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Fear and anxiety play a central role in mammalian life, and there is considerable interest in clarifying their nature, identifying their biological underpinnings, and determining their consequences for health and disease. Here we provide a roundtable discussion on the nature and biological bases of fear- and anxiety-related states, traits, and disorders. The discussants include scientists familiar with a wide variety of populations and a broad spectrum of techniques. The goal of the roundtable was to take stock of the state of the science and provide a roadmap to the next generation of fear and anxiety research. Much of the discussion centered on the key challenges facing the field, the most fruitful avenues for future research, and emerging opportunities for accelerating discovery, with implications for scientists, funders, and other stakeholders. Understanding fear and anxiety is a matter of practical importance. Anxiety disorders are a leading burden on public health and existing treatments are far from curative, underscoring the urgency of developing a deeper understanding of the factors governing threat-related emotions.

It is impossible, even undesirable, for us to remember everything, thus intentional forgetting is an essential process for cognitive efficiency. Decades of research using an item-method directed forgetting paradigm demonstrate our ability to intentionally forget information. To-be-remembered (R) and to-be-forgotten (F) items are encoded differently, with R items better represented than F items in long-term memory. Consequently, we predicted that the well-established part-list cuing impairment of recall caused by re-exposure of some of the studied items prior to test should be greater when R items rather than F items serve as the part-list cues. We found that, relative to no part-list cues, R items reduced recall performance for the remaining R items, but F items improved recall performance for the remaining F items. We interpret this finding as evidence that F items disrupt the retrieval strategy less than R items do, and propose a context differentiation account.

In the color-word contingency learning paradigm, each word appears more often in one color (HI contingency) than in other colors (LO contingency). Despite the words being irrelevant, responses to the relevant colors quickly become faster to HI than to LOs—the contingency learning effect. Across four experiments (N = 1,490), the number of response-irrelevant word stimuli linked to each of the three response-relevant colors varied from 1 to 2 to 4. Our prediction, derived from the Parallel Episodic Processing (PEP) 2.0 model, was borne out: The magnitude of the contingency learning effect declined monotonically as more words were linked as HIs to each color. Inconsistent with the PEP model, however, we observed changes in response times not only in HI but also in LO trials, indicating a need to amend the model. Associative learning may therefore be a function of prioritizing high probability items at the expense of low probability items.

Our ability to forget on demand is called intentional forgetting, and it can be examined using the item-method directed forgetting paradigm. Recently, an inhibition account has gained popularity, arguing that to-be-forgotten (F) items are inhibited in working memory to impair their representations in long-term memory. In a series of experiments, we tested predictions from this inhibitory account by increasing the item and cue durations, respectively. Inhibition predicts decreased recognition for F items with increasing duration. In item recognition, increasing item duration increased memory for both to-be-remembered (R) and F items, in line with a selective rehearsal account of directed forgetting. There was no differential effect of cue duration on memory for R and F items. In associative recognition, increasing item duration increased memory for both R and F items but increasing cue duration increased memory only for R items, which is counter to an inhibition account.

The present study examined the associations among biased attentional responding to thin-ideal bodies, appearance comparisons, eating disorder-specific rumination, and body dissatisfaction. Sixty-seven females completed an attentional task capable of independently assessing biased attentional engagement with, and biased attentional disengagement from, images of thin-ideal bodies relative to images of non-thin bodies. Self-report measures of the other relevant constructs were also taken. Results revealed that a heightened tendency to engage in appearance comparisons was predicted by increased attentional engagement with thin-ideal bodies but not by impaired attentional disengagement from thin-ideal bodies. Moreover, a serial mediation analysis revealed that increased attentional engagement with thin-ideal bodies was associated with greater appearance comparison, which in turn was associated with greater eating disorder-specific rumination and consequently greater body dissatisfaction. The current findings suggest that increased attentional engagement with thin-ideal bodies might represent a pathway to body dissatisfaction, mediated by greater appearance comparison and eating-disorder specific rumination., Author(s): Laura Dondzilo [sup.1] [sup.2] , Julian Basanovic [sup.1] [sup.2] , Ben Grafton [sup.1] [sup.2] , Jason Bell [sup.2] , Georgia Turnbull [sup.2] , Colin MacLeod [sup.1] [sup.2] Author Affiliations: [...]

Memory is reliably enhanced for information read aloud compared with information read silently—this is known as the production effect. Theoretical accounts of this effect have been largely verbal in nature with very little exception, yet its robustness (and that of related phenomena) suggests that it is worth integrating into existing computational approaches to memory. A leading account of the production effect proposes that production leads to encoding of additional features at study and that these features are available at test to assist retrieval, conferring the observed memory benefit. We implement a version of this account into the Retrieving Effectively from Memory (REM) computational framework and examine its ability to capture key phenomena associated with the production effect. We compare and contrast the current implementation in REM with a pre-existing implementation of this effect in MINERVA2, in addition to discussing alternative conceptualizations and future work.

