Mind the Mood: Momentary Depression and Anxiety Moderate the Correspondence Between Subjective and Objective Cognitive Functioning in Fibromyalgia.

OBJECTIVE: Subjective cognitive dysfunction (SCD) affects 55-75% of individuals with fibromyalgia (FM), but those reporting cognitive difficulties often lack corresponding objective deficits. Symptoms of depression and anxiety are prevalent in FM and may account for part of this discrepancy. This study was undertaken to investigate whether momentary (within-day, across 7 days) changes in mood moderate the relationship between within-the-moment SCD and mental processing speed performance. METHODS: A total of 50 individuals with FM (mean age 44.8 years, mean education 15.7 years, 88% female, 86% White) completed momentary assessments of subjective cognitive functioning, depressive and anxious symptoms, and a test of processing speed. Assessments were completed 5 times per day for 8 consecutive days on a study-specific smartphone application. RESULTS: Momentary ratings of SCD were positively associated with mean reaction time (P < 0.001) and variability of processing speed (P = 0.02). Depressive symptoms moderated the relationship between SCD and processing speed, with lower correspondence when depressive symptoms were higher (P = 0.03). A similar moderating effect was demonstrated for both depression (P = 0.02) and anxiety (P = 0.03) on the association between SCD and variability in processing speed performance. CONCLUSION: Individuals with FM may have more accurate self-perception of momentary changes in mental processing speed during periods of less pronounced mood symptoms based on their corresponding objective processing speed performance. However, during moments of heightened depression and anxiety, we found increasingly less correspondence between SCD and objective performance, suggesting that psychological symptoms may play an important role in self-perception of cognitive dysfunction in FM as it relates to mental processing speed.

Existential isolation and the struggle for belief validation.

People exhibit a strong need for belief validation, which they meet by sharing reality with others. Here, we examine the hypothesis that existential isolation - feeling alone in one's experiences - interferes with people's ability to share reality and thus achieve validation for their beliefs. In Studies 1 and 2, participants read a scenario that presented a choice, rated the percent of their peers whom they thought would select each of the two options, and then reported their own choice and their certainty of it. Existential isolation was a significant negative predictor of expected agreement and certainty in both studies. Interpersonal isolation (i.e., loneliness) did not relate to either of these variables. Moreover, mediational analyses from Study 2 show that expected agreement mediated the relationship between existential isolation and certainty in the hypothesized manner: existential isolation predicted high levels of uncertainty because people high in existential isolation tended not to believe that others would make the same choice. In Study 3, existential isolation correlated negatively with expected agreement even after controlling for interpersonal isolation, self-esteem, and depression. The findings attest to the epistemic implications of existential isolation and provide insight for future research.

Association between vestibular function and rotational spatial orientation perception in older adults.

BACKGROUND: Spatial orientation is a complex process involving vestibular sensory input and possibly cognitive ability. Previous research demonstrated that rotational spatial orientation was worse for individuals with profound bilateral vestibular dysfunction. OBJECTIVE: Determine whether rotational and linear vestibular function were independently associated with large amplitude rotational spatial orientation perception in healthy aging. METHODS: Tests of rotational spatial orientation accuracy and vestibular function [vestibulo-ocular reflex (VOR), ocular and cervical vestibular evoked myogenic potentials (VEMP)] were administered to 272 healthy community-dwelling adults participating in the Baltimore Longitudinal Study of Aging. Using a mixed model multiple linear regression we regressed spatial orientation errors on lateral semicircular canal function, utricular function (ocular VEMP), and saccular function (cervical VEMP) in a single model controlling for rotation size, age, and sex. RESULTS: After adjusting for age, and sex, individuals with bilaterally low VOR gain (ß= 20.9, p = 0.014) and those with bilaterally absent utricular function (ß= 9.32, p = 0.017) made significantly larger spatial orientation errors relative to individuals with normal vestibular function. CONCLUSIONS: The current results demonstrate for the first time that either bilateral lateral semicircular canal dysfunction or bilateral utricular dysfunction are associated with worse rotational spatial orientation. We also demonstrated in a healthy aging cohort that increased age also contributes to spatial orientation ability.

