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Fresno A, Ramos Alvarado N, Núñez D, Ulloa JL, Arriagada J, Cloitre M, Bisson JI, Roberts NP, Shevlin M, Karatzias T. Initial validation of the International Trauma Questionnaire (ITQ) in a sample of Chilean adults. Eur J Psychotraumatol 2023; 14:2263313. [PMID: 37815059 PMCID: PMC10566396 DOI: 10.1080/20008066.2023.2263313] [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: 12/19/2022] [Accepted: 08/10/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) are stress-related disorders. The International Trauma Questionnaire (ITQ) is a widely used instrument to assess PTSD and CPTSD. To date, there is no evidence of the psychometric characteristics of the ITQ in Latin American countries. OBJECTIVE The aim of this study was to assess the construct and concurrent validity of the Latin American Spanish adaptation of the ITQ in a sample of Chilean adults. METHODS A sample of 275 Chilean young adults completed the ITQ, a traumatic life events checklist, the Adverse Childhood Experiences Questionnaire, the Depression Anxiety Stress Scales-21, and the Columbia-Suicide Severity Rating Scale short version. Four alternative confirmatory factor analysis models were tested. Correlation analyses were performed to determine concurrent validity with associated measures (number of reported traumatic events, number of adverse childhood experiences, anxiety, depression, and suicidal risk). RESULTS The second-order two-factor (PTSD and DSO) and the correlated first-order six-factor model provided acceptable fit; however, the first model showed a better fit based on the BIC difference. The PTSD and DSO dimensions, as well as the six ITQ clusters showed positive correlations with reported number of traumatic life-events, reported number of adverse childhood experiences, levels of anxiety, depression, and suicidal risk. CONCLUSIONS The ITQ Latin American Spanish adaptation provides acceptable psychometric evidence to assess PTSD and CPTSD in accordance with the ICD-11.
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Affiliation(s)
- Andrés Fresno
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Centro de Derecho de las Minorías y Gestión de la Diversidad, Universidad de Talca, Talca, Chile
| | - Nadia Ramos Alvarado
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Centro de Derecho de las Minorías y Gestión de la Diversidad, Universidad de Talca, Talca, Chile
| | - Daniel Núñez
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
| | - José Luis Ulloa
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
| | - Jessica Arriagada
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Neil P. Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
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2
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Radin AK, Shaw J, Brown SP, Flint H, Fouts T, McCue E, Skeie A, Peña C, Youell J, Ratzliff A, Powers DM, Biss M, Lemon H, Sandoval D, Hartmann J, Hammar E, Doty-Jones A, Wilson J, Austin G, Chan KCG, Zheng Z, Fruhbauerova M, Ross M, Stright M, Pullen S, Edwards C, Walton M, Kerbrat A, Comtois KA. Comparative effectiveness of safety planning intervention with instrumental support calls (ISC) versus safety planning intervention with two-way text message caring contacts (CC) in adolescents and adults screening positive for suicide risk in emergency departments and primary care clinics: Protocol for a pragmatic randomized controlled trial. Contemp Clin Trials 2023; 131:107268. [PMID: 37321352 PMCID: PMC10530453 DOI: 10.1016/j.cct.2023.107268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/24/2023] [Accepted: 06/11/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Suicide is a leading cause of death in adolescents and adults in the US. Follow-up support delivered when patients return home after an emergency department (ED) or primary care encounter can significantly reduce suicidal ideation and attempts. Two follow-up models to augment usual care including the Safety Planning Intervention have high efficacy: Instrumental Support Calls (ISC) and Caring Contacts (CC) two-way text messages, but they have never been compared to assess which works best. This protocol for the Suicide Prevention Among Recipients of Care (SPARC) Trial aims to determine which model is most effective for adolescents and adults with suicide risk. METHODS The SPARC Trial is a pragmatic randomized controlled trial comparing the effectiveness of ISC versus CC. The sample includes 720 adolescents (12-17 years) and 790 adults (18+ years) who screen positive for suicide risk during an ED or primary care encounter. All participants receive usual care and are randomized 1:1 to ISC or CC. The state suicide hotline delivers both follow-up interventions. The trial is single-masked, with participants unaware of the alternative treatment, and is stratified by adolescents/adults. The primary outcome is suicidal ideation and behavior, measured using the Columbia Suicide Severity Rating Scale (C-SSRS) screener at 6 months. Secondary outcomes include C-SSRS at 12 months, and loneliness, return to crisis care for suicidality, and utilization of outpatient mental health services at 6 and 12 months. DISCUSSION Directly comparing ISC and CC will determine which follow-up intervention is most effective for suicide prevention in adolescents and adults.
