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This Weekend in Gators Sports: Tennis Wins Big, Swim and Dive Stays Perfect
Florida swimming and diving and men’s tennis posted strong results on the road over the weekend. Gators men’s tennis returned to Gainesville stamping 15 wins on the weekend at the three-day Bedford Cup hosted by UCF, while Florida men’s and women’s swim and dive remained undefeated against Kentucky 31-0 all time. Men’s Tennis: Doubles Title […]
Hunter Green Named Ray’s Eight, Punting Matchup with Iowa
Washington punter Hunter Green was named one of the “Ray’s Eight” punters of the week by the Ray Guy Award after his 310-yard punting performance at USC. Green punted six times for an average of 51.7 yards with three pinned inside the 20-yard line. Two of his punts were downed at the one-yard line. His …
Columbus Councilmembers say mayor playing politics over damaged rec center
Three Columbus City Councilmembers accused Mayor Andrew Ginther of using a storm-damaged rec center as a “political prop” in a capital budget fight.
Sacramento entertainment spot tops list of best escape room in the United States
Three other California escape rooms also made the list by USA Today.
Wisconsin voters to decide limits on governor’s partial veto power
LA CROSSE, Wis. (WXOW) – Wisconsin voters will see three proposed constitutional amendments on their Nov. 3 ballot, including one dealing with the governor’s partial veto power.
College of Ag Sciences clubs get philanthropy boost from visiting ag company
Three clubs in Penn State’s College of Agricultural Sciences got a recent boost from a new donation from Pivot Bio, a company specializing in products that optimize crop production through specific nitrogen delivery.
Scamacca ‘very happy’ with first Italy goal in three years
Gianluca Scamacca is ‘very happy’ to have scored his first Italy goal in three years, paving the way for the 3-1 win over Turkiye in the Nations League.The Azzurri had quite a sluggish start again...
A health app designed for teachers
A new app is designed to help teachers stay healthy in their day-to-day work. The digital tool is the result of a three-year collaborative project between the Technical University of Munich (TUM) and ...
Joe Burrow Bengals Passing Records Watch: Week 5
Heading into the 2026 season, Joe Burrow has the weight of the world on his shoulders. Can he carry the Bengals back to the playoffs after missing in each of the last three seasons? In 2023, his season was shortened due to a freak wrist injury. That injury was so severe that "experts" on Twitter …
Raiders Coach Doesn’t Regret Taking Points Off Board
The Las Vegas Raiders lost by three points to the Chiefs, but Klint Kubiak doesn't regret taking three off the board.
Why I Don’t Think Ride Or Die Should Have Been Cancelled (And What Company Should Save It...)
(Welcome to my weekly streaming ratings report, the single best guide to what’s popular in streaming TV and what isn’t. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. If you were forwarded this email, please subscribe to get these insights each week.) So…I recently came across a Reddit thread, talking about films on streaming, wondering why there are no reliable sources out there for streaming ratings data. Sigh. Honestly, as annoyed as I am that so many still don’t realize that we have streaming ratings, I somewhat get it. Until now, there was such a long delay between when a show or film came to streaming and when we got its viewership data; I understand why people were confused. (But, as you know, this just changed.) Also, even back in the day, how many people knew how well films did on television? Luckily, as a reader, you’re in the know. Okay, on to this week’s issue. I want to take a look at Prime Video cancelling Ride or Die and whether I agree with that decision. Overall, we didn’t have any breakout hits (no TV shows landed over 20 million hours according to Nielsen) but we have a lot of steady performers on the streaming charts. Plus, we’ll look at where $50 million in missing box office dollars went. (Spoiler: straight-to-streaming.) All that, plus new episodes of The Secret Lives of Mormon Wives, Supergirl heads to streaming, a new YA show does well on Netflix, the viewership for the Daily Wire’s $50 million fantasy show, what TV show hit-maker can’t make streaming hits, CD sales, all the flops, bombs and misses, and a whole lot more. Let’s dive right in! (Reminder: The streaming ratings report focuses on the U.S. market and compiles data from Nielsen’s weekly top ten viewership ranks, Luminate’s Top Ten Data, JustWatch and Reelgood interest data, Samba TV household viewership, company datecdotes, Netflix hours viewed data, Google Trends, and IMDb to determine the most popular content. While most data points are current, Nielsen’s data covers the weeks of September 7th to September 13th, 2026. You can find a link to my terminology here.) Subscribe Television - Ride or Die Is a Hit…But It Got Cancelled? What The Data “Says” I hate the phrase “here’s what the data says”, even though sometimes I find myself using it. If data just told us everything, we data folks would be out of a job! Data is often messy, complicated and nuanced. When it comes to strategy, many of the best decisions can’t actually use “data”, since it’s vastly too complicated to model. Anyways, I’ve been singing the praises of Prime Video’s Ride Or Die this summer, a show that did very well for them. And yet…it got cancelled. Now, usually when a show gets cancelled, a bunch of websites say “a hit show got cancelled”... Here’s the thing, though: in this case, they’re right! The data “says” that this show was a hit. Specifically, out of 522 first seasons to make a week on the Nielsen charts since 