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DeSerisy M, Wall MM, Goldberg TE, Batistuzzo MC, Keyes K, de Joode NT, Lochner C, Marincowitz C, Narayan M, Anand N, Rapp AM, Stein DJ, Simpson HB, Margolis AE. Assessing harmonized intelligence measures in a multinational study. Glob Ment Health (Camb) 2024; 11:e22. [PMID: 38572246 PMCID: PMC10988151 DOI: 10.1017/gmh.2024.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/23/2024] [Accepted: 02/11/2024] [Indexed: 04/05/2024] Open
Abstract
Studies examining the neurocognitive and circuit-based etiology of psychiatric illness are moving toward inclusive, global designs. A potential confounding effect of these associations is general intelligence; however, an internationally validated, harmonized intelligence quotient (IQ) measure is not available. We describe the procedures used to measure IQ across a five-site, multinational study and demonstrate the harmonized measure's cross-site validity. Culturally appropriate intelligence measures were selected: four short-form Wechsler intelligence tests (Brazil, Netherlands, South Africa, United States) and the Binet Kamat (India). Analyses included IQ scores from 255 healthy participants (age 18-50; 42% male). Regression analyses tested between-site differences in IQ scores, as well as expected associations with sociodemographic factors (sex, socioeconomic status, education) to assess validity. Harmonization (e.g., a priori selection of tests) yielded the compatibility of IQ measures. Higher IQ was associated with higher socioeconomic status, suggesting good convergent validity. No association was found between sex and IQ at any site, suggesting good discriminant validity. Associations between higher IQ and higher years of education were found at all sites except the United States. Harmonized IQ scores provide a measure of IQ with evidence of good validity that can be used in neurocognitive and circuit-based studies to control for intelligence across global sites.
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Affiliation(s)
- Mariah DeSerisy
- Columbia University Medical Center, Mailman School of Public Health, Columbia University, New York, NY, USA
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA
| | - Melanie M. Wall
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA
- Department of Psychiatry, The New York State Psychiatric Institute, New York, NY, USA
| | - Terry E. Goldberg
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA
| | - Marcelo C. Batistuzzo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, Brazil
| | - Katherine Keyes
- Columbia University Medical Center, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Niels T. de Joode
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Clara Marincowitz
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Madhuri Narayan
- Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Institute of National Importance (INI), Bangalore, India
| | - Nitin Anand
- Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Institute of National Importance (INI), Bangalore, India
| | - Amy M. Rapp
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA
- Department of Psychiatry, The New York State Psychiatric Institute, New York, NY, USA
| | - Dan J. Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - H. Blair Simpson
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA
- Department of Psychiatry, The New York State Psychiatric Institute, New York, NY, USA
| | - Amy E. Margolis
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA
- Department of Psychiatry, The New York State Psychiatric Institute, New York, NY, USA
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Hezel DM, Rapp AM, Wheaton MG, Kayser RR, Rose SV, Messner GR, Middleton R, Simpson HB. Resilience predicts positive mental health outcomes during the COVID-19 pandemic in New Yorkers with and without obsessive-compulsive disorder. J Psychiatr Res 2022; 150:165-172. [PMID: 35385818 PMCID: PMC8957091 DOI: 10.1016/j.jpsychires.2022.03.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 12/16/2022]
Abstract
There has been substantial concern about the mental health effects of the COVID-19 pandemic, particularly for those with obsessive-compulsive disorder (OCD) given the overlap between OCD symptoms (e.g., excessive handwashing) and appropriate disease prevention measures. However, the pandemic has demonstrated heterogeneous mental health effects, suggesting that individual-level factors could play a role in buffering or exacerbating its deleterious impact. This study aimed to understand how individual differences in resilience were associated with trajectories of obsessive-compulsive, depression, and anxiety symptoms among healthy adults and those with OCD residing in New York City, considered the epicenter of the pandemic in the United States at its onset. The sample consisted of healthy individuals (n = 30) and people with OCD (n = 33) who completed clinical interviews and self-report questionnaires that assessed baseline resilience, OCD symptoms, depression, anxiety, and perceived positive effects of the pandemic at four assessment timepoints: baseline (April 2020) and one, two, and six months later. Linear mixed-effects growth models revealed that greater resilience was associated with stable trajectories of symptoms over time. Conversely, less resilience was associated with worsening obsessive-compulsive symptoms from the two-month to six-month assessment timepoints and worsening depressive symptoms at six months across both groups, and with worsening anxiety symptoms in individuals with OCD at six months. Resilience was correlated with the ability to appreciate "silver linings" of the pandemic. These findings highlight resilience as a potential treatment target for bolstering mental health outcomes among individuals with and without psychopathology during sustained and unprecedented periods of stress.
