History Of Episodes Research Articles

Bubble detective: City‐level analysis of house price cycles

AbstractThis paper investigates house price dynamics at high frequency using city‐level observations during the period 1994–2022 in Lithuania. We employ multiple time series‐based econometric procedures to examine whether real house prices and house price‐to‐rent ratios exhibit explosive behaviour. According to these recursive right‐tailed test results, we reject the null hypothesis of no‐bubble and find evidence for long and multiple periods of explosive behaviour in the housing market in all major cities during the sample period. While the size of bubbles varies across cities, especially when we use the house price‐to‐rent ratio, there is clearly a similar boom‐bust pattern in Lithuania. Large house price corrections can in turn have adverse effects on economic performance and financial stability, as experienced during the global financial crisis and other episodes in history.

Mega-sporting Events, Human Rights Abuses, And the Middle East

This thought piece explores the historical episodes regarding human rights issues and their relationship with the Olympics and other mega and major sporting events. We show how sporting events have long been used for opportunities for the world to see human rights abuses. We then discuss the mixture of money, media companies, and sporting events and how these forces are increasing the visibility of municipalities and states that host these events. We ask the question: Other than money, why do these sporting events continue to be awarded to Middle East counties that have long records of human rights abuses? Like many academic works we try and find the link between ideas and action. We conclude with a call to action and examine the IOC–UN partnership that began in 2009 and allowed the IOC to be directly involved in the UN agenda and also granted them the ability to attend the UN General Assembly meetings.

Diaspora Modern

Abstract Diaspora is a defining condition of the history of the past century, a prehistory to our disastrous moment in time and also the foundation of our political landscape. Yet it is notably absent in much art-historical discussion of modernism, despite the fact that the experiences of diaspora and migration are often embedded in the lives of modernist artists and other actors; in the formations, networks, and dispersals of modernist institutions and group affiliations; and in the deployment of characteristically modernist artistic strategies (temporal fragmentation, collage, montage, and the readymade) that manifest a dialectical entanglement of self and other. This essay ponders the disconnect between the historical structures of modernism in art and its theorization, and considers the questions: Can diaspora and diasporic thinking help further our understanding of the twentieth century in art? Can it help us in reconsidering modernism from a diasporic perspective today? As prompts for further thought, the text considers four historical episodes in which ideas of diaspora, modernity, and modernism are entwined: W.E.B. Du Bois and the First Universal Races Congress in London 1911; Georg Simmel, Du Bois, and Alain Locke in Berlin and the emergence of a matrix of modern sociological thinking; Mikhail Bakhtin in exile in Kazakhstan and the formation of his dialogical philosophy of language; and Aaron Douglas and Meyer Shapiro at the First American Artists’ Congress in 1936 and in the pages of Art Front.

Recovery after a suicidal episode: Developing and validating the Recovery Evaluation and Suicide Support Tool (RESST).

The personal recovery movement advocates for shifting emphasis from clinical symptom reduction toward reclaiming personal agency and creating meaning-filled lives despite the presence of distressing experiences. Corresponding personal recovery measures have been developed; however, there is no established psychometric assessment of personal recovery following a suicidal episode. This study addressed this gap by developing the Recovery Evaluation and Suicide Support Tool (RESST) and assessing its test score reliability, test score interpretations' validity, and psychometric properties. Throughout RESST's development, input from diverse stakeholders-including clinicians, researchers, and individuals with lived experience-was gathered to ensure a meaningful and useful scale. Exploratory factor analysis techniques were used with adults with a suicidal episode history (N = 502) to select and refine items, culminating in a 21-item scale with four distinct subscales: Self-Worth, Life Worth, Social Worth, and Self-Understanding. Confirmatory factor analysis techniques demonstrated model fit across three samples of adults with a suicidal episode history (combined N = 1,523), and test-retest reliability was obtained (N = 204). The results revealed that RESST scores exhibit an internally consistent and replicable factor structure, consistent with personal recovery theory. Additionally, the interpretation of test scores exhibited both convergent and discriminant validity. Mental health indices related to recovery, negative mood states, suicidality, and meaning in life had significant moderate-to-strong correlations with the RESST, supporting the validity of the test score interpretations and clinical relevance. This measure should aid research into recovery processes and understanding how recovery following a suicidal episode may be enhanced clinically and personally. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Risk factors for relapse or recurrence in women with bipolar disorder and recurrent major depressive disorder in the perinatal period: a systematic review.

