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Ferguson GM, Causadias JM, Simenec TS. Acculturation and Psychopathology. Annu Rev Clin Psychol 2023; 19:381-411. [PMID: 36854286 DOI: 10.1146/annurev-clinpsy-080921-080622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Acculturation and psychopathology are linked in integrated, interactional, intersectional, and dynamic ways that span different types of intercultural contact, levels of analysis, timescales, and contexts. A developmental psychopathology approach can be useful to explain why, how, and what about psychological acculturation results in later adaptation or maladaptation for acculturating youth and adults. This review applies a conceptual model of acculturation and developmental psychopathology to a widely used framework of acculturation variables producing an Integrated Process Framework of Acculturation Variables (IP-FAV). This new comprehensive framework depicts major predisposing acculturation conditions (why) as well as acculturation orientations and processes (how) that result in adaptation and maladaptation across the life span (what). The IP-FAV is unique in that it integrates both proximal and remote acculturation variables and explicates key acculturation processes to inform research, practice, and policy.
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Affiliation(s)
- Gail M Ferguson
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA;
| | - José M Causadias
- School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, USA
| | - Tori S Simenec
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA;
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Abstract
In foundational texts on schizophrenia, the mental disorder was constitutively linked to a specific disintegration of subjectivity (often termed a self-disorder). Apart from Scharfetter's work on ego-pathology, research on self-disorders generally faded into oblivion, and self-disorders were only rediscovered as notable psychopathological features of the schizophrenia spectrum nearly two decades ago. Subsequently, the Examination of Anomalous Self-Experience (EASE) scale was constructed to allow systematic assessment of non-psychotic self-disorders. This Review is the first systematic review of empirical studies on self-disorders based on the EASE or other related scales. The results consistently show that self-disorders hyper-aggregate in schizophrenia spectrum disorders but not in other mental disorders; that self-disorders are found in individuals at a clinical risk of developing psychosis; that self-disorders show a high degree of temporal stability; that self-disorders predict the later development of schizophrenia spectrum disorders; and that self-disorders correlate with the canonical dimensions of the psychopathology of schizophrenia, impaired social functioning, and suicidality. Issues with the methods of the reviewed literature are critically discussed and the role of self-disorders in clinical psychiatry and future research is outlined.
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Affiliation(s)
- Mads Gram Henriksen
- Centre for Subjectivity Research, Department of Communication, University of Copenhagen, Copenhagen, Denmark; Mental Health Centre Amager, University Hospital of Copenhagen, Copenhagen, Denmark; Mental Health Centre Glostrup, University Hospital of Copenhagen, Copenhagen, Denmark.
| | - Andrea Raballo
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy; Centre for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
| | - Julie Nordgaard
- Mental Health Centre Amager, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Moltrecht B, Deighton J, Patalay P, Edbrooke-Childs J. Effectiveness of current psychological interventions to improve emotion regulation in youth: a meta-analysis. Eur Child Adolesc Psychiatry 2021; 30:829-848. [PMID: 32108914 PMCID: PMC8140974 DOI: 10.1007/s00787-020-01498-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 02/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research investigating the role of emotion regulation (ER) in the development and treatment of psychopathology has increased in recent years. Evidence suggests that an increased focus on ER in treatment can improve existing interventions. Most ER research has neglected young people, therefore the present meta-analysis summarizes the evidence for existing psychosocial intervention and their effectiveness to improve ER in youth. A systematic review and meta-analysis was conducted according to the PRISMA guidelines. Twenty-one randomized-control-trials (RCTs) assessed changes in ER following a psychological intervention in youth exhibiting various psychopathological symptoms. We found moderate effect sizes for current interventions to decrease emotion dysregulation in youth (g = - 0.46) and small effect sizes to improve emotion regulation (g = 0.36). Significant differences between studies including intervention components, ER measures and populations studied resulted in large heterogeneity. This is the first meta-analysis that summarizes the effectiveness for existing interventions to improve ER in youth. The results suggest that interventions can enhance ER in youth, and that these improvements correlate with improvements in psychopathology. More RCTs including larger sample sizes, different age groups and psychopathologies are needed to increase our understanding of what works for who and when.
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Affiliation(s)
- Bettina Moltrecht
- Division of Psychology and Language Sciences, University College London, 26 Bedford Way, Bloomsbury, London, WC1H 0AP, UK.
- Anna Freud National Centre for Children and Families, London, UK.
| | - Jessica Deighton
- Division of Psychology and Language Sciences, University College London, 26 Bedford Way, Bloomsbury, London, WC1H 0AP, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Julian Edbrooke-Childs
- Division of Psychology and Language Sciences, University College London, 26 Bedford Way, Bloomsbury, London, WC1H 0AP, UK
- Anna Freud National Centre for Children and Families, London, UK
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D’Agata F, Caroppo P, Spalatro A, Lavagnino L, Abbate Daga G, Boghi A, Bergui M, Cicerale A, Vitiello B, Fassino S, Derntl B, Amianto F. Emotional imagination of negative situations: Functional neuroimaging in anorexia and bulimia. PLoS One 2021; 16:e0231684. [PMID: 33836002 PMCID: PMC8034744 DOI: 10.1371/journal.pone.0231684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 03/09/2021] [Indexed: 11/18/2022] Open
Abstract
Aim The present study aims to extend the knowledge of the neural correlates of emotion processing in first episode subjects affected by anorexia nervosa (AN) or bulimia nervosa (BN). We applied an emotional distress paradigm targeting negative emotions thought to be relevant for interpersonal difficulties and therapeutic resistance mechanisms. Methods The current study applied to 44 female participants with newly diagnosed AN or BN and 20 matched controls a neuroimaging paradigm eliciting affective responses. The measurements also included an extensive assessment comprising clinical scales, neuropsychological tests, measures of emotion processing and empathy. Results AN and BN did not differ from controls in terms of emotional response, emotion matching, self-reported empathy and cognitive performance. However, eating disorder and psychopathological clinical scores, as well as alexithymia levels, were increased in AN and BN. On a neural level, no significant group differences emerged, even when focusing on a region of interest selected a priori: the amygdala. Some interesting findings put in relation the hippocampal activity with the level of Body Dissatisfaction of the participants, the relative importance of the key nodes for the common network in the decoding of different emotions (BN = right amygdala, AN = anterior cingulate area), and the qualitative profile of the deactivations. Conclusions Our data do not support the hypothesis that participants with AN or BN display reduced emotional responsiveness. However, peculiar characteristics in emotion processing could be associated to the three different groups. Therefore, relational difficulties in eating disorders, as well as therapeutic resistance, could be not secondary to a simple difficulty in feeling and identifying basic negative emotions in AN and BN participants.
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Affiliation(s)
- Federico D’Agata
- Department of Neurosciences, University of Torino, Turin, Italy
- Computational Imaging Group for MR diagnostics & therapy, Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
- * E-mail:
| | - Paola Caroppo
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Angela Spalatro
- Department of Neurosciences, University of Torino, Turin, Italy
| | - Luca Lavagnino
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, UT Houston Medical School, Houston, Texas, United States of America
| | | | - Andrea Boghi
- ASL TO2 San Giovanni Bosco Hospital, Turin, Italy
| | - Mauro Bergui
- Department of Neurosciences, University of Torino, Turin, Italy
| | | | - Benedetto Vitiello
- Department of Public Health and Pediatric Sciences, University of Torino, Turin, Italy
| | - Secondo Fassino
- Department of Neurosciences, University of Torino, Turin, Italy
| | - Birgit Derntl
- Department for Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Abstract
Psychiatric disorders are studied at multiple levels, but there is no agreement on how these levels are related to each other, or how they should be understood in the first place. In this paper, I provide an account of levels and their relationships that is suited for psychopathology, drawing from recent debates in philosophy of science. Instead of metaphysical issues, the focus is on delivering an understanding of levels that is relevant and useful for scientific practice. I also defend a pragmatic approach to the question of reduction, arguing that even in-principle reductionists should embrace pluralism in practice. Finally, I discuss the benefits and challenges in integrating explanations and models of different levels.
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Affiliation(s)
- Markus I. Eronen
- Department of Theory and History of Psychology, University of Groningen, Grote Kruisstraat 2/1 9712 TS Groningen, Netherlands
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Kronström K, Multimäki P, Ristkari T, Parkkola K, Sillanmäki L, Sourander A. Ten-year changes in the psychosocial well-being, psychopathology, substance use, suicidality, bullying, and sense of coherence of 18-year-old males: a Finnish population-based time-trend study. Eur Child Adolesc Psychiatry 2021; 30:313-325. [PMID: 32232581 PMCID: PMC7932936 DOI: 10.1007/s00787-020-01517-4] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
Abstract
We studied Finnish 18-year-old males attending obligatory military call-up assessments in 1999 (n = 2340) and 2009 (n = 4309) on time-trend changes in psychosocial well-being, psychopathology, substance use, suicidality, bullying, and sense of coherence. Subjects filled in questionnaires, including the Young Adult Self-Report (YASR) for psychopathology and the Orientation to Life Questionnaire (SOC-13) for sense of coherence. The prevalence of minor mental health problems in the last 6 months decreased from 22.3% in 1999 to 18.6% in 2009 (OR 0.8, 95% CI 0.7-0.9), whereas severe mental health problems remained stable. Suicidal thoughts decreased from 5.7 to 3.7% (OR 0.6, 95% CI 0.5-0.8). The use of illicit drugs decreased from 6.0 to 4.7% (OR 0.8, 95% CI 0.6-0.95), but being drunk at least once a week increased from 10.3 to 13.4% (OR 1.3, 95% CI 1.0-1.5). Attention problems increased in YASR syndrome domains (mean score 2.9 vs 3.2, p < 0.001) and so did somatic complains (mean score 1.7 vs 1.9, p = 0.005). The SOC-13 scores remained stable. The percentage of males who had studied during the past 6 months increased from 91.4 to 93.4% (OR 1.3, 95% CI 1.1-1.6), while being employed decreased from 64.9 to 49.4% (OR 0.5, 95% CI 0.5-0.6). The positive findings included reductions in the prevalence of suicidal thoughts and the use of illicit drugs, but being drunk at least once a week increased. Self-reported somatic problems and attention problems increased. Despite changes in society and family structures, there were only minor overall changes in psychopathology.
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Affiliation(s)
- Kim Kronström
- Department of Adolescent Psychiatry, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Petteri Multimäki
- Department of Adolescent Psychiatry, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland
| | - Terja Ristkari
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | | | - Lauri Sillanmäki
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
- Department of Child Psychiatry, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland.
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Gillespie SM, Kongerslev MT, Bo S, Abu-Akel AM. Schizotypy and psychopathic tendencies interactively improve misattribution of affect in boys with conduct problems. Eur Child Adolesc Psychiatry 2021; 30:885-897. [PMID: 32476073 PMCID: PMC8140966 DOI: 10.1007/s00787-020-01567-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/25/2020] [Indexed: 11/26/2022]
Abstract
Psychopathic tendencies are associated with difficulties in affective theory of mind (ToM), that is, in recognizing others affective mental states. In clinical and non-clinical adult samples, it has been shown that where psychopathic tendencies co-occur with schizophrenia spectrum disorders, the impairing effects of psychopathic tendencies on ToM are attenuated. These effects are yet to be examined in adolescents. We examined if the impairing effect of psychopathic tendencies on affective ToM was attenuated with increasing severity of schizotypal personality disorder (PD) in a sample of 80 incarcerated adolescent boys. We showed that the impairing effect of psychopathic tendencies on the recognition of neutral mental states, but not positive or negative mental states, was evident when the relative severity of schizotypal PD was low. However, with higher scores on both measures, we observed better performance in judging neutral mental states. The preservation of affective ToM in adolescents who show elevations in psychopathic tendencies and schizotypal PD may enable them to manipulate and extort their victims for personal gain. Our results emphasize the need to consider comorbidity in clinical case formulation when working with adolescents with conduct problems and psychopathic tendencies. More broadly, our results also suggest that the pattern of social cognitive abilities associated with co-occurring psychopathology does not always conform to an often-theorized double-dose of deficit hypothesis.
