1
|
Liao W, Luo X, Kong F, Sun Y, Ye Z. Association between non-restorative sleep and psychotic-like experiences among Chinese college students: A latent profile and moderated mediation analysis. Schizophr Res 2024; 270:295-303. [PMID: 38944976 DOI: 10.1016/j.schres.2024.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 04/07/2024] [Accepted: 06/22/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Non-restorative sleep (NRS) is a core symptom of insomnia that has considerable consequences for daily life. However, the association between NRS and psychotic-like experiences (PLEs) remains unclear. The current study was designed to explore the relationship between NRS and PLEs as well as the mediation/moderation role of rumination and resilience among college students in China. METHODS 3060 college students were recruited from two universities in South China from September 21st to October 26th, 2022. Non-restorative Sleep Scale, 8-item Positive Subscale of the Community Assessment of Psychic Experiences, Ruminative Response Scale, and 10-item Connor-Davidson Resilience Scale were administered. Latent profile analysis and moderated mediation analysis were performed. RESULTS 11.3 % participants reported frequent PLEs in the past one month. Three profiles of rumination were identified and named as "low rumination" group (27.7 %), "medium rumination" group (55.3 %), and "high rumination" group (16.9 %). NRS directly predicted PLEs, and rumination played a significant mediation role between NRS and PLEs. Resilience significantly moderated the association between NRS and rumination as well as the association between NRS and PLEs. CONCLUSIONS NRS, rumination and resilience are important predictors to PLEs. Strategies on increasing restorative sleep, decreasing rumination, and enhancing resilience are of great significance in the prevention of PLEs.
Collapse
Affiliation(s)
- Wenna Liao
- Department of Public Teaching, Guangdong Open University, Guangzhou, China
| | - Xianghan Luo
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fanxu Kong
- Department of Public Teaching, Guangdong Open University, Guangzhou, China
| | - Yongpeng Sun
- Department of Public Teaching, Guangdong Open University, Guangzhou, China
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, China.
| |
Collapse
|
2
|
Aydın EF, Özcan H, Yılmaz S, Aşkın S, Koca Laçin T, Topu EN. Homocysteine, hopelessness, rumination, affective temperaments, and clinical course in patients with bipolar disorder-1. Nord J Psychiatry 2024; 78:465-476. [PMID: 38713772 DOI: 10.1080/08039488.2024.2347633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/14/2024] [Accepted: 04/21/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE This study aimed to explore the associations between homocysteine, rumination, affective temperaments, clinical features, and hopelessness in bipolar disorder-1 (BD-1). MATERIALS AND METHODS In total, 57 euthymic patients with BD-1 and 57 healthy controls were included. The Beck Hopelessness Scale (BHS), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Ruminative Responses Scale Short Form (RRS-SF) were administered. Homocysteine, folate, and vitamin B12 levels were measured. RESULTS The BHS total (p = 0.047), TEMPS-A irritable (p = 0.007), and TEMPS-A cyclothymic (p= 0.001) scores were significantly higher than the control group in the BD-1 group. Hyperhomocysteinemia (HHcy) was found in 33.3% of the patients (n = 19). In the HHcy group, age of onset of disease (p = 0.020) was significantly lower than the non-HHcy group in patients. Previous suicide attempt number was significantly correlated with scores of reflective pondering, brooding, and global rumination in BD-1 (p ˂ 0.05). Except for hyperthymic temperament, all types of affective temperaments were correlated with the scores of RRS-SF brooding (p ˂ 0.05) in the BD-1 group. The RRS-SF brooding scores significantly correlated with the BHS total scores (r = 0.263, p < 0.05); the TEMPS-A hyperthymic (β = -0.351, p = 0.001) and TEMPS-A irritable (β = 0.536, p < 0.001) scores significantly predicted the BHS total scores in the BD-1 group. CONCLUSIONS The findings may lead clinical efforts and future clinical trials to explore and intervene in related sources and presentations of BD-1's adverse consequences.
Collapse
Affiliation(s)
- Esat Fahri Aydın
- Department of Psychiatry, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Halil Özcan
- Department of Psychiatry, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Sinan Yılmaz
- Department of Public Health, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Seda Aşkın
- Health Services Vocational School, Ataturk University, Erzurum, Turkey
| | - Tuğba Koca Laçin
- Department of Psychiatry, Ankara Etlik City Hospital, Ankara, Turkey
| | - Elif Nur Topu
- Department of Psychiatry, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
3
|
Marchitelli R, Paillère Martinot ML, Trouvé A, Banaschewski T, Bokde ALW, Desrivières S, Flor H, Garavan H, Gowland P, Heinz A, Brühl R, Nees F, Papadopoulos Orfanos D, Paus T, Poustka L, Hohmann S, Holz N, Vaidya N, Fröhner JH, Smolka MN, Walter H, Whelan R, Schumann G, Martinot JL, Artiges E. Coupled changes between ruminating thoughts and resting-state brain networks during the transition into adulthood. Mol Psychiatry 2024:10.1038/s41380-024-02610-9. [PMID: 38956372 DOI: 10.1038/s41380-024-02610-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 05/03/2024] [Accepted: 05/13/2024] [Indexed: 07/04/2024]
Abstract
Perseverative negative thoughts, known as rumination, might arise from emotional challenges and preclude mental health when transitioning into adulthood. Due to its multifaceted nature, rumination can take several ruminative response styles, that diverge in manifestations, severity, and mental health outcomes. Still, prospective ruminative phenotypes remain elusive insofar. Longitudinal study designs are ideal for stratifying ruminative response styles, especially with resting-state functional MRI whose setup naturally elicits people's ruminative traits. Here, we considered self-rated questionnaires on rumination and psychopathology, along with resting-state functional MRI data in 595 individuals assessed at age 18 and 22 from the IMAGEN cohort. We conducted independent component analysis to characterize eight single static resting-state functional networks in each subject and session and furthermore conducted a dynamic analysis, tackling the time variations of functional networks during the entire scanning time. We then investigated their longitudinal mediation role between changes in three ruminative response styles (reflective pondering, brooding, and depressive rumination) and changes in internalizing and co-morbid externalizing symptoms. Four static and two dynamic networks longitudinally differentiated these ruminative styles and showed complemental sensitivity to internalizing and co-morbid externalizing symptoms. Among these networks, the right frontoparietal network covaried with all ruminative styles but did not play any mediation role towards psychopathology. The default mode, the salience, and the limbic networks prospectively stratified these ruminative styles, suggesting that maladaptive ruminative styles are associated with altered corticolimbic function. For static measures, only the salience network played a longitudinal causal role between brooding rumination and internalizing symptoms. Dynamic measures highlighted the default-mode mediation role between the other ruminative styles and co-morbid externalizing symptoms. In conclusion, we identified the ruminative styles' psychometric and neural outcome specificities, supporting their translation into applied research on young adult mental healthcare.
Collapse
Affiliation(s)
- Rocco Marchitelli
- Ecole Normale Supérieure Paris-Saclay, University Paris-Saclay, University Paris-City, INSERM U1299 "Developmental Trajectories & Psychiatry, Centre Borelli CNRS UMR9010, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Ecole Normale Supérieure Paris-Saclay, University Paris-Saclay, University Paris-City, INSERM U1299 "Developmental Trajectories & Psychiatry, Centre Borelli CNRS UMR9010, Gif-sur-Yvette, France
- AP-HP Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Alain Trouvé
- Ecole Normale Supérieure Paris-Saclay, University Paris-Saclay, University Paris-City, INSERM U1299 "Developmental Trajectories & Psychiatry, Centre Borelli CNRS UMR9010, Gif-sur-Yvette, France
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, and German Center for Mental Health (DZPG) partner site Mannheim-Heidelberg-Ulm, Heidelberg University, Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sylvane Desrivières
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, 68131, Mannheim, Germany
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, 05405, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, UK
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Berlin, Germany
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, and German Center for Mental Health (DZPG) partner site Mannheim-Heidelberg-Ulm, Heidelberg University, Mannheim, Germany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | | | - Tomáš Paus
- Department of Psychiatry and Neuroscience, Faculty of Medicine, CHU Sainte-Justine Research Center, Population Neuroscience Laboratory, University of Montreal, Montreal, QC, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, and German Center for Mental Health (DZPG) partner site Mannheim-Heidelberg-Ulm, Heidelberg University, Mannheim, Germany
| | - Nathalie Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, and German Center for Mental Health (DZPG) partner site Mannheim-Heidelberg-Ulm, Heidelberg University, Mannheim, Germany
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Psychotherapy, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), ISTBI Fudan University, Shanghai, China
- Department of Psychiatry and Neuroscience, Charité University Medicine, Berlin, Germany
| | - Jean-Luc Martinot
- Ecole Normale Supérieure Paris-Saclay, University Paris-Saclay, University Paris-City, INSERM U1299 "Developmental Trajectories & Psychiatry, Centre Borelli CNRS UMR9010, Gif-sur-Yvette, France.