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Affiliation(s)
- Anna K Radin
- St. Luke's Health System, Applied Research Division, Boise, ID, United States.
| | - Jenny Shaw
- St. Luke's Health System, Applied Research Division, Boise, ID, United States
| | - Siobhan P Brown
- University of Washington, Department of Biostatistics, Seattle, WA, United States
| | - Hilary Flint
- St. Luke's Health System, Applied Research Division, Boise, ID, United States
| | - Tara Fouts
- St. Luke's Health System, Applied Research Division, Boise, ID, United States
| | - Elizabeth McCue
- St. Luke's Health System, Applied Research Division, Boise, ID, United States
| | - Anton Skeie
- St. Luke's Health System, Applied Research Division, Boise, ID, United States
| | - Cecelia Peña
- St. Luke's Health System, Applied Research Division, Boise, ID, United States
| | - Jonathan Youell
- St. Luke's Health System, Applied Research Division, Boise, ID, United States
| | - Anna Ratzliff
- University of Washington, Department of Psychiatry and Behavioral Sciences,, Seattle, WA, United States
| | - Diane M Powers
- University of Washington, Department of Psychiatry and Behavioral Sciences,, Seattle, WA, United States
| | - Matthew Biss
- Idaho Crisis and Suicide Hotline, Boise, ID, United States; SPARC Lived Experience Advisory Board, ID, United States
| | - Hannah Lemon
- Idaho Crisis and Suicide Hotline, Boise, ID, United States
| | | | | | | | - Amelia Doty-Jones
- St. Luke's Health System, Behavioral Health Service Line, Boise, ID, United States
| | - Jacob Wilson
- St. Luke's Health System, Behavioral Health Service Line, Boise, ID, United States; Cornerstone Whole Healthcare Organization, Inc., McCall, ID, United States
| | - George Austin
- Idaho Crisis and Suicide Hotline, Boise, ID, United States
| | - Kwun C G Chan
- University of Washington, Department of Biostatistics, Seattle, WA, United States
| | - Zihan Zheng
- University of Washington, Department of Biostatistics, Seattle, WA, United States
| | - Martina Fruhbauerova
- University of Washington, Department of Psychiatry and Behavioral Sciences,, Seattle, WA, United States
| | - Michelle Ross
- St. Luke's Health System, Behavioral Health Service Line, Boise, ID, United States
| | - Megan Stright
- St. Luke's Health System, Behavioral Health Service Line, Boise, ID, United States
| | - Samuel Pullen
- St. Luke's Health System, Behavioral Health Service Line, Boise, ID, United States; Novant Health, Psychiatry and Mental Health Institute, Winston-Salem, NC, United States; Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC, United States
| | - Christopher Edwards
- St. Luke's Health System, Behavioral Health Service Line, Boise, ID, United States; National Staffing Solutions (Contracted Provider for Optum Serve), Twin Falls, ID, United States
| | - Michael Walton
- St. Luke's Health System, Behavioral Health Service Line, Boise, ID, United States
| | - Amanda Kerbrat
- University of Washington, Department of Psychiatry and Behavioral Sciences,, Seattle, WA, United States
| | - Katherine Anne Comtois
- University of Washington, Department of Psychiatry and Behavioral Sciences,, Seattle, WA, United States
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3
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Ramos-Martín J, Pérez-Berlanga JM, Oliver J, Moreno-Küstner B. Non-lethal suicidal behavior in university students of Spain during COVID-19. Front Psychiatry 2023; 14:1155171. [PMID: 37533884 PMCID: PMC10390698 DOI: 10.3389/fpsyt.2023.1155171] [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: 01/31/2023] [Accepted: 07/03/2023] [Indexed: 08/04/2023] Open
Abstract
Background Suicide is the fourth external cause of death in the world, in persons between the ages of l5 and 29. The objectives of this study were to measure the prevalence of suicidal behavior in university students and analyze the relationship of suicide risk with psychological distress, resilience, and family and social support. Methods An observational and transversal study wherein the students at the University of Malaga (Spain) completed an online questionnaire which included items from different scales, sociodemographic and academic questions, and the subjective impact of the COVID-19 pandemic. Descriptive analyses and prevalence rates of suicidal behavior were calculated, and bivariate analyses, multiple linear regression, and a mediation and moderation analyses were conducted. Results A total of 2,212 students completed the questionnaire. The prevalence of the last 6 months was 30.4% wishing for death, 14.7% suicidal ideation, 5% self-harm injuries, and 0.5% suicide attempts. Psychological distress, family and social support were linked to the risk of suicide. Lastly, resilience and family support measure and moderate the relation between psychological stress and suicide risk. Conclusion Psychological distress is a risk factor for suicidal behavior, while resilience and family and social support are linked to a lower risk of suicide.
