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Allen KB, Tan PZ, Sullivan JA, Baumgardner M, Hunter H, Glovak SN. An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context. Clin Child Fam Psychol Rev 2023; 26:1025-1051. [PMID: 37819403 DOI: 10.1007/s10567-023-00458-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.
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Affiliation(s)
- Kristy Benoit Allen
- Departments of Applied Behavioral Science and Psychology, University of Kansas, Lawrence, KS, USA.
| | - Patricia Z Tan
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Megan Baumgardner
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Hannah Hunter
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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2
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Bylsma LM, Tan PZ, Silk JS, Forbes EE, McMakin DL, Dahl RE, Ryan ND, Ladouceur CD. The late positive potential during affective picture processing: Associations with daily life emotional functioning among adolescents with anxiety disorders. Int J Psychophysiol 2022; 182:70-80. [PMID: 36174791 PMCID: PMC10023197 DOI: 10.1016/j.ijpsycho.2022.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 11/22/2021] [Revised: 09/04/2022] [Accepted: 09/21/2022] [Indexed: 11/27/2022]
Abstract
Pediatric anxiety disorders are characterized by potentiated threat responses and maladaptive emotion regulation (ER). The Late Positive Potential (LPP) is a neural index of heightened attention to emotional stimuli. Anxious individuals typically exhibit a larger LPP to unpleasant stimuli, but the LPP may also be blunted to unpleasant and pleasant stimuli for those with co-morbid depression. While a larger LPP is thought to reflect greater emotional reactivity, it is unknown to what extent variation in the LPP to laboratory stimuli corresponds to daily emotional functioning. We assessed the LPP in the laboratory in response to unpleasant, pleasant, and neutral images in combination with ecological momentary assessment of emotional reactivity and regulation in daily life among youth (9-14 years old; 55 % female) with anxiety disorders (ANX, N = 130) and no psychiatric diagnoses (ND, N = 47). We tested whether LPP amplitudes to unpleasant and pleasant stimuli (vs. neutral) are greater in ANX (vs. ND) youth and whether LPP amplitudes inversely correlate with co-morbid depression symptoms. We also examined associations between the LPP and daily life emotional functioning among ANX and ND youth. We found no group-by-valence effects on LPP amplitudes. Within ANX youth, higher depression symptoms were associated with smaller LPP amplitudes to unpleasant, but not pleasant, stimuli relative to neutral stimuli. Larger LPP amplitudes to emotional (relative to neutral) stimuli were correlated with use of specific ER strategies among ANX and ND youth but not emotional reactivity. While the LPP may reflect initial emotional reactivity to laboratory stimuli, it is associated with ER behaviors, and not emotional reactivity, in daily life.
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Affiliation(s)
- Lauren M Bylsma
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America; Department of Psychology, University of Pittsburgh, United States of America
| | - Patricia Z Tan
- Department of Psychiatry, University of California - Los Angeles School of Medicine, United States of America
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, United States of America
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America; Department of Psychology, University of Pittsburgh, United States of America
| | - Dana L McMakin
- Department of Psychology, Florida International University, United States of America
| | - Ronald E Dahl
- Department of Human Development, University of California, Berkeley, United States of America
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America; Department of Psychology, University of Pittsburgh, United States of America.
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Tan PZ, Bylsma LM, Silk JS, Siegle GJ, Forbes EE, McMakin DL, Dahl RE, Ryan ND, Ladouceur CD. Neural indices of performance monitoring are associated with daily emotional functioning in youth with anxiety disorders: An ERP and EMA study. Int J Psychophysiol 2022; 178:34-42. [PMID: 35679962 PMCID: PMC10023196 DOI: 10.1016/j.ijpsycho.2022.06.004] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 05/21/2022] [Accepted: 06/03/2022] [Indexed: 10/18/2022]
Abstract
Excessive monitoring of one's performance is a characteristic of anxiety disorders that has been linked to alterations in implicit emotion regulation (ER), including elevations in neural measures of performance monitoring (i.e., error- and correct-related negativity; ERN and CRN). Elevations in ERN and CRN amplitudes have been reported consistently in anxiety disorders, suggesting that an overactive performance monitoring system is linked to ER difficulties in anxiety. Yet, the relevance of these lab-based neural measures for day-to-day emotional functioning remains poorly understood. This study examined the degree to which ERN and CRN amplitudes are associated with measures of daily ER difficulties in youth with anxiety disorders. Youth (N = 100, Mage = 11.14, SDage = 1.46) completed a computerized flanker task assessing the ERN and CRN. They then completed a 5-day ecological momentary assessment (EMA) protocol assessing their daily ER (i.e., intensity of momentary and peak negative affect, intensity of worry, reliance on maladaptive ER strategies). Results showed that more negative mean CRN amplitudes were associated with higher levels of negative emotional reactivity and more intense worries. There were no significant associations between ERN amplitude and EMA measures. Furthermore, elevations in CRN were linked to more frequent use of maladaptive ER strategies (i.e., rumination, physiological reactivity, avoidance). Together, results indicate that among youth with anxiety, individual differences in CRN, but not ERN, amplitudes are related to daily ER difficulties. Findings highlight the clinical utility of a lab-based neural measure of ER, suggesting that the CRN, rather than the ERN, reflects individual ER differences in the context of daily life among youth with pediatric anxiety disorders. As such, the CRN might serve as an important dimensional index of a treatment target that can be tracked with a validated, multi-method measure.
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Affiliation(s)
- Patricia Z Tan
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles David Geffen School of Medicine, United States of America
| | - Lauren M Bylsma
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America; Department of Psychology, University of Pittsburgh, United States of America
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, United States of America
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Dana L McMakin
- Department of Psychology, Florida International University, United States of America
| | - Ronald E Dahl
- Institute of Human Development, University of California, Berkeley, United States of America
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America; Department of Psychology, University of Pittsburgh, United States of America.
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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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Tan PZ, Rozenman M, Chang SW, Jurgiel J, Truong HV, Piacentini J, Loo SK. The ERN as a neural index of changes in performance monitoring following attention training in pediatric obsessive-compulsive disorder. Biol Psychol 2021; 166:108206. [PMID: 34662675 DOI: 10.1016/j.biopsycho.2021.108206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 10/20/2022]
Abstract
Evidence of associations between obsessive compulsive disorder (OCD) and alterations in neural indices of performance monitoring, i.e., elevated neural activity following errors, have accelerated interest in the error-related negativity (ERN) as a biomarker for pediatric OCD. The study investigates the degree to which attention bias training is linked to changes in neural measures of performance monitoring (ERN, correct response negativity or CRN) and whether pre-to-post training changes in these neural indices are associated with symptom changes in youth with OCD. The sample included 36 youth (8-17 years) diagnosed with OCD who completed a 12-session attention training program and pre- and post-training EEG assessment of performance monitoring using cognitive and emotional flanker tasks. The emotional flanker task was individualized to each participant's negative ratings of stimuli at pre-treatment to enhance salience of threat-related stimuli across youth. Results indicated that unlike participants who received attentional control protocol (CON), those who received attentional bias modification protocol (ABM) showed significant attenuations in neural activity following erroneous and correct responses in the emotional flanker task. The ERN amplitude during the cognitive flanker task was unchanged in both ABM and CON groups. Attenuations in the ERN were also linked to decreases in social anxiety and depressive symptoms. Findings highlight the relevance of including emotionally-salient tasks when investigating potential neural mechanisms of treatments and suggest that alterations in neural processes underlying performance monitoring can be targeted via attention training programs in pediatric OCD.
