This study assessed whether different types of childhood maltreatment (CM) (i.e., abuse vs. neglect) had differential relationships with heart rate variability (HRV) and baroreflex sensitivity (BRS), ...two established markers of autonomic functioning. Additionally, this study used a moderated mediation model to investigate the potentially mediating role of HRV in the relationship between CM subtypes and adult psychopathology, and whether these relationships differed in those with high vs. low resting HRV. Secondary analysis was performed using the MIDUS II Biomarker Project dataset. Structural equation modeling was used to assess the relationships between key variables at baseline, as well as reactivity and recovery to stressor tasks. Baseline pathways from abuse and neglect to BRS were nonsignificant, as was the pathway from HRV to psychopathology. Notably, greater abuse was significantly predictive of lower HRV (standardized ß = -.42, p<.01) while greater neglect was significantly predictive of higher HRV (standardized ß = .32, p<.05). Additionally, higher childhood abuse was significantly predictive of greater adult psychopathology (standardized ß = .39, p<.001), but childhood neglect was not found to be related to adult psychopathology in this sample. Significant relationships between target variables were only found in those with low HRV. Our findings suggest that greater differentiation between abuse and neglect are appropriate in investigations of the impact of CM on adult physical and mental health outcomes. Additionally, our findings contribute further evidence that low HRV may be a transdiagnostic endophenotype for mood-related pathology.
Background: Phelan-McDermid syndrome (PMS) is a rare neurodevelopmental disorder caused by haploinsufficiency of the SHANK3 gene and characterized by global developmental delays, deficits in speech ...and motor function, and autism spectrum disorder (ASD). Monogenic causes of ASD such as PMS are well suited to investigations with novel therapeutics, as interventions can be targeted based on established genetic etiology. While preclinical studies have demonstrated that the neuropeptide oxytocin can reverse electrophysiological, attentional, and social recognition memory deficits in Shank3-deficient rats, there have been no trials in individuals with PMS. The purpose of this study is to assess the efficacy and safety of intranasal oxytocin as a treatment for the core symptoms of ASD in a cohort of children with PMS.Methods: Eighteen children aged 5–17 with PMS were enrolled. Participants were randomized to receive intranasal oxytocin or placebo (intranasal saline) and underwent treatment during a 12-week double-blind, parallel group phase, followed by a 12-week open-label extension phase during which all participants received oxytocin. Efficacy was assessed using the primary outcome of the Aberrant Behavior Checklist-Social Withdrawal (ABC-SW) subscale as well as a number of secondary outcome measures related to the core symptoms of ASD. Safety was monitored throughout the study period.Results: There was no statistically significant improvement with oxytocin as compared to placebo on the ABC-SW (Mann–Whitney U = 50, p = 0.055), or on any secondary outcome measures, during either the double-blind or open-label phases. Oxytocin was generally well tolerated, and there were no serious adverse events.Limitations: The small sample size, potential challenges with drug administration, and expectancy bias due to relying on parent reported outcome measures may all contribute to limitations in interpreting results.Conclusion: Our results suggest that intranasal oxytocin is not efficacious in improving the core symptoms of ASD in children with PMS.
Chronic pain is responsible for detrimental consequences such as suffering and disability. Many trauma survivors subsequently develop chronic pain, though the mechanisms for this relationship are ...unknown. Hyperexcitability of spinal neurons (central sensitization) is thought to underlie many types of chronic pain experienced by trauma survivors. Novel research shows that trauma exposure promotes central sensitization by sensitizing spinal nociception (the neural signals that encode pain) and impairing the supraspinal ability to inhibit incoming nociception (disinhibition). Thus, trauma may sensitize physiological systems to over-respond to subsequent stressors (i.e., stress sensitization) and ultimately promote chronic pain. However, the mechanism for this is currently unknown. Trauma exposure promotes systemic inflammation (elevated inflammation throughout the body), and systemic inflammation is known to promote central sensitization and chronic pain. Therefore, systemic inflammation may be a mechanism that promotes central sensitization in trauma survivors. This study sampled 48 pain-free participants and used mediation analysis to assess if traumatic events lead to higher systemic inflammation and central sensitization. Systemic inflammation was assessed via high-sensitivity C-Reactive Protein (hs-CRP) levels. Central sensitization processes were assessed using two experimental pain paradigms. Sensitization of spinal nociception was assessed from temporal summation of pain and NFR (TS-Pain; TS-NFR). Disinhibition was assessed from conditioned modulation of pain and NFR (CPM-Pain; CPM-NFR). Trauma exposure was positively correlated with TS-NFR. Mediation results found that trauma exposure was significantly associated with hs-CRP, such that higher levels of trauma exposure were related to higher levels of systemic inflammation. However, systemic inflammation was not significantly associated with any pain outcome. There was no evidence that inflammation mediated the effect of trauma exposure on markers of central sensitization. These findings suggest that trauma exposure may lead to stress sensitization, which increases spinal sensitization (a risk marker for chronic pain). Further work is needed to expand upon these findings; however, current outcomes and the reported effect sizes can guide future research.
