social avoidance and withdrawal. To this end, we recruited a sample of highly socially anxious undergraduate students (N=46) to examine whether we could detect the presence of experimentally manipulated virtual social contexts via wristband sensors. Using a multitask machine learning pipeline, we leveraged passively sensed biobehavioral streams to detect contexts relevant to social anxiety, including (1) whether people were in a social situation, (2) size of the social group, (3) degree of social evaluation, and (4) phase of social situation (anticipating, actively experiencing, or had just participated in an experience). Results demonstrated the feasibility of detecting most virtual social contexts, with stronger predictive accuracy when detecting whether individuals were in a social situation or not and the phase of the situation, and weaker predictive accuracy when detecting the level of social evaluation. They also indicated that sensing streams are differentially important to prediction based on the context being predicted. Our findings also provide useful information regarding design elements relevant to passive context detection, including optimal sensing duration, the utility of different sensing modalities, and the need for personalization. We discuss implications of these findings for future work on context detection (e.g., just-in-time adaptive intervention development).
The network theory of prolonged grief posits that causal interactions among symptoms of prolonged grief play a significant role in their coherence and persistence as a syndrome. Drawing on recent ...developments in the broader network approach to psychopathology, we argue that advancing our understanding of the causal system that gives rise to prolonged grief will require that we (a) strengthen our assessment of each component of the grief syndrome, (b) investigate intra-individual relationships among grief components as they evolve over time within individuals, (c) incorporate biological and social components into network studies of grief, and (d) generate formal theories that posit precisely how these biological, psychological, and social components interact with one another to give rise to prolonged grief disorder.
•Prolonged grief may arise from causal relations among its constituent symptoms.•Robust assessments of individual prolonged grief symptoms are needed.•Idiographic models can advance our understanding of grief syndrome.•Formalizing theories of grief will equip us to better evaluate those theories.•The network theory of grief should adopt a biopsychosocial systems perspective.
Most research on emotion regulation has focused on understanding individual emotion regulation strategies. Preliminary research, however, suggests that people often use several strategies to regulate ...their emotions in a given emotional scenario (polyregulation). The present research examined who uses polyregulation, when polyregulation is used, and how effective polyregulation is when it is used. College students (
N
= 128; 65.6% female; 54.7% White) completed an in-person lab visit followed by a 2-week ecological momentary assessment protocol with six randomly timed survey prompts per day for up 2 weeks. At baseline, participants completed measures assessing past-week depression symptoms, social anxiety-related traits, and trait emotion dysregulation. During each randomly timed prompt, participants reported up to eight strategies used to change their thoughts or feelings, negative and positive affect, motivation to change emotions, their social context, and how well they felt they were managing their emotions. In pre-registered analyses examining the 1,423 survey responses collected, polyregulation was more likely when participants were feeling more intensely negative and when their motivation to change their emotions was stronger. Neither sex, psychopathology-related symptoms and traits, social context, nor subjective effectiveness was associated with polyregulation, and state affect did not moderate these associations. This study helps address a key gap in the literature by assessing emotion polyregulation in daily life.
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