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Affiliation(s)
- Patricia Z Tan
- Department of Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavior, David Geffen School of Medicine, University of California Los Angeles, USA
| | | | - Susanna W Chang
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavior, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Joseph Jurgiel
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavior, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Holly V Truong
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavior, David Geffen School of Medicine, University of California Los Angeles, USA
| | - John Piacentini
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavior, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Sandra K Loo
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavior, David Geffen School of Medicine, University of California Los Angeles, USA
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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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Torgrimson SJ, Tan PZ, Grammer JK. Associations among response inhibition, motivational beliefs, and task persistence in early elementary school. J Exp Child Psychol 2021; 208:105141. [PMID: 33862528 DOI: 10.1016/j.jecp.2021.105141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 11/25/2022]
Abstract
Task persistence is an important learning-related behavior associated with academic success. Although persistence has been related to motivational beliefs and cognitive skills, these constructs are typically studied independently, limiting our understanding of relations among them. The current investigation was designed to understand how these concepts are related in early elementary school, a developmental period characterized by high motivational beliefs, growth in cognitive control, and the transition to school. Interest, perceived competence, and response inhibition were evaluated as predictors of children's (N = 73, Mage = 6.91 years) likelihood to demonstrate high persistence on a challenging puzzle task. Results provided evidence that motivational constructs are not sufficient for understanding differences in persistent behavior during this developmental period. Specifically, relations between interest and perceived competence and task persistence were present only for children with moderate to high response inhibition skills. Moreover, gender differences in task persistence emerged, indicating that although interest and perceived competence motivated all students to exhibit persistence, girls were still more likely to demonstrate task persistence than boys. Overall, findings suggest that task persistence in elementary school is a complex behavior that requires both cognitive control skills to support engagement and the motivation to continue engaging as task difficulty increases.
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Affiliation(s)
- Sarah Jo Torgrimson
- School of Education & Information Studies, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Patricia Z Tan
- Department of Psychiatry, UCLA School of Medicine, Los Angeles, CA 90024, USA
| | - Jennie K Grammer
- School of Education & Information Studies, University of California, Los Angeles, Los Angeles, CA 90095, USA
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Tan PZ, Oppenheimer CW, Ladouceur CD, Butterfield RD, Silk JS. A review of associations between parental emotion socialization behaviors and the neural substrates of emotional reactivity and regulation in youth. Dev Psychol 2020; 56:516-527. [PMID: 32077721 PMCID: PMC7155917 DOI: 10.1037/dev0000893] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [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] [Indexed: 12/26/2022]
Abstract
As highlighted by Eisenberg, Cumberland, and Spinrad (1998), parents play a critical role in children's socioemotional development, in part, by shaping how children and adolescents process, respond to, and regulate their emotions (i.e., emotional reactivity/regulation). Although evidence for associations between parenting behavior and youth's emotional processing has relied primarily on behavioral measures of emotion, researchers have begun to examine how parenting is related to the neural substrates of youth's reactivity and regulation. This article reviews a growing literature linking parental behavior with structural brain development as well as functional activity and connectivity in neural regions supporting emotional reactivity/regulation during infancy, childhood, and adolescence. By focusing on normative parental behaviors, we evaluate the evidence for associations between typical variations in caregiving and neural processes thought to support youth's emotional reactivity/regulation. The purpose of this review is to (1) extend the model put forth by Eisenberg and colleagues to consider the ways that parenting behaviors are related to neural substrates of youth's emotional reactivity and regulation; (2) review the empirical evidence for associations between parenting, particularly parental "emotion-related socialization behaviors" (ERSBs), and neural substrates of youth's emotional reactivity/regulation; and (3) recommend future directions for this emerging area of research. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Peris TS, Rozenman M, Gonzalez A, Vreeland A, Piacentini J, Tan PZ, Ricketts EJ. Family functioning in pediatric trichotillomania, obsessive compulsive disorder, and healthy comparison youth. Psychiatry Res 2019; 281:112578. [PMID: 31586836 DOI: 10.1016/j.psychres.2019.112578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 10/25/2022]
Abstract
Pediatric trichotillomania (TTM) is an understudied condition that can be highly impairing; little is known about family environmental features that shape its development and course. We examined family functioning among age and gender-matched groups of youth with primary TTM (n = 30; mean age = 12.87), obsessive compulsive disorder (OCD; n = 30; mean age = 12.70), and no psychiatric history (healthy controls; HC; n = 30; mean age = 12.46). An additional group of n = 25 TTM cases was employed to examine relationships between TTM severity and family functioning. All youth completed standardized diagnostic assessment, including the Family Environment Scale (FES) and Children's Report of Parenting Behavior Inventory (CRPBI). Family functioning was more impaired among both TTM and OCD cases relative to controls, as evidenced by higher levels of child-reported FES conflict and lower cohesion, expressiveness, and organization. Less consistent findings emerged on parent report, with cohesion, but not conflict, distinguishing the HC and clinical groups. In keeping with prior research, parents of TTM-affected youth also reported lower expressiveness and cohesion than parents in the OCD group. There was limited evidence for links between hair-pulling severity and family impairment and no links to parenting behavior. Findings are discussed in terms of implications for family focused treatment.
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Affiliation(s)
- Tara S Peris
- UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, United States.
| | | | - Araceli Gonzalez
- California State University Long Beach, Long Beach, CA 90840, United States
| | | | - John Piacentini
- UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, United States
| | - Patricia Z Tan
- UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, United States
| | - Emily J Ricketts
- UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, United States
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McGuire JF, Tan PZ, Piacentini J. Symptom Dimension Response in Children and Adolescents with Obsessive-Compulsive Disorder. J Clin Child Adolesc Psychol 2019; 48:529-538. [PMID: 30644767 DOI: 10.1080/15374416.2018.1540009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This report examined the nature of obsessive-compulsive disorder (OCD) symptoms nominated for treatment and investigate improvement in OCD symptom dimensions. Youth with OCD (N = 71) participated in a clinical trial that compared exposure-based cognitive behavior therapy (CBT) to psychoeducation plus relaxation training (PRT). Participants completed a baseline assessment to characterize OCD severity. Next, parents and youth collaboratively developed an OCD symptom treatment hierarchy. Afterward, these symptoms were independently reassessed at each session by youth and parents. After 12 sessions, a posttreatment assessment was completed by independent evaluators. A greater incidence of baseline aggressive/checking symptoms predicted a positive CBT treatment response. For parent ratings of youth distress, CBT outperformed PRT across symptom dimensions, but hoarding symptoms exhibited a slower rate of improvement relative to other dimensions across treatments. For youth distress ratings, CBT outperformed PRT across most symptom dimensions. Although symmetry/ordering symptoms exhibited a slower rate of improvement relative to other dimensions across treatments, post hoc tests found no difference in the average distress rating for symmetry/ordering symptoms between treatment groups. Finally, across symptom dimensions, parents reported a linear reduction in youth distress, whereas youth experienced a nonlinear reduction in distress that diminished over treatment. Exposure-based CBT is beneficial for OCD symptoms and remains the principle treatment for pediatric OCD. However, as symmetry/ordering symptoms exhibited improvement from CBT and PRT, there is some shared treatment mechanisms that improves these symptoms. Finally, as youth perceive diminishing distress reduction over time, clinicians are encouraged to employ appropriate reinforcement strategies in treatment.
