Linear Mixed-effects Analysis Research Articles

The effects of pathology and one-level versus two-level arthrodesis on cervical spine intervertebral helical axis of motion

The etiology of adjacent segment disease after anterior cervical discectomy and fusion (ACDF) remains controversial. Range of motion (ROM) is typically used to infer the effects of arthrodesis on adjacent segment motion following ACDF, however, ROM only measures the total amount of motion. In contrast, the helical axis of motion (HAM) quantifies how the motion occurs and may provide additional insight into the etiology of adjacent segment pathology. Synchronized biplane radiographs of the cervical spine were acquired at 30 images per second while 62 ACDF patients and 38 control participants performed dynamic neck flexion/extension. A validated tracking process matched digitally reconstructed radiographs created from subject-specific bone models to the radiographs with sub-millimeter accuracy. The intervertebral HAM was then calculated and compared between pre and 1 year post surgery in patients, and between patients and controls at corresponding motion segments using linear mixed-effects analysis. Small differences in the anterior/posterior location of the HAM were found between the symptomatic motion segments before surgery and corresponding motion segments in controls. No changes in the HAM of motion segments adjacent to the arthrodesis were observed from pre to 1-year post-surgery. No differences in adjacent segment HAM were found between patients with one- versus two-level arthrodesis. Neither symptomatic pathology nor arthrodesis appear to change the way motion occurs in the cervical spine during flexion/extension one year after one or two-level arthrodesis. These results suggest ACDF does not alter short-term adjacent segment kinematics in a way that would contribute to the development of adjacent segment disease.

Utility of linear mixed effects models for event-related potential research with infants and children

Event-related potentials (ERPs) are advantageous for investigating cognitive development. However, their application in infants/children is challenging given children’s difficulty in sitting through the multiple trials required in an ERP task. Thus, a large problem in developmental ERP research is high subject exclusion due to too few analyzable trials. Common analytic approaches (that involve averaging trials within subjects and excluding subjects with too few trials, as in ANOVA and linear regression) work around this problem, but do not mitigate it. Moreover, these practices can lead to inaccuracies in measuring neural signals. The greater the subject exclusion, the more problematic inaccuracies can be. We review recent developmental ERP studies to illustrate the prevalence of these issues. Critically, we demonstrate an alternative approach to ERP analysis—linear mixed effects (LME) modeling—which offers unique utility in developmental ERP research. We demonstrate with simulated and real ERP data from preschool children that commonly employed ANOVAs yield biased results that become more biased as subject exclusion increases. In contrast, LME models yield accurate, unbiased results even when subjects have low trial-counts, and are better able to detect real condition differences. We include tutorials and example code to facilitate LME analyses in future ERP research.

Impact of Mindfulness Training on Spanish Police Officers\u2019 Mental and Emotional Health: a Non-Randomized Pilot Study

ObjectivesThe purpose of this exploratory non-randomized controlled study was to determine the acceptance and effectiveness of an 8-week mindfulness-based intervention (MBI) co-designed by a police officer.MethodsA pretest-posttest control group design was followed. Participants (MBI group = 20; control group = 18) answered baseline and post-training self-reported measures. In addition, the weekly emotional state of the MBI group was collected. Paired-samples t-test and analysis of covariance were performed for pre-post within-group and between-group differences, respectively, as well as linear mixed effects analysis of repeated measures for week-by-week data.ResultsHigh acceptance and attendance rates, as well as significant pre-post within-group differences in the MBI group in mindfulness (η2 = 0.43), self-compassion (η2 = 0.43), depression (η2 = 0.54), anxiety (η2 = 0.46), stress (η2 = 0.51), difficulties in emotion regulation, sleep quality (η2 = 0.57), and burnout (η2 = 0.31–0.47), were identified. Moreover, police officers who underwent the MBI experienced a week by week decrease of anger, disgust, anxiety, sadness, and desire. Finally, after adjusting for pre-test scores, significant between-group differences were found in the way of attending to internal and external experiences (observing mindfulness facet; ηp2 = 0.21), depression symptoms (ηp2 = 0.23), general distress (ηp2 = 0.24), and the degree of physical and psychological exhaustion (personal burnout; ηp2 = 0.20).ConclusionsThe preliminary effectiveness of this MBI on psychopathology and quality of life outcomes in Spanish police officers was discussed. Previous evidence regarding the promising use of MBIs in this population was supported.

