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Hein K, Zarate D, Burleigh T, Stavropoulos V. Pixels and perception: Mapping the association between digital media and psychotic-like experiences in adolescents. Compr Psychiatry 2024; 134:152509. [PMID: 38905775 DOI: 10.1016/j.comppsych.2024.152509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 06/08/2024] [Accepted: 06/11/2024] [Indexed: 06/23/2024] Open
Abstract
INTRODUCTION Psychotic-like experiences (PLEs) during adolescence can lead to psychotic disorders. Digital media usage has been suggested to link to PLEs, but research is limited on how different types of screen exposure may differentially relate to PLEs over time. This study aimed to examine longitudinal associations between screen usage patterns and PLEs in adolescents. METHODS Participants comprised 11,876 adolescents assessed annually from ages 9-12 years as part of the Adolescent Brain Cognitive Development study (ABCD). Screen usage (TV, video games, online video, social media, texting, video chat) and PLEs were assessed via self-report. Longitudinal network analysis models were estimated to examine connections between screen usage types and PLEs across three time points. RESULTS Two clusters were formed, including digital media for socializing (e.g., social media/texting/video chat) and digital media for entertainment (e.g., online video/video games/TV). Texting and online video(s) had the highest centrality at each time point, suggesting importance in the network. PLE symptoms of hallucinations and concentration difficulties exhibited higher centrality than other symptoms. Online video and TV were influential bridges between screen usage and PLEs. Network structure significantly differed between ages 9-10 and 10-12 years, but global strength was unchanged over time. DISCUSSION Results highlight the importance of understanding the associations between specific screen usage types and PLE symptoms. Texting and online video usage appear most influential in the development of adolescent PLEs over time. Findings can inform targeted interventions to promote healthy screen habits and reduce PLEs in at-risk youth.
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Zhang WX, Yang MB, Zhang KC, Xi M, Si SB. Characteristics of symptoms and development of psychological status in late Chinese adolescence. J Affect Disord 2024; 361:310-321. [PMID: 38851434 DOI: 10.1016/j.jad.2024.05.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/04/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Many late adolescents experience a state of psychological sub-health, requiring early recognition and intervention. This study aims to assess the psychological state of late Chinese adolescents and uncover developmental trend of mental health through network analysis. METHOD We analyzed data from 9072 Chinese high school adolescents in Shandong Province surveyed in 2020-2021, and divided them into the normal, the suspected, and the abnormal groups based on Symptom Checklist 90 (SCL-90) scores. Network analysis was employed to identify the core symptoms and bridge symptoms across different states. RESULTS Anxiety and depression were the most central symptoms, without gender differences. Core symptoms, network structure, and network invulnerability varied across different psychological states. The abnormal group exhibited the highest value of natural connectivity, followed by the suspected and normal groups. This pattern extended to bridge networks. While not meeting diagnostic criteria, the suspected group demonstrated abnormalities in network edge invariance and global strength invariance. LIMITATIONS The cross-sectional design cannot establish causality, and biases in self-report measurements cannot be ignored. CONCLUSION Compared to traditional scale indicators, network structural characteristics may be a more sensitive assessment indicator.
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Affiliation(s)
- Wei-Xia Zhang
- Department of Physical Education, Northwestern Polytechnical University, Xi'an, China
| | - Meng-Bi Yang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Ke-Chuang Zhang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Min Xi
- Hospital of Northwestern Polytechnical University, Xi'an, China; The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, The Key Laboratory of Neuro-informatics and Rehabilitation Engineering of Ministry of Civil Affairs, Xi'an, China
| | - Shu-Bin Si
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China; Key Laboratory of Industrial Engineering and Intelligent Manufacturing (Ministry of Industry and Information Technology), Xi'an, China.
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Enting M, de Jongh MAC, Joosen MCW, Bakker M, van der Kruijssen DTF, Geuze RE, Kupper N. The cross-sectional and longitudinal interconnectedness of physical, psychological and role functioning following physical trauma: A network analysis. J Psychosom Res 2024; 184:111833. [PMID: 38959575 DOI: 10.1016/j.jpsychores.2024.111833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/26/2024] [Accepted: 06/11/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE Surviving physical trauma can have a large impact on one's daily life. Patients are at increased risk for poor physical health, psychological complaints, and problems in role functioning - which is often experienced simultaneously. The present study explores the interconnectedness of physical, psychological, and role functioning during the first two years post-injury, both cross-sectionally and longitudinally from a network perspective. METHODS 3785 trauma patients (Mage = 64.2 years, SDage = 18.9 years, 50.5% female) completed questionnaires on physical, psychological, and role functioning across six measurement occasions during the first two years post-injury. The Injury Severity Score (ISS) was retrieved from the local trauma registry. Mixed graphical network models and cross-lagged network models were estimated to examine which items of recovery played a central role and were mostly related to other items in cross-sectional and longitudinal networks respectively. RESULTS The cross-sectional networks showed especially strong interconnections between impairments of physical and role functioning and also within post-traumatic stress symptoms. The longitudinal networks extended these results by showing that pain, impaired mobility, limitations in self-care, anxiety/depressive symptoms, and several post-traumatic stress symptoms were strong predictors for impairments in functioning at later stages of recovery. CONCLUSION Our findings showed that impairments in physical, psychological, and role functioning experienced by trauma patients are largely intertwined across the two years following injury. Monitoring physical impairments and psychological complaints early in recovery might help to more promptly provide the best fitting aftercare for trauma patients, which can improve recovery on the long-term.
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Affiliation(s)
- Manon Enting
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Well-Being, the Netherlands; Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, the Netherlands.
| | | | - Margot C W Joosen
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Well-Being, the Netherlands
| | - Marjan Bakker
- Department of Methodology and Statistics, Tilburg University, the Netherlands
| | | | - Ruth E Geuze
- Department of Orthopedics, ETZ Hospital, Tilburg, the Netherlands
| | - Nina Kupper
- Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
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Guo Z, Cui Y, Qiu R, Bu L, Yang T, Li Y, Zhu X. The association of impulsivity with depression and anxiety symptoms: A transdiagnostic network analysis and replication. J Affect Disord 2024; 359:100-108. [PMID: 38772504 DOI: 10.1016/j.jad.2024.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/11/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Impulsivity increases the risk for depression and anxiety. However, the granular pathways among them remain unknown. A network approach that moves from disorder-level analysis to symptom-level analysis can provide further understanding of psychopathological mechanisms. In this study, we examined the network structure of impulsivity and separate and comorbid symptoms of depression and anxiety. METHODS Regularized partial-correlation networks were estimated using cross-sectional data from 1047 Chinese participants aged 18-26 years (main dataset, mean age = 21.45 ± 2.01 years) and 325 Chinese participants aged 18-36 years (an independent replication dataset, mean age = 21.49 ± 3.73 years), including impulsivity-depression, impulsivity-anxiety, and impulsivity-depression-anxiety networks. The datasets were collected from 1 June 2023 to 4 August 2023 and from 27 April 2022 to 16 May 2022, respectively. Impulsivity, depression, and anxiety were assessed using Barratt Impulsiveness Scale Version 11, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7, respectively. Bridge centrality was analyzed, and a network comparison test (NCT) was conducted to investigate the differences between the main dataset and replication dataset. RESULTS The motor impulsivity dimension was revealed to be closely connected with individual symptoms of depression and anxiety regardless of whether they were in separate disorder forms or comorbid forms. In all the networks, motor impulsivity was the most important bridge node. The NCT showed comparable network connectivity and network structure between the main and replication datasets. LIMITATIONS The use of cross-sectional data limited the inferences about the direction of causality between variables. CONCLUSIONS These findings elucidate the psychopathological mechanisms underlying how impulsivity functions within depression, anxiety, and comorbidity and support that motor impulsivity is an important risk factor across different mental disorders and is responsible for comorbidity. The implications of these findings are discussed.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Lingbo Bu
- Teaching Evaluation Center, Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
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Jiang Z, Xu H, Wang X, Zhang W, Zhang A, Yu L, Hu S, Yang K, Yang Q, Li Y, Cui Y, Li Y. Psychopathology of cognitive disengagement syndrome (CDS): a network analysis based on CBCL scales in 72,106 Chinese school students. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02540-5. [PMID: 39096387 DOI: 10.1007/s00787-024-02540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 07/22/2024] [Indexed: 08/05/2024]
Abstract
Cognitive Disengagement Syndrome (CDS) is a cluster of behavioral problems that severely affect an individual's functioning. Currently, there is no consensus on the main clinical features of CDS, and further exploration in large samples is needed. Using a cluster-stratified random sampling method, 72,106 children and adolescents were recruited from five provinces in mainland China for this study. Using both the traditional two-factor scoring method and the CBCL DSM-oriented scales, we assessed individual behavioral problems from psychopathological and DSM-oriented perspectives. Network analysis was employed to explore the relationship between CDS and behavioral problems. The various networks were compared by gender and age subgroups. Among 72,106 participants (mean age, 11.49 years; minimum age, 5 years; maximum age, 16 years), there were 36,449 males (50.5%) and 35,657 females (49.5%). From a psychopathological perspective, the motor symptoms node was associated with the sad node and the withdrawn node, while the cognitive symptoms node was linked to the nervous node and the self-conscious node. In terms of gender, males had stronger associations of the motor symptoms node with the sad node and the withdrawn node than females (P = 0.043), and weaker associations of the cognitive symptoms node with the nervous node than females (P = 0.027). In terms of growth stage, the adolescent group had stronger associations of the cognitive symptoms node with the nervous node and the self-conscious node than the child group (P = 0.016, 0.001). From DSM perspective, motor symptoms node were associated with sad node, and cognitive symptoms node were related to can't concentrate node, nervous node, and worthless node. With increasing age, there was an upward trend in the strength of the cognitive and motor symptoms node. CDS is closely linked to psychological and behavioral issues, especially internalizing problems, with differences observed by gender and growth stage. The connection between CDS and the affective, anxiety, and ADH symptoms is particularly pronounced.
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Affiliation(s)
- Zhongliang Jiang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Hui Xu
- Big Data Center, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Xianbin Wang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Wenyan Zhang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Anyi Zhang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Liping Yu
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Shujin Hu
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Kai Yang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Qinghao Yang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Yanlin Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China.
| | - Ying Li
- Department of Psychosomatic Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University 56 Nanlishi Road, Beijing, 100101, China.
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Moron M, Mengel-From J, Semkovska M. Monozygotic twins discordant for depression: An extended network comparison of depressive symptoms, cognitive functions and daily activities. J Psychiatr Res 2024; 177:412-419. [PMID: 39094514 DOI: 10.1016/j.jpsychires.2024.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024]
Abstract
Monozygotic twins share the same genotype; however, they can be phenotypically discordant on various traits. Studying discordant monozygotic twins allows the investigation of differences in associations between symptoms and psychopathological risk factors, controlled for shared genetic liability. The network approach to psychopathology suggests that depressive symptoms, along with risk and protective factors (e.g., cognition, daily activities), form a complex system of mutually interacting components. We compared monozygotic twins discordant for lifetime depression on their respective extended networks of depressive symptoms, cognitive functions and daily activities (intellectual, physical, social), and evaluated if these networks differ in their associations between variables and in the role of each variable within the network. Regularized partial correlations investigated the networks' composition in 147 monozygotic twin pairs discordant for depression from the Danish Twin Registry. Affected twins had stronger overall associations within their network of depressive symptoms, cognitive functions and daily activities than their unaffected co-twins, while the importance of the network components' associations did not differ between the co-twins. In affected twins, decreased frequency in experiencing happiness had the strongest association with remaining variables (i.e., the most influence in activating other network elements). Also, variables from different groups were significantly associated (e.g., loneliness with delayed memory, pessimism with low social activities, verbal learning with intellectual activities). In unaffected twins, both mood symptoms and cognitive functions were important, but between-groups associations were quasi-absent. These results suggest that external events affecting the ability to feel happiness likely trigger the psychopathological process (depression network activation), independently from the genetic predisposition to depression.
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Affiliation(s)
- Marcin Moron
- DeFREE Research Cluster, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Jonas Mengel-From
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Maria Semkovska
- DeFREE Research Cluster, Department of Psychology, University of Southern Denmark, Odense, Denmark.
