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Carmichael J, Ponsford J, Gould KR, Tiego J, Forbes MK, Kotov R, Fornito A, Spitz G. A Transdiagnostic, Hierarchical Taxonomy of Psychopathology Following Traumatic Brain Injury (HiTOP-TBI). J Neurotrauma 2024. [PMID: 38970424 DOI: 10.1089/neu.2024.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2024] Open
Abstract
Psychopathology, including depression, anxiety, and post-traumatic stress, is a significant yet inadequately addressed feature of moderate-severe traumatic brain injury (TBI). Progress in understanding and treating post-TBI psychopathology may be hindered by limitations associated with conventional diagnostic approaches, specifically the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). The Hierarchical Taxonomy of Psychopathology (HiTOP) offers a promising, transdiagnostic alternative to psychiatric classification that may more effectively capture the experiences of individuals with TBI. However, HiTOP lacks validation in the TBI population. To address this gap, we administered a comprehensive questionnaire battery, including 56 scales assessing homogeneous symptom components and maladaptive traits within HiTOP, to 410 individuals with moderate-severe TBI. We evaluated the reliability and unidimensionality of each scale and revised those with psychometric problems. Using a top-down, exploratory latent variable approach (bass-ackwards modeling), we subsequently constructed a hierarchical model of psychopathological dimensions tailored to TBI. The results showed that, relative to norms, participants with moderate-severe TBI experienced greater problems in the established HiTOP internalizing and detachment spectra, but fewer problems with thought disorder and antagonism. Fourteen of the 56 scales demonstrated psychometric problems, which often appeared reflective of the TBI experience and associated disability. The Hierarchical Taxonomy of Psychopathology Following Traumatic Brain Injury (HiTOP-TBI) model encompassed broad internalizing and externalizing spectra, splitting into seven narrower dimensions: Detachment, Dysregulated Negative Emotionality, Somatic Symptoms, Compensatory and Phobic Reactions, Self-Harm and Psychoticism, Rigid Constraint, and Harmful Substance Use. This study presents the most comprehensive empirical classification of psychopathology after TBI to date. It introduces a novel, TBI-specific transdiagnostic questionnaire battery and model, which addresses the limitations of conventional DSM and ICD diagnoses. The empirical structure of psychopathology after TBI largely aligned with the established HiTOP model (e.g., a detachment spectrum). However, these constructs need to be interpreted in relation to the unique experiences associated with TBI (e.g., considering the injury's impact on the person's social functioning). By overcoming the limitations of conventional diagnostic approaches, the HiTOP-TBI model has the potential to accelerate our understanding of the causes, correlates, consequences, and treatment of psychopathology after TBI.
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Affiliation(s)
- Jai Carmichael
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Kate Rachel Gould
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Roman Kotov
- Stony Brook University, New York, New York, USA
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Gershon Spitz
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Haywood D, Castle DJ, Hart NH. Avoiding the pitfalls of the DSM-5: A primer for health professionals. Gen Hosp Psychiatry 2024; 90:88-90. [PMID: 39053381 DOI: 10.1016/j.genhosppsych.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/13/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, School of Sport, Exercise, and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - David J Castle
- Department of Health, Tasmanian Centre for Mental Health Service Innovation Hobart, Tasmania, Australia; Department of Psychiatry, University of Tasmania, Hobart, Tasmania, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, School of Sport, Exercise, and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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Pérez-Esteban A, Díez-Gómez A, Pérez-Albéniz A, Al-Halabí S, Lucas-Molina B, Debbané M, Fonseca-Pedrero E. The assessment of transdiagnostic dimensions of emotional disorders: Validation of the Multidimensional Emotional Disorders Inventory (MEDI) in adolescents with subthreshold anxiety and depression. J Affect Disord 2024; 357:138-147. [PMID: 38685278 DOI: 10.1016/j.jad.2024.04.081] [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: 09/26/2023] [Revised: 03/27/2024] [Accepted: 04/21/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. METHOD The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. RESULTS The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LIMITATIONS Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. CONCLUSION The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.
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Affiliation(s)
| | | | | | | | | | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
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Haywood D, Kotov R, Krueger RF, Wright AGC, Forbes MK, Dauer E, Baughman FD, Rossell SL, Hart NH. Reconceptualizing mental health in cancer survivorship. Trends Cancer 2024:S2405-8033(24)00106-7. [PMID: 38890021 DOI: 10.1016/j.trecan.2024.05.008] [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: 02/26/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/20/2024]
Abstract
Mental health for cancer survivors in both research and clinical applications has strongly adopted a traditional nosological approach, involving the classification of psychopathology into discrete disorders. However, this approach has recently faced considerable criticism due to issues such as high comorbidity and within-disorder symptom heterogeneity across populations. Moreover, there are additional specific issues impacting the validity of traditional approaches in cancer survivorship populations, including the physiological effects of cancer and its treatments. In response, we provide the case for the hierarchical dimensional approach within psycho-oncology, in particular the Hierarchical Taxonomy of Psychopathology (HiTOP). We discuss not only the potential utility of HiTOP to research and clinical applications within psycho-oncology, but also its limitations, and what is required to apply this approach within cancer survivorship.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Aidan G C Wright
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA; Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Frank D Baughman
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Susan L Rossell
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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Crowe ML, Hawn SE, Wolf EJ, Keane TM, Marx BP. Trauma exposure and transdiagnostic distress: Examining shared and posttraumatic stress disorder-specific associations. J Trauma Stress 2024; 37:372-383. [PMID: 38229407 DOI: 10.1002/jts.23009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/14/2023] [Accepted: 12/01/2023] [Indexed: 01/18/2024]
Abstract
We examined transdiagnostic and posttraumatic stress disorder (PTSD)-specific associations with multiple forms of trauma exposure within a nationwide U.S. sample (N = 1,649, 50.0% female) of military veterans overselected for PTSD. A higher-order Distress factor was estimated using PTSD, major depressive disorder (MDD), and generalized anxiety disorder (GAD) symptoms as indicators. A structural equation model spanning three assessment points over an average of 3.85 years was constructed to examine the unique roles of higher-order Distress and PTSD-specific variance in accounting for the associations between trauma exposure, measured using the Life Events Checklist (LEC) and Deployment Risk and Resiliency Inventory Combat subscale (DRRI-C), and psychosocial impairment. The results suggest the association between trauma exposure and PTSD symptoms was primarily mediated by higher-order distress (70.7% of LEC effect, 63.2% of DRRI-C effect), but PTSD severity retained a significant association with trauma exposure independent of distress, LEC: β = .10, 95% CI [.06, .13]; DRRI-C: β = .11, 95% CI [.07, .14]. Both higher-order distress, β = .31, and PTSD-specific variance, β = .36, were necessary to account for the association between trauma exposure and future impairment. Findings suggest that trauma exposure may contribute to comorbidity across a range of internalizing symptoms as well as to PTSD-specific presentations.
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Affiliation(s)
- Michael L Crowe
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Sage E Hawn
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- National Center for PTSD, Boston, Massachusetts, USA
| | - Erika J Wolf
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD, Boston, Massachusetts, USA
| | - Terence M Keane
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD, Boston, Massachusetts, USA
| | - Brian P Marx
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD, Boston, Massachusetts, USA
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Thompson AJ, Henrich CC, Steelesmith DL, Hughes J, Ruch D, Bridge JA, Campo JV, Fontanella CA. Identifying Subgroups of Youth Suicide Decedents Based on Clinical Profiles of Psychiatric and Medical Diagnoses: A Latent Class Analysis. J Adolesc Health 2024; 74:1191-1197. [PMID: 38520430 DOI: 10.1016/j.jadohealth.2024.02.006] [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: 05/22/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To identify risk subgroups of youth suicide decedents using demographic and clinical psychiatric and medical diagnostic profiles to inform tailored youth suicide prevention efforts. METHODS This study linked Ohio Medicaid and death certificate data for Medicaid enrolled youth aged 8-25 years who died by suicide between January 1, 2010, and December 31, 2020 (N = 511). Latent class analysis was used to identify distinct clinical risk subgroups. RESULTS Three latent classes were identified. Internalizing problems were common across all classes, but especially prevalent in class 1, the High Internalizing + Multiple Comorbidities group (n = 152, 30%). A prior history of suicidal behavior was confined to class 1 decedents, who were otherwise characterized by substance misuse, and multiple psychiatric and medical comorbidities. Class 2 decedents, the Internalizing + Externalizing group (n = 176, 34%), were more often younger, male, Black, and unlikely to have a history of substance misuse. Decedents in class 3, the Internalizing + Substance Misuse group (n = 183, 36%), were more often older and likely to have a history of substance misuse, but unlikely to exhibit other externalizing problems. DISCUSSION Internalizing psychopathology is particularly common among youth who die by suicide, with comorbid externalizing psychopathology, substance misuse, and medical problems contributing to youth suicide risk. Because less than a third of youth who die by suicide have a prior history of recognized suicidal thinking or behavior, universal screening for youth suicide risk should be considered, particularly in younger children, and efforts to integrate suicide prevention in traditional health care settings should be prioritized.
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Affiliation(s)
- Amanda J Thompson
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio.
| | | | - Danielle L Steelesmith
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer Hughes
- Big Lots Behavioral Health Services and Division of Child and Family Psychiatry, Nationwide Children's Hospital, Columbus, Ohio; Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Donna Ruch
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio State University, Columbus, Ohio
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio State University, Columbus, Ohio
| | - John V Campo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cynthia A Fontanella
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
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Hur J, Tillman RM, Kim HC, Didier P, Anderson AS, Islam S, Stockbridge MD, De Los Reyes A, DeYoung KA, Smith JF, Shackman AJ. Adolescent social anxiety is associated with diminished discrimination of anticipated threat and safety in the bed nucleus of the stria terminalis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.30.564701. [PMID: 38853920 PMCID: PMC11160578 DOI: 10.1101/2023.10.30.564701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Social anxiety-which typically emerges in adolescence-lies on a continuum and, when extreme, can be devastating. Socially anxious individuals are prone to heightened fear, anxiety, and the avoidance of contexts associated with potential social scrutiny. Yet most neuroimaging research has focused on acute social threat. Much less attention has been devoted to understanding the neural systems recruited during the uncertain anticipation of potential encounters with social threat. Here we used a novel fMRI paradigm to probe the neural circuitry engaged during the anticipation and acute presentation of threatening faces and voices in a racially diverse sample of 66 adolescents selectively recruited to encompass a range of social anxiety and enriched for clinically significant levels of distress and impairment. Results demonstrated that adolescents with more severe social anxiety symptoms experience heightened distress when anticipating encounters with social threat, and reduced discrimination of uncertain social threat and safety in the bed nucleus of the stria terminalis (BST), a key division of the central extended amygdala (EAc). Although the EAc-including the BST and central nucleus of the amygdala-was robustly engaged by the acute presentation of threatening faces and voices, the degree of EAc engagement was unrelated to the severity of social anxiety. Together, these observations provide a neurobiologically grounded framework for conceptualizing adolescent social anxiety and set the stage for the kinds of prospective-longitudinal and mechanistic research that will be necessary to determine causation and, ultimately, to develop improved interventions for this often-debilitating illness.
