The association between income inequality and adult mental health at the subnational level—a systematic review

Purpose

A systematic review was undertaken to determine whether research supports: (i) an association between income inequality and adult mental health when measured at the subnational level, and if so, (ii) in a way that supports the Income Inequality Hypothesis (i.e. between higher inequality and poorer mental health) or the Mixed Neighbourhood Hypothesis (higher inequality and better mental health).

Methods

Systematic searches of PsycINFO, Medline and Web of Science databases were undertaken from database inception to September 2020. Included studies appeared in English-language, peer-reviewed journals and incorporated measure/s of objective income inequality and adult mental illness. Papers were excluded if they focused on highly specialised population samples. Study quality was assessed using a custom-developed tool and data synthesised using the vote-count method.

Results

Forty-two studies met criteria for inclusion representing nearly eight million participants and more than 110,000 geographical units. Of these, 54.76% supported the Income Inequality Hypothesis and 11.9% supported the Mixed Neighbourhood Hypothesis. This held for highest quality studies and after controlling for absolute deprivation. The results were consistent across mental health conditions, size of geographical units, and held for low/middle and high income countries.

Conclusions

A number of limitations in the literature were identified, including a lack of appropriate (multi-level) analyses and modelling of relevant confounders (deprivation) in many studies. Nonetheless, the findings suggest that area-level income inequality is associated with poorer mental health, and provides support for the introduction of social, economic and public health policies that ameliorate the deleterious effects of income inequality.

Clinical registration number

PROSPERO 2020 CRD42020181507.

     

Number and density discrimination rely on a common metric: Similar psychophysical effects of size, contrast, and divided attention

While observers are adept at judging the density of elements (e.g., in a random-dot image), it has recently been proposed that they also have an independent visual sense of number. To test the independence of number and density discrimination, we examined the effects of manipulating stimulus structure (patch size, element size, contrast, and contrast-polarity) and available attentional resources on both judgments. Five observers made a series of two-alternative, forced-choice discriminations based on the relative numerosity/density of two simultaneously presented patches containing 16-1,024 Gaussian blobs. Mismatches of patch size and element size (across reference and test) led to bias and reduced sensitivity in both tasks, whereas manipulations of contrast and contrast-polarity had varied effects on observers, implying differing strategies. Nonetheless, the effects reported were consistent across density and number judgments, the only exception being when luminance cues were made available. Finally, density and number judgment were similarly impaired by attentional load in a dual-task experiment. These results are consistent with a common underlying metric to density and number judgments, with the caveat that additional cues may be exploited when they are available.     

Levels of transient gap junctions between the retinal pigment epithelium and the neuroblastic retina are influenced by catecholamines and correlate with patterns of cell production

Retinal mitosis takes place at the interface between the retinal pigment epithelium (RPE) and the neural retina. Multiple studies have highlighted the essential role that gap junction-mediated communication plays in the regulation of retinal organogenesis. Here, the localization pattern and function of the gap junction protein connexin 43 were examined in vivo in the rat at the interface between the retina and RPE during the main phases of retinal cell production. Connexin 43 was expressed at this site from E15 onward, and levels were subsequently temporally regulated. When Cx43 protein levels were reduced experimentally, by using antisense oligodeoxynucleotides, mitotic activity in the retina decreased significantly. Conversely, in the hypopigmented eye elevated mitotic levels were associated with a significant increase of connexin 43. Both excess protein levels and elevated mitosis were corrected by the in vivo administration of L-DOPA (a dopamine precursor and intermediary compound in the melanin synthesis pathway). These findings suggest that connexin 43-mediated communication between the retina and RPE is essential for the correct pacing of retinal organogenesis. Furthermore, this pathway may be gated by levels of ocular catecholamines.     

Transient tritanopia in migraine: evidence for a large-field retinal abnormality in blue-yellow opponent pathways