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Affiliation(s)
- Dianne M Hezel
- Department of Psychiatry, Columbia University Irving Medical Center, 622 W. 168 St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1052 Riverside Dr., New York, NY, 10032, USA.
| | - Amy M Rapp
- Department of Psychiatry, Columbia University Irving Medical Center, 622 W. 168 St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1052 Riverside Dr., New York, NY, 10032, USA
| | | | - Reilly R Kayser
- Department of Psychiatry, Columbia University Irving Medical Center, 622 W. 168 St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1052 Riverside Dr., New York, NY, 10032, USA
| | - Sarah V Rose
- Department of Psychiatry, Columbia University Irving Medical Center, 622 W. 168 St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1052 Riverside Dr., New York, NY, 10032, USA
| | - Gabrielle R Messner
- Department of Psychiatry, Columbia University Irving Medical Center, 622 W. 168 St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1052 Riverside Dr., New York, NY, 10032, USA
| | - Rachel Middleton
- Department of Psychiatry, Columbia University Irving Medical Center, 622 W. 168 St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1052 Riverside Dr., New York, NY, 10032, USA
| | - H Blair Simpson
- Department of Psychiatry, Columbia University Irving Medical Center, 622 W. 168 St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1052 Riverside Dr., New York, NY, 10032, USA
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Rapp AM, Dixon De Silva LE, Escovar E, Chavira DA. Psychometrics of the Multidimensional Anxiety Scale for Children in Latinx adolescents. Journal of Latinx Psychology 2022. [DOI: 10.1037/lat0000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hezel DM, Rapp AM, Glasgow S, Cridland G, Blair Simpson H. Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic. Cognitive and Behavioral Practice 2022; 30:263-272. [PMID: 35228790 PMCID: PMC8864948 DOI: 10.1016/j.cbpra.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/26/2021] [Indexed: 11/03/2022]
Abstract
In response to the COVID-19 pandemic and consequential shutdown measures, many mental health professionals started providing therapy to patients exclusively via telehealth. Our research center, which specializes in studying and treating obsessive-compulsive disorder (OCD), historically has provided in-person exposure and response prevention (ERP) to adults with OCD, but shifted to telehealth during the pandemic. Unlike in other modes of talk therapy, ERP's emphasis on therapist-supervised exposures presented unique opportunities and challenges to delivering treatment entirely via a virtual platform. This paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021 and offers recommendations for future study and practice. Though we observed a number of drawbacks to fully remote ERP, we also discovered advantages to delivering ERP this way, meriting additional research attention.