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Affiliation(s)
- Javier Ramos-Martín
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
| | - José Manuel Pérez-Berlanga
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
| | - Jesús Oliver
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
- Departamento de Psicología, Facultad de Ciencias Humanas y Sociales, Universidad Pontificia Comillas, Madrid, Spain
| | - Berta Moreno-Küstner
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
- Instituto de Biomedicina de Málaga (IBIMA), Málaga, Spain
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4
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Meng F, Zhu X, Gao Q, Li X, Chen J, Sa Q. Integrating the Interpersonal Theory of Suicide Into the Relations Between Cyber-Victimization and Suicidality Among Adolescents: A Short-Term Prospective Study. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP981-NP1006. [PMID: 35438527 PMCID: PMC9709550 DOI: 10.1177/08862605221086638] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The relation between cyber-victimization and suicidality among adolescents has been well documented; however, the mechanisms underlying this association have not been well investigated. Drawing upon the interpersonal theory of suicide, this study aimed to examine the mediating mechanisms (i.e., thwarted belongingness and perceived burdensomeness) underlying longitudinal, bidirectional relations between cyber-victimization and suicidal ideation/attempts among adolescents and explore gender differences in the mechanisms. Participants were 497 Chinese adolescents (46.1% male; Mage = 13.28, SD = .66), who completed the assessment of cyber-victimization, thwarted belongingness, and perceived burdensomeness, suicidal ideation/attempts at three-time points. The time interval between each two assessments is two weeks. Results showed the reciprocal relations between cyber-victimization and thwarted belongingness/perceived burdensomeness, between thwarted belongingness and suicidal ideation/suicide attempts, and between perceived burdensomeness and suicide attempts. Longitudinal mediation analyses indicated that Time 2 thwarted belongingness mediated the relation between Time 1 cyber-victimization and Time 3 suicidal ideation/suicide attempts. Besides, the reverse pathway from Time 1 suicidal ideation to Time 3 cyber-victimization was also mediated by Time 2 thwarted belongingness, but it was only significant in females, as suggested by multiple-group analyses. According to the aforementioned results, the interpersonal theory of suicide provides a useful framework for understanding relations between cyber-victimization and suicidality. Findings suggest that intervention targeted at improving the need to belong may help reduce suicide risk and lower cyber-victimization. Anti-cyber-victimization should be integrated into suicide intervention and prevention programs, and gender differences should be taken into account in order to enhance the program's effectiveness.
