Discovery of a highly potent, selective, orally bioavailable inhibitor of KAT6A/B histone acetyltransferases with efficacy against KAT6A-high ER+ breast cancer

KAT6A, and its paralog KAT6B, are histone lysine acetyltransferases (HAT) that acetylate histone H3K23 and exert an oncogenic role in several tumor types including breast cancer where KAT6A is frequently amplified/overexpressed. However, pharmacologic targeting of KAT6A to achieve therapeutic benefit has been a challenge. Here we describe identification of a highly potent, selective, and orally bioavailable KAT6A/KAT6B inhibitor CTx-648 (PF-9363), derived from a benzisoxazole series, which demonstrates anti-tumor activity in correlation with H3K23Ac inhibition in KAT6A over-expressing breast cancer. Transcriptional and epigenetic profiling studies show reduced RNA Pol II binding and downregulation of genes involved in estrogen signaling, cell cycle, Myc and stem cell pathways associated with CTx-648 anti-tumor activity in ER-positive (ER+) breast cancer. CTx-648 treatment leads to potent tumor growth inhibition in ER+ breast cancer in vivo models, including models refractory to endocrine therapy, highlighting the potential for targeting KAT6A in ER+ breast cancer.

Inhibition of METTL3 Results in a Cell-Intrinsic Interferon Response That Enhances Antitumor Immunity

Therapies that enhance antitumor immunity have altered the natural history of many cancers. Consequently, leveraging nonoverlapping mechanisms to increase immunogenicity of cancer cells remains a priority. Using a novel enzymatic inhibitor of the RNA methyl-transferase METTL3, we demonstrate a global decrease in N6-methyladenosine (m6A) results in double-stranded RNA (dsRNA) formation and a profound cell-intrinsic interferon response. Through unbiased CRISPR screens, we establish dsRNA-sensing and interferon signaling are primary mediators that potentiate T-cell killing of cancer cells following METTL3 inhibition. We show in a range of immunocompetent mouse models that although METTL3 inhibition is equally efficacious to anti-PD-1 therapy, the combination has far greater preclinical activity. Using SPLINTR barcoding, we demonstrate that anti-PD-1 therapy and METTL3 inhibition target distinct malignant clones, and the combination of these therapies overcomes clones insensitive to the single agents. These data provide the mole-cular and preclinical rationale for employing METTL3 inhibitors to promote antitumor immunity in the clinic.

SIGNIFICANCE

This work demonstrates that METTL3 inhibition stimulates a cell-intrinsic interferon response through dsRNA formation. This immunomodulatory mechanism is distinct from current immunotherapeutic agents and provides the molecular rationale for combination with anti-PD-1 immune-checkpoint blockade to augment antitumor immunity. This article is featured in Selected Articles from This Issue, p. 2109.

Stressor-response functions as a generalizable model for context dependence

Defining the context dependence of ecological states or processes is a fundamental goal of ecology. Stressor-response functions are the quantitative representation of context dependence, where the context (environmental contingency) is defined by location on the stressor (x) axis, and represents a unifying concept in biological science.

Pharmacologic Reduction of Mitochondrial Iron Triggers a Noncanonical BAX/BAK-Dependent Cell Death

Cancer cell metabolism is increasingly recognized as providing an exciting therapeutic opportunity. However, a drug that directly couples targeting of a metabolic dependency with the induction of cell death in cancer cells has largely remained elusive. Here we report that the drug-like small-molecule ironomycin reduces the mitochondrial iron load, resulting in the potent disruption of mitochondrial metabolism. Ironomycin promotes the recruitment and activation of BAX/BAK, but the resulting mitochondrial outer membrane permeabilization (MOMP) does not lead to potent activation of the apoptotic caspases, nor is the ensuing cell death prevented by inhibiting the previously established pathways of programmed cell death. Consistent with the fact that ironomycin and BH3 mimetics induce MOMP through independent nonredundant pathways, we find that ironomycin exhibits marked in vitro and in vivo synergy with venetoclax and overcomes venetoclax resistance in primary patient samples.

SIGNIFICANCE

Ironomycin couples targeting of cellular metabolism with cell death by reducing mitochondrial iron, resulting in the alteration of mitochondrial metabolism and the activation of BAX/BAK. Ironomycin induces MOMP through a different mechanism to BH3 mimetics, and consequently combination therapy has marked synergy in cancers such as acute myeloid leukemia. This article is highlighted in the In This Issue feature, p. 587.

Non-genetic determinants of malignant clonal fitness at single-cell resolution

All cancers emerge after a period of clonal selection and subsequent clonal expansion. Although the evolutionary principles imparted by genetic intratumour heterogeneity are becoming increasingly clear¹, little is known about the non-genetic mechanisms that contribute to intratumour heterogeneity and malignant clonal fitness². Here, using single-cell profiling and lineage tracing (SPLINTR)-an expressed barcoding strategy-we trace isogenic clones in three clinically relevant mouse models of acute myeloid leukaemia. We find that malignant clonal dominance is a cell-intrinsic and heritable property that is facilitated by the repression of antigen presentation and increased expression of the secretory leukocyte peptidase inhibitor gene (Slpi), which we genetically validate as a regulator of acute myeloid leukaemia. Increased transcriptional heterogeneity is a feature that enables clonal fitness in diverse tissues and immune microenvironments and in the context of clonal competition between genetically distinct clones. Similar to haematopoietic stem cells³, leukaemia stem cells (LSCs) display heritable clone-intrinsic properties of high, and low clonal output that contribute to the overall tumour mass. We demonstrate that LSC clonal output dictates sensitivity to chemotherapy and, although high- and low-output clones adapt differently to therapeutic pressure, they coordinately emerge from minimal residual disease with increased expression of the LSC program. Together, these data provide fundamental insights into the non-genetic transcriptional processes that underpin malignant clonal fitness and may inform future therapeutic strategies.

Abstract 1130: First-in-class KAT6A/KAT6B inhibitor CTx-648 (PF-9363) demonstrates potent anti-tumor activity in ER+ breast cancer with KAT6A dysregulation

KAT6A is a lysine histone acetyltransferase (HAT) of the MYST family of HATs. KAT6A, and its paralog KAT6B, have been shown to acetylate histone H3K23Ac and regulate diverse biological processes, including transcription, cell-cycle progression, stem cell maintenance and development. Molecular dysregulation of KAT6A has been observed in several cancers, including amplifications in breast, lung, ovarian cancer along with oncogenic fusions in AML. In breast cancer, KAT6A is amplified as part of the 8p11 amplicon in 10-15% of the patient population, which correlates with a worse clinical outcome in the estrogen receptor+ (ER+) subtype. Here we present identification of a first-in-class potent KAT6A/KAT6B tool inhibitor CTx-648 (PF-9363), that possesses high selectivity versus other MYST family members (KAT7, KAT5, KAT8) and other KATs, demonstrating anti-tumor activity in breast cancer. Using genetic and pharmacological approaches, we have demonstrated several ER+ breast cancer cell lines including KAT6A amplified and over-expressing models, are dependent on KAT6A enzymatic function. Epigenomic profiling studies using bulk and nascent RNA-seq combined with ATAC-seq revealed CTx-648 leads to downregulation of a specific set of genes involved in ESR1 pathway, cell cycle and stem cell pathways. In vivo target validation studies showed strong anti-tumor activity of CTx-648 in several ER+ breast cancer cell line and patient-derived xenograft models, including models harboring endocrine therapy resistance ESR1 mutations, highlighting promise for this novel therapy in ER+ breast cancer population. Based on the strength of the pre-clinical data, a selective KAT6 inhibitor (PF-07248144) is now commencing a Phase 1 clinical study in Advanced or Metastatic Solid Tumors.