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Pan C, Zhang Q, Zhu Y, Kong S, Liu J, Zhang C, Wang F, Zhang X. Module control of network analysis in psychopathology. iScience 2024; 27:110302. [PMID: 39045106 PMCID: PMC11263636 DOI: 10.1016/j.isci.2024.110302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/12/2024] [Accepted: 06/14/2024] [Indexed: 07/25/2024] Open
Abstract
The network approach to characterizing psychopathology departs from traditional latent categorical and dimensional approaches. Causal interplay among symptoms contributed to dynamic psychopathology system. Therefore, analyzing the symptom clusters is critical for understanding mental disorders. Furthermore, despite extensive research studying the topological features of symptom networks, the control relationships between symptoms remain largely unclear. Here, we present a novel systematizing concept, module control, to analyze the control principle of the symptom network at a module level. We introduce Module Control Network (MCN) to identify key modules that regulate the network's behavior. By applying our approach to a multivariate psychological dataset, we discover that non-emotional modules, such as sleep-related and stress-related modules, are the primary controlling modules in the symptom network. Our findings indicate that module control can expose central symptom cluster governing psychopathology network, offering novel insights into the underlying mechanisms of mental disorders and individualized approach to psychological interventions.
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Affiliation(s)
- Chunyu Pan
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210024, China
- Northeastern University, Shenyang, Liaoning 110169, China
| | - Quan Zhang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
- Institute for Healthy China, Tsinghua University, Beijing 100084, China
| | - Yue Zhu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210024, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu 210024, China
| | - Shengzhou Kong
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210024, China
| | - Juan Liu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210024, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu 210024, China
| | | | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210024, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu 210024, China
- Department of Mental Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Xizhe Zhang
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu 210033, China
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Han B, Yan J, Xiong R, Wang M, Liu J, Jia L, Dou J, Liu X, Fan H, Li J, Zhang C, Sun X, Du H, Ma Y, Teng S, Jiang N, Lu G. The relationship between psychological distress and cognitive failure among breast cancer survivors: a network analysis. Front Psychol 2024; 15:1420125. [PMID: 39055990 PMCID: PMC11271155 DOI: 10.3389/fpsyg.2024.1420125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Background Psychological distress is highly prevalent and has a severe impact on the quality of life among breast cancer survivors. This type of distress is associated with cognitive failure. However, previous studies have focused solely on the total scale scores of these two concepts while ignoring the unique relationship between specific components. In the present study, we utilized network analysis to explore the relationship between psychological distress and cognitive failure in breast cancer survivors. Methods The network analysis approach was adopted to estimate the regularized partial correlation network in a cross-sectional sample of 409 breast cancer survivors. All participants were assessed using the Depression Anxiety Stress Scale and the Cognitive Failure Questionnaire. The Gaussian Graphical Model was employed to estimate the network, centrality indices, and edge weights, providing a description of the characteristics of the network. Results The results indicated that anxiety-stress and depression-stress were the strongest edges in the community of psychological distress. Distractibility-memory was the strongest edge in the community of cognitive failure. Distractibility and memory were the most central nodes, with the highest expected influence in the network. Depression and motor coordination acted as important bridge nodes with the highest bridge expected influence. Conclusion Distractibility and memory in cognitive failure played important roles in activating and maintaining the relationship network. Motor coordination was identified as the crucial pathway for the impact of cognitive failure on psychological distress. Interventions targeting these specific issues might be more effective in improving cognitive failure and reducing psychological distress among breast cancer survivors.
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Affiliation(s)
- Bingxue Han
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Jialin Yan
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Ruoyu Xiong
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Miaomiao Wang
- College of Teacher Education, Weifang University, Weifang, Shandong, China
| | - Jinxia Liu
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Liping Jia
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Jinhua Dou
- Student Affairs Department, Shandong Second Medical University, Weifang, Shandong, China
| | - Xiaoli Liu
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Huaju Fan
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Jianying Li
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Caiyun Zhang
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Xiuhong Sun
- Department of Thyroid and Breast Surgery, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China
| | - He Du
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Yufeng Ma
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Shuai Teng
- Psychological Counseling Center, Weifang University, Weifang, Shandong, China
| | - Nengzhi Jiang
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Guohua Lu
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
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Chen C, Li C, Fei S, Chen W. Network analysis of trait aggression among community youths and juvenile offenders. BMC Psychol 2024; 12:387. [PMID: 38987815 PMCID: PMC11238466 DOI: 10.1186/s40359-024-01872-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 06/26/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE The mainstream view in trait aggression research has regarded the structure as representing the latent cause of the cognitions, emotions, and behaviors that supposedly reflect its nature. Under network perspective, trait aggression is not a latent cause of its features but a dynamic system of interacting elements. The current study uses network theory to explain the structure of relationships between trait aggression features in juvenile offenders and their peers. METHODS Network analysis was applied to investigate the dynamic system of trait aggression operationalized by the Buss-Perry Aggression Questionnaire in a sample of community youths (Mage = 17.46, N = 715) and juvenile offenders (Mage = 18.36, N = 834). RESULTS The facet level networks showed that anger is a particularly effective mechanism for activating all other traits. In addition, anger was more strongly associated with physical aggression and the overall network strength was greater in juvenile delinquency networks than in their peers. The item level networks revealed that A4 and A6 exhibited the highest predictability and strength centrality in both samples. Also, the Bayesian network indicated that these two items were positioned at the highest level in the model. There are similarities and differences between juvenile delinquents and community adolescents in trait aggression. CONCLUSION Trait aggression was primarily activated by difficulty controlling one's temper and feeling like a powder keg.
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Affiliation(s)
- Chen Chen
- School of Psychology, Guizhou Normal University, Guiyang, China
- Inner Mongolia Student Bullying Prevention Research Center, Tongliao, China
| | - Chenglong Li
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Shienyu Fei
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Wei Chen
- School of Psychology, Guizhou Normal University, Guiyang, China.
- Inner Mongolia Student Bullying Prevention Research Center, Tongliao, China.
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Zhang S, Chen Y. A Note on Ising Network Analysis with Missing Data. PSYCHOMETRIKA 2024:10.1007/s11336-024-09985-2. [PMID: 38971882 DOI: 10.1007/s11336-024-09985-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/05/2024] [Indexed: 07/08/2024]
Abstract
The Ising model has become a popular psychometric model for analyzing item response data. The statistical inference of the Ising model is typically carried out via a pseudo-likelihood, as the standard likelihood approach suffers from a high computational cost when there are many variables (i.e., items). Unfortunately, the presence of missing values can hinder the use of pseudo-likelihood, and a listwise deletion approach for missing data treatment may introduce a substantial bias into the estimation and sometimes yield misleading interpretations. This paper proposes a conditional Bayesian framework for Ising network analysis with missing data, which integrates a pseudo-likelihood approach with iterative data imputation. An asymptotic theory is established for the method. Furthermore, a computationally efficient Pólya-Gamma data augmentation procedure is proposed to streamline the sampling of model parameters. The method's performance is shown through simulations and a real-world application to data on major depressive and generalized anxiety disorders from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC).
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Affiliation(s)
- Siliang Zhang
- School of Statistics, East China Normal University, Columbia House, Room 5.16 Houghton Street, WC2A 2AE, London, UK
| | - Yunxiao Chen
- Department of Statistics, London School of Economics and Political Science, Room 5.16 Columbia House, Houghton Street, London, WC2A 2AE, UK.
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11
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Wang Y, Xu Y, Wu P, Zhou Y, Zhang H, Li Z, Tang Y. Exploring the interplay between core and mood symptoms in schizophrenia: A network analysis. Schizophr Res 2024; 269:28-35. [PMID: 38723518 DOI: 10.1016/j.schres.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/14/2024] [Accepted: 04/22/2024] [Indexed: 06/17/2024]
Abstract
BACKGROUND Schizophrenia is a complex neuropsychiatric disorder characterized by positive symptoms, negative symptoms, cognitive deficits, and co-occurring mood symptoms. Network analysis offers a novel approach to investigate the intricate relationships between these symptom dimensions, potentially informing personalized treatment strategies. METHODS A cross-sectional study was conducted from November 2019 to October 2021, involving 1285 inpatients with schizophrenia in Liaoning Province, China. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA-14), and Montreal Cognitive Assessment (MoCA). Network analysis was conducted to investigate the network structure, central symptoms, and bridge symptoms. RESULTS The network analysis uncovered profound interconnectivity between core symptoms and the anxiety-depression community. Central symptoms, such as psychic anxiety, poor rapport, delusions, and attention, were identified as potential therapeutic targets. Bridge symptoms, including insomnia, depressed mood, anxiety-somatic, conceptual disorganization, and stereotyped thinking, emerged as key nodes facilitating interactions between symptom communities. The stability and reliability of the networks were confirmed through bootstrapping procedures. DISCUSSION The findings highlight the complex interplay between schizophrenia symptoms, emphasizing the importance of targeting affective symptoms and cognitive impairment in treatment. The identification of central and bridge symptoms suggests potential pathways for personalized interventions aimed at disrupting self-reinforcing symptom cycles. The study underscores the need for a transdiagnostic, personalized approach to schizophrenia treatment.
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Affiliation(s)
- Yucheng Wang
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, China; School of Public Health, China Medical University, Shenyang, China.
| | - Yixiao Xu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China.
| | - Peiyi Wu
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yang Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China; School of Basic Medicine Peking Union Medical, Beijing, China.
| | - Huanrui Zhang
- Department of Geriatrics, the First Hospital of China Medical University, Shenyang, China.
| | - Zijia Li
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yanqing Tang
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, China.
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12
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de Vos JA, Radstaak M, Ten Klooster PM, Bohlmeijer ET, Westerhof GJ. Exploring mental health dynamics during eating disorder treatment: A psychometric network study with panel data. Psychother Res 2024; 34:790-803. [PMID: 37683123 DOI: 10.1080/10503307.2023.2254918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
To explore mental health associations during eating disorder (ED) treatment. Based on the dual-continua model of mental health, general and ED-specific psychopathology, as well as emotional, psychological, and social well-being were considered as mental health domains. Network analyses with panel data were applied to explore within- (temporal and contemporaneous networks) and between-person effects in a sample of 1250 female ED patients during 12 months of outpatient treatment. The associations between the domains and their centrality were examined. Autoregressive and cross-lagged effects were also estimated. ED psychopathology was the most central domain in the temporal network. ED psychopathology changes predicted further ED psychopathology changes and small changes in the other domains. Weak bi-directional associations were found between changes in the well-being domains and general psychopathology. In contrast to the temporal network, ED psychopathology was the least central and psychological well-being the most central domain in the contemporaneous and between-subjects networks. This suggests a central role of psychological well-being for experiencing mental health within time points. ED psychopathology may change relatively independent from other mental health domains. Well-being domains may be considered as more stable aspects of mental health.
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Affiliation(s)
- Jan Alexander de Vos
- Stichting Human Concern, Centrum voor eetstoornissen, Amsterdam, The Netherlands
- Research Department, GGZ Friesland, Leeuwarden, The Netherlands
| | - Mirjam Radstaak
- Psychology, Health and Technology, and the Centre for eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands
| | - Peter M Ten Klooster
- Psychology, Health and Technology, and the Centre for eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands
| | - Ernst T Bohlmeijer
- Psychology, Health and Technology, and the Centre for eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands
| | - Gerben J Westerhof
- Psychology, Health and Technology, and the Centre for eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands
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13
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Klaufus LH, Verlinden E, van der Wal MF, Cuijpers P, Chinapaw MJM, Boschloo L. Exploring the Association of Age with Depressive Symptomatology in Childhood and Adolescence: A Network Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:669-679. [PMID: 35939779 DOI: 10.1080/15374416.2022.2096044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to explore the association of age with individual depression and anxiety symptoms and their connectivity (i.e., number/strength of connections with other symptoms) in girls and boys. METHOD Our study comprised cross-sectional data from 31,960 Dutch girls and 32,162 Dutch boys aged 8 to 18 and considered 11 depression symptoms and 14 anxiety symptoms measured by the Revised Child Anxiety and Depression Scale. Network estimations were used to examine whether age was associated with individual symptoms and, in a separate step, with the connectivity of depression symptoms with other depression symptoms and with the connectivity of depression symptoms with anxiety symptoms. RESULTS Age was, in general, positively associated with depression symptoms in girls, but not in boys, and with the connectivity of depression symptoms with other depression symptoms in both sexes. These findings were the most profound for energy-related symptoms in girls. Age was, in general, negatively associated with anxiety symptoms and not or negatively associated with the connectivity of depression symptoms with anxiety symptoms in girls and boys, respectively. Substantial differences across symptoms were found. CONCLUSIONS This study shows that it is important to focus on individual symptoms, for age is mainly associated with energy-related depression symptoms and their connectivity in girls. Future etiologic studies may examine the role of energy-related depression symptoms in the development of depressive symptomatology in girls as these symptoms seem potential targets for the prevention of depression in the female population.