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Sha Z, Sun KY, Jung B, Barzilay R, Moore TM, Almasy L, Forsyth JK, Prem S, Gandal MJ, Seidlitz J, Glessner JT, Alexander-Bloch AF. The copy number variant architecture of psychopathology and cognitive development in the ABCD ® study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.14.24307376. [PMID: 38798629 PMCID: PMC11118651 DOI: 10.1101/2024.05.14.24307376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Importance Childhood is a crucial developmental phase for mental health and cognitive function, both of which are commonly affected in patients with psychiatric disorders. This neurodevelopmental trajectory is shaped by a complex interplay of genetic and environmental factors. While common genetic variants account for a large proportion of inherited genetic risk, rare genetic variations, particularly copy number variants (CNVs), play a significant role in the genetic architecture of neurodevelopmental disorders. Despite their importance, the relevance of CNVs to child psychopathology and cognitive function in the general population remains underexplored. Objective Investigating CNV associations with dimensions of child psychopathology and cognitive functions. Design Setting and Participants ABCD® study focuses on a cohort of over 11,875 youth aged 9 to 10, recruited from 21 sites in the US, aiming to investigate the role of various factors, including brain, environment, and genetic factors, in the etiology of mental and physical health from middle childhood through early adulthood. Data analysis occurred from April 2023 to April 2024. Main Outcomes and Measures In this study, we utilized PennCNV and QuantiSNP algorithms to identify duplications and deletions larger than 50Kb across a cohort of 11,088 individuals from the Adolescent Brain Cognitive Development® study. CNVs meeting quality control standards were subjected to a genome-wide association scan to identify regions associated with quantitative measures of broad psychiatric symptom domains and cognitive outcomes. Additionally, a CNV risk score, reflecting the aggregated burden of genetic intolerance to inactivation and dosage sensitivity, was calculated to assess its impact on variability in overall and dimensional child psychiatric and cognitive phenotypes. Results In a final sample of 8,564 individuals (mean age=9.9 years, 4,532 males) passing quality control, we identified 4,111 individuals carrying 5,760 autosomal CNVs. Our results revealed significant associations between specific CNVs and our phenotypes of interest, psychopathology and cognitive function. For instance, a duplication at 10q26.3 was associated with overall psychopathology, and somatic complaints in particular. Additionally, deletions at 1q12.1, along with duplications at 14q11.2 and 10q26.3, were linked to overall cognitive function, with particular contributions from fluid intelligence (14q11.2), working memory (10q26.3), and reading ability (14q11.2). Moreover, individuals carrying CNVs previously associated with neurodevelopmental disorders exhibited greater impairment in social functioning and cognitive performance across multiple domains, in particular working memory. Notably, a higher deletion CNV risk score was significantly correlated with increased overall psychopathology (especially in dimensions of social functioning, thought disorder, and attention) as well as cognitive impairment across various domains. Conclusions and Relevance In summary, our findings shed light on the contributions of CNVs to interindividual variability in complex traits related to neurocognitive development and child psychopathology.
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Affiliation(s)
- Zhiqiang Sha
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - Kevin Y. Sun
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - Benjamin Jung
- Section on Neurobehavioral and Clinical Research, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ran Barzilay
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - Tyler M. Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Almasy
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Smrithi Prem
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
- Graduate Program in Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Michael J. Gandal
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - Joseph T. Glessner
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Aaron F. Alexander-Bloch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
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Randau M, Reinholt N, Pernet C, Oranje B, Rasmussen BS, Arnfred S. Robust single-trial event-related potentials differentiate between distress and fear disorders. Psychophysiology 2024; 61:e14500. [PMID: 38073133 DOI: 10.1111/psyp.14500] [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: 07/20/2023] [Revised: 10/24/2023] [Accepted: 11/21/2023] [Indexed: 04/17/2024]
Abstract
Recent evidence indicates that measures of brain functioning as indexed by event-related potentials (ERPs) on the electroencephalogram align more closely to transdiagnostic measures of psychopathology than to categorical taxonomies. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a transdiagnostic, dimensional framework aiming to solve issues of comorbidity, symptom heterogeneity, and arbitrary diagnostic boundaries. Based on shared features, the emotional disorders are allocated into subfactors Distress and Fear. Evidence indicates that disorders that are close in the HiTOP hierarchy share etiology, symptom profiles, and treatment outcomes. However, further studies testing the biological underpinnings of the HiTOP are called for. In this study, we assessed differences between Distress and Fear in a range of well-studied ERP components. In total, 50 patients with emotional disorders were divided into two groups (Distress, N = 25; Fear, N = 25) according to HiTOP criteria and compared against 37 healthy comparison (HC) subjects. Addressing issues in traditional ERP preprocessing and analysis methods, we applied robust single-trial analysis as implemented in the EEGLAB toolbox LIMO EEG. Several ERP components were found to differ between the groups. Surprisingly, we found no difference between Fear and HC for any of the ERPs. This suggests that some well-established results from the literature, e.g., increased error-related negativity in OCD, are not a shared neurobiological correlate of the Fear subfactor. Conversely, for Distress, we found reductions compared to Fear and HC in several ERP components across paradigms. Future studies could utilize HiTOP-validated psychopathology measures to more precisely define subfactor groups.
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Affiliation(s)
- Martin Randau
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nina Reinholt
- Psychiatric Research Unit, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
| | - Cyril Pernet
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bob Oranje
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Copenhagen University Hospital, Copenhagen, Denmark
| | - Belinda S Rasmussen
- Psychiatric Research Unit, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
| | - Sidse Arnfred
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Research Unit, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
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Clark HM, Hankin BL, Narayan AJ, Davis EP. Risk and resilience factors for psychopathology during pregnancy: An application of the Hierarchical Taxonomy of Psychopathology (HiTOP). Dev Psychopathol 2024; 36:545-561. [PMID: 36734236 PMCID: PMC10397364 DOI: 10.1017/s0954579422001390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Pregnancy is a time of increased vulnerability to psychopathology, yet limited work has investigated the extent to which variation in psychopathology during pregnancy is shared and unshared across syndromes and symptoms. Understanding the structure of psychopathology during pregnancy, including associations with childhood experiences, may elucidate risk and resilience factors that are transdiagnostic and/or specific to particular psychopathology phenotypes. Participants were 292 pregnant individuals assessed using multiple measures of psychopathology. Confirmatory factor analyses found evidence for a structure of psychopathology consistent with the Hierarchical Taxonomy of Psychopathology (HiTOP). A common transdiagnostic factor accounted for most variation in psychopathology, and both adverse and benevolent childhood experiences (ACEs and BCEs) were associated with this transdiagnostic factor. Furthermore, pregnancy-specific anxiety symptoms most closely reflected the dimension of Fear, which may suggest shared variation with manifestations of fear that are not pregnancy-specific. ACEs and BCEs also linked to specific prenatal psychopathology involving thought problems, detachment, and internalizing, externalizing, antagonistic, and antisocial behavior. These findings extend the dimensional and hierarchical HiTOP model to pregnant individuals and show how maternal childhood risk and resilience factors relate to common and specific forms of psychopathology during pregnancy as a period of enhanced vulnerability.
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Affiliation(s)
- Hannah M Clark
- Department of Psychology, Brandeis University, 415 South St., Waltham, MA, 02453, USA
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 East Daniel St., Champaign, IL, 61820, USA
| | - Angela J Narayan
- Department of Psychology, University of Denver, 2155 South Race St., Denver, CO, 80208, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, 2155 South Race St., Denver, CO, 80208, USA
- Department of Pediatrics, University of California, Irvine, 3028 Hewitt Hall, Irvine, CA, 92697, USA
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Asgel Z, Kouakou MR, Koller D, Pathak GA, Cabrera-Mendoza B, Polimanti R. Unraveling COVID-19 relationship with anxiety disorders and symptoms using genome-wide data. J Affect Disord 2024; 352:333-341. [PMID: 38382819 PMCID: PMC10939738 DOI: 10.1016/j.jad.2024.02.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND There is still a limited understanding of the dynamics contributing to the comorbidity of COVID-19 and anxiety outcomes. METHODS To dissect the pleiotropic mechanisms contributing to COVID-19/anxiety comorbidity, we used genome-wide data from UK Biobank (up to 420,531 participants), FinnGen Project (up to 329,077 participants), Million Veteran Program (175,163 participants), and COVID-19 Host Genetics Initiative (up to 122,616 cases and 2,475,240 controls). Specifically, we assessed global and local genetic correlation and genetically inferred effects linking COVID-19 outcomes (infection, hospitalization, and severe respiratory symptoms) to anxiety disorders and symptoms. RESULTS We observed a strong genetic correlation of anxiety disorder with COVID-19 positive status (rg = 0.35, p = 2×10-4) and COVID-19 hospitalization (rg = 0.31, p = 7.2×10-4). Among anxiety symptoms, "Tense, sore, or aching muscles during worst period of anxiety" was genetically correlated with COVID-19 positive status (rg = 0.33, p = 0.001), while "Frequent trouble falling or staying asleep during worst period of anxiety" was genetically correlated with COVID-19 hospitalization (rg = 0.24, p = 0.004). Through a latent causal variable analysis, we observed that COVID-19 outcomes have statistically significant genetic causality proportion (gcp) on anxiety symptoms (e.g., COVID-19 positive status→"Recent easy annoyance or irritability" │gcp│ = 0.18, p = 6.72×10-17). Conversely, anxiety disorders appear to have a possible causal effect on COVID-19 (│gcp│ = 0.38, p = 3.17×10-9). Additionally, we also identified multiple loci with evidence of local genetic correlation between anxiety and COVID-19. These appear to be related to genetic effects shared with lung function, brain morphology, alcohol and tobacco use, and hematologic parameters. CONCLUSIONS This study provided insights into the pleiotropic mechanisms linking COVID-19 and anxiety outcomes, suggesting differences between dynamics related to anxiety disorders and those related to anxiety symptoms.
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Affiliation(s)
- Zeynep Asgel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Manuela R Kouakou
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Dora Koller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain
| | - Gita A Pathak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Brenda Cabrera-Mendoza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA.
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Basterfield C, Fitzsimmons-Craft EE, Taylor CB, Eisenberg D, Wilfley DE, Newman MG. Internalizing psychopathology and its links to suicidal ideation, dysfunctional attitudes, and help-seeking readiness in a national sample of college students. J Affect Disord 2024; 350:255-263. [PMID: 38224742 PMCID: PMC11057016 DOI: 10.1016/j.jad.2024.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Recent evidence suggests that multiple emotional disorders may be better assessed using dimensional models of psychopathology. The current study utilized a cross-sectional population survey of college students (N = 8613 participants) to examine the extent to which broad psychopathology factors accounted for specific associations between emotional problems and clinical and behavioral validators: suicidality, dysfunctional attitudes, and treatment seeking. METHODS Confirmatory factor models were estimated to identify the best structure of psychopathology. Models were then estimated to examine the broad and specific associations between each psychopathology indicator and the clinical and behavioral validators. RESULTS The hierarchical model of psychopathology with internalizing problems at the top, fear, and distress at the second level, and five specific symptom dimensions at the third level evidenced the best fit. The associations between symptom indicators of psychopathology and clinical and behavioral validators were relatively small and inconsistent. Instead, much of the association between clinical and behavioral validators and emotional problems operated at a higher-order level. LIMITATIONS The cross-sectional nature of the survey precludes the ability to make conclusions regarding causality. CONCLUSIONS Researchers should focus on investigating the shared or common components across emotional disorders, particularly concerning individuals presenting with higher rates of suicidal ideation dysfunctional attitudes, and help-seeking behavior. Using higher-order dimensions of psychopathology could simplify the complex presentation of multiple co-occurring disorders and suggest valid constructs for future investigations.
