Exposure Therapy: Stimulus Intensity as a Factor in Treatment Preference

Currently, a host of treatments are available for treating anxiety disorders, including specific phobia. Treatment of specific phobia includes pharmacological, psychosocial, and combined approaches. Exposure therapy, however, is considered the leading psychological treatment for specific phobia, and has shown to be effective. Exposure therapy challenges held beliefs about feared stimuli/situations and attempts to integrate new learning about the feared object/situation. Despite exposure being effective to treat specific phobia, it is associated with low adherence and high dropout rates. There is a need to examine, therefore, ways to improve patient adherence for exposure. A way to examine this issue is to assess patient preferences for currently available treatments for specific phobia, and to examine directly the various methods for delivering exposure (e.g., stimuli intensity presentation). Furthermore, it is important to assess individuals’ perception of efficacy on various methods of delivering exposure stimuli (e.g., low intensity versus high intensity). Also, it is essential to examine individual willingness to engage in different presentation of stimuli intensity. Participants (N = 1,065) were assessed for dental care-related fear and anxiety, and 279 of those individuals with high levels of fear/anxiety were included in the analyses regarding treatment preferences. Participants rated their preference for types of treatments (e.g., exposure, flooding, systematic desensitization) and were asked to rank order-based on personal preference. Then participants watched two video examples of exposure (i.e., low intensity and high intensity) and asked to rate their preference for the two methods to deliver exposure stimuli. After, participants rank ordered several approaches for delivering exposure stimuli by personal preference. Finally, participants were given a free choice to watch either a black screen (e.g., avoidance), low intensity exposure video, or high intensity exposure video over three trials. Results indicated that participants rated relaxation as the most preferred type of treatment for dental phobia. In regard to exposure stimuli, participants rated the low intensity exposure stimuli with greater preference (e.g., more efficacious and more willing to engage in the treatment) than the high intensity exposure stimuli. A majority of participants watched the low intensity (39.6%) and the avoidance video (32.8%) two or more times over the three trials demonstrating a behavioral preference for video content. A Latent Class Analysis suggested distinct groups (i.e., Low to Avoidant, and Avoidant) based on the patterns of video choice over the three trials. Findings of this study highlight differences in patient preferences for specific phobia treatment, which ultimately can impact oral health care services and training. Utilizing low intensity exposure stimuli may be a promising way to get patient buy-in and ease into higher intensity stimuli and possible improve treatment outcomes

Efficacy of Self-Directed Exposure Using Smart Phone Technology: First versus Third Person Perspective

Exposure therapy, including its self-directed forms, is effective for treatment of specific phobias. Nevertheless, there are issues with patient adherence in the use of exposure therapy, including its self-directed formats. Technological advancements, as with smartphones, may improve adherence to self-directed exposure therapy, perhaps due to exposure stimuli being more readily accessible. Thus, there is a need to examine how presenting phobic material on a smartphone might promote increased adherence in conducting self-directed exposure. Additionally, exposure can incorporate phobic material from different perspectives (i.e., first-person or third-person), which is one factor that may impact treatment effectiveness. Participants (N = 36) were randomly assigned to a treatment or control condition, and completed a pre-assessment and then a post-assessment two weeks later. The assessment consisted of a multimodal approach (e.g., self-report, physiological response, and overt behavior). Participants in the treatment condition were instructed to watch a standard exposure video of a dental examination and prophylaxis three times daily for two weeks. One week of videos was shown in a first-person perspective and the same video was shown in a third-person perspective for one week. Results indicated that the smartphone-based stimuli were utilized by the participants, and that the treatment was acceptable to them. There was a significant interaction of time by condition for self-reported anxiety during a behavioral avoidance task. Participants in the treatment condition had significantly lower self-reported anxiety at the post-assessment compared to the pre-assessment, and no change in anxiety was found for the control group from pre- to post-assessment. A significant decrease in heart rate and trait anxiety was found from pre- to post-assessment for all participants. Results demonstrated the potential utility of smartphone-based self-directed exposure therapy for specific phobia

Can Skills Training Prevent Relationship Problems in At-Risk Couples? Four-Year Effects of a Behavioral Relationship Education Program

Eighty-three couples were stratified into groups at high and low risk for relationship distress and randomized to either the Self-Regulatory Prevention and Relationship Enhancement Program (Self-PREP) or a control condition. As predicted, there were differential effects of Self-PREP on high-risk and low-risk couples. Because of low statistical power, results must be interpreted cautiously, but at 1-year follow-up high-risk couples in Self-PREP showed trends toward better communication than control couples. However, there was no difference in the communication of Self-PREP and control low-risk couples. High-risk couples receiving Self-PREP exhibited higher relationship satisfaction at 4 years than control couples, but in low-risk couples relationship satisfaction was higher in the control condition. High-risk couples seemed to benefit from skills-based relationship education, but low-risk couples did not

Mutant calreticulin knockin mice develop thrombocytosis and myelofibrosis without a stem cell self-renewal advantage.

