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Miller GE, Carroll AL, Armstrong CC, Craske MG, Zinbarg RE, Bookheimer SY, Ka-Yi Chat I, Vinograd M, Young KS, Nusslock R. Major stress in early childhood strengthens the association between peripheral inflammatory activity and corticostriatal responsivity to reward. Brain Behav Immun 2024; 117:215-223. [PMID: 38244947 PMCID: PMC10932835 DOI: 10.1016/j.bbi.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Severe, chronic stress during childhood accentuates vulnerability to mental and physical health problems across the lifespan. To explain this phenomenon, the neuroimmune network hypothesis proposes that childhood stressors amplify signaling between peripheral inflammatory cells and developing brain circuits that support processing of rewards and threats. Here, we conducted a preliminary test of the basic premises of this hypothesis. METHODS 180 adolescents (mean age = 19.1 years; 68.9 % female) with diverse racial and ethnic identities (56.1 % White; 28.3 % Hispanic; 26.1 % Asian) participated. The Childhood Trauma Interview was administered to quantify early adversity. Five inflammatory biomarkers were assayed in antecubital blood - C-reactive protein, tumor necrosis factor-a, and interleukins-6, -8, and -10 - and were averaged to form a composite score. Participants also completed a functional MRI task to measure corticostriatal responsivity to the anticipation and acquisition of monetary rewards. RESULTS Stress exposure and corticostriatal responsivity interacted statistically to predict the inflammation composite. Among participants who experienced major stressors in the first decade of life, higher inflammatory activity covaried with lower corticostriatal responsivity during acquisition of monetary rewards. This relationship was specific to participants who experienced major stress in early childhood, implying a sensitive period for exposure, and were evident in both the orbitofrontal cortex and the ventral striatum, suggesting the broad involvement of corticostriatal regions. The findings were independent of participants' age, sex, racial and ethnic identity, family income, and depressive symptoms. CONCLUSIONS Collectively, the results are consistent with hypotheses suggesting that major stress in childhood alters brain-immune signaling.
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Affiliation(s)
- Gregory E Miller
- Institute for Policy Research, Northwestern University, United States; Department of Psychology, Northwestern University, United States.
| | - Ann L Carroll
- Institute for Policy Research, Northwestern University, United States
| | - Casey C Armstrong
- Institute for Policy Research, Northwestern University, United States
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, United States
| | - Richard E Zinbarg
- Institute for Policy Research, Northwestern University, United States; The Family Institute at Northwestern University, United States
| | - Susan Y Bookheimer
- Department of Psychology, University of California, Los Angeles, United States
| | - Iris Ka-Yi Chat
- Department of Psychology & Neuroscience, Temple University, United States
| | - Meghan Vinograd
- Department of Psychology, University of California, Los Angeles, United States
| | - Katherine S Young
- Department of Psychology, University of California, Los Angeles, United States
| | - Robin Nusslock
- Institute for Policy Research, Northwestern University, United States; Department of Psychology, Northwestern University, United States
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Carroll AL, Damme KS, Alloy LB, Bart CP, Ng TH, Titone MK, Chein J, Cichocki AC, Armstrong CC, Nusslock R. Risk for bipolar spectrum disorders associated with positive urgency and orbitofrontal cortical grey matter volume. Neuroimage Clin 2022; 36:103225. [PMID: 36242853 PMCID: PMC9668630 DOI: 10.1016/j.nicl.2022.103225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/03/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022]
Abstract
Bipolar spectrum disorders (BSDs) are associated with reward hypersensitivity, impulsivity, and structural abnormalities within the brain's reward system. Using a behavioral high-risk study design based on reward sensitivity, this paper had two primary objectives: 1) investigate whether elevated positive urgency, the tendency to act rashly when experiencing extreme positive affect, is a risk for or correlate of BSDs, and 2) examine the nature of the relationship between positive urgency and grey matter volume in fronto-striatal reward regions, among individuals at differential risk for BSD. Young adults (ages 18-28) screened to be moderately reward sensitive (MReward; N = 42), highly reward sensitive (HReward; N = 48), or highly reward sensitive with a lifetime BSD (HReward + BSD; N = 32) completed a structural MRI scan and the positive urgency subscale of the UPPS-P scale. Positive urgency scores varied with BSD risk (MReward < HReward < HReward + BSD; ps≤0.05), and positive urgency interacted with BSD risk group in predicting lateral OFC volume (p <.001). Specifically, the MReward group showed a negative relationship between positive urgency and lateral OFC volume. By contrast, there was no relationship between positive urgency and lateral OFC grey matter volume among the HReward and HReward + BSD groups. The results suggest that heightened trait positive urgency is a pre-existing vulnerability for BSD that worsens with illness onset, and there is a distinct relationship between positive urgency and lateral OFC volume among individuals at high versus low risk for BSD. These findings have implications for understanding the expression and development of impulsivity in BSDs.