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Affiliation(s)
- Leonie H Klaufus
- Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit
| | - Eva Verlinden
- Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam
| | - Marcel F van der Wal
- Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit
| | - Lynn Boschloo
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit
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14
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Sahm AHJ, Witthöft M, Bailer J, Mier D. Putting the Vicious Cycle to the Test: Evidence for the Cognitive Behavioral Model of Persistent Somatic Symptoms From an Online Study. Psychosom Med 2024; 86:569-575. [PMID: 38666664 DOI: 10.1097/psy.0000000000001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
OBJECTIVE In clinical practice, persistent somatic symptoms are regularly explained using a cognitive-behavioral model (CBM). In the CBM, predisposing, perpetuating, and precipitating factors are assumed to interact and to cause the onset and endurance of somatic symptoms. However, these models are rarely investigated in their entirety. METHODS We conducted an online survey during the COVID-19 pandemic. A total of 2114 participants from the general German population completed questionnaires that measured different factors of the CBM. We used state negative affectivity and neuroticism as predisposing factors, fear of a COVID-19 infection as the precipitating factor, and somatic symptoms, misinterpretation of bodily symptoms, attention allocation to bodily symptoms, and health anxiety as perpetuating factors. Moreover, we added safety and avoidance behavior as end points to the model. We conducted a psychological network analysis to exploratively study the relationships between the model's different factors and tested the assumptions of the CBM by evaluating a structural equation model (SEM) that incorporated all factors of the model. RESULTS Network analyses revealed clustering in our data: Health anxiety and different cognitive factors are closely related, whereas somatic symptoms and state negative affectivity are strongly associated. Our SEM showed adequate fit. CONCLUSIONS Our findings from an exploratory and a confirmatory approach give empirical support for the CBM, suggesting it as a suitable model to explain bodily symptoms in the general population and to possibly guide clinical practice. The network model additionally indicates the necessity to apply an individualized CBM for patients, depending on a preponderance of either persistent somatic symptoms or health concerns.
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Affiliation(s)
- Alexander H J Sahm
- From the Department of Psychology (Sahm, Mier), University of Konstanz, Konstanz; Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology (Witthöft), Johannes Gutenberg-University Mainz, Mainz; and Department of Clinical Psychology, Central Institute of Mental Health (Bailer), University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
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15
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Yang Z, Luo Y, Chen F, Qi M, Luo R, Li Y, Wang Y. Exploring the Co-Occurrence of Depressive Symptoms and Aggression among Chinese Adolescents: Patterns and Stability. J Youth Adolesc 2024:10.1007/s10964-024-02028-0. [PMID: 38877364 DOI: 10.1007/s10964-024-02028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/28/2024] [Indexed: 06/16/2024]
Abstract
Depressive symptoms and aggression frequently occur together, and this co-occurrence may result in more severe developmental problems. However, it is unclear if there are distinct patterns of co-occurrence. This study investigated the co-occurrence patterns of depressive symptoms and aggression, and examined their stability and demographic characteristics. A total of 1010 Chinese adolescents (50.6% girls; mean age at T1 = 12.54 years, SD = 0.42) participated in annual surveys over three years (2019-2021). Three different patterns of co-occurrence were found except for the normal group: depression-dominant co-occurrence (13.6%), aggression-dominant co-occurrence (3.2%), and moderate co-occurrence (6.0%) (T1). In these co-occurrence patterns, adolescents classified as aggression-dominant co-occurrence exhibited the most instability and frequent changes, while adolescents classified as depression-dominant co-occurrence exhibited the most stability. Boys or younger adolescents were more likely to exhibit the aggression-dominant co-occurrence, while girls or older adolescents were more likely to exhibit the depression-dominant co-occurrence. The findings indicate that the co-occurrence patterns observed are distinct and are dominated by aggression or depression, which implies the need for targeted intervention practices.
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Affiliation(s)
- Zhengqian Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yuhan Luo
- School of education, Minzu University of China, Beijing, China
| | - Fumei Chen
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Mengdi Qi
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Rui Luo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yajun Li
- Shenzhen Guangming District Institute of Education Science, Shenzhen, China
| | - Yun Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.
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16
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Liu Q, Wu Y, Yu C, Pei Y. Social activities and depressive symptoms among migrant middle-aged and older adults in China: a network analysis. Front Psychol 2024; 15:1376180. [PMID: 38939230 PMCID: PMC11210719 DOI: 10.3389/fpsyg.2024.1376180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
Background This study investigated the central symptom within the depression network and examined the relationship between social activities and depressive symptoms among migrant middle-aged and older adults in China. Methods We analyzed data from 1,926 migrants aged 45 and older, derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Using network analysis, we identified the central depressive symptom and assessed the association between various social activities and depressive symptoms. Results Network analysis revealed that depressed mood was the most central symptom. Regarding mitigation of depressive symptoms, informal social activities predominantly influenced positive emotions and somatic symptoms. Formal activities were mainly revealed through positive emotions. Solitary activities were manifested primarily through positive emotions and somatic symptoms. In addition, informal and solitary activities showed a stronger correlation with the alleviation of depressive symptoms compared to formal activities. Conclusion The findings underscore the importance of addressing depressed mood in treating depression among migrant middle-aged and older adults. Recognizing the differential impacts of various social activities can aid in the development of customized prevention and intervention strategies aimed at enhancing the mental well-being of this demographic in China.
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Affiliation(s)
- Qian Liu
- School of Public Administration, Hunan Normal University, Changsha, China
| | - Yuanyuan Wu
- School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, China
| | - Chang Yu
- College of Arts and Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York City, NY, United States
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17
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Melani MS, Paiva JM, Mendlowicz MV, Vilete L, Luz MP, Ventura PR, Passos RBF, Berger W. Are There Differences Among Evidence-Based Psychotherapies for Treating Different DSM-5 PTSD Symptom Clusters? A Systematic Review and Meta-analysis of Controlled Clinical Trials. J Nerv Ment Dis 2024; 212:332-343. [PMID: 38810096 DOI: 10.1097/nmd.0000000000001769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
ABSTRACT Posttraumatic stress disorder (PTSD) is a heterogeneous disease defined by four Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) symptom clusters: reexperiencing, avoidance, negative alterations in cognitions and mood, and hyperarousal. There are effective evidence-based psychotherapies (EBPs) for PTSD. However, given the variety of PTSD clinical presentations, we conducted the first meta-analysis investigating whether DSM-5 PTSD symptom clusters show different responses to EBPs. We systematically reviewed the literature for controlled clinical trials in five databases, performed a meta-analysis, and evaluated the methodological quality of the studies. We screened 633 studies and included seven. Three showed high risk, two showed some concerns, and one showed a low risk of bias. The symptom clusters do not seem to respond differently to EBPs (SMD cluster B: -0.40; 95% confidence interval [CI], -0.87 to 0.08; cluster C: -0.49; 95% CI, -0.90 to -0.08; cluster D: -0.44; 95% CI, -0.94 to 0.05; cluster E: -0.54; 95% CI, -1.07 to -0.0), even when analyzed by the therapeutic focuses. The findings dovetail nicely with the network theory of PTSD symptom, as although it is a heterogeneous disorder, the EBPs seem to promote a kind of cascade of symptom improvement.
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Affiliation(s)
- Marina S Melani
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | - Jéssica M Paiva
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | | | - Liliane Vilete
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | - Mariana P Luz
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | - Paula Rui Ventura
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | | | - William Berger
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
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18
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Bua A, Moirano G, Pizzi C, Rusconi F, Migliore E, Richiardi L, Popovic M. Maternal antenatal mental health and its associations with perinatal outcomes and the use of healthcare services in children from the NINFEA birth cohort study. Eur J Pediatr 2024; 183:2769-2781. [PMID: 38564067 DOI: 10.1007/s00431-024-05525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
To investigate the associations between maternal mental health disorders before and during pregnancy and perinatal outcomes and child healthcare utilization between 6 and 18 months of age. Among the 6814 mother-child pairs from the Italian Internet-based NINFEA birth cohort, maternal depression, anxiety, and sleep disorders diagnosed by a physician before and during pregnancy were assessed through self-reported questionnaires completed during pregnancy and 6 months after delivery. Perinatal outcomes (preterm birth, birth weight, small for gestational age, congenital anomalies, and neonatal intensive care unit (NICU)) and children's healthcare utilization (emergency department (ED) visits, hospitalizations, and outpatient visits) were reported by mothers at 6 and 18 months postpartum. We used regression models adjusted for maternal age, education, parity, country of birth, region of delivery, and household income. Maternal mental health disorders were not associated with perinatal outcomes, except for depression, which increased the risk of offspring admission to NICU, and anxiety disorders during pregnancy, which were associated with preterm birth and lower birth weight. Children born to mothers with depression/anxiety disorders before pregnancy, compared to children of mothers without these disorders, had an increased odds of a visit to ED for any reason (odds ratio (ORadj) = 1.26, 95% confidence interval (CI): 1.02-1.54), of an ED visit resulting in hospitalization (ORadj = 1.75, 95%CI: 1.27-2.42), and of planned hospital admissions (ORadj = 1.55, 95%CI: 1.01-2.40). These associations with healthcare utilization were similar for mental disorders also during pregnancy. The association pattern of maternal sleep disorders with perinatal outcomes and child healthcare utilization resembled that of maternal depression and/or anxiety disorders with these outcomes. Conclusion: Antenatal maternal mental health is a potential risk factor for child-health outcomes and healthcare use. Early maternal mental health interventions may help to promote child health and reduce healthcare costs. What is Known: • Poor maternal mental health affects pregnancy outcomes and child health, and children of mothers with mental health conditions tend to have increased healtcare utilization. • Parents with poor mental health often face challenges in caring for their children and have less parenting self-efficacy, which could potentially lead to frequent medical consultations for minor health issues. What is New: • Maternal pre-pregnancy mental disorders were not associated with preterm birth, low birth weight, SGA, and congenital anomalies, except for depression, which increased the risk of offspring admission to NICU. Anxiety disorders during pregnancy were associated with lower birth weight and an increased odds of preterm birth. • Maternal depression and/or anxiety and sleep disorders, both before and during pregnancy, were associated with an increase in children's healthcare utilization between 6 and 18 months of life.
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Affiliation(s)
- Adriana Bua
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Franca Rusconi
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | - Enrica Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
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19
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Pátková Daňsová P, Chvojka E, Cígler H, Lacinová L. Mild differences in the role of somatic symptoms in depression networks in pregnancy and postpartum: A comparison with women outside peripartum. J Psychiatr Res 2024; 174:165-171. [PMID: 38636153 DOI: 10.1016/j.jpsychires.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
Depression is one of the most prevalent mental ailments in pregnancy. Many authors have discussed the appropriateness of somatic symptoms for depression assessment in pregnancy and postpartum. However, no study has examined the role of somatic symptoms in networks of pregnant and postpartum women compared to women outside peripartum. Here, we show that somatic symptoms are essential to depression assessment during pregnancy and postpartum. We compared networks of the nine PHQ-9 items across pregnant women (n = 894, Mage = 29.29), women in postpartum (n = 586, Mage = 29.83) and women outside peripartum (n = 1029, Mage = 24.87). While three of the five somatic symptoms in PHQ-9 were more present in pregnant women than in those outside the peripartum, the three networks were highly similar regarding the position of the somatic symptoms and their relation to the emotional-cognitive symptoms. Most depression symptoms in pregnant women were predicted by other depression symptoms to a lesser extent than in postpartum and outside peripartum. Other external variables are therefore needed to explain these sensations in pregnancy. In addition to the incidence of somatic symptoms, practitioners should ask pregnant women about their attributions of these.
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Affiliation(s)
- Petra Pátková Daňsová
- The Psychology Research Institute, Faculty of Social Studies, Masaryk University, Czech Republic.
| | - Edita Chvojka
- Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, Utrecht University, Netherlands.
| | - Hynek Cígler
- The Psychology Research Institute, Faculty of Social Studies, Masaryk University, Czech Republic.
| | - Lenka Lacinová
- The Psychology Research Institute, Faculty of Social Studies, Masaryk University, Czech Republic.
