The traditional concept of 'categorical' psychiatric disorders has been challenged as many of the symptoms display a continuous distribution in the general population. We suggest that this is the case for emotional dysregulation, a key component in several categorical psychiatric disorder constructs. We used voxel-based magnetic resonance imaging morphometry in healthy human subjects (n ¼ 87) to study how self-reported subclinical symptoms associated with emotional dysregulation relate to brain regions assumed to be critical for emotion regulation. To measure a pure emotional dysregulation, we also corrected for subclinical symptoms of non-emotional attentional dysregulation. We show that such subclinical emotional symptoms correlate negatively with the grey matter volume of lateral orbitofrontal cortex bilaterally-a region assumed to be critical for emotion regulation and dysfunctional in psychiatric disorders involving emotional dysregulation. Importantly, this effect is mediated both by a decrease in volume associated with emotional dysregulation and an increase in volume due to non-emotional attentional dysregulation. Exploratory analysis suggests that other regions involved in emotional processing such as insula and ventral striatum also show a similar reduction in grey matter volume mirroring clinical disorders associated with emotional dysregulation. Our findings support the concept of continuous properties in psychiatric symptomatology.
Leufsta herrgård. The herrgård in the mid-eighteenth century, viewed from the north, from the direction of the lower forge. To the right is the bruksgatan, leading to the church and, just beyond it, the bruk of� ce. Courtesy of Jernkontoret. This book is printed on acid-free paper.
BackgroundMentalisation-based treatment (MBT) in borderline personality disorder (BPD) has a growing evidence base, but there is a lack of effectiveness and moderator studies. The present study examined the effectiveness of MBT in a naturalistic setting and explored psychiatric and psychological moderators of outcome.MethodBorderline and general psychiatric symptoms, suicidality, self-harm, alexithymia and self-image were measured in a group of BPD patients (n = 75) receiving MBT; assessments were made at baseline, and subsequently after 6, 12 and 18 months (when treatment ended). Borderline symptoms were the primary outcome variable.ResultsBorderline symptoms improved significantly (d = 0.79, p < .001), as did general psychiatric symptoms, suicidality, self-harm, self-rated alexithymia and self-image. BPD severity or psychological moderators had no effect on outcome. Younger patients improved more on self-harm, although this could be explained by the fact that older patients had considerably lower baseline self-harm.ConclusionsMBT seems to be an effective treatment in a naturalistic setting for BPD patients. This study is one of the first studies of MBT showing that outcomes related to mentalisation, self-image and self-rated alexithymia improved. Initial symptom severity did not influence results indicating that MBT treatment is well adapted to patients with severe BPD symptoms.Trial registrationThe study was retrospectively registered 25 September 2017 in the ClinicalTrials.gov PRS registry, no. NCT03295838.
T he central role of the iron industry in Britain's industrialization is a textbook commonplace. Iron was one of those sectors in which indisputably revolutionary changes took place. The use of coke in smelting, the application of steam power, and the perfecting of coal-fired refining methods transformed the prospects of the British iron industry in the course of the eighteenth century. Perhaps not surprisingly, the historiography of iron has long been fixed upon these dramatic turning points. Ashton's classic Iron and steel in the industrial revolution took 1775-the year of James Watt's steam engine patent-as pivotal. Birch's Economic history of the British iron and steel industry begins in 1784, the date at which Henry Cort patented his 'puddling and rolling' technique. 2 The most important recent contribution to the literature, Hyde's Technological change and the British iron industry, notwithstanding its methodological advance over older accounts, stands in a well-established tradition. 3 Technological questions have always been foremost. Historians have found the organization of the iron industry a less compelling topic. Nor have they devoted much attention to the ways in which the market for iron functioned. Yet questions of industrial and commercial organization were of paramount importance. In the absence of technological transformation-something of which contemporaries only became sure in the 1780s-organizational change was the only means of meeting the rapidly growing demand for iron in the British Isles.A conceptual shift is needed if the eighteenth-century iron industry is to be adequately understood. Indeed, our appreciation of the role of iron in British industrialization will be enhanced only if we stop speaking of an iron industry. The term is anachronistic. Contemporaries referred to the 'iron trade', something that embraced both the primary processing of iron and the subsequent manufacturing of metalwares. The iron trade involved a variety of actors, from the owners of blast furnaces-through forgemasters, slitting mill proprietors, wholesale ironmongers, inter-1 This article reports the preliminary findings of the project 'Baltic iron and the organization of the British iron market in the eighteenth century' (Economic and Social Research Council award R000223109). Chris Evans acknowledges a Caird Short-Term Fellowship from the National Maritime Museum that enabled him to pursue research on the role of the Navy Board in the market for bar iron, and Göran Rydén acknowledges the support of Axel och Margaret Ax:son Johnsons Stiftelse för allmännyttiga ändamål.2 Ashton, Iron and steel; Birch, Economic history. 3 Hyde, Technological change. For a survey of the historiography, see Harris, British iron industry.
Ever since the publication of the Encyclopédie, in the decades after mid-eighteenth century, there has been an on-going debate about the implications of the metaphor of enlightenment, mainly based on themes discussed in Diderot’s and d’Alembert’s work. Sadly, however, one major field has been left outside; scholars have dealt with two branches of the tree of knowledge, science and the liberal arts, but ignored the branch of mechanical arts. This article takes a starting-point in the reintroduction of political economy, with division of labour, and technology into an assessment of the Enlightenment. It has the ambition of discussing the process whereby progress became a central feature of eighteenth-century thinking, as well as relating this to a discussion about travelling to other places. It deals with Swedish travellers going to Britain, and central Europe, to view differently organised trades with elaborate division of labour, more skilled artisans, fitted<br />into a commercial economy.
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