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Zhan J, Liu C, Wang Z, Cai Z, He J. Effects of game-based digital interventions for mental disorders: A meta-analysis. J Affect Disord 2024; 362:731-741. [PMID: 39029672 DOI: 10.1016/j.jad.2024.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 07/04/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
With increasing research attention on game-based digital interventions for mental disorders, a number of studies have been conducted to explore the effectiveness of digital game-based interventions on mental disorders. However, findings from previous research were inconsistent. Thus, we conducted a comprehensive meta-analytic review of the effectiveness of game-based digital interventions for mental disorders. By searching the articles in databases, we identified 53 studies in which 2433 participants were involved, and 282 effect sizes were extracted. Among the 53 studies, 14 employed within-group (pre/post) designs, and the remaining 39 utilized controlled trial designs. Using a three-level random-effects meta-analytic model, a medium effect size of game-based digital interventions (g = 0.47, 95 % CI: 0.33, 0.61) was revealed in the controlled trial designs and a close-to-medium effect size (g = 0.45, 95 % CI: 0.32, 0.58) was found in the within-group (pre/post) designs, indicating close-to-medium-sized efficacy of game-based digital interventions for mental disorders. Moderator analyses showed that age in the controlled trial designs had contributed to the heterogeneity in previous studies, suggesting that interventions might be more effective for the elderly. However, given that only a limited number of studies were focused on the elderly, more studies with older participants should be conducted in the future to provide more robust evidence and explore the mechanisms of how digital gaming interventions can be more effective in improving mental disorders symptoms.
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Affiliation(s)
- Jieni Zhan
- School of Psychology, Central China Normal University, Wuhan, Hubei, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
| | - Caiyan Liu
- School of Psychology, Central China Normal University, Wuhan, Hubei, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
| | - Zhikeng Wang
- School of Psychology, Central China Normal University, Wuhan, Hubei, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
| | - Zhihui Cai
- School of Psychology, Central China Normal University, Wuhan, Hubei, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China.
| | - Jinbo He
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, 518172, P.R. China.
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Cai Y, She X, Singh MK, Wang H, Wang M, Abbey C, Rozelle S, Tong L. general psychopathology factor in Chinese adolescents and its correlation with trans-diagnostic protective psycho-social factors. J Affect Disord 2024; 361:245-255. [PMID: 38848970 DOI: 10.1016/j.jad.2024.05.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/30/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Comorbidity in mental disorders is prevalent among adolescents, with evidence suggesting a general psychopathology factor ("p" factor) that reflects shared mechanisms across different disorders. However, the association between the "p" factor and protective factors remains understudied. The current study aimed to explore the "p" factor, and its associations with psycho-social functioning, in Chinese adolescents. METHODS 2052 students, aged 9-17, were recruited from primary and secondary schools in Shanghai, China. Multiple rating scales were used to assess psychological symptoms and psycho-social functioning. Confirmatory factor analysis was conducted to verify the fit of models involving different psychopathology domains such as externalizing, internalizing, and the "p" factor. Subsequently, structural equation models were used to explore associations between the extracted factors and psycho-social functioning, including emotion regulation, mindful attention awareness, self-esteem, self-efficacy, resilience, and perceived support. RESULTS The bi-factor model demonstrated a good fit, with a "p" factor accounting for 46 % of symptom variation, indicating that the psychological symptoms of Chinese adolescents could be explained by internalizing, externalizing, and the "p" factor. Psychologically, a higher "p" was positively correlated with emotion suppression and negatively correlated with mindful attention awareness, emotion reappraisal, self-esteem, and resilience. Socially, a higher "p" was associated with decreased perceived support. LIMITATIONS Only common symptoms were included as this study was conducted at school. Furthermore, the cross-sectional design limited our ability to investigate causal relationships. CONCLUSIONS A "p" factor exists among Chinese adolescents. Individuals with higher "p" factor levels were prone to experience lower levels of psycho-social functions.
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Affiliation(s)
- Yuqing Cai
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China
| | - Xinshu She
- Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, University of California Davis, CA 95817, USA.
| | - Huan Wang
- Stanford Center of China's Economy and Institutions, Stanford, CA 94305, USA
| | - Min Wang
- Stanford Center of China's Economy and Institutions, Stanford, CA 94305, USA
| | - Cody Abbey
- Stanford Center of China's Economy and Institutions, Stanford, CA 94305, USA
| | - Scott Rozelle
- Stanford Center of China's Economy and Institutions, Stanford, CA 94305, USA
| | - Lian Tong
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China.
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Shafran R, Egan SJ, de Valle M, Davey E, Carlbring P, Creswell C, Wade TD. A guide for self-help guides: best practice implementation. Cogn Behav Ther 2024; 53:561-575. [PMID: 38900562 DOI: 10.1080/16506073.2024.2369637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
Guided self-help is an evidence-based intervention used globally. Self-help is a fundamental part of the stepped care model of mental health services that enables the efficient use of limited resources. Despite its importance, there is little information defining the role of the guide and the key competences required. In this context, the guide is defined as the person who facilitates and supports the use self-help materials. This article sets out the role of the guide in guided self-help. It considers practical issues such as the importance of engagement to motivate clients for early change, personalising the intervention, structuring sessions, how best to use routine outcome monitoring and supervision requirements. Key competences are proposed, including generic competences to build the relationship as well as specific competences such as being able to clearly convey the role of the guide to clients. Guides should be prepared for "self-help drift", a concept akin to therapist drift in more traditional therapies. Knowing how to identify mental health problems, use supervision and manage risk and comorbidity are all key requirements for guides. The paper concludes by calling for increased recognition and value of the role of the guide within mental health services.
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Affiliation(s)
- Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Sarah J Egan
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Madelaine de Valle
- Flinders Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Emily Davey
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Tracey D Wade
- Flinders Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
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Villanueva-Blasco VJ, Eslava D, Olave L, Torrens M. Electronic interventions in primary care to address substance use: A systematic review. Addict Behav 2024; 156:108073. [PMID: 38821009 DOI: 10.1016/j.addbeh.2024.108073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 06/02/2024]
Abstract
The present systematic review aims to identify electronic interventions for addressing substance use and understand their effectiveness in primary care settings. A systematic search was carried out in the Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library. The search included the keywords "electronic intervention", "substance use", "primary care" and synonyms. To determine the quality and recommendation of the analyzed interventions, the efficacy results reported by the studies were considered, as well as the Mixed Methods Appraisal Tool (MMAT) assessment and the GRADE Evidence Assessment. Twenty-one electronic interventions in Primary Care were identified: internet, mobile or tablet applications, text messages, emails, automated telephone calls, or electronic self-reports. These interventions had diverse components, incorporating theories that have proven effective in face-to-face interventions as their theoretical frameworks. Some of them were complementary to in-person treatment, while others replaced it. Six interventions (28.5 %) displayed high quality: HealthCall, AB-CASI, Quit Genius, eCHECKUP-TOGO, CBI, and TES. Another nine interventions (42.8 %) were found to have moderate-high quality: Alcohol y Salud, IVR-BI, Program of Wallace et al., Let's Talk About Smoking, SMSalud, ESCAPE, AAC-ASPIRE, iQuit, and Programa VIH. One intervention (4.7 %) had moderate-low quality: Vive sin tabaco ¡Decídete! The remaining five interventions (23.8 %) were found to have very low quality: Connection to health, cSBI, Teen Well Check, the program of Helzer et al. (2008), and Down your drink. The programs with the highest recommendation for addressing alcohol-related issues are HealthCall and AB-CASI; for tobacco use, it is Quit Genius; for cannabis use, it is eCHECKUP-TOGO; for addressing both legal and illegal substances, it is CBI and TES. Finally, for specific illicit drug use, the only recommended program is CBI. This last intervention, CBI, is of the highest quality and, therefore, can be considered a model intervention for dissemination in the primary care setting.
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Affiliation(s)
- Víctor J Villanueva-Blasco
- Faculty of Health Sciences, Valencian International University, C/ Pintor Sorolla, 21, 46002, Spain; Research Group on Health and Psycho-Social Adjustment (GI-SAPS), Valencian International University, Spain; Research Network in Primary Addiction Care (RIAPAd), Spain.
| | - Dalila Eslava
- Research Network in Primary Addiction Care (RIAPAd), Spain; Faculty of Human Sciences and Education, University of Zaragoza, Spain.
| | - Leticia Olave
- Faculty of Health Sciences, Valencian International University, C/ Pintor Sorolla, 21, 46002, Spain; Research Group on Health and Psycho-Social Adjustment (GI-SAPS), Valencian International University, Spain.
| | - Marta Torrens
- Research Network in Primary Addiction Care (RIAPAd), Spain; Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Research Institute, Spain; School of Medicine, Universitat de Vic-Central de Catalunya (UCC), Spain.
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Ruiz-Gutiérrez J, Miras-Aguilar MDM, Rodríguez-Pérez N, Ventura L, González Gómez J, Del Barrio AG, Gónzalez-Blanch C. Bridging personality dimensions and eating symptoms: A transdiagnostic network approach. EUROPEAN EATING DISORDERS REVIEW 2024; 32:930-942. [PMID: 38722045 DOI: 10.1002/erv.3102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/14/2024] [Accepted: 04/26/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVE Eating disorders (ED) have recently been studied from a network approach, conceptualising them as a complex system of interconnected variables, while highlighting the role of non-ED symptoms and personality dimensions. This study aims to explore the connections between personality and ED symptoms, identify central nodes, and compare the EDs network to a healthy control network. METHODS We employed network analysis to examine the personality-ED symptom connections in 329 individuals with an ED diagnosis and 192 healthy controls. We estimated a regularised partial correlation network and the indices of centrality and bridge centrality to identify the most influential nodes for each group. Network differences between groups were also examined. RESULTS Low Self-Directedness and high Harm avoidance emerged as central bridge nodes, displaying the strongest relationship with ED symptoms. Both networks differed in their global connectivity and structure, although no differences were found in bridge centrality and centrality indices. CONCLUSIONS These findings shed light on the role of personality dimensions, such as Self-Directedness and Harm Avoidance in the maintenance of ED psychopathology, supporting the transdiagnostic conceptualisation of ED. This study advances a deeper understanding of the complex interplay between personality dimensions and ED symptoms, offering potential directions for clinical interventions.
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Affiliation(s)
- Jose Ruiz-Gutiérrez
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
| | | | | | - Ludovica Ventura
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
- Faculty of Medicine and Mental Health, University of Cantabria, Santander, Spain
| | - Jana González Gómez
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | - Andrés Gómez Del Barrio
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
- Faculty of Medicine and Mental Health, University of Cantabria, Santander, Spain
- Eating Disorders Unit, Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
- Biomedical Research Centre of Mental Health (CIBERSAM), ISCIII, Madrid, Spain
| | - Cesar Gónzalez-Blanch
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
- Mental Health Centre, Marqués de Valdecilla University Hospital, Santander, Spain
- Faculty of Health Sciences, University Europea del Atlántico, Santander, Spain
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Jiménez-Gonzalo L, García-Batalloso I, Márquez-González M, Cabrera I, Olazarán J, Losada-Baltar A. The role of hyperarousal for understanding the associations between sleep problems and emotional symptoms in family caregivers of people with dementia. A network analysis approach. J Sleep Res 2024:e14310. [PMID: 39147575 DOI: 10.1111/jsr.14310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/23/2024] [Accepted: 07/26/2024] [Indexed: 08/17/2024]
Abstract
Caregiving for a family member with dementia is a stressful situation that has been associated with symptoms of depression, anxiety, and insomnia. Several models have highlighted the role of hyperarousal for understanding sleep disorders; however, there is little evidence about how insomnia, depression, and anxiety are linked together. Network analysis could help to explore the mechanisms underlying the associations between these disorders. A total of 368 community-dwelling family caregivers of a person with dementia took part in the study. The depression-anxiety-sleep symptoms network was composed of 26 items using the R package qgraph to estimate and visualise the network. The results showed that the strongest symptoms in the network were shakiness, tension, restlessness, nervousness, and restless sleep. Tension was the symptom with the most predictive power, restless sleep was the most important shortcut node in the connection between other symptoms. The central stability coefficient showed adequate indices. The strength of hyperarousal symptoms suggested a prominent role of this variable. Our results invite the hypothesis that sleep problems may trigger symptoms specific to depression via fatigue or energy loss. This study is the first to examine the network structure of the associations between the symptoms of depression, anxiety, and insomnia in a sample of informal caregivers, and to explore the role of hyperarousal in this network.
