SEE TRACEY DOI101093/BRAIN/AWW147 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Mechanisms of chronic pain remain poorly understood. We tracked brain properties in subacute back pain patients longitudinally for 3 years as they either recovered from or transitioned to chronic pain. Whole-brain comparisons indicated corticolimbic, but not pain-related circuitry, white matter connections predisposed patients to chronic pain. Intra-corticolimbic white matter connectivity analysis identified three segregated communities: dorsal medial prefrontal cortex-amygdala-accumbens, ventral medial prefrontal cortex-amygdala, and orbitofrontal cortex-amygdala-hippocampus. Higher incidence of white matter and functional connections within the dorsal medial prefrontal cortex-amygdala-accumbens circuit, as well as smaller amygdala volume, represented independent risk factors, together accounting for 60% of the variance for pain persistence. Opioid gene polymorphisms and negative mood contributed indirectly through corticolimbic anatomical factors, to risk for chronic pain. Our results imply that persistence of chronic pain is predetermined by corticolimbic neuroanatomical factors.

Overgeneral autobiographical memory (OGM) is a robust phenomenon in depression, but the extent to which OGM predicts the course of depression is not well-established. This meta-analysis synthesized data from 15 studies to examine the degree to which OGM 1) correlates with depressive symptoms at follow-up, and 2) predicts depressive symptoms at follow-up over and above initial depressive symptoms. Although the effects are small, specific and categoric/overgeneral memories generated during the Autobiographical Memory Test significantly predicted the course of depression. Fewer specific memories and more categoric/overgeneral memories were associated with higher follow-up depressive symptoms, and predicted higher follow-up symptoms over and above initial symptoms. Potential moderators were also examined. The age and clinical depression status of participants, as well as the length of follow-up between the two depressive symptom assessments, significantly moderated the predictive relationship between OGM and the course of depression. The predictive relationship between specific memories and follow-up depressive symptoms became greater with increasing age and a shorter length of follow-up, and the predictive relationship was stronger for participants with clinical depression diagnoses than for nonclinical participants. These findings highlight OGM as a predictor of the course of depression, and future studies should investigate the mechanisms underlying this relationship. KeywordsAutobiographical memory specificity; Overgeneral autobiographical memory; Course of depression; Meta-analysis Overgeneral Autobiographical Memory as a Predictor of the Course of Depression: A Meta-AnalysisOver the past 20 years, a large body of research has accumulated on the overgeneral autobiographical memory (OGM) phenomenon in depression. First described by Williams and Broadbent (1986) in their study of suicidal patients, OGM refers to the finding that, when asked to come up with a specific memory in response to a cue word, some individuals are less specific Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptBehav Res Ther. Author manuscript; available in PMC 2011 July 1. Published in final edited form as:Behav Res Ther. 2010 July ; 48(7): 614-625. doi:10.1016/j.brat.2010.03.013. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscriptand/or more overgeneral in their memory retrieval than others. In particular, much research has shown that individuals with depression are characterized by higher levels of OGM than nondepressed controls . Mor...

Levels of the stress-sensitive hormone cortisol increase dramatically in the first 30-40 minutes after waking, an effect known as the cortisol awakening response (CAR). There is considerable crosssectional evidence that psychosocial stress is associated with an increased CAR, and the CAR has been found to be altered in the presence of stress-related diseases, including Major Depressive Disorder (MDD). To date, no prospective longitudinal studies have examined whether individual differences in the CAR serve as a premorbid risk factor for MDD. In a sample of 230 late adolescents, clinical diagnoses of MDD were predicted from the CAR as well as other indicators of basal cortisol functioning gathered one year earlier, including: waking cortisol levels, bedtime cortisol levels, the size of the CAR, average cortisol, and the slope of the diurnal cortisol rhythm across the waking day. Age and gender, health and health behaviors, baseline neuroticism, exposure to stressful life events and past episodes of mood and anxiety disorders were included as covariates, to help ensure effects are attributable to the CAR rather than related variables. A higher baseline CAR was associated with a significantly increased risk of developing MDD by follow-up, even when excluding individuals with baseline MDD. No other baseline cortisol measures were significant prospective predictors of MDD. In summary, the CAR is a significant prospective risk factor for the development of MDD in young adults, providing some support for the possibility that a heightened CAR may play a role in the etiology of Major Depressive Disorder.

Background-Several theories have posited a common internalizing factor to help account for the relationship between mood and anxiety disorders. These disorders are often comorbid and strongly covary. Other theories and data suggest that personality traits may account, at least in part, for comorbidity between depression and anxiety. The present study examines the relationship between neuroticism and an internalizing dimension common to mood and anxiety disorders.

One of the goals of the NIH Toolbox for Assessment of Neurological and Behavioral Function was to identify or develop brief measures of emotion for use in prospective epidemiologic and clinical research. Emotional health has significant links to physical health and exerts a powerful effect on perceptions of life quality. Based on an extensive literature review and expert input, the Emotion team identified 4 central subdomains: Negative Affect, Psychological Well-Being, Stress and Self-Efficacy, and Social Relationships. A subsequent psychometric review identified several existing self-report and proxy measures of these subdomains with measurement characteristics that met the NIH Toolbox criteria. In cases where adequate measures did not exist, robust item banks were developed to assess concepts of interest. A population-weighted sample was recruited by an online survey panel to provide initial item calibration and measure validation data. Participants aged 8 to 85 years completed self-report measures whereas parents/guardians responded for children aged 3 to 12 years. Data were analyzed using a combination of classic test theory and item response theory methods, yielding efficient measures of emotional health concepts. An overview of the development of the NIH Toolbox Emotion battery is presented along with preliminary results. Norming activities led to further refinement of the battery, thus enhancing the robustness of emotional health measurement for researchers using the NIH Toolbox. Neurology In everyday terms, the word "emotion" evokes connotations of strong feelings, often negative and distressing when they tax our capacity to maintain our poise. It is unpleasant when we are extended beyond our usual resources by stressful life events including poverty, unemployment, oppression, discrimination, and disease. However, positive emotions can be reflections of well-being in our lives, and positive social relationships can buffer stress and enhance health. Recognizing the full spectrum of emotional life and its impact on health, the mandate for the NIH Toolbox was to develop assessments with a broad focus, beyond just negative emotion, or emotional distress. The original Request for Proposals alluded to several additional aspects of the experience and expression of emotion relevant to health in the general population including the importance of psychological well-being, the role of important aspects of positive functioning, such as adaptability, resilience, and self-efficacy, and the importance of the interpersonal and social context in which emotions arise and may be expressed.Feedback provided through an NIH Toolbox Expert Request for Information (RFI) was also consistent with this desire for a broad emphasis on emotional health. As part of this RFI, we obtained input from 147 experts (64% of 232 invited experts), including key opinion leaders from the NIH research program staff and NIH-funded investigators with a broad focus in neurologic and behavioral