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Kandaswamy R, Hannon E, Arseneault L, Mansell G, Sugden K, Williams B, Burrage J, Staley JR, Pishva E, Dahir A, Roberts S, Danese A, Mill J, Fisher HL, Wong CCY. DNA methylation signatures of adolescent victimization: analysis of a longitudinal monozygotic twin sample. Epigenetics 2020; 16:1169-1186. [PMID: 33371772 PMCID: PMC8813077 DOI: 10.1080/15592294.2020.1853317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Accumulating evidence suggests that individuals exposed to victimization at key developmental stages may have different epigenetic fingerprints compared to those exposed to no/minimal stressful events, however results are inconclusive. This study aimed to strengthen causal inference regarding the impact of adolescent victimization on the epigenome by controlling for genetic variation, age, gender, and shared environmental exposures. We conducted longitudinal epigenome-wide association analyses (EWAS) on DNA methylation (DNAm) profiles of 118 monozygotic (MZ) twin pairs from the Environmental Risk study with and without severe adolescent victimization generated using buccal DNA collected at ages 5, 10 and 18, and the Illumina EPIC array. Additionally, we performed cross-sectional EWAS on age-18 blood and buccal DNA from the same individuals to elucidate tissue-specific signatures of severe adolescent victimization. Our analyses identified 20 suggestive differentially methylated positions (DMPs) (P < 5e-05), with altered DNAm trajectories between ages 10–18 associated with severe adolescent victimization (∆Beta range = −5.5%−5.3%). Age-18 cross-sectional analyses revealed 72 blood (∆Beta range = −2.2%−3.4%) and 42 buccal (∆Beta range = −3.6%−4.6%) suggestive severe adolescent victimization-associated DMPs, with some evidence of convergent signals between these two tissue types. Downstream regional analysis identified significant differentially methylated regions (DMRs) in LGR6 and ANK3 (Šidák P = 5e-09 and 4.07e-06), and one upstream of CCL27 (Šidák P = 2.80e-06) in age-18 blood and buccal EWAS, respectively. Our study represents the first longitudinal MZ twin analysis of DNAm and severe adolescent victimization, providing initial evidence for altered DNA methylomic signatures in individuals exposed to adolescent victimization.
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Affiliation(s)
- Radhika Kandaswamy
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Eilis Hannon
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Louise Arseneault
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,ESRC Centre for Society & Mental Health, King's College London, London, UK
| | - Georgina Mansell
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Karen Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Benjamin Williams
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Joe Burrage
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - James R Staley
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ehsan Pishva
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Aisha Dahir
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Susanna Roberts
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London UK
| | - Andrea Danese
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,King's College London, Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, London UK.,National & Specialist CAMHS Clinic for Trauma, Anxiety and Depression, South London & Maudsley NHS Foundation Trust, London, UK
| | - Jonathan Mill
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Helen L Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,ESRC Centre for Society & Mental Health, King's College London, London, UK
| | - Chloe C Y Wong
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Brassard MR, Hart SN, Glaser D. Psychological maltreatment: An international challenge to children's safety and well being. CHILD ABUSE & NEGLECT 2020; 110:104611. [PMID: 32660756 DOI: 10.1016/j.chiabu.2020.104611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment. OBJECTIVES This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment. PARTICIPANTS AND SETTINGS NA. METHOD Literature review, intervention description of fabricated or induced illness, and expert opinion. RESULTS PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence. CONCLUSIONS PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.
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Affiliation(s)
| | - Stuart N Hart
- Indiana University Purdue University at Indianapolis, USA
| | - Danya Glaser
- Great Ormond Street Hospital for Children and University College, London, UK
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53
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Danese A, McLaughlin KA, Samara M, Stover CS. Psychopathology in children exposed to trauma: detection and intervention needed to reduce downstream burden. BMJ 2020; 371:m3073. [PMID: 33214140 PMCID: PMC7673907 DOI: 10.1136/bmj.m3073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrea Danese
- King's College London, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, London, UK
| | | | | | - Carla S Stover
- Yale Early Stress and Adversity Consortium, Yale University Child Study Center, New Haven CT, USA
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54
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Scott BG, Fike EA, McCullen JR. Depressive symptoms among stress-exposed youth: Relations with tonic and phasic indices of autonomic functioning. Dev Psychobiol 2020; 63:1029-1042. [PMID: 33200408 DOI: 10.1002/dev.22056] [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: 06/15/2020] [Revised: 10/03/2020] [Accepted: 10/11/2020] [Indexed: 11/10/2022]
Abstract
Theoretical models of adolescent depression postulate that one possible individual vulnerability factor for the development of depressive symptoms is autonomic dysregulation. However, there is limited and mixed support for these models among ethnically diverse and higher risk stress-exposed youth. Therefore, this study investigated the relations between both tonic and phasic indices of parasympathetic autonomic functioning (i.e., resting high-frequency heart rate variability [HF-HRV] and root mean square of successive differences [RMSSD]; HF-HRV and RMSSD reactivity to a mental arithmetic stressor) and depressive symptoms among 80 severely stress-exposed youth (51% female; 11-17 years of age) from diverse backgrounds (61.3% ethnic minority; caregiver-reported median family income = $20,000-$49,999 per year). Results demonstrated that lower resting HF-HRV and RMSSD, but not HF-HRV and RMSSD reactivity, was associated with greater youth depressive symptoms. Our findings suggest that lower resting parasympathetic autonomic functioning may be a potential vulnerability factor of depressive symptoms among stress-exposed youth, instead of specific emotional responses to stressors. These findings will need to be replicated in larger samples of stress-exposed youth and youth at higher risk for or exhibiting clinical levels of depressive symptoms to better elucidate relations with autonomic functioning and depressive symptoms among adolescents.
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Weissman DG, Nook EC, Dews AA, Miller AB, Lambert HK, Sasse SF, Somerville LH, McLaughlin KA. Low Emotional Awareness as a Transdiagnostic Mechanism Underlying Psychopathology in Adolescence. Clin Psychol Sci 2020; 8:971-988. [PMID: 33758688 PMCID: PMC7983841 DOI: 10.1177/2167702620923649] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The ability to identify and label one's emotions is associated with effective emotion regulation, rendering emotional awareness important for mental health. We evaluated how emotional awareness was related to psychopathology and whether low emotional awareness was a transdiagnostic mechanism explaining the increase in psychopathology during the transition to adolescence and as a function of childhood trauma-specifically violence exposure. In Study 1, children and adolescents (N=120, aged 7-19 years) reported on emotional awareness and psychopathology. Emotional awareness was negatively associated with psychopathology (p-factor) and worsened across age in females but not males. In Study 2 (N=262, aged 8-16 years), we replicated these findings and demonstrated longitudinally that low emotional awareness mediated increases in p-factor as a function of age in females and violence exposure. These findings indicate that low emotional awareness may be a transdiagnostic mechanism linking adolescent development, sex, and trauma with the emergence of psychopathology.
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Affiliation(s)
| | - Erik C Nook
- Department of Psychology, Harvard University, Cambridge, MA
| | | | - Adam Bryant Miller
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC
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Weissman DG, Jenness JL, Colich NL, Miller AB, Sambrook KA, Sheridan MA, McLaughlin KA. Altered Neural Processing of Threat-Related Information in Children and Adolescents Exposed to Violence: A Transdiagnostic Mechanism Contributing to the Emergence of Psychopathology. J Am Acad Child Adolesc Psychiatry 2020; 59:1274-1284. [PMID: 31473292 PMCID: PMC7048648 DOI: 10.1016/j.jaac.2019.08.471] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Exposure to violence in childhood is associated with increased risk for multiple forms of internalizing and externalizing psychopathology. We evaluated how exposure to violence in early life influences neural responses to neutral and threat-related stimuli in childhood and adolescence, developmental variation in these associations, and whether these neural response patterns convey transdiagnostic risk for psychopathology over time. METHOD Participants were 149 youths (75 female and 74 male), aged 8 to 17 years (mean = 12.8, SD = 2.63), who had experienced physical abuse, sexual abuse, or domestic violence (n = 76) or had never experienced violence (n = 73). Participants underwent functional magnetic resonance imaging scanning while passively viewing fearful, neutral, and scrambled faces presented rapidly in a block design without specific attentional demands. Internalizing and externalizing psychopathology were assessed concurrently with the scan and 2 years later and were used to compute a transdiagnostic general psychopathology factor (p factor). RESULTS Exposure to violence was associated with reduced activation in the dorsal anterior cingulate cortex (dACC) and frontal pole (1,985 voxels, peak x, y, z = 6, 4, 40) when viewing fearful (versus scrambled) faces, and reduced activation in dorsomedial prefrontal cortex and superior frontal gyrus (1,970 voxels, peak x, y, z = 16, 64, 10) when viewing neutral faces, but not amygdala activation or connectivity. Lower dACC response to fearful faces predicted increase in the p factor 2 years later (B = -0.186, p = .031) and mediated the association of violence exposure with longitudinal increases in the p factor. CONCLUSION Reduced recruitment of the dACC-a region involved in salience processing, conflict monitoring, and cognitive control-in response to threat-related cues may convey increased transdiagnostic psychopathology risk in youths exposed to violence.
