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Selby EA, Harnedy LE, Hiner M, Kim J. Developmental and Momentary Dynamics in the Onset and Maintenance of Nonsuicidal Self-Injurious Behavior and Borderline Personality Disorder. Curr Psychiatry Rep 2022; 24:897-909. [PMID: 36422833 DOI: 10.1007/s11920-022-01396-3] [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] [Accepted: 11/01/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Traditional conceptualizations of both nonsuicidal self-injury (NSSI) and borderline personality disorder (BPD) typically rely on static and unidirectional, linear associations between key biopsychosocial vulnerabilities. Instead, we argue that utilizing a complex dynamic systems view of NSSI and BPD will advance the field, as such conceptual models allow for analysis of bottom-up effects for key vulnerabilities on disorder and behavior emergence, as well as top-down effects of the emergent disorder on underlying vulnerabilities. RECENT FINDINGS Following the presentation of a novel framework highlighting momentary and developmental dynamics, we explore several advances in the field that exhibit key dynamic qualities or inform dynamic conceptualizations of NSSI and BPD. At the momentary dynamic level, several advances are being made with multimethod and repeated assessment approaches, as well as advanced bidirectional and complex modeling procedures. Additional progress is being made at the developmental dynamic level, although several questions have arisen regarding the problem of onset and subsequent trajectory, particularly with issues such as pain perception and the interplay between interpersonal, emotional, and behavioral symptoms before and after treatment. Self-injury and BPD both exhibit substantial momentary and developmental dynamics in underlying vulnerabilities, including potential variance in momentary dynamics as a function of psychopathological developmental stage (e.g., onset versus maintenance versus recovery). Recent work has highlighted the necessity of utilizing multimodal research to encapsulate a holistic view of the interplay of several vulnerability factors, the developmental importance of assessment timing, and the need to examine the dynamic interplay between affect, behavior, and interpersonal experiences in BPD and/or NSSI. Research also indicated substantial variation in key vulnerability factors at both between- and within-person levels, highlighting the utility of harnessing statistical models that allow for the simultaneous incorporation of numerous variables at both levels and across several time points. As such, by using a complex dynamic systems conceptualization, we can begin to better understand integrated connections between key vulnerabilities, how they collectively interact in the short term, and how changes in the dynamic interplay between vulnerabilities may arise over the long term and with successful treatment.
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Affiliation(s)
- Edward A Selby
- Department of Psychology, The State University of New Jersey, Tillett 101, 53 Avenue E. Piscatway, Rutgers, NJ, 08854, USA.
| | - Lauren E Harnedy
- Department of Psychology, The State University of New Jersey, Tillett 101, 53 Avenue E. Piscatway, Rutgers, NJ, 08854, USA
| | | | - Joanne Kim
- Department of Psychology, The State University of New Jersey, Tillett 101, 53 Avenue E. Piscatway, Rutgers, NJ, 08854, USA
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Funkhouser CJ, Katz AC, Meissel EEE, Stevens ES, Weinberg A, Nabb CB, Shankman SA. Associations Between Repetitive Negative Thinking and Habituation of Defensive Responding Within and Between Sessions. AFFECTIVE SCIENCE 2022; 3:616-627. [PMID: 36385910 PMCID: PMC9537406 DOI: 10.1007/s42761-022-00121-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
Repetitive negative thinking (RNT) is a transdiagnostic risk factor for internalizing psychopathology, and theoretical models suggest that RNT may maintain symptoms by interfering with psychophysiological habituation. The present study therefore examined associations between RNT and habituation within and between study sessions. Community members (N=86) completed a habituation task involving exposure to acoustic probes at up to five sessions spaced 7 days apart on average. Eyeblink startle response was measured using the electromyography startle magnitude. Self-reported anxiety was assessed before and after the habituation task at each session. Multilevel growth curve modeling indicated that RNT was associated with a higher "floor" (i.e., asymptote) of startle responding as evidenced by reduced within-session startle habituation at later sessions. Results suggest that RNT may disrupt startle habituation and are consistent with theoretical models proposing that RNT sustains physiological activation to support avoidance of negative emotional contrasts or perceived future threats. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-022-00121-w.
