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Rolling J, Ligier F, Rabot J, Bourgin P, Reynaud E, Schroder CM. Sleep and circadian rhythms in adolescents with attempted suicide. Sci Rep 2024; 14:8354. [PMID: 38594272 PMCID: PMC11004139 DOI: 10.1038/s41598-024-57921-2] [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: 10/23/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Sleep and circadian rhythm disorders are very common in adolescents and have been linked to suicidal ideation. However, little is known about adolescent sleep before a suicide attempt (SA). The objectives of this study were to compare the sleep of adolescents aged 13 to 18 over a period of 4 weeks before a SA compared to a non-SA group, then to analyze the association between sleep, support social and well-being based on information from validated questionnaires. In 2015, 250 adolescents were included, 55 were recruited the day after a SA in French hospitals (before SA evaluations were retrospective). Logistic regression analyzes showed that during school days, bedtime was equivalent in both groups, but sleep onset latency was significantly longer in SA (86 min vs. 52 min, p = 0.016), and wake-up time was earlier (6 h 22 vs. 6 h 47, p = 0.002), resulting in a shorter total sleep time of 44 min (OR = 0.76, CI 95% [0.61-0.93]) the month preceding SA. Adolescents with longer sleep time performed better on perceived psychological well-being (p = 0.005), relationship with parents (p = 0.011) and school environment (p < 0.001). Results indicate a significant change in the quantity and quality of adolescents' subjective sleep in the 4 weeks preceding SA requiring objective measures to study the predictive properties of sleep in SA.
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Affiliation(s)
- Julie Rolling
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 1 Porte de l'Hôpital, BP 426, 67091, Strasbourg Cedex, Strasbourg, France.
- Regional Center for Psychotraumatism Great East, Strasbourg University Hospital, Strasbourg, France.
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France.
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, Strasbourg, France.
| | - Fabienne Ligier
- University Center for Child and Adolescent Psychiatry, Nancy Psychotherapeutic Center, University of Lorraine, Nancy, France
- EA4360 APEMAC, MICS, University of Lorraine, Nancy, France
| | - Juliette Rabot
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 1 Porte de l'Hôpital, BP 426, 67091, Strasbourg Cedex, Strasbourg, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
| | - Patrice Bourgin
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, Strasbourg, France
| | - Eve Reynaud
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
- Centre de Recherche en Neurosciences de Lyon CRNL U1028, UMR5292, Université Claude Bernard Lyon 1, CNRS, INSERM, Forgetting, Bron, France
| | - Carmen M Schroder
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 1 Porte de l'Hôpital, BP 426, 67091, Strasbourg Cedex, Strasbourg, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, Strasbourg, France
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Lu J, Zhao X, Wei X, He G. Risky decision-making in major depressive disorder: A three-level meta-analysis. Int J Clin Health Psychol 2024; 24:100417. [PMID: 38023370 PMCID: PMC10661582 DOI: 10.1016/j.ijchp.2023.100417] [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: 06/13/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Background Individuals with major depressive disorder (MDD) are usually observed making inappropriate risky decisions. However, whether and to what extent MDD is associated with impairments in risky decision-making remains unclear. We performed a three-level meta-analysis to explore the relationship between risky decision-making and MDD. Method We searched the Web of Science, PubMed, Scopus, and PsycINFO databases up to February 7, 2023, and calculated Hedges' g to demonstrate the difference in risky decision-making between MDD patients and healthy controls (HCs). The moderating effect of sample and task characteristics were also revealed. Results Across 73 effect sizes in 39 cross-sectional studies, MDD patients exhibited greater risk-seeking than HCs (Hedges' g = 0.187, p = .030). Furthermore, age (p = .068), region (p = .005), and task type (p < .001) were found to have moderating effects. Specifically, patients preferred risk-seeking over HCs as age increased. European patients showed significantly increased risk-seeking compared to American and Asian patients. Patients in the Iowa Gambling Task (IGT) exhibited a notable rise in risk-seeking compared to other tasks, along with an increased risk aversion in the Balloon Analogue Risk Task (BART). The multiple-moderator analysis showed that only task type had significant effects, which may be explained by a tentative framework of "operationalization-mechanism-measure" specificity. Conclusions MDD patients generally exhibit higher risk-seeking than HCs. It implies that impaired risky decision-making might be a noteworthy symptom of depression, which should be placed more emphasis for clinical management and psycho-education.
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Affiliation(s)
- Jiaqi Lu
- Department of Psychology and Behavioral Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, PR China
| | - Xu Zhao
- Department of Psychology and Behavioral Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, PR China
| | - Xuxuan Wei
- Department of Psychology and Behavioral Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, PR China
| | - Guibing He
- Department of Psychology and Behavioral Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, PR China
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Gerin MI, Viding E, Puetz VB, Armbruster-Genc DJ, Rankin G, McCrory EJ. Atypical Interpersonal Problem-Solving and Resting-state Functional Connectivity in Adolescents with Maltreatment Experience. Curr Neuropharmacol 2024; 22:290-301. [PMID: 37818587 PMCID: PMC10788892 DOI: 10.2174/1570159x22666231002145440] [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: 04/28/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Childhood maltreatment is associated with altered neurocognitive functioning, which is thought to reflect, in part, adaptation to early adverse environmental experiences. However, we continue to lack a precise mechanistic understanding linking atypical neurocognitive processing with social functioning and psychiatric outcomes following early adversity. OBJECTIVE The present work investigated interpersonal problem-solving, resting-state functional connectivity (rsFC), and mental health symptoms in adolescents with documented maltreatment experience and explored whether altered neural function contributes in part to poorer social functioning. METHODS Forty adolescents (aged 12-17) with documented experiences of abuse or neglect and a carefully matched group of 42 non-maltreated peers participated in this study that measured task-based interpersonal problem-solving skills and rsFC. RESULTS Adolescents with maltreatment experience showed poorer interpersonal problem-solving performance, which partly accounted for their elevated mental health symptoms. Resting-state seed-based analyses revealed that adolescents with maltreatment experience showed a significant increase in rsFC between medial Default Mode Network (DMN) hubs, the medial prefrontal cortex (mPFC), with a posterior cluster, including the posterior cingulate cortex (PCC), precuneus (PCu), retrosplenial cortex (RSC), and lingual gyrus (LG). Moderation analyses revealed that maltreatment-related increased DMN rsFC partly accounted for poorer performance in interpersonal problem-solving. CONCLUSION Poorer interpersonal problem-solving, partly accounted for by atypical coupling between DMN medial hubs, was associated with maltreatment exposure. Interventions tailored to enhance interpersonal problem-solving represents a promising avenue to promote resilience and reduce the likelihood of mental health disorder following maltreatment experience.
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Affiliation(s)
- Mattia I. Gerin
- Division of Psychology and Language Sciences, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Vanessa B. Puetz
- Division of Psychology and Language Sciences, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | | | - Georgia Rankin
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Eamon J. McCrory
- Division of Psychology and Language Sciences, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
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Dawe-Lane E, Flouri E. Parenting in the early years and self-harm in adolescence: The role of control and reward systems in childhood. J Affect Disord 2023; 339:788-798. [PMID: 37474012 PMCID: PMC11139656 DOI: 10.1016/j.jad.2023.07.061] [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: 03/13/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Research suggests that early parenting may contribute to the development of self-harm but this has not been examined longitudinally. In this study, we explored the relationship between early parenting and self-harm in adolescence and considered whether (1) emotion regulation and (2) decision-making in childhood mediate the relationship between early parenting and self-harm. METHOD Using longitudinal data from the Millennium Cohort Study (MCS), we tested mediation models exploring the relationship between early parenting and self-harm in adolescence via emotion regulation and decision-making. Parenting was assessed at age 3 with measures of conflict, closeness and discipline. The trajectories of independence & self-regulation and emotional dysregulation were modelled from ages 3 to 7 years through latent growth curve analysis, with individual predicted slope and intercept values used in the mediation models. Decision-making (deliberation time, total time, delay aversion, quality of decision making, risk adjustment, risk-taking) was assessed using the Cambridge Gambling Task (CGT) at age 11. RESULTS In our sample (n = 11,145), we found no evidence of a direct association between early parenting and self-harm in adolescence. However, there were indirect effects of parenting (conflict and closeness) on self-harm via the slope of emotional dysregulation. Furthermore, delay aversion was positively associated with self-harm in adolescence. LIMITATIONS It must be acknowledged that we cannot determine causality and that self-report measures of parenting are vulnerable to several biases. CONCLUSION The findings support early identification and interventions for children exhibiting chronic emotional dysregulation and decision-making characterised by a bias for smaller, immediate over larger, delayed rewards.
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Affiliation(s)
- E Dawe-Lane
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
| | - E Flouri
- Institute of Education, Psychology and Human Development, University College London, London, United Kingdom
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Abstract
OBJECTIVE Impulsivity is an important risk for suicidality, which is common in patients with major depressive disorder (MDD). The goal of this study was to examine multiple facets of impulsivity in depressed patients compared with healthy controls and to assess their relationship to suicidality. METHOD Outpatients diagnosed with MDD using the Structured Clinical Interview for DSM-IV were recruited. Two groups were constituted as "MDD in remission" (n=32) and "MDD" (n=71). The "healthy control" group (n=30) consisted of individuals who had never been diagnosed with any psychiatric disorder. Impulsivity was assessed with the Barratt Impulsivity Scale (BIS), a self-rating measure, and with the following behavioral tasks: Go/No-go Task, Iowa Gambling Task, and Balloon Analogue Risk Task. The scores of the 3 groups (n=133) were compared to evaluate the effect of MDD. The scores were also analyzed and compared in the patients in the 2 MDD groups (n=103) with respect to their current and lifetime suicidality. RESULTS There was no difference in the 3 groups in task scores, but nonplanning BIS was correlated with the severity of depressive symptoms. Patients with suicidal ideation (SI) had higher BIS total and attention impulsivity scores and more commission errors on the Go/No-go Task, reflecting failure in response inhibition, compared with the patients without SI. CONCLUSIONS Failure to show differences in impulsivity-related tasks suggests that there might be no relationship between the state of depression and impulsivity. However, these findings confirm that there is an association between SI and response inhibition and the attention facet of impulsivity in depression.
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Chen H, Hong L, Tong S, Li M, Sun S, Xu Y, Liu J, Feng T, Li Y, Lin G, Lu F, Cai Q, Xu D, Zhao K, Zheng T. Cognitive impairment and factors influencing depression in adolescents with suicidal and self-injury behaviors: a cross-sectional study. BMC Psychiatry 2023; 23:247. [PMID: 37046299 PMCID: PMC10099683 DOI: 10.1186/s12888-023-04726-8] [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: 09/02/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide attempts (SAs) by adolescent patients with depression have become serious public health problems. There is still insufficient research evidence on the effects of NSSI and SAs on neurocognitive functioning in adolescents. Cognitive function alterations may be associated with SAs and self-injury. NSSI and SAs have different influencing factors. METHODS Participants were recruited from outpatient clinics and included 142 adolescent patients with depression (12-18 years old). This cohort included the SAs group (n = 52), NSSI group (n = 65), and depression without SAs/NSSI control group (n = 25). All participants underwent a clinical interview and neuropsychological assessment for group comparisons, and post-hoc tests were performed. Finally, partial correlation analysis was used to explore factors related to changes in cognitive function. RESULTS The SAs group performed significantly worse than the control group in executive function and working memory. The depression score was directly proportional to the executive function of the SAs group, whereas cognitive functioning in the NSSI group was associated with borderline traits and rumination. CONCLUSIONS These findings suggest that impairment of executive function and working memory may be a common pattern in adolescent depressed patients with SAs. However, borderline traits and rumination may be indicative of NSSI but not SAs.