It is well known that the perinatal period supposes a considerable risk of relapse for women with bipolar disorder (BD) and recurrent major depressive disorder (rMDD), with the consequences that this entails. Therefore, the authors sought to provide a critical appraisal of the evidence related to specific risk factors for this population with the aim of improving the prevention of relapses during pregnancy and postpartum. The authors conducted a systematic review assessing 18 original studies that provided data on risk factors for relapse or recurrence of BD and/or rMDD in the perinatal period (pregnancy and postpartum). Recurrences of BD and rMDD are more frequent in the postpartum period than in pregnancy, with the first 4-6 weeks postpartum being especially complicated. In addition, women with BD type I are at higher risk than those with BD type II and rMDD, and the most frequent presentation of perinatal episodes of both disorders is a major depressive episode. Other risk factors consistently repeated were early age of onset of illnesses, severity criteria, primiparity, abrupt discontinuation of treatment, and personal or family history of perinatal affective episodes. This review shows that there are common and different risk factors according to the type of disorder and to perinatal timing (pregnancy or postpartum) that should be known for an adequate prevention of relapses.

Effects of MIdazolam versus MOrphine in acute cardiogenic pulmonary edema and chronic obstructive pulmonary disease: An analysis of MIMO trial

AimsChronic obstructive pulmonary disease (COPD) is an important comorbidity in heart failure. The MIMO trial showed that patients with acute cardiogenic pulmonary edema (ACPE) treated with midazolam had fewer serious adverse events than those treated with morphine. In this post hoc analysis, we examined whether the presence/ absence of COPD modifies the reduced risk of midazolam over morphine. MethodsPatients >18 years old clinically diagnosed with ACPE and with dyspnea and anxiety were randomized (1:1) at emergency department arrival to receive either intravenous midazolam or morphine. In this post hoc analysis, we calculated the relative risk (RR) of serious adverse events in patients with and without COPD. Calculating the CochranMantel-Haenszel interaction test, we evaluated if COPD modified the reduced risk of serious adverse events in the midazolam arm compared to morphine. ResultsOverall, 25 (22.5%) of the 111 patients randomized had a history of COPD. Patients with COPD were more commonly men with a history of previous episodes of heart failure, than participants without COPD. In the COPD group, the RR for the incidence of serious adverse events in the midazolam versus morphine arm was 0.36 (95%CI, 0.1–1.46). In the group without COPD, the RR was 0.44 (95%CI, 0.22–0.91). The presence of COPD did not modify the reduced risk of serious adverse events in the midazolam arm compared to morphine (p for interaction =0.79). ConclusionsThe reduced risk of serious adverse events in the midazolam group compared with morphine is similar in patients with and without COPD.

Soluble factors in COVID-19 mRNA vaccine-induced myocarditis causes cardiomyoblast hypertrophy and cell injury: a case report

BackgroundInflammation affecting the heart and surrounding tissues is a clinical condition recently reported following COVID-19 mRNA vaccination. Assessing trends of these events related to immunization will improve vaccine safety surveillance and best practices for forthcoming vaccine campaigns. However, the causality is unknown, and the mechanisms associated with cardiac myocarditis are not understood.Case presentationAfter the first dose, we reported an mRNA vaccine-induced perimyocarditis in a young patient with a history of recurrent myocardial inflammation episodes and progressive loss of cardiac performance. We tested this possible inflammatory cytokine-mediated cardiotoxicity after vaccination in the acute phase (ten days), and we found a significant elevation of MCP-1, IL-18, and IL-8 inflammatory mediators. Still, these cytokines decreased considerably at the recovery phase (42 days later). We used the cardiomyoblasts cell line to test the effect of serum on cell viability, observing that serum from the acute phase reduced the cell viability to 75%. We did not detect this toxicity in cells when we tested serum from the patient in the recovery phase. We also tested serum-induced hypertrophy, a phenomenon in myocarditis and heart failure. We found that acute phase-serum has hypertrophy effects, increasing 25% of the treated cardiac cells’ surface and significantly increasing B-type natriuretic peptide. However, we did not observe the hypertrophic effect in the recovery phase or sera from healthy controls.ConclusionOur results opened the possibility of the inflammatory cytokines or serum soluble mediators as key factors for vaccine-associated myocarditis. In this regard, identifying anti-inflammatory molecules that reduce inflammatory cytokines could help avoid vaccine-induced myocardial inflammation.