Inter- and Intra-Individual Variability of Personal Health Risk of Combined Particle and Gaseous Pollutants across Selected Urban Microenvironments

Exposure surrogates, such as air quality measured at a fixed-site monitor (FSM) or residence, are typically used for health estimates. However, people spend various amounts of time in different microenvironments, including the home, office, outdoors and in transit, where they are exposed to different magnitudes of particle and gaseous air pollutants. Health risks caused by air pollution exposure differ among individuals due to differences in activity, microenvironmental concentration, as well as the toxicity of pollutants. We evaluated individual and combined added health risks (AR) of exposure to PM2.5, NO2, and O3 for 21 participants in their daily life based on real-world personal exposure measurements. Exposure errors from using surrogates were quantified. Inter- and intra-individual variability in health risks and key contributors in variations were investigated using linear mixed-effects models and correlation analysis, respectively. Substantial errors were found between personal exposure concentrations and ambient concentrations when using air quality measurements at either FSM or the residence location. The mean exposure errors based on the measurements taken at either the FSM or residence as exposure surrogates was higher for NO2 than PM2.5, because of the larger spatial variability in NO2 concentrations in urban areas. The daily time-integrated AR for the combined PM2.5, NO2, and O3 (TIARcombine) ranged by a factor of 2.5 among participants and by a factor up to 2.5 for a given person across measured days. Inter- and intra-individual variability in TIARcombine is almost equally important. Several factors were identified to be significantly correlated with daily TIARcombine, with the top five factors, including PM2.5, NO2 and O3 concentrations at ‘home indoor’, O3 concentrations at ‘office indoor’ and ambient PM2.5 concentrations. The results on the contributors of variability in the daily TIARcombine could help in targeting interventions to reduce daily health damage related to air pollutants.

Neuropsychiatric symptoms as a sign of small vessel disease progression in cognitive impairment.

Neuropsychiatric symptoms associate cross-sectionally with cerebral small vessel disease but it is not clear whether these symptoms could act as early clinical markers of small vessel disease progression. We investigated whether longitudinal change in Neuropsychiatric Inventory (NPI) scores associated with white matter hyperintensity (WMH) progression in a memory clinic population. We included participants from the prospective Sunnybrook Dementia Study with Alzheimer's disease and vascular subtypes of mild cognitive impairment and dementia with two MRI and ≥ 1 NPI. We conducted linear mixed-effects analyses, adjusting for age, atrophy, vascular risk factors, cognition, function, and interscan interval. At baseline (n=124), greater atrophy, age, vascular risk factors and total NPI score were associated with higher baseline WMH volume, while longitudinally, all but vascular risk factors were associated. Change in total NPI score was associated with change in WMH volume, χ2=7.18, p=0.007, whereby a one-point change in NPI score from baseline to follow-up was associated with a 0.0017 change in normalized WMH volume [expressed as cube root of (WMH volume cm³ as % intracranial volume)], after adjusting for age, atrophy, vascular risk factors and interscan interval. In memory clinic patients, WMH progression over 1-2 years associated with worsening neuropsychiatric symptoms, while WMH volume remained unchanged in those with stable NPI scores in this population with low background WMH burden.

