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Zhang L, James SH, Strauss GP. Environmental resource reductions predict greater severity of negative symptoms in schizophrenia. Schizophr Res 2023; 261:94-99. [PMID: 37716206 PMCID: PMC10840833 DOI: 10.1016/j.schres.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/17/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
No pharmacological or psychosocial interventions effectively treat negative symptoms in schizophrenia (SZ), despite the identification of biological and psychological mechanistic targets. Limited treatment progress may result from failure to account for non-person-level environmental factors that present barriers to performing recreational, social, and goal-directed activities. The bioecosystem model of negative symptoms proposes that four interactive ecosystems (i.e. microsystem, mesosystem, exosystem, and macrosystem) influence person-level factors (e.g., dysfunctional beliefs, glutamate, cortico-striatal functioning) to initiate and maintain negative symptoms. The current study tested this hypothesis by examining whether indirect environmental factors (e.g., access to resources for performing activities in the built environment) were associated with dysfunctional beliefs (defeatist performance, asocial, anhedonic) and negative symptoms (anhedonia, avolition, asociality). Self-reports of indirect environmental factors (i.e., the built environment), dysfunctional beliefs, and negative symptoms were collected from 31 individuals with SZ and 29 matched healthy controls. Mediation analyses were conducted with dysfunctional beliefs as the predictor, indirect environmental factors as mediator, and negative symptoms as the outcome. Individuals with SZ reported reduced access to environmental resources for performing recreational, goal-directed, and social activities; these reductions were associated with greater negative symptom severity. Mediation analyses indicated that the effect of dysfunctional beliefs on negative symptoms was mediated by participants' satisfaction with resources for performing activities in their environment. These findings suggest that psychosocial treatments could be augmented to not only target dysfunctional beliefs, but also environmental processes that lead these beliefs to emerge and contribute to negative symptoms.
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Affiliation(s)
- Luyu Zhang
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Sydney H James
- Department of Psychology, University of Georgia, Athens, GA, USA
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Pykett J, Campbell N, Fenton SJ, Gagen E, Lavis A, Newbigging K, Parkin V, Williams J. Urban precarity and youth mental health: An interpretive scoping review of emerging approaches. Soc Sci Med 2023; 320:115619. [PMID: 36641884 DOI: 10.1016/j.socscimed.2022.115619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 10/09/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Circumstances of living are key to shaping emotional and affective experiences, long term health, wellbeing and opportunities. In an era characterised by rapid urbanisation across the majority of the world, there is increasing interest in the interaction between mental health and urban environments, but insufficient attention is paid to how mental health is situated in space and time. Socio-economic inequalities are prevalent in many urban environments globally, making conditions of living highly precarious for some social groups including young people. There remains a large volume of unmet mental health service needs, and young people are impacted by uncertain economic futures. The purpose of this scoping review is to develop an interdisciplinary and globally-informed understanding of the urban conditions which affect youth mental health across a range of scales, and to identify protective factors which can promote better youth mental health. We seek to broaden the scope of urban mental health research beyond the physical features of urban environments to develop an interpretive framework based on perspectives shared by young people. We illustrate how concepts from social theory can be used as an integrative framework to emphasise both young people's lived experiences and the wider cultural and political dynamics of urban mental health.
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Affiliation(s)
- Jessica Pykett
- School of Geography, Earth and Environmental Sciences, Institute for Mental Health and Centre for Urban Wellbeing, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Niyah Campbell
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Sarah-Jane Fenton
- School of Social Policy and Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Elizabeth Gagen
- Department of Geography and Earth Sciences, Aberystwyth University, Llandinam Building, Penglais Campus, Aberystwyth, SY23 3DB, Wales, UK.
