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Brazil: Lessons from a Disaster
By Antonio Martins (Outras Palavras) Defeats become deeper and more prolonged when we misunderstand what caused them, avoid correcting course, and embrace “solutions” that only compound our mistakes. Lula’s government and the Brazilian left suffered a disaster in Sunday’s election. Contrary to every poll, the president finished the first round 2.2 million votes behind Flávio Bolsonaro—and, more significantly, 3.4 million votes below his total four years ago, when the machinery of the state was working against him and in favor of his opponent. His vote share declined in 98 percent of Brazil’s municipalities. The PL, the main party of the far right, elected 121 deputies and 28 senators, becoming the largest caucus in both houses of Congress. The parties aligned with the Centrão—Brazil’s bloc of transactional center-right parties—were somewhat diminished, but will still hold roughly 250 seats in the Chamber of Deputies and 35 in the Senate. That will make it easier to assemble the majorities needed to amend the Constitution or impeach Supreme Federal Court justices. If elected, Flávio Bolsonaro could appoint four members of the Court, substantially altering its internal balance of power. What produced these results? How can the far right be prevented from consolidating them into a prolonged political hegemony? And what is the essential change of direction the left now needs? Explaining the Disaster Across the commercial media and the exuberant chaos of digital platforms, interpretations are multiplying. Some focus on specific episodes: Lula’s absence from the Globo debate, his very close relationship with Alexandre de Moraes, or his emphasis on issues supposedly remote from most people’s everyday concerns, such as rare earth minerals. Among the more systemic interpretations, three seem especially questionable. One argues that the principal defeat was not the left’s, since its congressional representation declined only slightly. The decisive movement captured at the ballot box, according to this view, was a shift within the right itself—from the more moderate and transactional forces of the Centrão toward the more ideological and radicalized forces of the PL and Novo. A second interpretation holds that the nature of electoral and political processes has changed. The material interests and aspirations of society, it argues, no longer play the central role they once did; they have given way to forms of subjective self-identification that the left has yet to understand. And a third concludes that, because of these two developments, we should expect a political winter: a prolonged period in which the far right and the broader right dominate Brazilian political life. There are important elements in all three interpretations. The problem lies in what they deny or leave out: Lula’s third government was a small-bore government. It offered the majorities that elected it neither a clearly better life nor reasons to believe again in politics and its power to transform society. These failures flowed from two fatal accommodations, which I will examine below. As a result, the government suffered a slow but steady erosion of support. And, as has happened in so many Western countries, it gave the far right the opportunity to present itself as anti-system and to benefit from popular frustration and distress. The interpretation that emphasizes the migration of votes from the center-right and traditional right toward the far right has been advanced, among others, by the courageous journalist Leonardo Sakamoto. In his UOL column on Monday, October 5, he highlights the miserable behavior of the traditional conservative parties. Over the past four years, they repeatedly joined forces with the “neo”-fascists, helping to “normalize” them—a criticism that could equally be directed at almost the entire corporate media. Believing they could use the far right as a stepping stone, they instead ended up partly devoured by it. This was especially true in the Senate, where the PL’s gain of 13 senators and Novo’s gain of two came at the expense of the PSD, which lost nine; the MDB, which lost two; the PSDB, which lost two; and the PP, which lost one. Sakamoto’s observation is accurate and necessary, but it leaves uncomfortable questions unanswered. Why did the erosion of the Centrão benefit the far right rather than, for example, producing growth for the left—as has happened so many times before, both in Brazil and elsewhere? The answer is not difficult. Throughout its four years in office, Lula’s third government was almost invariably associated with the Centrão. Here lies its first accommodation: accepting the limits imposed by conservative institutions; avoiding, as much as possible, any attempt to strain those limits through popular pressure; and believing only in the modest changes that could be squeezed through openings in Congress. The failure of the campaign to end the six-day workweek is emblematic. Lula could have electrified the presidential race by pairing it with a popular campaign for passage of the measure. Instead, he chose to place his hopes in the hands of Senate president Rodrigo Alcolumbre. He generated no mass mobilization, did not force his opponents onto an uncomfortable defensive, and won no victory. In September 2025, the government squandered the greatest of its many opportunities to shake up conservative power in Congress. Popular opposition to the so-called Shielding Amendment—which, if approved, would have restricted criminal proceedings against members of Congress—brought crowds into the streets, mobilized primarily by artists and social movements. This opened the possibility for a broader political education: a campaign that could begin exposing the limits and dysfunctions of Brazil’s political system while putting Bolsonaro’s movement on the defensive for its predictable support of political privilege. The amendment was defeated. But the executive branch then backed away from the fight. It remained associated with an institutional world widely seen as corrupt, elitist, and indifferent to ordinary people’s struggles. In doing so, it forfeited its credibility as a vehicle for the protest vote. On Sunday, it reaped the bitter fruits. Are We Doomed? Taking a different approach from Sakamoto, the philosopher Moysés Pinto Neto and other writers have drawn attention, in their first analyses of October 4, to the fragmentation of the public sphere produced by Big Tech platforms. Through their algorithms, these platforms present each person with a different view of social reality. As a consequence, it becomes much harder to identify common material problems and demands—for example, the fight for labor rights or for a properly funded public health system. Voters no longer embrace such demands, these authors argue, because they no longer see themselves as part of a collective. Instead, they tend to value the identities assigned to them by neoliberal subjectivity—the role of the entrepreneur, for example. On this interpretation, the left’s possible error lies in clinging to outdated illusions. Moysés’s warning is highly relevant and resonates with