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Affiliation(s)
| | - Inés García-Batalloso
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Márquez-González
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Isabel Cabrera
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Javier Olazarán
- Department of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Fundación Maria Wolff, Madrid, Spain
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Lamichhane B, Moukaddam N, Sabharwal A. Mobile sensing-based depression severity assessment in participants with heterogeneous mental health conditions. Sci Rep 2024; 14:18808. [PMID: 39138328 PMCID: PMC11322485 DOI: 10.1038/s41598-024-69739-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 08/08/2024] [Indexed: 08/15/2024] Open
Abstract
Mobile sensing-based depression severity assessment could complement the subjective questionnaires-based assessment currently used in practice. However, previous studies on mobile sensing for depression severity assessment were conducted on homogeneous mental health condition participants; evaluation of possible generalization across heterogeneous groups has been limited. Similarly, previous studies have not investigated the potential of free-living audio data for depression severity assessment. Audio recordings from free-living could provide rich sociability features to characterize depressive states. We conducted a study with 11 healthy individuals, 13 individuals with major depressive disorder, and eight individuals with schizoaffective disorders. Communication logs and location data from the participants' smartphones and continuous audio recordings of free-living from a wearable audioband were obtained over a week for each participant. The depression severity prediction model trained using communication log and location data features had a root mean squared error (rmse) of 6.80. Audio-based sociability features further reduced the rmse to 6.07 (normalized rmse of 0.22). Audio-based sociability features also improved the F1 score in the five-class depression category classification model from 0.34 to 0.46. Thus, free-living audio-based sociability features complement the commonly used mobile sensing features to improve depression severity assessment. The prediction results obtained with mobile sensing-based features are better than the rmse of 9.83 (normalized rmse of 0.36) and the F1 score of 0.25 obtained with a baseline model. Additionally, the predicted depression severity had a significant correlation with reported depression severity (correlation coefficient of 0.76, p < 0.001). Thus, our work shows that mobile sensing could model depression severity across participants with heterogeneous mental health conditions, potentially offering a screening tool for depressive symptoms monitoring in the broader population.
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Affiliation(s)
| | - Nidal Moukaddam
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Knedgen MM, Starr RA. A tradeoff between safety and freedom: Adults' lived experiences of ARFID. J Eat Disord 2024; 12:107. [PMID: 39095806 PMCID: PMC11295605 DOI: 10.1186/s40337-024-01071-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Avoidant restrictive food intake disorder (ARFID) is characterized as a pattern of restrictive eating leading to significant medical and/or psychosocial impairment (American Psychiatric Association in Diagnostic and statistical manual of mental disorders, American Psychiatric Association, Washington, D.C., 2013). Most existing research on ARFID utilizes quantitative methodologies to study children and adolescents. As a result, the experiences of adults with ARFID have been underrepresented in research. To fill this gap, the current study examines the lived experiences of adults with a DSM-5 diagnosis of ARFID. METHOD Participants (n = 9) included adult women aged 20-42 (M = 27, SD = 6.2) recruited from social media advertising. Open-ended, semi-structured interviews were conducted. Data were analyzed using interpretative phenomenological analysis (IPA). RESULTS One of three overarching themes identified by IPA will be discussed in this study: "A tradeoff between safety and freedom," which consists of two subthemes: (a) Ensuring safety from food unknowns and (c) Longing for Freedom. This overarching theme explores the influence of ARFID on an individual's sense of safety and freedom. DISCUSSION This study is one of few to qualitatively examine ARFID, and the only to do so using IPA. Findings offer novel insights relevant to researchers and clinicians who treat adults with ARFID and who wish to increase consideration and understanding of patient lived experience in their work.
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Affiliation(s)
- Megan M Knedgen
- Department of Psychology, Antioch University Seattle, Seattle, WA, USA.
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Rachel A Starr
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Verdejo-Garcia A, Rossi G, Albein-Urios N, Lozano OM, Diaz-Batanero C. Identifying internalizing transdiagnostic profiles through motivational and cognitive control systems: Relations with symptoms, functionality, and quality of life. Compr Psychiatry 2024; 133:152498. [PMID: 38788615 DOI: 10.1016/j.comppsych.2024.152498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The diversity of patients' symptomatology among people seeking treatment on community-based mental health services poses significant challenges to traditional models of care. Recent approaches favor identifying transdiagnostic factors that allow a better understanding of patient heterogeneity and designing more effective and quality interventions. This study examines the heterogeneity of patients with internalizing symptoms based on profiles identified with cognitive and motivational control variables. Differences between these profiles on dimensional measures of psychopathology and quality of life are examined. METHODS 263 patients were selected by non-probabilistic sampling procedures on mental health services in the province of Huelva (Spain). A latent class analysis on the standardized scale scores of The Behavioral Inhibition/Behavioral Activation System Scales and the Effortful Control Scale of the Adult Temperament Questionnaire Short-Form was conducted. Profiles were compared on the scores of the Inventory of Depression and Anxiety Symptoms-II, the WHO Disability Assessment Schedule II, and the Health Assessment Questionnaire SF-36. RESULTS The four latent profile solution is the one that showed the best fit indicators and substantive interpretability, with a kappa of 0.94 in the cross-validation procedure with 75% of the sample. No sex differences were found between the profiles (χ32 5.17, p = .160). Profiles #1 and #3, both characterized by an imbalance between low activation and high inhibition, had lower well-being, lower functionality, and quality of life. When comparing profile #2 (featuring the highest inhibitory control) lower scores on most internalizing scales are observed, specially claustrophobia, social anxiety, panic mania. Profile #4 (low control, high activation, and high inhibition) showed greater scores on both mania and euphoria and lower scores on emotional role. CONCLUSIONS We identified four distinctive profiles that had overly increased behavioral inhibition (as expected in internalizing disorders) and differed in the degree of imbalance between inhibition and activation systems, and between motivational systems and top-down cognitive control. The profile characterized by high activation and reduced cognitive (inhibitory) control was the one showing greater mood-related symptoms and lower levels of quality of life. These profiles could be generated by treatment providers to guide clinical management in an evidence-based manner.
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Affiliation(s)
- A Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - G Rossi
- Personality and Psychopathology research group (PEPS), Department of Psychology (PE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - N Albein-Urios
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - O M Lozano
- University of Huelva, Department of Clinical and Experimental Psychology, Huelva, Spain; University of Huelva, Research Center for Natural Resources, Health and the Environment, Huelva, Spain
| | - C Diaz-Batanero
- University of Huelva, Department of Clinical and Experimental Psychology, Huelva, Spain; University of Huelva, Research Center for Natural Resources, Health and the Environment, Huelva, Spain.
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Reis A, Westhoff M, Quintarelli H, Hofmann SG. Mindfulness as a therapeutic option for obsessive-compulsive disorder. Expert Rev Neurother 2024; 24:735-741. [PMID: 38889066 DOI: 10.1080/14737175.2024.2365945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is a prevalent mental health issue characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that can cause significant life impairment. Despite cognitive-behavioral therapy (CBT) being the most effective treatment, some individuals experience insufficient symptom reduction or relapse. AREAS COVERED This special report explores the potential of mindfulness-based interventions as complementary treatments for OCD, examining the specific techniques used and their practical application. In the initial section, the authors examine ten randomized control trial studies included in the meta-analysis conducted by Chien et al. (2022), demonstrating the effectiveness of mindfulness interventions. The authors focus on elucidating the specific mindfulness techniques used in these studies. Then, the authors discuss the integration of these mindfulness strategies into CBT, focusing on enhancing emotional regulation, cognitive flexibility, and acceptance of intrusive thoughts. EXPERT OPINION While mindful based interventions (MBIs) show promise as adjunctive treatments for OCD, variability in OCD symptoms and treatment responses necessitate individualized therapeutic approaches. Further research is required to refine mindfulness-based techniques and optimize their effectiveness. Incorporating MBIs into standard CBT protocols may improve outcomes for patients with persistent OCD symptoms.
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Affiliation(s)
- Andreas Reis
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Marlon Westhoff
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Hicham Quintarelli
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Stefan G Hofmann
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
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Denfield GH, Kyzar EJ. The Nested States Model: A Phenomenologically-Grounded Model of the Mind. Psychopathology 2024:1-15. [PMID: 39084192 DOI: 10.1159/000540319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Subjective experience is central to the nature of mental illness, yet it has not played a central role in most empirical approaches to psychopathology. While phenomenological perspectives in psychiatry have seen a recent resurgence, there remains a need for more detailed models of psychopathological processes based on explicit phenomenological and enactive foundations. SUMMARY We present a framework derived from the Nested States Model (NSM) through which such phenomenologically-grounded models might be constructed. The NSM describes the dynamic structure of subjective experience as a system of nested states that reciprocally influence one another across hierarchical layers. Here, we show how the NSM provides a scheme for characterizing patterns of experience that comprise various psychopathological processes. We demonstrate the utility of this scheme both for clinical practice and for building our knowledge of psychopathological processes more broadly. KEY MESSAGES The NSM can advance three aims that we see as critical for the lasting integration of phenomenological approaches to psychopathology within psychiatry. First, we show that the NSM provides a means for constructing clinical formulations and treatment considerations that center squarely on an individual's subjective experiences. Second, the NSM supplies a framework for organizing findings from clinical-phenomenological research that can guide the construction of broader phenomenologically-grounded models of psychopathological processes. Lastly, the NSM aligns our perspective on subjective experience with emerging perspectives on brain dynamics, helping to bridge phenomenological work with ongoing neurophysiological research.
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Affiliation(s)
- George H Denfield
- Department of Psychiatry, Columbia University, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
- Creedmoor Psychiatric Center, Queens, New York, USA
| | - Evan J Kyzar
- Department of Psychiatry, Columbia University, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
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Willfors C, Borg J, Kleberg JL, Hallman A, Van Der Poll M, Lundin Remnélius K, Björlin Avdic H, Bölte S, Nordgren A. Symptoms of autism in Williams syndrome: a transdiagnostic approach. Sci Rep 2024; 14:17583. [PMID: 39080307 PMCID: PMC11289373 DOI: 10.1038/s41598-024-68089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024] Open
Abstract
Williams syndrome (WS) is associated with atypical social communication and cognition reminiscent of the behaviours observed in autism. Nonetheless, WS also differs significantly from autism, such as regarding social motivation, which is typically enhanced in WS and reduced in autism. This study sought to examine the conditions' transdiagnostic similarities and differences for autistic symptoms and social functioning, and their developmental trajectories, by comparing individuals with WS (n = 24) and those diagnosed with idiopathic autism (n = 24) and attention deficit hyperactivity disorder (ADHD; n = 24), aged 9 to 53 years, on measures of autism, social functioning, IQ and cooccurring psychiatric conditions. Although only 12.5% in the WS group met the criteria for an autism diagnosis, a majority exhibited distinct difficulties within social communication, social cognition, repetitive behaviours, and atypical sensory reactivity resembling autism. Conversely, elevated social motivation and a high number of social initiatives accompany these characteristics. No group differences in the developmental trajectories of autism symptoms were found. Our results demonstrate that autistic behaviours are more frequent in individuals with WS, than in individuals with idiopathic ADHD, and emphasize the need for clinical management of these behaviours.
