The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress of a Non-clinical College Sample

The current study investigated whether mindfulness and psychological flexibility uniquely and separately accounted for variability in psychological distress (somatization, depression, anxiety, and general psychological distress). An ethnically diverse, non-clinical sample of college undergraduates (N = 494, 76% female) completed a web-based survey that included the self-report measures of interest. Consistent with prior research, psychological flexibility and mindfulness were positively associated with each other, and tested separately, both variables were negatively associated with somatization, depression, anxiety, and general psychological distress. Results also revealed that psychological flexibility and mindfulness accounted for unique variance in all four measures of distress. These findings suggest that mindfulness and psychological flexibility are interrelated but not redundant constructs, and that both constructs are important for understanding the onset and maintenance of somatization, depression, anxiety, and general distress

Relations Among Self-Concealment, Mindfulness, and Internalizing Problems

Self-concealment and mindfulness can be viewed as two fairly stable emotion/behavior regulation tendencies, which are often linked to a range of internalizing problems. The current study examined whether low levels of mindfulness and higher levels of self-concealment predict higher levels of depression, anxiety, and somatization for both men and women. An ethnically diverse sample of college undergraduate females (n = 738) and males (n = 249) completed a web-based survey that included the self-report measures of interest. Path analysis models were evaluated separately for male participants and female participants. The findings from these models revealed that low levels of mindfulness predict higher levels of depression, anxiety, and somatization above the effects of self-concealment, age, and ethnicity for both men and women. Low levels of self-concealment predicted higher levels of depression and anxiety above the effects of mindfulness, age, and ethnicity for both men and women, and low levels of self-concealment predicted higher levels of somatization for women. Contrary to predictions, self-concealment did not predict somatization in men above the effects of mindfulness, age, and ethnicity. These findings suggest that mindfulness and self-concealment are distinct predictors useful for understanding the correlates of internalizing problems

Learning How to Help Others: Two-year-olds’ Social Learning of a Prosocial Act

Engaging in prosocial behaviors (acts that benefit others) is associated with many positive outcomes in children, including the development of positive peer relationships, academic achievement, and good psychological functioning. This study examines the social learning mechanisms toddlers use to acquire prosocial behaviors. This brief report presents a new experimental procedure in which 2-year-olds (28-32 months, N=30) saw a video of an adult performing a novel prosocial behavior in response to another person’s distress. The children then had the opportunity to imitate and implement the behaviors in response to their own parent’s physical distress. Children who saw the video were more likely to perform the novel action and to display non-demonstrated prosocial behaviors relative to a) children who did not view the video but saw a parent in distress and b) children who saw the video but witnessed their mother engage in a neutral activity. These results suggest that toddlers imitate and emulate prosocial behaviors for social interaction and that children can apply such behaviors in appropriate situations

Measuring Children’s Perceptions of Their Mother’s Depression: The Children’s Perceptions of Others’ Depression Scale – Mother Version

Several theoretical perspectives suggest that knowledge of children’s perceptions of and beliefs about their parents’ depression may be critical for understanding its impact on children. This paper describes the development and preliminary evidence for the psychometric properties of a new measure, the Children’s Perceptions of Others’ Depression – Mother Version (CPOD-MV), which assesses theoretically- and empirically driven constructs related to children’s understanding and beliefs about their mothers’ depression. These constructs include children’s perceptions of the severity, chronicity, and impairing nature of their mothers’ depression; self-blame for their mother’s depression; and beliefs about their abilities to deal with their mother\u27s depression by personally coping or alleviating the mother’s depression. The CPOD-MV underwent two stages of development. First: (1) a review of the literature to identify the key constructs; (2) focus groups to help generate items; and (3) clinicians’ ratings on the relevance and comprehensibility of the drafted items. Second was a study of the measure’s psychometric properties. The literature review, focus groups, and item reduction techniques yielded a 21-item measure. Reliability, factor structure, and discriminant, convergent and concurrent validity were tested in a sample of 91 10- to17- year-old children whose mothers had been treated for depression. The scale had good internal consistency, factor structure suggestive of a single construct, discriminant, concurrent, convergent, and incremental validity, suggesting the importance of measuring children’s perceptions of their mothers’ depression, beyond knowledge of mothers’ depression symptom level, when explaining which children have the greatest risk for emotional and behavioral problems among children of depressed mothers. These findings support continued development and beginning clinical applications of the scale

Changes in Genetic and Environmental Influences on Trait Anxiety from Middle Adolescence to Early Adulthood

Background: Middle adolescence to early adulthood is an important developmental period for the emergence of anxiety. Genetically-influenced stable traits are thought to underlie internalizing psychopathology throughout development, but no studies have examined changes in genetic and environmental influences on trait anxiety during this period. Method: A longitudinal twin study design was used to study same-sex twin pairs (485 monozygotic pairs, 271 dizygotic pairs) at three ages, 14, 18, and 21 years, to examine developmental shifts in genetic and environmental effects on trait anxiety. Results: The heritability of trait anxiety increased with age, particularly between ages 14 and 18, no significant new genetic influences emerged after age 14, and the genetic influences were highly correlated across the three ages, supporting developmentally stable genetic risk factors. The environmental effects shared by members of a family decreased in influence across adolescence, while the influence of environmental effects unique to each individual twin remained relatively stable over the course of development and were largely age-specific. Limitations: The twin study design does not inform about specific genes and environmental risk factors. Conclusions: Genetic influences increased in importance from middle to late adolescence but common genetic factors influenced trait anxiety across the three ages. Shared environmental influences decreased in importance and demonstrated negligible influence by late adolescence/early adulthood. Nonshared environmental effects were almost entirely age-specific. These findings support the importance of developmentally-sensitive interventions that target shared environmental factors prior to middle adolescence and shifting non-shared environmental risks at each age

Collectivity of 0\u3csup\u3e+\u3c/sup\u3e States in \u3csup\u3e160\u3c/sup\u3eGd

Excited 0+ states in 160Gd have been examined with the (n,n′γ) reaction at incident neutron energies up to 2.8 MeV. Gamma-ray excitation functions and angular distribution measurements allow the confirmation of the existence of 0+ states at 1379.70 keV and 1558.30 keV, but we reject the assignments of additional previously suggested 0+ candidates. Limits on the level lifetimes of the observed 0+ states permit an evaluation of the collectivity of these states

Tick Extracellular Vesicles Enable Arthropod Feeding and Promote Distinct Outcomes of Bacterial Infection

Extracellular vesicles are thought to facilitate pathogen transmission from arthropods to humans and other animals. Here, we reveal that pathogen spreading from arthropods to the mammalian host is multifaceted. Extracellular vesicles from Ixodes scapularis enable tick feeding and promote infection of the mildly virulent rickettsial agent Anaplasma phagocytophilum through the SNARE proteins Vamp33 and Synaptobrevin 2 and dendritic epidermal T cells. However, extracellular vesicles from the tick Dermacentor andersoni mitigate microbial spreading caused by the lethal pathogen Francisella tularensis. Collectively, we establish that tick extracellular vesicles foster distinct outcomes of bacterial infection and assist in vector feeding by acting on skin immunity. Thus, the biology of arthropods should be taken into consideration when developing strategies to control vector-borne diseases

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570