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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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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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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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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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Harris J, Loth E, Sethna V. Tracing the paths: a systematic review of mediators of complex trauma and complex post-traumatic stress disorder. Front Psychiatry 2024; 15:1331256. [PMID: 38510809 PMCID: PMC10951104 DOI: 10.3389/fpsyt.2024.1331256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Complex trauma is associated with complex-posttraumatic stress disorder (CPTSD). While dissociative processes, developmental factors and systemic factors are implicated in the development of CPTSD, there are no existing systematic reviews examining the underlying pathways linking complex trauma and CPTSD. This study aims to systematically review evidence of mediating factors linking complex trauma exposure in childhood (birth to eighteen years of age) and subsequent development of CPTSD (via self-reports and diagnostic assessments). All clinical, at-risk and community-sampled articles on three online databases (PsycINFO, MedLine and Embase) were systematically searched, along with grey literature from ProQuest. Fifteen articles were eligible for inclusion according to pre-determined eligibility criteria and a search strategy. Five categories of mediating processes were identified: 1) dissociative processes; 2) relationship with self; 3) emotional developmental processes; 4) social developmental processes; and 5) systemic and contextual factors. Further research is required to examine the extent to which targeting these mediators may act as mechanisms for change in supporting individuals to heal from complex trauma. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022346152.
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Affiliation(s)
- Joseph Harris
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Science, School of Academic Psychiatry, King’s College London, London, England, United Kingdom
| | - Vaheshta Sethna
- Department of Social, Genetic & Developmental Psychiatry Centre, School of Mental Health & Psychological Sciences, King’s College London, London, England, United Kingdom
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Mena MP, Lazarus RA, Otero KA, Santisteban DA. Evaluation of Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) implemented in community-based settings. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:363-381. [PMID: 38093644 PMCID: PMC11425153 DOI: 10.1002/jcop.23099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 10/20/2023] [Accepted: 11/16/2023] [Indexed: 02/10/2024]
Abstract
Effective family-based interventions are needed for youth who are experiencing emotional and behavioral difficulties and who are impacted by powerful environmental stressors. Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) is a manualized and evidence-based, multicomponent family-based treatment that has been shown to be efficacious in research settings. The purpose of this paper is to report on the effectiveness of implementing CIFFTA for the treatment of Latino and Black youth and families in community settings. Utilization of services offered and changes in youth presenting problems and family functioning were used to evaluate the program. Two hundred thirty-two youth (11-18 years of age) and their caregivers were recruited over 2 years and CIFFTA was delivered by experienced masters-level family therapists over a 12-16-week period. Seventy-six percent met the 8-session criteria for retention in treatment and 71% completed treatment. Results showed significant improvements in youth behavioral and emotional presenting problems, reduction in family conflict and improvement in family cohesion and communication. Caregiver well-being such as reductions in parental stress, relational frustration, and improvement in parental confidence also showed significant improvement. Analyses of reliable change indices showed a substantial improvement in youth who entered the program in the clinical range of presenting problems. The findings point to CIFFTA's ability to retain youth and families who tend to underutilize needed services, to significant reductions in presenting problems, and to improvements in family functioning when implemented in a community setting.
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Affiliation(s)
- Maite P. Mena
- School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
| | - Rebecca A. Lazarus
- School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
| | - Kristal A. Otero
- School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
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Evans SC, Karlovich AR, Khurana S, Edelman A, Buza B, Riddle W, López-Sosa D. Evidence Base Update on the Assessment of Irritability, Anger, and Aggression in Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:277-308. [PMID: 38275270 PMCID: PMC11042996 DOI: 10.1080/15374416.2023.2292041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Irritability, anger, and aggression have garnered significant attention from youth mental health researchers and clinicians; however, fundamental challenges of conceptualization and measurement persist. This article reviews the evidence base for assessing these transdiagnostic constructs in children and adolescents. METHOD We conducted a preregistered systematic review of the evidence behind instruments used to measure irritability, anger, aggression, and related problems in youth. Searches were conducted in PsycINFO and PubMed, identifying 4,664 unique articles. Eligibility criteria focused on self- and proxy-report measures with peer-reviewed psychometric evidence from studies in English with youths ages 3-18. Additional measures were found through ancillary search strategies (e.g. book chapters, review articles, test publishers). Measures were screened and coded by multiple raters with acceptable reliability. RESULTS Overall, 68 instruments met criteria for inclusion, with scales covering irritability (n = 15), anger (n = 19), aggression (n = 45), and/or general overt externalizing problems (n = 27). Regarding overall psychometric support, 6 measures (8.8%) were classified as Excellent, 46 (67.6%) were Good, and 16 (23.5%) were Adequate. Descriptive information (e.g. informants, scales, availability, translations) and psychometric properties (e.g. reliability, validity, norms) are summarized. CONCLUSIONS Numerous instruments for youth irritability, anger, and aggression exist with varying degrees of empirical support for specific applications. Although some measures were especially strong, none had uniformly excellent properties across all dimensions, signaling the need for further research in particular areas. Findings promote conceptual clarity while also producing a well-characterized toolkit for researchers and clinicians addressing transdiagnostic problems affecting youth.
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Affiliation(s)
- Spencer C. Evans
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Sakshi Khurana
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Department of Psychology, Harvard University, Cambridge, MA, USA
- College of Education, DePaul University, Chicago, IL, USA
| | - Audrey Edelman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Bianca Buza
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - William Riddle
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Denise López-Sosa
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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McCarthy MJ, Wicker A, Roddy J, Remiker M, Roy I, McCoy M, Cerino ES, Baldwin J. Feasibility and utility of mobile health interventions for depression and anxiety in rural populations: A scoping review. Internet Interv 2024; 35:100724. [PMID: 38352194 PMCID: PMC10863305 DOI: 10.1016/j.invent.2024.100724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Despite the potential of mobile health (mHealth) to address high rates of depression and anxiety in underserved rural communities, most mHealth interventions do not explicitly consider the realities of rural life. The aim of this scoping review is to identify and examine the available literature on mHealth interventions that consider the needs of rural populations in order to gauge their feasibility and utility for addressing depression and anxiety. Additionally, we provide an overview of rural users' perceptions about and preferences for mHealth-delivered mental health screening and intervention systems. Out of 169 articles identified, 16 met inclusion criteria. Studies were conducted across a wide range of countries, age groups, and rural subpopulations including individuals with bipolar disorder, anxiety, perinatal depression, PTSD, and chronic pain, as well as refugees, veterans, and transgender and LGBTQ+ individuals. All interventions were in the feasibility/acceptability testing stage for rural users. Identified strengths included their simplicity, accessibility, convenience, availability of support between sessions with providers, and remote access to a care team. Weaknesses included problems with charging phone batteries and exceeding data limits, privacy concerns, and general lack of comfort with app-based support. Based upon this review, we provide recommendations for future mHealth intervention development including the value of developer-user coproduction methods, the need to consider user variation in access to and comfort with smartphones, and potential data or connectivity limitations, mental health stigma, and confidentiality concerns in rural communities.