Citation Format: Shikhar Sharma, Jay Chung, Sean Uryu, Amanda Rickard, Natalie Nady, Showkhin Khan, Zhenxiong Wang, Yong Zhang, Haikuo Zhang, Pei-Pei Kung, Eric Greenwald, Karen Maegley, Patrick Bingham, Hieu Lam, Ylva E. Bozikis, Hendrik Falk, Elizabeth Allan, Vicky M. Avery, Miriam S. Butler, Michelle A. Camerino, Catalina Carrasco-Pozo, Susan A. Charman, Melissa J. Davis, Mark A. Dawson, Dawson Sarah-Jane, Melanie de Silva, Matthew L. Dennis, Olan Dolezal, Rachel Lagiakos, Geoffrey J. Lindeman, Laura MacPherson, Stewart Nuttall, Thomas S. Peat, Bin Ren, Alexandra E. Stupple, Elliot Surgenor, Chin Wee Tan, Tim Thomas, Jane E. Visvader, Anne K. Voss, Francois Vaillant, Karen L. White, James Whittle, Yuqing Yang, Soroor Hediyeh-Zadeh, Paul A. Stupple, Ian P. Street, Brendon J. Monahan, Thomas Paul. First-in-class KAT6A/KAT6B inhibitor CTx-648 (PF-9363) demonstrates potent anti-tumor activity in ER+ breast cancer with KAT6A dysregulation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1130.

HBO1 is required for the maintenance of leukaemia stem cells

Acute myeloid leukaemia (AML) is a heterogeneous disease characterized by transcriptional dysregulation that results in a block in differentiation and increased malignant self-renewal. Various epigenetic therapies aimed at reversing these hallmarks of AML have progressed into clinical trials, but most show only modest efficacy owing to an inability to effectively eradicate leukaemia stem cells (LSCs)1. Here, to specifically identify novel dependencies in LSCs, we screened a bespoke library of small hairpin RNAs that target chromatin regulators in a unique ex vivo mouse model of LSCs. We identify the MYST acetyltransferase HBO1 (also known as KAT7 or MYST2) and several known members of the HBO1 protein complex as critical regulators of LSC maintenance. Using CRISPR domain screening and quantitative mass spectrometry, we identified the histone acetyltransferase domain of HBO1 as being essential in the acetylation of histone H3 at K14. H3 acetylated at K14 (H3K14ac) facilitates the processivity of RNA polymerase II to maintain the high expression of key genes (including Hoxa9 and Hoxa10) that help to sustain the functional properties of LSCs. To leverage this dependency therapeutically, we developed a highly potent small-molecule inhibitor of HBO1 and demonstrate its mode of activity as a competitive analogue of acetyl-CoA. Inhibition of HBO1 phenocopied our genetic data and showed efficacy in a broad range of human cell lines and primary AML cells from patients. These biological, structural and chemical insights into a therapeutic target in AML will enable the clinical translation of these findings.

A Behavioral Activation Mobile Health App for Smokers With Depression: Development and Pilot Evaluation in a Single-Arm Trial

Background

The integration of Behavioral Activation Treatment for Depression (BAT-D) into smoking cessation interventions is a promising approach to address depression as a barrier to quitting. However, this approach has only been tested as a face-to-face intervention, which has low reach.

Objective

The aims of the study were to develop a BAT-D mobile health app with high potential reach and determine its feasibility, acceptability, and preliminary effects on theory-based behavioral processes of behavioral activation, reduced depressive symptoms, and smoking cessation.

Methods

Following a user-centered design process consisting of competitive analysis, focus groups, and prototype testing, we conducted a single-arm pilot trial of Actify!, a BAT-D app for depressed smokers. Participants used SmokefreeTXT along with Actify! to provide cessation content that had not yet been built into the app for this initial phase of pilot testing. Participants in the trial were current, daily smokers with mild to moderate depressive symptoms. We examined use outcomes for all enrolled participants and process and cessation outcomes at 6 weeks postenrollment for study completers (16/17, 94% retention).

Results

Regarding acceptability, average number of log-ins per participant was 16.6 (SD 13.7), and 63% (10/16) reported being satisfied overall with the app. Posttreatment interviews identified some usability challenges (eg, high perceived burden of planning and scheduling values-based activities). There was a significant decrease in depressive symptoms from baseline to follow-up (mean change in Patient Health Questionnaire–9 scores was –4.5, 95% CI –7.7 to –1.3; P=.01). Additionally, carbon monoxide (CO)-confirmed, 7-day point prevalence abstinence (PPA) at 6-week follow-up was 31% (5/16), and the 30-day PPA was 19% (3/16).

Conclusions

Results demonstrate promising engagement with Actify! and potential for impact on theory-based change processes and cessation outcomes. Preliminary quit rates compare favorably to previous trials of smoking cessation apps for the general population (ie, short-term, self-reported 30-day quit rates in the 8% to 18% range) and a previous trial of face-to-face BAT-D for depressed smokers (ie, CO-confirmed, 7-day PPA rate of 17% at end of treatment).

Targeting enhancer switching overcomes non-genetic drug resistance in acute myeloid leukaemia

Non-genetic drug resistance is increasingly recognised in various cancers. Molecular insights into this process are lacking and it is unknown whether stable non-genetic resistance can be overcome. Using single cell RNA-sequencing of paired drug naïve and resistant AML patient samples and cellular barcoding in a unique mouse model of non-genetic resistance, here we demonstrate that transcriptional plasticity drives stable epigenetic resistance. With a CRISPR-Cas9 screen we identify regulators of enhancer function as important modulators of the resistant cell state. We show that inhibition of Lsd1 (Kdm1a) is able to overcome stable epigenetic resistance by facilitating the binding of the pioneer factor, Pu.1 and cofactor, Irf8, to nucleate new enhancers that regulate the expression of key survival genes. This enhancer switching results in the re-distribution of transcriptional co-activators, including Brd4, and provides the opportunity to disable their activity and overcome epigenetic resistance. Together these findings highlight key principles to help counteract non-genetic drug resistance.

Survival of the Fittest: Darwinian Selection Underpins Chemotherapy Resistance in AML

Intratumor heterogeneity driving therapeutic resistance is a major challenge in cancer management. Recently in Nature, Shlush et al. (2017) provide a tour de force of genomics coupled to functional assays to demonstrate that resistance emerges from a pre-existing subpopulation of acute myeloid leukemia (AML) cells with a stem cell transcription program.