arguments such as Naomi Klein and Astra Taylor’s “Apocalyptic Fascism and the Billionaires’ Bet.” Unlike a century ago, the far right no longer promises a radiant future. It concentrates instead on resentment—especially that of young men. “They belong to a generation that fears it may never own a home, but compensates with the pleasure it gets from constantly provoking progressives online. Convinced their future has been stolen, they share memes romanticizing historical authoritarian regimes,” the authors write. But Moysés seems to confuse this danger with inevitability. He fails to see that the left’s answer cannot be adaptation. On the contrary, it must strengthen the possibility of politics as collective action. Nor does he recognize that precisely such a reversal is already becoming possible in some of the most promising mobilizations of the twenty-first century: the election, at the end of 2025, of the young Muslim Zohran Mamdani as mayor of New York, on a platform centered on the intensely material fight for an affordable city; the Left Party’s victory in Berlin two weeks ago, built around the demand to expropriate private real-estate corporations; and the very recent wave of demonstrations in Spain—including an occupation of Madrid’s Puerta del Sol—in which tens of thousands of young people mobilized by the Tenants’ Union have demanded limits on rents. By putting itself in the straitjacket of the “fiscal framework” in the first months of 2022, Lula’s third government adopted the second fatal accommodation of its term. Faced with conservative institutions and a country devastated by four years of Bolsonaro, increased public investment was the government’s remaining weapon for offering a more dignified life to the majority and forging an anti-conservative pact with them. The same state that disburses 1 trillion reais a year to enrich a small class of rentiers could instead spend money to extend the Family Health Strategy to every Brazilian, at a cost of 30 billion reais; provide full-day public schooling and childcare to all adolescents and children—and, especially, relief to their mothers; achieve universal sanitation while cleaning up polluted urban rivers; multiply metro systems; begin transforming the urban peripheries; and undertake many other urgently needed projects. In April 2023, an article in Outras Palavras warned that the fiscal framework could “shrink the Lula government and preserve the forces that condemn the country to inequality and regression.” A year later, another article showed that restraints on public spending were strangling policies vital to ordinary people and undermining the president’s popularity. In November 2024 came a reality check, in the form of the government’s humiliating defeat in the municipal elections. Even then, the fiscal lock was neither removed nor loosened. On the contrary: throughout the government’s four years, fiscal restraint remained central to its political narrative. The administration proudly proclaimed that it had “put the state’s accounts in order,” without grasping either how misleading that phrase was—given the payment of 1 trillion reais in interest—or how badly the message was hurting it politically. Lula finally woke up in September 2026. The increase in Bolsa Família benefits, after four years of being frozen; the announcement that anti-obesity drugs would be offered through Brazil’s public health system; and the ban on online betting showed that the state has the power to act decisively on behalf of the majority when those in government are willing to confront obstacles. The huge marches that closed the campaign in Fortaleza, Salvador, Rio de Janeiro, and São Paulo on the eve of October 4 showed how such initiatives can mobilize activists and the broader public. But it was too late—and too little to change the outcome of the first round. History has not ended The possibility of a turnaround in the three weeks leading up to November 25 cannot be ruled out. It will not be simple or easy. Lula must not only make up a deficit of 2.2 million votes; he must also offset the movement of voters who backed other right-wing candidates in the first round, most of whom are likely to move toward Flávio Bolsonaro. Pulling that off will require a broad, grassroots effort to win over voters, potentially reinforced by new initiatives from Lula. The coming hours and days will be decisive. If Bolsonaro’s movement also wins the presidency, the result will create a high-risk situation for Brazilian sovereignty and democracy. The enormous challenges posed by such an outcome would require the left to reexamine, in depth and with a genuine willingness to engage in self-criticism, its political projects—or its lack of them—and its practices. But would that mean we are condemned to the long winter of far-right hegemony that some analyses are beginning to forecast? It is far too early to say, suggests a recent text by Álvaro García Linera, the thinker who served as vice president of Bolivia under Evo Morales. His central hypothesis is that this political current will prove short-lived. At a moment when the entire world is once again talking about sovereignty and protecting national economies, the far right offers a stale, recolonizing neoliberalism. Its submission to the United States is as blatant and pathetic as Flávio and Eduardo Bolsonaro’s overtures to Donald Trump. Its project amounts to something like every man for himself: greater inequality, capitalism without limits, devastation, and supremacism. Will it work? In the United States, just two years into his second term, Trump himself is reaching record levels of unpopularity and may be on the verge of losing Republican control of both the House and Senate in November. Every new beginning is difficult. Whatever the outcome of the second round, the defeats of October 4 show how profoundly the Brazilian left will have to rethink and rebuild. But just as it would be foolish to underestimate the seriousness of its mistakes, it would be equally foolish to conclude that rebuilding a political project is no longer possible. History has not ended. The times are moving faster than ever. Originally published in Portuguese by Outras Palavras. English translation by Eric Blanc; I’ve added the subtitles. More We can’t stop the far right at home or abroad without a revitalized labor movement, which is yet another reason why you should become a sustaining supporter of the Emergency Workplace Organizing Committee (EWOC) — one of US labor’s pivotal bright spots. Relatedly, Jacobin published a short piece of mine reflecting on a decade of Bernie Sanders inspiring a whole new generation of young worker organizers.
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Who: Winnipeg Jets (1-0-1, 4th place Central Division) @ Pittsburgh Penguins (2-0-0, 1st place Metropolitan Division) When: 7:30 p.m. eastern How to Watch: Locally televised game on Sportsnet Pittsburgh, Sportsnet+ up in Canada, out-of-market streaming on ESPN+ Pens’ Path Ahead: Up next for the Penguins will be two road games against division opponent, Washington on Wednesday […]
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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