Virtual reality Post Traumatic Stress Disorder (PTSD) exposure therapy results with active duty Iraq war combatants

Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experience including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that at least 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) delivered exposure therapy for PTSD has been used with reports of positive outcomes. The aim of the current paper is to present the rationale and brief description of a Virtual Iraq PTSD VR therapy application and present initial findings from its use with PTSD patients. Thus far, Virtual Iraq consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback needed to iteratively evolve the system was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Results from an open clinical trial at San Diego Naval Medical Center of the first 18 treatment completers indicate that 14 no longer meet PTSD diagnostic criteria at post-treatment, with only one not maintaining treatment gains at 3 month follow-up. Clinical tests are also currently underway at Ft. Lewis, Emory University, Weill Cornell Medical College, Walter Reed Army Medical Center and 10 other sites. Other sites are preparing to use the application for a variety of PTSD and VR research purposes.

A dual QPSK soft-demapper for ECMA-368 exploiting time-domain spreading and guard interval diversity

When considering the relative fast processing speed and low power requirements for Wireless Personal Area Networks (WPAN) and Wireless Universal Serial Bus (USB) consumer based products, then the efficiency and cost effectiveness of these products become paramount. This paper presents an improved soft-output QPSK demapper suitable for the products above that not only exploits time diversity and guard carrier diversity, but also merges the demapping and symbol combining functions together to minimize CPU cycles, or memory access dependant upon the chosen implementation architecture. The proposed demapper is presented in the context of Multiband OFDM version of UWB (ECMA-368) as the chosen physical implementation for high-rate Wireless USB.

Dual carrier modulation demapping methods and performances for wireless USB

Dual Carrier Modulation (DCM) was chosen as the higher data rate modulation scheme for MB-OFDM (Multiband Orthogonal Frequency Division Multiplexing) in the UWB (Ultra-Wide Band) radio platform ECMA-368. ECMA-368 has been chosen as the physical implementation for high data rate Wireless USB (W-USB) and Bluetooth 3.0. In this paper, different demapping methods for the DCM demapper are presented, being Soft Bit, Maximum Likely (ML) Soft Bit and Log Likelihood Ratio (LLR). Frequency diversity and Channel State Information (CSI) are further techniques to enhance demapping methods. The system performance for those DCM demapping methods simulated in realistic multi-path environments are provided and compared.

Modeling energy consumption of dual-hop relay based MAC protocols in ad hoc networks

Given that the next and current generation networks will coexist for a considerable period of time, it is important to improve the performance of existing networks. One such improvement recently proposed is to enhance the throughput of ad hoc networks by using dual-hop relay-based transmission schemes. Since in ad hoc networks throughput is normally related to their energy consumption, it is important to examine the impact of using relay-based transmissions on energy consumption. In this paper, we present an analytical energy consumption model for dual-hop relay-based medium access control (MAC) protocols. Based on the recently reported relay-enabled Distributed Coordination Function (rDCF), we have shown the efficacy of the proposed analytical model. This is a generalized model and can be used to predict energy consumption in saturated relay-based ad hoc networks. This model can predict energy consumption in ideal environment and with transmission errors. It is shown that using a relay results in not only better throughput but also better energy efficiency. Copyright (C) 2009 Rizwan Ahmad et al.

A dual QPSK soft-demapper for multiband OFDM exploiting time-domain spreading and guard interval diversity

When considering the relative fast processing speeds and low power requirements for Wireless Personal Area Networks (WPAN) including Wireless Universal Serial Bus (WUSB) consumer based products, then the efficiency and cost effectiveness of these products become paramount. This paper presents an improved soft-output QPSK demapper suitable for the products above that not only exploits time diversity and guard carrier diversity, but also merges the demapping and symbol combining functions together to minimize CPU cycles, or memory access dependant upon the chosen implementation architecture. The proposed demapper is presented in the context of Multiband OFDM version of Ultra Wideband (UWB) (ECMA-368) as the chosen physical implementation for high-rate Wireless US8(1).

Enhancing MB-OFDM throughput with dual circular 32-QAM

Quadrature Phase Shift Keying (QPSK) and Dual Carrier Modulation (DCM) are currently used as the modulation schemes for Multiband Orthogonal Frequency Division Multiplexing (MB-OFDM) in the ECMA-368 defined Ultra-Wideband (UWB) radio platform. ECMA-368 has been chosen as the physical radio platform for many systems including Wireless USB (W-USB), Bluetooth 3.0 and Wireless HDMI; hence ECMA-368 is an important issue to consumer electronics and the users experience of these products. To enable the transport of high-rate USB, ECMA-368 offers up to 480 Mb/s instantaneous bit rate to the Medium Access Control (MAC) layer, but depending on radio channel conditions dropped packets unfortunately result in a lower throughput. This paper presents an alternative high data rate modulation scheme that fits within the configuration of the current standard increasing system throughput by achieving 600 Mb/s (reliable to 3.1 meters) thus maintaining the high rate USB throughput even with a moderate level of dropped packets. The modulation system is termed Dual Circular 32-QAM (DC 32-QAM). The system performance for DC 32-QAM modulation is presented and compared with 16-QAM and DCM1.