Behavioral and neural responses during fear conditioning and extinction in a large transdiagnostic sample

BackgroundDysregulation of fear learning has been associated with psychiatric disorders that have altered positive and negative valence domain function. While amygdala-insula-prefrontal circuitry is considered important for fear learning, there have been inconsistencies in neural findings in healthy and clinical human samples. This study aimed to delineate the neural substrates and behavioral responses during fear learning in a large, transdiagnostic sample with predominantly depressive and/or anxious dysfunction. MethodsTwo-hundred and eighty-two individuals (52 healthy participants; 230 participants with depression and/or anxiety-related problems) from the Tulsa 1000 study, an ongoing, naturalistic longitudinal study based on a dimensional psychopathological framework, completed a Pavlovian fear learning task during functional magnetic resonance imaging. Linear mixed-effects analyses examined condition-by-time effects on brain activation (CS+, CS- across familiarization, conditioning, and extinction trials). A data-driven latent profile analysis (LPA) examined distinct patterns of behavioral and neural responses to threat across fear conditioning and extinction, while logistic regression analyses evaluated cognitive-affective predictors of latent profiles. ResultsWhole-brain analyses revealed a condition-by-time interaction in the anterior insula, postcentral gyrus, superior temporal gyrus, middle frontal gyrus, and cerebellum but not amygdala. The LPA identified distinct latent profiles across subjective and neural levels of measurement. Anterior insula profiles were characterized by marginal differences in age and state anxiety. ConclusionsOur findings demonstrate that human fear learning recruits a distributed network of regions involved in interoceptive, cognitive, motivational, and psychomotor processes. Data-driven analyses identified distinct profiles of subjective and neural responses during fear learning that transcended clinical diagnoses, but no robust relationships to demographic or cognitive-affective variable were identified.

Celebrity status, sex, and variation in psychopathy predicts judgements of and proclivity to generate and distribute deepfake pornography

With the advent of means to generate and disseminate fake, sexualised images of others for the purposes of financial gain, harassment, or sexual gratification, there is a need to assess and understand the public's awareness and judgements of said behaviour. In two independently-sampled studies, we used moderation (Study 1; n = 290, 42% female) and linear mixed effects (Study 2; n = 364, 51% female) analyses to investigate whether judgements of deepfaking (measured across 12 self-report items) differed as a function of victim status (celebrity, non-celebrity), victim and participant demographics, and image use (sharing, own sexual gratification), whilst controlling for the potential covariates of psychopathy and beliefs about a just world. We consistently observed more lenient judgements of deepfake generation and dissemination for victims who were celebrities and male, and when images were created for self-sexual gratification rather than being shared. Moreover, lenient judgements, as well as proclivity to act were predicted by greater levels of psychopathy. We discuss our findings in the context of future research needing to better understand the general public's rationale for said disparity in judgements, as well as identifying and combating barriers to disclose victimisation. Open data and a preprint of this paper are available at https://osf.io/fp85q/?view_only = 8006547d6a524f4fbb9dd55005c73319.

Oxytocin system gene methylation is associated with empathic responses towards children

Empathy is an essential component of sensitive caregiving behavior, which in turn is an important predictor of children’s healthy social-emotional development. The oxytocin (OXT) system plays a key role in promoting sensitive parenting and empathy. In this study, we investigated how OXT system gene methylation was associated with empathic processes in nulliparous women (M age = 23.60, SD =0.44)—measuring both physiological facial muscle responses and ratings of compassion and positive affect to affective images depicting children. Linear mixed effects analyses demonstrated that lower methylation levels in the OXT and OXTR genes were related to enhanced empathic responses. The effect of OXT system gene methylation on empathic processes was partly qualified by an interaction with individual variations in women’s care motivation. Our findings provide experimental evidence for an association between the methylation of OXT system genes and empathy.

Association between neighborhood health behaviors and body mass index in Northern Norway: evidence from the Tromsø Study.