2020, it’s the 75th biggest. On Amazon, Ride or Die is eighth out of 41 first seasons: That’s top 15th percentile all time, almost exactly, which is my definition of a “hit”! I mean, outside of Reacher, Amazon needed a hit this summer! (Admittedly, Off Campus did well for Amazon in the spring, but Ride or Die performed even better.) So what happened? Why did Amazon cancel one of their rare 2026 bright spots? Well, Deadline reported a reason—which I’ll get to—but I’d break it down into three relevant questions: What is a given streamer’s reasoning? Is that reasoning sound? Could the stated reason not be the real reason? According to Deadline, Amazon felt the show “over-indexed” in middle-aged women. (This was based on leaks from within Amazon.) The logic is this: Amazon already reaches this demographic because of unlimited two-day shipping bundled with Prime, so they don’t really need more shows like this. Now, it’s my job to ask if that’s a good reason, and I’ll be honest, in this case, I don’t think it is. Sure, this show may “over-index” in middle-aged women—I’ll just assume that’s the case here—but I think folks often oversell how important over-indexing actually is. When a show is a “hit”, it isn’t a bit bigger than its rivals; it’s usually multiples bigger. For example, Elle only made the charts for two weeks at 8.3 million hours each. So Ride or Die was 80% bigger in its first two weeks, and likely had a much stronger hold, with its terrific 13 million hours in week three. Ride or Die was nearly three times bigger than Sterling Point through three weeks too. And that means that _Elle, Sterling Point a_nd other Amazon YA shows need to not just over-index a little with younger women (assuming that’s who Amazon prefers over middle-aged women), but massively over-index. Otherwise, more people in that demo (and a bunch more besides) likely watched Ride or Die. (I’ll try to explore this concept more in a future article.) And don’t get me started on how Ride or Die did compared to a certain (very, very popular, possibly the world’s most popular) YouTuber’s reality show…which didn’t make the charts after its first week and likely cost much, much more than Ride or Die. All to say, Amazon-MGM Studios/Prime Video can tell reporters that this show didn’t reach the right audience, but that excuse feels weak to me. So this leads to the third question: could other reasons have come into play? Yes! Renewal or cancellation decisions rarely (I’m tempted to say “never”) boil down to one variable. At its simplest, it’s two things: budget versus viewership. But often factors like critical acclaim, ownership and, yes, personal opinion come into play. In this case, Amazon has a new executive running things, and this show isn’t owned by Amazon-MGM Studios (unlike Elle). And yes, it may not have indexed with the right target viewers, too. Likely all of those factors came into play.1 My guess is ownership ended up mattering most. Amazon doesn’t own Ride or Die. It’s actually produced by another major studio. Fortunately/allegedly, this show is being shopped around. I can think of one brand new CEO who should consider it for one of his two major streamers…especially if he wants to rebuild goodwill in Hollywood. His name is on this list of exec producers of Ride or Die… If David Ellison needs some goodwill—and he does—rescue this female-led show tomorrow and grab some good headlines for a day. The data justifies it. Quick Notes on TV We’re just getting started with this issue, but the rest is for paid subscribers of the Entertainment Strategy Guy, so if you’d like to find out… How The Secret Lives of Mormon Wives latest season did on Hulu, post-controversy... Whether Supergirl soared on HBO Max... Why the box office is losing money due to the streamers... The viewership for the Daily Wire’s $50 million fantasy show... Updates on The Gentlemen, Lanterns, Outer Banks, King of the Hill and more... What former hit-maker has three streaming flops in a row... Whether The Mandalorian and Grogu popped in week two... All the flops, bombs and misses... And a whole lot more... ...please subscribe! We can only keep doing this great work with your support. If you want an idea of just how much content you’d get in a full issue, check out this older issue. Coming Soon! Oh man, we’re almost caught up! We just have two more issues, then the streaming Ratings Report will be coming out just two weeks after a TV show premieres! Next issue, I’ll be looking at the first two weeks of the NFL Thursday night games on streaming, a huge new spinoff, Reacher’s Neagly on Prime Video, and the latest edition of Monster: The Lizzie Borden Story on Netflix, the return of Slow Horses on Apple and MobLand (quietly one of their biggest shows) on Paramount+, and Dancing with the Stars on both ABC and Disney+. Plus I’ll take a look at animation for adults in 2026. The week after, a ton of movies are coming to streaming: Toy Story 5 on Disney+, Backrooms on HBO Max, Jackass: Best and Last on Paramount+ and The Breadwinner on Netflix, plus a Unabomber film on Netflix and a romcom on Prime Video. Woody Harrelson and Matthew McConaughey have a show on Apple, along with a game show inspired by Willy Wonka that everyone seems to hate. Long term, some crazy (but hopefully crazy like a fox) IP news. FX ordered a new Sons of Anarchy show from Charlie Hunnam, but it’s not about the biker gang. No, it features the show’s cast playing themselves in a new “meta-thriller”. Huh. And a lot of the cast is coming back. Next, Ryan Gosling is producing a Flintstones movie about a “grown-up Bamm-Bamm Rubble”. Also, huh. This one is in “early development” so we’ll see what happens. Both projects are based on IP, but also seem to have crazy takes on the IP, which I like.