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Affiliation(s)
- Charlotte Willfors
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
- Department of Clinical Genetics and Genomics, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden.
| | - Jacqueline Borg
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm Health Care Services, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Cognitive and Computational Neuropsychiatry, Karolinska Institute, Stockholm Health Care Services, Stockholm, Sweden
- Neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Johan Lundin Kleberg
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm Health Care Services, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Astrid Hallman
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Marcus Van Der Poll
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Karl Lundin Remnélius
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institute, Stockholm Health Care Services, Stockholm, Sweden
| | - Hanna Björlin Avdic
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm Health Care Services, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institute, Stockholm Health Care Services, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Ann Nordgren
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Genetics and Genomics, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Laboratory Medicine, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
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13
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Inostroza C, Bustos C, Bühring V, González L, Cova F. Stress, repetitive negative thinking, and mental health in Chilean university students: an ecological momentary assessment study. Front Psychol 2024; 15:1400013. [PMID: 39100565 PMCID: PMC11295934 DOI: 10.3389/fpsyg.2024.1400013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/24/2024] [Indexed: 08/06/2024] Open
Abstract
Background Mental disorders in university students are a growing attention problem in the international community due to their high prevalence and serious consequences. One possible reason is university students' difficulties in coping with stress. Repetitive negative thinking (RNT) is a transdiagnostic process that, when combined with stress, can lead to the development of various disorders. We aim to determine the effect of stress and RNT on predicting various mental health syndromes in university students across 7 days. Method Prospective observational study using Momentary Ecological Assessment (EMA) with the OURMIND Mobile App. On day one, 238 university students responded to the SCL-90R questionnaire for symptoms of depression, anxiety, hostility, obsession, psychoticism, paranoia, somatization, and interpersonal sensitivity; RNT styles questionnaires, RRS for rumination and negative reflection, PSWQ for worry; SISCO-II for term academic stress, and sociodemographic. EMA consisted of five assessments a day for 6 days; each time, the students answered items about academic and non-academic stress (EMA-stress), reactive RNT duration and intrusiveness (EMA-RNT process), and reactive RNT rumination, reflection, and worry (EMA-RNT content). On day eight, symptoms were re-assessed. Seven hierarchical stepwise linear regression models were used to test the predictive power of the study variables in the development of SCL-90R symptoms. Results When comparing models, adding baseline symptoms increased the models' predictive power in all symptom groups. In most cases, including EMA-stress generated greater predictive power, except for paranoia and interpersonal sensitivity. Adding the EMA-RNT process increased the prediction of paranoia and obsessive symptoms; for hostility symptoms, RNT styles increased predictive power. For the final regression models, considering the initial symptoms, the EMA-RNT process predicted the progression of symptoms in six out of eight groups, while EMA-non-academic stress predicted the remaining two. Additionally, living with other relatives or friends was a predictor of depressive symptoms. Discussion The stress of university life impacts the development of psychiatric symptoms in university students. These results provide evidence of RNT as a transdiagnostic process in several syndromic groups. Universal preventive programs should consider the impact of academic and non-academic stress on university students' mental health. Targeting RNT would also benefit selective preventive interventions.
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Affiliation(s)
- Carolina Inostroza
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | - Claudio Bustos
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | - Vasily Bühring
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | - Lorena González
- Programa de Magíster en Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | - Félix Cova
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
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Pérez-Esteban A, Díez-Gómez A, Pérez-Albéniz A, Al-Halabí S, Lucas-Molina B, Debbané M, Fonseca-Pedrero E. The assessment of transdiagnostic dimensions of emotional disorders: Validation of the Multidimensional Emotional Disorders Inventory (MEDI) in adolescents with subthreshold anxiety and depression. J Affect Disord 2024; 357:138-147. [PMID: 38685278 DOI: 10.1016/j.jad.2024.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/27/2024] [Accepted: 04/21/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. METHOD The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. RESULTS The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LIMITATIONS Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. CONCLUSION The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.
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Affiliation(s)
| | | | | | | | | | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
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15
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She R, Lin J, Wong KM, Yang X. Cognitive-behavioral statuses in depression and internet gaming disorder of adolescents: A transdiagnostic approach. PLoS One 2024; 19:e0304715. [PMID: 38990809 PMCID: PMC11239029 DOI: 10.1371/journal.pone.0304715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/16/2024] [Indexed: 07/13/2024] Open
Abstract
To investigate the comorbidity of adolescent depression and Internet gaming disorder (IGD) and their shared and unique cognitive-behavioral factors (i.e., self-esteem, dysfunctional attitudes, hopelessness, and coping), a large-scale school-based survey was conducted among 3147 Chinese secondary school students in Hong Kong. Probable depression and IGD were screened using the Centre for Epidemiological Studies-Depression Scale and DSM-5 IGD checklist, respectively. Multinomial logistic regression was performed to identify the associations between different condition statuses and cognitive-behavioral factors. Four groups were identified, including comorbidity group (having probable depression and IGD), IGD group (having probable IGD alone), depression group (probable depression alone), and healthy group (neither condition). Comorbidity group showed the worst cognitive-behavioral statuses, followed by depression group and then IGD group. Compared with healthy group, those with lower self-esteem and higher hopelessness and dysfunctional attitudes were more likely to be classified into depression group and comorbidity group, while maladaptive coping was positively associated with all three disorder groups. The results suggest that depression and IGD may share common cognitive-behavioral mechanisms (e.g., maladaptive coping) but also own their uniqueness regarding specific factors (e.g., hopelessness and self-esteem). A transdiagnostic intervention approach targeting the common factors may effectively address the comorbidity.
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Affiliation(s)
- Rui She
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiaxi Lin
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kei Man Wong
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xue Yang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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16
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Tang SJ, Holle J, Dadario NB, Ryan M, Lesslar O, Teo C, Sughrue M, Yeung J. Personalized, parcel-guided non-invasive transcranial magnetic stimulation for the treatment of post-concussive syndrome: safety and proof of concept. Brain Inj 2024:1-11. [PMID: 38965876 DOI: 10.1080/02699052.2024.2371975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 06/15/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE To determine the safety and proof of concept of a parcel-guided, repetitive Transcranial Magnetic Stimulation (rTMS) in patients who develop a heterogeneous array of symptoms, known collectively as post-concussive syndrome (PCS), following traumatic brain injury (TBI). METHODS We performed a retrospective review of off-label, individualized, parcel-guided rTMS in 19 patients from December 2020 to May 2023. Patients had at least one instance of mild, moderate, or severe TBI and developed symptoms not present prior to injury. rTMS targets were identified based on machine learning connectomic software using functional connectivity anomaly matrices compared to healthy controls. EuroQol (EQ-5D), as a measurement of quality of life, and additional questionnaires dependent on individual's symptoms were submitted prior to, after, and during follow-up from rTMS. RESULTS Nineteen patients showed improvement in EQ-5D and Rivermead Post Concussion Symptoms Questionnaires - 3 after treatment and follow-up. For nine patients who developed depression, five (55%) attained response and remission based on the Beck Depression Inventory after treatment. Eight of ten patients with anxiety had a clinically significant reduction in Generalized Anxiety Disorder-7 scores during follow-up. CONCLUSION Parcel-guided rTMS is safe and may be effective in reducing PCS symptoms following TBI and should incite further controlled studies.
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Affiliation(s)
- Si Jie Tang
- School of Medicine, University of California Davis Medical Center, Sacramento, California, USA
| | | | - Nicholas B Dadario
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
| | | | | | | | | | - Jacky Yeung
- Cingulum Health, Sydney, Australia
- Department of Neurosurgery, Yale University School of Medicine institution, New Haven, Connecticut, USA
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17
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Pilatti A, Correa P, Michelini Y, Bravo AJ, Pacini G, Pautassi RM. The Association Between Mindfulness Facets and Substance Use via Emotional Psychopathology and Coping Motives in Argentinian College Students. Subst Use Misuse 2024:1-12. [PMID: 38956825 DOI: 10.1080/10826084.2024.2370026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Background: Prior studies suggest that lower levels of mindfulness contribute to the motivation of using alcohol to cope with distress. Research examining this possibility is scarce or limited to alcohol, but not marijuana, related outcomes. Objectives: We examined separate models (for alcohol and for marijuana) to determine the associations between trait mindfulness (describing, acting with awareness, non-judging, non-reactivity) and alcohol and marijuana outcomes (use indicators and negative consequences) via emotional psychopathology (i.e., a latent variable assessing symptoms of depression and anxiety) and alcohol/marijuana coping motives. Results: The final analytic sample consisted of 456 participants (Mean age = 22.96 ± 3.12 years; 66.2% women) for the alcohol model; and 232 participants (Mean age = 22.96 ± 3.01 years; 66.2% women) for the marijuana model. Two path models were conducted, such that indirect paths were examined for each trait mindfulness facet on alcohol/marijuana outcomes (e.g., describing → emotional psychopathology → alcohol coping motives → binge drinking frequency). Within the comprehensive alcohol model, describing, acting with awareness, non-judging and non-reactivity were associated with less binge drinking frequency and lower number of alcohol-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of drinking to cope motives. For the marijuana model, describing, acting with awareness, and non-judging of inner experience were associated with less marijuana quantity (grams) consumed and lower number of marijuana-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of marijuana coping motives. Conclusions: Prevention and intervention programs of alcohol and marijuana in Argentina may benefit from improving mindfulness skills and targeting emotional psychopathology and motives to use drugs, to prevent or reduce negative drug-related consequences.
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Affiliation(s)
- Angelina Pilatti
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto de Investigaciones Psicológicas, IIPsi-CONICET-UNC, Córdoba, Argentina
| | - Pablo Correa
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto de Investigaciones Psicológicas, IIPsi-CONICET-UNC, Córdoba, Argentina
| | - Yanina Michelini
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto de Investigaciones Psicológicas, IIPsi-CONICET-UNC, Córdoba, Argentina
| | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, USA
| | - Gianpiero Pacini
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ricardo M Pautassi
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto de Investigación Médica M. y M. Ferreyra, INIMEC-CONICET-UNC, Córdoba, Argentina
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18
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Raposo CF, Nobre PJ, Manão AA, Pascoal PM. Understanding sexual distress related to sexual function (SDRSF): A preliminary framework based on a qualitative study with clinical sexologists. Int J Clin Health Psychol 2024; 24:100473. [PMID: 39021678 PMCID: PMC467054 DOI: 10.1016/j.ijchp.2024.100473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/21/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Sexual distress related to sexual function (SDRSF) is pivotal in diagnosing sexual dysfunction. However, there is a lack of theoretical models for its comprehension and of knowledge concerning how to address it in clinical practice. Aim To contribute to theory building and clinical practice about SDRSF by collecting clinicians' accounts, aiming to inform a preliminary framework to study and intervene in SDRSF. Method Reflexive thematic analysis was used to analyze the data from 16 semi-structured interviews with clinical sexologists. Results: Three main themes were created: (1) Burning from the inside, (2) Wicked games, and (3) Running up that hill. Participants revealed a multidimensional understanding of SDRSF in clinical settings that integrates individual, sociocultural, interpersonal and situational factors. This underscores the interconnected nature of SDRSF, revealing its links to different facets of overall distress in clinical settings. We present a preliminary framework that may be analytically generalized to enhance the comprehension of the specificities of SDRSF. Conclusion These insights frame a comprehensive conceptualization of SDRSF in clinical settings that goes beyond sexual activity and implies that interpersonal and societal factors need to be considered in research and intervention in this field.
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Affiliation(s)
- Catarina F. Raposo
- Center for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of Porto, Portugal
| | - Pedro J. Nobre
- Center for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of Porto, Portugal
| | - Andreia A. Manão
- Lusófona University, HEI‐Lab: Digital Human‐Environment Interaction Labs, Portugal
| | - Patrícia M. Pascoal
- Lusófona University, HEI‐Lab: Digital Human‐Environment Interaction Labs, Portugal
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19
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Kolbuszewska MT, Tavares IM, Nobre PJ, Dawson SJ. Using network analysis to model associations between psychological symptoms, sexual function, and sexual distress in women. Int J Clin Health Psychol 2024; 24:100479. [PMID: 39040481 PMCID: PMC11262177 DOI: 10.1016/j.ijchp.2024.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/19/2024] [Indexed: 07/24/2024] Open
Abstract
Background Psychological difficulties, including depression, anxiety, and somatization, are among the most important predictors for women's sexual function (i.e., arousal, desire, lubrication, pain, and satisfaction) and sexual distress. These associations have largely been studied at the construct level, with little research examining which specific symptoms might be most important for maintaining links between psychological difficulties and domains of sexual function. The present research sought to establish and characterize networks of women's psychological symptoms, sexual function, and sexual distress, and identify potential bridge symptoms that connect them. Methods In a cross-sectional study, 725 women reported on their sexual function, sexual distress, and depressive, anxiety, and somatization symptoms. A series of network analyses was used to identify central symptoms and connections between psychological symptoms, sexual function domains, and sexual distress. Results Across the modeled networks, sexual distress and pain during sex were consistent bridges between other sexual function domains and psychological symptoms. Discussion Overall, our models revealed sexual distress as an important potential mediator between sexual function problems and psychological symptoms that might contribute to the development and maintenance of comorbid sexual function and psychological problems.