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Affiliation(s)
- Steven M Gillespie
- Department of Psychological Sciences, University of Liverpool, Liverpool, L69 3GB, UK.
| | - Mickey T Kongerslev
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Sune Bo
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
- Department of Child and Adolescent Psychiatry, Region Zealand, Roskilde, Denmark
| | - Ahmad M Abu-Akel
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Haifa, Haifa, Israel
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Fried EI, von Stockert S, Haslbeck JMB, Lamers F, Schoevers RA, Penninx BWJH. Using network analysis to examine links between individual depressive symptoms, inflammatory markers, and covariates. Psychol Med 2020; 50:2682-2690. [PMID: 31615595 DOI: 10.1017/s0033291719002770] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies investigating the link between depressive symptoms and inflammation have yielded inconsistent results, which may be due to two factors. First, studies differed regarding the specific inflammatory markers studied and covariates accounted for. Second, specific depressive symptoms may be differentially related to inflammation. We address both challenges using network psychometrics. METHODS We estimated seven regularized Mixed Graphical Models in the Netherlands Study of Depression and Anxiety (NESDA) data (N = 2321) to explore shared variances among (1) depression severity, modeled via depression sum-score, nine DSM-5 symptoms, or 28 individual depressive symptoms; (2) inflammatory markers C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α); (3) before and after adjusting for sex, age, body mass index (BMI), exercise, smoking, alcohol, and chronic diseases. RESULTS The depression sum-score was related to both IL-6 and CRP before, and only to IL-6 after covariate adjustment. When modeling the DSM-5 symptoms and CRP in a conceptual replication of Jokela et al., CRP was associated with 'sleep problems', 'energy level', and 'weight/appetite changes'; only the first two links survived covariate adjustment. In a conservative model with all 38 variables, symptoms and markers were unrelated. Following recent psychometric work, we re-estimated the full model without regularization: the depressive symptoms 'insomnia', 'hypersomnia', and 'aches and pain' showed unique positive relations to all inflammatory markers. CONCLUSIONS We found evidence for differential relations between markers, depressive symptoms, and covariates. Associations between symptoms and markers were attenuated after covariate adjustment; BMI and sex consistently showed strong relations with inflammatory markers.
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Affiliation(s)
- E I Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - S von Stockert
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - J M B Haslbeck
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - F Lamers
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - R A Schoevers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Monterubio GE, Fitzsimmons-Craft EE, Balantekin KN, Sadeh-Sharvit S, Goel NJ, Laing O, Firebaugh ML, Flatt RE, Cavazos-Rehg P, Taylor CB, Wilfley DE. Eating disorder symptomatology, clinical impairment, and comorbid psychopathology in racially and ethnically diverse college women with eating disorders. Int J Eat Disord 2020; 53:1868-1874. [PMID: 32918315 PMCID: PMC7669650 DOI: 10.1002/eat.23380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/23/2020] [Accepted: 08/11/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To examine eating disorder (ED) symptomatology, related clinical impairment, and comorbid psychopathology in college women with EDs across five racial and two ethnic groups. METHOD Participants were 690 women from 28 US universities who screened positive for an ED. Thirteen variables assessing ED symptoms, related clinical impairment, and comorbid psychopathology were compared across racial and ethnic groups using analyses of variance (ANOVAs) and independent samples t-tests. RESULTS Across racial groups, significant differences emerged in binge eating and laxative use. Asian women reported significantly more binge eating than White women (p < .01). Individuals self-identified as the "Other" racial group reported greater laxative use than Asian and White women (ps ≤ .01). No other significant differences emerged across all other variables (ps ≥ .13). Across ethnic groups, Hispanic women reported significantly more laxative use (p < .01), and more comorbid insomnia symptoms (p = .03) than non-Hispanic women. No other significant differences were observed (ps ≥ .24). DISCUSSION Findings suggest that binge eating, laxative use, and insomnia symptoms differ across racial and ethnic groups in US college women who screened positive for EDs. Findings can inform tailoring of ED screening to reduce current disparities in these underrepresented populations.
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Affiliation(s)
- Grace E Monterubio
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Katherine N Balantekin
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- University of New York at Buffalo, Buffalo, New York, USA
| | - Shiri Sadeh-Sharvit
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
| | - Neha J Goel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Institue for Inclusion, Inquiry and Innovation (iCubed), Virginia Commonwealth University, Richmond, Virginia, USA
| | - Olivia Laing
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Rachael E Flatt
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Dingemans AE, van Son GE, Vanhaelen CB, van Furth EF. Depressive symptoms rather than executive functioning predict group cognitive behavioural therapy outcome in binge eating disorder. Eur Eat Disord Rev 2020; 28:620-632. [PMID: 32692421 PMCID: PMC7689843 DOI: 10.1002/erv.2768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/15/2020] [Accepted: 06/22/2020] [Indexed: 12/15/2022]
Abstract
Executive functions play an important role in mediating self-control and self-regulation. It has been suggested that the inability to control eating in Binge Eating Disorder (BED) may indicate inefficiencies in executive functioning. This study investigated whether executive functioning predicted cognitive behavioural therapy outcome in BED while accounting for other possible predictors: depressive symptoms, interpersonal factors, eating disorder psychopathology, and self-esteem. Executive functioning and other predictors were assessed in 91 patients with BED by means of neuropsychological tests and questionnaires at baseline. Eating disorder (ED) symptoms were assessed during treatment at variable time points. Potential predictor variables were investigated using multivariate Cox regression models. Recovery was defined by means of two different indicators based on the Eating Disorder Examination-Questionnaire: (a) showing a 50% reduction in baseline symptom ED severity and/or reaching the clinical significance cut-off; and (b) achieving abstinence of objective binge eating. Severity of depressive symptoms was a significant predictor for outcome on both indicators. Patients with no or mild depressive symptoms recovered faster (i.e., 50% reduction in ED symptoms and abstinence of objective binge eating) than those with severe depressive symptoms, which is in line with previous studies. Executive functioning was not related to treatment outcome in this study.
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Affiliation(s)
- Alexandra E. Dingemans
- Rivierduinen Eating Disorders UrsulaLeidenThe Netherlands
- Institute of PsychologyLeiden UniversityLeidenThe Netherlands
| | | | | | - Eric F. van Furth
- Rivierduinen Eating Disorders UrsulaLeidenThe Netherlands
- Department of PsychiatryLeiden University Medical CenterLeidenThe Netherlands
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11
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Schreuder MJ, Hartman CA, George SV, Menne-Lothmann C, Decoster J, van Winkel R, Delespaul P, De Hert M, Derom C, Thiery E, Rutten BPF, Jacobs N, van Os J, Wigman JTW, Wichers M. Early warning signals in psychopathology: what do they tell? BMC Med 2020; 18:269. [PMID: 33050891 PMCID: PMC7557008 DOI: 10.1186/s12916-020-01742-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 08/10/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Despite the increasing understanding of factors that might underlie psychiatric disorders, prospectively detecting shifts from a healthy towards a symptomatic state has remained unattainable. A complex systems perspective on psychopathology implies that such symptom shifts may be foreseen by generic indicators of instability, or early warning signals (EWS). EWS include, for instance, increasing variability, covariance, and autocorrelation in momentary affective states-of which the latter was studied. The present study investigated if EWS predict (i) future worsening of symptoms as well as (ii) the type of symptoms that will develop, meaning that the association between EWS and future symptom shifts would be most pronounced for congruent affective states and psychopathological domains (e.g., feeling down and depression). METHODS A registered general population cohort of adolescents (mean age 18 years, 36% male) provided ten daily ratings of their affective states for 6 consecutive days. The resulting time series were used to compute EWS in feeling down, listless, anxious, not relaxed, insecure, suspicious, and unwell. At baseline and 1-year follow-up, symptom severity was assessed by the Symptom Checklist-90 (SCL-90). We selected four subsamples of participants who reported an increase in one of the following SCL-90 domains: depression (N = 180), anxiety (N = 192), interpersonal sensitivity (N = 184), or somatic complaints (N = 166). RESULTS Multilevel models showed that EWS in feeling suspicious anticipated increases in interpersonal sensitivity, as hypothesized. EWS were absent for other domains. While the association between EWS and symptom increases was restricted to the interpersonal sensitivity domain, post hoc analyses showed that symptom severity at baseline was related to heightened autocorrelations in congruent affective states for interpersonal sensitivity, depression, and anxiety. This pattern replicated in a second, independent dataset. CONCLUSIONS The presence of EWS prior to symptom shifts may depend on the dynamics of the psychopathological domain under consideration: for depression, EWS may manifest only several weeks prior to a shift, while for interpersonal sensitivity, EWS may already occur 1 year in advance. Intensive longitudinal designs where EWS and symptoms are assessed in real-time are required in order to determine at what timescale and for what type of domain EWS are most informative of future psychopathology.
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Affiliation(s)
- Marieke J Schreuder
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Internal Postal Code: CC72, Triade Building Entrance 24, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Internal Postal Code: CC72, Triade Building Entrance 24, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Sandip V George
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Internal Postal Code: CC72, Triade Building Entrance 24, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Claudia Menne-Lothmann
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Universiteitssingel 40, 6299 ER, Maastricht, The Netherlands
| | - Jeroen Decoster
- University Psychiatric Centre, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Ruud van Winkel
- University Psychiatric Centre, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Universiteitssingel 40, 6299 ER, Maastricht, The Netherlands
- Mondriaan Mental Health Care, John F. Kennedylaan 301, 6419 XZ, Heerlen, The Netherlands
| | - Marc De Hert
- University Psychiatric Centre, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Antwerp Health Law and Ethics Chair - AHLEC, University of Antwerp, Antwerp, Belgium
| | - Catherine Derom
- Centre of Human Genetics, University Hospital Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Evert Thiery
- Department of Neurology, Ghent University Hospital, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Universiteitssingel 40, 6299 ER, Maastricht, The Netherlands
| | - Nele Jacobs
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Universiteitssingel 40, 6299 ER, Maastricht, The Netherlands
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Valkenburgerweg 177, 6419 AT, Heerlen, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Universiteitssingel 40, 6299 ER, Maastricht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, London, SE5 8AF, UK
- Department Psychiatry, Brain Center Rudolf Magnus,, Utrecht University Medical Centre, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Internal Postal Code: CC72, Triade Building Entrance 24, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Internal Postal Code: CC72, Triade Building Entrance 24, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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12
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Spiller TR, Levi O, Neria Y, Suarez-Jimenez B, Bar-Haim Y, Lazarov A. On the validity of the centrality hypothesis in cross-sectional between-subject networks of psychopathology. BMC Med 2020; 18:297. [PMID: 33040734 PMCID: PMC7549218 DOI: 10.1186/s12916-020-01740-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the network approach to psychopathology, psychiatric disorders are considered networks of causally active symptoms (nodes), with node centrality hypothesized to reflect symptoms' causal influence within a network. Accordingly, centrality measures have been used in numerous network-based cross-sectional studies to identify specific treatment targets, based on the assumption that deactivating highly central nodes would proliferate to other nodes in the network, thereby collapsing the network structure and alleviating the overall psychopathology (i.e., the centrality hypothesis). METHODS Here, we summarize three types of evidence pertaining to the centrality hypothesis in psychopathology. First, we discuss the validity of the theoretical assumptions underlying the centrality hypothesis in psychopathology. We then summarize the methodological aspects of extant studies using centrality measures as predictors of symptom change following treatment, while delineating their main findings and several of their limitations. Finally, using a specific dataset of 710 treatment-seeking patients with posttraumatic stress disorder (PTSD) as an example, we empirically examine node centrality as a predictor of therapeutic change, replicating the approach taken by previous studies, while addressing some of their limitations. Specifically, we investigated whether three pre-treatment centrality indices (strength, predictability, and expected influence) were significantly correlated with the strength of the association between a symptom's change and the change in the severity of all other symptoms in the network from pre- to post-treatment (Δnode-Δnetwork association). Using similar analyses, we also examine the predictive validity of two simple non-causal node properties (mean symptom severity and infrequency of symptom endorsement). RESULTS Of the three centrality measures, only expected influence successfully predicted how strongly changes in nodes/symptoms were associated with change in the remainder of the nodes/symptoms. Importantly, when excluding the amnesia node, a well-documented outlier in the phenomenology of PTSD, none of the tested centrality measures predicted symptom change. Conversely, both mean symptom severity and infrequency of symptom endorsement, two standard non-network-derived indices, were found to be more predictive than expected influence and remained significantly predictive also after excluding amnesia from the network analyses. CONCLUSIONS The centrality hypothesis in its current form is ill-defined, showing no consistent supporting evidence in the context of cross-sectional, between-subject networks.