Prior exposure to concussions in patients with isolated REM sleep behavior disorder

ObjectiveTraumatic brain injury is associated with the late development of neurodegenerative diseases such as the synucleinopathies. Isolated REM sleep behavior disorder (IRBD) constitutes an early manifestation of the synucleinopathies. We assessed whether lifetime history of concussive episodes is common in IRBD and examined its characteristics and clinical significance. MethodsPrior exposure to concussions was evaluated by interviewing polysomnographically-confirmed IRBD patients and controls without IRBD, and by the BRAIN-Q questionnaire. ResultsWe recruited 199 IRBD patients aged 73.2 ± 7.7 years and 168 age and sex matched controls. Previous history of concussion was more common in patients than in controls (21.1% versus 10.1%, p = 0.004). In patients, concussions occurred at the age of 24.7 ± 20.6 years. The interval between concussion and IRBD diagnosis was 43.0 ± 19.0 years. There were no differences between patients and controls in the causes of concussions (e.g., traffic accidents, sport practice), and number of events resulting in skull fractures, urgent medical assistance, and hospitalization. After a follow-up of 5.7 ± 4.7 years from IRBD diagnosis, 21.1% patients developed an overt synucleinopathy with an interval of 49.3 ± 24.2 years between concussion and synucleinopathy diagnosis. The risk to develop a synucleinopathy was similar between patients with and without concussions (p = 0.57). ConclusionsPrevious history of concussion is common in IRBD. Our observations may suggest that in individuals with increased susceptibility, early-life concussions may trigger a slow neurodegenerative process leading four decades later to IRBD. This study highlights the need for head injury prevention, particularly in early life.

Forensic Evaluation of a Single Episode of a Disorder of Arousal in a Sleepwalking Defense: Cognitive Function Versus Prior Clinical History.

Introduction The clinical diagnosis of disorders of arousal (DOA) is based primarily on a clinical history including amnesia for episodes. The presence of amnesia means the patient cannot provide direct evidence. In a forensic setting, when the defendant has been charged criminally with violent actions or sexual related assaults allegedly during sleep, a sleepwalking defense may be presented. As opposed to clinical history, the prosecution generally focuses on the single episode of alleged DOA that resulted in the criminal charges against the defendant. The prosecution will argue that this episode of complex behavior was not consistent with a DOA. A past history of purported episodes is not proof that a recent single episode must be a DOA. However, most sleepwalking defenses rely heavily on standard clinical evaluations despite the fact they have no direct connection with the current criminally charged episode. The International Classification of Sleep Disorders (ICSD-3) General Diagnostic Criteria C for DOAs that states "limited or no associated cognition" should be present. Recent real time studies of DOAs have shown that during DOA episodes the prefrontal cortex (PRC) is deactivated while the motor cortex remains active. Conclusion The PFC is the location of almost all executive functions including inhibition, planning, memory, and many others. Thus, when the PFC is deactivated, these higher cognitive functions are not available. The presence of higher cognitive functions during an alleged episode of DOA would be inconsistent with a deactivated PFC and thus inconsistent with generally accepted brain activity during a NREM parasomnia. This would be direct evidence that the episode could not be a DOA but occurred during wakefulness. Clinical trial No.

Global Transmission of Fed Hikes: The Role of Policy Credibility and Balance Sheets

ABSTRACT: Contrary to historical episodes, the 2022–2023 tightening of US monetary policy has not yet triggered financial crisis in emerging markets. Why is this time different? To answer this question, we analyze the current situation through the lens of historical evidence. In emerging markets, the financial channel–based transmission of US policy historically led to more adverse outcomes compared to advanced economies, where the trade channel fails to smooth out these negative effects. When the Federal Reserve increases interest rates, global investors tend to shed risky assets in response to the tightening global financial conditions, affecting emerging markets more severely due to their lower credit ratings and higher risk profiles. This time around, the escape from emerging market assets and the increase in risk spreads have been limited. We document that the historical experience of higher risk spreads and capital outflows can be largely explained by the lack of credible monetary policies and dollar-denominated debt. The improvement in monetary policy frameworks combined with reduced levels of dollar-denominated debt have helped emerging markets weather the recent Federal Reserve hikes.

133 Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Case Report.