- Department of Psychiatry, Lab-D-PSY, EPS Barthélémy Durand, Etampes, France.
| | - Eric Artiges
- Ecole Normale Supérieure Paris-Saclay, University Paris-Saclay, University Paris-City, INSERM U1299 "Developmental Trajectories & Psychiatry, Centre Borelli CNRS UMR9010, Gif-sur-Yvette, France
- Department of Psychiatry, Lab-D-PSY, EPS Barthélémy Durand, Etampes, France
| |
Collapse
|
4
|
Scott J, Iorfino F, Capon W, Crouse J, Nelson B, Chanen AM, Dwyer D, Conus P, Bechdolf A, Ratheesh A, Raballo A, Yung A, Berk M, McKenna S, Hockey S, Hutcheon A, Scott E, McGorry P, Shah J, Hickie IB. Staging 2.0: refining transdiagnostic clinical staging frameworks to enhance reliability and utility for youth mental health. Lancet Psychiatry 2024; 11:461-471. [PMID: 38643773 DOI: 10.1016/s2215-0366(24)00060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 04/23/2024]
Abstract
Globally, 75% of depressive, bipolar, and psychotic disorders emerge by age 25 years. However, these disorders are often preceded by non-specific symptoms or attenuated clinical syndromes. Difficulties in determining optimal treatment interventions for these emerging mental disorders, and uncertainties about accounting for co-occurring psychopathology and illness trajectories, have led many youth mental health services to adopt transdiagnostic clinical staging frameworks. In this Health Policy paper, an international working group highlights ongoing challenges in applying transdiagnostic staging frameworks in clinical research and practice, and proposes refinements to the transdiagnostic model to enhance its reliability, consistent recording, and clinical utility. We introduce the concept of within-stage heterogeneity and describe the advantages of defining stage in terms of clinical psychopathology and stage modifiers. Using examples from medicine, we discuss the utility of categorising stage modifiers into factors associated with progression (ie, potential predictors of stage transition) and extension (ie, factors associated with the current presentation that add complexity to treatment selection). Lastly, we suggest how it is possible to revise the currently used transdiagnostic staging approach to incorporate these key concepts, and how the revised framework could be applied in clinical and research practice.
Collapse
Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - William Capon
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Jacob Crouse
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Barnaby Nelson
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrew M Chanen
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Dominic Dwyer
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Philippe Conus
- General Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, CCM, Charité Universitatsmedizin, Berlin, Germany
| | - Aswin Ratheesh
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrea Raballo
- Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
| | - Alison Yung
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
| | - Sarah McKenna
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Samuel Hockey
- Lived Experience Working Group, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Alexis Hutcheon
- Lived Experience Working Group, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Elizabeth Scott
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Pat McGorry
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jai Shah
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
5
|
Arnison T, Evans B, Schrooten MGS, Persson J, Palermo TM. Adolescent Girls' Musculoskeletal Pain is More Affected by Insomnia Than Boys, and Through Different Psychological Pathways. THE JOURNAL OF PAIN 2024:104571. [PMID: 38763259 DOI: 10.1016/j.jpain.2024.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
Prior research has established that insomnia is predictive of pain in adolescents and that psychological mechanisms have a crucial role in this relationship. Adolescent girls report more insomnia and pain than boys, yet little is known of gender differences in how insomnia influences pain. This study assessed gender differences in levels and trajectories of insomnia and pain during adolescence, and whether rumination and negative mood mediated the effect of insomnia on pain. Longitudinal survey data measured on 5 annual occasions (Nbaseline = 2,767) were analyzed in a multigroup longitudinal serial mediation model. A final model was generated with insomnia as the predictor, rumination and depressed mood as mediators, pain as the outcome, and gender as the grouping variable. The results showed that insomnia predicted pain in adolescents, with an effect 3.5 times larger in girls than boys. Depressed mood was the main mediator in boys. In girls, rumination was the only significant mediator. There were significant gender differences in the effects of insomnia on rumination and pain, and in the effects of rumination on depressed mood and pain, with stronger effects in girls. These results highlight that girls and boys should be considered separately when studying the relationship between insomnia and pain. PERSPECTIVE: Levels of insomnia and pain are progressively higher in adolescent girls than boys, across adolescence. The predictive strength of insomnia symptoms for future pain is 3.5 times greater in girls, with distinct gender-specific underlying pathways: rumination partially mediates this effect in girls, while depressed mood does so in boys.
Collapse
Affiliation(s)
- Tor Arnison
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Örebro County, Sweden; School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden.
| | - Brittany Evans
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Martien G S Schrooten
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Jonas Persson
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Stockholm County, Sweden
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology, Pediatrics & Psychiatry, University of Washington School of Medicine, Seattle, Washington
| |
Collapse
|
6
|
Yoon L, Keenan KE, Hipwell AE, Forbes EE, Guyer AE. Hooked on a thought: Associations between rumination and neural responses to social rejection in adolescent girls. Dev Cogn Neurosci 2023; 64:101320. [PMID: 37922608 PMCID: PMC10641579 DOI: 10.1016/j.dcn.2023.101320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023] Open
Abstract
Rumination is a significant risk factor for psychopathology in adolescent girls and is associated with heightened and prolonged physiological arousal following social rejection. However, no study has examined how rumination relates to neural responses to social rejection in adolescent girls; thus, the current study aimed to address this gap. Adolescent girls (N = 116; ages 16.95-19.09) self-reported on their rumination tendency and completed a social evaluation fMRI task where they received fictitious feedback (acceptance, rejection) from peers they liked or disliked. Rejection-related neural activity and subgenual anterior cingulate cortex (sgACC) connectivity were regressed on rumination, controlling for rejection sensitivity and depressive symptoms. Rumination was associated with distinctive neural responses following rejection from liked peers including increased neural activity in the precuneus, inferior parietal gyrus, dorsolateral prefrontal cortex, and supplementary motor area (SMA) and reduced sgACC connectivity with multiple regions including medial prefrontal cortex, precuneus and ventrolateral prefrontal cortex. Greater precuneus and SMA activity mediated the effect of rumination on slower response time to report emotional state after receiving rejection from liked peers. These findings provide clues for distinctive cognitive processes (e.g., mentalizing, conflict processing, memory encoding) following the receipt of rejection in girls with high levels of rumination.
Collapse
Affiliation(s)
- Leehyun Yoon
- Center for Mind and Brain, University of California, Davis, Davis, CA 95618, USA
| | - Kate E Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL 60637, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Amanda E Guyer
- Center for Mind and Brain, University of California, Davis, Davis, CA 95618, USA; Department of Human Ecology, University of California, Davis, Davis, CA 95616, USA.
| |
Collapse
|
7
|
Wong SMY, Chen EYH, Lee MCY, Suen YN, Hui CLM. Rumination as a Transdiagnostic Phenomenon in the 21st Century: The Flow Model of Rumination. Brain Sci 2023; 13:1041. [PMID: 37508974 PMCID: PMC10377138 DOI: 10.3390/brainsci13071041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Rumination and its related mental phenomena share associated impairments in cognition, such as executive functions and attentional processes across different clinical conditions (e.g., in psychotic disorders). In recent decades, however, the notion of rumination has been increasingly narrowed to the "self-focused" type in depressive disorders. A closer review of the literature shows that rumination may be construed as a broader process characterized by repetitive thoughts about certain mental contents that interfere with one's daily activities, not only limited to those related to "self". A further examination of the construct of rumination beyond the narrowly focused depressive rumination would help expand intervention opportunities for mental disorders in today's context. We first review the development of the clinical construct of rumination with regard to its historical roots and its roles in psychopathology. This builds the foundation for the introduction of the "Flow Model of Rumination (FMR)", which conceptualizes rumination as a disruption of a smooth flow of mental contents in conscious experience that depends on the coordinated interactions between intention, memory, affect, and external events. The conceptual review concludes with a discussion of the impact of rapid technological advances (such as smartphones) on rumination. Particularly in contemporary societies today, a broader consideration of rumination not only from a cognition viewpoint, but also incorporating a human-device interaction perspective, is necessitated. The implications of the FMR in contemporary mental health practice are discussed.
Collapse
Affiliation(s)
- Stephanie M Y Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Michelle C Y Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y N Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christy L M Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| |
Collapse
|
8
|
Wong SMY, Ip CH, Hui CLM, Suen YN, Wong CSM, Chang WC, Chan SKW, Lee EHM, Lui SSY, Chan KT, Wong MTH, Chen EYH. Prevalence and correlates of suicidal behaviours in a representative epidemiological youth sample in Hong Kong: the significance of suicide-related rumination, family functioning, and ongoing population-level stressors. Psychol Med 2023; 53:4603-4613. [PMID: 35650661 PMCID: PMC10388322 DOI: 10.1017/s0033291722001519] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/28/2022] [Accepted: 05/06/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Young people are most vulnerable to suicidal behaviours but least likely to seek help. A more elaborate study of the intrinsic and extrinsic correlates of suicidal ideation and behaviours particularly amid ongoing population-level stressors and the identification of less stigmatising markers in representative youth populations is essential. METHODS Participants (n = 2540, aged 15-25) were consecutively recruited from an ongoing large-scale household-based epidemiological youth mental health study in Hong Kong between September 2019 and 2021. Lifetime and 12-month prevalence of suicidal ideation, plan, and attempt were assessed, alongside suicide-related rumination, hopelessness and neuroticism, personal and population-level stressors, family functioning, cognitive ability, lifetime non-suicidal self-harm, 12-month major depressive disorder (MDD), and alcohol use. RESULTS The 12-month prevalence of suicidal ideation, ideation-only (no plan or attempt), plan, and attempt was 20.0, 15.4, 4.6, and 1.3%, respectively. Importantly, multivariable logistic regression findings revealed that suicide-related rumination was the only factor associated with all four suicidal outcomes (all p < 0.01). Among those with suicidal ideation (two-stage approach), intrinsic factors, including suicide-related rumination, poorer cognitive ability, and 12-month MDE, were specifically associated with suicide plan, while extrinsic factors, including coronavirus disease 2019 (COVID-19) stressors, poorer family functioning, and personal life stressors, as well as non-suicidal self-harm, were specifically associated with suicide attempt. CONCLUSIONS Suicide-related rumination, population-level COVID-19 stressors, and poorer family functioning may be important less-stigmatising markers for youth suicidal risks. The respective roles played by not only intrinsic but also extrinsic factors in suicide plan and attempt using a two-stage approach should be considered in future preventative intervention work.