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20
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Röttgering JG, Varkevisser TMCK, Gorter M, Belgers V, De Witt Hamer PC, Reijneveld JC, Klein M, Blanken TF, Douw L. Symptom networks in glioma patients: understanding the multidimensionality of symptoms and quality of life. J Cancer Surviv 2024; 18:1032-1041. [PMID: 36922442 PMCID: PMC11082018 DOI: 10.1007/s11764-023-01355-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE To comprehend the complex relationship between symptoms and health-related quality of life (HRQoL) in patients with diffuse glioma, we applied symptom network analysis to identify patterns of associations between depression, cognition, brain tumor-related symptoms, and HRQoL. Additionally, we aimed to compare global strength between symptom networks to understand if symptoms are more tightly connected in different subgroups of patients. METHODS We included 256 patients and stratified the sample based on disease status (preoperative vs. postoperative), tumor grade (grade II vs. III/IV), and fatigue status (non-fatigued vs. fatigued). For each subgroup of patients, we constructed a symptom network. In these six networks, each node represented a validated subscale of a questionnaire and an edge represented a partial correlation between two nodes. We statistically compared global strength between networks. RESULTS Across the six networks, nodes were highly correlated: fatigue severity, depression, and social functioning in particular. We found no differences in GS between the networks based on disease characteristics. However, global strength was lower in the non-fatigued network compared to the fatigued network (5.51 vs. 7.49, p < 0.001). CONCLUSIONS Symptoms and HRQoL are highly interrelated in patients with glioma. Interestingly, nodes in the network of fatigued patients were more tightly connected compared to non-fatigued patients. IMPLICATIONS FOR CANCER SURVIVORS We introduce symptom networks as a method to understand the multidimensionality of symptoms in glioma. We find a clear association between multiple symptoms and HRQoL, which underlines the need for integrative symptom management targeting fatigue in particular.
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Affiliation(s)
- J G Röttgering
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands.
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Medical Psychology, Boelelaan 1117, Amsterdam, The Netherlands.
| | - T M C K Varkevisser
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Boelelaan 1117, Amsterdam, The Netherlands
| | - M Gorter
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Boelelaan 1117, Amsterdam, The Netherlands
| | - V Belgers
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurology, Boelelaan 1117, Amsterdam, The Netherlands
| | - P C De Witt Hamer
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurosurgery, Boelelaan 1117, Amsterdam, The Netherlands
| | - J C Reijneveld
- Department of Neurology, SEIN, Heemstede, The Netherlands
| | - M Klein
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Medical Psychology, Boelelaan 1117, Amsterdam, The Netherlands
| | - T F Blanken
- Department of Psychological Methods, University of Amsterdam, 1018 WT, Amsterdam, The Netherlands
| | - L Douw
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Boelelaan 1117, Amsterdam, The Netherlands
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21
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Jiang X, Zhang K. Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01719-w. [PMID: 38782807 DOI: 10.1007/s10578-024-01719-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.
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Affiliation(s)
- Xiaoliu Jiang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China
| | - Kuo Zhang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China.
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22
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Liu C, Liu T, Fang J, Liu X, Du C, Luo Q, Song L, Liu G, Li W, Li W, Geng L. Identifying symptom clusters and temporal interconnections in patients with lung tumors after CT-guided microwave ablation: A network analysis. Support Care Cancer 2024; 32:377. [PMID: 38780815 DOI: 10.1007/s00520-024-08560-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE To explore symptom clusters and interrelationships using a network analysis approach among symptoms in patients with lung tumors who underwent computed tomography (CT)-guided microwave ablation (MWA). METHODS A longitudinal study was conducted, and 196 lung tumor patients undergoing MWA were recruited and were measured at 24 h, 48 h, and 72 h after MWA. The Chinese version of the MD Anderson Symptom Inventory and the Revised Lung Cancer Module were used to evaluate symptoms. Network analyses were performed to explore the symptom clusters and interrelationships among symptoms. RESULTS Four stable symptom communities were identified within the networks. Distress, weight loss, and chest tightness were the central symptoms. Distress, and weight loss were also the most key bridge symptoms, followed by cough. Three symptom networks were temporally stable in terms of symptom centrality, global connectivity, and network structure. CONCLUSION Our findings identified the central symptoms, bridge symptoms, and the stability of symptom networks of patients with lung tumors after MWA. These network results will have important implications for future targeted symptom management intervention development. Future research should focus on developing precise interventions for targeting central symptoms and bridge symptoms to promote patients' health.
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Affiliation(s)
- Chunqin Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
- School of Medicine, Jinggangshan University, Ji'an, Jiangxi, China
| | - Tianchi Liu
- Department of Out-Patient, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jia Fang
- Department of Nursing, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Xiaohua Liu
- Department of Out-Patient, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chunling Du
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qin Luo
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Liqin Song
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Guangxin Liu
- School of Nursing, Shandong First Medical University, Tai'an, Shandong, China
| | - Wenjuan Li
- Department of Out-Patient, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Weifeng Li
- Department of Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
| | - Li Geng
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Alcalde E, Rouquette A, Wiernik E, Rigal L. How do men and women differ in their depressive symptomatology? A gendered network analysis of depressive symptoms in a French population-based cohort. J Affect Disord 2024; 353:1-10. [PMID: 38395202 DOI: 10.1016/j.jad.2024.02.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/05/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The experience of depressive manifestations and the presentation of symptoms in clinical settings may differ in men and women. Despite the extensive literature, it remains unclear how depressive manifestations interact at symptom levels in men and women. First, we aimed to describe and compare depressive networks by sex. Second, we examined symptom connections to Clinical depression and Functional Limitations as a proxy of self-recognition of a depressive episode. METHODS We estimated networks from the 20 CES-D items in men and women from a large population-based French cohort. We computed centrality measures and ran comparisons. Then, we re-estimated two networks in men and women separately, adding, on the one hand, Clinical Depression and, on the other hand, Limitations due to a depressive episode. RESULTS Over 200,000 participants were included in this study. Women were twice as likely to have a previous diagnosis of depression. Sex-ratio was less pronounced (1,7:1) for Limitations due to depression. Centrality measures revealed similar symptom patterns. However, network structures differed between men and women. We found some symptom connections to Clinical depression and Limitations to be non-invariant according to sex. LIMITATIONS Cross-sectional data does not capture the direction of the connections between symptoms and an eventual diagnosis. We lacked data about the diagnosis's context and could not account for other factors influencing depressive symptomatology. CONCLUSIONS Network structures differed, suggesting gender-specific mechanisms in activating symptoms and depressive states. Addressing central symptoms evoking depressed moods with tailored interventions may serve to tackle depressive states in men and women.
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Affiliation(s)
- Eugenia Alcalde
- Université Paris-Saclay, UVSQ, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, France; IRIS, INSERM U997, Aubervilliers, France.
| | - Alexandra Rouquette
- Université Paris-Saclay, UVSQ, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, France; Public Health and Epidemiology Department, AP-HP Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Emmanuel Wiernik
- Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, UMS 011 Population-based Cohorts Unit, Paris, France
| | - Laurent Rigal
- Université Paris-Saclay, UVSQ, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, France; Public Health and Epidemiology Department, AP-HP Paris-Saclay University, Le Kremlin-Bicêtre, France
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24
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Shin H, Park C. Mastery is central: an examination of complex interrelationships between physical health, stress and adaptive cognition, and social connection with depression and anxiety symptoms. Front Psychiatry 2024; 15:1401142. [PMID: 38751422 PMCID: PMC11094708 DOI: 10.3389/fpsyt.2024.1401142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Background Research has established the link between physical health, stress and cognition, and social connection with depression and anxiety. Nevertheless, an understanding of the comorbidity of depression and anxiety symptoms and their complex interrelationships with relevant factors remains still limited. This study investigated the complex pattern of interplay between depression and anxiety symptoms and pertinent physical, cognitive, and social factors and potential gender differences. Methods Using a sample of 600 middle-aged men and women, depression and anxiety as well as physical health, perceived stress and mastery, and social connection were assessed. The network structure of depression and anxiety symptoms and risk and resilience factors were characterized by examining interrelationships and the centrality indices of Strength and Bridge Strength. Gender differences were examined using the Network Comparison Test. Results Perceived stress and mastery were central bridge factors influencing comorbid depression and anxiety symptoms, and perceived stress, anhedonia, and mastery exhibited strong inter-connections to each other. The connections of physical health-anhedonia and sleep disturbance-irritability were stronger in men than in women, while social connection with family was linked to interpersonal problems only in women. Conclusions The results underscore that prevention and interventions targeting reducing perceptions of stress and promoting mastery would prevent onset or recurrence of depression and anxiety symptoms among middle-aged men and women. Engaging in behavioral activities to maintain physical health and ensuring adequate sleep could be particularly beneficial for men in reducing overall symptom severity.
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Affiliation(s)
- Huiyoung Shin
- Department of Psychology, Jeonbuk National University, Jeonju, Republic of Korea
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25
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Besckow EM, Ledebuhr KNB, Pires CS, Rocha MJD, Kuntz NEB, Godoi B, Bortolatto CF, Brüning CA. Dopaminergic Modulation and Computational ADMET Insights for the Antidepressant-like Effect of N-(3-(Phenylselanyl)prop-2-yn-1-yl)benzamide. ACS Chem Neurosci 2024; 15:1904-1914. [PMID: 38639539 DOI: 10.1021/acschemneuro.4c00092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
The compound N-(3-(phenylselanyl)prop-2-yn-1-yl)benzamide (SePB), which combines a selenium atom and a benzamide nucleus in an organic structure, has demonstrated a fast antidepressant-like effect in mice. This action is influenced by the serotonergic system and represents a promising development in the search for novel antidepressant drugs to treat major depressive disorder (MDD), which often resists conventional treatments. This study aimed to further explore the mechanism underlying the antidepressant-like effect of SePB by investigating the involvement of the dopaminergic and noradrenergic systems in the tail suspension test (TST) in mice and evaluating its pharmacokinetic profile in silico. Preadministration of the dopaminergic antagonists haloperidol (0.05 mg/kg, intraperitoneally (i.p.)), a nonselective antagonist of dopamine (DA) receptors, SCH23390 (0.01 mg/kg, subcutaneously (s.c.)), a D1 receptor antagonist, and sulpiride (50 mg/kg, i.p.), a D2/3 receptor antagonist, before SePB (10 mg/kg, intragastrically (i.g.)) prevented the anti-immobility effect of SePB in the TST, demonstrating that these receptors are involved in the antidepressant-like effect of SePB. Administration of the noradrenergic antagonists prazosin (1 mg/kg, i.p.), an α1-adrenergic antagonist, yohimbine (1 mg/kg, i.p.), an α2-adrenergic antagonist, and propranolol (2 mg/kg, i.p.), a β-adrenergic antagonist, did not block the antidepressant-like effect of SePB on TST, indicating that noradrenergic receptors are not involved in this effect. Additionally, the coadministration of SePB and bupropion (a noradrenaline/dopamine reuptake inhibitor) at subeffective doses (0.1 and 3 mg/kg, respectively) produced antidepressant-like effects. SePB also demonstrated good oral bioavailability and low toxicity in computational absorption, distribution, metabolism, excretion, and toxicity (ADMET) analyses. These findings suggest that SePB has potential as a new antidepressant drug candidate with a particular focus on the dopaminergic system.
