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Daníelsdóttir HB, Aspelund T, Shen Q, Halldorsdottir T, Jakobsdóttir J, Song H, Lu D, Kuja-Halkola R, Larsson H, Fall K, Magnusson PKE, Fang F, Bergstedt J, Valdimarsdóttir UA. Adverse Childhood Experiences and Adult Mental Health Outcomes. JAMA Psychiatry 2024:2815834. [PMID: 38446452 PMCID: PMC10918580 DOI: 10.1001/jamapsychiatry.2024.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/15/2023] [Accepted: 12/31/2023] [Indexed: 03/07/2024]
Abstract
Importance Exposure to adverse childhood experiences (ACEs) has consistently been associated with multiple negative mental health outcomes extending into adulthood. However, given that ACEs and psychiatric disorders cluster within families, it remains to be comprehensively assessed to what extent familial confounding contributes to associations between ACEs and clinically confirmed adult psychiatric disorders. Objective To investigate whether associations between ACEs and adult mental health outcomes remain after adjusting for familial (genetic and environmental) confounding. Design, Setting, and Participants This Swedish twin cohort study used a discordant twin pair design based on monozygotic (MZ) and dizygotic (DZ) twins. A total of 25 252 adult twins (aged 18-47 years) from the Swedish Twin Registry born between 1959 and 1998 were followed up from age 19 years until 2016, with a maximum follow-up time of 39 years. Data were analyzed from April 2022 to November 2023. Exposures A total of 7 ACEs, including family violence, emotional abuse or neglect, physical neglect, physical abuse, sexual abuse, rape, and hate crime, were assessed with items from the Life Stressor Checklist-Revised in a web-based survey. Main Outcomes and Measures Adult (ages >18 years) clinical diagnosis of psychiatric disorders (ie, depressive, anxiety, alcohol or drug misuse, or stress-related disorders) were obtained from the Swedish National Patient Register. Results Of 25 252 twins included in the study (15 038 female [59.6%]; mean [SD] age at ACE assessment, 29.9 [8.7] years), 9751 individuals (38.6%) reported exposure to at least 1 ACE. A greater number of ACEs was associated with increased odds of any psychiatric disorder in the full cohort (odds ratio [OR] per additional ACE, 1.52; 95% CI, 1.48-1.57). The association remained but ORs per additional ACE were attenuated in DZ (1.29; 95% CI, 1.14-1.47) and MZ (1.20; 95% CI, 1.02-1.40) twin pairs. Individuals who were exposed to sexual abuse compared with those who were not exposed had increased odds of any clinically confirmed psychiatric disorder in all comparisons: full cohort (OR, 3.09; 95% CI, 2.68-3.56), DZ twin pairs (OR, 2.10; 95% CI, 1.33-3.32), and MZ twin pairs (1.80; 95% CI, 1.04-3.11). Conclusions and relevance This study found that associations between ACEs and adult mental health outcomes remained after controlling for shared genetic and environmental factors, which was particularly evident after multiple ACEs or sexual abuse. These findings suggest that targeted interventions may be associated with reduced risks of future psychopathology.
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Affiliation(s)
- Hilda Björk Daníelsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Qing Shen
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
- Institute for Advanced Study, Tongji University, Shanghai, China
| | | | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Huan Song
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Donghao Lu
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Katja Fall
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Patrik K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jacob Bergstedt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur Anna Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
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2
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Aspelund SG, Halldorsdottir T, Agustsson G, Sigurdardottir Tobin HR, Wu LM, Amidi A, Johannsdottir KR, Lutgendorf SK, Telles R, Daly HF, Sigurdardottir K, Valdimarsdottir HB, Baldursdottir B. Biological and psychological predictors of cognitive function in breast cancer patients before surgery. Support Care Cancer 2024; 32:88. [PMID: 38185720 DOI: 10.1007/s00520-023-08282-5] [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: 06/16/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE Research suggests that cancer-related cognitive impairment (CRCI) can occur before breast cancer (BC) treatment. The limited extant evidence suggests the underlying mechanisms could be stress-related. Potential psychological and biological predictors of CRCI prior to any BC treatment were examined. METHODS 112 treatment-naïve women with BC and 67 healthy controls (HC) completed a neuropsychological test battery to assess cognitive impairment and a self-report battery to assess cognitive complaints, cancer-related stress, depressive and anxiety symptoms. Morning and evening cortisol and α-amylase were collected from saliva. Multilinear regressions were conducted. RESULTS Treatment-naïve BC patients were more frequently impaired in verbal memory and processing speed and reported more cognitive complaints (all p < .001) than HC. BC patients and HC did not differ in overall cognitive impairment (p = .21). Steeper α-amylase, lower cancer-related stress and younger age was associated with better overall cognitive function in treatment-naïve BC patients. Higher depressive symptoms predicted higher levels of cognitive complaints in BC patients. CONCLUSION Overall, these findings suggest that stress plays a role in CRCI. This study is the first to associate α-amylase with cognitive function in cancer patients, informing future research. The findings on impairment in processing speed and verbal memory among treatment-naïve BC highlight the need to screen for such impairments among BC patients and indicate that future studies on CRCI should include baseline assessments prior to BC treatment. If replicated, these findings could inform the development and testing of appropriate interventions to decrease CRCI among cancer patients. CLINICAL TRIALS REGISTRATION NUMBER NCT04418856, date of registration: 06.05.2020.
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Affiliation(s)
| | | | - Gudjon Agustsson
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
| | | | - Lisa M Wu
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Ali Amidi
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Kamilla R Johannsdottir
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
| | - Susan K Lutgendorf
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Rachel Telles
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | | | | | - Heiddis B Valdimarsdottir
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
- Department of Population Health Science and Policy, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Birna Baldursdottir
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland.
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3
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Li Y, Jiang J, Halldorsdottir T, Zhu H, Bertone-Johnson E, Valdimarsdóttir UA, Zhou X, Zhang W, Lu D. Premenstrual disorders and gender differences in adolescent mental health. J Affect Disord 2023; 340:930-937. [PMID: 37543115 DOI: 10.1016/j.jad.2023.08.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Gender differences in mental health emerge in adolescence. The timing coincides with the development of premenstrual disorders (PMDs). Here, we examine the association between PMDs and adolescent mental health in the context of gender differences. METHODS A cross-sectional analysis comprising 21,239[10,563 (49.7 %) girls] individuals aged 10-19 years from the Santai Youth Mental Health Promotion Cohort in China. Possible PMDs, major depression disorder (MDD), general anxiety disorder (GAD), history of self-injury, and high suicide-risk status were surveyed using standard questionnaires. We used logistic regression to contrast the prevalence of outcomes between girls with and without PMDs, and boys. RESULTS The prevalence rates of possible MDD and GAD were comparable between girls without PMDs and boys [OR1.03 (0.96-1.11) and 0.99 (0.92-1.07)], whereas a higher burden was observed in girls with PMDs [OR4.76(4.31-5.26) and 3.86(3.50-4.27), respectively]. Moreover, MDD/GAD prevalence among premenarchal girls was comparable to their peer boys. Greater gender differences in self-injury and high suicide-risk status were also found for girls with PMDs [OR 4.70 (4.22-5.24) and 7.49 (6.6-8.5)] than that for girls without PMDs [OR1.45(1.33-1.59) and 1.81 (1.62-2.03)]. LIMITATION Girls with PMDs may have overreported depressive and/or anxiety symptoms due to the overlap of symptomology. CONCLUSIONS The greater gender differences in adolescent mental ill-health among girls with PMDs lend support to the hypothesis that PMDs play an important role in the gender disparities in adolescent mental health, particularly in depression and anxiety.