Collapse
Affiliation(s)
- Stephanie M. Y. Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Charlie H. Ip
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christy L. M. Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y. N. Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Corine S. M. Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - W. C. Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Sherry K. W. Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Edwin H. M. Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Simon S. Y. Lui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - K. T. Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Michael T. H. Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric Y. H. Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| |
Collapse
|
9
|
Funk J, Kopf-Beck J, Watkins E, Ehring T. Does an app designed to reduce repetitive negative thinking decrease depression and anxiety in young people? (RETHINK): a randomized controlled prevention trial. Trials 2023; 24:295. [PMID: 37098547 PMCID: PMC10129320 DOI: 10.1186/s13063-023-07295-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/05/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The first onset of common mental health disorders, such as mood and anxiety disorders, mostly lies in adolescence or young adulthood. Hence, effective and scalable prevention programs for this age group are urgently needed. Interventions focusing on repetitive negative thinking (RNT) appear especially promising as RNT is an important transdiagnostic process involved in the development of depression and anxiety disorders. First clinical trials indeed show positive effects of preventative interventions targeting RNT on adult as well as adolescent mental health. Self-help interventions that can be delivered via a mobile phone app may have the advantage of being highly scalable, thus facilitating prevention on a large scale. This trial aims to investigate whether an app-based RNT-focused intervention can reduce depressive and anxiety symptoms in young people at risk for mental health disorders. METHODS The trial will be conducted in a sample (planned N = 351) of individuals aged 16-22 years with elevated levels of RNT but no current depression or anxiety disorder. In a randomized controlled between-subjects design, two versions of the app-based self-help intervention will be compared to a waiting list control condition. The full RNT-focused intervention encompasses a variety of RNT-reducing strategies, whereas the concreteness training intervention focuses on only one of these strategies, i.e., concrete thinking. The primary outcome (depressive symptoms) and secondary outcomes (anxiety symptoms and RNT) will be measured at pre-intervention, post-intervention (6 weeks after pre-intervention), and follow-up (18 weeks after pre-intervention). DISCUSSION This trial aims to find out whether targeting RNT via an app is an effective and feasible way of preventing depression and anxiety disorders in adolescents. Since app-based interventions are highly scalable, this trial might contribute to tackling challenges related to the increasing rates of mental health disorders among young people. TRIAL REGISTRATION https://www.drks.de , DRKS00027384. Registered on 21 February 2022-prospectively registered.
Collapse
Affiliation(s)
- Julia Funk
- Department of Psychology, LMU Munich, Munich, Germany.
| | | | - Edward Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, UK
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
| |
Collapse
|
10
|
Wang T, Li M, Xu S, Xiang A, Xu X, Wang H. The relationship between sleep quality and depression: Critical roles of reflective and brooding rumination and sleep-related cognition. PSYCHOL HEALTH MED 2023; 28:955-963. [PMID: 36106351 DOI: 10.1080/13548506.2022.2124293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
There is a complex interplay between sleep problems and depression. This study explored the possible effects of rumination and dysfunctional beliefs about sleep on the relationship between sleep quality and depression. A cross-sectional survey of 1240 Chinese adults was conducted to assess the possible relationships. The results showed a chain mediating effect of reflection rumination and brooding rumination on the relationship between sleep quality and depression, accounting for 38.91% of the total variance. A moderating role of unreasonable attitudes about sleep was also discovered among the study participants, which enhanced the relationship between reflection and brooding, leading to a further increase in this relationship. Individually-tailored approaches targeting rumination and cognition may more effectively alleviate depression or co-morbid sleep problems and depression than the current standards of care.
Collapse
Affiliation(s)
- Tao Wang
- Department of Basic Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Min Li
- Department of Military Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Song Xu
- Health Service Training Center, No.991 Hospital of PLA, Xiangyang, Hubei, China
| | - Aiguo Xiang
- People's Hospital of Fengdu County, Chongqing, China
| | - Xiaoxiao Xu
- Department of Basic Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Haiquan Wang
- Department of Basic Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| |
Collapse
|
11
|
Emotion Regulation Strategies as Risk Factors for Developmental Psychopathology: a Meta-analytic Review of Longitudinal Studies based on Cross-lagged Correlations and Panel Models. Res Child Adolesc Psychopathol 2023; 51:295-315. [PMID: 36208360 DOI: 10.1007/s10802-022-00980-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 02/09/2023]
Abstract
Cross-sectional relationships between emotion regulation strategies (ERSs) and several psychopathological conditions among children and adolescents have been well-demonstrated. However, the longitudinal associations of ERSs on psychopathological manifestations during development remain unclear, especially considering their reciprocal influences over time. This meta-analytic review was based on a set of ERSs referring to a comprehensive evidence-based model of ER processes. Three hundred thirty-five studies were screened. The meta-analytic procedures were based on 60 studies (N = 20, 191; age: M [SD] = 10.27 [4.36]; years of follow-up: M [SD] = 2.23 [2.76]), which primarily assessed prospective associations between ERt1 and internalizing/externalizing psychopathology (PSY)t2. The cross-lagged correlations among these variables were also considered. Results showed: i) a small prospective association between ERt1 and PSY t2, which was independent of age and length of follow-up period. Adaptive and maladaptive domains of ER were significant moderators. Deficits in adaptive ER seemed more associated to externalizing PSY, whereas maladaptive ER was more associated to internalizing PSY; ii) cross-lagged correlations were comparable with ERt1 - PSY t2 associations. Nevertheless, the detrimental effects of PSY t1 on levels of adaptive ERt2 were larger than the protective effects of adaptive ERt1 on PSYt2. iii) When the other cross-lagged correlations were controlled for, the meta-analytic cross-lagged panel model demonstrated that maladaptive ERt1 was a significant predictor of PSYt2. ER processes should be considered transdiagnostic risk factors for psychopathology during development. Homotypic and heterotypic continuity of psychopathological conditions might reflect the stability or dynamic organization of adaptive and maladaptive ERSs over time.
Collapse
|
12
|
Karnaze MM, Kious BM, Feuerman LZ, Classen S, Robinson JO, Bloss CS, McGuire AL. Public mental health during and after the SARS-CoV-2 pandemic: Opportunities for intervention via emotional self-efficacy and resilience. Front Psychol 2023; 14:1016337. [PMID: 36755671 PMCID: PMC9899813 DOI: 10.3389/fpsyg.2023.1016337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
Importance During the pandemic, the number of United States adults reporting clinically significant symptoms of anxiety and depression sky-rocketed, up from 11% in 2020 to more than 40% in 2021. Our current mental healthcare system cannot adequately accommodate the current crisis; it is therefore important to identify opportunities for public mental health interventions. Objective Assess whether modifiable emotional factors may offer a point of intervention for the mental health crisis. Design setting and participants From January 13 to 15, 2022, adults living in the United States were recruited via Amazon Mechanical Turk to complete an anonymous survey. Main outcomes and measures Linear regressions tested whether the primary outcomes during the SARS-CoV-2 pandemic (depressive and anxiety symptoms, burnout) were associated with hypothesized modifiable risk factors (loneliness and need for closure) and hypothesized modifiable protective factors (the ability to perceive emotions and connect with others emotionally; emotion-regulation efficacy; and resilience, or the ability to "bounce back" after negative events). Results The sample included 1,323 adults (mean [SD] age 41.42 [12.52] years; 636 women [48%]), almost half of whom reported clinically significant depressive (29%) and/or anxiety (15%) symptoms. Approximately 90% of participants indicated feeling burned out at least once a year and nearly half of participants (45%) felt burned out once a week or more. In separate analyses, depressive symptoms (Model A), anxiety symptoms (Model B), and burnout (Model C) were statistically significantly associated with loneliness (βModel A, 0.38; 95% CI, 0.33-0.43; βModel B, 0.30; 95% CI, 0.26-0.36; βModel C, 0.34; 95% CI, 0.28-0.41), need for closure (βModel A, 0.09; 95% CI, 1.03-1.06; βModel B, 0.13; 95% CI, 0.97-0.17; βModel C, 0.11; 95% CI, 0.07-0.16), recent stressful life events (βModel A, 0.14; 95% CI, 0.10-0.17; βModel B, 0.14; 95% CI, 0.11-0.18; βModel C, 0.10; 95% CI, 0.06-0.15), and resilience (βModel A, -0.10; 95% CI, -0.15 to -0.05; βModel B, -0.18; 95% CI, -0.23 to -0.13; βModel C, -0.11; 95% CI, -0.17 to -0.05). In addition, depressive and anxiety symptoms were associated with emotional self-efficacy (βModel A, -0.17; 95% CI, -0.22 to -0.12; βModel B, -0.11; 95% CI, -0.17 to -0.06), and beliefs about the malleability of emotions (βModel A, -0.08; 95% CI, -0.12 to -0.03; βModel B, -0.09; 95% CI, -0.13 to -0.04). Associations between loneliness and symptoms were weaker among those with more emotional self-efficacy, more endorsement of emotion malleability beliefs, and greater resilience, in separate models. Analyses controlled for recent stressful life events, optimism, and social desirability. Conclusion and relevance Public mental health interventions that teach resilience in response to negative events, emotional self-efficacy, and emotion-regulation efficacy may protect against the development of depressive symptoms, anxiety, and burnout, particularly in the context of a collective trauma. Emotional self-efficacy and regulation efficacy may mitigate the association between loneliness and mental health, but loneliness prevention research is also needed to address the current mental health crisis.
