Prior research has yielded inconsistent findings on neurocognitive deficits, particularly in response inhibition and set shifting, when comparing patients with trichotillomania (TTM) to healthy comparison groups. This study used baseline data (N = 36) from a clinical trial of behavior therapy for TTM to test two possible explanations for these mixed results: (a) neurocognitive deficits are only noted among more severely symptomatic patients with TTM; and (b) age of onset is differentially associated with deficits in response inhibition vs. set shifting. Results were inconsistent with these hypotheses. Age of onset was not significantly correlated with either neurocognitive assessment. Interviewer ratings of TTM symptom severity or impairment were not significantly related to neurocognitive test performance. Self-reported symptom severity correlated significantly with motor response inhibition, but in the direction opposite to our expectation, such that faster reaction times to inhibit a dominant response were associated with more severe symptoms. Discussion centered on several possible explanations, including the possibilities that either (a) measurement methods or (b) variation across samples in the prevalence of ADHD comorbidity, not measured in this study, could explain mixed findings on the neuropsychological profile of TTM.

Prior studies of behavior therapy for trichotillomania (TTM) have shown that response is variable, and relapse after treatment discontinuation is common. Little information is available concerning prognostic factors capable of predicting individual differences in response or maintenance of improvement. The present study is a secondary analysis of a randomized controlled trial (N = 36) of the Comprehensive Behavioral (ComB) model of treatment for TTM (Carlson et al., 2021). We investigated age, disorder history, pre-treatment symptom severity, longest prior period of abstinence from pulling, and Emotion and Intention hair pulling styles as predictors of initial response. We studied age, disorder history, pre-treatment symptom severity, longest prior period of abstinence from pulling, and post-treatment symptom severity or hair-pulling abstinence as predictors of relapse following treatment. Older age significantly predicted lower TTM severity following treatment. Lower pre-treatment severity significantly predicted lower severity of TTM at the 3-month follow-up.

Background:Latina mothers' stress is associated with their children's health behaviors and risk for obesity; however, existing pediatric health promotion programs have not focused on maternal stress reduction. Methods:Herein we describe a study design that will examine the acceptability and feasibility of Calma, Conversa, y Cría (CCC) a 6-week mindful parenting intervention designed to reduce stress. We present the results of qualitative research with Latina mothers and experts in Latinx health and mindfulness who provided culturally-relevant feedback on existing mindful parenting strategies to inform the development of CCC. Fifty Latina mothers of children ages 3-11 years will be randomly assigned to CCC or an enhanced usual care health education intervention. Acceptability will be assessed through participant satisfaction surveys and exit interviews. Feasibility will be determined through detailed tracking of recruitment, retention, and attendance rates. A signal regarding any group differences in maternal stress, health-related parenting practices, child diet, child physical activity, and child quality of life will be explored. Discussion:The development of interventions that can reduce maternal stress and risk for obesity in Latinx children is critical to significantly reduce negative health impacts in this underserved population. Our approach includes the identification of effective cultural adaptations that should improve the feasibility and acceptability of mindful parenting strategies in Latinx families, ideally reducing maternal stress and improving parenting behaviors related to child health. If successful, CCC will be examined in a larger efficacy trial involving the measurement of objective biomarkers of children's chronic disease risk.

Push-coring is used to collect Holocene-aged coral sub-fossils, but its applications can be limited by underlying reef geology. Here, we report on a new approach of coring inundated coastal karst formations—i.e., coral holes—to determine the historical context of coral reefs in Guam. Three cores were extracted and processed to recover coral fragments as well as abundances of the photosymbiotic foraminifera Baculogypsina sphaerulata, a proxy for water clarity. Coral fragments, with the oldest dating to a median calibrated age of 221 cal. BP (1729 CE), revealed greater than 100 years of consistent accumulation and composition, suggesting a period of relative stability for macrobenthos. However, we documented a drop in B. sphaerulata abundance from approximately 100 years cal. BP, suggesting a period of environmental decline in Guam. Our results provide the first multi-centennial record of coral assemblages from Guam and provide a proof of concept for future historical investigations.