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Affiliation(s)
- Michael J. McCarthy
- Department of Social Work, Northern Arizona University, 19 W McConnell Dr., Flagstaff, AZ 86011, United States of America
| | - Alexandra Wicker
- Department of Psychological Sciences, Northern Arizona University, 1100 S Beaver St., Flagstaff, AZ 86011, United States of America
| | - Juliette Roddy
- Department of Criminology & Criminal Justice, Northern Arizona University, 5 E McConnell Dr., Flagstaff, AZ 86011, United States of America
| | - Mark Remiker
- Center for Health Equity Research, Northern Arizona University, 1395 Knoles Drive, Flagstaff, AZ 86011, United States of America
| | - Indrakshi Roy
- Center for Health Equity Research, Northern Arizona University, 1395 Knoles Drive, Flagstaff, AZ 86011, United States of America
| | - Megan McCoy
- Department of Social Work, Northern Arizona University, 19 W McConnell Dr., Flagstaff, AZ 86011, United States of America
| | - Eric S. Cerino
- Department of Psychological Sciences, Northern Arizona University, 1100 S Beaver St., Flagstaff, AZ 86011, United States of America
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, 1395 Knoles Drive, Flagstaff, AZ 86011, United States of America
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Frewen P, Vincent A, Olff M. Childhood trauma histories in men and women assessed by the childhood attachment and relational trauma screen (CARTS) and the global psychotrauma screen (GPS): Results from the global collaboration on traumatic stress (GC-TS). CHILD ABUSE & NEGLECT 2024; 149:106610. [PMID: 38184904 DOI: 10.1016/j.chiabu.2023.106610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Whether there are biological sex differences in rates of childhood trauma exposure perpetrated by female versus male biological parents remains largely unknown. Moreover, the relative risk posed by various vulnerability factors for transdiagnostic mental health outcomes among females vs. males in adulthood has received insufficient attention. OBJECTIVE To compare biological sex differences in the long-term impact of childhood abuse and neglect on transdiagnostic mental health outcomes, especially comparing the outcomes of childhood maltreatment perpetrated by biological mothers vs. fathers. PARTICIPANTS AND SETTING 3129 participants (2784 female [89 %]) were recruited online, the majority (82 %) of whom endorsed having a childhood trauma history and a high number of mental health problems. METHODS Online surveys were administered. Specifically, the Childhood Attachment and Relational Trauma Screen (CARTS) was completed as a relationally-contextualized screening measure of both positive and traumatic-neglectful experiences during childhood, comparing severity of perpetration by male vs. female biological parents. Further, the Global Psychotrauma Screen (GPS) was completed to assess the relative risk of five vulnerability factors, including childhood abuse and neglect, for long-term transdiagnostic mental health outcomes. Statistical analyses elucidate group differences between males and females primarily by way of t-tests and associated effect sizes (Cohen's d). RESULTS Biological sex differences were shown for childhood maltreatment perpetration by male vs. female biological parents, wherein responses to CARTS showed that females reported that their biological mothers exhibited less positivity (d = 0.21), less attachment security (d = 0.22), more negative feelings toward them (d = 0.28), were more emotionally abusive (d = 0.17), and held more negative relational beliefs about them (d = 0.24). Comparably, males reported that their biological fathers were more physically abusive (d = 0.15) and that they held more negative relational beliefs toward their fathers (d = 0.25). Risk factors including having a history of childhood trauma and neglect were associated with transdiagnostic mental health problems among both females (d = 0.57) and males (d = 0.46), with other risk factors evidencing similar results. CONCLUSIONS Childhood trauma and neglect is a risk factor for transdiagnostic mental health outcomes among both females and males, although the two biological sexes may exhibit different levels of risk of being maltreated by female and male biological parents. Specifically, females reported having more emotionally abusive biological mothers, while males reported having more physically abusive biological fathers.
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Affiliation(s)
- Paul Frewen
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada; Department of Psychology, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada.
| | - Andrew Vincent
- Department of Psychology, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada
| | - Miranda Olff
- Amsterdam University Medical Centers, University of Amsterdam, ARQ National Psychotrauma Center, The Netherlands, 1012 WX Amsterdam, Netherlands
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72
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Cao C, Chen M, Yang S, Xu Y, Gu J. Childhood maltreatment, multilocus HPA-axis genetic variation and adolescent comorbidity profiles of depressive and anxiety symptoms. CHILD ABUSE & NEGLECT 2024; 149:106683. [PMID: 38335561 DOI: 10.1016/j.chiabu.2024.106683] [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: 06/29/2023] [Revised: 01/21/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Despite a growing body of evidence showing both genetic and environmental influences on adolescent depression and anxiety, the involved comorbid mechanisms regarding gene-by-environment (G × E) interaction remain unclear. OBJECTIVE The current study was the first to investigate the extent to which multilocus hypothalamic-pituitary-adrenal (HPA)-axis genetic variants moderated the association between childhood maltreatment and adolescent comorbid depression and anxiety. METHODS The participants were 827 Chinese Han adolescents (Mage = 16.45 ± 1.37 years; 50.2 % girls). A theory-driven multilocus genetic profile score (MGPS) was computed by calculating alleles of core HPA-axis genes (CRHR1, NR3C1, NR3C2, and FKBP5) associated with heightened stress reactivity. Childhood maltreatment was retrospectively collected using Childhood Trauma Questionnaire. Comorbidity profiles of self-reported adolescent depressive and anxiety symptoms were constructed via person-centered latent profile analysis. RESULTS Three heterogeneous comorbidity profiles of depressive and anxiety symptoms were identified: comorbid severe symptoms (9.7 %), comorbid moderate symptoms (46.4 %) and comorbid mild symptoms (43.9 %). The HPA-axis related MGPS significantly interacted with childhood maltreatment, especially emotional maltreatment (emotional abuse: OR = 1.14, 95 % CI [1.03, 1.26], p < .01; emotional neglect: OR = 1.07, 95 % CI [1.01, 1.13], p < .05), to distinguish the comorbid severe symptoms profile from the comorbid mild symptoms profile (OR = 1.03, 95 % CI [1.01, 1.06], p < .05). CONCLUSION The HPA-axis related genes showed an additive polygenic sensitivity toward childhood maltreatment, which might be one of the polygenic G × E mechanisms underlying adolescent comorbid depression and anxiety.
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Affiliation(s)
- Cong Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Meijing Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shan Yang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yajing Xu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Junlian Gu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Wierenga LM, Ruigrok A, Aksnes ER, Barth C, Beck D, Burke S, Crestol A, van Drunen L, Ferrara M, Galea LAM, Goddings AL, Hausmann M, Homanen I, Klinge I, de Lange AM, Geelhoed-Ouwerkerk L, van der Miesen A, Proppert R, Rieble C, Tamnes CK, Bos MGN. Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100283. [PMID: 38312851 PMCID: PMC10837069 DOI: 10.1016/j.bpsgos.2023.100283] [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: 05/11/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 02/06/2024] Open
Abstract
There are prominent sex/gender differences in the prevalence, expression, and life span course of mental health and neurodiverse conditions. However, the underlying sex- and gender-related mechanisms and their interactions are still not fully understood. This lack of knowledge has harmful consequences for those with mental health problems. Therefore, we set up a cocreation session in a 1-week workshop with a multidisciplinary team of 25 researchers, clinicians, and policy makers to identify the main barriers in sex and gender research in the neuroscience of mental health. Based on this work, here we provide recommendations for methodologies, translational research, and stakeholder involvement. These include guidelines for recording, reporting, analysis beyond binary groups, and open science. Improved understanding of sex- and gender-related mechanisms in neuroscience may benefit public health because this is an important step toward precision medicine and may function as an archetype for studying diversity.
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Affiliation(s)
- Lara Marise Wierenga
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Amber Ruigrok
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Eira Ranheim Aksnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dani Beck
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Sarah Burke
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lina van Drunen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Maria Ferrara
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Liisa Ann Margaret Galea
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Lise Goddings
- University College London Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Markus Hausmann
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Inka Homanen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Ineke Klinge
- Dutch Society for Gender & Health, the Netherlands
- Gendered Innovations at European Commission, Brussels, Belgium
| | - Ann-Marie de Lange
- Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Lineke Geelhoed-Ouwerkerk
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Anna van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ricarda Proppert
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Carlotta Rieble
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Christian Krog Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Marieke Geerte Nynke Bos
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
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Moll K. Editorial: Thinking outside the box - enhancing causal models of neurodevelopmental disorders. J Child Psychol Psychiatry 2024; 65:257-259. [PMID: 38328988 DOI: 10.1111/jcpp.13928] [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] [Accepted: 12/04/2023] [Indexed: 02/09/2024]
Abstract
Neurodevelopmental disorders are best conceptualised as the result of multiple risk factors, which accumulate and determine the likelihood of reaching the threshold for fulfilling agreed diagnostic criteria. This multiple-risk framework allows the inclusion of research findings focusing on single disorders, while highlighting the need for extending and specifying existing causal models. Such specifications need to address at least three challenges: First, causal models need to account for the heterogeneity of symptoms within neurodevelopmental disorders, the dissociations between disorders, and also the high comorbidity rates observed between them. Second, causal models need to take into account the fact that associations between risk factors and psychopathology may be developmentally conditioned and are likely to change over time. Third, causal models need to incorporate a better understanding of the causal pathways between neurobiological risk factors and their interaction with environmental risk factors. Several articles in the present issue address these challenges, by assessing the interplay between neurobiological and environmental risk factors, and their impact on psychopathology, and by investigating how this relationship changes over time.
