Anxiety and Posttraumatic Stress Disorder in the Context of Human Brain Evolution:A Role for Theory in DSM-V?

The “hypervigilance, escape, struggle, tonic immobility”\ud evolutionarily hardwired acute peritraumatic response\ud sequence is important for clinicians to understand. Our\ud commentary supplements the useful article on human\ud tonic immobility (TI) by Marx, Forsyth, Gallup, Fusé and Lexington (2008). A hallmark sign of TI is peritraumatic\ud tachycardia, which others have documented as a\ud major risk factor for subsequent posttraumatic stress\ud disorder (PTSD). TI is evolutionarily highly conserved\ud (uniform across species) and underscores the need for\ud DSM-V planners to consider the inclusion of evolution\ud theory in the reconceptualization of anxiety and PTSD.\ud We discuss the relevance of evolution theory to the\ud DSM-V reconceptualization of acute dissociativeconversion\ud symptoms and of epidemic sociogenic disorder(epidemic “hysteria”). Both are especially in need of attention in light of the increasing threat of terrorism\ud against civilians. We provide other pertinent examples.\ud Finally, evolution theory is not ideology driven (and\ud makes testable predictions regarding etiology in “both\ud directions”). For instance, it predicted the unexpected\ud finding that some disorders conceptualized in DSM-IV-TR as innate phobias are conditioned responses and thus better conceptualized as mild forms of PTSD. Evolution\ud theory may offer a conceptual framework in\ud DSM-V both for treatment and for research on psychopathology.\u

Preponderance of Late-spiking Neurons in Rat Lateral Amygdala

Whole-cell recordings from rat lateral amygdala (LA) revealed two populations of principal neurons, that have similar pyramid-like morphologies but differing in firing pattern: late-spiking (LS, 66%) and regular-spiking (RS, 34%). The presence of large numbers of LS neurons arguably supports recent suggestions that the LA should be considered to be a functional extension of perirhinal cortex

Human brain evolution and the "Neuroevolutionary Time-depth Principle:" Implications for the Reclassification of fear-circuitry-related traits in DSM-V and for studying resilience to warzone-related posttraumatic stress disorder.