Saccular function is associated with both angular and distance errors on the triangle completion test.

OBJECTIVE: The present study was designed to determine whether healthy older adults with age-related vestibular loss have deficits in spatial navigation. METHODS: 154 adults participating in the Baltimore Longitudinal Study of Aging were tested for semicircular canal, saccular, and utricular function and spatial navigation ability using the blindfolded Triangle Completion Test (TCT). Multiple linear regression was used to investigate the relationships between each measure of vestibular function and performance on the TCT (angular error, end point error, and distance walked) while controlling for age and sex. RESULTS: Individuals with abnormal saccular function made larger angular errors (ß = 4.2°, p < 0.05) and larger end point errors (ß = 13.6 cm, p < 0.05). Independent of vestibular function, older age was associated with larger angular (ß's = 2.2-2.8°, p's < 0.005) and end point errors (ß's = 7.5-9.0 cm, p's < 0.005) for each decade increment in age. CONCLUSIONS: Saccular function appears to play a prominent role in accurate spatial navigation during a blindfolded navigation task. SIGNIFICANCE: We hypothesize that gravitational cues detected by the saccule may be integrated into estimation of place as well as heading direction.

Community-dwelling adults with a history of falling report lower perceived postural stability during a foam eyes closed test than non-fallers.

Perceived postural stability has been reported to decrease as sway area increases on firm surfaces. However, changes in perceived stability under increasingly challenging conditions (e.g., removal of sensory inputs) and the relationship with sway area are not well characterized. Moreover, whether perceived stability varies as a function of age or history of falls is unknown. Here we investigate how perceived postural stability is related to sway area and whether this relationship varies as a function of age and fall history while vision and proprioceptive information are manipulated. Sway area was measured in 427 participants from the Baltimore Longitudinal Study of Aging while standing with eyes open and eyes closed on the floor and a foam cushion. Participants rated their stability [0 (completely unstable) to 10 (completely stable)] after each condition, and reported whether they had fallen in the past year. Perceived stability was negatively associated with sway area (cm2) such that individuals who swayed more felt less stable across all conditions (ß = - 0.53, p < 0.001). Perceived stability decreased with increasing age (ß = - 0.019, p < 0.001), independent of sway area. Fallers had a greater decline in perceived stability across conditions (F = 2.76, p = 0.042) compared to non-fallers, independent of sway area. Perceived postural stability declined as sway area increased during a multisensory balance test. A history of falling negatively impacts perceived postural stability when vision and proprioception are simultaneously challenged. Perceived postural stability may provide additional information useful for identifying individuals at risk of falls.

Reduced vestibular function is associated with longer, slower steps in healthy adults during normal speed walking.

BACKGROUND: Vestibular signals contribute to balance and walking. With aging, vestibular function declines and gait speed decreases. Vestibular loss contributes to decreasing gait speed, but this influence could be linked to spatial and/or temporal aspects of gait. We investigated the relationship between vestibular function (semicircular canal and otolith function) and spatial and temporal gait parameters in a cohort of adults. METHODS: 113 community-dwelling healthy adults (mean age 72.2 (14.6) years) participating in the Baltimore Longitudinal Study of Aging were tested. Horizontal semicircular canal (SCC) function was evaluated using quantitative vestibulo-ocular reflex gain. Otolith function was measured with cervical and ocular vestibular evoked myogenic potentials. Gait kinematics were collected during normal speed walking. Multiple linear regressions examined the association between spatial and temporal gait parameters and SCC and otolith function separately, controlling for age, gender, height, and either cadence (for spatial gait outcomes) or stride length (for temporal gait outcomes) to account for gait speed effects. RESULTS: Vestibular SCC function was significantly associated with both spatial and temporal gait parameters. Every 0.1 decrease in SCC function resulted in longer stride length (ß = -.04 m, p = 0.004), longer stance time (ß = 15.8 ms, p < 0.003), and a slower cadence (ß = -2.1 steps/minute, p < 0.001). Otolith function was not associated with any gait parameter. CONCLUSIONS: Reduced horizontal SCC function was associated with longer, slower steps in a cohort of healthy adults. These results indicate that vestibular signals contribute to specific spatial and temporal aspects of gait thought to contribute to upright balance.