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13
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Boecking B, Klasing S, Brueggemann P, Rose M, Mazurek B. Lipid parameters and depression in patients with chronic tinnitus: A cross-sectional observation. J Psychosom Res 2024; 179:111613. [PMID: 38492273 DOI: 10.1016/j.jpsychores.2024.111613] [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: 09/11/2023] [Revised: 01/04/2024] [Accepted: 02/17/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Pathophysiological theories assume importance of metabolic abnormalities in patients with major depression - and possibly chronic tinnitus. Although chronic tinnitus frequently correlates with depression, links between high-density lipoprotein (HDL) and depression are uninvestigated. METHODS Two-hundred patients with chronic tinnitus (Mage = 55; 51% female) were examined. Serum levels of total cholesterol (TC), triglycerides (TGs), HDL, low-density lipoprotein cholesterol (LDL), non-HDL, as well as LDL/HDL and TC/HDL ratios were analysed. Questionnaires included depression subscales of the ICD-10 Symptom Rating, the Hospital Anxiety and Depression Scale (HADS_D), and the Berlin Mood Questionnaire (BSF). Multivariate analyses of covariance and linear regression models - which controlled age, tinnitus-related distress and perceived stress - investigated between-subgroup differences (p < 0.05) and linear associations between HDL indices and depression (p < 0.01). RESULTS HDL levels did not differ for tinnitus-symptom durations, smoking and alcohol use levels, statin or antihypertensive drug use, and body-mass indices. Relative to non-to-mildly depressed patients with chronic tinnitus, patients with moderate-to-severe depression (n = 45; 23%) had significantly lower HDL levels (d = -0.35) and higher LDL/HDL (d = 0.39) and TC/HDL ratios (d = 0.40). Across participants, HDL-levels were negatively associated with depression as measured by the HADS_D and BSF_indifference scales. CONCLUSIONS In keeping with general depression research, low serum HDL levels correlate with depressive symptomatology in patients with chronic tinnitus. This association may be influenced by proximal (e.g. modulations of HPA-axis activity) or distal factors (e.g. maladaptive coping behaviours) - both of which should be conceptualized within psychological stimulus-processing frameworks.
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Affiliation(s)
| | - Sven Klasing
- Tinnitus Center, Charité - Universitatsmedizin Berlin, Germany
| | | | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité - Universitatsmedizin Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité - Universitatsmedizin Berlin, Germany.
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Harris JL, Swanson B, Petersen IT. A Developmentally Informed Systematic Review and Meta-Analysis of the Strength of General Psychopathology in Childhood and Adolescence. Clin Child Fam Psychol Rev 2024; 27:130-164. [PMID: 38112921 PMCID: PMC10938301 DOI: 10.1007/s10567-023-00464-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 12/21/2023]
Abstract
Considerable support exists for higher-order dimensional conceptualizations of psychopathology in adults. A growing body of work has focused on understanding the structure of general and specific psychopathology in children and adolescents. No prior meta-analysis has examined whether the strength of the general psychopathology factor (p factor)-measured by explained common variance (ECV)-changes from childhood to adolescence. The primary objective of this multilevel meta-analysis was to determine whether general psychopathology strength changes across development (i.e. across ages) in childhood and adolescence. Several databases were searched in November 2021; 65 studies, with 110 effect sizes (ECV), nested within shared data sources, were identified. Included empirical studies used a factor analytic modeling approach that estimated latent factors for child/adolescent internalizing, externalizing, and optionally thought-disordered psychopathology, and a general factor. Studies spanned ages 2-17 years. Across ages, general psychopathology explained over half (~ 56%) of the reliable variance in symptoms of psychopathology. Age-moderation analyses revealed that general factor strength remained stable across ages, suggesting that general psychopathology strength does not significantly change across childhood to adolescence. Even if the structure of psychopathology changes with development, the prominence of general psychopathology across development has important implications for future research and intervention.
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Affiliation(s)
- Jordan L Harris
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Avenue G60, Iowa City, IA, 52242, USA.
| | - Benjamin Swanson
- Department of Psychological Sciences, University of Arkansas, Fayetteville, AR, USA
| | - Isaac T Petersen
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Avenue G60, Iowa City, IA, 52242, USA
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Boysen GA. Dissociative Identity Disorder: A Review of Research From 2011 to 2021. J Nerv Ment Dis 2024; 212:174-186. [PMID: 38412243 DOI: 10.1097/nmd.0000000000001764] [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] [Indexed: 02/29/2024]
Abstract
ABSTRACT Dissociative identity disorder (DID) has historically been one of the most controversial topics in the study of psychopathology. Building on a previous review of empirical research on DID from 2000 to 2010, the present review examined DID research from 2011 to 2021. The research output included 56 case studies and 104 empirical studies. Within the empirical studies, approximately 1354 new cases of DID emerged, which resulted in an average samples of approximately 20. Reanalysis of previous samples was standard in the literature with only 40% of reported cases being new. Studies emerged from dozens of countries across the world, but the majority of cases were from Western counties, especially the United States. Diagnosis primarily relied upon validated measures, but 74% of all new cases came from six research groups. Overall, research on DID is steady but methodologically limited in ways that make generalization, especially about etiology, difficult.
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Affiliation(s)
- Guy A Boysen
- Department of Psychology, McKendree University, Lebanon, Illinois
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van der Cruijsen R, Begeer S, Crone EA. The role of autism and alexithymia traits in behavioral and neural indicators of self-concept and self-esteem in adolescence. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241232860. [PMID: 38411147 DOI: 10.1177/13623613241232860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
LAY ABSTRACT Developing a positive view of the self is important for maintaining a good mental health, as feeling negative about the self increases the risk of developing internalizing symptoms such as feelings of depression and anxiety. Even though autistic individuals regularly struggle with these internalizing feelings, and both self-concept and internalizing feelings are known to develop during adolescence, there is a lack of studies investigating the development of positive self-concept and self-esteem in autistic adolescents. Here, we studied academic, physical, and prosocial self-concept as well as self-esteem in adolescent males with and without autism on both the behavioral and neural level. We additionally focused on similarities in one's own and peers' perspectives on the self, and we assessed a potential role of alexithymia (i.e. having trouble identifying and describing one's feelings) in developing a more negative view of the self. Results showed that there were no group differences in self-esteem, self-concept, or underlying neural activation. This shows that autistic adolescent males use the same neural processes when they evaluate their traits. However, regardless of clinical diagnosis, a higher number of autism traits was related to a less positive physical and prosocial self-concept, whereas more difficulty identifying one's feelings was related to lowered self-esteem and less activation in medial prefrontal cortex during self-evaluations. Therefore, in treatment of autistic adolescents with low self-esteem, it is important to take into account and possibly aim to improve alexithymic traits as well.
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Rapisarda F, Guay S, Ouellet-Morin I, Bond S, Geoffrion S. Longitudinal assessment of psychological distress and its determinants in a sample of firefighters based in Montreal, Canada. Front Psychol 2024; 15:1303063. [PMID: 38425559 PMCID: PMC10902061 DOI: 10.3389/fpsyg.2024.1303063] [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: 09/27/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Firefighters face elevated risks of common mental health issues, with distress rates estimated at around 30%, surpassing those of many other occupational groups. While exposure to potentially traumatic events (PTEs) is a well-recognized risk factor, existing research acknowledges the need for a broader perspective encompassing multidimensional factors within the realm of occupational stress. Furthermore, this body of evidence heavily relies on cross-sectional studies. This study adopts an intensive longitudinal approach to assess psychological distress and its determinants among firefighters. Methods Participants were recruited from 67 fire stations in Montreal, Canada, meeting specific criteria: full-time employment, smartphone ownership, and recent exposure to at least one PTE, or first responder status. Subjects underwent a telephone interview and were directed to use an app to report depressive, post-traumatic, and generalized anxiety symptoms every 2 weeks, along with work-related stressors, social support, and coping styles. Analyses involved 274 participants, distinguishing between those exceeding clinical thresholds in at least one distress measure (the "distressed" subgroup) and those deemed "resilient." The duration and onset of distress were computed for the distressed group, and linear mixed models were employed to evaluate determinants for each psychological distress variable. Results Clinical psychological distress was observed in 20.7% of participants, marked by depressive, post-traumatic, and anxiety symptoms, often within the first 4-week reference period. Contextual factors (operational climate, social support, solitude) and individual factors (coping style, solitude and lifetime traumatic events in private life) exhibited more significant impacts on psychological distress than professional pressures within the firefighters' work environment. Discussion This study reports lower rates of psychological distress than previous research, possibly attributable to sample differences. It highlights that reported symptoms often represent a combined and transient layer of distress rather than diagnosable mental disorders. Additionally, determinants analysis underscores the importance of interpersonal relationships and coping mechanisms for mental health prevention interventions within this worker group. The findings carry implications for the development of prevention and support programs for firefighters and similar emergency workers.
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Affiliation(s)
- Filippo Rapisarda
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Stéphane Guay
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- Département de Psychiatrie et d’Addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- École de Criminologie, Faculté des Arts et des Sciences, Université de Montréal, Montreal, ON, Canada
| | - Isabelle Ouellet-Morin
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- École de Criminologie, Faculté des Arts et des Sciences, Université de Montréal, Montreal, ON, Canada
| | - Suzie Bond
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- Département de Sciences Humaines, Lettres et Communications, Université TÉLUQ, Quebec City, QC, Canada
| | - Steve Geoffrion
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- École de Psychoéducation, Faculté des Arts et des Sciences, Université de Montréal, Montreal, QC, Canada
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18
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Martínez M, Damme KS, Vargas T, Yang B, Rompilla DJ, Stephens J, Qu Y, Mittal VA, Haase CM. Longitudinal study of peer victimization, social support, and mental health during early adolescence. Psychol Med 2024:1-16. [PMID: 38314519 PMCID: PMC11298578 DOI: 10.1017/s0033291724000035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND Peer victimization predicts the development of mental health symptoms in the transition to adolescence, but it is unclear whether and how parents and school environments can buffer this link. METHODS We analyzed two-year longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study, involving a diverse sample of 11 844 children across the United States (average at baseline = 9.91 years; standard deviation = 0.63; range = 8.92-11.08; complete case sample = 8385). Longitudinal associations between peer victimization and two-year changes in mental health symptoms of major depression disorder (MDD), separation anxiety (SA), prodromal psychosis (PP), and attention-deficit/hyperactivity disorder (ADHD) were examined including a wide range of covariates. Mixed linear models were used to test for the moderating effects of parental warmth and prosocial school environment. RESULTS 20% of children experienced peer victimization. Higher exposure to peer victimization was associated with increases in MDD, SA, and ADHD symptoms. Parental warmth was associated with decreases in MDD symptoms but did not robustly buffer the link between peer victimization and mental health symptoms. Prosocial school environment predicted decreases in PP symptoms and buffered the link between peer victimization and MDD symptoms but amplified the link between peer victimization and SA and ADHD symptoms. CONCLUSIONS Peer victimization is associated with increases in mental health symptoms during the transition to adolescence. Parental warmth and prosocial school environments might not be enough to counter the negative consequences of peer victimization on all mental health outcomes.
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Affiliation(s)
- Matías Martínez
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | | | - Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Beiming Yang
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - D. J. Rompilla
- Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jacquelyn Stephens
- Osher Center for Integrative Health, Medical Social Sciences Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yang Qu
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Vijay A. Mittal
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Osher Center for Integrative Health, Medical Social Sciences Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | - Claudia M. Haase
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Interdepartmental Neuroscience, Northwestern University, Evanston, IL, USA
- Buffett Institute for Global Studies, Northwestern University, Evanston, IL, USA
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Sadeh Y, Graham L, Curtis M, Janson M, Kim J, Schwartz A, Undset A, Denejkina A. Posttraumatic stress and depression symptom classes in parents of trauma-exposed children: a transdiagnostic perspective using pooled individual participant data. Eur J Psychotraumatol 2024; 15:2299194. [PMID: 38197328 PMCID: PMC10783838 DOI: 10.1080/20008066.2023.2299194] [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: 05/25/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024] Open
Abstract
Background: In the aftermath of child trauma, post-traumatic stress (PTS) and depression symptoms often co-occur among trauma exposed children and their parents. Studies have used latent class analysis (LCA) to examine PTS and depression symptoms and identify homogeneous subgroups among trauma exposed children. However, little is known about subgroups or classes of PTS and depression reactions of parents of traumatised children.Objectives: (1) Determine PTS and depression symptom classes at 2-9 months post-trauma, and (2) to examine sociodemographic covariates among parents of trauma exposed children.Methods: Using harmonised individual participant data (n = 702) from eight studies (Australia, UK, US) included in the Prospective studies of Acute Child Trauma and Recovery Data Archive (PACT/R), we modelled these phenomena at the symptom level using LCA.Results: Our LCA yielded three solutions: 'high internalizing symptom' class (11%); 'low PTS-high depression' class (17%); and 'low internalizing symptom' class (72%). Parents of children in the 'low PTS-high depression' class were more likely to have children of older age and be part of an ethnic minority, compared to the 'low internalizing symptoms' class. Mothers were more likely to be in the 'high internalizing symptom' class compared to the 'low internalizing symptoms' class.Conclusions: These findings reveal a qualitative structure and relationship between depression and PTS symptoms that highlights the importance of assessing and targeting a broad range of internalising symptoms in post-trauma psychological treatment.