The DSM-III, DSM-IV, DSM-IV-TR and ICD-10 have judiciously minimized discussion of etiologies to distance clinical psychiatry from Freudian psychoanalysis. With this goal mostly achieved, discussion of etiological factors should be reintroduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). A research agenda for the DSM-V advocated the "development of a pathophysiologically based classification system". The author critically reviews the neuroevolutionary literature on stress-induced and fear circuitry disorders and related amygdala-driven, species-atypical fear behaviors of clinical severity in adult humans. Over 30 empirically testable/falsifiable predictions are presented. It is noted that in DSM-IV-TR and ICD-10, the classification of stress and fear circuitry disorders is neither mode-of-acquisition-based nor brain-evolution-based. For example, snake phobia (innate) and dog phobia (overconsolidational) are clustered together. Similarly, research on blood-injection-injury-type-specific phobia clusters two fears different in their innateness: 1) an arguably ontogenetic memory-trace-overconsolidation-based fear (hospital phobia) and 2) a hardwired (innate) fear of the sight of one's blood or a sharp object penetrating one's skin. Genetic architecture-charting of fear-circuitry-related traits has been challenging. Various, non-phenotype-based architectures can serve as targets for research. In this article, the author will propose one such alternative genetic architecture. This article was inspired by the following: A) Nesse's "Smoke-Detector Principle", B) the increasing suspicion that the "smooth" rather than "lumpy" distribution of complex psychiatric phenotypes (including fear-circuitry disorders) may in some cases be accounted for by oligogenic (and not necessarily polygenic) transmission, and C) insights from the initial sequence of the chimpanzee genome and comparison with the human genome by the Chimpanzee Sequencing and Analysis Consortium published in late 2005. Neuroevolutionary insights relevant to fear circuitry symptoms that primarily emerge overconsolidationally (especially Combat related Posttraumatic Stress Disorder) are presented. Also introduced is a human-evolution-based principle for clustering innate fear traits. The "Neuroevolutionary Time-depth Principle" of innate fears proposed in this article may be useful in the development of a neuroevolution-based taxonomic re-clustering of stress-triggered and fear-circuitry disorders in DSM-V. Four broad clusters of evolved fear circuits are proposed based on their time-depths: 1) Mesozoic (mammalian-wide) circuits hardwired by wild-type alleles driven to fixation by Mesozoic selective sweeps; 2) Cenozoic (simian-wide) circuits relevant to many specific phobias; 3) mid Paleolithic and upper Paleolithic (Homo sapiens-specific) circuits (arguably resulting mostly from mate-choice-driven stabilizing selection); 4) Neolithic circuits (arguably mostly related to stabilizing selection driven by gene-culture co-evolution). More importantly, the author presents evolutionary perspectives on warzone-related PTSD, Combat-Stress Reaction, Combat-related Stress, Operational-Stress, and other deployment-stress-induced symptoms. The Neuroevolutionary Time-depth Principle presented in this article may help explain the dissimilar stress-resilience levels following different types of acute threat to survival of oneself or one's progency (aka DSM-III and DSM-V PTSD Criterion-A events). PTSD rates following exposure to lethal inter-group violence (combat, warzone exposure or intentionally caused disasters such as terrorism) are usually 5-10 times higher than rates following large-scale natural disasters such as forest fires, floods, hurricanes, volcanic eruptions, and earthquakes. The author predicts that both intentionally-caused large-scale bioevent-disasters, as well as natural bioevents such as SARS and avian flu pandemics will be an exception and are likely to be followed by PTSD rates approaching those that follow warzone exposure. During bioevents, Amygdala-driven and locus-coeruleus-driven epidemic pseudosomatic symptoms may be an order of magnitude more common than infection-caused cytokine-driven symptoms. Implications for the red cross and FEMA are discussed. It is also argued that hospital phobia as well as dog phobia, bird phobia and bat phobia require re-taxonomization in DSM-V in a new "overconsolidational disorders" category anchored around PTSD. The overconsolidational spectrum category may be conceptualized as straddling the fear circuitry spectrum disorders and the affective spectrum disorders categories, and may be a category for which Pitman's secondary prevention propranolol regimen may be specifically indicated as a "morning after pill" intervention. Predictions are presented regarding obsessive-compulsive disorder (OCD) (e.g., female-pattern hoarding vs. male-pattern hoarding) and "culture-bound" acute anxiety symptoms (taijin-kyofusho, koro, shuk yang, shook yong, suo yang, rok-joo, jinjinia-bemar, karoshi, gwarosa, Voodoo death). Also discussed are insights relevant to pseudoneurological symptoms and to the forthcoming Dissociative-Conversive disorders category in DSM-V, including what the author terms fright-triggered acute pseudo-localized symptoms (i.e., pseudoparalysis, pseudocerebellar imbalance, psychogenic blindness, pseudoseizures, and epidemic sociogenic illness). Speculations based on studies of the human abnormal-spindle-like, microcephaly-associated (ASPM) gene, the microcephaly primary autosomal recessive (MCPH) gene, and the forkhead box p2 (FOXP2) gene are made and incorporated into what is termed "The pre-FOXP2 Hypothesis of Blood-Injection-Injury Phobia." Finally, the author argues for a non-reductionistic fusion of "distal (evolutionary) neurobiology" with clinical "proximal neurobiology," utilizing neurological heuristics. It is noted that the value of re-clustering fear traits based on behavioral ethology, human-phylogenomics-derived endophenotypes and on ontogenomics (gene-environment interactions) can be confirmed or disconfirmed using epidemiological or twin studies and psychiatric genomics

Economics and Engineering for Preserving Digital Content

Progress towards practical long-term preservation seems to be stalled. Preservationists cannot afford specially developed technology, but must exploit what is created for the marketplace. Economic and technical facts suggest that most preservation ork should be shifted from repository institutions to information producers and consumers. Prior publications describe solutions for all known conceptual challenges of preserving a single digital object, but do not deal with software development or scaling to large collections. Much of the document handling software needed is available. It has, however, not yet been selected, adapted, integrated, or deployed for digital preservation. The daily tools of both information producers and information consumers can be extended to embed preservation packaging without much burdening these users. We describe a practical strategy for detailed design and implementation. Document handling is intrinsically complicated because of human sensitivity to communication nuances. Our engineering section therefore starts by discussing how project managers can master the many pertinent details.