Abstract Introduction We present a case of chronic subdural hematoma refractory to burr hole surgery treated successfully with middle meningeal artery embolization. Presentation of Case 61-year-old gentleman presented with a history of headaches and single episodes of vomiting. Neurological examination was normal. A non-contrast computed tomography (CT) scan of the head showed chronic subdural hematoma with midline shift. The patient was managed with burr hole surgery but there was no improvement in the symptoms and CT findings of recollection of blood in subdural space. The patient was then managed endovascularly with embolization of the middle meningeal artery (MMA), patient recovered fully after the endovascular treatment. Discussion Chronic subdural hematoma can present clinically with vomiting and headache, if refractory to burr hole surgery it can be managed with the embolization of the middle meningeal artery. Conclusions Subdural hematoma can be successfully managed by endovascular treatment.

Association of driving while intoxicated and suicide ideation and attempts in South Korea: a study in a nationally representative sample

Evidence indicating driving as a means for suicide has been consistently reported. However, there have been few reported studies examining the association between driving while intoxicated (DWI) and suicide. We aimed to investigate the associations between DWI and suicide ideation and suicide attempts taking into account the frequency and amount of alcohol consumption. This cross-sectional study used data from semi-structured, face-to-face interviews conducted with a nationally representative sample of the Korea Community Health Survey in 2009, 2013, and 2017. The study included 267,457 adult participants who drank alcohol at least once and had driven a motor vehicle at least once in the preceding year. The DWI group comprised participants who had driven under the influence of alcohol at least once in the preceding year. The associations between DWI and suicide ideation and suicide attempts were examined using a logistic regression model, adjusting for the frequency and amount of alcohol consumption and history of depressive episodes in the preceding year. The role of DWI as a risk factor for suicide was also examined in an analysis stratified by the frequency and amount of alcohol consumption. The DWI group included 39,062 (14.6%) subjects, who were at higher risk for suicide ideation (adjusted odds ratio [aOR] = 1.91; 95% CI 1.81–2.01) and suicide attempts (aOR = 1.56; 1.27–1.92) than those not involved in DWI. Increased risks of suicide ideation and suicide attempts were observed in most strata in the stratified analysis. People who engage in DWI may have an increased risk of suicide ideation and suicide attempts; this relationship was generally observed regardless of the frequency and amount of alcohol consumption.

580 A Surgical Dilemma; Complicated Case of Dandy Walker Malformation

Abstract Case summary A 24-year-old male presented to the department with a 1-week history of sudden onset posterior headache and multiple episodes of vomiting. He reported similar episodes 8 months prior with ataxia which resolved itself. He has a past medical history of dandy walker malformation (DWM) diagnosed in early infancy and a shunt inserted at 3 months old due to hydrocephalus. Initial blood investigations revealed extremely low platelets, low TLC and markedly raised potassium along with splenomegaly. Neurological examination was unremarkable with GCS of E4V5M6. A CT scan revealed hydrocephalus requiring revision shunt surgery. However, surgery was avoided due to the risks associated with thrombocytopenia therefore multiple specialists were consulted before a final decision could be reached. Discussion DWM is a rare congenital malformation typically presenting in early childhood characterised by hypoplasia of the cerebellar vermis, posterior fossa dilation and cystic enlargement of 4th ventricle. A complication of DWM is hydrocephalus, which requires surgery to correct via shunt insertion. However, this patients’ haematological instabilities risks deterioration and even death during surgery as preoperative thrombocytopenia has been associated with increased intra- and post-operative mortality. As such the patient was not advised surgery initially however the hydrocephalus was causing severe headaches to the patient ultimately making it difficult for surgeons to decide when surgery should be performed. On follow up, the patient was discharged with no shunt revision due to resolution of symptoms. This case highlighted the need for skilled physicians across multiple specialities to make a shared decision about surgical or conservative management.

Politics and eminent domain: Evidence from the 1879 California constitution

This paper explores the politics of eminent domain, using a specific historical episode: the enactment of the new California constitution in 1879. It presents evidence that the failure of a constitutional provision that would have codified eminent domain powers for water development resulted from a complex interchange of economic interests among farmers, miners, and urban residents. This evidence was manifested in delegate behavior on the floor of the constitutional convention in 1878, including various roll-call votes, which are subjected to an econometric analysis. The results have implications for the interpretation of legislative eminent domain decisions, and the degree to which economic development processes are shaped by the institutional environment in which they occur.

