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Bárez-López S, Montero-Pedrazuela A, Bosch-García D, Venero C, Guadaño-Ferraz A. Increased anxiety and fear memory in adult mice lacking type 2 deiodinase. Psychoneuroendocrinology 2017; 84:51-60. [PMID: 28654773 DOI: 10.1016/j.psyneuen.2017.06.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/02/2017] [Accepted: 06/08/2017] [Indexed: 12/14/2022]
Abstract
A euthyroid state in the brain is crucial for its adequate development and function. Impairments in thyroid hormones (THs; T3 or 3,5,3'-triiodothyronine and T4 or thyroxine) levels and availability in brain can lead to neurological alterations and to psychiatric disorders, particularly mood disorders. The thyroid gland synthetizes mainly T4, which is secreted to circulating blood, however, most actions of THs are mediated by T3, the transcriptionally active form. In the brain, intracellular concentrations of T3 are modulated by the activity of type 2 (D2) and type 3 (D3) deiodinases. In the present work, we evaluated learning and memory capabilities and anxiety-like behavior at adult stages in mice lacking D2 (D2KO) and we analyzed the impact of D2-deficiency on TH content and on the expression of T3-dependent genes in the amygdala and the hippocampus. We found that D2KO mice do not present impairments in spatial learning and memory, but they display emotional alterations with increased anxiety-like behavior as well as enhanced auditory-cued fear memory and spontaneous recovery of fear memory following extinction. D2KO mice also presented reduced T3 content in the hippocampus and decreased expression of the T3-dependent gene Dio3 in the amygdala suggesting a hypothyroid status in this structure. We propose that the emotional dysfunctions found in D2KO mice can arise from the reduced T3 content in their brain, which consequently leads to alterations in gene expression with functional consequences. We found a downregulation in the gene encoding for the calcium-binding protein calretinin (Calb2) in the amygdala of D2KO mice that could affect the GABAergic transmission. The current findings in D2KO mice can provide insight into emotional disorders present in humans with DIO2 polymorphisms.
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Affiliation(s)
- Soledad Bárez-López
- Department of Endocrine and Nervous System Pathophysiology, Instituto de Investigaciones Biomédicas "Alberto Sols'', Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Arturo Duperier, 4, 28029, Madrid, Spain; Department of Endocrine, U-708, Center for Biomedical Research on Rare Diseases (Ciberer), Instituto de Salud Carlos III, Madrid, Spain.
| | - Ana Montero-Pedrazuela
- Department of Endocrine and Nervous System Pathophysiology, Instituto de Investigaciones Biomédicas "Alberto Sols'', Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Arturo Duperier, 4, 28029, Madrid, Spain.
| | - Daniel Bosch-García
- Department of Endocrine and Nervous System Pathophysiology, Instituto de Investigaciones Biomédicas "Alberto Sols'', Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Arturo Duperier, 4, 28029, Madrid, Spain.
| | - César Venero
- Department of Psychobiology, Universidad Nacional de Educación a Distancia, Juan del Rosal 10, 28040, Madrid, Spain.
| | - Ana Guadaño-Ferraz
- Department of Endocrine and Nervous System Pathophysiology, Instituto de Investigaciones Biomédicas "Alberto Sols'', Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Arturo Duperier, 4, 28029, Madrid, Spain; Department of Endocrine, U-708, Center for Biomedical Research on Rare Diseases (Ciberer), Instituto de Salud Carlos III, Madrid, Spain.