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Affiliation(s)
- Evelyn Mianes Besckow
- Laboratory of Biochemistry and Molecular Neuropharmacology (LABIONEM), Graduate Program in Biochemistry and Bioprospecting (PPGBBio), Chemical, Pharmaceutical and Food Sciences Center (CCQFA), Federal University of Pelotas (UFPel), Pelotas, RS 96010-900, Brazil
| | - Kauane Nayara Bahr Ledebuhr
- Laboratory of Biochemistry and Molecular Neuropharmacology (LABIONEM), Graduate Program in Biochemistry and Bioprospecting (PPGBBio), Chemical, Pharmaceutical and Food Sciences Center (CCQFA), Federal University of Pelotas (UFPel), Pelotas, RS 96010-900, Brazil
| | - Camila Simões Pires
- Laboratory of Biochemistry and Molecular Neuropharmacology (LABIONEM), Graduate Program in Biochemistry and Bioprospecting (PPGBBio), Chemical, Pharmaceutical and Food Sciences Center (CCQFA), Federal University of Pelotas (UFPel), Pelotas, RS 96010-900, Brazil
| | - Marcia Juciele da Rocha
- Laboratory of Biochemistry and Molecular Neuropharmacology (LABIONEM), Graduate Program in Biochemistry and Bioprospecting (PPGBBio), Chemical, Pharmaceutical and Food Sciences Center (CCQFA), Federal University of Pelotas (UFPel), Pelotas, RS 96010-900, Brazil
| | - Natália Emanuele Biolosor Kuntz
- Nucleus of Synthesis and Application of Organic and Inorganic Compounds (NUSAACOI), Federal University of Fronteira Sul (UFFS), Cerro Largo, RS 97900-000, Brazil
| | - Benhur Godoi
- Nucleus of Synthesis and Application of Organic and Inorganic Compounds (NUSAACOI), Federal University of Fronteira Sul (UFFS), Cerro Largo, RS 97900-000, Brazil
| | - Cristiani Folharini Bortolatto
- Laboratory of Biochemistry and Molecular Neuropharmacology (LABIONEM), Graduate Program in Biochemistry and Bioprospecting (PPGBBio), Chemical, Pharmaceutical and Food Sciences Center (CCQFA), Federal University of Pelotas (UFPel), Pelotas, RS 96010-900, Brazil
| | - César Augusto Brüning
- Laboratory of Biochemistry and Molecular Neuropharmacology (LABIONEM), Graduate Program in Biochemistry and Bioprospecting (PPGBBio), Chemical, Pharmaceutical and Food Sciences Center (CCQFA), Federal University of Pelotas (UFPel), Pelotas, RS 96010-900, Brazil
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26
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Pascalidis J, Bathelt J. The "central" importance of loneliness in mental health: A network psychometric study. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2024. [PMID: 38679279 DOI: 10.1002/ijop.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/30/2024] [Indexed: 05/01/2024]
Abstract
Loneliness is linked to negative mental health outcomes like depression and social anxiety. However, it is unclear how loneliness and these conditions are connected. This study aims to address two questions: (a) Are there pathways connecting loneliness to these conditions? (b) What symptoms play a role in these pathways? Using network analyses, the study examined a representative sample of 962 adults from the UK (mean age = 46, females = 492). The network analysis revealed four dimensions: depression, social anxiety and two dimensions for loneliness (isolation and social connectedness). Two distinct pathways were identified for the transmission of symptoms between loneliness, social anxiety and depression. The depression-isolation pathway involved a node representing the perceived loss of social connections. The social anxiety-social connectedness pathway was characterised by intimate interaction contexts. These findings suggest that loneliness is associated with different symptom pathways, potentially contributing to comorbidity between loneliness, social anxiety and depression.
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Affiliation(s)
- John Pascalidis
- Department of Psychology, Royal Holloway, University of London, London, UK
| | - Joe Bathelt
- Department of Psychology, Royal Holloway, University of London, London, UK
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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27
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Linardon J, Greenwood CJ, Aarsman S, Fuller-Tyszkiewicz M. Investigating change in network structure of eating disorder symptoms after delivery of a smartphone app-based intervention. Psychol Med 2024:1-9. [PMID: 38587016 DOI: 10.1017/s0033291724000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND Eating disorder (ED) research has embraced a network perspective of psychopathology, which proposes that psychiatric disorders can be conceptualized as a complex system of interacting symptoms. However, existing intervention studies using the network perspective have failed to find that symptom reductions coincide with reductions in strength of associations among these symptoms. We propose that this may reflect failure of alignment between network theory and study design and analysis. We offer hypotheses for specific symptom associations expected to be disrupted by an app-based intervention, and test sensitivity of a range of statistical metrics for identifying this intervention-induced disruption. METHODS Data were analyzed from individuals with recurrent binge eating who participated in a randomized controlled trial of a cognitive-behavioral smartphone application. Participants were categorized into one of three groups: waitlist (n = 155), intervention responder (n = 49), and intervention non-responder (n = 77). Several statistical tests (bivariate associations, network-derived strength statistics, network invariance tests) were compared in ability to identify change in network structure. RESULTS Hypothesized disruption to specific symptom associations was observed through change in bivariate correlations from baseline to post-intervention among the responder group but were not evident from symptom and whole-of-network based network analysis statistics. Effects were masked when the intervention group was assessed together, ignoring heterogeneity in treatment responsiveness. CONCLUSION Findings are consistent with our contention that study design and analytic approach influence the ability to test network theory predictions with fidelity. We conclude by offering key recommendations for future network theory-driven interventional studies.
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Affiliation(s)
- Jake Linardon
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
| | - Christopher J Greenwood
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Stephanie Aarsman
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
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Jurado-González F, García-Torres F, Contreras A, Muñoz-Navarro R, González-Blanch C, Adrián Medrano L, Ruiz-Rodríguez P, Moreno EM, Pérez-Dueñas C, Cano-Vindel A, Moriana JA. Comparing psychological versus pharmacological treatment in emotional disorders: A network analysis. PLoS One 2024; 19:e0301675. [PMID: 38568925 PMCID: PMC10990220 DOI: 10.1371/journal.pone.0301675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Transdiagnostic group cognitive behavioural therapy (TD-GCBT) is more effective in improving symptoms and severity of emotional disorders (EDs) than treatment as usual (TAU; usually pharmacological treatment). However, there is little research that has examined the effects of these treatments on specific symptoms. This study used Network Intervention Analysis (NIA) to investigate the direct and differential effects of TD-GCBT + TAU and TAU on specific symptoms of anxiety and depression. Data are from a multicentre randomised clinical trial (N = 1061) comparing TD-GCBT + TAU versus TAU alone for EDs. The networks included items from the PHQ-9 (depression) and GAD-7 (anxiety) questionnaire and mixed graphical models were estimated at pre-treatment, post-treatment and 3-, 6- and 12-month follow-up. Results revealed that TD-GCBT + TAU was associated with direct effects, mainly on several anxiety symptoms and depressed mood after treatment. New direct effects on other depressive symptoms emerged during the follow-up period promoted by TD-GCBT compared to TAU. Our results suggest that the improvement of anxiety symptoms after treatment might precipitate a wave of changes that favour a decrease in depressive symptomatology. NIA is a methodology that can provide fine-grained insight into the likely pathways through which treatments exert their effects.
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Affiliation(s)
- Francisco Jurado-González
- Department of Psychology, University of Cordoba/Maimonides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain
| | - Francisco García-Torres
- Department of Psychology, University of Cordoba/Maimonides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain
| | - Alba Contreras
- University Catholique San Antonio of Murcia, Murcia, Spain
| | - Roger Muñoz-Navarro
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Teruel, Spain
| | - César González-Blanch
- Mental Health Centre, Marqués de Valdecilla University Hospital—IDIVAL, Santander, Cantabria, Spain
| | | | - Paloma Ruiz-Rodríguez
- Castilla La Nueva Primary Care Centre, Health Service of Madrid, Fuenlabrada, Madrid, Spain
| | - Eliana M. Moreno
- Department of Psychology, University of Cordoba/Maimonides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain
| | - Carolina Pérez-Dueñas
- Department of Psychology, University of Cordoba/Maimonides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain
| | | | - Juan A. Moriana
- Department of Psychology, University of Cordoba/Maimonides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain
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Seneldir A, Akirmak U, Halfon S. Cross-Informant Compatibility of Depression Symptoms in Children: A Network Approach. Child Psychiatry Hum Dev 2024; 55:308-319. [PMID: 35916982 PMCID: PMC10891223 DOI: 10.1007/s10578-022-01403-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
Utilizing multiple informants to assess children's depressive symptoms increases diagnostic accuracy, reliability, and validity of inferences. However, previous studies have found low to moderate agreement among informants. We applied network statistics to gain insight into children and their mothers' differential perceptions of depressive symptoms. The sample included children and mother dyads (n = 185) who applied to psychotherapy services at an outpatient university clinic. Mothers filled out the Child Behavior Checklist, which includes a depression subscale, and children filled out the Children's Depression Inventory. We computed association networks for thirteen depressive symptoms separately for children and mothers using the graphical LASSO. Sadness had the highest strength centrality in the networks of both children and mothers, but the pattern of connectivity and centrality of other symptoms differed. We discussed our findings within the framework of network theory.
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Affiliation(s)
- Ayse Seneldir
- Department of Psychology, Istanbul Bilgi University, Istanbul, Turkey.
- Vrije University Amsterdam, Amsterdam, Netherlands.
| | - Umit Akirmak
- Department of Psychology, Istanbul Bilgi University, Istanbul, Turkey
| | - Sibel Halfon
- Department of Psychology, Istanbul Bilgi University, Istanbul, Turkey
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30
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Buchwald K, Narayanan A, Siegert RJ, Vignes M, Arrowsmith K, Sandham M. Centrality statistics of symptom networks of schizophrenia: a systematic review. Psychol Med 2024; 54:1061-1073. [PMID: 38174555 DOI: 10.1017/s003329172300363x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The network theory of psychological disorders posits that systems of symptoms cause, or are associated with, the expression of other symptoms. Substantial literature on symptom networks has been published to date, although no systematic review has been conducted exclusively on symptom networks of schizophrenia, schizoaffective disorder, and schizophreniform (people diagnosed with schizophrenia; PDS). This study aims to compare statistics of the symptom network publications on PDS in the last 21 years and identify congruences and discrepancies in the literature. More specifically, we will focus on centrality statistics. Thirty-two studies met the inclusion criteria. The results suggest that cognition, and social, and occupational functioning are central to the network of symptoms. Positive symptoms, particularly delusions were central among participants in many studies that did not include cognitive assessment. Nodes representing cognition were most central in those studies that did. Nodes representing negative symptoms were not as central as items measuring positive symptoms. Some studies that included measures of mood and affect found items or subscales measuring depression were central nodes in the networks. Cognition, and social, and occupational functioning appear to be core symptoms of schizophrenia as they are more central in the networks, compared to variables assessing positive symptoms. This seems consistent despite heterogeneity in the design of the studies.
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Affiliation(s)
- Khan Buchwald
- School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
| | - Ajit Narayanan
- Engineering, Computer, and Mathematical Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, New Zealand
| | - Richard John Siegert
- School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
| | - Matthieu Vignes
- School of Mathematical and Computational Sciences, Massey University, Tennent Drive, Palmerston North, New Zealand
| | - Kim Arrowsmith
- School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
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Hong S, Cha EJ, Moon Y, Ryu SH, Jeon HJ. Network Analysis Revealed the Role of Helplessness as a Central Feature Among Late-Life Depressive Symptoms in Patients With Mild Cognitive Impairment and Early Stage Dementia. Psychiatry Investig 2024; 21:371-379. [PMID: 38695044 PMCID: PMC11065523 DOI: 10.30773/pi.2023.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/07/2023] [Accepted: 01/02/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE It has been reported that depressive symptoms in older adults are different from those in younger adults, especially when accompanied by cognitive decline. However, few studies have investigated the network structure of depressive symptoms in this population. METHODS The participants consisted of 627 older adults (>60 yr) who were diagnosed with mild cognitive impairment (MCI) or early stage dementia. Among them, 36.7% were male and the mean age was 76.20±7.71 years. The Korean form of Geriatric Depression Scale (KGDS) was used to evaluate their depressive symptoms and network analyses were performed using bootnet R-package to identify the central features among depressive symptoms. RESULTS Of all the KGDS items, we found that KGDS 2 (often feel helpless) had the highest node strength followed by KGDS 21 (in good spirits), KGDS 14 (not confident at all), and KGDS 15 (cheerful and happy). In terms of node betweenness, KGDS 2 also showed the highest value. The edge weights of edges connected to node KGDS 2 were strongest in KGDS 3 (restless and fidgety) and KGDS 28 (easily get tired). CONCLUSION In this study, we presented which symptoms are central among the elderly with MCI and early stage dementia. This result not only increases the understanding of depressive symptoms in this group but would also help determine target symptoms in the treatment program.