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Affiliation(s)
- Yuchen Li
- Department of Mental Health Center, Sichuan University, Chengdu, China; Department of Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Jingwen Jiang
- Department of Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Thorhildur Halldorsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Hongru Zhu
- Department of Mental Health Center, Sichuan University, Chengdu, China
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA; Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Unnur A Valdimarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Xiaobo Zhou
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, TX, USA
| | - Wei Zhang
- Department of Mental Health Center, Sichuan University, Chengdu, China; Department of Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China.
| | - Donghao Lu
- Department of Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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4
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Matosin N, Arloth J, Czamara D, Edmond KZ, Maitra M, Fröhlich AS, Martinelli S, Kaul D, Bartlett R, Curry AR, Gassen NC, Hafner K, Müller NS, Worf K, Rehawi G, Nagy C, Halldorsdottir T, Cruceanu C, Gagliardi M, Gerstner N, Ködel M, Murek V, Ziller MJ, Scarr E, Tao R, Jaffe AE, Arzberger T, Falkai P, Kleinmann JE, Weinberger DR, Mechawar N, Schmitt A, Dean B, Turecki G, Hyde TM, Binder EB. Associations of psychiatric disease and ageing with FKBP5 expression converge on superficial layer neurons of the neocortex. Acta Neuropathol 2023; 145:439-459. [PMID: 36729133 PMCID: PMC10020280 DOI: 10.1007/s00401-023-02541-9] [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: 12/19/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/03/2023]
Abstract
Identification and characterisation of novel targets for treatment is a priority in the field of psychiatry. FKBP5 is a gene with decades of evidence suggesting its pathogenic role in a subset of psychiatric patients, with potential to be leveraged as a therapeutic target for these individuals. While it is widely reported that FKBP5/FKBP51 mRNA/protein (FKBP5/1) expression is impacted by psychiatric disease state, risk genotype and age, it is not known in which cell types and sub-anatomical areas of the human brain this occurs. This knowledge is critical to propel FKBP5/1-targeted treatment development. Here, we performed an extensive, large-scale postmortem study (n = 1024) of FKBP5/1, examining neocortical areas (BA9, BA11 and ventral BA24/BA24a) derived from subjects that lived with schizophrenia, major depression or bipolar disorder. With an extensive battery of RNA (bulk RNA sequencing, single-nucleus RNA sequencing, microarray, qPCR, RNAscope) and protein (immunoblot, immunohistochemistry) analysis approaches, we thoroughly investigated the effects of disease state, ageing and genotype on cortical FKBP5/1 expression including in a cell type-specific manner. We identified consistently heightened FKBP5/1 levels in psychopathology and with age, but not genotype, with these effects strongest in schizophrenia. Using single-nucleus RNA sequencing (snRNAseq; BA9 and BA11) and targeted histology (BA9, BA24a), we established that these disease and ageing effects on FKBP5/1 expression were most pronounced in excitatory superficial layer neurons of the neocortex, and this effect appeared to be consistent in both the granular and agranular areas examined. We then found that this increase in FKBP5 levels may impact on synaptic plasticity, as FKBP5 gex levels strongly and inversely correlated with dendritic mushroom spine density and brain-derived neurotrophic factor (BDNF) levels in superficial layer neurons in BA11. These findings pinpoint a novel cellular and molecular mechanism that has potential to open a new avenue of FKBP51 drug development to treat cognitive symptoms in psychiatric disorders.
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Affiliation(s)
- Natalie Matosin
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany.
- Molecular Horizons, School of Chemistry and Molecular Biosciences, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, 2522, Australia.
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, 2522, Australia.
| | - Janine Arloth
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, 85764, Neuherberg, Germany
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Katrina Z Edmond
- Molecular Horizons, School of Chemistry and Molecular Biosciences, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, 2522, Australia
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, 2522, Australia
| | - Malosree Maitra
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Anna S Fröhlich
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Silvia Martinelli
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Dominic Kaul
- Molecular Horizons, School of Chemistry and Molecular Biosciences, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, 2522, Australia
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, 2522, Australia
| | - Rachael Bartlett
- Molecular Horizons, School of Chemistry and Molecular Biosciences, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, 2522, Australia
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, 2522, Australia
| | - Amber R Curry
- Molecular Horizons, School of Chemistry and Molecular Biosciences, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, 2522, Australia
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, 2522, Australia
| | - Nils C Gassen
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Neurohomeostasis Research Group, Institute of Psychiatry, Clinical Centre, University of Bonn, Bonn, Germany
| | - Kathrin Hafner
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Nikola S Müller
- Institute of Computational Biology, Helmholtz Zentrum München, 85764, Neuherberg, Germany
| | - Karolina Worf
- Institute of Computational Biology, Helmholtz Zentrum München, 85764, Neuherberg, Germany
| | - Ghalia Rehawi
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, 85764, Neuherberg, Germany
| | - Corina Nagy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Cristiana Cruceanu
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Miriam Gagliardi
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Nathalie Gerstner
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, 85764, Neuherberg, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Maik Ködel
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Vanessa Murek
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Michael J Ziller
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Elizabeth Scarr
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
- Synaptic Neurobiology and Cognition Laboratory, Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Ran Tao
- The Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Andrew E Jaffe
- The Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Thomas Arzberger
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- Centre for Neuropathology and Prion Research, Ludwig-Maximilians University Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Peter Falkai
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Joel E Kleinmann
- The Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Daniel R Weinberger
- The Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Naguib Mechawar
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, São Paulo, 05453-010, Brazil
| | - Brian Dean
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
- Synaptic Neurobiology and Cognition Laboratory, Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Thomas M Hyde
- The Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany.
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA.
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Thorisdottir IE, Agustsson G, Oskarsdottir SY, Kristjansson AL, Asgeirsdottir BB, Sigfusdottir ID, Valdimarsdottir HB, Allegrante JP, Halldorsdottir T. Effect of the COVID-19 pandemic on adolescent mental health and substance use up to March, 2022, in Iceland: a repeated, cross-sectional, population-based study. Lancet Child Adolesc Health 2023; 7:347-357. [PMID: 36913961 PMCID: PMC10005790 DOI: 10.1016/s2352-4642(23)00022-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Poor mental health in the first year of the COVID-19 pandemic has been well documented in adolescents; however, less is known about the longer-term effect of the pandemic. We aimed to examine adolescent mental health and substance use as well as covariates associated with these outcomes 1 year or more into the pandemic. METHODS A nationwide sample of adolescents aged 13-18 years enrolled in school in Iceland were invited to complete surveys administered during October-November or February-March, 2018, October-November, 2020, February-March or October-November, 2021, and February-March 2022. The survey was in Icelandic for all administrations and offered to adolescents aged 13-15 years in English in 2020 and 2022 and in Polish in 2022. Surveys assessed depressive symptoms (Symptom Checklist-90); mental wellbeing (Short Warwick Edinburgh Mental Wellbeing Scale); and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Covariates comprised age, gender, and migration status as determined by language spoken at home, level of social restrictions based on residency, parental social support, and sleep duration (≥8 h nightly). Weighted mixed-effect models were used to determine the effect of time and the covariates on mental health and substance use. The main outcomes were assessed in all participants with more than 80% of the necessary data, and multiple imputation was used to handle missing data. Bonferroni corrections were used to adjust for multiple testing and analyses were considered significant at a p value of <0·0017. FINDINGS 64 071 responses were submitted and analysed between 2018 and 2022. Elevated depressive symptoms and worsened mental wellbeing across girls and boys aged 13-18 years were observed to have been maintained up to 2 years into the pandemic (p>0·0017). Alcohol intoxication initially decreased during the pandemic but increased again as social restrictions eased (p<0·0001). No changes were observed in cigarette smoking and e-cigarette use during the COVID-19 pandemic. Higher levels of parental social support and an average sleep duration of 8 h or more per night were associated with mental health better outcomes and less substance use (p<0·0001). Social restrictions and migration background were inconsistently associated with the outcomes. INTERPRETATION Population-level prevention targeting adolescent depressive symptoms should be prioritised in health policy in the wake of COVID-19. FUNDING Icelandic Research Fund.