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Affiliation(s)
- Joseph F McGuire
- a Division of Child and Adolescent Psychiatry , Johns Hopkins University School of Medicine.,b Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry , University of California
| | - Patricia Z Tan
- b Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry , University of California
| | - John Piacentini
- b Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry , University of California
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Ricketts EJ, Sturm A, McMakin DL, McGuire JF, Tan PZ, Smalberg FB, McCracken JT, Colwell CS, Piacentini J. Changes in Sleep Problems Across Attention-Deficit/Hyperactivity Disorder Treatment: Findings from the Multimodal Treatment of Attention-Deficit/Hyperactivity Disorder Study. J Child Adolesc Psychopharmacol 2018; 28:690-698. [PMID: 30388029 PMCID: PMC7364298 DOI: 10.1089/cap.2018.0038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Indexed: 01/23/2023]
Abstract
Objective: Stimulant medication and behavior therapy are efficacious for youth with attention-deficit/hyperactivity disorder (ADHD). However, research suggests that stimulants may start and/or worsen sleep problems for youth. Further, the impact of behavior therapy for ADHD on sleep is unknown. This study examined the frequency of sleep problems and effects of stimulant medication, behavior therapy, and their combination on sleep problems in youth with ADHD. This study also explored the influence of dimensional baseline ratings of ADHD symptom subtype and psychiatric comorbidity on sleep outcomes. Methods: Participants were 576 children (aged 7-9 years) with ADHD-Combined type from the Multimodal Treatment of ADHD study that compared methylphenidate, behavior therapy, and their combination to community care. Before treatment, parents completed the Child Behavior Checklist used to derive a total sleep problems score. Parents also completed ratings of oppositionality and ADHD symptom severity, whereas youth completed ratings of depression and anxiety. These ratings were readministered after treatment. Results: General linear mixed-effects models were used to assess change in total sleep problems across treatment. The combined group exhibited a statistically significant reduction in total sleep problems (z = -5.81, p < 0.001). Reductions in total sleep problems in methylphenidate (z = -3.11, p = 0.05), behavior therapy (z = -2.99, p = 0.08), or community care (z = -1.59, p > 0.99) did not reach statistical significance. Change in psychiatric symptoms did not significantly moderate change in total sleep problems by treatment assignment. Greater baseline oppositional defiant disorder severity predicted less reduction in total sleep problems, χ2(1) = 3.86, p < 0.05. Conclusions: Findings suggest that combination of methylphenidate and behavior therapy is efficacious for reducing parent-reported sleep problems in young children with ADHD-Combined type relative to community care. However, potential ameliorative effects of monotherapy treatments (i.e., methylphenidate, behavior therapy) should be examined. Future replication is needed to confirm findings.
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Affiliation(s)
- Emily J. Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.,Address correspondence to: Emily J. Ricketts, PhD, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 760 Westwood Plz, Los Angeles, CA 90024
| | - Alexandra Sturm
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Dana L. McMakin
- Department of Psychology, Florida International University, Miami, Florida.,Department of Neurology, Nicklaus Children's Hospital, Miami, Florida
| | - Joseph F. McGuire
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patricia Z. Tan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Fallon B. Smalberg
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Christopher S. Colwell
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
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12
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Ladouceur CD, Tan PZ, Sharma V, Bylsma LM, Silk JS, Siegle GJ, Forbes EE, McMakin DL, Dahl RE, Kendall PC, Mannarino A, Ryan ND. Error-related brain activity in pediatric anxiety disorders remains elevated following individual therapy: a randomized clinical trial. J Child Psychol Psychiatry 2018; 59:1152-1161. [PMID: 29603219 PMCID: PMC6165715 DOI: 10.1111/jcpp.12900] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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] [Accepted: 02/01/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Anxiety disorders are associated with an overactive action monitoring system as indexed by a larger error-related negativity (ERN). This study tests whether ERN magnitude changes following treatment, predicts response to treatment, and varies by treatment type. METHODS The sample included 130 youth (9-14 years): youth with an anxiety disorder (ANX; n = 100) and healthy control (HC; n = 30) youth with no lifetime DSM-IV disorders. ANX youth were randomized to either a manualized cognitive-behavior therapy (CBT) or a comparison child-centered therapy (CCT). The ERN was assessed before and after 16 sessions of treatment and within a comparable interval for HC. Subjective ratings about making errors on the task were obtained following each testing session. The ClinicalTrials.gov identifier is NCT00774150. RESULTS The ERN was larger in ANX than HC youth but ERN magnitude did not significantly change following treatment in the ANX youth, regardless of treatment type, and baseline ERN did not predict treatment response. Post-task ratings revealed that ANX youth worried more about task performance feedback than HC. Like the ERN, mean ratings did not significantly change following treatment. However, these ratings were not correlated with ERN amplitude. CONCLUSIONS Findings of greater ERN in pediatric anxiety disorders are replicated in a larger sample. More importantly, findings from this randomized control trial show that a larger ERN and feeling worried about performance feedback remain unchanged following treatment and are unrelated to treatment response. Such findings suggest that action monitoring systems remain overactive in anxious youth treated with psychotherapy, suggesting the need for future investigation of whether novel complimentary cognitive and emotional training programs can modify these systems would be warranted.
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Affiliation(s)
- Cecile D. Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Patricia Z. Tan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Vinod Sharma
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Lauren M. Bylsma
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jennifer S. Silk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Greg J. Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Erika E. Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Dana L. McMakin
- Department of Psychology, Florida International University, Miami, FL
| | - Ronald E. Dahl
- Institute of Human Development, University of California, Berkeley, CA
| | | | | | - Neal D. Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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13
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Bendezú JJ, Cole PM, Tan PZ, Armstrong LM, Reitz EB, Wolf RM. Child language and parenting antecedents and externalizing outcomes of emotion regulation pathways across early childhood: A person-centered approach. Dev Psychopathol 2018; 30:1253-1268. [PMID: 29144222 PMCID: PMC5955771 DOI: 10.1017/s0954579417001675] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Decreases in children's anger reactivity because of the onset of their autonomous use of strategies characterizes the prevailing model of the development of emotion regulation in early childhood (Kopp, 1989). There is, however, limited evidence of the varied pathways that mark this development and their proposed antecedents and consequences. This study used a person-centered approach to identify such pathways, antecedents, and outcomes. A sample of 120 children from economically strained rural and semirural households were observed while waiting to open a gift at ages 24, 36, and 48 months. Multitrajectory modeling of children's anger expressions and strategy use yielded three subgroups. As they aged, typically developing children's strategy use (calm bids and focused distraction) increased while anger expressions decreased. Later developing children, though initially elevated in anger expression and low in strategy use, demonstrated marked growth across indicators and did not differ from typically developing children at 48 months. At-risk children, despite developing calm bidding skills, did not display longitudinal self-distraction increases or anger expression declines. Some predicted antecedents (12-24 month child language skills and language-capitalizing parenting practices) and outcomes (age 5 years externalizing behavior) differentiated pathways. Findings illustrate how indicator-specific departures from typical pathways signal risk for behavior problems and point to pathway-specific intervention opportunities.
