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Flyers Still Winless, Fall 4-1 to Lightning On Monday
The Philadelphia Flyers (0-2-2) are still searching for their first win of the season after falling 4-1 to the Tampa […]
St. Louis Cardinals Biggest 2027 Challenge? Managing Expectations
I have been a St. Louis Cardinals fan for more than five decades and I have lived through many different eras of losing seasons, championships and everything in between. I can’t recall any of them being more unclear about what the expectations should be for an upcoming season than the one that will hopefully begin […]
Jaylen Brown erupts in Sixers preseason debut
Jaylen Brown played in his first game with the Sixers, even though it was technically in the preseason.
Four Lakers players will miss Monday's preseason opener
The Lakers will be without four players when they open their 2026-27 preseason schedule on Monday.
‘American Idol’ alum Caleb Flynn sentenced to life without parole for murdering wife
‘American Idol’ alum Caleb Flynn, who competed in season 12, was sentenced to life without the possibility of parole for murdering his wife Ashley as she slept in their home on Feb. 16.
Three Storylines to Monitor in Timberwolves Preseason Opener vs. Bucks
The new-look Timberwolves will kick off their preseason in Milwaukee on Monday.
Padres’ Potential Game 4 Starter Comes Back from Paternity List
Walker Buehler has spent the season being one of the San Diego Padres' most valuable starting pitchers. That might not be immediately apparent from the overlying statistics, but the metrics under the surface show a different picture. San Diego will be all hands on deck after dropping both games to the Milwaukee Brewers at American …
What control! Zidane oozes class during France match 🎥
Zinedine Zidane has reasons to make fans optimistic about the future of the French national team.And on Monday (5), he gave fans another reason to rise from their seats at the Stade de France.During t...
One Question For Boston Celtics About Style of Play
The Celtics seem destined to play faster this season, but how exactly will they do that?
Paris Johnson Jr. to miss rest of season
Cardinals OT Paris Johnson Jr. will miss rest of 2026 because of injury
Week 6 honor roll for Central Texas high school football
Week 6 of the Central Texas high school football season is in the books. Here is the honor roll for the Austin area.
The science behind the Superdome’s roar during the Domecoming game
Superdome Decibels Debunked: How loud was the Dome when Steve Gleason blocked the punt?
Jeremy Fears Jr. Voted Big Ten’s Preseason Best
Michigan landed two guards on the preseason All-Big Ten team, and Jeremy Fears Jr. had the last word. #GoGreen
The Case for Hope for Washington Nationals Ahead of Offseason
With the offseason arrived, why there's reason for optimism surrounding the Washington Nationals this offseason
On Your Side: Better Business Bureau shares tips for winterizing your home and car
The Better Business Bureau has tips to help you winterize your home and vehicle so you’re prepared for anything the season throws at you.
Knicks’ 3 Most Intriguing Regular Season Matchups
As the regular season approaches, the Knicks will officially go from the hunters to the hunted. After a wild offseason, especially in the significantly strengthened Eastern Conference, the defending champions will face much tougher challenges this season. Teams in the East like the Miami Heat, Toronto Raptors, and Philadelphia 76ers all made moves to strengthen …
Chargers' Omarion Hampton numbers may shock you after four weeks
These Chargers running back Omarion Hampton's stats may surprise you over the first four weeks of the season.
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
SnakePit Post-season GDT, #6
Probably safe to say that both results in the National League Division Series went in the way most readers of the SnakePit wanted, with the Padres and Dodgers both losing. The NL gets a travel day today, as the series relocate to San Diego and Atlanta respectively, before resuming on Wednesday. So, today, it’s the […]
Alexandria health official urges flu shots as season arrives, warns flu can be serious
Keaton Wagler Stays Positive After Struggling in Clippers Preseason Debut
Keaton Wagler speaks after his preseason debut with the Los Angeles Clippers.
Tony Gilroy on leaving the politics of 'Andor' behind for his 9-composer music drama 'Behemoth!'
Tony Gilroy’s “Behemoth!” premiered over the weekend as the centerpiece of the New York Film Festival. Gilroy’s first film since the Star Wars series “Andor” concluded its acclaimed two-season run,
Memphis Grizzlies Ranked 6th-Worst NBA Team Entering 2026 Preseason
Do you agree with this ranking for the Memphis Grizzlies?