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Affiliation(s)
| | - Gudjon Agustsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | | | - Alfgeir Logi Kristjansson
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA; Icelandic Centre for Social Research and Analysis, Reykjavik, Iceland
| | - Bryndis Bjork Asgeirsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Icelandic Centre for Social Research and Analysis, Reykjavik, Iceland
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Icelandic Centre for Social Research and Analysis, Reykjavik, Iceland; Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Heiddis Bjork Valdimarsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Philip Allegrante
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Thorhildur Halldorsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
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Halldorsdottir T, Fraire MG, Drabick DAG, Ollendick TH. Co-Occurring Conduct Problems and Anxiety: Implications for the Functioning and Treatment of Youth with Oppositional Defiant Disorder. Int J Environ Res Public Health 2023; 20:3405. [PMID: 36834097 PMCID: PMC9962766 DOI: 10.3390/ijerph20043405] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Conduct problems and anxiety symptoms commonly co-occur among youths with oppositional defiant disorder (ODD); however, how these symptoms influence functioning and treatment outcomes remains unclear. This study examined subtypes based on these co-occurring symptoms in a clinical sample of 134 youths (Mage = 9.67, 36.6% female, 83.6% white) with ODD and the predictive power of these subgroups for youth functioning and psychosocial treatment outcomes. The latent profile analysis (LPA) was used to identify subgroups based on parent- and self-reported conduct problems and anxiety symptoms. Differences among the subgroups in clinician-, parent-, and/or self-reported accounts of symptom severity, school performance, underlying processing known to be impaired across ODD, conduct and anxiety disorders, self-concept, and psychosocial treatment outcomes were examined. Four distinct profiles were identified: (1) Low Anxiety/Moderate Conduct Problems (n = 42); (2) High Anxiety/Moderate Conduct Problems (n = 33); (3) Moderate Anxiety/Moderate Conduct Problems (n = 40); and (4) Moderate Anxiety/High Conduct Problems (n = 19). The Moderate Anxiety/High Conduct Problems group exhibited more severe behavioral problems, greater difficulties with negative emotionality, emotional self-control, and executive functioning; they also demonstrated worse long-term treatment outcomes than the other subgroups. These findings suggest more homogeneous subgroups within and across diagnostic categories may result in a deeper understanding of ODD and could inform nosological systems and intervention efforts.
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Affiliation(s)
- Thorhildur Halldorsdottir
- Department of Psychology, School of Social Sciences, Reykjavik University, 102 Reykjavik, Iceland
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Maria G Fraire
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Deborah A. G. Drabick
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA 19122, USA
| | - Thomas H. Ollendick
- Child Study Center, Department of Psychology, Virginia Tech, Blacksburg, VA 24060, USA
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7
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Jonsdottir SD, Hauksdottir A, Aspelund T, Jakobsdottir J, Runarsdottir H, Gudmundsdottir B, Tomasson G, Valdimarsdottir UA, Halldorsdottir T, Thordardottir EB. Risk factors for workplace sexual harassment and violence among a national cohort of women in Iceland: a cross-sectional study. The Lancet Public Health 2022; 7:e763-e774. [PMID: 36057275 PMCID: PMC9449977 DOI: 10.1016/s2468-2667(22)00201-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/29/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
Background Sexual harassment and violence in the workplace are a serious public health concern for women worldwide with substantial costs due to sick leave and personnel turnover. Yet little is known about the prevalence of sexual harassment and violence at a population level, especially across work sectors. The aim of this study was to investigate the prevalence of workplace sexual harassment and violence by demographic factors and work sectors among Icelandic women. Methods For this cross-sectional study we analysed nationally representative, de-identified individual-level data from women who had responded to an online survey item about self-labelled current and lifetime workplace sexual harassment or violence as part of the Stress and Gene Analysis (SAGA) study, a cross-sectional nationally representative study done from March 1, 2018, to July 1, 2019. Eligible participants were women who resided in Iceland, were aged between 18 and 69 years, spoke Icelandic, and had a registered address from the Icelandic Population Register or a telephone number from the online 1819 service. We used binomial and Poisson regression analysis to study the cross-sectional association between workplace sexual harassment and violence and demographic factors (eg, age, sexual orientation, and education) and factors relating to the workplace (eg, work schedule), across works sectors. Findings Of 113 814 eligible women, 104 197 were invited to complete the online survey, of whom 30 403 women responded and were included in the SAGA cohort. 15 799 women answered the item about exposure to workplace sexual harassment or violence. 11 286 [71·4%] of 15 799 women answered the question about sexual orientation that were included in the survey from June, 2018. 5291 (33·5%) of 15 799 of participants reported having experienced workplace sexual harassment or violence during their lifetime, and 1178 (7·5%) in their current workplace. Such exposure in the current workplace was most common among women who were young (age 18–24 years: prevalence ratio [PR] 3·89 [95% CI 2·66–5·71]; age 25–34 years: 3·66 [2·53–5·31]), single (1·27 [1·12–1·43]), and worked shifts (2·32 [2·02–2·67]), with the highest prevalence rates observed among women in work sectors of public figures (15·67 [9·34–25·12]), tourism (15·01 [11·01–20·13]), and the legal system and security (13·56 [7·00–24·66]). Lifetime exposure to workplace sexual harassment or violence was more common among women who belonged to sexual minorities than among heterosexual women (PR 1·35 [1·24–1·46]). Interpretation Lifetime exposure to workplace sexual harassment or violence seems common among women in a Nordic welfare state. These findings provide nuanced targets for prevention and for public policies aimed at promoting women's safety in the work environment. Funding Icelandic Gender Equality Fund, European Research Council, and Icelandic Centre for Research.
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8
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Yang Q, Þórðardóttir EB, Hauksdóttir A, Aspelund T, Jakobsdóttir J, Halldorsdottir T, Tomasson G, Rúnarsdóttir H, Danielsdottir HB, Bertone-Johnson ER, Sjölander A, Fang F, Lu D, Valdimarsdóttir UA. Association between adverse childhood experiences and premenstrual disorders: a cross-sectional analysis of 11,973 women. BMC Med 2022; 20:60. [PMID: 35184745 PMCID: PMC8859885 DOI: 10.1186/s12916-022-02275-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Childhood abuse and neglect have been associated with premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). However, the associations of other adverse childhood experiences (ACEs) and the cumulative number of ACEs with PMDs remain to be explored. METHODS To evaluate the associations of the cumulative number and types of ACEs with PMDs, we conducted a cross-sectional analysis with a subsample of menstruating women within the Stress-And-Gene-Analysis (SAGA) cohort, assessed for PMDs and ACEs (N=11,973). The cumulative and individual exposure of 13 types of ACEs was evaluated by a modified ACE-International Questionnaire. A modified version of the Premenstrual Symptom Screening Tool was used to identify probable cases of PMDs, further sub-grouped into PMS and PMDD. Prevalence ratios (PRs) of PMDs in relation to varying ACEs were estimated using Poisson regression. RESULTS At a mean age of 34.0 years (standard deviation (SD) 9.1), 3235 (27%) met the criteria of probable PMDs, including 2501 (21%) for PMS and 734 (6%) for PMDD. The number of ACEs was linearly associated with PMDs (fully-adjusted PR 1.12 per ACE, 95% CI 1.11-1.13). Specifically, the PR for PMDs was 2.46 (95% CI 2.21-2.74) for women with 4 or more ACEs compared with women with no ACEs. A stronger association was observed for probable PMDD compared to PMS (p for difference <0.001). The associations between ACEs and PMDs were stronger among women without PTSD, anxiety, or depression, and without childhood deprivation and were stronger among women a lower level of social support (p for interaction<0.001). All types of ACEs were positively associated with PMDs (PRs ranged from 1.11 to 1.51); the associations of sexual abuse, emotional neglect, family violence, mental illness of a household member, and peer and collective violence were independent of other ACEs. CONCLUSIONS Our findings suggest that childhood adverse experiences are associated with PMDs in a dose-dependent manner. If confirmed by prospective data, our findings support the importance of early intervention for girls exposed to ACEs to minimize risks of PMDs and other morbidities in adulthood.