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14
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Tan PZ, Silk JS, Dahl RE, Kronhaus D, Ladouceur CD. Age-Related Developmental and Individual Differences in the Influence of Social and Non-social Distractors on Cognitive Performance. Front Psychol 2018; 9:863. [PMID: 29937742 PMCID: PMC6002742 DOI: 10.3389/fpsyg.2018.00863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/14/2018] [Indexed: 11/24/2022] Open
Abstract
This study sought to examine age-related differences in the influences of social (neutral, emotional faces) and non-social/non-emotional (shapes) distractor stimuli in children, adolescents, and adults. To assess the degree to which distractor, or task-irrelevant, stimuli of varying social and emotional salience interfere with cognitive performance, children (N = 12; 8-12y), adolescents (N = 17; 13-17y), and adults (N = 17; 18-52y) completed the Emotional Identification and Dynamic Faces (EIDF) task. This task included three types of dynamically-changing distractors: (1) neutral-social (neutral face changing into another face); (2) emotional-social (face changing from 0% emotional to 100% emotional); and (3) non-social/non-emotional (shapes changing from small to large) to index the influence of task-irrelevant social and emotional information on cognition. Results yielded no age-related differences in accuracy but showed an age-related linear reduction in correct reaction times across distractor conditions. An age-related effect in interference was observed, such that children and adults showed slower response times on correct trials with socially-salient distractors; whereas adolescents exhibited faster responses on trials with distractors that included faces rather than shapes. A secondary study goal was to explore individual differences in cognitive interference. Results suggested that regardless of age, low trait anxiety and high effortful control were associated with interference to angry faces. Implications for developmental differences in affective processing, notably the importance of considering the contexts in which purportedly irrelevant social and emotional information might impair, vs. improve cognitive control, are discussed.
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Affiliation(s)
- Patricia Z. Tan
- Department of Psychiatry, UCLA School of Medicine, Los Angeles, CA, United States
| | - Jennifer S. Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ronald E. Dahl
- Community Health Sciences & Joint Medical Program, School of Public Health, University of California, Berkeley, Berkely, CA, United States
| | - Dina Kronhaus
- Cambridge Computational Biology Institute & Wolfson Brain Imaging Centre, Faculty of Music and Computer Laboratory, University of Cambridge, Cambridge, United Kingdom
| | - Cecile D. Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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15
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Ricketts EJ, Sturm A, McMakin DL, McGuire JF, Tan PZ, Smalberg F, McCracken JT, Colwell CS, Piacentini J. 0764 Changes In Sleep Patterns across Attention-deficit/hyperactivity Disorder Treatment: Findings from The MTA Study. Sleep 2018. [DOI: 10.1093/sleep/zsy061.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E J Ricketts
- University of California, Los Angeles, Division of Child and Adolescent Psychiatry, Los Angeles, CA
| | - A Sturm
- University of California, Los Angeles, Division of Child and Adolescent Psychiatry, Los Angeles, CA
| | - D L McMakin
- Florida International University, Department of Psychology, Miami, FL
- Nicklaus Children’s Hospital, Department of Neurology, Miami, FL
| | - J F McGuire
- Johns Hopkins University School of Medicine, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - P Z Tan
- University of California, Los Angeles, Division of Child and Adolescent Psychiatry, Los Angeles, CA
| | - F Smalberg
- University of California, Los Angeles, Division of Child and Adolescent Psychiatry, Los Angeles, CA
| | - J T McCracken
- University of California, Los Angeles, Division of Child and Adolescent Psychiatry, Los Angeles, CA
| | - C S Colwell
- University of California, Los Angeles, Division of Child and Adolescent Psychiatry, Los Angeles, CA
| | - J Piacentini
- University of California, Los Angeles, Division of Child and Adolescent Psychiatry, Los Angeles, CA
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16
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Wallace ML, McMakin DL, Tan PZ, Rosen D, Forbes EE, Ladouceur CD, Ryan ND, Siegle GJ, Dahl RE, Kendall PC, Mannarino A, Silk JS. The role of day-to-day emotions, sleep, and social interactions in pediatric anxiety treatment. Behav Res Ther 2016; 90:87-95. [PMID: 28013054 DOI: 10.1016/j.brat.2016.12.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 11/22/2016] [Accepted: 12/16/2016] [Indexed: 01/23/2023]
Abstract
Do day-to-day emotions, social interactions, and sleep play a role in determining which anxious youth respond to supportive child-centered therapy (CCT) versus cognitive behavioral therapy (CBT)? We explored whether measures of day-to-day functioning (captured through ecological momentary assessment, sleep diary, and actigraphy), along with clinical and demographic measures, were predictors or moderators of treatment outcome in 114 anxious youth randomized to CCT or CBT. We statistically combined individual moderators into a single, optimal composite moderator to characterize subgroups for which CCT or CBT may be preferable. The strongest predictors of better outcome included: (a) experiencing higher positive affect when with one's mother and (b) fewer self-reported problems with sleep duration. The composite moderator indicated that youth for whom CBT was indicated had: (a) more day-to-day sleep problems related to sleep quality, efficiency, and waking, (b) day-to-day negative events related to interpersonal concerns, (c) more DSM-IV anxiety diagnoses, and (d) college-educated parents. These findings illustrate the value of both day-to-day functioning characteristics and more traditional sociodemographic and clinical characteristics in identifying optimal anxiety treatment assignment. Future studies will need to enhance the practicality of real-time measures for use in clinical decision making and evaluate additional anxiety treatments.
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Affiliation(s)
- Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15260, USA; Department of Statistics, University of Pittsburgh, 230 South Bouquet Street, Pittsburgh, PA 15260, USA.
| | - Dana L McMakin
- Department of Psychology, Florida International University, 11200 S. W. 8th Street, Miami, FL 33199, USA.
| | - Patricia Z Tan
- Department of Psychiatry, University of California, 757 Westwood Plaza, Los Angeles, CA 90095, USA.
| | - Dana Rosen
- Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, Pittsburgh, PA 15260, USA.
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15260, USA.
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15260, USA.
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15260, USA.
