Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial

BACKGROUND Comorbid anxiety in bipolar disorder (BD) is associated with greater illness severity, reduced treatment response, and greater impairment. Treating anxiety in the context of BD is crucial for improving illness course and outcomes. The current study examined the feasibility, acceptability and preliminary efficacy of the Unified Protocol (UP), a transdiagnostic cognitive behavioral therapy, as an adjunctive treatment to pharmacotherapy for BD and comorbid anxiety disorders. METHODS Twenty-nine patients with BD and at least one comorbid anxiety disorder were randomized to pharmacotherapy treatment-as-usual (TAU) or TAU with 18 sessions of the UP (UP+TAU). All patients completed assessments every four weeks to track symptoms, functioning, emotion regulation and temperament. Linear mixed-model regressions were conducted to track symptom changes over time and to examine the relationship between emotion-related variables and treatment response. RESULTS Satisfaction ratings were equivalent for both treatment groups. Patients in the UP+TAU group evidenced significantly greater reductions over time in anxiety and depression symptoms (Cohen's d's>0.80). Baseline levels of neuroticism, perceived affective control, and emotion regulation ability predicted magnitude of symptom change for the UP+TAU group only. Greater change in perceived control of emotions and emotion regulation skills predicted greater change in anxiety related symptoms. LIMITATIONS This was a pilot feasibility and acceptability trial; results should be interpreted with caution. CONCLUSIONS Treatment with the UP+TAU was rated high in patient satisfaction, and resulted in significantly greater improvement on indices of anxiety and depression relative to TAU. This suggests that the UP may be a feasible treatment approach for BD with comorbid anxiety.This work was supported by a Postdoctoral National Research Service Award from the National Institutes of Health [F32 MH098490] to K. Ellard. (F32 MH098490 - Postdoctoral National Research Service Award from the National Institutes of Health)Accepted manuscrip

Probing dark matter substructure in the gravitational lens HE0435-1223 with the WFC3 grism

Strong gravitational lensing provides a powerful test of Cold Dark Matter (CDM) as it enables the detection and mass measurement of low mass haloes even if they do not contain baryons. Compact lensed sources such as Active Galactic Nuclei (AGN) are particularly sensitive to perturbing subhalos, but their use as a test of CDM has been limited by the small number of systems which have significant radio emission which is extended enough avoid significant lensing by stars in the plane of the lens galaxy, and red enough to be minimally affected by differential dust extinction. Narrow-line emission is a promising alternative as it is also extended and, unlike radio, detectable in virtually all optically selected AGN lenses. We present first results from a WFC3 grism narrow-line survey of lensed quasars, for the quadruply lensed AGN HE0435-1223. Using a forward modelling pipeline which enables us to robustly account for spatial blending, we measure the [OIII] 5007 \AA~ flux ratios of the four images. We find that the [OIII] fluxes and positions are well fit by a simple smooth mass model for the main lens. Our data rule out a $M_{600}>10^{8} (10^{7.2}) M_\odot$ NFW perturber projected within $\sim$1\farcs0 (0\farcs1) arcseconds of each of the lensed images, where $M_{600}$ is the perturber mass within its central 600 pc. The non-detection is broadly consistent with the expectations of $\Lambda$CDM for a single system. The sensitivity achieved demonstrates that powerful limits on the nature of dark matter can be obtained with the analysis of $\sim20$ narrow-line lenses.Comment: Accepted for publication in MNRAS, 15 pages, 8 figure

Nutrition, Exercise, and Wellness Treatment in bipolar disorder: proof of concept for a consolidated intervention

Background: This pilot study examines the proof of concept of a consolidated Nutrition, Exercise, and Wellness Treatment (NEW Tx) for overweight individuals with bipolar disorder. Findings: Five participants completed NEW Tx, a 20-week individual cognitive behavioral therapy-based treatment comprising three modules: Nutrition teaches appropriate serving sizes and balanced diet; Exercise emphasizes increasing weekly physical activity; Wellness focuses on skills for healthy decision-making. Participants attended most sessions and reported high satisfaction with the treatment. Participants’ weight, cholesterol and trigyclerides decreased over the study duration as well as number of daily calories and sugar intake. We found that weekly exercise duration more than tripled over the study duration and depressive symptoms and functioning have improved. Conclusions: These results offer proof of concept that consolidated NEW Tx is feasible and acceptable and has the potential to improve nutrition, exercise, wellness, and mood symptoms in bipolar disorder. Future iterations of NEW Tx will reflect the strengths and lessons learned from this study

