Faculty Bibliography

Prenatal exposures to alcohol (PAE) and tobacco (PTE) are known to produce adverse neonatal and childhood outcomes including damage to the developing auditory system. Knowledge of the timing, extent, and combinations of these exposures on effects on the developing system is limited. As part of the physiological measurements from the Safe Passage Study, Auditory Brainstem Responses (ABRs) and Transient Otoacoustic Emissions (TEOAEs) were acquired on infants at birth and one-month of age. Research sites were in South Africa and the Northern Plains of the U.S. Prenatal information on alcohol and tobacco exposure was gathered prospectively on mother/infant dyads. Cluster analysis was used to characterize three levels of PAE and three levels of PTE. Repeated-measures ANOVAs were conducted for newborn and one-month-old infants for ABR peak latencies and amplitudes and TEOAE levels and signal-to-noise ratios. Analyses controlled for hours of life at test, gestational age at birth, sex, site, and other exposure. Significant main effects of PTE included reduced newborn ABR latencies from both ears. PTE also resulted in a significant reduction of ABR peak amplitudes elicited in infants at 1-month of age. PAE led to a reduction of TEOAE amplitude for 1-month-old infants but only in the left ear. Results indicate that PAE and PTE lead to early disruption of peripheral, brainstem, and cortical development and neuronal pathways of the auditory system, including the olivocochlear pathway.

Spreading depolarization (SD) is a sudden, large, and synchronous depolarization of principal cells which also involves interneurons and astrocytes. It is followed by depression of neuronal activity, and it slowly propagates across brain regions like cortex or hippocampus. SD is considered to be mechanistically relevant to migraine, epilepsy, and traumatic brain injury (TBI), but there are many questions about its basic neurophysiology and spread. Research into SD in hippocampus using slices is often used to gain insight and SD is usually triggered by a focal stimulus with or without an altered extracellular buffer. Here, we optimize an in vitro experimental model allowing us to record SD without focal stimulation, which we call spontaneous. This method uses only an altered extracellular buffer containing 0 mM Mg²⁺ and 5 mM K⁺ and makes it possible for simultaneous patch and extracellular recording in a submerged chamber plus intrinsic optical imaging in slices of either sex. We also add methods for quantification and show the quantified optical signal is much more complex than imaging alone would suggest. In brief, acute hippocampal slices were prepared with a chamber holding a submerged slice but with flow of artificial cerebrospinal fluid (aCSF) above and below, which we call interface-like. As soon as slices were placed in the chamber, aCSF with 0 Mg²⁺/5 K⁺ was used. Most mouse slices developed SD and did so in the first hour of 0 Mg²⁺/5 K⁺ aCSF exposure. In addition, prolonged bursts we call seizure-like events (SLEs) occurred, and the interactions between SD and SLEs suggest potentially important relationships. Differences between rats and mice in different chambers are described. Regarding optical imaging, SD originated in CA3 and the pattern of spread to CA1 and the dentate gyrus was similar in some ways to prior studies but also showed interesting differences. In summary, the methods are easy to use, provide new opportunities to study SD, new insights, and are inexpensive. They support previous suggestions that SD is diverse, and also suggest that participation by the dentate gyrus merits greater attention.

Automatic emotion regulation (AER) plays a vital role in the neuropathology underlying both suicide and self-harm via modifying emotional impact effortlessly. However, both the effortless account and the neural mechanisms of AER are undetermined. To investigate the neural changes at AER, we collected functional MRI (fMRI) in 31 participants who attended to neutral and disgust pictures in three conditions: watching, goal intention (GI), and reappraisal by implementation intention (RII). Results showed that RII (but not GI) decreased negative feelings and bilateral amygdala activity without increasing cognitive efforts, evidenced by the reduced effort rating and less prefrontal engagement during RII compared with during watching and GI. These emotion-regulatory effects of RII cannot be explained by emotional habituation, as the supplementary experiment (N = 31) showed no emotional habituation effects when the same disgust pictures were presented repeatedly three times for each watching and GI condition. Task-based network analysis showed both RII and GI relative to watching increased functional connectivities (FCs) of the ventral anterior cingulate cortex to the left insula and right precuneus during conditions, two FCs subserving goal setup. However, RII relative to GI exhibited weaker FCs in brain networks subserving effortful control, memory retrieval, aversive anticipation, and motor planning. In these FCs, the FC intensity of putamen-operculum/lingual and paracentral-superior temporal gyri positively predicted regulatory difficulty ratings. These findings suggest that the setup of implementation intention automatizes emotion regulation by reducing the online mobilization of emotion-coping neural systems.

This article discusses empirical research findings that demonstrate psychobiological dysregulation among violently traumatized mothers of very young children and then describes what effects this dysregulation can have on the mother-infant relationship. Out of this research, the first author developed CAVES originally as an experimental evaluation technique and test-intervention. The theoretical premise, evidence-base, and signature features of the CAVES are described along with a case example showing how it quickly became the foundation for a new brief psychotherapeutic model for traumatized parents and their very young children ages 0 to 4, CAVEAT. The essentials of CAVEAT as a 16-session manualized treatment model are also presented with a case example as illustration. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Abstract (German) Dieser Artikel diskutiert empirische Forschungsergebnisse, die bei gewalt- sam traumatisierten Muttern von Kleinkindern eine psychobiologische Dysregulation nachweisen, und beschreibt deren Auswirkungen auf die Mutter-Kind-Beziehung. Aus dieser Forschung entwickelte der Erstautor die CAVES als experimentelle Evaluationstechnik und Test-Intervention. Die theoretischen Grundlagen, die Evidenzbasis und Hauptmerkmale der CAVES werden zusammen mit einem Fallbeispiel beschrieben, das zeigt, wie CAVES zu einem neuen Modell fur eine kurze Psychotherapie fur traumatisierte Eltern und ihre Kinder im Alter von 0 bis 4 wurde (CAVEAT). Das Behandlungsmodell der CAVEAT mit 16 Sitzungen, das auch als Manual besteht, wird anhand eines Fallbeispiels veranschaulicht (PsycInfo Database Record (c) 2022 APA, all rights reserved)

As more young people feel safe to outwardly identify as transgender or gender expansive (TGE), meaning that their gender identity does not align with the sex they were assigned at birth, an increasing number of youth who identify as TGE seek gender-affirming medical care (GAMC). GAMC raises a number of ethical questions, such as the capacity of a minor to assent or consent, the role of parents or legal guardians in decisions about treatment, and implications for equitable access to care when differing parental or custodial viewpoints are present. These questions are further complicated by the difficulties in explaining the limits of long-term research in GAMC, with regard to the preservation of fertility, for example. We present two de-identified composite case studies to highlight dilemmas that may arise and offer recommendations to better support patient- and family-centered decision making for GAMC. These include employing a multidisciplinary shared decision-making approach, disentangling informed consent and assent from chronological age, developing a consistent approach to the assessment of decisional capacity, and developing age-appropriate informational materials.