An Application of the “Recursive Flexible Window” Methodology to Test for Financial Bubbles in a Major Stock Market

Identifying and dating financial bubbles in real time is in the forefront of current empirical research. Their accuracy provides real time useful “warning alerts” to central bankers and fiscal regulators. The complexity of their nonlinear structure and the inherent sudden break mechanisms makes the econometric testing challenging. The new recursive flexible window methodology provided by Phillips, Shi, and Yu (2015) gives consistent results and delivers significant power gains when multiple bubbles occur. It successfully identifies well-known historical episodes of exuberance and collapse. In this paper we look at the Indian stock market indices, the SENSEX, and the NIFTY 50, to see if there is any evidence of a bubble there. We use monthly data for each series, with the Sensex data spanning April 1979 to October 2018 and NIFTY 50 data spanning July 1990 to October 2018. The existence of bubbles in this index will give us some indication of where bubbles are more likely to occur, and therefore provide evidence of potential economic (financial) crises.

Recurrent episodes of Takotsubo cardiomyopathy in systemic sclerosis

Systemic sclerosis is an autoimmune disease characterized by fibrosis and small vessel vasculopathy, which affects various organ systems, such as the heart. Takotsubo cardiomyopathy is a transient cardiomyopathy in reaction to an emotional or physical trigger. There may be clinical and pathogenetic overlap between Takotsubo cardiomyopathy and primary systemic sclerosis heart disease, and some patients with systemic sclerosis have been diagnosed with recurrent Takotsubo cardiomyopathy. Our large systemic sclerosis clinical cohort was reviewed to identify cases diagnosed with Takotsubo cardiomyopathy. The clinical features, laboratory and imaging results were reviewed and evaluated to perform a comparison between cases. We identified five patients with systemic sclerosis, all female (age 68.6 ± 5.7 years), who were diagnosed with Takotsubo cardiomyopathy. Two of these patients had recurrent episodes: one case with a history of multiple episodes and the other with one recurrence. Typical features included repolarization abnormalities on the electrocardiogram and transient left ventricular dysfunction observed using echocardiography or cardiac magnetic resonance imaging. Our findings build upon previous reports and observations that systemic sclerosis may cause Takotsubo cardiomyopathy. To our knowledge, this is the largest case series of Takotsubo syndrome in patients with systemic sclerosis. This association may provide novel insights into the aetiopathogenesis of Takotsubo cardiomyopathy as part of primary systemic sclerosis heart involvement.

Critical Stenosis Because of Vocal Cord Synechiae in a Child

Stridor is a clinical sign of an underlying disease and a common reason for pediatric emergency department (PED) consultation. Patients presenting with stridor must be evaluated to determine the origin of this abnormality. We present the case of a 7-year-old female patient who presented to our Pediatric Emergency Department with a history of recurrent episodes of stridor with increasing frequency over the previous 4 years, for this reason she was previously admitted to the pediatric intensive care unit. Findings from the otorhinolaryngologic assessment with flexible fiber-optic endoscopy led to a diagnosis of congenital synechia of the vocal cords. The cervical CT scan evidenced critical stenosis of the airway. An initial cordectomy and placement of a silicone device for fixation were performed. Subsequently, the patient required 6 additional interventions for progressive dilation of the glottic space at the level of the vocal cords and injections of mitomycin C injections (an antineoplastic that inhibits collagen proliferation). This case highlights the importance of additional studies (especially examination of the upper airway) when atypical or recurrent findings are revealed by the clinical history, physical examination, or disease course in patients with croup to prioritize cases severe enough to require pediatric intensive care unit admission.

Adding meaning to memories: How parietal cortex combines semantic content with episodic experience.

