Emotion regulation in psychosis

OBJECTIVES The emotional experience of individuals who experience psychosis has to a large extent been neglected, possibly in part due to the historical divide between the psychoses and neuroses. However recent research would suggest that individuals who experience psychosis experience emotional dysfunction to a similar extent as those with other mental health problems. The relatively new field of emotion regulation may provide insight into emotional dysfunction in psychosis and therefore the aim of this thesis is to better understand emotional experience and regulation in psychosis in comparison with other mental health problems and healthy volunteers.DESIGN This study used a between-groups design and was based on an opportunity sample of patients attending clinical psychology departments.METHODS Three groups of participants were recruited for this study comprising of 21 individuals who had experienced psychosis, 21 individuals with an anxiety/mood disorder and 21 healthy volunteers. The participants completed 2 measures of emotion regulation: the Emotion Regulation Questionnaire (ERQ) and the Emotion Regulation Questionnaire-2 (ERQ-2); a measure of emotional experience: the Basic Emotions Scale and a measure of coping strategies: the Brief COPE.RESULTS The clinical groups were found to utilise similar emotion regulation strategies and in comparison to healthy volunteers they used significantly more dysfunctional and less functional strategies. The clinical groups were found to experience similar levels of emotions and in comparison to healthy volunteers they experienced greater levels of negatively valenced emotions and lower levels of happiness. The clinical groups were also found to use greater amounts of maladaptive coping strategies and lesser amounts of problem-focussed coping strategies than the healthy volunteers.CONCLUSIONS Overall it appears that emotional experience and regulation in psychosis may be more similar to neuroses than originally was believed to be the case. This would suggest therefore that theories of psychosis should take into consideration emotional dysfunction. Difficulties with emotion regulation should be considered as potential contributory factors in the development, maintenance and course of psychosis. Further research is required in order to validate the findings of this study and to further develop theories of emotion regulation in psychosis

Statutory frameworks, institutions and policy processes for climate adaptation : Final Report

Funded under the National Climate Change Adaptation Research Facility, this study addresses two objectives: To assess the extent to which existing statutory frameworks, associated institutions and policy processes support or impede national adaptation planning and practice, and To make a significant contribution to the development and implementation of a strategic national policy framework. The rationale for conducting this study was two-fold. First, that significant climate change is unavoidable and that it is in Australia’s national interest to adapt to those changes. Climate impacts are many and varied, direct and indirect, hard to predict and quantify generally but particularly at the local scale, and impacts will inevitably affect all sectors and jurisdictions. For this reason, it is a complex policy problem. The IPCC, for example, identifies ten key areas of impact for Australia including increasing frequency and intensity of extreme events such as droughts, bushfires and floods, higher peak temperatures for longer periods of time, and sea level rise. Despite the lack of hard economic data with respect to costs and benefits that might underpin formal business cases to determine precise levels of investment needed for adaptation, the case to adapt is compelling considering the projected effects to Australia’s economy, infrastructure, communities, environment and human life. Second, Australia’s capacity to adapt to climate change will rely on robust, efficient, transparent, fair and flexible institutions which build a resilient and enabling environment in which the necessary behavioural change can occur. While humans and our institutions have a remarkable capacity to adapt to all manner of change, this can occur at great cost to society as a whole or certain segments of it without the guiding hand of judicious policy intervention. This report synthesises our key findings against the two project objectives. In doing so, it focuses on (i) where institutional arrangements currently support or impede climate adaptation policy, and (ii) where revisions or new institutions may be required, and the potential for a strategic national policy framework to achieve those reforms

5α-TETRAHYDROCORTICOSTERONE: A TOPICAL ANTI-INFLAMMATORY GLUCOCORTICOID WITH AN IMPROVED THERAPEUTIC INDEX IN A MURINE MODEL OF DERMATITIS

Background and PurposeGlucocorticoids are powerful anti-inflammatory drugs, but are associated with many side-effects. Topical application in atopic dermatitis leads to skin thinning, metabolic changes, and adrenal suppression. 5α-Tetrahydrocorticosterone (5αTHB) is a potential selective anti-inflammatory with reduced metabolic effects. Here, the efficacy and side-effect profile of 5αTHB were compared with hydrocortisone in preclinical models of irritant dermatitis.Experimental ApproachAcute irritant dermatitis was invoked in ear skin of male C57BL/6 mice with a single topical application of croton oil. Inflammation was assessed as oedema via ear weight following treatment with 5αTHB and hydrocortisone. Side-effects of 5αTHB and hydrocortisone were assessed following chronic topical steroid treatment (28 days) to non-irritated skin. Skin thinning was quantified longitudinally by caliper measurements and summarily by qPCR for transcripts for genes involved in extracellular matrix homeostasis; systemic effects of topical steroid administration also were assessed. Clearance of 5αTHB and hydrocortisone were measured following intravenous and oral administration.Key Results5αTHB suppressed ear swelling in mice, with ED50 similar to hydrocortisone (23 μg vs. 13 μg). Chronic application of 5αTHB did not cause skin thinning, adrenal atrophy, weight loss, thymic involution, or raised insulin levels, all of which were observed with topical hydrocortisone. Transcripts for genes involved in collagen synthesis and stability were adversely affected by all doses of hydrocortisone, but only by the highest dose of 5αTHB (8× ED50). 5αTHB was rapidly cleared from the systemic circulation.Conclusions and ImplicationsTopical 5αTHB has potential to treat inflammatory skin conditions, particularly in areas of delicate skin