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Affiliation(s)
- Marta T. Kolbuszewska
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada
| | - Inês M. Tavares
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pedro J. Nobre
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Samantha J. Dawson
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada
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20
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Jenkinson PM, Fotopoulou A, Ibañez A, Rossell S. Interoception in anxiety, depression, and psychosis: a review. EClinicalMedicine 2024; 73:102673. [PMID: 38873633 PMCID: PMC11169962 DOI: 10.1016/j.eclinm.2024.102673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 05/08/2024] [Accepted: 05/17/2024] [Indexed: 06/15/2024] Open
Abstract
Research has examined the relationship between interoception and anxiety, depression, and psychosis; however, it is unclear which aspects of interoception have been systematically examined, what the combined findings are, and which areas require further research. To answer these questions, we systematically searched and narratively synthesised relevant reviews, meta-analyses, and theory papers (total n = 34). Existing systematic reviews and meta-analyses (anxiety n = 2; depression n = 2; psychosis n = 0), focus on cardiac interoceptive accuracy (heartbeat perception), and indicate that heartbeat perception is not systematically impaired in anxiety or depression. Heartbeat perception might be poorer in people with psychosis, but further evidence is needed. Other aspects of interoception, such as different body systems and processing levels, have been studied but not systematically reviewed. We highlight studies examining these alternative bodily domains and levels, review the efficacy of interoception-based psychological interventions, and make suggestions for future research. Funding Wellcome Trust UK.
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Affiliation(s)
- Paul M. Jenkinson
- Faculty of Psychology, Counselling and Psychotherapy, The Cairnmillar Institute, Melbourne, Australia
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Agustin Ibañez
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Susan Rossell
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
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McKay J, Williams K, Stewart J. You just want a break from the hatred of failure: the lived experience of being a student physiotherapist perfectionist and considerations for educators. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:893-918. [PMID: 37823973 PMCID: PMC11208254 DOI: 10.1007/s10459-023-10287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/24/2023] [Indexed: 10/13/2023]
Abstract
Perfectionism is a personality orientation associated with mental health and adjustment problems. Recent evidence demonstrates that perfectionism is widespread among students and on the rise, with recent generations of students placing increasingly more importance on perfection. Whilst the extant literature is vast, it tends to focus on psychopathology and identification of perfectionism correlates rather than the experience of student perfectionism. Furthermore, the education literature is scant and there is a need to understand the deeper processes and nuances of perfectionism, particularly within health professions education where intense study demands, competition to gain entry to educational programmes, and professional cultures may nurture the problem. This phenomenological study explored the lived experiences of ten physiotherapy students as they wrestled with perfectionism in the various facets of their studies. Semi-structured interviews were undertaken, and participants completed log sheets to document perfectionism-related experiences. Idiographic profiles were composed and interview transcripts were analysed, drawing upon features of both phenomenological and thematic analysis. Perfectionism was found to have toxic consequences for the learning experience. Harmful phenomenological experiences included perpetual and excessive achievement striving, punitive self-criticism and health and wellbeing difficulties. A range of sabotaging learning behaviours such as self-handicapping and feedback avoidance was also illuminated, and cultural and organisational influences perceived to foster perfectionism emerged. Findings are discussed in relation to underlying processes and implications for educators. The prospect of findings transferring to other educational contexts is highlighted.
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Affiliation(s)
- Jane McKay
- School of Health and Life Sciences Learning Development Centre, Glasgow Caledonian University, Glasgow, Scotland.
| | - Kim Williams
- School of Health and Life Sciences, Glasgow Caledonian University, Learning Development Centre, Glasgow, Scotland
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22
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Zhang L, Takahashi Y. Relationships between obsessive-compulsive disorder and the big five personality traits: A meta-analysis. J Psychiatr Res 2024; 177:11-23. [PMID: 38964090 DOI: 10.1016/j.jpsychires.2024.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 05/31/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
Although several studies have examined the relationships between obsessive-compulsive disorder (OCD) and the Big Five personality traits (i.e., neuroticism, extraversion, openness, agreeableness, and conscientiousness), the results have been inconsistent. Therefore, this meta-analysis comprehensively examined the relationships between OCD and these traits. In total, 23 studies (29 independent datasets) with 30,138 participants were analyzed. The pooled effect size was 0.34 (95% confidence interval [CI]: 0.28, 0.40) for neuroticism, -0.14 (95% CI: -0.18, -0.10) for extraversion, -0.04 (95% CI: -0.09, 0.02) for openness, -0.10 (95% CI: -0.16, -0.04) for agreeableness, and -0.03 (95% CI: -0.11, 0.05) for conscientiousness, indicating that OCD was associated with higher scores for neuroticism and lower scores for extraversion and agreeableness. Meta-regression and subgroup analyses indicated that heterogeneity was mainly due to differences in sample types and OCD measurement instruments. Sensitivity analysis showed that the results of the meta-analysis were robust. Overall, neuroticism was a maladaptive trait, whereas extraversion and agreeableness were adaptive traits for OCD. Although the results could be sample- and instrument-specific, our findings may inform preventions and interventions for OCD symptoms.
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Affiliation(s)
- Lei Zhang
- Graduate School of Education, Kyoto University, Kyoto, Japan
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Egan SJ, Greene D, Callaghan T, Raghav S, Funk J, Badenbach T, Talam S, Kemp G, McEvoy P, Ehring T, Kopf-Beck J. Worry and rumination as a transdiagnostic target in young people: a co-produced systematic review and meta-analysis. Cogn Behav Ther 2024:1-24. [PMID: 38923912 DOI: 10.1080/16506073.2024.2369936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
PROTOCOL REGISTRATION PROSPERO (CRD42023408899).
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Affiliation(s)
- Sarah J Egan
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Danyelle Greene
- Australian Institute for Business and Economics, University of Queensland, Brisbane, Australia
| | - Thomas Callaghan
- Discipline of Psychology, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | | | - Julia Funk
- Department of Psychology, LMU Munich, Munchen, Germany
| | | | | | - Georgia Kemp
- Independent Lived Experience Expert Consultant, UK
| | - Peter McEvoy
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munchen, Germany
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Pedro LMR, de Oliveira MF, Pereira MD, da Fonseca AD, Canavarro MC. Factors Associated with Prospective Acceptability and Preferences for Unified Transdiagnostic Cognitive-Behavioral Treatments and Group Therapy in the Portuguese General Population. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01391-1. [PMID: 38839662 DOI: 10.1007/s10488-024-01391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
Group transdiagnostic cognitive-behavioral therapy (CBT) offers a promising solution for limited mental health access in Portugal. Understanding barriers to patient adherence is crucial for successful implementation. This study aimed to characterize the prospective acceptability and preferences for unified transdiagnostic CBT and group therapy in the Portuguese general population and explore their correlates. A sample of 243 participants (18-88 years old), recruited online, completed an online survey collecting information on sociodemographic and clinical characteristics, acceptability of transdiagnostic CBT treatments, specifically of Unified Protocol (UP), acceptability of group therapy, therapeutic format preferences, beliefs about group therapy and help-seeking attitudes. Most participants were receptive to and perceived as useful both unified transdiagnostic CBT and group therapy. Overall, participants presented significantly more favorable attitudes than unfavorable attitudes toward unified transdiagnostic CBT and group therapy (p < .001). Multivariate analyses revealed that (1) favorable attitudes toward transdiagnostic treatments were negatively associated with being employed and positively associated with living in an urban area, and higher efficacy scores; (2) unfavorable attitudes toward transdiagnostic treatments were positively associated with being married/cohabitating and negatively associated with vulnerability scores; (3) being female, living in an urban area, and higher efficacy and myth scores emerged as positive predictors of favorable attitudes toward group therapy; and (4) efficacy and vulnerability scores and help-seeking propensity emerged as negative predictors of unfavorable attitudes toward group therapy. These findings highlight the importance of delineating strategies to increase knowledge and acceptance of unified transdiagnostic CBT and group therapy in the Portuguese population, addressing specific individual characteristics.
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Affiliation(s)
- Liliana Maria Rodrigues Pedro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal.
| | | | - Marco Daniel Pereira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Ana Dias da Fonseca
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
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25
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Miranda O, Kiehl SM, Qi X, Brannock MD, Kosten T, Ryan ND, Kirisci L, Wang Y, Wang L. Enhancing post-traumatic stress disorder patient assessment: leveraging natural language processing for research of domain criteria identification using electronic medical records. BMC Med Inform Decis Mak 2024; 24:154. [PMID: 38835009 PMCID: PMC11151516 DOI: 10.1186/s12911-024-02554-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Extracting research of domain criteria (RDoC) from high-risk populations like those with post-traumatic stress disorder (PTSD) is crucial for positive mental health improvements and policy enhancements. The intricacies of collecting, integrating, and effectively leveraging clinical notes for this purpose introduce complexities. METHODS In our study, we created a natural language processing (NLP) workflow to analyze electronic medical record (EMR) data and identify and extract research of domain criteria using a pre-trained transformer-based natural language model, all-mpnet-base-v2. We subsequently built dictionaries from 100,000 clinical notes and analyzed 5.67 million clinical notes from 38,807 PTSD patients from the University of Pittsburgh Medical Center. Subsequently, we showcased the significance of our approach by extracting and visualizing RDoC information in two use cases: (i) across multiple patient populations and (ii) throughout various disease trajectories. RESULTS The sentence transformer model demonstrated high F1 macro scores across all RDoC domains, achieving the highest performance with a cosine similarity threshold value of 0.3. This ensured an F1 score of at least 80% across all RDoC domains. The study revealed consistent reductions in all six RDoC domains among PTSD patients after psychotherapy. We found that 60.6% of PTSD women have at least one abnormal instance of the six RDoC domains as compared to PTSD men (51.3%), with 45.1% of PTSD women with higher levels of sensorimotor disturbances compared to men (41.3%). We also found that 57.3% of PTSD patients have at least one abnormal instance of the six RDoC domains based on our records. Also, veterans had the higher abnormalities of negative and positive valence systems (60% and 51.9% of veterans respectively) compared to non-veterans (59.1% and 49.2% respectively). The domains following first diagnoses of PTSD were associated with heightened cue reactivity to trauma, suicide, alcohol, and substance consumption. CONCLUSIONS The findings provide initial insights into RDoC functioning in different populations and disease trajectories. Natural language processing proves valuable for capturing real-time, context dependent RDoC instances from extensive clinical notes.
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Affiliation(s)
- Oshin Miranda
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | | | - Xiguang Qi
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | | | - Thomas Kosten
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Neal David Ryan
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Levent Kirisci
- University of Pittsburgh School of Pharmacy, Pittsburgh, PA, 15213, USA
| | - Yanshan Wang
- University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA, 15213, USA
| | - LiRong Wang
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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26
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Hadjistavropoulos HD, McCall HC, Dear BF, Beahm JD, Carleton RN, Titov N. Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study. J Anxiety Disord 2024; 104:102861. [PMID: 38640867 DOI: 10.1016/j.janxdis.2024.102861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/07/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment for various mental health concerns. Canadian PSP report favorable attitudes toward ICBT, and preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted of a longitudinal observational study of 560 Canadian PSP who participated in ICBT. It was designed to assess the longer term effectiveness of ICBT and moderators of outcomes by gender, linguistic and occupational group, and years of occupational experience. We evaluated symptom change at 8, 26, and 52 weeks post-enrollment, and results among PSP who had elevated clinical scores, showed large reductions (Hedges' g) in symptoms of depression (g = 1.3), anxiety (g =1.48), posttraumatic stress (g =1.24), panic (g =1.19), and anger (g =1.07) and moderate reductions in symptoms of social anxiety (g =.48-.56). Moderator analyses revealed modest differences in pre-treatment symptoms among certain groups but no group differences in symptom change over time. Clients showed good completion of treatment materials and reported high treatment satisfaction. The results suggest further study of ICBT tailored to PSP is warranted, including evaluating ICBT tailored for PSP in other countries.