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Affiliation(s)
- Qian Yang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Edda Björk Þórðardóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Arna Hauksdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Thor Aspelund
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Jóhanna Jakobsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Thorhildur Halldorsdottir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland.,Department of Psychology, Reykjavik University, IS-101, Reykjavik, Iceland
| | - Gunnar Tomasson
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Harpa Rúnarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Hilda Björk Danielsdottir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Elizabeth R Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA-01003, USA.,Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA-01003, USA
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Donghao Lu
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA-02115, USA.
| | - Unnur Anna Valdimarsdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA-02115, USA
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9
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Thorarinsdottir K, Holmes EA, Hardarson J, Stephenssen ES, Jonasdottir MH, Kanstrup M, Singh L, Hauksdottir A, Halldorsdottir T, Gudmundsdottir B, Thordardottir E, Valdimarsdottir U, Bjornsson A. Using a Brief Mental Imagery Competing Task to Reduce the Number of Intrusive Memories: An Exploratory Case Series with Trauma Exposed Women in Iceland (Preprint). JMIR Form Res 2022; 6:e37382. [PMID: 35857368 PMCID: PMC9491830 DOI: 10.2196/37382] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Novel interventions should be developed for people who have undergone psychological trauma. In a previous case study, we found that the number of intrusive memories of trauma could be reduced with a novel intervention. The intervention included a brief memory reminder, a visuospatial task and mental rotation, and targeted trauma memory hotspots one at a time in separate sessions. Objective This case series (N=3) extended the first case study with 3 new cases to determine whether a similar pattern of beneficial results is observed. We explored whether the brief intervention would result in reduced numbers of intrusive memories and whether it would impact symptoms of posttraumatic stress, depression and anxiety, and general functioning. Acceptability of the intervention was also explored. Methods A total of 3 women completed the study: 2 with posttraumatic stress disorder and other comorbidities and 1 with subthreshold posttraumatic stress disorder. The primary outcome was the change in the number of intrusive memories from the baseline phase to the intervention phase and at the 1-month follow-up, with an assessment of the intrusion frequency at 3 months. Participants monitored the number of intrusive memories in a daily diary for 1 week at baseline, for maximum of 6 weeks during the intervention phase and for 1 week at the 1-month and 3-month follow-ups. The intervention was delivered in person or digitally, with guidance from a clinical psychologist. A repeated AB design was used (A was a preintervention baseline phase and B intervention phase). Intrusions were targeted individually, creating repetitions of an AB design. Results The total number of intrusive memories was reduced from the baseline to the intervention phase for all participants. The total number for participant 3 (P3) reduced from 38.8 per week during the baseline phase to 18.0 per week in the intervention phase. It was 13 at the 3-month follow-up. The total number for P4 reduced from 10.8 per week at baseline to 4.7 per week in the intervention phase. It was 0 at the 3-month follow-up. The total number for P5 was reduced from 33.7 at baseline to 20.7 per week in the intervention phase. It was 8 at the 3-month follow-up. All participants reported reduction in posttraumatic stress symptoms in the postintervention phase. Depression and anxiety symptoms reduced in 2 of the 3 participants in the postintervention phase. Acceptability was favorable. Conclusions We observed good compliance with the intervention and intrusive memory diary in all 3 cases. The number of intrusive memories was reduced for all participants during the intervention phase and at the 1-month follow-up, with some improvement in other symptoms and functioning. Further research should explore the remote delivery of the intervention and whether nonspecialists can deliver the intervention effectively.
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Affiliation(s)
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Johann Hardarson
- Department of Psychology, University of Iceland, Reykjavík, Iceland
| | | | | | - Marie Kanstrup
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Laura Singh
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Swedish Collegium for Advanced Study, Uppsala University, Uppsala, Sweden
| | - Arna Hauksdottir
- The Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Thorhildur Halldorsdottir
- The Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Psychology, University of Reykjavik, Reykjavik, Iceland
| | - Berglind Gudmundsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- The National University Hospital of Iceland, University of Iceland, Reykjavik, Iceland
| | - Edda Thordardottir
- The Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Unnur Valdimarsdottir
- The Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland
- The National University Hospital of Iceland, University of Iceland, Reykjavik, Iceland
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Andri Bjornsson
- Department of Psychology, University of Iceland, Reykjavík, Iceland
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10
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Daníelsdóttir HB, Aspelund T, Thordardottir EB, Fall K, Fang F, Tómasson G, Rúnarsdóttir H, Yang Q, Choi KW, Kennedy B, Halldorsdottir T, Lu D, Song H, Jakobsdóttir J, Hauksdóttir A, Valdimarsdóttir UA. Adverse childhood experiences and resilience among adult women: A population-based study. eLife 2022; 11:e71770. [PMID: 35101173 PMCID: PMC8806181 DOI: 10.7554/elife.71770] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023] Open
Abstract
Background Adverse childhood experiences (ACEs) have consistently been associated with elevated risk of multiple adverse health outcomes, yet their contribution to coping ability and psychiatric resilience in adulthood is unclear. Methods Cross-sectional data were derived from the ongoing Stress-And-Gene-Analysis cohort, representing 30% of the Icelandic nationwide female population, 18-69 years. Participants in the current study were 26,198 women with data on 13 ACEs measured with the ACE-International Questionnaire. Self-reported coping ability was measured with the Connor-Davidson Resilience Scale and psychiatric resilience was operationalized as absence of psychiatric morbidity. Generalized linear regression assuming normal or Poisson distribution were used to assess the associations of ACEs with coping ability and psychiatric resilience controlling for multiple confounders. Results Number of ACEs was inversely associated with adult resilience in a dose-dependent manner; every 1SD unit increase in ACE scores was associated with both lower levels of coping ability (β = -0.14; 95% CI-0.15,-0.13) and lower psychiatric resilience (β = -0.28; 95% CI-0.29,-0.27) in adulthood. Compared to women with 0 ACEs, women with ≥5 ACEs had 36% lower prevalence of high coping ability (PR = 0.64, 95% CI 0.59,0.70) and 58% lower prevalence of high psychiatric resilience (PR = 0.42; 95% CI 0.39,0.45). Specific ACEs including emotional neglect, bullying, sexual abuse and mental illness of household member were consistently associated with reduced adult resilience. We observed only slightly attenuated associations after controlling for adult socioeconomic factors and social support in adulthood. Conclusions Cumulative ACE exposure is associated with lower adult resilience among women, independent of adult socioeconomic factors and social support, indicating that adult resilience may be largely determined in childhood. Funding This work was supported by the European Research Council (Consolidator grant; UAV, grant number 726413), and the Icelandic Center for Research (Grant of excellence; UAV, grant number 163362-051). HBD was supported by a doctoral grant from the University of Iceland Research Fund.