Neuroimaging studies of human memory have consistently found that univariate responses in parietal cortex track episodic experience with stimuli (whether stimuli are 'old' or 'new'). More recently, pattern-based fMRI studies have shown that parietal cortex also carries information about the semantic content of remembered experiences. However, it is not well understood how memory-based and content-based signals are integrated within parietal cortex. Here, we used voxel-wise encoding models and a recognition memory task to predict the fMRI activity patterns evoked by complex natural scene images based on (a) the episodic history and (b) the semantic content of each image in humans (males and females). Models were generated and compared across distinct subregions of parietal cortex and for occipitotemporal cortex. We show that parietal and occipitotemporal regions each encode memory and content information, but they differ in how they combine this information. Among parietal subregions, angular gyrus was characterized by robust and overlapping effects of memory and content. Moreover, subject-specific semantic tuning functions revealed that successful recognition shifted the amplitude of tuning functions in angular gyrus but did not change the selectivity of tuning. In other words, effects of memory and content were additive in angular gyrus. This pattern of data contrasted with occipitotemporal cortex where memory and content effects were interactive: memory effects were preferentially expressed by voxels tuned to the content of a remembered image. Collectively, these findings provide unique insight into how parietal cortex combines information about episodic memory and semantic content.SIGNIFICANCE STATEMENT:Neuroimaging studies of human memory have identified multiple brain regions that not only carry information about 'whether' a visual stimulus is successfully recognized but also 'what' the content of that stimulus includes. However, a fundamental and open question concerns how the brain integrates these two types of information (memory and content). Here, using a powerful combination of fMRI analysis methods, we show that parietal cortex-particularly, the angular gyrus-robustly combines memory- and content-related information, but these two forms of information are represented via additive, independent signals. In contrast, memory effects in high-level visual cortex critically depend on (and interact with) content representations. Together, these findings reveal multiple and distinct ways in which the brain combines memory- and content-related information.

Neurotological emergencies: a narrative review.

Vestibular symptoms, including vertigo, dizziness, and gait unsteadiness, are a frequent reason of urgent medical assistance. Their causes are numerous and diverse, including neurological, otorhinolaryngological, and systemic diseases. Therefore, following a systematic approach is essential to differentiate striking but benign conditions from others that can compromise the patient's life. This study is intended to review vestibular disorders from a practical perspective and provide guidance to physicians involved in the emergency care of patients with vestibular symptoms. A narrative review was performed, revisiting the main causes of vestibular disorders. Based on the speed of onset, duration, and history of similar episodes in the past, vestibular disorders can be categorized into three syndromic entities (acute, recurrent, and chronic vestibular syndromes). The most representative conditions pertaining to each group were reviewed (including their diagnosis and treatment) and a practical algorithm was proposed for their correct management in the acute care setting. Carrying out a correct categorization of the vestibular disorders is essential to avoid diagnostic pitfalls. This review provides useful tools for clinicians to approach their patients with vestibular symptoms at the emergency room.

Temporal dynamics of neurobehavioral hormone sensitivity in a scaled-down experimental model of early pregnancy and parturition.

The hormonal changes of pregnancy and parturition can trigger robust changes in affective state, particularly among patients with a history of postpartum depression. However, more work is needed to elucidate the temporal dynamics of symptom emergence. The current study explored how quickly hormone-sensitive (HS+) individuals can be differentiated from hormone-insensitive (HS-) controls in the context of a tightly controlled experimental hormone manipulation, and which symptoms demonstrate the most rapid, consistent, and largest response during this protocol. Participants were female, non-pregnant, and euthymic, with a history of DSM-5 major depressive episode with peripartum onset (n = 15) or parous healthy controls with no psychiatric history (n = 15). Perinatal hormonal changes were simulated by inducing hypogonadism, adding back estradiol (E2) and progesterone (P4) to reach first-trimester levels for 8 weeks, and then subsequently withdrawing both hormones. Those reporting a 30% or greater increase during addback or withdrawal on select subscales of the Inventory of Depression and Anxiety Symptoms (IDAS) were identified as HS+. Participants provided daily ratings of symptoms throughout the study via the Daily Record of Severity of Problems. Results indicated that HS+ participants could be differentiated from HS- participants early in the hormone protocol, with many symptoms showing significantly greater change from baseline within the first week of addback. Notably, the most rapid symptom increases were observed for Anger/Irritability, Mood Swings, Overwhelm, Lethargy, Increased Appetite, Joint and Muscle Pain, and Breast Tenderness, reaching 50% of peak group contrast within the first week of hormone addback. The largest group effects were observed for Anger/Irritability, followed by Fatigue and Anxiety, and the most consistent group effects were observed for Anger/Irritability, Interpersonal Conflict, Overwhelm, and Hopelessness. Findings support the role of reproductive hormones in the onset of perinatal affective disorders. The rapid emergence of anger and irritability in HS+ participants suggests that these symptoms may be early indicators of perinatal hormone sensitivity.