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Affiliation(s)
- Kristina Moll
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, Ludwig-Maximilans-University Munich, Munich, Germany
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75
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Shu Y, Ao N, Wen X, Cui Z, Qu D, Chen R. The p factor outweighs the specific internalizing factor in predicting recurrences of adolescent depression. Eur Psychiatry 2024; 67:e28. [PMID: 38425212 PMCID: PMC10988157 DOI: 10.1192/j.eurpsy.2024.18] [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: 08/21/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The early prediction of adolescent depression recurrence poses a significant challenge in the field. This study aims to investigate and compare the abilities of the general psychopathology factor (p) and the specific internalizing factor, in predicting depression recurrence over a 2-year course, as well as identifying remitted depressed adolescents from healthy adolescents. Longitudinal changes of these two factors in different trajectory groups were also tracked to examine their sensitivity to sustained remission and relapse. METHODS We included 255 baseline-remitted depressed adolescents and a healthy control group (n = 255) matched in age, sex, and race, sourced from the Adolescent Brain Cognitive Development Study. The linear mixed model was employed for the statistical analysis. RESULTS The p factor not only effectively discriminated between remitted depressed adolescents and healthy controls but also robustly predicted the depression recurrence over a subsequent 2-year course. The specific internalizing factor could only differentiate remitted depressed adolescents from healthy controls. Additionally, a noteworthy longitudinal decline of the p factor in the sustained-remission group was observed. CONCLUSIONS Psychopathology factors serve as the inherent and enduring measurement of long-term mental health aberrations. Longitudinal results indicate that the p factor is more sensitive to respond to sustained remission than the internalizing factor. The ability of the overall p factor to anticipate depression relapse, unlike the specific internalizing factor, suggests the clinical interventions should monitor and mitigate the coincident symptoms across all dimensions to preempt relapse of adolescent depression, rather than an exclusive focus on internalizing symptoms.
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Affiliation(s)
- Yinuo Shu
- Chinese Institute for Brain Research, Beijing, China
| | - Na Ao
- Chinese Institute for Brain Research, Beijing, China
| | - Xue Wen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zaixu Cui
- Chinese Institute for Brain Research, Beijing, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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76
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Blais MA, Kelley SE, Ruchensky JR, Richardson LA, Massey C, Stein MB. Deriving the Transdiagnostic Scales From the Personality Assessment Inventory and SPECTRA: Indices of Psychopathology: A Demonstration. Clin Psychol Psychother 2024; 31:e2967. [PMID: 38572780 DOI: 10.1002/cpp.2967] [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: 10/05/2023] [Revised: 12/21/2023] [Accepted: 02/21/2024] [Indexed: 04/05/2024]
Abstract
Transdiagnostic models of psychopathology address many of the shortcomings common to categorical diagnostic systems. These empirically derived models conceptualize psychopathology as a few broad interrelated and hierarchically arranged dimensions, with an overarching general psychopathology dimension, the p-factor, at the apex. While transdiagnostic models are gaining prominence in mental health research, the lack of available tools has limited their clinical translation. The present study explored the potential of creating transdiagnostic scales from the joint factor structure of the Personality Assessment Inventory, Alternative Model of Personality Disorder trait scales (AMPD), and the clinical scales of the SPECTRA: Indices of Psychopathology (SPECTRA). Exploratory factor analysis in a clinical sample (n = 212) identified five factors corresponding to the Negative Affect/Internalizing, Detachment, Antagonism/Externalizing, Disinhibition/Externalizing, and Thought Disorder transdiagnostic dimensions. Goldberg's "Bass-Ackward" method supported a hierarchical structure. Five composite transdiagnostic scales were created by summing each factor's highest loading PAI and SPECTRA scales. A global psychopathology scale was created by summing the five composite scales. All the composite scales demonstrated adequate internal consistency. Correlations between the composite scales and the NEO Five-Factor Inventory-3 provide initial validity evidence for four composite and global scales. The composite thought disorder scale had no conceptually corresponding NEO domain. Clinical implications and study limitations are discussed.
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Affiliation(s)
- Mark A Blais
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Shannon E Kelley
- Department of Clinical Psychology, William James College, Newton, Massachusetts, USA
| | - Jared R Ruchensky
- Department of Psychology & Philosophy, Sam Houston State University, Huntsville, Texas, USA
| | - Laura A Richardson
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Christina Massey
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Michelle B Stein
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Evans SC, Burke JD. The Affective Side of Disruptive Behavior: Toward Better Understanding, Assessment, and Treatment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:141-155. [PMID: 38656139 DOI: 10.1080/15374416.2024.2333008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Historically, much of the progress made in youth mental health research can be classified as focusing on externalizing problems, characterized by disruptive behavior (e.g. aggression, defiance), or internalizing problems, characterized by intense negative affect (e.g. depression, anxiety). Until recently, however, less attention has been given to topics that lie somewhere in between these domains, topics that we collectively refer to as the affective side of disruptive behavior. Like the far side of the moon, the affective side of disruptive behavior captures facets of the phenomenon that may be less obvious or commonly overlooked, but are nonetheless critical to understand. This affective side clarifies socially disruptive aspects of traditionally "externalizing" behavior by elucidating proximal causation via intense negative affect (traditionally "internalizing"). Such problems include irritability, frustration, anger, temper loss, emotional outbursts, and reactive aggression. Given a recent explosion of research in these areas, efforts toward integration are now needed. This special issue was developed to help address this need. Beyond the present introductory article, this collection includes 4 empirical articles on developmental psychopathology topics, 4 empirical articles on applied treatment/assessment topics, 1 evidence base update review article on measurement, and 2 future directions review articles concerning outbursts, mood, dispositions, and youth psychopathology more broadly. By deliberatively investigating the affective side of disruptive behavior, we hope these articles will help bring about better understanding, assessment, and treatment of these challenging problems, for the benefit of youth and families.
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Affiliation(s)
| | - Jeffrey D Burke
- Department of Psychological Sciences, University of Connecticut
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78
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Berg M, Schemer L, Kirchner L, Scholten S. Mind the Gap - Ideas for Making Clinical Research More Relevant for Practitioners and Patients. CLINICAL PSYCHOLOGY IN EUROPE 2024; 6:e12419. [PMID: 39119222 PMCID: PMC11303909 DOI: 10.32872/cpe.12419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/06/2024] [Indexed: 08/10/2024] Open
Affiliation(s)
- Max Berg
- Clinical Psychology Group, University of Marburg, Marburg, Germany
| | - Lea Schemer
- Department of Clinical Psychology and Psychotherapy, RPTU Kaiserslautern-Landau, Landau, Germany
| | - Lukas Kirchner
- Clinical Psychology Group, University of Marburg, Marburg, Germany
| | - Saskia Scholten
- Department of Clinical Psychology and Psychotherapy, RPTU Kaiserslautern-Landau, Landau, Germany
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Schaeuffele C, Meine LE, Schulz A, Weber MC, Moser A, Paersch C, Recher D, Boettcher J, Renneberg B, Flückiger C, Kleim B. A systematic review and meta-analysis of transdiagnostic cognitive behavioural therapies for emotional disorders. Nat Hum Behav 2024; 8:493-509. [PMID: 38228727 PMCID: PMC10963275 DOI: 10.1038/s41562-023-01787-3] [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: 04/12/2023] [Accepted: 11/17/2023] [Indexed: 01/18/2024]
Abstract
Transdiagnostic cognitive behavioural psychotherapy (TD-CBT) may facilitate the treatment of emotional disorders. Here we investigate short- and long-term efficacy of TD-CBT for emotional disorders in individual, group and internet-based settings in randomized controlled trials (PROSPERO CRD42019141512). Two independent reviewers screened results from PubMed, MEDLINE, PsycINFO, Google Scholar, medRxiv and OSF Preprints published between January 2000 and June 2023, selected studies for inclusion, extracted data and evaluated risk of bias (Cochrane risk-of-bias tool 2.0). Absolute efficacy from pre- to posttreatment and relative efficacy between TD-CBT and control treatments were investigated with random-effects models. Of 56 identified studies, 53 (6,705 participants) were included in the meta-analysis. TD-CBT had larger effects on depression (g = 0.74, 95% CI = 0.57-0.92, P < 0.001) and anxiety (g = 0.77, 95% CI = 0.56-0.97, P < 0.001) than did controls. Across treatment formats, TD-CBT was superior to waitlist and treatment-as-usual. TD-CBT showed comparable effects to disorder-specific CBT and was superior to other active treatments for depression but not for anxiety. Different treatment formats showed comparable effects. TD-CBT was superior to controls at 3, 6 and 12 months but not at 24 months follow-up. Studies were heterogeneous in design and methodological quality. This review and meta-analysis strengthens the evidence for TD-CBT as an efficacious treatment for emotional disorders in different settings.