Collapse
Affiliation(s)
- Melissa M. Karnaze
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, United States
| | - Brent M. Kious
- Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Lindsay Z. Feuerman
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Sarah Classen
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Jill O. Robinson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Cinnamon S. Bloss
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, United States
| | - Amy L. McGuire
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States,*Correspondence: Amy L. McGuire,
| |
Collapse
|
13
|
Beck S, Whitaker K, Cropley M. Is rumination associated with psychological distress after a cancer diagnosis? A systematic review. J Psychosoc Oncol 2023; 41:584-609. [PMID: 36604965 DOI: 10.1080/07347332.2022.2145925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: The aim of this work was to review evidence on the association between psychological rumination and distress in those diagnosed with cancer. Methods: Six databases were searched for studies exploring rumination alongside overall assessments of psychological distress, depression, anxiety, or stress. Results: Sixteen studies were identified. Rumination was associated with distress cross-sectionally and longitudinally. However, once baseline depression was controlled for, the association was no longer seen. The emotional valence of ruminative thoughts and the style in which they were processed, rather than their topic, was associated with distress. Brooding and intrusive rumination were associated with increased distress, deliberate rumination had no association, and reflection/instrumentality had mixed findings. Conclusions: This review highlights that it is not necessarily the topic of content, but the style and valence of rumination that is important when considering its association with distress. The style of rumination should be the target of clinical intervention, including brooding and intrusion.
Collapse
Affiliation(s)
- Sarah Beck
- School of Psychology, University of Surrey, Guildford, UK
| | | | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, UK
| |
Collapse
|
14
|
Nardi B, Del Prete L, Amatori G, Carpita B, Carmassi C, Pompili M, Dell'Osso L. An attempted "suicide pact" in Covid-19 era - psychiatric perspectives. BMC Psychiatry 2022; 22:686. [PMID: 36333800 PMCID: PMC9636834 DOI: 10.1186/s12888-022-04333-z] [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] [Received: 04/19/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND A "suicide pact" is a joint and actively induced death of two individuals with the essential and unavoidable characteristic of a mutual consent. One of the partners (dominant in the relationship, commonly male) usually induces the action and in most cases, it is the one who actively carries it out. Undiagnosed psychopathological dimension or pathological subthreshold traits are found in those who enter into suicide agreements, the presence of cluster B personality traits such as narcissistic or borderline is of particular relevance in the dominant partner, while in the submissive one dependent personality traits are more frequent. As in the case of other similar health emergencies, COVID-19 pandemic seems to lead to greater suicidality, including the "suicide pacts" of couples whose motivation varies including firstly financial problems, strictly followed by fear of infection and not being able to return home from abroad. CASE PRESENTATION We reported a case of a couple who entered a suicide agreement consequently to the economic difficulties caused by COVID-19 pandemic, hospitalized in our department. Both partners were assessed with Adult Autism Subthreshold Spectrum (AdAS Spectrum) and both crossed the threshold for clinically relevant autistic traits (M = 67; F = 49). CONCLUSION This case further confirms the link between COVID-19 pandemics and suicidality. The role of autism spectrum traits as a vulnerability factor towards the development of severe psychopathological consequences after traumatic events is also stressed.
Collapse
Affiliation(s)
- Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy.
| | - Luca Del Prete
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Giulia Amatori
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Faculty of Medicine and Psychology, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| |
Collapse
|
15
|
Rowley M, Topciu R, Owens M. A Systematic Review of Mechanisms Underpinning Psychological Change Following Nature Exposure in an Adolescent Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12649. [PMID: 36231949 PMCID: PMC9566701 DOI: 10.3390/ijerph191912649] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
This systematic review aimed to identify mechanisms of psychological change following exposure to nature within an adolescent population. Keyword searches within Scopus, PsychINFO and Web of Science were carried out to include articles published by 14 September 2021. Records were reviewed in line with inclusion criteria: samples with an average age of 24 and under, exposure to nature vs. control using an experimental or quasi-experimental design and outcomes of mental health and psychological status. The review resulted in 27 papers that were assessed for methodological quality and manually searched for mediation analyses. A range of psychological outcomes were identified and grouped into 10 categories: Mood and Affect, Mental Health, Wellbeing, Perceived Restoration, Stress, Energy, Cognitive Functioning, Resilience, Self-Concept and Pro-Social Behaviour. Only one formal mediation analysis was reported, highlighting a mediating role of belonging in increases in resilience. Limitations include the majority use of university student samples and over half of the papers being of low methodological quality. No firm conclusions on key mechanisms in an adolescent population were made due to insufficient evidence of mediating variables. The development of methodologically rigorous experimental studies with the inclusion of statistical pathway modelling is needed to test and specify plausible mechanisms.
Collapse
Affiliation(s)
- Megan Rowley
- CEDAR (Clinical Education Development and Research), University of Exeter, Exeter EX4 4QQ, UK
- The ROWAN Group, Exeter EX4 4QQ, UK
- Somerset Foundation Trust NHS, Taunton TA1 5DA, UK
| | - Raluca Topciu
- CEDAR (Clinical Education Development and Research), University of Exeter, Exeter EX4 4QQ, UK
- Department of Psychology, University of Exeter, Exeter EX4 4QQ, UK
| | - Matthew Owens
- The ROWAN Group, Exeter EX4 4QQ, UK
- Department of Psychology, University of Exeter, Exeter EX4 4QQ, UK
| |
Collapse
|
16
|
Otto MW, Birk JL, Fitzgerald HE, Chauvin GV, Gold AK, Carl JR. Stage models for major depression: Cognitive behavior therapy, mechanistic treatment targets, and the prevention of stage transition. Clin Psychol Rev 2022; 95:102172. [DOI: 10.1016/j.cpr.2022.102172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/12/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
|
17
|
Pedersen H, Grønnæss I, Bendixen M, Hagen R, Kennair LEO. Metacognitions and brooding predict depressive symptoms in a community adolescent sample. BMC Psychiatry 2022; 22:157. [PMID: 35232425 PMCID: PMC8887018 DOI: 10.1186/s12888-022-03779-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/08/2022] [Indexed: 02/01/2023] Open
Abstract
Depressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16-20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.
Collapse
Affiliation(s)
- Helene Pedersen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingrid Grønnæss
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mons Bendixen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roger Hagen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway ,grid.5510.10000 0004 1936 8921Research institute, Modum Bad, Vikersund, Norway
| | | |
Collapse
|
18
|
Guo T, Zhang Z, Taylor A, Hall DL, Yeung AS, Kramer AF, Zou L. Association of social support with negative emotions among Chinese adolescents during Omicron-related lockdown of Shenzhen City: The roles of rumination and sleep quality. Front Psychiatry 2022; 13:957382. [PMID: 36046154 PMCID: PMC9423767 DOI: 10.3389/fpsyt.2022.957382] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/26/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Adolescents are likely to suffer from negative emotions such as depression and anxiety due to the rapid development of biological, cognitive and social changes. Previous studies have indicated possible risk (rumination) and protective (good social support and high sleep quality) factors for depression and anxiety among this age group. The present study is the first to investigate the association between social support and negative emotions during the Outbreak of Omicron variant, on this basis, to further determine the mediating role of rumination and sleep quality on this link. METHOD A total of 1,065 Chinese middle- and high-school students (51.5% female, M age = 13.80, SD = 1.20) completed a psychosocial battery, including the Social Support Rating Scale (SSRS), the Pittsburgh Sleep Quality Index (PSQI), the Ruminative Responses Scale (RRS), the Depression Anxiety Stress Scale (DASS). Serial multiple mediation analysis was conducted using PROCESS macro based on SPSS. RESULTS Social support, rumination, and sleep quality were significantly negatively correlated with negative emotional states (Ps < 0.05). Further, rumination and sleep quality were found to partially mediate the relationship between social support and negative emotional states. CONCLUSIONS For early detection and prevention of depression and anxiety, providing sufficient social support is necessary for adolescents, because rumination and sleep problems are reported during stressful periods, such as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Tianyou Guo
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Zhihao Zhang
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Alyx Taylor
- School of Rehabilitation, Sport and Psychology, AECC University College, Bournemouth, United Kingdom
| | - Daniel L Hall
- Mongan Institute, Harvard Medical School, Boston, MA, United States.,Massachusetts General Hospital, Boston, MA, United States
| | - Albert S Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Arthur F Kramer
- Department of Psychology, Center for Cognitive and Brain Health, Northeastern University, Boston, MA, United States.,Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Liye Zou
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| |
Collapse
|
19
|
Suk JW, Poppert Cordts KM, Garvey W, Lerdahl A, Soltis-Vaughan B, Bohn A, Edwards R, Blair RJ, Hwang S, Hwang S. Research Audit on Clinical Utility of Dimensional Disruptive Mood and Behavior Psychopathologies in Child and Adolescent Psychiatry Practice. Front Psychiatry 2022; 13:742148. [PMID: 35463527 PMCID: PMC9020472 DOI: 10.3389/fpsyt.2022.742148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
To investigate the utility of dimensional psychopathologies of disruptive mood and behavior disorders (DBDs) by applying latent profile analysis (LPA) for characterization of youth referred to the tertiary outpatient clinic of child and adolescent psychiatry clinic and pharmacological treatment choices. One hundred fifty-eight children and adolescents with significant DBDs symptoms participated. Core dimensional psychopathologies of DBDs (irritability, callous-unemotional trait, and reactive-proactive aggressive behavior), DSM diagnoses, prescribed medications, and behavioral and emotional problems (Child Behavior Checklist, CBCL) were measured at baseline (clinic intake) and at 3-month follow-up. Latent Profile Analysis (LPA) was applied to characterize the study population based on the levels and interrelations among the core dimensional DBDs psychopathologies. Following LPA, the differences in clinical and treatment features between the latent classes were analyzed. LPA revealed two latent classes based on severity of DBDs symptoms. Class 1 (the moderate group) was characterized by relatively low scores on all trans-diagnostic indicators, whereas class 2 (the severe/critical group) showed higher levels of the dimensional psychopathologies and the majority of CBCL subscales. In addition, the severe/critical group was more often prescribed antipsychotic medications, and also experienced more frequent medication changes (addition, increasing the dose, and trial of different medications). Our findings suggested that application of LPA to a cluster of dimensional DBDs psychopathologies may provide valuable characterization of the youths referred to a tertiary outpatient child and adolescent psychiatric clinic, and offer insight into the providers' decision making on psychotropic medications, by overall severity of these psychopathologies rather than by single categorical diagnosis or single externalizing psychopathology.
