Dysconnectivity of the Nucleus Accumbens and Amygdala in Youths with Thought Problems: A Dimensional Approach

Background: Youths with thought problems (TP) are at risk to develop psychosis and obsessive-compulsive disorder (OCD). Yet, the pathophysiological mechanisms underpinning TP are still unclear. Functional magnetic resonance imaging (fMRI) studies have shown that striatal and limbic alterations are associated with psychosis-like and obsessive-like symptoms in individuals at clinical risk for psychosis, schizophrenia, and OCD. More specifically, nucleus accumbens (NAcc) and amygdala are mainly involved in these associations. The current study aims to investigate the neural correlates of TP in youth populations using a dimensional approach and explore potential cognitive functions and neurotransmitters associated with it. Methods: Seed-to-voxels functional connectivity analyses using NAcc and amygdala as regions-of-interest were conducted with resting-state fMRI data obtained from 1360 young individuals, and potential confounders related to TP such as anxiety and cognitive functions were included as covariates in multiple regression analyses. Replicability was tested in using an adult cohort. In addition, functional decoding and neurochemical correlation analyses were performed to identify the associated cognitive functions and neurotransmitters. Results: The altered functional connectivities between the right NAcc and posterior parahippocampal gyrus, between the right amygdala and lateral prefrontal cortex, and between the left amygdala and the secondary visual area were the best predictors of TP in multiple regression model. These functional connections are mainly involved in social cognition and reward processing. Conclusions: The results show that alterations in the functional connectivity of the NAcc and the amygdala in neural pathways involved in social cognition and reward processing are associated with severity of TP in youths.

Deliberative and Affective Risky Decisions in Teenagers: Different Associations with Maladaptive Psychological Functioning and Difficulties in Emotion Regulation?

Using network analysis, we investigated the relationships between maladaptive psychological functioning, difficulties in emotion regulation, and risk-taking in deliberative and affective behavioral decisions. Participants (103 adolescents aged between 13 and 19 years, 62% boys) took the Cold (deliberative) and Hot (affective) versions of the Columbia Card Task and completed the Youth Self-Report (YSR) and the Difficulties in Emotion Regulation Scale (DERS). In contrast to the view that risk propensity increases from preadolescence to middle adolescence and decreases at later ages, our study revealed no age-specific trend. YSR syndrome scales were significantly correlated with risk propensity, but only in the Cold version. The YSR Thought Problems scale was the most central node in the network, linking internalizing and externalizing problems with risk propensity in the Cold CCT. Lack of emotional Clarity was the only DERS consistently linked with risk-taking both in correlation and network analyses. Maladaptive psychological functioning and difficulties in emotion regulation were linked with risk propensity in affective risky decisions through deliberative processes. The statistical significance of direct and indirect effects was further examined using nonparametric mediation analyses. Our study highlights the role of cognitive factors that in each variable set might account for risk-taking in teenagers.

Youth Self Report Thought Problems and Sleep Difficulties Are Linked to Suicidal Ideation Among Psychiatrically Hospitalized Adolescents

Objectives: Thought problems, such as hallucinations and delusional or disorganized ideas, have been associated with increased sleep problems and risk for suicidal ideation (SI). Sleep problems have also been linked directly to suicidality in adolescence. The nature of the relationship between these symptoms among adolescents with acute suicidality is not well understood. This study aims to examine the interrelationships between thought problems, sleep difficulties, and SI in adolescents psychiatrically hospitalized for safety concerns, with the goal of informing suicide risk screening and intervention for this population. Methods: Participants included adolescents (n = 690) aged 11-18. A retrospective chart review was used to obtain scores on study measures, including the Suicidal Ideation Questionnaire Junior (SIQ-Jr), the thought problems and sleep disturbance scales on the Youth Self Report (YSR), and mental health diagnoses using the Children's Interview for Psychiatric Syndromes (ChIPS). Results: Findings indicate that SIQ-Jr scores are moderately correlated with both YSR thought problems (r = 0.51, p < 0.001) and YSR sleep disturbance (r = 0.47, p < 0.001). Further, linear regression analyses support the hypotheses that thought problems (β = 0.28) and sleep difficulties (β = 0.11) are uniquely associated with SI, beyond the significant effects of depression (β = 0.36) and female sex (β = -0.07); R² = 0.43, F (8, 673) = 62.49, p < 0.001). Conclusions: These results suggest that sleep interventions and treatment of thought problems may be important for reducing SI, within and outside the context of depression. Furthermore, the adolescent version of the YSR may be a useful tool to evaluate these risk factors alongside other psychiatric concerns.