PURPOSE: To determine whether the magnitude of transient tritanopia (TT) differs between migraine and control groups. TT is a retinal phenomenon characterized by a paradoxical reduction in sensitivity to short-wavelength (purple) stimuli after extinction of long-wavelength (yellow) adapting displays. A group difference in the magnitude of TT would provide evidence for a retinal contribution to the S-cone-specific color-processing abnormalities that have been reported in migraine. METHODS: Thirty-two migraineurs and 32 age- and sex-matched control participants were tested with a four-alternative, forced-choice procedure to determine S-cone increment and decrement detection thresholds before and after adaptation to a long-wavelength (yellow) display and a neutral (white) display. Migraine history, migraine triggers, and pattern sensitivity were also assessed. RESULTS: Both groups' detection thresholds for increment (purple) S-cone stimuli were increased after extinction of the long-wavelength adapting display compared with the neutral display, demonstrating TT. This loss of sensitivity was significantly greater in the migraine group. In contrast, loss of sensitivity to decrement (yellow) S-cone stimuli was less marked and did not differ between the groups. The magnitude of TT correlated positively with indices of pattern sensitivity and susceptibility to visually triggered migraines but not with migraine history. CONCLUSIONS: These results demonstrate that abnormalities in a specific retinal circuit contribute to decreased short-wavelength sensitivity after adaptation in migraine. As thresholds did not correlate with indices of migraine history, it is unlikely that this finding reflects cumulative damage induced by repeated migraine episodes.     

Orientation discrimination and contrast detection thresholds in migraine for cardinal and oblique angles

PURPOSE: To determine whether orientation discrimination deficits in migraine, which have been found to depend on the spatial frequency of the stimulus, are due to precortical dysfunction or to abnormal patterns of orientation tuning at cortical loci. Further, to assess whether any cortical involvement is restricted to the striate cortex or whether higher cortical areas are also involved. Orientation-specific abnormalities would provide evidence of cortical dysfunction. METHODS: Orientation-discrimination and contrast-detection thresholds were assessed at cardinal (0 degrees) and oblique (45 degrees) orientations using explicit lines defined by Gabor patches. To test for extrastriate dysfunction, participants made orientation judgments using virtual lines defined by two widely spaced circles. Migraine history, migraine triggers, and pattern sensitivity were also assessed. Twenty migraineurs (10 with visual aura, 10 without) and 20 control participants were tested. RESULTS: Orientation-discrimination thresholds were lower for discriminations made about the cardinal axis than for discriminations made about the oblique axis, a well-documented phenomenon known as the oblique effect. Relative to the control group, the migraine group exhibited orientation-specific sensitivity losses on explicit and virtual judgments. Orientation-discrimination thresholds about the oblique axis were significantly elevated in the migraine group. In contrast, the migraine and control groups' detection thresholds did not differ. CONCLUSIONS: These findings reflect abnormal function of striate and extrastriate cortex in migraine. In addition, the discrimination data are consistent with wider orientation-tuning curves for orientation-sensitive cells in migraine, whereas the detection data suggest peak sensitivity does not differ between the groups.     

The Poggendorff illusion affects manual pointing as well as perceptual judgements

Pointing movements made to a target defined by the imaginary intersection of a pointer with a distant landing line were examined in healthy human observers in order to determine whether such motor responses are susceptible to the Poggendorff effect. In this well-known geometric illusion observers make systematic extrapolation errors when the pointer abuts a second line (the inducer). The kinematics of extrapolation movements, in which no explicit target was present, where similar to those made in response to a rapid-onset (explicit) dot target. The results unambiguously demonstrate that motor (pointing) responses are susceptible to the illusion. In fact, raw motor biases were greater than for perceptual responses: in the absence of an inducer (and hence also the acute angle of the Poggendorff stimulus) perceptual responses were near-veridical, whilst motor responses retained a bias. Therefore, the full Poggendorff stimulus contained two biases: one mediated by the acute angle formed between the oblique pointer and the inducing line (the classic Poggendorff effect), which affected both motor and perceptual responses equally, and another bias, which was independent of the inducer and primarily affected motor responses. We conjecture that this additional motor bias is associated with an undershoot in the unknown direction of movement and provide evidence to justify this claim. In conclusion, both manual pointing and perceptual judgements are susceptible to the well-known Poggendorff effect, supporting the notion of a unitary representation of space for action and perception or else an early locus for the effect, prior to the divergence of processing streams.     

A common visual metric for approximate number and density

There is considerable interest in how humans estimate the number of objects in a scene in the context of an extensive literature on how we estimate the density (i.e., spacing) of objects. Here, we show that our sense of number and our sense of density are intertwined. Presented with two patches, observers found it more difficult to spot differences in either density or numerosity when those patches were mismatched in overall size, and their errors were consistent with larger patches appearing both denser and more numerous. We propose that density is estimated using the relative response of mechanisms tuned to low and high spatial frequencies (SFs), because energy at high SFs is largely determined by the number of objects, whereas low SF energy depends more on the area occupied by elements. This measure is biased by overall stimulus size in the same way as human observers, and by estimating number using the same measure scaled by relative stimulus size, we can explain all of our results. This model is a simple, biologically plausible common metric for perceptual number and density.     