Variational inference is an alternative estimation technique for Bayesian models. Recent work shows that variational methods provide consistent estimation via efficient, deterministic algorithms. Other tools, such as model selection using variational AICs (VAIC) have been developed and studied for the linear regression case. While mixed effects models have enjoyed some study in the variational context, tools for model selection are lacking. One important feature of model selection in mixed effects models, particularly longitudinal models, is the selection of the random effects which in turn determine the covariance structure for the repeatedly sampled outcome. To address this, we derive a VAIC specifically for variational mixed effects (VME) models. We also implement a parameter-efficient VME as part of our study which reduces any general random effects structure down to a single subject-specific score. This model accommodates a wide range of random effect structures including random intercept and slope models as well as random functional effects. Our VAIC can model and perform selection on a variety of VME models including more classic longitudinal models as well as longitudinal scalar-on-function regression. As we demonstrate empirically, our VAIC performs well in discriminating between correctly and incorrectly specified random effects structures. Finally, we illustrate the use of VAICs for VMEs on two datasets: a study of lead levels in children and a study of diffusion tensor imaging.

Over the past ∼15 y, unconventional oil and gas (UOG) production utilizing hydraulic fracturing and horizontal drilling has increased dramatically in the Marcellus Shale in the Appalachian region of the USA. The area also has a long history of conventional oil and gas (COG) production as well as coal mining, and the 3 extractive activities (UOG, COG, and coal mining) often occur in the same watersheds. Produced water and wastewater from oil and gas (OG) extraction can have very high concentrations of dissolved metals, radionuclides, and other solutes. Previous studies have documented streamwater pollution associated with spills and releases of these fluids, but it remains unclear whether OG development has broad regional effects on streamwater quality. This study assessed whether COG and UOG well densities in watersheds were associated with water-quality metrics, including specific conductance, dissolved metals, nutrients, radium isotopes, and anions, when controlling for coal mining and land cover. Water quality was measured at 120 stream sites with non-nested watersheds in the Marcellus Shale region. Linear modeling revealed that COG well density was associated with higher concentrations of Mg and Cl−, and UOG well density was associated with higher 228Ra:224Ra ratios, suggesting that this ratio might be a useful indicator of UOG development in watersheds. Adding OG well density to linear models explaining the concentrations of water-quality variables improved R2 by ≤0.04, indicating little increase in explanatory power. However, linear regression coefficients indicated that an increase in COG well density from 0 to 11 wells/km2 (the maximum well density observed in our study area) could be associated with 35× increases in Mg and Cl− concentrations, although the SE of these estimates was large. This research suggests that OG well density may have small but measurable effects on streamwater quality; however, the effects of other human activities and land uses, such as coal extraction and urban development, are likely larger and more environmentally relevant.

The hypotelminorheic is a groundwater-fed shallow subterranean habitat, occurring a few metres below the surface and emerging at a seepage spring. Little is known about the habitat requirements for the amphipods and isopods that live there, and forest quality and other surface parameters have been largely unexplored. Urban parks, encompassing protected lands from ballfields to forests, are not necessarily secure sites, because of non-compatible uses and changing park boundaries. Almost all records for this fauna in the study area are in parks. Using data from sampling in parklands of south-east Washington, DC, exploratory analyses were conducted at two spatial scales - the seeps and pervious land patches surrounded by impervious surfaces (which range from 0.59 to 231 ha). Habitat quality, fragmentation and geological variables were calculated, and exploratory logistic regression models were fitted to predict occupancy. Hypotelminorheic macroinvertebrates were found at 66 of 207 seeps and 15 of 27 patches. Five species were collected, three of which were uncommon. Only patches containing three or more seeps and >7.6 ha were inhabited. Occurrence of one or more species in seeps was associated with distance inside the forest, taller tree canopy, elevation and geological formation. There is a threshold amount of habitat below which a population can no longer exist. Few patches of forest remain that are sufficiently large for habitation, and conservation actions should prioritize forested patches with three or more seeps. In addition, the development of forested corridors to enhance connectivity among populations, education of the public about the value of the hypotelminorheic, and development of field methods to detect habitats is recommended. Urban parklands can be important reservoirs for species of conservation concern.

Historical Functional Linear Models (HFLM) quantify associations between a functional predictor and functional outcome where the predictor is an exposure variable that occurs before, or at least concurrently with, the outcome. Prior work on the HFLM has largely focused on estimation of a surface that represents a time-varying association between the functional outcome and the functional exposure. This existing work has employed frequentist and spline-based estimation methods, with little attention paid to formal inference or adjustment for multiple testing and no approaches that implement wavelet-bases. In this work, we propose a new functional regression model that estimates the time-varying, lagged association between a functional outcome and a functional exposure. Building off of recently developed function-on-function regression methods, the model employs a novel use the wavelet-packet decomposition of the exposure and outcome functions that allows us to strictly enforce the temporal ordering of exposure and outcome, which is not possible with existing wavelet-based functional models. Using a fully Bayesian approach, we conduct formal inference on the time-varying lagged association, while adjusting for multiple testing. We investigate the operating characteristics of our wavelet-packet HFLM and compare them to those of two existing estimation procedures in simulation. We also assess several inference techniques and use the model to analyze data on the impact of lagged exposure to particulate matter finer than 2.5μg, or PM2.5, on heart rate variability in a cohort of journeyman boilermakers during the morning of a typical day's shift.

