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Trump uses anti-transgender slur to attack South Carolina Senate candidate
(CNN) — President Donald Trump on Monday used an anti-transgender slur to attack Democratic South Carolina Senate candidate Dr. Annie Andrews, as he tries to push his hand-picked GOP candidate,
Mike Elko Gives Update On Texas A&M Freshman Linebacker Injury
Mike Elko offered positive news on freshman linebacker Tamarion Watkins as Texas A&M prepares for a major SEC road test against No. 14 Missouri.
DEEP DIVE: How Politics Is, and Is Not, Addressing Domestic Violence and Sexual Assault
In a conversation with U.S Senate candidate Peggy Flanagan last week with members of our young Future Forward editorial board, we talked about how powerful it is for four Minnesota women to be running for the two highest offices in the state — including Governor. We also talked about
Why Your TV Is Overrun by Political Ads (Hint: It’s the Law)
When it comes to candidate ads, the rule is simple, TV stations can't say no. They can say anything they want, and TV stations must air it.
What’s new in Android’s October 2026 Google System Updates
The monthly “Google System Release Notes” primarily detail what’s new in Play services, Play Store, and Play system update across...
Essay: Do political debates still matter to voters?
Political debates aren't just about candidates performing well. They're an opportunity for voters to hear real answers, see how candidates think and engage in democracy.
Hamilton County health officials urge families to update vaccines ahead of flu season
As flu season approaches, the Hamilton County Health Department is renewing its warning for families to make sure they are protected with the most current vacci
‘Please get vaccinated,’ state health secretary urges as new COVID-19 vaccines roll out
In the midst of a historic measles outbreak, state and local health officials crammed into the family-owned Hilltop Pharmacy in Allentown on Monday to...
Fall Preview with Entertainment Correspondent Mike Marra
Airdate: October 5th, 2026 Leoni Township Update with Administrator Mike JesterOctober 5, 2026City Treasurer Hosting Town Hall Meeting SeriesOctober 5, 2026Tecumseh Appleumpkin Festival This WeekendOctober 5, 2026Fall Preview with Entertainment Correspondent Mike MarraOctober 5, 2026Disney’s Frozen Premieres Thursday at The SaukOctober 5, 2026Alison McGlynn & Lilly Hayworth, The Annex Collective SalonOctober 5, 2026John Spink, Nite…
Doctors, insurers sue Newsom over health insurance premium increases
Doctors and health insurers have filed suit alleging Gov. Gavin Newsom and the California Legislature violated the law when they approved a healthcare tax that could substantially increase insurance premiums
Five fall business updates for Liberty Hill
New businesses are moving into Liberty Hill, including Crazy Falafels, Cashmere Bar + Board, Gracie Barra, QuesaLab and Milano Nail Spa.
Send us your questions for Texas Senate candidate James Talarico
Calling all Texas Republicans, Democrats, and Independents! Are you a registered voter in Texas? Then submit questions for CNN & Jubilee’s Town Hall with James Talarico on Wednesday, October 14 and engage in a direct conversation with the Texas Democratic Senate candidate on the issues that matter most to you.
Candidates to field questions at San Joaquin Delta College forum on Tuesday
The forum will be held from 6 p.m. to 8 p.m. in the college’s Dawn Mabalon Forum. It is free and open to the public.
Trump’s midterm messaging undercuts GOP candidates
Many Republican candidates have found themselves in surprisingly competitive races
Trump’s midterm messaging undercuts GOP candidates
Many Republican candidates have found themselves in surprisingly competitive races
Samsung rolling out Android 17 for more Galaxy devices in the US
Samsung’s Android 17 rollout is speeding up, with more last-gen Galaxy devices now getting One UI 9 updates in the...
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.
NFL Star Tyreek Hill Gets Big Update After Eagles Suggestion
A top NFL free-agent wide receiver, Tyreek Hill, is expected to find a new team soon, according to ESPN. As Hill fully recovers from the setback he suffered last season, the speedy wide receiver’s agent made it clear that he will likely find a new team in the coming days. Recently, the Eagles were pegged […] The post NFL Star Tyreek Hill Gets Big Update After Eagles Suggestion appeared first on HEAVY.
College volleyball rankings after Week 6: Updated AVCA Coaches Poll
Here's the latest AVCA Coaches Poll after the last week's worth of games during the 2026 women's college volleyball season.