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Affiliation(s)
- Fanchen Meng
- Academy of Psychology and Behavior,
Tianjin
Normal University, Tianjin, China
| | - Xinxin Zhu
- Department of Psychology,
University
of Edinburgh, Edinburgh,UK
| | - Qianqian Gao
- School of Psychology,
South China
Normal University, Guangzhou,
China
| | - Xiang Li
- Department of Applied Social
Sciences, The Hong Kong
Polytechnic University, Hong Kong
| | - Jing Chen
- Clinical Operation Department,
TenNor
Therapeutics, Suzhou, China
| | - Qieer Sa
- CAS Key Laboratory of Mental
Health, Institute of
Psychology, Beijing, China
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5
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Padrós-Blázquez F, Pintor Sánchez BE, Valdés García KP. Análisis psicométrico de la escala de ideación suicida de Roberts en universitarios mexicanos. PSICUMEX 2022. [DOI: 10.36793/psicumex.v13i1.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
El incremento observado en las tasas de suicidio en jóvenes hace necesario contar con escalas de cribaje para la identificación de personas en riesgo. La escala de ideación suicida de Roberts (EIS) es un instrumento breve que ha mostrado propiedades psicométricas adecuadas en adolescentes mexicanos. El objetivo del presente estudio fue corroborar la estructura de dicho instrumento mediante un análisis factorial confirmatorio (AFC) y analizar sus propiedades psicométricas en estudiantes universitarios. Aplicando un método cuantitativo instrumental, se administró la EIS a 1190 universitarios. Los resultados del AFC corroboran la estructura unifactorial de la EIS; asimismo, la consistencia interna, reportada con el alfa de Cronbach ordinal (αO = 0.813), resultó adecuada. Se concluye que el instrumento muestra una estructura unifactorial y que las características psicométricas de los reactivos fueron adecuadas, resalta que 2.9 % de la muestra obtuvo una puntuación que indica alto riesgo suicida.
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6
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Wastler HM, Núñez D. Psychotic experiences, emotion regulation, and suicidal ideation among Chilean adolescents in the general population. Front Psychiatry 2022; 13:983250. [PMID: 36465305 PMCID: PMC9710630 DOI: 10.3389/fpsyt.2022.983250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Psychotic experiences are associated with increased risk for suicide. Despite this well-established finding, very little is known about factors that contribute to this relationship. The current study investigated the relationship between psychotic experiences, emotion regulation, and suicidal ideation among 1,590 Chilean adolescents in the general population. Participants completed self-report measures of psychotic experiences (Community Assessment of Psychic Experiences), emotion regulation (Emotion Regulation Questionnaire), depression (Patient Health Questionnaire-9), and suicidal ideation (Columbia Suicide Severity Rating Scale). Statistical analyses included Mann-Whitney U tests, point-biserial correlations, logistic regression, and moderation analyses. Results suggest that paranoid ideation, bizarre experiences, and perceptual abnormalities were moderately associated with suicidal ideation. Additionally, greater expressive suppression and cognitive reappraisal were associated with suicidal ideation. Results from the logistic regression indicate that paranoid ideation, perceptual abnormalities, and expressive suppression have the strongest relationship with suicidal ideation, even when controlling for depression and relevant demographic variables. Additionally, paranoid ideation interacted with expressive suppression to predict suicidal ideation, with expressive suppression having the strongest relationship with suicidal ideation when paranoid ideation was low to moderate. Taken together, these findings support the broader literature suggesting that emotion regulation might be a transdiagnostic risk factor for suicidal ideation. Additional longitudinal research is needed to examine whether expressive suppression and other maladaptive emotion regulation strategies serve as a mechanism for suicidal ideation both in the general population and among individuals with psychotic experiences.
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Affiliation(s)
- Heather M. Wastler
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, United States
| | - Daniel Núñez
- Faculty of Psychology, Universidad de Talca, Talca, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
- Programa de Investigación Asociativa, Faculty of Psychology, Centro de Investigación en Ciencias Cognitivas, Universidad de Talca, Talca, Chile
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7
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Murga C, Cabezas R, Mora C, Campos S, Núñez D. Examining associations between symptoms of eating disorders and symptoms of anxiety, depression, suicidal ideation, and perceived family functioning in university students: A brief report. Int J Eat Disord 2022; 56:783-789. [PMID: 35906992 DOI: 10.1002/eat.23787] [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: 12/09/2021] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We examined the relationships between eating disorders symptoms (EDs), suicidal ideation, depressive and anxiety symptoms, and perceived family functioning in a sample of university students aged 18-25 years (N = 397). METHOD Assessment of symptoms was carried out with the Eating Disorder Diagnostic Scale, Beck Anxiety Inventory and Beck Depression Inventory, among others. We explored the associations between the domains using network analysis. RESULTS We found that physical anxiety symptoms, followed by cognitive and physical depressive symptoms showed the greatest centrality in the current network. Perceived family functioning was negatively related to eating disorder symptoms. DISCUSSION We provide evidence regarding the relevant role of anxiety and depression symptoms in the presentation of ED symptoms in university students. These findings provide new insights to improve preventive interventions to timely reduce symptoms and risk factors associated with EDs. PUBLIC SIGNIFICANCE Using a network approach, we found specific associations between physical anxiety symptoms, cognitive and physical depressive symptoms, eating disorders symptoms, suicidal ideation and perceived family functioning in university students. These variables can be potential targets to develop evidence-based preventive strategies in this population. A better understanding of these complex associations and the role of family variables could enhance the effectiveness of interventions in both clinical and educational settings.