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Díaz-García A, González-Robles A, Fernández-Álvarez J, García-Palacios A, Baños RM, Botella C. Efficacy of a Transdiagnostic internet-based treatment for emotional disorders with a specific component to address positive affect: Study protocol for a randomized controlled trial. BMC Psychiatry 2017; 17:145. [PMID: 28424068 PMCID: PMC5397807 DOI: 10.1186/s12888-017-1297-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/01/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Emotional disorders (ED) are among the most prevalent mental disorders. However, less than 50% of people suffering from ED receive the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which tries to address the underlying processes common to ED. Most of these programs focus primarily on down-regulating negative affectivity, rather than increasing strengths and up-regulating positive affectivity. The data suggest the existence of disturbances in positive affectivity in these disorders, and so new interventions focusing on these problems are greatly needed. It is also essential to provide assistance to all the people in need. Information and Communication Technologies can be very useful. This study aims to evaluate the efficacy of a transdiagnostic Internet-based treatment for ED in a community sample. The protocol includes traditional CBT components, as well as a specific component to address positive affect. We intend to test this protocol, including this specific component or not, versus a waiting list control group. Moreover, we aim to test the differential effect of this specific component, and study the effectiveness (in terms of patients' acceptance) of using a self-applied Internet-based program. This paper presents the study protocol. METHODS The study is a randomized controlled trial. 207 participants will be randomly assigned to: a)Transdiagnostic Internet-based protocol (TIBP), b)Transdiagnostic Internet-based protocol + positive affect component (TIBP + PA), or c)a Waiting List control group (WL). Primary outcomes measures will be the BDI-II, the BAI, and the PANAS. Secondary outcomes will include diagnosis-specific measures of the principal disorder. Participants' treatment acceptance will also be measured. Participants will be assessed at pre-, post-treatment, and 3- and 12- month follow-ups. The data will be analyzed based on the Intention-to-treat principle. Per protocol analyses will also be performed. DISCUSSION To the best of our knowledge, this is the first study of a transdiagnostic Internet-based treatment for ED with a specific component to up-regulate positive affectivity. This intervention could contribute to improve the efficiency and effectiveness of current treatment programs for ED, promote the dissemination of EBTs, and help to decrease the high prevalence of ED. TRIAL REGISTRATION ClinicalTrial.gov: NCT02578758 . Registered 15 October 2015.
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Affiliation(s)
| | | | | | - Azucena García-Palacios
- Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Rosa María Baños
- Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Cristina Botella
- Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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Shihata S, McEvoy PM, Mullan BA, Carleton RN. Intolerance of uncertainty in emotional disorders: What uncertainties remain? J Anxiety Disord 2016; 41:115-24. [PMID: 27212227 DOI: 10.1016/j.janxdis.2016.05.001] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 05/03/2016] [Accepted: 05/05/2016] [Indexed: 01/04/2023]
Abstract
The current paper presents a future research agenda for intolerance of uncertainty (IU), which is a transdiagnostic risk and maintaining factor for emotional disorders. In light of the accumulating interest and promising research on IU, it is timely to emphasize the theoretical and therapeutic significance of IU, as well as to highlight what remains unknown about IU across areas such as development, assessment, behavior, threat and risk, and relationships to cognitive vulnerability factors and emotional disorders. The present paper was designed to provide a synthesis of what is known and unknown about IU, and, in doing so, proposes broad and novel directions for future research to address the remaining uncertainties in the literature.
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Affiliation(s)
- Sarah Shihata
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Peter M McEvoy
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia; Centre for Clinical Interventions, Perth, Australia.
| | - Barbara Ann Mullan
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Nilsen TS, Handegård BH, Eisemann M, Kvernmo S. Predictors of rate of change for children and youth with emotional disorders: a naturalistic observational study. Child Adolesc Psychiatry Ment Health 2016; 10:11. [PMID: 27152119 PMCID: PMC4857241 DOI: 10.1186/s13034-016-0098-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine demographic and clinical characteristics as potential predictors of change for children and youth with emotional disorders treated at two child and adolescent mental health outpatient services (CAMHS) in Norway. METHODS The study was of naturalistic observational type with "treatment as usual" (TAU). The sample consisted of 84 children and youth with emotional disorders. The Health of the Nation Outcome Scale (HONOSCA), and the Children's Global Assessment Scale (CGAS) were administered at intake (T0), during the assessment (T1) and approximately six months after assessment (T2). Change was analysed by means of the linear mixed models procedure. RESULTS For the HONOSCA total score, youths with a diagnosis of depression had statistically higher symptom severity levels at baseline and significantly lower change rates as compared to youths with an anxiety disorder. CONCLUSIONS The current study adds to the limited knowledge of predictors of rate of change for children and adolescents with emotional disorders treated within CAMHS. Our results point to a special need to improve clinical care for depressed children and adolescents. Important limitations comprising the external validity of the study concern missing data, a small study sample, and lack of information regarding the content and extent of the service provided.