Apple Releases Third iOS 27.2 Beta
Apple today seeded the third beta of an upcoming iOS 27.2 update to developers for testing purposes, with the update coming two weeks after Apple released the second iOS 27.2 beta. Apple also seeded a new iPadOS 27.2 beta. Registered developers can download the beta updates by opting in under Settings > General > Software Update and selecting the iOS 27 developer beta. iOS 27.2 includes Apple's redesigned Health app with new Insight and Longevity tabs.
Apple releases third iOS 27.2 developer beta for iPhone
Apple has released the third iOS 27.2 developer beta for iPhone. The update follows the release of iOS 27 to...
HGTV’s Eilyn Jimenez Shares Health Update After Cervical Cancer Diagnosis
Find out how the 'Divided by Design' host is doing now.
Saquon Barkley injury update is encouraging news for Eagles
The Philadelphia Eagles may not be forced to compete without their star running back for long.
Nations League Liveblog: Italy vs. Turkiye
This page will update live with the latest relevant news, no need to refresh the page!Join us for all the build-up and action as it happens from the Nations League, as Italy try to build momentum agai...
Flu season is already spiking in Hamilton County local health officials say
Hamilton County health officials are urging residents to get up to date on recommended and school-required vaccinations ahead of the cold and flu season.The Ha
Banijay Entertainment Consolidates U.S. Operations to 'Banijay America' Under CEO Ben Samek
Banijay Entertainment Oct. 5 announced it is consolidating its U.S. operations under a new moniker, Banijay America, under the direction of CEO Ben Samek, who reports to Jane Turton, deputy CEO of Banijay Entertainment. The company is restructuring its operational footprint to centralize leadership and operational support while keeping its individual production labels creatively independent. … Continue reading "Banijay Entertainment Consolidates U.S. Operations to ‘Banijay America’ Under CEO Ben Samek"
Health conference to cover GLP-1 drugs, hormone therapy, youth sports
The Area Health Education Center (AHEC) will host its 42nd Annual Update in Medicine Conference.
Obama to campaign with El-Sayed in Detroit as ex-president gets more involved in midterms
Obama is upping involvement in the midterm election. He taped two dozen ads last week for Democratic candidates for governor and Senate that will be released in the coming days and weeks.
Apple notifies Apple Cash users about two upcoming changes
Apple Cash’s terms and conditions have just been updated, and Apple is notifying users about two upcoming changes in particular.
Updated AAP guidance warns raw dairy poses severe health risks
Unpasteurized milk, cheese and other "raw" dairy products are unsafe to drink or eat, especially for young children and those who are pregnant or breastfeeding, according to updated guidance from the American Academy of Pediatrics.
Congressional candidates discuss expanding executive power and need for political will
Congressional approval ratings are in the tank. By some measures this is one of the least productive sessions of Congress in living memory. WGLT's Charlie Schlenker reports those things may not change much any time soon.
Your Vote 2026 Maine Calling candidate interview: Bobby Charles, Republican for governor
Maine Calling host Jennifer Rooks interviews Republican gubernatorial candidate Bobby Charles ahead of the November election.
Saquon Barkley injury update: Latest on Eagles star running back
Saquon Barkley has undergone testing on his injured hamstring as the Eagles prepare to face Jacksonville in London
Democrats expand target list as polls point in their favor
Democrats are expanding the number of Republican-held House seats they hope to flip in November as polling moves in their favor ahead of the midterm elections. The Democratic Congressional Campaign Committee announced Monday that it added six candidates to its “Red to Blue” program, bringing the total to 46. The program provides candidates with strategic […]
Lamar Jackson sends 1-word message over ankle injury status
Lamar Jackson injury update: The Baltimore Ravens quarterback is opening up about the injury he sustained in Week 4.
Harris County judge candidates find common ground on flooding, Houston Health, at Sunday forum
Democratic candidate Letitia Plummer and Republican candidate Orlando Sanchez shared the stage at a forum organized by The Metropolitan Organization on Sunday, October 4.
Gen Z women want politicians who can make the ‘American dream’ feel attainable
Affordability is the top issue for Gen Z women. But few candidates are appealing to them with a message strong enough to cut through the noise.