Mental health stigma in depressed Latinos over the course of therapy: Results from a randomized controlled trial

OBJECTIVE

The current study examined the course, correlates, and predictors of mental health stigma among depressed, Spanish-speaking Latinos that were receiving treatment. This population faces significant disparities in mental health treatment and carries high levels of mental health stigma.

METHOD

The study utilized data generated from a randomized clinical trial (N = 46) that evaluated the efficacy of Behavioral Activation and Supportive Counseling for depression among Latinos.

RESULTS

Mental health stigma decreased over time; these decreases were more pronounced among individuals who were randomized to Supportive Counseling. Mental health stigma was positively associated with depressive symptoms and therapeutic alliance over time. Mental health stigma was not related to treatment attrition.

CONCLUSIONS

These preliminary findings indicate that mental health stigma continues to be relevant among individuals who are actively participating in treatment. Receiving mental health treatment may be sufficient to dispel some of the stigmatizing views endorsed by underserved clinical populations.

Sex Differences in the Association between Heavy Drinking and Behavioral Distress Tolerance and Emotional Reactivity Among Non-Depressed College Students

Background

Heavy episodic drinking (HED) is a common behavior among college students that is associated with severe negative consequences. Negative reinforcement processes have been applied to elucidate mechanisms underlying relationships between consumption of alcohol and the desire to alleviate negative feelings. Distress tolerance (DT) and emotional reactivity are two mechanisms that are consistent with the self-medication model that may contribute to HED. The current study investigated relationships between DT, emotional reactivity, defined as frustration reactivity and irritability reactivity, and HED in a non-depressed college population. Given differential patterns of consumption and motivation for drinking between males and females, sex differences were also examined.

Short Summary

The study examined two constructs consistent with negative reinforcement processes, behavioral distress tolerance (DT) and emotional reactivity (frustration reactivity and irritability reactivity), to explain heavy episodic drinking (HED) among non-depressed college students. Behavioral DT and frustration reactivity independently predicted HED. Higher HED was associated with higher frustration reactivity and lower behavioral DT in women, but nor in men.

Methods

One-hundred-ten college students without depressive symptoms completed alcohol use measures and the Paced Auditory Serial Attention Task (PASAT-C) to assess behavioral DT and emotional reactivity.

Results

DT and frustration reactivity independently predicted HED. The association between DT and HED was moderated by sex such that higher levels of DT predicted higher HED among females, but not among males. Higher frustration reactivity scores were associated with a greater number of HED.

Conclusions

Results provide supporting evidence that DT and emotional reactivity are distinct factors, and that they predict HED independently. Results underscore the importance of examining sex differences when evaluating the association between HED and negative reinforcement processes in this population.

Early psychosocial deprivation and adolescent risk-taking: The role of motivation and executive control

Risk-taking in adolescence has been often associated with early life adversities. However, the impact of such macrolevel factors on risk behavior has been rarely studied in humans. To address these gaps we recruited a sample of young adolescents who were part of a randomized control trial of foster care. Children institutionalized at or soon after birth were randomly assigned either to be removed from institutions and placed into a family or foster care intervention or to remain in institutions receiving care as usual. These children were subsequently followed up through 12 years of age and compared with a sample of children who had never been institutionalized. Using this sample, we examined the impact of early childhood deprivation on risk-taking behavior and explored the role of motivation (i.e., sensation seeking) and executive control (i.e., planning). Early psychosocial deprivation decreased engagement in risk-taking among young adolescents by reducing sensation seeking, a motivation often associated with risk-taking in adolescence. The impact of early psychosocial deprivation on sensation seeking and consequently on engagement in risk-taking was further reduced by its deleterious effects on executive control. These findings challenge the traditional view according to which risk behavior is a maladaptive response to adversities and suggest that it may represent adolescents' attempts to fulfill important motivations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Association between Distress Tolerance and Alcohol Related Problems: The Pathway of Drinking to Cope

Binge drinking (BD) and alcohol related problems (ARP) are highly prevalent among college students. However, current models examining ARP suggest drinking quantity only accounts for a portion of the variance, suggesting other variables contribute to ARP. Distress tolerance (DT), or the ability to withstand negative affect, is associated with alcohol misuse and may be an important mechanism related to ARP. However, studies have reported inconsistent findings on this association, which may be due to the use of only global scores to measure DT rather than specific DT components. Furthermore, the mechanisms underlying this association remain unknown. Drinking to cope with negative affect has been associated with both DT and ARP, suggesting it may be a mechanism explaining the relationship between DT and ARP. The current study examined the association between specific proposed DT components (i.e., tolerance, absorption, appraisal, and regulation) and drinking to cope and ARP in 147 college students who BD. A hierarchical linear regression was performed in order to examine which DT component best predicted ARP. Four follow-up mediation models were then tested to examine whether drinking to cope mediated the relationship between each DT component and ARP. Appraisal of DT was the only DT component that significantly predicted ARP, in the model controlling for drinking quantity and sex differences. Drinking to cope mediated the relationship between ARP and tolerance, absorption, and regulation, but not appraisal of DT. Implications for furthering our understanding of DT and treatment of BD as it relates to DT are explored.

An experimental paradigm examining the influence of frustration on risk-taking behavior

The present study examined the impact of frustration on risk-taking in college students with low and high ADHD symptomatology (L-ADHD and H-ADHD). Participants completed the Balloon Analogue Risk Task (BART) following induced frustration from a mood manipulation task (experimental session) and following no mood manipulation (control session). A manipulation check revealed a significant three-way interaction where the H-ADHD group reported higher frustration levels compared to the L-ADHD group, particularly in response to the frustration induction in the experimental condition. Primary results revealed that the L-ADHD group exploded significantly fewer balloons in the experimental condition compared to the control condition; there was a nonsignificant difference of balloon explosions across conditions for the H-ADHD group. The study provides initial laboratory-based support for the impact of frustration on the risk behavior of those with low and high levels of ADHD, with potential implications for future studies and ultimately for intervention.

Distress Tolerance Interacts With Negative Life Events to Predict Depressive Symptoms Across Adolescence

Adolescence is a vulnerable period for the development of depressive disorders. Recent research has demonstrated the importance of distress tolerance in the onset and maintenance of depression during adulthood; however, little is known about its role in predicting depressive symptoms among adolescents. The current study examines the effect of distress tolerance and co-occurring negative life events on the developmental trajectory of depressive symptoms from middle to late adolescence. Our sample included 117 adolescent boys and girls (44.4% female, 54.6% White). Participants were, on average, 16 years old at baseline (SD = 0.90) and completed self-report inventories of negative life events and depressive symptoms; distress tolerance was assessed using a behavioral measure. Utilizing a latent growth curve approach, we found a significant interaction between distress tolerance and negative life events in predicting increases in depressive symptoms over time. Follow-up analyses suggest that negative life events were associated with greater increases in depressive symptoms over time for adolescents with lower levels of distress tolerance only. The study highlights the moderating role of distress intolerance in the relation between negative life events and depressive symptoms, and underscores the importance of targeting distress tolerance for treating depression among youth.