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Affiliation(s)
- Yaara Sadeh
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Leila Graham
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael Curtis
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Melissa Janson
- Gevirtz Graduate School of Education, Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA, USA
| | - Jeeeun Kim
- Soro Orot Institute, Inc. (Soro Orot Institute – Counselor Group for Counseling and Education of Multicultural and Social Justice Issues), Seoul, Korea
| | - Ashlyn Schwartz
- Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Public Health, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Andrea Undset
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Anna Denejkina
- Translational Health Research Institute; YouthInsight, Sydney, Australia
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Xiao Z, Obsuth I, Meinck F, Murray AL. Relations between childhood psychological maltreatment and mental health dimensions within a higher-order model. Int J Clin Health Psychol 2024; 24:100416. [PMID: 37822450 PMCID: PMC10563048 DOI: 10.1016/j.ijchp.2023.100416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
Background Experiences of childhood psychological maltreatment have been found to be associated with various mental health outcomes, and this association persists into adulthood. Objective This study investigated whether some types of psychological maltreatment are more harmful than others; whether the harms associated with different types of psychological maltreatment are generalized or specific to particular domains of psychopathology; and whether the associations vary by gender. Method Participants (N = 544, 63.9 % mother as primary caregiver) were Chinese adults from various regions in China. Participants completed measures of childhood psychological maltreatment experiences perpetrated by their primary caregiver and the mental health outcomes of depression, anxiety, anger, physical aggression, and hostility. The data were analyzed in a hierarchical model in which depression and anxiety were defined as indicators of an internalizing factor, while anger, physical aggression, and hostility were defined as indicators of an externalizing factor. Internalizing and externalizing then defined a higher-order general psychopathology factor. The results suggested equivalent harms of psychological abuse and psychological neglect. Further, the associations between psychological maltreatment and mental health were not unique to specific symptom domains but showed broadband associations with general psychopathology. Results These findings suggest that trans-diagnostic interventions may be the most effective approach for addressing the mental health impacts of psychological maltreatment. Conclusion Childhood psychological maltreatment may pose a broadband risk for any and all forms of psychopathology.
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Affiliation(s)
- Zhuoni Xiao
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ingrid Obsuth
- Clinical & Health Psychology, University of Edinburgh, Edinburgh, UK
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
- Faculty of Health Sciences, North-West University, Vanderbijlpark, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Hoy N, Lynch SJ, Waszczuk MA, Reppermund S, Mewton L. Transdiagnostic biomarkers of mental illness across the lifespan: A systematic review examining the genetic and neural correlates of latent transdiagnostic dimensions of psychopathology in the general population. Neurosci Biobehav Rev 2023; 155:105431. [PMID: 37898444 DOI: 10.1016/j.neubiorev.2023.105431] [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: 07/12/2023] [Revised: 09/26/2023] [Accepted: 10/21/2023] [Indexed: 10/30/2023]
Abstract
This systematic review synthesizes evidence from research investigating the biological correlates of latent transdiagnostic dimensions of psychopathology (e.g., the p-factor, internalizing, externalizing) across the lifespan. Eligibility criteria captured genomic and neuroimaging studies investigating general and/or specific dimensions in general population samples across all age groups. MEDLINE, Embase, and PsycINFO were searched for relevant studies published up to March 2023 and 46 studies were selected for inclusion. The results revealed several biological correlates consistently associated with transdiagnostic dimensions of psychopathology, including polygenic scores for ADHD and neuroticism, global surface area and global gray matter volume. Shared and unique associations between symptom dimensions are highlighted, as are potential age-specific differences in biological associations. Findings are interpreted with reference to key methodological differences across studies. The included studies provide compelling evidence that the general dimension of psychopathology reflects common underlying genetic and neurobiological vulnerabilities that are shared across diverse manifestations of mental illness. Substantive interpretations of general psychopathology in the context of genetic and neurobiological evidence are discussed.
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Affiliation(s)
- Nicholas Hoy
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
| | - Samantha J Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia; Department of Psychiatry, Université de Montréal, Montreal, Canada; Research Centre, CHU Sainte-Justine, Montreal, Canada
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, United States
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia; Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Louise Mewton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Rief W, Hofmann SG, Berg M, Forbes MK, Pizzagalli DA, Zimmermann J, Fried E, Reed GM. Do We Need a Novel Framework for Classifying Psychopathology? A Discussion Paper. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e11699. [PMID: 38357431 PMCID: PMC10863678 DOI: 10.32872/cpe.11699] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
Introduction The ICD-11 and DSM-5 are the leading systems for the classification of mental disorders, and their relevance for clinical work and research, as well as their impact for policy making and legal questions, has increased considerably. In recent years, other frameworks have been proposed to supplement or even replace the ICD and the DSM, raising many questions regarding clinical utility, scientific relevance, and, at the core, how best to conceptualize mental disorders. Method As examples of the new approaches that have emerged, here we introduce the Hierarchical Taxonomy of Psychopathology (HiTOP), the Research Domain Criteria (RDoC), systems and network approaches, process-based approaches, as well as a new approach to the classification of personality disorders. Results and Discussion We highlight main distinctions between these classification frameworks, largely related to different priorities and goals, and discuss areas of overlap and potential compatibility. Synergies among these systems may provide promising new avenues for research and clinical practice.
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Affiliation(s)
- Winfried Rief
- Clinical Psychology and Psychotherapy Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Stefan G. Hofmann
- Translational Clinical Psychology Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Max Berg
- Clinical Psychology and Psychotherapy Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Miriam K. Forbes
- School of Psychological Sciences, Australian Hearing Hub, Macquarie University Sydney, Sydney, Australia
| | - Diego A. Pizzagalli
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research & McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | - Eiko Fried
- Clinical Psychology Group, Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Geoffrey M. Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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23
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Martinez S, Garcia-Romeu A, Perez F, Jones JD. Resilience Phenotypes and Psychological Functioning among Individuals with Opioid Use Disorder. Subst Use Misuse 2023; 59:41-49. [PMID: 37752751 PMCID: PMC10829514 DOI: 10.1080/10826084.2023.2259450] [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: 09/28/2023]
Abstract
BACKGROUND Opioid use disorder (OUD) is a heterogeneous disorder. However, there is a lack of deep phenotyping investigations focusing on important psychological constructs such as resilience that may impact OUD. The present study aimed to investigate the relationship between trait resilience and the five-factor model of personality (FFM) among individuals with opioid use disorder (OUD). We also explored whether the FFM and trait resilience form specific phenotypes associated with psychological functioning. METHODS This secondary analysis of an epigenetic study included participants of African ancestry (n = 72), an understudied population, who met DSM-5 criteria for OUD. Participants completed measures to assess personality traits, trait resilience, current and previous drug use, and psychological functioning (depression, anxiety, and stress). RESULTS Linear regression revealed a significant relationship between resilience (CD-RISC-25 score) and the FFM, R2 = 0.56, F(5,62) = 15.7, p<.001. Further, a two-cluster classification emerged as the optimal solution from the cluster analysis. Cluster 1 (n = 33, 45.8% of the sample) showed lower resilience (CD-RISC-25 score: M = 58.6, SD = 11.2) compared to Cluster 2 (n = 35, 48.6%; CD-RISC-25 score: M = 76.1, SD = 11.9). The "High-Resilience Cluster" (Cluster 2) was characterized by higher FFM traits of: Extraversion, Openness, Agreeableness, and Conscientiousness, and lower Neuroticism versus Cluster 1. Multivariate analysis of variance revealed statistically significant differences between the two resilience clusters concerning other psychological symptoms, Λ = 0.732, F(4, 50) = 7.05, p < 0.003. CONCLUSIONS These findings suggest associations between the FFM and trait resilience among individuals with OUD. Two distinct "resilience phenotypes" emerged, with high-resilience individuals displaying less stress, anxiety, and depressive symptoms. Results highlight the clinical importance of resilience as a potential target for intervention in people with OUD.
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Affiliation(s)
- Suky Martinez
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Albert Garcia-Romeu
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Freymon Perez
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Jermaine D. Jones
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
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24
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Snyder HR, Silton RL, Hankin BL, Smolker HR, Kaiser RH, Banich MT, Miller GA, Heller W. The dimensional structure of internalizing psychopathology: Relation to diagnostic categories. Clin Psychol Sci 2023; 11:1044-1063. [PMID: 37982000 PMCID: PMC10655959 DOI: 10.1177/21677026221119483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Recent approaches aim to represent the dimensional structure of psychopathology, but relatively little research has rigorously tested sub-dimensions within internalizing psychopathology. This study tests pre-registered models of the dimensional structure of internalizing psychopathology, and their relations with current and lifetime depressive and anxiety disorders diagnostic data, in adult samples harmonized across three sites (n=427). Across S-1 bifactor and hierarchical models, we found converging evidence for both general and specific internalizing dimensions. Depression, generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic attacks were all associated with a general internalizing factor that we posit primarily represents motivational anhedonia. GAD was also associated with a specific anxious apprehension factor, and SAD with specific anxious apprehension and low positive affect factors. We suggest that dimensional approaches capturing shared and specific internalizing symptom facets more accurately describe the structure of internalizing psychopathology and provide useful alternatives to categorical diagnoses to advance clinical science.
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Affiliation(s)
| | | | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Harry R Smolker
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Roselinde H Kaiser
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Marie T Banich
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute of Cognitive Science, University of Colorado Boulder
| | - Gregory A Miller
- Department of Psychology, University of Illinois at Urbana-Champaign
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, UCLA
| | - Wendy Heller
- Department of Psychology, University of Illinois at Urbana-Champaign
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25
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Goulter N, Oberth C, McMahon RJ, Lansford JE, Dodge KA, Crowley DM, Bates JE, Pettit GS. Predictive Validity of Adolescent Callous-Unemotional Traits and Conduct Problems with Respect to Adult Outcomes: High- and Low-Risk Samples. Child Psychiatry Hum Dev 2023; 54:1321-1335. [PMID: 35262849 PMCID: PMC9931993 DOI: 10.1007/s10578-022-01334-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/03/2022]
Abstract
Current understanding of the predictive validity of callous-unemotional (CU) traits is limited by (a) the focus on externalizing psychopathology and antisocial behaviors, (b) a lack of long-term prospective longitudinal data, (c) samples comprised of high-risk or low-risk individuals. We tested whether adolescent CU traits and conduct problems were associated with theoretically relevant adult outcomes 12-18 years later. Participants were drawn from two studies: higher-risk Fast Track (FT; n = 754) and lower-risk Child Development Project (CDP; n = 585). FT: conduct problems positively predicted externalizing and internalizing psychopathology and partner violence, and negatively predicted health, wellbeing, and education. Three conduct problems × CU traits interaction effects were also found. CDP: CU traits positively predicted depression and negatively predicted health and education; conduct problems positively predicted externalizing and internalizing psychopathology and substance use, and negatively predicted wellbeing. CU traits did not provide incremental predictive validity for multiple adult outcomes relative to conduct problems.