CSUN in D.C. Internship Expands Student’s Public Health Career Aspirations
For Josiah Morrow, a three-month internship in Washington, D.C., turned the nation’s capital into a classroom — and helped shape his future in healthcare.
Amazon Hires Three Netflix Business Affairs Execs
The streamer has moved to a genre-based model for its business affairs operation.
How a controversial camera system is monitoring mental health patients
The Lampard Inquiry started back in September 2024 and I remember going to the first hearing in Chelmsford. Subscribe The bereaved families made placards of their loved ones, they stood outside in silence and then laid flowers to mark the moment. Now, two years on, in a process meant to last another two years, there’s been a development. Last week, we were told the chair, Baroness Lampard, pictured below, could be looking at making interim recommendations. Throughout the process, she has remarked that although this inquiry is looking at almost 2,000 people who were under the care of Essex mental health services from 2000-2023 when they died, the findings could have national implications for other trusts. ‘Records 24 hours a day in patient’s bedroom’ So why has this happened? One system that the inquiry is going to take a closer look at is a controversial monitoring system called Oxevision. It monitors some vital signs of patients remotely by using a camera placed in a room. It’s used by 40% of NHS mental health trusts. But campaigners, particularly the group Stop Oxevision, have asked for this technology to be removed from mental health wards as soon as possible. I spoke to a member, Hat Porter, today and they described to me what they thought this technology did and explained their concerns: “It records 24 hours a day and it’s located in a patient’s bedroom, which is obviously somewhere you’d usually expect to be a private place. “Our concerns are that the use of the technology has been has been kind of implemented as a substitute for proper in-person support, that it’s kind of over relied on and that there’s a lot of misunderstandings and that the presence of a camera, which has often been used without people’s consent, sometimes without even their knowledge, that that has a really big impact on privacy, dignity and human rights.” ‘Not sufficient’ I put it to them that the company behind Oxevision would dispute their claims about consent and in videos I’ve seen online from NHS trusts, they make it clear that the technology is complementary to trained staff and not a replacement. [ ](https://channel4news.substack.com/p/the-nottingham-inquiry-what-lessons) [ How the Nottingham inquiry shines a spotlight on other key mental health care failings ](https://channel4news.substack.com/p/the-nottingham-inquiry-what-lessons) Victoria Macdonald · Feb 12 [ Read full story ](https://channel4news.substack.com/p/the-nottingham-inquiry-what-lessons) A team of lawyers has been working on the inquiry and with bereaved family members who have concerns about this technology. I spoke to solicitor Priya Singh, from Hodge Jones & Allen, who made the point that questions usually asked by nurses would be missing from using devices like this. “It’s not sufficient to say, oh, the patient is moving around. Somebody must go in and say, are you okay? Are you distressed? Do you want help? Is there anything I can do? Share Channel 4 News “How are you spending your time? So I think a lot of our families cannot see the function of it when ultimately the patient should only really be observed when they’ve been prescribed to be observed, they can be observed more, but that more should really be happening face to face.” The Chair will hear evidence over the next two weeks and then a decision made after that, which could have national impact if she does decide this technology should be investigated or even removed. The Department of Health and Social Care said: “The Government is committed to ensuring that lessons are learned from the Lampard Inquiry to improve patient safety. “We are confident that the Inquiry will play an important role in identifying wider learnings for the health system following the tragic events in Essex and will contribute to improvements in patient safety.” We approached LIO Health, which runs Oxevision, for comment. Subscribe Share Channel 4 News Leave a comment
Greater Fort Worth Association of REALTORS: The Aging Homeowner is Becoming a Business Issue
Learn about aging as a homeowner in this sponsored article by Greater Fort Worth Association of REALTORS.
