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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
Five Plays: NC State First Quarter
Louisville lost another football game on Saturday. They also lost another game that they should have won. Penalties had been a major issue for this team, but they replaced that issue with turnovers this time around. But the biggest issue remains, and that issue is blown coverages by the secondary. For the second straight week, […]
Sphere Entertainment Sinks 12% on Analyst Downgrade: Demand “Softening Faster Than Expected”
Sphere’s own ticket-sales milestones show the same slowdown the analyst sees
Gypsy Rose Blanchard addresses 'significant tension' with Ken Urker's sister
Gypsy Rose Blanchard is responding to criticism from Ken Urker's sister following the death of Urker, the father of her daughter.
Why Sphere Entertainment (SPHR) Stock Is Trading Lower Today
What Happened? Shares of content production and distribution company Sphere Entertainment (NYSE:SPHR) fell 12.3% in the afternoon session after Craig-Hallum ...
Team Dresch, pioneering WA punk rock band, returns with ‘Furthermore’
Team Dresch are finally putting out their third album, “Furthermore,” the long-awaited follow-up to 1996’s “Captain My Captain.”
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 […]
Google Wallet for Android adds 12th digital state ID
Following the last launch at the end of August, Google Wallet is rolling out support for Oklahoma state IDs on Android.
Banijay Entertainment Unites US Operations With Banijay America Following All3Media Merger
Ben Samek will serve as the CEO of this division, which will now house Turnkey Studio Services
Banijay Entertainment Unites US Operations With Banijay America Following All3Media Merger
Ben Samek will serve as the CEO of this division, which will now house Turnkey Studio Services
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.
Computer science student is a CEO before earning diploma
Marcel Slowikowski (’26 computer science) launched an AI startup this summer, months before he earns his computer science degree.
Utah plows ahead with more health AI pilots for prescriptions, women’s health
Utah plans to allow an AI product to evaluate patients and write new drug prescriptions without prior human review.
Mystery Hill launches first after dark experience
BLOWING ROCK — Mystery Hill, home of North Carolina’s only Natural Gravitational Anomaly, will remain open after sunset this fall for Mystery Hill After Dark, a new evening event series
The #2 Movie on Netflix Is a Thrilling Documentary About a Charismatic Serial Killer
"The Widower: 'Til Death Do Us Part" follows the twisting story of Thomas Randolph, also known as the "Black Widower," of whose six wives, four ended up dead.
How a 'superwoman' who plays pro tackle football has built a flag football powerhouse
During the fall, Rachel Karos coaches Willowbrook flag football. Come spring, she is a professional tackle football player in the WNFC.
Olivia Rodrigo’s Unraveled tour might be 2026’s best
WASHINGTON – For her third major tour, Olivia Rodrigo literally brought herself some well-deserved flowers.
Inter keen on Cagliari rising star Alessandro Romano
Inter show no inentions in slowing down their recruitments following a very active summer market as the Nerazzurri are keen on acquiring the services of Cagliari and Azzurri rising star Alessandro Rom...
No stadium has a story like the Superdome
The Superdome has weathered the highest of highs and the lowest of lows to represent the complicated and celebrated history of its city.
Former White House press secretary Karoline Leavitt lands her next gig as Fox News contributor
Leavitt follows Kayleigh McEnany, the former press secretary who joined Fox in 2021.
Sphere Entertainment options flow analysis amid an 11.6% stock drop
Sphere Entertainment options flow analysis amid an 11.6% stock drop
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
Claims that genAI speeds up PC ports of classic games are either "false" or missing the point, says Banjo Kazooie: Recompiled developer
A Banjo Kazooie: Recompiled developer has spoken out against the idea that generative AI allows for faster PC ports and, therefore, better preservation.
NFIB jobs report shows small business hiring slowed in September
NFIB’s September jobs report shows a decline in hiring activity among small businesses as the labor market continues to soften.
