Cortisol levels in response to starting school in children at increased risk for social phobia

Background: Research on depression has identified hyperactivity of the HPA axis as a potential contributory factor to the intergenerational transmission of affective symptoms. However, this has not yet been examined in the context of social phobia. The current study compared HPA axis activity in response to a universal social stressor (starting school) in children of 2 groups of women: one with social phobia and one with no history of anxiety (comparison group). To determine specificity of effects of maternal social phobia, a third group of children were also examined whose mothers had generalised anxiety disorder (GAD). Method: Children provided salivary cortisol samples in the morning, afternoon and at bedtime across 3 time-blocks surrounding the school start: a month before starting school (baseline), the first week at school (stress response), and the end of the first school term (stress recovery). Child behavioural inhibition at 14 months was also assessed to explore the influence of early temperament on later stress responses. Results: All children displayed an elevation in morning and afternoon cortisol from baseline during the first week at school, which remained elevated until the end of the first term. Children in the social phobia group, however, also displayed an equivalent elevation in bedtime cortisol, which was not observed for comparison children or for children of mothers with GAD. Children in the social phobia group who were classified as 'inhibited' at 14 months displayed significantly higher afternoon cortisol levels overall. Summary: A persistent stress response to school in the morning and afternoon is typical for all children, but children of mothers with social phobia also display atypical elevations in evening cortisol levels when at school - signalling long-term disruption of the circadian rhythm in HPA axis activity. This is the first study to report HPA axis disruption in children at risk of developing social phobia, and future research should aim to determine whether this represents a pathway for symptom development, taking early temperament into account

Heterogeneity in patient-reported outcomes following low-intensity mental health interventions: a multilevel analysis.

BACKGROUND: Variability in patient-reported outcomes of psychological treatments has been partly attributed to therapists--a phenomenon commonly known as therapist effects. Meta-analytic reviews reveal wide variation in therapist-attributable variability in psychotherapy outcomes, with most studies reporting therapist effects in the region of 5% to 10% and some finding minimal to no therapist effects. However, all except one study to date have been conducted in high-intensity or mixed intervention groups; therefore, there is scarcity of evidence on therapist effects in brief low-intensity psychological interventions. OBJECTIVE: To examine therapist effects in low-intensity interventions for depression and anxiety in a naturalistic setting. DATA AND ANALYSIS: Session-by-session data on patient-reported outcome measures were available for a cohort of 1,376 primary care psychotherapy patients treated by 38 therapists. Outcome measures included PHQ-9 (sensitive to depression) and GAD-7 (sensitive to general anxiety disorder) measures. Three-level hierarchical linear modelling was employed to estimate therapist-attributable proportion of variance in clinical outcomes. Therapist effects were evaluated using the intra-cluster correlation coefficient (ICC) and Bayesian empirical predictions of therapist random effects. Three sensitivity analyses were conducted: 1) using both treatment completers and non-completers; 2) a sub-sample of cases with baseline scores above the conventional clinical thresholds for PHQ-9 and GAD-7; and 3) a two-level model (using patient-level pre- and post-treatment scores nested within therapists). RESULTS: The ICC estimates for all outcome measures were very small, ranging between 0% and 1.3%, although most were statistically significant. The Bayesian empirical predictions showed that therapist random effects were not statistically significantly different from each other. Between patient variability explained most of the variance in outcomes. CONCLUSION: Consistent with the only other study to date in low intensity interventions, evidence was found to suggest minimal to no therapist effects in patient-reported outcomes. This draws attention to the more prominent source of variability which is found at the between-patient level

Lagrangian description of the fluid flow with vorticity in the relativistic cosmology

We develop the Lagrangian perturbation theory in the general relativistic cosmology, which enables us to take into account the vortical effect of the dust matter. Under the Lagrangian representation of the fluid flow, the propagation equation for the vorticity as well as the density is exactly solved. Based on this, the coupling between the density and vorticity is clarified in a non-perturbative way. The relativistic correspondence to the Lagrangian perturbation theory in the Newtonian cosmology is also emphasized.Comment: 14 pages (RevTeX); accepted for publication in Phys. Rev.

Investigating the maximum resolution of µXRF core scanners: a 1800 year storminess reconstruction from the Outer Hebrides

Micro x-ray fluorescence (µXRF) core scanning is capable of measuring the elemental composition of lake sediment at sub-millimetre resolution, but bioturbation and physical mixing may degrade environmental signals at such fine scales. The aim of this research is to determine the maximum possible resolution at which meaningful environmental signals may be reconstructed from lake sediments using this method. Sediment from a coastal lake in the Outer Hebrides, Scotland, has been analysed using calibrated element measurements to reconstruct storminess since AD 200. We find that a Ca/K ratio in lake-core sediments reflects the presence of fine calcium carbonate shell fragments, a constituent of sand in the catchment that is washed and blown into the lake. Variations in this ratio are significantly correlated with instrumental records of precipitation and low pressures, suggesting it is a proxy for storminess. Furthermore, identification of a c. 60-year cycle supports a climatic influence on Ca/K, as this cycle is frequently identified in reconstructions of the North Atlantic Oscillation and North Atlantic sea-surface temperature. Comparison with weather records at different resolutions and spectral analysis indicate that µXRF data from Loch Hosta can be interpreted at sub-decadal resolutions (equivalent to core depth intervals of 3–5 mm in this location). Therefore, we suggest that sub-centimetre sampling using µXRF core scanning could be beneficial in producing environmental reconstructions in many lake settings where sediments are not varved