Testing structural models of psychopathology at the genomic level

Genome-wide association studies (GWAS) have revealed hundreds of genetic loci associated with the vulnerability to major psychiatric disorders, and post-GWAS analyses have shown substantial genetic correlations among these disorders. This evidence supports the existence of a higher-order structure of psychopathology at both the genetic and phenotypic levels. Despite recent efforts by collaborative consortia such as the Hierarchical Taxonomy of Psychopathology (HiTOP), this structure remains unclear. In this study, we tested multiple alternative structural models of psychopathology at the genomic level, using the genetic correlations among fourteen psychiatric disorders and related psychological traits estimated from GWAS summary statistics. The best-fitting model included four correlated higher-order factors - externalizing, internalizing, thought problems, and neurodevelopmental disorders - which showed distinct patterns of genetic correlations with external validity variables and accounted for substantial genetic variance in their constituent disorders. A bifactor model including a general factor of psychopathology as well as the four specific factors fit worse than the above model. Several model modifications were tested to explore the placement of some disorders - such as bipolar disorder, obsessive-compulsive disorder, and eating disorders - within the broader psychopathology structure. The best-fitting model indicated that eating disorders and obsessive-compulsive disorder, on the one hand, and bipolar disorder and schizophrenia, on the other, load together on the same thought problems factor. These findings provide support for several of the HiTOP higher-order dimensions and suggest a similar structure of psychopathology at the genomic and phenotypic levels.

Disturbances in reality testing as markers of risk in offspring of parents with bipolar disorder: a systematic review from a developmental psychopathology perspective

OBJECTIVES

This comprehensive review examined the prevalence and progression of disturbances in reality testing (DRT), defined as psychotic symptoms, cognitive disruptions, and thought problems, in offspring of parents with bipolar disorder (O-BD). Our approach was grounded in a developmental psychopathology perspective and considered a broader phenotype of risk within the bipolar-schizophrenia spectrum as measured by categorical and dimensional assessments of DRT in high-risk youth.

METHODS

Relevant studies were identified from numerous sources (e.g., PubMed, reference sections, and colleagues). Inclusion criteria were: (i) family risk studies published between 1975 and 2012 in which O-BD were contrasted with a comparison group (e.g., offspring of parents who had other psychiatric disorders or were healthy) on DRT outcomes and (ii) results reported for categorical or dimensional assessments of DRT (e.g., schizophrenia, psychotic symptoms, cluster A personality traits, or thought problems), yielding a total of 23 studies.

RESULTS

Three key findings emerged: (i) categorical approaches of DRT in O-BD produced low incidence base rates and almost no evidence of significant differences in DRT between O-BD and comparison groups, whereas (ii) many studies using dimensional assessments of DRT yielded significant group differences in DRT. Furthermore, (iii) preliminary evidence from dimensional measures suggested that the developmental progression of DRT in O-BD might represent a prodrome of severe psychological impairment.

CONCLUSIONS

Preliminary but promising evidence suggests that DRT is a probable marker of risk for future impairment in O-BD. Methodological strengths and weaknesses, the psychometric properties of primary DRT constructs, and future directions for developmental and longitudinal research with O-BD are discussed.