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Affiliation(s)
- Hilda Björk Daníelsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
- Department of Medical Epidemiology & Biostatistics, Karolinska InstitutetStockholmSweden
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
| | | | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro UniversityÖrebroSweden
- Institute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Gunnar Tómasson
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
| | - Harpa Rúnarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
| | - Qian Yang
- Department of Medical Epidemiology & Biostatistics, Karolinska InstitutetStockholmSweden
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General HospitalBostonUnited States
- Harvard T.H. Chan School of Public HealthBostonUnited States
| | - Beatrice Kennedy
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala UniversityUppsalaSweden
| | - Thorhildur Halldorsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
- Department of Psychology, Reykjavík UniversityReykjavikIceland
| | - Donghao Lu
- Institute of Environmental Medicine, Karolinska InstitutetStockholmSweden
- Harvard T.H. Chan School of Public HealthBostonUnited States
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan UniversityChengduChina
| | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
| | - Unnur Anna Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of IcelandReykjavíkIceland
- Department of Medical Epidemiology & Biostatistics, Karolinska InstitutetStockholmSweden
- Harvard T.H. Chan School of Public HealthBostonUnited States
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11
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Thorarinsdottir K, Holmes EA, Hardarson J, Hedinsdottir U, Kanstrup M, Singh L, Hauksdottir A, Halldorsdottir T, Gudmundsdottir B, Valdimarsdottir U, Thordardottir EB, Gamble B, Bjornsson A. Correction: Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: Case Study in Iceland. JMIR Form Res 2021; 5:e34897. [PMID: 34889751 PMCID: PMC8723828 DOI: 10.2196/34897] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Johann Hardarson
- Department of Psychology, University of Iceland, Reykjavik, Iceland
| | | | - Marie Kanstrup
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Laura Singh
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Swedish Collegium for Advanced Study, Uppsala, Sweden
| | - Arna Hauksdottir
- Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Thorhildur Halldorsdottir
- Department of Psychology, University of Iceland, Reykjavik, Iceland.,Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Berglind Gudmundsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Unnur Valdimarsdottir
- Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
| | | | - Beau Gamble
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Andri Bjornsson
- Department of Psychology, University of Iceland, Reykjavik, Iceland
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12
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Thorarinsdottir K, Holmes EA, Hardarson J, Hedinsdottir U, Kanstrup M, Singh L, Hauksdottir A, Halldorsdottir T, Gudmundsdottir B, Valdimarsdottir U, Thordardottir EB, Gamble B, Bjornsson A. Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: Case Study in Iceland. JMIR Form Res 2021; 5:e29873. [PMID: 34734830 PMCID: PMC8603162 DOI: 10.2196/29873] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/11/2021] [Accepted: 07/05/2021] [Indexed: 01/20/2023] Open
Abstract
Background Additional interventions are needed for survivors of psychological trauma because of several barriers to and limitations of existing treatment options (eg, need to talk about the trauma in detail). Case studies are an important step in exploring the development of novel interventions, allowing detailed examination of individual responses to treatment over time. Here, we present a case study that aims to test a novel intervention designed to disrupt memory reconsolidation, taking a single-symptom approach by focusing on intrusive memories of a traumatic event. Objective This study aims to examine a novel brief cognitive intervention to reduce the number of intrusive memories of trauma in an Icelandic setting and to extend previous studies by examining long-term effects for up to 3 months. The intervention was guided by a clinical psychologist and comprised a brief memory reminder, followed by Tetris gameplay with mental rotation, targeting one memory at a time in each session. Methods This was a single case study in Iceland with a woman in her 50s (drawn from an epidemiological study of trauma) with subthreshold posttraumatic stress disorder and a diagnosis of obsessive-compulsive disorder and social anxiety disorder. The participant had four different intrusive memories from a traumatic event that happened in her childhood. The primary outcome was the change in the number of intrusive memories from baseline to intervention phase and to follow-ups. The number of intrusions was monitored in a daily diary for 4 weeks preintervention, 8 weeks during the intervention, and 1 week at 1-month and 3-month follow-ups. Intrusions were targeted one by one over six intervention sessions, creating four repetitions of an AB design (ie, length of baseline A and intervention phase B varied for each memory). We examined changes in both the total number of intrusions (summed across all four memories) and individually for each memory. In addition, we explored whether having fewer intrusive memories would have an impact on functioning, posttraumatic stress, and depression or anxiety symptoms. Results The total number of intrusions per week was 12.6 at baseline, 6.1 at the intervention phase (52% reduction from baseline), 3.0 at the 1-month follow-up (76% reduction), and 1.0 at the 3-month follow-up (92% reduction). Reductions in the symptoms of posttraumatic stress and depression were observed postintervention. Sleep, concentration, stress, and functioning improved. The participant considered the gameplay intervention acceptable and helpful in that she found that the memories disappeared while she was playing. Conclusions This guided brief cognitive intervention reduced the number of intrusive memories over the intervention phase and follow-ups. The brief memory reminder was well tolerated, removing the need to discuss trauma in detail. The next steps require an extension to more cases and exploring remote delivery of the intervention.
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Affiliation(s)
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Johann Hardarson
- Department of Psychology, University of Iceland, Reykjavik, Iceland
| | | | - Marie Kanstrup
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Laura Singh
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Swedish Collegium for Advanced Study, Uppsala, Sweden
| | - Arna Hauksdottir
- Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Thorhildur Halldorsdottir
- Department of Psychology, University of Iceland, Reykjavik, Iceland.,Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Berglind Gudmundsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Unnur Valdimarsdottir
- Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
| | | | - Beau Gamble
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Andri Bjornsson
- Department of Psychology, University of Iceland, Reykjavik, Iceland
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13
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Halldorsdottir T, Thorisdottir IE, Meyers CCA, Asgeirsdottir BB, Kristjansson AL, Valdimarsdottir HB, Allegrante JP, Sigfusdottir ID. Adolescent well-being amid the COVID-19 pandemic: Are girls struggling more than boys? JCPP Adv 2021; 1:e12027. [PMID: 34514467 PMCID: PMC8420409 DOI: 10.1002/jcv2.12027] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [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: 02/26/2021] [Accepted: 07/02/2021] [Indexed: 11/19/2022] Open
Abstract
Background Differential effects of the coronavirus SARS‐CoV‐2 (COVID‐19) pandemic and associated public restrictions on adolescent girls and boys are emerging but have not been elucidated. This study examined gender differences across broad indicators of adolescent well‐being during the COVID‐19 pandemic in Iceland, and explored potential explanations for these differences. Methods In total, 523 youth (56.5% girls) born in Iceland in 2004 completed measures on mental health problems (depressive symptoms, anger and suicide attempts) and measures designed for this study to assess broad indicators of adolescent well‐being (e.g., day‐to‐day life, academic performance, family and peer relationships, and mental and physical health) and behavioral changes during the COVID‐19 pandemic. Mental health problems during the pandemic were compared to expected scores based on nationwide ratings of same‐aged peers in 2018. Results Although both boys and girls appeared affected, girls reported a greater negative impact across all the broad indicators of well‐being and behavioral change during COVID‐19 than boys, and their depressive symptoms were above and beyond the expected nationwide scores (t(1514) = 4.80, p < .001, Cohen's d = 0.315). Higher depressive symptoms were associated with increased passive social media use and decreased connecting with family members via telephone or social media among girls, and decreased sleeping and increased online gaming alone among boys. Concern about others contracting COVID‐19, changes in daily and school routines, and not seeing friends in person were among the primary contributors to poor mental health identified by youth, particularly girls. Conclusions Adolescents were broadly negatively affected by the COVID‐19 pandemic and accompanying restrictions; however, this negative impact was more pronounced in girls. The findings suggest that a steady routine and remaining socially connected may help youth cope with the uncertainty and social restrictions associated with a pandemic. Moreover, healthcare providers, teachers, and other professionals should pay close attention to depressive symptoms among girls during a pandemic.
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Affiliation(s)
| | | | - Caine C A Meyers
- Icelandic Center for Social Research and Analysis Reykjavik Iceland
| | | | - Alfgeir Logi Kristjansson
- Department of Social and Behavioral Sciences School of Public Health West Virginia University Morgantown West Virginia USA
| | - Heiddis B Valdimarsdottir
- Department of Psychology Reykjavik University Reykjavik Iceland.,Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York City New York USA
| | - John P Allegrante
- Department of Health and Behavior Studies, Teachers College Columbia University New York City New York USA.,Department of Sociomedical Sciences Mailman School of Public Health Columbia University New York City New York USA
| | - Inga Dora Sigfusdottir
- Department of Psychology Reykjavik University Reykjavik Iceland.,Icelandic Center for Social Research and Analysis Reykjavik Iceland.,Department of Sociomedical Sciences Mailman School of Public Health Columbia University New York City New York USA
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Thorisdottir IE, Asgeirsdottir BB, Kristjansson AL, Valdimarsdottir HB, Jonsdottir Tolgyes EM, Sigfusson J, Allegrante JP, Sigfusdottir ID, Halldorsdottir T. Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study. Lancet Psychiatry 2021; 8:663-672. [PMID: 34090582 DOI: 10.1016/s2215-0366(21)00156-5] [Citation(s) in RCA: 140] [Impact Index Per Article: 46.7] [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: 01/28/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage. METHODS In this longitudinal, population-based study, surveys were administered to a nationwide sample of 13-18-year-olds in Iceland in October or February in 2016 and 2018, and in October, 2020 (during the COVID-19 pandemic). The surveys assessed depressive symptoms with the Symptom Checklist-90, mental wellbeing with the Short Warwick Edinburgh Mental Wellbeing Scale, and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Demographic data were collected, which included language spoken at home although not ethnicity data. We used mixed effects models to study the effect of gender, age, and survey year on trends in mental health outcomes. FINDINGS 59 701 survey responses were included; response rates ranged from 63% to 86%. An increase in depressive symptoms (β 0·57, 95% CI 0·53 to 0·60) and worsened mental wellbeing (β -0·46, 95% CI -0·49 to -0·42) were observed across all age groups during the pandemic compared with same-aged peers before COVID-19. These outcomes were significantly worse in adolescent girls compared with boys (β 4·16, 95% CI 4·05 to 4·28, and β -1·13, 95% CI -1·23 to -1·03, respectively). Cigarette smoking (OR 2·61, 95% CI 2·59 to 2·66), e-cigarette use (OR 2·61, 95% CI 2·59 to 2·64), and alcohol intoxication (OR 2·59, 95% CI 2·56 to 2·64) declined among 15-18-year-olds during COVID-19, with no similar gender differences. INTERPRETATION Our results suggest that COVID-19 has significantly impaired adolescent mental health. However, the decrease observed in substance use during the pandemic might be an unintended benefit of isolation, and might serve as a protective factor against future substance use disorders and dependence. Population-level prevention efforts, especially for girls, are warranted. FUNDING Icelandic Research Fund. TRANSLATION For the Icelandic translation of the abstract see Supplementary Materials section.