More About When I's Meet: The Intergroup Ramifications of I-Sharing, Part II.

Previous research on I-sharing (the belief that one has shared the same, in-the-moment subjective experience with another person) revealed its promise for improving intergroup relations. We expand on this research by (a) pursuing the mechanism underlying I-sharing's effects; (b) asking whether I-sharing promotes positive, behavioral intergroup outcomes; and (c) asking whether the effects of I-sharing generalize to the outgroup at large. Study 1 rules out the possibility that I-sharing promotes liking for an outgroup member via a process of subtyping. Study 2 shows that I-sharing promotes liking for an outgroup member because it promotes a general feeling of subjective connection to the I-sharer. Study 3 provides evidence that I-sharing promotes helping across intergroup lines, and Study 4 shows that I-sharing with one outgroup member reduces infrahumanization of the outgroup more generally. These four studies contribute to our growing understanding of the unique impact that I-sharing has on intergroup outcomes.

Human like me: Evidence that I-sharing humanizes the otherwise dehumanized.

People persistently undermine the humanness of outgroup members, leaving researchers perplexed as to how to address this problem of 'dehumanization' (Haslam & Loughnan, , Ann Rev of Psychol, 65, 399; Leyens, , Group Process Intergroup Relat, 12, 807). Here, we test whether I-sharing (i.e., sharing a subjective experience) counters this tendency by promoting the humanization of outgroup members. In Study 1, White participants had a face-to-face meeting with a White or Black confederate and either did or did not I-share with this confederate. The extent to which participants humanized the outgroup member depended on whether or not they I-shared with her. Study 2 tested the effect of I-sharing on the two distinct dimensions of dehumanization (Haslam, , Pers Soc Psychol Rev, 10, 252). Conceptually replicating the results of Study 1, participants who I-shared with a social class ingroup or outgroup member rated their partner as higher in human nature than those who did not I-share with their partner. These results add to the growing literature on I-sharing's implications for intergroup processes and suggest effective ways of tackling a persistent problem.

When shared group membership signifies shared subjective experience: I-sharing and the minimal group paradigm.

Ingroup favoritism is pervasive. It emerges even in the minimal group paradigm, where participants are assigned to novel groups based on seemingly insignificant characteristics. Yet many of the grouping schemes used in minimal group research may imply something significant: namely, that ingroup members will share in-the-moment subjective experience, or I-share. Two studies examine the role of inferred I-sharing in the minimal group paradigm. We found that (1) people inferred that they would I-share with ingroup members more than outgroup members; (2) inferred I-sharing increased ingroup favoritism; and (3) inferred I-sharing accounted for this ingroup favoritism. Moreover, expecting to I-share with the outgroup improved participants' attitudes toward the outgroup. These results converge with other research suggesting that people favor ingroup members, in part, because they expect to I-share with them.

Association of Alterations in Gray Matter Volume With Reduced Evoked-Pain Connectivity Following Short-Term Administration of Pregabalin in Patients With Fibromyalgia.