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Affiliation(s)
- Natalie Goulter
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.
| | - Carla Oberth
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Robert J McMahon
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | | | - Kenneth A Dodge
- Center for Child and Family Policy, Duke University, Durham, NC, USA
| | - D Max Crowley
- Human Development and Family Studies, Pennsylvania State University, State College, PA, USA
| | - John E Bates
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Gregory S Pettit
- Human Development and Family Studies, Auburn University, Auburn, AL, USA
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26
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Knefel M, Karatzias T, Spinazzola J, Shevlin M, Ford JD. The relationship of posttraumatic stress disorder and developmental trauma disorder with childhood psychopathology: A network analysis. J Anxiety Disord 2023; 99:102766. [PMID: 37690357 DOI: 10.1016/j.janxdis.2023.102766] [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: 04/12/2022] [Revised: 07/25/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Potentially traumatic experiences are a major risk factor for mental disorders in children and adolescents. Posttraumatic psychopathology includes trauma-specific disorders such as posttraumatic stress disorder (PTSD) as well as other psychiatric disorders. Developmental Trauma Disorder (DTD) has been proposed as a developmentally sensitive diagnosis. We aimed to further illuminate the co-occurrence of psychiatric conditions with DTD and PTSD. METHOD In a convenience sample of families of 507 children and adolescents (mean age = 12.11 years old, SD = 2.92; 48.5% female), we assessed DTD, PTSD, and screened for psychiatric disorders. We estimated network models including DTD, PTSD and ten psychiatric conditions. RESULTS We found that DTD and PTSD share both common and differential comorbidity features on disorder-, domain-, and symptom-level. The differential comorbidity patterns of the DTD and PTSD domains placed DTD close to both externalizing and internalizing psychopathology while PTSD was primarily linked to internalizing conditions. CONCLUSIONS Our study provides evidence for the complex clinical presentation of posttraumatic psychopathology over and above PTSD in children. DTD and PTSD provide useful and distinct diagnostic categories for children who are also experiencing internalizing conditions, and DTD may be especially relevant for children who are experiencing externalizing psychopathology.
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Affiliation(s)
- Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria; Department of Internal Medicine, Landesklinikum Baden , Baden bei Wien, Austria.
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK; Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | | | - Mark Shevlin
- Ulster University, School of Psychology, Coleraine, UK
| | - Julian D Ford
- University of Connecticut School of Medicine, Farmington, CT, USA
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27
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Conway CC, Kotov R, Krueger RF, Caspi A. Translating the hierarchical taxonomy of psychopathology (HiTOP) from potential to practice: Ten research questions. AMERICAN PSYCHOLOGIST 2023; 78:873-885. [PMID: 36227328 PMCID: PMC10097839 DOI: 10.1037/amp0001046] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a novel diagnostic system grounded in empirical research into the architecture of mental illness. Its basic units are continuous dimensions-as opposed to categories-that are organized into a hierarchy according to patterns of symptom co-occurrence observed in quantitative studies. Previous HiTOP discussions have focused on existing evidence regarding the model's structure and ability to account for neurobiological, social, cultural, and clinical variation. The present article looks ahead to the next decade of applied research and clinical practice using the HiTOP rubric. We highlight 10 topics where HiTOP has the potential to make significant breakthroughs. Research areas include genetic influences, environmental contributions, neural mechanisms, real-time dynamics, and lifespan development of psychopathology. We also discuss development of novel assessments, forecasting methods, and treatments. Finally, we consider implications for clinicians and educators. For each of these domains, we propose directions for future research and venture hypotheses as to what HiTOP will reveal about psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Roman Kotov
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert F. Krueger
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA
- Social, Genetic, and Developmental Psychiatry Research Centre, King’s College London, London, United Kingdom
- PROMENTA Center, University of Oslo, Oslo, Norway
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28
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Pingeton BC, Cochran A, Goodman SH, Laurent H, Sbrilli MD, Knight B, Newport DJ, Stowe ZN. Positive affect improves a transdiagnostic model of perinatal depression symptoms. J Affect Disord 2023; 336:112-119. [PMID: 37230263 PMCID: PMC10448502 DOI: 10.1016/j.jad.2023.05.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Accurate measurement of perinatal depression is vital. We aimed to 1) test whether a factor that measured positive affect (PA) bettered a transdiagnostic model of depression symptoms and 2) replicate the model in a second sample. METHODS We conducted secondary analyses from two samples (n's = 657 and 142) of women in treatment at perinatal psychiatric clinics. Data were derived from items from seven commonly used measures. We compared fit indices from our original factor model-one general and six specific factors derived from the Research Domain Criteria (Loss, Potential Threat, Frustrative Nonreward, and Sleep-Wakefulness) and depression literatures (Somatic and Coping)-to our novel factor model with a PA factor. The PA factor was created by recategorizing items that measured affective states with a positive valence into a new factor. Sample 1 data were split into six perinatal periods. RESULTS In both samples, the addition of a PA factor improved model fit. At least partial metric invariance was found between perinatal periods, with the exception of trimester 3 - postpartum period 1. LIMITATIONS Our measures did not operationalize PA in the same way as in the positive valence system in RDoC and we were unable to perform longitudinal analyses on our cross-validation sample. CONCLUSIONS Clinicians and researchers are encouraged to consider these findings as a template for understanding symptoms of depression in perinatal patients, which can be used to guide treatment planning and the development of more effective screening, prevention, and intervention tools to prevent deleterious outcomes.
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Affiliation(s)
- Blaire C Pingeton
- Department of Psychology, Emory University, United States of America.
| | - Amy Cochran
- Department of Mathematics, Department of Population Health Sciences, University of Wisconsin, United States of America
| | - Sherryl H Goodman
- Department of Psychology, Emory University, United States of America
| | - Heidemarie Laurent
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Marissa D Sbrilli
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Bettina Knight
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, United States of America
| | - D Jeffrey Newport
- Departments of Psychiatry and Behavioral Sciences and Women's Health, University of Texas at Austin Dell Medical School, United States of America
| | - Zachary N Stowe
- Department of Psychiatry, University of Wisconsin at Madison, United States of America
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29
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Fried EI, Proppert RKK, Rieble CL. Building an Early Warning System for Depression: Rationale, Objectives, and Methods of the WARN-D Study. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e10075. [PMID: 38356901 PMCID: PMC10863640 DOI: 10.32872/cpe.10075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 07/02/2023] [Indexed: 02/16/2024] Open
Abstract
Background Depression is common, debilitating, often chronic, and affects young people disproportionately. Given that only 50% of patients improve under initial treatment, experts agree that prevention is the most effective way to change depression's global disease burden. The biggest barrier to successful prevention is to identify individuals at risk for depression in the near future. To close this gap, this protocol paper introduces the WARN-D study, our effort to build a personalized early warning system for depression. Method To develop the system, we follow around 2,000 students over 2 years. Stage 1 comprises an extensive baseline assessment in which we collect a broad set of predictors for depression. Stage 2 lasts 3 months and zooms into participants' daily experiences that may predict depression; we use smartwatches to collect digital phenotype data such as sleep and activity, and we use a smartphone app to query participants about their experiences 4 times a day and once every Sunday. In Stage 3, we follow participants for 21 months, assessing transdiagnostic outcomes (including stress, functional impairment, anxiety, and depression) as well as additional predictors for future depression every 3 months. Collected data will be utilized to build a personalized prediction model for depression onset. Discussion Overall, WARN-D will function similarly to a weather forecast, with the core difference that one can only seek shelter from a thunderstorm and clean up afterwards, while depression may be successfully prevented before it occurs.
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Affiliation(s)
- Eiko I. Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | | | - Carlotta L. Rieble
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
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30
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Laifer LM, DiLillo D, Brock RL. Prenatal negative affectivity and trauma-related distress predict mindful parenting during toddler age: Examining parent-infant bonding as a mechanism. Dev Psychopathol 2023; 35:1036-1050. [PMID: 34649640 DOI: 10.1017/s0954579421000894] [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] [Indexed: 11/07/2022]
Abstract
Despite findings demonstrating the importance of parental present-centered awareness, factors undermining mindful parenting have received less attention. Increasingly, evidence points to parental psychopathology as a salient risk factor for parenting difficulties. Thus, the goal of the present study was to investigate specific dimensions of parental trauma-related distress and general negative affectivity during pregnancy as predictors of mindful parenting during toddler age. Parental psychopathology, parent-infant bonding, and mindful parenting were assessed in a sample of heterosexual couples (N = 159) across four waves of data collection spanning pregnancy to child age two. Data were analyzed using path analysis within a dyadic framework. Results demonstrated the unique impact of maternal trauma-related distress during pregnancy (e.g., intrusions and avoidance) on facets of mindful parenting more than two years later. Further, among both mothers and fathers, general negative affectivity common across internalizing disorders undermined mindful parenting through impaired parent-infant bonding. Findings highlight the need for early intervention efforts that incorporate mindfulness strategies to reduce subthreshold symptoms of prenatal psychopathology, promote healthy bonding, and improve parental awareness and self-regulation, thereby enhancing the overall parent-child relationship.
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31
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Snorrason I, Kuckertz JM, Swisher VS, Pendo K, Rissman AJ, Ricketts EJ. Hair pulling disorder and skin picking disorder have relatively limited associations with negative emotionality: A meta-analytic comparison across obsessive-compulsive and related disorders. J Anxiety Disord 2023; 98:102743. [PMID: 37499420 DOI: 10.1016/j.janxdis.2023.102743] [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: 12/18/2022] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
The obsessive-compulsive and related disorders (OCRD) chapter in DSM-5 includes two relatively distinct groups of disorders: (1) Compulsive disorders [i.e., obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD)] and (2) grooming disorders [i.e., skin picking disorder (SPD) and hair pulling disorder (HPD)]. The two groups may relate differently with negative emotionality; however, the literature has produced mixed findings. The current study sought to quantify the concurrent association between negative emotionality and each of the five OCRDs. We conducted systematic reviews of research reporting correlations between (1) negative emotionality (i.e., depression, anxiety, stress, negative affect, and neuroticism) and (2) severity of OCRD symptoms in both clinical and non-clinical adult samples. We used three-level meta-analytic models to estimate the size of the correlations. Negative emotionality had robust positive correlation with symptoms of OCD [k = 156, r = 0.44, 95% CI= 0.43-0.46], BDD [k = 58, r = 0.45, 95% CI= 0.43-48], and HD [k = 67, r = 0.39, 95% CI= 0.36-0.42] but significantly smaller correlation with SPD [k = 31, r = 0.31, 95% CI= 0.27-0.34] and HPD [k = 24, r = 0.28, 95% CI= 0.25-0.32]. Overall, the results indicate that grooming disorders have relatively limited associations with negative emotionality. Implications for classification of OCRDs within the broader taxonomy of psychopathology are discussed.
