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Ecological momentary assessment (EMA) is increasingly used to study suicidal thoughts and behaviors (STBs). There is a potential ethical obligation for researchers to intervene when receiving information about suicidal thoughts in real time. A possible concern, however, is that intervening when receiving responses that indicate high risk for suicide during EMA research may impact how participants respond to questions about suicidal thoughts and thus affect the validity and integrity of collected data. We leveraged data from a study of adults and adolescents (N = 434) recruited during a hospital visit for STBs to examine whether monitoring and intervening on high-risk responses affects subsequent participant responding. Overall, we found mixed support for the notion that intervening on high-risk responses influences participants' ratings. Although we observed some evidence of discontinuity in subsequent responses at the threshold used to trigger response-contingent interventions, it was not clear that such discontinuity was caused by the interventions; lower subsequent responses could be due to effective intervention, participant desire to not be contacted again, or regression to the mean. Importantly, the likelihood of completing surveys did not change from before to after response-contingent intervention. Adolescents were significantly more likely than adults, however, to change their initial suicidal intent ratings from above to below the high-risk threshold after viewing automated response-contingent pop-up messages. Studies explicitly designed to assess the potential impact of intervening on high-risk responses in real-time monitoring research are needed, as this will inform effective, scalable strategies for intervening during moments of high suicide risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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BACKGROUND: Race-based anxiety is a critical health issue within the Black community. Mindfulness interventions hold promise for treating race-based anxiety in Black Americans; however, there are many barriers that prevent Black Americans from using these treatments, such as low cultural relevance, significant time burdens, and excessive costs. OBJECTIVE: This study is a replication and extension of findings that "healing attempt"-a brief (<60-minute), digital, music-based mindfulness intervention-is a feasible and acceptable intervention for race-based anxiety in Black Americans. In this study, we tested this research question among those with little-to-no meditation experience. METHODS: The participants were 4 Black American adults with elevated race-based trait anxiety and little-to-no meditation experience. We used a series of multiple-baseline single-case experiments and conducted study visits on Zoom (Zoom Video Communications) to assess whether the intervention can decrease state anxiety and increase mindfulness and self-compassion in Black Americans. We also assessed feasibility and acceptability using quantitative and qualitative scales. RESULTS: In line with our hypotheses, "healing attempt" increased mindfulness/self-compassion (Tau-U range: 0.57-0.86; P<.001) and decreased state anxiety (Tau-U range: -0.93 to -0.66; P<.001), with high feasibility and acceptability (the average likelihood of recommending "healing attempt" was 88 out of 100). CONCLUSIONS: "healing attempt" may represent a feasible intervention for race-based anxiety in Black Americans with elevated race-based anxiety and little or no mindfulness experience. Future between-subjects randomized feasibility trials can assess whether the intervention can give rise to lasting improvements in race-based anxiety, mindfulness, and self-compassion. TRIAL REGISTRATION: OSF Registries osf.io/k5m93; https://osf.io/k5m93.

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This study replicates and extends findings that "healing attempt"-a brief digital music-based mindfulness intervention-represents a feasible and potentially effective intervention for race-based anxiety in the Black community.

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This study examined descriptions of suicidal thoughts and behavior (STB) to identify risk and protective factors that may present in clinical settings among university students from Latin America. Our focus was on answering the following key questions: How are suicidal thoughts and behavior described? What are reasons for wanting to die and for living? What impact do STBs have on motivations to seek or avoid psychological treatment? To this end, 55 qualitative interviews were completed with university students from Colombia and Mexico who recently endorsed emotional difficulties in the World Mental Health International College Student (WMH-ICS) surveys. Interviews were coded to identify themes specific to STBs. Findings revealed insight on symptom presentations and consequences of STBs. Participants described uncontrollable somatic symptoms during periods of high suicide risk, which serves as a relevant clinical marker for health providers. An important reason for living was to avoid suffering for family, which was protective against suicide and motivates familial involvement in treatment planning. Participants sought solutions to emotional problems after experiencing STBs, including psychological treatment. Cultural stigma of mental illness induced feelings of shame and burden, which led to avolition, avoidance, and nondisclosure of symptom severity. This study provides insight into the utility of evaluating cultural context in (a) detecting antecedents to STBs frequently reported as somatic symptoms, (b) identifying protective factors against suicide, and (c) recognizing how stigma of mental illness and suicide, shame avoidance, and familism might influence personal motivations to seek or avoid help for emotional distress.