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Affiliation(s)
- Sumin Hong
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Eun Jung Cha
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Yeonsil Moon
- Department of Neurology, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
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32
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Doppenberg-Smit GE, Lamers F, van Linde ME, Braamse AMJ, Sprangers MAG, Beekman ATF, Verheul HMW, Dekker J. Network analysis used to investigate the interplay among somatic and psychological symptoms in patients with cancer and cancer survivors: a scoping review. J Cancer Surviv 2024:10.1007/s11764-024-01543-0. [PMID: 38530627 DOI: 10.1007/s11764-024-01543-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/22/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Patients with cancer often experience multiple somatic and psychological symptoms. Somatic and psychological symptoms are thought to be connected and may reinforce each other. Network analysis allows examination of the interconnectedness of individual symptoms. The aim of this scoping review was to examine the current state of knowledge about the associations between somatic and psychological symptoms in patients with cancer and cancer survivors, based on network analysis. METHODS This scoping review followed the five-stage framework of Arksey and O'Malley. The literature search was conducted in May, 2023 in PubMed, APA PsycINFO, Embase Cochrane central, and CINAHL databases. RESULTS Thirty-two studies were included, with eleven using longitudinal data. Seventeen studies reported on the strength of the associations: somatic and psychological symptoms were associated, although associations among somatic as well as among psychological symptoms were stronger. Other findings were the association between somatic and psychological symptoms was stronger in patients experiencing more severe symptoms; associations between symptoms over time remained rather stable; and different symptoms were central in the networks, with fatigue being among the most central in half of the studies. IMPLICATIONS FOR CANCER SURVIVORS Although the associations among somatic symptoms and among psychological symptoms were stronger, somatic and psychological symptoms were associated, especially in patients experiencing more severe symptoms. Fatigue was among the most central symptoms, bridging the somatic and psychological domain. These findings as well as future research based on network analysis may help to untangle the complex interplay of somatic and psychological symptoms in patients with cancer.
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Affiliation(s)
- G Elise Doppenberg-Smit
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands.
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Myra E van Linde
- Department of Medical Oncology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Annemarie M J Braamse
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Mirjam A G Sprangers
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Erasmus MC, Dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - Joost Dekker
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
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Mohammadi Z, Dehghani M, Fathali Lavasani F, Farahani H, Ashouri A. A network analysis of ICD-11 Complex PTSD, emotional processing, and dissociative experiences in the context of psychological trauma at different developmental stages. Front Psychiatry 2024; 15:1372620. [PMID: 38532985 PMCID: PMC10963615 DOI: 10.3389/fpsyt.2024.1372620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Objective Traumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model. Method This study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes. Variables were assessed using The International Trauma Questionnaire, International Measurement of Exposure to Traumatic Event checklist, Baker Emotional Processing Questionnaire, and Dissociative Experiences. A regularized partial correlation network and Glasso algorithm, in combination with Extended Bayesian information criteria, were applied to estimate the network structure. Results Signs of unprocessed emotions and disturbance in self-organization symptoms were the most important symptoms in the symptom network, forming strong connections with other nodes. Thereby, these two symptoms can be regarded as the most important clinical manifestations in the symptom network following traumatic experiences. Three distinct symptom communities were identified: the community of traumatic experiences (childhood, adolescence, adulthood), the community of dissociative experiences (amnesia, depersonalization/derealization, and absorption), and the community of emotional processing (suppression, unpleasant emotional experience, Signs of unprocessed emotions, avoidance, and emotional control, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms). The strongest edges observed were between childhood trauma-adolescence trauma (0.473) in the community of traumatic experiences, between amnesia and depersonalization/derealization (0.644) in the community of dissociative experiences, and between disturbance in self-organization symptoms and unprocessed emotions (0.324) in the community of emotional processing, indicating the recurrent occurrence of these symptoms. Conclusion In this study, disturbance in self-organization symptoms was identified as the central psychopathologic symptom in individuals experiencing traumas at different developmental stages. It seems that adolescent trauma and not childhood trauma plays a more decisive role in the symptoms that a person manifests after traumatic experiences. Also, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms were recognized in the cluster of emotional processing symptoms and can have substantial roles in prioritizing therapeutic measures.
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Affiliation(s)
- Zahra Mohammadi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mahmood Dehghani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Fathali Lavasani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Ashouri
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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van den Berg JW, van Beek DJ, Bouman YHA, Janssen E, Smid WJ, Gijs L. Understanding the Risk of Sexual Reoffending in Adult Men: A Network-Based Model. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2024; 36:135-157. [PMID: 36731100 DOI: 10.1177/10790632231153633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The predominant approach to understand dynamic risk factors of sexual reoffending has been referred to as the Propensities Model (Thornton, 2016). According to this model, dynamic risk factors can be conceptualized as latent constructs whose change alters the risk of sexual reoffending. Despite its strengths and contributions to research, this model does not offer answers to the question of how dynamic risk factors contribute to the risk of sexual reoffending, or of how sustained change in risk might take place. In this paper we introduce the Network-Based Model of Risk of Sexual Reoffending (NBM-RSR), which addresses several limitations and constraints of the Propensities Model and offers empirically testable propositions regarding the nature and development of the risk of sexual reoffending. The NBM-RSR considers risk of sexual reoffending to involve a self-sustaining network of causally connected dynamic risk factors. Consistent with this, an increased risk of sexual reoffending is characterized through a network that contains more and stronger interconnected dynamic risk factors with a higher strength. Sustained change in risk of sexual reoffending occurs when activity in the network exceeds a critical point resulting in a new self-sustaining network. Propositions based on the NBM-RSR are introduced and translated into testable hypotheses. These propositions revolve around (a) risk of sexual reoffending resulting from the construction of a network of causally connected dynamic risk factors, (b) network stability, sudden changes, and critical transitions, and (c) dynamic risk factors' relative influence on risk of sexual reoffending.
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Affiliation(s)
- Jan Willem van den Berg
- Transfore, Outpatient Clinic De Tender, Deventer, the Netherlands
- Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven, Belgium
| | - Daan J van Beek
- Private practice of clinical psychology, Utrecht, The Netherlands
| | | | - Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven, Belgium
| | | | - Luk Gijs
- Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven, Belgium
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Zhou J, Zhou J, Feng Z, Feng L, Xiao L, Chen X, Yang J, Feng Y, Wang G. Identifying the core residual symptom in patients with major depressive disorder using network analysis and illustrating its association with prognosis: A study based on the national cohorts in China. Gen Hosp Psychiatry 2024; 87:68-76. [PMID: 38325144 DOI: 10.1016/j.genhosppsych.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To identify the core residual symptom of MDD and assess its relationship with patients' long-term outcomes. METHOD All patients were administered antidepressants during the acute phase and treated continuously. The 521 patients remitted at month 6 of a multicenter prospective project were included. Remission was defined as a Quick Inventory of Depressive Symptoms-Self-Report total score of ≤5. Functional impairments were measured with the Sheehan Disability Scale, quality of life with the Quality of Life Enjoyment and Satisfaction Questionnaire - short form, and family burden with the Family Burden Scale of Disease. Visits were scheduled at baseline, weeks 2, 8, 12, and month 6. RESULTS Difficulty with concentration/decision making was the core residual symptom of MDD, determined with the centrality measure of network analysis. It was positively associated with functional impairments and family burden (r = 0.35, P < 0.01 and r = 0.31, P < 0.01, respectively) and negatively associated with life satisfaction (r = -0.29, P < 0.01). The exhibition of this residual symptom was associated with a family history of psychiatric disorders (OR = 2.610 [1.242-5.485]). CONCLUSIONS The core residual symptom of MDD, difficulty with concentration/decision making, is associated with poorer social functioning, heavier family burden, and lower life satisfaction. Early detection and intervention of this symptom may be beneficial. CLINICAL TRIALS REGISTRATION NUMBER (Chinese Clinical Trials.gov identifier) ChiCTR-OOC-17012566 and ChiCTR-INR-17012574.
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Affiliation(s)
- Jingjing Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jia Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zizhao Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Le Xiao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xu Chen
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jian Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Wierenga LM, Ruigrok A, Aksnes ER, Barth C, Beck D, Burke S, Crestol A, van Drunen L, Ferrara M, Galea LAM, Goddings AL, Hausmann M, Homanen I, Klinge I, de Lange AM, Geelhoed-Ouwerkerk L, van der Miesen A, Proppert R, Rieble C, Tamnes CK, Bos MGN. Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100283. [PMID: 38312851 PMCID: PMC10837069 DOI: 10.1016/j.bpsgos.2023.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 02/06/2024] Open
Abstract
There are prominent sex/gender differences in the prevalence, expression, and life span course of mental health and neurodiverse conditions. However, the underlying sex- and gender-related mechanisms and their interactions are still not fully understood. This lack of knowledge has harmful consequences for those with mental health problems. Therefore, we set up a cocreation session in a 1-week workshop with a multidisciplinary team of 25 researchers, clinicians, and policy makers to identify the main barriers in sex and gender research in the neuroscience of mental health. Based on this work, here we provide recommendations for methodologies, translational research, and stakeholder involvement. These include guidelines for recording, reporting, analysis beyond binary groups, and open science. Improved understanding of sex- and gender-related mechanisms in neuroscience may benefit public health because this is an important step toward precision medicine and may function as an archetype for studying diversity.
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Affiliation(s)
- Lara Marise Wierenga
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Amber Ruigrok
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Eira Ranheim Aksnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dani Beck
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Sarah Burke
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lina van Drunen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Maria Ferrara
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Liisa Ann Margaret Galea
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Lise Goddings
- University College London Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Markus Hausmann
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Inka Homanen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Ineke Klinge
- Dutch Society for Gender & Health, the Netherlands
- Gendered Innovations at European Commission, Brussels, Belgium
| | - Ann-Marie de Lange
- Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Lineke Geelhoed-Ouwerkerk
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Anna van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ricarda Proppert
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Carlotta Rieble
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Christian Krog Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Marieke Geerte Nynke Bos
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
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Zhang C, Ye B, Guo Z. Identification of central symptoms of children depression and development of two short version of Children's Depression Inventory: Based on network analysis and machine learning. J Affect Disord 2024; 346:242-251. [PMID: 37944708 DOI: 10.1016/j.jad.2023.10.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Using network analysis to study the central symptoms is important for understanding the mechanism of depression symptoms and selecting items for the short version depression screening scale. This study aimed to identify the central symptoms of depression and develop the short and effective depression screening tools for Chinese rural children. METHODS Firstly, the 2458 individuals (Mage = 10.74; SDage = 1.64; 51.2 % were female) were recruited from the rural children's mental health database. Children's Depression Inventory (CDI) was used to assess depression symptoms. Then, network analysis was used to identify the central symptoms of depression. The accuracy, stability, and gender invariance of the depression symptoms network were tested. Finally, a short version of CDI with central symptoms (CDI-SC) and a new CDI-10 (CDI-10-N) were developed by network analysis and feature selection techniques to optimize the existing CDI-10. Their performances in screening depression symptoms were validated by the cutoff threshold and machine learning. RESULTS The central symptoms of Chinese rural children's depression were sadness, self-hatred, loneliness and self-deprecation. This result was accurate and stable and depression symptoms network has gender invariance. The AUC values of CDI-10-N and CDI-SC are over 0.9. The CDI-10-N has a higher AUC than CDI-10. The optimal cutoff thresholds for CDI-10-N and CDI-SC are 6 and 1. The performance of machine learning on AUC generally outperforms those of cutoff threshold. CONCLUSIONS The central symptoms identified in this study should be highlighted in screening depression symptoms, and CDI-10-N and CDI-SC are effective tools for screening depression symptoms in Chinese rural children.
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Affiliation(s)
- Chao Zhang
- School of Psychology & Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China
| | - Baojuan Ye
- School of Psychology & Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China.
| | - Zhifang Guo
- School of Education Sciences, Shangrao Normal University, China
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Yuan GF, Liu C, Li X, Fung HW, Wong MYC, Lam SKK, An Y, Feng X. Hurting myself to cope: Using network analysis to understand the association between perceived stigma and non-suicidal self-injury functions among men who have sex with men in China. Arch Psychiatr Nurs 2024; 48:43-50. [PMID: 38453281 DOI: 10.1016/j.apnu.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/04/2023] [Accepted: 01/05/2024] [Indexed: 03/09/2024]
Abstract
Prior studies have demonstrated that perceived stigma is robustly associated with risky and life-threatening behaviors, including non-suicidal self-injury (NSSI), among men who have sex with men (MSM). However, studies regarding the relationship between perceived stigma and NSSI are limited. The present study aimed to investigate the network structure of perceived stigma and NSSI functions, along with bridge nodes, to elucidate how they co-exist. A sample of 2610 Chinese MSM (mean age = 23.99, age range: 18-68 years) was recruited from an online survey platform. All participants completed a web-based survey with measures of perceived stigma and NSSI functions. Results indicated that 'negative attitudes towards homosexuality' and 'disappointment in gay son' were identified as the most central nodes in the perceived stigma network, whereas 'seeking attention' and 'influencing others to change' ranked highest on centrality in the NSSI network. Two bridge connections were exhibited within the combined perceived stigma and NSSI network model: 'unwelcoming in public' and 'avoiding unpleasant tasks' from perceived stigma and NSSI communities, respectively. This is among the first studies investigating the co-occurrence between perceived stigma and NSSI from the network approach. Our findings provide an empirically-based perspective on the importance of family- and community-based interventions, with potential clinical implications for reducing NSSI among sexual and gender minority groups.