Long-wavelength iteration scheme and scalar-tensor gravity

Inhomogeneous and anisotropic cosmologies are modeled withing the framework of scalar-tensor gravity theories. The inhomogeneities are calculated to third-order in the so-called long-wavelength iteration scheme. We write the solutions for general scalar coupling and discuss what happens to the third-order terms when the scalar-tensor solution approaches at first-order the general relativistic one. We work out in some detail the case of Brans-Dicke coupling and determine the conditions for which the anisotropy and inhomogeneity decay as time increases. The matter is taken to be that of perfect fluid with a barotropic equation of state.Comment: 13 pages, requires REVTeX, submitted to Phys. Rev.

Adolescent self-control predicts midlife hallucinatory experiences:40-year follow-up of a national birth cohort

Associations between self-control in adolescence and adult mental health are unclear in the general population; to our knowledge, no study has investigated self-control in relation to psychotic-like symptoms

Newtonian Cosmology in Lagrangian Formulation: Foundations and Perturbation Theory

The ``Newtonian'' theory of spatially unbounded, self--gravitating, pressureless continua in Lagrangian form is reconsidered. Following a review of the pertinent kinematics, we present alternative formulations of the Lagrangian evolution equations and establish conditions for the equivalence of the Lagrangian and Eulerian representations. We then distinguish open models based on Euclidean space $\R^3$ from closed models based (without loss of generality) on a flat torus \T^3. Using a simple averaging method we show that the spatially averaged variables of an inhomogeneous toroidal model form a spatially homogeneous ``background'' model and that the averages of open models, if they exist at all, in general do not obey the dynamical laws of homogeneous models. We then specialize to those inhomogeneous toroidal models whose (unique) backgrounds have a Hubble flow, and derive Lagrangian evolution equations which govern the (conformally rescaled) displacement of the inhomogeneous flow with respect to its homogeneous background. Finally, we set up an iteration scheme and prove that the resulting equations have unique solutions at any order for given initial data, while for open models there exist infinitely many different solutions for given data.Comment: submitted to G.R.G., TeX 30 pages; AEI preprint 01

Diagnostic change 10 years after a first episode of psychosis

Background. A lack of an aetiologically based nosology classification has contributed to instability in psychiatric diag-noses over time. This study aimed to examine the diagnostic stability of psychosis diagnoses using data from an inci-dence sample of psychosis cases, followed up after 10 years and to examine those baseline variables which were associated with diagnostic change. Method. Data were examined from the ÆSOP and ÆSOP-10 studies, an incidence and follow-up study, respectively, of a population-based cohort of first-episode psychosis cases from two sites. Diagnosis was assigned using ICD-10 and DSM-IV-TR. Diagnostic change was examined using prospective and retrospective consistency. Baseline variables asso-ciated with change were examined using logistic regression and likelihood ratio tests. Results. Slightly more (59.6%) cases had the same baseline and lifetime ICD-10 diagnosis compared with DSM-IV-TR (55.3%), but prospective and retrospective consistency was similar. Schizophrenia, psychotic bipolar disorder and drug-induced psychosis were more prospectively consistent than other diagnoses. A substantial number of cases with other diagnoses at baseline (ICD-10, n = 61; DSM-IV-TR, n = 76) were classified as having schizophrenia at 10 years

Biological and psychosocial risk factors for psychotic major depression

AIMS: Few studies have investigated risk factors for psychotic major depression (PMD). We aimed to investigate the biological and psychosocial risk factors associated with PMD compared with other psychotic disorders. METHODS: Based on the aetiology and ethnicity in schizophrenia and other psychoses (ÆSOP) study, we used a case-control study to identify and recruit, at baseline and 10-year follow-up, all first episode cases of psychosis, presenting for the first time to specialist mental health services in defined catchment areas in the UK. Population-based controls were recruited from the same areas. Data were collected on: sociodemographics; social isolation; childhood adversity; life events; minor physical anomalies; and neurological soft signs. RESULTS: Living alone (aOR = 2.26, CI = 1.21-4.23), basic level qualification (aOR = 2.89, CI = 1.08-7.74), being unemployed (aOR = 2.12, CI = 1.13-3.96), having contact with friends less than monthly (aOR = 4.24, CI = 1.62-11.14), having no close confidants (aOR = 4.71, CI = 2.08-10.68), having experienced childhood adversity (aOR = 2.57, CI = 1.02-6.44), family history of mental illness (aOR = 10.68, CI = 5.06-22.52), family history of psychosis (aOR = 12.85, CI = 5.24-31.51), and having more neurological soft signs (aOR = 1.15, CI = 1.07-1.24) were all associated with a follow-up diagnosis of PMD and schizophrenia. Few variables associated with PMD were also associated with a diagnosis of bipolar disorder. Minor physical anomalies were associated with a follow-up diagnosis of schizophrenia and bipolar disorder, but not PMD. CONCLUSIONS: Risk factors associated with PMD appear to overlap with those for schizophrenia, but less so for bipolar disorder. Future work on the differential aetiology of PMD, from other psychoses is needed to find the 'specifier' between PMD and other psychoses. Future research on aetiology in PMD, and perhaps other psychoses, should account for diagnostic change.status: publishe