Collapse
Affiliation(s)
- Ji-Woo Suk
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | | | - William Garvey
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Arica Lerdahl
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | | | - Alexandra Bohn
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ryan Edwards
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Robert James Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | | |
Collapse
|
20
|
Semenova N. Psychocorrection of adolescents with suicidal behavior with the CBT-SP method. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:98-105. [DOI: 10.17116/jnevro202212203198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
21
|
Carvalho SA, Skvarc D, Barbosa R, Tavares T, Santos D, Trindade IA. A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness. Clin Psychol Psychother 2021; 29:524-541. [PMID: 34269493 DOI: 10.1002/cpp.2643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/28/2021] [Accepted: 07/06/2021] [Indexed: 12/27/2022]
Abstract
Literature suggests that acceptance and commitment therapy (ACT) is effective in improving well-being and in reducing psychopathological symptoms commonly experienced by people with chronic illness (CI). Compassion-focused therapy (CFT) reduces psychological distress, especially in individuals with high levels of shame and self-criticism, but few studies have explored CFT in CI. Additionally, studies almost exclusively compared ACT and CFT with inactive controls (wait-list; treatment as usual). Also, there is an interest in developing cost-effective mental health solutions, such as low-intensity online psychological interventions. This randomized controlled trial (RCT) aimed to assess the acceptability and compare the efficacy of four-session online ACT (n = 25) and CFT (n = 24) interventions in a sample of people with CI. Results showed both interventions were acceptable, with attrition rates at post-intervention comparable to those found in similar studies (around 50%). Intention-to-treat analyses showed that participants presented significantly less illness-related shame, less uncompassionate self-responding and more valued living after the intervention, although no difference was found between conditions. Results were sustained at 3- and 6-month follow-up. Results did not find statistical differences between conditions through reliable change index (RCI). Correlation between demographics and RCI showed that, at post-intervention, younger participants presented more behavioural awareness, men presented more valued action, and participants with CI for shorter periods presented less uncompassionate self-responding and less anxiety. Results suggest that low-intensity (four sessions) online ACT and CFT are cost-effective approaches to promote mental health of individuals with CI. Results and limitations are thoroughly discussed.
Collapse
Affiliation(s)
- Sérgio A Carvalho
- Universidade Lusófona de Humanidades e Tecnologias, Escola de Psicologia e Ciências da Vida, HEI-Lab, Lisboa, Portugal.,Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - David Skvarc
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Rosa Barbosa
- Unidade de Psico-Oncologia, Núcleo Regional do Centro da Liga Portuguesa Contra o Cancro (Portuguese League Against Cancer), Coimbra, Portugal
| | - Tito Tavares
- Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Diana Santos
- Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Inês A Trindade
- Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
22
|
Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
Collapse
Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
| |
Collapse
|
23
|
Wong SMY, Hui CLM, Wong CSM, Suen YN, Chan SKW, Lee EHM, Chang WC, Wong GHY, Chen EYH. Induced ideas of reference during social unrest and pandemic in Hong Kong. Schizophr Res 2021; 229:46-52. [PMID: 33618286 DOI: 10.1016/j.schres.2021.01.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/05/2021] [Accepted: 01/29/2021] [Indexed: 12/18/2022]
Abstract
Ideas of reference (IOR) are often implicated in predicting psychosis onset. They have been conceptualized to present on a continuum, from oversensitive psychological reactions to delusional thoughts. It is however unknown to what extent IOR may be triggered by collective environmental stress. We obtained timely data from 9873 individuals to assess IOR in relation to trauma exposure in the 2019-2020 social unrest in Hong Kong. Two levels of IOR are distinguished: attenuated IOR (IOR-A), being the experience of feeling particularly referred to within a group; and exclusive IOR (IOR-E), the experience of feeling exclusively referred to while others are not. Logistic regressions showed that event-based rumination was a shared predictor for IOR-A (OR = 1.07, CI = 1.03-1.10) and IOR-E (OR = 1.09, CI = 1.02-1.17). For IOR-A, three categories of social unrest-related traumatic events (TEs) were significant predictors, including being attacked or having experienced sexual violence (OR = 4.14, CI = 1.93-8.85), being arrested (OR = 4.48, CI = 1.99-10.10), and being verbally abused (OR = 2.66, CI = 1.28-5.53). Being arrested was significant for IOR-E (OR = 3.87, CI = 1.03-14.52), though not when rumination was included. Education level also significantly predicted IOR-E (OR = 0.72, CI = 0.52-0.99). Further analysis revealed that rumination significantly mediated between TEs and IOR severity (β = 0.26, SE = 0.01, CI = 0.24-0.28). The findings are consistent with the hypothesis that IOR-A and IOR-E occur as levels on a continuum, but each has some distinctive correlates. Extrinsic events may play a more prominent role in IOR-A, while intrinsic factors, such as cognitive capacity, may play a more prominent role in IOR-E. The involvement of rumination across the IOR spectrum suggests an opportunity for intervention.
Collapse
Affiliation(s)
- Stephanie M Y Wong
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Christy L M Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Corine S M Wong
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Y N Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Sherry K W Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong
| | - Edwin H M Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - W C Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong
| | - Gloria H Y Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Eric Y H Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.
| |
Collapse
|
24
|
Pathways to well-being: Untangling the causal relationships among biopsychosocial variables. Soc Sci Med 2021; 272:112846. [DOI: 10.1016/j.socscimed.2020.112846] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 12/30/2019] [Accepted: 02/08/2020] [Indexed: 02/07/2023]
|
25
|
Scott J, Meyer TD. Brief Research Report: A Pilot Study of Cognitive Behavioral Regulation Therapy (CBT-REG) for Young People at High Risk of Early Transition to Bipolar Disorders. Front Psychiatry 2021; 11:616829. [PMID: 33584378 PMCID: PMC7874073 DOI: 10.3389/fpsyt.2020.616829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022] Open
Abstract
Attempts to increase early identification of individuals in the early stages of bipolar disorders (i.e., individuals at high risk of bipolar disorders and/or experiencing a subthreshold syndrome with bipolar symptoms) have highlighted the need to develop high benefit-low risk interventions. We suggest that any new psychological therapy should (i) be acceptable to young people seeking help for the first time, (ii) be applicable to "at risk" conditions and sub-syndromal states and (iii) consider pluripotent factors that may be linked to illness progression not only for bipolar disorders specifically but also for other potential disease trajectories. However, evidence indicates that current interventions for youth with emerging mood disorders mainly represent approaches abbreviated from "disorder-specific" therapies used with older adults and are primarily offered to first episode cases of bipolar disorders who are also receiving psychotropic medication. This brief report discusses empirical findings used to construct core targets for therapeutic interventions that might reduce or delay transition to full-threshold bipolar disorders. We describe an intervention that includes strategies for problem-solving, reducing sleep-wake cycle disturbances, self-management of rumination and that addresses the needs of individuals with "sub-threshold" presentations who are probably at risk of developing a bipolar or other major mental disorders. Outcome data from a case series of 14 youth indicates that the intervention appears to demonstrate a relatively high benefit-to-risk ratio, promising levels of engagement with the therapy modules, and the therapy appears to be acceptable to a wide range of help-seeking youth with early expressions of bipolar psychopathology.
Collapse
Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Thomas D Meyer
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas HSC, Houston, TX, United States
| |
Collapse
|
26
|
Collin G, Bauer CCC, Anteraper SA, Gabrieli JDE, Molokotos E, Mesholam-Gately R, Thermenos HW, Seidman LJ, Keshavan MS, Shenton ME, Whitfield-Gabrieli S. Hyperactivation of Posterior Default Mode Network During Self-Referential Processing in Children at Familial High-Risk for Psychosis. Front Psychiatry 2021; 12:613142. [PMID: 33633608 PMCID: PMC7900488 DOI: 10.3389/fpsyt.2021.613142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/04/2021] [Indexed: 11/28/2022] Open
Abstract
Patients with schizophrenia spectrum disorders show disturbances in self-referential processing and associated neural circuits including the default mode network (DMN). These disturbances may precede the onset of psychosis and may underlie early social and emotional problems. In this study, we examined self-referential processing in a group of children (7-12 years) at familial high risk (FHR) for psychosis (N = 17), compared to an age and sex-matched group of healthy control (HC) children (N = 20). The participants were presented with a list of adjectives and asked to indicate whether or not the adjectives described them (self-reference condition) and whether the adjectives described a good or bad trait (semantic condition). Three participants were excluded due to chance-level performance on the semantic task, leaving N = 15 FHR and N = 19 HC for final analysis. Functional MRI (fMRI) was used to measure brain activation during self-referential vs. semantic processing. Internalizing and externalizing problems were assessed with the Child Behavior Checklist (CBCL). Evaluating main effects of task (self > semantic) showed activation of medial prefrontal cortex in HC and precuneus/posterior cingulate cortex (PCC) in FHR. Group-comparison yielded significant results for the FHR > HC contrast, showing two clusters of hyperactivation in precuneus/ PCC (p = 0.004) and anterior cerebellum / temporo-occipital cortex (p = 0.009). Greater precuneus/PCC activation was found to correlate with greater CBCL internalizing (r = 0.60, p = 0.032) and total (r = 0.69, p = 0.009) problems. In all, this study shows hyperactivity of posterior DMN during self-referential processing in pre-adolescent FHR children. This finding posits DMN-related disturbances in self-processing as a developmental brain abnormality associated with familial risk factors that predates not just psychosis, but also the prodromal stage. Moreover, our results suggest that early disturbances in self-referential processing may be related to internalizing problems in at-risk children.