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Affiliation(s)
- Hong Chen
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, 325035, Wenzhou, China
| | - Lan Hong
- The Third Hospital of QuZhou, 324000, Quzhou, China
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Mengjia Li
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Tianqi Feng
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Yuting Li
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Guangyao Lin
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Fanfan Lu
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Qiaole Cai
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China.
| | - Ke Zhao
- Lishui Second People's Hospital Afliated to Wenzhou Medical University, 323000, Lishui, China.
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China.
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China.
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Zhang Y, Lai S, Wu W, Wang Y, Zhao H, He J, Zhu Y, Chen G, Qi Z, Chen P, Lv S, Song Z, Hu Y, Miao H, Yan S, Luo Y, Ran H, Huang X, Lu X, Zhong S, Jia Y. Associations between executive function impairment and biochemical abnormalities in depressed adolescents with non-suicidal self-injury. J Affect Disord 2022; 298:492-499. [PMID: 34737017 DOI: 10.1016/j.jad.2021.10.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND H protons magnetic resonance spectroscopy (1H-MRS) has been used to detect the biochemical metabolism changes and the mechanism of executive dysfunction in major depressive disorder (MDD). While, finding information associated with non-suicidal self-injury (NSSI) among adolescents with MDD is challenging. The present study aimed to examine the executive function and biochemical metabolism alterations, as well as to elucidate their associations in depressed adolescents with NSSI. METHODS A total of 86 adolescents with MDD (40 with NSSI, and 46 without NSSI) and 28 healthy controls were recruited in the current study. The executive function was assessed by Digital symbol test (DST), Wisconsin Card Sorting Test (WCST), Trail Making Test, part B (TMT-B), and Verbal fluency (VF). Bilateral metabolite levels of the prefrontal cortex (PFC), anterior cingulated cortex (ACC), lenticular nucleus (LN) of basal ganglia and thalamus were obtained by 1H-MRS at 3.0 T, and then the ratios of N-acetyl aspartate (NAA) and choline-containing compounds (Cho) to creatine (Cr) were determined, respectively. Finally, association analysis was conducted to investigate their relationships. RESULTS The depressed adolescents with NSSI showed significantly lower VF scores than those without NSSI and healthy controls. We also found significantly higher NAA/Cr ratios in the right thalamus, while significantly lower Cho/Cr ratios in the right thalamus of NSSI group than the MDD without NSSI group and healthy controls. And NSSI group also showed lower NAA/Cr ratio in the right LN than the MDD without NSSI group. For MDD with NSSI, the NAA/Cr ratios of the left thalamus were positively correlated with the time of TMTB and the Cho/Cr ratios of the left ACC were positively correlated with the VF scores. CONCLUSIONS Depressed adolescents with NSSI may have executive dysfunction and NAA and Cho metabolism abnormalities in the thalamus. And the NAA/Cr ratios of the right LN could distinguish NSSI from depressed adolescents. Further, the executive dysfunction may be associated with the abnormal NAA metabolism in the left thalamus and ACC.
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Affiliation(s)
- Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Weige Wu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; The Department of Child and Adolescent Psychology Xiamen Xianyue hospital, Fujian 361012, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yunxia Zhu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guangmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- School of Management, Jinan University, Guangzhou 510316, China
| | - Zijin Song
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yilei Hu
- School of Management, Jinan University, Guangzhou 510316, China
| | - Haofei Miao
- School of Management, Jinan University, Guangzhou 510316, China
| | - Shuya Yan
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510316, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510316, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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Carpenter RK, Alloway TP. Exploring working memory, self-criticism, and rumination as factors related to self-harm. Psychol Rep 2022:332941221074258. [PMID: 35084275 DOI: 10.1177/00332941221074258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of self-harm and the relative emotional influences are well understood, but certain cognitive factors such as working memory, rumination, and self-criticism are not fully explored. The aim of the current study is to examine specific aspects of cognition to explore their influence on self-harming behaviors. Participants included 101 undergraduates from a British University. Factors were measured using the Centre for Epidemiological Studies Depression Scale, the Depressive Experiences Questionnaire, Ruminative Response Scale, and the Automated Working Memory Assessment. Findings indicated a greater incidence of self-harming behaviors among those who demonstrated higher depressive symptoms, but depression scores were not significantly related to self-harm. Additionally, a binary logistic regression indicated that self-criticism was associated with the presence of self-harming behavior, and a Classification and Regression Trees found that the single strongest predictor of self-harming behavior was a belief that love needs to be continually earned from others. Incorporating treatments that reduce self-criticism, such as improving self-compassion with Compassionate Mind Training, may address underlying mechanisms that trigger self-harm behavior. Keywords: rumination, depression, self-criticism, working memory, self-harm.
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Decision-making and cognitive control in adolescent suicidal behaviors: a qualitative systematic review of the literature. Eur Child Adolesc Psychiatry 2021; 30:1839-1855. [PMID: 32388626 DOI: 10.1007/s00787-020-01550-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive variables and adolescent suicidal behaviors. The online search strategy identified 17 neurocognitive studies examining either cognitive control or decision-making processes in adolescents with past suicidal behaviors. Several studies have reported that adolescents with a history of suicidal behaviors present neuropsychological differences in the cognitive control (using Go/NoGo, suicide Stroop Test, continuous performance test, suicide/death Implicit Association Test), and decision-making (Iowa Gambling Task, Cambridge Gambling Task, cost computation, delay discounting, loss aversion tasks) domains. Due to a lack of replication or conflicting findings, our systematic review suggests that no firm conclusion can be drawn as to whether altered decision-making or poor cognitive control contribute to adolescent suicidal behaviors. However, these results collectively suggest that further research is warranted. Limitations included scarcity of longitudinal studies and a lack of homogeneity in study designs, which precluded quantitative analysis. We propose remediating ways to continue neuropsychological investigations of suicide risk in adolescence, which could lead to the identification of novel therapeutic targets and predictive markers, enabling early intervention in suicidal youth.
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Fadum EA, Carlsen EØ, Ramberg M, Strand LA, Håberg SE, Borud E, Martinussen M. Social and life skills in adolescents who have self-harmed: analysis of survey responses from a national sample of adolescents in Norway. BMJ Open 2021; 11:e054707. [PMID: 34772755 PMCID: PMC8593742 DOI: 10.1136/bmjopen-2021-054707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Social and life skills (SLS) may be important in the prevention and treatment of self-harm, but few studies have described this relationship. We examined three components of SLS in adolescents who reported self-harm that was, according to themselves, diagnosed by a clinician. DESIGN Cross-sectional. SETTING National screening prior to military service. PARTICIPANTS 176 284 residents of Norway born in 1999-2001 received a declaration of health. We included 171 486 individuals (84 153 (49%) women and 87 333 (51%) men) who were 17 (n=1 67 855) or 18 years of age (n=3631) when they completed the declaration. OUTCOME MEASURE The main outcome was clinically diagnosed self-harm, defined as self-harm that the adolescents themselves stated had been diagnosed by a clinician. Components of SLS were social interactions; coping strategies; and emotional regulation/aggression. The association between SLS and self-reported clinically diagnosed self-harm was assessed in hierarchical multiple regression models controlling for sex; school absence; and feelings of emotional pain. RESULTS Three percent (n=5507) of the adolescents reported clinically diagnosed self-harm. The three components of SLS together added little to the prediction of clinically diagnosed self-harm (∆R2=0.02). After controlling for school absence and emotional pain, emotional regulation/aggression was the only SLS-component that was independently associated with clinically diagnosed self-harm (OR 1.33, 95% CI 1.31 to 1.36). The young men who said they had been clinically diagnosed for self-harm scored slightly worse on social interactions (Hedge's g (g) = -0.13, p<0.001) and emotional regulation/aggression (g = -0.18, p<0.001) than the young women in this group. CONCLUSION Young women and young men who reported clinically diagnosed self-harm had more problems with emotional regulation/aggression than other adolescents, but did not have worse social interactions or coping strategies.
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Affiliation(s)
- Elin Anita Fadum
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Akershus, Norway
| | - Ellen Øen Carlsen
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Akershus, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria Ramberg
- Department of Child and Adolescent Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Leif Aage Strand
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Akershus, Norway
| | - Siri Eldevik Håberg
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Akershus, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Oslo, Norway
| | - Einar Borud
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Akershus, Norway
- Institute of Community Medicine, UiT The Arctic University of Norway Faculty of Health Sciences, Tromso, Troms, Norway
| | - Monica Martinussen
- Regional Centre for Child and Youth Mental Health & Child Welfare, UiT The Arctic University of Norway, Tromso, Norway
- Norwegian Command and Staff College, Norwegian Defence University College, Oslo, Norway
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Geoffroy PA, Oquendo MA, Courtet P, Blanco C, Olfson M, Peyre H, Lejoyeux M, Limosin F, Hoertel N. Sleep complaints are associated with increased suicide risk independently of psychiatric disorders: results from a national 3-year prospective study. Mol Psychiatry 2021; 26:2126-2136. [PMID: 32355334 DOI: 10.1038/s41380-020-0735-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/21/2022]
Abstract
Prior research suggests that sleep disturbances are associated with increased risk of suicide. However, sleep disturbances are associated with a wide range of psychiatric disorders, and it is unknown whether this association is independent of psychopathology. In a large nationally representative prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used structural equation modeling to examine the shared and specific effects of three sleep complaints (i.e., trouble falling asleep, early morning awakening, and hypersomnia) on the 3-year occurrence of attempting suicide. Because psychiatric disorders increase the risk of suicide attempt almost exclusively through a general psychopathology factor representing their shared effect, covariates included that factor, prior history of suicide attempt, and a wide range of sociodemographic and clinical characteristics. The 3-year prevalence rate of suicide attempt was 0.6% (n = 241). Compared with participants who did not attempt suicide between the two waves, those who did reported significantly more frequently having trouble falling asleep (44.6% vs. 16.6%), early morning awakening (38.9% vs. 12.7%), and hypersomnia (35.0% vs. 10.7%). Following adjustments, effects of sleep complaints on this risk were significant and exerted almost exclusively through a general sleep complaints factor representing the shared effect across all sleep complaints. There were no residual associations of any individual sleep complaint with attempting suicide above that association. Sleep complaints are associated with an increased risk of attempting suicide independently of psychopathology, and should be included in suicide risk assessments as these symptoms may provide targets for reducing the risks of suicidal behaviors.