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15260, USA.
| | - Ronald E Dahl
- School of Public Health, University of California, 50 University Hall, Berkeley, CA 94720, USA.
| | - Philip C Kendall
- Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, USA.
| | - Anthony Mannarino
- Allegheny General Hospital, Four Allegheny Center, Pittsburgh, PA 15212, USA.
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, Pittsburgh, PA 15260, USA.
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17
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Allen KB, Silk JS, Meller S, Tan PZ, Ladouceur CD, Sheeber LB, Forbes EE, Dahl RE, Siegle GJ, McMakin DL, Ryan ND. Parental autonomy granting and child perceived control: effects on the everyday emotional experience of anxious youth. J Child Psychol Psychiatry 2016; 57:835-42. [PMID: 26549516 PMCID: PMC4861695 DOI: 10.1111/jcpp.12482] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 11/29/2014] [Revised: 09/04/2015] [Accepted: 09/14/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Childhood anxiety is associated with low levels of parental autonomy granting and child perceived control, elevated child emotional reactivity and deficits in child emotion regulation. In early childhood, low levels of parental autonomy granting are thought to decrease child perceived control, which in turn leads to increases in child negative emotion. Later in development, perceived control may become a more stable, trait-like characteristic that amplifies the relationship between parental autonomy granting and child negative emotion. The purpose of this study was to test mediation and moderation models linking parental autonomy granting and child perceived control with child emotional reactivity and emotion regulation in anxious youth. METHODS Clinically anxious youth (N = 106) and their primary caregivers were assessed prior to beginning treatment. Children were administered a structured diagnostic interview and participated in a parent-child interaction task that was behaviorally coded for parental autonomy granting. Children completed an ecological momentary assessment protocol during which they reported on perceived control, emotional reactivity (anxiety and physiological arousal) and emotion regulation strategy use in response to daily negative life events. RESULTS The relationship between parental autonomy granting and both child emotional reactivity and emotion regulation strategy use was moderated by child perceived control: the highest levels of self-reported physiological responding and the lowest levels of acceptance in response to negative events occurred in children low in perceived control with parents high in autonomy granting. Evidence for a mediational model was not found. In addition, child perceived control over negative life events was related to less anxious reactivity and greater use of both problem solving and cognitive restructuring as emotion regulation strategies. CONCLUSION Both parental autonomy granting and child perceived control play important roles in the everyday emotional experience of clinically anxious children.
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Affiliation(s)
| | | | - Suzanne Meller
- Department of Psychology, University of Pittsburgh, PA, USA
| | - Patricia Z. Tan
- Department of Psychiatry, University of California, Los Angeles, CA, USA
| | | | | | | | | | - Greg J. Siegle
- Department of Psychiatry, University of Pittsburgh, PA, USA
| | | | - Neal D. Ryan
- Department of Psychiatry, University of Pittsburgh, PA, USA
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18
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Silk JS, Tan PZ, Ladouceur CD, Meller S, Siegle GJ, McMakin DL, Forbes EE, Dahl RE, Kendall PC, Mannarino A, Ryan ND. A Randomized Clinical Trial Comparing Individual Cognitive Behavioral Therapy and Child-Centered Therapy for Child Anxiety Disorders. J Clin Child Adolesc Psychol 2016; 47:542-554. [PMID: 26983904 DOI: 10.1080/15374416.2016.1138408] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study compared individual cognitive behavioral therapy (CBT) and a supportive child-centered therapy (CCT) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1-year follow-up, as well as on real-world measures of emotional functioning. Youth (N = 133; ages 9-14) with anxiety disorders (generalized, separation, and/or social anxiety) were randomized using a 2:1 ratio to CBT (n = 90) or CCT (n = 43), which served as an active comparison. Treatment response and recovery at posttreatment and 1-year follow-up were assessed by Independent Evaluators, and youth completed ecological momentary assessment of daily emotions throughout treatment. The majority of youth in both CBT and CCT were classified as treatment responders (71.1% for CBT, 55.8% for CCT), but youth treated with CBT were significantly more likely to fully recover, no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual symptoms (66.7% for CBT vs. 46.5% for CCT). Youth treated with CBT also reported significantly lower negative emotions associated with recent negative events experienced in daily life during the latter stages of treatment relative to youth treated with CCT. Furthermore, a significantly higher percentage of youth treated with CBT compared to CCT were in recovery at 1-year follow-up (82.2% for CBT vs. 65.1% for CCT). These findings indicate potential benefits of CBT above and beyond supportive therapy on the breadth, generalizability, and durability of treatment-related gains.
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Affiliation(s)
- Jennifer S Silk
- a Department of Psychology , University of Pittsburgh.,b Department of Psychiatry , University of Pittsburgh School of Medicine
| | - Patricia Z Tan
- c Department of Psychiatry and Biobehavioral Sciences , University of California, Los Angeles
| | - Cecile D Ladouceur
- b Department of Psychiatry , University of Pittsburgh School of Medicine
| | | | - Greg J Siegle
- b Department of Psychiatry , University of Pittsburgh School of Medicine
| | - Dana L McMakin
- b Department of Psychiatry , University of Pittsburgh School of Medicine
| | - Erika E Forbes
- b Department of Psychiatry , University of Pittsburgh School of Medicine
| | - Ronald E Dahl
- d School of Public Health , University of California at Berkeley
| | | | | | - Neal D Ryan
- b Department of Psychiatry , University of Pittsburgh School of Medicine
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19
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Tan PZ, Lee KH, Dahl RE, Nelson EE, Stroud LJ, Siegle GJ, Morgan JK, Silk JS. Associations between maternal negative affect and adolescent's neural response to peer evaluation. Dev Cogn Neurosci 2014; 8:28-39. [PMID: 24613174 PMCID: PMC5125388 DOI: 10.1016/j.dcn.2014.01.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 09/03/2013] [Revised: 01/29/2014] [Accepted: 01/30/2014] [Indexed: 12/21/2022] Open
Abstract
Parenting is often implicated as a potential source of individual differences in youths' emotional information processing. The present study examined whether parental affect is related to an important aspect of adolescent emotional development, response to peer evaluation. Specifically, we examined relations between maternal negative affect, observed during parent-adolescent discussion of an adolescent-nominated concern with which s/he wants parental support, and adolescent neural responses to peer evaluation in 40 emotionally healthy and depressed adolescents. We focused on a network of ventral brain regions involved in affective processing of social information: the amygdala, anterior insula, nucleus accumbens, and subgenual anterior cingulate, as well as the ventrolateral prefrontal cortex. Maternal negative affect was not associated with adolescent neural response to peer rejection. However, longer durations of maternal negative affect were associated with decreased responsivity to peer acceptance in the amygdala, left anterior insula, subgenual anterior cingulate, and left nucleus accumbens. These findings provide some of the first evidence that maternal negative affect is associated with adolescents' neural processing of social rewards. Findings also suggest that maternal negative affect could contribute to alterations in affective processing, specifically, dampening the saliency and/or reward of peer interactions during adolescence.