Pokémon GO Halloween 2026: Part One
Pokémon GO’s Halloween 2026 Part One event runs from October 27 at 10:00 a.m. to November 1 at 10:00 a.m. local time, bringing three new costume Pokémon: Pikachu wearing a hat and capelet, Zubat wearing a top hat, and Sinistea wearing a bow! Expect spooky wild encounters, costume raids, and trick-or-treat surprises that can reward […]
Angels To Face Decision On Ill-Fitting First Baseman
Nolan Schanuel’s elite contact skills contrast sharply with a glaring lack of power, forcing the Halos to weigh his high-floor production against more traditional middle-of-the-order threats.
Pat Bryant catches all three targets
Denver Broncos WR Pat Bryant (ankle) caught all three of his targets for 47 yards in Week 4 before exiting with an ankle injury.
Jamie Foxx opens up 3 years after health scare, talks new standup special
Actor, comedian and singer Jamie Foxx opens up to ABC News three years after a health scare nearly ended his life.
Nobel medicine prize goes to 3 scientists for research into brain activity
The Nobel Prize in medicine has been awarded to three scientists whose work led to a tool that uses light to help unravel how the brain works
Spurs employ three-guard lineup during Silver & Black Scrimmage
De'Aaron Fox, Stephon Castle and Dylan Harper played together in what coach Mitch Johnson called "on-the-job training."
Fear is bigger than ever… and Zero Latency VR has the science to prove it
MELBOURNE, Australia — Zero Latency VR, the world’s largest and most innovative immersive VR network, is celebrating a double Halloween anniversary: three years since the launch of Outbreak, …
DHS buys three detention centers in California for $950 million
The GEO Group, a Florida-based private prison corporation, announced Monday that it had sold the detention facilities, including the Adelanto ICE Processing Center, totaling 2,644 Beds.
How former Cyclones performed in Week 4 of the NFL
Ten former Cyclones made appearances in Week 4 of the NFL and played a combined 543 snaps on offense, defense and special teams. Breece Hall – New York Jets Hall did not play against the Chicago Bears due to a quad injury sustained during the Lions game in week three. Jake Hummel – Houston Texans Hummel […]
3 scientists share Nobel Prize in Physiology and Medicine for work in optogenetics
The Nobel Foundation awarded its prize in physiology and medicine Monday to three scientists who researched how nerve cells affect the brain.
Offensive Line Looks Offensive: Spartans Rank Last in Sacks Allowed
From personnel shifts to coaching failures, a crumbling front wall has left the Spartans reeling as record-breaking sack numbers threaten to derail the Pat Fitzgerald era.
Comcast Business 2026 Cybersecurity Threat Report: 79.3 Billion Events Show AI Pressurizing the Threat Landscape
Comcast Business has released its 2026 Cybersecurity Threat Report, an analysis of 79.3 billion cybersecurity events detected across its cybersecurity custom...
Apple event is reportedly happening next week, per Mark Gurman
Apple is expected to launch three new products next week on October 13, and per Mark Gurman, the product unveilings will happen at “an event.”
DeSean Bishop Is the X-Factor Arkansas Must Contain
Arkansas knows exactly where Tennessee’s offensive plan begins. It begins with DeSean Bishop. The Volunteers running back enters Fayetteville after one of the best performances in the country this season. Bishop rushed 34 times for 220 yards and three touchdowns in Tennessee’s 24-14 win over Auburn, turning a game with quarterback uncertainty into a statement …
Samsung One UI 9 Rollout: These Galaxy Phones Are Getting Android 17
Samsung’s One UI 9 rollout is expanding. See which Galaxy phones are getting Android 17, which devices are next, and how to check for the update.
Three Japanese regional banks consider business integration
The Japanese lenders concerned are Procrea Holdings, Akita Bank, and Bank of Iwate.
Three Preseason Goals For Bulls' First Round Pick Dailyn Swain
To secure his place in Chicago’s future, the versatile rookie must rediscover his offensive aggression, leverage his elite defensive length, and prove he can impact winning beyond scoring.
Scientists reveal what seven days of fasting does to the human body
Scientists found that prolonged fasting triggers major changes throughout the body, but many of the most interesting effects only appeared after about three days without food. The results suggest fasting may influence health in ways that go beyond weight loss and could eventually inspire treatments that mimic its effects.