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Affiliation(s)
- Carter J. Funkhouser
- Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison St, Chicago, IL 60607 USA
| | - Andrea C. Katz
- VA Puget Sound Health Care System, Seattle Division, 1660 South Columbian Way, Seattle, WA 98108 USA
| | - Emily E. E. Meissel
- Department of Psychology, San Diego State University/University of California San Diego, 6363 Alvarado Ct, San Diego, CA 92120 USA
| | | | - Anna Weinberg
- Department of Psychology, McGill University, 2001 McGill College Ave., Montreal, Quebec, H3A 1G1 Canada
| | - Carver B. Nabb
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lake Shore Dr, Chicago, IL 60611 USA
| | - Stewart A. Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lake Shore Dr, Chicago, IL 60611 USA
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Oppenheimer CW, Glenn CR, Miller AB. Future Directions in Suicide and Self-Injury Revisited: Integrating a Developmental Psychopathology Perspective. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:242-260. [PMID: 35380885 PMCID: PMC9840868 DOI: 10.1080/15374416.2022.2051526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The recent rise in suicide rates among children and adolescents has made suicide prevention in youth a major focus of government agencies and mental health organizations. In 2012, Nock presented future directions in the study of self-injurious thoughts and behavior (SITBs), highlighting the need to better examine which risk factors are associated with "each part of the pathway" to suicidal and non-suicidal self-injury in order to inform prevention and intervention efforts. Over the past decade, we have made important advances in understanding the development of SITBs and effective interventions. However, there are still major gaps of knowledge in our understanding of how to prevent suicide. Researchers have recently called for more studies focusing particularly on the pathway from suicidal ideation to suicidal behavior. However, we caution against prioritizing only a part of the suicide risk continuum (e.g., the transition from suicidal ideation to suicidal behavior) while minimizing research focusing on earlier developmental points of the pathway to suicide (e.g., the first development of suicidal ideation). We emphasize that childhood and adolescence represent a critical opportunity to intervene and prevent SITBs by altering developmental trajectories toward persistent and escalating SITBs over time. We advocate for integrating a developmental psychopathology perspective into future youth suicide research that focuses on how and when risk for SITBs first emerges and develops across childhood into emerging adulthood. This research is critical for informing interventions aimed at bending developmental pathways away from all SITBs. Here, we describe the need for future research that integrates key developmental psychopathology principles on 1) the identification of the continuum from developmentally typical to atypical as SITBs first emerge and develop, particularly among young children in early to middle childhood, 2) the way in which expressions of and risk for SITBs change across development, 3) how SITBs dynamically move along a continuum from typical to atypical over time, and 4) suicide prevention efforts. We also offer recommendations for future directions that focus on identifying disparities in SITBs occurring among minoritized youth within a developmental psychopathology perspective.
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Affiliation(s)
- Caroline W Oppenheimer
- RTI International, Mental Health Risk and Resilience Program, Research Triangle Park, North Carolina, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine R Glenn
- Department of Psychology, Virginia Consortium Program in Clinical Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Adam Bryant Miller
- RTI International, Mental Health Risk and Resilience Program, Research Triangle Park, North Carolina, USA
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, North Carolina, USA
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Funkhouser CJ, Correa KA, Letkiewicz AM, Cozza EM, Estabrook R, Shankman SA. Evaluating the criterion validity of hierarchical psychopathology dimensions across models: Familial aggregation and associations with research domain criteria (sub)constructs. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:575-586. [PMID: 34553953 DOI: 10.1037/abn0000687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) posits that psychopathology is a hierarchy of correlated dimensions. Numerous studies have examined the validity of these dimensions using bifactor models, in which each disorder loads onto both a general and specific factor (e.g., internalizing, externalizing). Although bifactor models tend to fit better than alternative models, concerns have been raised about bifactor model selection, factor reliability, and interpretability. Therefore, we compared the reliability and validity of several higher-order HiTOP dimensions between bifactor and correlated factor models using familial aggregation and associations with Research Domain Criteria (RDoC; sub)constructs as validators. Lifetime psychopathology was assessed in a community sample (N = 504) using dimensional disorder severity scales calculated from semistructured interview data. A series of unidimensional, correlated factor, and bifactor models were fit to model several HiTOP dimensions. A bifactor model with two specific factors (internalizing and disinhibited externalizing) and a correlated two-factor model provided the best fit to the data. HiTOP dimensions had adequate reliability in the correlated factor model, but suboptimal reliability in the bifactor model. The disinhibited externalizing dimension was highly correlated across the two models and was familial, yet largely unrelated to RDoC (sub)constructs in both models. The internalizing dimension in the correlated factor model and the general factor in the bifactor model were highly correlated and had similar validity patterns, suggesting the general factor was largely redundant with the internalizing dimension in the correlated factor model. These findings support concerns about the interpretability of psychopathology dimensions in bifactor models. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Liu H, Funkhouser CJ, Langenecker SA, Shankman SA. Set Shifting and Inhibition Deficits as Potential Endophenotypes for Depression. Psychiatry Res 2021; 300:113931. [PMID: 33894683 PMCID: PMC8141023 DOI: 10.1016/j.psychres.2021.113931] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/08/2021] [Indexed: 01/06/2023]
