Pathways of Psychopathic Traits to Aggression Through Affective Correlates

This thesis project examines the roles of empathy facets and emotion dysregulation in the relationship between psychopathic personality traits and aggression within an undergraduate sample. The project addresses three gaps in research – how psychopathic personality traits relate to empathy facets from a recently developed measure of empathy (Affective and Cognitive Measure of Empathy [ACME]; Vachon & Lynam, 2016); how psychopathic traits indirectly affect aggression functions (i.e., reactive, proactive) through empathy facets; and how emotion regulation contributes to these relations, above and beyond empathy. The sample was comprised of 368 university students. Findings indicated that largely all psychopathic traits were negatively related to empathy; however, the traits diverged in association to emotion dysregulation. Path modeling indicated that impulsive-antisocial psychopathic traits exerted positive indirect effects on proactive and reactive aggression through different affective correlates (i.e., empathy, emotion dysregulation, respectively). Similarly, interpersonal-affective traits had indirect effects through affective correlates, but with some differential implications for increased proactive aggression through empathy and decreased reactive aggression through level of emotion dysregulation. In all, this study contributes to further conceptualization of affective correlates of psychopathic traits and towards understanding the contributions of empathy and emotion regulation to aggression in psychopathy. This understanding may potentially inform efforts to reduce aggression among individuals with varying levels of psychopathic traits

Studying the Long-term Impact of COVID-19 in Kids (SLICK). Healthcare use and costs in children and young people following community-acquired SARS-CoV-2 infection:protocol for an observational study using linked primary and secondary routinely collected healthcare data from England, Scotland and Wales

IntroductionSARS-CoV-2 infection rarely causes hospitalisation in children and young people (CYP), but mild or asymptomatic infections are common. Persistent symptoms following infection have been reported in CYP but subsequent healthcare use is unclear. We aim to describe healthcare use in CYP following community-acquired SARS-CoV-2 infection and identify those at risk of ongoing healthcare needs.Methods and analysisWe will use anonymised individual-level, population-scale national data linking demographics, comorbidities, primary and secondary care use and mortality between 1 January 2019 and 1 May 2022. SARS-CoV-2 test data will be linked from 1 January 2020 to 1 May 2022. Analyses will use Trusted Research Environments: OpenSAFELY in England, Secure Anonymised Information Linkage (SAIL) Databank in Wales and Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 in Scotland (EAVE-II). CYP aged ≥4 and <18 years who underwent SARS-CoV-2 reverse transcription PCR (RT-PCR) testing between 1 January 2020 and 1 May 2021 and those untested CYP will be examined.The primary outcome measure is cumulative healthcare cost over 12 months following SARS-CoV-2 testing, stratified into primary or secondary care, and physical or mental healthcare. We will estimate the burden of healthcare use attributable to SARS-CoV-2 infections in the 12 months after testing using a matched cohort study of RT-PCR positive, negative or untested CYP matched on testing date, with adjustment for confounders. We will identify factors associated with higher healthcare needs in the 12 months following SARS-CoV-2 infection using an unmatched cohort of RT-PCR positive CYP. Multivariable logistic regression and machine learning approaches will identify risk factors for high healthcare use and characterise patterns of healthcare use post infection.Ethics and disseminationThis study was approved by the South-Central Oxford C Health Research Authority Ethics Committee (13/SC/0149). Findings will be preprinted and published in peer-reviewed journals. Analysis code and code lists will be available through public GitHub repositories and OpenCodelists with meta-data via HDR-UK Innovation Gateway

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Proceedings of the 13th annual conference of INEBRIA

CITATION: Watson, R., et al. 2016. Proceedings of the 13th annual conference of INEBRIA. Addiction Science & Clinical Practice, 11:13, doi:10.1186/s13722-016-0062-9.The original publication is available at https://ascpjournal.biomedcentral.comENGLISH SUMMARY : Meeting abstracts.https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-016-0062-9Publisher's versio

Examining the Effects of State Anger on Self-reported Psychopathic Trait Inventories

Research indicates that experiencing anger is linked to social undesirability and temporarily induces a host of significant changes within an individual, such as hostile attribution bias, lower trust, increased impulsivity, poorer decision-making, and preferential recall. Such changes theoretically may inflate psychopathy scores due to a greater ability or willingness to endorse attitudes, behaviors, cognitions, and emotions that are regarded as reflective of psychopathic traits and may potentially introduce random error variance into measurement. Such distortion due to mood may bear important implications for applied settings where one individual’s scores are measured at a single time point, rather than research where variables are aggregated across a sizeable sample and mood effects may be negligible. To that end, this dissertation project examined the effects of a mood induction procedure (MIP) that elicited state anger on self-reported psychopathic traits through an experimental design. A total of 92 participants from Amazon’s Mechanical Turk were randomized into an anger MIP using autobiographical recall or into a control group. A series of mean level comparison analyses tested the effects of state anger on self-reported psychopathic traits across three prominent measures. Results indicated that, despite an effective mood induction of anger, the scores on self-report psychopathic traits on both total and subscale scores did not significantly differ between the anger group and the control group. Further, results were unchanged when covarying for trait anger levels or impact of the contemporary COVID-19 pandemic and held up when considering normative personality traits. In all, these findings support the reliability of three well-established self-reported psychopathy measures during state anger, however, replication and extension to other populations is warranted