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Affiliation(s)
- Pierre A Geoffroy
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France. .,Université de Paris, NeuroDiderot, Inserm, F-75019, Paris, France. .,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France.
| | - Maria A Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philippe Courtet
- INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, 10032, USA
| | - Hugo Peyre
- Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France.,Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Michel Lejoyeux
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Frédéric Limosin
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Nicolas Hoertel
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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12
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Yan S, Yang J, Ye M, Chen S, Xie C, Huang J, Liu H. Post-traumatic Growth and Related Influencing Factors in Discharged COVID-19 Patients: A Cross-Sectional Study. Front Psychol 2021; 12:658307. [PMID: 34122242 PMCID: PMC8189317 DOI: 10.3389/fpsyg.2021.658307] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study is to investigate the current state of post-traumatic growth (PTG) and identify its influencing factors in discharged COVID-19 patients. PTG refers to individual experiences of significant positive change arising from the struggle with a major life crisis. This descriptive cross-sectional study used the convenient sampling method to recruit 140 discharged COVID-19 patients in Hunan, China. The results show that the PTG of the discharged COVID-19 patients was positively correlated with self-esteem, post-traumatic stress disorder, coping style tendency, and social support, but negatively correlated with the time from onset to diagnosis. Our findings could provide guidance on improving the psychological state and well-being of discharged COVID-19 patients.
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Affiliation(s)
- Shixin Yan
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jun Yang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shihao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Xiangya Nursing School of Central South University, Changsha, China
| | - Chaoying Xie
- Changsha Public Health Treatment Center, Changsha, China
| | - Jin Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haiyang Liu
- Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, China
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13
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Santamarina-Perez P, Mendez I, Eiroa-Orosa FJ, Singh MK, Gorelik A, Picado M, Font E, Moreno E, Martínez E, Morer A, Cordovilla C, Romero S. Visual memory improvement in adolescents at high risk for suicide who are receiving psychotherapy at a community clinic. Psychiatry Res 2021; 298:113796. [PMID: 33609921 DOI: 10.1016/j.psychres.2021.113796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 02/06/2021] [Indexed: 01/09/2023]
Abstract
The current study aims to: 1) investigate cognitive differences among adolescents at risk for suicide versus healthy controls (HC) and 2) identify cognitive changes associated with response to psychotherapy among adolescents at high risk for suicide. Thirty-five adolescents at high risk for suicide (HR), and 14 HC adolescents were recruited. Clinical and cognitive assessments were conducted in both groups at baseline and 16 weeks later (after the patients completed psychotherapy). HR and HC adolescents were compared at baseline and at completion of the study. We also conducted further analysis by separating into two groups the HR adolescents who responded to psychotherapy (n=17) and those who did not (n=11). At baseline, the HR group had significantly lower performance on verbal memory and processing speed than the HC group. At week 16, HR adolescents performed as well as HC adolescents in all cognitive domains. Among patients, better performance on visual memory was observed in those who responded to psychotherapy compared to those who did not. We concluded that lower performance on verbal memory and processing speed may be associated with a high risk for suicide among adolescents. Improvement in visual memory might be related to a lower risk for suicide in adolescents.
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Affiliation(s)
- Pilar Santamarina-Perez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain.
| | - Iria Mendez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain
| | - Francisco José Eiroa-Orosa
- Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, University of Barcelona, Spain
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Aaron Gorelik
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Marisol Picado
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain
| | - Elena Font
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain
| | - Elena Moreno
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain
| | - Esteve Martínez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Institute d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Carlos Cordovilla
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain
| | - Soledad Romero
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Institute d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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14
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Perrain R, Dardennes R, Jollant F. Risky decision-making in suicide attempters, and the choice of a violent suicidal means: an updated meta-analysis. J Affect Disord 2021; 280:241-249. [PMID: 33220560 DOI: 10.1016/j.jad.2020.11.052] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/02/2020] [Accepted: 11/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Studies showed disadvantageous decision-making in suicide attempters. The present meta-analysis aims to examine the stability of these findings and related questions. METHODS EMBASE and Pubmed databases were searched for studies published between 01/01/2000 and 01/01/2020 with an additional search through bibliographical references. English or French articles published in peer-reviewed journals, reporting quantitative task-based measures of decision-making in suicide attempters were included: 3,582 records were identified, 33 full-text articles screened, and 21 articles finally included. RESULTS All studies were conducted in mood disorders; 18 used the Iowa Gambling Task (IGT) and 3 the Cambridge Gamble Task (CGT). With the IGT, suicide attempters showed riskier choices than patient controls (Hedges' g=-0.28 95%CI (-0.44 - -0.12)) and healthy controls (g=-0.54 (-0.83 - -0.25)) with no significant difference between control groups. The difference between suicide attempters and patient controls was not related to age group, mood disorder type, author, or research center while an effect of time of publication was found (p=0.006). Poorer performance was also found in suicide attempters compared to patient controls when using the CGT (g=-0.57 95%CI (-0.82 - -0.31)). Suicide attempters who used a violent means showed poorer IGT performance than those who used a non-violent means (3 studies). LIMITATION Limited number of studies outside mood disorders. No data to calculate a gender effect. CONCLUSION The present meta-analysis confirmed riskier decision-making in suicide attempters. Although group differences appear to be of modest effect size in general, they were particularly marked in the subgroup of those who used a violent suicidal means.
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Affiliation(s)
- Rebecca Perrain
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France
| | - Roland Dardennes
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France
| | - Fabrice Jollant
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France; McGill Group for suicide studies, McGill University, Montréal, Canada; Nîmes academic hospital (CHU), Nîmes, France; Equipe Moods, INSERM UMR-1178, Paris, France.
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15
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Neurocognitive vulnerability to youth suicidal behavior. J Psychiatr Res 2020; 131:119-126. [PMID: 32961501 PMCID: PMC7669668 DOI: 10.1016/j.jpsychires.2020.08.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/09/2020] [Accepted: 08/25/2020] [Indexed: 11/20/2022]
Abstract
Neurocognitive deficits have been associated with suicidal behavior in adults with major depressive disorder (MDD), but it is unclear if similar impairments are linked to youth suicidal behavior. This study compared neurocognitive functioning in suicidal and non-suicidal youth with a lifetime history of MDD and explored whether neurocognitive functioning predicted future suicide attempts. Neurocognition was examined using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Iowa Gambling Task (IGT) in 309 youths ages 12-15 (117 suicide attempters; 132 suicidal ideators; 60 never-suicidal). Prospective analyses included 284 youths (41 youth with a future attempt; 243 without a future attempt). Multivariate analysis of variance (MANOVA) yielded a significant group-by-sex interaction effect [Wilks' Λ = 0.901, F (16, 560) = 1.87, p = .021] for the primary neurocognitive outcomes, guiding the decision to stratify the sample by sex. Female suicide attempters and ideators were slower to respond correctly to both positive and negative emotion words than never-suicidal controls on tests of affective bias. Male suicide attempters and ideators made significantly more total and between errors than never-suicidal subjects. Exploratory analyses found that total commission errors on the Affective Go/No-Go (AGN) test significantly predicted future suicide attempts in females, and that higher strategy scores on Spatial Working Memory (SWM) tests predicted future male attempts. Study findings identified sex-specific neurocognitive deficits that differentiate suicidal and non-suicidal youth with histories of MDD. Extended longitudinal studies are needed to elucidate the temporal association between neurocognitive impairments and suicidal behavior and frame targets for early preventive interventions.
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16
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Alacreu-Crespo A, Guillaume S, Sénèque M, Olié E, Courtet P. Cognitive modelling to assess decision-making impairments in patients with current depression and with/without suicide history. Eur Neuropsychopharmacol 2020; 36:50-59. [PMID: 32456851 DOI: 10.1016/j.euroneuro.2020.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/16/2020] [Accepted: 04/23/2020] [Indexed: 02/01/2023]
Abstract
It has been reported that decision making is impaired in suicide attempters. Decision making is a complex process and little is known about its different components. Yet, this information would help to understand the functioning of suicidal minds. In this study, the Prospect Valence-Learning (PVL) computational model was applied to the Iowa Gambling Task (IGT) to investigate and compare decision-making components in patients with affective disorder and with/without history of suicide attempts and in healthy controls. To this aim, 116 inpatients with current major depressive episode (among whom 62 suicide attempters) and 38 healthy controls were recruited. Decision-making performance was measured using the IGT. The Bayesian computational PVL model was applied to compare the feedback sensitivity, loss aversion, learning/memory, and choice consistency components of decision making in the different groups. Depressive symptomatology was assessed using the Beck Depression Inventory short form (BDI-SF). The total IGT net score and the loss aversion and learning/memory scores were lower in suicide attempters than in healthy controls. The choice consistency score was low in all patients (with/without suicide history) compared with healthy controls. Moreover, patients with high BDI score showed a positive relationship between the choice consistency score and suicide attempt. These findings suggest that decision-making impairment in depressed patients with and without suicidal history might be the result of underlying problems in feedback processing and task learning, which influence the building of long-term strategies. All these impairments should be targeted in therapeutic strategies for suicidal patients.
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Affiliation(s)
- A Alacreu-Crespo
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France.
| | - S Guillaume
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
| | - M Sénèque
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
| | - E Olié
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
| | - P Courtet
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
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17
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Simplicio MD, Appiah-Kusi E, Wilkinson P, Watson P, Meiser-Stedman C, Kavanagh DJ, Holmes EA. Imaginator: A Proof-of-Concept Feasibility Trial of a Brief Imagery-Based Psychological Intervention for Young People Who Self-Harm. Suicide Life Threat Behav 2020; 50:724-740. [PMID: 32057131 PMCID: PMC7613067 DOI: 10.1111/sltb.12620] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 11/18/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The Imaginator study tested the feasibility of a short mental imagery-based psychological intervention for young people who self-harm and used a stepped-wedge design to investigate effects on self-harm frequency reduction at 3 and 6 months. METHOD A total of 38 participants aged 16-25 were recruited via community self-referral and mental health services. Participants were randomized to immediate delivery of Functional Imagery Training (FIT) or usual care followed by delayed delivery after 3 months. FIT comprised two face-to-face sessions, five phone sessions, and use of a smartphone app. Outcomes' assessment was blind to allocation. RESULTS Three quarters of those who began treatment completed face-to-face sessions, and 57% completed five or more sessions in total. Self-harm frequency data were obtained on 76% of the sample at 3 months (primary outcome) and 63% at 6 months. FIT produced moderate reductions in self-harm frequency at 3 months after immediate (d = 0.65) and delayed delivery (d = 0.75). The Immediate FIT group maintained improvements from 3 to 6 months (d = 0.05). Participants receiving usual care also reduced self-harm (d = 0.47). CONCLUSIONS A brief mental imagery-based psychological intervention targeting self-harm in young people is feasible and may comprise a novel transdiagnostic treatment for self-harm.