A Prospective Examination of the Relations Between Emotional Abuse and Anxiety: Moderation by Distress Tolerance

Anxiety, the most common and impairing psychological problem experienced by youth, is associated with numerous individual and environmental factors. Two such factors include childhood emotional abuse (CEA) and low distress tolerance (DT). The current study aimed to understand how CEA and low DT impacted anxiety symptoms measured annually across 5 years among a community sample of youth. We hypothesized DT would moderate the relationship between CEA and anxiety, such that youth with higher levels of CEA and lower levels of DT would have elevated anxiety over time. Community youth (N = 244) were annually assessed across 5 years using the Revised Child Anxiety and Depression Scale, Childhood Trauma Questionnaire, and Behavioral Indicator of Resiliency to Distress. Higher CEA at baseline was associated with higher anxiety at baseline, higher anxiety at each annual assessment, and with greater overall decreases in anxiety over time. Lower DT was associated with higher anxiety at baseline, but did not predict changes in anxiety over time. Baseline DT significantly moderated the relationship between baseline CEA and anxiety, such that youth with both higher CEA and lower DT had the highest anxiety at each annual assessment. Youth with lower DT and higher CEA scores had the highest level of anxiety symptoms across time.

The developmental trajectory of perceived stress mediates the relations between distress tolerance and internalizing symptoms among youth

The current study examines the relation between distress tolerance, perceived stress, and internalizing symptoms across adolescence. Participants included 331 youth, ages 10 to 14 at the first wave of the study, assessed annually over 5 years. A latent growth curve approach was used to test three research questions, including whether perceived stress would increase across adolescence, whether distress tolerance (as measured by a behavioral task) would predict changes in perceived stress, and whether changes in perceived stress would mediate the relation between distress tolerance and internalizing symptoms. Results suggest that, consistent with previous findings, rates of perceived stress do increase across adolescence. Further, findings indicate that distress intolerance at baseline predicted increases in perceived stress, which in turn drove increases in internalizing symptoms. These findings point to the critical role of distress tolerance in bringing about changes in depression and anxiety symptoms and suggest support for utilizing a negative reinforcement framework to understand the emergence of internalizing symptomology.

Native freshwater species get out of the way: Prussian carp (Carassius gibelio) impacts both fish and benthic invertebrate communities in North America

Prussian carp (Carassius gibelio) are one of the most noxious non-native species in Eurasia. Recently, Prussian carp, a non-native freshwater fish species, were genetically confirmed in Alberta, Canada and have been rapidly expanding their range in North America since establishment. Given their rapid range expansion, there is an increasing need to determine how Prussian carp may impact native species. We assessed the severity of the Prussian carp invasion by (i) determining their impact on fish communities, (ii) assessing their impact on benthic invertebrate communities, (iii) evaluating if Prussian carp alter abiotic conditions, and (iv) identifying where we find higher abundances of Prussian carp. When Prussian carp were established, we found significant changes to the fish community. Correspondingly, the degree of impact to benthic invertebrate communities was related to the stage of invasion (none, early or recent), where changes in fish communities were significantly concordant with changes in benthic invertebrate communities. Finally, we found that higher abundances of Prussian carp were significantly associated with lower abundances of a majority of native fish species. Altogether, using three lines of evidence, we determine that Prussian carp can have wide-ranging impacts on freshwater ecosystems in North America, pressing the need for management intervention.

The prospective relationship between distress tolerance and cigarette smoking expectancies in adolescence

The current study examined the prospective relationship between distress tolerance (DT) and positive and negative cigarette smoking outcome expectancies, which are reliable predictors of the onset and maintenance of smoking behaviors. Data from a longitudinal study (N = 204) examining risk behaviors in adolescence were used to assess whether DT predicts individual differences in rate of change in smoking outcome expectancies over 4 annual assessment waves through adolescence. Adolescents (mean age at first wave: 13.03 years; SD = 0.88 years) completed a behavioral task assessing DT at baseline and a self-report measure of adolescent smoking expectancies annually across 4 years. Latent growth curve models were estimated to test our hypotheses. Results showed that DT at baseline did not significantly predict initial levels of negative affect reduction (NAR) expectancies, but NAR expectancies increased more quickly over time for adolescents with lower DT. Moreover, as hypothesized, DT did not prospectively predict significant changes in smoking expectancies outside of the domain of NAR, including negative physical feelings, negative social impression, and boredom reduction expectancies. These findings suggest that DT is a useful indicator of adolescent expectancies about the consequences of cigarette smoking, particularly those focused on reducing negative affect. Thus, DT may be an important target for preventing smoking initiation among adolescents via this putative mechanism. Theoretical and clinical implications are discussed within the context of observed effect sizes. (PsycINFO Database Record

Click chemistry enables preclinical evaluation of targeted epigenetic therapies

The success of new therapies hinges on our ability to understand their molecular and cellular mechanisms of action. We modified BET bromodomain inhibitors, an epigenetic-based therapy, to create functionally conserved compounds that are amenable to click chemistry and can be used as molecular probes in vitro and in vivo. We used click proteomics and click sequencing to explore the gene regulatory function of BRD4 (bromodomain containing protein 4) and the transcriptional changes induced by BET inhibitors. In our studies of mouse models of acute leukemia, we used high-resolution microscopy and flow cytometry to highlight the heterogeneity of drug activity within tumor cells located in different tissue compartments. We also demonstrate the differential distribution and effects of BET inhibitors in normal and malignant cells in vivo. This study provides a potential framework for the preclinical assessment of a wide range of drugs.

A novel training approach to activate alternative behaviors for smoking in depressed smokers

The current research developed and tested a novel training strategy to alter the implicit associations between alternative behaviors to smoking and negative affect, and explored its effects on depressive symptoms and on smoking behavior as part of a quit attempt. Using a joystick, participants identified as smokers with depressive symptoms were trained to approach alternative behaviors to smoking in the context of negative affect. Specifically, in the experimental condition, participants were trained to avoid smoking-related targets and to approach alternative activities. In the control condition, participants pushed and pulled an equal amount of smoking and alternative activity-related targets. Compared with the participants in the control condition, those in the experimental condition showed an increase in the accessibility of the alternative activity relative to smoking and a decrease in depressive symptoms. Smoking outcomes did not differ significantly across the 2 conditions. Taken together these results indicate that the value of alternative behaviors to smoking can be modified in the lab without participants' conscious intentions with implications for depressive symptomatology. Future research is required to explore the impact of such training on smoking outcomes. (PsycINFO Database Record

Negative affect mediates the relation between trait urgency and behavioral distress tolerance

Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. (PsycINFO Database Record

Depressive Symptoms and Cigarette Demand as a Function of Induced Stress

INTRODUCTION

Depressed smokers may disproportionately value cigarettes as compared to other reinforcers in the context of increases in negative affect (NA). Thus, cigarette demand may be an important construct for understanding the relationship between depression, NA change, and tobacco use. The aim of the current study was to examine the interaction between depressive symptoms and change in NA as a function of induced mood as a predictor of cigarette demand.