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Affiliation(s)
- Heather D Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada.
| | - Hugh C McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Blake F Dear
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - Janine D Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nickolai Titov
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
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27
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de Aguiar ACL, Bloc LG. Transdiagnosis of alcohol use and psychopathologies: A systematic review. Addict Behav Rep 2024; 19:100543. [PMID: 38628974 PMCID: PMC11019097 DOI: 10.1016/j.abrep.2024.100543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/21/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
Multiple diagnoses are the rule in Mental Health and alcohol use disorder (AUD) is a psychopathology with many comorbidities, requiring interventions that consider common factors, which means using a transdiagnostic perspective. This study aimed to identify in the scientific literature the main common transdiagnostic factors that link AUD to other psychopathologies in people over 18 years of age. A systematic review of the literature was carried out in the portals of the databases Pubmed, PsychINFO and CAPES. 37 articles were selected for analysis, which resulted in 25 transdiagnostic factors linked to AUD and to several other related disorders and health conditions. The results emphasize the variety of disorders and health conditions related to AUD, which highlights the importance of transdiagnostic factors for these conditions as targets for both scientific research and therapeutic interventions for this population.
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Affiliation(s)
- Ana Caroline Leite de Aguiar
- University of Fortaleza (Unifor), Washington Soares Avenue, 1321, Edson Queiroz, Fortaleza, Ceará 60811-905, Brazil
| | - Lucas Guimarães Bloc
- University of Fortaleza (Unifor), Washington Soares Avenue, 1321, Edson Queiroz, Fortaleza, Ceará 60811-905, Brazil
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28
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Scott J, Iorfino F, Capon W, Crouse J, Nelson B, Chanen AM, Dwyer D, Conus P, Bechdolf A, Ratheesh A, Raballo A, Yung A, Berk M, McKenna S, Hockey S, Hutcheon A, Scott E, McGorry P, Shah J, Hickie IB. Staging 2.0: refining transdiagnostic clinical staging frameworks to enhance reliability and utility for youth mental health. Lancet Psychiatry 2024; 11:461-471. [PMID: 38643773 DOI: 10.1016/s2215-0366(24)00060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 04/23/2024]
Abstract
Globally, 75% of depressive, bipolar, and psychotic disorders emerge by age 25 years. However, these disorders are often preceded by non-specific symptoms or attenuated clinical syndromes. Difficulties in determining optimal treatment interventions for these emerging mental disorders, and uncertainties about accounting for co-occurring psychopathology and illness trajectories, have led many youth mental health services to adopt transdiagnostic clinical staging frameworks. In this Health Policy paper, an international working group highlights ongoing challenges in applying transdiagnostic staging frameworks in clinical research and practice, and proposes refinements to the transdiagnostic model to enhance its reliability, consistent recording, and clinical utility. We introduce the concept of within-stage heterogeneity and describe the advantages of defining stage in terms of clinical psychopathology and stage modifiers. Using examples from medicine, we discuss the utility of categorising stage modifiers into factors associated with progression (ie, potential predictors of stage transition) and extension (ie, factors associated with the current presentation that add complexity to treatment selection). Lastly, we suggest how it is possible to revise the currently used transdiagnostic staging approach to incorporate these key concepts, and how the revised framework could be applied in clinical and research practice.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - William Capon
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Jacob Crouse
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Barnaby Nelson
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrew M Chanen
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Dominic Dwyer
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Philippe Conus
- General Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, CCM, Charité Universitatsmedizin, Berlin, Germany
| | - Aswin Ratheesh
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrea Raballo
- Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
| | - Alison Yung
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
| | - Sarah McKenna
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Samuel Hockey
- Lived Experience Working Group, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Alexis Hutcheon
- Lived Experience Working Group, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Elizabeth Scott
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Pat McGorry
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jai Shah
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
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29
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Sun K, Chen M, Feng D, Cao C. Intergenerational Transmission of Depressive Symptoms from Mothers to Adolescents: A Moderated Mediation Model. Child Psychiatry Hum Dev 2024; 55:600-612. [PMID: 36327044 DOI: 10.1007/s10578-022-01460-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 08/09/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
Substantial literature investigating the intergenerational transmission of depressive symptoms has primarily focused on mothers and adolescents, whereas less is known about the potential role of fathers, especially their parenting behaviors. This study aimed to address this gap by examining the mediating role of maternal parenting, and the moderating role of paternal parenting in this intergenerational transmission pathway. A total of 528 Chinese community adolescents (Mage = 12.70 ± 1.49 years; 48.7%, girls) and their mothers participated. After adolescent sex, age, maternal educational levels, and monthly household income were controlled for, both maternal warmth and rejection mediated the association between maternal and adolescent depressive symptoms. More importantly, paternal warmth buffered the adverse effect of maternal depressive symptoms and maternal rejection on adolescent depressive symptoms. These findings highlight the buffering role of paternal parenting in blocking the intergenerational transmission risk of depressive symptoms from mothers to adolescents and emphasize the need for father-focused interventions.
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Affiliation(s)
- Kexin Sun
- School of Nursing and Rehabilitation, Shandong University, No. 44 West Wenhua Road, 250012, Jinan, Shandong Province, China
| | - Meijing Chen
- School of Nursing and Rehabilitation, Shandong University, No. 44 West Wenhua Road, 250012, Jinan, Shandong Province, China
| | - Danjun Feng
- School of Nursing and Rehabilitation, Shandong University, No. 44 West Wenhua Road, 250012, Jinan, Shandong Province, China
| | - Cong Cao
- School of Nursing and Rehabilitation, Shandong University, No. 44 West Wenhua Road, 250012, Jinan, Shandong Province, China.
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30
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Brown JM, Sofis M, Zimmer S, Kaplan BA. Delay discounting is associated with addiction and mental health measures while controlling for health behaviors and health barriers in a large US sample. Addict Behav Rep 2024; 19:100545. [PMID: 38680208 PMCID: PMC11046061 DOI: 10.1016/j.abrep.2024.100545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/20/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024] Open
Abstract
Background Excessive discounting of future rewards [delay discounting (DD)] may be a transdiagnostic process and treatment target underlying behavioral health outcomes, including trauma, depression, anxiety, and problematic substance use. However, multiple health behaviors and barriers are also related to these outcomes, including social media usage, adverse childhood experiences (ACEs), sleep quality, healthcare access, housing status, and exercise. To extend research examining DD as transdiagnostic process, we recruited a large, heterogenous sample to examine the association between DD, problematic substance use, and mental health outcomes while controlling for certain health behaviors and health barriers. Method In a cross-sectional online survey of 3992 US residents, we administered validated measures of PTSD, depression, anxiety, and problematic alcohol, stimulant, and opioid use. Using linear or ordinal logistic models, scores for each outcome were regressed onto DD while controlling for demographics, health behaviors, and health barriers. Results Including only DD and demographics, DD was associated with each outcome at low effect sizes (ƒ2 = .013, OR range = 1.08-1.16). Except for opioid ASSIST scores, these relationships held when controlling for social media usage, sleep, housing status, healthcare access, ACEs, physical exercise, and demographic variables (ƒ2 = .002, OR range = 1.03-1.12), increasing confidence that DD concurrently and directly relates to four of these five clinical outcomes. Discussion These findings support the conceptualization of DD as a transdiagnostic process underlying certain psychopathologies and suggest targeting DD in co-occurring substance use disorder and/or mental health treatments may result in clinically significant outcomes.
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Affiliation(s)
- Jeremiah M. Brown
- Advocates for Human Potential, 490-B Boston Post Road, Sudbury, MA 01776, USA
| | - Michael Sofis
- Advocates for Human Potential, 490-B Boston Post Road, Sudbury, MA 01776, USA
| | - Sara Zimmer
- Advocates for Human Potential, 490-B Boston Post Road, Sudbury, MA 01776, USA
| | - Brent A. Kaplan
- Advocates for Human Potential, 490-B Boston Post Road, Sudbury, MA 01776, USA
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31
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Wade TD, Shafran R, Cooper Z. Developing a protocol to address co-occurring mental health conditions in the treatment of eating disorders. Int J Eat Disord 2024; 57:1291-1299. [PMID: 37278186 DOI: 10.1002/eat.24008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE While co-occurring mental health conditions are the norm in eating disorders, no testable protocol addresses management of these in psychotherapy. METHOD The literature on managing mental health conditions that co-occur with eating disorders is outlined and reviewed. RESULTS In the absence of clear evidence to inform managing co-occurring mental health conditions, we advocate for use of an iterative, session-by-session measurement to guide practice and research. We identify three data-driven treatment approaches (focus solely on the eating disorder; multiple sequential interventions either before or after the eating disorder is addressed; integrated interventions), and the indications for their use. Where a co-occurring mental health condition/s impede effective treatment of the eating disorder, and an integrated intervention is required, we outline a four-step protocol for three broad intervention approaches (alternate, modular, transdiagnostic). A research program is suggested to test the usefulness of the protocol. DISCUSSION Guidelines that provide a starting point to improving outcomes for people with eating disorders that can be evaluated/researched are offered in the current paper. These guidelines require further elaboration with reference to: (1) whether any difference in approach is required where the co-occurring mental health condition is a comorbid symptom or condition; (2) the place of biological treatments within these guidelines; (3) precise guidelines for selecting among the three broad intervention approaches when adapting care for co-occurring conditions; (4) optimal approaches to involving consumer input into identifying the most relevant co-occurring conditions; (5) detailed specification on how to determine which adjuncts to add. PUBLIC SIGNIFICANCE Most people with an eating disorder also have another diagnosis or an underlying trait (e.g., perfectionism). Currently no clear guidelines exist to guide treatment in this situation, which often results in a drift away from evidence-based techniques. This paper outlines data-driven strategies for treating eating disorders and the accompanying comorbid conditions and a research program that can test the usefulness of the different approaches suggested.
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Affiliation(s)
- Tracey D Wade
- Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Flinders University, Bedford Park, South Australia, Australia
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Zafra Cooper
- Yale School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Oxford University, Oxford, UK
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32
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Steiger H. "You mean it's more than just an eating disorder?": Commentary on Wade et al. (2023). Int J Eat Disord 2024; 57:1375-1378. [PMID: 37694494 DOI: 10.1002/eat.24060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
Drawing from literature on measurement-based care and prognostic indices in eating disorder (ED) treatment, Wade et al. offer an algorithm for treating co-occurring mental-health conditions (i.e., psychiatric comorbidity) in people with EDs, and for studying effects of comorbidity-oriented treatments. Advocating session-by-session measurement to inform adaptive treatment, their proposal outlines a process for adjusting conventional ED treatment to situations in which comorbidity impedes treatment progress. The plan is methodical and responsive to evidence suggesting that peoples' early in-treatment change has more power, prognostically, than do indices of comorbidity. In the absence of data to inform practices in some areas, the authors intentionally leave key questions unanswered until future results are in. But this means that they reserve comment on how to determine that comorbidity is interfering with treatment response, or to select the best-fitting of available comorbidity-oriented options. Likewise, the proposal draws most of its inspiration from literature on individual (mainly cognitive-behavioral) psychotherapy and, as a result, does not fully represent biopsychosocial perspectives, or elaborate upon the place in comorbidity management of biological treatments, family, and carer involvement, or more complex integrated approaches. Considerations on how to apply the latter methods would broaden the plan's scope.
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Affiliation(s)
- Howard Steiger
- Eating Disorders Continuum, Douglas Institute, Montreal, Quebec, Canada
- Psychiatry Department, McGill University, Montreal, Quebec, Canada
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33
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Adams SW, Layne CM, Contractor AA, Allwood MA, Armour C, Inslicht SS, Maguen S. The Middle-Out Approach to reconceptualizing, assessing, and analyzing traumatic stress reactions. J Trauma Stress 2024; 37:433-447. [PMID: 38049964 DOI: 10.1002/jts.23005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023]
Abstract
Alternative models of traumatic stress and broader psychopathology have been proposed to address issues of heterogeneity, comorbidity, clinical utility, and equitable representation. However, systematic and practical methods and guidelines to organize and apply these models remain scarce. The Middle-Out Approach is a novel, integrative, contextually informed framework for organizing and applying existing empirical methods to evaluate current and alternative traumatic stress reactions. Rather than beginning to identify traumatic stress reactions from the top-down (i.e., disorder-first approach) or bottom-up (i.e., symptom-first approach), constructs are evaluated from the middle out (i.e., presentation-first approach), unconstrained by higher-order disorders or lower-order diagnostic symptoms. This approach provides innovation over previous methods at multiple levels, including the conceptualization of traumatic stress reactions as well as the type of assessments and data sources used and how they are used in statistical analyses. Conceptualizations prioritize the identification of middle-order phenotypes, representing person-centered clinical presentations, which are informed by the integration of multidimensional, transdiagnostic, and multimodal (e.g., psychosocial, physiological) assessments and/or data sources. Integrated data are then analyzed concurrently using person-centered statistical models to identify precise, discrete, and representative health outcomes within broader heterogeneous samples. Subsequent variable-centered analyses are then used to identify culturally sensitive and contextually informed correlates of phenotypes, their clinical utility, and the differential composition within and between broader traumatic stress reactions. Examples from the moral injury literature are used to illustrate practical applications that may increase clinical utility and the accurate representation of health outcomes for diverse individuals and communities.