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57
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Peer victimization and its impact on adolescent brain development and psychopathology. Mol Psychiatry 2020; 25:3066-3076. [PMID: 30542059 DOI: 10.1038/s41380-018-0297-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 12/24/2022]
Abstract
Chronic peer victimization has long-term impacts on mental health; however, the biological mediators of this adverse relationship are unknown. We sought to determine whether adolescent brain development is involved in mediating the effect of peer victimization on psychopathology. We included participants (n = 682) from the longitudinal IMAGEN study with both peer victimization and neuroimaging data. Latent profile analysis identified groups of adolescents with different experiential patterns of victimization. We then associated the victimization trajectories and brain volume changes with depression, generalized anxiety, and hyperactivity symptoms at age 19. Repeated measures ANOVA revealed time-by-victimization interactions on left putamen volume (F = 4.38, p = 0.037). Changes in left putamen volume were negatively associated with generalized anxiety (t = -2.32, p = 0.020). Notably, peer victimization was indirectly associated with generalized anxiety via decreases in putamen volume (95% CI = 0.004-0.109). This was also true for the left caudate (95% CI = 0.002-0.099). These data suggest that the experience of chronic peer victimization during adolescence might induce psychopathology-relevant deviations from normative brain development. Early peer victimization interventions could prevent such pathological changes.
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58
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A longitudinal twin study of victimization and loneliness from childhood to young adulthood. Dev Psychopathol 2020; 34:367-377. [PMID: 33046153 DOI: 10.1017/s0954579420001005] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The present study used a longitudinal and discordant twin design to explore in depth the developmental associations between victimization and loneliness from mid-childhood to young adulthood. The data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 individuals born in England and Wales during 1994-1995. Diverse forms of victimization were considered, differing across context, perpetrator, and timing of exposure. The results indicated that exposure to different forms of victimization was associated with loneliness in a dose-response manner. In childhood, bullying victimization was uniquely associated with loneliness, over and above concurrent psychopathology, social isolation, and genetic risk. Moreover, childhood bullying victimization continued to predict loneliness in young adulthood, even in the absence of ongoing victimization. Within-twin pair analyses further indicated that this longitudinal association was explained by genetic confounds. In adolescence, varied forms of victimization were correlated with young adult loneliness, with maltreatment, neglect, and cybervictimization remaining robust to controls for genetic confounds. These findings indicate that vulnerability to loneliness in victimized young people varies according to the specific form of victimization in question, and also to the developmental period in which it was experienced.
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59
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Tanksley PT, Barnes JC, Boutwell BB, Arseneault L, Caspi A, Danese A, Fisher HL, Moffitt TE. Identifying Psychological Pathways to Polyvictimization: Evidence from a Longitudinal Cohort Study of Twins from the United Kingdom. JOURNAL OF EXPERIMENTAL CRIMINOLOGY 2020; 16:431-461. [PMID: 32831812 PMCID: PMC7115958 DOI: 10.1007/s11292-020-09422-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Examine the extent to which cognitive/psychological characteristics predict later polyvictimization. We employ a twin-based design that allows us to test the social neurocriminology hypothesis that environmental factors influence brain-based characteristics and influence behaviors like victimization. METHODS Using data from the Environmental Risk Longitudinal Twin Study (N = 1986), we capitalize on the natural experiment embedded in a discordant-twin design that allows for the adjustment of family environments and genetic factors. RESULTS The findings indicate that self-control, as well as symptoms of conduct disorder and anxiety, are related to polyvictimization even after adjusting for family environments and partially adjusting for genetic influences. After fully adjusting for genetic factors, only self-control was a statistically significant predictor of polyvictimization. CONCLUSION The findings suggest polyvictimization is influenced by cognitive/psychological characteristics that individuals carry with them across contexts. Policies aimed at reducing victimization risks should consider interventions that address cognitive functioning and mental health.
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Affiliation(s)
- Peter T Tanksley
- School of Criminal Justice, University of Cincinnati, Cincinnati, OH 45221, USA
| | - J C Barnes
- School of Criminal Justice, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Brian B Boutwell
- School of Applied Sciences, University of Mississippi, Oxford, MS 38677, USA
- John D. Bower School of Population Health, University of Mississippi Medical Center, Oxford, MS 38677, USA
| | - Louise Arseneault
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Avshalom Caspi
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
- Department of Psychology & Neuroscience, Duke University Box 104410, Durham, NC, 27708, USA
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27708, USA
- Center for Genomic and Computational Biology, Duke University Box 90338, Durham NC, 27708, USA
| | - Andrea Danese
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
- National and Specialist Child Traumatic Stress and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London, UK
| | - Helen L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Terrie E Moffitt
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
- Department of Psychology & Neuroscience, Duke University Box 104410, Durham, NC, 27708, USA
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27708, USA
- Center for Genomic and Computational Biology, Duke University Box 90338, Durham NC, 27708, USA
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60
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Kim JH, Choi JY. Influence of childhood trauma and post-traumatic stress symptoms on impulsivity: focusing on differences according to the dimensions of impulsivity. Eur J Psychotraumatol 2020; 11:1796276. [PMID: 33029332 PMCID: PMC7473132 DOI: 10.1080/20008198.2020.1796276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Impulsivity, a trait and multidimensional construct, is associated with a wide range of impulsive behaviours. Although it is well documented that childhood trauma (CT) affects impulsivity, few studies examine whether its effects depend on particular dimensions of impulsivity and the role post-traumatic stress symptoms play in the relationship between childhood trauma and different dimensions of impulsivity. OBJECTIVE This research aims to explore the relationships between CT, PTSD, and impulsivity in a heterogeneous clinical sample. We also sought to examine whether the influence of CT on impulsivity differs across the dimensions of impulsivity. METHOD We investigated the relationships between CT, symptoms of post-traumatic stress disorder (PTSD), and five dimensions of impulsivity using a sample of 162 non-psychotic psychiatric patients without neurocognitive diagnoses. Participants completed the Childhood Trauma Questionnaire (CTQ), Impact of Event Scale - Revised (IES), and the UPPS-P Impulsive Behaviour Scale (UPPS-P). RESULTS The results of structural equation modelling showed that CT is associated with PTSD symptoms, in addition to four of the five dimensions of impulsivity in the UPPS-P:positive urgency, negative urgency, lack of premeditation, and lack of perseverance. The indirect effect of CT through PTSD symptoms was significant only for the two types of urgency. CONCLUSIONS The results of this study suggest that interventions that aim to alleviate impulsive behaviour derived from high urgency should pay particular attention to the presence of CT and PTSD symptoms.
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Affiliation(s)
- Ji Hye Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, Seoul, South Korea
| | - Ji Young Choi
- Department of Child Studies, Inha University, Incheon, South Korea
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61
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Wade M, Zeanah CH, Fox NA, Nelson CA. Global deficits in executive functioning are transdiagnostic mediators between severe childhood neglect and psychopathology in adolescence. Psychol Med 2020; 50:1687-1694. [PMID: 31391139 PMCID: PMC8026012 DOI: 10.1017/s0033291719001764] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Children reared in institutions experience profound deprivation that is associated with both heightened levels of psychopathology and deficits in executive functioning (EF). It is unclear whether deficits in EF among institutionally-reared children serve as a vulnerability factor that increases risk for later psychopathology. It is also unclear whether this putative association between EF and psychopathology is transdiagnostic (i.e. cuts across domains of psychopathology), or specific to a given syndrome. Thus, we examined whether global deficits in EF mediate the association between severe childhood neglect and general v. specific psychopathology in adolescence. METHODS The sample consisted of 188 children from the Bucharest Early Intervention Project, a longitudinal study examining the brain and behavioral development of children reared in Romanian institutions and a comparison group of never-institutionalized children. EF was assessed at age 8, 12, and 16 using a well-validated measure of neuropsychological functioning. Psychopathology was measured as general (P) and specific internalizing (INT) and externalizing (EXT) factors at age 12 and 16. RESULTS Institutionally-reared children had lower global EF and higher general psychopathology (P) at all ages compared to never-institutionalized children. Longitudinal path analysis revealed that the effect of institutionalization on P at age 16 operated indirectly through poorer EF from ages 8 to 12. No indirect effects involving EF were observed for INT or EXT at age 16. CONCLUSIONS We conclude that stable, global deficits in EF serve as a cognitive endophenotype that increases transdiagnostic vulnerability to psychopathology in adolescence among those who have experienced profound early neglect.
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Affiliation(s)
- Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto
| | - Charles H. Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland
| | - Charles A. Nelson
- Boston Children’s Hospital of Harvard Medical School
- Harvard Graduate School of Education
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Kotov R, Jonas KG, Carpenter WT, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs K, Reininghaus U, Slade T, South SC, Sunderland M, Waszczuk MA, Widiger TA, Wright AGC, Zald DH, Krueger RF, Watson D. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum. World Psychiatry 2020; 19:151-172. [PMID: 32394571 PMCID: PMC7214958 DOI: 10.1002/wps.20730] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a scientific effort to address shortcomings of traditional mental disorder diagnoses, which suffer from arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. This paper synthesizes evidence on the validity and utility of the thought disorder and detachment spectra of HiTOP. These spectra are composed of symptoms and maladaptive traits currently subsumed within schizophrenia, other psychotic disorders, and schizotypal, paranoid and schizoid personality disorders. Thought disorder ranges from normal reality testing, to maladaptive trait psychoticism, to hallucinations and delusions. Detachment ranges from introversion, to maladaptive detachment, to blunted affect and avolition. Extensive evidence supports the validity of thought disorder and detachment spectra, as each spectrum reflects common genetics, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, biomarkers, and treatment response. Some of these characteristics are specific to one spectrum and others are shared, suggesting the existence of an overarching psychosis superspectrum. Further research is needed to extend this model, such as clarifying whether mania and dissociation belong to thought disorder, and explicating processes that drive development of the spectra and their subdimensions. Compared to traditional diagnoses, the thought disorder and detachment spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and higher acceptability to clinicians. Validated measures are available to implement the system in practice. The more informative, reliable and valid characterization of psychosis-related psychopathology offered by HiTOP can make diagnosis more useful for research and clinical care.