The prevalence of overweight and obesity has risen rapidly worldwide, and the ongoing obesity pandemic is one of the most severe public health concerns in modern society. The average body mass index (BMI) of people living in Northern Norway has also steadily increased since the late 1970s. This study aimed to understand how individuals' health behavior is associated with the general health behavior of the people in their neighborhood. Using the population-based Tromsø Study, we examined the life course association between average leisure time physical activity at the neighborhood level and the BMI of individuals living in the same neighborhood. We used a longitudinal dataset following 25,604 individuals living in 33 neighborhoods and performed a linear mixed-effects analysis. The results showed that participants living in neighborhoods whose residents were more physically active during their leisure time, were likely to have a significantly lower BMI (-0.9 kg/m², 95% CI -1.5 to -0.4). Also, individuals living in neighborhoods whose residents were doing mainly manual work, had significantly higher BMIs (0.7 kg/m², 95% CI 0.4-1.0). Our results showed a strong association between the average leisure time physical activity level of neighborhood residents and the higher BMI levels of residents of the same neighborhood.

Corticospinal Tract Microstructure Correlates With Beta Oscillatory Activity in the Primary Motor Cortex After Stroke.

Cortical beta oscillations are reported to serve as robust measures of the integrity of the human motor system. Their alterations after stroke, such as reduced movement-related beta desynchronization in the primary motor cortex, have been repeatedly related to the level of impairment. However, there is only little data whether such measures of brain function might directly relate to structural brain changes after stroke. This multimodal study investigated 18 well-recovered patients with stroke (mean age 65 years, 12 males) by means of task-related EEG and diffusion-weighted structural MRI 3 months after stroke. Beta power at rest and movement-related beta desynchronization was assessed in 3 key motor areas of the ipsilesional hemisphere that are the primary motor cortex (M1), the ventral premotor area and the supplementary motor area. Template trajectories of corticospinal tracts (CST) originating from M1, premotor cortex, and supplementary motor area were used to quantify the microstructural state of CST subcomponents. Linear mixed-effects analyses were used to relate tract-related mean fractional anisotropy to EEG measures. In the present cohort, we detected statistically significant reductions in ipsilesional CST fractional anisotropy but no alterations in EEG measures when compared with healthy controls. However, in patients with stroke, there was a significant association between both beta power at rest (P=0.002) and movement-related beta desynchronization (P=0.003) in M1 and fractional anisotropy of the CST specifically originating from M1. Similar structure-function relationships were neither evident for ventral premotor area and supplementary motor area, particularly with respect to their CST subcomponents originating from premotor cortex and supplementary motor area, in patients with stroke nor in controls. These data suggest there might be a link connecting microstructure of the CST originating from M1 pyramidal neurons and beta oscillatory activity, measures which have already been related to motor impairment in patients with stroke by previous reports.

Impact of the COVID-19 Pandemic on Objectively Measured Physical Activity and Sedentary Behavior Among Overweight Young Adults: Yearlong Longitudinal Analysis.