Abstract The Revised Strain Index (RSI), a model that quantifies physical exposure from individual hand/wrist exertions, tasks, and multi-task jobs, was used to quantify exposure for 1372 incident-eligible manufacturing, service and healthcare workers. Workers were followed for an average of 2.5 years (maximum 6 years) and had an average carpal tunnel syndrome (CTS) incidence rate of 4.6 per 100 person-years. Exceeding the a-priori RSI limit of 10.0 showed increased risk of CTS (Hazard Ratio (HR) = 1.45, 95% CI: 1.11–1.91, p = 0.01). There also was a dose-response relationship using proposed low (RSI ≤ 8.5, HR = 1.00), medium (HR = 1.42 (95% CI: 0.96–2.09, p = 0.08)), and high limits (RSI > 15, HR = 1.79 (95% CI: 1.19–2.69, p = 0.01), respectively. RSI as a continuous variable showed CTS risk increased steadily by between 1.9% and 3.3% per unit increase in RSI (p ≤ 0.03). These results suggest that the RSI is a useful tool for surveillance as well as for job intervention/design and continuous improvement processes. Practitioner Summary The Revised Strain Index (RSI) quantifies physical exposure from individual hand/wrist exertions, tasks, and multi-task jobs. Increased cumulative RSI scores (i.e. daily exposure score) are associated with increased risk of carpal tunnel syndrome (CTS). The RSI is potentially useful as a risk surveillance and intervention design tool.

Objective: This study is the first controlled trial of comprehensive behavioral (ComB) treatment of trichotillomania (TTM). ComB provides individualized treatment based on factors triggering and maintaining hair pulling. Method: Participants (N = 36) were adults (M = 34.08 years old, SD = 12.26) meeting DSM5 criteria for TTM. A majority were female (80%) and Caucasian (75%), whereas 17% were African American and 19% Hispanic/Latinx. In a parallel-group design, participants were randomly assigned to (a) Immediate ComB (12 sessions) or (b) Minimal Attention Control (MAC), followed by delayed ComB after week 12. Follow-up continued through week 38. Primary outcomes were self-report (Massachusetts General Hospital Hair pulling Scale; MGHHPS) and interviewer-rated (NIMH-Trichotillomania Impact Scale and Trichotillomania Severity Scale; TIS/TSS) TTM symptom severity, as well as diagnosis (Trichotillomania Diagnostic Interview). Results: Immediate efficacy of ComB (vs. MAC) was statistically significant (p = .03) for self-reported symptoms, with an effect size d = -.78, but not significant for interviewer-rated symptoms or diagnostic status. Immediate ComB was significantly more likely than MAC (27% vs. 0%) to lead to complete abstinence from hair pulling at week 12. Follow-ups showed good maintenance of effects. Conclusions: Efficacy of ComB was established for self-reported symptoms. Future research is needed to establish whether the lack of more widespread effects stems from limitations of the model or to a need for more extensive therapist training, as secondary analyses suggested stronger results among therapists with more TTM experience.

This study used follow-up data from a randomized controlled trial of a cognitive-behavioral therapy intervention for trichotillomania. The aim of this study was to explore the relationship between strategy use and two cognitive measures. Thirty participants met diagnostic criteria at the start of the study and completed a follow-up assessment 3- or 6-months post-treatment. The sample was 80% female and the mean age was 34.Participants completed a trichotillomania strategy use form which presents a list of strategies that are organized into 5 categories: sensory (e.g., using a scalp massager), cognitive (e.g., cognitive restructuring), affective (e.g., engaging in pleasurable activities), motor (e.g., using fidget toys), and place (e.g., putting sticky notes on mirrors). Participants were asked to circle any strategies they currently use, and the number of strategies used in each domain was counted. Participants also completed cognitive measures including a stop-signal task and a gambling task. Correlational analyses were conducted comparing the primary outcome variables on the cognitive measures to the number of strategies used in each of the 5 domains. Pearson correlations revealed significant negative correlations between the use of motor pulling strategies and mean decision-making time on the gambling task r (28) = −.619, p < .001 and stop signal reaction time r (28) = −.418, p = .022. Spearman rank-order correlations confirmed these results. The use of motor coping strategies is associated with faster responses to task relevant stimuli. The current findings indicate that fast motor-based response time may make motor-based strategies more accessible to these individuals.