Collapse
Affiliation(s)
- Guusje Collin
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, Netherlands
| | - Clemens C C Bauer
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychology, Northeastern University, Boston, MA, United States
| | - Sheeba Arnold Anteraper
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychology, Northeastern University, Boston, MA, United States
| | - John D E Gabrieli
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Elena Molokotos
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Raquelle Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Heidi W Thermenos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychology, Northeastern University, Boston, MA, United States
| |
Collapse
|
27
|
Mendle J, Beam CR, McKone KMP, Koch MK. Puberty and Transdiagnostic Risks for Mental Health. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30:687-705. [PMID: 32109337 DOI: 10.1111/jora.12552] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Puberty in girls represents a notable period of vulnerability for different psychological disorders. The research literature has primarily considered external and contextual factors that might explain these rises in symptomatology. In the present study, we investigate relations of pubertal status and timing with individual cognitive, emotional, and behavioral tendencies, commonly identified as transdiagnostic processes, in a sample of N = 228 girls (Mage = 11.75 years). We also test whether these transdiagnostic processes mediate associations of pubertal status and pubertal timing with depressive symptoms. Results support greater endorsement of rumination, co-rumination, negative urgency, and both anxious and angry rejection sensitivity in girls with more advanced pubertal status, as well as in girls with early pubertal timing. Higher levels of transdiagnostic processes fully mediated associations of pubertal status and timing with depressive symptoms at significant and marginally significant levels, respectively. Although the data are cross-sectional, these findings offer promising preliminary evidence that transdiagnostic processes represent an important mental health risk in early adolescent girls.
Collapse
|
28
|
Martínez R, Senra C, Fernández-Rey J, Merino H. Sociotropy, Autonomy and Emotional Symptoms in Patients with Major Depression or Generalized Anxiety: The Mediating Role of Rumination and Immature Defenses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165716. [PMID: 32784694 PMCID: PMC7459840 DOI: 10.3390/ijerph17165716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
The relationships between dimensions of personality (sociotropy and autonomy), coping strategies (rumination: brooding and reflection subtypes, and immature defenses) and symptoms of depression and anxiety were explored in patients with Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). A total of 279 patients completed questionnaires including measures of personality dimensions, rumination, immature defenses, depression and anxiety. Our findings suggested that sociotropy and autonomy may be associated with both depressive and anxious symptoms in patients with MDD and with GAD. Multiple mediation analyses indicated that brooding always acted as a mediating link between personality vulnerabilities (sociotropy and autonomy) and depressive and anxiety symptoms, independently of the patient group. In addition, in patients with MDD and those with GAD, brooding and immature defenses functioned together by linking sociotropy and autonomy, respectively, with depressive symptoms. Our results also showed that, in patients with GAD, both types of rumination explained the relationship between sociotropy and autonomy and anxiety symptoms. Overall, our findings provided evidence of the transdiagnostic role of the brooding, linking the vulnerability of personality dimensions and emotional symptoms. They also indicated that reflection and immature defenses can operate in conjunction with brooding, depending on the type of vulnerability and emotional context.
Collapse
Affiliation(s)
- Ruth Martínez
- Child and Youth Mental Health Unit, Álvaro Cunqueiro Hospital, 36213 Vigo, Spain;
| | - Carmen Senra
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (J.F.-R.); (H.M.)
| | - José Fernández-Rey
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (J.F.-R.); (H.M.)
| | - Hipólito Merino
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (J.F.-R.); (H.M.)
| |
Collapse
|
29
|
Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination. Behav Res Ther 2020; 127:103573. [DOI: 10.1016/j.brat.2020.103573] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/23/2019] [Accepted: 01/24/2020] [Indexed: 12/11/2022]
|
30
|
Hvenegaard M, Moeller SB, Poulsen S, Gondan M, Grafton B, Austin SF, Kistrup M, Rosenberg NGK, Howard H, Watkins ER. Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: phase II trial. Psychol Med 2020; 50:11-19. [PMID: 30630555 DOI: 10.1017/s0033291718003835] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although cognitive-behavioural therapy (CBT) is an effective treatment for depression, less than half of patients achieve satisfactory symptom reduction during treatment. Targeting known psychopathological processes such as rumination may increase treatment efficacy. The aim of this study was to test whether adding group rumination-focused CBT (RFCBT) that explicitly targets rumination to routine medical management is superior to adding group CBT to routine medical management in treating major depression. METHODS A total of 131 outpatients with major depression were randomly allocated to 12 sessions group RFCBT v. group CBT, each in addition to routine medical management. The primary outcome was observer-rated symptoms of depression at the end of treatment measured on the Hamilton Rating Scale for Depression. Secondary outcomes were rumination at post-treatment and depressive symptoms at 6 months follow-up (Trial registered: NCT02278224). RESULTS RFCBT significantly improved observer-rated depressive symptoms (Cohen's d 0.38; 95% CI 0.03-0.73) relative to group CBT at post-treatment on the primary outcome. No post-treatment differences were found in rumination or in depressive symptoms at 6 months follow-up, although these secondary analyses may have been underpowered. CONCLUSIONS This is the first randomized controlled trial providing evidence of benefits of RFCBT in major depression compared with CBT. Group RFCBT may be a beneficial alternative to group CBT for major depression.
Collapse
Affiliation(s)
- Morten Hvenegaard
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Stine B Moeller
- Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Gondan
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ben Grafton
- Cognition and Emotion Lab, School of Psychology, University of Western Australia, Crawley, Australia
| | - Stephen F Austin
- Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark
| | - Morten Kistrup
- Psychiatric Outpatient Service, Mental Health Centre North Zealand, Hillerød, Denmark
| | - Nicole G K Rosenberg
- Psychotherapeutic Clinic Nannasgade, Mental Health Centre Copenhagen, Capital Region Mental Health Services, Copenhagen, Denmark
| | - Henriette Howard
- Mental Health Centre for Child and Adolescent Psychiatry, Glostrup, Denmark
| | - Edward R Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, UK
| |
Collapse
|
31
|
Grierson AB, Scott J, Glozier N, Hickie IB, Amminger PG, Killackey E, McGorry PD, Pantelis C, Phillips L, Scott E, Yung AR, Purcell R. Can youth at high risk of illness progression be identified by measures of rumination and sleep-wake disturbance. Early Interv Psychiatry 2019; 13:1214-1219. [PMID: 30485651 DOI: 10.1111/eip.12757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 04/09/2018] [Accepted: 10/17/2018] [Indexed: 02/05/2023]
Abstract
AIM Clinical staging models offer a useful framework for understanding illness trajectories, where individuals are located on a continuum of illness progression from stage 0 (at-risk but asymptomatic) to stage 4 (end-stage disease). Importantly, clinical staging allows investigation of risk factors for illness progression with the potential to target trans-diagnostic mechanisms at an early stage, especially in help-seeking youth who often present with sub-threshold syndromes. While depressive symptoms, rumination and sleep-wake disturbances may worsen syndrome outcomes, the role of these related phenomena has yet to be examined as risk factors for trans-diagnostic illness progression in at-risk youth. METHODS This study is a prospective follow-up of 248 individuals aged 12 to 25 years presenting to headspace services with sub-threshold syndromes (stage 1) classified under the clinical staging model to determine transition to threshold syndromes (stage 2). Factor analysis of depression, rumination and sleep-wake patterns was used to identify key dimensions and any associations between factors and transition to stage 2 at follow-up. RESULTS At 1 year, 9% of cases met criteria for stage 2 (n = 22). One of three identified factors, namely the factor reflecting the commonalities shared between rumination and sleep-wake disturbance, significantly differentiated cases that transitioned to stage 2 vs those that did not demonstrate transition. Items loading onto this factor, labelled Anergia, included depression severity and aspects of rumination and sleep-wake disturbance that were characterized as introceptive. CONCLUSIONS Common dimensions between rumination and sleep-wake disturbance present a detectable trans-diagnostic marker of illness progression in youth, and may represent a target for early intervention.
Collapse
Affiliation(s)
- Ashlee B Grierson
- Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Jan Scott
- Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia.,Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Nick Glozier
- Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul G Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eoin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Lisa Phillips
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth Scott
- Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia.,School of Medicine, Notre Dame University, Sydney, New South Wales, Australia
| | - Alison R Yung
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Rosemary Purcell
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
32
|
Peters AT, Burkhouse KL, Kinney KL, Phan KL. The roles of early-life adversity and rumination in neural response to emotional faces amongst anxious and depressed adults. Psychol Med 2019; 49:2267-2278. [PMID: 30419983 PMCID: PMC6513724 DOI: 10.1017/s0033291718003203] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Early-life adversity (ELA) is a risk factor for internalizing psychopathology (IP). ELA is also linked to alterations in neural phenotypes of emotion processing and maladaptive emotion regulatory strategies, such as ruminative brooding, in adulthood. We therefore expected that ELA would predict cortical brain activation to emotional faces in transdiagnostic IP and in turn, mediate the extent of rumination amongst patients with IPs and ELA (IP + ELA). METHOD One hundred and thirty-two individuals, including 102 treatment-seeking adults with heterogeneous IPs and 30 healthy controls (HCs) performed an Emotional Face-Matching Task during functional magnetic resonance imaging. Whole-brain analyses compared HC (n = 30), IP (n = 52), and IP + ELA (n = 50) neural responses to emotional (angry, fearful, happy, and sad) faces v. shapes, controlling for depression and anxiety symptoms. Parameter estimates of activation were extracted for significant between-group differences and tested as a mediator of ruminative brooding in IP + ELA. RESULTS IP + ELA demonstrated increased activation in the superior frontal gyrus and anterior cingulate cortex (fear), superior parietal lobule, precuneus, posterior cingulate, and inferior temporal gyrus (fear only), and cuneus (fear and angry). These regions were preferentially correlated with ruminative brooding in IP + ELA, many of which mediated the link between IP + ELA and ruminative brooding. CONCLUSIONS Results provide evidence that ELA history amongst IP patients augments engagement of brain regions involved in emotion processing, above and beyond what is accounted for by current symptoms. Though longitudinal designs are needed, alterations in the neural correlates of maladaptive processing of socio-emotional information may be a common pathway by which ELA poses risk for psychopathology.