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Affiliation(s)
| | | | - Alfgeir Logi Kristjansson
- Icelandic Center for Social Research and Analysis, Reykjavik, Iceland; Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Heiddis Bjork Valdimarsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Jon Sigfusson
- Icelandic Center for Social Research and Analysis, Reykjavik, Iceland
| | - John Philip Allegrante
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Inga Dora Sigfusdottir
- Icelandic Center for Social Research and Analysis, Reykjavik, Iceland; Department of Psychology, Reykjavik University, Reykjavik, Iceland; Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Thorhildur Halldorsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
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15
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Halldorsdottir T, Thorisdottir IE, Meyers CCA, Asgeirsdottir BB, Kristjansson AL, Valdimarsdottir HB, Allegrante JP, Sigfusdottir ID. Adolescent well-being amid the COVID-19 pandemic: Are girls struggling more than boys? JCPP Adv 2021. [PMID: 34514467 DOI: 10.1111/jcv2.12027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Differential effects of the coronavirus SARS-CoV-2 (COVID-19) pandemic and associated public restrictions on adolescent girls and boys are emerging but have not been elucidated. This study examined gender differences across broad indicators of adolescent well-being during the COVID-19 pandemic in Iceland, and explored potential explanations for these differences. METHODS In total, 523 youth (56.5% girls) born in Iceland in 2004 completed measures on mental health problems (depressive symptoms, anger and suicide attempts) and measures designed for this study to assess broad indicators of adolescent well-being (e.g., day-to-day life, academic performance, family and peer relationships, and mental and physical health) and behavioral changes during the COVID-19 pandemic. Mental health problems during the pandemic were compared to expected scores based on nationwide ratings of same-aged peers in 2018. RESULTS Although both boys and girls appeared affected, girls reported a greater negative impact across all the broad indicators of well-being and behavioral change during COVID-19 than boys, and their depressive symptoms were above and beyond the expected nationwide scores (t(1514) = 4.80, p < .001, Cohen's d = 0.315). Higher depressive symptoms were associated with increased passive social media use and decreased connecting with family members via telephone or social media among girls, and decreased sleeping and increased online gaming alone among boys. Concern about others contracting COVID-19, changes in daily and school routines, and not seeing friends in person were among the primary contributors to poor mental health identified by youth, particularly girls. CONCLUSIONS Adolescents were broadly negatively affected by the COVID-19 pandemic and accompanying restrictions; however, this negative impact was more pronounced in girls. The findings suggest that a steady routine and remaining socially connected may help youth cope with the uncertainty and social restrictions associated with a pandemic. Moreover, healthcare providers, teachers, and other professionals should pay close attention to depressive symptoms among girls during a pandemic.
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Affiliation(s)
| | | | - Caine C A Meyers
- Icelandic Center for Social Research and Analysis Reykjavik Iceland
| | | | - Alfgeir Logi Kristjansson
- Department of Social and Behavioral Sciences School of Public Health West Virginia University Morgantown West Virginia USA
| | - Heiddis B Valdimarsdottir
- Department of Psychology Reykjavik University Reykjavik Iceland
- Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York City New York USA
| | - John P Allegrante
- Department of Health and Behavior Studies, Teachers College Columbia University New York City New York USA
- Department of Sociomedical Sciences Mailman School of Public Health Columbia University New York City New York USA
| | - Inga Dora Sigfusdottir
- Department of Psychology Reykjavik University Reykjavik Iceland
- Icelandic Center for Social Research and Analysis Reykjavik Iceland
- Department of Sociomedical Sciences Mailman School of Public Health Columbia University New York City New York USA
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Halldorsdottir T, Kurtoic D, Müller-Myhsok B, Binder EB, Blair C. Neurobiology of Self-Regulation: Longitudinal Influence of FKBP5 and Intimate Partner Violence on Emotional and Cognitive Development in Childhood. Am J Psychiatry 2019; 176:626-634. [PMID: 30947533 DOI: 10.1176/appi.ajp.2019.18091018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/30/2022]
Abstract
OBJECTIVE Self-regulation includes the volitional and nonvolitional regulation of emotional, cognitive, and physiological responses to stimulation. It develops from infancy through individual characteristics and the environment, with the stress hormone system as a central player. Accordingly, the authors hypothesized that genes involved in regulating the stress system, such as FK506 binding protein 5 (FKBP5), interact with early-life stress exposure, such as exposure to intimate partner violence (IPV), to predict self-regulation indicators and associated outcomes, including behavioral and learning problems in school. METHODS Study participants were a longitudinal birth cohort of 910 children for whom FKBP5 genotypes were available and who were assessed for exposure to IPV during the first 2 years of life as well as multiple measures of self-regulation: stress-induced cortisol reactivity and fear-elicited emotional reactivity at 7, 15, and 24 months, executive function at 36, 48, and 60 months, and emotional and behavioral difficulties and reading and math achievement in school grades 1, 2, and 5. Data were analyzed using longitudinal clustering and ordinal logistic regression procedures followed by mixed linear modeling. RESULTS Children with two copies of a risk FKBP5 haplotype and IPV exposure were significantly more likely to have a developmental trajectory characterized by high, prolonged stress-induced cortisol reactivity and emotional reactivity in toddlerhood, followed by low executive function at school entry and high emotional and behavior problems and low reading ability in the primary school grades. CONCLUSIONS The interaction of FKBP5 and IPV affects the physiological response to stress early in life, with consequences for emotional and cognitive self-regulation. Targeting self-regulation may present an early intervention strategy for children facing genetic and environmental risk.