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Affiliation(s)
- Shane W Adams
- Mental Illness Research Education and Clinical Center (MIRECC), VA San Francisco Health Care System, San Francisco, California, USA
- Department of Psychiatry, University of California-San Francisco, San Francisco, California, USA
| | - Christopher M Layne
- College of Psychology, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | | | - Maureen A Allwood
- Department of Psychology, John Jay College of Criminal Justice-City University of New York, New York, New York, USA
| | - Chérie Armour
- School of Psychology, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Sabra S Inslicht
- Department of Psychiatry, University of California-San Francisco, San Francisco, California, USA
- Mental Health Service, VA San Francisco Health Care System, San Francisco, California, USA
| | - Shira Maguen
- Department of Psychiatry, University of California-San Francisco, San Francisco, California, USA
- Mental Health Service, VA San Francisco Health Care System, San Francisco, California, USA
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34
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Rassaby M, Rogers JM, Taylor CT. Validation of the Approach-Avoidance Temperament Questionnaire in Individuals with Anxiety and Depression. J Pers Assess 2024:1-13. [PMID: 38776435 DOI: 10.1080/00223891.2024.2350466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Abstract
The Approach-Avoidance Temperament Questionnaire (ATQ) is a well-established measure assessing heightened sensitivity and reactivity to reward/positive stimuli (approach temperament) and to punishment/negative stimuli (avoidance temperament). These basic dimensions of personality are believed to be important for understanding the etiology and maintenance of anxiety and depressive disorders. Despite the ATQ's potential utility in clinical psychology research, its psychometric properties and factor structure have yet to be examined in a psychiatric sample. The aims of the present study were to 1) conduct confirmatory factor analysis to replicate the ATQ's factor structure in individuals diagnosed with an anxiety or depressive disorder (N = 244), 2) assess internal consistency and convergent and divergent validity, and 3) explore differences in approach and avoidance temperaments in individuals with versus without a diagnosis of anxiety or depression. Results confirmed the original two-factor structure of the ATQ in a clinical sample, with approach and avoidance temperaments representing orthogonal dimensions. The measure demonstrated strong internal consistency, convergent and divergent validity, and predictive validity. Individuals with anxiety and depression scored higher on avoidance items and lower on approach items compared to those without clinical diagnoses. This study supports the use of the ATQ in clinical populations.
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Affiliation(s)
- Madeleine Rassaby
- UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University
| | - Jeffrey M Rogers
- UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University
| | - Charles T Taylor
- UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University
- Department of Psychiatry, University of California San Diego, San Diego, California
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Müller-Bardorff M, Schulz A, Paersch C, Recher D, Schlup B, Seifritz E, Kolassa IT, Kowatsch T, Fisher A, Galatzer-Levy I, Kleim B. Optimizing Outcomes in Psychotherapy for Anxiety Disorders Using Smartphone-Based and Passive Sensing Features: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e42547. [PMID: 38743473 PMCID: PMC11134235 DOI: 10.2196/42547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/06/2022] [Accepted: 10/20/2022] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Psychotherapies, such as cognitive behavioral therapy (CBT), currently have the strongest evidence of durable symptom changes for most psychological disorders, such as anxiety disorders. Nevertheless, only about half of individuals treated with CBT benefit from it. Predictive algorithms, including digital assessments and passive sensing features, could better identify patients who would benefit from CBT, and thus, improve treatment choices. OBJECTIVE This study aims to establish predictive features that forecast responses to transdiagnostic CBT in anxiety disorders and to investigate key mechanisms underlying treatment responses. METHODS This study is a 2-armed randomized controlled clinical trial. We include patients with anxiety disorders who are randomized to either a transdiagnostic CBT group or a waitlist (referred to as WAIT). We index key features to predict responses prior to starting treatment using subjective self-report questionnaires, experimental tasks, biological samples, ecological momentary assessments, activity tracking, and smartphone-based passive sensing to derive a multimodal feature set for predictive modeling. Additional assessments take place weekly at mid- and posttreatment and at 6- and 12-month follow-ups to index anxiety and depression symptom severity. We aim to include 150 patients, randomized to CBT versus WAIT at a 3:1 ratio. The data set will be subject to full feature and important features selected by minimal redundancy and maximal relevance feature selection and then fed into machine leaning models, including eXtreme gradient boosting, pattern recognition network, and k-nearest neighbors to forecast treatment response. The performance of the developed models will be evaluated. In addition to predictive modeling, we will test specific mechanistic hypotheses (eg, association between self-efficacy, daily symptoms obtained using ecological momentary assessments, and treatment response) to elucidate mechanisms underlying treatment response. RESULTS The trial is now completed. It was approved by the Cantonal Ethics Committee, Zurich. The results will be disseminated through publications in scientific peer-reviewed journals and conference presentations. CONCLUSIONS The aim of this trial is to improve current CBT treatment by precise forecasting of treatment response and by understanding and potentially augmenting underpinning mechanisms and personalizing treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT03945617; https://clinicaltrials.gov/ct2/show/results/NCT03945617. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42547.
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Affiliation(s)
- Miriam Müller-Bardorff
- Experimental Psychopathology and Psychotherapy, Department of Psychiatry and Psychology, University of Zurich, Zurich, Switzerland
| | - Ava Schulz
- Experimental Psychopathology and Psychotherapy, Department of Psychiatry and Psychology, University of Zurich, Zurich, Switzerland
| | - Christina Paersch
- Experimental Psychopathology and Psychotherapy, Department of Psychiatry and Psychology, University of Zurich, Zurich, Switzerland
| | - Dominique Recher
- Experimental Psychopathology and Psychotherapy, Department of Psychiatry and Psychology, University of Zurich, Zurich, Switzerland
| | - Barbara Schlup
- Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Psychiatric University Hospital Zurich, Zurich, Switzerland
| | | | - Tobias Kowatsch
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Aaron Fisher
- Department of Psychology, University of California at Berkeley, Berkeley, CA, United States
| | | | - Birgit Kleim
- Experimental Psychopathology and Psychotherapy, Department of Psychiatry and Psychology, University of Zurich, Zurich, Switzerland
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Khazaie H, Rezaei F, Faridmarandi B, Zakiei A, Jananeh M, Mahdavi S, Nazari A, Komasi S. The sensitivity of the ICD-11 trait model to the symptoms of clinical disorders in young adults. Personal Ment Health 2024. [PMID: 38741371 DOI: 10.1002/pmh.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/25/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024]
Abstract
Hierarchical psychopathology contributes to providing a broader picture of the links between emerging personality structures such as the DSM-5/ICD-11 trait models and clinical disorders. The present study aimed to predict the specific and general clinical symptoms by the less studied constructs of the ICD-11 model (negative affectivity, detachment, dissociality, disinhibition, and anankastia). Data from 642 young adults from Iran (63% female, 18-34 years) were collected by three mental symptom scales and the Personality Inventory for DSM-5 (PID-5), which was recently used to harmonize the constructs of the DSM-5 and ICD-11 trait models. Multiple linear regressions showed that the ICD-11 model significantly predicted both the specific clinical symptoms (ranging from R2 = 0.15 to 0.40) and the general factor of clinical symptoms extracted by exploratory factor analysis (R2 = 0.40, all p < 0.001). Negative affectivity was the strongest construct correlated with both the specific symptoms (ranging from β = 0.36 to 0.69) and the general symptom factor (β = 0.59, all p < 0.001). Because the ICD-11 trait model is a practical structure related to the clinical psychopathology in young adults, screening for maladaptive traits can help clinicians in case formulation for diagnosis and treatment.
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Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzin Rezaei
- Roozbeh Hospital, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Behrooz Faridmarandi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Minoo Jananeh
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Sahar Mahdavi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Amin Nazari
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Saeid Komasi
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
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Tømmerås T, Backer-Grøndahl A, Høstmælingen A, Laland H, Gomez MB, Apeland A, Karlsson LRA, Grønlie AA, Torsvik S, Bringedal GE, Monica A, Fisher PA, Gardner F, Kjøbli J, Malmberg-Heimonen I, Nissen-Lie HA. Study protocol for a randomized controlled trial of supportive parents - coping kids (SPARCK)-a transdiagnostic and personalized parent training intervention to prevent childhood mental health problems. BMC Psychol 2024; 12:264. [PMID: 38741201 DOI: 10.1186/s40359-024-01765-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND To meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents - coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent-child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group). METHODS We describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with 252 families randomly allocated to SPARCK or UC. Assessment of key variables will be conducted at pre-, post-, and six-month follow-up. DISCUSSION The current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology. TRIAL REGISTRATION ClinicalTrials.gov ID: NTCT05800522.
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Affiliation(s)
- T Tømmerås
- Norwegian Center for Child Behavioral Development, Oslo, Norway.
| | | | - A Høstmælingen
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - H Laland
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - M B Gomez
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - A Apeland
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - L R A Karlsson
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - A A Grønlie
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - S Torsvik
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - G E Bringedal
- Norwegian Center for Child Behavioral Development, Oslo, Norway
| | - Aas Monica
- Norwegian Center for Child Behavioral Development, Oslo, Norway
- Social, Genetic and Developmental Psychiatry Centre, Psychology and Neuroscience, Kings College, London, UK
| | - Phillip Andrew Fisher
- Norwegian Center for Child Behavioral Development, Oslo, Norway
- Stanford University, Graduate School of Education, Stanford, US
| | - Frances Gardner
- Norwegian Center for Child Behavioral Development, Oslo, Norway
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - John Kjøbli
- Norwegian Center for Child Behavioral Development, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Ira Malmberg-Heimonen
- Norwegian Center for Child Behavioral Development, Oslo, Norway
- Oslo Metropolitan University, Faculty of Social Work, Oslo, Norway
| | - Helene Amundsen Nissen-Lie
- Norwegian Center for Child Behavioral Development, Oslo, Norway
- University of Oslo, Department of Psychology, Oslo, Norway
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Hoza B, Shoulberg EK. Transdiagnostic considerations are critical to understanding childhood neurodevelopmental disorders. Front Hum Neurosci 2024; 18:1385873. [PMID: 38774129 PMCID: PMC11106478 DOI: 10.3389/fnhum.2024.1385873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
Growing dissatisfaction with the current categorical diagnostic systems has led to a movement toward transdiagnostic dimensional approaches to assessment of childhood mental health disorders. We argue that a transdiagnostic approach is especially important and appropriate when screening for neurodevelopmental disorders during early childhood. In the early childhood years, symptoms often appear in the form of developmental delays that could portend a variety of different disorders. Early intervention at this point is critical, even though a final endpoint disorder is not yet apparent. Intervening early has the potential to grow the area of weakness, possibly correcting or at least ameliorating these delays. Early intervention requires a multidisciplinary approach integrating efforts across settings and providers that monitor the development of young children. We argue here that young children's language ability is central to the development of social cognition, and a prerequisite for adequate social functioning. Social deficits are defining features of a subset of neurodevelopmental disorders such as autism spectrum disorder and social (pragmatic) communication disorder. Critically, impairment in social functioning is common in additional neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD), learning disorders, and even motor disorders. For this reason, we argue that, at the earliest sign of a possible neurodevelopmental disorder, children should be screened for language deficits prior to initiating a focused assessment for a specific type of neurodevelopmental disorder such as ADHD. Any detected language deficits should be considered in the design and implementation of the assessment, as well as the ultimate intervention plan.