OBJECTIVE: Pregabalin (PGB) is an α2 δ calcium-channel subunit ligand that has previously been shown to reduce chronic pain in multiple conditions. Preclinical studies indicate that PGB may down-regulate brain glutamate release while also inhibiting astrocyte induction of glutamatergic synapse formation, and recent clinical findings support the notion that PGB modulates glutamatergic activity and functional brain connectivity in order to produce analgesia. The present study was undertaken to examine concurrent changes in brain gray matter volume (GMV) or evoked-pain connectivity in humans receiving PGB. METHODS: Sixteen female fibromyalgia patients participated in a randomized double-blind 2-period crossover study of PGB versus placebo. Before and after each period, patients underwent high-resolution structural and evoked pressure-pain functional brain imaging. GMV was analyzed using voxel-based morphometry, and functional connectivity during evoked pressure-pain was assessed. RESULTS: PGB administration significantly reduced GMV within the posterior insula bilaterally, whereas there were no significant changes in insular GMV following placebo treatment. GMV reductions in the medial frontal gyrus were also observed when comparing PGB versus placebo treatment, and were associated with reduced clinical pain. These reductions in insular GMV were associated with concomitant reductions in connectivity to the default mode network, which was also associated with reduced clinical pain. CONCLUSION: Short-term PGB treatment altered brain structure and evoked-pain connectivity, and these decreases were associated with reduced clinical pain. We speculate that these fairly rapid changes in GMV may be related to brain neuroplasticity. It is unknown whether these effects are generalizable to other chronic pain states.

In the Blink of an I: On Delayed but Identical Subjective Reactions and Their Effect on Self-Interested Behavior.

People believe that they have shared an identical subjective experience--that they have I-shared--when they react identically and simultaneously to the same stimulus. Despite growing evidence for I-sharing, researchers have yet to ask whether simultaneity really makes a difference. We test the importance of simultaneity for I-sharing effects. Participants played prisoner's dilemma with someone who shared their subjective self, their objective self, or neither. Some participants learned this information immediately; others, after a short delay. Time delay decreased cooperation in the subjective similarity condition, but not in the objective similarity or neither conditions. These findings underscore the importance of simultaneity for I-sharing effects and highlight the implications of I-sharing for cooperation and self-interested behavior.

Increased brain gray matter in the primary somatosensory cortex is associated with increased pain and mood disturbance in patients with interstitial cystitis/painful bladder syndrome.

PURPOSE: Interstitial cystitis is a highly prevalent pain condition estimated to affect 3% to 6% of women in the United States. Emerging data suggest there are central neurobiological components to the etiology of this disease. We report the first brain structural imaging findings from the MAPP network with data on more than 300 participants. MATERIALS AND METHODS: We used voxel based morphometry to determine whether human patients with chronic interstitial cystitis display changes in brain morphology compared to healthy controls. A total of 33 female patients with interstitial cystitis without comorbidities and 33 age and gender matched controls taken from the larger sample underwent structural magnetic resonance imaging at 5 MAPP sites across the United States. RESULTS: Compared to controls, females with interstitial cystitis displayed significant increased gray matter volume in several regions of the brain including the right primary somatosensory cortex, the superior parietal lobule bilaterally and the right supplementary motor area. Gray matter volume in the right primary somatosensory cortex was associated with greater pain, mood (anxiety) and urological symptoms. We explored these correlations in a linear regression model, and found independent effects of these 3 measures on primary somatosensory cortex gray matter volume, namely clinical pain (McGill pain sensory total), a measure of urgency and anxiety (HADS). CONCLUSIONS: These data support the notion that changes in somatosensory gray matter may have an important role in pain sensitivity as well as affective and sensory aspects of interstitial cystitis. Further studies are needed to confirm the generalizability of these findings to other pain conditions.

Altered resting state connectivity of the insular cortex in individuals with fibromyalgia.

UNLABELLED: The insular cortex (IC) and cingulate cortex (CC) are critically involved in pain perception. Previously we demonstrated that fibromyalgia (FM) patients have greater connectivity between the insula and default mode network at rest, and that changes in the degree of this connectivity were associated with changes in the intensity of ongoing clinical pain. In this study we more thoroughly evaluated the degree of resting-state connectivity to multiple regions of the IC in individuals with FM and healthy controls. We also investigated the relationship between connectivity, experimental pain, and current clinical chronic pain. Functional connectivity was assessed using resting-state functional magnetic resonance imaging in 18 FM patients and 18 age- and sex-matched healthy controls using predefined seed regions in the anterior, middle, and posterior IC. FM patients exhibited greater connectivity between 1) right mid IC and right mid/posterior CC and right mid IC, 2) right posterior IC and left CC, and 3) right anterior IC and left superior temporal gyrus. Healthy controls displayed greater connectivity between left anterior IC and bilateral medial frontal gyrus/anterior cingulate cortex; and left posterior IC and right superior frontal gyrus. Within the FM group, greater connectivity between the IC and CC was associated with decreased pressure-pain thresholds. PERSPECTIVE: These data provide further support for altered resting-state connectivity between the IC and other brain regions known to participate in pain perception/modulation, which may play a pathogenic role in conditions such as FM. We speculate that altered IC connectivity is associated with the experience of chronic pain in individuals with FM.