Ground Zero Blues Club
A Labor of Love for its Three Managers It is no mystery why Ground Zero Blues Club (GZBC) is one of the most famous blues clubs in the country. It is a genuine juke joint where customers are treated to great live music along with genuine hospitality serving up Southern food favorites like barbecue […]
Stanford Professor One Of Three Scientists Awarded The Nobel Prize In Medicine
Stanford professor Karl Deisseroth joins Peter Hegemann and Georg Nagel as winners of the 2026 Nobel Prize in Physiology or Medicine for their work on optogenetics.
Universal Expands EMEA Retail and Partnerships for 'Shrek 5'
Universal builds excitement for 'Shrek 5's' summer 2027 release with new EMEA retail, events and partnerships. Donkey spin-off film set for 2028 release.
Cybersecurity portal to fight bad guys open for business: NMFTA
The NMFTA has launched its threat portal, where targets of successful and unsuccessful cyberattacks can share their stories.
Sexual misconduct allegations threaten to topple veteran LA Democrat
LA Democrat Jimmy Gomez is facing a strong socialist challenger.
Nobel medicine prize goes to 3 scientists for research into brain activity
The Nobel Prize in medicine was awarded Monday to three scientists working on the mechanisms the brain uses to switch on, or off, the activity of individual nerve cells.
Top Links 1245 Jobs in health care. Jobs for women. The US labour market is segmenting. Chernobyl’s radiation and Lenin’s love of literature.
Thank you for your support of Chartbook. Your generosity keeps this show on the road. Elmer Bischoff, Two Figures at the Seashore, 1957 The only really dynamic job-creator in the US economy is health care:
Jobs in health care. Jobs for women. The US labour market is segmenting. Chernobyl’s radiation and Lenin’s love of literature.
Thank you for opening your Chartbook email. Elmer Bischoff, Two Figures at the Seashore, 1957 The only really dynamic job-creator in the US economy is health care: The largest crunch has come in Federal government, which has shed 2.7 m jobs. Source: tchouvkov on Twitter Tech is struggling. [ Joey Politano 🏳️🌈@JosephPolitano The US tech sector continues bleeding jobs in official data released today—overall, employment decreased by 17k last month and is down 69k over the last year That's nearly as bad as the worst of the 2024 tech-cession, and much worse than the 2022 boom or even pre-2020 norms 12:42 PM · Oct 2, 2026 · 15.2K Views 15 Replies · 47 Reposts · 390 Likes ](https://x.com/JosephPolitano/status/2106001807847940232?s=20) The new jobs are all for women. [ Justin Wolfers@JustinWolfers I'm not sure who saw this coming, but so far nearly all the jobs created during the second Trump administration have gone to women. 1:09 PM · Oct 2, 2026 · 33K Views 70 Replies · 146 Reposts · 644 Likes ](https://x.com/JustinWolfers/status/2106008723533533601?s=20) Meanwhile, real wages are being eaten up by modest over-target inflation. [ Heather Long@byHeatherLong The financial pain is real: Wage growth fell to 3% (y/y) in September. That's the lowest in 5 years. Wage growth: 3% Inflation: ~3.4% Inflation has eaten up all wage gains for the average worker since April. Many people are having to make hard choices about what to buy and what … 1:24 PM · Oct 2, 2026 · 37K Views 24 Replies · 275 Reposts · 533 Likes ](https://x.com/byHeatherLong/status/2106012367712620728?s=20) HEY READERS, THANK YOU for opening the Chartbook email. I hope it brightens your day. I enjoy putting out the newsletter, but tbh, what keeps this flow going is the generosity of those readers who clicked the subscription button. If you are persuaded to click, please consider the annual subscription of $60. It is both better value for you and a much better deal for me, as it involves only one credit card charge. Why feed the payments companies if we don’t have to. Subscribe Elmer Bischoff, Bathers, 1960 Americans are disillusioned with higher ed. For contributing subscribers only. Subscribe Where the Chernobyl radiation went. h/t Simon Kuestenmacher aka simongerman600 How Lenin’s love of literature shaped the Russian Revolution - Tariq Ali This, then, was the intellectual atmosphere in which Lenin came of age. His father, a highly cultured conservative, was the chief inspector of schools in his region and much respected as an educationalist. At home, Shakespeare, Goethe and Pushkin, among others, were read aloud on Sunday afternoons. It was impossible for the Ulyanov family – “Lenin” was a pseudonym adopted to outwit the tsarist secret police – to escape high culture. At high school, Lenin fell in love with Latin. His headteacher had high hopes that he might become a philologist and Latin scholar. History willed otherwise, but Lenin’s passion for Latin, and taste for the classics, never left him. He read Virgil, Ovid, Horace and Juvenal in the original, as well as Roman senatorial orations. He devoured Goethe during his two decades in exile, reading and rereading Faust many times. Lenin put his knowledge of the classics to good use in the time leading up to the October revolution of 1917. In April of that year, he broke with Russian social-democratic orthodoxy and, in a set of radical theses, called for a socialist revolution in Russia. A number of his own close comrades denounced him. In a sharp riposte, Lenin quoted Mephistopheles from Goethe’s masterwork: “Theory, my friend, is grey, but green is the eternal tree of life.” Source: The Guardian Elmer Bischoff, The River, 1953 If you’ve scrolled this far, you know you want to click: Subscribe