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Affiliation(s)
- Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Katherine G Jonas
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | - Michael N Dretsch
- Walter Reed Army Institute of Research, US Army Medical Research Directorate - West, Silver Spring, MD, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Miriam K Forbes
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey Hobbs
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
- ESRC Centre for Society and Mental Health, King's College London, London, UK
- Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Abuse, University of Sydney, Sydney, NSW, Australia
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Abuse, University of Sydney, Sydney, NSW, Australia
| | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Thomas A Widiger
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, South Bend, IN, USA
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DiLalla LF, John SG. A genetically informed examination of the relations between inaccurate emotion expression and recognition and experiencing peer victimization. SOCIAL DEVELOPMENT 2020. [DOI: 10.1111/sode.12410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Lisabeth Fisher DiLalla
- Family and Community Medicine Southern Illinois University School of Medicine Carbondale Illinois
| | - Sufna Gheyara John
- Department of Psychiatry University of Arkansas for Medical Sciences Little Rock Arkansas
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64
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Social-relational exposures and well-being: Using multivariate twin data to rule-out heritable and shared environmental confounds. JOURNAL OF RESEARCH IN PERSONALITY 2020; 83. [PMID: 32317811 DOI: 10.1016/j.jrp.2019.103880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aims of the present study were as follows: (1) Using a large sample of adults, estimate overlap between social-relational exposures measured at midlife and well-being measured at midlife and approximately 9-years later. (2) Using a subsample of twins, test for heritable variation in social-relational exposures, and (3) controlling for heritable and shared environmental variation, estimate overlap between social-relational exposures and well-being, both concurrently and approximately 9-years later. Results indicated small-to-moderate overlap between exposures and well-being (mean r = .29, range = .05 to .54). There was also evidence for heritable variation in exposures, and after accounting for these genetic factors, the degree of overlap between social-relational exposures and well-being decreased (mean r = .09, range = -.07 to .33).
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Kelly EV, Newton NC, Stapinski LA, Conrod PJ, Barrett EL, Champion KE, Teesson M. A Novel Approach to Tackling Bullying in Schools: Personality-Targeted Intervention for Adolescent Victims and Bullies in Australia. J Am Acad Child Adolesc Psychiatry 2020; 59:508-518.e2. [PMID: 31051243 DOI: 10.1016/j.jaac.2019.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 04/01/2019] [Accepted: 04/24/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine the secondary effects of a personality-targeted intervention on bullying and harms among adolescent victims and bullies. METHOD Outcomes were examined for victims and bullies in the Climate and Preventure study, Australia. Participants completed self-report measures at baseline and four follow-up assessments (6, 12, 24, and 36 months). Thirteen intervention schools (n = 1,087) received Preventure, a brief personality-targeted cognitive-behavioral therapy intervention for adolescents with high-risk personality types (hopelessness, anxiety sensitivity, impulsivity, sensation seeking). Thirteen control schools (n = 1,103) received health education as usual. Bullying was examined for high-risk victims (n = 143 in Preventure schools versus n = 153 in control schools) and bullies (n = 63 in Preventure schools versus n = 67 in control schools) in the total sample. Harms were examined for high-risk victims (n = 110 in Preventure schools versus n = 87 in control schools) and bullies (n = 50 in Preventure schools versus n = 30 in control schools) in independent schools. RESULTS There was no significant intervention effect for bullying victimization or perpetration in the total sample. In the subsample, mixed models showed greater reductions in victimization (b = -0.208, 95% CI -0.4104 to -0.002, p < .05), suicidal ideation (b = -0.130, 95% CI -0.225 to -0.034, p < .01), and emotional symptoms (b = -0.263, 95% CI -0.466 to -0.061, p < .05) among high-risk victims in Preventure versus control schools. Conduct problems (b = -0.292, 95% CI -0.554 to -0.030, p < .05) showed greater reductions among high-risk bullies in Preventure versus control schools, and suicidal ideation showed greater reductions among high-risk female bullies in Preventure versus control schools (b = -0.820, 95% CI -1.198 to -0.442, p < .001). CONCLUSION The findings support targeting personality in bullying prevention. CLINICAL TRIAL REGISTRATION INFORMATION The CAP Study: Evaluating a Comprehensive Universal and Targeted Intervention Designed to Prevent Substance Use and Related Harms in Australian Adolescents; http://www.anzctr.org.au/; ACTRN12612000026820.
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Affiliation(s)
- Erin V Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Medicine and Health, The University of Sydney, Australia, and the NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; Centre de Recherche, Centre Hospitalier Ste-Justine, Montreal, Quebec, Canada.
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Medicine and Health, The University of Sydney, Australia, and the NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Medicine and Health, The University of Sydney, Australia, and the NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | | | - Emma L Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Medicine and Health, The University of Sydney, Australia, and the NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Medicine and Health, The University of Sydney, Australia, and the NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Medicine and Health, The University of Sydney, Australia, and the NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Caspi A, Houts RM, Ambler A, Danese A, Elliott ML, Hariri A, Harrington H, Hogan S, Poulton R, Ramrakha S, Rasmussen LJH, Reuben A, Richmond-Rakerd L, Sugden K, Wertz J, Williams BS, Moffitt TE. Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study. JAMA Netw Open 2020; 3:e203221. [PMID: 32315069 PMCID: PMC7175086 DOI: 10.1001/jamanetworkopen.2020.3221] [Citation(s) in RCA: 264] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
IMPORTANCE Mental health professionals typically encounter patients at 1 point in patients' lives. This cross-sectional window understandably fosters focus on the current presenting diagnosis. Research programs, treatment protocols, specialist clinics, and specialist journals are oriented to presenting diagnoses, on the assumption that diagnosis informs about causes and prognosis. This study tests an alternative hypothesis: people with mental disorders experience many different kinds of disorders across diagnostic families, when followed for 4 decades. OBJECTIVE To describe mental disorder life histories across the first half of the life course. DESIGN, SETTING, AND PARTICIPANTS This cohort study involved participants born in New Zealand from 1972 to 1973 who were enrolled in the population-representative Dunedin Study. Participants were observed from birth to age 45 years (until April 2019). Data were analyzed from May 2019 to January 2020. MAIN OUTCOMES AND MEASURES Diagnosed impairing disorders were assessed 9 times from ages 11 to 45 years. Brain function was assessed through neurocognitive examinations conducted at age 3 years, neuropsychological testing during childhood and adulthood, and midlife neuroimaging-based brain age. RESULTS Of 1037 original participants (535 male [51.6%]), 1013 had mental health data available. The proportions of participants meeting the criteria for a mental disorder were as follows: 35% (346 of 975) at ages 11 to 15 years, 50% (473 of 941) at age 18 years, 51% (489 of 961) at age 21 years, 48% (472 of 977) at age 26 years, 46% (444 of 969) at age 32 years, 45% (429 of 955) at age 38 years, and 44% (407 of 927) at age 45 years. The onset of the disorder occurred by adolescence for 59% of participants (600 of 1013), eventually affecting 86% of the cohort (869 of 1013) by midlife. By age 45 years, 85% of participants (737 of 869) with a disorder had accumulated comorbid diagnoses. Participants with adolescent-onset disorders subsequently presented with disorders at more past-year assessments (r = 0.71; 95% CI, 0.68 to 0.74; P < .001) and met the criteria for more diverse disorders (r = 0.64; 95% CI, 0.60 to 0.67; P < .001). Confirmatory factor analysis summarizing mental disorder life histories across 4 decades identified a general factor of psychopathology, the p-factor. Longitudinal analyses showed that high p-factor scores (indicating extensive mental disorder life histories) were antedated by poor neurocognitive functioning at age 3 years (r = -0.18; 95% CI, -0.24 to -0.12; P < .001), were accompanied by childhood-to-adulthood cognitive decline (r = -0.11; 95% CI, -0.17 to -0.04; P < .001), and were associated with older brain age at midlife (r = 0.14; 95% CI, 0.07 to 0.20; P < .001). CONCLUSIONS AND RELEVANCE These findings suggest that mental disorder life histories shift among different successive disorders. Data from the present study, alongside nationwide data from Danish health registers, inform a life-course perspective on mental disorders. This perspective cautions against overreliance on diagnosis-specific research and clinical protocols.
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Affiliation(s)
- Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
- Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- PROMENTA Center, University of Oslo, Oslo, Norway
| | - Renate M. Houts
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Antony Ambler
- Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Andrea Danese
- Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Maxwell L. Elliott
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Ahmad Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - HonaLee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Sean Hogan
- Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Line J. Hartmann Rasmussen
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Aaron Reuben
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Leah Richmond-Rakerd
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
- Center for Developmental Science, University of North Carolina at Chapel Hill, Chapel Hill
| | - Karen Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Jasmin Wertz
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Benjamin S. Williams
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
- Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- PROMENTA Center, University of Oslo, Oslo, Norway
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Danese A. Annual Research Review: Rethinking childhood trauma-new research directions for measurement, study design and analytical strategies. J Child Psychol Psychiatry 2020; 61:236-250. [PMID: 31762042 DOI: 10.1111/jcpp.13160] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 12/19/2022]
Abstract
Childhood trauma is a key modifiable risk factor for psychopathology. Despite significant scientific advances, traumatised children still have poorer long-term outcomes than nontraumatised children. New research paradigms are, thus, needed. To this end, the review examines three dominant assumptions about measurement, design and analytical strategies. Current research warns against using prospective and retrospective measures of childhood trauma interchangeably; against interpreting cross-sectional differences in putative mediating mechanisms between adults with or without a history of childhood trauma as evidence of longitudinal changes from pre-trauma conditions; and against directly applying explanatory models of resilience or vulnerability to psychopathology in traumatised children to forecast individual risk in unseen cases. The warnings equally apply to research on broader measures of adverse childhood experiences (ACEs). Further research examining these assumptions can generate new insights on how to prevent childhood trauma and its detrimental effects.