The orientation and dynamics of cell division within the plane of the developing vertebrate retina

The orientation of a dividing cell within the plane of the tissue plays an essential role in regulating cell fate in a range of developing structures. To assess its potential role in the developing vertebrate retina we used standard confocal microscopy of fixed tissue and time-lapse confocal imaging of living tissue to examine the orientation of cell division and mitotic spindle rotation within the plane of the retinal neuroepithelium. Based on the study of three rat strains and chick, we report in contrast to recent findings that during the main phase of cell production (E18-P4 in the rat and E6-E11 in the chick) dividing cells are randomly orientated with respect to key anatomical landmarks as well as the orientation of their dividing neighbours. Results from live imaging of neonatal rat retinae support these findings and suggest that unlike the developing cortex, in which metaphase plates often rotate extensively before coming to rest in anaphase, retinal mitotic spindle rotations prior to cell division are minimal. Furthermore, the orientation of metaphase entry largely defines that which is finally adopted during anaphase. Hence, the dynamics of metaphase progression through to anaphase in the retina appear to differ markedly from the brain, and cell divisions within the plane of the tissue are randomly orientated. These results contribute to a growing body of evidence that suggests that the current paradigm with respect to asymmetric division derived from the study of invertebrates cannot be generalized to the developing vertebrate nervous system.     

Biases and sensitivities in the Poggendorff effect when driven by subjective contours

PURPOSE: A consensus in the existing literature suggests that the Poggendorff effect (a perceptual misalignment of two collinear transversal segments when separated by a pair of parallel contours) persists when the parallels are defined by Kanizsa-like subjective contours. However, previous studies have often been complicated by a lack of quantitative measures of effect size, statistical tests of significance, appropriate measures of baseline and control biases, or stringent definition of subjective contours. The aim of this study was thus to determine whether subjective contours are capable of driving the Poggendorff effect once other factors are accounted for. METHODS: Twenty participants were tested on a number of test and control figures incorporating first-order (luminance-defined) and subjective parallels using the method of adjustment. All figures were tested at two different orientations, and observer sensitivities and observer biases were assessed. RESULTS: A systematic response bias (in the direction of the classical effect) was found for Poggendorff figures that incorporated subjective parallels. The effect was highly significant and greater than for control figures. There was no concomitant change in judgment sensitivity (positional certainty). Finally, there was a positive correlation between the effect size for figures incorporating first-order and subjective parallels. CONCLUSIONS: The findings reported demonstrate conclusively that true Kanizsa-like subjective contours are capable of driving the Poggendorff effect. Further, the data are consistent with a growing body of evidence that suggests both first-order and subjective contours are processed at early loci in the visual pathways when position is encoded.     

Cell division and cleavage orientation in the developing retina are regulated by L-DOPA

Recent studies have highlighted a potential link between the cleavage orientation of a dividing neuroblast and the regulation of daughter cell fate in the developing vertebrate retina. There is evidence to suggest that this process is at least partially regulated by the presence of the retinal pigment epithelium (RPE) and/or RPE-derived factors. In addition to a lack of melanin in the RPE, the albino retina is characterized by abnormal patterns of cell proliferation and cellular organization during development as well as cell-type specific deficits in the adult. We examined mitotic spindle orientation in vivo in developing pigmented and albino rat retinae along with other parameters of cell division to determine whether RPE abnormalities in the albino influence these aspects of retinal development. In the albino, mitotic indices were elevated, an excess of cells remained in the cell cycle, dividing cells were not so tightly apposed to the ventricular margin, and an excessive proportion of divisions was vertically oriented (i.e., with the mitotic spindle aligned perpendicular to the plane of the neuroepithelium). Administration of L-DOPA (a melanin precursor found at reduced concentrations in the hypopigmented eye) regulated the distribution of spindle orientations and reduced levels of mitosis in a manner consistent with an endogenous role in the control of these processes. These findings highlight the multiple roles that L-DOPA plays in the regulation of retinal development and cast light on the diversity of anatomical abnormalities found in the albino visual system. J. Comp. Neurol. 496:369-381, 2006. (c) 2006 Wiley-Liss, Inc.