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Affiliation(s)
- Toril Sørheim Nilsen
- Research Group For Clinical Psychology, Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway ,Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North-Norway, P.O. Box 19, 9038 Tromsø, Norway
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Martin Eisemann
- Research Group For Mental Ehealth, Department of psychology, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Siv Kvernmo
- Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North-Norway, P.O. Box 19, 9038 Tromsø, Norway ,Research Group of Pediatrics, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
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Nilsen TS, Handegård BH, Eisemann M, Kvernmo S. Evaluating change in symptomatic and functional level of children and youth with emotional disorders: a naturalistic observation study. Eur Child Adolesc Psychiatry 2015; 24:1219-31. [PMID: 25572868 DOI: 10.1007/s00787-014-0671-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/25/2014] [Indexed: 10/24/2022]
Abstract
The objective of the study is to describe the changes in symptomatic and functional impairment for children and youth with emotional disorders treated at child and adolescent mental health outpatient services (CAMHS) in Norway. The study was of naturalistic observational type in which the treatment can be classified as "treatment as usual" (TAU). The Strengths and Difficulties Questionnaire (SDQ), the Health of the Nation Outcome Scale (HONOSCA) and the Children's Global Assessment Scale (CGAS) were used as measures of change. The information from multiple informants allowed the evaluation of change from different perspectives. The sample consisted of 84 children and youth with emotional disorders treated at two CAMHS in the North of Norway. The SDQ, the HONOSCA and the CGAS were administered at intake (T0), during assessment (T1) and approximately, 6 months after T1 (T2). Change was analysed by means of the Linear Mixed Models procedure. The results show that children and youth with emotional disorders experience a statistically significant improvement per month during outpatient treatment according to nearly all the measures of change. For the clinician rated scores, change rates during active assessment/treatment were larger than during the waitlist period. Evaluating change from the perspective of clinical significance showed that only a small proportion of the subjects had change scores that were statistically reliable and clinically significant. Whether an actual change has occurred is uncertain for the majority of patients.
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Liu Y, Han Y, Shi J, Li R, Li S, Jin N, Gu Y, Guo H. Effect of peer education on self-management and psychological status in type 2 diabetes patients with emotional disorders. J Diabetes Investig 2014. [PMID: 26221528 PMCID: PMC4511309 DOI: 10.1111/jdi.12311] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aims/Introduction The purpose of the present study was to assess the effect of peer education in type 2 diabetes patients with emotional disorders on the metabolic index and psychological status. Materials and Methods Educators use psychological scales to screen type 2 diabetes patients with emotional disorders. Participants were divided into usual and peer education groups. Both groups received usual diabetes education. Peer leaders were recruited to provide support with the peer education group for 6 months. The metabolic index, diabetes knowledge, self-management, diabetes-related distress, emotional status and quality of life were compared at the end of the study. Results A total of 127 patients participated in the study. There were 20 peer leaders engaged in the study as volunteers for peer education. All participants completed the study and fulfilled the scales. Improvements in the peer education group were significant compared with the usual education group with respect to anxiety (49.0 ± 9.65 vs 54.0 ± 8.48), depression (51.3 ± 7.97 vs 55.8 ± 7.52), diabetes knowledge (18.8 ± 2.46 vs 16.3 ± 2.08), distress (2.67 ± 0.55 vs 3.02 ± 0.56), self-management (66.5 ± 4.26 vs 62.4 ± 5.88) and quality of life (−1.98 ± 0.82 vs −2.50 ± 0.71), whereas no significant difference existed with respect to the metabolic index. Conclusions Peer education, providing more attention to diabetes patients with emotional disorders, is a preferred model for delivering care.
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Affiliation(s)
- Yan Liu
- General Hospital of Dagang Oilfield, Tianjin Medical University Tianjin, China
| | - Ying Han
- General Hospital of Dagang Oilfield, Tianjin Medical University Tianjin, China
| | - Jieli Shi
- General Hospital of Dagang Oilfield, Tianjin Medical University Tianjin, China
| | - Ruixia Li
- General Hospital of Dagang Oilfield, Tianjin Medical University Tianjin, China
| | - Sufen Li
- General Hospital of Dagang Oilfield, Tianjin Medical University Tianjin, China
| | - Nana Jin
- General Hospital of Dagang Oilfield, Tianjin Medical University Tianjin, China
| | - Yong Gu
- The Fifth People's Hospital Of Shanghai, Fudan University Shanghai, China
| | - Honglei Guo
- The Fifth People's Hospital Of Shanghai, Fudan University Shanghai, China ; Key Laboratory of Hormones, Tianjin Medical University Tianjin, China
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Notebaert L, Clarke PJ, Grafton B, MacLeod C. Validation of a novel attentional bias modification task: the future may be in the cards. Behav Res Ther 2015; 65:93-100. [PMID: 25594940 DOI: 10.1016/j.brat.2014.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/22/2014] [Accepted: 12/12/2014] [Indexed: 11/21/2022]
Abstract
Attentional bias modification (ABM) is a promising therapeutic tool aimed at changing patterns of attentional selectivity associated with heightened anxiety. A number of studies have successfully implemented ABM using the modified dot-probe task. However others have not achieved the attentional change required to achieve emotional benefits, highlighting the need for new ABM methods. The current study compared the effectiveness of a newly developed ABM task against the traditional dot-probe ABM task. The new person-identity-matching (PIM) task presented participants with virtual cards, each depicting a happy and angry person. The task encourages selective attention toward or away from threat by requiring participants to make matching judgements between two cards, based either on the identities of the happy faces, or of the angry faces. Change in attentional bias achieved by both ABM tasks was measured by a dot-probe assessment task. Their impact on emotional vulnerability was assessed by measuring negative emotional reactions to a video stressor. The PIM task succeeded in modifying attentional bias, and exerting an impact on emotional reactivity, whereas this was not the case for the dot-probe task. These results are considered in relation to the potential clinical utility of the current task in comparison to traditional ABM methodologies.