Host erythrocyte polymorphisms and exposure to Plasmodium falciparum in Papua New Guinea

Contains fulltext : 69991.pdf (publisher's version ) (Open Access)BACKGROUND: The protection afforded by human erythrocyte polymorphisms against the malaria parasite, Plasmodium falciparum, has been proposed to be due to reduced ability of the parasite to invade or develop in erythrocytes. If this were the case, variable levels of parasitaemia and rates of seroconversion to infected-erythrocyte variant surface antigens (VSA) should be seen in different host genotypes. METHODS: To test this hypothesis, P. falciparum parasitaemia and anti-VSA antibody levels were measured in a cohort of 555 asymptomatic children from an area of intense malaria transmission in Papua New Guinea. Linear mixed models were used to investigate the effect of alpha+-thalassaemia, complement receptor-1 and south-east Asian ovalocytosis, as well as glucose-6-phosphate dehydrogenase deficiency and ABO blood group on parasitaemia and age-specific seroconversion to VSA. RESULTS: No host polymorphism showed a significant association with both parasite prevalence/density and age-specific seroconversion to VSA. CONCLUSION: Host erythrocyte polymorphisms commonly found in Papua New Guinea do not effect exposure to blood stage P. falciparum infection. This contrasts with data for sickle cell trait and highlights that the above-mentioned polymorphisms may confer protection against malaria via distinct mechanisms

The effect of reducing the 'jumping to conclusions' bias on treatment decision-making capacity in psychosis: A randomised controlled trial with mediation analysis

BackgroundEvidence-based psychological interventions to support treatment decision-making capacity (‘capacity’) in psychosis do not currently exist. This study sought to establish whether reducing the extent to which this group form conclusions based on limited evidence, alsoknown as the ‘jumping to conclusions’ (JTC) bias, could improve capacity.MethodsIn a randomised-controlled open trial, 37 patients aged 16-65 years diagnosed with schizophrenia-spectrum disorders were randomly assigned (1:1) to receive a single-session intervention designed to reduce the JTC bias (MCT-JTC; adapted from MetacognitiveTraining) or an attention control (AC) condition designed to control for therapist attention, duration, modality and face validity. Primary outcomes were treatment decision-making capacity measured by the MacArthur Competency Assessment Tool for Treatment (MacCATT)and the jumping-to-conclusions reasoning bias measured by draws to decision on the Beads task, each of which were administered by the psychologist delivering the intervention.ResultsThose receiving MCT-JTC had large improvements in overall capacity (d=0.96,

A collaborative comparison of Objective Structured Clinical Examination (OSCE) standard setting methods at Australian medical schools

Background: A key issue underpinning the usefulness of the OSCE assessment to medical education is standard-setting, but the majority of standard-setting methods remain challenging for performance assessment because they produce varying passing marks. Several studies have compared standard setting methods; however, most of these studies are limited by their experimental scope, or use data on examinee performance at a single OSCE station or from a single medical school. This collaborative study between ten Australian medical schools investigated the effect of standard-setting methods on OSCE cut scores and failure rates. Methods: This research used 5,256 examinee scores from seven shared OSCE stations to calculate cut scores and failure rates using two different compromise standard-setting methods, namely the Borderline Regression and Cohen's methods. Results: The results of this study indicate that Cohen's method yields similar outcomes to the Borderline Regression method, particularly for large examinee cohort sizes. However, with lower examinee numbers on a station, the Borderline Regression method resulted in higher cut scores and larger difference margins in the failure rates. Conclusion: Cohen's method yields similar outcomes as the Borderline Regression method and its application for benchmarking purposes and in resource-limited settings is justifiable, particularly with large examinee numbers

Does Stress-Related Poor Diet Quality Explain Socioeconomic Inequities in Health? A Structural Equation Mediation Analysis in Women and Men

Objectives Individuals with a lower socioeconomic position (SEP) have poorer health than their more advantaged counterparts. Psychosocial stress and diet quality have been shown to individually mediate associations between SEP and health, however studies have not yet investigated whether psychosocial stress and diet quality jointly mediate these associations. This is an important research question as stress-related unhealthy eating is often invoked as an explanation for diet-related health inequities, particularly among women, seemingly with no empirical justification. This study examined whether psychosocial stress and diet quality jointly mediate associations between SEP and self-rated health (SRH) in women and men. Methods Adults living in Canada who participated in the 2018 or 2019 International Food Policy Study were included (n = 5645). Participants reported SEP using indicators that reflect materialist (educational attainment, perceived income adequacy) and psychosocial pathways (subjective social status) underlying health inequities. Participants also reported psychosocial stress, dietary intake (to estimate diet quality via the Healthy Eating Index-2015) and SRH. Structural equation modelling simultaneously modelled multiple pathways linking the three indicators of SEP (educational attainment, perceived income adequacy, subjective social status) with SRH mediated by psychosocial stress and diet quality, stratified by gender. Results There was no evidence that psychosocial stress and diet quality jointly mediated associations between SEP and SRH in women or men. Diet quality mediated associations between educational attainment and SRH in women and men, and between subjective social status and SRH in men. Psychosocial stress mediated associations between perceived income adequacy and SRH in women and men, and between subjective social status and SRH in women. Conclusions Although often invoked as an explanation for diet-related health inequities, stress-related poor diet quality did not mediate associations between SEP and SRH in women or men. However, psychosocial stress and diet quality individually mediated some of these associations, indicating that SEP was partially embodied via these pathways, with some differences by gender. Funding Sources Canadian Institutes of Health Research