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Affiliation(s)
- Ivar Snorrason
- Center for OCD & Related Disorders (CORD), Massachusetts General Hospital, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
| | - Jennie M Kuckertz
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; OCD Institute, McLean Hospital, Belmont, MA, United States
| | - Valerie S Swisher
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, United States
| | - Kevin Pendo
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, United States
| | - Ariel J Rissman
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, United States
| | - Emily J Ricketts
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, United States
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32
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Laroque FM, Boers E, Afzali MH, Conrod PJ. Personality-specific pathways from bullying victimization to adolescent alcohol use: a multilevel longitudinal moderated mediation analysis. Dev Psychopathol 2023; 35:1454-1467. [PMID: 35129105 DOI: 10.1017/s0954579421001358] [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: 11/06/2022]
Abstract
Bullying victimization is common in adolescence and has been associated with a broad variety of psychopathology and alcohol use. The present study assessed time-varying associations between bullying victimization and alcohol use through internalizing and externalizing symptoms and whether this indirect association throughout time is moderated by personality. This 5-year longitudinal study (3,800 grade 7 adolescents) used Bayesian multilevel moderated mediation models: independent variable was bullying victimization; moderators were four personality dimensions (anxiety sensitivity, hopelessness, impulsivity, and sensation seeking); internalizing symptoms (anxiety, depressive symptoms) and externalizing symptoms (conduct, hyperactivity problems) were the mediators; and alcohol use, the outcome. Results indicated significant between, within, and lagged effects on alcohol use through internalizing and externalizing symptoms. There were significant between and within effects on alcohol use through internalizing symptoms for adolescents with high anxiety sensitivity and hopelessness, and significant between, within, and lagged effects on alcohol use through externalizing symptoms for adolescents with high impulsivity and sensation seeking. These findings implicate two risk pathways that account for how bullying victimization enhances alcohol use risk and emphasize the importance of personality profiles that can shape the immediate and long-term consequences of victimization.
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Affiliation(s)
- Flavie M Laroque
- Department of Psychiatry and Addiction, University of Montreal, and CHU Ste Justine Research Center, Montreal, QC, Canada
| | - Elroy Boers
- Department of Psychiatry and Addiction, University of Montreal, and CHU Ste Justine Research Center, Montreal, QC, Canada
| | - Mohammad H Afzali
- Department of Psychiatry and Addiction, University of Montreal, and CHU Ste Justine Research Center, Montreal, QC, Canada
| | - Patricia J Conrod
- Department of Psychiatry and Addiction, University of Montreal, and CHU Ste Justine Research Center, Montreal, QC, Canada
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Grogans SE, Bliss-Moreau E, Buss KA, Clark LA, Fox AS, Keltner D, Cowen AS, Kim JJ, Kragel PA, MacLeod C, Mobbs D, Naragon-Gainey K, Fullana MA, Shackman AJ. The nature and neurobiology of fear and anxiety: State of the science and opportunities for accelerating discovery. Neurosci Biobehav Rev 2023; 151:105237. [PMID: 37209932 PMCID: PMC10330657 DOI: 10.1016/j.neubiorev.2023.105237] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Abstract
Fear and anxiety play a central role in mammalian life, and there is considerable interest in clarifying their nature, identifying their biological underpinnings, and determining their consequences for health and disease. Here we provide a roundtable discussion on the nature and biological bases of fear- and anxiety-related states, traits, and disorders. The discussants include scientists familiar with a wide variety of populations and a broad spectrum of techniques. The goal of the roundtable was to take stock of the state of the science and provide a roadmap to the next generation of fear and anxiety research. Much of the discussion centered on the key challenges facing the field, the most fruitful avenues for future research, and emerging opportunities for accelerating discovery, with implications for scientists, funders, and other stakeholders. Understanding fear and anxiety is a matter of practical importance. Anxiety disorders are a leading burden on public health and existing treatments are far from curative, underscoring the urgency of developing a deeper understanding of the factors governing threat-related emotions.
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Affiliation(s)
- Shannon E Grogans
- Department of Psychology, University of Maryland, College Park, MD 20742, USA
| | - Eliza Bliss-Moreau
- Department of Psychology, University of California, Davis, CA 95616, USA; California National Primate Research Center, University of California, Davis, CA 95616, USA
| | - Kristin A Buss
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802 USA
| | - Lee Anna Clark
- Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Andrew S Fox
- Department of Psychology, University of California, Davis, CA 95616, USA; California National Primate Research Center, University of California, Davis, CA 95616, USA
| | - Dacher Keltner
- Department of Psychology, University of California, Berkeley, Berkeley, CA 94720, USA
| | | | - Jeansok J Kim
- Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Philip A Kragel
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - Colin MacLeod
- Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Perth, WA 6009, Australia
| | - Dean Mobbs
- Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, California 91125, USA; Computation and Neural Systems Program, California Institute of Technology, Pasadena, CA 91125, USA
| | - Kristin Naragon-Gainey
- School of Psychological Science, University of Western Australia, Perth, WA 6009, Australia
| | - Miquel A Fullana
- Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain; Imaging of Mood, and Anxiety-Related Disorders Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Alexander J Shackman
- Department of Psychology, University of Maryland, College Park, MD 20742, USA; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA; Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA.
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34
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Petre LM, Gheorghe DA, Watson D, Mitrofan L. Romanian Inventory of Depression and Anxiety Symptoms (IDAS-II). Front Psychol 2023; 14:1159380. [PMID: 37484097 PMCID: PMC10359186 DOI: 10.3389/fpsyg.2023.1159380] [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: 02/05/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023] Open
Abstract
Background The Inventory of Depression and Anxiety Symptoms (IDAS-II) is a self-report measure comprising 99 items divided into 18 non-overlapping scales that allows for a dimensional assessment of depression, anxiety, and bipolar symptoms. The IDAS-II is currently available in English, Turkish, Spanish, German, and Swedish. This study's major goal was to adapt and validate the IDAS-II to the Romanian population. Method Participants from a community sample (N = 1,072) completed the IDAS-II (Romanian version) and additional measures assessing depression and anxiety disorders. Results Item-level factor analyses validated the unidimensionality of the scales, and internal consistency results indicated that most symptom scales had satisfactory alpha coefficient values. Based on previous structural analyses, a confirmatory factor analysis (CFA) on the IDAS-II scales confirmed a three-component model of "Distress," "Obsessions/Fear," and "Positive Mood." Convergent and discriminant validity were established by correlational analyses with other symptom measures. Limitations This study was conducted using a sample from the general population and several of the employed measures have limitations. Specifically, the current study was unable to employ Romanian versions of the gold-standard instruments that assess well-being, obsessive-compulsive disorder, and claustrophobia. Conclusion The IDAS-II (Romanian version) is the first clinical measure to assess internalizing dimensions of the Hierarchical Taxonomy of Psychopathology (HiTOP) model that is available for the Romanian population.
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Affiliation(s)
- Ligiana Mihaela Petre
- Department of Applied Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
| | - Delia Alexandra Gheorghe
- Department of Experimental and Theoretical Neuroscience, Transylvanian Institute of Neuroscience, Cluj-Napoca, Romania
| | - David Watson
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - Laurentiu Mitrofan
- Department of Applied Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
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Haws JK, Laifer LM, Acosta LM, Ralston AL, Ruggiero KJ, Davidson TM, Andrews AR. A Distinction Without a Difference? A Multi-Method Approach to Understanding PTSD and Depression Symptom Overlap Among Disaster-Exposed Adolescents. Res Child Adolesc Psychopathol 2023; 51:1021-1035. [PMID: 36881210 DOI: 10.1007/s10802-023-01042-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/08/2023]
Abstract
Among adolescents exposed to trauma, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur. Despite the prevalence of comorbidity, the question of how PTSD and MDD are related and appropriate conceptual models for understanding their linkage in adolescence remains unclear. This study applies a multi-methodological approach to advance conceptual and theoretical understanding of the overlap between PTSD and MDD diagnoses/symptoms. We tested three methodological approaches with three distinct theoretical underpinnings on the structure of each disorder proposed in the literature: confirmatory factor analysis (CFA) with dimensional constructs, latent class analysis (LCA) with person-based categorical constructs, and network analysis with symptom-to-symptom associations. Across the three different analytical approaches, there was a significant overlap between PTSD and MDD. Overall, there was no compelling evidence for distinct boundaries between disorders among trauma-exposed adolescents. Instead, we found considerable evidence that the typical latent-construct-based conceptualizations, whether categorical or dimensional, may need revision.
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Affiliation(s)
- James Kyle Haws
- Department of Family Medicine, and the Adult and Child Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado School of Medicine, 13199 E. Montview Blvd, Suite 300, Aurora, CO, 80045, USA.
| | - Lauren M Laifer
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Laura M Acosta
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Allura L Ralston
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Tatiana M Davidson
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Arthur R Andrews
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
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36
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Montes SA, Sanchez RO. The underlying structure of the Personality Inventory for DSM-5 (PID-5): a general factor of personality psychopathology. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2023; 12:79-90. [PMID: 38807698 PMCID: PMC11129047 DOI: 10.5114/cipp/163182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/26/2022] [Accepted: 04/12/2023] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The psychopathology of personality is currently undergoing a paradigm shift from a categorical to a dimensional approach. This work aimed to study the underlying structure of pathological personality traits of the DSM-5 Alternative Model for Personality Disorders (AMPD). For this purpose, the internal structure of a version of the Personality Inventory for the DSM-5 (PID-5) was examined by a confirmatory factor analysis. This version assesses the five higher-order pathological personality domains (negative affectivity, detachment, antagonism, disinhibition, and psychoticism) and the 25 lower-order pathological personality facets through a reduced number of items. Four alternative models were compared: five-factor oblique; second-order (five first-order factors and one second-order factor); bifactor (five specific factors and a general factor), and one-factor. PARTICIPANTS AND PROCEDURE We worked with an Argentinean sample of N = 525 subjects from the general population who answered the Argentine version of the PID-5. RESULTS The five-factor model was slightly superior to the second order model, and the bifactor model presented the best fit. CONCLUSIONS These findings, while preliminary, suggest that the PID-5 facets could reflect five specific pathological personality traits (which correspond to AMPD domains) but also a general factor (which would reflect a general propensity for psychopathology).
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Affiliation(s)
- Silvana A. Montes
- CONICET (National Scientific and Technical Research Council), Buenos Aires, Argentina
- Faculty of Psychology, National University of Mar del Plata, Mar del Plata, Argentina
| | - Roberto O. Sanchez
- Faculty of Psychology, National University of Mar del Plata, Mar del Plata, Argentina
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Vlemincx E. Dysfunctional breathing: a dimensional, transdiagnostic perspective. Eur Respir J 2023; 61:2300629. [PMID: 37290807 DOI: 10.1183/13993003.00629-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/02/2023] [Indexed: 06/10/2023]
Affiliation(s)
- Elke Vlemincx
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Health Psychology, KU Leuven, Leuven, Belgium
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
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Destrée L, Albertella L, Jobson L, McGorry P, Chanen A, Ratheesh A, Davey C, Polari A, Amminger P, Yuen HP, Hartmann J, Spooner R, Fontenelle LF, Nelson B. The association between stressful experiences and OCD symptoms in young adults at transdiagnostic risk. J Affect Disord 2023; 328:128-134. [PMID: 36812805 DOI: 10.1016/j.jad.2023.02.059] [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] [Received: 09/17/2022] [Revised: 12/06/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND It is unclear whether there is a specific association between stressful experiences and obsessive-compulsive symptoms or whether this relationship is due to stressful experiences increasing risk for psychopathology generally. AIMS The current study examined the association between stressful experiences and obsessive-compulsive symptom dimensions, while adjusting for coexisting psychiatric symptoms and psychological distress in a young adult transdiagnostic at-risk sample. METHODS Forty-three participants completed self-report measures assessing obsessive-compulsive symptoms, stressful experiences, and a range of other psychiatric symptoms. Regression models examined the relationship between stressful experiences and different obsessive-compulsive symptoms dimensions (i.e., symmetry, fear of harm, contamination, and unacceptable thoughts), adjusting for the influence of coexisting psychiatric symptoms and psychological distress. RESULTS The results showed that there was an association between stressful experiences and obsessive-compulsive symptoms dimension of symmetry. Symptoms of borderline personality disorder were positively associated with the obsessive-compulsive symptom dimensions of symmetry and fear of harm symptoms. Symptoms of psychosis were found to be negatively associated with the obsessive-compulsive symptoms dimension of fear of harm. CONCLUSIONS These findings have implications for understanding the psychological mechanisms that underlie symmetry symptoms and highlight the need to study OCS dimensions separately to inform more precise, mechanism-targeted interventions.
