Anger Expression and Risk of Coronary Heart Disease: Evidence From the Nova Scotia Health Survey

Background Whereas some studies have found that anger increases the risk of incident coronary heart disease (CHD), others found anger to be protective. Prior studies did not account for different types of anger expression, which may be associated with opposing levels of cardiovascular risk. This study examines whether distinct types of anger expression differentially predict incident CHD. Methods We conducted a population-based, observational prospective study of 785 randomly selected Canadian men and women (50% each) aged 46 to 92 years and free of CHD in 1995. Using videotaped interviews, trained coders rated 3 types of anger expression: constructive anger (discussing anger to resolve the situation), destructive anger justification (blaming others for one's anger), and destructive anger rumination (brooding over an anger-inducing incident). The association between anger expression type per SD and incident CHD was estimated using Cox proportional hazards models adjusted for sex, age, cardiovascular risk factors, depressive symptoms, hostility, and anxiety. Interactions of anger expression type and gender were also tested. Results There were 115 incident CHD events (14.6%) during 6,584 person-years of follow-up. The association between clinically assessed constructive anger expression and CHD varied by gender (P for interaction = .02); higher levels were associated with a lower risk of incident CHD in men only (hazard ratio 0.58, 95% CI 0.43-0.80, P < .001), whereas higher levels of destructive anger justification was associated with a 31% increased risk of CHD in both sexes (hazard ratio 1.31, 95% CI 1.03-1.67, P = .03) and predicted CHD incidence independent of covariates and depressive symptoms, hostility, and anxiety. Conclusions Decreased constructive anger in men and increased destructive anger justification in men and women are associated with increased risk of 10-year incident CHD

Children's computation of complex linguistic forms: a study of frequency and imageability effects.

This study investigates the storage vs. composition of inflected forms in typically-developing children. Children aged 8-12 were tested on the production of regular and irregular past-tense forms. Storage (vs. composition) was examined by probing for past-tense frequency effects and imageability effects--both of which are diagnostic tests for storage--while controlling for a number of confounding factors. We also examined sex as a factor. Irregular inflected forms, which must depend on stored representations, always showed evidence of storage (frequency and/or imageability effects), not only across all children, but also separately in both sexes. In contrast, for regular forms, which could be either stored or composed, only girls showed evidence of storage. This pattern is similar to that found in previously-acquired adult data from the same task, with the notable exception that development affects which factors influence the storage of regulars in females: imageability plays a larger role in girls, and frequency in women. Overall, the results suggest that irregular inflected forms are always stored (in children and adults, and in both sexes), whereas regulars can be either composed or stored, with their storage a function of various item- and subject-level factors

Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: The Canadian Nova Scotia Health Survey

AIMS: Positive affect is believed to predict cardiovascular health independent of negative affect. We examined whether higher levels of positive affect are associated with a lower risk of coronary heart disease (CHD) in a large prospective study with 10 years of follow-up. METHODS AND RESULTS: We examined the association between positive affect and cardiovascular events in 1739 adults (862 men and 877 women) in the 1995 Nova Scotia Health Survey. Trained nurses conducted Type A Structured Interviews, and coders rated the degree of outwardly displayed positive affect on a five-point scale. To test that positive affect predicts incident CHD when controlling for depressive symptoms and other negative affects, we used as covariates: Center for Epidemiological Studies Depressive symptoms Scale, the Cook Medley Hostility scale, and the Spielberger Trait Anxiety Inventory. There were 145 (8.3%) acute non-fatal or fatal ischaemic heart disease events during the 14 916 person-years of observation. In a proportional hazards model controlling for age, sex, and cardiovascular risk factors, positive affect predicted CHD (adjusted HR, 0.78; 95% CI 0.63-0.96 per point; P = 0.02), the covariate depressive symptoms continued to predict CHD as had been published previously in the same patients (HR, 1.04; 95% CI 1.01-1.07 per point; P = 0.004) and hostility and anxiety did not (both P > 0.05). CONCLUSION: In this large, population-based study, increased positive affect was protective against 10-year incident CHD, suggesting that preventive strategies may be enhanced not only by reducing depressive symptoms but also by increasing positive affect