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Affiliation(s)
- Tobias R Spiller
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.
| | - Ofir Levi
- Division of Mental Health, Medical Corps, Israel Defense Forces, Tel Aviv, Israel
- Social Work Department, Ruppin Academic Center, Emek Hefer, Israel
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Neria
- Departments of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Benjamin Suarez-Jimenez
- Departments of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Amit Lazarov
- Departments of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
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13
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Abstract
BACKGROUND Psychopathology research is changing focus from group-based "disease models" to a personalized approach inspired by complex systems theories. This approach, which has already produced novel and valuable insights into the complex nature of psychopathology, often relies on repeated self-ratings of individual patients. So far, it has been unknown whether such self-ratings, the presumed observables of the individual patient as a complex system, actually display complex dynamics. We examine this basic assumption of a complex systems approach to psychopathology by testing repeated self-ratings for three markers of complexity: memory, the presence of (time-varying) short- and long-range temporal correlations; regime shifts, transitions between different dynamic regimes; and sensitive dependence on initial conditions, also known as the "butterfly effect," the divergence of initially similar trajectories. METHODS We analyzed repeated self-ratings (1476 time points) from a single patient for the three markers of complexity using Bartels rank test, (partial) autocorrelation functions, time-varying autoregression, a non-stationarity test, change point analysis, and the Sugihara-May algorithm. RESULTS Self-ratings concerning psychological states (e.g., the item "I feel down") exhibited all complexity markers: time-varying short- and long-term memory, multiple regime shifts, and sensitive dependence on initial conditions. Unexpectedly, self-ratings concerning physical sensations (e.g., the item "I am hungry") exhibited less complex dynamics and their behavior was more similar to random variables. CONCLUSIONS Psychological self-ratings display complex dynamics. The presence of complexity in repeated self-ratings means that we have to acknowledge that (1) repeated self-ratings yield a complex pattern of data and not a set of (nearly) independent data points, (2) humans are "moving targets" whose self-ratings display non-stationary change processes including regime shifts, and (3) long-term prediction of individual trajectories may be fundamentally impossible. These findings point to a limitation of popular statistical time series models whose assumptions are violated by the presence of these complexity markers. We conclude that a complex systems approach to mental health should appreciate complexity as a fundamental aspect of psychopathology research by adopting the models and methods of complexity science. Promising first steps in this direction, such as research on real-time process monitoring, short-term prediction, and just-in-time interventions, are discussed.
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Affiliation(s)
- Merlijn Olthof
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Fred Hasselman
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- School of Pedagogical and Educational Sciences, Radboud University, Nijmegen, The Netherlands
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14
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Branje S, Geeraerts S, de Zeeuw EL, Oerlemans AM, Koopman-Verhoeff ME, Schulz S, Nelemans S, Meeus W, Hartman CA, Hillegers MHJ, Oldehinkel AJ, Boomsma DI. Intergenerational transmission: Theoretical and methodological issues and an introduction to four Dutch cohorts. Dev Cogn Neurosci 2020; 45:100835. [PMID: 32823179 PMCID: PMC7451818 DOI: 10.1016/j.dcn.2020.100835] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/27/2020] [Accepted: 08/04/2020] [Indexed: 01/09/2023] Open
Abstract
Behaviors, traits and characteristics are transmitted from parents to offspring because of complex genetic and non-genetic processes. We review genetic and non-genetic mechanisms of intergenerational transmission of psychopathology and parenting and focus on recent methodological advances in disentangling genetic and non-genetic factors. In light of this review, we propose that future studies on intergenerational transmission should aim to disentangle genetic and non-genetic transmission, take a long-term longitudinal perspective, and focus on paternal and maternal intergenerational transmission. We present four large longitudinal cohort studies within the Consortium on Individual Development, which together address many of these methodological challenges. These four cohort studies aim to examine the extent to which genetic and non-genetic transmission from the parental generation shapes parenting behavior and psychopathology in the next generation, as well as the extent to which self-regulation and social competence mediate this transmission. Conjointly, these four cohorts provide a comprehensive approach to the study of intergenerational transmission.
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Affiliation(s)
- Susan Branje
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Sanne Geeraerts
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Eveline L de Zeeuw
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anoek M Oerlemans
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - M Elisabeth Koopman-Verhoeff
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Susanne Schulz
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Stefanie Nelemans
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Wim Meeus
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Albertine J Oldehinkel
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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15
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Liang Y, Zhou Y, Ruzek JI, Liu Z. Patterns of childhood trauma and psychopathology among Chinese rural-to-urban migrant children. Child Abuse Negl 2020; 108:104691. [PMID: 32854057 DOI: 10.1016/j.chiabu.2020.104691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 07/22/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Exposure to childhood trauma can cause psychopathology and negative psychosocial outcomes across the lifespan. Rural-to-urban migrant children are commonly exposed to traumatic experiences (TEs). However, no study has comprehensively examined patterns of childhood trauma in Chinese culture. The current study aimed to examine patterns of childhood trauma exposure among Chinese rural-to-urban migrant children. METHODS A large-scale (N = 15,890) cross-sectional survey of rural-to-urban migrant workers' children in grades 4 to 9 was conducted in Beijing. Childhood TEs, including accidents and injuries, interpersonal violence, and vicarious trauma, as well as demographics and internalizing and externalizing behaviors, were measured. RESULTS Four patterns of childhood trauma were found: low trauma exposure (60.4%), vicarious trauma exposure (23.9%), domestic violence exposure (10.5%), and multiple trauma exposure (5.3%). Age, gender, parents' marital status, father's education level, family support and peer support differentiated the four TE patterns. Both internalizing and externalizing behaviors were more severe in patterns with more types of TEs. CONCLUSIONS Our findings provide a better understanding of childhood trauma in Chinese culture and the relationship between TEs and mental health. Clinicians and policy makers should tailor prevention and treatment programs according to different patterns of victimization.
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Affiliation(s)
- Yiming Liang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - Yueyue Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - Josef I Ruzek
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China.
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16
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Braun TD, Quinn DM, Stone A, Gorin AA, Ferrand J, Puhl RM, Sierra J, Tishler D, Papasavas P. Weight Bias, Shame, and Self-Compassion: Risk/Protective Mechanisms of Depression and Anxiety in Prebariatic Surgery Patients. Obesity (Silver Spring) 2020; 28:1974-1983. [PMID: 32808737 PMCID: PMC8650800 DOI: 10.1002/oby.22920] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/30/2020] [Accepted: 05/14/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Psychopathology in bariatric surgery patients may contribute to adverse postoperative sequelae, including weight regain, substance use, and self-harm. This cross-sectional study aimed to advance the understanding of the risk and protective paths through which weight bias associates with depressive and anxiety symptoms in bariatric surgery candidates (BSC). METHODS BSC recruited from a surgical clinic (N = 213, 82.2% women, 43 [SD 12] years, mean BMI: 49 [SD 9] kg/m2 ) completed measures of experienced weight bias (EWB), internalized weight bias (IWB), body and internalized shame, and self-compassion; anxiety and depression screeners were accessed from medical charts. Multiple regression and PROCESS bootstrapping estimates tested our hypothesized mediation model as follows: EWB→IWB→body shame→shame→self-compassion→symptoms. RESULTS After accounting for EWB and IWB, internalized shame accounted for greater variance in both end points than body shame. EWB was associated with greater anxiety through risk paths implicating IWB, body shame, and/or internalized shame. Protective paths associated EWB with fewer depressive and anxiety symptoms among those with higher self-compassion. CONCLUSIONS The findings suggest a potentially important role for weight bias and shame in psychological health among BSC and implicate self-compassion, a trainable affect-regulation strategy, as a protective factor that may confer some resiliency. Future research using longitudinal and causal designs is warranted.
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Affiliation(s)
- Tosca D Braun
- Department of Psychiatry and Human Behavior, The Miriam Hospital and Alpert Medical School of Medicine, Brown University, Providence, Rhode Island, USA
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Diane M Quinn
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Andrea Stone
- Surgical Weight Loss Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Amy A Gorin
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Jennifer Ferrand
- Institute of Living, Division of Health Psychology, Hartford Hospital, Hartford, Connecticut, USA
| | - Rebecca M Puhl
- Department of Human Development & Family Sciences, Rudd Center for Food Policy & Obesity, University of Connecticut, Storrs, Connecticut, USA
| | - Jessica Sierra
- Institute of Living, Division of Health Psychology, Hartford Hospital, Hartford, Connecticut, USA
| | - Darren Tishler
- Surgical Weight Loss Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Pavlos Papasavas
- Surgical Weight Loss Center, Hartford Hospital, Hartford, Connecticut, USA
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17
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Abstract
BACKGROUND A dominant methodology in contemporary clinical neuroscience is the use of dimensional self-report questionnaires to measure features such as psychological traits (e.g., trait anxiety) and states (e.g., depressed mood). These dimensions are then mapped to biological measures and computational parameters. Researchers pursuing this approach tend to equate a symptom inventory score (plus noise) with some latent psychological trait. MAIN TEXT We argue this approach implies weak, tacit, models of traits that provide fixed predictions of individual symptoms, and thus cannot account for symptom trajectories within individuals. This problem persists because (1) researchers are not familiarized with formal models that relate internal traits to within-subject symptom variation and (2) rely on an assumption that trait self-report inventories accurately indicate latent traits. To address these concerns, we offer a computational model of trait depression that demonstrates how parameters instantiating a given trait remain stable while manifest symptom expression varies predictably. We simulate patterns of mood variation from both the computational model and the standard self-report model and describe how to quantify the relative validity of each model using a Bayesian procedure. CONCLUSIONS Ultimately, we would urge a tempering of a reliance on self-report inventories and recommend a shift towards developing mechanistic trait models that can explain within-subject symptom dynamics.
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Affiliation(s)
- Paul B Sharp
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK.