Harlandale makes E-N high school football power rankings season debut
Harlandale makes E-N high school football power rankings season debut after winning fourth game in a row.
José Altuve Continues to Add to His Remarkable Astros Career
At 36, Altuve added another solid season and moved within one home run of the all-time postseason record.
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 …
Atlanta Hawks Ranked 14th-Best NBA Team Entering 2026 Preseason
The Atlanta Hawks are ranked the 14th-best NBA team entering the 2026 preseason.
How to Watch Celebrity Weakest Link Season 2, Episode 3
Watch Celebrity Weakest Link live with TV channel, start time and streaming info. Stream Season 2, Episode 3 on Fubo — no cable required, free trial.
How to Watch Law & Order Toronto: Criminal Intent Season 2 Premiere
Watch Law & Order Toronto: Criminal Intent live with TV channel, start time and streaming info. Stream Season 2 Premiere on Fubo — no cable required.
Darko Rajakovic Reveals What’s Behind Kawhi Leonard’s Delayed Raptors Return
Toronto prioritizes long-term health over preseason minutes as the superstar ramps up his reconditioning process.
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.
Arizona WR Tre Spivey out for season with foot injury
At least one of the trio of starting wide receivers injured in Arizona’s last game won’t be back on the field this season. UA coach Brent Brennan confirmed Monday that junior Tre Spivey will miss the remainder of the season after suffering a foot injury in Saturday’s 34-7 win over Cincinnati. Brennan said Spivey will […]
ACC Coach Takes Shot at Penn State for Preseason Bias
Pat Narduzzi slams the Nittany Lions' unearned ranking, fueling the fiery debate over Big Ten favoritism and the flawed system of awarding prestige before kickoff.
Edison's Entertainment Complex Female Athlete Of Month: Jess Sever Has Made Important Contributions To Edwardsville Girls Flag Football Team
Edwardsville sophomore Jess Sever has five touchdowns as the undefeated Tigers girls flag football team advances in the IHSA postseason.
The Packers’ easy portion of the schedule is over
Moving forward, Green Bay Packers’ schedule is much tougher than the first four weeks of the 2026 season
Overwatch Season 5 skins and Mythics Revealed by Blizzard
Get ready for a spooky season in Overwatch
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.
Lakers at Kings: What to Watch
Two available starting spots, Walker Kessler’s debut and the Lakers’ bench production headline Monday’s preseason opener in Sacramento.
Your ballot, your move: Early voting starts Oct. 6
By Kevin Hendricks, nm.news — New Mexico voters can start casting ballots Oct. 6 for the Nov. 3 general election. There’s no reason to wait in line on Election Day, or to walk into the booth guessing. Early voting opens Oct. 6 at county clerk offices. On Oct. 17 it expands to more locations across […]
Chelsea Duo Nominated For 2026 Golden Boy Award
Two Chelsea stars headline the 2026 Golden Boy awards for a second consecutive season as the Blues hunt for a winner of the award for the first time.
Ana Navarro addresses Rosie O’Donnell’s potential return to “The View” (exclusive)
O’Donnell previously said that she’d return for season 30, while EW later confirmed a formal ask hadn’t gone out at the time.
Donovan Jackson to miss extended time
Vikings OG Donovan Jackson set to miss rest of regular season because of injury
‘The Batman Part II’ halts production as director Matt Reeves steps away for personal reasons
After years of delays, ‘The Batman Part II’ has ‘temporarily paused’ production as director Matt Reeves ‘focuses on a family matter.’
Braiden McGregor set to miss rest of season
Jets LB Braiden McGregor unlikely to play again in 2026 after torn pectoral
Bills player dismisses Patriots hero as ‘practice squad player’
After a 0-3 start to the season, the New England Patriots were able to bounce back in a big way on Sunday afternoon, pulling off an upset win over the Buffalo Bills on the road after Patriots wide receiver Efton Chism III made a ridiculous catch to give the Patriots the lead with under two…
Bones About Town takes over Main Street
Spooky season has made its way to Main Street — along with some new residents. Skeletons have taken over lampposts along the street, where they’ll live for all of October.
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
How to Watch CIA Season 2 Premiere
Watch CIA live with TV channel, start time and streaming info. Stream Season 2 Premiere on Fubo — no cable required, free trial available.
How to Watch Line of Fire Season 1, Episode 3
Watch Line of Fire live with TV channel, start time and streaming info. Stream Season 1, Episode 3 on Fubo — no cable required, free trial available.