Some children with autism spectrum disorder (ASD) exhibit minimal vocal-verbal (or speech) skills and benefit from using alternative forms of communication. A speech-generating device (SGD) is an ...augmentative and alternative form of communication that permits vocal output when an individual presses symbols, icons, or text on a screen. To facilitate expansive communicative repertoires, behavior-analytic researchers have developed a preliminary model to establish icon discrimination using SGDs. Icon discrimination involves selecting an icon in an array of other icons. Prior research has evaluated a within-stimulus fading procedure to establish icon discrimination with young ASD children using SGDs. However, there are a few limitations worthy of mention: the (a) participants exhibited high levels of correct responding during baseline, (b) within-stimulus fading involved progressing through a multi-phase protocol without evaluating the necessity of each phase, and (c) icon array only included four icons. A subsequent study replicated the within-stimulus fading procedures with fewer phases and the simultaneous introduction of response prompts. Thus, the current studies aimed to address these limitations and extend the icon discrimination SGD behavior-analytic literature.Study 1 aimed to assess the isolated effects of differential reinforcement (i.e., baseline contingencies described by earlier studies) to screen for the necessity of treatment when establishing and maintaining icon discrimination with four- and eight-icon arrays, respectively. Study 2 aimed to teach icon discrimination to participants who did not acquire this skill during the assessment (Study 1) in four- and eight-icon arrays while evaluating the necessity for each phase and response prompts. Study 3 aimed to further characterize the participant pool by assessing relevant skills (e.g., vocal imitation) that might change or differentially predict for whom the procedures may be effective. The general findings of these studies indicate that (a) differential reinforcement is sufficient to establish icon discrimination in multi-sized arrays for most participants, (b) only a subset of phases is necessary to establish and maintain icon discrimination, and (c) favorable changes in related skills occurred for a subset of participants. The implications of these findings are further discussed throughout the dissertation document.
Physical frailty is associated with increased risk for dementia and other neurologic sequelae. However, the neurobiological changes underlying frailty and frailty risk remain unknown. The association ...of cerebral white matter structure with current and future frailty was examined. Atherosclerosis Risk in Communities Study Neurocognitive Study participants who underwent 3T brain MRI were included. Frailty status was classified according to the Fried criteria. Cerebral white matter integrity was defined using white matter hyperintensity (WMH) volume and microstructure, measured using diffusion tensor imaging fractional anisotropy (FA) and mean diffusivity (MD). Multivariable linear regression was used to relate baseline frailty to white matter structure; multivariable logistic regression was used to relate baseline white matter to frailty risk among participants non-frail at baseline. In the cross-sectional analysis (N=1,754; mean age: 76 years) frailty was associated with greater WMH volume, lower FA, and greater MD. These associations remained consistent after excluding participants with history of stroke or dementia. Among participants non-frail at baseline who completed follow-up frailty assessment (N=1,379; 6.6-year follow-up period), each standard deviation increase in WMH volume was associated with 1.46 higher odds of frailty at follow-up. Composite FA and MD measures were not associated with future frailty; however, secondary analyses found several significant white matter tract-specific associations with frailty risk. The current study demonstrates a robust association of WMH volume with current and future frailty. Although measures of white matter microstructure were altered in frail individuals, these measures were not generally associated with progression from frail to non-frail status.