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Affiliation(s)
- Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
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Olivier E, Azarnia P, Morin AJS, Houle SA, Dubé C, Tracey D, Maïano C. The moderating role of teacher-student relationships on the association between peer victimization and depression in students with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 98:103572. [PMID: 31954946 DOI: 10.1016/j.ridd.2020.103572] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/25/2019] [Accepted: 01/02/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Students with intellectual disabilities (ID) are at increased risk of peer victimization and depressive symptoms. Little is known about the protective and aggravating factors that influence the association between peer victimization and depressive symptoms among students with ID. AIMS This study assesses the moderating role of two facets of teacher-student relationships (TSR)-warmth and conflict-on the association between peer victimization and depressive symptoms. METHODS A sample of 395 students (aged 11-22) with mild and moderate ID was recruited in Canada and Australia. RESULTS Hierarchical multiple regressions indicated that victimization and TSR conflict were both associated with higher levels of depressive symptoms, and that TSR conflict moderated the associations between both TSR warmth and victimization, and depressive symptoms. TSR warmth was related to lower levels of depression only for students who also reported a low level of TSR conflict. Similarly, associations between victimization and depression were weaker among students exposed to more conflictual TSR. CONCLUSIONS Students with ID are at increased risk of developing depressive symptoms when exposed to negative social relationships (i.e., peer victimization or TSR conflict). For these students, the benefits of TSR warmth were far less important than the consequences of conflict.
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Affiliation(s)
- Elizabeth Olivier
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Canada.
| | - Parin Azarnia
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Canada
| | - Simon A Houle
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Canada
| | - Céleste Dubé
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Canada
| | - Danielle Tracey
- School of Education, Western Sydney University, Sydney, Australia
| | - Christophe Maïano
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Saint-Jérôme, Canada
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Evidence that Different Types of Peer Victimization have Equivalent Associations with Transdiagnostic Psychopathology in Adolescence. J Youth Adolesc 2020; 49:590-604. [PMID: 32026235 DOI: 10.1007/s10964-020-01202-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 01/24/2020] [Indexed: 02/07/2023]
Abstract
Experiences of peer victimization are common in adolescence and have been associated with a broad variety of psychopathology in adolescence. The present study aimed to test whether some types of victimization are more harmful than others; whether the harms associated with different types of peer victimization are specific to particular domains of psychopathology; and whether these relationships vary by gender. Participants included adolescents aged 14-15 from a nationally representative cohort study (n= 3335; mean age 14.4 years; 49.1% female; 90.1% spoke English as the main language at home). Participants provided self-report information on their experiences of peer victimization, as well as symptoms of depression, anxiety, conduct problems, hyperactivity and inattention, and substance use. These data were analyzed in a dimensional and hierarchical framework using latent variable indirect effects modeling. The associations between peer victimization and psychopathology were not unique to specific symptom domains, but rather showed broadband associations with all symptom domains via a transdiagnostic association with general psychopathology. For example, an average of only 9% of the total relationship with each symptom domain was unique to the symptom-domain level, with the remaining proportion accounted for by higher-order factors (i.e., internalizing, externalizing, and general psychopathology). Further, the strength of the relationships did not vary as a function of the type of peer victimization experience (i.e., physical, verbal, or relational), and showed evidence of strict measurement invariance by gender. These findings suggest that peer victimization might present a useful target for the prevention of general psychopathology.
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Meehan AJ, Latham RM, Arseneault L, Stahl D, Fisher HL, Danese A. Developing an individualized risk calculator for psychopathology among young people victimized during childhood: A population-representative cohort study. J Affect Disord 2020; 262:90-98. [PMID: 31715391 PMCID: PMC6916410 DOI: 10.1016/j.jad.2019.10.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/23/2019] [Accepted: 10/25/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Victimized children are at greater risk for psychopathology than non-victimized peers. However, not all victimized children develop psychiatric disorders, and accurately identifying which victimized children are at greatest risk for psychopathology is important to provide targeted interventions. This study sought to develop and internally validate individualized risk prediction models for psychopathology among victimized children. METHODS Participants were members of the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative British birth cohort of 2,232 twins born in 1994-1995. Victimization exposure was measured prospectively between ages 5 and 12 years, alongside a comprehensive range of individual-, family-, and community-level predictors of psychopathology. Structured psychiatric interviews took place at age-18 assessment. Logistic regression models were estimated with Least Absolute Shrinkage and Selection Operator (LASSO) regularization to avoid over-fitting to the current sample, and internally validated using 10-fold nested cross-validation. RESULTS 26.5% (n = 591) of E-Risk participants had been exposed to at least one form of severe childhood victimization, and 60.4% (n = 334) of victimized children met diagnostic criteria for any psychiatric disorder at age 18. Separate prediction models for any psychiatric disorder, internalizing disorders, and externalizing disorders selected parsimonious subsets of predictors. The three internally validated models showed adequate discrimination, based on area-under-the-curve estimates (range = =0.66-0.73), and good calibration. LIMITATIONS External validation in wholly-independent data is needed before clinical implementation. CONCLUSIONS Findings offer proof-of-principle evidence that prediction modeling can be useful in supporting identification of victimized children at greatest risk for psychopathology. This has the potential to inform targeted interventions and rational resource allocation.
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Affiliation(s)
- Alan J. Meehan
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rachel M. Latham
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Louise Arseneault
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Daniel Stahl
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Helen L. Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Andrea Danese
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National and Specialist CAMHS Trauma, Anxiety, and Depression Clinic, South London and Maudsley NHS Foundation Trust, London, UK.
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Burke Quinlan E, Banaschewski T, Barker GJ, Bokde AL, Bromberg U, Büchel C, Desrivières S, Flor H, Frouin V, Garavan H, Heinz A, Brühl R, Martinot JL, Paillère Martinot ML, Nees F, Papadopoulos Orfanos D, Paus T, Poustka L, Hohmann S, Smolka MN, Fröhner JH, Walter H, Whelan R, Schumann G. Identifying biological markers for improved precision medicine in psychiatry. Mol Psychiatry 2020; 25:243-253. [PMID: 31676814 PMCID: PMC6978138 DOI: 10.1038/s41380-019-0555-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 01/24/2023]
Abstract
Mental disorders represent an increasing personal and financial burden and yet treatment development has stagnated in recent decades. Current disease classifications do not reflect psychobiological mechanisms of psychopathology, nor the complex interplay of genetic and environmental factors, likely contributing to this stagnation. Ten years ago, the longitudinal IMAGEN study was designed to comprehensively incorporate neuroimaging, genetics, and environmental factors to investigate the neural basis of reinforcement-related behavior in normal adolescent development and psychopathology. In this article, we describe how insights into the psychobiological mechanisms of clinically relevant symptoms obtained by innovative integrative methodologies applied in IMAGEN have informed our current and future research aims. These aims include the identification of symptom groups that are based on shared psychobiological mechanisms and the development of markers that predict disease course and treatment response in clinical groups. These improvements in precision medicine will be achieved, in part, by employing novel methodological tools that refine the biological systems we target. We will also implement our approach in low- and medium-income countries to understand how distinct environmental, socioeconomic, and cultural conditions influence the development of psychopathology. Together, IMAGEN and related initiatives strive to reduce the burden of mental disorders by developing precision medicine approaches globally.
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Affiliation(s)
- Erin Burke Quinlan
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King’s College London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Gareth J. Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
| | - Arun L.W. Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Uli Bromberg
- University Medical Centre Hamburg-Eppendorf, House W34, 3.OG, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Büchel
- University Medical Centre Hamburg-Eppendorf, House W34, 3.OG, Martinistr. 52, 20246, Hamburg, Germany
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King’s College London, United Kingdom
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany,Department of Psychology, School of Social Sciences, University of Mannheim, 68131 Mannheim, Germany
| | - Vincent Frouin
- NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, Vermont, USA
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany [or depending on journal requirements can be: Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2 - 12, Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 “Neuroimaging & Psychiatry”, University Paris Sud – Paris Saclay, University Paris Descartes; DIGITEO labs, Gif sur Yvette; France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 “Neuroimaging & Psychiatry”, University Paris Sud – Paris Saclay, University Paris Descartes; and AP-HP.Sorbonne Université, Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany,University Medical Centre Hamburg-Eppendorf, House W34, 3.OG, Martinistr. 52, 20246, Hamburg, Germany
| | | | - Tomáš Paus
- Rotman Research Institute, Baycrest and Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, M6A 2E1, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Juliane H. Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Gunter Schumann
- PONS Research Group, Dept of Psychiatry and Psychotherapy, Campus Charite Mitte, Humboldt University, Berlin and Leibniz Institute for Neurobiology, Magdeburg, Germany, and Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, P.R. China
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Ramos KÁDA, Rafael RDMR, Penna LHG, Depret DG, Ribeiro LV, Carinhanha JI. Sheltered adolescents’ background of exposure to violence and distressful experiences. Rev Bras Enferm 2020; 73:e20180714. [DOI: 10.1590/0034-7167-2018-0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 05/29/2019] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: to analyze the exposure to violence and distressful experiences lived by adolescents in institutional shelters in the city of Rio de Janeiro (previous to their admittance). Methods: a cross-sectional study carried out in public institutional shelter units, with a sample of 72 adolescents aged between 12 and 18 years. Data on sociodemographic aspects, family relationships and distressful experiences were obtained by means of the Parcours Amoureux des Jeunes instrument, validated for use in Brazil. Statistical analysis included estimates of prevalence and 95% confidence intervals. Results: high magnitudes of distressful experiences and overlapping abuses lived by adolescents were observed, especially violent events (72.2%), social exclusion (59.1%), and sexual harassment (48.6%). Conclusions: the study shows that adolescents under institutional sheltering come from a background of severe and frequent distressful experiences. These took place in multiple environments: family (prior to their institutional reception), community, and group.