- Wellcome Centre for Human Neuroimaging, University College London, London, UK.
| | - Gregory A Miller
- University of California, Los Angeles, USA
- University of Illinois at Urbana-Champaign, Champaign, USA
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Eran Eldar
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- The Hebrew University of Jerusalem, Jerusalem, IL, Israel
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18
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Wagner AF, Zickgraf HF, Lane-Loney S. Caregiver accommodation in adolescents with avoidant/restrictive food intake disorder and anorexia nervosa: Relationships with distress, eating disorder psychopathology, and symptom change. Eur Eat Disord Rev 2020; 28:657-670. [PMID: 32896966 DOI: 10.1002/erv.2786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/21/2020] [Revised: 07/13/2020] [Accepted: 08/02/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The role of family and caregiver accommodation is a well-defined maintenance factor for anxiety disorders and OCD. Family accommodation for patients with eating disorders is beginning to be described and characterized, but gaps in the literature remain. The current project compares levels of accommodation in families of those with anorexia nervosa (AN) to those with avoidant/restrictive food intake disorder (ARFID). It additionally establishes whether accommodation changes over the course of treatment and the extent to which these changes are related to changes in eating disorder pathology. METHODS A total of 39 adolescents with ARFID and 59 with AN presenting to a partial hospitalization program were included, with measures completed at intake and discharge. RESULTS Caregivers of adolescents with AN and those with ARFID reported similar levels of accommodation, with the exception of the Reassurance Seeking subscale of the Accommodation and Enabling Scale for Eating Disorders (AESED). Additionally, accommodation decreased significantly from intake to discharge for both patient groups. Intake AESED scores were also significantly related to caregiver distress, and changes in AESED scores were related to decreases in relevant eating disorder psychopathology for both groups. CONCLUSIONS The results of the current study highlight the importance of considering family accommodation for ARFID patients and point to the need for future research to capture changes in accommodation over the course of treatment in relation to the delivery of evidence-based interventions and subsequent changes in ED symptoms.
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Affiliation(s)
- Allison F Wagner
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Psychology, Clinical Studies Program, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Hana F Zickgraf
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Susan Lane-Loney
- Department of Adolescent Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
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19
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Bozzatello P, De Rosa ML, Rocca P, Bellino S. Effects of Omega 3 Fatty Acids on Main Dimensions of Psychopathology. Int J Mol Sci 2020; 21:ijms21176042. [PMID: 32839416 PMCID: PMC7504659 DOI: 10.3390/ijms21176042] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/11/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
The usefulness of polyunsaturated fatty acids on inflammatory, cardiovascular, and the nervous system was studied in the last decades, but the mechanisms underlying their benefic properties are still partially unknown. These agents seem to express their action on the membrane phospholipid composition and permeability and modulation of second messenger cascades. In psychiatry, the efficacy and tolerability of omega-3 fatty acids were investigated in several psychiatric disorders, including major depression, bipolar disorder, personality disorders, high-risk conditions to develop psychosis, attention-deficit hyperactivity disorder, and autism spectrum disorders. Initial findings in this field are promising, and some relevant questions need to be addressed. In particular, the effects of these agents on the main symptom dimensions have to be investigated in a trans-diagnostic perspective. The present systematic review is aimed to examine the available data on the efficacy of omega-3 fatty acids on domains of psychotic symptoms, affective symptoms, impulsivity, and aggressiveness, and harmful behaviors, and suicide risk.
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Affiliation(s)
- Paola Bozzatello
- Department of Neuroscience, Faculty of Medicine, University of Turin, 10126 Turin, Italy; (P.B.); (M.L.D.R.); (P.R.)
- Center for Personality Disorders, Psychiatric Clinic, 10126 Turin, Italy
| | - Maria Laura De Rosa
- Department of Neuroscience, Faculty of Medicine, University of Turin, 10126 Turin, Italy; (P.B.); (M.L.D.R.); (P.R.)
- Center for Personality Disorders, Psychiatric Clinic, 10126 Turin, Italy
| | - Paola Rocca
- Department of Neuroscience, Faculty of Medicine, University of Turin, 10126 Turin, Italy; (P.B.); (M.L.D.R.); (P.R.)
| | - Silvio Bellino
- Department of Neuroscience, Faculty of Medicine, University of Turin, 10126 Turin, Italy; (P.B.); (M.L.D.R.); (P.R.)
- Center for Personality Disorders, Psychiatric Clinic, 10126 Turin, Italy
- Correspondence: ; Tel.: +39-011-6634848; Fax: +39-011-673473
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20
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Haines N, Beauchaine TP. Moving beyond Ordinary Factor Analysis in Studies of Personality and Personality Disorder: A Computational Modeling Perspective. Psychopathology 2020; 53:157-167. [PMID: 32663821 PMCID: PMC7529707 DOI: 10.1159/000508539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/06/2020] [Indexed: 01/03/2023]
Abstract
Almost all forms of psychopathology, including personality disorders, are arrived at through complex interactions among neurobiological vulnerabilities and environmental risk factors across development. Yet despite increasing recognition of etiological complexity, psychopathology research is still dominated by searches for large main effects causes. This derives in part from reliance on traditional inferential methods, including ordinary factor analysis, regression, ANCOVA, and other techniques that use statistical partialing to isolate unique effects. In principle, some of these methods can accommodate etiological complexity, yet as typically applied they are insensitive to interactive functional dependencies (modulating effects) among etiological influences. Here, we use our developmental model of antisocial and borderline traits to illustrate challenges faced when modeling complex etiological mechanisms of psychopathology. We then consider how computational models, which are rarely used in the personality disorders literature, remedy some of these challenges when combined with hierarchical Bayesian analysis.
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Affiliation(s)
- Nathaniel Haines
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
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21
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Abstract
In this editorial for the collection on complexity in mental health research, we introduce and summarize the inaugural contributions to this collection: a series of theoretical, methodological, and empirical papers that aim to chart a path forward for investigating mental health in all its complexity. A central theme emerges from these contributions: if we are to make genuine progress in explaining, predicting, and treating mental illness, we must study the systems from which psychopathology emerges. As the articles in this collection make clear, the systems that give rise to psychopathology encompass a host of components across biological, psychological, and social levels of analysis, intertwined in a web of complex interactions. The task of advancing our understanding of these systems will be a challenging one. Yet, this challenge presents a unique opportunity. From physics to ecology, there is a rapidly evolving body of interdisciplinary research dedicated to investigating complex systems. This work provides clear guidance for psychiatric research, opportunities for collaboration, and a set of tools and concepts from which we can draw in our efforts to understand mental health, helping us move toward our ultimate aim of improving the prevention and treatment of psychopathology.
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Affiliation(s)
- Eiko I. Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Donald J. Robinaugh
- Department of Psychiatry, Harvard Medical School & Massachusetts General Hospital, Boston, MA USA
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22
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Cao X, Wang L, Cao C, Fang R, Chen C, Hall BJ, Elhai JD. Depicting the associations between different forms of psychopathology in trauma-exposed adolescents. Eur Child Adolesc Psychiatry 2020; 29:827-837. [PMID: 31489500 DOI: 10.1007/s00787-019-01400-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/09/2019] [Accepted: 08/30/2019] [Indexed: 01/21/2023]
Abstract
Psychiatric comorbidity in traumatized youth is prevalent, but such associations between two disorders may be confounded with other comorbid conditions. Few studies have examined the unique relationships among multiple disorders. Which disorders maximally explain the relationships between others and whether such disorders differ by sex remain largely unknown. Using a construct-level network approach, this study characterized the independent associations among nine prevalent emotional and behavioral disorders/problems evaluated by the PTSD Checklist for DSM-5, the Revised Children's Anxiety and Depression Scale, and the Youth Self-Report in a sample of 1181 disaster-exposed adolescents (53.9% girls; a mean age of 14.3 ± 0.8 years). The associations were strong among the seven internalizing problems and between the two externalizing ones, but weaker between these two spectra of psychopathology. Major depressive disorder (MDD) was most strongly connected with others, maximally accounting for the associations, especially those between the two spectra. Overall and individual association strength and the connecting role of MDD were generally equivalent across sex. These findings highlight the necessity of MDD in linking comorbid forms of psychopathology in traumatized youth, and suggest MDD as a potential intervention priority in this population.
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Affiliation(s)
- Xing Cao
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China.
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Chengqi Cao
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ruojiao Fang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Chen
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, OH, USA
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
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de Jong M, Spinhoven P, Korrelboom K, Deen M, van der Meer I, Danner UN, van der Schuur S, Schoorl M, Hoek HW. Effectiveness of enhanced cognitive behavior therapy for eating disorders: A randomized controlled trial. Int J Eat Disord 2020; 53:447-457. [PMID: 32040244 PMCID: PMC7317943 DOI: 10.1002/eat.23239] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Enhanced cognitive behavior therapy (CBT-E) is a transdiagnostic treatment suitable for the full range of eating disorders (EDs). Although the effectiveness of CBT(-E) is clear, it is not being used as widely in clinical practice as guidelines recommend. The aim of the present study was to compare the effectiveness of CBT-E with treatment as usual (TAU), which was largely based on CBT principles. METHOD We conducted a randomized controlled trial on a total of 143 adult patients with an ED who received either CBT-E or TAU. The primary outcome was recovery from the ED. Secondary outcome measures were levels of ED psychopathology, anxiety, and depressive symptoms. Self-esteem, perfectionism, and interpersonal problems were repeatedly measured to examine possible moderating effects. We explored differences in duration and intensity between conditions. RESULTS After 80 weeks, there were no differences between conditions in decrease in ED psychopathology, or symptoms of anxiety and depression. However, in the first six weeks of treatment there was a larger decrease in ED psychopathology in the CBT-E condition. Moreover, when the internationally most widely used definition of recovery was applied, the recovery rate at 20 weeks of CBT-E was significantly higher (57.7%) than of TAU (36.0%). At 80 weeks, this difference was no longer significant (CBT-E 60.9%; TAU 43.6%). Furthermore, CBT-E was more effective in improving self-esteem and was also the less intensive and shorter treatment. DISCUSSION With broader use of CBT-E, the efficiency, accessibility and effectivity (on self-esteem) of treatment for EDs could be improved.
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Affiliation(s)
- Martie de Jong
- Center for Eating DisordersPsyQ, Part of Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden UniversityLeidenThe Netherlands
- Department of PsychiatryLeiden University Medical CenterLeidenThe Netherlands
| | - Kees Korrelboom
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Methodology and Statistics Unit, Institute of PsychologyLeiden UniversityLeidenThe Netherlands
| | - Iris van der Meer
- Center for Eating DisordersPsyQ, Part of Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
| | | | - Selma van der Schuur
- Center for Eating Disorders—PsyQPart of Lentis Psychiatric InstituteGroningenThe Netherlands
| | - Maartje Schoorl
- Institute of Psychology, Leiden UniversityLeidenThe Netherlands
| | - Hans W. Hoek
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Department of PsychiatryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of EpidemiologyColumbia University, Mailman School of Public HealthNew YorkNew York
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McLaughlin KA, Colich NL, Rodman AM, Weissman DG. Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience. BMC Med 2020; 18:96. [PMID: 32238167 PMCID: PMC7110745 DOI: 10.1186/s12916-020-01561-6] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/17/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transdiagnostic processes confer risk for multiple types of psychopathology and explain the co-occurrence of different disorders. For this reason, transdiagnostic processes provide ideal targets for early intervention and treatment. Childhood trauma exposure is associated with elevated risk for virtually all commonly occurring forms of psychopathology. We articulate a transdiagnostic model of the developmental mechanisms that explain the strong links between childhood trauma and psychopathology as well as protective factors that promote resilience against multiple forms of psychopathology. MAIN BODY We present a model of transdiagnostic mechanisms spanning three broad domains: social information processing, emotional processing, and accelerated biological aging. Changes in social information processing that prioritize threat-related information-such as heightened perceptual sensitivity to threat, misclassification of negative and neutral emotions as anger, and attention biases towards threat-related cues-have been consistently observed in children who have experienced trauma. Patterns of emotional processing common in children exposed to trauma include elevated emotional reactivity to threat-related stimuli, low emotional awareness, and difficulties with emotional learning and emotion regulation. More recently, a pattern of accelerated aging across multiple biological metrics, including pubertal development and cellular aging, has been found in trauma-exposed children. Although these changes in social information processing, emotional responding, and the pace of biological aging reflect developmental adaptations that may promote safety and provide other benefits for children raised in dangerous environments, they have been consistently associated with the emergence of multiple forms of internalizing and externalizing psychopathology and explain the link between childhood trauma exposure and transdiagnostic psychopathology. Children with higher levels of social support, particularly from caregivers, are less likely to develop psychopathology following trauma exposure. Caregiver buffering of threat-related processing may be one mechanism explaining this protective effect. CONCLUSION Childhood trauma exposure is a powerful transdiagnostic risk factor associated with elevated risk for multiple forms of psychopathology across development. Changes in threat-related social and emotional processing and accelerated biological aging serve as transdiagnostic mechanisms linking childhood trauma with psychopathology. These transdiagnostic mechanisms represent critical targets for early interventions aimed at preventing the emergence of psychopathology in children who have experienced trauma.