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Affiliation(s)
- Thorhildur Halldorsdottir
- The Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Kurtoic, Müller-Myhsok, Binder); the Center of Public Health Sciences, University of Iceland, Reykjavík (Halldorsdottir); the Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, U.K. (Müller-Myhsok); the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Binder); the Department of Applied Psychology, New York University, New York (Blair); the Department of Human Development and Family Studies, Pennsylvania State University, University Park, and the Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill (Family Life Project Key Investigators)
| | - Dunja Kurtoic
- The Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Kurtoic, Müller-Myhsok, Binder); the Center of Public Health Sciences, University of Iceland, Reykjavík (Halldorsdottir); the Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, U.K. (Müller-Myhsok); the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Binder); the Department of Applied Psychology, New York University, New York (Blair); the Department of Human Development and Family Studies, Pennsylvania State University, University Park, and the Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill (Family Life Project Key Investigators)
| | - Bertram Müller-Myhsok
- The Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Kurtoic, Müller-Myhsok, Binder); the Center of Public Health Sciences, University of Iceland, Reykjavík (Halldorsdottir); the Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, U.K. (Müller-Myhsok); the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Binder); the Department of Applied Psychology, New York University, New York (Blair); the Department of Human Development and Family Studies, Pennsylvania State University, University Park, and the Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill (Family Life Project Key Investigators)
| | - Elisabeth B Binder
- The Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Kurtoic, Müller-Myhsok, Binder); the Center of Public Health Sciences, University of Iceland, Reykjavík (Halldorsdottir); the Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, U.K. (Müller-Myhsok); the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Binder); the Department of Applied Psychology, New York University, New York (Blair); the Department of Human Development and Family Studies, Pennsylvania State University, University Park, and the Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill (Family Life Project Key Investigators)
| | - Clancy Blair
- The Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Kurtoic, Müller-Myhsok, Binder); the Center of Public Health Sciences, University of Iceland, Reykjavík (Halldorsdottir); the Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, U.K. (Müller-Myhsok); the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Binder); the Department of Applied Psychology, New York University, New York (Blair); the Department of Human Development and Family Studies, Pennsylvania State University, University Park, and the Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill (Family Life Project Key Investigators)
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Halldorsdottir T, Piechaczek C, Soares de Matos AP, Czamara D, Pehl V, Wagenbuechler P, Feldmann L, Quickenstedt-Reinhardt P, Allgaier AK, Freisleder FJ, Greimel E, Kvist T, Lahti J, Räikkönen K, Rex-Haffner M, Arnarson EÖ, Craighead WE, Schulte-Körne G, Binder EB. Polygenic Risk: Predicting Depression Outcomes in Clinical and Epidemiological Cohorts of Youths. Am J Psychiatry 2019; 176:615-625. [PMID: 30947532 DOI: 10.1176/appi.ajp.2019.18091014] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [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: 11/30/2022]
Abstract
OBJECTIVE Identifying risk factors for major depression and depressive symptoms in youths could have important implications for prevention efforts. This study examined the association of polygenic risk scores (PRSs) for a broad depression phenotype derived from a large-scale genome-wide association study (GWAS) in adults, and its interaction with childhood abuse, with clinically relevant depression outcomes in clinical and epidemiological youth cohorts. METHODS The clinical cohort comprised 279 youths with major depression (mean age=14.76 years [SD=2.00], 68% female) and 187 healthy control subjects (mean age=14.67 years [SD=2.45], 63% female). The first epidemiological cohort included 1,450 youths (mean age=13.99 years [SD=0.92], 63% female). Of those, 694 who were not clinically depressed at baseline underwent follow-ups at 6, 12, and 24 months. The replication epidemiological cohort comprised children assessed at ages 8 (N=184; 49.2% female) and 11 (N=317; 46.7% female) years. All cohorts were genome-wide genotyped and completed measures for major depression, depressive symptoms, and/or childhood abuse. Summary statistics from the largest GWAS to date on depression were used to calculate the depression PRS. RESULTS In the clinical cohort, the depression PRS predicted case-control status (odds ratio=1.560, 95% CI=1.230-1.980), depression severity (β=0.177, SE=0.069), and age at onset (β=-0.375, SE=0.160). In the first epidemiological cohort, the depression PRS predicted baseline depressive symptoms (β=0.557, SE=0.200) and prospectively predicted onset of moderate to severe depressive symptoms (hazard ratio=1.202, 95% CI=1.045-1.383). The associations with depressive symptoms were replicated in the second epidemiological cohort. Evidence was found for an additive, but not an interactive, effect of the depression PRS and childhood abuse on depression outcomes. CONCLUSIONS Depression PRSs derived from adults generalize to depression outcomes in youths and may serve as an early indicator of clinically significant levels of depression.
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Affiliation(s)
- Thorhildur Halldorsdottir
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Charlotte Piechaczek
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Ana Paula Soares de Matos
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Verena Pehl
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Petra Wagenbuechler
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Lisa Feldmann
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Peggy Quickenstedt-Reinhardt
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Antje-Kathrin Allgaier
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Franz Joseph Freisleder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Ellen Greimel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Tuomas Kvist
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Jari Lahti
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Katri Räikkönen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Monika Rex-Haffner
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Eiríkur Örn Arnarson
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - W Edward Craighead
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Gerd Schulte-Körne
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers)
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Matosin N, Halldorsdottir T, Binder EB. Understanding the Molecular Mechanisms Underpinning Gene by Environment Interactions in Psychiatric Disorders: The FKBP5 Model. Biol Psychiatry 2018; 83:821-830. [PMID: 29573791 DOI: 10.1016/j.biopsych.2018.01.021] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [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: 09/01/2017] [Revised: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 12/21/2022]
Abstract
Epidemiologic and genetic studies suggest common environmental and genetic risk factors for a number of psychiatric disorders, including depression, bipolar disorder, and schizophrenia. Genetic and environmental factors, especially adverse life events, not only have main effects on disease development but also may interact to shape risk and resilience. Such gene by adversity interactions have been described for FKBP5, an endogenous regulator of the stress-neuroendocrine system, conferring risk for a number of psychiatric disorders. In this review, we present a molecular and cellular model of the consequences of FKBP5 by early adversity interactions. We illustrate how altered genetic and epigenetic regulation of FKBP5 may contribute to disease risk by covering evidence from clinical and preclinical studies of FKBP5 dysregulation, known cell-type and tissue-type expression patterns of FKBP5 in humans and animals, and the role of FKBP5 as a stress-responsive molecular hub modulating many cellular pathways. FKBP5 presents the possibility to better understand the molecular and cellular factors contributing to a disease-relevant gene by environment interaction, with implications for the development of biomarkers and interventions for psychiatric disorders.
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Affiliation(s)
- Natalie Matosin
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Thorhildur Halldorsdottir
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
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Halldorsdottir T, de Matos APS, Awaloff Y, Arnarson EÖ, Craighead WE, Binder EB. FKBP5 moderation of the relationship between childhood trauma and maladaptive emotion regulation strategies in adolescents. Psychoneuroendocrinology 2017; 84:61-65. [PMID: 28654774 DOI: 10.1016/j.psyneuen.2017.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Received: 02/15/2017] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 01/30/2023]
Abstract
Maladaptive emotion regulation strategies, such as rumination and catastrophizing, are transdiagnostic risk factors for psychopathology. FK506-binding protein 51 (FKBP5) has been found to moderate the relationship between stressful life events and various psychiatric disorders. Given the cross-disorder moderation effect of FKBP5 at the diagnostic level, the aim of the current study was to examine whether the relationship between exposure to childhood trauma and transdiagnostic maladaptive emotion regulation processes would also be moderated by genetic FKBP5 variation in a community sample of adolescents. We hypothesized that adolescent carriers of the FKBP5 CATT haplotype composed of rs9296158, rs3800373, rs1360780, and rs9470080, that has been associated with increased risk for psychiatric disorders in adulthood, would also show higher levels of rumination and catastrophizing. Participants included 1345 genotyped adolescents (Mage=13.95, 64.2% female; 100% European Caucasians of Portuguese descent) who completed self-report measures on exposure to childhood trauma and emotion regulation strategies. Genotypes of rs9296158, rs3800373, rs1360780, and rs9470080 were used to estimate the CATT haplotype (carriers versus non-carriers). Consistent with our hypotheses and previous findings, adolescent CATT haplotype carriers with higher levels of childhood trauma endorsed higher levels of both rumination and catastrophizing compared to non-carriers. Given the association of these maladaptive emotion regulation processes and psychiatric disorders, the findings suggest possible psychological mechanisms why FKBP5 haplotype carriers exposed to childhood trauma are more vulnerable to developing a psychiatric disorder later in life.
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Affiliation(s)
| | | | - Yvonne Awaloff
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Germany.
| | - Eiríkur Örn Arnarson
- Landspitali-University Hospital, University of Iceland, Faculty of Medicine, School of Health Sciences, Reykjavík, Iceland.
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences and Department of Psychology, Emory University School of Medicine, USA.
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Germany; Department of Psychiatry and Behavioral Sciences and Department of Psychology, Emory University School of Medicine, USA.
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Halldorsdottir T, Sundqvist M, Olofsson Bagge R. Lymphovascular invasion and p53 as risk factors for local recurrence after mastectomy. Breast 2017. [DOI: 10.1016/s0960-9776(17)30301-6] [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: 11/26/2022] Open
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Affiliation(s)
- Thorhildur Halldorsdottir
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany;
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany;
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322
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Halldorsdottir T. Evidence Mounting for Gene-by-Environment Interactions at the FKBP5 Locus Predicting Psychiatric Symptoms. Biol Psychiatry 2016; 80:e89-e91. [PMID: 27968728 DOI: 10.1016/j.biopsych.2016.09.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 09/01/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Thorhildur Halldorsdottir
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.