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Tachi S, Asamizu M, Uchida Y, Katayama S, Naruse M, Masuya J, Ichiki M, Inoue T. Victimization In Childhood Affects Depression In Adulthood Via Neuroticism:A Path Analysis Study. Neuropsychiatr Dis Treat 2019; 15:2835-2841. [PMID: 31632031 PMCID: PMC6781847 DOI: 10.2147/ndt.s220349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/12/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Adverse experiences, such as low care, overprotection, or abuse in childhood increase the likelihood of depression via their effects on personality traits. Similarly, being victimized in childhood may affect the likelihood of depression via personality traits. In this case-control study, we hypothesized that being victimized in childhood is associated with depression in adulthood via its effect on neuroticism, and verified this hypothesis using path analysis. SUBJECTS AND METHODS Eighty-two major depressive disorder (MDD) patients and 350 age-and-sex matched healthy controls completed self-administered questionnaires of demographic data, Patient Health Questionnaire-9, neuroticism, and victimization. The association between victimization, neuroticism, and depressive symptoms or having major depression was investigated by path analysis. RESULTS Multiple group path analysis, in which depressive symptoms were considered as dependent variables, showed that the direct effect of victimization in childhood on depressive symptoms was not statistically significant in either healthy controls or MDD patients (standardized path coefficient: 0.079 and 0.084, respectively), but their indirect effects via neuroticism were statistically significant (standardized path coefficient: 0.059 and 0.141, respectively). Path analysis, in which the distinction between healthy controls and MDD patients was a dependent variable, showed that both direct effects and indirect effects of victimization in childhood via neuroticism on the distinction between healthy controls and MDD patients were statistically significant (standardized path coefficient: 0.186 and 0.164, respectively). LIMITATIONS Recall bias and the relatively small number of MDD patients are limitations of this study. Because it was a case-control survey, this study could not make any conclusions regarding causal associations. CONCLUSION This study suggests the possibility of causal associations between victimization in childhood and depressive symptoms or MDD in adulthood, and the mediation of this association by neuroticism.
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Affiliation(s)
- Shuichiro Tachi
- Department of Psychiatry, Tokyo Medical University, Tokyo160-0023, Japan
- Seijin Hospital, Tokyo121-0815, Japan
| | | | - Yoshihiro Uchida
- Department of Psychiatry, Tokyo Medical University, Tokyo160-0023, Japan
- Seijin Hospital, Tokyo121-0815, Japan
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki300-0395, Japan
| | - Shigemasa Katayama
- Department of Psychiatry, Tokyo Medical University, Tokyo160-0023, Japan
- Seijin Hospital, Tokyo121-0815, Japan
| | - Mayu Naruse
- Department of Psychiatry, Tokyo Medical University, Tokyo160-0023, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Tokyo160-0023, Japan
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki300-0395, Japan
| | - Masahiko Ichiki
- Department of Psychiatry, Tokyo Medical University, Tokyo160-0023, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo160-0023, Japan
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74
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Baker AJL, Brassard M. Predictors of variation in sate reported rates of psychological maltreatment: A survey of statutes and a call for change. CHILD ABUSE & NEGLECT 2019; 96:104102. [PMID: 31386997 DOI: 10.1016/j.chiabu.2019.104102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/17/2019] [Accepted: 07/23/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Psychological maltreatment (PM) is equivalent in harm to other forms of child maltreatment and yet it is not included in all US State child abuse statutes and past research using the National Child Abuse and Neglect Data System (NCANDS, 1998, 2007, 2008) identified 300-480-fold differences in substantiated cases across US States. This variation is inconsistent with the significance of the problem and the availability of reliable operational definitions. PARTICIPANTS AND SETTING US State statutes were coded and compared with reported rates of four different forms of child maltreatment in the 2014 and 1998 NCANDS data sets. METHODS Data were extracted from NCCANDS and State statutes were coded independently by the authors (kappa = .96). RESULTS For 2014, the difference in reported rates of PM between the State with the lowest rate and the State with the highest rate was 523-fold which was much higher than for physical (30-fold) and sexual abuse (20-fold) but not neglect (524-fold). Statutes still use the term "mental injury" from the original Child Abuse Prevention and Treatment Act (Child Abuse Prevention & Treatment Act, 1974) and two thirds did not define it. Reported rates of PM in NCANDS were not correlated with whether PM was defined in the statute but when a harm standard was present, reported rates were statistically lower. Almost 70% of statutes mentioned a current trend (e.g., sexual/human trafficking) demonstrating a willingness by States to amend statutes. CONCLUSIONS A common, reliable definition of PM (and other forms of maltreatment) in CAPTA, NCANDS, and US State statutes is necessary for the US to have a surveillance system that allows for the assessment of the effects of policies on reported rates of all forms of maltreatment.
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Affiliation(s)
- Amy J L Baker
- Director of Research, Vincent J. Fontana Center, NY Foundling, 590 6th Ave, New York, NY 10011, United States.
| | - Marla Brassard
- Professor of Psychology and Education, Teachers College, Columbia University, United States
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75
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Söder E, Clamor A, Lincoln TM. Hair cortisol concentrations as an indicator of potential HPA axis hyperactivation in risk for psychosis. Schizophr Res 2019; 212:54-61. [PMID: 31455519 DOI: 10.1016/j.schres.2019.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 07/10/2019] [Accepted: 08/05/2019] [Indexed: 12/24/2022]
Abstract
A chronic hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis is assumed to be an important indicator of vulnerability for psychosis. Despite the considerable research on this topic, putative social origins of HPA axis hyperactivation have received little attention in the literature so far. Also, the inconsistency of previous findings calls for new and reliable methods in the assessment of HPA axis activation. To address these issues, we used hair cortisol concentrations as an indicator of chronic HPA axis activation in participants at elevated risk for psychosis (clinical risk: n = 43, familial risk: n = 32) and low-risk controls (n = 35), and assessed its relation with a variety of social stressors. We also tested the interaction effect between social stressors and familial risk status on hair cortisol concentrations (moderation analysis). Participants at elevated risk for psychosis did not show significantly higher hair cortisol concentrations than low-risk controls. However, severe social stressors (child abuse experiences, traumatic events) predicted hair cortisol concentrations in the total sample. This relationship was not significantly moderated by familial risk status (as a marker of genetic risk). The results challenge the assumption that HPA axis hyperactivation is an early vulnerability indicator for psychosis but leave the possibility that it manifests only at more severe risk stages. Furthermore, the findings suggest that acquired experiences contribute to the emergence of HPA axis hyperactivation, which might occur via a gene-environment correlation rather than via a gene-environment interaction.
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Affiliation(s)
- Eveline Söder
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany.
| | - Annika Clamor
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - Tania M Lincoln
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany
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76
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Lee LO, Aldwin CM, Kubzansky LD, Mroczek DK, Spiro A. The long arm of childhood experiences on longevity: Testing midlife vulnerability and resilience pathways. Psychol Aging 2019; 34:884-899. [PMID: 31524422 DOI: 10.1037/pag0000394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Adverse early experiences have been associated with higher mortality risk, but evidence varies by type of experiences, and relatively little is known about the role of favorable early experiences on health in later life. This study evaluated the independent contributions to longevity of favorable and unfavorable early experiences, including psychosocial stressors, childhood socioeconomic status (SES), and close relationships. We also examined 4 midlife psychosocial factors as vulnerability and resilience pathways potentially mediating these associations. The sample included 1,042 men from the VA Normative Aging Study. Early experiences were assessed retrospectively in 1961-1970 and 1995. Midlife psychosocial factors were measured in 1985-1991 and included stressful life events (SLEs), negative affect, life satisfaction, and optimism. Mortality was assessed through 2016. In multiple mediator structural equation models, which account for the overlap among pathways, higher number of SLEs in midlife mediated the association of having more childhood psychosocial stressors to reduced longevity, supporting stress continuity as a vulnerability pathway. Higher optimism in midlife also mediated the association of higher childhood SES to greater longevity. In single mediator models, higher life satisfaction in midlife transmitted the benefits of higher childhood SES and presence of close relationships onto longevity. Higher optimism also mediated the association of fewer childhood psychosocial stressors to longevity. However, these indirect effects were attenuated when accounting for shared variance among mediators, suggesting overlapping pathways. Findings offer novel evidence on unique and shared pathways linking specific dimensions of early experiences to longevity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Lewina O Lee
- National Center for Posttraumatic Stress Disorder
| | | | | | | | - Avron Spiro
- Massachusetts Veterans Epidemiology Research and Information Center
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77
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Weissman DG, Bitran D, Miller AB, Schaefer JD, Sheridan MA, McLaughlin KA. Difficulties with emotion regulation as a transdiagnostic mechanism linking child maltreatment with the emergence of psychopathology. Dev Psychopathol 2019; 31:899-915. [PMID: 30957738 PMCID: PMC6620140 DOI: 10.1017/s0954579419000348] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Childhood maltreatment is associated with increased risk for most forms of psychopathology. We examine emotion dysregulation as a transdiagnostic mechanism linking maltreatment with general psychopathology. A sample of 262 children and adolescents participated; 162 (61.8%) experienced abuse or exposure to domestic violence. We assessed four emotion regulation processes (cognitive reappraisal, attention bias to threat, expressive suppression, and rumination) and emotional reactivity. Psychopathology symptoms were assessed concurrently and at a 2-year longitudinal follow-up. A general psychopathology factor (p factor), representing co-occurrence of psychopathology symptoms across multiple internalizing and externalizing domains, was estimated using confirmatory factor analysis. Maltreatment was associated with heightened emotional reactivity and greater use of expressive suppression and rumination. The association of maltreatment with attention bias varied across development, with maltreated children exhibiting a bias toward threat and adolescents a bias away from threat. Greater emotional reactivity and engagement in rumination mediated the longitudinal association between maltreatment and increased general psychopathology over time. Emotion dysregulation following childhood maltreatment occurs at multiple stages of the emotion generation process, in some cases varies across development, and serves as a transdiagnostic mechanism linking child maltreatment with general psychopathology.