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Affiliation(s)
- Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA.
| | - Natalie L Colich
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195, USA
| | - Alexandra M Rodman
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA
| | - David G Weissman
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA
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25
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Oltmanns JR, Rivera JR, Cole J, Merchant A, Steiner JP. Personality psychopathology: Longitudinal prediction of change in body mass index and weight post-bariatric surgery. Health Psychol 2020; 39:245-254. [PMID: 31944798 PMCID: PMC7021354 DOI: 10.1037/hea0000842] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Bariatric surgery is an effective treatment for obesity, which has been increasing worldwide. However, bariatric surgery causes dramatic physical changes that can cause significant stress. Prior research has found that psychological variables such as personality traits and levels of psychopathology can influence success after bariatric surgery (in terms of body mass index [BMI] reduction and weight loss). However, most prior studies have been limited by small sample sizes, inconsistent follow up, and categorical assessment of psychopathology. METHOD The present study examines the predictive utility of the Personality Assessment Inventory (PAI) scales for three bariatric surgery outcomes (BMI reduction, weight loss, and percent excess weight loss [%EWL]) across 10 follow-up points 5 years after surgery. It also examines the largest sample of bariatric surgery-completing patients (N = 2,267) on the PAI to date. Latent growth modeling was used to examine change in the outcome variables. RESULTS Results indicate that personality and psychopathology variables predicted less BMI reduction, weight loss, and %EWL 5 years after surgery and also affected the trajectories of change in the outcome variables across time. The PAI scales predicted more variance in the 5-year BMI outcomes than did age and gender. The most robust effects were for scales assessing phobias, traumatic stress, identity problems, and negative relationships. CONCLUSION The PAI may be useful to clinical health psychologists who conduct recommended psychological evaluations with potential bariatric surgery candidates. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Jonathan Cole
- Bluegrass Health Psychology
- St. Joseph’s Center for Weight Loss Surgery
| | - Amanda Merchant
- Bluegrass Health Psychology
- St. Joseph’s Center for Weight Loss Surgery
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Lydecker JA, Cotter E, Grilo CM. Associations of Weight Bias with Disordered Eating Among Latino and White Men. Obesity (Silver Spring) 2019; 27:1982-1987. [PMID: 31603628 PMCID: PMC6868326 DOI: 10.1002/oby.22632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/03/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study examined associations of different aspects of weight bias, which can include negative attitudes toward and beliefs about obesity, with eating/weight-related psychopathology. METHODS Participants (N = 544) were White (n = 376) and Latino (n = 168) men living in the United States who completed an online battery of established measures of weight bias (both attitudes toward and beliefs about obesity) and eating/weight-related psychopathology. RESULTS Among White men, negative attitudes toward obesity were associated significantly with dietary restraint, overvaluation of weight/shape, and body dissatisfaction, whereas among Latino men, negative attitudes toward obesity were associated significantly with overvaluation of weight/shape. Among White men, less negative attitudes toward people with obesity were associated with decreased use of compensatory behaviors, and weaker beliefs about the controllabilty of obesity were associated with decreased overeating and binge eating. Among Latino men, neither attitudes about people with obesity nor beliefs about the controllability of obesity were associated with eating-disordered behaviors. CONCLUSIONS Weight bias was related to eating/weight-related psychopathology in men, with fewer associations observed among Latino men than White men. This highlights that associations with psychopathology may vary by ethnicity. Future research is needed to clarify the mechanism by which weight-biased attitudes and beliefs are associated with eating/weight-related psychopathology and why this might differ between White and Latino men.
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Affiliation(s)
| | - Elizabeth Cotter
- Department of Health Studies, American University, Washington, DC
| | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
- Department of Psychology, Yale University, New Haven, CT
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Chao AM, Wadden TA, Walsh OA, Gruber KA, Alamuddin N, Berkowitz RI, Tronieri JS. Effects of Liraglutide and Behavioral Weight Loss on Food Cravings, Eating Behaviors, and Eating Disorder Psychopathology. Obesity (Silver Spring) 2019; 27:2005-2010. [PMID: 31746553 PMCID: PMC6873814 DOI: 10.1002/oby.22653] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/29/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE This exploratory analysis examined the effects of intensive behavioral therapy (IBT) for obesity ("IBT-alone"), IBT plus liraglutide 3.0 mg/d ("IBT-liraglutide"), and IBT plus liraglutide 3.0 mg/d plus 12 weeks of a portion-controlled diet that provided 1,000 to 1,200 kcal/d ("Multicomponent") on changes in food cravings, eating behaviors, and eating disorder psychopathology at 24 and 52 weeks post randomization. METHODS Adults with obesity (mean age = 47.6 ± 11.8 years and BMI = 38.4 ± 4.9 kg/m2 ; 79.3% female; 54.0% non-Hispanic white; 44.7% black) were randomized to IBT-alone (n = 50), IBT-liraglutide (n = 50), or Multicomponent (n = 50). RESULTS At weeks 24 and 52, liraglutide-treated groups reported significantly larger declines in weight concern relative to the IBT-alone group. At week 24, compared with IBT-alone, liraglutide-treated groups reported significantly greater reductions in dietary disinhibition, global eating disorder psychopathology, and shape concern. The Multicomponent group had significantly greater reductions in binge eating at week 24 relative to the IBT-alone group. However, differences among groups were no longer significant at week 52. Groups did not differ in total food cravings at week 24 or 52. CONCLUSIONS The combination of liraglutide and IBT was associated with greater short-term improvements in dietary disinhibition, global eating disorder psychopathology, and shape concern than IBT alone.
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Affiliation(s)
- Ariana M. Chao
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Olivia A. Walsh
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Kathryn A. Gruber
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Naji Alamuddin
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
- Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Science, Philadelphia, PA, USA
| | - Jena Shaw Tronieri
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
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28
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Tang A, Fox NA, Nelson CA, Zeanah CH, Slopen N. Externalizing trajectories predict elevated inflammation among adolescents exposed to early institutional rearing: A randomized clinical trial. Psychoneuroendocrinology 2019; 109:104408. [PMID: 31442936 PMCID: PMC6842705 DOI: 10.1016/j.psyneuen.2019.104408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There has been mounting interest in the pathophysiological relation between inflammation and psychopathology. In this paper, we examined associations between internalizing and externalizing psychopathology and inflammation in adolescents with a history of severe psychosocial deprivation and children reared in typical family contexts. METHOD The Bucharest Early Intervention Project is a longitudinal randomized trial of high-quality foster care as an alternative to institutional care. This report is based on 56 institutionalized children randomized to care as usual, 59 institutionalized children randomized to foster care, and 101 never institutionalized children who were recruited as an in-country comparison sample. Externalizing and internalizing behaviors were reported by parents and teachers at ages 8, 12, and 16. At age 16, C-reactive protein (CRP) was derived from blood spots in a subset of participants (n = 127). Multiple-group latent growth curve models were used to examine externalizing and internalizing trajectories and their associations with CRP. RESULTS Among children assigned to care as usual, higher levels of externalizing behaviors at age 8, as well as smaller decreases in these behaviors from 8 to 16 years predicted higher levels of CRP at age 16. In the same group of children, higher internalizing behaviors at age 8, but not the rate of change in these behaviors, also predicted higher levels of CRP. In contrast, these relations were not observed in the children assigned to foster care and never institutionalized controls. CONCLUSIONS Early institutional rearing is associated with a coupling of psychopathology and inflammation, whereas early placement into foster care buffers against these risks. These findings have implications for promoting healthy mental and physical development amongst institutionalized children.
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States.
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States
| | - Charles A Nelson
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States
| | - Charles H Zeanah
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Natalie Slopen
- Shool of Public Health, University of Maryland, College Park, MD, United States
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Grillon C, Robinson OJ, Cornwell B, Ernst M. Modeling anxiety in healthy humans: a key intermediate bridge between basic and clinical sciences. Neuropsychopharmacology 2019; 44:1999-2010. [PMID: 31226707 PMCID: PMC6897969 DOI: 10.1038/s41386-019-0445-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 12/11/2022]
Abstract
Animal models of anxiety disorders are important for elucidating neurobiological defense mechanisms. However, animal models are limited when it comes to understanding the more complex processes of anxiety that are unique to humans (e.g., worry) and to screen new treatments. In this review, we outline how the Experimental Psychopathology approach, based on experimental models of anxiety in healthy subjects, can mitigate these limitations and complement research in animals. Experimental psychopathology can bridge basic research in animals and clinical studies, as well as guide and constrain hypotheses about the nature of psychopathology, treatment mechanisms, and treatment targets. This review begins with a brief review of the strengths and limitations of animal models before discussing the need for human models of anxiety, which are especially necessary to probe higher-order cognitive processes. This can be accomplished by combining anxiety-induction procedures with tasks that probe clinically relevant processes to identify neurocircuits that are potentially altered by anxiety. The review then discusses the validity of experimental psychopathology and introduces a methodological approach consisting of five steps: (1) select anxiety-relevant cognitive or behavioral operations and associated tasks, (2) identify the underlying neurocircuits supporting these operations in healthy controls, 3) examine the impact of experimental anxiety on the targeted operations in healthy controls, (4) utilize findings from step 3 to generate hypotheses about neurocircuit dysfunction in anxious patients, and 5) evaluate treatment mechanisms and screen novel treatments. This is followed by two concrete illustrations of this approach and suggestions for future studies.
