Prehistoric climate change repeatedly channelled human migrations across Arabia

by Max Planck Society

The site of Khall Amayshan 4 in northern Saudi Arabia, where evidence of repeated

 visits by early humans over the last 400,000 years was found, associated with the 

remains of ancient lakes. Credit: Palaeodeserts Project (Michael Petraglia)

Recent research in Arabia—a collaboration between scientists at the Max Planck Institute for the Science of Human History in Jena, Germany, the Heritage Commission of the Saudi Ministry of Culture, and many other Saudi and international researchers—has begun to document the incredibly rich prehistory of Saudi Arabia, the largest country in Southwest Asia. Previous research in the region has focused on the coastal and woodland margins, while human prehistory in the vast interior areas remained poorly understood.

The new findings, including the oldest dated evidence for humans in Arabia at 400,000 years ago, are described as a breakthrough in Arabian archaeology by Dr. Huw Groucutt, lead author of the study and head of the "Extreme Events' Max Planck Society Research Group in Jena, Germany, based at the Max Planck Institute for Chemical Ecology.

The discovery of thousands of stone tools reveals multiple waves of human occupation and shows changing human culture over time. At the site of Khall Amayshan 4 (KAM 4), nestled in a hollow between large dunes, researchers found evidence for six phases of lake formation, five of them associated with stone tools made by early humans at around 400,000, 300,000, 200,000, 100,000, and 55,000 years ago. Each phase of human occupation is characterized by a different kind of material culture, documenting the transition from the Lower Paleolithic Acheulean 'handaxe' culture to different kinds of stone flake-based Middle Paleolithic technologies. Excavations at the Jubbah Oasis, 150 km to the east, also recovered stone tools, dating to 200,000 and 75,000 years ago.

A 400,000 year ‘handaxe’ stone tool from Khall Amayshan 4. Credit: Palaeodeserts Project (Ian Cartwright)

Green Arabia

The dating of the archaeological sites—achieved primarily through a technique called luminescence dating, which records the length of time since tiny grains of sediment were last exposed to sunlight—shows that each occupation dates to a time when rainfall is known to have increased in the region. In addition, all of the stone tool assemblages are associated with the distinctive sediments produced by freshwater lakes. The findings therefore show that, within a dominant pattern of aridity, occasional short phases of increased rainfall led to the formation of thousands of lakes, wetlands, and rivers that crossed most of Arabia, forming key migration routes for humans and animals such as hippos.

While today the Nefud desert is a very arid region, deep hollows between the large sand dunes created places for small lakes to form during occasional increases in rainfall. As a result, the Nefud region was periodically transformed from one of the most uninhabitable parts of Southwest Asia into a lush grassland that provided opportunities for repeated population movements.

A storm arrives during archaeological excavation of the remains of ancient lake in 

northern Saudi Arabia, where ancient humans lived alongside animals such as hippos. 

Credit: Palaeodeserts Project (Klint Janulis)

Wider implications

Unlike bones and other organic materials, stone tools preserve very easily, and their character is largely influenced by learned cultural behaviors. As a result, they illuminate the background of their makers and show how cultures developed along their own unique trajectories in different areas. The Khall Amayshan 4 and Jubbah Oasis findings reflect short-lived pulses of occupation that represent the initial phases of migration waves.

Each phase of human occupation in northern Arabia shows a distinct kind of material culture, suggesting that populations arrived in the area from multiple directions and source areas. This diversity sheds unique light on the extent of cultural differences in Southwest Asia during this timeframe, and indicates strongly sub-divided populations. In some cases the differences in material culture are so great as to indicate the contemporary presence of different hominin species in the region, suggesting that Arabia may also have been an interface zone for different hominin groups originating in Africa and Eurasia. Animal fossils indicate a similar pattern: although the north Arabian fossil record shows a prominent African character, some species came from the north, while others represent long-time residents of Arabia.

The findings highlight the importance of filling in the gaps in the hominin map. "Arabia has long been seen as empty place throughout the past," says Dr. Groucutt. "Our work shows that we still know so little about human evolution in vast areas of the world and highlights the fact that many surprises are still out there."

"It's remarkable; every time it was wet, people were there," says project leader Prof. Michael Petraglia, from the Max Planck Institute for the Science of Human History. "This work puts Arabia on the global map for human prehistory," he adds.