Collapse
Affiliation(s)
- Amy T Peters
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Katie L Burkhouse
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Kerry L Kinney
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - K. Luan Phan
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| |
Collapse
|
33
|
Abstract
In psychiatry, clinical staging raises awareness of the need to understand disease trajectories and heterotypic continuity; it draws attention to individuals at risk of developing disorders, such as those with a family history or subsyndromal presentations; and it actively promotes greater attention to prevention strategies and interventions for individuals at ultra-high risk of developing a severe mental disorder. Staging paradigms have been increasingly applied in early intervention in psychoses, but there are issues in broadening the scope of clinical staging to the more prevalent affective disorders. For example, it is potentially more complex to devise a model that considers the varying clinical presentations of the late prodromal stage of bipolar disorder and where to locate depressive episodes that precede the first manic episode and how to describe subthreshold manic syndromes, especially hypomania. The above issues might be resolved if we had a greater understanding of the risk factors, biomarkers or endophenotypes for the onset and progression of bipolar disorder. This level of understanding is not yet available in psychiatry, but clinical staging may help us improve our knowledge of the pathophysiological correlates of disease progression and reduce our over-reliance on cross-sectional assessments of symptoms in bipolar disorders.
Collapse
Affiliation(s)
- J Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, United Kingdom.
| | - C Henry
- Institut pasteur, unité perception et mémoire, F-75015 Paris, France - Université Paris-Est, UMR S955, UPEC, F-94000 Créteil, France - AP-HP, Hôpital Henri-Mondor, Albert-Chenevier, pôle de psychiatrie, F-94000 Créteil, France
| |
Collapse
|
34
|
McGuire TC, McCormick KC, Koch MK, Mendle J. Pubertal Maturation and Trajectories of Depression During Early Adolescence. Front Psychol 2019; 10:1362. [PMID: 31244742 PMCID: PMC6582206 DOI: 10.3389/fpsyg.2019.01362] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/24/2019] [Indexed: 12/28/2022] Open
Abstract
Beginning at puberty, prevalence of depression in females rises dramatically. The physical changes of puberty coincide with a period of social flux, during which relationships become less stable and more prone to conflict. While this social upheaval is normatively distressing for girls, it may be especially so for girls with cognitive styles that leave them more susceptible to depression. The present study investigated depressive symptoms at two time points during early pubertal maturation. N = 110 girls (M age = 11.57, SD = 0.98) reported on depressive symptomology, pubertal maturation, ruminative coping style, frequency of peer conflict, and rejection sensitivity. Multivariate analyses suggest more advanced pubertal development and greater rejection sensitivity at Time 1 predicted higher levels of depressive symptoms at Time 2, after accounting for baseline levels of depressive symptoms and all other social and cognitive correlates of depression. This effect was also found in early maturing girls. Menarche status was not significant. Since menarche occurs toward the end of puberty, results suggest that risk for worsening depression is not associated with completing puberty, or with menstruation itself. Rather, increases in depressive symptoms seem to be associated with physical changes that emerge early in the pubertal transition, especially for early maturing girls, paired with anticipatory concerns about social rejection.
Collapse
Affiliation(s)
- Taylor C. McGuire
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Kathleen C. McCormick
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | - Mary Kate Koch
- Department of Human Development, Cornell University, Ithaca, NY, United States
| | - Jane Mendle
- Department of Human Development, Cornell University, Ithaca, NY, United States
| |
Collapse
|
35
|
Mood symptoms and suicidality across the autism spectrum. Compr Psychiatry 2019; 91:34-38. [PMID: 31003723 DOI: 10.1016/j.comppsych.2019.03.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Autism spectrum is a psychopathological dimension which encompasses a wide range of clinical presentations: from subthreshold forms and autistic traits (AT), that can be found in the general population, to full-blown autism spectrum disorder (ASD). Many studies reported high rates of comorbidity between both ASD and AT and mood disorders, as well as a high prevalence of suicidal ideation among patients with ASD/AT. The aim of this study was to investigate the presence of mood symptoms and suicidal ideation and behaviors in patients with full-blown ASD and in subjects with AT, as well in a healthy control (HC) group, with a specific focus on which of the autistic features may be predictive of suicidal ideation and behaviors. METHODS We recruited 262 adult subjects: 34 with ASD without intellectual impairment or language disability (ASD group), 68 fulfilling only one symptom criterion for ASD according to DSM-5 but who do not meet criteria for a full-blown diagnosis of ASD (AT group), and 160 HC. All subjects were assessed with the Structured Clinical Interview for DSM-5 (SCID-5); in addition, they were asked to fill two questionnaires: The Mood Spectrum, Self-report (MOODS-SR) and the Adult Autism Subthreshold Spectrum (AdAS Spectrum). RESULTS ASD subjects reported significantly higher AdAS Spectrum and MOODS-SR total scores, as well as higher MOODS-SR depressive component total scores, when compared with AT and HC subjects. AT subjects scored significantly higher than the HC group. No significant differences were reported between ASD and AT subjects for the suicidality score according to MOODS-SR, despite both groups scored significantly higher than the HC group. The strongest predictor of suicidality score were MOODS-SR depressive component score and AdAS Spectrum Restricted interests and rumination domain score. CONCLUSIONS Our results highlight a correlation between autism and mood spectrum, as well as between suicidality and both ASD and AT. Subthreshold forms of ASD should be accurately investigated due to their relationship with suicidal thoughts and behaviors.
Collapse
|
36
|
Mazzer K, Boersma K, Linton SJ. A longitudinal view of rumination, poor sleep and psychological distress in adolescents. J Affect Disord 2019; 245:686-696. [PMID: 30447567 DOI: 10.1016/j.jad.2018.11.053] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 10/17/2018] [Accepted: 11/03/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Given the high prevalence and negative impact of psychological problems during adolescence, examining transdiagnostic factors that may have scope to positively influence a variety of psychological problems is imperative. The main purpose of this study was to investigate the longitudinal relationship between rumination and psychological distress and whether sleep mediated this relationship over a 2 year period. METHODS Participants were 1620 high school students in the 7th and 8th grade at baseline from 17 public schools in three middle Sweden communities. Students completed questionnaires at school during the spring of 2014, 2015 and 2016. Rumination and psychological distress were self-reported, and sleep duration was calculated from reported bed-times, wake-times and sleep onset latencies. RESULTS Sleep duration declined with age, whereas rumination and psychological distress increased. Rumination was predictive of future psychological distress and distress at a given time was predictive of concurrent rumination. Sleep duration did not consistently mediate the reciprocal relationships between rumination and psychological distress over time. LIMITATIONS Stronger longitudinal associations may have been obtained by using smaller measurement intervals or further delineation of outcome constructs. CONCLUSIONS Reducing rumination, rather than targeting sleep patterns, may work towards preventing the development of a number of psychological problems and is a strategy anticipated to function across disorders to improve young people's mental wellbeing.
Collapse
Affiliation(s)
- K Mazzer
- Centre for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Fakultetsgatan 1, 70182, Örebro, Sweden.
| | - K Boersma
- Centre for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Fakultetsgatan 1, 70182, Örebro, Sweden
| | - S J Linton
- Centre for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Fakultetsgatan 1, 70182, Örebro, Sweden
| |
Collapse
|
37
|
Alba J, Calvete E. Bidirectional Relationships Between Stress, Depressive Symptoms, and Cognitive Vulnerabilities in Adolescents. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.2.87] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Depression is a highly prevalent problem in adolescence, with great clinical and social relevance. Recent models of psychopathology in childhood and adolescence underscore that the relationships between stress, cognitive vulnerabilities, and depressive symptoms are bidirectional. In addition, according to cognitive therapy models, cognitive vulnerabilities are organized hierarchically, with deep schemas guiding more superficial cognitive processes such as rumination. The present study examines the longitudinal predictive relationships between two levels of cognitions (early maladaptive schemas and rumination), stressors, and depression. Method: A sample of 584 Spanish adolescents (262 girls; mean age = 15.99, SD = 1.10) completed measures of depression, stressors, rumination, and three early maladaptive schema domains (disconnection and rejection, impaired autonomy and other-directedness) over 4 intervals of 4 months. Path analysis was used to test the hypotheses of the study. Results: Disconnection and rejection domain systematically predicted an increase in depression, new stressors, and rumination over time. In addition, depressive symptoms predicted an increase of disconnection/rejection scores at all time points. Finally, from Time 2 on, stressors predicted an increase in all schema domains. Discussion: The outcomes suggest the importance of the disconnection and rejection schema domain. These results are important to understand the mechanisms underlying stress and depression in adolescents.
Collapse
|
38
|
Kane NS, Hoogendoorn CJ, Tanenbaum ML, Gonzalez JS. Physical symptom complaints, cognitive emotion regulation strategies, self-compassion and diabetes distress among adults with Type 2 diabetes. Diabet Med 2018; 35:1671-1677. [PMID: 30264898 PMCID: PMC7313242 DOI: 10.1111/dme.13830] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2018] [Indexed: 12/20/2022]
Abstract
AIMS Diabetes-related distress is common among adults with Type 2 diabetes and is consistently associated with poorer self-management and treatment outcomes. However, little is known about the psychological factors that may contribute to or protect against diabetes distress. This study examined illness burden, and positive and negative ways of thinking and relating to oneself in times of stress, as independent correlates of diabetes distress, cross sectionally and longitudinally. METHOD A total of 120 adults treated for Type 2 diabetes reported their physical symptom complaints, cognitive emotion regulation, self-compassion and diabetes distress at baseline; 110 completed a 3-month follow-up assessment of diabetes distress. Pearson correlations and multivariable linear regression tested baseline and longitudinal relationships. RESULTS Baseline diabetes distress was associated with greater use of negative cognitive emotion regulation strategies (r = 0.43, P < 0.01), greater tendency towards self-criticism, self-judgement and over-identification (r = 0.37, P < 0.01), and greater physical symptom burden (r = 0.50, P < 0.01). Baseline physical symptoms and negative cognitive emotion regulation were independently associated with baseline diabetes distress. Baseline physical symptoms and negative aspects of self-compassion significantly predicted diabetes distress over 3 months. Positive aspects of cognitive emotion regulation and self-compassion were not independently associated with diabetes distress cross sectionally or longitudinally. CONCLUSION Greater symptom burden along with the use of negative cognitive emotion regulation and negative aspects of self-compassion were independently associated with diabetes distress. If these relations are explained by causal influence, these modifiable factors could be fruitful targets for intervention research.