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Affiliation(s)
| | - Debbie Bitran
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Adam Bryant Miller
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | | | - Margaret A. Sheridan
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA
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78
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Forbes MK, Rapee RM, Krueger RF. Opportunities for the prevention of mental disorders by reducing general psychopathology in early childhood. Behav Res Ther 2019; 119:103411. [PMID: 31202004 PMCID: PMC6679974 DOI: 10.1016/j.brat.2019.103411] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/01/2019] [Accepted: 05/24/2019] [Indexed: 02/04/2023]
Abstract
This paper explores the concept that reducing general psychopathology early in the life course provides unprecedented opportunities to prevent the development of all forms of psychopathology later in life. We review empirical evidence for the existence of the general factor of psychopathology and theories regarding the psychological nature of the factor. We then highlight specific examples of environmental risk factors for general psychopathology and discuss translational implications for the transdiagnostic prevention of psychopathology beginning in early childhood. Ultimately, we propose a developmentally informed and transdiagnostic stepped care approach to intervention in which reduction of general psychopathology in early childhood represents the foundational step for prevention and intervention of subsequent psychopathology. This model heralds three key benefits over the current treatment zeitgeist: (1) Reducing the burden and confusion in healthcare and education systems by providing a coherent and systematic structure for early intervention across a child's development, (2) maximising the breadth of the impact of intervention by focusing on common shared risks across psychopathology, and (3) increasing the efficiency of intervention by corresponding with the development of psychopathology and leveraging the emergence of general psychopathology in early childhood.
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Affiliation(s)
- Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia.
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Twin Cities, USA
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79
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Hankin BL. A choose your own adventure story: Conceptualizing depression in children and adolescents from traditional DSM and alternative latent dimensional approaches. Behav Res Ther 2019; 118:94-100. [PMID: 31026717 PMCID: PMC6547377 DOI: 10.1016/j.brat.2019.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/09/2019] [Accepted: 04/17/2019] [Indexed: 01/15/2023]
Abstract
For the past several decades, the phenomenon of depression largely has been defined, classified, and thus assessed and analyzed, according to criteria based on the Diagnostic and Statistical Manual (now DSM5). A substantial body of knowledge on epidemiology, course, risk factors, correlates, consequences, assessment, and intervention for youth depression is based on this classical nosological approach to conceptualizing depression. Yet, recent structural and classification approaches, such as latent dimensional bifactor models (e.g., P factor model; Caspi et al., 2014) and hierarchical organizations (e.g., HiTOP; Kotov, Waszczuk, Krueger, Forbes, & Watson, 2017), have been proposed and supported as alternative options to characterize features of depression. This paper considers conceptualizations of depression among youth with a particular focus on validity: how important clinical outcomes and risks (genetic, neural, temperament, early pubertal timing, stress, and cognitive) relate to depression when ascertained via traditional DSM-defined depression versus more recent latent dimensional model approaches. The construct validity of depression, in terms of associations within respective nomological networks, varies by depression conceptualization. Clinical scientists and applied practitioners need to clearly think through the nature of what depression is and how the latent construct is conceptualized and measured. Conclusions reached for research, teaching, and evidence-based clinical work are affected and may not be the same across different conceptual and nosological organizational schemes.
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80
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Kahr Nilsson K, Landorph S, Houmann T, Olsen EM, Skovgaard AM. Developmental and mental health characteristics of children exposed to psychosocial adversity and stressors at the age of 18-months: Findings from a population-based cohort study. Infant Behav Dev 2019; 57:101319. [PMID: 31154136 DOI: 10.1016/j.infbeh.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 03/02/2019] [Accepted: 04/06/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Prior research on adverse experiences in early childhood has mainly focused on at-risk populations while studies of unselected populations are scarce. This topic therefore remains to be elucidated in broader child populations. Accordingly, the aim of this study was to examine if and to what extent children from a general population sample are exposed to psychosocial adversity and stressors in early childhood and whether the development and mental health of children with and without such exposure differ at the age of 18-months. METHODS A random sample of the Copenhagen Child Cohort (CCC2000) comprising 210 children and their parents participated in the study when the children were approximately 18-months. Information on exposures was obtained from a semi-structured interview including the Mannheim Parent Interview (MPI) and classified in agreement with the Multiaxial Classification of Child and Adolescent Psychiatric Disorders (ICD-10), and the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). Child development was assessed with the Bayley Scales of Infant and Toddler Development - Second Edition (BSID-II), while mental health was measured using the Child Behavior Check List (CBCL 1½-5). RESULTS Among the 210 children, 91 (43%) had been exposed to psychosocial adversity and persistent stressors. The exposed children differed from the non-exposed children by poorer cognitive development and behavioral regulation, as well as more attention problems and anxious/depressed symptoms. The children exposed to adverse caregiving environments were specifically more likely to have delayed cognitive development than the rest of the sample. CONCLUSIONS In a general population sample of children aged 18-months, exposure to psychosocial adversity and stressors was associated with poorer development and mental health in cognitive and affective domains. These findings highlight an avenue for further research with potential implications for early preventative practices.
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Affiliation(s)
- Kristine Kahr Nilsson
- Center for Developmental & Applied Psychological Science (CeDAPS), Department of Communication and Psychology, Aalborg University, Denmark.
| | - Susanne Landorph
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Glostrup, Denmark
| | - Tine Houmann
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Else Marie Olsen
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Denmark; Center for Clinical Research and Prevention, Capital Region, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Denmark
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81
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Baldwin JR, Arseneault L, Caspi A, Moffitt TE, Fisher HL, Odgers CL, Ambler A, Houts RM, Matthews T, Ougrin D, Richmond-Rakerd LS, Takizawa R, Danese A. Adolescent Victimization and Self-Injurious Thoughts and Behaviors: A Genetically Sensitive Cohort Study. J Am Acad Child Adolesc Psychiatry 2019; 58:506-513. [PMID: 30768402 PMCID: PMC6494951 DOI: 10.1016/j.jaac.2018.07.903] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/07/2018] [Accepted: 08/15/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Victimized adolescents have an increased risk of self-injurious thoughts and behaviors. However, poor understanding of causal and non-causal mechanisms underlying this observed risk limits the development of interventions to prevent premature death in adolescents. This study tested whether pre-existing family-wide and individual vulnerabilities account for victimized adolescents' increased risk of self-injurious thoughts and behaviors. METHOD Participants were 2,232 British children followed from birth to 18 years of age as part of the Environmental Risk Longitudinal Twin Study. Adolescent victimization (maltreatment, neglect, sexual victimization, family violence, peer/sibling victimization, cyber victimization, and crime victimization) was assessed through interviews with participants and co-informant questionnaires at the 18-year assessment. Suicidal ideation, self-harm, and suicide attempt in adolescence were assessed through interviews with participants at 18 years. RESULTS Victimized adolescents had an increased risk of suicidal ideation (odds ratio [OR] 2.40, 95% CI 2.11-2.74), self-harm (OR 2.38, 95% CI 2.10-2.69), and suicide attempt (OR 3.14, 95% CI 2.54-3.88). Co-twin control and propensity score matching analyses showed that these associations were largely accounted for by pre-existing familial and individual vulnerabilities, respectively. Over and above their prior vulnerabilities, victimized adolescents still showed a modest increase in risk for suicidal ideation (OR 1.45, 95%CI 1.10-1.91) and self-harm (OR 1.50, 95% CI 1.18-1.91) but not for suicide attempt (OR 1.28, 95% CI 0.83-1.98). CONCLUSION Risk for self-injurious thoughts and behaviors in victimized adolescents is explained only in part by the experience of victimization. Pre-existing vulnerabilities account for a large proportion of the risk. Therefore, effective interventions to prevent premature death in victimized adolescents should not only target the experience of victimization but also address pre-existing vulnerabilities.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Ryu Takizawa
- Graduate School of Education, The University of Tokyo, Japan
| | - Andrea Danese
- King's College London, UK; National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and the Maudsley NHS Foundation Trust, London, UK.