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Affiliation(s)
- Louise Destrée
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia; Orygen, Parkville, VIC, Australia.
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Laura Jobson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew Chanen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Aswin Ratheesh
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher Davey
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrea Polari
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul Amminger
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jessica Hartmann
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Rachael Spooner
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Stochl J, Jones H, Soneson E, Wagner AP, Khandaker GM, Zammit S, Heron J, Hammerton G, Bullmore ET, Dolan R, Fonagy P, Goodyer IM, Perez J, Jones PB. Stratification of adolescents across mental phenomena emphasizes the importance of transdiagnostic distress: a replication in two general population cohorts. Eur Child Adolesc Psychiatry 2023; 32:797-807. [PMID: 34792650 PMCID: PMC10147756 DOI: 10.1007/s00787-021-01909-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Abstract
Characterizing patterns of mental phenomena in epidemiological studies of adolescents can provide insight into the latent organization of psychiatric disorders. This avoids the biases of chronicity and selection inherent in clinical samples, guides models of shared aetiology within psychiatric disorders and informs the development and implementation of interventions. We applied Gaussian mixture modelling to measures of mental phenomena from two general population cohorts: the Avon Longitudinal Study of Parents and Children (ALSPAC, n = 3018) and the Neuroscience in Psychiatry Network (NSPN, n = 2023). We defined classes according to their patterns of both positive (e.g. wellbeing and self-esteem) and negative (e.g. depression, anxiety, and psychotic experiences) phenomena. Subsequently, we characterized classes by considering the distribution of diagnoses and sex split across classes. Four well-separated classes were identified within each cohort. Classes primarily differed by overall severity of transdiagnostic distress rather than particular patterns of phenomena akin to diagnoses. Further, as overall severity of distress increased, so did within-class variability, the proportion of individuals with operational psychiatric diagnoses. These results suggest that classes of mental phenomena in the general population of adolescents may not be the same as those found in clinical samples. Classes differentiated only by overall severity support the existence of a general, transdiagnostic mental distress factor and have important implications for intervention.
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Affiliation(s)
- Jan Stochl
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK.
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK.
- Department of Kinanthropology, Charles University, Prague, Czechia.
| | - Hannah Jones
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma Soneson
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK
| | - Adam P Wagner
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Golam M Khandaker
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Stanley Zammit
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Jon Heron
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma Hammerton
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Edward T Bullmore
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK
| | - Ray Dolan
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - Peter Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Ian M Goodyer
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK
| | - J Perez
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute of Biomedical Research of Salamanca (IBSAL), Psychiatry Unit, Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Peter B Jones
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Watts AL, Latzman RD, Boness CL, Kotov R, Keyser-Marcus L, DeYoung CG, Krueger RF, Zald DH, Moeller FG, Ramey T. New approaches to deep phenotyping in addictions. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:361-375. [PMID: 36174150 PMCID: PMC10050231 DOI: 10.1037/adb0000878] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The causes of substance use disorders (SUDs) are largely unknown and the effectiveness of their treatments is limited. One crucial impediment to research and treatment progress surrounds how SUDs are classified and diagnosed. Given the substantial heterogeneity among individuals diagnosed with a given SUD (e.g., alcohol use disorder [AUD]), identifying novel research and treatment targets and developing new study designs is daunting. METHOD In this article, we review and integrate two recently developed frameworks, the National Institute on Drug Abuse's Phenotyping Assessment Battery (NIDA PhAB) and the Hierarchical Taxonomy of Psychopathology (HiTOP), that hope to accelerate progress in understanding the causes and consequences of psychopathology by means of deep phenotyping, or finer-grained analysis of phenotypes. RESULTS AND CONCLUSIONS NIDA PhAB focuses on addiction-related processes across multiple units of analysis, whereas HiTOP focuses on clinical phenotypes and covers a broader range of psychopathology. We highlight that NIDA PhAB and HiTOP together provide deep and broad characterizations of people diagnosed with SUDs and complement each other in their efforts to address widely known limitations of traditional classification systems and their diagnostic categories. Next, we show how NIDA PhAB and HiTOP can be integrated to facilitate optimal rich phenotyping of addiction-related phenomena. Finally, we argue that such deep phenotyping promises to advance our understanding of the neurobiology of SUD and addiction, which will guide the development of personalized medicine and interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Ashley L Watts
- Department of Psychological Sciences, University of Missouri
| | | | - Cassandra L Boness
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University
| | | | | | | | - David H Zald
- Center for Advanced Human Brain Research, Department of Psychiatry, Rutgers University
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Giusto A, Romer A, Lovero K, dos Santos PF, Greene C, Gouveia L, Suleman A, Feliciano P, Oquendo MA, Mootz J, Wainberg ML. Examination of the Factor Structure of Psychopathology in a Mozambican Sample. Clin Psychol Sci 2023; 11:409-424. [PMID: 37181407 PMCID: PMC10181828 DOI: 10.1177/21677026221122773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Factor-analytic studies are needed in global samples to advance understanding of psychopathology. We aimed to examine the structure of psychopathology and a general psychopathology ('p') factor using data from a cross-sectional study of 971 adults (63% women) from Maputo City, Mozambique. We used confirmatory factor analyses of symptoms from 15 psychiatric disorders to test common models of the structure of psychopathology. Models including internalizing, substance use, and thought disorder factors as well as a general p-factor fit the data well. Measurement invariance testing revealed that factor loadings on p differed by gender. Higher levels of p, internalizing, and thought disorder factors were associated with greater suicide risk, psychiatric comorbidity, chronic medical illnesses, and poorer functioning. A general psychopathology ('p') factor and internalizing, substance use, and thought disorder factors are identifiable in this Mozambican sample. Understanding psychopathology dimensions is a step toward building more scalable mental health service approaches globally.
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Affiliation(s)
- Ali Giusto
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
| | - Adrienne Romer
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Belmont, MA, USA
| | - Kathryn Lovero
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Palmira Fortunado dos Santos
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
| | - Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Lidia Gouveia
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
| | - Antonio Suleman
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
| | - Paulino Feliciano
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
| | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 200, Philadelphia, Pennsylvania, USA
| | - Jennifer Mootz
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
| | - Milton L. Wainberg
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
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Laifer LM, O'Hara MW, DiLillo D, Brock RL. Risk for trauma-related distress following difficult childbirth: Trajectories of traumatic intrusions across 2 years postpartum. Arch Womens Ment Health 2023; 26:191-200. [PMID: 36719513 PMCID: PMC10083078 DOI: 10.1007/s00737-023-01296-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023]
Abstract
There is heightened risk for maternal posttraumatic stress disorder (PTSD) during the perinatal period. However, it is unclear whether pregnancy and childbirth uniquely contribute to PTSD symptoms above and beyond elevations in negative affectivity that commonly occur among postpartum women (e.g., irritability, fatigue, depressed mood) and past trauma exposure. The present study explored the associations between childbirth stressors and trauma-related distress (TRD; intrusion and avoidance symptoms) across the 2 years following childbirth in a community sample of women (n = 159). Maternal TRD was assessed at pregnancy and four additional timepoints across 2 years postpartum. At pregnancy, mothers completed surveys measuring exposure to trauma and pregnancy-related anxiety. They also reported on pregnancy and childbirth complications across the first 6 months postpartum. Consistent with predictions, labor/delivery complications uniquely predicted increased maternal intrusions during the first 6 months postpartum above and beyond past trauma exposure. Furthermore, growth mixture models identified a subset of women with intrusion symptoms that persisted up to 2 years postpartum and, on average, exceeded the screening threshold for PTSD. Women who experienced greater labor complications were more likely to exhibit this clinical profile relative to low, stable symptoms. Findings highlight the importance of ongoing screening for TRD across the first 2 years postpartum, particularly among women who experience greater labor/delivery complications.
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Affiliation(s)
- Lauren M Laifer
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE, 68588-0308, USA.
| | - Michael W O'Hara
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - David DiLillo
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE, 68588-0308, USA
| | - Rebecca L Brock
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE, 68588-0308, USA
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Mollon J, Almasy L, Jacquemont S, Glahn DC. The contribution of copy number variants to psychiatric symptoms and cognitive ability. Mol Psychiatry 2023; 28:1480-1493. [PMID: 36737482 PMCID: PMC10213133 DOI: 10.1038/s41380-023-01978-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/05/2023]
Abstract
Copy number variants (CNVs) are deletions and duplications of DNA sequence. The most frequently studied CNVs, which are described in this review, are recurrent CNVs that occur in the same locations on the genome. These CNVs have been strongly implicated in neurodevelopmental disorders, namely autism spectrum disorder (ASD), intellectual disability (ID), and developmental delay (DD), but also in schizophrenia. More recent work has also shown that CNVs increase risk for other psychiatric disorders, namely, depression, bipolar disorder, and post-traumatic stress disorder. Many of the same CNVs are implicated across all of these disorders, and these neuropsychiatric CNVs are also associated with cognitive ability in the general population, as well as with structural and functional brain alterations. Neuropsychiatric CNVs also show incomplete penetrance, such that carriers do not always develop any psychiatric disorder, and may show only mild symptoms, if any. Variable expressivity, whereby the same CNVs are associated with many different phenotypes of varied severity, also points to highly complex mechanisms underlying disease risk in CNV carriers. Comprehensive and longitudinal phenotyping studies of individual CNVs have provided initial insights into these mechanisms. However, more work is needed to estimate and predict the effect of non-recurrent, ultra-rare CNVs, which also contribute to psychiatric and cognitive outcomes. Moreover, delineating the broader phenotypic landscape of neuropsychiatric CNVs in both clinical and general population cohorts may also offer important mechanistic insights.
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Affiliation(s)
- Josephine Mollon
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine, Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Sebastien Jacquemont
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
- Center Hospitalier Universitaire Sainte-Justine Research Center, Montreal, QC, Canada
| | - David C Glahn
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
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Letkiewicz AM, Spring JD, Li LY, Weinberg A, Shankman SA. Childhood trauma predicts blunted error monitoring in adulthood: An event-related potential study. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:427-439. [PMID: 36653556 PMCID: PMC10065923 DOI: 10.3758/s13415-023-01061-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
Abuse and neglect have detrimental consequences on emotional and cognitive functioning during childhood and adolescence, including error monitoring, which is a critical aspect of cognition that has been implicated in certain internalizing and externalizing psychopathologies. It is unclear, however, whether (a) childhood trauma has effects on error monitoring and, furthermore whether, (b) error monitoring mediates the relation between childhood trauma and psychopathology in adulthood. To this end, in a large sample of young adults (ages 18-30) who were oversampled for psychopathology (N = 390), the present study assessed relations between childhood trauma and error-related negativity (ERN), which is a widely used neurophysiological indicator of error monitoring. Cumulative childhood trauma predicted ERN blunting, as did two specific types of traumas: sexual abuse and emotional neglect. Furthermore, the ERN partially mediated the effects of cumulative childhood trauma and emotional neglect on externalizing-related symptoms. Future studies should further examine the relations between childhood trauma and error monitoring in adulthood, which can help to inform intervention approaches.