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Affiliation(s)
- Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA.
| | - Oliver J Robinson
- University College London, Institute of Cognitive Neuroscience, London, UK
| | - Brian Cornwell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
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Abstract
BACKGROUND Many agree that the biopsychosocial contributions to psychopathology are complex, yet it is unclear how we can make sense of this complexity. One approach is to reduce this complexity to a few necessary and sufficient biopsychosocial factors; although this approach is easy to understand, it has little explanatory power. Another approach is to fully embrace complexity, proposing that each instance of psychopathology is caused by a partially unique set of biopsychosocial factors; this approach has high explanatory power, but is impossible to comprehend. Due to deficits in either explanatory power or comprehensibility, both approaches limit our ability to make substantial advances in understanding, predicting, and preventing psychopathology. Thus, how can we make sense of biopsychosocial factor complexity? MAIN TEXT There is a third possible approach that can resolve this dilemma, with high explanatory power and high comprehensibility. This approach involves understanding, predicting, and preventing psychopathology in terms of a small set of psychological primitives rather than biopsychosocial factors. Psychological primitives are the fundamental and irreducible elements of the mind, mediating all biopsychosocial factor influences on psychopathology. All psychological phenomena emerge from these primitives. Over the past decade, this approach has been successfully applied within basic psychological science, most notably affective science. It explains the sum of the evidence in affective science and has generated several novel research directions. This approach is equally applicable to psychopathology. The primitive-based approach does not eliminate the role of biopsychosocial factors, but rather recasts them as indeterminate causal influences on psychological primitives. In doing so, it reframes research away from factor-based questions (e.g., which situations cause suicide?) and toward primitive-based questions (e.g., how are suicidality concepts formed, altered, activated, and implemented?). This is a valuable shift because factor-based questions have indeterminate answers (e.g., infinite situations could cause suicide) whereas primitive-based questions have determinate answers (e.g., there are specific processes that undergird all concepts). CONCLUSION The primitive-based approach accounts for biopsychosocial complexity, ties clinical science more directly to basic psychological science, and could facilitate progress in understanding, predicting, and preventing psychopathology.
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Affiliation(s)
- Joseph C Franklin
- Department of Psychology, Florida State University, 1107 W Call St, Tallahassee, FL, 32304, USA.
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31
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Evans BC, Felton JW, Lagacey MA, Manasse SM, Lejuez CW, Juarascio AS. Impulsivity and affect reactivity prospectively predict disordered eating attitudes in adolescents: a 6-year longitudinal study. Eur Child Adolesc Psychiatry 2019; 28:1193-1202. [PMID: 30693374 PMCID: PMC6663641 DOI: 10.1007/s00787-018-01267-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/20/2018] [Indexed: 12/19/2022]
Abstract
Eating disorders (EDs) are associated with significant psychological and physical comorbidities, and adolescence is a particularly high-risk time for the development of EDs. Impulsivity (i.e., acting with little conscious judgment or forethought) and affect reactivity (i.e., changes in negative affect in response to a stressor) are hypothesized to contribute to the development of binge/purge ED pathology. The current study is the first to examine the prospective relationships between impulsivity and affect reactivity as predictors of the development of ED attitudes in adolescents over time. Two hundred six adolescents participated in a longitudinal study examining the development of psychopathology. ED attitudes were assessed via the College Eating Disorders Screen annually for 6 years. Baseline impulsivity and affect reactivity were also assessed. Affect reactivity, impulsivity, and their interaction were examined as baseline predictors of changes in ED attitudes over time using latent growth modeling. Results of latent growth modeling indicated that ED attitudes increased over time. The interaction between impulsivity and affect reactivity significantly predicted the slope of ED attitudes, such that the relationship between impulsivity and ED attitudes was strongest for those with elevated levels of affect reactivity. Findings suggest that greater levels of affect reactivity and impulsivity are key risk factors for the development of ED attitudes in adolescents. Subsequent research should examine the relation between affect reactivity and impulsivity in predicting objectively measured ED behaviors, in addition to ED attitudes. Further investigation may implicate affect reactivity and impulsivity as important targets for early intervention to prevent onset of ED symptoms in adolescents.
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Affiliation(s)
- Brittney C Evans
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
| | - Julia W Felton
- Division of Public Health, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA
| | - Madeline A Lagacey
- Department of Psychology, The University of South Florida, 4202 East Fowler Ave, PCD 4118G, Tampa, FL, 33620, USA
| | - Stephanie M Manasse
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Carl W Lejuez
- Department of Psychology, The University of Kansas, Strong Hall 1450 Jayhawk Blvd, Lawrence, KS, 66045, USA
| | - Adrienne S Juarascio
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
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Shephard E, Fatori D, Mauro LR, de Medeiros Filho MV, Hoexter MQ, Chiesa AM, Fracolli LA, Brentani H, Ferraro AA, Nelson CA, Miguel EC, Polanczyk GV. Effects of Maternal Psychopathology and Education Level on Neurocognitive Development in Infants of Adolescent Mothers Living in Poverty in Brazil. Biol Psychiatry Cogn Neurosci Neuroimaging 2019; 4:925-934. [PMID: 31345780 PMCID: PMC6863387 DOI: 10.1016/j.bpsc.2019.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Adolescent motherhood remains common in developing countries and is associated with risk factors that adversely impact infant neurodevelopment, including poverty, low maternal education, and increased maternal psychopathology. Yet, no published work has assessed how these factors affect early brain development in developing countries. METHODS This pilot study examined effects of maternal psychopathology and education on early neurocognitive development in a sample of adolescent mothers (N = 50, final n = 31) and their infants living in poverty in São Paulo, Brazil. Maternal symptoms of anxiety, depression, and attention-deficit/hyperactivity disorder and education level were assessed during pregnancy. Infant neurocognitive development was assessed at 6 months of age, with oscillatory power and functional connectivity in the theta (4-6 Hz), alpha (6-9 Hz), and gamma (30-50 Hz) frequencies derived from resting-state electroencephalography; temperament (negative affect, attention, and regulation); and cognitive, language, and motor skills. Cluster-based permutation testing and graph-theoretical methods were used to identify alterations in oscillatory power and connectivity that were associated with maternal psychopathology and education. Correlations between power and connectivity alterations were examined in relation to infants' overt cognitive behavioral abilities. RESULTS Increased maternal anxiety and lower maternal education were associated with weaker oscillatory connectivity in alpha-range networks. Infants with the weakest connectivity in the alpha network associated with maternal anxiety also showed the lowest cognitive ability. Greater maternal anxiety and attention-deficit/hyperactivity disorder were associated with increased absolute and relative theta power. CONCLUSIONS Our findings highlight the importance of addressing maternal psychopathology and improving education in poor adolescent mothers to prevent negative effects on infant neurodevelopment.
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Affiliation(s)
- Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
| | - Daniel Fatori
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Larissa Rezende Mauro
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Marcelo Q Hoexter
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Anna M Chiesa
- School of Nursing, Universidade de São Paulo, São Paulo, Brazil
| | | | - Helena Brentani
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Alexandre A Ferraro
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Graduate School of Education, Harvard University, Cambridge, Massachusetts
| | - Euripedes C Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme V Polanczyk
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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Ivezaj V, Fu E, Lydecker JA, Duffy AJ, Grilo CM. Racial Comparisons of Postoperative Weight Loss and Eating-Disorder Psychopathology Among Patients Following Sleeve Gastrectomy Surgery. Obesity (Silver Spring) 2019; 27:740-745. [PMID: 30925196 PMCID: PMC6478551 DOI: 10.1002/oby.22446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/28/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE This study aimed to examine racial differences in postoperative eating-disorder psychopathology, psychosocial functioning, and weight loss among adults with loss-of-control (LOC) eating following sleeve gastrectomy. METHODS Participants were 123 patients (n = 74 non-Hispanic White and n = 49 non-Hispanic Black) who underwent sleeve gastrectomy surgery within the previous 4 to 9 months and reported regular LOC eating during the previous month. The Eating Disorder Examination Bariatric Surgery Version assessed LOC eating, eating-disorder psychopathology, and meal patterns. Participants completed self-report measures, including the Beck Depression Inventory-II and Medical Outcomes Study Short-Form Health Survey. RESULTS Presurgical BMI did not differ by race, but Black patients had significantly less percent total weight loss and percent excess weight loss than White patients. Black and White patients did not differ significantly in LOC eating frequency, onset time of postoperative LOC eating, eating-disorder psychopathology, depressive symptoms, or physical or mental health-related quality of life. White patients were significantly more likely to meet criteria for lifetime binge-eating disorder than Black patients. Black patients were significantly more likely to skip breakfast and dinner and engage in night eating than White patients. CONCLUSIONS Our findings suggest that among patients with LOC eating following sleeve gastrectomy surgery, there exist few racial differences in current eating-disorder psychopathology and psychosocial functioning, although Black patients achieved less weight loss than White patients.
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Affiliation(s)
| | - Emily Fu
- Yale School of Public Health, New Haven, CT, 06519
| | | | - Andrew J. Duffy
- Yale New Haven Health System
- Yale University, New Haven, CT, 06511
| | - Carlos M. Grilo
- Yale School of Medicine, New Haven, CT, 06519
- Yale University, New Haven, CT, 06511
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Becker SP, Willcutt EG. Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology. Eur Child Adolesc Psychiatry 2019; 28:603-613. [PMID: 29524018 PMCID: PMC6131087 DOI: 10.1007/s00787-018-1136-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/23/2018] [Indexed: 02/06/2023]
Abstract
Sluggish cognitive tempo (SCT) is separable from attention-deficit/hyperactivity disorder (ADHD) and other psychopathologies, and growing evidence demonstrates SCT to be associated with impairment in both children and adults. However, it remains unclear how SCT should optimally be conceptualized. In this article, we argue that multiple models of psychopathology should be leveraged to make substantive advances to our understanding of SCT. Both categorical and dimensional approaches should be used, including the Diagnostic and Statistical Manual of Mental Disorders (DSM) nosology, the Research Domain Criteria (RDoC) initiative, and hierarchical models of psychopathology. Studies are needed to determine whether individuals categorized with SCT can be reliably identified and differentiated from individuals without SCT in pathophysiological, neuropsychological, behavioral, and daily life functioning. Studies are also needed to evaluate the validity and utility of SCT as a transdiagnostic and dimensional construct. In considering SCT as a dimensional and potentially transdiagnostic construct, we describe ways in which SCT might be examined within the RDoC framework, including negative valence systems, cognitive systems, and arousal/regulatory systems, as well as within hierarchical models of psychopathology. Conceptualizing SCT within both categorical and dimensional models of psychopathology will help to better understand the causes, developmental pathways, and clinical implications of SCT, both as a construct in its own right and also in relation to other psychopathologies.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA.
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 10006, Cincinnati, OH, 45229, USA.
| | - Erik G Willcutt
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA
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Daly A, Gallagher S. Towards a Phenomenology of Self-Patterns in Psychopathological Diagnosis and Therapy. Psychopathology 2019; 52:33-49. [PMID: 31018215 PMCID: PMC6878753 DOI: 10.1159/000499315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 03/14/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 11/19/2022]
Abstract
Categorization-based diagnosis, which endeavors to be consistent with the third-person, objective measures of science, is not always adequate with respect to problems concerning diagnostic accuracy, demarcation problems when there are comorbidities, well-documented problems of symptom amplification, and complications of stigmatization and looping effects. While psychiatric categories have proved useful and convenient for clinicians in identifying a recognizable constellation of symptoms typical for a particular disorder for the purposes of communication and eligibility for treatment regimes, the reification of these categories has without doubt had negative consequences for the patient and also for the general understanding of psychiatric disorders. We argue that a complementary, integrated framework that focuses on descriptive symptom-based classifications (drawing on phenomenological interview methods and narrative) combined with a more comprehensive conception of the human subject (found in the pattern theory of self), can not only offer a solution to some of the vexed issues of psychiatric diagnosis but also support more efficacious therapeutic interventions.