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Affiliation(s)
- Ann L. Carroll
- Department of Psychology, Northwestern University, Evanston IL, United States,Corresponding author at: Northwestern University, Department of Psychology, Swift Hall, 2029 Sheridan Road, Evanston, IL 60208, United States.
| | - Katherine S.F. Damme
- Department of Psychology, Northwestern University, Evanston IL, United States,Institute for Innovation in Developmental Sciences, Chicago IL, United States
| | - Lauren B. Alloy
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Corinne P. Bart
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Tommy H. Ng
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Madison K. Titone
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Jason Chein
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Anna C. Cichocki
- Department of Psychology, Northwestern University, Evanston IL, United States
| | - Casey C. Armstrong
- Department of Psychology, Northwestern University, Evanston IL, United States
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston IL, United States,Institute for Policy Research, Northwestern University, Evanston IL, United States
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Bart CP, Nusslock R, Ng TH, Titone MK, Carroll AL, Damme KS, Young CB, Armstrong CC, Chein J, Alloy LB. Decreased reward-related brain function prospectively predicts increased substance use. J Abnorm Psychol 2021; 130:886-898. [PMID: 34843292 PMCID: PMC8634780 DOI: 10.1037/abn0000711] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Substance use and addiction are prominent global health concerns and are associated with abnormalities in reward sensitivity. Reward sensitivity and approach motivation are supported by a fronto-striatal neural circuit including the orbitofrontal cortex (OFC), ventral striatum (VS), and dorsal striatum (DS). Although research highlights abnormalities in reward neural circuitry among individuals with problematic substance use, questions remain about whether such use arises from excessively high, or excessively low, reward sensitivity. This study examined whether reward-related brain function predicted subsequent substance use course. Participants were 79 right-handed individuals (Mage = 21.52, SD = 2.19 years), who completed a monetary incentive delay (MID) fMRI task, and follow-up measures assessing substance use frequency and impairment. The average duration of the follow-up period was 9.1 months. Regions-of-interest analyses focused on the reward anticipation phase of the MID. Decreased activation in the VS during reward anticipation predicted increased substance use frequency at follow-up. Decreased DS activation during reward anticipation predicted increased substance use frequency at follow-up, but this finding did not pass correction for multiple comparisons. Analyses adjusted for relevant covariates, including baseline substance use and the presence or absence of a lifetime substance use disorder prior to MRI scanning. Results support the reward hyposensitivity theory, suggesting that decreased reward-related brain function is a risk factor for increased substance use. Results have implications for understanding the pathophysiology of problematic substance use and highlight the importance of the fronto-striatal reward circuit in the development and maintenance of addiction. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Garrett AS, Chang KD, Singh MK, Armstrong CC, Walshaw PD, Miklowitz DJ. Neural changes in youth at high risk for bipolar disorder undergoing family-focused therapy or psychoeducation. Bipolar Disord 2021; 23:604-614. [PMID: 33432670 PMCID: PMC8273209 DOI: 10.1111/bdi.13045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 10/12/2020] [Accepted: 12/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients with mood disorders may benefit from psychosocial interventions through changes in brain networks underlying emotion processing. In this study, we used functional magnetic resonance imaging (fMRI) to investigate treatment-related changes in emotion processing networks in youth at familial high risk for bipolar disorder (BD). METHODS Youth, ages 9-17, were randomly assigned to family-focused therapy for high-risk youth (FFT-HR) or an active comparison treatment, Enhanced Care (EC). Before and after these 4-month treatments, participants underwent fMRI while viewing happy, fearful, and calm facial expressions. Twenty youth in FFT-HR and 20 in EC were included in analyses of pre- to post-treatment changes in activation across the whole brain. Significant clusters were assessed for correlation with mood symptom improvement. RESULTS In the dorsolateral prefrontal cortex (DLPFC), activation increased from pre- to post-treatment in the FFT-HR group and decreased in the EC group. Insula activation decreased in the FFT-HR group and did not change in the EC group. Across both treatments, decreasing activation in the hippocampus and amygdala was correlated with pre- to post-treatment improvement in hypomania, while increasing activation in the DLPFC was correlated with pre- to post-treatment improvement in depression. DISCUSSION Psychosocial treatment addresses abnormalities in emotion regulation networks in youth at high risk for BD. Increased prefrontal cortex activation suggests enhanced emotion regulation from pre- to post-treatment with FFT-HR. Improvements in family interactions may facilitate the development of prefrontal resources that provide protection against future mood episodes.