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Affiliation(s)
- Carmen Schaeuffele
- Department of Education and Psychology, Freie Universitaet Berlin, Berlin, Germany.
| | - Laura E Meine
- Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland.
| | - Ava Schulz
- Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Maxi C Weber
- Department of Education and Psychology, Freie Universitaet Berlin, Berlin, Germany
| | - Angela Moser
- Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Christina Paersch
- Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Dominique Recher
- Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Johanna Boettcher
- Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | - Babette Renneberg
- Department of Education and Psychology, Freie Universitaet Berlin, Berlin, Germany
| | | | - Birgit Kleim
- Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
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Ye L, Tang X, Zhong J, Li W, Xu T, Xiang C, Gu J, Feng H, Luo Q, Wang G. Unraveling the complex pathophysiology of white matter hemorrhage in intracerebral stroke: A single-cell RNA sequencing approach. CNS Neurosci Ther 2024; 30:e14652. [PMID: 38433011 PMCID: PMC10909628 DOI: 10.1111/cns.14652] [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: 09/30/2023] [Revised: 01/10/2024] [Accepted: 02/10/2024] [Indexed: 03/05/2024] Open
Abstract
AIM This study aims to elucidate the cellular dynamics and pathophysiology of white matter hemorrhage (WMH) in intracerebral hemorrhage (ICH). METHODS Using varying doses of collagenase IV, a consistent rat ICH model characterized by pronounced WMH was established. Verification was achieved through behavioral assays, hematoma volume, and histological evaluations. Single-cell suspensions from the hemorrhaged region of the ipsilateral striatum on day three post-ICH were profiled using single-cell RNA sequencing (scRNA-seq). Gene Ontology (GO) and gene set variation analysis (GSVA) further interpreted the differentially expressed genes (DEGs). RESULTS Following WMH induction, there was a notable increase in the percentage of myeloid cells and oligodendrocyte precursor cells (OPCs), alongside a reduction in the percentage of neurons, microglia, and oligodendrocytes (OLGs). Post-ICH WMH showed homeostatic microglia transitioning into pro-, anti-inflammatory, and proliferative states, influencing lipid metabolic pathways. Myeloid cells amplified chemokine expression, linked with ferroptosis pathways. Macrophages exhibited M1 and M2 phenotypes, and post-WMH, macrophages displayed a predominance of M2 phenotypes, characterized by their anti-inflammatory properties. A surge in OPC proliferation aligned with enhanced ribosomal signaling, suggesting potential reparative responses post-WMH. CONCLUSION The study offers valuable insights into WMH's complex pathophysiology following ICH, highlighting the significance and utility of scRNA-seq in understanding the cellular dynamics and contributing to future cerebrovascular research.
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Affiliation(s)
- Lisha Ye
- Department of Neurophysiology and Neuropharmacology, Institute of Special Environmental Medicine and Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
| | - Xiaoyan Tang
- Department of Neurophysiology and Neuropharmacology, Institute of Special Environmental Medicine and Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
| | - Jun Zhong
- Department of Neurosurgery, Key Laboratory of Neurotrauma, Southwest HospitalThird Military Medical University (Army Medical University)ChongqingChina
| | - Wenfeng Li
- Department of Neurophysiology and Neuropharmacology, Institute of Special Environmental Medicine and Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
| | - Ting Xu
- Department of Neurophysiology and Neuropharmacology, Institute of Special Environmental Medicine and Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
| | - Chao Xiang
- Department of NeurosurgeryZhengzhou University People's Hospital (Henan Provincial People's Hospital)ZhengzhouHenanChina
| | - Jianjun Gu
- Department of NeurosurgeryZhengzhou University People's Hospital (Henan Provincial People's Hospital)ZhengzhouHenanChina
| | - Hua Feng
- Department of Neurosurgery, Key Laboratory of Neurotrauma, Southwest HospitalThird Military Medical University (Army Medical University)ChongqingChina
| | - Qianqian Luo
- Department of Neurophysiology and Neuropharmacology, Institute of Special Environmental Medicine and Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
| | - Guohua Wang
- Department of Neurophysiology and Neuropharmacology, Institute of Special Environmental Medicine and Co‐innovation Center of NeuroregenerationNantong UniversityNantongJiangsuChina
- Department of Neurosurgery, Key Laboratory of Neurotrauma, Southwest HospitalThird Military Medical University (Army Medical University)ChongqingChina
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Rizeq J. Affective forecasting and psychopathology: A scoping review. Clin Psychol Rev 2024; 108:102392. [PMID: 38244480 DOI: 10.1016/j.cpr.2024.102392] [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: 08/22/2023] [Revised: 12/12/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
Affective forecasting - estimations of future emotional reactions - is an important aspect of future thinking that informs judgement and decision making. Biases in affective forecasting have been noted generally and with people with emotional disturbances specifically. Still, the role of affective forecasting within models of psychopathology has received little attention. Given the state of the literature, a scoping review method was adopted to summarize and synthesize the methodological approaches used in measuring affective forecasting within the context of psychopathology and the scope of the evidence on this association. Three databases were searched for research published on or before November 13th, 2023. Original quantitative research that examined affective forecasting and its association with psychopathology was reviewed. Data were charted using a form designed for this study. Overall, the review highlights the heterogeneity in operationalization of affective forecasting. The majority of the evidence supports an association between severity of psychopathology and intensity of affective forecasts, with notable exceptions, which are discussed within the scope of methodology and operationalization of affective forecasting. This remains an important process to investigate in information processing models of psychopathology to elucidate its role in the development and maintenance of psychopathology and potential as a target for intervention.
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Affiliation(s)
- Jala Rizeq
- School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
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82
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Meyer K, Schoofs N, Hildebrandt A, Bermpohl F, Priebe K. What to think or how to think - is symptom reduction in posttraumatic symptomatology associated with change in posttraumatic cognitions or perseverative thinking? A latent change score model approach. Psychother Res 2024:1-16. [PMID: 38412334 DOI: 10.1080/10503307.2024.2316009] [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: 08/31/2023] [Accepted: 02/01/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE Patients with posttraumatic stress disorder (PTSD) report changes in what they think of the world and themselves, referred to as posttraumatic cognitions, and changes in how they think, reflected in increased perseverative thinking. We investigated whether pre-post therapy changes in the two aspects of thinking were associated with pre-post therapy changes in posttraumatic symptom severity. METHOD 219 d clinic patients with posttraumatic stress symptoms received trauma-focused psychotherapy with cognitive behavioral and metacognitive elements. The posttraumatic cognitions inventory (PTCI), the perseverative thinking questionnaire (PTQ), and the Davidson trauma scale (DTS) were applied at two occasions, pre- and post-therapy. Using latent change score models, we investigated whether change in PTCI and change in PTQ were associated with change in DTS and its subscales. We then compared the predictive value of PTQ and PTCI in joint models. RESULTS When jointly modeled, change in overall DTS score was associated with change in both PTCI and PTQ. Concerning DTS subscales, reexperiencing and avoidance were significantly associated with change in PTCI, but not in PTQ. CONCLUSION Results indicate that both aspects of cognition may be valuable targets of psychotherapy. A focus on posttraumatic cognitions might be called for in patients with severe reexperiencing and avoidance.