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Affiliation(s)
- Guangzhe Frank Yuan
- School of Education Science, Leshan Normal University, Leshan, China; Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Caimeng Liu
- School of Education Science, Leshan Normal University, Leshan, China.
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Hong Wang Fung
- Department of Social Work, Faculty of Social Sciences, The Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
| | - Yuanyuan An
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.
| | - Xueyou Feng
- Center for Mental Health Education and Counseling, Guangzhou College of Commerce, Guangzhou, China
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Smid WJ, Wever EC, Van den Heuvel N. Dynamic Individual Risk Networks: Personalized Network Modelling Based on Experience Sampling Data. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2024; 36:107-129. [PMID: 37073777 DOI: 10.1177/10790632231170823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Following a network perspective, risk of sexual reoffending can be understood as a construct that emerges from the interactions between risk factors. If these interrelationships are validly mapped out, this leads to an increased understanding of the risk and thus may contribute to more effective and/or more efficient interventions. This paper reports on personalized network modeling mapping the interrelationships of dynamic risk factors for an individual convicted of sexual offenses, using experience sampling (ESM) based on Stable-2007 items. The longitudinal character of ESM enables both the assessment of interrelations between risk factors within a timeframe and the relationships between risk factors over time. Networks are calculated and compared to the clinical assessment of interrelationships between the risk factors.
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40
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Mesbah R, Koenders MA, Spijker AT, de Leeuw M, van Hemert AM, Giltay EJ. Dynamic time warp analysis of individual symptom trajectories in individuals with bipolar disorder. Bipolar Disord 2024; 26:44-57. [PMID: 37269209 DOI: 10.1111/bdi.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Manic and depressive mood states in bipolar disorder (BD) may emerge from the non-linear relations between constantly changing mood symptoms exhibited as a complex dynamic system. Dynamic Time Warp (DTW) is an algorithm that may capture symptom interactions from panel data with sparse observations over time. METHODS The Young Mania Rating Scale and Quick Inventory of Depressive Symptomatology were repeatedly assessed in 141 individuals with BD, with on average 5.5 assessments per subject every 3-6 months. Dynamic Time Warp calculated the distance between each of the 27 × 27 pairs of standardized symptom scores. The changing profile of standardized symptom scores of BD participants was analyzed in individual subjects, yielding symptom dimensions in aggregated group-level analyses. Using an asymmetric time-window, symptom changes that preceded other symptom changes (i.e., Granger causality) yielded a directed network. RESULTS The mean age of the BD participants was 40.1 (SD 13.5) years old, and 60% were female participants. Idiographic symptom networks were highly variable between subjects. Yet, nomothetic analyses showed five symptom dimensions: core (hypo)mania (6 items), dysphoric mania (5 items), lethargy (7 items), somatic/suicidality (6 items), and sleep (3 items). Symptoms of the "Lethargy" dimension showed the highest out-strength, and its changes preceded those of "somatic/suicidality," while changes in "core (hypo)mania" preceded those of "dysphoric mania." CONCLUSION Dynamic Time Warp may help to capture meaningful BD symptom interactions from panel data with sparse observations. It may increase insight into the temporal dynamics of symptoms, as those with high out-strength (rather than high in-strength) could be promising targets for intervention.
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Affiliation(s)
- R Mesbah
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Mental Health Care PsyQ Kralingen, Department of Mood Disorders, Rotterdam, The Netherlands
| | - M A Koenders
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Social Sciences, Leiden University, Institute of Psychology, Leiden, The Netherlands
| | - A T Spijker
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Mental Health Care Rivierduinen, Leiden, The Netherlands
| | - M de Leeuw
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Mental Health Care Rivierduinen, Bipolar Disorder Outpatient Clinic, Leiden, The Netherlands
| | - A M van Hemert
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - E J Giltay
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Health Campus The Hague, Leiden University, The Hague, The Netherlands
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41
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Glück VM, Engelke P, Hilger K, Wong AHK, Boschet JM, Pittig A. A network perspective on real-life threat, anxiety, and avoidance. J Clin Psychol 2024; 80:23-38. [PMID: 37531080 DOI: 10.1002/jclp.23575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 02/27/2023] [Accepted: 07/16/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Anxiety, approach, and avoidance motivation crucially influence mental and physical health, especially when environments are stressful. The interplay between anxiety and behavioral motivation is modulated by multiple individual factors. This proof-of-concept study applies graph-theoretical network analysis to explore complex associations between self-reported trait anxiety, approach and avoidance motivation, situational anxiety, stress symptoms, perceived threat, perceived positive consequences of approach, and self-reported avoidance behavior in real-life threat situations. METHODS A total of 436 participants who were matched on age and gender (218 psychotherapy patients, 218 online-recruited nonpatients) completed an online survey assessing these factors in response to the COVID-19 pandemic. RESULTS AND DISCUSSION The resulting cross-sectional psychological network revealed a complex pattern with multiple positive (e.g., between trait anxiety, avoidance motivation, and avoidance behavior) and negative associations (e.g., between approach and avoidance motivation). The patient and online subsample networks did not differ significantly, however, descriptive differences may inform future research.
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Affiliation(s)
- Valentina M Glück
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Paula Engelke
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Kirsten Hilger
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Alex H K Wong
- Department of Clinical Psychology, Erasmus School of Social and Behavioural Sciences, Rotterdam, Netherlands
| | - Juliane M Boschet
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Andre Pittig
- Translational Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
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Fonseca-Pedrero E, Díez-Gómez A, de la Barrera U, Sebastian-Enesco C, Ortuño-Sierra J, Montoya-Castilla I, Lucas-Molina B, Inchausti F, Pérez-Albéniz A. Suicidal behaviour in adolescents: A network analysis. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:3-10. [PMID: 32493673 DOI: 10.1016/j.rpsm.2020.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 03/20/2020] [Accepted: 04/01/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Suicidal behaviour has not yet been analysed from a network approach in adolescent samples. It is imperative to incorporate new psychological models to understand suicidal behaviour from a different perspective. The main objective of this work was twofold: (a) to examine suicidal behaviour through network analysis and (b) to estimate the psychological network between suicidal behaviour and protective and risk factors in school-age adolescents. METHOD Participants were 443 students (M=14.3 years; SD=0.53; 51.2% female) selected incidentally from different schools. Different instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, prosocial behaviour, subjective well-being, emotional intelligence, self-esteem, depressive symptomatology, empathy, positive and negative affect, and emotional regulation. RESULTS The resulting network of suicidal behaviour was strongly interconnected. The most central node in terms of strength and expected influence was "Consider taking your own life". In the estimated psychological network of suicidal behaviour and risk and protective factors, the nodes with the highest strength were depressive symptomatology, positive affect, and empathic concern. The most influential nodes were those related to emotional intelligence abilities. Suicidal behaviour was positively connected to depression symptoms and negative affect, and negatively connected to self-esteem and positive affect. The results of the stability analysis indicated that the networks were accurately estimated. CONCLUSIONS Suicidal behaviour can be conceptualized as a dynamic, complex system of cognitive, emotional, and affective characteristics. The new psychopathological and psychometric models allow us to analyse and understand human behaviour and mental health problems from a new perspective, suggesting new forms of conceptualization, evaluation, intervention, and prevention.
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Affiliation(s)
- Eduardo Fonseca-Pedrero
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, Spain; Departamento de Psiquiatría, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain; Programa Riojano de Investigación en Salud Mental (PRISMA), Logroño, Spain.
| | - Adriana Díez-Gómez
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, Spain; Programa Riojano de Investigación en Salud Mental (PRISMA), Logroño, Spain
| | - Usue de la Barrera
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Valencia, Valencia, Spain
| | - Carla Sebastian-Enesco
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, Spain; Programa Riojano de Investigación en Salud Mental (PRISMA), Logroño, Spain
| | - Javier Ortuño-Sierra
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, Spain; Programa Riojano de Investigación en Salud Mental (PRISMA), Logroño, Spain
| | - Inmaculada Montoya-Castilla
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Valencia, Valencia, Spain
| | - Beatriz Lucas-Molina
- Psicología Evolutiva y de la Educación, Universidad de Valencia, Valencia, Spain
| | - Félix Inchausti
- Departamento de Salud Mental, Servicio Riojano de Salud, Spain
| | - Alicia Pérez-Albéniz
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, Spain; Programa Riojano de Investigación en Salud Mental (PRISMA), Logroño, Spain
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Wolpe N, Vituri A, Jones PB, Shahar M, Fernandez-Egea E. The longitudinal structure of negative symptoms in treatment resistant schizophrenia. Compr Psychiatry 2024; 128:152440. [PMID: 38039918 DOI: 10.1016/j.comppsych.2023.152440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/29/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND AND HYPOTHESIS The negative symptoms of schizophrenia are strong prognostic factors but remain poorly understood and treated. Five negative symptom domains are frequently clustered into the motivation and pleasure (MAP) and emotional expression (EE) 'dimensions', but whether this structure remains stable and behaves as a single entity or not remains unclear. STUDY DESIGN We examined a cohort of 153 patients taking clozapine for treatment-resistant schizophrenia in a regional mental health clinic. Patients were assessed longitudinally over a mean period of 45 months using validated scales for positive, negative and mood symptoms. Network analyses were performed to identify symptom 'communities' and their stability over time. The influence of common causes of secondary negative symptoms as well as centrality measures were also examined. STUDY RESULTS Across patients at baseline, two distinct communities matching the clinical domains of MAP and EE were found. These communities remained highly stable and independent over time. The communities remained stabled when considering psychosis, depression, and sedation severity, and these causes of secondary negative symptoms were clustered into the MAP community. Centrality measures also remained stable over time, with similar centrality measures across symptoms. CONCLUSIONS Our results suggest that MAP and EE are independent dimensions that remain highly stable over time in chronic schizophrenia patients treated with clozapine. Common causes of secondary negative symptoms mapped onto the MAP dimension. Our results emphasise the need for clinical trials to address either MAP or EE, and that treating causes of secondary negative symptoms may improve MAP.
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Affiliation(s)
- Noham Wolpe
- Department of Physical Therapy, The Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel; Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Aya Vituri
- Tel Aviv Center for Artificial Intelligence & Data Science (TAD), Tel Aviv University, 6997801, Israel
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridge CB21 5EF, UK
| | - Moni Shahar
- Tel Aviv Center for Artificial Intelligence & Data Science (TAD), Tel Aviv University, 6997801, Israel
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridge CB21 5EF, UK.
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Wu R, Guang Z, Wang Y, Xue B, Zhang A, Dawa Y, Guo C, Tong X, Wang S, Lu C. Eating disorders symptoms and depressive symptoms in Chinese Tibetan University students: a network analysis. BMC Psychiatry 2023; 23:957. [PMID: 38129774 PMCID: PMC10734136 DOI: 10.1186/s12888-023-05452-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Depression is being increasingly acknowledged as a global public health concern, and following this trend, attention towards eating disorders (EDs) has surged within China's national consciousness. EDs symptoms frequently coexist with various mental health conditions, including depression. However, research focusing on EDs symptoms and depressive symptoms among Tibetan students in China remains scant. This study employs network analysis to estimate the relational network between EDs and depressive symptoms. METHODS Tibetan (n = 2,582) and Han (n = 1,743) students from two universities in the Xizang Autonomous Region, China, completed the Eating Attitude Test-26 (EAT-26) and the Patient Health Questionnaire-9 (PHQ-9). We estimated the network structure of EDs symptoms and depressive symptoms, identified central and bridge symptoms, and examined whether network characteristics differed by gender and ethnic. RESULTS The core symptoms identified within this study were Calorie_awareness, Desire_to_thin and Fatigue. Conversely, bridge symptoms included Appetite, Suicide, Anhedonia, Guilty, Body_fat_awareness, and Food_preoccupation. The study also revealed no significant gender differences within the network model. However, disparities among ethnic groups were observed within the network structure. CONCLUSIONS Our study examined the correlation between EDs symptoms and depressive symptoms in Tibetan college students. Focusing on the individual's quest for the perfect body shape and some Tibetan students' appetite problems - potentially stemming from transitioning to a new university environment, adapting to the school canteen's diet, or being away from their hometown - could aid in the prevention and management of EDs and depression symptoms. It could reduce the incidence of complications by helping students maintain good physical and mental health. Concurrently, our research provides insights into the relatively higher levels of depression triggered by the unique plateau environment.