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Rapp AM, Tan PZ, Grammer JK, Gehring WJ, Miller GA, Chavira DA. Cultural group differences in the association of neural sensitivity to social feedback and social anxiety among diverse adolescents. J Psychiatr Res 2021; 143:400-408. [PMID: 34637997 PMCID: PMC8557129 DOI: 10.1016/j.jpsychires.2021.09.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/30/2021] [Accepted: 09/22/2021] [Indexed: 01/19/2023]
Abstract
Social anxiety disproportionately impacts individuals from certain cultural and developmental groups, namely those from Latinx and Asian American cultures and adolescents. Neural sensitivity to social feedback has been shown to vary across individuals and could contribute to this disparity by further exacerbating differences; thus, this could be an important phenomenon for understanding, preventing, and treating social anxiety. The goal of the present study was to examine the association of social anxiety with a neural correlate of feedback processing, the feedback-related negativity (FRN), and determine if there was a moderating effect of racial/ethnic group. A community sample of 104 Latinx (n = 41), Asian American (n = 24), and non-Latinx White (NLW; n = 39) adolescents (ages 13-17) completed a computerized peer feedback task while continuous electroencephalogram was recorded. Social anxiety and FRN measures were differentially associated as a function of race/ethnicity. NLW adolescents demonstrated greater FRN responses to acceptance feedback as social anxiety increased, whereas FRN responses to both rejection and acceptance feedback were related to greater social anxiety for Asian American adolescents. Notably, the Latinx group showed the greatest FRN responses yet endorsed the least amount of social anxiety, with no relation between social anxiety and FRN detected. Results highlight cultural variation in the relation between neural correlates of self-regulatory processes and social anxiety. This information could guide culturally-informed models of social anxiety that adopt a multiple units of analysis framework.
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Affiliation(s)
- Amy M. Rapp
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA, USA, 90095,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, USA, 10032,New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY USA, 10032
| | - Patricia Z. Tan
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, USA, 90024,Department of Psychology, University of Southern California, 3620 South McClintock Avenue, Los Angeles, CA, USA, 90089
| | - Jennie K. Grammer
- Graduate School of Education and Information Studies, University of California, Los Angeles, 457 Portola Plaza, Los Angeles, CA, USA, 90095
| | - William J. Gehring
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, USA, 48109
| | - Gregory A. Miller
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA, USA, 90095,Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, USA, 90024
| | - Denise A. Chavira
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA, USA, 90095
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Rapp AM, Grammer JK, Tan PZ, Gehring WJ, Chavira DA, Miller GA. Collectivism is Associated with Enhanced Neural Response to Socially-Salient Errors among Adolescents. Soc Cogn Affect Neurosci 2021; 16:1150-1159. [PMID: 34041547 PMCID: PMC8599179 DOI: 10.1093/scan/nsab065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 04/05/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
The perceived salience of errors can be influenced by individual-level motivational factors. Specifically, those who endorse a high degree of collectivism, a cultural value that emphasizes prioritization of interpersonal relationships, may find errors occurring in a social context to be more aversive than individuals who endorse collectivism to a lesser degree, resulting in upregulation of a neural correlate of error-monitoring, the error-related negativity (ERN). This study aimed to identify cultural variation in neural response to errors occurring in a social context in a sample of diverse adolescents. It was predicted that greater collectivism would be associated with enhanced neural response to errors occurring as part of a team. Participants were 95 Latinx (n = 35), Asian American (n = 20), and non-Latinx White (n = 40) adolescents (ages 13-17) who completed a go/no-go task while continuous electroencephalogram was recorded. The task included social (team) and non-social (individual) conditions. ERN was quantified using mean amplitude measures. Regression models demonstrated that collectivism modulated neural response to errors occurring in a social context, an effect that was most robust for Latinx adolescents. Understanding cultural variation in neural sensitivity to social context could inform understanding of both normative and maladaptive processes associated with self-regulation.