METHODS

Participants included 73 young adult daily smokers (41.70% female, 73.60% White, age M (SD) = 19.70 (1.15)) who attended two experimental sessions: one stress and one neutral. During each session, participants completed ratings of depressive symptoms, NA, and cigarette demand.

RESULTS

We examined the predictive utility of depressive symptoms, change in NA as a result of a stressor, and the interaction between depressive symptoms and NA change on demand indices. Separate models were constructed by session. Results indicated significant interactive effects between depressive symptoms and change in NA for predicting intensity, breakpoint, and P max during the stress session. Specifically, change in NA moderated the relationship between depression and demand indices such that among individuals high in NA change, depressive symptoms were positively related to P max and breakpoint, whereas among individuals low in NA change, depressive symptoms were positively related to intensity.

CONCLUSIONS

When exposed to stress, cigarettes may become more valuable for individuals with depressive symptoms.

IMPLICATIONS

This study contributes to the literature attempting to understand the complex relationships between depression, stress-related changes in NA, and tobacco use. This study suggests that one mechanism that may be important to the relationship between depression and tobacco use is cigarette demand. Specifically, for individuals with elevated depressive symptoms, certain aspects of cigarette demand may be higher (intensity, breakpoint, and P max) when exposed to stress, which may contribute to tobacco use being maintained over time.

Risk-Taking Propensity in Older Adolescents: Internalizing Symptoms, Gender, and Negative Reinforcement

OBJECTIVE

Engagement in risk behaviors, including substance use, risky sex, and violence, tends to increase throughout adolescence into young adulthood. One motivational process that may underlie risk behaviors during adolescence is negative reinforcement. Moreover, gender and internalizing symptoms (e.g., depression and anxiety) may both convey risk for negative reinforcement-based risk taking. Along these lines, the aims of the current study were to (a) examine gender differences in negative reinforcement-based risk-taking propensity and (b) examine internalizing symptoms as a moderator of the relationship between gender and negative reinforcement-based risk-taking propensity.

METHOD

Participants included 103 youth between the ages of 18 and 21 (50.49% female, age M(SD) = 19.41(1.06)) who were recruited from a large Mid-Atlantic university between September 2013 and November 2014. Participants completed self-report assessments of internalizing symptomatology and a computerized behavioral analog assessment of negative reinforcement-based risk-taking propensity.

RESULTS

Results indicated that, overall, female older adolescents were riskier under conditions of negative reinforcement than male older adolescents. In addition, internalizing symptoms significantly moderated the relationship between gender and negative reinforcement-based risk-taking propensity such that the relationship between gender and negative reinforcement-based risk-taking propensity was nonsignificant at high levels of internalizing symptoms, and female gender was significantly positively predictive of heightened negative reinforcement-based risk-taking propensity at low levels of internalizing symptoms.

CONCLUSIONS

Thus, although female youth overall were riskier, the predictive utility of gender for negative reinforcement-based risk taking may be most relevant at low levels of internalizing symptoms. Results are discussed in terms of implications for future prevention and intervention.

Different pathways explain alcohol-related problems in female and male college students

OBJECTIVES

Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways.

METHODS

College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs.

RESULTS

Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males.

CONCLUSIONS

Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption.

Behavioral Activation Treatment for Smoking (BATS) in smokers with depressive symptomatology

Purpose

Cigarette smoking remains the primary preventable cause of mortality and morbidity globally. The overarching goal of the paper is to disseminate the Behavioral Activation Treatment for Smoking (BATS), which integrates behavioral activation principles with standard treatment guidelines to assist individuals in achieving short- and long-term smoking cessation. Through a series of sequential steps, BATS guides individuals who wish to quit smoking to increase their engagement in healthy, pleasurable, and value-consistent activities.

Design/methodology/approach

The document provides the BATS rationale and contains an abridged manual for use by clinicians and/or researchers in the context of clinical trials. Findings: BATS is accruing empirical evidence that suggests its ability to promote successful smoking cessation outcomes while decreasing any associated depressive symptoms.

Findings

BATS is accruing empirical evidence that suggests its ability to promote successful smoking cessation outcomes while decreasing any associated depressive symptoms.

Practical implications

A description of key components, forms, and strategies to address common treatment barriers are included.

Originality/value

BATS’s strong roots in learning theories and its idiographic nature allow for the intervention to be implemented flexibly across a wide range of settings and smoking populations. The treatment may also be combined seamlessly with pharmacotherapies. BATS targets both cigarette smoking and depressive symptoms, which constitute a significant barrier to cessation, through a common pathway: increasing rewarding activities. The treatment offers a parsimonious complement to standard smoking cessation treatments.

Functional interdependence of BRD4 and DOT1L in MLL leukemia

Targeted therapies against disruptor of telomeric silencing 1-like (DOT1L) and bromodomain-containing protein 4 (BRD4) are currently being evaluated in clinical trials. However, the mechanisms by which BRD4 and DOT1L regulate leukemogenic transcription programs remain unclear. Using quantitative proteomics, chemoproteomics and biochemical fractionation, we found that native BRD4 and DOT1L exist in separate protein complexes. Genetic disruption or small-molecule inhibition of BRD4 and DOT1L showed marked synergistic activity against MLL leukemia cell lines, primary human leukemia cells and mouse leukemia models. Mechanistically, we found a previously unrecognized functional collaboration between DOT1L and BRD4 that is especially important at highly transcribed genes in proximity to superenhancers. DOT1L, via dimethylated histone H3 K79, facilitates histone H4 acetylation, which in turn regulates the binding of BRD4 to chromatin. These data provide new insights into the regulation of transcription and specify a molecular framework for therapeutic intervention in this disease with poor prognosis.

Evaluation of the Environmental Supports Scale with a Community Sample of Adolescents

Environmental sources of psychosocial support have been found to modulate or protect against the development of psychopathology and risk behavior among adolescents. Capturing sources of environmental support across multiple developmental contexts requires the availability of well-validated, concise assessments-of which there are few in the existing literature. In order to address this need, the current study explored the factor structure, concurrent and convergent validity of the Environmental Supports Scale (ESS; Genetic, Social, and General Psychology Monographs, 117; 395-417, 1991) with a community sample of adolescents. An unconstrained exploratory factor analysis revealed a separate factor for home, school, and neighborhood settings. Internal consistency and test-retest reliability were evaluated for each factor. Concurrent and predictive validity analyses revealed that the ESS was associated in the expected directions across a range of constructs relevant to adolescent development including internalizing symptoms, well-being, external influences, and engagement in risk behavior. Convergent validity for the neighborhood context was established with an assessment of neighborhood environmental adversity. A brief assessment of perceived environmental support across key developmental contexts provides an important tool for research on resilience processes during adolescence and may help illuminate key protective factors and inform intervention and prevention efforts.