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Affiliation(s)
- Betsy Hoza
- Department of Psychological Science, University of Vermont, Burlington, VT, United States
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Alonso L, Peeva P, Fernández-del Valle Alquicira T, Erdelyi N, Gil Nolskog Á, Bader M, Winter Y, Alenina N, Rivalan M. Poor Decision Making and Sociability Impairment Following Central Serotonin Reduction in Inducible TPH2-Knockdown Rats. Int J Mol Sci 2024; 25:5003. [PMID: 38732220 PMCID: PMC11084943 DOI: 10.3390/ijms25095003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Serotonin is an essential neuromodulator for mental health and animals' socio-cognitive abilities. However, we previously found that a constitutive depletion of central serotonin did not impair rat cognitive abilities in stand-alone tests. Here, we investigated how a mild and acute decrease in brain serotonin would affect rats' cognitive abilities. Using a novel rat model of inducible serotonin depletion via the genetic knockdown of tryptophan hydroxylase 2 (TPH2), we achieved a 20% decrease in serotonin levels in the hypothalamus after three weeks of non-invasive oral doxycycline administration. Decision making, cognitive flexibility, and social recognition memory were tested in low-serotonin (Tph2-kd) and control rats. Our results showed that the Tph2-kd rats were more prone to choose disadvantageously in the long term (poor decision making) in the Rat Gambling Task and that only the low-serotonin poor decision makers were more sensitive to probabilistic discounting and had poorer social recognition memory than other low-serotonin and control individuals. Flexibility was unaffected by the acute brain serotonin reduction. Poor social recognition memory was the most central characteristic of the behavioral network of low-serotonin poor decision makers, suggesting a key role of social recognition in the expression of their profile. The acute decrease in brain serotonin appeared to specifically amplify the cognitive impairments of the subgroup of individuals also identified as poor decision makers in the population. This study highlights the great opportunity the Tph2-kd rat model offers to study inter-individual susceptibilities to develop cognitive impairment following mild variations of brain serotonin in otherwise healthy individuals. These transgenic and differential approaches together could be critical for the identification of translational markers and vulnerabilities in the development of mental disorders.
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Affiliation(s)
- Lucille Alonso
- Institut für Biologie, Humboldt-Universität zu Berlin, 10099 Berlin, Germany; (L.A.); (T.F.-d.V.A.); (Y.W.)
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany (M.B.)
- Univ. Bordeaux, CNRS, IINS, UMR 5297, F-33000 Bordeaux, France
| | - Polina Peeva
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
| | - Tania Fernández-del Valle Alquicira
- Institut für Biologie, Humboldt-Universität zu Berlin, 10099 Berlin, Germany; (L.A.); (T.F.-d.V.A.); (Y.W.)
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany (M.B.)
| | - Narda Erdelyi
- Institut für Biologie, Humboldt-Universität zu Berlin, 10099 Berlin, Germany; (L.A.); (T.F.-d.V.A.); (Y.W.)
| | - Ángel Gil Nolskog
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany (M.B.)
| | - Michael Bader
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany (M.B.)
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Institute for Biology, University of Lübeck, 23562 Lübeck, Germany
| | - York Winter
- Institut für Biologie, Humboldt-Universität zu Berlin, 10099 Berlin, Germany; (L.A.); (T.F.-d.V.A.); (Y.W.)
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany (M.B.)
| | - Natalia Alenina
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
| | - Marion Rivalan
- Institut für Biologie, Humboldt-Universität zu Berlin, 10099 Berlin, Germany; (L.A.); (T.F.-d.V.A.); (Y.W.)
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany (M.B.)
- NeuroPSI—Paris-Saclay Institute of Neuroscience, CNRS—Université Paris-Saclay, F-91400 Saclay, France
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Van den Bergh BRH, Antonelli MC, Stein DJ. Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation. Curr Opin Psychiatry 2024; 37:237-250. [PMID: 38415742 DOI: 10.1097/yco.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health. RECENT FINDINGS (1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse. SUMMARY During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.
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Affiliation(s)
| | - Marta C Antonelli
- Laboratorio de Programación Perinatal del Neurodesarrollo, Instituto de Biología Celular y Neurociencias "Prof.E. De Robertis", Facultad de Medicina. Universidad de Buenos Aires, Buenos Aires, Argentina
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Munich, Germany
| | - Dan J Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
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Antuña-Camblor C, Gómez-Salas FJ, Burgos-Julián FA, González-Vázquez A, Juarros-Basterretxea J, Rodríguez-Díaz FJ. Emotional Regulation as a Transdiagnostic Process of Emotional Disorders in Therapy: A Systematic Review and Meta-Analysis. Clin Psychol Psychother 2024; 31:e2997. [PMID: 38747373 DOI: 10.1002/cpp.2997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 05/21/2024]
Abstract
CONTEXT Several studies have shown that emotional regulation (ER) is a transdiagnostic construct of emotional disorders. Therefore, if therapy improves ER, it would improve psychological distress. OBJECTIVE This review assesses and compares the changes in ER due to psychological treatment in different therapies. METHODS A systematic review and meta-analysis of RCTs published in the databases PubMed, PsycINFO and Web of Science was performed. It was registered in PROSPERO under the number CRD42023387317. Two independent experts in the field reviewed the articles. RESULTS A total of 18 articles met the criteria for inclusion in the review. Analysis of these studies suggests that in unified protocol (UP), cognitive behaviour therapy, dialectical behaviour therapy (DBT) and mindfulness, there is evidence to support that a moderate effect occurs during treatment. Furthermore, in mindfulness and DBT, the effect was moderate in the follow-up period, while in UP, it was high. LIMITATIONS Given the heterogeneity of the applied interventions and the methodological limitations found in the reviewed trials, the results should be interpreted with caution. CONCLUSIONS UP, cognitive behaviour therapy, DBT and mindfulness can improve ER after therapy, while UP, DBT and mindfulness in the follow-up period. Other therapies, such as SKY or Flotation REST, require more research.
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Lloyd A, Roiser JP, Skeen S, Freeman Z, Badalova A, Agunbiade A, Busakhwe C, DeFlorio C, Marcu A, Pirie H, Saleh R, Snyder T, Fearon P, Viding E. Reviewing explore/exploit decision-making as a transdiagnostic target for psychosis, depression, and anxiety. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024:10.3758/s13415-024-01186-9. [PMID: 38653937 DOI: 10.3758/s13415-024-01186-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 04/25/2024]
Abstract
In many everyday decisions, individuals choose between trialling something novel or something they know well. Deciding when to try a new option or stick with an option that is already known to you, known as the "explore/exploit" dilemma, is an important feature of cognition that characterises a range of decision-making contexts encountered by humans. Recent evidence has suggested preferences in explore/exploit biases are associated with psychopathology, although this has typically been examined within individual disorders. The current review examined whether explore/exploit decision-making represents a promising transdiagnostic target for psychosis, depression, and anxiety. A systematic search of academic databases was conducted, yielding a total of 29 studies. Studies examining psychosis were mostly consistent in showing that individuals with psychosis explored more compared with individuals without psychosis. The literature on anxiety and depression was more heterogenous; some studies found that anxiety and depression were associated with more exploration, whereas other studies demonstrated reduced exploration in anxiety and depression. However, examining a subset of studies that employed case-control methods, there was some evidence that both anxiety and depression also were associated with increased exploration. Due to the heterogeneity across the literature, we suggest that there is insufficient evidence to conclude whether explore/exploit decision-making is a transdiagnostic target for psychosis, depression, and anxiety. However, alongside our advisory groups of lived experience advisors, we suggest that this context of decision-making is a promising candidate that merits further investigation using well-powered, longitudinal designs. Such work also should examine whether biases in explore/exploit choices are amenable to intervention.
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Affiliation(s)
- Alex Lloyd
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Ze Freeman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Aygun Badalova
- Institute of Neurology, University College London, London, UK
| | | | | | | | - Anna Marcu
- Young People's Advisor Group, London, UK
| | | | | | | | - Pasco Fearon
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK
| | - Essi Viding
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
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Thomson A, Lawrence EG, Oliver BR, Wright B, Hosang GM. Self-directed digital interventions for the improvement of emotion regulation-effectiveness for mental health and functioning in adolescents: protocol for a systematic review. BMJ Open 2024; 14:e081556. [PMID: 38658015 PMCID: PMC11043735 DOI: 10.1136/bmjopen-2023-081556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/29/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Research suggests that problems with emotion regulation, that is, how a person manages and responds to an emotional experience, are related to a range of psychological disorders (eg, bipolar disorder, anxiety and depression). Interventions targeting emotion regulation have been shown to improve mental health in adults, but evidence on related interventions for adolescents is still emerging. Increasingly, self-directed digital interventions (eg, mobile apps) are being developed to target emotion regulation in this population, but questions remain about their effectiveness. This systematic review aimed to synthesise evidence on current self-directed digital interventions available to adolescents (aged 11-18 years) and their effectiveness in addressing emotion regulation, psychopathology and functioning (eg, academic achievement). METHODS AND ANALYSIS Several electronic databases will be searched (eg, MEDLINE, PsycINFO, ACM Digital Library) to identify all studies published any time after January 2010 examining self-directed digital interventions for adolescents, which include an emotion regulation component. This search will be updated periodically to identify any new relevant research from the selected databases. Data on the study characteristics (eg, author(s)) and methodology, participant characteristics (eg, age) and the digital interventions used to address emotion (dys-)regulation (eg, name, focus) will be extracted. A narrative synthesis of all studies will be presented. If feasible, the effectiveness data will be synthesised using appropriate statistical techniques. The methodological quality of the included studies will be assessed with the Effective Public Health Practice Project quality assessment tool. ETHICS AND DISSEMINATION Ethical approval is not required for this study. Findings will be disseminated widely via peer-reviewed publications and presentations at conferences related to this field. REGISTRATION DETAILS PROSPERO CRD42022385547.
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Affiliation(s)
- Abigail Thomson
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Erin G Lawrence
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Bonamy R Oliver
- UCL Institute of Education, University College London, London, UK
| | - Ben Wright
- East London NHS Foundation Trust, London, UK
- City University of London, London, UK
| | - Georgina M Hosang
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Keidel K, Lu X, Suzuki S, Murawski C, Ettinger U. Association of temporal discounting with transdiagnostic symptom dimensions. NPJ MENTAL HEALTH RESEARCH 2024; 3:13. [PMID: 38627606 PMCID: PMC11021403 DOI: 10.1038/s44184-024-00060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/15/2024] [Indexed: 04/19/2024]
Abstract
Temporal discounting (TD), the tendency to devalue future rewards as a function of delay until receipt, is aberrant in many mental disorders. Identifying symptom patterns and transdiagnostic dimensions associated with TD could elucidate mechanisms responsible for clinically impaired decision-making and facilitate identifying intervention targets. Here, we tested in a general population sample (N = 731) the extent to which TD was related to different symptom patterns and whether effects of time framing (dates/delay units) and monetary magnitude (large/small) had particularly strong effects in people scoring higher on specific symptom patterns. Analyses revealed that TD was related to symptom patterns loading on anxious-depression and inattention-impulsivity-overactivity dimensions. Moreover, TD was lower in the date than the delay version and with higher magnitudes, especially in people scoring higher on the inattention-impulsivity-overactivity dimension. Overall, this study provides evidence for TD as a transdiagnostic process across affective and impulsivity-related dimensions. Future studies should test framing interventions in clinical populations characterized by impulsivity.Preregistration: This research was preregistered at https://osf.io/fg9sc .
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Affiliation(s)
- Kristof Keidel
- Department of Psychology, University of Bonn, Bonn, Germany
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Xiaping Lu
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Shinsuke Suzuki
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
- Faculty of Social Data Science, Hitotsubashi University, Tokyo, Japan
- HIAS Brain Research Center, Hitotsubashi University, Tokyo, Japan
| | - Carsten Murawski
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Bonn, Germany.