Abstract
The etiology of Major Depressive Disorder (MDD) is poorly understood, and identifying endophenotypes, or intermediate processes implicated in pathophysiology, for MDD may inform treatment and identification/prevention efforts. Impaired set-shifting and inhibition are commonly observed in MDD; however, few studies have examined they are endophenotypes for MDD. Thus, the present study tested whether set-shifting and/or inhibition satisfy several endophenotype criteria: specifically, whether they were (1) impaired in current MDD, (2) impaired in remitted MDD, and (3) familial (i.e., correlated within sibling pairs). Set-shifting and inhibition were assessed using subtests from the Delis-Kaplan Executive Function System. Psychopathology was assessed using the Structured Clinical Interview for DSM-5. Results indicated set-shifting deficits were familial and present in both current MDD and in remitted MDD individuals who had no current disorders, suggesting they may be state-independent. Inhibition was familial, but was generally not impaired in current nor remitted MDD (although the remitted MDD group with no current disorders exhibited impairments on one of the two inhibition tasks). These findings indicate that impaired set-shifting is a promising endophenotype candidate for MDD. Findings are limited to young adults, and further research is needed to test generalizability to other populations, evaluate longitudinal relationships, and examine other endophenotype criteria.
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Affiliation(s)
- Huiting Liu
- Evidence Based Treatment Centers of Seattle, 1200 5th Ave #800, Seattle, WA 98101, USA
| | - Carter J Funkhouser
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607, USA; Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 North Lake Shore Drive, Chicago, IL 60611, USA
| | - Scott A Langenecker
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607, USA; University of Utah, Department of Psychiatry, 501 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Stewart A Shankman
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607, USA; Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 North Lake Shore Drive, Chicago, IL 60611, USA.
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Funkhouser CJ, Correa KA, Gorka SM, Nelson BD, Phan KL, Shankman SA. The replicability and generalizability of internalizing symptom networks across five samples. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:191-203. [PMID: 31829638 PMCID: PMC6980885 DOI: 10.1037/abn0000496] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The popularity of network analysis in psychopathology research has increased exponentially in recent years. Yet, little research has examined the replicability of cross-sectional psychopathology network models, and those that have used single items for symptoms rather than multiitem scales. The present study therefore examined the replicability and generalizability of regularized partial correlation networks of internalizing symptoms within and across 5 samples (total N = 2,573) using the Inventory for Depression and Anxiety Symptoms, a factor analytically derived measure of individual internalizing symptoms. As different metrics may yield different conclusions about the replicability of network parameters, we examined both global and specific metrics of similarity between networks. Correlations within and between nonclinical samples suggested considerable global similarities in network structure (rss = .53-.87) and centrality strength (rss = .37-.86), but weaker similarities in network structure (rss = .36-.66) and centrality (rss = .04-.54) between clinical and nonclinical samples. Global strength (i.e., connectivity) did not significantly differ across all 5 networks and few edges (0-5.5%) significantly differed between networks. Specific metrics of similarity indicated that, on average, approximately 80% of edges were consistently estimated within and between all 5 samples. The most central symptom (i.e., dysphoria) was consistent within and across samples, but there were few other matches in centrality rank-order. In sum, there were considerable similarities in network structure, the presence and sign of individual edges, and the most central symptom within and across internalizing symptom networks estimated from nonclinical samples, but global metrics suggested network structure and symptom centrality had weak to moderate generalizability from nonclinical to clinical samples. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Carter J. Funkhouser
- University of Illinois at Chicago Department of Psychology
- Northwestern University Department of Psychiatry and Behavioral Sciences
| | - Kelly A. Correa
- University of Illinois at Chicago Department of Psychology
- Northwestern University Department of Psychiatry and Behavioral Sciences
| | | | | | - K. Luan Phan
- The Ohio State University Department of Psychiatry and Behavioral Health
| | - Stewart A. Shankman
- University of Illinois at Chicago Department of Psychology
- Northwestern University Department of Psychiatry and Behavioral Sciences
- University of Illinois at Chicago Department of Psychiatry
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