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Affiliation(s)
- Kristina Meyer
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Nikola Schoofs
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Hildebrandt
- Department of Psychology, Psychological Methods and Statistics, Carl von Ossietzky Universität Oldenburg, Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Kathlen Priebe
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
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83
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Lee E, Lee D, Baek JH, Kim SY, Park WY. Transdiagnostic clustering and network analysis for questionnaire-based symptom profiling and drug recommendation in the UK Biobank and a Korean cohort. Sci Rep 2024; 14:4500. [PMID: 38402308 PMCID: PMC10894302 DOI: 10.1038/s41598-023-49490-7] [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: 06/29/2023] [Accepted: 12/08/2023] [Indexed: 02/26/2024] Open
Abstract
Clinical decision support systems (CDSSs) play a critical role in enhancing the efficiency of mental health care delivery and promoting patient engagement. Transdiagnostic approaches that utilize raw psychological and biological data enable personalized patient profiling and treatment. This study introduces a CDSS incorporating symptom profiling and drug recommendation for mental health care. Among the UK Biobank cohort, we analyzed 157,348 participants for symptom profiling and 14,358 participants with a drug prescription history for drug recommendation. Among the 1307 patients in the Samsung Medical Center cohort, 842 were eligible for analysis. Symptom profiling utilized demographic and questionnaire data, employing conventional clustering and community detection methods. Identified clusters were explored using diagnostic mapping, feature importance, and scoring. For drug recommendation, we employed cluster- and network-based approaches. The analysis identified nine clusters using k-means clustering and ten clusters with the Louvain method. Clusters were annotated for distinct features related to depression, anxiety, psychosis, drug addiction, and self-harm. For drug recommendation, drug prescription probabilities were retrieved for each cluster. A recommended list of drugs, including antidepressants, antipsychotics, mood stabilizers, and sedative-hypnotics, was provided to individual patients. This CDSS holds promise for efficient personalized mental health care and requires further validation and refinement with larger datasets, serving as a valuable tool for mental healthcare providers.
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Affiliation(s)
- Eunjin Lee
- Samsung Genome Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Dongbin Lee
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - So Yeon Kim
- Department of Artificial Intelligence, Ajou University, Suwon, Republic of Korea
- Department of Software and Computer Engineering, Ajou University, Suwon, Republic of Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
- Department of Health Science and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
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84
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Sun K, Cao C. The effects of childhood maltreatment, recent interpersonal and noninterpersonal stress, and HPA-axis multilocus genetic variation on prospective changes in adolescent depressive symptoms: A multiwave longitudinal study. Dev Psychopathol 2024:1-12. [PMID: 38389485 DOI: 10.1017/s0954579424000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Based on a multiwave, two-year prospective design, this study is the first to examine the extent to which multilocus hypothalamic-pituitary-adrenal axis (HPA axis)-related genetic variants, childhood maltreatment, and recent stress jointly predicted prospective changes in adolescent depressive symptoms. A theory-driven multilocus genetic profile score (MGPS) was calculated to combine the effects of six common polymorphisms within HPA-axis related genes (CRHR1, NR3C1, NR3C2, FKBP5, COMT, and HTR1A) in a sample of Chinese Han adolescents (N = 827; 50.2% boys; Mage = 16.45 ± 1.36 years). The results showed that the three-way interaction of HPA-axis related MGPS, childhood maltreatment and recent interpersonal, but not noninterpersonal, stress significantly predicted prospective changes in adolescent depressive symptoms. For adolescents with high but not low HPA-axis related MGPS, exposure to severe childhood maltreatment predisposed individuals more vulnerable to recent interpersonal stress, exhibiting greater prospective changes in adolescent depressive symptoms. The findings provide preliminary evidence for the cumulative risk mechanism regarding gene-by-environment-by-environment (G × E1 × E2) interactions that underlie the longitudinal development of adolescent depressive symptoms and show effects specific to interpersonal stress.
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Affiliation(s)
- Kexin Sun
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Cong Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
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85
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Miranda O, Kiehl S, Qi X, Ryan ND, Kirisci L, Brannock MD, Kosten T, 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. RESEARCH SQUARE 2024:rs.3.rs-3973337. [PMID: 38464073 PMCID: PMC10925404 DOI: 10.21203/rs.3.rs-3973337/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
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 an 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, allmpnet-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 superior 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. Women had the highest abnormalities of sensorimotor systems, while veterans had the highest abnormalities of negative and positive valence systems. 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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86
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Pflanz CP, Gallacher J, Bauermeister S. A psychometric evaluation of the 16-item PHQ-ADS concomitant anxiety and depression scale in the UK biobank using item response theory. J Affect Disord 2024; 347:335-344. [PMID: 38000468 DOI: 10.1016/j.jad.2023.11.067] [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: 06/06/2023] [Revised: 11/07/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) provides a reliable and valid measure of concomitant depression and anxiety. However, research on its psychometric efficiency and optimal scale length using item-response theory (IRT) has not been reported. This study aimed to optimize the length of the PHQ-ADS scale without losing information by discarding items that were a poor fit to the IRT model. METHODS The UK Biobank is a large cohort study designed to investigate risk factors for a broad range of disease. PHQ-ADS data were available from n = 152,826 participants (age = 55.87 years; SD = 7.73; 56.4 % female), 30.4 % of the entire UK Biobank sample. Psychometric properties of the PHQ-ADS were investigated using a 2-parameter IRT and Mokken analysis. Item statistics included discrimination, difficulty and Loevinger H coefficients of monotonicity. RESULTS In the entire 16-item scale, item discrimination ranged from 1.40 to 4.22, with the item 'worrying' showing the highest level of discrimination and the item 'sleep disturbance' showing the lowest. Mokken analysis showed that the 16-item PHQ-ADS scale could be reduced to a 7-item scale without loss of test information. The reduced scale comprised mainly items measuring cognitive-affective symptoms of anxiety/depression, whereas items measuring somatic symptoms were discarded. The revised scale showed high discrimination and scalability. LIMITATIONS Findings are limited by the use of cross-sectional data that only included the baseline online questionnaire, but not other waves. CONCLUSIONS IRT is a useful technique for scale reductions which serve the clinical and epidemiological need to optimize screening questionnaires to reduce redundancy and maximize information. A reduced-item 7-item PHQ-ADS scale reduces the response burden on participants in epidemiological research settings, without loss of information.
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Affiliation(s)
- Chris Patrick Pflanz
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom.
| | - John Gallacher
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Sarah Bauermeister
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom
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Vancappel A, Gillet N, Fouquereau E, Chevalier S, Aubouin-Bonnaventure J, Coillot H, Mangolini A, Jansen E, Dicosimo C, El-Hage W. Development of a revised version of the transdiagnostic skills scale (T2S-R). Front Psychol 2024; 15:1290692. [PMID: 38410398 PMCID: PMC10895014 DOI: 10.3389/fpsyg.2024.1290692] [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: 09/20/2023] [Accepted: 01/30/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction The transdiagnostic approach has been shown to offer promising prospects in psychopathology, based on the observation that common factors may be involved in different psychiatric disorders. The transdiagnostic skills scale (T2S) was developed recently to assess the skills that are disrupted in these disorders. However, studies have shown that the T2S has lower predictive power for externalizing than internalizing disorders. This may be due to the fact that the skills assessed do not include the control of urges and cravings. The aims of the current study are thus to develop a revised version of the T2S (T2S-R) integrating this dimension, and to assess its factor structure and invariance across employment status (workers vs. students) and the level of psychopathology. Method We recruited 1,298 French participants online through social media. They completed the revised version of the T2S and the symptomatic transdiagnostic test (S2T), which evaluates 11 clusters of psychiatric symptoms. We assessed the factor structure, internal consistency, invariance, and predictive validity of the revised T2S. Results We found a good fit for a bifactor exploratory structural equation modeling (B-ESEM) approach including a global skills factor and seven specific factors. The results also indicate that the new dimension (i.e., control of urges and cravings) has good predictive value, especially for externalizing problems. We also found total invariance of the scale across employment status and partial invariance across the level of psychopathology. Conclusion The revised version of the T2S-R has good psychometric properties. It predicts better externalizing problems than the original version. However, the scale remains more correlated with internalizing than externalizing problems. We discuss the implications of the results on the transdiagnostic conceptualization and the interest of using a mixed approach combining transdiagnostic and diagnostic analyses.