The study is reported in Nature.

Stone tools linked to ancient human ancestors in Arabia have surprisingly recent date

More information: Multiple hominin dispersals into Southwest Asia over the past 400,000 years, Nature (2021). DOI: 10.1038/s41586-021-03863-y , www.nature.com/articles/s41586-021-03863-y

Journal information: Nature 

Provided by Max Planck Society 

Dogs distinguish between intentional and unintentional action

by Max Planck Society

Dogs and experimenter sat on opposite sides of the partition. Dogs were fed through 

the gap in the partition. Credit: Katharina Schulte

Over their long shared history, dogs have developed a range of skills for bonding with human beings. Their ability to make sense of human actions, demonstrated by every "sit," "lay down," and "roll over," is just one such skill. But whether dogs understand human intentions, or merely respond to outcomes, remains unclear. The ability to recognize another's intentions—or at least conceive of them—is a basic component of theory of mind, the ability to attribute mental states to oneself and others, long regarded as uniquely human. Do dogs have this basic component of theory of mind, the ability to tell the difference between something done on purpose and something done by accident?

To answer this question, a team of researchers in Germany conducted an experiment that examined how dogs reacted when food rewards were withheld, both intentionally and unintentionally. They found that dogs respond differently depending on whether the actions of the experimenter were intentional or unintentional. This, the researchers say, shows that dogs can distinguish between actions that were done on purpose or accidentally.

To reach their conclusions, the researchers conducted an experiment using the "unable vs. unwilling" paradigm. This works by examining whether test subjects react differently toward a human experimenter who either intentionally (the unwilling condition) or unintentionally (the unable condition) withholds rewards from them. Despite being an established paradigm in studies of human and animal cognition, the unable vs. unwilling paradigm had never been previously used to investigate dogs.

The experiment was conducted with 51 dogs, each of which was tested under three conditions. In each condition, the dog was separated from the human tester by a transparent barrier. The basic situation was that the experimenter fed the dog pieces of dog food through a gap in the barrier. In the "unwilling" condition, the experimenter suddenly withdrew the reward through the gap in the barrier and placed it in front of herself. In the "unable-clumsy" condition, the experimenter brought the reward to the gap in the barrier and "tried" to pass it through the gap but then "accidentally" dropped it. In the "unable-blocked" condition, the experimenter again tried to give the dog a reward, but was unable to because the gap in the barrier was blocked. In all conditions, the reward remained on the tester's side of the barrier.

Dogs went around the partition to access the withheld rewards faster when these 

were withheld unintentionally than when they were withheld intentionally.

 Credit: Josepha Erlacher

"If dogs are indeed able to ascribe intention in action to humans," says Dr. Juliane Bräuer, "we would expect them to show different reactions in the unwilling condition compared to the two unable conditions. As it turns out, this is exactly what we observed."

The primary behavior measured by the researchers was the time dogs waited before approaching the reward they were denied. The researchers predicted that, if dogs are able to identify human intentions, they would wait longer before approaching the reward in the unwilling condition, where they were not supposed to have the reward, than in the two unable conditions in which the reward was, in fact, meant for them.

Not only did the dogs wait longer in the unwilling condition than in the unable conditions, they were also more likely to sit or lie down—actions often interpreted as appeasing behaviors—and stop wagging their tails.

Dogs were fed through the gap before the experimenter started to withhold the reward 

intentionally or unintentionally. Credit: Josepha Erlacher

"The dogs in our study clearly behaved differently depending on whether the actions of a human experimenter were intentional or unintentional," says Britta Schünemann, the first author of the study. "This suggests that dogs may indeed be able to identify humans' intention-in-action," adds Hannes Rakoczy from the University of Göttingen.

The team acknowledges that their findings may be met with skepticism and that further study is needed to address alternative explanations, such as behavioral cues on the part of experimenters or knowledge transfer from prior dog training.

"Nevertheless," the paper concludes, "the findings present important initial evidence that dogs may have at least one aspect of theory of mind: The capacity to recognize intention-in-action."

The study is published in Scientific Reports.

