Callous-Unemotional Traits and Fearlessness: A Cardiovascular Psychophysiological Perspective in Two Adolescent Samples using Virtual Reality

There has been a longstanding debate about the link between callous-unemotional traits and fearlessness. However, biological evidence for a relationship in adolescents is lacking. Using two adolescent samples, we measured emotional reactivity, and cardiac measures of sympathetic (pre-ejection period) and parasympathetic (respiratory sinus arrhythmia) reactivity during 3D TV and virtual reality fear induction. Study 1 included 62 community adolescents from a stratified sample. Study 2 included 60 adolescents from Emotional and Behavioral Difficulties schools. Results were consistent across both studies. Adolescents with high callous-unemotional traits showed coactivation of the sympathetic and parasympathetic nervous system. Consistent with these results, youths with callous-unemotional traits self-reported that they felt more in control after the fear induction. Thus, in both samples, youth with callous-unemotional traits displayed a physiological and emotional profile suggesting they maintained control during fear induction. Therefore, it is proposed here that a shift in thinking of youth with callous-unemotional traits as fearless to youth with callous-unemotional traits are better able to manage fearful situations, may be more appropriate

Getting evidence into policy: The need for deliberative strategies?

Getting evidence into policy is notoriously difficult. In this empirical case study we used document analysis and key informant interviews to explore the Australian federal government’s policy to implement a national bowel cancer screening programme, and the role of evidence in this policy. Our analysis revealed a range of institutional limitations at three levels of national government: within the health department, between government departments, and across the whole of government. These limitations were amplified by the pressures of the 2004 Australian federal election campaign. Traditional knowledge utilisation approaches, which rely principally on voluntarist strategies and focus on the individual, rather than the institutional level, are often insufficient to ensure evidence-based implementation. We propose three alternative models, based on deliberative strategies which have been shown to work in other settings: review of the evidence by a select group of experts whose independence is enshrined in legislation and whose imprimatur is required before policy can proceed; use of an advisory group of experts who consult widely with stakeholders and publish their review findings; or public discussion of the evidence by the media and community groups who act as more direct conduits to the decision-makers than researchers. Such deliberative models could help overcome the limitations on the use of evidence by embedding public review of evidence as the first step in the institutional decision-making processes. Highlights Achieving evidence-based policy implementation is much harder than the rhetoric suggests. Our case study showed traditional voluntarist approaches are not enough to overcome institutional filtering of the evidence. Deliberative strategies open up the decision-making processes to greater expert and public scrutiny. Our framework illustrates the potential for deliberative strategies to increase the relative weight of evidence in policy. This article challenges researchers and policy-makers to acknowledge and address the institutional context of decision-making. Keywords: Australia; Health policy; Decision-making; Evidence; Knowledge utilisation; Bowel cancer; Screening; DeliberativeNHMR

Incorporating evidence and politics in health policy: Can institutionalising evidence review make a difference?

Much of the evidence translation literature focuses narrowly on the use of evidence in the initial policy formulation stages, and downplays the crucial role of institutions and the inherently political nature of policy making. More recent approaches acknowledge the importance of institutional and political factors, but make no attempt to incorporate their influence into new models of evidence translation. To address this issue, this article uses data from a comparative case study of bowel cancer screening policy in Australia, the United Kingdom and New Zealand, to propose alternative models of evidence incorporation which apply to all stages of the policy process.Stacy Carter is supported by a NHMRC Career Development Fellowship (2012-2015) APP103296

'When good evidence is not enough: the role of context in bowel cancer screening policy in New Zealand'.

Bowel cancer is a serious health problem in developed countries. Australia, the United Kingdom (UK) and New Zealand (NZ) reviewed the same randomised controlled trial evidence on the benefits and harms of population-based bowel cancer screening. Yet only NZ, with the highest age standardised rate of bowel cancer mortality, decided against introducing a bowel cancer screening programme. This case study of policy making explores the unique resource, ethical, institutional and political environments in which the evidence was considered. It highlights the centrality of context in assessing the relative worth of evidence in policy making and raises questions about the suitability of knowledge utilisation strategies.NHMRC Program Grant (402764

Colorectal cancer screening: Why immunochemical fecal occult blood tests may be the best option

Abstract Background:There are many test options available for colorectal cancer screening. The choice of test relates to the objectives of those offering or considering screening. Discussion:While all screening programs aim to detect disease early in order to improve the length and/or quality of life for the individual, some organizations and individuals prefer screening tests that offer the opportunity for cancer prevention. Others favor maximizing participation or the opportunity for shared decision-making, including discussion of information on test quality and availability. We propose three additional objectives for screening: minimizing harms, optimizing economic efficiency and maximizing equity of access to screening. Summary:Applying these objectives to colorectal cancer screening, we advocate the use of immunochemical FOBTs as the preferred screening strategy, as it satisfies all three of these important objectives. Keywords:Screening objectives, Colorectal cancer, Fecal occult blood testing, Harm minimization, Equity, Economic efficiency, Prevention, Participatio

