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Pan N, Qin K, Patino LR, Tallman MJ, Lei D, Lu L, Li W, Blom TJ, Bruns KM, Welge JA, Strawn JR, Gong Q, Sweeney JA, Singh MK, DelBello MP. Aberrant brain network topology in youth with a familial risk for bipolar disorder: a task-based fMRI connectome study. J Child Psychol Psychiatry 2024; 65:1072-1086. [PMID: 38220469 PMCID: PMC11246494 DOI: 10.1111/jcpp.13946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Youth with a family history of bipolar disorder (BD) may be at increased risk for mood disorders and for developing side effects after antidepressant exposure. The neurobiological basis of these risks remains poorly understood. We aimed to identify biomarkers underlying risk by characterizing abnormalities in the brain connectome of symptomatic youth at familial risk for BD. METHODS Depressed and/or anxious youth (n = 119, age = 14.9 ± 1.6 years) with a family history of BD but no prior antidepressant exposure and typically developing controls (n = 57, age = 14.8 ± 1.7 years) received functional magnetic resonance imaging (fMRI) during an emotional continuous performance task. A generalized psychophysiological interaction (gPPI) analysis was performed to compare their brain connectome patterns, followed by machine learning of topological metrics. RESULTS High-risk youth showed weaker connectivity patterns that were mainly located in the default mode network (DMN) (network weight = 50.1%) relative to controls, and connectivity patterns derived from the visual network (VN) constituted the largest proportion of aberrant stronger pairs (network weight = 54.9%). Global local efficiency (Elocal, p = .022) and clustering coefficient (Cp, p = .029) and nodal metrics of the right superior frontal gyrus (SFG) (Elocal: p < .001; Cp: p = .001) in the high-risk group were significantly higher than those in healthy subjects, and similar patterns were also found in the left insula (degree: p = .004; betweenness: p = .005; age-by-group interaction, p = .038) and right hippocampus (degree: p = .003; betweenness: p = .003). The case-control classifier achieved a cross-validation accuracy of 78.4%. CONCLUSIONS Our findings of abnormal connectome organization in the DMN and VN may advance mechanistic understanding of risk for BD. Neuroimaging biomarkers of increased network segregation in the SFG and altered topological centrality in the insula and hippocampus in broader limbic systems may be used to target interventions tailored to mitigate the underlying risk of brain abnormalities in these at-risk youth.
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Affiliation(s)
- Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences; Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kun Qin
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Luis R. Patino
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Maxwell J. Tallman
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Du Lei
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences; Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Wenbin Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences; Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Thomas J. Blom
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kaitlyn M. Bruns
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jeffrey A. Welge
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jeffrey R. Strawn
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences; Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
| | - John A. Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences; Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Manpreet K. Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA
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Macoveanu J, Kjærstad HL, Halvorsen KS, Fisher PM, Vinberg M, Kessing LV, Miskowiak KW. Trajectory of reward-related abnormalities in unaffected relatives of patients with bipolar disorder - A longitudinal fMRI study. J Psychiatr Res 2024; 170:217-224. [PMID: 38157669 DOI: 10.1016/j.jpsychires.2023.12.035] [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: 04/20/2023] [Revised: 11/14/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
First-degree relatives of patients with bipolar disorder are at heightened risk of mood episodes, which may be attributed to the existence of endophenotypes i.e., heritable (neuro)biological changes present in patients and their unaffected relatives (UR). In this longitudinal MRI study, we aim to investigate the trajectories of aberrant reward-related functional changes identified in UR vs healthy controls (HC). Sixty-eight UR and 65 HC of similar age and gender distribution underwent MRI at baseline while performing a card guessing task. Of these, 29 UR and 36 HC were investigated with the same protocol following a 16-month period in average. We first identified brain regions showing group differences in the neural response to expected value (EV) and reward prediction error (PE) at baseline and analyzed how the reward-related response in these regions changed over time in UR vs HC. Relative to HC at baseline, UR showed lower EV signal in the right ventrolateral prefrontal cortex (vlPFC) and paracingulate gyrus and lower PE signal in the left vlPFC and dorsomedial PFC. The trajectories of these abnormalities in UR showed a normalization of the prefrontal EV signals, whereas the PE signals which correlated with depressive symptoms remained stable over time. While the UR showed both blunted EV and PE signals, none of these abnormalities increased over time, which is consistent with the observed stable mood symptoms.