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Affiliation(s)
- Patricia Z Tan
- University of Pittsburgh, Western Psychiatric Institute and Clinic, USA.
| | - Kyung Hwa Lee
- University of Pittsburgh, Western Psychiatric Institute and Clinic, USA
| | - Ronald E Dahl
- University of California at Berkeley, School of Public Health, USA
| | - Eric E Nelson
- Mood and Anxiety Disorders Program, National Institute of Mental Health, USA
| | - Laura J Stroud
- Department of Psychiatry and Human Behavior, Brown Medical School, USA
| | - Greg J Siegle
- University of Pittsburgh, Western Psychiatric Institute and Clinic, USA
| | - Judith K Morgan
- University of Pittsburgh, Western Psychiatric Institute and Clinic, USA
| | - Jennifer S Silk
- University of Pittsburgh, Western Psychiatric Institute and Clinic, USA
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20
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Abstract
Theory suggests temperamental reactivity [negative affectivity (NA)] and regulation [effortful control (EC)] predict variation in the development of emotion regulation (ER). However, few studies report such relations, particularly studies utilizing observational measures of children's ER behaviors in longitudinal designs. Using multilevel modeling, the present study tested whether (1) between-person differences in mean levels of mother-reported child NA and EC (aggregated across age) and (2) within-person changes in NA and EC from the ages of 18 to 42 months predicted subsequent improvements in laboratory-based observations of children's anger regulation from the ages of 24 to 48 months. As expected, mean level of EC (aggregated across age) predicted longer latency to anger; however, no other temperament variables predicted anger expression. Mean level of EC also predicted the latency to a child's use of one regulatory strategy, distraction. Finally, decreases in NA were associated with age-related changes in how long children used distractions and how quickly they bid calmly to their mother. Implications for relations between temperament and anger regulation are discussed in terms of both conceptual and methodological issues.
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21
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Silk JS, Sheeber L, Tan PZ, Ladouceur CD, Forbes EE, McMakin DL, Dahl RE, Siegle GJ, Kendall PC, Mannarino A, Ryan ND. "You can do it!": The role of parental encouragement of bravery in child anxiety treatment. J Anxiety Disord 2013; 27:439-46. [PMID: 23851000 PMCID: PMC3766422 DOI: 10.1016/j.janxdis.2013.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 08/01/2012] [Revised: 02/27/2013] [Accepted: 06/01/2013] [Indexed: 11/26/2022]
Abstract
Individual cognitive-behavioral therapy (CBT) provides anxious youth with skills and experiences to increase "brave" behavior in the face of feared situations. This study addresses whether parental encouragement of bravery during an anxiety provoking and potentially avoidable naturalistic speech task (a) differs between parents of youth (ages 9-13) with anxiety disorders (N=47) and parents of healthy non-anxious controls (N=20); (b) influences response to treatment; and (c) changes during treatment for anxious youth randomized to receive CBT (N=30) or Child-Centered Therapy (CCT; a non-directive active comparison treatment; N=17). Parent-child dyads were videotaped during a discussion of whether or not the child should complete an optional speech task. Parents of anxious youth showed less encouragement of bravery than parents of controls. Encouragement of bravery increased from pre- to post-treatment for youth who received CBT but not CCT, and pre-treatment encouragement of bravery predicted a better response to treatment, particularly for youth receiving CBT.
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Affiliation(s)
- Jennifer S. Silk
- University of Pittsburgh, Western Psychiatric Institute and Clinic
| | | | - Patricia Z. Tan
- University of Pittsburgh, Western Psychiatric Institute and Clinic
| | | | - Erika E. Forbes
- University of Pittsburgh, Western Psychiatric Institute and Clinic
| | - Dana L. McMakin
- University of Pittsburgh, Western Psychiatric Institute and Clinic
| | - Ronald E. Dahl
- University of California at Berkeley, School of Public Health
| | - Greg J. Siegle
- University of Pittsburgh, Western Psychiatric Institute and Clinic
| | | | | | - Neal D. Ryan
- University of Pittsburgh, Western Psychiatric Institute and Clinic
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22
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Cole PM, Ledonne EN, Tan PZ. A Longitudinal Examination of Maternal Emotions in Relation to Young Children's Developing Self-Regulation. Parent Sci Pract 2013; 13:113-132. [PMID: 23585731 PMCID: PMC3620203 DOI: 10.1080/15295192.2012.709152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study examines how young children's emotion and behavior relate to maternal emotions concurrently and as a function of children's developmental changes in self-regulation. DESIGN Mothers and their children (N = 120) participated in an 8 min waiting task at children's ages 18, 24, 36, and 48 months. Children's emotion expressions, misbehavior, and regulatory efforts were observed, and mothers rated their own emotions during the wait. RESULTS Children's emotion and behavior and maternal emotions related in expected directions at most time points. Over time, maternal positive emotion increased more if children were less angry, more content, or more engaged in regulatory efforts relative to age mates. Maternal negative emotion decreased more if children engaged more in regulatory efforts but less if children were angrier relative to age mates. CONCLUSIONS Individual differences in children's emotions may influence parental emotions. Over time, only the intra-individual decline in children's anger, not the decrease in their misbehavior or the increase in their regulatory efforts, predicted improvements in maternal emotions.
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Affiliation(s)
- Pamela M Cole
- Department of Psychology, The Pennsylvania State University, 309 Moore Building, University Park PA 16802, USA.
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23
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Tan PZ, Forbes EE, Dahl RE, Ryan ND, Siegle GJ, Ladouceur CD, Silk JS. Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. J Child Psychol Psychiatry 2012; 53:197-206. [PMID: 22176136 PMCID: PMC3258378 DOI: 10.1111/j.1469-7610.2011.02469.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [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] [Indexed: 11/29/2022]
Abstract
BACKGROUND Reviews have highlighted anxious youths' affective disturbances, specifically, elevated negative emotions and reliance on ineffective emotion regulation strategies. However, no study has examined anxious youth's emotional reactivity and regulation in real-world contexts. METHODS This study utilized an ecological momentary assessment approach to compare real-world emotional experiences of 65 youth with generalized anxiety disorder, social anxiety disorder, or social phobia (ANX) and 65 age-matched healthy controls (CON), ages 9-13 years. RESULTS Hierarchical linear models revealed that ANX reported higher levels of average past-hour peak intensity of nervous, sad and upset emotions than CON youth but similar levels during momentary reports of current emotion. As expected, ANX youth reported more frequent physiological reactions in response to a negative event; however, there were no group differences in how frequently they used cognitive-behavioral strategies. Avoidance, distraction and problem solving were associated with the down-regulation of all negative emotions except nervousness for both ANX and CON youth; however, group differences emerged for acceptance, rumination and physiological responding. CONCLUSIONS In real-world contexts, ANX youth do not report higher levels of momentary negative emotions but do report heightened negative emotions in response to challenging events. Moreover, ANX youth report no differences in how frequently they use adaptive regulatory strategies but are more likely to have physiological responses to challenging events. They are also less effective at using some strategies to down-regulate negative emotion than CON youth.