Emotion regulation mediates relationships between mindfulness facets and aggression dimensions

Recent years have witnessed an increase of research on socio-affective factors that can explain individual differences in aggressive tendencies across community and offender populations. Specifically, mindfulness and emotion regulation have emerged as important factors, which could also constitute important prevention and treatment targets. Yet, recent studies have advanced the possibility that mindfulness may also have a "dark" side, being associated with increased levels of aggression-related variables, especially when accounting for the variance associated with emotion regulation. The present study sought to elucidate relationships among mindfulness, emotion regulation, and aggression dimensions (i.e., verbal and physical aggression, anger, and hostility) across violent offender (N = 397) and community (N = 324) samples. Results revealed expected associations between both mindfulness and emotion regulation and aggression dimensions, such that greater impairments in mindfulness and emotion regulation were related to increased levels of aggression across samples. Further, analyses of indirect effects revealed that a latent emotion dysregulation factor accounted for (i.e., mediated) relationships between mindfulness facets and aggression dimensions in both samples. Previously reported positive associations between the residual variance in mindfulness scales (i.e., controlling for emotion regulation) and aggression-related variables were not replicated in the current samples. Taken together, findings suggest that mindfulness and emotion regulation have unequivocal relations with lower levels of aggression, and should therefore be considered as relevant targets for prevention and treatment programs aimed at reducing aggressive tendencies

Emotion regulation, mindfulness, and alexithymia: Specific or general impairments in sexual, violent, and homicide offenders?

Purpose: Problems in emotional functioning have been identified as a risk factor for both sexual and violent offending, yet the precise pattern of impairment in emotional functioning that is experienced by sexual and violent offenders remains unclear. Methods: In this study, we examined self-reported difficulties in emotion regulation, the use of different strategies for regulating emotions, levels of trait alexithymia, and dispositional mindfulness in men with a history of sexual offending, non-sexual violent offending, homicide, and community controls. Results: A comparison between these groups showed that while sexual offenders had some circumscribed difficulties in emotional nonacceptance, violent offenders showed more generalized problems in emotional nonacceptance, alexithymia, and mindfulness. In contrast, homicide offenders reported few difficulties compared with other offender groups. Conclusions: Our results have implications for the allocation of individuals to treatment modules aimed at improving emotion regulation to reduce negative affect and offending behavior

Psychopathy and response inhibition: A meta-analysis of go/no-go and stop signal task performance

Traditional and more modern conceptualizations of psychopathy cite problems with impulse control. However, the extent to which these problems represent a cardinal feature of the disorder has been debated. In this study, we conducted a preregistered systematic review and meta-analysis, searching Embase, Medline, PsycINFO, and PubMed, for studies from inception to January 6th, 2022. We included 21 studies, published between 2009 and 2021, that reported on the relationship of psychopathy with performance on the go/no-go or stop signal task. A multilevel random-effects meta-analysis, including 43 effect sizes from 17 studies (total N = 1394), showed a significant pooled association between psychopathy and response inhibition r = −0.143 (95 % CI: −0.250 to −0.034). The relatively small effect size, although statistically significant, calls in to question the extent to which difficulties in response inhibition should be considered a cardinal feature of psychopathic personality. The strength of the relationship did not significantly differ between non-criminal and criminal samples, gender, task type, tasks with or without an affective component, or by psychopathy trait dimension

Psychopathy and gaze cueing

Background and objectives Psychopathic traits – and especially callous affective features – have been linked to altered processing of others’ emotional expressions, and to reduced attention to the eyes. Despite the importance of gaze cueing (i.e., the tendency to orient attention toward where someone else is looking) for social functioning, few studies have investigated relationships between psychopathic traits and gaze cueing, and whether facial emotional expression influence these relationships, obtaining mixed results. To address this gap, the present study aimed to evaluate associations between psychopathic traits and gaze cueing for emotional and neutral expressions. Methods 65 non-clinical male participants (Mage = 27.3 years) completed two self-report measures of psychopathy and performed laboratory tasks to assess gaze-cueing for emotional vs. neutral faces and an arrow-cueing task as a comparison. Results Linear mixed models showed no significant associations of emotional (versus neutral) expressions, or psychopathy trait dimensions, with either gaze cueing or arrow cueing. Limitations Reliance on a convenience sample of non-clinical men, assessed with self-reports measures of psychopathy, and using static emotional stimuli limit the generalizability of our findings. Conclusions Findings suggest that psychopathic traits are not associated with individual differences in following others’ gaze to direct attention, and that there was no advantage for affective relative to neutral expressions