Gen Z women want politicians who can make the 'American dream' feel attainable
Affordability is the top issue for Gen Z women. But few candidates are appealing to them with a message strong enough to cut through the noise.
‘Primetime’: Is catching predators justice or just entertainment?
Rating: ★★★½ Starring Robert Pattinson, Skyler Gisondo, Merritt Wever Directed by Lance Oppenheim Rated R Release Date: Sept. 25, 2026 A man waits unknowingly inside a sting house. His eyes draw up to the sound of curtains ruffling as Chris Hansen (Robert Pattinson), host of Dateline NBC’s “To Catch a Predator,” enters flamboyantly. Hansen descends...
RYOBI Cleans Up Local Politics with Unlikely Mayoral Candidate 'Swifty'
McCann Birmingham and RYOBI unveil the first trailer for a documentary following the spot cleaner’s unlikely bid to become mayor of Staines
New Apple TV 4K launches next week with two major upgrades
New Apple products are reportedly launching October 13, including an updated Apple TV 4K with two major upgrades rumored.
New Dell System Update flaw lets hackers gain root privileges
Dell warned customers to patch a critical vulnerability in the System Update (DSU) command-line interface (CLI) deployment tool as soon as possible.
'Here & Now' Highlights: Charles Franklin, Jason Stein
A month before the 2026 election, the Marquette Law School Poll shows candidates for governor neck-and-neck — poll director Charles Franklin explained where voters stand and why. Enrollment caps for ...
Windows 11 26H2 brings a hidden performance boost — and may slash RAM usage
Windows 11 26H2 quietly brings several performance improvements, including a Low Latency Profile that makes common tasks feel faster. Some users are also reporting lower RAM usage after the update, although Microsoft has not confirmed that 26H2 itself is responsible.
2026-27 MLS NEXT schedule: Key dates to know
By MLSsoccer staffThe 2026-27 MLS NEXT season will be the seventh and largest in league history, expanding national competition and player development opportunities across North America's top youth so...
Neighborhood Intelligence Provides Business Update and Announces $45.5 Million Equity Financing with Participation from Management and a Single Institutional Investor
NASHVILLE, Tenn., October 05, 2026--Neighborhood Intelligence (NASDAQ: NXH) ("Neighborhood" or the "Company") today announced that it has entered into a definitive agreement for the purchase and sale of an aggregate of 16,485,508 shares of its common stock (or pre-funded warrants in lieu thereof) at a purchase price of $2.76 per share (or pre-funded warrant in lieu thereof) in a registered direct offering. In addition, the Company will issue warrants to purchase up to 16,123,189 shares of common
Health Agency says now is the time to update raspatory virus Vaccinations
COLDWATER, MI (WTVB) - As fall arrives and respiratory virus season gets underway, the Branch-Hillsdale-St. Jo...
Apple Releases MagSafe 3 Charging Cable Firmware Update
For the first time since February 2023, Apple has released a firmware update for the MagSafe 3 charging cable for the MacBook Pro and MacBook Air. Specifically, Apple last week released firmware version 3.2.0 for the USB-C to MagSafe 3 Cable. The previous firmware version for the cable was 3.1.12. It is unclear what is included in the latest firmware, as Apple does not publish release notes for this.
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.
Hunt Marketing Firm in Oxford Receives Accolade
For the third consecutive year, Hunt Marketing in Oxford has earned a place on the Inc. 5000 list of America’s fastest-growing private companies. Hunt ranked No. 4,009 on the 2026 list. “Being named to the Inc. 5000 list for a third time is meaningful because it validates the growth story we’re building,” said CEO and […]
MobileFuse Receives SBTi Validation for Its Science-Based Emissions Target
/PRNewswire/ -- MobileFuse, a leading advertising and technology platform, today announced that SBTi Services validated its science-based greenhouse gas...
Keller on what happens when all politics is actually national
President Trump's Massachusetts numbers and what they mean for GOP candidates
Galaxy S25’s stable One UI 9.0 update reaches the USA
Last week, Samsung released the stable version of One UI 9.0 (Android 17) to the Galaxy S25, Galaxy S25+, and the Galaxy S25 Ultra. However, the brand made it a
Business Roundup: Latham Aldi sets opening date, women-only gym expands into Slingerlands
Here's what's new in the Capital Region business scene.
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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