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Affiliation(s)
- Alexis Vancappel
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Nicolas Gillet
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
- Institut Universitaire de France, Paris, France
| | - Evelyne Fouquereau
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Séverine Chevalier
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Julia Aubouin-Bonnaventure
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Hélène Coillot
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Anna Mangolini
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Eline Jansen
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Cinzia Dicosimo
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Wissam El-Hage
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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88
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Mathersul DC, Zeitzer JM, Schulz-Heik RJ, Avery TJ, Bayley PJ. Emotion regulation and heart rate variability may identify the optimal posttraumatic stress disorder treatment: analyses from a randomized controlled trial. Front Psychiatry 2024; 15:1331569. [PMID: 38389985 PMCID: PMC10881770 DOI: 10.3389/fpsyt.2024.1331569] [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: 11/01/2023] [Accepted: 01/10/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction High variability in response and retention rates for posttraumatic stress disorder (PTSD) treatment highlights the need to identify "personalized" or "precision" medicine factors that can inform optimal intervention selection before an individual commences treatment. In secondary analyses from a non-inferiority randomized controlled trial, behavioral and physiological emotion regulation were examined as non-specific predictors (that identify which individuals are more likely to respond to treatment, regardless of treatment type) and treatment moderators (that identify which treatment works best for whom) of PTSD outcome. Methods There were 85 US Veterans with clinically significant PTSD symptoms randomized to 6 weeks of either cognitive processing therapy (CPT; n = 44) or a breathing-based yoga practice (Sudarshan kriya yoga; SKY; n = 41). Baseline self-reported emotion regulation (Difficulties in Emotion Regulation Scale) and heart rate variability (HRV) were assessed prior to treatment, and self-reported PTSD symptoms were assessed at baseline, end-of-treatment, 1-month follow-up, and 1-year follow-up. Results Greater baseline deficit in self-reported emotional awareness (similar to alexithymia) predicted better overall PTSD improvement in both the short- and long-term, following either CPT or SKY. High self-reported levels of emotional response non-acceptance were associated with better PTSD treatment response with CPT than with SKY. However, all significant HRV indices were stronger moderators than all self-reported emotion regulation scales, both in the short- and long-term. Veterans with lower baseline HRV had better PTSD treatment response with SKY, whereas Veterans with higher or average-to-high baseline HRV had better PTSD treatment response with CPT. Conclusions To our knowledge, this is the first study to examine both self-reported emotion regulation and HRV, within the same study, as both non-specific predictors and moderators of PTSD treatment outcome. Veterans with poorer autonomic regulation prior to treatment had better PTSD outcome with a yoga-based intervention, whereas those with better autonomic regulation did better with a trauma-focused psychological therapy. Findings show potential for the use of HRV in clinical practice to personalize PTSD treatment. Clinical trial registration ClinicalTrials.gov identifier, NCT02366403.
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Affiliation(s)
- Danielle C Mathersul
- School of Psychology, Murdoch University, Murdoch, WA, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
- Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - R Jay Schulz-Heik
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Timothy J Avery
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Peter J Bayley
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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Lavigne KM, Deng J, Raucher-Chéné D, Hotte-Meunier A, Voyer C, Sarraf L, Lepage M, Sauvé G. Transdiagnostic cognitive biases in psychiatric disorders: A systematic review and network meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110894. [PMID: 37956787 DOI: 10.1016/j.pnpbp.2023.110894] [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: 06/19/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
Psychiatric disorders are characterized by cognitive deficits, which have been proposed as a transdiagnostic feature of psychopathology ("C" factor). Similarly, cognitive biases (e.g., in attention, memory, and interpretation) represent common tendencies in information processing that are often associated with psychiatric symptoms. However, the question remains whether cognitive biases are also transdiagnostic or are specific to certain psychiatric disorders/symptoms. The current systematic review sought to address whether the proposed "C" factor of transdiagnostic cognitive dysfunction in psychopathology can be extended to cognitive biases. Overall, 31 studies comprising 4401 participants (2536 patients, 1865 non-clinical controls) met inclusion criteria, assessing 19 cognitive biases across 20 diagnostic categories, with most studies focusing on interpretation (k = 22) and attention (k = 11) biases and only 2 assessing memory biases. Traditional meta-analyses found a moderate effect size (g = 0.32) for more severe cognitive biases in all patients relative to non-clinical controls, as well as small but significant associations between interpretation biases and transdiagnostic symptom categories (general psychopathology: r = 0.20, emotion dysfunction: r = 0.17, psychotic symptoms: r = 0.25). Network meta-analyses revealed significant patient versus non-clinical control differences on attention and interpretation biases across diagnoses, as well as significant differences between diagnoses, with highest severity in panic disorder for attention biases and obsessive-compulsive disorder for interpretation biases. The current findings extend the big "C" interpretation of transdiagnostic cognitive dysfunction in psychiatric disorders to cognitive biases and transdiagnostic symptom dimensions. Results also suggest that while the presence of cognitive biases is transdiagnostic, bias severity differs across diagnoses, as in traditional neurocognitive deficits.
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Affiliation(s)
- Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada.
| | | | - Delphine Raucher-Chéné
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada
| | | | - Chloe Voyer
- Douglas Research Centre, Montreal, QC, Canada
| | - Lisa Sarraf
- Douglas Research Centre, Montreal, QC, Canada; Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada
| | - Geneviève Sauvé
- Douglas Research Centre, Montreal, QC, Canada; Département d'éducation et pédagogie, Université de Québec à Montréal, Montréal, QC, Canada
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Müller-Engelmann M, Bahnemann L, Kümmerle S. The effects of a combination of cognitive interventions and loving-kindness meditations (C-METTA) on guilt, shame and PTSD symptoms: results from a pilot randomized controlled trial. Eur J Psychotraumatol 2024; 15:2308439. [PMID: 38323870 PMCID: PMC10851818 DOI: 10.1080/20008066.2024.2308439] [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: 07/25/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024] Open
Abstract
Background: Trauma-related guilt and shame are crucial for the development and maintenance of PTSD (posttraumatic stress disorder). We developed an intervention combining cognitive techniques with loving-kindness meditations (C-METTA) that specifically target these emotions. C-METTA is an intervention of six weekly individual treatment sessions followed by a four-week practice phase.Objective: This study examined C-METTA in a proof-of-concept study within a randomized wait-list controlled trial.Method: We randomly assigned 32 trauma-exposed patients with a DSM-5 diagnosis to C-METTA or a wait-list condition (WL). Primary outcomes were clinician-rated PTSD symptoms (CAPS-5) and trauma-related guilt and shame. Secondary outcomes included psychopathology, self-criticism, well-being, and self-compassion. Outcomes were assessed before the intervention phase and after the practice phase.Results: Mixed-design analyses showed greater reductions in C-METTA versus WL in clinician-rated PTSD symptoms (d = -1.09), guilt (d = -2.85), shame (d = -2.14), psychopathology and self-criticism.Conclusion: Our findings support positive outcomes of C-METTA and might contribute to improved care for patients with stress-related disorders. The study was registered in the German Clinical Trials Register (DRKS00023470).