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Affiliation(s)
- Camila Murga
- Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Ruth Cabezas
- Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Carolina Mora
- Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Susana Campos
- ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile
| | - Daniel Núñez
- Faculty of Psychology, Universidad de Talca, Talca, Chile.,ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.,Associative Research Program, Research Center of Cognitive Sciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
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8
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Morales-Vives F, Ferrando PJ, Dueñas JM. Should suicidal ideation be regarded as a dimension, a unipolar trait or a mixture? A model-based analysis at the score level. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03224-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Screening questionnaires administered in community samples may allow to early identify suicidal ideation (S.I.). Although the results found in these samples suggest that S.I. behaves like a unipolar trait or a quasi-trait, it is routinely assessed using procedures developed for bipolar traits. Therefore, the main aim of this study is to determine whether there is a basis for modelling S.I. as a bipolar trait, a unipolar trait, or a quasi-trait with two classes of individuals (symptomatic and asymptomatic). In a community sample and mainly at the scoring level, we compare the results provided by fitting three models based on different assumptions: GRM (bipolar traits), LL-GRM (unipolar traits) and FMA (quasi-traits). 773 Spanish participants answered a S.I. and a life satisfaction questionnaires. GRM and LL-GRM provided equivalent results at the structural level, but not at the scoring level, especially in the conditional and marginal accuracy of the estimated scores. While the GRM scores are highly accurate only in a narrow range well above the mean, the LL-GRM scores are highly accurate in a much wider range around the mean. They also have different implications for the prediction of life satisfaction. FMA results suggest that an asymptomatic and a symptomatic class could not be clearly differentiated. In conclusion, LL-GRM would make it possible to accurately measure a larger number of subjects in a community sample than GRM, leaving fewer cases of vulnerable people unidentified. These results should be considered by researchers and professionals when deciding which modellings to use for screening purposes.
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9
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Lee DY, Kim C, Lee S, Son SJ, Cho SM, Cho YH, Lim J, Park RW. Psychosis Relapse Prediction Leveraging Electronic Health Records Data and Natural Language Processing Enrichment Methods. Front Psychiatry 2022; 13:844442. [PMID: 35479497 PMCID: PMC9037331 DOI: 10.3389/fpsyt.2022.844442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/09/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Identifying patients at a high risk of psychosis relapse is crucial for early interventions. A relevant psychiatric clinical context is often recorded in clinical notes; however, the utilization of unstructured data remains limited. This study aimed to develop psychosis-relapse prediction models using various types of clinical notes and structured data. METHODS Clinical data were extracted from the electronic health records of the Ajou University Medical Center in South Korea. The study population included patients with psychotic disorders, and outcome was psychosis relapse within 1 year. Using only structured data, we developed an initial prediction model, then three natural language processing (NLP)-enriched models using three types of clinical notes (psychological tests, admission notes, and initial nursing assessment) and one complete model. Latent Dirichlet Allocation was used to cluster the clinical context into similar topics. All models applied the least absolute shrinkage and selection operator logistic regression algorithm. We also performed an external validation using another hospital database. RESULTS A total of 330 patients were included, and 62 (18.8%) experienced psychosis relapse. Six predictors were used in the initial model and 10 additional topics from Latent Dirichlet Allocation processing were added in the enriched models. The model derived from all notes showed the highest value of the area under the receiver operating characteristic (AUROC = 0.946) in the internal validation, followed by models based on the psychological test notes, admission notes, initial nursing assessments, and structured data only (0.902, 0.855, 0.798, and 0.784, respectively). The external validation was performed using only the initial nursing assessment note, and the AUROC was 0.616. CONCLUSIONS We developed prediction models for psychosis relapse using the NLP-enrichment method. Models using clinical notes were more effective than models using only structured data, suggesting the importance of unstructured data in psychosis prediction.