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Affiliation(s)
- Martina Di Simplicio
- Centre for Psychiatry, Brain Sciences Division, Imperial College London, London, UK,MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Elizabeth Appiah-Kusi
- King’s College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), London, UK
| | - Paul Wilkinson
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Peter Watson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - David J. Kavanagh
- Centre for Children’s Health Research, Institute of Health & Biomedical Innovation, and School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
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18
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Zeif D, Yechiam E. Autism is not associated with poor or enhanced performance on the Iowa Gambling Task: A Meta-Analysis. Neurosci Biobehav Rev 2020; 113:440-447. [DOI: 10.1016/j.neubiorev.2020.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/17/2020] [Accepted: 04/11/2020] [Indexed: 12/31/2022]
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19
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Mathew AS, Davine TP, Snorrason I, Houghton DC, Woods DW, Lee HJ. Body-focused repetitive behaviors and non-suicidal self-injury: A comparison of clinical characteristics and symptom features. J Psychiatr Res 2020; 124:115-122. [PMID: 32135390 DOI: 10.1016/j.jpsychires.2020.02.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
Body-focused repetitive behaviors (BFRBs) and non-suicidal self-injury (NSSI) are recognized as distinct categories in the DSM-5. However, definitions and assessment of NSSI sometimes encompasses behaviors similar to BFRBs, and little data exist about their clinical differences. The current study examined clinical characteristics and symptom features associated with NSSI vs. BFRBs. The current sample included 1523 individuals who endorsed moderate to severe NSSI (n = 165) or BFRBs: hair pulling group (n = 102), skin picking group (n = 216), nail picking group (n = 253), nail biting group (n = 487), and cheek biting group (n = 300). Responders were asked to complete questionnaires on clinical features relevant for BFRBs and NSSI. NSSI and BFRBs had significant differences on several clinical features. Individuals in the NSSI group were more likely than individuals with BFRBs to report engaging in the behavior for social-affective reasons (i.e., to get out of doing something, or receive attention from others). Individuals in the NSSI group were also more likely to engage in the behavior to regulate tension and feelings of emptiness, and to experience relief during the act. In contrast, individuals in the BFRB groups were more likely to engage in the behavior automatically without reflective awareness, to reduce boredom, or to fix appearance. The NSSI group obtained significantly higher scores on questionnaires assessing stress, anxiety, depression, and harm avoidance. Overall, the results showed several notable differences between NSSI and BFRBs that are consistent with clinical literature and definitions of these problems in the DSM-5.
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Affiliation(s)
- Abel S Mathew
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Taylor P Davine
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | | | - David C Houghton
- Department of Psychiatry & Behavioral Sciences, University of Texas Medical Branch, USA
| | | | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, USA.
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20
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Borschmann R, Molyneaux E, Spry E, Moran P, Howard LM, Macdonald JA, Brown SJ, Moreno-Betancur M, Olsson CA, Patton GC. Pre-conception self-harm, maternal mental health and mother-infant bonding problems: a 20-year prospective cohort study. Psychol Med 2019; 49:2727-2735. [PMID: 30560741 DOI: 10.1017/s0033291718003689] [Citation(s) in RCA: 10] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother-infant bonding problems. METHODS The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3-9. VIHCS enrolment began in 2006 (when participants were aged 28-29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother-infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum. RESULTS Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20-29) reported higher levels of perinatal depressive symptoms and mother-infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42-7.39; mother-infant bonding problems adjusted β = 7.51, 95% CI 3.09-11.92]. There was no evidence that self-harm in adolescence (ages 15-17) was associated with either perinatal outcome. CONCLUSIONS Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother-infant bonding problems.
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Affiliation(s)
- Rohan Borschmann
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Section for Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Emma Molyneaux
- Section for Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Elizabeth Spry
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Paul Moran
- Centre for Academic Mental Health, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Louise M Howard
- Section for Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Jacqui A Macdonald
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Stephanie J Brown
- Healthy Mothers Healthy Families, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population of Global Health, The University of Melbourne, Melbourne, Australia
| | - Craig A Olsson
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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21
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Xiong W, Liu H, Gong P, Wang Q, Ren Z, He M, Zhou G, Ma J, Guo X, Fan X, Liu M, Yang X, Shen Y, Zhang X. Relationships of coping styles and sleep quality with anxiety symptoms among Chinese adolescents: A cross-sectional study. J Affect Disord 2019; 257:108-115. [PMID: 31301610 DOI: 10.1016/j.jad.2019.07.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/10/2019] [Accepted: 07/04/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Limited published research has examined the relationships of coping styles and sleep quality with anxiety symptoms in Chinese school adolescents. We aimed to explore the effect of coping styles and sleep quality on anxiety symptoms. Furthermore, we investigated the interactions of coping styles and sleep quality with anxiety symptoms. METHODS The survey was conducted in Jiangxi Province, China. The Simplified Coping Style Questionnaire, Pittsburgh Sleep Quality Index and Chinese Secondary School Students Anxiety Scale were utilized to assess sleep quality, coping styles and anxiety symptoms, respectively. Multiple logistic regression analysis was applied to explore the relationships of coping styles and sleep quality with anxiety symptoms. RESULTS A total of 3081 students participated in this study, 50.8% of whom were boys; the number of participants in grades 1, 2 and 3 were 979, 1085 and 1017, respectively. The prevalence of anxiety symptoms was 27.3%. Individuals with poor sleep quality were 3.558 (95% CI = 2.716-4.660) times as likely to have anxiety symptoms than those with good sleep quality. Higher negative coping style scores increased the prevalence of anxiety symptoms (OR = 2.101, 95% CI = 1.894-2.332), whereas higher positive coping style scores were related to reduced odds of anxiety symptoms (OR = 0.892, 95% CI = 0.800-0.995). Interactions of coping styles and sleep quality with anxiety symptoms were not found (all p > 0.05). The association between negative coping style and anxiety symptoms was mediated by sleep quality. LIMITATIONS This study was cross-sectional and limited to Ganzhou City. CONCLUSIONS The results of our study showed a higher prevalence of anxiety symptoms compared with the result of a previous study in Chinese school adolescents. Negative coping style and poor sleep quality were associated with an increased prevalence of anxiety symptoms, whereas positive coping style was related to a decreased prevalence of anxiety symptoms. Sleep quality was a mediating factor between negative coping style and anxiety symptoms.
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Affiliation(s)
- Wenjing Xiong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ping Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ge Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Juan Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xia Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xinwen Fan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Meitian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaodi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yue Shen
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China; China Population Communication Center, Beijing, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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McHugh CM, Chun Lee RS, Hermens DF, Corderoy A, Large M, Hickie IB. Impulsivity in the self-harm and suicidal behavior of young people: A systematic review and meta-analysis. J Psychiatr Res 2019; 116:51-60. [PMID: 31195164 DOI: 10.1016/j.jpsychires.2019.05.012] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/10/2019] [Accepted: 05/11/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Impulsivity is considered a possible phenotype underlying the expression of self-harm and suicidal behaviors. Yet impulsivity is a not a unitary construct and there is evidence that different facets of impulsivity follow different neurodevelopmental trajectories and that some facets may be more strongly associated with such behaviors than others. Moreover, it is unclear whether impulsivity is a useful predictor of self-harm or suicidal behavior in young people, a population already considered to display heightened impulsive behavior. METHODS A systematic review and meta-analysis of studies published in Medline, PubMed, PsychInfo or Embase between 1970 and 2017 that used a neurocognitive measure to assess the independent variable of impulsivity and the dependent variable of self-harm and/or suicidal behavior among young people (mean age < 30 years old). RESULTS 6183 titles were identified, 141 full texts were reviewed, and 18 studies were included, with 902 young people with a self-harm or suicidal behavior and 1591 controls without a history of these behaviors. Deficits in inhibitory control (13 studies, SMD 0.21, p-value = 0.002, 95% confidence interval (CI) (0.08-0.34), prediction interval (PI) = 0.06-0.35) and impulsive decision-making (14 studies, SMD 0.17, p-value = 0.008, 95% CI (0.045-0.3), PI = 0.03-0.31) were associated with self-harm or suicidal behavior. There were no significant differences between measures of different facets of impulsivity (ie. delay discounting, risky decision-making, cognitive or response inhibition) and self-harm or suicidal behavior. CONCLUSION Multiple facets of impulsivity are associated with suicidal behavior in young people. Future suicide research should be designed to capture impulsive states and investigate the impact on different subtypes of impulsivity.
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Affiliation(s)
- Catherine M McHugh
- CRE Optymise, Brain and Mind Centre, University of Sydney, 94 Mallett street, Camperdown, NSW, 2050, Australia; Centre for Research Excellence in Suicide Prevention, University of Sydney, Australia.
| | - Rico Sze Chun Lee
- CRE Optymise, Brain and Mind Centre, University of Sydney, 94 Mallett street, Camperdown, NSW, 2050, Australia; Brain and Mental Health Laboratory, Monash University, Melbourne, Australia
| | - Daniel F Hermens
- CRE Optymise, Brain and Mind Centre, University of Sydney, 94 Mallett street, Camperdown, NSW, 2050, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, Australia
| | - Amy Corderoy
- University of Notre Dame Australia, School of Medicine, Sydney, Australia
| | - Matthew Large
- University of New South Wales, School of Psychiatry, Sydney, Australia
| | - Ian B Hickie
- CRE Optymise, Brain and Mind Centre, University of Sydney, 94 Mallett street, Camperdown, NSW, 2050, Australia; Brain and Mental Health Laboratory, Monash University, Melbourne, Australia
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23
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Carr KL, Stewart MW. Effectiveness of School-based Health Center Delivery of a Cognitive Skills Building Intervention in Young, Rural Adolescents: Potential Applications for Addiction and Mood. J Pediatr Nurs 2019; 47:23-29. [PMID: 31022629 DOI: 10.1016/j.pedn.2019.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Uniquely positioned, school nurses address two of the most critical adolescent health issues - addiction and mood. Cognitive behavioral therapy, the mainstay in management of adolescent mood disorders, demonstrates promise in the treatment and prevention of addictive behaviors. Quality decision-making may protect adolescents from substance abuse. Executive function, a neurocognitive aspect of decision-making, involves impulse control, future thinking, and behavioral regulation. Further, the continuum of addition implicates executive function, which makes executive function a viable target for prevention and treatment of substance use. This pilot study examined the effectiveness of a nurse-led cognitive skills training intervention, Creating Opportunities for Personal Empowerment, on executive function and mood in a novel population and setting. DESIGN AND METHODS The study sample included adolescents ranging in age from 12 to 15 years and enrolled in a rural school-based health center. Fifteen (n = 15) adolescents completed the seven-week cognitive skills building intervention led by a nurse practitioner. Researchers measured executive function, anxiety, and depression at: baseline, after the intervention series, and three-months later. RESULTS One domain of executive function - behavioral regulation - improved, as did anxiety. Depression showed short-term improvement. Metacognition did not change over time. CONCLUSIONS Preliminary results indicate that cognitive skills building delivered by school nurses may enhance aspects of executive function linked with addiction and coping, such as behavioral regulation. Further, this intervention may also improve mood in this population. PRACTICE IMPLICATIONS Delivery of cognitive skills training by school nurses could be an accessible, effective piece in addressing addiction and mood in young, rural adolescents.
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Affiliation(s)
- Kayla L Carr
- University of Mississippi Medical Center, MS, United States of America.
| | - Mary W Stewart
- University of Mississippi Medical Center, MS, United States of America.