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Affiliation(s)
- Amy M Rapp
- Department of Psychology, University of California, Los Angeles, USA.,Department of Psychiatry, Columbia University, New York, NY 10032, USA.,New York State Psychiatric Institute, USA
| | - Jennie K Grammer
- Graduate School of Education and Information Studies, University of California, Los Angeles, CA, USA
| | - Patricia Z Tan
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - William J Gehring
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Denise A Chavira
- Department of Psychology, University of California, Los Angeles, USA
| | - Gregory A Miller
- Department of Psychology, University of California, Los Angeles, USA.,Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Rapp AM, Chavira DA, Sugar CA, Asarnow JR. Incorporating family factors into treatment planning for adolescent depression: Perceived parental criticism predicts longitudinal symptom trajectory in the Youth Partners in Care trial. J Affect Disord 2021; 278:46-53. [PMID: 32949872 PMCID: PMC7704900 DOI: 10.1016/j.jad.2020.09.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aimed to clarify the predictive significance of youth perceptions of parental criticism assessed using a brief measure designed to enhance clinical utility. We hypothesized that high perceived parental criticism would be associated with more severe depression over 18-months of follow-up. METHODS The study involved secondary analyses from the Youth Partners in Care trial, which demonstrated that a quality improvement intervention aimed at increasing access to evidence-based depression treatment in primary care led to improved depression outcomes at post-treatment compared to usual care enhanced by provider education regarding depression evaluation/management. Patients (N = 418; ages 13-21) were assessed at four time points: baseline; post-treatment (six-month follow-up); 12- and 18-month follow-ups. The primary analysis estimated the effect of perceived parental criticism on likelihood of severe depression (i.e., Center for Epidemiological Studies-Depression Scale ≥ 24) over post-intervention follow-ups using a repeated-measures logistic regression model. Secondarily, a linear mixed-effects growth model examined symptom trajectories from baseline through 18-months using the Mental Health Index-5, a measure of emotional distress available at all time-points. RESULTS High perceived parental criticism emerged as a robust predictor of clinically-elevated depression (OR=1.66, p=.02) and a more pernicious symptom trajectory over 18-months (β =-1.89, p<.0001). LIMITATIONS The association between the self-report perceived criticism and traditional expressed emotion measures derived from verbal and nonverbal parental behaviors was not evaluated. CONCLUSIONS Results support perceived parental criticism as a predictor of youth depression outcomes over 18-months. This brief measure can be feasibly integrated within clinical assessment to assist clinicians in optimizing treatment benefits.
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Affiliation(s)
- Amy M Rapp
- Department of Psychology, University of California, Los Angeles; Department of Psychiatry, Columbia University; New York State Psychiatric Institute
| | | | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Biostatistics, University of California, Los Angeles
| | - Joan R Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles.
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Dixon De Silva LE, Ponting C, Rapp AM, Escovar E, Chavira DA. Trauma Exposure and Mental Health Symptoms in Rural Latinx Adolescents: The Role of Family Processes. Child Psychiatry Hum Dev 2020; 51:934-942. [PMID: 32086665 DOI: 10.1007/s10578-020-00971-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Previous research suggests that rural Latinx youth are more likely to experience traumatic events and are at higher risk for developing subsequent psychopathology compared to non-Latinx white youth. The aim of this study is to understand how family processes and values affect risk for internalizing and externalizing symptoms among rural Latinx youth (N = 648, mage = 15.7 (SD = 1.2)) who are exposed to trauma. Multiple mediation analyses were performed to understand if family variables such as familism and family conflict explain the relationship between trauma exposure and psychopathology. Results suggest that familism partially mediates the relationship between trauma exposure and internalizing and externalizing symptoms, whereas family conflict partially mediates the relationship between trauma exposure and externalizing symptoms. These findings show that family variables are differentially impacted by trauma and have a separate and unique impact on mental health outcomes among rural Latinx youth. Specifically, our findings suggest that familial support or closeness may constitute a nonspecific protective factor for psychopathology among Latinx youth, whereas family conflict creates a stressful home environment that may deter adolescent trauma recovery and lead specifically to externalizing symptoms.
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Affiliation(s)
- Louise E Dixon De Silva
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA.