BackgroundThe COVID-19 pandemic has impacted multiple aspects of daily living, including behaviors associated with occupation, transportation, and health. It is unclear how these changes to daily living have impacted physical activity and sedentary behavior.ObjectiveIn this study, we add to the growing body of research on the health impact of the COVID-19 pandemic by examining longitudinal changes in objectively measured daily physical activity and sedentary behavior among overweight or obese young adults participating in an ongoing weight loss trial in San Diego, California.MethodsData were collected from 315 overweight or obese (BMI: range 25.0-39.9 kg/m2) participants aged from 18 to 35 years between November 1, 2019, and October 30, 2020, by using the Fitbit Charge 3 (Fitbit LLC). After conducting strict filtering to find valid data on consistent wear (>10 hours per day for ≥250 days), data from 97 participants were analyzed to detect multiple structural changes in time series of physical activity and sedentary behavior. An algorithm was designed to detect multiple structural changes. This allowed for the automatic identification and dating of these changes in linear regression models with CIs. The number of breakpoints in regression models was estimated by using the Bayesian information criterion and residual sum of squares; the optimal segmentation corresponded to the lowest Bayesian information criterion and residual sum of squares. To quantify the changes in each outcome during the periods identified, linear mixed effects analyses were conducted. In terms of key demographic characteristics, the 97 participants included in our analyses did not differ from the 210 participants who were excluded.ResultsAfter the initiation of the shelter-in-place order in California on March 19, 2021, there were significant decreases in step counts (−2872 steps per day; 95% CI −2734 to −3010), light physical activity times (−41.9 minutes; 95% CI −39.5 to −44.3), and moderate-to-vigorous physical activity times (−12.2 minutes; 95% CI −10.6 to −13.8), as well as significant increases in sedentary behavior times (+52.8 minutes; 95% CI 47.0-58.5). The decreases were greater than the expected declines observed during winter holidays, and as of October 30, 2020, they have not returned to the levels observed prior to the initiation of shelter-in-place orders.ConclusionsAmong overweight or obese young adults, physical activity times decreased and sedentary behavior times increased concurrently with the implementation of COVID-19 mitigation strategies. The health conditions associated with a sedentary lifestyle may be additional, unintended results of the COVID-19 pandemic.

Lung function assessment and its association with blood chromium in a chromate exposed population

Hexavalent chromium [Cr(VI)] and its compounds have been associated with various respiratory diseases, while few studies have attempted to determine its adverse effect on lung function. To explore the potential early indicators of health surveillance for respiratory diseases induced by chromate exposure, a longitudinal cohort study including 515 workers with 918 measurements across 2010–2017 was conducted to investigate the impact of individual internal exposure on lung function. Inductively coupled plasma mass spectrometry (ICP-MS) and spirometry were used to measure whole blood chromium (blood Cr) and lung function respectively. In the linear mixed-effects analysis, each 1- unit increase in Ln- transformed blood Cr was significantly associated with estimated effect percentage decreases of 1.80 (0.35, 3.15) % in FEV1, 0.77 (0.10, 1.43) % in FEV1/FVC, 2.78 (0.55, 4.98) % in PEF, and 2.73 (0.59, 4.71) % in FEF25–75% after adjusting for related covariates. Exposure- response curve depicted the reduction of lung function with blood Cr increase, and the reference value of blood Cr was proposed as 6 μg/L considering the lung function as health outcome. Based on the repeated-measure analysis, compared with the low frequency group, subjects with high frequency of high exposure across 2010–2017 had an additional reduction of 5.65 (0, 11.3) % in FVC. Subjects with medium frequency showed more obvious declines of 9.48 (4.16, 14.87) % in FVC, 8.63 (3.49, 13.97) % in FEV1, 12.94 (3.34, 22.53) % in PEF and 10.97 (3.63, 18.30) % in MVV. These findings suggested that short- term high exposure to Cr associated with obstructive ventilatory impairment, and long- term exposure further led to restrictive ventilatory impairment.

Effect of rTMS on fractional anisotropy, radial diffusivity, and axonal volume in select fiber tracts in patients with traumatic brain injury

