This review examines recent functional neuroimaging research of resting-state regional connectivity between brain regions in anxiety disorders. Studies compiled in the PubMedNational Center for Biotechnology Information database targeting resting-state functional connectivity in anxiety disorders were reviewed. Diagnoses included posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), panic disorder (PD), and specific phobia (SP).Alterations to network connectivity were demonstrated in PTSD, GAD, SAD, OCD, and PD in several resting-state investigations. Differences from control subjects were primarily observed in the default mode network within PTSD, SAD, and OCD. Alterations within the salience network were observed primarily in PTSD, GAD, and SAD. Alterations in corticostriatal networks were uniquely observed in OCD. Finally, alterations within somatosensory networks were observed in SAD and PD investigations. Resting-state studies involving SPs as a primary diagnosis (with or without comorbidities) were not generated during the literature search. The emerging use of resting-state paradigms may be an effective method for understanding associations between anxiety disorders. Targeted studies of PD and SPs, meta-analyses of the studies conducted to date, and studies of the impact of specific comorbid presentations, are recommended future research directions. W W W Études de neuroimagerie à l'état de repos : une nouvelle façon d'identifier les différences et les similitudes des troubles anxieux?Cette revue examine la recherche récente en neuroimagerie fonctionnelle sur la connectivité régionale à l'état de repos entre les régions du cerveau dans les troubles anxieux. Des études de la base de données PubMed-National Center for Biotechnology Information portant sur la connectivité fonctionnelle à l'état de repos dans les troubles anxieux ont été examinées. Les diagnostics incluaient notamment le trouble de stress post-traumatique (TSPT), le trouble d'anxiété généralisée (TAG), le trouble d'anxiété sociale (TAS), le trouble obsessionnel-compulsif (TOC), le trouble panique (TP), et la phobie spécifique (PS). Les modifications de la connectivité du réseau ont été démontrées dans les TSPT, TAG, TAS, TOC et TP dans plusieurs investigations à l'état de repos. Les différences par rapport aux sujets témoins ont été surtout observées dans le réseau du mode par défaut dans le TSPT, le TAS, et le TOC. Les modifications du réseau de saillie ont été surtout observées dans le TSPT, le TAG, et le TAS. Les modifications des réseaux corticostriataux ont été observées seulement dans le TOC. Enfin, les modifications des réseaux somatosensoriels ont été observées dans les investigations du TAS et du TP. Les études à l'état de repos impliquant les PS comme diagnostic primaire (avec ou sans comorbidités) n'ont pas été générées durant la recherche de la littérature. L'utilisation naissante des paradigmes de l'état au repos peut se révéler une méthode ef...

In recent years, a number of new neuroimaging techniques have detected covert awareness in some patients previously thought to be in a vegetative state/unresponsive wakefulness syndrome. This raises worries for patients, families, and physicians, as it indicates that the existing diagnostic error rate in this patient group is higher than assumed. Recent research on a subset of these techniques, called active paradigms, suggests that false positive and false negative findings may result from applying different statistical methods to patient data. Due to the nature of this research, these errors may be unavoidable, and may draw into question the use of active paradigms in the clinical setting. We argue that false positive and false negative findings carry particular moral risks, which may bear on investigators' decisions to use certain methods when independent means for estimating their clinical utility are absent. We review and critically analyze this methodological problem as it relates to both fMRI and EEG active paradigms. We conclude by drawing attention to three common clinical scenarios where the risk of diagnostic error may be most pronounced in this patient group.

Paradoxical lucidity in dementia is a clinically significant but understudied phenomenon. A provisional definition was proposed by the 2018 National Institute on Aging expert workshop and published in Alzheimer's and Dementia. However, several conceptual features of this definition remain vague, creating barriers to robust clinical research. Here, we critically analyze the provisional definition and present a refined definition that can be applied in clinical research. The refined definition is based on an analytic process our research group recently undertook to operationalize paradoxical lucidity for our own study protocol. Our goal is to facilitate debate and potentially harmonize interpretations of paradoxical lucidity among research groups.

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The general public is subject to triage policies that allocate scarce lifesaving resources during the COVID-19 pandemic, one of the worst public health emergencies in the past 100 years. However, public attitudes toward ethical principles underlying triage policies used during this pandemic are not well understood. Three experiments (preregistered; online samples; N = 1,868; U.S. residents) assessed attitudes toward ethical principles underlying triage policies. The experiments evaluated assessments of utilitarian, egalitarian, prioritizing the worst-off, and social usefulness principles in conditions arising during the COVID-19 pandemic, involving resource scarcity, resource reallocation, and bias in resource allocation toward at-risk groups, such as the elderly or people of color. We found that participants agreed with allocation motivated by utilitarian principles and prioritizing the worst-off during initial distribution of resources and disagreed with allocation motivated by egalitarian and social usefulness principles. At reallocation, participants agreed with giving priority to those patients who received the resources first. Lastly, support for utilitarian allocation varied when saving the greatest number of lives resulted in disadvantage for at-risk or historically marginalized groups. Specifically, participants expressed higher levels of agreement with policies that shifted away from maximizing benefits to one that assigned the same priority to members of different groups if this mitigated disadvantage for people of color. Understanding these attitudes can contribute to developing triage policies, increase trust in health systems, and assist physicians in achieving their goals of patient care during the COVID-19 pandemic.

Determining the prognosis of comatose patients is difficult, and yet this information is vital for informing treatment decisions. While fMRI offers promise as a prognostic tool, further research is needed into its use. Weijer et al. provide the first analysis of the ethical issues surrounding such research in comatose patients.

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Community-based substance abuse prevention initiatives often rely on the empowerment of community residents. Few studies, however, have examined predictors of empowerment in substance abuse prevention contexts. This study tested a path model that included two environment-related variables (i.e., residents' awareness of community substance abuse problems and perceived incivilities in their community), two variables representing residents' perceptions of their community (i.e., sense of community and perceived police responsiveness to drug crime) and citizen participation as predictors of the intrapersonal component of psychological empowerment. The model was found to provide a good fit to the data from a random sample of urban residents (n=283) who participated in an evaluation of a National Institute of Justice community policing initiative in the Southwestern United States. Findings suggest that empowerment-based interventions aimed at preventing substance abuse and its related harmful consequences should incorporate activities that specifically address sense of community and police responsiveness to drug crime. Limitations and directions for future research are discussed.