There is an abundance of interventions for challenging behaviors; however, the majority of them or costly or require an abundance of resources. Caregivers struggle to consistently implement the ...interventions due to the intensity and the amount of time and dedication the intervention may require. Additionally, finding the appropriate treatment for the child may not be feasible due to location, lack of accessibility, or lack of resources. Non-contingent reinforcement schedule has been found to be effective in reducing the challenging behaviors of children with autism spectrum disorder, regardless of the function of the behavior. Non-contingent reinforcement schedule is also useful when the function of the behavior is not easily replaced by a more adaptive behavior, for example, if the behavior is reinforced by self-stimulation or environmental factors, that cannot be removed (Saini, Fisher, & Pisman, 2017). The use of parent-mediated intervention is cost-effective because it reduces the need for the therapist to be consistently present. Additionally, research has shown that including families in treatment can increase the effectiveness of the treatment and it can lead to positive-child engagement (Beudoin, Sebire & Couture, 2019). This study aimed to find a cost-effective intervention that could be implemented by the caregivers. As well as be accessible to those who have limited access to resourcesThe study had three parent-child dyads, using an ABAB single-case design. During the A phase, the caregivers maintained their normal routine, except for counting the targeted challenging behaviors for the same 2 hours each day. During the B phase, the intervention was introduced, and caregivers delivered a non-contingent praise statement every 15 minutes, regardless of the targeted challenging behaviors were present. Two of the children participants’ targeted challenging behaviors decreased when the intervention was implemented and increased when the intervention was removed. The third child’s caregiver did not implement the intervention faithfully, so it is unknown if the intervention would have been effective. This study required minimum resources and was found to be effective for two of the three child participants. Limitations, recommendations, and clinical implications are discussed.
Today we are witnessing a new science of placebo, a complex discipline that encompasses several experimental approaches and translational implications. Modern neurobiological tools have been used to ...answer important questions in placebo research, such as the top-down modulation of sensory and motor systems as well as the influence of cognition, emotions, and learning on symptoms, diseases, and responses to treatments. What we have learned is that there is not one single placebo effect, but many. This review highlights the translational implications of this new knowledge, ranging from clinical trial design to medical practice to social and ethical issues.
Human paternal behavior is multidimensional, and extant research has yet to delineate how hormone patterns may be related to different dimensions of fathering. Further, although studies vary in their ...measurement of hormones (i.e., basal or reactivity), it remains unclear whether basal and/or reactivity measures are predictive of different aspects of men's parenting. We examined whether men's testosterone and cortisol predicted fathers' involvement in childcare and play with infants and whether fathers' testosterone and cortisol changed during fathers' first interaction with their newborn. Participants were 298 fathers whose partners gave birth in a UNICEF-designated “baby-friendly” hospital, which encourages fathers to hold their newborns 1 h after birth, after mothers engage in skin-to-skin holding. Salivary testosterone and cortisol were measured before and after fathers' first holding of their newborns. Basal and short-term changes in cortisol and testosterone were analyzed. Fathers were contacted 2–4 months following discharge to complete questionnaires about childcare involvement. Fathers' cortisol decreased during the time they held their newborns on the birthing unit. Fathers' basal testosterone in the immediate postnatal period predicted their greater involvement in childcare. Both basal and reactivity cortisol predicted fathers' greater involvement in childcare and play. Results suggest that reduced basal testosterone is linked with enhanced paternal indirect and direct parenting effort months later, and that higher basal cortisol and increases in cortisol in response to newborn interaction are predictive of greater paternal involvement in childcare and play, also months later. Findings are discussed in the context of predominating theoretical models on parental neuroendocrinology.
•Cortisol (C) and testosterone (T) are hormones theorized to influence paternal care.•We measured fathers' C and T before and after they held their newborns after birth.•From C and T, we predicted fathers' parenting behaviors 2–4 months later.•Higher C (basal & acute reactivity) predicted fathers' care in multiple domains.•Lower basal T predicted more paternal involvement in direct and indirect care.
Consciousness directs the actions of the agent for its own purposive gains. It re-organises a stimulus-response linear causality to deliver generative, creative agent action that evaluates the ...subsequent experience prospectively. This inversion of causality affords special properties of control that are not accounted for in integrated information theory (IIT), which is predicated on a linear, deterministic cause-effect model. IIT remains an incomplete, abstract, and disembodied theory without explanation of the psychobiology of consciousness that serves the vital agency the organism.
Health disparities (differences in health by socioeconomic groups) are a pressing issue in our society. This article provides an overview of a multilevel approach that seeks to understand the ...mechanisms underlying health disparities by considering factors at the individual, family, and neighborhood levels. In addition, we describe an approach to connecting these factors to various levels of biological processes (systemic inflammation, cellular processes, and genomic pathways) that drive disease pathophysiology. In the second half of the article, we address the question of why some low-socioeconomic-status (low-SES) individuals manage to maintain good physical health. We identify naturally occurring psychosocial factors that help buffer these individuals from adverse physiological responses and pathogenic processes leading to chronic disease. What is protective for low-SES individuals is not the same as what is protective for high-SES individuals, and this needs to be taken into account in interventions aimed at reducing health disparities.
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