Abstract Traumatic brain injury (TBI) frequently involves damage to the white matter tracts in the brain. Repetitive transcranial magnetic stimulation (rTMS) can improve many of the sequelae of TBI, including depression and executive order dysfunction. This raises the question of whether rTMS treatment may result in measurable changes in the diffusion properties of white matter tracts, especially in those proximal to the rTMS treatment target location. In this study, 33 Veterans diagnosed with mild or moderate TBI (age 20-69 years; mild (n = 27) and moderate (n = 6) underwent the rTMS protocol that is FDA approved for major depression, receiving one treatment per day, five days per week, for four weeks (either treatment (n=17) or sham (n=16) version). Each participant underwent cognitive testing, as well as T1-weighted (T1W) and diffusion weighted (DWI) MR imaging scans, at the baseline, immediate post-treatment, and one month follow up timepoints. DWIs were processed using the Automated Fiber Quantification (AFQ) pipeline (Yeatman et al. 2012). This procedure identifies 20 white matter fiber tracts in the brain and obtain the diffusion parameters, e.g. fractional anisotropy (FA) and radial diffusivity (RD), at the100 discrete segments along the central portions of the fiber tracts. AFQ outcomes from each timepoint will be subjected to a linear mixed effects analysis to determine what effect rTMS treatment has on the diffusion properties in fibers proximal to the target, especially the superior longitudinal fasciculus. We will control for age, years of education, and baseline diffusivity values. Diffusion parameters of interest include fractional anisotropy, radial diffusivity, and one non-diffusivity variable, tract volume. We also plan to correlate these outcomes with performance on an executive function task. Keywords: DTI, AFQ, LME, rTMS

Configurations of mother-child and father-child attachment as predictors of internalizing and externalizing behavioral problems: An individual participant data (IPD) meta-analysis.

An unsettled question in attachment theory and research is the extent to which children's attachment patterns with mothers and fathers jointly predict developmental outcomes. In this study, we used individual participant data (IPD) meta-analysis to assess whether early attachment networks with mothers and fathers are associated with children's internalizing and externalizing behavioral problems. Following a pre-registered protocol, data from 9 studies and 1,097 children (mean age: 28.67 months) with attachment classifications to both mothers and fathers were included in analyses. We used a linear mixed effects analysis to assess differences in children's internalizing and externalizing behavioral problems as assessed via the average of both maternal and paternal reports based on whether children had two, one, or no insecure (or disorganized) attachments. Results indicated that children with an insecure attachment relationship with one or both parents were at higher risk for elevated internalizing behavioral problems compared with children who were securely attached to both parents. Children whose attachment relationships with both parents were classified as disorganized had more externalizing behavioral problems compared to children with either one or no disorganized attachment relationship with their parents. Across attachment classification networks and behavioral problems, findings suggest (a) an increased vulnerability to behavioral problems when children have insecure or disorganized attachment to both parents, and (b) that mother-child and father-child attachment relationships may not differ in the roles they play in children's development of internalizing and externalizing behavioral problems.

Τα άτονα φωνήεντα στη Νέα Ελληνική των Ελλήνων μεταναστών στον Καναδά

We examine the pattern of unstressed middle vowel raising for 50 Greek immigrants who moved to Canada during the period 1945-197 5, 38 of whom are speakers from northen Greece and 12 are from the Peloponnese. Using linear mixed effects analysis of 9011 tokens of all five vowels produced during semi-structured interviews, we show that raising occurs in both groups. However, only northern Greek speakers raise unstressed /e/ and /o/ to an extent that they are differentiated from their stressed counterparts. We also show that raised variants are not the same as the high vowels /i/ and /u/.

Neurocognitive outcomes in Malawian children exposed to malaria during pregnancy: An observational birth cohort study.