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Hegedűs KM, Szkaliczki A, Gál BI, Andó B, Janka Z, Álmos PZ. Decision-making performance of depressed patients within 72 h following a suicide attempt. J Affect Disord 2018; 235:583-588. [PMID: 29702452 DOI: 10.1016/j.jad.2018.04.082] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/05/2018] [Accepted: 04/14/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND The significance of decision-making in suicidal behaviour is often highlighted; however, the performance of persons in suicide crisis is unknown. This study aimed to explore the comprehensive decision-making profile of depressed patients following a suicide attempt. METHODS Decision-making was measured by reward- ("ABCD") and punishment- ("EFGH") sensitive versions of the Iowa Gambling Task (IGT) in 59 medication-free depressed patients within 72 h after a suicide attempt and in 46 healthy control subjects. Severity of depressive symptoms was assessed in the patient group by the Hamilton Depression Rating Scale. RESULTS Performance of the two groups differed significantly on the IGT ABCD, while a trend towards significant differences was seen on the IGT EFGH. Severity of depressive symptoms did not affect the depressed participants' decision-making performance. LIMITATIONS Subjects were not matched for years of education. Administration of the IGT ABCD and IGT EFGH was not counterbalanced. Methods of suicide attempts and history of previous attempts were not collected. CONCLUSIONS Individuals with a recent suicide attempt showed decision-making dysfunction on both IGT versions. However, on the EFGH, the overall difference between groups was not significant, depressed participants' performance remained poor during all blocks. Their behaviour reflected a focus on best immediate possible outcomes, not regarding future adverse consequences. This could be a result of psychological and cognitive alterations which modulate suicidal behaviour independent from mood. Further longitudinal studies should verify this possibility. Investigation of state-dependent neuropsychological characteristics of suicidal behaviour might be essential for detecting acute suicidal crisis.
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Affiliation(s)
- Klára M Hegedűs
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary.
| | - Andrea Szkaliczki
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary
| | - Bernadett I Gál
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary
| | - Bálint Andó
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary
| | - Zoltán Janka
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary
| | - Péter Z Álmos
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary
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25
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Dahlgren MK, Hooley JM, Best SG, Sagar KA, Gonenc A, Gruber SA. Prefrontal cortex activation during cognitive interference in nonsuicidal self-injury. Psychiatry Res Neuroimaging 2018; 277:28-38. [PMID: 29803001 DOI: 10.1016/j.pscychresns.2018.04.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 04/10/2018] [Accepted: 04/27/2018] [Indexed: 11/22/2022]
Abstract
Nonsuicidal self-injury (NSSI), deliberate behavior resulting in self-inflicted damage to oneself, is common, particularly among female adolescents, and may be a form of maladaptive emotion regulation. Cognitive interference, a specific type of processing associated with inhibiting prepotent responses in favor of less automatic ones, is utilized in treatment strategies to shift patients' thoughts and behaviors away from maladaptive responses and replace them with more adaptive ones. We examined cognitive interference processing using the Multi-Source Interference Task (MSIT) in females with NSSI behavior (n=15) and healthy control females (n=15). Functional magnetic resonance imaging (fMRI) data were collected concurrently. Results revealed similar between-group performance on the MSIT; however, women with NSSI behavior exhibited altered patterns of neural activation during the MSIT. Specifically, the NSSI group demonstrated increased cingulate cortex (CC) and decreased dorsolateral prefrontal cortex (DLPFC) activation compared to the control group. Further, within the NSSI group, DLPFC activation inversely correlated with emotional reactivity and self-reported impulsivity, suggesting that decreased DLPFC activation is associated with poorer emotional control and increased impulsivity. Taken together, these results indicate that women with NSSI behavior utilize different cortical areas during cognitive interference processing, which may have broader implications regarding the treatment efficacy of cognitive-based therapies.
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Affiliation(s)
- M Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychology, Tufts University, Medford, MA 02155, USA
| | - Jill M Hooley
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA
| | - Stephanie G Best
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA; Behavioral Health Partial Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA.
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26
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Pinquart M, Pfeiffer JP, Becker K. Perceived Attainment of Developmental Tasks in Adolescents With and Without Mental Disorders. ZEITSCHRIFT FUR ENTWICKLUNGSPSYCHOLOGIE UND PADAGOGISCHE PSYCHOLOGIE 2018. [DOI: 10.1026/0049-8637/a000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. The present study compared the perceived attainment of developmental tasks of 220 adolescents diagnosed with anxiety disorder, attention-deficit / hyperactivity disorder, conduct disorder, or depression with a matched sample of 220 peers without a mental illness. The clinical sample perceived lower success with solving personal, social, and socio-institutional developmental tasks compared with their healthy peers. Comparisons across diagnoses identified the largest differences between students with internalizing disorders (anxiety, depression) versus other disorders. We conclude that psychological interventions with adolescents with mental disorders should promote their attainment of age-typical developmental goals.
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Affiliation(s)
- Martin Pinquart
- Universität Marburg, Fachbereich Psychologie, AG Kinder- und Jugendpsychologie
| | - Jens P. Pfeiffer
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Fachbereich Medizin
| | - Katja Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Fachbereich Medizin
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27
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Viksveen P, Bjønness SE, Berg SH, Cardenas NE, Game JR, Aase K, Storm M. User involvement in adolescents' mental healthcare: protocol for a systematic review. BMJ Open 2017; 7:e018800. [PMID: 29273667 PMCID: PMC5778296 DOI: 10.1136/bmjopen-2017-018800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION User involvement has become a growing importance in healthcare. The United Nations state that adolescents have a right to be heard, and user involvement in healthcare is a legal right in many countries. Some research provides an insight into the field of user involvement in somatic and mental healthcare for adults, but little is known about user involvement in adolescents' mental healthcare, and no overview of the existing research evidence exists. METHODS AND ANALYSIS The aim of this systematic review is to provide an overview of existing research reporting on experiences with and the effectiveness and safety issues associated with user involvement for adolescents' mental healthcare at the individual and organisational level. A systematic literature search and assessment of published research in the field of user involvement in adolescents' mental healthcare will be carried out. Established guidelines will be used for data extraction (Cochrane Collaboration guidelines, Strengthening the Reporting of Observational studies in Epidemiology and Critical Appraisal Skills Programme (CASP)), critical appraisal (Cochrane Collaboration guidelines and Pragmatic-Explanatory Continuum Indicator Summary) and reporting of results (Preferred Reporting Items for Systematic reviews and Meta-Analyses, Consolidated Standards of Reporting Trials and CASP). Confidence in the research evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Adolescents are included as coresearchers for the planning and carrying out of this systematic review. This systematic review will provide an overview of the existing research literature and thereby fill a knowledge gap. It may provide various stakeholders, including decision-makers, professionals, individuals and their families, with an overview of existing knowledge in an underexplored field of research. ETHICS AND DISSEMINATION Ethics approval is not required for this systematic review as we are not collecting primary data. The results will be published in a peer-reviewed journal and at conference presentations and will be shared with stakeholder groups.
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Affiliation(s)
- Petter Viksveen
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Stig Erlend Bjønness
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Siv Hilde Berg
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | | | - Julia Rose Game
- International Baccalaureate, St Olav videregående skole (High School), Stavanger, Norway
| | - Karina Aase
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marianne Storm
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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28
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Abstract
UNLABELLED The current paper reviews extant quantitative and qualitative literature into how Non-Suicidal Self-Injury cessation occurs, and individuals' experiences of stopping. Specific search criteria utilizing a PRISMA format were used across 5 databases, which resulted in 454 papers being identified. After utilizing exclusion criteria and then review, nine of the 454 papers identified were retained for extensive synthesis and critique. RESULTS Results from 8 of the identified papers indicated that both intra and inter personal factors can influence self-injury cessation. These include: family support, self-esteem, emotional regulation, and professional help. Only 1 paper articulated a cessation process, describing it as a procedural event of developing interpersonal strength, then implementing alternative coping strategies. Limitations and implications of the studies are reported, concluding that further research is warranted to inform effective prevention and treatment strategies to ameliorate this growing public health concern.
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29
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Tucker JM, Cadieux A, Culver K, Smith L, Stratbucker W. Psychiatric diagnoses and medication treatment among patients presenting for paediatric weight management: associations with adiposity, aerobic fitness and cardiometabolic health. Clin Obes 2017; 7:145-150. [PMID: 28320057 DOI: 10.1111/cob.12185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/19/2017] [Accepted: 02/08/2017] [Indexed: 01/31/2023]
Abstract
We compared anthropometry, cardiometabolic risk and aerobic fitness among obese youth in weight management who were diagnosed with one or more psychiatric disorders (PD), with (PD+M) or without (PD-M) a prescribed psychotropic medication with those with no PD (NPD). Physical measures were evaluated at baseline, and psychiatric diagnoses and related medications were identified from medical records. Of 99 patients 64 (65%) had a diagnosed PD, and of those, 23 (36%) had a related medication (PD+M). Compared to NPD, PD-M had a higher body mass index (BMI) (P = 0.003), BMI z-score (P = 0.015), percent body fat (P = 0.005) and waist circumference (P < 0.001), after adjusting for age, but PD+M did not. Cardiometabolic risk did not differ between groups, but aerobic fitness was lower among PD-M (P = 0.001) and PD+M (P = 0.008) compared to NPD. Obese youth in weight management exhibit high rates of psychiatric diagnoses that are associated with lower fitness and higher adiposity and may impact treatment efficacy.
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Affiliation(s)
- J M Tucker
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - A Cadieux
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - K Culver
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - L Smith
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - W Stratbucker
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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30
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Macchi R, MacKew L, Davis C. Is decision-making ability related to food choice and facets of eating behaviour in adolescents? Appetite 2017; 116:442-455. [PMID: 28536057 DOI: 10.1016/j.appet.2017.05.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 05/01/2017] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To test the prediction that poor decision-making would predict poor eating-related behaviours, which in turn would relate to elevated body mass index (BMI) percentile. METHODS Associations among decision-making ability, eating behaviours, and BMI percentile were examined in a sample of 311 healthy male and female adolescents, aged 14-18 years. Structural equation modelling was used to test the proposed relationships. RESULTS The predicted model was a good fit to the data and all paths between latent and indicator variables were significant. Impulsive responding significantly predicted poor food choice and overeating. No significant relationships emerged between eating-related variables and BMI percentile. CONCLUSIONS Findings from this study extend the existing research in adults and offer a more comprehensive understanding of factors that may contribute to eating behaviours and weight status in teenagers.