| | - Carolyn Ponting
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Amy M Rapp
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
| | - Emily Escovar
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
- Deapartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Denise A Chavira
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
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Ponting C, Lee SS, Escovar EL, Rapp AM, Camacho A, Calderon I, Chavira DA. Family factors mediate discrimination related stress and externalizing symptoms in rural Latino adolescents. J Adolesc 2018; 69:11-21. [PMID: 30205197 PMCID: PMC10030083 DOI: 10.1016/j.adolescence.2018.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 08/22/2018] [Accepted: 08/26/2018] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Externalizing disorders are more prevalent in rural than urban settings and account for disproportionately high mental health service costs for rural adolescents. Although cultural stressors such as discrimination have been associated with externalizing problems in ethnic minority youth broadly, this relationship is understudied in Latinos, particularly those in rural settings. Further, though the associations of family processes such as familism and family conflict have been studied in relation to youth externalizing symptoms, whether these processes change in the face of adolescent discrimination stress remains unknown. METHODS A moderated multiple mediation model was used to examine the association between perceived discrimination, externalizing symptoms, and the indirect effect of family factors (familism, and family conflict) in a large sample (n = 455) of rural Latino youth. We also evaluated whether indirect and direct effects of discrimination on externalizing symptoms differed in boys versus girls. RESULTS Familism and family conflict each independently mediated the relationship between discrimination related stress and externalizing symptoms. However, discrimination had a direct effect on externalizing symptoms for boys only. In girls, this association held only when family factors were accounted for. Post-hoc analyses reveal that the moderating effect of sex on discrimination is driven by differences in rule-breaking behavior, as opposed to aggressive behavior. CONCLUSION Findings suggest that discrimination is associated with changes in the family environment which in turn invoke elevated risk for externalizing problems. Further, family-focused interventions that address externalizing problems may be especially effective for adolescent girls.
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Affiliation(s)
- Carolyn Ponting
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Steve S Lee
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Emily L Escovar
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amy M Rapp
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alvaro Camacho
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Ignacio Calderon
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Denise A Chavira
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Rapp AM, Chavira DA, Sugar CA, Asarnow JR. Integrated Primary Medical-Behavioral Health Care for Adolescent and Young Adult Depression: Predictors of Service Use in the Youth Partners in Care Trial. J Pediatr Psychol 2017; 42:1051-1064. [PMID: 28369443 PMCID: PMC5896616 DOI: 10.1093/jpepsy/jsx057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/01/2017] [Accepted: 02/08/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives Depression, a chronic and disabling condition, frequently has its first onset during adolescence, underscoring the value of early effective treatment and prevention. Integrated medical-behavioral health care provides one strategy for improving treatment access for adolescents and young adults (AYA). Methods This study examined predictors of accessing treatment in a multisite randomized controlled trial evaluating an integrated collaborative care intervention aimed at improving access to evidence-based depression treatment through primary health care, compared with usual care. Results The integrated care intervention was able to overcome barriers to care associated with an initial reluctance to pursue active treatment and older age. Service use was low in both conditions among less acculturated/non-English-speaking families. Conclusions Results support the value of integrated medical-behavioral health care for improving rates of care. Findings highlight mechanisms by which integrated care may lead to improved rates of care and outcomes for AYA, an underserved and understudied group.
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Affiliation(s)
- Amy M. Rapp
- Department of Psychology, University of California
| | | | - Catherine A. Sugar
- Department of Biostatistics, Los Angeles School of Public Health, University of California
- Department of Psychiatry and Biobehavioral Sciences, Los Angeles Semel Institute for Neuroscience and Human Behavior, University of California
| | - Joan R. Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Los Angeles Semel Institute for Neuroscience and Human Behavior, University of California
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Rapp AM, Lau A, Chavira DA. Differential associations between Social Anxiety Disorder, family cohesion, and suicidality across racial/ethnic groups: Findings from the National Comorbidity Survey-Adolescent (NCS-A). J Anxiety Disord 2017; 48:13-21. [PMID: 27697370 DOI: 10.1016/j.janxdis.2016.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 10/21/2022]
Abstract
The proposed research seeks to introduce a novel model relating Social Anxiety Disorder (SAD) and suicide outcomes (i.e., passive suicidal ideation, active suicidal ideation, and suicide attempts) in diverse adolescents. This model posits that family cohesion is one pathway by which suicide risk is increased for socially anxious youth, and predicts that the relationships between these variables may be of different strength in Latino and White subgroups and across gender. Data from a sample of Latino (n=1922) and non-Hispanic White (hereafter referred to as White throughout) (n=5648) male and female adolescents who participated in the National Comorbidity Survey-Adolescent were used for this study. Analyses were conducted using generalized structural equation modeling. Results showed that the mediation model held for White females. Further examination of direct pathways highlighted SAD as a risk factor unique to Latinos for active suicidal ideation and suicide attempt, over and above comorbid depression and other relevant contextual factors. Additionally, family cohesion showed a strong association with suicide outcomes across groups, with some inconsistent findings for White males. Overall, it appears that the mechanism by which SAD increases risk for suicidality is different across groups, indicating further need to identify relevant mediators, especially for racial/ethnic minority youth.