BackgroundAnnually 125 million pregnancies are at risk of malaria infection. However, the impact of exposure to malaria in pregnancy on neurodevelopment in children is not well understood. We hypothesized that malaria in pregnancy and associated maternal immune activation result in neurodevelopmental delay in exposed offspring.Methods and findingsBetween April 2014 and April 2015, we followed 421 Malawian mother–baby dyads (median [IQR] maternal age: 21 [19, 28] years) who were previously enrolled (median [IQR] gestational age at enrollment: 19.7 [17.9, 22.1] weeks) in a randomized controlled malaria prevention trial with 5 or 6 scheduled assessments of antenatal malaria infection by PCR. Children were evaluated at 12, 18, and/or 24 months of age with cognitive tests previously validated in Malawi: the Malawi Developmental Assessment Tool (MDAT) and the MacArthur–Bates Communicative Development Inventories (MCAB-CDI). We assessed the impact of antenatal malaria (n [%] positive: 240 [57.3]), placental malaria (n [%] positive: 112 [29.6]), and maternal immune activation on neurocognitive development in children. Linear mixed-effects analysis showed that children exposed to antenatal malaria between 33 and 37 weeks gestation had delayed language development across the 2-year follow-up, as measured by MCAB-CDI (adjusted beta estimate [95% CI], −7.53 [−13.04, −2.02], p = 0.008). Maternal immune activation, characterized by increased maternal sTNFRII concentration, between 33 and 37 weeks was associated with lower MCAB-CDI language score (adjusted beta estimate [95% CI], −8.57 [−13.09, −4.06], p < 0.001). Main limitations of this study include a relatively short length of follow-up and a potential for residual confounding that is characteristic of observational studies.ConclusionsThis mother–baby cohort presents evidence of a relationship between malaria in pregnancy and neurodevelopmental delay in offspring. Malaria in pregnancy may be a modifiable risk factor for neurodevelopmental injury independent of birth weight or prematurity. Successful interventions to prevent malaria during pregnancy may reduce the risk of neurocognitive delay in children.

Neural correlates of extinguished threat recall underlying the commonality between pediatric anxiety and irritability

BackgroundAnxiety and irritability frequently co-occur in youth and are mediated by aberrant threat responses. However, empirical evidence on neural mechanisms underlying this co-occurrence is limited. To address this, we apply data-driven latent phenotyping to data from a prior report of a well-validated threat extinction recall fMRI paradigm. MethodsParticipants included 59 youth (28 anxiety disorder, 31 healthy volunteers; Mage=13.15 yrs) drawn from a transdiagnostic sample of 331 youth, in which bifactor analysis was conducted to derive latent factors representing shared vs. unique variance of dimensionally-assessed anxiety and irritability. Participants underwent threat conditioning and extinction. Approximately three weeks later, during extinction recall fMRI, participants made threat-safety discriminations under two task conditions: current threat appraisal and explicit recall of threat contingencies. Linear mixed-effects analyses examined associations of a “negative affectivity” factor reflecting shared anxiety and irritability variance with whole-brain activation and task-dependent amygdala connectivity. ResultsDuring recall of threat-safety contingencies, higher negative affectivity was associated with greater prefrontal (ventrolateral/ventromedial, dorsolateral, orbitofrontal), motor, temporal, parietal, and occipital activation. During threat appraisal, higher negative affectivity was associated with greater amygdala-inferior parietal lobule connectivity to threat/safety ambiguity. LimitationsSample included only healthy youth and youth with anxiety disorders. Results may not generalize to other diagnoses for which anxiety and irritability are also common, and our negative affectivity factor should be interpreted as anxiety disorders with elevated irritability. Reliability of some subfactors was poor. ConclusionsAberrant amygdala-prefrontal-parietal circuitry during extinction recall of threat-safety stimuli may be a mechanism underlying the co-occurrence of pediatric anxiety and irritability.

From lollipops to lidocaine: The need for a universal print-to-speech framework.

There is a strong relationship between reading and articulation (Lervåg & Hulme, 2009; Pan et al., 2011). Given the tight coupling of these processes, innovative approaches are needed to understand the intricacies associated with print-speech connections. Here we ran a series of tightly controlled experiments to examine the impact of mouth perturbations on silent reading. We altered the mouth, via somatosensory feedback, in several ways: (a) a large lollipop in the mouth (E1), (b) a candy stick (bite bar) held horizontally between the teeth (E2), and (c) lidocaine that served to numb the mouth (E3). Three tasks were completed: (a) picture categorization, (b) "spell" lexical decision (Spell-LDT; "does the letter string spell a real word, yes or no?"), and (c) "sound" lexical decision (Sound-LDT; "does the letter string sound like a real word, yes or no?"). Participants (N = 97; E1 = 27; E2 = 32; E3 = 38) completed each of the tasks two times: once with a somatosensory perturbation (lollipop, bite bar, or lidocaine) and once without. For each experiment, a linear mixed effects analysis was run. Overall, we found that the lollipop (E1) and lidocaine (E3) had some specific effects on word recognition (e.g., for "no" responses), particularly in the Spell-LDT, whereas the bite bar (E2) had no effect on word recognition. The picture categorization task was not impacted by any perturbations. These findings provide evidence that sensorimotor information is connected to reading. We discuss how these findings advance our understanding of a print-to-speech framework. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mindfulness-based therapy compared to cognitive behavioral therapy for opioid-treated chronic low back pain: Protocol for a pragmatic randomized controlled trial