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82
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Belsky DW, Caspi A, Arseneault L, Corcoran DL, Domingue BW, Harris KM, Houts RM, Mill JS, Moffitt TE, Prinz J, Sugden K, Wertz J, Williams B, Odgers CL. Genetics and the geography of health, behaviour and attainment. Nat Hum Behav 2019; 3:576-586. [PMID: 30962612 DOI: 10.1038/s41562-019-0562-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 02/19/2019] [Indexed: 01/06/2023]
Abstract
Young people's life chances can be predicted by characteristics of their neighbourhood1. Children growing up in disadvantaged neighbourhoods exhibit worse physical and mental health and suffer poorer educational and economic outcomes than children growing up in advantaged neighbourhoods. Increasing recognition that aspects of social inequalities tend, in fact, to be geographical inequalities2-5 is stimulating research and focusing policy interest on the role of place in shaping health, behaviour and social outcomes. Where neighbourhood effects are causal, neighbourhood-level interventions can be effective. Where neighbourhood effects reflect selection of families with different characteristics into different neighbourhoods, interventions should instead target families or individuals directly. To test how selection may affect different neighbourhood-linked problems, we linked neighbourhood data with genetic, health and social outcome data for >7,000 European-descent UK and US young people in the E-Risk and Add Health studies. We tested selection/concentration of genetic risks for obesity, schizophrenia, teen pregnancy and poor educational outcomes in high-risk neighbourhoods, including genetic analysis of neighbourhood mobility. Findings argue against genetic selection/concentration as an explanation for neighbourhood gradients in obesity and mental health problems. By contrast, modest genetic selection/concentration was evident for teen pregnancy and poor educational outcomes, suggesting that neighbourhood effects for these outcomes should be interpreted with care.
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Affiliation(s)
- Daniel W Belsky
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA. .,Robert N. Butler Columbia Aging Center, Columbia University, New York, NY, USA.
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Center for Genomic and Computational Biology, Duke University, Durham, NC, USA.,MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Louise Arseneault
- MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David L Corcoran
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Benjamin W Domingue
- Stanford Graduate School of Education, Stanford University, Palo Alto, CA, USA
| | - Kathleen Mullan Harris
- Carolina Population Center and Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Renate M Houts
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Jonathan S Mill
- Complex Disease Epigenetics Group, University of Exeter Medical School, Exeter, UK
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Center for Genomic and Computational Biology, Duke University, Durham, NC, USA.,MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph Prinz
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Karen Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Jasmin Wertz
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Benjamin Williams
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Candice L Odgers
- Department of Psychological Science, University of California at Irvine, Irvine, CA, USA. .,Sanford School of Public Policy, Duke University, Durham, NC, USA.
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83
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Snyder HR, Friedman NP, Hankin BL. Transdiagnostic mechanisms of psychopathology in youth: Executive functions, dependent stress, and rumination. COGNITIVE THERAPY AND RESEARCH 2019; 43:834-851. [PMID: 31551642 DOI: 10.1007/s10608-019-10016-z] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Executive function (EF) deficits have been proposed as transdiagnostic risk factors for psychopathology, and recent research suggests EF impairments are associated with what is shared across forms of psychopathology (p factor). However, most research has not employed methods that differentiate between EF components, and little is known about the mediating mechanisms linking EF and psychopathology dimensions. The current study tested associations between the latent unity/diversity model of EF and latent dimensions of psychopathology and investigated mediating mechanisms in a community sample of 292 youth age 13-22. The results confirmed the finding that poor EF is associated with internalizing psychopathology in older youth via higher dependent stress and rumination, and showed that this pathway was transdiagnostic, predicting the p factor rather than internalizing specifically. Links with psychopathology were specific to the common EF factor, rather than updating- or shifting-specific EF.
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Affiliation(s)
- Hannah R Snyder
- Department of Psychology, Brandeis University, Brown 125, 415 South St. Waltham, MA
| | - Naomi P Friedman
- Department of Psychology and Neuroscience and Institute for Behavioral Genetics, University of Colorado Boulder, 345 UCB, Boulder CO 80309
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E. Daniel Street, Champaign IL 61820
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Richmond-Rakerd LS, Trull TJ, Gizer IR, McLaughlin K, Scheiderer EM, Nelson EC, Agrawal A, Lynskey MT, Madden PA, Heath AC, Statham DJ, Martin NG. Common genetic contributions to high-risk trauma exposure and self-injurious thoughts and behaviors. Psychol Med 2019; 49:421-430. [PMID: 29729685 PMCID: PMC7410360 DOI: 10.1017/s0033291718001034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Prior research has documented shared heritable contributions to non-suicidal self-injury (NSSI) and suicidal ideation (SI) as well as NSSI and suicide attempt (SA). In addition, trauma exposure has been implicated in risk for NSSI and suicide. Genetically informative studies are needed to determine common sources of liability to all three self-injurious thoughts and behaviors, and to clarify the nature of their associations with traumatic experiences. METHODS Multivariate biometric modeling was conducted using data from 9526 twins [59% female, mean age = 31.7 years (range 24-42)] from two cohorts of the Australian Twin Registry, some of whom also participated in the Childhood Trauma Study and the Nicotine Addiction Genetics Project. RESULTS The prevalences of high-risk trauma exposure (HRT), NSSI, SI, and SA were 24.4, 5.6, 27.1, and 4.6%, respectively. All phenotypes were moderately to highly correlated. Genetic influences on self-injurious thoughts and behaviors and HRT were significant and highly correlated among men [rG = 0.59, 95% confidence interval (CI) (0.37-0.81)] and women [rG = 0.56 (0.49-0.63)]. Unique environmental influences were modestly correlated in women [rE = 0.23 (0.01-0.45)], suggesting that high-risk trauma may confer some direct risk for self-injurious thoughts and behaviors among females. CONCLUSIONS Individuals engaging in NSSI are at increased risk for suicide, and common heritable factors contribute to these associations. Preventing trauma exposure may help to mitigate risk for self-harm and suicide, either directly or indirectly via reductions in liability to psychopathology more broadly. In addition, targeting pre-existing vulnerability factors could significantly reduce risk for life-threatening behaviors among those who have experienced trauma.
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Affiliation(s)
- Leah S. Richmond-Rakerd
- Dept. of Psychology & Neuroscience, Duke University
- Dept. of Psychological Sciences, University of Missouri
| | | | - Ian R. Gizer
- Dept. of Psychological Sciences, University of Missouri
| | | | - Emily M. Scheiderer
- Dept. of Psychological Sciences, University of Missouri
- Dept. of Clinical and Counselling Psychology, NHS Grampian, Royal Cornhill Hospital, Aberdeen, UK
| | | | - Arpana Agrawal
- Dept. of Psychiatry, Washington University School of Medicine
| | - Michael T. Lynskey
- Dept. of Psychiatry, Washington University School of Medicine
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | | | - Andrew C. Heath
- Dept. of Psychiatry, Washington University School of Medicine
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85
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Connolly EJ, Kavish N. The Causal Relationship between Childhood Adversity and Developmental Trajectories of Delinquency: A Consideration of Genetic and Environmental Confounds. J Youth Adolesc 2018; 48:199-211. [PMID: 30471056 DOI: 10.1007/s10964-018-0960-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/08/2018] [Indexed: 11/25/2022]
Abstract
An extensive line of research has found that children exposed to multiple forms of early life adversity are more likely to engage in high levels of delinquent behavior during adolescence. Several studies examining this association have used a range of multivariate statistical techniques capable of controlling for observable covariates. Fewer studies have used family-based research designs to additionally control for unobservable confounds, such as genetic and shared environmental influences, that may be associated with exposure to childhood adversity and delinquency. The current study analyzes self-report data on 2534 full-siblings (50% female) from the National Longitudinal Survey of Youth 1997 to conduct a sibling-comparison analysis to provide a rigorous test of the causal hypothesis that exposure to childhood adversity causes differences in developmental patterns of delinquent behavior. Results from multivariate latent growth curve models revealed that childhood adversity was associated with higher starting levels of delinquency during adolescence and slower rates of decline from adolescence to emerging adulthood. Results from multivariate sibling-comparison models, however, revealed that siblings exposed to higher levels of childhood adversity reported higher starting levels of delinquent behavior, but not slower declines over time, suggesting that childhood adversity may not be directly associated with long-term patterns of delinquent behavior after genetic and shared environmental factors are taken into account. Implications of these results for future research are discussed.