Juventus Following Dutch Duo Ahead of Next Summer
Two high-ranking Juventus officials attended the recent Nations League game between Germany and the Netherlands to keep tabs on Brian Brobbey and Virgil van Dijk. The pair is on their radar ahead of n...
The Science Enabling a Steady Supply of Critical Minerals
Researchers are collaborating across disciplines to unlock domestic sources of valuable materials and lower costs.
Italy’s Meloni follows pop stars in seeking to trademark her voice to combat AI deepfakes
Italian Premier Giorgia Meloni has applied to trademark her voice with the European Union intellectual property office in a bid to bolster protections against AI-generated deepfakes | KNSS Radio
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, …
Ninja Theory developers announce they are facing redundancy, as the studio starts laying off staff following widespread Xbox cuts
Ninja Theory staff on LinkedIn have shared either farewell messages or sombre posts on the ongoing redundancy process happening at Ninja Theory.
USA TODAY Sports Super 15 East region football rankings, Week 8
Here are the latest USA TODAY Sports East Region rankings following a wild week of high school football action.
World Mental Health Day Preview
Marina Kerlow, Licensed Marriage and Family Therapist, joined Fox 5 DC.
Weaner Pig Breakeven at $22.46, Up $12.25 From Last Week
When you consider that today’s purchased weaner would be sold in March 2027 using April 2027 futures, the weaner breakeven was $22.46, up $12.25 for the week, and $0.57 below the average cash price for the week of $23.03.
Sphere Entertainment (NYSE:SPHR) Shares Gap Down Following Analyst Downgrade
Sphere Entertainment (NYSE:SPHR) Shares Gap Down Following Analyst Downgrade
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.
Davids Fights Washington Healthcare Cuts with Plan to Lower Costs, Protect Kansas Hospitals
WASHINGTON, D.C. — Today, U.S. Representative Sharice Davids (KS-03) introduced a comprehensive package of healthcare legislation that directly counters Washington’s recent healthcare rollbacks, which are increasing monthly costs and closing rural hospitals. Davids’ efforts would protect Kansas families from rising medical costs, block new federal red tape, and keep local hospitals and health clinics open.
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.
Beazley and Zurich Global Specialty Names New CEO
Kristof Terryn has been appointed as chief executive of Beazley and Zurich Global Specialty following Switzerland-based Zurich Insurance Group AG’s acquisition of British firm Beazley plc…
US services sector activity slows in September; price pressures mount
US services sector activity slowed in September, with strong domestic demand stretching supply chains and raising prices paid by businesses for inputs, indicating that inflation could remain high into next year.
‘NCIS’ Star Mark Harmon Reveals Why He and His Wife Pam Dawber Keep a Low Profile
They've been married since the late ’80s!
Science Corp. Announces Long-Term (36 Months) Results of PRIMA BCI Clinical Trial Showing Durable Vision Restoration in Blind Patients Suffering from Geographic Atrophy
Science Corporation, the neural engineering and brain-computer interface (BCI) company, today announced long-term (36 months) followup data from its pivotal ...
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.”
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 …
Syracuse Football: How Do Oddsmakers Feel About Matchup with Virginia?
The Orange are back in action this weekend against the Cavaliers following a 42-41 win over UConn.
First DLC for ‘Halloween: The Game’ Arrives October 27, Featuring a Free ‘Halloween 5’ Map
As expected, the first DLC for IllFonic's 'Halloween: The Game' will arrive just in time for Halloween on October 27.