A systematic review of depression psychotherapies among Latinos

For decades, the literature has reported persistent treatment disparities among depressed Latinos. Fortunately, treatment development and evaluation in this underserved population has expanded in recent years. This review summarizes outcomes across 36 unique depression treatment studies that reported treatment outcomes for Latinos. Results indicated that there was significant variability in the quality of RCT and type/number of cultural adaptations. The review suggested that there might a relation between cultural adaptations with treatment outcomes; future studies are warranted to confirm this association. Cognitive Behavioral Therapy was the most evaluated treatment (CBT; n=18, 50% of all evaluations), followed by Problem Solving Therapy (PST; n=4), Interpersonal Therapy (IPT; n=4), and Behavioral Activation (BA; n=3). CBT seems to fare better when compared to usual care, but not when compared to a contact-time matched control condition or active treatment. There is growing support for PST and IPT as efficacious depression interventions among Latinos. IPT shows particularly positive results for perinatal depression. BA warrants additional examination in RCT. Although scarce, telephone and in-home counseling have shown efficacy in reducing depression and increasing retention. Promotora-assisted trials require formal assessment. Limitations and future directions of the depression psychotherapy research among Latinos are discussed.

The efficacy of behavioral activation treatment among depressed Spanish-speaking Latinos

OBJECTIVE

Major depressive disorder (MDD) is highly prevalent among U.S. Spanish-speaking Latinos, but the lack of empirically supported treatments precludes this population's access to quality mental health care.

METHOD

Following the promising results of an open-label trial of the Behavioral Activation Treatment for Depression (BATD) among Spanish-speaking Latinos, the authors conducted a randomized control trial (RCT; N = 46) that compared BATD to supportive counseling. Study outcomes included depression, BATD proposed mechanisms of change, and nonspecific psychotherapy factors.

RESULTS

Relative to supportive counseling, BATD led to greater decreases in depressive symptoms over time (p = .04) and greater MDD remission at the end of treatment (p = .01). Activity level (p = .01) and environmental reward (p = .05) showed greater increases over time among those who received BATD compared to supportive counseling. Treatment adherence, therapeutic alliance, and treatment satisfaction did not differ between the groups over time (ps > 0.17). The 1-month follow-up suggested sustained clinical gains across therapies.

CONCLUSIONS

The current study adds to a growing treatment literature and provides support that BATD is efficacious in reducing depression and increasing activity level and environmental reward in the largest, yet historically underserved U.S. ethnic minority population. This trial sets the stage for a larger RCT that evaluates the transportability and generalizability of BATD in an effectiveness trial. (PsycINFO Database Record

Adolescent Callous-Unemotional Traits and Parental Knowledge as Predictors of Unprotected Sex Among Youth

Risky sexual behavior among adolescents is common and results in many negative consequences. The present study investigated longitudinal predictors of adolescents' likelihood of engaging in unprotected sexual intercourse. Parental knowledge, or the extent to which parents know about their children's activities, whereabouts, and friendships, is a robust predictor of youth risk behavior, including risky sexual behavior. However, parenting practices are typically less potent as predictors of subsequent behavior among youth with high levels of callous-unemotional (CU) traits. We conducted three logistic regression models, each of which examined parental knowledge in a different way (through child report, parent report, and a discrepancy score), allowing us to examine parental knowledge, CU traits, and their interaction as predictors of adolescents' subsequent engagement in sex without a condom. Results indicated that adolescents who perceived their parents to possess greater knowledge were less likely to engage in unprotected sex. Higher parent report of parental knowledge was also related to decreased likelihood of engaging in unprotected sex, but only for adolescents with high levels of CU traits. In addition, greater discrepancy between parent and adolescent reports of parental knowledge was related to increased likelihood of engaging in unprotected sex, but only for adolescents with low levels of CU traits. Results highlight the importance of considering both parent and adolescent perceptions of parental knowledge and have important implications for prevention and intervention efforts.

Early adolescent symptoms of social phobia prospectively predict alcohol use

OBJECTIVE

The current study examined whether social phobia (SP) symptoms in early adolescence prospectively predicted alcohol use through middle adolescence in a community sample of youth.

METHOD

Data from an ongoing longitudinal study (N = 277) of mechanisms of HIV-related risk behaviors in youth were used to assess the extent to which SP symptoms in early adolescence (mean [SD] age = 11.00 years [0.81]) would predict alcohol use across five annual assessment waves. Adolescents completed measures of SP symptoms, depressive symptoms, and alcohol use at each wave.

RESULTS

Higher SP symptoms at baseline predicted higher average odds of alcohol consumption during subsequent waves but did not significantly predict an increase in the odds of alcohol use as a function of time. Within a lagged model, SP symptoms measured at a prior assessment point (1 year earlier) predicted greater odds of drinking alcohol at the following assessment point. Importantly, alcohol use did not significantly predict SP symptoms over time. These results suggest that early SP symptoms are an important risk factor for increased odds of subsequent alcohol use.

CONCLUSIONS

The present findings highlight that elevated SP symptoms place adolescents at risk for early alcohol use. Early interventions targeting SP symptoms may be crucial for the prevention of problematic alcohol use in early to mid-adolescence. Implications for prevention and treatment approaches are discussed.

Sex differences in self-report and behavioral measures of disinhibition predicting marijuana use across adolescence

Disinhibition has been consistently linked to substance use across development. Recent research suggests, however, that these relations may be influenced by both sex and measurement approach. The current study examined the moderating effect of sex on the association between behavioral and self-report measures of disinhibition and marijuana use across adolescence. Participants were 115 boys and 89 girls initially evaluated at Grade 8 using a laboratory behavioral assessment and self-report questionnaires of disinhibitory variables. Marijuana use was measured annually from Grades 9 through 12. Results suggest that boys and girls did not differ on either self-reported or behaviorally assessed levels of disinhibition, and that disinhibition measured using both approaches was associated with increases in marijuana use over time. There was a significant interaction between sex and disinhibition, suggesting that boys (but not girls) who self-reported elevations in disinhibition evidenced greater increases in marijuana use. The current findings add to a growing literature supporting the importance of using multiple methods to assess disinhibition and highlight the critical role of biological sex in understanding these relations.

Motivational Interviewing to Reduce Substance Use in Adolescents with Psychiatric Comorbidity

Substance use among adolescents with one or more psychiatric disorders is a significant public health concern. In this study, 151 psychiatrically hospitalized adolescents, ages 13-17 with comorbid psychiatric and substance use disorders, were randomized to a two-session Motivational Interviewing intervention to reduce substance use plus treatment as usual (MI) vs. treatment as usual only (TAU). Results indicated that the MI group had a longer latency to first use of any substance following hospital discharge relative to TAU (36 days versus 11 days). Adolescents who received MI also reported less total use of substances and less use of marijuana during the first 6 months post-discharge, although this effect was not significant across 12 months. Finally, MI was associated with a significant reduction in rule-breaking behaviors at 6-month follow-up. Future directions are discussed, including means of extending effects beyond 6 months and dissemination of the intervention to community-based settings.