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Affiliation(s)
- Amy S. Garrett
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Manpreet K. Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Casey C. Armstrong
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA
| | - Patricia D. Walshaw
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA
| | - David J. Miklowitz
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA
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O'Neill J, Piacentini J, Chang S, Ly R, Lai TM, Armstrong CC, Bergman L, Rozenman M, Peris T, Vreeland A, Mudgway R, Levitt JG, Salamon N, Posse S, Hellemann GS, Alger JR, McCracken JT, Nurmi EL. Glutamate in Pediatric Obsessive-Compulsive Disorder and Response to Cognitive-Behavioral Therapy: Randomized Clinical Trial. Neuropsychopharmacology 2017; 42:2414-2422. [PMID: 28409563 PMCID: PMC5645751 DOI: 10.1038/npp.2017.77] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/27/2017] [Accepted: 04/10/2017] [Indexed: 02/04/2023]
Abstract
Cognitive-behavioral therapy (CBT) is effective for pediatric obsessive-compulsive disorder (OCD), but non-response is common. Brain glutamate (Glu) signaling may contribute to OCD pathophysiology and moderate CBT outcomes. We assessed whether Glu measured with magnetic resonance spectroscopy (MRS) was associated with OCD and/or CBT response. Youths aged 7-17 years with DSM-IV OCD and typically developing controls underwent 3 T proton echo-planar spectroscopic imaging (PEPSI) MRS scans of pregenual anterior cingulate cortex (pACC) and ventral posterior cingulate cortex (vPCC)-regions possibly affected by OCD-at baseline. Controls returned for re-scan after 8 weeks. OCD youth-in a randomized rater-blinded trial-were re-scanned after 12-14 weeks of CBT or after 8 weeks of minimal-contact waitlist; waitlist participants underwent a third scan after crossover to 12-14 weeks of CBT. Forty-nine children with OCD (mean age 12.2±2.9 years) and 29 controls (13.2±2.2 years) provided at least one MRS scan. At baseline, Glu did not differ significantly between OCD and controls in pACC or vPCC. Within controls, Glu was stable from scan-to-scan. Within OCD subjects, a treatment-by-scan interaction (p=0.034) was observed, driven by pACC Glu dropping 19.5% from scan-to-scan for patients randomized to CBT, with minor increases (3.8%) for waitlist participants. The combined OCD participants (CBT-only plus waitlist-CBT) also showed a 16.2% (p=0.004) post-CBT decrease in pACC Glu. In the combined OCD group, within vPCC, lower pre-CBT Glu predicted greater post-CBT improvement in symptoms (CY-BOCS; r=0.81, p=0.00025). Glu may be involved in the pathophysiology of OCD and may moderate response to CBT.
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Affiliation(s)
- Joseph O'Neill
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA,Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, 760 Westwood Plaza 58-557A, Los Angeles, CA 90024-1759, USA, Tel: 310 825 5709, Fax: 310 206 4446, E-mail:
| | - John Piacentini
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Susanna Chang
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Ronald Ly
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Tsz M Lai
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Casey C Armstrong
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Lindsey Bergman
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Michelle Rozenman
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Tara Peris
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Allison Vreeland
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Ross Mudgway
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Jennifer G Levitt
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Noriko Salamon
- UCLA Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA, USA
| | - Stefan Posse
- Department of Neurology, University of New Mexico, Albuquerque, NM, USA,Department of Physics & Astronomy, University of New Mexico, Albuquerque, NM, USA,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - Gerhard S Hellemann
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Jeffry R Alger
- UCLA Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA, USA,UCLA Department of Neurology, UCLA Medical Center, Los Angeles, CA, USA
| | - James T McCracken
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Erika L Nurmi
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