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Affiliation(s)
- Meike Müller-Engelmann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
- Faculty Human Sciences, Department Psychology, Medical School Hamburg, Hamburg, Germany
| | - Luisa Bahnemann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Stella Kümmerle
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
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91
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Bird BM, Levitt EE, Stewart SH, Wanklyn SG, Meyer EC, Murphy JG, McDevitt-Murphy ME, MacKillop J. Posttraumatic stress and delay discounting: a meta-analytic review. Psychol Med 2024; 54:437-446. [PMID: 37947238 DOI: 10.1017/s0033291723003069] [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] [Indexed: 11/12/2023]
Abstract
Delay discounting-the extent to which individuals show a preference for smaller immediate rewards over larger delayed rewards-has been proposed as a transdiagnostic neurocognitive process across mental health conditions, but its examination in relation to posttraumatic stress disorder (PTSD) is comparatively recent. To assess the aggregated evidence for elevated delay discounting in relation to posttraumatic stress, we conducted a meta-analysis on existing empirical literature. Bibliographic searches identified 209 candidate articles, of which 13 articles with 14 independent effect sizes were eligible for meta-analysis, reflecting a combined sample size of N = 6897. Individual study designs included case-control (e.g. examination of differences in delay discounting between individuals with and without PTSD) and continuous association studies (e.g. relationship between posttraumatic stress symptom severity and delay discounting). In a combined analysis of all studies, the overall relationship was a small but statistically significant positive association between posttraumatic stress and delay discounting (r = .135, p < .0001). The same relationship was statistically significant for continuous association studies (r = .092, p = .027) and case-control designs (r = .179, p < .001). Evidence of publication bias was minimal. The included studies were limited in that many did not concurrently incorporate other psychiatric conditions in the analyses, leaving the specificity of the relationship to posttraumatic stress less clear. Nonetheless, these findings are broadly consistent with previous meta-analyses of delayed reward discounting in relation to other mental health conditions and provide further evidence for the transdiagnostic utility of this construct.
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Affiliation(s)
- Brian M Bird
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Emily E Levitt
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Department of Psychology, Neuroscience, & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sonya G Wanklyn
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
| | - Eric C Meyer
- Department of Counseling and Behavioral Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | | | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Viding E, McCrory E, Baskin-Sommers A, De Brito S, Frick P. An 'embedded brain' approach to understanding antisocial behaviour. Trends Cogn Sci 2024; 28:159-171. [PMID: 37718176 DOI: 10.1016/j.tics.2023.08.013] [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: 03/09/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023]
Abstract
Antisocial behaviour (ASB) incurs substantial costs to the individual and society. Cognitive neuroscience has the potential to shed light on developmental risk for ASB, but it cannot achieve this potential in an 'essentialist' framework that focuses on the brain and cognition isolated from the environment. Here, we present the case for studying the social transactional and iterative unfolding of brain and cognitive development in a relational context. This approach, which we call the study of the 'embedded brain', is needed to fully understand how risk for ASB arises during development. Concentrated efforts are required to develop and unify methods to achieve this approach and reap the benefits for improved prevention and intervention of ASB.
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Affiliation(s)
- Essi Viding
- Division of Psychology and Language Sciences, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London, Gower Street, London, WC1E 6BT, UK
| | | | - Stephane De Brito
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Paul Frick
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
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93
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Mattingley S, Youssef GJ, Graeme L, Sloan E, Manning V, Hall K. Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people. J Clin Psychol 2024; 80:261-278. [PMID: 37597248 DOI: 10.1002/jclp.23579] [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: 11/05/2022] [Revised: 04/24/2023] [Accepted: 07/23/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people. METHOD Participants (N = 385; 62.3% female; aged 16-25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms. RESULTS Both NU (adjusted odds ratio [ORadj ] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found. CONCLUSIONS These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.
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Affiliation(s)
- Sophie Mattingley
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - George J Youssef
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Liam Graeme
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Elise Sloan
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Victoria Manning
- Monash Addiction Research Centre (MARC), Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
- Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, Victoria, Australia
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94
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Vancappel A, Raysseguier C, Coillot H, Jansen E, Bouyer C, Mangolini A, Barbe PG, Debout-Courtault C, Pierre-le Seac'h M, Kazour F, Courtois R, El-Hage W. Development and validation of the Symptomatic Transdiagnostic Test (S2T). L'ENCEPHALE 2024; 50:32-39. [PMID: 36641268 DOI: 10.1016/j.encep.2022.11.004] [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: 05/16/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The categorical approach in psychiatry has received many criticisms. Modern research tends to develop a transdiagnostic approach. However, transdiagnostic works lack an overall understanding and focus mainly on anxiety and depression. The aim of the present study was to develop an easy to use tool to evaluate multiple dimensions opening the way for further research in the transdiagnostic approach. This will allow researchers to quickly assess the efficacy of psychotherapeutic interventions on multiple psychopathological dimensions. METHOD First, we identified the main symptoms of psychopathology in a sample of mental healthcare workers. Second, we developed the Symptomatic Transdiagnostic Test (S2T) to assess the main symptoms of psychopathology. Third, we evaluated its psychometric properties (exploratory and confirmatory factor analysis, internal consistency) in three non-clinical samples and one clinical sample. RESULTS The 66-item S2T included eleven factors referring to: i) negative thoughts and mood; ii) psycho-traumatic and maladaptive symptoms; iii) addiction symptoms; iv) disturbed eating behavior; v) disturbed perception and behavior; vi) panic and agoraphobia; vii) emotional lability; viii) dejection; ix) neurodevelopmental manifestations; x) anxiety and xi) psychic hyperactivity. We found a high internal consistency for the general scale (α=0.96) and the subscales. We found a good concurrent validity. As expected, we found higher levels of symptoms within the clinical population as compared to the non-clinical samples, except for addiction symptoms and disrupted eating behavior. We found negative associations between the symptomatic dimensions and psychological skills. CONCLUSION The S2T is a relevant tool for clinicians and researchers to assess the psychopathological profile. The main psychopathological symptoms are negatively related to the psychological skills.
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Affiliation(s)
- A Vancappel
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France; Département de psychologie, EE 1901 Qualipsy, qualité de vie et santé psychologique, université de Tours, Tours, France; Inserm, UMR 1253, iBrain, université de Tours, Tours, France.
| | - C Raysseguier
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France
| | - H Coillot
- Département de psychologie, EE 1901 Qualipsy, qualité de vie et santé psychologique, université de Tours, Tours, France
| | - E Jansen
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France
| | - C Bouyer
- Pôle cardiovasculaire et métabolique, CHU de Cayenne, Cayenne, France
| | - A Mangolini
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France
| | - P G Barbe
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France
| | | | | | - F Kazour
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France; Inserm, UMR 1253, iBrain, université de Tours, Tours, France
| | - R Courtois
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France; Département de psychologie, EE 1901 Qualipsy, qualité de vie et santé psychologique, université de Tours, Tours, France
| | - W El-Hage
- Pôle de psychiatrie-addictologie, CHRU de Tours, Tours, France; Inserm, UMR 1253, iBrain, université de Tours, Tours, France
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95
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Ra JS. Combination of sugar-sweetened beverage consumption, screen-based sedentary time, and sleep duration and their association with South Korean adolescents' mental health. Front Public Health 2024; 11:1293505. [PMID: 38312139 PMCID: PMC10835739 DOI: 10.3389/fpubh.2023.1293505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/18/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction This study examines the combinations of sugar-sweetened beverage (SSB) consumption, screen-based sedentary time, and sleep duration and their association with adolescents' depressive symptoms and suicidal ideation. Methods This research followed a crosssectional study design. Secondary data analysis was conducted on the data collected from 21,046 high school students who had participated in the 17th Korea Youth Risk Behavior Web-Based Survey in 2021. A complex sampling analysis, including descriptive and logistic regression analyses, was conducted in SPSS Statistics 26.0. Results The combination of low SSB consumption, excessive screen-based sedentary time, and short sleep duration was associated with an increase in depressive symptoms. In addition, a combination of medium/high SSB consumption, appropriate/excessive screen-based sedentary time, and short sleep duration was associated with an increase in depressive symptoms. Finally, the combination of high SSB consumption, excessive screen-based sedentary time, and short sleep duration was associated with an increase in suicidal ideation. Discussion The findings demonstrate that healthcare providers should develop and conduct family-and school-based programs to restrict SSB consumption, screen-based sedentary behaviors, and sleep duration to improve adolescents' mental health.