Loss of the Mono-ADP-ribosyltransferase, Tiparp, Increases Sensitivity to Dioxin-induced Steatohepatitis and Lethality

The aryl hydrocarbon receptor (AHR) mediates the toxic effects of the environmental contaminant dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin; TCDD). Dioxin causes a range of toxic responses, including hepatic damage, steatohepatitis, and a lethal wasting syndrome; however, the mechanisms are still unknown. Here, we show that the loss of TCDD-inducible poly(ADP-ribose) polymerase (Tiparp), an ADP-ribosyltransferase and AHR repressor, increases sensitivity to dioxin-induced toxicity, steatohepatitis, and lethality. Tiparp(-/-) mice given a single injection of 100 μg/kg dioxin did not survive beyond day 5; all Tiparp(+/+) mice survived the 30-day treatment. Dioxin-treated Tiparp(-/-) mice exhibited increased liver steatosis and hepatotoxicity. Tiparp ADP-ribosylated AHR but not its dimerization partner, the AHR nuclear translocator, and the repressive effects of TIPARP on AHR were reversed by the macrodomain containing mono-ADP-ribosylase MACROD1 but not MACROD2. These results reveal previously unidentified roles for Tiparp, MacroD1, and ADP-ribosylation in AHR-mediated steatohepatitis and lethality in response to dioxin.

Childhood emotional abuse and borderline personality features: The role of anxiety sensitivity among adolescents

Borderline personality disorder (BPD) is a pervasive personality disorder that poses a burden for affected individuals, their family members and society as a whole. Current research suggests that early childhood abuse, including emotional abuse, may be an important predictor of later BPD symptomology. Further, an emerging body of literature suggests that anxiety sensitivity (AS) may serve as a form of emotional vulnerability and be a key variable in the relation between abuse and the development of BPD symptomatology. This literature has relied on retrospective recall of abuse and AS in adult samples. As a result, there is a dearth of literature examining these variables in adolescence, which is a developmental period in which personality traits begin to emerge. This study explored the impact of AS in the development of BPD symptoms in a group of 277 adolescents. Results suggest a significant indirect effect of emotional abuse on BPD symptoms via AS, after controlling for sex, grade and prior levels of AS (indirect effect = 0.04, standard error (SE) = 0.02 (95% confidence interval (CI) = 0.001-0.070)). These findings suggest that, among adolescents, AS may serve as an important contributor to the development of BPD symptoms. Implications for interventions and future research are further discussed.

An experimental investigation of the functional relationship between social phobia and cigarette smoking

INTRODUCTION

Individuals with social phobia (SP) represent a large group with elevated rates of cigarette smoking and cessation rates lower than that of individuals without psychopathology. For individuals with SP, cigarette smoking may be used to reduce social anxiety in anticipation of and during social situations. However, no study to date has experimentally examined this association. The aim of the current study was to experimentally examine the relationship between cigarette smoking and SP as a function of induced social stress.

METHOD

We recruited daily smokers ages 18-21 who scored in either a clinical or normative range on the Social Interaction Anxiety Scale (SIAS). Participants included 54 smokers (42.6% female, 77.8% White, age M(SD)=19.65(1.18), CPSD M(SD)=7.67(4.36), 46.30% high SP) who attended two sessions: one social stress session and one neutral session.

RESULTS

Results indicated that high SP smokers experienced significant decreases in negative affect (NA) following smoking a cigarette when experiencing social stress. This effect was specific to high SP smokers under social stress and was not observed among individuals' average in SP or when examining changes in positive affect.

CONCLUSIONS

For individuals with SP, cigarette smoking may be maintained due to changes in NA associated with smoking specifically in the context of social stress. These results speak to the importance of targeted cessation interventions that address the nature of smoking for individuals with SP.

Liver X receptor regulates hepatic nuclear O-GlcNAc signaling and carbohydrate responsive element-binding protein activity

Liver X receptor (LXR)α and LXRβ play key roles in hepatic de novo lipogenesis through their regulation of lipogenic genes, including sterol regulatory element-binding protein (SREBP)-1c and carbohydrate responsive element-binding protein (ChREBP). LXRs activate lipogenic gene transcription in response to feeding, which is believed to be mediated by insulin. We have previously shown that LXRs are targets for glucose-hexosamine-derived O-linked β-N-acetylglucosamine (O-GlcNAc) modification enhancing their ability to regulate SREBP-1c promoter activity in vitro. To elucidate insulin-independent effects of feeding on LXR-mediated lipogenic gene expression in vivo, we subjected control and streptozotocin-treated LXRα/β(+/+) and LXRα/β(-/-) mice to a fasting-refeeding regime. We show that under hyperglycemic and hypoinsulinemic conditions, LXRs maintain their ability to upregulate the expression of glycolytic and lipogenic enzymes, including glucokinase (GK), SREBP-1c, ChREBPα, and the newly identified shorter isoform ChREBPβ. Furthermore, glucose-dependent increases in LXR/retinoid X receptor-regulated luciferase activity driven by the ChREBPα promoter was mediated, at least in part, by O-GlcNAc transferase (OGT) signaling in Huh7 cells. Moreover, we show that LXR and OGT interact and colocalize in the nucleus and that loss of LXRs profoundly reduced nuclear O-GlcNAc signaling and ChREBPα promoter binding activity in vivo. In summary, our study provides evidence that LXRs act as nutrient and glucose metabolic sensors upstream of ChREBP by modulating GK expression, nuclear O-GlcNAc signaling, and ChREBP expression and activity.

Social anxiety, acute social stress, and reward parameters interact to predict risky decision-making among adolescents

Risk-taking behavior increases during adolescence, leading to potentially disastrous consequences. Social anxiety emerges in adolescence and may compound risk-taking propensity, particularly during stress and when reward potential is high. However, the manner in which social anxiety, stress, and reward parameters interact to impact adolescent risk-taking is unclear. To clarify this question, a community sample of 35 adolescents (15-18yo), characterized as having high or low social anxiety, participated in a study over two separate days, during each of which they were exposed to either a social stress or a control condition, while performing a risky decision-making task. The task manipulated, orthogonally, reward magnitude and probability across trials. Three findings emerged. First, reward magnitude had a greater impact on the rate of risky decisions in high social anxiety (HSA) than low social anxiety (LSA) adolescents. Second, reaction times (RTs) were similar during the social stress and the control conditions for the HSA group, whereas the LSA group's RTs differed between conditions. Third, HSA adolescents showed the longest RTs on the most negative trials. These findings suggest that risk-taking in adolescents is modulated by context and reward parameters differentially as a function of social anxiety.

The association between anxiety sensitivity and motivation to quit smoking among women and men in residential substance use treatment

BACKGROUND

Smoking-attributed mortality is the leading cause of death among individuals in residential substance use treatment. As such, identifying factors that influence smoking cessation is highly relevant and important for this group. Motivation to quit (MTQ) smoking is one such factor that is related to smoking cessation.

OBJECTIVES

In the present study we examine the relationship between Anxiety Sensitivity (AS) and MTQ among individuals enrolled in a residential substance use treatment center in Washington, DC. In light of gender differences in smoking cessation as well as factors that contribute to cessation, we examined this relationship by gender in men and women using multiple group path analysis.