ObjectiveChronic low back pain (CLBP) is disabling and costly. Existing therapies have proven suboptimal, with many patients resorting to long-term opioid therapy, which can cause harms. Cognitive behavioral (CBT) and mindfulness-based (MBT) therapies can be effective and offer unique skills for safe pain coping. This article describes the protocol for a study evaluating comparative effectiveness of CBT and MBT in adults with opioid-treated CLBP. DesignPragmatic, multi-center randomized controlled trial (RCT). SettingsCommunity and outpatient care. ParticipantsPlanned enrollment of 766 adults (383/group) with CLBP treated with long-term opioids (≥3 months; ≥15 mg/day morphine-equivalent dose). InterventionsCBT or MBT consisting of eight weekly therapist-led, two-hour group sessions, and home practice (≥30 min/day, 6 days/week) during the 12-month study. Main outcome measuresMain outcome measures, collected by self-report at baseline, then three, six, nine and 12 months post-entry, include co-primary measures: pain intensity (Numeric Rating Scale) and function (Oswestry Disability Index), and secondary measures: quality of life (Medical Outcomes Study) and average daily opioid dose (Timeline Followback). Baseline scores of depression, anxiety, and opioid misuse questionnaires will be assessed as potential contributors to the heterogeneity of treatment response. Intention-to-treat, linear mixed-effects analysis will examine treatment effectiveness. Qualitative data will augment the quantitative measures. ConclusionsThis will be the largest RCT comparing CBT and MBT in opioid-treated CLBP. It will provide evidence on the impact of these interventions, informing clinical decisions about optimal therapy for safe, effective care, improving quality of life and decreasing opioid-related harm among adults with refractory CLBP.

Association between tobacco use and symptomatology in individuals at ultra-high risk to develop a psychosis: A longitudinal study

BackgroundThe high prevalence rates and impact of tobacco smoking in individuals with a psychotic disorder have become an increasing interest. Little is known about tobacco smoking in individuals at ultra-high risk of psychosis (UHR). MethodsWe studied 345 UHR individuals of the high-risk study of the European network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI). Smoking status and the number of cigarettes per day were assessed at multiple moments using the CIDI. Symptom severity at each time point was assessed using CAARMS. Linear mixed-effects analyses were conducted to examine the multi-cross-sectional and prospective associations between (change in) smoking behaviour and symptomatology. FindingsAt baseline, 175 individuals (53%) smoked tobacco with an average of 12.4 (SD = 9.0) cigarettes per day. Smokers did not significantly differ in symptom severity from non-smokers on general, positive, negative, emotional, cognitive, behavioural, or motor symptoms across time. However, associations were found between the number of cigarettes and the severity of general psychopathology (estimate 0.349, SE 0.146, p = 0.017). Change in the number of cigarettes had no significant effect on change in general symptom severity (estimate 0.330, SE 0.285, p = 0.248). InterpretationSmoking prevalence in UHR individuals is high. Cigarette consumption was associated with higher levels of general symptoms. However, we observed no association between change in number of cigarettes and symptom severity. Given the fact that smoking is associated with poorer health and worse outcomes in people with psychosis, the clinical high-risk phase offers a window of opportunity for prevention and cessation interventions.