Anticipatory activation in the amygdala and anterior cingulate in generalized anxiety disorder and prediction of treatment response

OBJECTIVE: The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alterations in anticipatory amygdala function and whether anticipatory activity in the anterior cingulate cortex predicts treatment response. METHOD: Functional magnetic resonance imaging (fMRI) was employed with 14 generalized anxiety disorder patients and 12 healthy comparison subjects matched for age, sex, and education. The event-related fMRI paradigm was composed of one warning cue that preceded aversive pictures and a second cue that preceded neutral pictures. Following the fMRI session, patients received 8 weeks of treatment with extended-release venlafaxine. RESULTS: Patients with generalized anxiety disorder showed greater anticipatory activity than healthy comparison subjects in the bilateral dorsal amygdala preceding both aversive and neutral pictures. Building on prior reports of pretreatment anterior cingulate cortex activity predicting treatment response, anticipatory activity in that area was associated with clinical outcome 8 weeks later following treatment with venlafaxine. Higher levels of pretreatment anterior cingulate cortex activity in anticipation of both aversive and neutral pictures were associated with greater reductions in anxiety and worry symptoms. CONCLUSIONS: These findings of heightened and indiscriminate amygdala responses to anticipatory signals in generalized anxiety disorder and of anterior cingulate cortex associations with treatment response provide neurobiological support for the role of anticipatory processes in the pathophysiology of generalized anxiety disorder.

A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents

Cognitive behaviour therapy (CBT) for young people with obsessive compulsive disorder (OCD) has become the treatment of first choice. However, the literature is largely based on studies emphasising exposure and response prevention. In this study, we report on a randomised controlled trial of CBT for young people carried out in typical outpatient clinic conditions which focused on cognitions. A randomised controlled trial compares 10 sessions of manualised cognitive behavioural treatment with a 12-week waiting list for adolescents and children with OCD. Assessors were blind to treatment allocation. 21 consecutive patients with OCD aged between 9 and 18 years were recruited. The group who received treatment improved more than a comparison group who waited for 3 months. The second group was treated subsequently using the same protocol and made similar gains. In conclusion, CBT can be delivered effectively to young people with OCD in typical outpatient settings.

Pathways to inflated responsibility beliefs in adolescent obsessive-compulsive disorder: a preliminary investigation

Background: An inflated sense of responsibility is characteristic of obsessive-compulsive disorder (OCD). No previous studies have investigated its origins. Five potential pathways to inflated responsibility beliefs have been proposed; these are tested in this study. Method: A novel measure, the Origins Questionnaire for Adolescents (OQA), was developed to assess experiences on these five pathways. Reliability of the OQA was investigated. The experiences on the five pathways to inflated responsibility beliefs of sixteen adolescents with a history of OCD were compared to sixteen adolescents with no history of OCD. Parents also reported on adolescents’ experiences on the five pathways. Results: Inter-rater reliability was high. The internal consistency of the subscales were only partly satisfactory. The groups differed on one pathway; the clinical group reported a higher sense of responsibility for significant incidents with a negative outcome prior to onset of OCD. Conclusions: An inflated sense of responsibility, in combination with the occurrence of specific incidents, might act as a vulnerability factor for development of OCD. Future research should consider how to measure the subtle effects of experiences of responsibility over the course of development.

Early identification of stimulant treatment responders, partial responders and non-responders using objective measures in children and adolescents with hyperkinetic disorder

Background: The aim of this study was to evaluate stimulant medication response following a single dose of methylphenidate (MPH) in children and young people with hyperkinetic disorder using infrared motion analysis combined with a continuous performance task (QbTest system) as objective measures. The hypothesis was put forward that a moderate testdose of stimulant medication could determine a robust treatment response, partial response and non-response in relation to activity, attention and impulse control measures. Methods: The study included 44 children and young people between the ages of 7-18 years with a diagnosis of hyperkinetic disorder (F90 & F90.1). A single dose-protocol incorporated the time course effects of both immediate release MPH and extended release MPH (Concerta XL, Equasym XL) to determine comparable peak efficacy periods post intake. Results: A robust treatment response with objective measures reverting to the population mean was found in 37 participants (84%). Three participants (7%) demonstrated a partial response to MPH and four participants (9%) were determined as non-responders due to deteriorating activity measures together with no improvements in attention and impulse control measures. Conclusion: Objective measures provide early into prescribing the opportunity to measure treatment response and monitor adverse reactions to stimulant medication. Most treatment responders demonstrated an effective response to MPH on a moderate testdose facilitating a swift and more optimal titration process.

Sadness in mothers’ ‘baby-talk’ predicts affective disorder in adolescent offspring

‘Baby-talk’ is common across cultures. It underpins infant vocal preferences, and helps regulate infant engagement. Its longer-term significance is unclear. In a longitudinal study, we found indications of ‘sadness’ in postnatally depressed mothers’ baby-talk statistically mediated effects of maternal depression on offspring adolescent affective disorder.