Recent research has emphasized the importance of the metabolic cluster, which includes glucose intolerance, dyslipidemia, and high blood pressure, as a strong predictor of the obesity-related morbidities and premature mortality. Fundamental to this association, commonly referred to as the metabolic syndrome, is the close interaction between abdominal fat patterning, total body adiposity, and insulin resistance. As the initial step in identifying major genetic loci influencing these phenotypes, we performed a genomewide scan by using a 10-centiMorgan map in 2,209 individuals distributed over 507 nuclear Caucasian families. Pedigreebased analysis using a variance components linkage model demonstrated a quantitative trait locus (QTL) on chromosome 3 (3q27) strongly linked to six traits representing these fundamental phenotypes [logarithm of odds (lod) scores ranged from 2.4 to 3.5]. This QTL exhibited possible epistatic interaction with a second QTL on chromosome 17 (17p12) strongly linked to plasma leptin levels (lod ‫؍‬ 5.0). Situated at these epistatic QTLs are candidate genes likely to influence two biologic precursor pathways of the metabolic syndrome. O besity is a common and chronic disorder associated with decreased longevity and increased morbidity from a variety of diseases, including type 2 diabetes mellitus, hypertension, stroke, and coronary heart disease (1). Fat distribution, specifically the pattern known as upper-body, abdominal, or visceral obesity, is a major predictor of the adverse metabolic profile predisposing to these health risks (2). Thus, abdominal-visceral fat size has emerged as a significant precursor of glucose intolerance, hyperinsulinemia, elevated plasma triglycerides, decreased high density lipoprotein-cholesterol, and increased blood pressure (3). Fundamental to this metabolic milieu are close interactions between total body adiposity, abdominalvisceral fat size, and insulin resistance. Reaven (4) provided evidence to suggest that resistance to insulin-stimulated glucose uptake is associated with a series of related metabolic variables, termed ''syndrome X,'' which cluster in the same individual and include glucose intolerance, disturbed plasma lipids, and high blood pressure (4). Because of close similarities of these features with those associated with abdominal obesity, the more collective term metabolic syndrome was introduced (5).The etiology of the abdominal obesity-metabolic syndrome is complex and is thought to involve metabolic, neuroendocrine, and genetic interactions. A metabolic-neuroendocrine cascade has been proposed in which increased free fatty acid flux from the highly lipolytic visceral adipocytes, together with imbalances in sex hormones, could cause the insulin resistance and hyperinsulinemia, with their metabolic consequences (6). Weight gain with preferential deposition of adipocytes in the abdominal-visceral region is considered secondary to adoption of Westernized diet, activity lifestyle, and reactivity to emotional, intellectual, and physical stresses (5...

Considerable research shows that withdrawal severity is inconsistently related to smoking cessation outcomes. This may result from measurement problems or failure to scrutinize important dimensions of the withdrawal experience. Two recent studies demonstrated that withdrawal elevation and variations in the time course of withdrawal were related to relapse in smokers treated with the nicotine patch (T. M. Piasecki, M. C. Fiore, & T. B. Baker, 1998). This article reports a conceptual replication and extension of those findings in unaided quitters. Evidence for temporal heterogeneity was found across different types of withdrawal symptoms. Patterns or slopes of affect and urge reports over time predicted smoking status at follow-up, as did mean elevation in withdrawal symptoms. These results suggest that affect and urge withdrawal symptoms make independent contributions to relapse and that relapse is related to both symptom severity and trajectory.

Symptoms of depression have been associated with increased smoking prevalence and failure to quit smoking in several cross-sectional and population-based studies. Few studies, however, have prospectively examined the ability of current symptoms of depression to predict failure to quit smoking in treatment-motivated smokers. Pretreatment depressed mood was assessed by 3 different methods in 3 separate samples, 2 of which comprised smokers receiving combined pharmacological and behavioral treatments and a 3rd in which smokers received self-help materials only. In all studies, time in days from quit day until the 1st cigarette was ascertained to document survival. Survival analyses showed that in all 3 studies survival time was significantly and negatively related to measures of even very low levels of pretreatment depressed mood. Results were replicated across 3 independent samples and were robust and uniformly clear, indicating that low levels of depressive symptoms assessed at baseline predict time to 1st cigarette smoked after attempted quitting.

Given the limited success of conventional treatments for veterans with posttraumatic stress disorder (PTSD), investigations of alternative approaches are warranted. We examined the effects of a breathing-based meditation intervention, Sudarshan Kriya yoga, on PTSD outcome variables in U.S. male veterans of the Iraq or Afghanistan war. We randomly assigned 21 veterans to an active (n = 11) or waitlist control (n = 10) group. Laboratory measures of eye-blink startle and respiration rate were obtained before and after the intervention, as were self-report symptom measures; the latter were also obtained 1 month and 1 year later. The active group showed reductions in PTSD scores, d = 1.16, 95% CI [0.20, 2.04], anxiety symptoms, and respiration rate, but the control group did not. Reductions in startle correlated with reductions in hyperarousal symptoms immediately postintervention (r =. 93, p <. 001) and at 1-year follow-up (r =. 77, p =. 025). This longitudinal intervention study suggests there may be clinical utility for Sudarshan Kriya yoga for PTSD.

A consensus conference on the reasons for the undertreatment of depression was organized by the National Depressive and Manic Depressive Association (NDMDA) on January 17–18,1996. The target audience included health policymakers, clinicians, patients and their families, and the public at large. Six key questions were addressed: (1) Is depression undertreated in the community and in the clinic? (2) What is the economic cost to society of depression? (3) What have been the efforts in the past to redress undertreatment and how successful have they been? (4) What are the reasons for the gap between our knowledge of the diagnosis and treatment of depression and actual treatment received in this country? (5) What can we do to narrow this gap? (6) What can we do immediately to narrow this gap?

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These results suggest that even during the deepest stage of sleep, sensory and sensorimotor areas in insomnia subjects may still be relatively active compared to control subjects and to the rest of the sleeping brain.