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Affiliation(s)
- Anya Daly
- School of Philosophical and Historical Studies, The University of Melbourne, Melbourne, Victoria, Australia,
| | - Shaun Gallagher
- Lillian and Morrie Moss Chair of Excellence in Philosophy, Department of Philosophy, University of Memphis, Memphis, Tennessee, USA
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Huzard D, Ghosal S, Grosse J, Carnevali L, Sgoifo A, Sandi C. Low vagal tone in two rat models of psychopathology involving high or low corticosterone stress responses. Psychoneuroendocrinology 2019; 101:101-110. [PMID: 30448728 DOI: 10.1016/j.psyneuen.2018.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 12/22/2022]
Abstract
The two stress-responsive physiological systems, autonomic nervous system (ANS) and hypothalamus-pituitary-adrenal (HPA) axis exert complementary and interrelated actions in the organism. Individuals that suffer stress-related psychopathologies frequently present simultaneous alterations -i.e., either low or high- responsiveness- in both systems. However, there is scarce evidence establishing whether a priori alterations in these systems -i.e., independent of previous stress exposure- may predispose to the development of psychopathologies possibly due to the lack of animal models simultaneously involving aberrant HPA and SNS responses. In this study, we describe two animal models selectively bred according to their differential (either high, 'High', or low, 'Low') glucocorticoid responsiveness to stress, in comparison to a third line of rats that displays intermediate ('Inter') glucocorticoid responses. The two extreme lines may be considered distinct models of psychopathology; the High line representing a model of constitutive mood alterations while the Low line a model of vulnerability to develop stress-induced psychopathologies. We recorded the electrocardiogram in rats from the three lines and quantified heart rate variability and vagal tone indexes during rest and stress challenges. Rats from both High and Low lines displayed higher heart rate and lower basal vagal tone than the Inter group, both at resting and following stress exposure. Specific pharmacological manipulations probing the relative contribution of sympathetic and parasympathetic components on HR modulation confirmed a relative lower vagal tone in High and Low lines and discarded differences in the sympathetic regulation of heart rate between the lines. Therefore, the two genetically-selected High and Low glucocorticoid rat lines emerge as two valuable preclinical models of psychopathology involving two key risk factors for psychiatric and cardiovascular disorders, namely dysregulations in the HPA axis and cardiac vagal functioning.
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Affiliation(s)
- Damien Huzard
- Laboratory of Behavioral Genetics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sriparna Ghosal
- Laboratory of Behavioral Genetics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Jocelyn Grosse
- Laboratory of Behavioral Genetics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Luca Carnevali
- Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy.
| | - Andrea Sgoifo
- Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Carmen Sandi
- Laboratory of Behavioral Genetics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
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Tang W, Lu Y, Yang Y, Xu J. An epidemiologic study of self-reported sleep problems in a large sample of adolescent earthquake survivors: The effects of age, gender, exposure, and psychopathology. J Psychosom Res 2018; 113:22-29. [PMID: 30190044 DOI: 10.1016/j.jpsychores.2018.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/21/2017] [Revised: 06/12/2018] [Accepted: 07/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND This study investigated the prevalence of sleep problems and their associated risk factors in child and adolescent survivors three years after the 2013 Ya'an earthquake. METHODS A total of 6132 adolescent survivors aged 9-18 years were invited to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Logistic analysis was used to identify possible relationships of sleep disturbance scores with earthquake exposures, mental health and demographic characteristics. RESULTS More than a quarter of the sample showed sleep problems of some kind, with 23.1% sleeping fewer than 7 h per night, 32.5% having difficulty falling asleep, 24.2% having difficulty remaining asleep, 25.3% having poor sleep quality, 17.4% having nightmares and 44.6% having difficulty functioning during daytime hours. Older participants were at a significantly higher risk of sleep issues than younger children (OR 2.89), and the subjects had significantly elevated risks of probable anxiety (OR 3.47), probable depression (OR 2.45), and probable posttraumatic stress disorder (OR 1.89). Other risk factors for sleep problems were earthquake exposure variables, including being injured (OR 1.42), having a parent injured (OR 1.27), witnessing death (OR 1.32) or feeling extremely scared (OR 1.22) in the Ya'an earthquake. CONCLUSIONS Sleep disturbances are common in adolescent earthquake survivors, and they are associated with age, gender, psychiatric symptoms and factors related to earthquake exposure. These results highlight the importance of development- and gender-specific interventions to prevent sleep disturbances after a major earthquake.
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Affiliation(s)
- Wanjie Tang
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China; Centre for Educational and Health Psychology, Sichuan University, Chengdu, China; Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Lu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
| | - Yanchun Yang
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
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Kaczkurkin AN, Moore TM, Calkins ME, Ciric R, Detre JA, Elliott MA, Foa EB, Garcia de la Garza A, Roalf DR, Rosen A, Ruparel K, Shinohara RT, Xia CH, Wolf DH, Gur RE, Gur RC, Satterthwaite TD. Common and dissociable regional cerebral blood flow differences associate with dimensions of psychopathology across categorical diagnoses. Mol Psychiatry 2018; 23:1981-1989. [PMID: 28924181 PMCID: PMC5858960 DOI: 10.1038/mp.2017.174] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 05/24/2017] [Accepted: 06/23/2017] [Indexed: 11/08/2022]
Abstract
The high comorbidity among neuropsychiatric disorders suggests a possible common neurobiological phenotype. Resting-state regional cerebral blood flow (CBF) can be measured noninvasively with magnetic resonance imaging (MRI) and abnormalities in regional CBF are present in many neuropsychiatric disorders. Regional CBF may also provide a useful biological marker across different types of psychopathology. To investigate CBF changes common across psychiatric disorders, we capitalized upon a sample of 1042 youths (ages 11-23 years) who completed cross-sectional imaging as part of the Philadelphia Neurodevelopmental Cohort. CBF at rest was quantified on a voxelwise basis using arterial spin labeled perfusion MRI at 3T. A dimensional measure of psychopathology was constructed using a bifactor model of item-level data from a psychiatric screening interview, which delineated four factors (fear, anxious-misery, psychosis and behavioral symptoms) plus a general factor: overall psychopathology. Overall psychopathology was associated with elevated perfusion in several regions including the right dorsal anterior cingulate cortex (ACC) and left rostral ACC. Furthermore, several clusters were associated with specific dimensions of psychopathology. Psychosis symptoms were related to reduced perfusion in the left frontal operculum and insula, whereas fear symptoms were associated with less perfusion in the right occipital/fusiform gyrus and left subgenual ACC. Follow-up functional connectivity analyses using resting-state functional MRI collected in the same participants revealed that overall psychopathology was associated with decreased connectivity between the dorsal ACC and bilateral caudate. Together, the results of this study demonstrate common and dissociable CBF abnormalities across neuropsychiatric disorders in youth.
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Affiliation(s)
- A N Kaczkurkin
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - T M Moore
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M E Calkins
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R Ciric
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J A Detre
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M A Elliott
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - E B Foa
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - A Garcia de la Garza
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D R Roalf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - A Rosen
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - K Ruparel
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C H Xia
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Philadelphia Veterans Administration Medical Center, Philadelphia, PA, USA
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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van Stolk-Cooke K, Brown A, Maheux A, Parent J, Forehand R, Price M. Crowdsourcing Trauma: Psychopathology in a Trauma-Exposed Sample Recruited via Mechanical Turk. J Trauma Stress 2018; 31:549-557. [PMID: 30025175 PMCID: PMC6107385 DOI: 10.1002/jts.22303] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 03/21/2018] [Accepted: 04/02/2018] [Indexed: 11/09/2022]
Abstract
Although crowdsourcing websites like Amazon's Mechanical Turk (MTurk) allow researchers to conduct research efficiently, it is unclear if MTurk and traditionally recruited samples are comparable when assessing the sequela of traumatic events. We compared the responses to validated self-report measures of posttraumatic stress disorder (PTSD) and related constructs that were given by 822 participants recruited via MTurk and had experienced a DSM-5 Criterion A traumatic event to responses obtained in recent samples of participants recruited via traditional methods. Results suggested that the rate of PTSD in the present sample (19.8%) was statistically higher than that found in a recent systematic review of studies that used only traditional recruitment methods. The severity of PTSD reported in the MTurk sample was significantly greater than that reported in a college sample, d = 0.24, and significantly less than that reported in a veteran sample, d = 0.90. The factor structure of PTSD found in the MTurk sample was consistent with prevailing models of PTSD. Findings indicate that crowdsourcing may improve access to this hard-to-reach population.
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Affiliation(s)
| | - Andrew Brown
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Anne Maheux
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Justin Parent
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Rex Forehand
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Matthew Price
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
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40
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Goel NJ, Sadeh-Sharvit S, Flatt RE, Trockel M, Balantekin KN, Fitzsimmons-Craft EE, Monterubio GE, Firebaugh ML, Jacobi C, Wilfley DE, Taylor CB. Correlates of suicidal ideation in college women with eating disorders. Int J Eat Disord 2018; 51:579-584. [PMID: 29626350 PMCID: PMC6002903 DOI: 10.1002/eat.22865] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/15/2018] [Accepted: 03/15/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To identify the correlates of suicidal ideation (SI) in a large sample of college women with eating disorders (EDs). METHOD A total of 690 female college students from 28 US colleges who screened positive for an ED, with the exception of anorexia nervosa, were assessed for SI. Univariate logistic regression analyses were performed to determine independent correlates of SI. Measures included: ED psychopathology, ED behaviors (i.e., binge eating, vomiting, laxatives, compulsive exercise), current co-morbid psychopathology (i.e., depression, anxiety, insomnia), weight/shape concerns, ED-related clinical impairment, and body mass index (BMI). All significant variables were included in a backward binary multivariate logistic regression model to determine which variables were most strongly associated with SI. RESULTS A total of 25.6% of the sample reported SI. All variables examined were significantly independently associated with SI, with the exception of compulsive exercise. Depression, anxiety, and vomiting remained as significant correlates of SI in the multivariate logistic regression model. DISCUSSION ED screening on college campuses should assess for suicidality, and prevention and treatment efforts should target vomiting and co-morbid depression and anxiety symptoms to reduce risk of SI for high-risk individuals.
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Affiliation(s)
- Neha J. Goel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for mHealth, Palo Alto University, Palo Alto, CA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Shiri Sadeh-Sharvit
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for mHealth, Palo Alto University, Palo Alto, CA, USA
- School of Psychology, Interdisciplinary Center, Herzliya, Israel
| | - Rachael E. Flatt
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for mHealth, Palo Alto University, Palo Alto, CA, USA
| | - Mickey Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Katherine N. Balantekin
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Grace E. Monterubio
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - C. Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for mHealth, Palo Alto University, Palo Alto, CA, USA
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Haas LM, McArthur BA, Burke TA, Olino TM, Abramson LY, Alloy LB. Emotional clarity development and psychosocial outcomes during adolescence. ACTA ACUST UNITED AC 2018; 19:563-572. [PMID: 29781646 DOI: 10.1037/emo0000452] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Past research on emotional clarity (EC), the ability to identify and label one's own emotions, has illustrated an association between EC deficits and poor psychosocial outcomes during the adolescent years. Although past research has connected EC to psychosocial outcomes during adolescence in cross-sectional and longitudinal designs, no studies have traced the trajectory of EC over time to determine the developmental course of the construct during adolescence. Thus, this study investigated how EC developed over five years during adolescence and what factors were associated with the developmental trajectory of emotional clarity. Participants included a diverse sample of 640 adolescents (M age at Time 1 = 12.55 years; 53.0% female; 52.2% African American; 48.0% eligible for free school lunch). Results indicated that EC tended to decrease over adolescence, and females, on average, had a steeper decline of EC over time than males. The trajectory of EC predicted psychosocial outcomes, including depression and well-being. Results are discussed with the ultimate goal of informing novel prevention and intervention programs to promote adaptive emotional functioning during an influential time in human development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison
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Stattin H, Seiffge-Krenke I, Hendry L, Kloep M, Beyers W. Adolescent psychopathology in times of change: Introduction to the special issue. J Adolesc 2018; 65:228-230. [PMID: 29606359 DOI: 10.1016/j.adolescence.2018.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this special issue is to understand better the many changes in adolescent psychopathology have taken place over the last decades. The factors associated with adjustment problems and psychopathology in adolescence today are not necessarily the same as the factors that predicted problems and psychopathology in the past. But the basic strategies for connecting negative experiences with adolescent psychopathology remain as important today as they were for understanding adolescent psychopathology decades ago. This is well exemplified in the studies included in this Special Issue. What all this studies have in common is that parenting and the family environment are assumed to play a key role in adolescents' adjustment and psychopathology. Finally, given that all papers in this special issue are based on conference presentations at the 15th Biennial Conference of the European Association for Research on Adolescence (EARA), some more information on that conference in included in this introduction.