Yale School of Medicine On the Science of Childhood Anxiety, Say, Anxiety Disorders Are the Most Common Mental Health Challenges In Youth
Credit: Matt Bradbury October 5, 2026 - By Isabella Backman - Anxiety disorders are the most common mental health challenges in youth. Left untreated, they can disrupt the lives of both children and their families. The good news is that with intervention, most children will overcome these conditions. Across Yale School of Medicine, scientists are working to understand anxiety at every level, from common anxious behaviors to molecular biomarkers in the brain. They are using their findings to develop and disseminate new evidence-based treatments for childhood anxiety. Today, the go-to treatment for childhood anxiety disorders is cognitive behavioral therapy (CBT). This is a form of psychotherapy that teaches children skills for confronting anxious thoughts and helps them practice managing situations that cause anxiety. While it is the gold-standard treatment backed by considerable scientific evidence, up to 50% of children will not see sufficient benefit from CBT alone. Wendy Silverman, PhD, Alfred A. Messer Professor in the Child Study Center, co-directs the Anxiety and Mood Disorders Program alongside Eli Lebowitz, PhD, associate professor in the Child Study Center. One of their main interests is learning how to improve outcomes beyond CBT. “We’re developing cutting-edge, research-based knowledge that can reduce the suffering that anxiety causes children and their families,” says Silverman. Changing parent behavior YSM experts are investigating how to improve CBT outcomes for children by involving the parents. Silverman’s research has uncovered two main components of parent intervention that improve childhood anxiety: not enabling children to completely avoid the things that make them anxious and taking steps to enhance their autonomy. Parents may unintentionally reinforce their child’s anxiety by allowing them to avoid what makes them anxious. They also may unintentionally limit the children’s sense of autonomy by being overly intrusive. “One of the things that we take pride in is that we’ve focused on trying to understand what parents need to do, and to test our ideas and see if changing the parents’ behaviors is enhancing the effects of CBT,” Silverman says. “Our findings thus far suggest that they do." As much as CBT can be helpful, it can also be challenging to get one’s child to do the necessary steps for CBT to work. This is one important reason why Lebowitz created a novel intervention program for parents named Supportive Parenting for Anxious Childhood Emotions (SPACE). Existing intervention programs often teach parents to act as therapists for their child, such as training them on how to practice breathing exercises. “It makes sense, but this doesn’t work very well in practice,” says Lebowitz. “And part of the reason, I think, is that it’s not easy to get your kid to do things, especially if they’re not excited about doing it.” SPACE is unique because it focuses entirely on parent involvement and changing parental behavior—children are not involved in the sessions. For example, parents learn how to use supportive messages that convey confidence that their child can tolerate and manage distress. “It might sound like a parent saying to a child, ‘I get that this is really hard for you, but I know that you can handle it,’” Lebowitz says. The program also works with parents to identify the ways in which they are accommodating anxious behaviors. “We’ll pick one thing that parents are doing that is an accommodation and help them make a detailed plan for how they’re going to change that,” Lebowitz explains. Treating Anxiety in Children and Adolescents Much of the existing research on SPACE has focused on parents of children under age 14. Ongoing studies are now exploring its use with parents of older teens. “Both anxiety and accommodation can interfere with normative developmental shifts during the teen years, including increased autonomy and individuation from parents,” says Rebecca Etkin, PhD, associate research scientist in the Child Study Center. “In this sense, SPACE may be particularly well-suited for anxious teens and their parents. We want to see whether it is effective during this distinct developmental window.” Unfortunately, many families in need of CBT face barriers, including limited availability of services and geographic constraints. One way to improve access is digital interventions. Silverman and her team are developing an evidence-based digitized intervention program for parents that they can access directly from their computer or smart phone. “The work we’re doing will be one of the very few parent interventions that is digitized and importantly tested for effectiveness,” she says. Creating interventions for anxiety-related challenges Silverman and Lebowitz recently received a generous gift to develop and test other interventions that help parents reduce other child anxiety-related behavioral and emotional difficulties, such as restrictive eating and unexplained somatic symptoms. One of these projects in particular focuses on understanding the risks of social media and its potential benefits, including offering a sense of connection. “A lot of research has focused on the idea that social media is harmful and the less of it the better,” says Lebowitz. “But we actually see is that this is not quite right—there are negatives, but there are also positives. So, we’re trying to get a little bit more nuanced of a picture.” The team is working with teens with social anxiety and their parents over an extended period to better understand their social