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Affiliation(s)
- Allison M Letkiewicz
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA.
| | - Justin D Spring
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
| | - Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
| | - Anna Weinberg
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
- Department of Psychology, Northwestern University, Chicago, IL, USA
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Wang M, Eaton NR. Linking non-suicidal self-injury to psychopathology: The utility of transdiagnostic and DSM-based models. J Affect Disord 2023; 332:55-63. [PMID: 37004904 DOI: 10.1016/j.jad.2023.03.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/02/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
Non-suicidal self-injury (NSSI) is a significant public health concern, and its primary formal link to the universe of psychopathology content in DSM diagnoses has been mostly through borderline personality disorder (BPD). Recent research has produced ample evidence of weaknesses of diagnoses relative to transdiagnostic psychopathology dimensions, and found that NSSI-related variables like suicidality are best predicted by transdiagnostic versus diagnosis-based variables. These findings suggest a need to characterize how NSSI may relate to different forms of psychopathology classification constructs. We examined how transdiagnostic dimensions of psychopathology relate to NSSI, focusing on how transdiagnostic (shared) variance of dimensional psychopathology spectra might differentially explained the variance in NSSI relative to traditional DSM diagnoses. In two nationally representative United States samples (Ns = 34,653 and 36,309), we modeled the common distress-fear-externalizing transdiagnostic comorbidity model and investigated questions of predictive utility of these dimensional and categorical psychopathology structures. Transdiagnostic dimensions were superior in predicting NSSI compared to common DSM-IV and DSM-5 diagnoses. These dimensions accounted for 33.6-38.7 % of NSSI variance across all analyses in both samples. DSM-IV/DSM-5 diagnoses, however, demonstrated only modest incremental prediction of NSSI over and above the transdiagnostic dimensions. These results support a transdiagnostic reconceptualization of NSSI's links with psychopathology and highlight the importance of transdiagnostic dimensions for predicting clinical outcomes relating to self-injurious behaviors. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Mengxing Wang
- Department of Psychology, Stony Brook University, United States of America.
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, United States of America
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Haahr-Pedersen I, Vallières F, Hansen M, Aldamman K, Schmidt-Rasmussen V, Bramsen RH, Spitz P, Hyland P. Evidence of a traumatic stress dimension of psychopathology among at-risk children living in Denmark. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04381-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
AbstractThe Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative model of psychopathology. HiTOP proposes that trauma-related distress is a facet of Internalizing psychopathology, but recent evidence with young people suggests that it may reflect a unique dimension of psychopathology. This study assessed the latent structure of child and adolescent psychopathology to determine whether there is evidence of a unique ‘Traumatic Stress’ dimension, and how dimensions of psychopathology are associated with specific types of childhood adversity and trauma, and suicidal ideation and self-injurious behavior. Participants were children and adolescents aged 1–17 years (N = 1,800) who were in contact with the Danish child protection system due to suspected child abuse. Confirmatory factor analysis was used to determine the optimal latent structure of psychopathology, and structural equation modelling was used to determine how the dimensions of psychopathology were associated with different forms of trauma and adversity and suicidality/self-harm. The best fitting model included three factors of Internalizing, Externalizing, and Traumatic Stress. The Traumatic Stress dimensions was associated with older age, living outside of the family home, parental mental illness, higher levels of parental conflict, and the presence of domestic violence in the child’s home. The Traumatic Stress dimension was not associated with suicidality/self-harm. This study provides additional evidence of a distinct dimension of Traumatic Stress among young people. Further studies are needed to determine if these findings are replicable, particularly in older participants.
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Berlin J, Wallinius M, Nilsson T, Karlén MH, Delfin C. Exploring the psychometric properties of the externalizing spectrum inventory-brief form in a Swedish forensic psychiatric inpatient sample. BMC Psychiatry 2023; 23:184. [PMID: 36944949 PMCID: PMC10031895 DOI: 10.1186/s12888-023-04609-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The Externalizing Spectrum Inventory-Brief Form (ESI-BF) [1] is a 160-item self-report instrument designed for the assessment of externalizing psychopathology, yet few studies to date have evaluated its psychometric properties, structural fit, and criterion validity in forensic psychiatric settings. METHODS Here, we investigated these aspects in a sample of forensic psychiatric inpatients (n = 77) from a maximum-security forensic psychiatric hospital in Sweden. We firstly investigated the reliability. Secondly, using confirmatory factor analysis, the structure of the ESI-BF. And thirdly, using a Bayesian approach, assessed how the three ESI-BF subfactors relate to criterion measures of antisocial behaviors, substance use, and lifetime externalizing spectrum diagnoses. RESULTS The ESI-BF demonstrated good to adequate reliability and internal consistency, with all but four facet scales exhibiting α and ω values ≥ 0.80. Average inter-item correlations for the facet scales ranged from 0.31 to 0.74. However, all structural models exhibited poor to mediocre fit, with model fit values for the CFI being 0.66, 0.79 and 0.87 and RMSEA values of 0.14, 0.12 and 0.09. for the unidimensional correlated factors and bifactor model, respectively. Regarding criterion validity, all subscales of the item-based ESI-BF three-factor model exhibited robust correlations with the Life History of Aggression total, aggression and antisocial/consequences subscales, with correlations ranging from 0.29 to 0.55. All ESI-BF subfactors demonstrated robust associations, yet with different externalizing outcomes, lending tentative support to its criterion validity. CONCLUSION Despite remaining ambiguities regarding its structural fit, the ESI-BF may be promising for assessing externalizing psychopathology in forensic psychiatric populations. However, further investigation of the ESI-BF is needed before any firm conclusions can be drawn about its appropriateness in forensic psychiatric settings.
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Affiliation(s)
- Johan Berlin
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden.
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden.
- Rättspsykiatriska regionkliniken, Box 1223, 351 12, Växjö, Sweden.
| | - Märta Wallinius
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - Thomas Nilsson
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department for Forensic Psychiatry, The National Board of Forensic Medicine, Gothenburg, Sweden
- Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Malin Hildebrand Karlén
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department for Forensic Psychiatry, The National Board of Forensic Medicine, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Institute for Globally Distributed Open Research and Education (IGDORE), Gothenburg, Sweden
| | - Carl Delfin
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
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Critchley HD, Sherrill SP, Ewing DL, van Praag CG, Habash-Bailey H, Quadt L, Eccles JA, Meeten F, Jones AM, Garfinkel SN. Cardiac interoception in patients accessing secondary mental health services: A transdiagnostic study. Auton Neurosci 2023; 245:103072. [PMID: 36709619 DOI: 10.1016/j.autneu.2023.103072] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/19/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Abnormalities in the regulation of physiological arousal and interoceptive processing are implicated in the expression and maintenance of specific psychiatric conditions and symptoms. We undertook a cross-sectional characterisation of patients accessing secondary mental health services, recording measures relating to cardiac physiology and interoception, to understand how physiological state and interoceptive ability relate transdiagnostically to affective symptoms. METHODS Participants were patients (n = 258) and a non-clinical comparison group (n = 67). Clinical diagnoses spanned affective disorders, complex personality presentations and psychoses. We first tested for differences between patient and non-clinical participants in terms of cardiac physiology and interoceptive ability, considering interoceptive tasks and a self-report measure. We then tested for correlations between cardiac and interoceptive measures and affective symptoms. Lastly, we explored group differences across recorded clinical diagnoses. RESULTS Patients exhibited lower performance accuracy and confidence in heartbeat discrimination and lower heartbeat tracking confidence relative to comparisons. In patients, greater anxiety and depression predicted greater self-reported interoceptive sensibility and a greater mismatch between performance accuracy and sensibility. This effect was not observed in comparison participants. Significant differences between patient groups were observed for heart rate variability (HRV) although post hoc differences were not significant after correction for multiple comparisons. Finally, accuracy in heartbeat tracking was significantly lower in schizophrenia compared to other diagnostic groups. CONCLUSIONS The multilevel characterisation presented here identified certain physiological and interoceptive differences associated with psychiatric symptoms and diagnoses. The clinical stratification and therapeutic targeting of interoceptive mechanisms is therefore of potential value in treating certain psychiatric conditions.
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Affiliation(s)
- Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland.
| | - Samantha P Sherrill
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Donna L Ewing
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Humanities and Social Science, University of Brighton, United Kingdom of Great Britain and Northern Ireland
| | - Cassandra Gould van Praag
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Department of Psychiatry, University of Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Haniah Habash-Bailey
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Lisa Quadt
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Jessica A Eccles
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Fran Meeten
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Anna-Marie Jones
- Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
| | - Sarah N Garfinkel
- Institute of Cognitive Neuroscience, University College London, United Kingdom of Great Britain and Northern Ireland
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State of illness-dependent associations of neuro-cognition and psychopathological syndromes in a large transdiagnostic cohort. J Affect Disord 2023; 324:589-599. [PMID: 36586619 DOI: 10.1016/j.jad.2022.12.129] [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] [Received: 12/14/2021] [Revised: 05/19/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND There is a lack of knowledge regarding the relationship between dimensional psychopathological syndromes and neurocognitive functions, particularly across the major psychiatric disorders (i.e., Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia (SZ)). METHOD SANS, SAPS, HAMA, HAM-D, and YMRS were assessed in 1064 patients meeting DSM-IV-TR criteria for MDD, BD, SZ or schizoaffective disorder (SZA). In addition, a comprehensive neuropsychological test battery was administered. Psychopathological syndromes derived from factor analysis and present state of illness were used to explore psychopathology-cognition relationships. Correlational analyses were corrected for age, sex, verbal IQ, years of education, and DSM-IV-TR diagnosis. Age of onset and total duration of hospitalizations as proxies for illness severity were tested as moderators on the cognition - psychopathology relationship. RESULTS The negative syndrome, positive formal thought disorder as well as the paranoid-hallucinatory syndrome exhibited associations with neuro-cognition in an illness state-dependent manner, while the psychopathological factors depression and increased appetite only showed weak associations. Illness severity showed moderating effects on the neurocognitive-psychopathology relationship only for the negative syndrome and positive formal thought disorder. LIMITATIONS No healthy control subjects were entered into the analyses because of lack of variance in psychopathological symptoms, which prevents from drawing conclusions regarding the relative level of potential cognitive impairments. CONCLUSIONS This study suggests the relationship of neuro-cognition and psychopathology to be highly state of illness-dependent across affective and psychotic disorders. Results hint at the moderating effects of illness severity on psychopathological factors that might be more treatment resistant.
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Stevens KL, Teich CD, Longenecker JM, Sponheim SR. Relational memory function in schizophrenia: Electrophysiological evidence for early perceptual and late associative abnormalities. Schizophr Res 2023; 254:99-108. [PMID: 36821940 DOI: 10.1016/j.schres.2023.02.019] [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] [Received: 08/05/2022] [Revised: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
We used event-related potentials (ERPs) to examine encoding and retrieval during episodic memory in people with schizophrenia (SZ) and biological relatives of SZ (SZr). To isolate contextual from item-specific aspects of memory, we employed the Relational and Item-Specific Encoding (RISE) task. Twenty two healthy controls (HCs), 22 SZ, and 19 SZr, encoded visual depictions of objects when displayed alone (item-specific) or in pairs (relational encoding), and were later tested on recognition of specific objects and whether pairs of objects had appeared together. An early posterior component (P2) during encoding predicted later recognition and was diminished in SZ. A late negative potential (LNP) over left frontal brain regions during recognition was larger for relationally encoded objects than new and item-specific encoded objects in HCs. This pattern was absent for SZ and SZr. Smaller P2 and LNP components were associated with greater self-reported cognitive-perceptual abnormalities. Early posterior brain responses likely relevant to perceptual functions supporting memory formation were diminished in schizophrenia. Late frontal electrophysiological responses associated with relational aspects of memory appear diminished in SZ and SZr, potentially reflecting the influence of genetic liability for schizophrenia on brain functions supporting episodic memory.
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Affiliation(s)
- Kara L Stevens
- Minneapolis VA Health Care System, United States of America; University of Minnesota-Twin Cities, United States of America
| | - Collin D Teich
- Minneapolis VA Health Care System, United States of America; University of Minnesota-Twin Cities, United States of America
| | - Julia M Longenecker
- VA Pittsburgh Healthcare Center, United States of America; University of Pittsburgh, United States of America
| | - Scott R Sponheim
- Minneapolis VA Health Care System, United States of America; University of Minnesota-Twin Cities, United States of America.
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