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Introduction: Psilocybin use has been linked to lowered odds of crime-related outcomes across a host of observational studies. No studies have investigated how these associations may differ among those of different races and ethnicities. Methods: Using a nationally-representative sample of 734,061 adults from the National Survey on Drug Use and Health (2002-2020), we investigated whether race and ethnicity moderate the associations between lifetime psilocybin use and four measures of crime arrests (property crime, assault, serious violence, and miscellaneous crimes). Results: First, we replicated prior findings and demonstrated that psilocybin confers lowered odds of crime arrests for all four outcomes in question. Second, we demonstrated that race and ethnicity moderate the associations between lifetime psilocybin use and crime arrests for three of our four outcomes. Third, we examined the associations between psilocybin and crime arrests across different races and ethnicities (White, Black, Indigenous, Asian, Multiracial, and Hispanic participants). Psilocybin conferred lowered odds of at least one crime arrest outcome for all racial and ethnic groups except for Black and Hispanic participants. Discussion: Future investigations should take an intersectional approach to studying the interrelationship of sociodemographic factors, psychedelic use, and crime, examine the structural factors (i.e., systemic racism) that may underlie these results, and investigate whether psychedelics can alleviate mental health disorders that contribute to cycles of recriminalization for communities of color.

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Genetic variation in mitochondrial and nuclear genomes can perturb mitonuclear interactions and lead to phenotypic differences between individuals and populations. Despite their importance to most complex traits, it has been difficult to identify the interacting mitonuclear loci. Here, we present a novel advanced intercrossed population of Saccharomyces cerevisiae yeasts, called the Mitonuclear Recombinant Collection (MNRC), designed explicitly for detecting mitonuclear loci contributing to complex traits. For validation, we focused on mapping genes that contribute to the spontaneous loss of mitochondrial DNA (mtDNA) that leads to the petite phenotype in yeast. We found that rates of petite formation in natural populations are variable and influenced by genetic variation in nuclear DNA, mtDNA and mitonuclear interactions. We mapped nuclear and mitonuclear alleles contributing to mtDNA stability using the MNRC by integrating a term for mitonuclear epistasis into a genome-wide association model. We found that the associated mitonuclear loci play roles in mitotic growth most likely responding to retrograde signals from mitochondria, while the associated nuclear loci with main effects are involved in genome replication. We observed a positive correlation between growth rates and petite frequencies, suggesting a fitness tradeoff between mitotic growth and mtDNA stability. We also found that mtDNA stability was correlated with a mobile mitochondrial GC-cluster that is present in certain populations of yeast and that selection for nuclear alleles that stabilize mtDNA may be rapidly occurring. The MNRC provides a powerful tool for identifying mitonuclear interacting loci that will help us to better understand genotype-phenotype relationships and coevolutionary trajectories.

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Esta investigación analizó las actitudes hacia la muerte expresadas por un grupo de adultos jóvenes en contexto COVID-19. Los participantes fueron 10 jóvenes residentes en la región de Tarapacá (60% mujeres, 40% hombres) entre 18 a 29 años. La metodología tuvo un enfoque mixto de preponderancia cualitativa y diseño secuencial. En la primera etapa, se administró el Perfil Revisado de Actitudes hacia la muerte [PAM-R] para medir cinco actitudes: Miedo a la muerte; Evitación de la muerte; Aceptación de acercamiento; Aceptación de escape; y Aceptación neutral. Posteriormente, se aplicaron entrevistas semiestructuradas que profundizaron los resultados, mediante la exploración de las percepciones, emociones y pensamientos de los participantes durante la pandemia. Finalmente, se triangularon los datos cuantitativos y cualitativos para obtener una mayor validez. Los resultados señalan a estas actitudes como un fenómeno contextual, cuya expresión depende de diversos elementos personales y del entorno, siendo los más importantes los miedos asociados a familiares. En jóvenes, la muerte fue comprendida como una realidad lejana. Esto influyó en una alta neutralidad y bajo miedo a la muerte propia. El contexto COVID-19 actuó como un factor influyente en las actitudes, particularmente en el miedo al contagio o a la posibilidad de morir. Si bien los jóvenes reconocieron la peligrosidad del virus, sus necesidades emocionales-afectivas se vislumbraron como problemas más urgentes. Por lo tanto, los miedos en contexto COVID-19 no evitaron la exposición al contagio en compañía de amigos. Estas conductas fueron significadas como medidas de autocuidado psicológico, particularmente en jóvenes con Aceptación de Escape.