Objective: Assessment of possible relationships between work-related psychosocial measures and self-reported low back pain (LBP) outcomes in a large pooled dataset of 1929 participants from 82 facilities in the United States. Methods: Pooled data from three prospective cohort studies were used to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for relationships between psychosocial factors and the LBP outcomes. Personal and occupational confounders were controlled for in adjusted Logistic regression models. Results: Supervisor support and job satisfaction were significantly (P < 0.05) related to all three LBP outcomes. Other psychosocial factors were significantly (P < 0.05) associated with at least one of the LBP outcomes. Adjusted ORs ranged from approximately 1.50 to 3.50 for most associations. Conclusions: There is a significant relationship between work-related psychosocial measures and LBP outcomes.

OBJECTIVESmoking reexposure after a quit attempt (i.e., lapse) increases relapse risk, but lapse recovery is possible. Using a 6-day analogue model of smoking cessation and lapse, this study tested the effect of a single lapse cigarette on the risk of subsequent smoking. Abstinence self-efficacy (ASE) and depressive symptoms (using the Center for Epidemiological Studies Depression Scale, CES-D) were also examined as hypothesized moderators of lapse recovery.METHODAfter receiving cessation counseling and achieving 2 days of incentivized abstinence, 54 daily smokers (mean age: 41 years, 61% African American, 63% male) were randomly assigned to smoke 1 cigarette or to a no-lapse control condition. Participants were then offered monetary incentives to abstain for 3 more days and smoking was monitored.RESULTSCompared to the control condition, participants who experienced a lapse had a 2.5 times greater risk of smoking in the first 24 hours Furthermore, a lapse resulted in much greater risk of subsequent smoking compared to the control condition among individuals with lower postquit ASE scores (p = .044) and greater CES-D scores (p = .040).CONCLUSIONSThese findings provide preliminary evidence that a single lapse cigarette after quitting plays a causal role in subsequent smoking and suggest that individuals with lower postquit ASE and greater depressive symptoms are less likely to recover from a lapse. Future research should investigate factors associated with lapse recovery and failure so that effective lapse-responsive strategies can be developed. Laboratory models provide an efficient and controlled method to examine such processes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Hyperprolactinemia is an endocrine disorder associated with infertility in many species, including elephants. In a recent survey of zoos accredited by the Association of Zoos and Aquariums (AZA), over half of African elephant females (N = 101) were not cycling normally, 30% of which exhibited hyperprolactinemia. We examined whether life experience and temperament predict ovarian cyclicity and circulating prolactin status in individual African elephant females. We hypothesized that, similar to humans, acyclicity and hyperprolactinemia in elephants will be associated with an apprehensive or fearful, anxious temperament, and an increased number of potentially challenging life events (transfers, deaths and births). Ninety-five adult African elephant females housed at 37 AZA institutions were included in this study. Blood samples were collected twice a month for 1 year to determine ovarian cycle (cycling, n = 44; irregular, n = 13; non-cycling, n = 38) and prolactin (normal, n = 44; low; n = 23; high; n = 28) status. Keeper ratings on a 6-point scale were obtained on 32 temperament traits in 85 of these elephants. We determined that giving birth and being exposed to herd mates entering the facility were positively associated with normal ovarian cycle and prolactin profiles. By contrast, age, serum cortisol, and an increased number of herd mates leaving a facility were negatively associated with both. Contrary to our hypothesis, hyperprolactinemia was associated with a popular and caring temperament rating, whereas consistently low prolactin was associated with a fearful, apprehensive temperament. These findings indicate that pituitary-ovarian function may be impacted by life history (cyclicity) and temperament (prolactin), which should be taken into consideration when making management decisions.

Introduction The looming vulnerability model holds that people become anxious when they perceive threats as growing larger and accelerating toward them in space and time. Preliminary research suggested that a guided imagery induction designed to activate a sense that health consequences of smoking are a looming threat led more smokers to attempt to quit. This study tested the effect on quit attempts in a larger sample and examined age, sex, and sensation seeking as moderators. Aims and Methods Adult smokers (≥10 cigarettes/day) screened for risk of anxiety or mood disorders (N = 278, 52% male; 77% African American) were randomly assigned to receive (1) looming vulnerability or (2) neutral guided imagery exercises. At a 4-week follow-up, they reported quit attempts, smoking rate, self-efficacy, outcome expectancies, and contemplation status. Results Those in the looming condition (17%) were no more likely than those in the control condition (20%) to make a quit attempt. There were no significant group differences in expectancies, contemplation, or follow-up smoking rate, and no significant moderators. Conclusions The looming induction was the same one used in earlier work in which it had stronger effects. Those who respond to it with increased urgency about quitting smoking might be offset by others who are more reactant and deny the message. Inconsistencies across studies may reflect differences in inclusion criteria, such that the present sample was on average heavier smokers with longer smoking history and more severe nicotine dependence, yet higher self-efficacy. Implications An induction designed to activate a sense that the health consequences of smoking constitute a looming vulnerability failed to increase quit attempts or reduce smoking rate among adult daily smokers. Inconsistencies across studies might reflect varying sample characteristics resulting from changes in screening criteria.

