Objective To determine if specific measures of heart rate variability (HRV) are associated with the total score on a seven-item inventory for Sudden Unexplained Death in Epilepsy (SUDEP). Methods Nineteen subjects with intractable partial seizures, at least three per month, were enrolled in a randomized clinical trial of omega-3 fatty acids in epilepsy. At study entry, subjects underwent a 1-hour ECG recording for the determination of HRV. To estimate the risk of SUDEP, we assembled a seven-item inventory (The SUDEP-7 Inventory) from risk factors prospectively validated by Walczak al. [6] The SUDEP-7 score was then correlated with measures of HRV using the Pearson Correlation and other parametric and non-parametric methods. Results Subjects were highly refractory, with a mean seizure frequency of 22.8 seizures per month. Scores on the SUDEP-7 inventory ranged from 1 – 7 of a maximum possible score of 12. RMSSD, a measure of high frequency HRV was inversely correlated with the SUDEP-7 score, r = −0.64, p =0.004. Subjects with higher SUDEP-7 scores had reduced levels of HRV (RMSSD). Other time-dependent measures of HRV (SDNN, SDANN) were not significantly correlated with SUDEP risk scores. Conclusions RMSSD, a measure of HRV, which reflects the integrity of vagus nerve-mediated autonomic control of the heart, is highly associated with the total score on a new 7-item SUDEP risk inventory. Lower RMSSD values were associated with higher risk scores on a new SUDEP risk inventory. This provides new evidence that HRV (specifically RMSSD) is a marker of SUDEP risk.

BackgroundSudden unexpected death in epilepsy (SUDEP) is a major cause of death in those with drug-resistant epilepsy (DRE). There is a need for inventories and biomarkers associated with the risk for SUDEP.ObjectiveTo explore the revised SUDEP Risk Inventory (SUDEP-7) in a cohort with DRE and determine the association with Heart Rate and other covariates.MethodsTwenty-five subjects with severe DRE were enrolled in a clinical trial for epilepsy. Baseline demographics, duration of epilepsy, seizure types, seizure frequency, seizure severity, AEDs, and vital signs were collected. Heart rate variability (HRV) was calculated from 1-h recordings of ECG. A SUDEP Risk Inventory (SUDEP-7) was administered, which included seven validated and weighted risk factors initially identified by Walczak et al. as factors associated with SUDEP risk.ResultsThe total score on the revised SUDEP-7 ranged from 1 to 7, mean = 3.4 (SD 1.8). The SUDEP Risk Inventory score was inversely correlated with RMSSD (Pearson r = −0.45, p = 0.027). The following variables were significantly associated with RMSSD: epilepsy duration (p = 0.02), age (p = 0.03), and developmental intellectual disability (p < 0.001). The correlation between RMSSD and SUDEP-7 tended to persist also after the adjustment for patient age (r = −0.40, p = 0.05). Two subjects died of SUDEP: their SUDEP-7 scores were above average and in the upper twenty-fifth and fiftieth percentiles, respectively (6 and 4, mean = 3.4).ConclusionRMSSD, a measure of low frequency HRV, was significantly associated with SUDEP Risk Inventory (SUDEP-7) scores. Using a multivariate model, the covariates of developmental intellectual disability, age, and duration of epilepsy were also significantly associated with decreased HRV. The correlation between decreased HRV and a higher SUDEP-7 score remained unchanged even after the adjustment for patient age. The results suggest that older age, greater duration of epilepsy, and the presence of developmental intellectual disability may increase the risk of SUDEP through their direct influence on decreasing the vagus nerve-mediated HRV. Further validation of the SUDEP-7 inventory is indicated.Trial RegistrationClinicalTrials.gov, NCT00871377.

Scholars and popular commentators have often stereotyped emotion as a tool that citizens use to reason about politics in place of hard fact and critical thought. Indeed, critics have often seen emotion as a potentially dangerous force that can sway the unsophisticated masses to undesirable ends. This article challenges the view that emotion is an outgrowth of low sophistication, arguing that high sophisticates are more likely to experience emotion in reaction to politics and that emotions are more influential on the political behavior of high sophisticates. Drawing upon appraisal theory, this article develops a theory of how political engagement elicits emotionality about politics, and how emotion interacts with understanding and motivation to produce its greatest impact on the behavior of those citizens who are the most politically sophisticated. Behavioral effects are examined in the contexts of presidential voting behavior and Iraq War policy attitudes. Hypotheses are tested on pooled American National Election Studies (ANES) data and an original web-based survey of undergraduates.

Social categorization processes may be initiated by physical appearance, which have the potential to influence how people evaluate others. Categorizations ground what stereotypes and prejudices, if any, become activated. Gender is one of the first features people notice about others. Much less is known about individuals who may transgress gender expectations, including people who are transgender. Using an experiment, this study investigates whether the attitudes that people have about transgender people and rights are influenced by information and facial images. We hypothesize that mere exposure to transgender people, via information and images of faces, should be a source of prejudice reduction. We randomly provide participants with vignettes defining transgender and also randomize whether these vignettes come with facial images, varying the physical features of gendered individuals. We find our treatments have lower levels of discomfort and transphobia but have little effect on transgender rights attitudes. We further find that the impacts are stronger among Democrats than among Republicans. Our findings support the argument that people are in general unfamiliar with transgender people, and the mere exposure to outgroups can be a source of prejudice reduction.KEY WORDS: survey experiment, impression formation processes, expectation violation theory, mere exposure effect,LGBT, transgender 197 0162-895X

The lesbian, gay, bisexual, transgender (LGBT) community includes a diverse set of groups, including distinct groups based on sexual orientation and/or gender identity, but it is not clear whether the public makes distinctions in their attitudes toward these subgroups. If they do, what factors motivate individuals to evaluate gays and lesbians differently from transgender people? This study analyzes Americans’ attitudes toward these communities, and it evaluates their support for nondiscrimination protections. We find that public attitudes are significantly more negative toward transgender people and policies pertaining to them than they are toward gay men and lesbians and related policies. The analyses reveal that differences in these attitudes are associated with social contact effects, variation in cognitive consistency, elite cues, and the varying magnitudes of key political factors, such as religiosity and partisanship.

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NCT00871377.

Political advertisements can shift attitudes and behaviors to become more exclusionary toward social out-groups. However, people who engage in an antidiscrimination exercise in the context of an experiment may respond differently to such ads. What interventions might foster inclusive attitudes in the presence of political communications about social policy issues like transgender rights? We examined two scalable antidiscrimination exercises commonly used in applied settings: describing a personal narrative of discrimination and perspective-taking. We then showed people political ads that are favorable or opposed to transgender rights to determine whether those interventions moderate how receptive people are to the messages. Relying on two demographically representative survey experiments of adults in the United States (study 1 N = 1,291; study 2 N = 1,587), we found that personal recollections of discriminatory experiences did not reduce exclusionary attitudes, but perspective-taking had some effects, particularly among those who fully complied with the exercise. However, both studies revealed potential backfire effects; recalling a discriminatory experience induced negative attitudes among a subset of the participants, and participants who refused to perspective-take when prompted also held more negative attitudes. Importantly, political ads favorable toward transgender rights consistently resulted in more positive attitudes toward transgender people. Future work needs to carefully examine heterogeneous responses and resistance to antidiscrimination interventions and examine what particular aspects of the political ads induced the attitude change.