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Affiliation(s)
- Julian Macoveanu
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark.
| | - Hanne Lie Kjærstad
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark
| | - Kaja Sofie Halvorsen
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Department of Psychology, University of Copenhagen, Denmark
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Eckstrand KL, Silk JS, Nance M, Wallace ML, Buckley N, Lindenmuth M, Flores L, Alarcón G, Quevedo K, Phillips ML, Lenniger CJ, Sammon MM, Brostowin A, Ryan N, Jones N, Forbes EE. Medial Prefrontal Cortex Activity to Reward Outcome Moderates the Association Between Victimization Due to Sexual Orientation and Depression in Youth. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1289-1297. [PMID: 36064188 PMCID: PMC9842132 DOI: 10.1016/j.bpsc.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Sexual minority youth (SMY) are 3 times more likely to experience depression than heterosexual peers. Minority stress theory posits that this association is explained by sexual orientation victimization, which acts as a stressor to impact depression. For those vulnerable to the effects of stress, victimization may worsen depression by altering activity in neural reward systems. This study examines whether neural reward systems moderate the influence of sexual orientation victimization, a common and distressing experience in SMY, on depression. METHODS A total of 81 participants ages 15 to 22 years (41% SMY, 52% marginalized race) reported sexual orientation victimization, depression severity, and anhedonia severity, and underwent a monetary reward functional magnetic resonance imaging task. Significant activation to reward > neutral outcome (pfamilywise error < .05) was determined within a meta-analytically derived Neurosynth reward mask. A univariate linear model examined the impact of reward activation and identity on victimization-depression relationships. RESULTS SMY reported higher depression (p < .001), anhedonia (p = .03), and orientation victimization (p < .001) than heterosexual youth. The bilateral ventral striatum, medial prefrontal cortex (mPFC), anterior cingulate cortex, and right orbitofrontal cortex were significantly active to reward. mPFC activation moderated associations between sexual orientation victimization and depression (p = .03), with higher depression severity observed in those with a combination of higher mPFC activation and greater orientation victimization. CONCLUSIONS Sexual orientation victimization was related to depression but only in the context of higher mPFC activation, a pattern observed in depressed youth. These novel results provide evidence for neural reward sensitivity as a vulnerability factor for depression in SMY, suggesting mechanisms for disparities, and are a first step toward a clinical neuroscience understanding of minority stress in SMY.
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Affiliation(s)
| | - Jennifer S. Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Melissa Nance
- Department of Psychology, University of Missouri St. Louis, St. Louis, MO
| | | | - Nicole Buckley
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | - Luis Flores
- Department of Psychology, Queen’s University, Kingston, Ontario, Canada
| | - Gabriela Alarcón
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Karina Quevedo
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | - M. McLean Sammon
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Alyssa Brostowin
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Neal Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Neil Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Erika E. Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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Acheson DT, Vinograd M, Nievergelt CM, Yurgil KA, Moore TM, Risbrough VB, Baker DG. Prospective examination of pre-trauma anhedonia as a risk factor for post-traumatic stress symptoms. Eur J Psychotraumatol 2022; 13:2015949. [PMID: 35070161 PMCID: PMC8774051 DOI: 10.1080/20008198.2021.2015949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Anhedonia, the reduction of pleasure and reward-seeking behaviour, is a transdiagnostic symptom with well-described neural circuit mediators. Although typically observed during disease state, extant hypotheses suggest that anhedonia may also be an early risk factor for development of psychopathology. Understanding the contribution of anhedonia to the trauma-response trajectory may bolster inferences about biological mechanisms contributing to pre-trauma risk versus trauma-related symptom expression, knowledge of which could aid in targeted interventions. OBJECTIVE Using a prospective, longitudinal design in a population at risk for trauma disorders, we tested the hypothesis that anhedonia may be a pre-trauma risk factor for post-traumatic stress disorder (PTSD) symptoms. METHODS Adult male participants from the Marine Resilience Study (N = 2,593) were assessed across three time-points (pre-deployment, 3-month and 6-month post-deployment). An anhedonia factor was extracted from self-report instruments pre-trauma and tested for its relationship with development of PTSD re-experiencing symptoms after deployment. RESULTS Higher pre-deployment anhedonia predicted increased PTSD intrusive re-experiencing symptoms at 3- and 6-months post-deployment when controlling for pre-trauma PTSD and depression symptoms. Depression symptoms were not significant predictors of subsequent PTSD intrusive re-experiencing symptoms. Anhedonia at 3 mo also robustly predicted maintenance of PTSD intrusive re-experiencing symptoms at the 6 mo time point. CONCLUSIONS Pre-deployment anhedonia may be a pre-trauma risk factor for PTSD, not simply a state-dependent effect of trauma exposure and PTSD symptom expression. Anhedonia may contribute to persistence and/or chronicity of re-experiencing symptoms after the emergence of PTSD symptoms.
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Affiliation(s)
- Dean T Acheson
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Meghan Vinograd
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Caroline M Nievergelt
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Kate A Yurgil
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.,Department of Psychological Sciences, Loyola University New Orleans, New Orleans, LA, USA
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Victoria B Risbrough
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Dewleen G Baker
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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5
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Pizzagalli DA, Roberts AC. Prefrontal cortex and depression. Neuropsychopharmacology 2022; 47:225-246. [PMID: 34341498 PMCID: PMC8617037 DOI: 10.1038/s41386-021-01101-7] [Citation(s) in RCA: 202] [Impact Index Per Article: 101.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 01/03/2023]
Abstract
The prefrontal cortex (PFC) has emerged as one of the regions most consistently impaired in major depressive disorder (MDD). Although functional and structural PFC abnormalities have been reported in both individuals with current MDD as well as those at increased vulnerability to MDD, this information has not translated into better treatment and prevention strategies. Here, we argue that dissecting depressive phenotypes into biologically more tractable dimensions - negative processing biases, anhedonia, despair-like behavior (learned helplessness) - affords unique opportunities for integrating clinical findings with mechanistic evidence emerging from preclinical models relevant to depression, and thereby promises to improve our understanding of MDD. To this end, we review and integrate clinical and preclinical literature pertinent to these core phenotypes, while emphasizing a systems-level approach, treatment effects, and whether specific PFC abnormalities are causes or consequences of MDD. In addition, we discuss several key issues linked to cross-species translation, including functional brain homology across species, the importance of dissecting neural pathways underlying specific functional domains that can be fruitfully probed across species, and the experimental approaches that best ensure translatability. Future directions and clinical implications of this burgeoning literature are discussed.
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Affiliation(s)
- Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School & McLean Hospital, Belmont, MA, USA.
| | - Angela C Roberts
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
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6
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Eckstrand KL, Forbes EE, Bertocci MA, Chase HW, Greenberg T, Lockovich J, Stiffler R, Aslam HA, Graur S, Bebko G, Phillips ML. Trauma Affects Prospective Relationships Between Reward-Related Ventral Striatal and Amygdala Activation and 1-Year Future Hypo/Mania Trajectories. Biol Psychiatry 2020; 89:868-877. [PMID: 33536131 PMCID: PMC8052260 DOI: 10.1016/j.biopsych.2020.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Trauma exposure is associated with a more severe, persistent course of affective and anxiety symptoms. Markers of reward neural circuitry function, specifically activation to reward prediction error (RPE), are impacted by trauma and predict the future course of affective symptoms. This study's purpose was to determine how lifetime trauma exposure influences relationships between reward neural circuitry function and the course of future affective and anxiety symptoms in a naturalistic, transdiagnostic observational context. METHODS A total of 59 young adults aged 18-25 (48 female and 11 male participants, mean ± SD = 21.5 ± 2.0 years) experiencing psychological distress completed the study. Participants were evaluated at baseline, 6, and 12 months. At baseline, the participants reported lifetime trauma events and completed a monetary reward functional magnetic resonance imaging task. Affective and anxiety symptoms were reported at each visit, and trajectories were calculated using MPlus. Neural activation during RPE and other phases of reward processing were determined using SPM8. Trauma and reward neural activation were entered as predictors of symptom trajectories. RESULTS Trauma exposure moderated prospective relationships between left ventral striatum (β = -1.29, p = .02) and right amygdala (β = 0.58, p = .04) activation to RPE and future hypo/mania severity trajectory: the interaction between greater trauma and greater left ventral striatum activation to RPE was associated with a shallower increase in hypo/mania severity, whereas the interaction between greater trauma and greater right amygdala activation to RPE was associated with increasing hypo/mania severity. CONCLUSIONS Trauma exposure affects prospective relationships between markers of reward circuitry function and affective symptom trajectories. Evaluating trauma exposure is thus crucial in naturalistic and treatment studies aiming to identify neural predictors of future affective symptom course.
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Affiliation(s)
- Kristen L Eckstrand
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michele A Bertocci
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tsafrir Greenberg
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jeanette Lockovich
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ricki Stiffler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Haris A Aslam
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Simona Graur
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Genna Bebko
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
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