This research analyzed the attitudes towards death expressed by a group of young adults in a COVID-19 context. The participants were 10 young residents in the Tarapacá region (60% women, 40% men) between 18 and 29 years old. The methodology had a mixed approach of qualitative preponderance and sequential design. First, the Death Attitude Profile-Revised [DAP-R] was administered to measure five attitudes: Fear of Death, Death Avoidance, Approach Acceptance, Escape Acceptance, and Neutral Acceptance. Subsequently, semi-structured interviews were applied that deepened the results, by exploring the perceptions, emotions and thoughts of the participants during the pandemic. Finally, the quantitative and qualitative data were triangulated to obtain greater validity. The results point to these attitudes as a contextual phenomenon, the expression of which depends on various personal and environmental elements, the most important being the fears associated with family members. In young people, death was understood as a distant reality. This influenced a high neutrality and low fear of own death. The COVID-19 context acted as an influencing factor in attitudes, particularly in fear of contagion or the possibility of dying. Although the young people recognized the dangerousness of the virus, their emotional-affective needs were seen as more urgent problems. Therefore, fears in the COVID-19 context did not prevent exposure to contagion in the company of friends. These behaviors were signified as measures of psychological self-care, particularly in young people with Escape Acceptance.

Este estudo teve como objetivo analisar as atitudes de um grupo de jovens adultos em relação a morte no contexto de COVID-19. Nela participaram 10 jovens que vivem na região de Tarapacá (60% mulheres, 40% homens) os quais tinham entre 18 e 29 anos. A metodologia da pesquisa teve uma abordagem mista de preponderância qualitativa e desenho de investigação sequencial. Na primeira etapa, foi administrado o Perfil Revisado de Atitudes em Relação a Morte [PAM-R] para medir cinco atitudes: Medo da morte; Evitar a morte; Aceitação de abordagem; Aceitação de fuga; e aceitação neutra. Posteriormente, foram aplicadas entrevistas semi-estruturadas que aprofundaram os resultados, explorando as percepções, emoções e pensamentos dos participantes durante a pandemia. Por fim, os dados quantitativos e qualitativos foram triangulados para obter maior validade. Os resultados apontam essas atitudes como um fenômeno contextual, cuja expressão depende de diversos elementos pessoais e do meio ambiente, sendo o mais importante deles, os medos associados aos parentes. Nos jovens, a morte era entendida como uma realidade distante. Isso influenciou uma alta neutralidade e pouco medo da propia morte. O contexto de COVID-19 atuou como um fator influente nas atitudes, particularmente no medo de contágio ou na possibilidade de morrer. Enquanto os jovens reconheciam o perigo do vírus, suas necessidades emotivas e afetivas eram vistas como problemas mais urgentes. Portanto, os temores no contexto de COVID-19 não impediram a exposição ao contágio na companhia de amigos. Esses comportamentos foram considerados como medidas de autocuidado psicológico, particularmente em jovens com Aceitação da Fuga da morte.