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Affiliation(s)
- Patricia Z. Tan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Erika E. Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Ronald E. Dahl
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA,School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Neal D. Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Greg J. Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Cecile D. Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Jennifer S. Silk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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Pemberton Roben CK, Bass AJ, Moore GA, Murray-Kolb L, Tan PZ, Gilmore RO, Buss KA, Cole PM, Teti LO. Let Me Go: The Influences of Crawling Experience and Temperament on the Development of Anger Expression. Infancy 2011; 17:558-577. [DOI: 10.1111/j.1532-7078.2011.00092.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Being able to wait is an essential part of self-regulation. In the present study, the authors examined the developmental course of changes in the latency to and duration of target-waiting behaviors by following 65 boys and 55 girls from rural and semirural economically strained homes from ages 18 months to 48 months. Age-related changes in latency to and duration of children's anger expressions and attention focus (e.g., self-initiated distraction) during an 8-min wait for a gift were found. On average, at 18 and 24 months of age, children were quick to react angrily and slower to shift attention away from the desired object than they were at later ages. Over time, children were quicker to distract themselves. By 36 months, distractions occurred before children expressed anger, and anger expressions were briefer. At 48 months, children typically made a quick bid to their mothers about having to wait before distracting themselves; on average, they did not appear angry until the latter half of the wait. Unexpectedly, children bid to their mothers as much at age 48 months as they had at 18 months; however, bids became less angry as children got older. Developmental changes in distraction and bidding predicted age-related changes in the latency to anger. Findings are discussed in terms of the neurocognitive control of attention around age 30 months, the limitations of children's self-regulatory efforts at age 48 months, and the importance of fostering children's ability to forestall, as well as modulate, anger.
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Affiliation(s)
- Pamela M Cole
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA.
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Wang H, Wen R, Huang L, Bi R, Tan PZ. [Synthesis and biological activities of new 5-HT2A selective ligands--N-substituted-piperidinyl-4-phenylthioether and sulfone derivatives]. Yao Xue Xue Bao 2001; 36:274-7. [PMID: 12580055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
AIM A series of 4-piperidinylthioether and sulfone derivatives of 4-[1-hydroxy-1-(2,3-dimethoxyphenyl) methyl]-N-2-(4-fluorophenylethyl) piperidine (MDL 100907) were synthesized in order to find new 5-HT2A selective ligands. METHODS Title compounds 2a-2c were synthesized from 2, 3-dimethoxythiophenol and tested for their affinities to 5-HT2A, 5-HT2C, 5-HT6 and 5-HT7 receptors and some other nervous transmitter receptors in vitro. RESULTS Compounds 2a-2c are new compounds. The results of the binding assay demonstrated that they have relatively high selectivity for 5-HT2A receptor in vitro. CONCLUSION Some sulfur containing analogues of MDL 100907 showed selective affinity to 5-HT2A receptor and are worth further study.
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Affiliation(s)
- H Wang
- Department of Medicinal Chemistry of Fudan University, Shanghai 200032, China
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Staley JK, Van Dyck CH, Tan PZ, Al Tikriti M, Ramsby Q, Klump H, Ng C, Garg P, Soufer R, Baldwin RM, Innis RB. Comparison of [(18)F]altanserin and [(18)F]deuteroaltanserin for PET imaging of serotonin(2A) receptors in baboon brain: pharmacological studies. Nucl Med Biol 2001; 28:271-9. [PMID: 11323237 DOI: 10.1016/s0969-8051(00)00212-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The regional distribution in brain, distribution volumes, and pharmacological specificity of the PET 5-HT(2A) receptor radiotracer [(18)F]deuteroaltanserin were evaluated and compared to those of its non-deuterated derivative [(18)F]altanserin. Both radiotracers were administered to baboons by bolus plus constant infusion and PET images were acquired up to 8 h. The time-activity curves for both tracers stabilized between 4 and 6 h. The ratio of total and free parent to metabolites was not significantly different between radiotracers; nevertheless, total cortical R(T) (equilibrium ratio of specific to nondisplaceable brain uptake) was significantly higher (34-78%) for [(18)F]deuteroaltanserin than for [(18)F]altanserin. In contrast, the binding potential (Bmax/K(D)) was similar between radiotracers. [(18)F]Deuteroaltanserin cortical activity was displaced by the 5-HT(2A) receptor antagonist SR 46349B but was not altered by changes in endogenous 5-HT induced by fenfluramine. These findings suggest that [(18)F]deuteroaltanserin is essentially equivalent to [(18)F]altanserin for 5-HT(2A) receptor imaging in the baboon.
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Affiliation(s)
- J K Staley
- Department of Psychiatry, Yale University School of Medicine and VA Connecticut Healthcare System, 06516, West Haven, CT 06516, USA.
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van Dyck CH, Soares JC, Tan PZ, Staley JK, Baldwin RM, Amici LA, Fu X, Garg PK, Seibyl JP, Charney DS, Innis RB. Equilibrium modeling of 5-HT(2A) receptors with [18F]deuteroaltanserin and PET: feasibility of a constant infusion paradigm. Nucl Med Biol 2000; 27:715-22. [PMID: 11150702 DOI: 10.1016/s0969-8051(00)00160-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
[(18)F]Altanserin has emerged as a promising positron emission tomography (PET) ligand for serotonin-2A (5-HT(2A)) receptors. The deuterium substitution of both of the 2'-hydrogens of altanserin ([(18)F]deuteroaltanserin) yields a metabolically more stable radiotracer with higher ratios of parent tracer to radiometabolites and increased specific brain uptake than [(18)F]altanserin. The slower metabolism of the deuterated analog might preclude the possibility of achieving stable plasma and brain activities with a bolus plus constant infusion within a reasonable time frame for an (18)F-labeled tracer (T(1/2) 110 min). Thus, the purpose of this study was to test the feasibility in human subjects of a constant infusion paradigm for equilibrium modeling of [(18)F]deuteroaltanserin with PET. Seven healthy male subjects were injected with [(18)F]deuteroaltanserin as a bolus plus constant infusion lasting 10 h postinjection. PET acquisitions and venous blood sampling were performed throughout the infusion period. Linear regression analysis revealed that time-activity curves for both specific brain uptake and plasma [(18)F]deuteroaltanserin concentration stabilized after about 5 h. This permitted equilibrium modeling and estimation of V(')(3) (ratio of specific uptake to total plasma parent concentration) and the binding potential V(3) (ratio of specific uptake to free plasma parent concentration). Cortical/cerebellar ratios were increased by 26% relative to those we previously observed with [(18)F]altanserin using similar methodology in a somewhat older subject sample. These results demonstrate feasibility of equilibrium imaging with [(18)F]deuteroaltanserin and suggest that it may be superior to [(18)F]altanserin as a PET radioligand.