Visual control of trunk translation and orientation during locomotion.

Previous studies have suggested distinct control of gait characteristics in the anterior-posterior (AP) and medial-lateral (ML) directions in response to visual input. Responses were larger to a ML visual stimulus, suggesting that vision plays a larger role in stabilizing gait in the ML direction. Here, we investigated responses of the trunk during locomotion to determine whether a similar direction dependence is observed. We hypothesized that translation of the trunk would show a similar ML dependence on vision, but that angular deviations of the trunk would show equivalent responses in all directions. Subjects stood or walked on a treadmill at 5 km/h while viewing a virtual wall of white triangles that moved in either the AP or ML direction according to a broadband input stimulus. Frequency response functions between the visual scene motion and trunk kinematics revealed that trunk translation gain was larger across all frequencies during walking compared with standing. Trunk orientation responses were not different from standing at very low frequencies; however, at high frequencies, trunk orientation gain was much higher during walking. Larger gains in response to ML visual scene motion were found for all trunk movements. Higher gains in the ML direction while walking suggest that visual feedback may contribute more to the stability of trunk movements in the ML direction. Vision modified trunk movement behavior on both a slow (translation) and fast (orientation) time scale suggesting a priority for minimizing angular deviations of the trunk. Overall, trunk responses to visual input were consistent with the theme that control of locomotion requires higher-level sensory input to maintain stability in the ML direction.

When I's meet: sharing subjective experience with someone from the outgroup.

Believing one shares a subjective experience with another (i.e., I-sharing) fosters connections among strangers and alters perceptions of the ingroup and outgroup. In this article, the authors ask whether I-sharing also fosters liking for members of a salient outgroup. Study 1 establishes that I-sharing promotes liking for the other sex, even among people with salient social identities. Study 2 shows that I-sharing promotes liking for a member of the sexual orientation outgroup, whether it occurs before or after group memberships get revealed. Study 3 focuses on salient race categories and looks at the effects of I-sharing versus value-sharing as a function of shared group membership. For those high in existential isolation, I-sharing trumps value-sharing, regardless of the I-sharer's social identity. I-sharing may offer a way of improving attitudes toward outgroup members that still enables people to embrace their differing social identities.

We're warmer (they're more competent): I-sharing and African Americans' perceptions of the ingroup and outgroup.

Researchers currently know very little about how African Americans regard themselves and their salient outgroup (i.e., European Americans). The current study examines how experiences with individual ingroup and outgroup members affect these evaluations on two key dimensions in intergroup research: warmth and competence. In particular, the study asks what effect I-sharing (i.e., sharing a subjective experience) with an African American or a European American has on African Americans' perceptions of the warmth and competence of their ingroup and outgroup. Results revealed an ingroup preference on the dimension of warmth when participants had I-shared with a fellow African American but not when they had I-shared with a European American. No such ingroup preference emerged on the dimension of competence. Instead, participants exhibited an outgroup preference on this dimension after I-sharing with a European American. The discussion entertains possible explanations for these differential effects of I-sharing on judgments of the ingroup and outgroup.

Symptom reporting in childhood asthma: a comparison of assessment methods.