2026 Outstanding Women in Business
The 18th annual Outstanding Women in Business awards recognize a dozen well-accomplished professionals from across the region and in many industries who go above and beyond. The committee selected the winners from more than 80 nominations, all of whom were worthy. The criteria evaluated each nominee’s professional achievements, community impact, ability to break the glass ceiling and mentorship of other professionals, particularly women. In addition to profiling these women in the following pages, the Worcester Business Journal will celebrate this year’s Outstanding Women in Business at a special luncheon on Oct. 28 at the College of the Holy Cross. To join the celebration of these exceptional women, visit WBJournal.com and register. – Mark Conti, editor This Year’s Judges Worcester Business Journal considered 54 Central Massachusetts professionals for the 2026 Outstanding Women in Business awards, based on 83 nominations. These nominees were independently evaluated by two volunteer judges, who scored each on their professional achievements, community contribution and mentorship of young professionals. Samantha P. McDonald is a partner at Bowditch. She is an experienced, client-focused real estate lawyer, concentrating on business and real estate property law. She has been recognized as a WBJ Power 100 in the Class of 2026 and a “Top Women of Law” in Massachusetts Lawyers Weekly. Dr. Kavita Babu is chief medical officer and vice president of medical affairs at Heywood Healthcare, where she provides strategic and clinical leadership to advance high-quality, patient-centered care across the organization. She is also a member of the WBJ Outstanding Women in Business Class of 2025.
Hellblade studio Ninja Theory has started laying off staff, following Xbox’s announcement that it faces closure
Two separate agreements with the studio “fell through”…
ESPN predicts Auburn's remaining schedule after SEC loss to Tennessee
How did Auburn football's 2026 outlook change following its Week 5 loss to Tennessee?
Sphere Entertainment (NYSE:SPHR) Downgraded by Craig Hallum to "Hold"
Craig Hallum lowered Sphere Entertainment from a "buy" rating to a "hold" rating and set a $132.00 price objective for the company. in a research report on Monday.
Apple Watch Prime Day Deals Arrive With New All-Time Low Prices for Series 12 and Ultra 4
Big Apple Watch discounts have started arriving ahead of Prime Big Deal Days, including new low prices on Apple Watch Series 12 and Apple Watch Ultra 4. These deals join some Apple Watch SE 3 discounts that we began tracking over the weekend, alongside other major early Prime Big Deal Days markdowns. Note: MacRumors is an affiliate partner with Amazon. When you click a link and make a purchase, we may receive a small payment, which helps us keep the site running.
Scientists Reveal The Optimal Amount of Sleep For Lower Dementia Risk
A huge analysis uncovered the sweet spot.
Star Wars Zero Company Has Received Its First Big Discount at Amazon Before Its October Prime Day Sale Begins, Dropping Below $50
Star Wars Zero Company has dropped to a new low price at Amazon ahead of the retailer's Prime Big Deal Days sale event, with a 20% discount across PS5 and Xbox Series X.
Nations League: the chances of reaching the quarter-finals 👀
Are Les Bleus in a strong position?In this edition of the Nations League, as in the previous one, the group stage will be followed by quarter-finals.The top two teams in each of the four groups will q...
Bromley Women 1-0 Reading Women: Match Report
The Royals are out of the cup, following a narrow defeat in South London on Sunday.
Cal-Maine cracks open new growth opportunities
Earnings plunge amid low egg prices and investments in prepared foods.
Yankees draw baseball’s hottest September arm in Game 2
The Yankees got one hit Saturday. Their reward for trying to even the series Monday is a starter who allowed […]
Why plugged-in pickle glows: Engineer burns 100-plus pickles to find answer
An engineer says glowing pickles owe their orange light to sparks igniting hydrogen near an electrode, with sodium ions supplying the color.
Business Beat : Halloween activities planned at the Branch County Fairgrounds
COLDWATER, MI (WTVB) - The Branch County Fairgrounds will host a pair of family-friendly Halloween events this...
Research Shows These 10 Diets Are Linked to Healthier Aging
A new study found that many different diets can slow biological aging.
Kansas City Royals news: Drew Waters elects free agency
And why do the Royals start out so slow?
Swedish regulator temporarily revokes Charm Entertainment AB’s casino licence following investigation
Spelinspektionen issued an interim revocation of Charm Entertainment AB’s licence to operate commercial land-based casino gaming.
U.S. Air Force removes all bombers from British air base
The move follows an investigation into a planned terror attack at the RAF Fairford base
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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