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Affiliation(s)
- Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Chungsoo Kim
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
| | - Seongwon Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.,Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Sun-Mi Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Yong Hyuk Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Jaegyun Lim
- Department of Laboratory Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.,Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
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10
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Montano CB, Jackson WC, Vanacore D, Weisler RH. Practical Advice for Primary Care Clinicians on the Safe and Effective Use of Vortioxetine for Patients with Major Depressive Disorder (MDD). Neuropsychiatr Dis Treat 2022; 18:867-879. [PMID: 35440869 PMCID: PMC9013418 DOI: 10.2147/ndt.s337703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/04/2022] [Indexed: 01/10/2023] Open
Abstract
Primary care clinicians have a vital role to play in the diagnosis and management of patients with major depressive disorder (MDD). This includes screening for MDD as well as identifying other possible psychiatric disorders including bipolar disorder and/or other comorbidities. Once MDD is confirmed, partnering with patients in the shared decision-making process while considering different treatment options and best management of MDD over the course of their illness is recommended. Vortioxetine has been approved for the treatment of adults with MDD since 2013, and subsequent US label updates indicate that vortioxetine may be particularly beneficial for specific populations of patients with MDD, including those with treatment-emergent sexual dysfunction and patients experiencing certain cognitive symptoms. Given these recent label updates, this prescribing guide for vortioxetine aims to provide clear and practical guidance for primary care clinicians on the safe and effective use of vortioxetine for the treatment of MDD, including how to identify appropriate patients for treatment.
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Affiliation(s)
- C Brendan Montano
- Montano Wellness LLC, Cromwell, CT, USA.,Department of Family Medicine, University of Connecticut Medical School, Farmington, CT, USA
| | - W Clay Jackson
- Department of Psychiatry and Family Medicine, West Cancer Center, Germantown, TN, USA.,Department of Psychiatry and Family Medicine, University of Tennessee College of Medicine, Memphis, TN, USA
| | - Denise Vanacore
- Department of Nursing, Messiah University, Mechanicsburg, PA, USA
| | - Richard H Weisler
- Richard H. Weisler MD, P.A. & Associates, Raleigh, NC, USA.,Department of Psychiatry, Duke University and the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Langer ÁI, Wardenaar K, Wigman JTW, Ulloa JL, Núñez D. A Latent Profile Analysis of Psychotic Experiences, Non-psychotic Symptoms, Suicidal Ideation and Underlying Mechanisms in a Sample of Adolescents From the General Population. Front Psychiatry 2022; 13:926556. [PMID: 35832591 PMCID: PMC9271879 DOI: 10.3389/fpsyt.2022.926556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/30/2022] [Indexed: 11/23/2022] Open
Abstract
Psychotic experiences (PEs) are prevalent in the general population, particularly in adolescents. PEs are associated with various negative outcomes such as psychotic, depressive, anxiety and post-traumatic stress disorders and suicidal behavior. Recent studies in the general population have suggested that what makes PEs relevant is not so much the experiences per se, but their association with non-psychotic comorbidity and other transdiagnostic domains. Thus, there is a need for a better understanding of how PEs exist in a larger psychopathological context in adolescents. In the present study we aimed to explore this, using latent profile analysis (LPA) to identify different patterns in which PEs, psychiatric symptoms and psychological processes co-occur. LPA was conducted using data from an adolescent general population subsample (n = 335) with PEs. We conducted LPA, using measures of PEs, psychiatric symptoms and behaviors (depression, anxiety post-traumatic stress disorder and suicidal behavior) and cognitive and affective processes of entrapment/defeat and emotional regulation as manifest variables. We found that the best fit was obtained with a four-class solution that distinguished primarily between different levels of overall severity: "low symptomatology" (19.1%), "mild-moderate symptomatology" (39.4%), "moderate symptomatology" (33.7%); "high symptomatology" (7.8%). Levels of depression, post-traumatic stress symptoms and defeat/entrapment were most differentiated between classes. The high symptomatology group showed the highest scores in all psychiatric symptoms suicidal ideation, and emotional/cognitive domains, except in cognitive reappraisal. This group also showed the highest usage of emotional suppression. Our results suggest that the assessment of mental health risk in adolescents should be aware that PEs exist in a broad context of other domains of psychopathology and transdiagnostic cognitive and affective processes.