Memory is reliably enhanced for information read aloud compared with information read silentlythe production effect.Three preregistered experiments examined whether the production effect arises from a time-consuming recollective processoperating at test that benefits items that were produced at study. To accomplish this, participants were required to respondwithin a short deadline under the assumption that a time-consuming recollective process would be less able to operatewhen less time is available. If so, the production effect under speeded responding instructions should be reduced relativeto a standard nonspeeded condition. Results generally supported this prediction. However, even under speeded respondinginstructions, there was a robust production effect, potentially suggesting that other, more rapid, processes also contributeto the production effect.

PURPOSE:To estimate the proportion of children with trachomatous inflammation-follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors. METHODS:IDP camps were identified from government census data. We conducted a subanalysis of data collected in these camps during 2014-2015 as part of surveys covering 37 districts of the Darfur States within the Global Trachoma Mapping Project. A random-effects hierarchical model was used to evaluate factors associated with TF in children or TT in adults. RESULTS:Thirty-six IDP camps were represented in the survey data, in which 1926 children aged 1-9 y were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1-9 y. Of 2139 individuals examined aged ≥15 y, 16 (0.7%) had TT. TT was strongly independently associated with being older and living alone. CONCLUSION:Trachoma is found at low levels in these camps, but still at levels where intervention is needed. Disease elimination in conflict-related settings presents a unique challenge for the trachoma community, and may require an innovative approach. Understanding how best to undertake trachoma elimination interventions in these areas should be prioritized.

PurposeIn suspected trachoma-endemic areas of Yemen, we sought to determine the prevalence of the sign trachomatous inflammation-follicular (TF) in children aged 1-9 years, and the potential individual and household risk factors for TF in that age group. We also sought to determine the prevalence of trichiasis in adults aged ≥15 years.MethodsWe conducted a cluster-sampled survey in each of 42 evaluation units (EUs) comprising 166 rural districts of nine Governorates (Adh Dhale'a, Al Hodeihah, Al Jawf, Hadramoot, Hajjah, Ibb, Lahj, Ma'rib, Taiz) using the Global Trachoma Mapping Project systems and methodologies. Fieldwork was undertaken from September 2013 to March 2015. Risk factors for TF in children aged 1-9 years were evaluated using multilevel random effects logistic regression.ResultsThe TF prevalence in children aged 1-9 years was ≥10% in two EUs (7 districts) and 5-9.9% in six EUs (24 districts). In adults aged ≥15 years, trichiasis prevalence was ≥0.2% in five EUs (19 districts). Being older (within the 1-9-year age bracket), being male, living in a household with higher numbers of children, and living in a household that reported the use of open defecation, were each independently associated with higher odds of TF.ConclusionsThese surveys provided baseline data to enable planning for trachoma elimination. The World Health Organization Alliance for the Global Elimination of Trachoma by 2020 stands ready to assist Yemen once security considerations permit further surveys and implementation of control activities.

PurposeTrachoma is to be eliminated as a public health problem by 2020. To help the process of planning interventions where needed, and to provide a baseline for later comparison, we set out to complete the map of trachoma in Afar, Ethiopia, by estimating trachoma prevalence in evaluation units (EUs) of grouped districts ("woredas").MethodsWe conducted seven community-based surveys from August to October 2013, using standardised Global Trachoma Mapping Project (GTMP) survey methodologies.ResultsWe enumerated 5065 households and 18,177 individuals in seven EUs covering 19 of Afar's 29 woredas; the other ten were not accessible. 16,905 individuals (93.0%) were examined, of whom 9410 (55.7%) were female. One EU incorporating four woredas (Telalak, Dalefage, Dewe, Hadele Ele) was shown to require full implementation of the SAFE strategy for three years before impact survey, with a trachomatous inflammation-follicular (TF) prevalence in 1-9-year-olds of 17.1% (95%CI 9.4-25.5), and a trichiasis prevalence in adults aged ≥15 years of 1.2% (95%CI 0.6-2.0). Five EUs, covering 13 woredas (Berahle, Aba'ala, Dupti, Kurri, Elidihare, Ayesayeta, Afamboo, Bure Mudaitu, Gewane, Amibara, Dulecho, Dalolo, and Konebo), had TF prevalences in children of 5-9.9% and need one round of azithromycin mass treatment and implementation of the F and E components of SAFE before re-survey; three of these EUs had trichiasis prevalences in adults ≥0.2%. The final EU (Mile, Ada'ar) had a sub-threshold TF prevalence and a trichiasis prevalence in adults just >0.2%.ConclusionTrachoma is a public health problem in Afar, and implementation of the SAFE strategy is required.