Freeze, Flight, Fight, Fright, Faint: Adaptationist Perspectives on the Acute Stress Response Spectrum

This article reviews the existing evolutionary perspectives on the acute stress response habitual faintness and blood-injection-injury type-specific phobia (BIITS phobia). In this article, an alternative evolutionary perspective, based on recent advances in evolutionary psychology, is proposed. Specifically, that fear-induced faintness (eg, fainting following the sight of a syringe, blood, or following a trivial skin injury) is a distinct Homo sapiens-specific extreme-stress survival response to an inescapable threat. The article suggests that faintness evolved in response to middle paleolithic intra-group and inter-group violence (of con-specifics) rather than as a pan-mammalian defense response, as is presently assumed. Based on recent literature, freeze, flight, fight, fright, faint provides a more complete description of the human acute stress response sequence than current descriptions. Faintness, one of three primary physiological reactions involved in BIITS phobia, is extremely rare in other phobias. Since heritability estimates are higher for faintness than for fears or phobias, the author suggests that trait-faintness may be a useful complement to trait-anxiety as an endophenotype in research on the human fear circuitry. Some implications for the forthcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as well as for clinical, health services, and transcriptomic research are briefly discusse

Evidence Based Complementary Intervention for Insomnia

Increasing scientific evidence point to a non-pharmacological complementary treatment for insomnia: white noise. Its presentation has been shown to induce sleep in human neonates and adults, probably by reducing the signal-to-noise ratio of ambient sound. White noise may be a simple, safe, cost-effective alternative to hypnotic medication in many psychiatric disorders, especially acute stress disorder and PTSD

Stop the Integration Principle?

Lord Slynn of Hadley is probably not primarily known as an environmental lawyer. His contributions to the development of European environmental law are, however, considerable. On May 24, 1988, Slynn delivered his famous opinion in the so-called Danish Bottles case. In that case, the European Court of Justice ( ECJ ) held that a system requiring manufacturers and importers to market beer and soft drinks only in reusable containers (which had to be approved by a National Agency for the Protection of the Environment) was subject to what is now article 34 of the Treaty on the Functioning of the European Union ( TFEU ) since the Lisbon Treaty entered into force. The importance of this judgment is that it enabled and facilitated the integration of environmental considerations into the market freedoms of the European Community (later the European Union). This Essay, in memory of Lord Slynn of Hadley, is therefore devoted to the process of integrating environmental requirements in other areas

A participatory methodology for large scale field trials in the UK

Farmer participation was essential in developing a uniquely useful set of wheat variety trials data on a wide range of organic farms over two years. Although the trials were successful, it became clear that some of the participating farmers felt there were some limitations in the process. These included a lack of ownership in the project and a concern for more researcher help. It was clear that a greater time in-vestment was needed at the start of the project to help with farmer understanding and ownership. De-spite the negative comments, farmers appreciated their involvement, particularly in contrasting their own views and information with that from the wider scene. Farmer participation is essential for systems-level research and this project helped to develop a small core of trained farmers and researchers

Stressful Experiences in Children and Adolescents: Initial Report from the PSEI-NCPV Honolulu Study

As part of a federal study of the biology of stress and resilience, a comprehensive, structured stress-history interview (PSEI-NCPV) was administered to 307 participants recruited in Honolulu. A moderate correlation between childhood stress and current depression was found. A relatively high rate of "severe bullying/hazing," and a high mean stress-intensity reating for "blood-drawing induced anxiety" call for further research

Household Leverage and the Deductibility of Home Mortgage Interest: Evidence from UK House Purchasers

During the last quarter century, mortgage interest deductibility has been gradually phased out. In 1974 a ceiling was set on the size of the mortgage eligible for interest deductibility (œ30,000 since 1983) and, beginning in 1993, the maximum rate at which interest under that ceiling could be deducted was reduced in four steps to zero in 1999. The combination of these changes gives a rich array of different debt tax penalties for different households in different years. We analyze over 117,000 loans originated in the UK during the 1988-91 and 1995-98 periods to finance home purchases. We first estimate a logit to predict whether a household's loan exceeds the œ30,000 ceiling. These predicted probabilities are then employed to construct debt tax penalty variables that are used to explain household LTVs on loans to finance home purchases. The penalty variables depend on the predicted probability of having a loan that exceeds the ceiling, the market mortgage rate, and exogenous household specific tax rates. From these results we compute estimates of the impact of removing deductibility on initial LTVs in the UK and on the weighted average cost of capital for owner-occupied housing. Removal of deductibility is estimated to reduce initial LTVs, which mitigates the rise in the weighted average cost of capital, by about 30 percent, with the reduction varying with household age, loan size (above or below the œ30,000 limit) and tax bracket.