| | - Anna Lavis
- Institute of Applied Health Research and Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Karen Newbigging
- School of Social Policy and Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Verity Parkin
- Liberal Arts and Natural Sciences Alumni, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Jessy Williams
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Perceived ostracism and paranoia: A test of potential moderating effects of psychological flexibility and inflexibility. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Krabbendam L, van Vugt M, Conus P, Söderström O, Abrahamyan Empson L, van Os J, Fett AKJ. Understanding urbanicity: how interdisciplinary methods help to unravel the effects of the city on mental health. Psychol Med 2021; 51:1099-1110. [PMID: 32156322 DOI: 10.1017/s0033291720000355] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty-first century urbanization poses increasing challenges for mental health. Epidemiological studies have shown that mental health problems often accumulate in urban areas, compared to rural areas, and suggested possible underlying causes associated with the social and physical urban environments. Emerging work indicates complex urban effects that depend on many individual and contextual factors at the neighbourhood and country level and novel experimental work is starting to dissect potential underlying mechanisms. This review summarizes findings from epidemiology and population-based studies, neuroscience, experimental and experience-based research and illustrates how a combined approach can move the field towards an increased understanding of the urbanicity-mental health nexus.
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Affiliation(s)
- Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
| | - Mark van Vugt
- Department of Experimental and Applied Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
| | - Ola Söderström
- Institut de Géographie, Université de Neuchâtel, Espace Louis-Agassiz, 2000, Neuchâtel, Switzerland
| | - Lilith Abrahamyan Empson
- Treatment and Early Intervention in Psychosis Program (TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
| | - Jim van Os
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne-Kathrin J Fett
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
- Department of Psychology, City, University of London, Northampton Square, LondonEC1V 0HB, UK
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Abstract
Rapid urbanization worldwide is associated to an increase of population in the urban settings and this is leading to new emerging mental health issues. This narrative mini-review is based on a literature search conducted through PubMed and EMBASE. A total of 113 articles published on the issue of urban mental health have been selected, cited, reviewed, and summarized. There are emerging evidences about the association between urbanization and mental health issues. Urbanization affects mental health through social, economic, and environmental factors. It has been shown that common mental syndromes report higher prevalence in the cities. Social disparities, social insecurity, pollution, and the lack of contact with nature are some of recognized factors affecting urban mental health. Further reserach studies and specific guidelines should be encouraged to help policy makers and urban designers to improve mental health and mental health care facilities in the cities; additional strategies to prevent and reduce mental illness in the urban settings should be also adopted globally.
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Griffiths SL, Birchwood M. A Synthetic Literature Review on the Management of Emerging Treatment Resistance in First Episode Psychosis: Can We Move towards Precision Intervention and Individualised Care? ACTA ACUST UNITED AC 2020; 56:medicina56120638. [PMID: 33255489 PMCID: PMC7761187 DOI: 10.3390/medicina56120638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 12/15/2022]
Abstract
Treatment resistance is prevalent in early intervention in psychosis services, and causes a significant burden for the individual. A wide range of variables are shown to contribute to treatment resistance in first episode psychosis (FEP). Heterogeneity in illness course and the complex, multidimensional nature of the concept of recovery calls for an evidence base to better inform practice at an individual level. Current gold standard treatments, adopting a ‘one-size fits all’ approach, may not be addressing the needs of many individuals. This following review will provide an update and critical appraisal of current clinical practices and methodological approaches for understanding, identifying, and managing early treatment resistance in early psychosis. Potential new treatments along with new avenues for research will be discussed. Finally, we will discuss and critique the application and translation of machine learning approaches to aid progression in this area. The move towards ‘big data’ and machine learning holds some prospect for stratifying intervention-based subgroups of individuals. Moving forward, better recognition of early treatment resistance is needed, along with greater sophistication and precision in predicting outcomes, so that effective evidence-based treatments can be appropriately tailored to the individual. Understanding the antecedents and the early trajectory of one’s illness may also be key to understanding the factors that drive illness course.
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Affiliation(s)
- Siân Lowri Griffiths
- Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK
- Correspondence: ; Tel.: +44-7912-4972-67
| | - Max Birchwood
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
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