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Gohier B, Senior C, Radua J, El-Hage W, Reichenberg A, Proitsi P, Phillips ML, Surguladze SA. Genetic modulation of the response bias towards facial displays of anger and happiness. Eur Psychiatry 2013; 29:197-202. [PMID: 23769682 DOI: 10.1016/j.eurpsy.2013.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 03/20/2013] [Accepted: 03/22/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Investigating genetic modulation of emotion processing may contribute to the understanding of heritable mechanisms of emotional disorders. The aim of the present study was to test the effects of catechol-O-methyltransferase (COMT) val158met and serotonin-transporter-linked promoter region (5-HTTLPR) polymorphisms on facial emotion processing in healthy individuals. METHODS Two hundred and seventy five (167 female) participants were asked to complete a computerized facial affect recognition task, which involved four experimental conditions, each containing one type of emotional face (fearful, angry, sad or happy) intermixed with neutral faces. Participants were asked to indicate whether the face displayed an emotion or was neutral. The COMT-val158met and 5-HTTLPR polymorphisms were genotyped. RESULTS Met homozygotes (COMT) showed a stronger bias to perceive neutral faces as expressions of anger, compared with val homozygotes. However, the S-homozygotes (5-HTTLPR) showed a reduced bias to perceive neutral faces as expressions of happiness, compared to L-homozygotes. No interaction between 5-HTTLPR and COMT was found. CONCLUSIONS These results add to the knowledge of individual differences in social cognition that are modulated via serotonergic and dopaminergic systems. This potentially could contribute to the understanding of the mechanisms of susceptibility to emotional disorders.
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Affiliation(s)
- B Gohier
- Université d'Angers, CHU Angers, Département de Psychiatrie, Angers, France; Laboratoire de Psychologie des Pays de la Loire, EA 4638, Université d'Angers, Angers, France.
| | - C Senior
- School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham, UK
| | - J Radua
- Institute of Psychiatry, King's College London, London, UK; FIDMAG, CIBERSAM, Sant Boi de Llobregat, Spain
| | - W El-Hage
- Institute of Psychiatry, King's College London, London, UK; Inserm U930, Université François Rabelais, CHRU de Tours, Tours, France
| | - A Reichenberg
- Institute of Psychiatry, King's College London, London, UK
| | - P Proitsi
- Institute of Psychiatry, King's College London, London, UK
| | - M L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - S A Surguladze
- Institute of Psychiatry, King's College London, London, UK; Cygnet Health Care, London, UK
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Chen J, Liu X, Rapee RM, Pillay P. Behavioural activation: a pilot trial of transdiagnostic treatment for excessive worry. Behav Res Ther 2013; 51:533-9. [PMID: 23827657 DOI: 10.1016/j.brat.2013.05.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 05/18/2013] [Accepted: 05/23/2013] [Indexed: 11/25/2022]
Abstract
Transdiagnostic interventions present pragmatic benefits in treatment dissemination and training of mental health professionals when faced with emotional disorders such as anxiety and depression. Excessive worry is a common feature across emotional disorders and represents an ideal candidate target for transdiagnostic intervention. The current pilot trial examined the efficacy of a behavioural activation treatment for worry (BAW) in a community population. 49 individuals experiencing excessive worry were randomised to waitlist or BAW receiving an 8 week group based intervention. Results demonstrated that BAW was successful in reducing excessive worry, depressive symptoms, cognitive avoidance, Intolerance of Uncertainty and improving problem solving orientation. Twice as many individuals showed clinically significant reductions in excessive worry after treatment compared to the waitlist control. Despite limitations to sample size and power, this study presents promising support for BAW as a practical transdiagnostic treatment for worry.
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Affiliation(s)
- Junwen Chen
- School of Psychology, Flinders University of South Australia, GPO Box 2100 Adelaide, SA 5001, Australia.
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