In a motivational interviewing (MI) framework of decision-making, we consider potential outcomes for both a primary choice and an alternative choice (DiClemente & Velazquez, 2002). Thus, we would expect that motivation to quit smoking is related to expectancies for quitting smoking and expectancies for continuing to smoke. While smoking expectancies have been frequently studied, less attention has been paid to abstinence expectancies. The present study sought to clarify the predictive utility of smoking and abstinence expectancies together for smoking motivation and behavior, versus measuring smoking expectancies alone. Expectancies were measured at baseline; outcomes were measured at baseline and one-month follow-up. Smoking expectancies were assessed via the Smoking Consequences Questionnaire-Adult (Copeland, Brandon, & Quinn, 1995), and abstinence expectancies were assessed via the Perceived Risks and Benefits of Quitting scale (McKee, O’Malley, Salovey, Krishnan-Sarin, & Mazure, 2005). Outcomes included motivation to quit (Contemplation Ladder, Biener & Abrams, 1991; Stage of Change, DiClemente et al., 1991), and average daily smoking rate. Data was analyzed for 183 smokers at baseline and 166 at follow-up. Baseline smoking expectancies and abstinence expectancies were each uniquely associated with concurrent motivation to quit, but not concurrent smoking rate. Abstinence expectancies uniquely predicted changes in smoking rate over time. Smoking and abstinence outcome expectancies may relate differently to smoking behavior, motivation to quit, and changes in these constructs over time.

IntroductionThe Cox proportional hazards model is frequently used to model survival or time-to-event data. In occupational settings it is common to have an occupational exposure as one of the explanatory variables in the model and the association between the outcome and this exposure is of interest. Interpretation of nonlinear exposure-response relationships is useful in epidemiological risk assessment and methods for modelling nonlinearities are needed in those situations when a linear exposure-response is not expected or when one desires to formally assess a nonlinear association.MethodsTruncated power basis expansions and penalised spline methods are demonstrated for estimating nonlinear exposure-response relationships. Interpretation of the nonlinear estimates are given. Methods are illustrated on a simulated data set under a known exposure-response relationship and in a data application examining the association between risk of carpal tunnel syndrome and job physical exposure as measured by the Strain Index in an occupational cohort.DiscussionRegression modelling often focuses on interpreting coefficient estimates. When exposure-response relationships are nonlinear and a nonparametric or smoothing method is used to estimate the relationship, the resulting regression coefficients are not individually interpretable. But, these methods do provide effect size estimates which are interpretable – estimates at specific exposures of interest. The methods can be coded directly in R, using readily available example R code as a guide.

Alcohol exposure in adolescence is a contributing factor toward reward-seeking behavior in adulthood. This reward-seeking behavior is assessed in animal models using the conditioned place preference (CPP) paradigm. In this study, ethanol-induced change in time spent by zebrafish on the initially non-preferred tank side was studied by conditioning adult zebrafish to ethanol dissolved in water (0.00% 1.00%; 1.25%; 1.50%; 1.60%; 1.75% vol/vol) paired with an initially non-preferred environment. Following a single conditioning cycle, fish swam unrestricted in the CPP chamber to assess changes in preference. Daily 20-min pre-exposure to ethanol for 1 week during the juvenile stage starting at either 20days post fertilization (dpf) or 40 dpf altered percent time spent on the ethanol-paired side in adulthood in a dose-dependent and sex-dependent manner. The results suggest that male and female zebrafish are an effective model in which to investigate behavioral correlates of ethanol-induced changes in neural circuits implicated in reward and anxiety.

Truncated power basis expansions and penalized spline methods are demonstrated for estimating nonlinear exposure-response relationships in the Cox proportional hazards model. R code is provided for fitting models to get point and interval estimates. The method is illustrated using a simulated data set under a known exposure-response relationship and in a data application examining risk of carpal tunnel syndrome in an occupational cohort.