Experiences of using an interactive audience response system in lectures

BACKGROUND: Lectures are good for presenting information and providing explanations, but because they lack active participation they have been neglected. METHODS: Students' experiences were evaluated after exposing them to the use of voting during lectures in their paediatrics course. Questions were delivered to the students taking paediatrics course. Thirty-six students out of the total of 40 (90%) attended the opening lecture, at which the first survey concerning previous experiences of lectures was performed. Thirty-nine students (98%) answered the second series of questions at the end of the paediatrics course. RESULTS: Most of the students felt that voting improved their activity during lectures, enhanced their learning, and that it was easier to make questions during lectures than earlier. CONCLUSIONS: The students gained new, exciting insights much more often during the paediatrics course than before. We as teachers found that voting during lectures could easily overcome some of the obstacles of good lecturing

Properties of satellite galaxies in the SDSS photometric survey: luminosities, colours and projected number density profiles

We analyze photometric data in SDSS-DR7 to infer statistical properties of faint satellites associated to isolated bright galaxies (M_r<-20.5) in the redshift range 0.03<z<0.1. The mean projected radial profile shows an excess of companions in the photometric sample around the primaries, with approximately a power law shape that extends up to ~700kpc. Given this overdensity signal, a suitable background subtraction method is used to study the statistical properties of the population of bound satellites, down to magnitude M_r=-14.5, in the projected radial distance range 100 < r_p/kpc < 3 R_{vir}. We have also considered a color cut consistent with the observed colors of spectroscopic satellites in nearby galaxies so that distant redshifted galaxies do not dominate the statistics. We have tested the implementation of this procedure using a mock catalog. We find that the method is effective in reproducing the true projected radial satellite number density profile and luminosity distributions, providing confidence in the results derived from SDSS data. The spatial extent of satellites is larger for bright, red primaries. Also, we find a larger spatial distribution of blue satellites. For the different samples analyzed, we derive the average number of satellites and their luminosity distributions down to M_r=-14.5. The mean number of satellites depends very strongly on host luminosity. Bright primaries (M_r<-21.5) host on average ~6 satellites with M_r<-14.5, while primaries with -21.5<M_r<-20.5 have less than 1 satellite per host. We provide Schechter function fits to the luminosity distributions of satellite galaxies with faint-end slopes -1.3+/-0.2. This shows that satellites of bright primaries lack an excess population of faint objects, in agreement with the results in the Milky Way and nearby galaxies.Comment: 14 pages, 13 figures. Accepted for publication in Astronomical Journa

Do Sleep Disturbances Predict or Moderate the Response to Psychotherapy in Bipolar Disorder?

This study examined whether sleep disturbance predicted or moderated responses to psychotherapy in participants who participated in STEP-BD, a national, multi-site study that examined the effectiveness of different treatment combinations for bipolar disorder. Participants received either a brief psychosocial intervention called collaborative care (CC; n=130), or intensive psychotherapy (IP; n=163), with study-based pharmacotherapy. Participants (N=243) were defined as current (past week) short sleepers (<6 hours/night), normal sleepers (6.5-8.5 hours/night), and long sleepers (≥9 hours/night), according to reported average nightly sleep duration the week before randomization. Sleep disturbances did not predict the likelihood of recovery nor time until recovery from a depressive episode. There was no difference in recovery rates between IP versus CC for normal sleepers, and medium effect sizes were observed for differences in short and long sleepers. In this study, sleep did not play a major role in predicting or moderating response to psychotherapy in bipolar disorder

The Lick AGN Monitoring Project 2011: Spectroscopic Campaign and Emission-Line Light Curves

In the Spring of 2011 we carried out a 2.5 month reverberation mapping campaign using the 3 m Shane telescope at Lick Observatory, monitoring 15 low-redshift Seyfert 1 galaxies. This paper describes the observations, reductions and measurements, and data products from the spectroscopic campaign. The reduced spectra were fitted with a multicomponent model in order to isolate the contributions of various continuum and emission-line components. We present light curves of broad emission lines and the AGN continuum, and measurements of the broad H-beta line widths in mean and root-mean square (rms) spectra. For the most highly variable AGNs we also measured broad H-beta line widths and velocity centroids from the nightly spectra. In four AGNs exhibiting the highest variability amplitudes, we detect anticorrelations between broad H-beta width and luminosity, demonstrating that the broad-line region "breathes" on short timescales of days to weeks in response to continuum variations. We also find that broad H-beta velocity centroids can undergo substantial changes in response to continuum variations; in NGC 4593 the broad H-beta velocity shifted by ~250 km/s over a one-month duration. This reverberation-induced velocity shift effect is likely to contribute a significant source of confusion noise to binary black hole searches that use multi-epoch quasar spectroscopy to detect binary orbital motion. We also present results from simulations that examine biases that can occur in measurement of broad-line widths from rms spectra due to the contributions of continuum variations and photon-counting noise.Comment: 33 pages, 28 figures, accepted for publication in ApJ Supplement Serie