Dogs may not return their owners' good deeds

More information: Britta Schünemann et al, Dogs distinguish human intentional and unintentional action, Scientific Reports (2021). DOI: 10.1038/s41598-021-94374-3

Journal information: Scientific Reports 

Provided by Max Planck Society 

Raining microbes? New study finds rain-borne bacteria colonize plants

Peer-Reviewed Publication

AMERICAN PHYTOPATHOLOGICAL SOCIETY

When it rains, plants are not only showered with water, but also microbes.  These rain-borne microbes have the opportunity to become part of a plant’s aboveground microbial community – known as the phyllosphere. Phyllosphere microbes can protect plants from disease and other stressors and understanding where they come from may help us improve plant health.  While plant microbiome research has historically focused on soil and seeds as sources of plant-associated microbes, new findings by scientists at Virginia Tech University suggest that rain may also be an important reservoir. 

A study recently published in Phytobiomes Journal led by Marco Mechan-Llontop and Boris Vinatzer examined rain as a reservoir of phyllosphere bacteria. After finding greater densities of microbes on the leaves of rain-exposed tomato plants compared to those grown in the lab, they set out to experimentally test whether rain-borne microbes could successfully colonize the phyllosphere of tomato plants.  “Although this is a simple question, it is actually really hard to answer since plants outside are exposed to many bacteria that come from the soil, rain, and the air,” noted Vinatzer.  

Additionally, while rain may contain important microbes, their quantities may be small–a milliliter of rain might only contain a few microbial cells.  To control for other external sources of microbes and inoculate plants with measurable doses of rain-borne microbes, Vinatzer and colleagues performed a laboratory experiment with rain they collected. They filtered the rainwater to obtain sterilized water and membranes containing the bacterial microbiota. These membranes were incubated to obtain a highly concentrated inoculum of rain-borne bacteria. They sprayed plants with this inoculum or with sterilized rainwater and distilled water (as negative controls) and incubated the plants for one week before characterizing their bacterial communities via DNA analyses.

Their analysis showed that inoculating plants with the rainwater microbial communities increased the abundance of over 100 bacterial taxa, indicating that microbes in rain can successfully colonize and grow on the surface of plants. This suggests rain is a potentially important reservoir for phyllosphere bacteria. The authors hope this research will pave the way for more research into the origins of plant-associated microorganisms and microbes that are efficiently distributed by rain. “The more we know about these bacteria, the better we can use them to our advantage to improve plant health,” says Vinatzer. For example, bacteria that suppress plant pathogens could be sprayed onto leaves to reduce or prevent disease.  The authors plan to continue their research examining the importance of rain in phyllosphere assembly and hope to identify beneficial bacteria from rain.

Read more about this research in “Experimental Evidence Pointing to Rain as a Reservoir of Tomato Phyllosphere Microbiota” by Marco Mechan-Llontop, Long Tian, Parul Sharma, Logan Heflin, Vivian Bernal-Galeano, David Haak, Christopher Clarke, and Boris Vinatzer. 

Lead author Marco E. Mechan-Llontop is currently a postdoctoral researcher in the Shade Lab at Michigan State University. Senior author Boris Vinatzer is a professor in the School of Plant and Environmental Sciences at Virginia Tech.

Author information: Eric Wang is a student at Millburn High School and is interested in how plant-microbial interactions vary among different kinds of plants. Mia Howard (@mia_how) is an assistant feature editor for Phytobiomes Journal and a postdoctoral researcher in the Lau Lab at Indiana University.  She is fascinated by how plants—often with help from microbes—protect themselves from herbivores with toxic chemicals.

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JOURNAL

Phytobiomes Journal

DOI

10.1094/PBIOMES-04-21-0025-R 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Experimental Evidence Pointing to Rain as a Reservoir of Tomato Phyllosphere Microbiota

ARTICLE PUBLICATION DATE

1-Jun-2021

Extreme sea levels to become much more common worldwide as Earth warms

Critical coastal events, happening once a century in recent times, to occur every year on average

Peer-Reviewed Publication

DOE/PACIFIC NORTHWEST NATIONAL LABORATORY

COLLEGE PARK, Md.—The news has been packed in recent months with severe climate and weather events—record-high temperatures from the Pacific Northwest to Sicily, flooding in Germany and the eastern United States, wildfires from Sacramento to Siberia to Greece. Events that seemed rare just a few decades ago are now commonplace.

