Val/Met BDNF as a genetic risk for a false sense of security in post-discharge suicide risk.

BACKGROUND: The time after discharge from psychiatric inpatient care is one of the most dangerous periods in terms of suicide risk. Predicting who is at higher risk could help with resource allocation to assure patients at high risk of suicide attempts are most closely followed. We previously showed that inpatients who improve their suicide ideation levels faster while in inpatient treatment are the ones with highest rates of post-discharge suicide. Here, we studied the possible genetic underpinnings associated with such risk. METHOD: We recorded the slope of suicide ideation recovery of 710 psychiatric inpatients from which we studied two genetic variants likely associated with suicide risk: The serotonin transporter variant 5-HTTLPR, and the BDNF gene variant Val66Met. RESULTS: We found that inpatients carrying the BDNF Met variant (hypothesized as conferring higher suicide risk) improved their suicide ideation scores faster than Val/Val carrying inpatients. No significant association was found for 5-HTTLPR. LIMITATIONS: The present sample was genetically homogenous, and future research should replicate these findings on a more diverse sample. CONCLUSIONS: In conclusion, we found a paradoxical result: Carrying the BDNF Met variant allows inpatients to improve faster, which was shown to confer higher risk at the post-discharge period. This may explain some inconsistencies in the literature in terms of the role of BDNF in suicide ideation and attempts.

Emotional self-regulation, impulsivity, 5-HTTLPR and tobacco use behavior among psychiatric inpatients.

BACKGROUND: While the serotonin transporter (SLC6A4) gene, 5-HTTLPR, interacts with the social environment to influence both emotional self-regulation and smoking behavior, less is known about interactions between emotional self-regulation and 5-HTTLPR or their joint influence on tobacco use. Here, we examined such interactions among psychiatric inpatients, the population with the highest rates of smoking. METHODS: Participants (506 adults) were psychiatric inpatients at The Menninger Clinic in Houston TX between 2012 and 16. Most were white (89%), male (55%), with a mean age of 32.3 years. Participants completed the Difficulties in Emotional Regulation Scale (DERS) at admission. We examined interactions with smoking among three DERS subscales and 5-HTTLPR, controlling for sex, race and age. RESULTS: Smoking rates were higher among those with the 5-HTTPLR L'L' genotype compared to peers carrying an S' allele (47.9% vs. 37.4%, respectively). Among S' allele carrying participants, impulse control difficulties (OR = 1.09; 95%CI: 1.03-1.14) and lack of emotion clarity (OR = 1.06; 95%CI: 1.00-1.11) increased risk for ever using tobacco, while accessing more ways to regulate emotion (OR = 0.95; 95%CI: 0.92-0.99) offered a protective effect against ever using tobacco. Neither demographic nor DERS covariates were associated with using tobacco among the L'L' group. LIMITATIONS: This ethnically homogenous sample limits generalizability and using a binary outcome can over-estimate a gene environment interaction effect. CONCLUSIONS: Emotional self-regulation exerts a stronger influence on using tobacco among carriers of an S' allele of 5-HTTLPR than peers with the L'L' genotype. Promoting emotional self-regulatory skills may have benefits for preventing tobacco use.

Insula and amygdala resting-state functional connectivity differentiate bipolar from unipolar depression.

OBJECTIVE: Distinguishing depressive episodes due to bipolar disorder (BD) or major depressive disorder (MDD) solely on clinical grounds is challenging. We aimed at comparing resting-state functional connectivity (rsFC) of regions subserving emotional regulation in similarly depressed BD and MDD. METHOD: We enrolled 76 in-patients (BD, n = 36; MDD, n = 40) and 40 healthy controls (HC). A seed-based approach was used to identify regions showing different rsFC with the insula and the amygdala. Insular and amygdalar parcellations were then performed along with diagnostic accuracy of the main findings. RESULTS: Lower rsFC between the left insula and the left mid-dorsolateral prefrontal cortex and between bilateral insula and right frontopolar prefrontal cortex (FPPFC) was observed in BD compared to MDD and HC. These results were driven by the dorsal anterior and posterior insula (PI). Lower rsFC between the right amygdala and the left anterior hippocampus was observed in MDD compared to BD and HC. These results were driven by the centromedial and laterobasal amygdala. Left PI/right FPPC rsFC showed 78% accuracy differentiating BD and MDD. CONCLUSION: rsFC of amygdala and insula distinguished between depressed BD and MDD. The observed differences suggest the possibility of differential pathophysiological mechanisms of emotional dysfunction in bipolar and unipolar depression.

Osteometric sex determination from the pelvis--does population specificity matter?

Sex determination from unknown skeletal remains is of vital importance in forensic anthropology, and much research has been conducted in this field. One of the most commonly used methods is to create discriminant function formulae from metric data. It is widely argued in the literature that these formulae are population-specific, as various populations differ with regard to general body size and degree of sexual dimorphism. However, the population of origin may not always be known, and formulae do not exist for all possible population groups. The aim of this study was to assess whether it is really necessary to develop population-specific formulae for pelvic measurements. For this purpose, skeletons from three different populations namely Greeks living on Crete (n=193), South African whites (n=200) and South African blacks (n=199) were used. Seven standard measurements from the innominate bone were employed and discriminant function formulae developed for each population separately, and then for all three populations combined. Classification accuracies indicate that very little is gained by keeping the populations separate. For example, in a stepwise calculation using all measurements the overall classification accuracy was 94.5% for the combined group, and 94.8%, 94.5% and 94.5% for the Greeks, SA whites and SA blacks respectively. In a direct analysis using pubic and ischial length, the overall combined accuracy was 89.8%, versus 89.3%, 90.0% and 89.0% for the three separate groups. When only the acetabular diameter was used, the corresponding figures were 82.5% versus 84.1%, 81.6% and 83.5%. These results indicate that population-specific formulae may not be necessary for pelvic data, but it should be kept in mind that the pelvis is highly dimorphic. More research is needed, also including other bones of the skeleton.