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Resumen Esta investigación analizó las actitudes hacia la muerte expresadas por un grupo de adultos jóvenes en contexto COVID-19. Los participantes fueron 10 jóvenes residentes en la región de Tarapacá (60% mujeres, 40% hombres) entre 18 a 29 años. La metodología tuvo un enfoque mixto de preponderancia cualitativa y diseño secuencial. En la primera etapa, se administró el Perfil Revisado de Actitudes hacia la muerte [PAM-R] para medir cinco actitudes: Miedo a la muerte; Evitación de la muerte; Aceptación de acercamiento; Aceptación de escape; y Aceptación neutral. Posteriormente, se aplicaron entrevistas semiestructuradas que profundizaron los resultados, mediante la exploración de las percepciones, emociones y pensamientos de los participantes durante la pandemia. Finalmente, se triangularon los datos cuantitativos y cualitativos para obtener una mayor validez. Los resultados señalan a estas actitudes como un fenómeno contextual, cuya expresión depende de diversos elementos personales y del entorno, siendo los más importantes los miedos asociados a familiares. En jóvenes, la muerte fue comprendida como una realidad lejana. Esto influyó en una alta neutralidad y bajo miedo a la muerte propia. El contexto COVID-19 actuó como un factor influyente en las actitudes, particularmente en el miedo al contagio o a la posibilidad de morir. Si bien los jóvenes reconocieron la peligrosidad del virus, sus necesidades emocionales-afectivas se vislumbraron como problemas más urgentes. Por lo tanto, los miedos en contexto COVID-19 no evitaron la exposición al contagio en compañía de amigos. Estas conductas fueron significadas como medidas de autocuidado psicológico, particularmente en jóvenes con Aceptación de Escape.

Abstract This research analyzed the attitudes towards death expressed by a group of young adults in a COVID-19 context. The participants were 10 young residents in the Tarapacá region (60% women, 40% men) between 18 and 29 years old. The methodology had a mixed approach of qualitative preponderance and sequential design. First, the Death Attitude Profile-Revised [DAP-R] was administered to measure five attitudes: Fear of Death, Death Avoidance, Approach Acceptance, Escape Acceptance, and Neutral Acceptance. Subsequently, semi-structured interviews were applied that deepened the results, by exploring the perceptions, emotions and thoughts of the participants during the pandemic. Finally, the quantitative and qualitative data were triangulated to obtain greater validity. The results point to these attitudes as a contextual phenomenon, the expression of which depends on various personal and environmental elements, the most important being the fears associated with family members. In young people, death was understood as a distant reality. This influenced a high neutrality and low fear of own death. The COVID-19 context acted as an influencing factor in attitudes, particularly in fear of contagion or the possibility of dying. Although the young people recognized the dangerousness of the virus, their emotional-affective needs were seen as more urgent problems. Therefore, fears in the COVID-19 context did not prevent exposure to contagion in the company of friends. These behaviors were signified as measures of psychological self-care, particularly in young people with Escape Acceptance.

Resumo Este estudo teve como objetivo analisar as atitudes de um grupo de jovens adultos em relação a morte no contexto de COVID-19. Nela participaram 10 jovens que vivem na região de Tarapacá (60% mulheres, 40% homens) os quais tinham entre 18 e 29 anos. A metodologia da pesquisa teve uma abordagem mista de preponderância qualitativa e desenho de investigação sequencial. Na primeira etapa, foi administrado o Perfil Revisado de Atitudes em Relação a Morte [PAM-R] para medir cinco atitudes: Medo da morte; Evitar a morte; Aceitação de abordagem; Aceitação de fuga; e aceitação neutra. Posteriormente, foram aplicadas entrevistas semi-estruturadas que aprofundaram os resultados, explorando as percepções, emoções e pensamentos dos participantes durante a pandemia. Por fim, os dados quantitativos e qualitativos foram triangulados para obter maior validade. Os resultados apontam essas atitudes como um fenômeno contextual, cuja expressão depende de diversos elementos pessoais e do meio ambiente, sendo o mais importante deles, os medos associados aos parentes. Nos jovens, a morte era entendida como uma realidade distante. Isso influenciou uma alta neutralidade e pouco medo da propia morte. O contexto de COVID-19 atuou como um fator influente nas atitudes, particularmente no medo de contágio ou na possibilidade de morrer. Enquanto os jovens reconheciam o perigo do vírus, suas necessidades emotivas e afetivas eram vistas como problemas mais urgentes. Portanto, os temores no contexto de COVID-19 não impediram a exposição ao contágio na companhia de amigos. Esses comportamentos foram considerados como medidas de autocuidado psicológico, particularmente em jovens com Aceitação da Fuga da morte.