METHODS

Participants (n = 472) completed a measure of MTQ, the structured clinical interview for DSM-IV (SCID-IV-TR), a measure of AS, and self-reported their number of cigarettes smoked per day prior to entering a restricted environment.

RESULTS

RESULTS indicated that AS was significantly related to MTQ in women (standardized path estimate = 0.21, p = .01), but was not significantly related to MTQ in men. Conclusions/Importance: Findings suggest the importance of considering AS as a factor in MTQ for women and subsequent smoking cessation among individuals in residential substance use treatment. RESULTS of this study contribute to the extant literature on predictors of MTQ and highlight the need for tailored cessation interventions with AS as one potential cessation treatment target.

Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity

Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time. Anxiety sensitivity has been identified as an important risk factor in the development of anxiety psychopathology. This study prospectively examined the development of anxiety symptoms in a sample of 277 adolescents (M age = 11.52; 44 % female, 56 % male) over a 3 year period including the influence of anxiety sensitivity on this development. Further, this study investigated whether there were distinct classes of adolescents based on their anxiety symptom trajectories and including anxiety sensitivity as a predictor. Consistent with other reports, findings indicated an overall decline in anxiety symptoms over time in the sample. However, three classes of adolescents were found with distinct anxiety symptom trajectories and anxiety sensitivity was an important predictor of class membership. Adolescents with elevated anxiety sensitivity scores were more likely to be classified as having high and increasing anxiety symptoms over time versus having moderate to low and decreasing anxiety symptoms over time. There are important implications for identification of adolescents and children who are at risk for the development of an anxiety disorder.

Longitudinal trajectories of sensation seeking, risk taking propensity, and impulsivity across early to middle adolescence

Adolescent substance use and abuse show associations with increases in disinhibitory constructs, including sensation seeking, risk taking propensity, and impulsivity. However, the longitudinal trajectories of these constructs from early to middle adolescence remain largely unknown. Thus, the current study examined these developmental trajectories in 277 adolescents (Mage=11.00 at Wave 1), over five consecutive yearly waves. Controlling for age, Hierarchical Linear Modeling analyses showed that sensation seeking increased linearly, whereas risk taking propensity and impulsivity demonstrated curvilinear changes. Specifically, risk taking propensity increased in the first four waves of assessment but did not evidence changes at the last assessment wave. Impulsivity, on the other hand peaked at wave four before subsequently declining. A comparison between females and males and Black and White adolescents suggested that these groups' trajectories were similar. Black adolescents' sensation seeking trajectory differed from adolescents who belonged to the "Other" racial group (i.e., adolescents who neither self-identified as Black or White). Generally, the study findings replicate and extend earlier work indicating that these risk factors increase across early adolescence and begin to level-off during middle adolescence. The importance of understanding the natural course of these core constructs is of great importance for directing future relevant prevention and intervention work.

The Relationship between Puberty and Risk Taking in the Real World and in the Laboratory

Adolescence is marked by the emergence and escalation of risk taking. Puberty has been long-implicated as constituting vulnerability for risk behavior during this developmental period. Sole reliance on self-reports of risk taking however poses limitations to understanding this complex relationship. There exist potential advantages of complementing self-reports by using the BART-Y laboratory task, a well-validated measure of adolescent risk taking. Toward this end, we examined the association between self-reported puberty and both self-reported and BART-Y risk taking in 231 adolescents. Results showed that pubertal status predicted risk taking using both methodologies above and beyond relevant demographic characteristics. Advantages of a multimodal assessment toward understanding the effects of puberty in adolescent risk taking are discussed and future research directions offered.

Brief report: The interaction of impulsivity with risk-taking is associated with early alcohol use initiation

Early alcohol use initiation is a well-established risk factor for the subsequent development of alcohol abuse and dependence. Separate lines of research indicate that impulsivity and risk-taking each are associated with early alcohol use. In this research, the association of the interaction of risk-taking and impulsivity with early alcohol initiation was examined. Results suggest the interaction between impulsivity and risk-taking was related to early alcohol initiation. Among children with lower levels of risk-taking, level of impulsivity was associated with beginning to drink. By contrast, among children with higher levels of risk-taking, level of impulsivity was not associated with the likelihood of initiating alcohol use. These findings suggest that early adolescence is a critical developmental period in which implementing an intervention to reduce impulsivity and risk-taking may be particularly effective to prevent the early initiation of alcohol use.

The efficacy of a behavioral activation intervention among depressed US Latinos with limited English language proficiency: study protocol for a randomized controlled trial

Background

Major depressive disorder is highly prevalent among Latinos with limited English language proficiency in the United States. Although major depressive disorder is highly treatable, barriers to depression treatment have historically prevented Latinos with limited English language proficiency from accessing effective interventions. The project seeks to evaluate the efficacy of behavioral activation treatment for depression, an empirically supported treatment for depression, as an intervention that may address some of the disparities surrounding the receipt of efficacious mental health care for this population.

Methods/design

Following a pilot study of behavioral activation treatment for depression with 10 participants which yielded very promising results, the current study is a randomized control trial testing behavioral activation treatment for depression versus a supportive counseling treatment for depression. We are in the process of recruiting 60 Latinos with limited English language proficiency meeting criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4^th and 5^th Edition for participation in a single-center efficacy trial. Participants are randomized to receive 10 sessions of behavioral activation treatment for depression (n = 30) or 10 sessions of supportive counseling (n = 30). Assessments occur prior to each session and at 1 month after completing treatment. Intervention targets include depressive symptomatology and the proposed mechanisms of behavioral activation treatment for depression: activity level and environmental reward. We will also examine other factors related to treatment outcome such as treatment adherence, treatment satisfaction, and therapeutic alliance.

Discussion

This randomized controlled trial will allow us to determine the efficacy of behavioral activation treatment for depression in a fast-growing, yet highly underserved population in US mental health services. The study is also among the first to examine the effect of the proposed mechanisms of change of behavioral activation treatment for depression (that is, activity level and environmental reward) on depression over time. To our knowledge, this is the first randomized controlled trial to compare an empirical-supported treatment to a control supportive counseling condition in a sample of depressed, Spanish-speaking Latinos in the United States.

Trial registration

Clinical Trials Register: NCT01958840; registered 8 October 2013.

A Case Series of a Behavioral Activation−Enhanced Smoking Cessation Program for Inpatient Substance Users With Elevated Depressive Symptoms

Smoking is the leading preventable cause of death and disease in the world and represents a critical public health problem. Smokers with substance use disorders and depressive symptoms have particular difficulties quitting smoking and represent an underserved population. The current study utilized a novel behavioral activation (BA)−enhanced smoking cessation treatment with three clients in residential substance use treatment who had elevated depressive symptoms. We present detailed descriptions of the treatment they received and the challenges they faced. Our clients, who received five individual BA-enhanced smoking cessation sessions and two follow-up booster sessions, benefited significantly from the BA treatment. Over an 8-week follow-up period, they did not relapse to smoking and experienced significant decreases in depressive symptoms. This suggests BA may be a beneficial treatment strategy for this particularly challenging population.