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Affiliation(s)
- Ruipeng Wu
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, People's Republic of China
| | - Zixuan Guang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
| | - Yingting Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
| | - Bei Xue
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
| | - Ailing Zhang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
| | - Yundan Dawa
- Department of Tibetan Medicine, University of Tibetan Medicine(UTC), 850000, Lhasa, People's Republic of China
| | - Chenghui Guo
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
| | - Xiaopeng Tong
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China
| | - Shaokang Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research On High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, 712082, Xianyang, People's Republic of China.
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, People's Republic of China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 510080, Guangzhou, People's Republic of China.
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Chen C, Cao C, Fang R, Wang L, Borsboom D. Revealing the psychopathological pathway linking trauma to post-traumatic stress disorder: longitudinal network approach. BJPsych Open 2023; 10:e2. [PMID: 38044677 PMCID: PMC10755552 DOI: 10.1192/bjo.2023.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/22/2023] [Accepted: 10/29/2023] [Indexed: 12/05/2023] Open
Abstract
The present study investigated the psychopathological processes of post-traumatic stress disorder (PTSD) following the network approach to psychopathology. The directed acyclic graph model was employed to analyse a large longitudinal data-set of Chinese children and adolescents exposed to a destructive earthquake. It was found that intrusion symptoms were first activated by trauma exposure, and subsequently activated other PTSD symptoms. The data are consistent with the idea that symptoms may form a self-sustaining dynamic network by interacting with each other to promote or maintain the chronicity of PTSD. The findings advance the current understanding about the psychopathological processes of PTSD, and inform further research and clinical practices on post-traumatic psychopathology.
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Affiliation(s)
- Chen Chen
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, China; and Department of Psychology, University of Chinese Academy of Sciences, China
| | - Chengqi Cao
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, China; and Department of Psychology, University of Chinese Academy of Sciences, China
| | - Ruojiao Fang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, China; and Department of Psychology, University of Chinese Academy of Sciences, China
| | - Li Wang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, China; and Department of Psychology, University of Chinese Academy of Sciences, China
| | - Denny Borsboom
- Department of Psychological Methods, University of Amsterdam, The Netherlands
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Horváth Z, Paksi B, Fernández-Aranda F, Jiménez-Murcia S, Demetrovics Z. The Predictive Role of Tolerance and Health Problems in Problem Gambling: A Cross-Sectional and Cross-Lagged Network Analyses. J Gambl Stud 2023; 39:1781-1798. [PMID: 36738377 PMCID: PMC9898861 DOI: 10.1007/s10899-023-10191-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/05/2023]
Abstract
The existing symptomatic networks of problem gambling are all based on cross-sectional data. Thus, there is a need to explore longitudinal symptom networks of problem gambling. Moreover, the replicability of cross-sectional symptom networks can be limited; therefore, further research should assess the convergence between cross-sectional networks of problem gambling symptoms. The present study aimed (i) to examine cross-sectional networks of problem gambling symptoms and evaluate their replicability and (ii) to examine a longitudinal cross-lagged network of problem gambling symptoms. The study included a representative sample of young adult gamblers (born between 1984 and 2000) from the first two waves of the Budapest Longitudinal Study (original sample: N = 2777; final sample: N = 335). The Problem Gambling Severity Index was used to assess symptoms of problem gambling. Cross-sectional symptom networks showed differences in the centrality of nodes. Correlations between the two cross-sectional networks were low in the presence vs. absence of edges, rank order of edge weights, and centrality estimates. However, network invariance tests indicated non-significant differences between them. The cross-lagged network revealed that the symptoms of tolerance and health problems could predict the subsequent presence of multiple problem gambling symptoms. Overall, limited evidence demonstrated the replicability of cross-sectional symptom networks of problem gambling. Future research needs to explore the utility of cross-sectional networks of problem gambling and assess more precisely causal relationships between problem gambling symptoms by distinguishing within- and between-subject effects.
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Affiliation(s)
- Zsolt Horváth
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella Utca 46, Budapest, 1064, Hungary.
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar.
| | - Borbála Paksi
- Institute of Education, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III., Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III., Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella Utca 46, Budapest, 1064, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
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Moffa G, Kuipers J, Kuipers E, McManus S, Bebbington P. Sexual abuse and psychotic phenomena: a directed acyclic graph analysis of affective symptoms using English national psychiatric survey data. Psychol Med 2023; 53:7817-7826. [PMID: 37485689 PMCID: PMC10755243 DOI: 10.1017/s003329172300185x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Sexual abuse and bullying are associated with poor mental health in adulthood. We previously established a clear relationship between bullying and symptoms of psychosis. Similarly, we would expect sexual abuse to be linked to the emergence of psychotic symptoms, through effects on negative affect. METHOD We analysed English data from the Adult Psychiatric Morbidity Surveys, carried out in 2007 (N = 5954) and 2014 (N = 5946), based on representative national samples living in private households. We used probabilistic graphical models represented by directed acyclic graphs (DAGs). We obtained measures of persecutory ideation and auditory hallucinosis from the Psychosis Screening Questionnaire, and identified affective symptoms using the Clinical Interview Schedule. We included cannabis consumption and sex as they may determine the relationship between symptoms. We constrained incoming edges to sexual abuse and bullying to respect temporality. RESULTS In the DAG analyses, contrary to our expectations, paranoia appeared early in the cascade of relationships, close to the abuse variables, and generally lying upstream of affective symptoms. Paranoia was consistently directly antecedent to hallucinations, but also indirectly so, via non-psychotic symptoms. Hallucinosis was also the endpoint of pathways involving non-psychotic symptoms. CONCLUSIONS Via worry, sexual abuse and bullying appear to drive a range of affective symptoms, and in some people, these may encourage the emergence of hallucinations. The link between adverse experiences and paranoia is much more direct. These findings have implications for managing distressing outcomes. In particular, worry may be a salient target for intervention in psychosis.
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Affiliation(s)
- Giusi Moffa
- University of Basel, Basel, Switzerland
- University College London, London, UK
| | - Jack Kuipers
- Department of Biosystems Science and Engineering, Eidgenossische Technische Hochschule Zurich, Basel, Switzerland
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He C, He Y, Yang T, Wu C, Lin Y, Yan J, Chang W, Chang F, Wang Y, Wu S, Cao B. Relationship of sleep-quality and social-anxiety in patients with breast cancer: a network analysis. BMC Psychiatry 2023; 23:887. [PMID: 38017507 PMCID: PMC10683122 DOI: 10.1186/s12888-023-05262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/08/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND There is a complex relationship between social anxiety and sleep quality. However, network analysis studies of associations between social anxiety and sleep quality are lacking, particularly among patients with breast cancer. The current study aimed to extend this research to a sample of patients with breast cancer and to examine symptom-level associations between social anxiety and sleep quality using network analysis. METHODS Network analysis was conducted to explore their associations and identify bridge items of social anxiety and sleep quality. RESULTS The network structure revealed 9 important edges between social anxiety and sleep quality. "Subjective sleep quality" had the highest EI value in the network. "Working difficulty under watching" and "Sleep disorders" had the highest BEI values in their own communities. CONCLUSION There are complex pathological correlation pathways between social anxiety and sleep quality in breast cancer patients. "Subjective sleep quality", "Working difficulty under watching" and "Sleep disorders" have the potential to be intervention targets for sleep disorder-social anxiety comorbidity. Medical staff can take corresponding interventions according to the the centrality indices and bridge centrality indicators identified in this study, which is likely to effectively reduce the comorbidity of sleep disorders and social anxiety.
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Affiliation(s)
- Chunyan He
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yang He
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Tianqi Yang
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Chao Wu
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yawei Lin
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Jiaran Yan
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Wei Chang
- Center for Aerospace Clinical Medicine, Department of Aerospace Medicine, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Fenxia Chang
- Department of Obstetrics and Gynecology, Xi 'an Daxing Hospital, Xi'an, 710000, Shaanxi, China
| | - Yameng Wang
- School of Clinical Medicine, Anhui Medical University, Hefei, 230000, Anhui, China
| | - Shengjun Wu
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
| | - Baohua Cao
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
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Hensing G, van Diepen C, Boström M, Bertilsson M. Validity of the Capacity to Work Index: Development of an Instrument to Measure Work Capacity in Relation to Depression and Anxiety in the General Working Population. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10150-2. [PMID: 37938436 DOI: 10.1007/s10926-023-10150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To develop an index to assess capacity to work in relation to common mental disorders (CMDs) in the general working population and field test its psychometric properties. METHODS Content analysis of three qualitative studies on people (n = 49) with their own experiences of working with CMD guided the items selected for the index. Face and content validity and test-retest reliability were performed. The index was field tested in two versions with 26 and 17 items, respectively, among health care professionals regarding internal reliability, component structure and concurrent validity. RESULTS The final version of the Capacity to Work Index (C2WI; 17 items) was normally distributed in the field test with high internal reliability (Cronbach's alpha, 0.84). Missing responses were randomly distributed and nonspecific. Principal component analysis showed one clear component with negatively framed items. Concurrent validity showed high correlation with the WHO-5 Well-Being Scale (Pearson's r, 0.68), but lower correlation for the general health question (r, - 0.44), one item of the Work Ability Index (r, - 0.33), and the Stress of Conscience constructs (r, 0.44). CONCLUSION The C2WI showed promising psychometric qualities. Low and negative correlation with the item from Work Ability Index suggests that the C2WI measures additional dimensions, but further testing in larger and more diverse samples is required.
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Affiliation(s)
- Gunnel Hensing
- Social Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
- Social Medicine, School of Public Health and Community Medicine, PO Box 453, SE-405 30, Göteborg, Sweden.
| | - Cornelia van Diepen
- Centre for Person-centred Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Maria Boström
- Social Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Monica Bertilsson
- Social Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Lemke T, Hökby S, Wasserman D, Carli V, Hadlaczky G. Associations between sleep habits, quality, chronotype and depression in a large cross-sectional sample of Swedish adolescents. PLoS One 2023; 18:e0293580. [PMID: 37917651 PMCID: PMC10621812 DOI: 10.1371/journal.pone.0293580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To investigate behavioral sleep habits, self-perceived quality of sleep, and chronotype, and to examine their association with clinically relevant levels of depression in Swedish adolescents. METHOD Questionnaire data were obtained from a representative sample of Swedish adolescents (n = 8449; 50.8% girls; aged 12-16). Depression was defined as >13 BDI-II scores. Logistic regression modelling estimated the effects of sleep duration, sleep quality, and chronotype on depression, adjusted for socio-demographic factors. RESULTS On weekdays, approximately 46% of adolescents slept less than the recommended length of eight hours per night (depressed: 68%, non-depressed: 40%). On weekends, however, only 17% slept shorter than recommended. Short weekday sleep duration was more common among girls than boys (53% vs. 38%) and girls reported worse sleep quality. The regression model showed that depression was predicted by weekday sleep duration (OR = 0.773, p < .0001), sleep quality (OR = 0.327, p < .0001), and late chronotype (OR = 1.126, p = .0017), but not by weekend sleep duration. A 30-minute increase in weekday sleep duration was associated with about 10% lower odds of depression. CONCLUSIONS A substantial proportion of Swedish adolescents do not seem to meet the sleep recommendations of eight hours per night. Short sleep duration on weekdays, poor sleep quality, and late chronotype were associated with increased risk of depression. Interventions promoting longer weekday sleep duration (e.g., later school start times) seem relevant in this context, but further research is needed to investigate the directionality and underlying mechanisms of these associations.
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Affiliation(s)
- Theresa Lemke
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Sebastian Hökby
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
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