Somatic mutations in the endoplasmic reticulum chaperone calreticulin (CALR) are detected in approximately 40% of patients with essential thrombocythemia (ET) and primary myelofibrosis (PMF). Multiple different mutations have been reported, but all result in a +1-bp frameshift and generate a novel protein C terminus. In this study, we generated a conditional mouse knockin model of the most common CALR mutation, a 52-bp deletion. The mutant novel human C-terminal sequence is integrated into the otherwise intact mouse CALR gene and results in mutant CALR expression under the control of the endogenous mouse locus. CALRdel/+ mice develop a transplantable ET-like disease with marked thrombocytosis, which is associated with increased and morphologically abnormal megakaryocytes and increased numbers of phenotypically defined hematopoietic stem cells (HSCs). Homozygous CALRdel/del mice developed extreme thrombocytosis accompanied by features of MF, including leukocytosis, reduced hematocrit, splenomegaly, and increased bone marrow reticulin. CALRdel/+ HSCs were more proliferative in vitro, but neither CALRdel/+ nor CALRdel/del displayed a competitive transplantation advantage in primary or secondary recipient mice. These results demonstrate the consequences of heterozygous and homozygous CALR mutations and provide a powerful model for dissecting the pathogenesis of CALR-mutant ET and PMF

Radio Astronomy

Contains reports on five research projects.National Science Foundation (Grant AST82-14296)National Aeronautics and Space Administration (Grant NAG W-373)National Aeronautics and Space Administration (Grant NAG5-537)U.S. Navy - Office of Naval Research (Contract N00014-84-C-2082)SM Systems and Research, Inc.Defense Advanced Research Project Agency (Contract MDA903-82-K-0521

Years off Your Life? The Effects of Homicide on Life Expectancy by Neighborhood and Race/Ethnicity in Los Angeles County

Homicide is one of the leading causes of death in Los Angeles County and is known to be elevated in low-income urban neighborhoods and in black males. However, because homicide occurs primarily among young adults, mortality rate statistics may underrepresent its importance. We estimated the impact of homicide on life expectancy by demographic group and geographic area in Los Angeles County, 2001–2006. Life expectancy estimates were calculated using mortality records and population estimates for Los Angeles County. Cause elimination techniques were used to estimate the impact of homicide on life expectancy. Homicide was estimated to reduce life expectancy by 0.4 years for Los Angeles County residents and by 2.1 years for black males. The impact of homicide on life expectancy was higher in low-income neighborhoods. In some low-income urban neighborhoods, homicide was estimated to decrease life expectancy in black males by nearly 5 years. Homicide causes substantial reductions in life expectancy in Los Angeles County. Its impact is magnified among black males and in low-income urban areas, underscoring the need for homicide reduction in urban centers

Radio Astronomy

Contains summary of research and reports on seven research projects.National Science Foundation (Grant AST82-14296)National Aeronautics and Space Administration (Grant NAGW-373)National Aeronautics and Space Administration (Contract NAS5-28410)U.S. Navy - Office of Naval Research (Contract N00014-84-C-2082)M.I.T. Sloan Fund for Basic ResearchNational Oceanic and Atmospheric Administration (Grant 04-8-M01-1)National Aeronautics and Space Administration (Grant NAG5-10)Defense Advanced Research Project Agency (Contract MDA 903-84-K-0297

Cortactin regulates cofilin and N-WASp activities to control the stages of invadopodium assembly and maturation

Invadopodia are matrix-degrading membrane protrusions in invasive carcinoma cells. The mechanisms regulating invadopodium assembly and maturation are not understood. We have dissected the stages of invadopodium assembly and maturation and show that invadopodia use cortactin phosphorylation as a master switch during these processes. In particular, cortactin phosphorylation was found to regulate cofilin and Arp2/3 complex–dependent actin polymerization. Cortactin directly binds cofilin and inhibits its severing activity. Cortactin phosphorylation is required to release this inhibition so cofilin can sever actin filaments to create barbed ends at invadopodia to support Arp2/3-dependent actin polymerization. After barbed end formation, cortactin is dephosphorylated, which blocks cofilin severing activity thereby stabilizing invadopodia. These findings identify novel mechanisms for actin polymerization in the invadopodia of metastatic carcinoma cells and define four distinct stages of invadopodium assembly and maturation consisting of invadopodium precursor formation, actin polymerization, stabilization, and matrix degradation

No evidence for association between tau gene haplotypic variants and susceptibility to Creutzfeldt-Jakob disease

Contains fulltext : 52965.pdf ( ) (Open Access)BACKGROUND: A polymorphism at codon 129 of the prion protein gene (PRNP) is the only well-known genetic risk factor for Creutzfeldt-Jakob disease (CJD). However, there is increasing evidence that other loci outside the PRNP open reading frame might play a role in CJD aetiology as well. METHODS: We studied tau protein gene (MAPT) haplotypic variations in a population of sporadic and variant CJD patients. We tested 6 MAPT haplotype tagging SNPs (htSNPs) in a Dutch population-based sample of sporadic CJD (sCJD) patients and a cognitively normal control group of similar age distribution. We genotyped the same polymorphisms in two other sample groups of sCJD cases from Italy and the UK. In addition, we compared MAPT haplotypes between sCJD and variant CJD (vCJD) patients. RESULTS: Single locus and haplotype analyses did not detect any significant difference between sCJD cases and controls. When we compared MAPT haplotypes between sCJD and variant CJD (vCJD) patients, we found that two of them were represented differently (H1f: 8% in sCJD versus 2% in vCJD; H1j:1% in sCJD versus 7% in vCJD). However, these two haplotypes were rare in both groups of patients, and taking the small sample sizes into account, we cannot exclude that the differences are due to chance. None of the p-values remained statistically significant after applying a multiple testing correction. CONCLUSION: Our study shows no evidence for an association between MAPT gene variations and sCJD, and some weak evidence for an association to vCJD