Metric analysis of sex differences in South African black and white pelves.

Sex determination of unknown skeletal material is one of the most vital determinations made by forensic anthropologists. Numerous studies have focussed on the differences, both osteometric and morphological, between the sexes of a particular racial phenotype and population. Previous work by a variety of researchers has underscored the necessity of population specific standards. The purpose of this research is to metrically assess sex differences in the pelvis of South African whites and blacks and develop standards tailored to these groups. Data were collected from 400 known sex/race skeletons from the Pretoria and Dart Collections. Nine measurements (traditional and newly developed) were taken and subjected to SPSS stepwise and direct discriminant analysis. Results indicated that there are significant differences (p < or = 0.001) between the sexes of both races for most measurements. Discriminant function analysis selected ischial length as the most sexually dimorphic dimension in whites (averaged 86% accuracy), while acetabulum diameter was most diagnostic in blacks (averaged 84% accuracy). Six functions were developed from the pelvic dimensions. Highest accuracy was achieved from Function 1 (including all dimensions) which averaged 95.5% correct classification in whites and 94% in blacks. Functions based on selected parts of the pelvis were not as effective and ranged from 73-86% in whites and 72-84% in blacks. This research provided evidence of the significant sex differences that exist between the pelves of South African whites and blacks whilst measurements used here for discriminant function analysis gave classifications with high accuracies. These results can be used to aid in the identification of human skeletal remains in South Africa.

Sexually dimorphic pelvic morphology in South African whites and blacks.

It is well known that there is metric and morphologic variation in the expression of sexual dimorphism between racial phenotypes and populations. Therefore, the purpose of this research is to assess morphologic sex differences in the pelves of South African whites and blacks. Results will be used to improve the identification of human skeletal remains by producing group specific standards. Morphologic features of both left and right os coxae were studied in a sample of 400 known sex/race individuals from the Pretoria and Dart collections. Bones that were clearly pathologic or visibly deformed were excluded from the study. Data were subjected to SPSS analysis. Results indicated that overall, public bone shape was the easiest to assess and was the most consistently reliable morphological indicator of sex in both sexes and population groups. At 88% average accuracy, the most discriminating traits in whites were pubic bone shape and subpubic concavity form. In blacks, greater sciatic notch form allowed the highest separation, averaging 87.5%, followed by pubic shape at 84.5%. Important findings included the fact that there were significant differences in the accuracy of sex determination from pelvic morphology between both males and females and whites and blacks. In conclusion, this study provides quantification of individual morphological traits in the os coxae of white and black South Africans that will be of value in forensic and archaeological analyses, especially when dealing with fragmentary remains. It also demonstrates that population differences affect the expression of sexual dimorphism and must be accounted for to develop the most effective methods of analysis.

Metric assessment of race from the pelvis in South Africans.

It is well known that there are measurable differences between whites and blacks in the size and proportions of skeletal components. There are also metric differences among populations within these racial phenotypes. The population specific quantification of this variation can be used to aid in the identification of racial affinity in the absence of a more racially definitive skeletal element like the skull. Therefore, the purpose of this research is to quantify these differences in the pelvis of South African whites and blacks. A sample of 400, ostensibly healthy known sex/race os coxae was examined. Skeletal material was obtained from the Pretoria and Dart collections. A series of 13 measurements were taken Data were subjected to SPSS stepwise and direct discriminant function analysis. Pubic length was chosen as best for discriminating between races for males and iliac breadth as best in females. Highest average accuracies (Function 1) were 88% for males (pubic length, greater sciatic notch posterior width, acetabulum diameter, total height) and 85% for females (pubic length, greater sciatic notch posterior width, acetabulum diameter, iliac breath). In conclusion, this research resulted in the development of standards of identification tailored to this population and unquestionably demonstrates that race differences in the skeleton are highly significant and must be considered in all skeletal analyses.

Lexical and prosodic cues in the comprehension of relative certainty.

This study examined the development of children's comprehension of the use of intonation and belief verbs to mark the relative certainty with which a speaker makes a statement. Subjects were presented with a task in which they had to guess the location of an object hidden in one of two boxes over a series of trials. As clues to location, the children were presented with contrasting pairs of statements by two puppets. In the first experiment with 30 children at each of three, four, five and six years of age, statements in each pair differed either with respect to the belief term included - know, think or guess - or with respect to terminal pitch contour - rising or falling. Results showed that three-year-olds did not use any information reliably to determine the location of the object, four-year-olds treated falling pitch as a more reliable indicator of location than rising pitch, and older children responded on the basis of the belief terms but not on the basis of prosody. In Experiment 2, 40 children at each of three, four and five years heard statements which differed with respect to both belief verbs and prosody. In one condition falling intonation was paired with the more certain belief term in each pair, and rising intonation with the less certain pair. In a second condition, the pairings were reversed. Results showed that, while four-year-olds could tell the difference between know and think, they could not use intonation information to determine the location. Five-year-olds used both lexical and prosodic information, with prosodic cues modulating the effects of lexical. Taken together, these experiments show that prosodic and lexical cues start to be used by children to interpret relative speaker certainty at about the same time developmentally, but that lexical cues initially appear to dominate while prosodic ones modulate their effects. Finally, it is argued that children's understanding of prosody will be best revealed in contexts in which they are required to respond to the pragmatic function of verbal stimuli rather than to the lexical content.