BACKGROUND: One barrier to receiving adequate asthma care is inaccurate estimations of symptom severity. AIMS: To interview parents of children with asthma in order to: (1) describe the range of reported illness severity using three unstructured methods of assessment; (2) determine which assessment method is least likely to result in a "critical error" that could adversely influence the child's care; and (3) determine whether the likelihood of making a "critical error" varies by sociodemographic characteristics. METHODS: A total of 228 parents of children with asthma participated. Clinical status was evaluated using structured questions reflecting National Asthma Education and Prevention Panel (NAEPP) criteria. Unstructured assessments of severity were determined using a visual analogue scale (VAS), a categorical assessment of severity, and a Likert scale assessment of asthma control. A "critical error" was defined as a parent report of symptoms in the lower 50th centile for each method of assessment for children with moderate-severe persistent symptoms by NAEPP criteria. RESULTS: Children with higher severity according to NAEPP criteria were rated on each unstructured assessment as more symptomatic compared to those with less severe symptoms. However, among the children with moderate-severe persistent symptoms, many parents made a critical error and rated children in the lower 50th centile using the VAS (41%), the categorical assessment (45%), and the control assessment (67%). The likelihood of parents making a critical error did not vary by sociodemographic characteristics. CONCLUSIONS: All of the unstructured assessment methods tested yielded underestimations of severity that could adversely influence treatment decisions. Specific symptom questions are needed for accurate severity assessments.

Seeing I to I: a pathway to interpersonal connectedness.

The authors introduce the construct of I-sharing--the belief that one shares an identical subjective experience with another person--and the role it plays in liking. In Studies 1-3, participants indicated their liking for an objectively similar and an objectively dissimilar person, one of whom I-shared with them and the other of whom did not. Participants preferred the objectively similar person but only when that person I-shared with them. Studies 4 and 5 highlight the role that feelings of existential isolation and the need for closeness play in people's attraction to I-sharers. In Study 4, people with high needs for interpersonal closeness responded to I-sharers and non-I-sharers with great intensity. In Study 5, priming participants with feelings of existential isolation increased their liking for I-sharers over objectively similar others. The results highlight the importance of shared subjective experience and have implications for interpersonal and intergroup processes.

Emergency percutaneous tracheostomy in trauma patients: an early experience.

BACKGROUND: In recent years, percutaneous tracheostomy (PCT) has become a routine practice in many hospitals. In the early publications, most authors considered adverse conditions such as short or fat neck or obesity as relative contraindications, whereas cervical injury and emergency were regarded as absolute contraindications. More recently, several reports demonstrated the safety and feasibility of PCT in patients with some of the above contraindications. We, like many others, gradually reduced the contraindications and expanded the indications for PCT. In this paper, we report our early experience with emergency PCT in trauma patients. METHODS: Ten adult patients suffering from multiple injuries after motor vehicle accident (7) or severe head and neck burns (3) required emergency surgical airway control after failure to accomplish orotracheal intubation. A modified Griggs' technique was used by experienced thoracic surgeons. Recorded data included patient demographics, clinical and anatomic conditions, length of procedure, and complications. Short-term follow-up was performed in the hospital by thoracic staff surgeons. Long-term follow-up was carried out in the outpatient clinic. RESULTS: Six male and 4 female patients underwent emergency PCT. The mean time from skin incision to intubation was 5.5 minutes including the oxygen insufflation period. There was no failure, no procedure-related complication, and no conversion to open technique. Five patients survived and underwent uneventful decannulation. In approximately 1 year of follow-up, there were no clinical symptoms or signs of complications related to the tracheostomy. CONCLUSIONS: Emergency PCT using a modified Griggs' technique is feasible and safe. In experienced hands, it might be even easier and faster than the open surgical tracheostomy.

A whole-genome assembly of Drosophila.

We report on the quality of a whole-genome assembly of Drosophila melanogaster and the nature of the computer algorithms that accomplished it. Three independent external data sources essentially agree with and support the assembly's sequence and ordering of contigs across the euchromatic portion of the genome. In addition, there are isolated contigs that we believe represent nonrepetitive pockets within the heterochromatin of the centromeres. Comparison with a previously sequenced 2.9- megabase region indicates that sequencing accuracy within nonrepetitive segments is greater than 99. 99% without manual curation. As such, this initial reconstruction of the Drosophila sequence should be of substantial value to the scientific community.