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Affiliation(s)
- Rosemarie Macchi
- Department of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | - Laura MacKew
- Department of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Caroline Davis
- Department of Kinesiology and Health Science, York University, Toronto, ON, Canada
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31
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Chamberlain SR, Redden SA, Grant JE. Associations between self-harm and distinct types of impulsivity. Psychiatry Res 2017; 250:10-16. [PMID: 28135642 PMCID: PMC5346483 DOI: 10.1016/j.psychres.2017.01.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/03/2016] [Accepted: 01/20/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There is an ongoing debate regarding how self-harm should be classified. The aim of this study was to characterize associations between self-harm and impulsivity. METHOD Total 333 adults (mean [SD] age 22.6 (3.6) years, 61% male) were recruited from the general community. History of self-harm was quantified using the Self-Harm Inventory (SHI), which asks about 22 self-harm behaviors. Principal components analysis was used to identify latent dimensions of self-harming behaviors. Relationships between self-harm dimensions and other measures were characterized using ordinary least squares regression. RESULTS Principal Components Analysis yielded a three factor solution, corresponding to self-injurious self-harm (e.g. cutting, overdoses, burning), interpersonal related self-harm (e.g. engaging in emotionally or sexually abusive relationships), and reckless self-harm (e.g. losing one's job deliberately, driving recklessly, abusing alcohol). Regression modelling showed that all three dimensions of self-harm were associated with lower quality of life. CONCLUSIONS This study suggests the existence of three distinct subtypes or 'latent factors' of self-harm: all three appear clinically important in that they are linked with worse quality of life. Clinicians should screen for impulse control disorders in people with self-harm, especially when it is self-injurious or involves interpersonal harm.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, UK
| | - Sarah A Redden
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago.
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32
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Allen KJD, Hooley JM. Negative mood and interference control in nonsuicidal self-injury. Compr Psychiatry 2017; 73:35-42. [PMID: 27888700 DOI: 10.1016/j.comppsych.2016.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/02/2016] [Accepted: 10/30/2016] [Indexed: 11/26/2022] Open
Abstract
People who engage in nonsuicidal self-injury (NSSI) often report high levels of impulsivity. However, results from behavioral tasks measuring impulsivity have been mixed: those with a history of NSSI generally perform comparably to healthy controls. Recent research suggests, however, that people who self-injure have specific deficits in response inhibition to negative emotional stimuli. Here, we extend this work by testing whether negative mood impairs interference control in NSSI. 33 participants reporting a history of NSSI (approximately half in the past year) and 31 age- and gender-matched healthy controls completed the multi-source interference task before and after a written negative mood induction designed to increase feelings of worthlessness, guilt, and shame. After the induction, the NSSI group reported increased negative mood but did not show worse interference control. In other words, increased negative mood did not correspond to increased behavioral impulsivity in participants reporting NSSI. Consistent with past research, the NSSI and healthy control groups showed equivalent task performance. This study adds to evidence that NSSI is not characterized by behavioral impulsivity, even in the context of negative mood.
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Affiliation(s)
- Kenneth J D Allen
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA.
| | - Jill M Hooley
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA.
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33
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de Cates AN, Rees K, Jollant F, Perry B, Bennett K, Joyce K, Leyden E, Harmer C, Hawton K, van Heeringen K, Broome MR. Are neurocognitive factors associated with repetition of self-harm? A systematic review. Neurosci Biobehav Rev 2016; 72:261-277. [PMID: 27923730 DOI: 10.1016/j.neubiorev.2016.10.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 09/13/2016] [Accepted: 10/27/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Prediction of self-harm is limited clinically. Early identification of individuals likely to repeat self-harm could improve outcomes and reduce suicide risk. Various neurocognitive deficits have been found in people who self-harm, but the ability of these to predict repetition has yet to be established AIMS: Identify neurocognitive factors that may predict repetition of self-harm. METHODS Systematic narrative review of English language publications assessing neurocognitive functioning and self-harm repetition, searching multiple databases from inception to March 2015. Quality of studies was appraised. A narrative synthesis was performed. RESULTS 7026 unique records were identified, and 169 full-texts assessed. 15 unique studies provided data. No imaging studies could be included. Most studies assessed cognitive control or problem solving, but neither factor was consistently associated with repetition. However, specific tasks may show promise. Two studies in adolescents suggest that value-based decision-making impairments could be predictive of repetition. There were too few results for memory to draw specific conclusions. CONCLUSIONS Selected studies suggest promise for particular neurocognitive factors and specific cognitive tasks in terms of repetition of self-harm.
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Affiliation(s)
- Angharad N de Cates
- Unit of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, UK; Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
| | - Karen Rees
- Division of Health Sciences, Warwick Medical School, University of Warwick, UK
| | - Fabrice Jollant
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal, Québec, Canada; Academic Hospital (CHU) of Nîmes, France
| | - Benjamin Perry
- Unit of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, UK; Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | | | - Katie Joyce
- Warwick Medical School, University of Warwick, UK
| | - Eimear Leyden
- University Hospitals of Coventry and Warwickshire, Coventry, UK
| | | | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK
| | - Kees van Heeringen
- Unit for Suicide Research, Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Matthew R Broome
- Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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Iorfino F, Hickie IB, Lee RSC, Lagopoulos J, Hermens DF. The underlying neurobiology of key functional domains in young people with mood and anxiety disorders: a systematic review. BMC Psychiatry 2016; 16:156. [PMID: 27215830 PMCID: PMC4878058 DOI: 10.1186/s12888-016-0852-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 05/08/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Mood and anxiety disorders are leading causes of disability and mortality, due largely to their onset during adolescence and young adulthood and broader impact on functioning. Key factors that are associated with disability and these disorders in young people are social and economic participation (e.g. education, employment), physical health, suicide and self-harm behaviours, and alcohol and substance use. A better understanding of the objective markers (i.e. neurobiological parameters) associated with these factors is important for the development of effective early interventions that reduce the impact of disability and illness persistence. METHODS We systematically reviewed the literature for neurobiological parameters (i.e. neuropsychology, neuroimaging, sleep-wake and circadian biology, neurophysiology and metabolic measures) associated with functional domains in young people (12 to 30 years) with mood and/or anxiety disorders. RESULTS Of the one hundred and thirty-four studies selected, 7.6 % investigated social and economic participation, 2.1 % physical health, 15.3 % suicide and self-harm behaviours, 6.9 % alcohol and substance use, whereas the majority (68.1 %) focussed on clinical syndrome. CONCLUSIONS Despite the predominance of studies that solely examine the clinical syndrome of young people the literature also provides evidence of distinct associations among objective measures (indexing various aspects of brain circuitry) and other functional domains. We suggest that a shift in focus towards characterising the mechanisms that underlie and/or mediate multiple functional domains will optimise personalised interventions and improve illness trajectories.
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Affiliation(s)
- Frank Iorfino
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Ian B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Rico S C Lee
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Jim Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia.
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de Cates AN, Broome MR. Can We Use Neurocognition to Predict Repetition of Self-Harm, and Why Might This Be Clinically Useful? A Perspective. Front Psychiatry 2016; 7:7. [PMID: 26858659 PMCID: PMC4728206 DOI: 10.3389/fpsyt.2016.00007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/11/2016] [Indexed: 12/13/2022] Open
Abstract
Over 800,000 people die by suicide each year globally, with non-fatal self-harm 20 times more common. With each episode of self-harm, the risks of future self-harm and suicide increase, as well as personal and healthcare costs. Therefore, early delineation of those at high risk of future self-harm is important. Historically, research has focused on clinical and demographic factors, but risk assessments based on these have low sensitivity to predict repetition. Various neurocognitive factors have been associated with self-harming behavior, but it is less certain if we can use these factors clinically (i) as risk markers to predict future self-harm and (ii) to become therapeutic targets for interventions. Recent systematic reviews and meta-analyses of behavioral tasks and fMRI studies point to an emerging hypothesis for neurocognition in self-harm: an underactive pre-frontal cortex is unable to respond appropriately to non-emotional stimuli, or inhibit a hyperactive emotionally-/threat-driven limbic system. However, there is almost no imaging data examining repetition of self-harm. Extrapolating from the non-repetition data, there may be several potential neurocognitive targets for interventions to prevent repeat self-harm: cognitive training; pharmacological regimes to promote non-emotional neurocognition; or other techniques, such as repetitive transcranial magnetic stimulation. Hence, there is an urgent need for imaging studies examining repetition and to test specific hypotheses. Until we investigate the functional neurocognitive basis underlying repetition of self-harm in a systematic manner using second-generational imaging techniques, we will be unable to inform third-generational imaging and potential future clinical applications.
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Affiliation(s)
- Angharad N. de Cates
- Unit of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Matthew R. Broome
- Unit of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
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Richard-Devantoy S, Olié E, Guillaume S, Courtet P. Decision-making in unipolar or bipolar suicide attempters. J Affect Disord 2016; 190:128-136. [PMID: 26496018 DOI: 10.1016/j.jad.2015.10.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Disadvantageous decision-making (mainly measured by the Iowa Gambling Task) has been demonstrated in patients with suicidal behavior compared to controls. We, therefore, aimed at clarifying the qualitative and quantitative relationship between decision-making and the risk of suicidal behavior in unipolar and bipolar disorders respectively, as well as establishing the strength of this relationship. METHODS (1) We conducted a cross-sectional study comparing IGT performances between 141 unipolar suicide attempters and 57 bipolar suicide attempters. (2) We conducted a systematic review and a meta-analysis of studies comparing IGT performances in patients with vs. without a history of suicidal acts in bipolar and unipolar disorder, together and separately. RESULTS (1) Among suicide attempters, bipolar and unipolar groups performed similarly (t(195)=-0.7; p=0.48). Unipolar non-attempters performed better IGT than unipolar suicide attempters (t(221)=3.1; p=0.002), only in female gender, whereas performances were similar in bipolar patients whatever the history of suicide attempt (t(77)=-0.3; p=0.7). (2) A meta-analysis of 10 studies confirmed significantly impaired decision-making with a moderate effect-size (-0.38 (95% CI[-0.61--0.16]; z=-3.3; p=0.001) in unipolar disorder and (g=-0.4 (95% CI[-0.75 to -0.05]; z=-2.2; p<0.026) in bipolar disorder suicide attempters compared to unipolar and bipolar non-attempters, respectively. LIMITATIONS It was not possible to analyse according to the level of lethality attempt. CONCLUSION Overall, a strong significant association was found between decision-making and the risk of suicidal behavior in unipolar disorder and bipolar disorder. However, further neuropsychological studies need to analyse separately unipolar and bipolar disorder and to study gender differences.