PurposeEthiopia is highly trachoma endemic. Baseline mapping was needed in Ethiopia's Somali Region to guide elimination efforts.MethodsCross-sectional community-based surveys were conducted in 34 suspected trachoma-endemic woredas, grouped as 14 evaluation units (EUs), using a standardised mapping methodology developed for the Global Trachoma Mapping Project.ResultsIn total, 53,467 individuals were enumerated. A total of 48,058 (89.9%) were present at the time of survey teams' visits and consented to examination. The prevalence of trachomatous inflammation-follicular (TF) among children aged 1-9 years ranged from 4.1% in the EU covering Danot, Boh, and Geladin woredas in Doolo Subzone to 38.1% in the EU covering Kebribeyah and Hareshen woredas in Fafan Subzone (East). The trichiasis prevalence among adults aged over 15 years varied from 0.1% in the EU covering Afder, Bare, and Dolobay woredas in Afder Subzone (West) to 1.2% in the EU covering Awbere in Fafan Subzone (West).ConclusionMass drug administration (MDA) with azithromycin is needed in 13 EUs (population 2,845,818). Two EUs (population 667,599) had TF prevalences in 1-9-year-olds of ≥30% and will require at least 5 years of MDA; 5 EUs (population 1,1193,032) had TF prevalences of 10-29.9% and need at least three years of MDA; 6 EUs (population 985,187) had TF prevalences of 5-9.9% and need at least one round of azithromycin distribution before re-survey. In all 13 of these EUs, implementation of facial cleanliness and environmental improvement measures is also needed. Surveys are still needed in the remaining 34 unmapped woredas of Somali Region.

BackgroundTrachoma, a leading cause of blindness, is targeted for global elimination as a public health problem by 2020. In order to contribute to this goal, countries should demonstrate reduction of disease prevalence below specified thresholds, after implementation of the SAFE strategy in areas with defined endemicity. Zimbabwe had not yet generated data on trachoma endemicity and no specific interventions against trachoma have yet been implemented.MethodsTwo trachoma mapping phases were successively implemented in Zimbabwe, with eight districts included in each phase, in September 2014 and October 2015. The methodology of the Global Trachoma Mapping Project was used.ResultsOur teams examined 53,211 people for trachoma in 385 sampled clusters. Of 18,196 children aged 1-9 years examined, 1526 (8.4%) had trachomatous inflammation-follicular (TF). Trichiasis was observed in 299 (1.0%) of 29,519 people aged ≥15 years. Of the 16 districts surveyed, 11 (69%) had TF prevalences ≥10% in 1-9-year-olds, indicative of active trachoma being a significant public health problem, requiring implementation of the A, F and E components of the SAFE strategy for at least 3 years. The total estimated trichiasis backlog across the 16 districts was 5506 people. The highest estimated trichiasis burdens were in Binga district (1211 people) and Gokwe North (854 people).ConclusionImplementation of the SAFE strategy is needed in parts of Zimbabwe. In addition, Zimbabwe needs to conduct more baseline trachoma mapping in districts adjacent to those identified here as having a public health problem from the disease.

PurposeIn suspected trachoma-endemic areas of Yemen, we sought to determine the prevalence of the sign trachomatous inflammation-follicular (TF) in children aged 1-9 years, and the potential individual and household risk factors for TF in that age group. We also sought to determine the prevalence of trichiasis in adults aged ≥15 years.MethodsWe conducted a cluster-sampled survey in each of 42 evaluation units (EUs) comprising 166 rural districts of nine Governorates (Adh Dhale'a, Al Hodeihah, Al Jawf, Hadramoot, Hajjah, Ibb, Lahj, Ma'rib, Taiz) using the Global Trachoma Mapping Project systems and methodologies. Fieldwork was undertaken from September 2013 to March 2015. Risk factors for TF in children aged 1-9 years were evaluated using multilevel random effects logistic regression.ResultsThe TF prevalence in children aged 1-9 years was ≥10% in two EUs (7 districts) and 5-9.9% in six EUs (24 districts). In adults aged ≥15 years, trichiasis prevalence was ≥0.2% in five EUs (19 districts). Being older (within the 1-9-year age bracket), being male, living in a household with higher numbers of children, and living in a household that reported the use of open defecation, were each independently associated with higher odds of TF.ConclusionsThese surveys provided baseline data to enable planning for trachoma elimination. The World Health Organization Alliance for the Global Elimination of Trachoma by 2020 stands ready to assist Yemen once security considerations permit further surveys and implementation of control activities.

Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. Analyses with sero-catalytic and antibody acquisition models provide insights into transmission history within each population. To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. We estimate the population half-life of sero-reversion for anti-Pgp3 antibodies to be 26 (95% credible interval (CrI): 21-34) years. We show SCRs below 0.015 (95% confidence interval (CI): 0.0-0.049) per year correspond to a prevalence of trachomatous inflammation-follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions.