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Roland A, Staring L, Van Puyvelde M, McGlone F, Mairesse O. Sleep, Mental Health, and the Need for Physical and Real-Life Social Contact with (Non-)Family Members during the COVID-19 Pandemic: A Bayesian Network Analysis. J Clin Med 2024; 13:3954. [PMID: 38999517 PMCID: PMC11242234 DOI: 10.3390/jcm13133954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/28/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: The forced social isolation implemented to prevent the spread of the COVID-19 virus was accompanied by a worsening of mental health, an increase in insomnia symptoms, and the emergence of 'skin hunger'-an increased longing for personal touch. This study aimed to enhance our understanding of the interconnection between sleep, mental health, and the need for physical (NPC) and real-life social contact (NRL-SC). Methods: A total of 2827 adults participated in an online survey during the second COVID-19 lockdown. A Bayesian Gaussian copula graphical model (BGCGM) and a Bayesian-directed acyclic graph (DAG) were estimated, and mixed ANOVAs were carried out. Results: NPC with non-family members (t(2091) = 12.55, p < 0.001, d = 0.27) and relational lifestyle satisfaction (t(2089) = 13.62, p < 0.001, d = 0.30) were lower during the second lockdown than before the pandemic. In our BGCGM, there were weak positive edges between the need for PC and RL-SC on one hand and sleep and mental health on the other. Conclusions: During the second lockdown, people craved less physical contact with non-family members and were less satisfied with their relational lifestyle than before the pandemic. Individuals with a greater need for PC and RL-SC reported poorer mental health (i.e., worry, depression, and mental fatigue).
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Affiliation(s)
- Aurore Roland
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Louise Staring
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Vital Signs and PERformance Monitoring (VIPER), LIFE Department, Royal Military Academy, 1000 Brussels, Belgium
| | - Martine Van Puyvelde
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Vital Signs and PERformance Monitoring (VIPER), LIFE Department, Royal Military Academy, 1000 Brussels, Belgium
- Clinical and Lifespan Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- School of Natural Sciences & Psychology, Faculty of Science, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Francis McGlone
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Espoo, Finland
| | - Olivier Mairesse
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Vital Signs and PERformance Monitoring (VIPER), LIFE Department, Royal Military Academy, 1000 Brussels, Belgium
- Laboratoire de Psychologie Médicale et Addictologie, CHU/UVC Brugmann, 1020 Brussels, Belgium
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Rief W, Asmundson GJG, Bryant RA, Clark DM, Ehlers A, Holmes EA, McNally RJ, Neufeld CB, Wilhelm S, Jaroszewski AC, Berg M, Haberkamp A, Hofmann SG. The future of psychological treatments: The Marburg Declaration. Clin Psychol Rev 2024; 110:102417. [PMID: 38688158 DOI: 10.1016/j.cpr.2024.102417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Abstract
Although psychological treatments are broadly recognized as evidence-based interventions for various mental disorders, challenges remain. For example, a substantial proportion of patients receiving such treatments do not fully recover, and many obstacles hinder the dissemination, implementation, and training of psychological treatments. These problems require those in our field to rethink some of our basic models of mental disorders and their treatments, and question how research and practice in clinical psychology should progress. To answer these questions, a group of experts of clinical psychology convened at a Think-Tank in Marburg, Germany, in August 2022 to review the evidence and analyze barriers for current and future developments. After this event, an overview of the current state-of-the-art was drafted and suggestions for improvements and specific recommendations for research and practice were integrated. Recommendations arising from our meeting cover further improving psychological interventions through translational approaches, improving clinical research methodology, bridging the gap between more nomothetic (group-oriented) studies and idiographic (person-centered) decisions, using network approaches in addition to selecting single mechanisms to embrace the complexity of clinical reality, making use of scalable digital options for assessments and interventions, improving the training and education of future psychotherapists, and accepting the societal responsibilities that clinical psychology has in improving national and global health care. The objective of the Marburg Declaration is to stimulate a significant change regarding our understanding of mental disorders and their treatments, with the aim to trigger a new era of evidence-based psychological interventions.
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Affiliation(s)
- Winfried Rief
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany.
| | | | - Richard A Bryant
- University of New South Wales, School of Psychology, Sydney, New South Wales, Australia
| | - David M Clark
- University of Oxford, Department of Experimental Psychology, Oxford, UK
| | - Anke Ehlers
- University of Oxford, Department of Experimental Psychology, Oxford, UK
| | - Emily A Holmes
- Uppsala University, Department of Women's and Children's Health, Uppsala, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Solna, Sweden
| | | | - Carmem B Neufeld
- University of São Paulo, Department of Psychology, Ribeirão Preto, SP, Brazil
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard School of Medicine, Boston, USA
| | - Adam C Jaroszewski
- Massachusetts General Hospital and Harvard School of Medicine, Boston, USA
| | - Max Berg
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany
| | - Anke Haberkamp
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany
| | - Stefan G Hofmann
- Philipps-University of Marburg, Department of Psychology, Translational Clinical Psychology Group, Marburg, Germany
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Campbell IH, Campbell H. The metabolic overdrive hypothesis: hyperglycolysis and glutaminolysis in bipolar mania. Mol Psychiatry 2024; 29:1521-1527. [PMID: 38273108 PMCID: PMC11189810 DOI: 10.1038/s41380-024-02431-w] [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: 08/14/2023] [Revised: 12/12/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
Evidence from diverse areas of research including chronobiology, metabolomics and magnetic resonance spectroscopy indicate that energy dysregulation is a central feature of bipolar disorder pathophysiology. In this paper, we propose that mania represents a condition of heightened cerebral energy metabolism facilitated by hyperglycolysis and glutaminolysis. When oxidative glucose metabolism becomes impaired in the brain, neurons can utilize glutamate as an alternative substrate to generate energy through oxidative phosphorylation. Glycolysis in astrocytes fuels the formation of denovo glutamate, which can be used as a mitochondrial fuel source in neurons via transamination to alpha-ketoglutarate and subsequent reductive carboxylation to replenish tricarboxylic acid cycle intermediates. Upregulation of glycolysis and glutaminolysis in this manner causes the brain to enter a state of heightened metabolism and excitatory activity which we propose to underlie the subjective experience of mania. Under normal conditions, this mechanism serves an adaptive function to transiently upregulate brain metabolism in response to acute energy demand. However, when recruited in the long term to counteract impaired oxidative metabolism it may become a pathological process. In this article, we develop these ideas in detail, present supporting evidence and propose this as a novel avenue of investigation to understand the biological basis for mania.
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Affiliation(s)
- Iain H Campbell
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK.
| | - Harry Campbell
- Usher Institute, Centre for Global Health Research, University of Edinburgh, Craigour House, 450 Old Dalkeith Rd, Edinburgh, EH16 4SS, UK
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4
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Goossens Z, Bilterys T, Van Looveren E, Malfliet A, Meeus M, Danneels L, Ickmans K, Cagnie B, Roland A, Moens M, Nijs J, De Baets L, Mairesse O. The Role of Anxiety and Depression in Shaping the Sleep-Pain Connection in Patients with Nonspecific Chronic Spinal Pain and Comorbid Insomnia: A Cross-Sectional Analysis. J Clin Med 2024; 13:1452. [PMID: 38592310 PMCID: PMC10932262 DOI: 10.3390/jcm13051452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: This exploratory study aims to explore the relationship between nonspecific chronic spinal pain (nCSP) and insomnia symptoms, by examining the interconnections, strengths, and directional dependence of the symptoms. In addition, we aim to identify the key symptoms of the nCSP-insomnia relationship and shed light on the bidirectional nature of this relationship. (2) Methods: This study is a secondary analysis of the baseline data (cross-sectional) from a randomized controlled trial, which examined the added value of Cognitive Behavioral Therapy for Insomnia (CBT-I) combined with cognition-targeted exercise therapy, conducted in collaboration with the Universiteit Gent and Vrije Universiteit Brussel (Belgium). One hundred and twenty-three nCSP patients with comorbid insomnia were recruited through the participating hospitals, advertisements, announcements in local newspapers, pharmacies, publications from support groups, and primary care. To explore the interconnections and directionality between symptoms and the strengths of the relationships, we estimated a regularized Gaussian graphical model and a directed acyclic graph. (3) Results: We found only one direct, but weak, link between sleep and pain, namely, between average pain and difficulties maintaining sleep. (4) Conclusions: Despite the lack of strong direct links between sleep and pain, pain and sleep seem to be indirectly linked via anxiety and depression symptoms, acting as presumable mediators in the network of nCSP and comorbid insomnia. Furthermore, feeling slowed down and fatigue emerged as terminal nodes, implying their role as consequences of the network.
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Affiliation(s)
- Zosia Goossens
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (A.R.); (O.M.)
| | - Thomas Bilterys
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Institute of Advanced Study, University of Warwick, Coventry CV4 7AL, UK
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK
| | - Eveline Van Looveren
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans, 9000 Ghent, Belgium; (L.D.); (B.C.)
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Research Foundation-Flanders (FWO), 1000 Brussels, Belgium
| | - Mira Meeus
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans, 9000 Ghent, Belgium; (L.D.); (B.C.)
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Movement & Nutrition for Health & Performance Research Group (MOVE), Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans, 9000 Ghent, Belgium; (L.D.); (B.C.)
| | - Aurore Roland
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (A.R.); (O.M.)
- Research Foundation-Flanders (FWO), 1000 Brussels, Belgium
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium;
- Department of Radiology, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (T.B.); (E.V.L.); (A.M.); (M.M.); (K.I.); (J.N.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Olivier Mairesse
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (A.R.); (O.M.)
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Vital Signs and PERformance Monitoring (VIPER), LIFE Department, Royal Military Academy, 1000 Brussels, Belgium
- Laboratoire de Psychologie Médicale et Addictologie, CHU/UVC Brugmann, 1020 Brussels, Belgium
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Calderon A, Baik SY, Ng MHS, Fitzsimmons-Craft EE, Eisenberg D, Wilfley DE, Taylor CB, Newman MG. Machine Learning and Bayesian Network Analyses Identifies Psychiatric Disorders and Symptom Associations with Insomnia in a national sample of 31,285 Treatment-Seeking College Students. RESEARCH SQUARE 2024:rs.3.rs-3944417. [PMID: 38464303 PMCID: PMC10925462 DOI: 10.21203/rs.3.rs-3944417/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background A better understanding of the structure of relations among insomnia and anxiety, mood, eating, and alcohol-use disorders is needed, given its prevalence among young adults. Supervised machine learning provides the ability to evaluate the discriminative accuracy of psychiatric disorders associated with insomnia. Combined with Bayesian network analysis, the directionality between symptoms and their associations may be illuminated. Methods The current exploratory analyses utilized a national sample of college students across 26 U.S. colleges and universities collected during population-level screening before entering a randomized controlled trial. Firstly, an elastic net regularization model was trained to predict, via repeated 10-fold cross-validation, which psychiatric disorders were associated with insomnia severity. Seven disorders were included: major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, post-traumatic stress disorder, anorexia nervosa, and alcohol use disorder. Secondly, using a Bayesian network approach, completed partially directed acyclic graphs (CPDAG) built on training and holdout samples were computed via a Bayesian hill-climbing algorithm to determine symptom-level interactions of disorders most associated with insomnia [based on SHAP (SHapley Additive exPlanations) values)] and were evaluated for stability across networks. Results Of 31,285 participants, 20,597 were women (65.8%); mean (standard deviation) age was 22.96 (4.52) years. The elastic net model demonstrated clinical significance in predicting insomnia severity in the training sample [R2 = .449 (.016); RMSE = 5.00 [.081]), with comparable performance in accounting for variance explained in the holdout sample [R2 = .33; RMSE = 5.47). SHAP indicated the presence of any psychiatric disorder was associated with higher insomnia severity, with major depressive disorder demonstrated to be the most associated disorder. CPDAGs showed excellent fit in the holdout sample and suggested that depressed mood, fatigue, and self-esteem were the most important depression symptoms that presupposed insomnia. Conclusion These findings offer insights into associations between psychiatric disorders and insomnia among college students and encourage future investigation into the potential direction of causality between insomnia and major depressive disorder. Trial registration Trial may be found on the National Institute of Health RePORTER website: Project Number: R01MH115128-05.
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Affiliation(s)
| | | | - Matthew H S Ng
- Nanyang Technological University, Rehabilitation Research Institute of Singapore
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Mesbah R, Koenders MA, Spijker AT, de Leeuw M, van Hemert AM, Giltay EJ. Dynamic time warp analysis of individual symptom trajectories in individuals with bipolar disorder. Bipolar Disord 2024; 26:44-57. [PMID: 37269209 DOI: 10.1111/bdi.13340] [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] [Indexed: 06/04/2023]
Abstract
BACKGROUND Manic and depressive mood states in bipolar disorder (BD) may emerge from the non-linear relations between constantly changing mood symptoms exhibited as a complex dynamic system. Dynamic Time Warp (DTW) is an algorithm that may capture symptom interactions from panel data with sparse observations over time. METHODS The Young Mania Rating Scale and Quick Inventory of Depressive Symptomatology were repeatedly assessed in 141 individuals with BD, with on average 5.5 assessments per subject every 3-6 months. Dynamic Time Warp calculated the distance between each of the 27 × 27 pairs of standardized symptom scores. The changing profile of standardized symptom scores of BD participants was analyzed in individual subjects, yielding symptom dimensions in aggregated group-level analyses. Using an asymmetric time-window, symptom changes that preceded other symptom changes (i.e., Granger causality) yielded a directed network. RESULTS The mean age of the BD participants was 40.1 (SD 13.5) years old, and 60% were female participants. Idiographic symptom networks were highly variable between subjects. Yet, nomothetic analyses showed five symptom dimensions: core (hypo)mania (6 items), dysphoric mania (5 items), lethargy (7 items), somatic/suicidality (6 items), and sleep (3 items). Symptoms of the "Lethargy" dimension showed the highest out-strength, and its changes preceded those of "somatic/suicidality," while changes in "core (hypo)mania" preceded those of "dysphoric mania." CONCLUSION Dynamic Time Warp may help to capture meaningful BD symptom interactions from panel data with sparse observations. It may increase insight into the temporal dynamics of symptoms, as those with high out-strength (rather than high in-strength) could be promising targets for intervention.
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Affiliation(s)
- R Mesbah
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Mental Health Care PsyQ Kralingen, Department of Mood Disorders, Rotterdam, The Netherlands
| | - M A Koenders
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Social Sciences, Leiden University, Institute of Psychology, Leiden, The Netherlands
| | - A T Spijker
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Mental Health Care Rivierduinen, Leiden, The Netherlands
| | - M de Leeuw
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Mental Health Care Rivierduinen, Bipolar Disorder Outpatient Clinic, Leiden, The Netherlands
| | - A M van Hemert
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - E J Giltay
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
- Health Campus The Hague, Leiden University, The Hague, The Netherlands
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Abplanalp SJ, Braff DL, Light GA, Joshi YB, Nuechterlein KH, Green MF. Clarifying directional dependence among measures of early auditory processing and cognition in schizophrenia: leveraging Gaussian graphical models and Bayesian networks. Psychol Med 2024:1-10. [PMID: 38287656 DOI: 10.1017/s0033291724000023] [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: 01/31/2024]
Abstract
BACKGROUND Research using latent variable models demonstrates that pre-attentive measures of early auditory processing (EAP) and cognition may initiate a cascading effect on daily functioning in schizophrenia. However, such models fail to account for relationships among individual measures of cognition and EAP, thereby limiting their utility. Hence, EAP and cognition may function as complementary and interacting measures of brain function rather than independent stages of information processing. Here, we apply a data-driven approach to identifying directional relationships among neurophysiologic and cognitive variables. METHODS Using data from the Consortium on the Genetics of Schizophrenia 2, we estimated Gaussian Graphical Models and Bayesian networks to examine undirected and directed connections between measures of EAP, including mismatch negativity and P3a, and cognition in 663 outpatients with schizophrenia and 630 control participants. RESULTS Chain structures emerged among EAP and attention/vigilance measures in schizophrenia and control groups. Concerning differences between the groups, object memory was an influential variable in schizophrenia upon which other cognitive domains depended, and working memory was an influential variable in controls. CONCLUSIONS Measures of EAP and attention/vigilance are conditionally independent of other cognitive domains that were used in this study. Findings also revealed additional causal assumptions among measures of cognition that could help guide statistical control and ultimately help identify early-stage targets or surrogate endpoints in schizophrenia.
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Affiliation(s)
- Samuel J Abplanalp
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David L Braff
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Gregory A Light
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Yash B Joshi
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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Zavlis O, Matheou A, Bentall R. Identifying the bridge between depression and mania: A machine learning and network approach to bipolar disorder. Bipolar Disord 2023; 25:571-582. [PMID: 36869637 DOI: 10.1111/bdi.13316] [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] [Indexed: 03/05/2023]
Abstract
OBJECTIVES Although the cyclic nature of bipolarity is almost by definition a network system, no research to date has attempted to scrutinize the relationship of the two bipolar poles using network psychometrics. We used state-of-the-art network and machine learning methodologies to identify symptoms, as well as relations thereof, that bridge depression and mania. METHODS Observational study that used mental health data (12 symptoms for depression and 12 for mania) from a large, representative Canadian sample (the Canadian Community Health Survey of 2002). Complete data (N = 36,557; 54.6% female) were analysed using network psychometrics, in conjunction with a random forest algorithm, to examine the bidirectional interplay of depressive and manic symptoms. RESULTS Centrality analyses pointed to symptoms relating to emotionality and hyperactivity as being the most central aspects of depression and mania, respectively. The two syndromes were spatially segregated in the bipolar model and four symptoms appeared crucial in bridging them: sleep disturbances (insomnia and hypersomnia), anhedonia, suicidal ideation, and impulsivity. Our machine learning algorithm validated the clinical utility of central and bridge symptoms (in the prediction of lifetime episodes of mania and depression), and suggested that centrality, but not bridge, metrics map almost perfectly onto a data-driven measure of diagnostic utility. CONCLUSIONS Our results replicate key findings from past network studies on bipolar disorder, but also extend them by highlighting symptoms that bridge the two bipolar poles, while also demonstrating their clinical utility. If replicated, these endophenotypes could prove fruitful targets for prevention/intervention strategies for bipolar disorders.
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Affiliation(s)
- Orestis Zavlis
- University of Manchester, Department of Social Statistics, Manchester, UK
| | - Andreas Matheou
- University of Manchester, Manchester Medical School, Manchester, UK
| | - Richard Bentall
- University of Sheffield, Department of Clinical Psychology, Sheffield, UK
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9
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Beattie E, Thomas K, Ponder WN, Meyer EC, Kimbrel NA, Cammarata C, Coe E, Pennington ML, Sacco A, Nee B, Leto F, Ostiguy W, Yockey RA, Carbajal J, Schuman DL, Gulliver SB. Network analysis of posttraumatic stress disorder in a treatment-seeking sample of US firefighters and emergency medical technicians. J Affect Disord 2023; 340:686-693. [PMID: 37595896 DOI: 10.1016/j.jad.2023.08.068] [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: 05/16/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND First responders, including firefighters and emergency medical technicians (EMTs), are under extreme stress from repeated exposure to potentially traumatic events. To optimize treatment for this population, it is critical to understand how the various posttraumatic stress disorder (PTSD) symptom factors are associated with one another so these relations may be targeted in treatment. METHOD Using a sample of treatment-seeking firefighters/EMTs (N = 342), we conducted a partial correlation network analysis of the eight-factor model. A Bayesian directed acyclic graph (DAG) was used to estimate causal associations between clusters. RESULTS Approximately 37 % of the sample screened positive for probable PTSD. Internal re-experiencing and external re-experiencing had the strongest edges. In the DAG, internal re-experiencing was the parent node and was potentially predictive of external re-experiencing, negative affect, dysphoric arousal, and avoidance. LIMITATIONS Data were drawn from a treatment-seeking sample that may not generalize to all firefighters/EMTs. CONCLUSIONS The current findings are consistent with prior research suggesting re-experiencing plays a critical role in developing and maintaining PTSD symptoms. Future research should investigate non-treatment-seeking first responders, as well as EMTs and firefighters as individual populations.
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Affiliation(s)
- Emily Beattie
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA.
| | - Katharine Thomas
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | | | - Eric C Meyer
- Department of Counseling and Behavioral Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Claire Cammarata
- New York City Office of Labor Relations Employee Assistance Program, USA
| | - Elizabeth Coe
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | | | - Angelo Sacco
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - Brian Nee
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - Frank Leto
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - William Ostiguy
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - R Andrew Yockey
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jose Carbajal
- Stephen F. Austin State University, Nacogdoches, TX, USA
| | | | - Suzy B Gulliver
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA; Texas A&M University Health Science Center, College of Medicine, College Station, TX, USA
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10
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Hunt B, Zarate D, Gill P, Stavropoulos V. Mapping the links between sexual addiction and gambling disorder: A Bayesian network approach. Psychiatry Res 2023; 327:115366. [PMID: 37542792 DOI: 10.1016/j.psychres.2023.115366] [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: 03/27/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 08/07/2023]
Abstract
Contemporary literature and recent classification systems have expanded the field of addictions to include problematic behaviours such as gambling and sexual addiction. However, conceptualisation of behavioural addictions is poorly understood and gender-based differences have emerged in relation to how these behaviours are expressed. The current research conducted partial-correlation and Bayesian network analyses to assess the symptomatic structure of gambling disorder and sexual addiction. Convenience community sampling recruited 937 adults aged 18 to 64 years (315 females, Mage = 30.02; 622 males, Mage = 29.46). Symptoms of problematic behaviours were measured using the Online Gambling Disorder Questionnaire (OGDQ) and the Bergen Yale Sex Addiction Scale (BYSAS). Results indicate distinct gender-based differences in the symptom networks of sexual addiction and gambling disorder, with a more complex network observed amongst men for both conditions. Addiction salience, withdrawal and dishonesty/deception were important components of the addictive network. Interpersonal conflict was more central for women while intrapsychic conflict a more prominent issue for men. Differences in the two symptom networks indicate separate disorders as opposed to a single underlying construct. Treating practitioners and community initiatives aimed at addressing sexual addiction and disordered gambling should consider gender, when designing educational or therapeutic interventions.
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Affiliation(s)
- Brian Hunt
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Daniel Zarate
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Peter Gill
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Vasileios Stavropoulos
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia; Department of Psychology, University of Athens, Greece
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11
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Lee KS, Gau SSF, Tseng WL. Autistic Symptoms, Irritability, and Executive Dysfunctions: Symptom Dynamics from Multi-Network Models. J Autism Dev Disord 2023:10.1007/s10803-023-05981-0. [PMID: 37453959 DOI: 10.1007/s10803-023-05981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 07/18/2023]
Abstract
Socio-cognitive difficulties in individuals with autism spectrum disorder (ASD) are heterogenuous and often co-occur with irritability symptoms, such as angry/grouchy mood and temper outbursts. However, the specific relations between individual symptoms are not well-represented in conventional methods analyzing aggregated autistic symptoms and ASD diagnosis. Moreover, the cognitive-behavioral mechanisms linking ASD to irritability are largely unknown. This study investigated the dynamics between autistic (Social Responsiveness Scale) and irritability (Affective Reactivity Index) symptoms and executive functions (Cambridge Neuropsychological Test Automated Battery) in a sample of children and adolescents with ASD, their unaffected siblings, and neurotypical peers (N = 345, aged 6-18 years, 78.6% male). Three complementary networks across the entire sample were computed: (1) Gaussian graphical network estimating the conditional correlations between symptom nodes; (2) Relative importance network computing relative influence between symptoms; (3) Bayesian directed acyclic graph estimating predictive directionality between symptoms. Networks revealed numerous partial correlations within autistic (rs = .07-.56) and irritability (rs = .01-.45) symptoms and executive functions (rs = -.83 to .67) but weak connections between clusters. This segregated pattern converged in all directed and supplementary networks. Plausible predictive paths were found between social communication difficulties to autism mannerisms and between "angry frequently" to "lose temper easily." Autistic and irritability symptoms are two relatively independent families of symptoms. It is unlikely that executive dysfunctions explain elevated irritability in ASD. Findings underscore the need for researching other mood and cognitive-behavioral bridge symptoms, which may inform individualized treatments for co-occurring irritability in ASD.
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Affiliation(s)
- Ka Shu Lee
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital & College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
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12
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Abplanalp SJ, Lee J, Horan WP, Kern RS, Penn DL, Green MF. A Bayesian Network Approach to Social and Nonsocial Cognition in Schizophrenia: Are Some Domains More Fundamental than Others? Schizophr Bull 2023; 49:997-1006. [PMID: 36869810 PMCID: PMC10318874 DOI: 10.1093/schbul/sbad012] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
OBJECTIVES Social and nonsocial cognition are defined as distinct yet related constructs. However, the relative independence of individual variables-and whether specific tasks directly depend on performance in other tasks-is still unclear. The current study aimed to answer this question by using a Bayesian network approach to explore directional dependencies among social and nonsocial cognitive domains. STUDY DESIGN The study sample comprised 173 participants with schizophrenia (71.7% male; 28.3% female). Participants completed 5 social cognitive tasks and the MATRICS Consensus Cognitive Battery. We estimated Bayesian networks using directed acyclic graph structures to examine directional dependencies among the variables. STUDY RESULTS After accounting for negative symptoms and demographic variables, including age and sex, all nonsocial cognitive variables depended on processing speed. More specifically, attention, verbal memory, and reasoning and problem solving solely depended on processing speed, while a causal chain emerged between processing speed and visual memory (processing speed → attention → working memory → visual memory). Social processing variables within social cognition, including emotion in biological motion and empathic accuracy, depended on facial affect identification. CONCLUSIONS These results suggest that processing speed and facial affect identification are fundamental domains of nonsocial and social cognition, respectively. We outline how these findings could potentially help guide specific interventions that aim to improve social and nonsocial cognition in people with schizophrenia.
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Affiliation(s)
- Samuel J Abplanalp
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham AL, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- WCG VeraSci, Durham, NC, USA
| | - Robert S Kern
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David L Penn
- Departement of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chappel Hill, NC, USA
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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13
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Yun JY, Yun YH. Health-promoting behavior to enhance perceived meaning and control of life in chronic disease patients with role limitations and depressive symptoms: a network approach. Sci Rep 2023; 13:4848. [PMID: 36964273 PMCID: PMC10039031 DOI: 10.1038/s41598-023-31867-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
The association between health-related role limitations in the mental and physical subdomains and clinical status (i.e., chronic disease and comorbid depressive symptoms) is mediated by health-promoting behaviors. To enhance health-promoting behaviors in adults with chronic disease, it is necessary to identify item-level associations among targets of health-related monitoring and management. Therefore, the current study used a network approach to examine associations among health-related role limitations, depressive symptoms, existential well-being, socioeconomic position, and health-promoting behavior in adults with chronic disease. A total of 535 adults (mean ± SD age = 62.9 ± 11.9 years; males, n = 231, females, n = 304) who were regularly visiting an outpatient clinic for chronic disease treatment participated in this cross-sectional study. Data on participant demographics, chronic disease diagnoses, socioeconomic status, health-related role limitations (12-item short form survey scores), depressive symptoms (patient health questionnaire-9 scores), existential well-being (scores for four items of the McGill quality of life questionnaire-Revised), and health-promoting behavior (Healthy Habits Questionnaire scores) were acquired. "Undirected regularized partial correlations" and "directional joint probability distributions" among these variables were calculated using a mixed graphical model (MGM) and directed acyclic graph (DAG). In the MGM, the most influential nodes were emotional well-being, feelings of failure, and health-related limitations affecting usual role and physical activities. According to both the MGM and DAG, the relationship between emotional well-being and feelings of failure mediated the relationships of health-related role limitations with concentration difficulty and suicidal ideation. A positive mindset was dependent on the probability distributions of suicidal ideation, controllability of life, and positive self-image. Both the meaning of life and a positive mindset had direct associations with proactive living. Specifically, proactive living was associated with a balanced diet, regular exercise, volunteering in the community, and nurturing intimacy in social interactions. The meaning and controllability of life in individuals with chronic diseases could mediate the relationships of health-promoting behavior with health-related limitations related to usual role activities, physical activities, and depressive symptoms. Thus, interventions targeting health-promoting behaviors should aim to enhance the meaning and controllability of life (as it pertains to limitations in usual role and physical activities), as well as promote proactive screening and timely psychiatric treatment of depressive symptoms including feelings of failure, concentration difficulties, and suicidal ideation.
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ho Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Family Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
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14
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Wrobel AL, Cotton SM, Jayasinghe A, Diaz‐Byrd C, Yocum AK, Turner A, Dean OM, Russell SE, Duval ER, Ehrlich TJ, Marshall DF, Berk M, McInnis MG. Childhood trauma and depressive symptoms in bipolar disorder: A network analysis. Acta Psychiatr Scand 2023; 147:286-300. [PMID: 36645036 PMCID: PMC10953422 DOI: 10.1111/acps.13528] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Childhood trauma is related to an increased number of depressive episodes and more severe depressive symptoms in bipolar disorder. The evaluation of the networks of depressive symptoms-or the patterns of relationships between individual symptoms-among people with bipolar disorder with and without a history of childhood trauma may assist in further clarifying this complex relationship. METHODS Data from over 500 participants from the Heinz C. Prechter Longitudinal Study of Bipolar Disorder were used to construct a series of regularised Gaussian Graphical Models. The networks of individual depressive symptoms-self-reported (Patient Health Questionnaire-9; n = 543) and clinician-rated (Hamilton Depression Rating Scale-17; n = 529)-among participants with bipolar disorder with and without a history of childhood trauma (Childhood Trauma Questionnaire) were characterised and compared. RESULTS Across the sets of networks, depressed mood consistently emerged as a central symptom (as indicated by strength centrality and expected influence); regardless of participants' history of childhood trauma. Additionally, feelings of worthlessness emerged as a key symptom in the network of self-reported depressive symptoms among participants with-but not without-a history of childhood trauma. CONCLUSION The present analyses-although exploratory-provide nuanced insights into the impact of childhood trauma on the presentation of depressive symptoms in bipolar disorder, which have the potential to aid detection and inform targeted intervention development.
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Affiliation(s)
- Anna L. Wrobel
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongVictoriaAustralia
- OrygenParkvilleVictoriaAustralia
| | - Sue M. Cotton
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Anuradhi Jayasinghe
- OrygenParkvilleVictoriaAustralia
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Claudia Diaz‐Byrd
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Anastasia K. Yocum
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Alyna Turner
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongVictoriaAustralia
- School of Medicine and Public HealthUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Olivia M. Dean
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongVictoriaAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Samantha E. Russell
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongVictoriaAustralia
| | - Elizabeth R. Duval
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Tobin J. Ehrlich
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - David F. Marshall
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Michael Berk
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongVictoriaAustralia
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
- Department of Psychiatry, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Melvin G. McInnis
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
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15
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Heeren A, Mouguiama-Daouda C, McNally RJ. A network approach to climate change anxiety and its key related features. J Anxiety Disord 2023; 93:102625. [PMID: 36030121 DOI: 10.1016/j.janxdis.2022.102625] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/13/2023]
Abstract
Research has pointed to startling worldwide rates of people reporting considerable anxiety vis-à-vis climate change. Yet, uncertainties remain regarding how climate anxiety's cognitive-emotional features and daily life functional impairments interact with one another and with climate change experience, pro-environmental behaviors, and general worry. In this study, we apply network analyses to examine the associations among these variables in an international community sample (n = 874). We computed two network models, a graphical Gaussian model to explore network structure, potential communities, and influential nodes, and a directed acyclic graph to examine the probabilistic dependencies among the variables. Both network models pointed to the cognitive-emotional features of climate anxiety as a potential hub bridging general worry, the experience of climate change, pro-environmental behaviors, and the functional impairments associated with climate anxiety. Our findings offer data-driven clues for the field's larger quest to establish the foundations of climate anxiety.