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Importance: Half of the people who die by suicide make a health care visit within 1 month of their death. However, clinicians lack the tools to identify these patients. Objective: To predict suicide attempts within 1 and 6 months of presentation at an emergency department (ED) for psychiatric problems. Design, Setting, and Participants: This prognostic study assessed the 1-month and 6-month risk of suicide attempts among 1818 patients presenting to an ED between February 4, 2015, and March 13, 2017, with psychiatric problems. Data analysis was performed from May 1, 2020, to November 19, 2021. Main Outcomes and Measures: Suicide attempts 1 and 6 months after presentation to the ED were defined by combining data from electronic health records (EHRs) with patient 1-month (n = 1102) and 6-month (n = 1220) follow-up surveys. Ensemble machine learning was used to develop predictive models and a risk score for suicide. Results: A total of 1818 patients participated in this study (1016 men [55.9%]; median age, 33 years [IQR, 24-46 years]; 266 Hispanic patients [14.6%]; 1221 non-Hispanic White patients [67.2%], 142 non-Hispanic Black patients [7.8%], 64 non-Hispanic Asian patients [3.5%], and 125 non-Hispanic patients of other race and ethnicity [6.9%]). A total of 137 of 1102 patients (12.9%; weighted prevalence) attempted suicide within 1 month, and a total of 268 of 1220 patients (22.0%; weighted prevalence) attempted suicide within 6 months. Clinicians' assessment alone was little better than chance at predicting suicide attempts, with externally validated area under the receiver operating characteristic curve (AUC) of 0.67 for the 1-month model and 0.60 for the 6-month model. Prediction accuracy was slightly higher for models based on EHR data (1-month model: AUC, 0.71; 6 month model: AUC, 0.65) and was best using patient self-reports (1-month model: AUC, 0.76; 6-month model: AUC, 0.77), especially when patient self-reports were combined with EHR and/or clinician data (1-month model: AUC, 0.77; and 6 month model: AUC, 0.79). A model that used only 20 patient self-report questions and an EHR-based risk score performed similarly well (1-month model: AUC, 0.77; 6 month model: AUC, 0.78). In the best 1-month model, 30.7% (positive predicted value) of the patients classified as having highest risk (top 25% of the sample) made a suicide attempt within 1 month of their ED visit, accounting for 64.8% (sensitivity) of all 1-month attempts. In the best 6-month model, 46.0% (positive predicted value) of the patients classified at highest risk made a suicide attempt within 6 months of their ED visit, accounting for 50.2% (sensitivity) of all 6-month attempts. Conclusions and Relevance: This prognostic study suggests that the ability to identify patients at high risk of suicide attempt after an ED visit for psychiatric problems improved using a combination of patient self-reports and EHR data.

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BACKGROUND: The Eliminate Hepatitis C San Diego County Initiative was established to provide a roadmap to reduce new HCV infections by 80% and HCV-related deaths by 65% by 2030. An estimate of the burden of HCV infections in San Diego County is necessary to inform planning and evaluation efforts. Our analysis was designed to estimate the HCV burden in San Diego County in 2018. METHODS: We synthesized data from the American Community Survey, Centers for Disease Control and Prevention, California Department of Public Health, Public Health Branch of California Correctional Health Care Services, San Diego Blood Bank, and published literature. Burden estimates were stratified by subgroup (people who inject drugs in the community [PWID], men who have sex with men in the community [MSM], general population in the community [stratified by age and sex], and incarcerated individuals). To account for parameter uncertainty, 100,000 parameter sets were sampled from each parameter's uncertainty distribution, and used to calculate the mean and 95% confidence interval estimates of the number of HCV seropositive adults in San Diego in 2018. FINDINGS: We found there were 55,354 (95% CI: 25,411-93,329) adults with a history of HCV infection in San Diego County in 2018, corresponding to an HCV seroprevalence of 2.1% (95% CI: 1.1-3.4%). Over 40% of HCV infections were among the general population aged 55-74 and one-third were among PWID. CONCLUSION: Our study found that the largest share of infections was among adults aged 55-74, indicating the importance of surveillance, prevention, testing, and linkages to care in this group to reduce mortality. Further, programs prioritizing PWID for increased HCV testing and linkage to care are important for reducing new HCV infections.