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Liow Y, Lazarus M, Loh V, Shorey S, Chee C, Young D, Valderas JM. Primary care physicians' perspectives on the identification and management of postnatal mental health problems. Fam Pract 2024; 41:185-193. [PMID: 38279950 DOI: 10.1093/fampra/cmae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Postnatal mental health problems (PMHPs) are prevalent and negatively affect mothers, children, and society. International and local guidelines recommend that Singapore primary care physicians (PCP) screen, assess, and manage mothers with PMHPs. However, little is known about their experiences and views. METHODS We conducted semi-structured interviews with 14 PCPs in Singapore. Interview questions elicited perspectives on the identification and management of mothers with PMHPs. The interview guide was developed from a conceptual framework incorporating the knowledge-attitudes-practices, self-efficacy, and socio-ecological models. Interviews were audio-recorded and transcribed. Thematic analysis was used to identify emergent themes. RESULTS Singapore PCPs viewed themselves as key providers of first-contact care to mothers with PMHPs. They believed mothers preferred them to alternative providers because of greater accessibility and trust. In detection, they were vigilant in identifying at-risk mothers and favoured clinical intuition over screening tools. PCPs were confident in diagnosing common PMHPs and believed that mothers not meeting diagnostic criteria must be readily recognized and supported. In managing PMHPs, PCPs expressed varying confidence in prescribing antidepressants, which were viewed as second-line to supportive counselling and psychoeducation. Impeding physician factors, constraining practice characteristics and health system limitations were barriers. Looking forward, PCPs aspired to leverage technology and multidisciplinary teams to provide comprehensive, team-based care for the mother-child dyad. CONCLUSION Singapore PCPs are key in identifying and managing mothers with PMHPs. To fully harness their potential in providing comprehensive care, PCPs need greater multidisciplinary support and technological solutions that promote remote disclosure and enhanced preparation for their role.
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Affiliation(s)
- Yiyang Liow
- National University Polyclinics, National University Health System, Singapore
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Monica Lazarus
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Victor Loh
- National University Polyclinics, National University Health System, Singapore
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cornelia Chee
- Department of Psychological Medicine, National University Hospital, National University Health System, Singapore
| | - Doris Young
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jose M Valderas
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Wang P, Wang Z, Qiu S. Universal, school-based transdiagnostic interventions to promote mental health and emotional wellbeing: a systematic review. Child Adolesc Psychiatry Ment Health 2024; 18:47. [PMID: 38600562 PMCID: PMC11007989 DOI: 10.1186/s13034-024-00735-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE This systematic review aims to evaluate the effectiveness of universal school-based transdiagnostic interventions in promoting the mental health of children and adolescents. It compares and discusses interventions targeting the prevention of mental disorders versus the promotion of mental health. Additionally, the roles of teachers and psychologists as intervention conductors are examined. METHODS A comprehensive search of the Psycinfo, Pubmed, and Web of Science databases was conducted without any time restrictions to identify relevant literature on universal school-based transdiagnostic interventions promoting children and adolescents' mental health. RESULTS AND DISCUSSION The findings reveal that universal school-based transdiagnostic promotion/prevention programs have a small to medium overall effect size. These interventions demonstrate a broad coverage of different aspects of children and adolescents' mental health. However, the relative effectiveness of teacher-led versus psychologist-led interventions remains unclear. Interventions focused on preventing mental disorders exhibit a higher effect size, albeit on a narrower range of mental health aspects for children and adolescents. SIGNIFICANCE This study enhances our understanding of universal school-based transdiagnostic interventions and their impact on children and adolescents' mental health. Further research is needed to elucidate the comparative efficacy of teacher-led and psychologist-led interventions and to explore the specific dimensions of mental health targeted by these interventions.
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Affiliation(s)
- Peng Wang
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK.
- Department of Language, Literature and Communication, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands.
| | - Zhaoqi Wang
- School of Foreign Studies, China University of Petroleum, Qingdao City, China
| | - Shuiwei Qiu
- Department of Cardiothoracic Surgery, Quzhou People's Hospital, Quzhou City, China
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Brancart X, Rossi G, Dierckx E, De Vos I, De Raedt R. Temperament Based Personality Types in Community-Dwelling Older Adults: A Latent Profile Analysis. Psychol Belg 2024; 64:24-41. [PMID: 38618169 PMCID: PMC11012024 DOI: 10.5334/pb.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/08/2024] [Indexed: 04/16/2024] Open
Abstract
Three adaptive trait-based personality types have been replicated across ages, cultures, clinical problems and clustering methods: Resilient, Undercontrolled and Overcontrolled type (RUO). Recently there is growing interest in and importance of biopsychosocial transdiagnostic factors underlying personality types, such as temperamental reactivity and self-regulation. Latter can be understood in terms of Behavioural Inhibition (BIS), Behavioural Activation Systems (BAS) and Effortful Control (EC). The occurrence of temperament based RUO types has not yet been confirmed in older adults with or without a mental disorder. Therefore, based on a person-centered approach, the current study investigates whether RUO types can be corroborated in older adults based on the aforementioned temperamental factors. Latent profile analysis yielded two distinct personality profiles in community-dwelling over-60s, which we tentatively labeled a resilient (n = 167) and overcontrolled/inhibited type (n = 241). Compared to the resilient type, the overcontrolled/inhibited type scored lower on EC and higher on BIS. We could not corroborate an undercontrolled type (profiles scored equally on BAS). Group comparisons revealed that overcontrolled/inhibited older adults demonstrated significantly more clinical symptoms, higher emotional instability, lower scores on adaptive traits, less resilience and were significantly more likely to use passive and avoidant coping styles, compared to resilient older adults.
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Affiliation(s)
- Xenia Brancart
- Xenia Brancart Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology research group (PEPS), Brussels, Belgium
- Ghent University (UG), Department of Experimental Clinical and Health Psychology, Ghent, Belgium
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
| | - Gina Rossi
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology research group (PEPS), Brussels, Belgium
| | - Eva Dierckx
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology research group (PEPS), Brussels, Belgium
- Alexianen Zorggroep Tienen (AZT), Psychiatric Hospital, Tienen, Belgium
| | - Indra De Vos
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
| | - Rudi De Raedt
- Ghent University (UG), Department of Experimental Clinical and Health Psychology, Ghent, Belgium
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
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48
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Ramos-Vera C, García O'Diana A, Basauri-Delgado M, Calizaya-Milla YE, Saintila J. Network analysis of anxiety and depressive symptoms during the COVID-19 pandemic in older adults in the United Kingdom. Sci Rep 2024; 14:7741. [PMID: 38565592 PMCID: PMC10987576 DOI: 10.1038/s41598-024-58256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/27/2024] [Indexed: 04/04/2024] Open
Abstract
The health crisis caused by COVID-19 in the United Kingdom and the confinement measures that were subsequently implemented had unprecedented effects on the mental health of older adults, leading to the emergence and exacerbation of different comorbid symptoms including depression and anxiety. This study examined and compared depression and anxiety symptom networks in two specific quarantine periods (June-July and November-December) in the older adult population in the United Kingdom. We used the database of the English Longitudinal Study of Aging COVID-19 Substudy, consisting of 5797 participants in the first stage (54% women) and 6512 participants in the second stage (56% women), all over 50 years of age. The symptoms with the highest centrality in both times were: "Nervousness (A1)" and "Inability to relax (A4)" in expected influence and predictability, and "depressed mood (D1"; bridging expected influence). The latter measure along with "Irritability (A6)" overlapped in both depression and anxiety clusters in both networks. In addition, a the cross-lagged panel network model was examined in which a more significant influence on the direction of the symptom "Nervousness (A1)" by the depressive symptoms of "Anhedonia (D6)", "Hopelessness (D7)", and "Sleep problems (D3)" was observed; the latter measure has the highest predictive capability of the network. The results report which symptoms had a higher degree of centrality and transdiagnostic overlap in the cross-sectional networks (invariants) and the cross-lagged panel network model of anxious and depressive symptomatology.
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Affiliation(s)
| | | | | | | | - Jacksaint Saintila
- Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru.
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Dafsari FS, Bewernick B, Böhringer S, Domschke K, Elsaesser M, Löbner M, Luppa M, Schmitt S, Wingenfeld K, Wolf E, Zehender N, Hellmich M, Müller W, Wagner M, Peters O, Frölich L, Riedel-Heller S, Schramm E, Hautzinger M, Jessen F. Perceived Physical Health and Cognitive Behavioral Therapy vs Supportive Psychotherapy Outcomes in Adults With Late-Life Depression: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2024; 7:e245841. [PMID: 38619842 PMCID: PMC11019392 DOI: 10.1001/jamanetworkopen.2024.5841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/06/2024] [Indexed: 04/16/2024] Open
Abstract
Importance Physical diseases co-occur with late-life depression (LLD). The influence of physical diseases and the subjective perception of physical health (PPH) on treatment outcome in LLD, however, is not well understood. Objective To assess the association of physical diseases and PPH with the outcomes of 2 different types of psychotherapy in LLD. Design, Setting, and Participants This post hoc secondary analysis of a multicenter, observer-blinded, controlled, parallel-group randomized clinical trial assessed participants 60 years or older with moderate to severe depression recruited at 7 psychiatric-psychotherapeutic outpatient trial sites in Germany from October 1, 2018, to November 11, 2020. Data analysis was performed from April 1 to October 31, 2023. Interventions Patients received LLD-specific cognitive behavioral therapy (LLD-CBT) or supportive unspecific intervention (SUI). Main Outcomes and Measures Depression severity, response, and remission were measured during treatment and at 6-month follow-up by the change in the 30-item Geriatric Depression Scale (GDS) score. Physical health and PPH were assessed by the number of physical diseases, Charlson Comorbidity Index (CCI), and the World Health Organization Quality of Life Brief Version physical health subscale. Results A total of 251 patients were randomized to LLD-CBT (n = 126) or SUI (n = 125), of whom 229 (mean [SD] age, 70.2 [7.1] years; 151 [66%] female) were included in the intention-to-treat analysis. Patients with low and moderate PPH at baseline had significantly less reduction in the GDS score across both treatment groups than patients with high PPH (estimated marginal mean difference [EMMD], 2.67; 95% CI, 0.37-4.97; P = .02 for low PPH and EMMD, 1.82; 95% CI, 0.22-3.42; P = .03 for moderate vs high PPH). Higher PPH at baseline was associated with higher likelihood of response (odds ratio [OR], 1.04; 95% CI, 1.00-1.06; P = .009) and remission at the end of treatment (OR, 1.04; 95% CI, 1.02-1.08; P = .002) and response (OR, 1.05; 95% CI, 1.02-1.08; P < .001) and remission at follow-up (OR, 1.06; 95% CI, 1.03-1.10; P < .001) across both treatment groups. However, a significant interaction of PPH with treatment group was observed with low PPH at baseline being associated with significantly larger reduction in GDS scores in SUI compared with LLD-CBT at the end of treatment (EMMD, -6.48; 95% CI, -11.31 to -1.64; P = .009) and follow-up (EMMD, -6.49; 95% CI, -11.51 to -1.47; P = .01). In contrast, patients with high PPH at baseline had a significantly greater reduction in GDS scores in LLD-CBT compared with SUI at all time points (week 5: EMMD, -4.08; 95% CI, -6.49 to -1.67; P = .001; end-of-treatment: EMMD, -3.67; 95% CI, -6.72 to -0.61; P = .02; and follow-up: EMMD, -3.57; 95% CI, -6.63 to -0.51; P = .02). The number of physical diseases or CCI at baseline did not have an effect on the change in GDS score, response, or remission, neither across both groups nor within either group. Conclusions and Relevance In this secondary analysis of a randomized clinical trial, subjective PPH was associated with treatment outcome, response, and remission in psychotherapy of LLD. Patients with LLD responded differently to LLD-CBT and SUI, depending on their baseline PPH score. Treatment approaches for patients with LLD should address PPH in personalized interventions. Trial Registration ClinicalTrials.gov Identifier: NCT03735576; Deutsches Register Klinischer Studien Identifier: DRKS00013769.
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Affiliation(s)
- Forugh S. Dafsari
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, and University Hospital Cologne, Cologne, Germany
| | - Bettina Bewernick
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Sabine Böhringer
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, and University Hospital Cologne, Cologne, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Moritz Elsaesser
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Sandra Schmitt
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Elena Wolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, and University Hospital Cologne, Cologne, Germany
| | - Nadine Zehender
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Wiebke Müller
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Disease, Bonn, Germany
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martin Hautzinger
- Department of Clinical Psychology and Psychotherapy, Eberhard Karls University, Tübingen, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, and University Hospital Cologne, Cologne, Germany
- German Center for Neurodegenerative Disease, Bonn, Germany
- Cellular Stress Response in Aging-Associated Diseases Cluster of Excellence, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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50
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DelPozo-Banos M, Stewart R, John A. Machine learning in mental health and its relationship with epidemiological practice. Front Psychiatry 2024; 15:1347100. [PMID: 38528983 PMCID: PMC10961376 DOI: 10.3389/fpsyt.2024.1347100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Affiliation(s)
| | - Robert Stewart
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Ann John
- Swansea University Medical School, Swansea, United Kingdom
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