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Affiliation(s)
- Alexandre Heeren
- Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Institute of Neuroscience, UCLouvain, Brussels, Belgium; National Fund for Scientific Research (FRS-FNRS), Brussels, Belgium.
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16
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Chen S, Bi K, Lyu S, Sun P, Bonanno GA. Depression and PTSD in the aftermath of strict COVID-19 lockdowns: a cross-sectional and longitudinal network analysis. Eur J Psychotraumatol 2022; 13:2115635. [PMID: 36186164 PMCID: PMC9518634 DOI: 10.1080/20008066.2022.2115635] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) are two highly comorbid psychological outcomes commonly studied in the context of stress and potential trauma. In Hubei, China, of which Wuhan is the capital, residents experienced unprecedented stringent lockdowns in the early months of 2020 when COVID-19 was first reported. The comorbidity between PTSD and MDD has been previously studied using network models, but often limited to cross-sectional data and analysis. Objectives: This study aims to examine the cross-sectional and longitudinal network structures of MDD and PTSD symptoms using both undirected and directed methods. Methods: Using three types of network analysis - cross-sectional undirected network, longitudinal undirected network, and directed acyclic graph (DAG) - we examined the interrelationships between MDD and PTSD symptoms in a sample of Hubei residents assessed in April, June, August, and October 2020. We identified the most central symptoms, the most influential bridge symptoms, and causal links among symptoms. Results: In both cross-sessional and longitudinal networks, the most central depressive symptoms included sadness and depressed mood, whereas the most central PTSD symptoms changed from irritability and hypervigilance at the first wave to difficulty concentrating and avoidance of potential reminders at later waves. Bridge symptoms showed similarities and differences between cross-sessional and longitudinal networks with irritability/anger as the most influential bridge longitudinally. The DAG found feeling blue and intrusive thoughts the gateways to the emergence of other symptoms. Conclusions: Combining cross-sectional and longitudinal analysis, this study elucidated central and bridge symptoms and potential causal pathways among PTSD and depression symptoms. Clinical implications and limitations are discussed.
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Affiliation(s)
- Shuquan Chen
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Kaiwen Bi
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, People’s Republic of China
| | - Shibo Lyu
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Pei Sun
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, People’s Republic of China
| | - George A. Bonanno
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, New York, NY, USA
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17
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Bai W, Feng Y, Sha S, Zhang Q, Cheung T, Zhang D, Su Z, Ng CH, Xiang YT. Comparison of Hypomanic Symptoms Between Bipolar I and Bipolar II Disorders: A Network Perspective. Front Psychiatry 2022; 13:881414. [PMID: 35633807 PMCID: PMC9135060 DOI: 10.3389/fpsyt.2022.881414] [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: 02/22/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hypomanic symptoms between bipolar-I disorder (BD-I) and bipolar-II disorder (BD-II) are often indistinguishable in clinical practice. This study compared the network structure of hypomanic symptoms between patients with BD-I and BD-II. METHODS The 32-item Hypomania Checklist (HCL-32) was used to assess hypomanic symptoms. Network model was generated in BD-I and BD-II patients. Centrality index of strength was used to quantify the importance of each symptom in the network. The Network Comparison Test (NCT) was used to assess the differences in hypomanic symptoms between BD-I and BD-II patients. RESULTS Altogether, 423 patients with BD (BD-I: 191 and BD-II: 232) were included. The most central symptom was HCL17 "I am more flirtatious and/or am more sexually active" (strength BD-I = 5.21) and HCL12 "I have more ideas, I am more creative" (strength BD-II = 6.84) in BD-I and BD-II samples, respectively. The results of NCT showed that four nodes (HCL12 "I have more ideas, I am more creative," HCL17 "I am more flirtatious and/or am more sexually active," HCL23 "My thoughts jump from topic to topic," and HCL31 "I drink more alcohol") were significantly different between the BD-I and BD-II samples. Two edges (HCL3 "I am more self-confident"-HCL17 "I am more flirtatious and/or am more sexually active," and HCL10 "I am physically more active (sport, etc.)"-HCL24 "I do things more quickly and/or more easily") were significantly stronger in BD-I compared to BD-II patients. CONCLUSION The network structure of hypomanic symptoms is different between BD-I and BD-II patients. Interventions targeting the respective central symptoms and edges should be developed for BD-I and BD-II separately.
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Affiliation(s)
- Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao, Macao SAR, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, Macao SAR, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Dexing Zhang
- Faculty of Medicine, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao, Macao SAR, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, Macao SAR, China
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