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RATIONALE: Pavlovian conditioned responses to cues that signal threat are rapidly acquired and tend to persist over time. However, recent research suggests that the ability to actively avoid or exert control over an anticipated threat can diminish the subsequent expression of Pavlovian responses. Studies in animal models suggest that active avoidance behavior and its consequences may be mediated by dopaminergic function. In the present study, we sought to replicate the finding that active control over threat can attenuate subsequent Pavlovian responding in humans and conducted exploratory analyses testing whether individual differences in blink rate, a putative index of dopaminergic function, might modulate this effect. METHODS: Participants underwent Pavlovian aversive conditioning, followed immediately by one of two conditions. In the active avoidance condition, participants had the opportunity to actively prevent the occurrence of an anticipated shock, whereas in a yoked extinction condition, participants passively observed the cessation of shocks, but with no ability to influence their occurrence. The following day, the conditioned stimuli were presented without shock, but both groups of participants had no opportunity to employ active instrumental responses. Blink rate was measured throughout the task, and skin conductance responses served as our index of Pavlovian conditioned responding. RESULTS: Consistent with our previous findings, we observed that the group that could actively avoid the shock on day 1 exhibited attenuated recovery of Pavlovian conditioned responses. Further, we found that individuals in the active avoidance group with higher blink rates exhibited a more robust attenuation of spontaneous recovery. CONCLUSION: This finding suggests that individual variation in dopaminergic function may modulate the efficacy with which active avoidance strategies can attenuate reactive Pavlovian responses.

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Freezing is a species-typical defensive reaction to conditioned threats. While the neural circuitry of aversive Pavlovian behavior has been extensively studied, less is known about the circuitry underlying more active responses to danger. Here we show that the flow of information between the basal amygdala (BA) and the nucleus accumbens (NAcc) is necessary for signaled active avoidance behavior. Rats trained to avoid shock by shuttling during an auditory conditioned stimulus showed increased expression of the activity-dependent protein c-Fos in the NAcc, specifically the shell subregion (NAccSh). Silencing neural activity in the NAccSh, but not in the adjacent NAcc core, disrupted avoidance behavior. Disconnection of the BA and the NAccSh was just as effective at disrupting avoidance behavior as bilateral NAccSh inactivations, suggesting learned avoidance behavior requires an intact BA-NAccSh circuit. Together, these data highlight an essential role for the amygdalar projection to the ventral striatum in aversively motivated actions.

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Traumatic events are proposed to play a role in the development of anxiety disorders, however not all individuals exposed to extreme stress experience a pathological increase in fear. Recent studies in animal models suggest that the degree to which one is able to control an aversive experience is a critical factor determining its behavioral consequences. In this study, we examined whether stressor controllability modulates subsequent conditioned fear expression in humans. Participants were randomly assigned to an escapable stressor condition, a yoked inescapable stressor condition, or a control condition involving no stress exposure. One week later, all participants underwent fear conditioning, fear extinction, and a test of extinction retrieval the following day. Participants exposed to inescapable stress showed impaired fear extinction learning and increased fear expression the following day. In contrast, escapable stress improved fear extinction and prevented the spontaneous recovery of fear. Consistent with the bidirectional controllability effects previously reported in animal models, these results suggest that one's degree of control over aversive experiences may be an important factor influencing the development of psychological resilience or vulnerability in humans.

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The hippocampus and cortex of the mammalian brain are regions involved in learning and long-term memory. Estrogen and lithium affect similar learning and memory molecular processes. We hypothesized that in ovariectomized mice lithium treatment will enhance genetic factors in the brain that are involved in neuroprotection, learning and memory. Our study used bilaterally ovariectomized (bOVX) C57BL÷6J mice treated for one month with 14.2 mM LiCl in their drinking water. Results indicate that LiCl-treated bOVX mice show enhanced cortical increases in mRNA expression of ER-alpha, NR1, Bcl-2, BDNF, and CaMkII-alpha; hippocampal mRNA showed no changes. Our results indicate that in bOVX C57BL÷6J mice, lithium enhances the expression of specific cortical genes coded for proteins involved in learning, memory and neuroprotection.

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