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Affiliation(s)
- Jin Suk Ra
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
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96
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Vize CE, G C Wright A. Translating the Transdiagnostic: Aligning Assessment Practices With Research Advances. Assessment 2024; 31:199-215. [PMID: 37706296 DOI: 10.1177/10731911231194996] [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] [Indexed: 09/15/2023]
Abstract
Researchers and clinicians working within the Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition, Text Rev (DSM-5-TR) framework face a difficult question: what does it mean to have an evidence-based assessment of a nonevidence-based diagnostic construct? Alternative nosological approaches conceptualize psychopathology as (a) hierarchical, allowing researchers to move between levels of description and (b) dimensional, eliminating artificial dichotomies between disorders and the dichotomy between mental illness and mental well-being. In this article, we provide an overview of ongoing efforts to develop validated measures of transdiagnostic nosologies (i.e., the Hierarchical Taxonomy of Psychopathology; HiTOP) with applications for measurement-based care. However, descriptive models like HiTOP, which summarize patterns of covariation among psychopathology symptoms, do not address dynamic processes underlying the problems associated with psychopathology. Ambulatory assessment, well-suited to examine such dynamic processes, has also developed rapidly in recent decades. Thus, the goal of the current article is twofold. First, we provide a brief overview of developments in constructing valid measures of the HiTOP model as well as developments in ambulatory assessment practices. Second, we outline how these parallel developments can be integrated to advance measurement-based treatment. We end with a discussion of some major challenges for future research to address to integrate advances more fully in transdiagnostic and ambulatory assessment practices.
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97
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Jackson L, Fallon V, Harrold JA, De Pascalis L. Psychosocial predictors of post-natal anxiety and depression: Using Structural Equation Modelling to investigate the relationship between pressure to breastfeed, health care professional support, post-natal guilt and shame, and post-natal anxiety and depression within an infant feeding context. MATERNAL & CHILD NUTRITION 2024; 20:e13558. [PMID: 37752680 PMCID: PMC10750005 DOI: 10.1111/mcn.13558] [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: 01/05/2023] [Revised: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 09/28/2023]
Abstract
High perceived pressure to breastfeed and poor perceived quality of health care professional support have been associated with early breastfeeding cessation, guilt, and shame. This is problematic because guilt and shame significantly predict post-natal anxiety and depression. No previous attempts have been made to provide quantitative evidence for relationships mapped between the post-natal social context, infant feeding method and post-natal emotional well-being. The current study aimed to empirically investigate aforementioned pathways. Structural equation modelling was applied to survey data provided online by 876 mothers. Guilt and shame both significantly predicted anxiety and depression. Poor health care professional support and high pressure to breastfeed increased anxiety and depression, and these effects were explained by indirect pathways through increases in guilt and shame. Formula feeding exclusivity was negatively correlated with post-natal anxiety symptoms. This finding may be explained by feelings of relief associated with observed infant weight gain and being able to share infant feeding responsibilities others e.g., with one's partner. This relationship was counterbalanced by an indirect pathway where greater formula feeding exclusivity positively predicted guilt, which increased post-natal anxiety score. While guilt acted as mediator of infant feeding method to increase post-natal depression and anxiety, shame acted independently of infant feeding method. These identified differences provide empirical support for the transferability of general definitions of guilt (i.e., as remorse for having committed a moral transgression) and shame (i.e., internalisation of transgressive remorse to the self), to an infant feeding context. Recommendations for health care practitioners and the maternal social support network are discussed.
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Affiliation(s)
- Leanne Jackson
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Vicky Fallon
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Joanne A. Harrold
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Leonardo De Pascalis
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
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98
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Hagstrøm J, Nielsen T, Sørensen ME, Aagaard K, Arendt Rasmussen M, Rosenberg JB, Mohammadzadeh P, Sevelsted A, Hernández-Lorca M, Fagerlund B, Rydkjær J, Pagsberg AK, Kaufman J, Ebdrup BH, Bilenberg N, Jepsen JRM. Dimensional profiling of psychopathology in children and adolescents based on the K-SADS-PL and an analysis of the construct validity of two ADHD symptom dimensions. Nord J Psychiatry 2024; 78:71-78. [PMID: 37755235 DOI: 10.1080/08039488.2023.2262997] [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: 04/12/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES The traditional view on psychiatric disorders as categorical and distinct is being challenged by perspectives emphasizing the relevance of dimensional and transdiagnostic assessment. However, most diagnostic instruments are based on a categorical view with a threshold-approach to disease classification. METHODS We here describe algorithms for dimensionalizing the psychopathological ratings of the widely used diagnostic interview for children and adolescents, the Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (K-SADS-PL). We further evaluate the criterion-related construct validity of the dimensionalized attention-deficit/hyperactivity disorder (ADHD) scales using Rasch models in a sample of 590 children (mean age 10.29 (.36), 49% girls). RESULTS The algorithms generate scores of current symptom load, i.e., the sum of clinician-rated symptoms within each disorder assessed with the interview. We found support for counting symptoms of inattention and hyperactivity/impulsivity, respectively, but not for a single combined ADHD scale. CONCLUSIONS The algorithms constitute an initial step in creating a framework for clinician-rated dimensional analyses of symptoms derived from the K-SADS-PL, but future studies are needed to further evaluate the construct validity of the remaining scales and the reliability and clinical utility of the method. We believe that our proposed algorithms offer a novel method of dimensional psychopathological assessment, which can be applied in multiple branches of child and adolescent psychiatry.
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Affiliation(s)
- Julie Hagstrøm
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Tine Nielsen
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Applied Research in Education and Social Science, UCL University College, Odense, Denmark
| | - Mikkel E Sørensen
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
| | - Kristina Aagaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Morten Arendt Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Julie B Rosenberg
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Parisa Mohammadzadeh
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - María Hernández-Lorca
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Birgitte Fagerlund
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
| | - Jacob Rydkjær
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Mental Health Odense, Research Unit (University Function), Mental Health Services in the Region of Southern Denmark, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
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99
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Perales JC, Flayelle M, Verdejo-García A, Clark L, Billieux J. Cognitive, computational and learning processes involved in behavioral addiction: Current views and future directions. Addict Behav 2024; 148:107874. [PMID: 37821335 DOI: 10.1016/j.addbeh.2023.107874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Affiliation(s)
- José C Perales
- Department of Experimental Psychology; Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain.
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Antonio Verdejo-García
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Luke Clark
- Department of Psychology and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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100
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Dercon Q, Mehrhof SZ, Sandhu TR, Hitchcock C, Lawson RP, Pizzagalli DA, Dalgleish T, Nord CL. A core component of psychological therapy causes adaptive changes in computational learning mechanisms. Psychol Med 2024; 54:327-337. [PMID: 37288530 DOI: 10.1017/s0033291723001587] [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: 06/09/2023]
Abstract
BACKGROUND Cognitive distancing is an emotion regulation strategy commonly used in psychological treatment of various mental health disorders, but its therapeutic mechanisms are unknown. METHODS 935 participants completed an online reinforcement learning task involving choices between pairs of symbols with differing reward contingencies. Half (49.1%) of the sample was randomised to a cognitive self-distancing intervention and were trained to regulate or 'take a step back' from their emotional response to feedback throughout. Established computational (Q-learning) models were then fit to individuals' choices to derive reinforcement learning parameters capturing clarity of choice values (inverse temperature) and their sensitivity to positive and negative feedback (learning rates). RESULTS Cognitive distancing improved task performance, including when participants were later tested on novel combinations of symbols without feedback. Group differences in computational model-derived parameters revealed that cognitive distancing resulted in clearer representations of option values (estimated 0.17 higher inverse temperatures). Simultaneously, distancing caused increased sensitivity to negative feedback (estimated 19% higher loss learning rates). Exploratory analyses suggested this resulted from an evolving shift in strategy by distanced participants: initially, choices were more determined by expected value differences between symbols, but as the task progressed, they became more sensitive to negative feedback, with evidence for a difference strongest by the end of training. CONCLUSIONS Adaptive effects on the computations that underlie learning from reward and loss may explain the therapeutic benefits of cognitive distancing. Over time and with practice, cognitive distancing may improve symptoms of mental health disorders by promoting more effective engagement with negative information.
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Affiliation(s)
- Quentin Dercon
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- UCL Institute of Mental Health, University College London, London, UK
| | - Sara Z Mehrhof
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Timothy R Sandhu
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Caitlin Hitchcock
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Rebecca P Lawson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, UK
| | - Camilla L Nord
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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