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Armstrong CC, Moody TD, Feusner JD, McCracken JT, Chang S, Levitt JG, Piacentini JC, O'Neill J. Graph-theoretical analysis of resting-state fMRI in pediatric obsessive-compulsive disorder. J Affect Disord 2016; 193:175-84. [PMID: 26773910 PMCID: PMC5767329 DOI: 10.1016/j.jad.2015.12.071] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 12/06/2015] [Accepted: 12/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND fMRI graph theory reveals resting-state brain networks, but has never been used in pediatric OCD. METHODS Whole-brain resting-state fMRI was acquired at 3T from 21 children with OCD and 20 age-matched healthy controls. BOLD connectivity was analyzed yielding global and local graph-theory metrics across 100 child-based functional nodes. We also compared local metrics between groups in frontopolar, supplementary motor, and sensorimotor cortices, regions implicated in recent neuroimaging and/or brain stimulation treatment studies in OCD. RESULTS As in adults, the global metric small-worldness was significantly (P<0.05) lower in patients than controls, by 13.5% (%mean difference=100%X(OCD mean - control mean)/control mean). This suggests less efficient information transfer in patients. In addition, modularity was lower in OCD (15.1%, P<0.01), suggesting less granular - or differently organized - functional brain parcellation. Higher clustering coefficients (23.9-32.4%, P<0.05) were observed in patients in frontopolar, supplementary motor, sensorimotor, and cortices with lower betweenness centrality (-63.6%, P<0.01) at one frontopolar site. These findings are consistent with more locally intensive connectivity or less interaction with other brain regions at these sites. LIMITATIONS Relatively large node size; relatively small sample size, comorbidities in some patients. CONCLUSIONS Pediatric OCD patients demonstrate aberrant global and local resting-state network connectivity topologies compared to healthy children. Local results accord with recent views of OCD as a disorder with sensorimotor component.
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Affiliation(s)
- Casey C. Armstrong
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute For Neurosciences, Los Angeles, CA, United States
| | - Teena D. Moody
- Division of Adult Psychiatry, UCLA Semel Institute For Neurosciences, Los Angeles, CA, United States
| | - Jamie D. Feusner
- Division of Adult Psychiatry, UCLA Semel Institute For Neurosciences, Los Angeles, CA, United States
| | - James T. McCracken
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute For Neurosciences, Los Angeles, CA, United States
| | - Susanna Chang
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute For Neurosciences, Los Angeles, CA, United States
| | - Jennifer G. Levitt
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute For Neurosciences, Los Angeles, CA, United States
| | - John C. Piacentini
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute For Neurosciences, Los Angeles, CA, United States
| | - Joseph O'Neill
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute for Neurosciences, 760 Westwood Plaza, Los Angeles, CA 90024-1759, United States.
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Savla GN, Vella L, Armstrong CC, Penn DL, Twamley EW. Deficits in domains of social cognition in schizophrenia: a meta-analysis of the empirical evidence. Schizophr Bull 2013; 39:979-92. [PMID: 22949733 PMCID: PMC3756768 DOI: 10.1093/schbul/sbs080] [Citation(s) in RCA: 447] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Social cognition is strongly associated with functional outcome in schizophrenia, making it an important target for treatment. Our goal was to examine the average magnitude of differences between schizophrenia patients (SCs) and normal comparison (NCs) patients across multiple domains of social cognition recognized by the recent NIMH consensus statement: theory of mind (ToM), social perception, social knowledge, attributional bias, emotion perception, and emotion processing. METHOD We conducted a meta-analysis of peer-reviewed studies of social cognition in schizophrenia, published between 1980 and November, 2011. RESULTS 112 studies reporting results from 3908 SCs and 3570 NCs met our inclusion criteria. SCs performed worse than NCs across all domains, with large effects for social perception (g = 1.04), ToM (g = 0.96), emotion perception (g = 0.89), and emotion processing (g = 0.88). Regression analyses showed that statistically significant heterogeneity in effects within domains was not explained by age, education, or gender. Greater deficits in social and emotion perception were associated with inpatient status, and greater deficits in emotion processing were associated with longer illness duration. CONCLUSIONS Despite the limitations of existing studies, including lack of standardization or psychometric validation of measures, the evidence for deficits across multiple social cognitive domains in schizophrenia is clear. Future research should examine the role of neurobiological and psychosocial factors in models linking various aspects of deficit in schizophrenia, including social cognition, in order to identify targets for intervention.
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Affiliation(s)
- Gauri N. Savla
- Department of Psychiatry, University of California, San Diego, La Jolla, CA;,To whom correspondence should be addressed; tel: 858-822-6449, fax: 858-822-7514, e-mail:
| | - Lea Vella
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA
| | - Casey C. Armstrong
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - David L. Penn
- Department of Psychology, University of North Carolina, Chapel Hill, Chapel Hill, NC
| | - Elizabeth W. Twamley
- Department of Psychiatry, University of California, San Diego, La Jolla, CA;,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA
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