Relation of Inflammation to Depression and Incident Coronary Heart Disease

Numerous studies have found that depression was a strong independent risk factor for incident coronary heart disease (CHD), with increasing risk in those with higher levels of depressive symptoms. The association between measures of inflammation (C-reactive protein, interleukin-6, and soluble intracellular adhesion molecule-1), depressive symptoms, and CHD incidence was examined in 1,794 subjects of the population-based Canadian Nova Scotia Health Survey. There were 152 incident CHD events (8.5%; 141 nonfatal, 11 fatal) during the 15,514 person-years of observation (incidence rate 9.8 events/1,000 person-years). Depression and inflammation were correlated at baseline and each significantly predicted CHD in separate models. When both risk factors were in the same model, each remained significant. The association between depressed group by the Center for Epidemiological Studies-Depression scale (score > or =10 vs 0 to 9) and CHD incidence (hazard rate 1.60, 95% confidence interval 1.12 to 2.27) was not reduced by the addition of inflammatory markers to the model (hazard rate 1.59, 95% confidence interval 1.12 to 2.26). Findings were similar after adjustment for aspirin, lipid-lowering medication, or antidepressant use, and the association did not vary by gender, smoking status, age, obesity, cardiovascular medication use, or antidepressant use. In conclusion, increased inflammation explained only a very small proportion of the association between depression and incident CHD

Short-Term Changes in Ambient Temperature and Risk of Ischemic Stroke

Background: Despite consistent evidence of a higher short-term risk of cardiovascular mortality associated with ambient temperature, there have been discrepant findings on the association between temperature and ischemic stroke. Moreover, few studies have considered potential confounding by ambient fine particulate matter air pollution <2.5 μm in diameter (PM2.5) and none have examined the impact of temperature changes on stroke in the subsequent hours rather than days. The aim of this study was to evaluate whether changes in temperature trigger an ischemic stroke in the following hours and days and whether humid days are particularly harmful. Methods: We reviewed the medical records of 1,705 patients residing in the metropolitan region of Boston, Mass., USA, who were hospitalized with neurologist-confirmed ischemic stroke, and we abstracted data on the time of symptom onset and clinical characteristics. We obtained hourly meteorological data from the National Weather Service station and hourly PM2.5 data from the Harvard ambient monitoring station. We used the time-stratified case-crossover design to assess the association between ischemic stroke and apparent temperature averaged over 1-7 days prior to stroke onset adjusting for PM2.5. We assessed whether differences in apparent temperature trigger a stroke within shorter time periods by examining the association between stroke onset and apparent temperature levels averaged in 2-hour increments prior to stroke onset (0-2 h through 36-38 h). We tested whether the association varied by health characteristics or by PM2.5, ozone or relative humidity. Results: The incidence rate ratio of ischemic stroke was 1.09 (95% confidence interval 1.01-1.18) following a 5°C decrement in average apparent temperature over the 2 days preceding symptom onset. The higher risk associated with cooler temperatures peaked in the first 14-34 h. There was no statistically significant difference in the association between temperature and ischemic stroke across seasons. The risk of ischemic stroke was not meaningfully different across subgroups of patients defined by health characteristics. The association between ischemic stroke and ambient temperature was stronger on days with higher levels of relative humidity. Conclusions: Lower temperatures are associated with a higher risk of ischemic stroke onset in both warm and cool seasons, and the risk is higher on days with higher levels of relative humidity. Based on this study and the body of literature on ambient temperature and cardiovascular events, identifying methods for mitigating cardiovascular risk may be warranted

Cancer and suicidal ideation and behaviours: Protocol for a systematic review and meta-analysis

Introduction Prevalence of suicidal ideation (SI) and behaviours are higher among patients with cancer than general population. No systematic review/meta-analysis investigated this topic; therefore, our aim will be to assess the relationship between cancer and SI and behaviours. Methods We will search PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO and Cochrane Library databases from their inception until 30 June 2018. Case-control and cohort studies focused on the association between cancer (any type) and suicidal outcomes (suicide, suicide attempt and SI) will be included. Two team members will independently: (A) perform the selection of the included studies and data extraction, with the supervision of a third member in case of discrepancies and (B) assess each study with: (1) Newcastle-Ottawa Scale (NOS); (2) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement; (3) Grading of Recommendations Assessment, Development and Evaluation (GRADE). We will conduct a random-effects meta-analysis. Individual and pooled ORs and associated 95% CIs will be calculated as well as between-study heterogeneity. We will examine the potential for publication bias. If possible, we will explore reasons for potential between-study heterogeneity. Ethics and dissemination This study does not require ethical approval. The study will be submitted to a peer-reviewed journal, will be publicly disseminated and will be the topic of research presentations.This work is partly supported by the Swedish Cancer Society (grant no: CAN 2014/417), Swedish Research Council for Health, Working Life, and Welfare (grant no: 2017-00531), Karolinska Institutet (Senior Researcher Award and Strategic Research Area in Epidemiology Award)