A new study, appearing in the journal Nature Climate Change August 30, looks specifically at extreme sea levels—the occurrence of exceptionally high seas due to the combination of tide, waves and storm surge. The study predicts that because of rising temperatures, extreme sea levels along coastlines the world over will become 100 times more frequent by the end of the century in about half of the 7,283 locations studied. That means, because of rising temperatures, an extreme sea level event that would have been expected to occur once every 100 years currently is expected to occur, on average, every year by the end of this century.

While the researchers say there is uncertainty—as always—about future climate, the most likely path is that these increased instances of sea level rise will occur even with a global temperature increase of 1.5 or 2 degrees Celsius compared to preindustrial temperatures. Scientists consider these temperatures the lower end of possible global warming. And the changes are likely to come sooner than the end of the century, with many locations experiencing a 100-fold increase in extreme sea level events by 2070.

 

Mapping effects, location by location

Claudia Tebaldi, a climate scientist at the Department of Energy’s Pacific Northwest National Laboratory, led an international team of researchers in the analysis. She brought together scientists who have led previous large studies of extreme sea levels and the effects of temperatures on sea level rise. The team pooled its data and introduced a novel synthesis method, treating the alternative estimates as expert voters, to map out likely effects of temperature increases ranging from 1.5 C to 5 C compared to preindustrial times.

The scientists found, not unexpectedly, that the effects of rising seas on extreme sea level frequency would be felt most acutely in the tropics and generally at lower latitudes compared to northern locations. Locations likely to be affected most include the Southern Hemisphere, areas along the Mediterranean Sea and the Arabian Peninsula, the southern half of North America’s Pacific coast, and areas including Hawaii, the Caribbean, the Philippines and Indonesia. In many of these regions, sea level is expected to rise faster than at higher latitudes.

Regions that will be less affected include the higher latitudes, the northern Pacific coast of North America, and the Pacific coast of Asia.

“One of our central questions driving this study was this: How much warming will it take to make what has been known as a 100-year event an annual event? Our answer is, not much more than what has already been documented,” said Tebaldi, who notes that the globe has already warmed about 1 C compared to preindustrial times.

The new study mirrors the assertion of the 2019 Intergovernmental Panel on Climate Change report, which stated that extreme sea level events would become much more common worldwide by the end of the century due to global warming.

“It’s not huge news that sea level rise will be dramatic even at 1.5 degrees and will have substantial effects on extreme sea level frequencies and magnitude” said Tebaldi. “This study gives a more complete picture around the globe. We were able to look at a wider range of warming levels in very fine spatial detail.”

The best- and worst-case scenarios put forth by the study vary, due to uncertainties that the study authors represented in remarkable detail. In one scenario, at the pessimistic end, 99 percent of locations studied will experience a 100-fold increase in extreme events by 2100 at 1.5 C of warming. In another, at the optimistic end, about 70 percent of locations don’t see much of a change even with a temperature increase of 5 C.

The authors call for more study to understand precisely how the changes will affect particular communities. They point out that the physical changes that their study describes will have varying impacts at local scales, depending on several factors, including how vulnerable the site is to rising waters and how prepared a community is for change.

Authors of the paper include Roshanka Ranasinghe of the IHE Delft Institute for Water Education in the Netherlands; Michalis Vousdoukas of the European Joint Research Centre in Italy; D.J. Rasmussen of Princeton University; Ben Vega-Westhoff and Ryan Sriver of the University of Illinois at Urbana-Champaign; Ebru Kirezci of the University of Melbourne in Australia; Robert E. Kopp of Rutgers University; and Lorenzo Mentaschi of the University of Bologna in Italy.

Tebaldi, the corresponding author, is a scientist at the Joint Global Change Research Institute, a partnership between PNNL and the University of Maryland where researchers explore the interactions between human, energy and environmental systems.

The study was funded by the U.S. Environmental Protection Agency and DOE’s Office of Science.

 

# # #

Pacific Northwest National Laboratory draws on its distinguishing strengths in chemistry, Earth sciences, biology and data science to advance scientific knowledge and address challenges in sustainable energy and national security. Founded in 1965, PNNL is operated by Battelle for the Department of Energy’s Office of Science, which is the single largest supporter of basic research in the physical sciences in the United States. DOE’s Office of Science is working to address some of the most pressing challenges of our time. For more information, visit PNNL's News Center. Follow us on Twitter, Facebook, LinkedIn and Instagram.