media habits and how their anxiety levels affect engagement with different platforms. The teens will answer questions sent to an app on their phones about mood and social media usage in an effort to capture emotional responses as they unfold. “We hope to develop interventions that can help make the best of social media while protecting against the more problematic effects,” Lebowitz says. The brain’s role in anxiety Researchers are also testing therapies to address anxiety at the neurological and molecular levels. In collaboration with Dylan Gee, PhD, professor of psychology in Yale's Faculty of Arts and Sciences, and Hilary Blumberg, MD, John and Hope Furth Professor of Psychiatric Neuroscience at Yale School of Medicine, Lebowitz and Silverman are using brain imaging to identify changes in a child’s brain before and after parents enroll in SPACE. In one study, children viewed anxiety-inducing images while undergoing magnetic resonance imaging (MRI); the researchers conducted scans with and without the children’s parents nearby. Before SPACE, children’s brains were better able to activate the regulatory circuitry needed to turn off an anxious response when their parents were nearby. But after SPACE, children could activate this circuitry even without the parent around. “As parents work on gradually reducing some of their accommodations, you can see a child get better at regulating their own fear system in the brain,” Lebowitz says. “It’s remarkable.” Research into the molecular underpinnings of anxiety can also inform new childhood anxiety treatments. In a recent study, Lebowitz, Silverman, and Flora Vaccarino, MD, Harris Professor in the Child Study Center, discovered that a protein known as fibroblast growth factor 2 (FGF2) could be protective from the toxic effects of stress. FGF2 levels in children and their parents were linked to the children’s risk of developing anxiety and depression, the study showed. The findings could help explain why some children who are exposed to early life trauma such as poverty or abuse are more prone to developing mental health disorders. And FGF2 could be a target for treatment. “This is very novel because it starts to give a clue to what is the molecular chain that connects those lived experiences to the actual psychological outcomes,” Lebowitz says. New ways to study and treat childhood anxiety Michael Crowley, PhD, associate professor in the Child Study Center, collaborates with Silverman and Lebowitz to study the role that attention plays in development and maintenance of childhood anxiety. There is a large body of research that shows that anxious children, like anxious adults, are prone to focus on threatening stimuli such as angry faces compared with neutral faces. This has led to innovative interventions that involve attention retraining. The idea is that if experts train children to look away from threatening stimuli, it may reduce their anxiety—especially children with social anxiety who are most prone to attend to threats. The researchers have just completed a clinical trial for attention retraining with 10- to 14-year-olds with social anxiety disorders and are currently analyzing the findings. Besides this innovative attention retraining research, as Crowly notes, “I like to design tasks that are engaging to kids,” Crowley says. “My goal is to assess something without the kids knowing what we are assessing.” With this goal in mind, Crowley has created a virtual game, named Boom, to study threat processing in children with anxiety disorders. The game is similar to that of hot potato—the child and three digital players take turns virtually passing a ball to each other’s gloves. At some point, the ball turns into a bomb, and as the bomb lands in each player’s glove, the outline of the glove turns yellow. The goal is to avoid having the bomb go off in your glove. What isn’t obvious is that the game is designed to measure different types of threatening stimuli, both ambiguous and direct. In the game, the direct threat occurs as the bomb is traveling towards your glove. The ambiguous threat is the yellow outlined glove as it is unknown where the bomb will travel next. While children play the game, Crowley’s team measures their brain activity using electroencephalography (EEG). The researchers have discovered that in kids with anxiety, the brain reacts more strongly to ambiguous threats than it does in their peers, but less strongly to direct threats. They believe that the initial abnormally large brain response to not knowing where the bomb is going impairs the brain's ability to properly respond when the threat is actually traveling the child’s way. “The brains of children with anxiety are unable to differentiate between threats you need to do something about and those that are not your problem.” Michael Crowley, PhD, develops innovative games for studying anxiety in children and adolescents.Credit: Matt Bradbury Based on these insights, Crowley hopes to study whether interventions like attention training could restore appropriate threat processing. Crowley’s team is also working on a test called the Balloon Risk Avoidance Task, which evaluates risk-taking and avoidance behaviors. It features a digital balloon that is full of air and about to burst. Kids have six seconds to let air out of the balloon. The more air they let out, the less risk they face that the balloon will pop. But at the same time, the balloon becomes less valuable as it deflates. “The more air you keep in the balloon, the more points you get,” Crowley explains. So far, the researchers have found that when the balloons pop