Examining hope as a transdiagnostic mechanism of change across anxiety disorders and CBT treatment protocols.

Hope is a trait that represents the capacity to identify strategies or pathways to achieve goals and the motivation or agency to effectively pursue those pathways. Hope has been demonstrated to be a robust source of resilience to anxiety and stress and there is limited evidence that, as has been suggested for decades, hope may function as a core process or transdiagnostic mechanism of change in psychotherapy. The current study examined the role of hope in predicting recovery in a clinical trial in which 223 individuals with 1 of 4 anxiety disorders were randomized to transdiagnostic cognitive behavior therapy (CBT), disorder-specific CBT, or a waitlist controlled condition. Effect size results indicated moderate to large intraindividual increases in hope, that changes in hope were consistent across the five CBT treatment protocols, that changes in hope were significantly greater in CBT relative to waitlist, and that changes in hope began early in treatment. Results of growth curve analyses indicated that CBT was a robust predictor of trajectories of change in hope compared to waitlist, and that changes in hope predicted changes in both self-reported and clinician-rated anxiety. Finally, a statistically significant indirect effect was found indicating that the effects of treatment on changes in anxiety were mediated by treatment effects on hope. Together, these results suggest that hope may be a promising transdiagnostic mechanism of change that is relevant across anxiety disorders and treatment protocols.R01 MH090053 - NIMH NIH HHSAccepted manuscrip

The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders a randomized clinical trial

IMPORTANCE: Transdiagnostic interventions have been developed to address barriers to the dissemination of evidence-based psychological treatments, but only a few preliminary studies have compared these approaches with existing evidence-based psychological treatments. OBJECTIVE: To determine whether the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is at least as efficacious as single-disorder protocols (SDPs) in the treatment of anxiety disorders. DESIGN, SETTING, AND PARTICIPANTS: From June 23, 2011, to March 5, 2015, a total of 223 patients at an outpatient treatment center with a principal diagnosis of panic disorder with or without agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, or social anxiety disorder were randomly assigned by principal diagnosis to the UP, an SDP, or a waitlist control condition. Patients received up to 16 sessions of the UP or an SDP for 16 to 21 weeks. Outcomes were assessed at baseline, after treatment, and at 6-month follow-up. Analysis in this equivalence trial was based on intention to treat. INTERVENTIONS: The UP or SDPs. MAIN OUTCOMES AND MEASURES: Blinded evaluations of principal diagnosis clinical severity rating were used to evaluate an a priori hypothesis of equivalence between the UP and SDPs. RESULTS: Among the 223 patients (124 women and 99 men; mean [SD] age, 31.1 [11.0] years), 88 were randomized to receive the UP, 91 to receive an SDP, and 44 to the waitlist control condition. Patients were more likely to complete treatment with the UP than with SDPs (odds ratio, 3.11; 95% CI, 1.44-6.74). Both the UP (Cohen d, −0.93; 95% CI, −1.29 to −0.57) and SDPs (Cohen d, −1.08; 95% CI, −1.43 to −0.73) were superior to the waitlist control condition at acute outcome. Reductions in clinical severity rating from baseline to the end of treatment (β, 0.25; 95% CI, −0.26 to 0.75) and from baseline to the 6-month follow-up (β, 0.16; 95% CI, −0.39 to 0.70) indicated statistical equivalence between the UP and SDPs. CONCLUSIONS AND RELEVANCE: The UP produces symptom reduction equivalent to criterion standard evidence-based psychological treatments for anxiety disorders with less attrition. Thus, it may be possible to use 1 protocol instead of multiple SDPs to more efficiently treat the most commonly occurring anxiety and depressive disorders.This study was funded by grant R01 MH090053 from the National Institute of Mental Health. (R01 MH090053 - National Institute of Mental Health)First author draf

The fables of pity: Rousseau, Mandeville and the animal-fable

Copyright @ 2012 Edinburgh University PressPrompted by Derrida’s work on the animal-fable in eighteenth-century debates about political power, this article examines the role played by the fiction of the animal in thinking of pity as either a natural virtue (in Rousseau’s Second Discourse) or as a natural passion (in Mandeville’s The Fable of the Bees). The war of fables between Rousseau and Mandeville – and their hostile reception by Samuel Johnson and Adam Smith – reinforce that the animal-fable illustrates not so much the proper of man as the possibilities and limitations of a moral philosophy that is unable to address the political realities of the state

Measurement of the half-life of the T=12\frac{1}{2} mirror decay of 19^{19}Ne and its implication on physics beyond the standard model

The $\frac{1}{2}^+ \rightarrow \frac{1}{2}^+$ superallowed mixed mirror decay of $^{19}$Ne to $^{19}$F is excellently suited for high precision studies of the weak interaction. However, there is some disagreement on the value of the half-life. In a new measurement we have determined this quantity to be $T_{1/2}$ = $17.2832 \pm 0.0051_{(stat)}$ $\pm 0.0066_{(sys)}$ s, which differs from the previous world average by 3 standard deviations. The impact of this measurement on limits for physics beyond the standard model such as the presence of tensor currents is discussed.Comment: 5 pages, 3 figures, 1 tabl

Transmitted Drug Resistance in the CFAR Network of Integrated Clinical Systems Cohort: Prevalence and Effects on Pre-Therapy CD4 and Viral Load

Human immunodeficiency virus type 1 (HIV-1) genomes often carry one or more mutations associated with drug resistance upon transmission into a therapy-naïve individual. We assessed the prevalence and clinical significance of transmitted drug resistance (TDR) in chronically-infected therapy-naïve patients enrolled in a multi-center cohort in North America. Pre-therapy clinical significance was quantified by plasma viral load (pVL) and CD4+ cell count (CD4) at baseline. Naïve bulk sequences of HIV-1 protease and reverse transcriptase (RT) were screened for resistance mutations as defined by the World Health Organization surveillance list. The overall prevalence of TDR was 14.2%. We used a Bayesian network to identify co-transmission of TDR mutations in clusters associated with specific drugs or drug classes. Aggregate effects of mutations by drug class were estimated by fitting linear models of pVL and CD4 on weighted sums over TDR mutations according to the Stanford HIV Database algorithm. Transmitted resistance to both classes of reverse transcriptase inhibitors was significantly associated with lower CD4, but had opposing effects on pVL. In contrast, position-specific analyses of TDR mutations revealed substantial effects on CD4 and pVL at several residue positions that were being masked in the aggregate analyses, and significant interaction effects as well. Residue positions in RT with predominant effects on CD4 or pVL (D67 and M184) were re-evaluated in causal models using an inverse probability-weighting scheme to address the problem of confounding by other mutations and demographic or risk factors. We found that causal effect estimates of mutations M184V/I ( pVL) and D67N/G ( and pVL) were compensated by K103N/S and K219Q/E/N/R. As TDR becomes an increasing dilemma in this modern era of highly-active antiretroviral therapy, these results have immediate significance for the clinical management of HIV-1 infections and our understanding of the ongoing adaptation of HIV-1 to human populations

Experimental evidence of parametric decay processes in the variable specific impulse magnetoplasma rocket (VASIMR) helicon plasma source

Decay waves have been observed in the megahertz range in the helium plasma generated by the variable specific impulse magnetoplasma rocket magnetoplasma thruster. They are measured using one of the tips of a triple probe connected to a 50 Ω input of a spectrum analyzer via a dc block (a small capacitor). The maximum amplitude of all waves is in the center of the plasma and does not appear correlated to the radial electron density or temperature profiles. The waves seem to be generated close to the helicon antenna that was 91 cm “upstream” from the measuring Langmuir probe. A possible explanation is parametric decay of the large amplitude helicon wave that also generates the plasma.This project was proudly supported by the International Science Linkages programme established under the Australian Government’s innovation statement Backing Australia’s Ability

Healthier prisons: The role of a prison visitors' centre

Since the inception of the prison as a ‘setting’ for health promotion, there has been a focus on how the health of those men and women who spend ‘time inside’ can at least be maintained and if possible, enhanced, during their prison sentence. This paper presents findings from a mainly qualitative evaluation of a prison visitors' centre in the UK. It reports experiences of prisoners' families, prisoners, prison staff, the local community and the ways in which the visitors' centre has contributed positively to their health and well-being. In addition, key stakeholders were interviewed to ascertain the role this visitors' centre has in policy frameworks related to re-offending. The findings from this evaluation underscore how the visitors' centre improved the quality of visits, and contributed towards the maintenance of family ties through the help and support it provides for families and prisoners. The paper concludes by suggesting that visitors' centres are an essential part of a modern prison service helping to address the government's health inequalities agenda

Longitudinal-Transverse Separations of Structure Functions at Low Q2Q^{2} for Hydrogen and Deuterium

We report on a study of the longitudinal to transverse cross section ratio, $R=\sigma_L/\sigma_T$, at low values of $x$ and $Q^{2}$, as determined from inclusive inelastic electron-hydrogen and electron-deuterium scattering data from Jefferson Lab Hall C spanning the four-momentum transfer range 0.06 $< Q^{2} < 2.8$ GeV$^{2}$. Even at the lowest values of $Q^{2}$, $R$ remains nearly constant and does not disappear with decreasing $Q^{2}$, as expected. We find a nearly identical behaviour for hydrogen and deuterium.Comment: 4 pages, 2 gigure