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JOURNAL

Nature Climate Change

DOI

10.1038/s41558-021-01127-1 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Extreme sea levels at different global warming levels

ARTICLE PUBLICATION DATE

30-Aug-2021

Antibiotics increase the risk of colon cancer

Peer-Reviewed Publication

UMEA UNIVERSITY

 

IMAGE: SOPHIA HARLID, RESEARCHER AT DEPARTMENT OF RADIATION SCIENCES, UMEÅ UNIVERSITY, SWEDEN. view more 

CREDIT: MATTIAS PETTERSSON.

There is a clear link between taking antibiotics and an increased risk of developing colon cancer within the next five to ten years. This has been confirmed by researchers at Umeå University, Sweden, after a study of 40,000 cancer cases. The impact of antibiotics on the intestinal microbiome is thought to lie behind the increased risk of cancer.

“The results underline the fact that there are many reasons to be restrictive with antibiotics. While in many cases antibiotic therapy is necessary and saves lives, in the event of less serious ailments that can be expected to heal anyway, caution should be exercised. Above all to prevent bacteria from developing resistance but, as this study shows, also because antibiotics may increase the risk of future colon cancer,” explains Sophia Harlid, cancer researcher at Umeå University.

Researchers found that both women and men who took antibiotics for over six months ran a 17 per cent greater risk of developing cancer in the ascending colon, the first part of the colon to be reached by food after the small intestine, than those who were not prescribed any antibiotics. However, no increased risk was found for cancer in the descending colon. Nor was there an increased risk of rectal cancer in men taking antibiotics, while women taking antibiotics had a slightly reduced incidence of rectal cancer.

The increased risk of colon cancer was visible already five to ten years after taking antibiotics. Although the increase in risk was greatest for those taking most antibiotics, it was also possible to observe an admittedly small, but statistically significant, increase in the risk of cancer after a single course of antibiotics.

The present study uses data on 40,000 patients from the Swedish Colorectal Cancer Registry from the period 2010–2016. These have been compared to a matched control group of 200,000 cancer-free individuals drawn from the Swedish population at large. Data on the individuals’ antibiotic use was collected from the Swedish Prescribed Drug Register for the period 2005–2016. The Swedish study broadly confirms the results of an earlier, somewhat smaller British study.

In order to understand how antibiotics increase the risk, the researchers also studied a non-antibiotic bactericidal drug used against urinary infections that does not affect the microbiome. There was no difference in the frequency of colon cancer in those who used this drug, suggesting that it is the impact of antibiotics on the microbiome that increases the risk of cancer. While the study only covers orally administered antibiotics, even intravenous antibiotics may affect the gut microbiota in the intestinal system.

“There is absolutely no cause for alarm simply because you have taken antibiotics. The increase in risk is moderate and the affect on the absolute risk to the individual is fairly small. Sweden is also in the process of introducing routine screening for colorectal cancer. Like any other screening programme, it is important to take part so that any cancer can be detected early or even prevented, as cancer precursors can sometimes be removed,” says Sophia Harlid. 

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JOURNAL

JNCI Journal of the National Cancer Institute

DOI

10.1093/jnci/djab125 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Antibiotics use and subsequent risk of colorectal cancer: A Swedish nation-wide population-based study

ARTICLE PUBLICATION DATE

31-Aug-2021

New research in American Journal of Psychiatry identifies risk factors for suicide attempt among soldiers

Peer-Reviewed Publication

AMERICAN PSYCHIATRIC ASSOCIATION

New research in the American Journal of Psychiatry identifies factors that may help assess suicide risk in soldiers. According to the study, Predictors of Suicide Attempt Within 30 Days After First Medically Documented Suicidal Ideation in U.S. Army Soldiers, suicide risk was highest within 30 days after ideation diagnosis and was more likely among women and combat medics.   

“This Suicide Prevention Month, it’s important to remember that research can help us better understand risk factors and which populations are more vulnerable,” said APA President Vivian Pender, M.D.  “It is also a reminder that we can all play a role in preventing suicide by learning to recognize signs of distress and reaching out to connect anyone at risk with help.”

The authors examined risk factors for suicide attempt within the first month after a diagnosis of suicidal ideation, looking at sociodemographic and service-related characteristics, psychiatric diagnoses, physical health care visits, injuries, and others. Using data from the Army Study to Assess Risk and Resilience in Servicemembers, the researchers reviewed records from more than 11,000 active duty enlisted soldiers with documented suicidal ideation and no prior documented suicide attempts.