US services sector activity slows in September; price pressures mount
US services sector activity slowed in September as supply chain strains and rising input prices signal persistent inflation risks into next year.
Did Jaguars' Pass Rush Turn a Corner in Sunday's Victory?
The Jacksonville Jaguars had their most productive pass-rushing game of the season in Sunday's victory, with the EDGE pair of Josh Hines-Allen and Travon Walker leading the way.
Alex Ovechkin Retiring at End of Season
Alex Ovechkin announced the 2026-27 season will be his last, including one final trip to Detroit. #RedWings
Washington Capitals star Alex Ovechkin announces this is his final NHL season
He broke Wayne Gretzky's career goal-scoring record in April 2025
Angels Offer A Blueprint For Bad Spending Decisions
The Los Angeles Angels make bad deals and throw away cash, which is how they lost 100 games this season.
Barcelona superstar set for salary raise as per prior agreement
Lamine Yamal’s start to the new season has been astonishing, and the player is operating at a level that any normal teenager should not even be able to dream of.He is, at this point, one of the best...
10 cool and cozy books for fall - Entertainment
Temperatures are cool, the couch is cozy, and the season’s greatest reads are calling your name. Here are 10 books to curl up with this fall.
Entertainment, work, study: 6 reasons the Dell XPS 13 is an everyday laptop worth looking at
The XPS 13 is a smart choice of notebook to cover all your daily needs
Florida's Jadan Baugh Has Another Tough Challenge Against South Carolina
After Missouri stifled the Heisman frontrunner, the Gators must revive their ground game against a relentless Gamecocks front to avoid a devastating mid-season collapse in Columbia.
Alexandria Health Department no longer offering free COVID-19, flu tests
The department is providing flu shots only to uninsured residents and has issued guidance for the respiratory virus season
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...
Spurs' Harris questionable for regular-season opener after straining left calf
The 6-foot-8 power forward will be reevaluated following the team’s five-game preseason schedule.
Answering Your Questions as Padres Near Disastrous End to Season
The San Diego Padres are inches away from total collapse, digging themselves into an 0-2 hole against the Milwaukee Brewers. They'll now turn home to a raucous Petco Park crowd with the hopes that they can stave off execution. The postseason allows for some insane turns of fortune. Could the Friars be the next recipient …
Boomers, Science Has Good News About Your Farting Habits
Based on self-reported results, millennials and Gen Xers fart more often than baby boomers. But there are reasons why seniors may have increased flatulence.
First Glance: Missouri Tigers
Aggies seeking a statement win to get the season back on track
HEALTH MINUTE: PREVENTING DANGEROUS RSV IN INFANTS
We’re officially in respiratory virus season. The U.S. Centers for Disease Control and Prevention says it typically runs October through mid-May, and the agency expects the U.S. will see a
Premier League viewership up 20% among young Americans, Nielsen Sports data shows
The Premier League has struck a chord with young Americans after the US co-hosted this year's World Cup, with viewership for the English top-flight up 20% among those aged 18-34 so far this season, shows data from Nielsen Sports released on Monday.
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...
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 …
Is It Healthy To Drink Apple Cider All Season Long? Nutritionists Explain
Gotta get that fall flavor.
'Chicago Fire' Season 15 cast – Who's back, exiting amid premiere
Prepare to see some changes when "Chicago Fire" returns this week. The NBC series will see multiple exits amid its 15th season, set to premiere Oct. 7.
Colorado influencers cash in on campaign season
Paid political messaging is increasingly showing up in Colorado social media feeds, sometimes without voters knowing who paid for it.
MLB News Outside The Confines: The Postseason hits the roof
All the news from the playoffs, including Drew Rasmussen, Ty France and the Brewers.
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.
Are the Brewers becoming more clutch in the Postseason?
Milwaukee’s ability in game one and two to comeback and win, makes this team feel that much more special
Caden Hunter pitched like a Top 100 prospect in 2026
Orioles prospect Caden Hunter pitched his way into MLB Pipeline’s Top 100 with a dominant 2026 season.
London City gelling, Man City flying
After five frantic weeks, the Women's Super League takes a two-week break, offering the perfect chance to take stock of a thrilling start to the season.
Spooky season watchlist
In October 2024, I drove into Gambrill State Park after dusk and joined others carrying blankets and lawn chairs — flashlight streams lighting the road and parking lot — as
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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