Physical Activity and Onset of Acute Ischemic Stroke: The Stroke Onset Study

Regular physical activity is known to decrease the risk of cardiovascular disease, but the risk of ischemic stroke immediately following moderate or vigorous physical activity remains unclear. The authors evaluated the risk of acute ischemic stroke immediately following physical activity and examined whether the risk was modified by regular physical activity. In a multicenter case-crossover study, the authors interviewed 390 ischemic stroke patients (209 men, 181 women) at 3 North American hospitals between January 2001 and November 2006. Physical activity during the hour before stroke symptoms arose was compared with usual frequency of physical activity over the prior year. Of the 390 subjects, 21 (5%) reported having engaged in moderate or vigorous physical activity during the hour before ischemic stroke onset, and 6 subjects had lifted an object weighing at least 50 pounds (≥23 kg) during that hour. The rate ratio for ischemic stroke was 2.3 (95% confidence interval (CI): 1.5, 3.7; P < 0.001) for moderate or vigorous physical activity in the previous hour and 2.6 (95% CI: 1.1, 5.9; P = 0.02) for lifting 50 pounds or more. People who reported engaging in moderate or vigorous physical activity at least 3 times per week experienced a 2-fold increased risk (95% CI: 1.2, 3.3) with each bout of physical activity, as compared with a 6.8-fold risk (95% CI: 2.5, 18.8) among more sedentary subjects (P for homogeneity = 0.03)

Multimodal imaging of the self-regulating developing brain

Self-regulation refers to the ability to control behavior, cognition, and emotions, and self-regulation failure is related to a range of neuropsychiatric problems. It is poorly understood how structural maturation of the brain brings about the gradual improvement in self-regulation during childhood. In a large-scale multicenter effort, 735 children (4-21 y) underwent structural MRI for quantification of cortical thickness and surface area and diffusion tensor imaging for quantification of the quality of major fiber connections. Brain development was related to a standardized measure of cognitive control (the flanker task from the National Institutes of Health Toolbox), a critical component of self-regulation. Ability to inhibit responses and impose cognitive control increased rapidly during preteen years. Surface area of the anterior cingulate cortex accounted for a significant proportion of the variance in cognitive performance. This finding is intriguing, because characteristics of the anterior cingulum are shown to be related to impulse, attention, and executive problems in neurodevelopmental disorders, indicating a neural foundation for self-regulation abilities along a continuum from normality to pathology. The relationship was strongest in the younger children. Properties of large-fiber connections added to the picture by explaining additional variance in cognitive control. Although cognitive control was related to surface area of the anterior cingulate independently of basic processes of mental speed, the relationship between white matter quality and cognitive control could be fully accounted for by speed. The results underscore the need for integration of different aspects of brain maturation to understand the foundations of cognitive development

The neural basis of auditory temporal discrimination in girls with fragile X syndrome

Fragile X syndrome (FXS) is a common genetic disorder in which temporal processing may be impaired. To our knowledge however, no studies have examined the neural basis of temporal discrimination in individuals with FXS using functional magnetic resonance imaging (fMRI). Ten girls with fragile X syndrome and ten developmental age-matched typically developing controls performed an auditory temporal discrimination task in a 3T scanner. Girls with FXS showed significantly greater brain activation in a left-lateralized network, comprising left medial frontal gyrus, left superior and middle temporal gyrus, left cerebellum, and left brainstem (pons), when compared to a developmental age-matched typically developing group of subjects who had similar in-scanner task performance. There were no regions that showed significantly greater brain activation in the control group compared to individuals with FXS. These data indicate that networks of brain regions involved in auditory temporal processing may be dysfunctional in FXS. In particular, it is possible that girls with FXS employ left hemispheric resources to overcompensate for relative right hemispheric dysfunction

Examining the Latent Structure and Correlates of Sensory Reactivity in Autism: A Multi-Site Integrative Data Analysis by the Autism Sensory Research Consortium

BACKGROUND: Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these supra-modal traits in the autistic population. METHODS: Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a general response pattern factor for each supra-modal construct and determine the added value of modality-specific response pattern scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO, and SEEK (sub)constructs. RESULTS: All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses supported the validity of a supra-modal HYPER construct (ω LIMITATIONS: Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to caregiver report of observable behaviors and excluded multisensory items that reflect many real-world sensory experiences. CONCLUSION: Of the three sensory response patterns, only HYPER demonstrated sufficient evidence for valid interpretation at the supra-modal level, whereas supra-modal HYPO/SEEK constructs demonstrated substantial psychometric limitations. For clinicians and researchers seeking to characterize sensory reactivity in autism, modality-specific response pattern scores may represent viable alternatives that overcome many of these limitations