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Affiliation(s)
- Álvaro I Langer
- Mind-Body Lab, Institute of Psychological Studies, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile.,Agencia Nacional de Investigaciòn y Desarrollo (ANID), Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.,Associative Research Program, Center of Cognitive Sciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Klaas Wardenaar
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, Netherlands
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, Netherlands
| | - José Luis Ulloa
- Agencia Nacional de Investigaciòn y Desarrollo (ANID), Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.,Associative Research Program, Center of Cognitive Sciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Daniel Núñez
- Agencia Nacional de Investigaciòn y Desarrollo (ANID), Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.,Associative Research Program, Center of Cognitive Sciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
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The Community Assessment of Psychic Experiences-Positive scale (CAPE-P15) accurately classifies and differentiates psychotic experience levels in adolescents from the general population. PLoS One 2021; 16:e0256686. [PMID: 34437593 PMCID: PMC8389461 DOI: 10.1371/journal.pone.0256686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 08/12/2021] [Indexed: 02/05/2023] Open
Abstract
Background There is increasing interest in studying psychotic symptoms in non-clinical populations, with the Community Assessment of Psychic Experiences-Positive scale (CAPE-P15) being one of the self-screening questionnaires used most commonly for this purpose. Further research is needed to evaluate the ability of the scale to accurately identify and classify positive psychotic experiences (PE) in the general population. Aim To provide psychometric evidence about the accuracy of the CAPE-P15 for detecting PE in a sample of Chilean adolescents from the general population and classifying them according to their PE severity levels. Method We administered the CAPE-P15 to a general sample of 1594 students aged 12 to 19. Based on Item Response Theory (IRT), we tested the accuracy of the instrument using two main parameters: difficulty and discrimination power of the 15 items. Results We found that the scale provides very accurate information about PE, particularly for high PE levels. The items with the highest capability to determine the presence of the latent trait were those assessing perceptual anomalies (auditory and visual hallucinations), bizarre experiences (a double has taken the place of others; being controlled by external forces), and persecutory ideation (conspiracy against me). Conclusions The CAPE-P15 is an accurate and suitable tool to screen PE and to accurately classify and differentiate PE levels in adolescents from the general population. Further research is needed to better understand how maladaptive psychological mechanisms influence relationships between PE and suicidal ideation (SI) in the general population.
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Núñez D, Monjes P, Campos S, Wigman JTW. Evidence for Specific Associations Between Depressive Symptoms, Psychotic Experiences, and Suicidal Ideation in Chilean Adolescents From the General Population. Front Psychiatry 2020; 11:552343. [PMID: 33584356 PMCID: PMC7876080 DOI: 10.3389/fpsyt.2020.552343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 12/28/2020] [Indexed: 01/23/2023] Open
Abstract
Associations between psychotic experiences and suicidal ideation are not yet fully understood, and the potential role of depressive symptoms in this relationship remains unclear. The current study examined relationships between depressive symptoms (DS), psychotic experiences (PE) and suicidal ideation (SI) using two complementary approaches on cross-sectional data from a community sample of adolescents aged 13-19 years (N = 1,591). First, we investigated the association between the three domains using mediation analysis, showing that depressive symptoms partly mediate the relationship between psychotic experiences and suicidal ideation. Second, we looked at associations between the three domains at item level using network analysis. Specific associations between symptoms of the three domains were found, indicating depressive symptoms of sadness, avolition, pessimism, and self-criticalness/worthlessness as the most central symptoms in the network. Suicidal ideation was associated with the depressive symptoms pessimism and worthlessness, to social anxiety, and to perceptual anomalies. Our results show that the mediating effect of depressive symptoms between psychotic experiences and suicidal ideation may be due to associations between specific aspects of SI, depressive symptoms and psychotic experiences. These findings can contribute to the planning of health services and programs aimed at the timely detection of psychopathology and suicidal risk in young people.
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Affiliation(s)
- Daniel Núñez
- Faculty of Psychology, Universidad de Talca, Talca, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.,Programa de Investigación Asociativa, Faculty of Psychology, Centro de Investigación en Ciencias Cognitivas, Universidad de Talca, Talca, Chile
| | - Pía Monjes
- Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Susana Campos
- Faculty of Psychology, Universidad de Talca, Talca, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile
| | - Johanna T W Wigman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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