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Affiliation(s)
- Stéphane Richard-Devantoy
- McGill University, Department of Psychiatry & Douglas Mental Health University, Institute McGill Group for Suicide Studies, FBC Building, 3rd floor, 6875 Boulevard Lasalle, Montréal (Québec), & Hôpital Régional de Saint-Jérôme, Saint-Jérôme, Québec, Canada; Laboratoire de Psychologie des Pays de la Loire EA 4638, Université de Nantes et Angers, France.
| | - Emilie Olié
- Université Montpellier & CHU Montpellier & Inserm, U1061 Montpellier, France
| | - Sébastien Guillaume
- Université Montpellier & CHU Montpellier & Inserm, U1061 Montpellier, France
| | - Philippe Courtet
- Université Montpellier & CHU Montpellier & Inserm, U1061 Montpellier, France
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Schatten HT, Armey MF, Andover MS. The roles of social stress and decision-making in non-suicidal self-injury. Psychiatry Res 2015; 229:983-91. [PMID: 26260569 PMCID: PMC4655439 DOI: 10.1016/j.psychres.2015.05.087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 05/05/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
Abstract
Research suggests that individuals with a history of non-suicidal self-injury (NSSI) do not have difficulty generating alternatives to social problems but choose more negative solutions, suggesting a deficit in decision-making. However, studies report no significant differences in risky decision-making on a performance-based task among individuals with and without NSSI histories. A limitation of these studies is that decision-making was only assessed at baseline. As individuals with a history of NSSI typically self-injure when experiencing negative emotions, decision-making ability may become impaired specifically in the presence of these emotions. The aim of the current study was to investigate decision-making ability among individuals with and without NSSI histories both at baseline and following a distressing social exclusion task. We compared individuals with (n=48) and without (n=72) NSSI histories on the Iowa Gambling Task, a behavioral measure of risky decision-making, before and after exclusion or inclusion on the Cyberball task. Results indicated no significant group differences in performance regardless of condition. When participants were grouped by racial/ethnic minority status, results indicated that non-Hispanic White individuals with a history of NSSI exhibited deterioration in risky decision-making ability following social exclusion. Potential explanations for these findings and clinical implications are discussed.
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Affiliation(s)
- Heather T. Schatten
- Alpert Medical School, Brown University, Department of Psychiatry and Human Behavior, Box G-BH, Providence, RI 02912 USA,Butler Hospital, Psychosocial Research Program, 345 Blackstone Blvd., Providence, RI 02906 USA,Corresponding author: Heather T. Schatten, Ph.D., Butler Hospital, Psychosocial Research Department, 345 Blackstone Boulevard, Providence, RI 02906 USA. , 401-680-4103 (office), 401-455-6235 (fax)
| | - Michael F. Armey
- Alpert Medical School, Brown University, Department of Psychiatry and Human Behavior, Box G-BH, Providence, RI 02912 USA,Butler Hospital, Psychosocial Research Program, 345 Blackstone Blvd., Providence, RI 02906 USA
| | - Margaret S. Andover
- Fordham University, Department of Psychology, 441 East Fordham Road, Bronx, NY 10458 USA
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Badoud D, Billieux J, Eliez S, Imhof A, Heller P, Eytan A, Debbané M. Covariance and specificity in adolescent schizotypal and borderline trait expression. Early Interv Psychiatry 2015; 9:378-87. [PMID: 24428891 DOI: 10.1111/eip.12120] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 12/07/2013] [Indexed: 10/25/2022]
Abstract
AIMS The first aim of the present study is to assess the overlap between borderline and schizotypal traits during adolescence. The second objective is to examine whether some psychological factors (i.e. cognitive coping mechanisms, impulsivity and encoding style) are differentially related to borderline and schizotypal traits and may therefore improve the efficiency of clinical assessments. METHODS One hundred nineteen community adolescents (57 male) aged from 12 to 19 years completed a set of questionnaires evaluating the expression of borderline and schizotypal traits as well as cognitive emotion regulation (CER), impulsivity and encoding style. RESULTS Our data first yielded a strong correlation between borderline and schizotypal scores (r = 0.70, P < 0.001). Secondly, linear regression models indicated that the 'catastrophizing' CER strategy and the 'lack of premeditation' impulsivity facet accounted for the level of borderline traits, whereas an internal encoding style predominantly explained schizotypal traits. CONCLUSIONS Our results support the abundant literature showing that borderline and schizotypal traits frequently co-occur. Moreover, we provide original data indicating that borderline and schizotypal traits during adolescence are linked to different specific psychological mechanisms. Thus, we underline the importance of considering these mechanisms in clinical assessments, in particular to help disentangle personality disorder traits in youths.
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Affiliation(s)
- Deborah Badoud
- Adolescence Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Joël Billieux
- Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Stephan Eliez
- Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
| | - Anouk Imhof
- Office Médico-Pédagogique, Clinical Outpatient Service of Geneva State, Geneva, Switzerland
| | - Patrick Heller
- Department of Mental Health and Psychiatry, University Hospital of Geneva, Chêne-Bourg, Switzerland
| | - Ariel Eytan
- Office Médico-Pédagogique, Clinical Outpatient Service of Geneva State, Geneva, Switzerland
| | - Martin Debbané
- Adolescence Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
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Vilgis V, Silk TJ, Vance A. Executive function and attention in children and adolescents with depressive disorders: a systematic review. Eur Child Adolesc Psychiatry 2015; 24:365-84. [PMID: 25633323 DOI: 10.1007/s00787-015-0675-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 01/03/2015] [Indexed: 11/26/2022]
Abstract
Numerous studies have shown that Major Depressive Disorder (MDD) in adults is associated with deficits in cognitive control. Particularly, impairment on executive function (EF) tasks has been observed. Research into EF deficits in children and adolescents with MDD has reported mixed results and it is currently unclear whether paediatric MDD is characterised by impairments in EF and attention. PsycInfo, Scopus and Medline were systematically searched to identify all studies that have investigated EF and attention in paediatric depressive disorders between 1994 and 2014. 33 studies meeting inclusion/exclusion criteria were identified. While across different domains of EF some studies identified a deficit in the clinical group, the majority of studies failed to find deficits in response inhibition, attentional set shifting, selective attention, verbal working memory, and verbal fluency. More research is needed to clarify the relationship between depressive disorders in children and adolescents and spatial working memory processing, sustaining attention, planning, negative attentional bias and measures of 'hot' EF. There is little support for EF deficits in paediatric depression. However, there are numerous methodological problems that may account for null findings. Alternatively, chronicity and/or severity of symptoms may explain discrepancies between cognitive deficits in adult and paediatric MDD. Recommendations for future studies are discussed.
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Affiliation(s)
- Veronika Vilgis
- Academic Child Psychiatry Unit, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia,
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Moran P, Coffey C, Romaniuk H, Degenhardt L, Borschmann R, Patton GC. Substance use in adulthood following adolescent self-harm: a population-based cohort study. Acta Psychiatr Scand 2015; 131:61-8. [PMID: 24954250 PMCID: PMC4293154 DOI: 10.1111/acps.12306] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether adolescents who self-harm are at increased risk of heavy and dependent substance use in adulthood. METHOD Fifteen-year prospective cohort study of a random sample of 1943 adolescents recruited from secondary schools across the state of Victoria, Australia. Data pertaining to self-harm and substance use was obtained at seven waves of follow-up, from mean age 15.9 years to mean age 29.1 years. RESULTS Substance use and self-harm were strongly associated during the adolescent years (odds ratio (OR): 3.3, 95% CI 2.1-5.0). Moreover, adolescent self-harmers were at increased risk of substance use and dependence syndromes in young adulthood. Self-harm predicted a four-fold increase in the odds of multiple dependence syndromes (sex- and wave-adjusted OR: 4.2, 95% CI: 2.7-6.6). Adjustment for adolescent anxiety/depression attenuated but did not eliminate most associations. Adolescent substance use confounded all associations, with the exception of multiple dependence syndromes, which remained robustly associated with adolescent self-harm (fully adjusted odds ratio: 2.0, 95% CI: 1.2-3.2). CONCLUSION Adolescent self-harm is an independent risk factor for multiple dependence syndromes in adulthood. This level of substance misuse is likely to contribute substantially to the premature mortality and disease burden experienced by individuals who self-harm.
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Affiliation(s)
- P Moran
- King's College London, Health Services & Population Research Department, Institute of PsychiatryLondon, UK
| | - C Coffey
- Centre for Adolescent Health, Royal Children's Hospital Murdoch Children's Research InstituteParkville, Vic., Australia
| | - H Romaniuk
- Clinical Epidemiology & Biostatistics Unit and Centre for Adolescent Health, Royal Children's Hospital, Murdoch Children's Research Institute, University of MelbourneParkville, Vic., Australia,Department of Paediatrics, University of MelbourneParkville, Vic., Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre, University of New South WalesSydney, NSW, Australia,School of Population and Global Health, University of MelbourneParkville, Vic., Australia
| | - R Borschmann
- King's College London, Health Services & Population Research Department, Institute of PsychiatryLondon, UK
| | - G C Patton
- Centre for Adolescent Health, Royal Children's Hospital Murdoch Children's Research InstituteParkville, Vic., Australia
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van Rooyen M, Naude L, Nel L, Esterhuyse K. The role of cognitive style in the stress and coping of black South African adolescents. J Ment Health 2014; 23:340-6. [PMID: 25405817 DOI: 10.3109/09638237.2014.971146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Although stress is a common phenomenon in all phases of life, it can be said that adolescence is a particularly stressful life stage. In South Africa, black adolescents are faced with many stressors and challenges which are placing demands on their emotional and cognitive resources. AIMS The aim of this study was to determine whether black South African adolescents with different cognitive styles (i.e. rational or experiential) differ in their levels of stress and coping. Furthermore, the common stressors that black adolescents experience and the coping styles predominantly used by black adolescents could be determined. METHODS One hundred and eighty-seven participants (88 males and 99 females) completed the Rational Experiential, the Coping Reponses and the Adolescent Stress Inventory. RESULTS Adolescents operating from an experiential cognitive style experienced more stress regarding school performance, school attendance, financial pressure and emerging adult responsibility than adolescents operating from a rational cognitive style. Adolescents employing a rational style sought more alternative rewards as a coping strategy, whereas adolescents employing an experiential style relied more on emotional discharge. CONCLUSIONS The findings of this study concur with previous research, but provide a unique perspective on adolescents' stress and coping in this South African context.
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Affiliation(s)
- Melinda van Rooyen
- Department of Psychology, Faculty of the Humanities, University of the Free State , Bloemfontein , South Africa
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Does cognitive behavioural therapy have a role in improving problem solving and coping in adolescents with suicidal ideation? COGNITIVE BEHAVIOUR THERAPIST 2014. [DOI: 10.1017/s1754470x14000129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractProblem-solving and coping skills deficits have been shown in adolescents who experience suicide-related behaviours, including suicidal ideation. Little evidence exists about effective interventions for this population. We undertook a pilot study of an Internet-based CBT programme that included problem-solving skills training to investigate its impact on skills deficits. The study employed a pre-test/post-test design. Outcomes of interest were negative problem orientation, emotion- and task-focused coping, and adolescents’ perception of helpfulness of the intervention. Participants, recruited via the school wellbeing team, were assessed at baseline, at weekly intervention sessions and immediately post-intervention. Twenty-one adolescents completed the intervention. Over the course of the intervention, negative problem-solving orientation improved and students relied less on emotion-focused coping strategies. Because there was no control group, we cannot be certain that the changes seen between baseline and post-intervention can be attributed to the intervention. Adolescents rated the problem-solving and cognitive restructuring modules as particularly helpful. Interventions that include enhancement of problem-solving skills, as well as cognitive restructuring to address adolescents’ appraisal of problems and their ability to solve them appear promising for adolescents with suicidal ideation. Further investigation is warranted.