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Halldorsdottir T, Jonsson H, Gudmundsson KG. A Few Observations on Health Service for Immigrants at a Primary Health Care Centre. Int J Family Med 2016; 2016:6963835. [PMID: 27563465 PMCID: PMC4987470 DOI: 10.1155/2016/6963835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/06/2016] [Accepted: 06/15/2016] [Indexed: 06/06/2023]
Abstract
Objective. Icelandic society is rapidly changing, from being an ethnically homogeneous population towards a multicultural immigrant society. In the hope of optimizing the service for immigrants at the health care centre, we decided to evaluate health care utilization by immigrants. Methods. As a case control study we invited all immigrants that attended the health care centre during a two-week period to participate. Paired controls of Icelanders were invited for comparison. Results. There were 57 immigrants, 48 females and 9 males, from 27 countries. Significantly more of the immigrant women were married, P < 0.001. Interpreters were needed in 21% of the consultations. The immigrants often attended the clinic and had the same diagnoses as did the nonimmigrants. The immigrants evaluated the quality of the service in Iceland as 4.3 and the service in their homeland as 1.68, P < 0.001. Conclusion. Immigrants attending a health care centre in Iceland came from all over the world, had the same diagnoses, and attended the clinic as often per annum as the nonimmigrants. Only one-fifth of them needed translators. The health and health care utilization of immigrants were similar to those of nonimmigrants.
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Halldorsdottir T, Ollendick TH. Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms. J Consult Clin Psychol 2016; 84:465-71. [DOI: 10.1037/ccp0000088] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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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Ollendick TH, Greene RW, Austin KE, Fraire MG, Halldorsdottir T, Allen KB, Jarrett MA, Lewis KM, Whitmore Smith M, Cunningham NR, Noguchi RJP, Canavera K, Wolff JC. Parent Management Training and Collaborative & Proactive Solutions: A Randomized Control Trial for Oppositional Youth. J Clin Child Adolesc Psychol 2015; 45:591-604. [PMID: 25751000 DOI: 10.1080/15374416.2015.1004681] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined the efficacy of Collaborative & Proactive Solutions (CPS) in treating oppositional defiant disorder (ODD) in youth by comparing this novel treatment to Parent Management Training (PMT), a well-established treatment, and a waitlist control (WLC) group. One hundred thirty-four youth (ages 7-14, 61.9% male, 83.6% White) who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for ODD were randomized to CPS, PMT, or WLC groups. ODD was assessed with semistructured diagnostic interviews, clinical global severity and improvement ratings, and parent report measures. Assessments were completed pretreatment, posttreatment, and at 6 months following treatment. Responder and remitter analyses were undertaken using intent-to-treat mixed-models analyses. Chronological age, gender, and socioeconomic status as well as the presence of comorbid attention deficit/hyperactivity and anxiety disorders were examined as predictors of treatment outcome. Both treatment conditions were superior to the WLC condition but did not differ from one another in either our responder or remitter analyses. Approximately 50% of youth in both active treatments were diagnosis free and were judged to be much or very much improved at posttreatment, compared to 0% in the waitlist condition. Younger age and presence of an anxiety disorder predicted better treatment outcomes for both PMT and CPS. Treatment gains were maintained at 6-month follow-up. CPS proved to be equivalent to PMT and can be considered an evidence-based, alternative treatment for youth with ODD and their families.
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Affiliation(s)
| | | | | | - Maria G Fraire
- b Department of Psychiatry , McLean Hospital/Harvard Medical School
| | | | - Kristy Benoit Allen
- d Western Psychiatric Institute and Clinic , University of Pittsburgh School of Medicine
| | | | - Krystal M Lewis
- f Department of Psychiatry , University of Illinois at Chicago
| | | | - Natoshia R Cunningham
- g Division of Behavioral Medicine and Clinical Psychology , Cincinnati Children's Hospital and Medical Center
| | | | - Kristin Canavera
- i Department of Psychology , St. Jude's Children's Research Hospital
| | - Jennifer C Wolff
- j Bradley/Hasbro Research Center , Brown University School of Medicine
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Halldorsdottir T, Ollendick TH, Ginsburg G, Sherrill J, Kendall PC, Walkup J, Sakolsky DJ, Piacentini J. Treatment Outcomes in Anxious Youth with and without Comorbid ADHD in the CAMS. J Clin Child Adolesc Psychol 2014; 44:985-91. [PMID: 25310142 DOI: 10.1080/15374416.2014.952008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study is to examine the influence of Attention-Deficit/Hyperactivity Disorder (ADHD), independent of Oppositional Defiant Disorder (ODD), on acute treatment response, remission rates and maintenance of gains at 6-month follow-up in anxious youth (ages 7-17, 76% Caucasian, 52% female) who received cognitive-behavioral therapy (CBT) alone, pharmacotherapy alone, the combination of CBT and pharmacotherapy or placebo pill in the Child/Adolescent Multimodal Study. Treatment response was defined as independent evaluator rated meaningful improvement in anxiety. Remission was operationalized as the absence of targeted anxiety disorders. ADHD and ODD were examined as moderators of outcomes at a diagnostic level. In the CBT group only, an ADHD diagnosis predicted poorer immediate treatment response and remission rates. However, these associations were not obtained for the pharmacotherapy groups. Participants with comorbid ODD were not less likely to achieve acute treatment response and remission rates than their counterparts across treatment conditions. Due to small sample size of the comorbid subgroups, our analyses must be considered preliminary. Nevertheless, our initial findings suggest further exploration of the separate roles of ADHD and ODD are worth pursuing, as they may be differentially associated with treatment outcomes in anxious youth treated with CBT but not youth treated with pharmacotherapy. If confirmed, findings may indicate that anxious youth with comorbid ADHD are less likely to benefit from CBT strategies alone and raise the possibility that these youth need adjunctive pharmacotherapy or psychosocial interventions.
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Affiliation(s)
| | - Thomas H Ollendick
- a Department of Psychology , Virginia Polytechnic Institute and State University
| | - Golda Ginsburg
- b Division of Child and Adolescent Psychiatry, John Hopkins University School of Medicine
| | - Joel Sherrill
- c Division of Services and Intervention Research, National Institute of Mental Health
| | | | - John Walkup
- e Department of Psychiatry , Weill Cornell Medical College and New York-Presbyterian Hospital
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Halldorsdottir T, Ollendick TH. Comorbid ADHD: Implications for the Treatment of Anxiety Disorders in Children and Adolescents. Cognitive and Behavioral Practice 2014. [DOI: 10.1016/j.cbpra.2013.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Saemundsen E, Juliusson H, Hjaltested S, Gunnarsdottir T, Halldorsdottir T, Hreidarsson S, Magnusson P. Prevalence of autism in an urban population of adults with severe intellectual disabilities--a preliminary study. J Intellect Disabil Res 2010; 54:727-735. [PMID: 20633201 DOI: 10.1111/j.1365-2788.2010.01300.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Research on the prevalence of autism in Iceland has indicated that one possible explanation of fewer autism cases in older age groups was due to an underestimation of autism in individuals with intellectual disabilities (IDs). The present study systematically searched for autism cases in the adult population of individuals with severe ID living in the city of Reykjavik, Iceland. METHODS Potential participants (n = 256) were recruited through the Regional Office for the Affairs of the Handicapped in Reykjavik. First, a screening tool for autism was applied, followed by the Childhood Autism Rating Scale and finally the Autism Diagnostic Interview-Revised (ADI-R). RESULTS The point prevalence of severe ID was 3.7/1000 (95% CI 3.2-4.1) with a male-female ratio of 1.2:1. Participation rate in the study was 46.5%. Participants were younger than non-participants and more often residents of group homes. The prevalence of autism was 21% (25/119) (95% CI 14.7-29.2) with a male-female ratio of 1.8:1. Of the individuals with autism, 10/25 (40%) were verbal according to the ADI-R definition, and 18/25 (72%) had active epilepsy and/or other neurological conditions and handicaps. CONCLUSION The study identified twice the number of autism cases than those previously recognised within the service system. Autism is a prevalent additional handicap in individuals with severe ID, which should always be considered in this population. There are indications that the estimated prevalence of autism found should be considered minimal.
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Affiliation(s)
- E Saemundsen
- State Diagnostic and Counselling Centre, Division of Autism, Kopavogur, Iceland.
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