unexpectedly, teens with social anxiety show distinct brain responses. Studying these responses can help psychologists understand the underlying pathways driving the various manifestations of anxiety. The genetics of anxiety When Thomas Fernandez, MD, associate professor in the Child Study Center and of psychiatry, was still in training, there was a lot of excitement about understanding the genetics associated with autism spectrum disorder. Since then, scientists have identified around 250 genes associated with autism. The genetic contribution to anxiety disorders, on the other hand, has historically received less attention. Anxiety is less heritable than autism, but the genetic contribution for anxiety disorders that emerge in childhood may be higher than for anxiety disorders overall. While scientists estimate the heritability of anxiety disorders in general to be around 30% to 50%, some studies suggest higher heritability for certain childhood-onset anxiety presentations. “I saw firsthand how researchers in the field went about finding vulnerability genes for autism,” Fernandez says. “So, we’re using a very similar playbook for childhood anxiety.” “I saw firsthand how researchers in the field went about finding vulnerability genes for autism. So, we’re using a very similar playbook for childhood anxiety.” Thomas Fernandez, MD Associate Professor In the Child Study Center and in Psychiatry Now, Fernandez and Emily Olfson, MD, PhD, assistant professor in the Child Study Center, are studying children and their parents to identify genetic changes that are present in the child but not the parents, known as “de novo mutations.” “All of us have some de novo mutations—maybe about 50 to 100 sprinkled throughout the genome,” Olfson says. “But when they occur within the coding regions of genes, they can be really disruptive.” Previous research shows that people with autism have higher rates of damaging de novo mutations than the general population. In 2022, Olfson, Lebowitz, Silverman, and Fernandez published a study on 68 children and their families that found that children with anxiety had similarly high levels of these mutations. Studying de novo mutations can help point the researchers to where they should be looking for genes associated with anxiety. “The end game is using the genes to steer us toward the right part of biology that we can then target to come up with better treatments,” Fernandez says. Building on those findings, the team is now studying more families to better understand how these de novo mutations, along with other genetic and environmental factors, shape pediatric anxiety disorders. They recently received a National Institutes of Health grant to enroll 750 new families over the next five years. Olfson is the principal investigator, with co-investigators Lebowitz, Fernandez, Silverman, and Shuangge Steven Ma, PhD, department chair and professor of biostatistics at Yale School of Public Health. Neurodevelopment, Risk Genes, and Mental Health Conditions - The Olfson Lab Joel Gelernter, MD, Foundations Fund Professor of Psychiatry, is interested in how different anxiety disorders differ genomically. “We are studying social phobia, panic disorder, and generalized anxiety disorder, working to understand why people differ in their risk to these specific anxiety disorders and evaluating various risk factors,” he says. Gelernter was recently involved in one of the largest studies to date of the genomics underlying anxiety disorder. The study included around 122,000 people with anxiety disorders and around 730,000 without. It found that some genetic differences associated with anxiety were linked to signaling that helps reduce overactivity in the nervous system. Many anxiety medications available today work by targeting this process. “It’s nice when the biology that you get out of a large genome-wide study ratifies things that we already know because that can help increase confidence in further findings from the study,” Gelernter says. Uncovering the neurobiology of psychiatric disorders John Krystal, MD, Robert L. McNeil, Jr. Professor of Translational Research and chair of the Department of Psychiatry, is interested in the neurobiology of psychiatric disorders, including post-traumatic stress disorder (PTSD), of which anxiety is a major symptom. In the late 1980s, Krystal’s team discovered that the drug yohimbine activated symptoms in patients with PTSD. “This was the first time we could link a specific biological mechanism to the symptoms of PTSD,” Krystal says. At the time, he adds, this finding was highly controversial. “A lot of people felt that PTSD was a purely psychological syndrome that didn’t have an underlying biology.” Since then, Krystal has dived deep into understanding the neurobiology of PTSD to learn how to better treat it. His team is evaluating the use of ketamine and psychedelics. These would be among the first treatments to be developed specifically for PTSD. They may also be applicable for other disorders including anxiety disorders, Krystal adds. An important gap in PTSD treatment is the absence of biological tests that inform how to best help patients manage their PTSD symptoms. A doctor doesn’t diagnose cancer based on how they feel. Rather, they use tests of the biology of the cancer to determine the best course of treatment. “And we can’t do that in any psychiatric disorder other than Alzheimer’s disease,” Krystal says. “But now we are building a foundation for this approach to the treatment of anxiety disorders for the first time.” Source: Yale School of Medicine
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