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Richard-Devantoy S, Berlim MT, Jollant F. A meta-analysis of neuropsychological markers of vulnerability to suicidal behavior in mood disorders. Psychol Med 2014; 44:1663-1673. [PMID: 24016405 DOI: 10.1017/s0033291713002304] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Suicidal behavior results from a complex interplay between stressful events and vulnerability factors, including cognitive deficits. However, it is not clear which cognitive tests may best reveal this vulnerability. The objective was to identify neuropsychological tests of vulnerability to suicidal acts in patients with mood disorders. METHOD A search was made of Medline, EMBASE and PsycINFO databases, and article references. A total of 25 studies (2323 participants) met the selection criteria. A total of seven neuropsychological tests [Iowa gambling task (IGT), Stroop test, trail making test part B, Wisconsin card sorting test, category and semantic verbal fluencies, and continuous performance test] were used in at least three studies to be analysed. RESULTS IGT and category verbal fluency performances were lower in suicide attempters than in patient controls [respectively, g = -0.47, 95% confidence interval (CI) -0.65 to -0.29 and g = -0.32, 95% CI -0.60 to -0.04] and healthy controls, with no difference between the last two groups. Stroop performance was lower in suicide attempters than in patient controls (g = 0.37, 95% CI 0.10-0.63) and healthy controls, with patient controls scoring lower than healthy controls. The four other tests were altered in both patient groups versus healthy controls but did not differ between patient groups. CONCLUSIONS Deficits in decision-making, category verbal fluency and the Stroop interference test were associated with histories of suicidal behavior in patients with mood disorders. Altered value-based and cognitive control processes may be important factors of suicidal vulnerability. These tests may also have the potential of guiding therapeutic interventions and becoming part of future systematic assessment of suicide risk.
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Affiliation(s)
- S Richard-Devantoy
- McGill University, Department of Psychiatry and Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
| | - M T Berlim
- McGill University, Department of Psychiatry and Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
| | - F Jollant
- McGill University, Department of Psychiatry and Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
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Wang B, Stanton B, Li X, Cottrell L, Deveaux L, Kaljee L. The influence of parental monitoring and parent-adolescent communication on Bahamian adolescent risk involvement: a three-year longitudinal examination. Soc Sci Med 2013; 97:161-9. [PMID: 24161101 DOI: 10.1016/j.socscimed.2013.08.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 07/18/2013] [Accepted: 08/08/2013] [Indexed: 11/26/2022]
Abstract
The literature suggests that parental monitoring can best be conceptualized and measured through the domains of parental knowledge, youth disclosure, parental solicitation, and parental control. Using longitudinal data on 913 grade-six Bahamian students followed over a period of three years, we examined the unique and independent roles of these domains of parental monitoring and parent-adolescent communication in relation to adolescent involvement in delinquency, substance use, and sexual risk behaviors. The results obtained with mixed-effects models indicate that parental knowledge, youth disclosure, and parental control are negatively associated with both delinquency and substance use. Open parent-adolescent communication was associated with decreased sexual risk behavior, whereas problematic parent-adolescent communication was associated with increased sexual risk behavior. The results obtained with path models indicate that youth disclosure is a significant longitudinal predictor of reduced adolescent delinquency and that parental control during early adolescence predicted reduced substance use in middle adolescence. The findings suggest that parental knowledge, youth disclosure and parental control differ in their impacts on substance use, delinquency and sexual risk behaviors. Problematic parent-adolescent communication is consistently associated with increases in all three types of adolescent risk behaviors. Future parental monitoring interventions should focus on enhancing parents' interpersonal communication skills and emphasize the differences in and importance of the unique components of parental monitoring.
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Affiliation(s)
- Bo Wang
- Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.
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McMahon EM, Corcoran P, McAuliffe C, Keeley H, Perry IJ, Arensman E. Mediating Effects of Coping Style on Associations Between Mental Health Factors and Self-Harm Among Adolescents. CRISIS 2013; 34:242-50. [DOI: 10.1027/0227-5910/a000188] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: There is evidence for an association between suicidal behavior and coping style among adolescents. Aims: The aims of this study were to examine associations between coping style, mental health factors, and self-harm thoughts and acts among Irish adolescents, and to investigate whether coping style mediates associations between mental health factors (depression, anxiety, and self-esteem) and self-harm. Method: A cross-sectional school-based survey was carried out. Information was obtained on history of self-harm, life events, and demographic, psychological, and lifestyle factors. Results: Emotion-oriented coping was strongly associated with poorer mental health and self-harm thoughts and acts. Problem-Oriented Coping was associated with better mental health. Mediating effects of Emotion-Oriented Coping on associations between mental health factors and deliberate self-harm (DSH) was found for both genders and between Problem-Oriented Coping and mental health factors for girls. Similar mediating effects of coping style were found when risk of self-harm thoughts was examined. Limitations: Since the methodology used was cross-sectional, it is impossible to draw conclusions regarding causal relationships between coping style and associated factors. The coping measure used was brief. Conclusions: Promotion of positive coping skills and reduction of emotion-focused approaches may build resilience to self-harm thoughts and acts among adolescents experiencing mental health problems.
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Affiliation(s)
| | | | | | - Helen Keeley
- Child and Adolescent Mental Health Services, HSE Southern Area, Mallow, Ireland
| | - Ivan J. Perry
- Department of Epidemiology and Public Health, University College Cork, Ireland
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Abstract
O Iowa Gambling Task (IGT) é uma tarefa amplamente utilizada na avaliação da capacidade de tomada de decisão. Neste artigo, procede-se à revisão da literatura, comparando-se as versões do IGT, as diferentes medidas de avaliação do desempenho e as alterações introduzidas nos procedimentos, nomeadamente no feedback, na aleatorização espacial dos baralhos, no número de ensaios e de cartas por baralho, nas instruções, na remuneração e na manipulação das recompensas e punições. Desta análise, conclui-se que as diversas versões da tarefa, as alterações nos procedimentos de aplicação e as diferentes medidas utilizadas na avaliação têm impacto no desempenho, prejudicam a comparação entre estudos e as generalizações dos resultados. Finalmente, apresentam-se sugestões para uma maior adequação dos procedimentos.
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47
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Desseilles M. [Predicting suicide or predicting the unpredictable in an uncertain world: Reinforcement Learning Model-Based analysis]. SANTE MENTALE AU QUEBEC 2013; 37:107-27. [PMID: 23666284 DOI: 10.7202/1014947ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In general, it appears that the suicidal act is highly unpredictable with the current scientific means available. In this article, the author submits the hypothesis that predicting suicide is complex because it results in predicting a choice, in itself unpredictable. The article proposes a Reinforcement learning model-based analysis. In this model, we integrate on the one hand, four ascending modulatory neurotransmitter systems (acetylcholine, noradrenalin, serotonin, and dopamine) with their regions of respective projections and afferences, and on the other hand, various observations of brain imaging identified until now in the suicidal process.
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Affiliation(s)
- Martin Desseilles
- Faculté de Médecine de l'Université de Namur; Clinique Psychiatrique des Frères Alexiens, Château de Ruyff, Henri-Chapelle, Belgique.
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48
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Balogh KN, Mayes LC, Potenza MN. Risk-taking and decision-making in youth: relationships to addiction vulnerability. J Behav Addict 2013; 2:10.1556/JBA.2.2013.1.1. [PMID: 24294500 PMCID: PMC3840427 DOI: 10.1556/jba.2.2013.1.1] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. METHODS Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. RESULTS Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. CONCLUSIONS Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors.
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Affiliation(s)
- Kornelia N. Balogh
- Department of Psychiatry, VA Connecticut Healthcare/Yale University School of Medicine, West Haven, CT, USA
| | - Linda C. Mayes
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA, Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA, Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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49
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Pan L, Segreti A, Almeida J, Jollant F, Lawrence N, Brent D, Phillips M. Preserved hippocampal function during learning in the context of risk in adolescent suicide attempt. Psychiatry Res 2013; 211:112-8. [PMID: 23158778 PMCID: PMC3570719 DOI: 10.1016/j.pscychresns.2012.07.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 07/11/2012] [Accepted: 07/12/2012] [Indexed: 10/27/2022]
Abstract
Impairment in decision-making is frequently observed in suicide attempters. Little is known, however, about neural circuitry underlying decision-making in adolescent attempters. Functional magnetic resonance imaging (fMRI) was used to assess decision-making and learning-related neural activity during Iowa Gambling Task (IGT) performance in adolescents with depression and suicide attempt (ATT, n=15), non-attempters with depression (NAT, n=14), and healthy controls (HC, n=13). ATT performed best on the IGT. A three group by two condition (high-risk versus low-risk) by three IGT block (each of 20 cards) whole-brain analysis (p<0.05, corrected) interaction was found in the left hippocampal, frontal and temporal cortical, striatal and thalamic regions. Post-hoc analyses revealed that during low-risk decisions in blocks 2 and 3, NAT, but not ATT, showed greater left hippocampal activation versus HC (p=0.0004, p=0.003); in block 2, during low-risk decisions NAT showed greater left middle temporal gyral activation versus HC (p=0.003); in block 3, during high-risk decisions ATT showed less activation in the right thalamus versus NAT (p=0.001) and during low risk decisions ATT showed greater activation than HC in the left caudate (p=0.002). NAT, but not ATT are differentiated from HC during performance of the IGT. Functional abnormalities in neural circuitry implicated in learning in the context of risk may underlie risk for MDD, but not risk for suicide attempt, in adolescence.
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Affiliation(s)
- Lisa Pan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
| | - AnnaMaria Segreti
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. Dr. Phillips has a
| | - Jorge Almeida
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. Dr. Phillips has a
| | - Fabrice Jollant
- Department of Psychiatry, Douglas Institute, McGill University, Montreal, Quebec, Canada
| | - Natalia Lawrence
- Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - David Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. Dr. Phillips has a
| | - Mary Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. Dr. Phillips has a,Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
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50
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Fikke LT, Melinder A, Landrø NI. The effects of acute tryptophan depletion on impulsivity and mood in adolescents engaging in non-suicidal self-injury. Hum Psychopharmacol 2013; 28:61-71. [PMID: 23359467 DOI: 10.1002/hup.2283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 11/14/2012] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is associated with impaired emotion regulation and impulsivity. Low serotonin (5-hydroxytryptamine) function is associated with NSSI, impaired emotion regulation and impulsivity. We investigated the effects of experimentally lowered 5-hydroxytryptamine activity, via acute tryptophan depletion (ATD), on impulsive action, reflection impulsivity and mood in female adolescents engaging in NSSI. METHODS Thirty-two female adolescents engaging in NSSI participated in a parallel group ATD study. Following ATD, impulsive action was assessed using the Continuous Performance Test, Identical Pairs Version. Reflection impulsivity was assessed using the Matching Familiar Figures Test. Mood-lowering was examined using the Profile of Mood States. RESULTS Following ATD, the participants showed an impulsive response style (as reflected in their low β) and increased attentional capacity (as reflected in their elevated d'). ATD did not affect reflection impulsivity or mood. CONCLUSIONS Acute tryptophan depletion caused an impulsive response style and increased attentional capacity. Importantly, the findings suggest that low serotonin function is a vulnerability among female adolescents for engaging in NSSI when in emotional distress.
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Affiliation(s)
- Linn T Fikke
- The Cognitive Developmental Research Unit, EKUP, Department of Psychology, University of Oslo, Norway.
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