About half (52.7%) of the solders identified with suicide ideation were in their first two years of service and 57.7% had never deployed. About 80% had had at least one outpatient visit in the previous two months. The most common psychiatric diagnoses were depression and related disorders, tobacco use disorder, anxiety disorder and adjustment disorder.  
 

In the study, 7.4% soldiers with suicidal ideation subsequently attempted suicide. Almost half of the attempts, 3.5%, occurred within 30 days after suicidal ideation. The risk for suicide attempt was highest on the first day after suicidal ideation diagnosis and decreased over time.

 

The study found that females, combat medics, individuals with an anxiety disorder diagnosis prior to suicidal ideation, and those diagnosed with a sleep disorder on the same day as the suicidal ideation were more likely to attempt suicide within 30 days.

"Identifying suicide risk in the population, in patients in primary care, and in patients in psychiatric care who frequently have suicide ideation, are all challenging and different questions,” said Robert J. Ursano, M.D., one of the study authors and Director, Center for the Study of Traumatic Stress, Uniformed Services University. “This paper importantly speaks to psychiatrists and other mental health care providers who have to make difficult treatment and management decisions for those specifically struggling with suicide ideation."

While depression-related diagnoses were common among the soldiers with suicide ideation, they were not associated with an increased risk of suicide attempt during the first month. Major depression was diagnosed in 24% of soldiers with suicide ideation and depression-related diagnoses (such as dysthymic disorder and adjustment disorder with depressed mood) were diagnosed in nearly 60% of soldiers on the same day suicide ideation was diagnosed. A diagnosis of posttraumatic stress disorder was also not associated with an increased risk of suicide attempt within 30 days. 

 

     National Suicide Prevention Lifeline                   Crisis Textline
     800-273-8255 or Chat with Lifeline                    Text TALK to 741741                             

More information

See also two recent articles on suicide risk published in the APA journal Psychiatric Services:

• Suicide Mortality Among Veterans Health Administration Care Recipients With Suicide Risk Record Flags, published online July 29, 2021
• Predicting the Transition From Suicidal Ideation to Suicide Attempt Among Sexual and Gender Minority Youths, published online August 4, 2021

More information is available in curated collections of Psychiatric Services articles on:

• Suicide Prevention, Part 1:  Identifying and Predicting Risk, Vulnerable Populations, Public Perceptions, and Priority Settings - October 2020
• Suicide Prevention, Part 2:  Evidence-Based Practices, Cost-Effectiveness, and Future Directions - November 2020

American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with 37,400 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.

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JOURNAL

American Journal of Psychiatry

DOI

10.1176/appi.ajp.2021.20111570 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Predictors of Suicide Attempt Within 30 Days After First Medically Documented Suicidal Ideation in U.S. Army Soldiers

ARTICLE PUBLICATION DATE

1-Sep-2021

COI STATEMENT

Dr. Kessler has received support for epidemiological studies from SanofiAventis; he has served as a consultant for DataStat, Holmusk, Johnson & Johnson Wellness and Prevention, RallyPoint Networks, Sage Pharmaceuticals, Shire, and Takeda and on advisory boards for Johnson & Johnson Services Lake Nona Life Project; and he has stock options in Mirah, PYM, and Roga Sciences. Dr. Stein has received research support from the Department of Defense, the Department of Veterans Affairs, and NIH; he has served as a consultant for Actelion, Acadia Pharmaceuticals, Aptinyx, ATAI Life Sciences, Boehringer Ingelheim, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, Engrail Therapeutics, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and on scientific advisory boards for the Anxiety and Depression Association of America and the Brain and Behavior Research Foundation; he receives remuneration for his editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry); and he has stock options in Epivario and Oxeia Biopharmaceuticals. The other authors report no financial relationships with commercial interests

Unmarried adults with heart disease living in rural areas face more hopelessness, increased risk of death

Journal of the American Heart Association Report

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, Sept. 1, 2021

DALLAS, Sept. 1, 2021 — Living in a rural setting and being unmarried were each linked to higher rates of hopelessness among people with heart disease, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

The study is the first to explore whether living in a rural setting is a significant risk factor for hopelessness. National statistics indicate U.S. adults – those with and without cardiovascular disease – who live in rural areas have higher rates of death than those who live in urban communities. Many known risk factors for heart disease – high blood pressure, obesity, cigarette smoking and low levels of physical activity – are also more prevalent among people who live in rural settings.