Collapse
Affiliation(s)
- N S Kane
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
- War Related Injury & Illness Study Center, VA New Jersey Health Care System, East Orange, NJ, USA
| | - C J Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - M L Tanenbaum
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - J S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
- Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, New York, NY, USA
- New York Regional Center for Diabetes Translation Research, New York, NY, USA
| |
Collapse
|
39
|
Abstract
SummaryRevisions of international classification systems for mental disorders have focused on improving the reliability of diagnostic criteria. However, the uncertain validity of the current diagnostic categories means that they do not always fulfil their key purposes, namely to guide treatment and predict outcomes. This is especially true when traditional diagnostic approaches are applied to adolescents and young adults with emerging illnesses. A clinical staging model, similar to those used in general medicine, could improve diagnosis in psychiatry and aid treatment decision-making, especially if applied to individuals aged about 15–25 years, which is the peak age range for the onset of severe mental disorders. Staging models may offer a new framework for the development of interventions with high benefit and low risk, and for research into neurobiological and psychosocial risk factors. However, this approach is not without controversy: some experts oppose its introduction, some argue that it represents a transdiagnostic model, and some suggest it is only viable if disorder-specific models are used.Learning Objectives• Gain awareness of some limitations of current approaches to psychiatric diagnosis• Review the basic principles of clinical staging models used in general medicine• Understand current research on the use of staging models in psychiatry, and attempts to apply these models to bipolar disorders
Collapse
|
40
|
Weiner L, Weibel S, de Sousa Gurgel W, Keizer I, Gex-Fabry M, Giersch A, Bertschy G. Measuring racing thoughts in healthy individuals: The Racing and Crowded Thoughts Questionnaire (RCTQ). Compr Psychiatry 2018; 82:37-44. [PMID: 29407357 DOI: 10.1016/j.comppsych.2018.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 01/04/2018] [Accepted: 01/11/2018] [Indexed: 02/05/2023] Open
Abstract
Racing thoughts refer to an acceleration and overproduction of thoughts, which have been associated with manic and mixed episodes. Phenomenology distinguishes 'crowded' from 'racing' thoughts, associated with mixed depression and mania, respectively. Recent data suggest racing thoughts might also be present in healthy individuals with sub-affective traits and symptoms. We investigated this assumption, with a 34-item self-rating scale, the Racing and Crowded Thoughts Questionnaire (RCTQ), and evaluated its reliability, factor structure, and concurrent validity. 197 healthy individuals completed the RCTQ, the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - autoquestionnaire (TEMPS-A), the Beck Depression Inventory (BDI), the Altman Self-Rating Mania scale (ASRM), and the Ruminative Response Scale (RRS). Exploratory factor analysis yielded a three-factor solution, labeled 'thought overactivation', 'burden of thought overactivation', and 'thought overexcitability'. Internal consistency of each of the three subscales of the RCTQ was excellent. The TEMPS-A cyclothymia score was associated with the three factors, suggesting good concurrent validity. The 'thought activation' subscale was selectively associated with current elated mood and included items conveying both the notion of increased amount and velocity of thoughts, whereas the 'burden of thought overactivation' subscale was associated with current low mood. The 'thought overexcitability' subscale included items conveying the notion of distractibility, and was associated with both elated and low mood. Rumination was not a significant predictor of RCTQ subscores. These results suggest that the RCTQ has good psychometric properties. Racing and crowded thoughts, as measured by the RCTQ, are a multi-faceted phenomenon, distinct from rumination, and particularly associated with mood instability even in its milder forms.
Collapse
Affiliation(s)
- Luisa Weiner
- INSERM U1114, Strasbourg, France; Psychiatry Department, University Hospital of Strasbourg, France.
| | - Sébastien Weibel
- INSERM U1114, Strasbourg, France; Psychiatry Department, University Hospital of Strasbourg, France
| | | | - Ineke Keizer
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Switzerland
| | - Marianne Gex-Fabry
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Switzerland
| | | | - Gilles Bertschy
- INSERM U1114, Strasbourg, France; Psychiatry Department, University Hospital of Strasbourg, France; Translational Medicine Federation, University of Strasbourg, France
| |
Collapse
|
41
|
Stange JP, Bessette KL, Jenkins LM, Peters AT, Feldhaus C, Crane NA, Ajilore O, Jacobs RH, Watkins ER, Langenecker SA. Attenuated intrinsic connectivity within cognitive control network among individuals with remitted depression: Temporal stability and association with negative cognitive styles. Hum Brain Mapp 2017; 38:2939-2954. [PMID: 28345197 DOI: 10.1002/hbm.23564] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/28/2017] [Accepted: 03/01/2017] [Indexed: 02/06/2023] Open
Abstract
Many individuals with major depressive disorder (MDD) experience cognitive dysfunction including impaired cognitive control and negative cognitive styles. Functional connectivity magnetic resonance imaging studies of individuals with current MDD have documented altered resting-state connectivity within the default-mode network and across networks. However, no studies to date have evaluated the extent to which impaired connectivity within the cognitive control network (CCN) may be present in remitted MDD (rMDD), nor have studies examined the temporal stability of such attenuation over time. This represents a major gap in understanding stable, trait-like depression risk phenotypes. In this study, resting-state functional connectivity data were collected from 52 unmedicated young adults with rMDD and 47 demographically matched healthy controls, using three bilateral seeds in the CCN (dorsolateral prefrontal cortex, inferior parietal lobule, and dorsal anterior cingulate cortex). Mean connectivity within the entire CCN was attenuated among individuals with rMDD, was stable and reliable over time, and was most pronounced with the right dorsolateral prefrontal cortex and right inferior parietal lobule, results that were corroborated by supplemental independent component analysis. Attenuated connectivity in rMDD appeared to be specific to the CCN as opposed to representing attenuated within-network coherence in other networks (e.g., default-mode, salience). In addition, attenuated connectivity within the CCN mediated relationships between rMDD status and cognitive risk factors for depression, including ruminative brooding, pessimistic attributional style, and negative automatic thoughts. Given that these cognitive markers are known predictors of relapse, these results suggest that attenuated connectivity within the CCN could represent a biomarker for trait phenotypes of depression risk. Hum Brain Mapp 38:2939-2954, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
| | | | | | - Amy T Peters
- University of Illinois at Chicago, Chicago, Illinois
| | | | | | | | | | | | | |
Collapse
|
42
|
Biseul I, Icick R, Seguin P, Bellivier F, Scott J. Feasibility and Acceptability of the 'HABIT' Group Programme for Comorbid Bipolar and Alcohol and Substance use Disorders. Clin Psychol Psychother 2016; 24:887-898. [PMID: 27761983 DOI: 10.1002/cpp.2053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/03/2016] [Accepted: 10/04/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVES We investigated the feasibility and acceptability of an integrated group therapy (called HABIT) for comorbid bipolar disorder (BD) and alcohol and substance use disorders (ASUD) (BD-ASUD), a disabling clinical presentation for which no specific treatment has been validated. The 14-session HABIT programme employs psychoeducation-oriented cognitive-behaviour therapy (CBT) followed by mindfulness-based relapse prevention (MBRP) therapy. METHOD Potential group participants were recruited from adult clients with a DSM-IV diagnosis of BD and an ASUD who were referred by their treating clinician. Observer-rated changes in mood symptoms and ASUD, attendance rates and subjective feedback are reported. RESULTS Eight of 12 clients referred to the programme initially agreed to join the group, six attended the first group session and five clients completed the programme. Group mean scores for mood symptoms improved over time, with slightly greater reductions in depression during the first module. About 50% of individuals showed clinically significant improvement (≥30% reduction) in alcohol and substance use. Attendance rates showed some variability between individuals and across sessions, but the average attendance rate of the group was marginally higher for the first module (86%) as compared with the second module (77%). Most clients reported high levels of general satisfaction with a group specifically targeted at individuals with BD-ASUD. CONCLUSION This small pilot study suggests our intensive group therapy is acceptable and feasible. If findings are replicated, we may have identified a therapy that, for the first time, leads to improvement in both mood and substance use outcomes in clients with difficult-to-treat comorbid BD-ASUD. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Comorbidity between bipolar and alcohol and substance use disorders (BD-ASUD) is frequent and highly disabling; Therapeutic research on approaches that can simultaneously help BD and ASUD is lacking; Previous research highlights the need for integrated treatment of both conditions but showed improvements limited to either element of the comorbid disorder; This pilot study supports the feasibility and acceptability of an intensive, 14-session group therapy programme that integrates CBT and mindfulness approaches.
Collapse
Affiliation(s)
- Isabelle Biseul
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France
| | - Romain Icick
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France.,Inserm, U1144, Paris, France.,Université Paris Descartes, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France
| | - Perrine Seguin
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France
| | - Frank Bellivier
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France.,Inserm, U1144, Paris, France.,Université Paris Descartes, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Centre for Affective Disorders, IPPN, London, UK
| |
Collapse
|