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Affiliation(s)
- C H van Dyck
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
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van Dyck CH, Tan PZ, Baldwin RM, Amici LA, Garg PK, Ng CK, Soufer R, Charney DS, Innis RB. PET quantification of 5-HT2A receptors in the human brain: a constant infusion paradigm with [18F]altanserin. J Nucl Med 2000; 41:234-41. [PMID: 10688105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
UNLABELLED [18F]altanserin has been used to label serotonin 5-HT2A receptors, which are believed to be important in the pathophysiology of schizophrenia and depression. The purpose of this study was to test the feasibility of a constant infusion paradigm for equilibrium modeling of [18F]altanserin with PET. Kinetic modeling with [18F]altanserin may be hampered by the presence of lipophilic radiometabolites observed in plasma after intravenous administration. METHODS Eight healthy volunteers were injected with [18F]altanserin as a bolus (208+/-9 MBq [5.62+/-0.25 mCi]) plus constant infusion (65+/-3 MBq/h [1.76+/-0.08 mCi/h]) ranging from 555 to 626 min (615+/-24 min) after injection. PET acquisitions (10-20 min) and venous blood sampling were performed every 30-60 min throughout the infusion period. RESULTS Linear regression analysis revealed that time-activity curves for both brain activity and plasma [18F]altanserin and metabolite concentrations stabilized after about 6 h. This permitted equilibrium modeling and estimation of V3' (ratio of specific uptake [cortical-cerebellar] to total plasma parent concentration after 6 h). Values of V3' ranged from 1.57+/-0.38 for anterior cingulate cortex to 1.02+/-0.39 for frontal cortex. The binding potential V3 (ratio of specific uptake to free plasma parent concentration after 6 h, using group mean f1) was also calculated and ranged from 169+/-41 for anterior cingulate cortex to 110+/-42 for frontal cortex. From 6 h onward, the rate of change for V3' and V3 was only 1.11+/-1.69 %/h. CONCLUSION These results demonstrate the feasibility of equilibrium imaging with [18F]altanserin over more than 5 radioactive half-lives and suggest a method to overcome difficulties associated with lipophilic radiolabeled metabolites. The stability in V3 and V3' once equilibrium is achieved suggests that a single PET acquisition obtained at 6 h may provide a reasonable measure of 5-HT2A receptor density.
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Affiliation(s)
- C H van Dyck
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06510, USA
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Bremner JD, Baldwin R, Horti A, Staib LH, Ng CK, Tan PZ, Zea-Ponce Y, Zoghbi S, Seibyl JP, Soufer R, Charney DS, Innis RB. Quantitation of benzodiazepine receptor binding with PET [11C]iomazenil and SPECT [123I]iomazenil: preliminary results of a direct comparison in healthy human subjects. Psychiatry Res 1999; 91:79-91. [PMID: 10515463 DOI: 10.1016/s0925-4927(99)00015-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Although positron emission tomography (PET) and single photon emission computed tomography (SPECT) are increasingly used for quantitation of neuroreceptor binding, almost no studies to date have involved a direct comparison of the two. One study found a high level of agreement between the two techniques, although there was a systematic 30% increase in measures of benzodiazepine receptor binding in SPECT compared with PET. The purpose of the current study was to directly compare quantitation of benzodiazepine receptor binding in the same human subjects using PET and SPECT with high specific activity [11C]iomazenil and [123I]iomazenil, respectively. All subjects were administered a single bolus of high specific activity iomazenil labeled with 11C or 123I followed by dynamic PET or SPECT imaging of the brain. Arterial blood samples were obtained for measurement of metabolite-corrected radioligand in plasma. Compartmental modeling was used to fit values for kinetic rate constants of transfer of radioligand between plasma and brain compartments. These values were used for calculation of binding potential (BP = Bmax/Kd) and product of BP and the fraction of free non-protein-bound parent compound (V3'). Mean values for V3' in PET and SPECT were as follows: temporal cortex 23+/-5 and 22+/-3 ml/g, frontal cortex23+/-6 and 22+/-3 ml/g, occipital cortex 28+/-3 and 31+/-5 ml/g, and striatum 4+/-4 and 7+/-4 ml/g. These preliminary findings indicate that PET and SPECT provide comparable results in quantitation of neuroreceptor binding in the human brain.
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Affiliation(s)
- J D Bremner
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520, USA.
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Tan PZ, Baldwin RM, Van Dyck CH, Al-Tikriti M, Roth B, Khan N, Charney DS, Innis RB. Characterization of radioactive metabolites of 5-HT2A receptor PET ligand [18F]altanserin in human and rodent. Nucl Med Biol 1999; 26:601-8. [PMID: 10587097 DOI: 10.1016/s0969-8051(99)00022-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study was performed to identify and characterize the radiometabolites of the serotonin 5-HT2A receptor ligand [18F]altanserin in supporting quantification of the target receptors by positron emission tomography. In analogy to its analog ketanserin, we postulated 4-(4-fluorobenzoyl)piperidine (FBP) and altanserinol for the previously observed two polar radiometabolites, corresponding to dealkylation at the piperidine nitrogen and reduction at the ketone, respectively. To test this hypothesis and characterize the in vivo and in vitro behavior of the radiometabolites, we synthesized nonradioactive authentic compounds altanserinol, 1-(4-fluorophenyl)-1-(piperidin-4-yl)methanol (FBPOH), and isolated nonradioactive FBP metabolite from monkey plasma. [18F]Altanserinol was obtained by NaBH4 reduction of [18F]altanserin, followed by acid hydrolysis. Identification of radiometabolites was carried out by high performance liquid chromatography and thin layer chromatography comparison of the radioactive plasma after injection of tracers with five authentic compounds. Human studies revealed that at least four radiometabolites, one identified as [18F]altanserinol, resulted from reduction of the ketone functionality. The N-dealkylation product [18F]FBP was not detectable; however, a radiometabolite of FBP was present in plasma after administration of [18F]altanserin. Monkey studies showed nonradioactive FBP was converted rapidly to a less polar metabolite. In rat, altanserin and altanserinol were converted to each other in vivo, and all the radiometabolites likely penetrated the blood-brain barrier and entered the brain. Displacement binding of altanserin to cloned serotonin 5-HT2A, 5-HT2C, 5-HT6, and 5-HT7 receptors showed Ki values of 0.3, 6.0, 1,756, and 15 nM; the binding of FBP and altanserinol to these four 5-HT subtypes was negligible. We conclude from these studies that the radiometabolites of [18F]altanserin from N-dealkylation and ketone reduction should not interfere with specific receptor quantification in an equilibrium paradigm.
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Affiliation(s)
- P Z Tan
- Yale University School of Medicine, Yale-VA Pet Center, West Haven, Connecticut 06511, USA.
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32
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Abstract
A complete remote control system was constructed for production of the PET 5-HT2A ligand [18F]altanserin by nitro-for-fluoro exchange. Comparing with published methods, the key features include (1) conducting azeotropic distillation and nucleophilic displacement in an open vessel heated by a commercial microwave oven; (2) purifying the product by a single HPLC procedure and (3) removing HPLC solvent by solid phase extraction. The preparation took 114 min with 23% yield and high quality.
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Affiliation(s)
- P Z Tan
- VA PET Center, Department of Psychiatry, Yale University School of Medicine, West Haven, CT 06516, USA.
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