Feelings of hopelessness, whether it’s a temporary response to a new event (a state), or an ongoing outlook toward life (a trait), are also linked to the progression and development of heart disease. Up to half of people with heart disease report hopeless feelings, and hopelessness can more than triple the risk of death or heart attack. And, while living in a rural area and hopelessness are each linked to heart disease, this study is the first to examine whether living in a rural setting affects hopelessness.

“That is what makes our findings so surprising,” said the study’s senior author Susan L. Dunn, Ph.D., R.N., FAHA, an associate professor and department head in the department of biobehavioral nursing science at the University of Illinois in Chicago. “We found that living in a rural area is a risk factor for hopelessness. Because we know hopelessness is predictive of death in people with heart disease, health care professionals need to recognize the subgroups who are most at risk and provide guidance and treatment.”

Researchers collected data from 628 adults at two hospitals in South Dakota and one hospital in Michigan. Participants were 18 years or older and had been diagnosed with a heart attack or severe chest pains (angina) or had undergone procedures to open clogged heart arteries (surgery or stent). About 25% of the study’s participants lived in a rural area. Overall, roughly one-third were women; about two-thirds were married and most (92%) were white. About half of the participants had a history of cardiovascular disease, and one-fourth suffered from depression.

Researchers used the State-Trait Hopelessness Scale, a self-reported questionnaire measuring a negative outlook and sense of helplessness toward the future, with higher scores equating to increased feelings of hopelessness.

Because hopelessness and depression are often associated yet distinctly different, participants also completed a questionnaire to measure the severity of their depression. In addition, decreased physical function is linked to feelings of hopelessness, so participants completed another questionnaire to gauge their ability to perform daily physical activities. Finally, researchers categorized where participants’ lived using census tract-based data.

Researchers found:

• Levels of state hopelessness (sparked by a new life event, such as a heart event) in adults with heart disease living in rural areas were 10% higher than among urban adults (58.8% to 48.8%, respectively).
• Levels of trait hopelessness (overall outlook on life) were relatively similar among rural and urban adults (59% to 55%, respectively).
• 20% more unmarried participants in rural areas experienced state hopelessness than their married, rural counterparts.

The authors suggest additional research is needed to assess whether adults with heart disease living in rural areas continue to have higher levels of state hopelessness than those who live in urban areas after hospital discharge and throughout their recovery. The connection between marital status among people living in rural areas to feelings of hopelessness is also important for future studies.

The study also has several important limitations. The sample size was small and included people living in the Great Lakes and the Great Plains regions, so more research is needed to examine rural and urban differences in various geographic regions throughout the U.S. and in the rest of the world. There was also limited racial and ethnic diversity among participants in the study, and unmarried partners who lived together were not specifically categorized.

“These results indicate that we need more information, and there is a need to develop effective prevention and treatment methods for people with heart disease who have feelings of hopelessness,” Dunn said.

###

Co-authors are Deb Bomgaars, Ph.D., R.N., C.N.E.; Gwenneth A. Jensen, Ph.D., R.N., C.N.S.; Lynn L. White, Ph.D., R.N., A.C.N.S.-B.C.; Kristin M. Van De Griend, Ph.D., M.P.H.; Angela K. Visser, M.S.; Madison P. Goodyke, B.S.N., R.N.; Anna Luong, B.S.N., R.N.; and Nathan L. Tintle, Ph.D. Authors’ disclosures are listed in the manuscript.

The study was funded by the Dordt University Office for Research and Scholarship.

Additional Resources:

• Multimedia is available on the right column of release link:https://newsroom.heart.org/news/unmarried-adults-with-heart-disease-living-in-rural-areas-face-more-hopelessness-increased-risk-of-death?preview=d69144e0370f32b4fc167773808b153f
• After Sept. 1, view the manuscript online.
• Advisory calls for bridging inequities in rural health
• Mortality in Rural America
• Coping with Feelings
• How Does Depression Affect the Heart?
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Statements and conclusions of studies published in the American Heart Association’s scientific journals are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here. 

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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JOURNAL

Journal of the American Heart Association

ARTICLE TITLE

Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients with Ischemic Heart Disease

ARTICLE PUBLICATION DATE

1-Sep-2021