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Affiliation(s)
- Amy M Rapp
- Department of Psychology, University of California Los Angeles, United States.
| | - Anna Lau
- Department of Psychology, University of California Los Angeles, United States
| | - Denise A Chavira
- Department of Psychology, University of California Los Angeles, United States
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Rapp AM, Bergman RL, Piacentini J, McGuire JF. Evidence-Based Assessment of Obsessive-Compulsive Disorder. J Cent Nerv Syst Dis 2016; 8:13-29. [PMID: 27594793 PMCID: PMC4994744 DOI: 10.4137/jcnsd.s38359] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/26/2016] [Accepted: 07/11/2016] [Indexed: 01/06/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%-2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress.
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Affiliation(s)
- Amy M Rapp
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - R Lindsay Bergman
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - John Piacentini
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph F McGuire
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
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Abstract
This article presents an overview of the existing, as well as newly developed, cognitive behavior therapy methods for treating the child anxiety triad (separation anxiety disorder, generalized anxiety disorder, and social phobia). For each disorder of the triad, the authors review diagnostic criteria, clinical presentation, disorder-specific treatment methods and innovations, and future directions for research.
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Affiliation(s)
- Olga Jablonka
- Children's Day Unit, Department of Child and Adolescent Psychiatry, Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, Unit 74, New York, NY 10032, USA
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Rapp AM, Mutschler DE, Wild B, Erb M, Lengsfeld I, Saur R, Grodd W. Neural correlates of irony comprehension: the role of schizotypal personality traits. Brain Lang 2010; 113:1-12. [PMID: 20071019 DOI: 10.1016/j.bandl.2009.11.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 10/06/2009] [Accepted: 11/21/2009] [Indexed: 05/28/2023]
Abstract
To detect that a conversational turn is intended to be ironic is a difficult challenge in everyday language comprehension. Most authors suggested a theory of mind deficit is crucial for irony comprehension deficits in psychiatric disorders like schizophrenia; however, the underlying pathophysiology and neurobiology are unknown and recent research highlights the possible role of language comprehension abnormalities. Fifteen female right-handed subjects completed personality testing as well as functional magnetic resonance imaging (fMRI) and neuropsychology. Subjects were recruited from the general population. No subject had a lifetime history of relevant psychiatric disorder; however, subjects differed in their score on the German version of the schizotypal personality questionnaire (SPQ). During fMRI scans, the subjects silently read 44 short text vignettes that ended in either an ironic or a literal statement. Imaging was performed using a 3 T Siemens scanner. The influence of schizotypy on brain activation was investigated by using an SPM5 regression analysis with the SPQ total score and the SPQ cognitive-perceptual score as regressors. Reading ironic in contrast to literal sentences activated a bilateral network including left medial prefrontal and left inferior parietal gyri. During reading of ironic sentences, brain activation in the middle temporal gyrus of both hemispheres showed a significant negative association with the SPQ total score and the SPQ cognitive-perceptual score. Significant positive correlation with the SPQ total score was present in the left inferior frontal gyrus. We conclude schizotypal personality traits are associated with a dysfunctional lateral temporal language rather than a theory of mind network.
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Affiliation(s)
- A M Rapp
- Department of Psychiatry, University of Tuebingen, Osianderstrasse 26, Tuebingen, Germany.
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