Psychopathic Traits and Politics: Examining Affiliation, Support of Political Issues, and the Role of Empathy

The relation of psychopathy to morality has been extensively examined, yet few studies have considered relations to political attitudes, which involve moral decision-making. We examined how psychopathic traits relate to political affiliation and opinions on political issues, using the triarchic conceptualization of psychopathy (Patrick, Fowles, & Krueger, 2009) and testing empathy components as mediators. Interpersonal-affective (Boldness and Meanness) traits were higher in Republicans compared to Democrats. Moreover, Boldness was associated with conservative opinions on economic issues, while Meanness evinced stronger relations to conservative opinions on social issues. Triarchic domains also evidenced unique associations to issues concerning minorities or discrimination. Further, empathy mediated relations between Meanness and decreased support for certain issues (e.g., affirmative action). Overall, psychopathy, particularly the interpersonal-affective traits, appear pertinent to political attitudes, while empathy deficits may statistically account for unique effects of Meanness

The Indirect Relationships Between Psychopathic Traits and Proactive and Reactive Aggression Through Empathy and Emotion Dysregulation

This study examined the extent to which empathy and emotion dysregulation facilitate the relationships between psychopathic personality traits and aggression, using a sample of 368 university students. Psychopathic traits were assessed with the Psychopathic Personality Inventory-Revised (PPI-R; Lilienfeld and Widows 2005), empathy via the Affective and Cognitive Measure of Empathy (ACME; Vachon and Lynam Assessment, 23, 135-149, 2016), and emotion dysregulation using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer Journal of Psychopathology and Behavioral Assessment, 26, 41-54, 2004). A series of structural equation models (SEM) compared indirect effects of psychopathic traits on proactive and reactive aggression (Reactive Proactive Aggression Questionnaire; Raine et al. Aggression and Violent Behavior, 16, 512-524, 2006) through empathy and emotion dysregulation. Findings indicated a significant and positive indirect effect of Self-Centered Impulsivity traits on proactive aggression through low empathy, whereas the positive indirect effect of Self-Centered Impulsivity on reactive aggression was through high emotion dysregulation. Both Fearless Dominance and Coldheartedness had significant negative indirect effects on reactive aggression through (low) levels of emotion dysregulation; Fearless Dominance also exhibited a negative indirect effect on proactive aggression via ACME total score. Moreover, Coldheartedness had a significant, positive indirect effect on proactive aggression through (low) empathy. In a final model that accounted for shared variance between empathy and emotion dysregulation, all indirect relationships were maintained, suggesting that each path is not better accounted for by variance in the other. In all, this study builds upon prior research on emotion-related correlates of psychopathy, suggesting differential pathways from psychopathic traits to proactive and reactive aggression

Combat Experiences, Personality, Iso-Strain, and Sleep Quality Affect Posttraumatic Stress Among Working Post-9/11 Veterans

We investigated the effects of combat experiences (CES), personality traits, sleep quality and iso-strain on posttraumatic stress symptoms (PTSS) among a sample (N=382) of working, post-9/11 Veterans. As prior occupational stress research has neglected the role of personality traits, we sought to examine how two of the Big Five traits (i.e., Neuroticism and Conscientiousness) affected PTSS. Greater scientific understanding of how personality contributes to the post-deployment etiology of PTSD may help customize interventions aimed at reintegrating Veterans. Baseline data were drawn from the five-year, randomized control, Department of Defense-funded “Study for Employment Retention of Veterans” (SERVe). After controlling for socioeconomic status, time since deployment (“dwell time”), and risk of homelessness, results indicated that CES and sleep quality were significant predictors of PTSS. However, while Neuroticism predicted PTSS severity, Contentiousness was unrelated. While no inferences of causality may be drawn from our cross-sectional sample, results suggest that personality traits may differentially affect PTSS. Further, negative emotions may play a stronger role than positive emotions in predicting severity of PTSS. To disentangle the potential confounding influence of trauma on personality traits and establish temporal precedence for drawing causal inferences, future research should use longitudinal, repeat-measure designs that estimate baseline personality levels prior to exposure to combat. Such an longitudinal approach would allow for a better understanding of the potential differential effects of personality on post-deployment acquisition of PTSD among reintegrating Veterans