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Affiliation(s)
- Eric J Connolly
- Department of Criminal Justice and Criminology, Sam Houston State University, Huntsville, TX, 77340, USA.
| | - Nicholas Kavish
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, 77340, USA
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86
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Schaefer JD. Use of Hierarchical Measures of Psychopathology to Capture the Long (and Wide) Shadow of Early Deprivation in the Bucharest Early Intervention Project Analysis. JAMA Psychiatry 2018; 75:1101-1102. [PMID: 30267048 DOI: 10.1001/jamapsychiatry.2018.2215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jonathan D Schaefer
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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87
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Wade M, Fox NA, Zeanah CH, Nelson CA. Effect of Foster Care Intervention on Trajectories of General and Specific Psychopathology Among Children With Histories of Institutional Rearing: A Randomized Clinical Trial. JAMA Psychiatry 2018; 75:1137-1145. [PMID: 30267045 PMCID: PMC6248099 DOI: 10.1001/jamapsychiatry.2018.2556] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
IMPORTANCE It is unclear whether early institutional rearing is associated with more problematic trajectories of psychopathology from childhood to adolescence and whether assignment to foster care mitigates this risk. OBJECTIVES To examine trajectories of latent psychopathology factors-general (P), internalizing (INT), and externalizing (EXT)-among children reared in institutions and to evaluate whether randomization to foster care is associated with reductions in psychopathology from middle childhood through adolescence. DESIGN, SETTING, AND PARTICIPANTS This longitudinal, intent-to-treat randomized clinical trial was conducted in Bucharest, Romania, where children residing in 6 institutions underwent baseline testing and were then randomly assigned to a care as usual group (CAUG) or a foster care group (FCG). A matched sample of a never-institutionalized group (NIG) was recruited to serve as a comparison group. The study commenced in April 2001, and the most recent (age 16 years) follow-up started in January 2015 and is ongoing. INTERVENTION Institutionally reared children randomized to high-quality foster homes. MAIN OUTCOMES AND MEASURES Psychopathology was measured using the MacArthur Health and Behavior Questionnaire. Teachers and/or caregivers reported on symptoms of psychopathology in several domains. RESULTS A total of 220 children (50.0% female; 119 ever institutionalized) were included in the analysis at the mean ages of 8, 12, and 16 years. A latent bifactor model with general (P) and specific internalizing (INT) and externalizing (EXT) factors offered a good fit to the data. At age 8 years, CAUG (mean, 0.41; 95% CI, 0.17-0.67) and FCG (mean, 0.30; 95% CI, 0.04-0.53) had higher P than NIG (mean, -0.40; 95% CI, -0.56 to -0.18). By age 16 years, FCG (mean, 0.07; 95% CI, -0.18 to 0.29) had lower P than CAUG (mean, 0.37; 95% CI, 0.13-0.60). This effect was likely driven by modest declines in P from age 8 years to age 16 years among FCG (slope, -0.12; 95% CI, -0.26 to 0.04) compared with CAUG, who remained stably high over this period (slope, -0.02; 95% CI, -0.19 to 0.14). Moreover, CAUG and FCG showed increasing divergence in EXT over time, such that FCG (mean, -0.30; 95% CI, -0.58 to -0.02) had fewer problems than CAUG (mean, 0.05; 95% CI, -0.25 to 0.36) by age 16 years. No INT differences were observed. CONCLUSIONS AND RELEVANCE Institutionalization increases transdiagnostic vulnerability to psychopathology from childhood to adolescence, a period of significant social and biological change. Early assignment to foster care partially mitigates this risk, thus highlighting the importance of social enrichment in buffering the effects of severe early neglect on trajectories of psychopathology. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00747396.
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Affiliation(s)
- Mark Wade
- Division of Developmental Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | - Charles H. Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana
| | - Charles A. Nelson
- Division of Developmental Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts,Harvard Graduate School of Education, Boston, Massachusetts
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88
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Abstract
In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able to measure a person's liability to mental disorder, comorbidity among disorders, persistence of disorders over time, and severity of symptoms. This single dimension of general psychopathology has been termed "p," because it conceptually parallels a dimension already familiar to behavioral scientists and clinicians: the "g" factor of general intelligence. As the g dimension reflects low to high mental ability, the p dimension represents low to high psychopathology severity, with thought disorder at the extreme. The dimension of p unites all disorders. It influences present/absent status on hundreds of psychiatric symptoms, which modern nosological systems typically aggregate into dozens of distinct diagnoses, which in turn aggregate into three overarching domains, namely, the externalizing, internalizing, and psychotic experience domains, which finally aggregate into one dimension of psychopathology from low to high: p. Studies show that the higher a person scores on p, the worse that person fares on measures of family history of psychiatric illness, brain function, childhood developmental history, and adult life impairment. A dimension of p may help account for ubiquitous nonspecificity in psychiatry: multiple disorders share the same risk factors and biomarkers and often respond to the same therapies. Here, the authors summarize the history of the unidimensional idea, review modern research into p, demystify statistical models, articulate some implications of p for prevention and clinical practice, and outline a transdiagnostic research agenda. [AJP AT 175: Remembering Our Past As We Envision Our Future October 1910: A Study of Association in Insanity Grace Helen Kent and A.J. Rosanoff: "No sharp distinction can be drawn between mental health and mental disease; a large collection of material shows a gradual and not an abrupt transition from the normal state to pathological states."(Am J Psychiatry 1910; 67(2):317-390 )].
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Affiliation(s)
- Avshalom Caspi
- From the Department of Psychology and Neuroscience, the Department of Psychiatry and Behavioral Sciences, and the Center for Genomic and Computational Biology, Duke University, Durham, N.C.; and the Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
| | - Terrie E Moffitt
- From the Department of Psychology and Neuroscience, the Department of Psychiatry and Behavioral Sciences, and the Center for Genomic and Computational Biology, Duke University, Durham, N.C.; and the Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
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89
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Stern A, Agnew-Blais J, Danese A, Fisher HL, Jaffee SR, Matthews T, Polanczyk GV, Arseneault L. Associations between abuse/neglect and ADHD from childhood to young adulthood: A prospective nationally-representative twin study. CHILD ABUSE & NEGLECT 2018; 81:274-285. [PMID: 29775871 PMCID: PMC6013278 DOI: 10.1016/j.chiabu.2018.04.025] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 05/04/2023]
Abstract
Child maltreatment has consistently been found to be associated with attention deficit/hyperactivity disorder (ADHD). However, the robustness of this association and the direction of the link between maltreatment and ADHD remain unclear. We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a cohort of 2232 British twins, to investigate the associations between exposure to abuse/neglect and ADHD in childhood and in young adulthood, and to test their robustness and specificity. We also aimed to test longitudinal associations between abuse/neglect and ADHD from childhood to young adulthood, controlling for confounders. Results indicated strong associations between abuse/neglect and ADHD in childhood and also in young adulthood. In childhood, the association was concentrated among children with comorbid conduct disorder. Longitudinal analyses showed that childhood ADHD predicted abuse/neglect in later years. This association was again concentrated among individuals with comorbid conduct disorder. Abuse/neglect in childhood was not associated with later ADHD in young adulthood after adjusting for childhood ADHD. Our study does not provide support of a causal link between child abuse/neglect and adult ADHD but highlights the possibility of a long-term effect of disruptive behaviors on the risk for experiencing abuse/neglect. These findings emphasize the need for clinicians treating people with ADHD, especially those with comorbid conduct disorder, to be aware of their increased risk for experiencing abuse/neglect. Interventions aimed at reducing risks of abuse/neglect should also focus on the environment of individuals with disruptive behaviors.
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Affiliation(s)
- Adi Stern
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Jessica Agnew-Blais
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Andrea Danese
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Helen L Fisher
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Sara R Jaffee
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
| | - Timothy Matthews
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | | | - Louise Arseneault
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
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90
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Marzi SJ, Sugden K, Arseneault L, Belsky DW, Burrage J, Corcoran DL, Danese A, Fisher HL, Hannon E, Moffitt TE, Odgers CL, Pariante C, Poulton R, Williams BS, Wong CC, Mill J, Caspi A. Analysis of DNA Methylation in Young People: Limited Evidence for an Association Between Victimization Stress and Epigenetic Variation in Blood. Am J Psychiatry 2018; 175:517-529. [PMID: 29325449 PMCID: PMC5988939 DOI: 10.1176/appi.ajp.2017.17060693] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE DNA methylation has been proposed as an epigenetic mechanism by which early-life experiences become "embedded" in the genome and alter transcriptional processes to compromise health. The authors sought to investigate whether early-life victimization stress is associated with genome-wide DNA methylation. METHOD The authors tested the hypothesis that victimization is associated with DNA methylation in the Environmental Risk (E-Risk) Longitudinal Study, a nationally representative 1994-1995 birth cohort of 2,232 twins born in England and Wales and assessed at ages 5, 7, 10, 12, and 18 years. Multiple forms of victimization were ascertained in childhood and adolescence (including physical, sexual, and emotional abuse; neglect; exposure to intimate-partner violence; bullying; cyber-victimization; and crime). RESULTS Epigenome-wide analyses of polyvictimization across childhood and adolescence revealed few significant associations with DNA methylation in peripheral blood at age 18, but these analyses were confounded by tobacco smoking and/or did not survive co-twin control tests. Secondary analyses of specific forms of victimization revealed sparse associations with DNA methylation that did not replicate across different operationalizations of the same putative victimization experience. Hypothesis-driven analyses of six candidate genes in the stress response (NR3C1, FKBP5, BDNF, AVP, CRHR1, SLC6A4) did not reveal predicted associations with DNA methylation in probes annotated to these genes. CONCLUSIONS Findings from this epidemiological analysis of the epigenetic effects of early-life stress do not support the hypothesis of robust changes in DNA methylation in victimized young people. We need to come to terms with the possibility that epigenetic epidemiology is not yet well matched to experimental, nonhuman models in uncovering the biological embedding of stress.
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Affiliation(s)
- Sarah J. Marzi
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Karen Sugden
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Louise Arseneault
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Daniel W. Belsky
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Joe Burrage
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - David L. Corcoran
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Andrea Danese
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Helen L. Fisher
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Eilis Hannon
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Terrie E. Moffitt
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Candice L. Odgers
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Carmine Pariante
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Richie Poulton
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Benjamin S. Williams
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Chloe C.Y. Wong
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Jonathan Mill
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
| | - Avshalom Caspi
- From the Social, Genetic, and Developmental Psychiatry Research Centre, the Department of Child and Adolescent Psychiatry, and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience, Social Science Research Institute, and the Center for Genomic and
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