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Affiliation(s)
| | | | | | | | - Wim Beyers
- University of Glamorgan, UK; Ghent University, Belgium
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43
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Smith KE, Crosby RD, Wonderlich SA, Forbush KT, Mason TB, Moessner M. Network analysis: An innovative framework for understanding eating disorder psychopathology. Int J Eat Disord 2018; 51:214-222. [PMID: 29451959 PMCID: PMC5946321 DOI: 10.1002/eat.22836] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 01/19/2018] [Accepted: 01/22/2018] [Indexed: 01/25/2023]
Abstract
Network theory and analysis is an emerging approach in psychopathology research that has received increasing attention across fields of study. In contrast to medical models or latent variable approaches, network theory suggests that psychiatric syndromes result from systems of causal and reciprocal symptom relationships. Despite the promise of this approach to elucidate key mechanisms contributing to the development and maintenance of eating disorders (EDs), thus far, few applications of network analysis have been tested in ED samples. We first present an overview of network theory, review the existing findings in the ED literature, and discuss the limitations of this literature to date. In particular, the reliance on cross-sectional designs, use of single-item self-reports of symptoms, and instability of results have raised concern about the inferences that can be made from network analyses. We outline several areas to address in future ED network analytic research, which include the use of prospective designs and adoption of multimodal assessment methods. Doing so will provide a clearer understanding of whether network analysis can enhance our current understanding of ED psychopathology and inform clinical interventions.
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Affiliation(s)
- Kathryn E Smith
- Neuropsychiatric Research Institute, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Stephen A Wonderlich
- Neuropsychiatric Research Institute, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
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44
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Brieant A, Holmes CJ, Maciejewski D, Lee J, Deater-Deckard K, King-Casas B, Kim-Spoon J. Positive and Negative Affect and Adolescent Adjustment: Moderation Effects of Prefrontal Functioning. J Res Adolesc 2018; 28:40-55. [PMID: 29460348 PMCID: PMC5823022 DOI: 10.1111/jora.12339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
We examined whether cognitive control moderates the effects of emotion on adolescent internalizing and externalizing symptomatology in a longitudinal study of 138 adolescents. Self-reported positive affect (PA) and negative affect and behavioral and neural indicators of cognitive control, indexed by performance and prefrontal hemodynamic response during a cognitive interference task, were collected at Time 1. Self-reported internalizing and externalizing symptomatology were collected at Time 1 and Time 2 (1 year later). Results indicated that higher PA predicted decreases in externalizing symptomatology, but only for adolescents with poor neural cognitive control. No moderation effects were found for behavioral cognitive control. Findings imply the beneficial effects of PA on the development of externalizing problems among adolescents with poor prefrontal functioning.
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Affiliation(s)
| | | | - Dominique Maciejewski
- GGZ ingest, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacob Lee
- Virginia Tech Carilion Research Institute, Roanoke, VA
| | - Kirby Deater-Deckard
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA
| | - Brooks King-Casas
- Department of Psychology, Virginia Tech, Blacksburg, VA
- Virginia Tech Carilion Research Institute, Roanoke, VA
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA
- Virginia Tech – Wake Forest School of Biomedical Engineering and Sciences, Blacksburg, VA
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45
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O'Connor C, Reulbach U, Gavin B, McNicholas F. A prospective longitudinal investigation of the (dis)continuity of mental health difficulties between mid- to late-childhood and the predictive role of familial factors. Eur Child Adolesc Psychiatry 2018; 27:289-300. [PMID: 28884353 DOI: 10.1007/s00787-017-1044-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/23/2017] [Indexed: 11/26/2022]
Abstract
Understanding individual variation in the continuity of youth mental health difficulties is critical for identifying the factors that promote recovery or chronicity. This study establishes the proportion of children showing psychopathology at 9 years, whose pathology had either remitted or persisted at 13. It describes the socio-demographic and clinical profiles of these groups, and examines the factors in 9-year-olds' familial environments that predict longitudinal remission vs. persistence of psychopathology. The study utilised data from a prospective longitudinal study of 8568 Irish children. Child psychopathology was assessed using the Strengths and Difficulties Questionnaire (SDQ). Analysis established the rates of continuity of SDQ classifications between 9 and 13 years. Analysis also investigated the familial factors that predicted the remission vs. persistence of psychopathological symptoms, controlling for socio-demographic and child factors. Average SDQ scores improved between the ages of 9 and 13, F(1, 7292) = 276.52, p < 0.001, [Formula: see text] = 0.04. Of children classified Abnormal aged 9, 41.1% remained so classified at 13, 21.4% were reclassified Borderline, and 37.6% Normal. Demographic and child risk factors for persistence of pathology were maleness (β = -1.00, p = 0.001, CI = 0.20-0.67), one-carer households (β = -0.71, p = 0.04, CI = 0.25-0.97), poor physical health (β = -0.64, p = 0.03, CI = 0.30-0.92), and low cognitive ability (β = 0.61, p = 0.002, CI = 1.26-2.70). Controlling for these factors, the only familial variable at 9 years that predicted subsequent pathological persistence was caregiver depression (β = -0.07, p = 0.03, CI = 0.87-0.99). The analysis highlights substantial rates of psychopathological discontinuity in a community sample and identifies the children most at risk of chronic mental health problems. These results will inform the targeting of early interventions and distribution of clinical resources.
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Affiliation(s)
- Cliodhna O'Connor
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland.
- School of Psychology, University College Dublin, Dublin, Ireland.
| | - Udo Reulbach
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
- Child & Family Centre, Drogheda, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Blanaid Gavin
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
- Children's Mental Health Clinic, Dublin, Ireland
| | - Fiona McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
- Lucena Clinic, Dublin, Ireland
- Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
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46
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Kirk RGW, Ramsden E. Working across species down on the farm: Howard S. Liddell and the development of comparative psychopathology, c. 1923-1962. Hist Philos Life Sci 2018; 40:24. [PMID: 29417236 PMCID: PMC5803279 DOI: 10.1007/s40656-018-0189-y] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/14/2018] [Indexed: 05/22/2023]
Abstract
Seeking a scientific basis for understanding and treating mental illness, and inspired by the work of Ivan Pavlov, American physiologists, psychiatrists and psychologists in the 1920s turned to nonhuman animals. This paper examines how new constructs such as "experimental neurosis" emerged as tools to enable psychiatric comparison across species. From 1923 to 1962, the Cornell "Behavior Farm" was a leading interdisciplinary research center pioneering novel techniques to experimentally study nonhuman psychopathology. Led by the psychobiologist Howard Liddell, work at the Behavior Farm formed part of an ambitious program to develop new preventative and therapeutic techniques and bring psychiatry into closer relations with physiology and medicine. At the heart of Liddell's activities were a range of nonhuman animals, including pigs, sheep, goats and dogs, each serving as a proxy for human patients. We examine how Pavlov's conceptualization of 'experimental neurosis' was used by Liddell to facilitate comparison across species and communication between researchers and clinicians. Our close reading of his experimental system demonstrates how unexpected animal behaviors and emotions were transformed into experimental virtues. However, to successfully translate such behaviors from the animal laboratory into the field of human psychopathology, Liddell increasingly reached beyond, and, in effect, redefined, the Pavlovian method to make it compatible and compliant with an ethological approach to the animal laboratory. We show how the resultant Behavior Farm served as a productive "hybrid" place, containing elements of experiment and observation, laboratory and field. It was through the building of close and more naturalistic relationships with animals over extended periods of time, both normal and pathological, and within and outside of the experimental space, that Liddell could understand, manage, and make useful the myriad behavioral complexities that emerged from the life histories of experimental animals, the researchers who worked with them, and their shared relationships to the wider physical and social environments.
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Affiliation(s)
- Robert G. W. Kirk
- Centre for the History of Science, Technology and Medicine (CHSTM),
Faculty of Biology, Medicine and Health, University of Manchester, CHSTM Simon Building, Oxford Road, Manchester, M13 9PL UK
| | - Edmund Ramsden
- School of History, Queen Mary University of London, Arts 2 Building, Mile End Road, London, E1 4NS UK
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47
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Atilola O, Ola B, Abiri G, Adewuya AO. Correlations between psychopathology and self-reported quality of life among adolescents in youth correctional facilities in Lagos, Nigeria: A short report. Crim Behav Ment Health 2018; 28:28-35. [PMID: 28752943 DOI: 10.1002/cbm.2042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 11/29/2016] [Accepted: 03/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The relationship between psychopathology and quality of life (QoL) and well-being among young incarcerated offenders has hardly been explored. AIMS Our aim was to test the hypothesis that higher self-rated psychopathology would be associated with lower QoL among adolescents resident within youth correctional facilities in Lagos. METHODS Psychopathology was assessed using the Strength and Difficulty Questionnaire (SDQ), while QoL was measured by using the Paediatric Quality of Life. RESULTS One hundred and sixty-five adolescents completed the study, mostly boys (n = 124; 75%) with a mean age of 14.3 ± 2.1 years. Nearly, a fifth (30, 18%) of respondents had abnormal total SDQ scores (≥17), suggestive of definite psychiatric disorder, while another 44 (27%) had highly probable psychopathology (total SDQ scores 15-16). There was strong negative correlation (r = -0.51, p < 0.001) between total SDQ scores and overall self-reported QoL among respondents. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although we were unable to infer direction of relationship between psychopathology and QoL among these adolescents, it is plausible to suppose that treatment of mental health problems could have a positive impact on rehabilitation and reintegration. Given the rate of likely psychopathology, mental health screening within young offender institutions should be routine, and followed, as necessary with full assessment and resultant treatment. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
- Department of Psychiatry, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Bolanle Ola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
- Department of Psychiatry, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Gbonjubola Abiri
- Child and Adolescent Unit, Federal Neuro-psychiatric Hospital Yaba, Lagos, Nigeria
| | - Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
- Department of Psychiatry, Lagos State University Teaching Hospital, Lagos, Nigeria
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48
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Allen JL, Sandberg S, Chhoa CY, Fearn T, Rapee RM. Parent-dependent stressors and the onset of anxiety disorders in children: links with parental psychopathology. Eur Child Adolesc Psychiatry 2018; 27:221-231. [PMID: 28791523 PMCID: PMC5842251 DOI: 10.1007/s00787-017-1038-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 08/02/2017] [Indexed: 11/30/2022]
Abstract
Exposure to stressors is associated with an increased risk for child anxiety. Investigating the family origins of stressors may provide promising avenues for identifying and intervening with children at risk for the onset of anxiety disorders and their families. The aim of this study was to compare the frequency of parent-dependent negative life events and chronic adversities experienced by children with an anxiety disorder (n = 34) in the 12 months prior to the onset of the child's most recent episode, compared to healthy controls (n = 34). Life events and chronic adversities were assessed using maternal report during an investigator-based interview, which provided independent panel ratings of the extent that reported experiences were related to parent behaviour. There were no group differences in the number of parent-dependent negative life events for anxious children compared to controls. However, significantly more parent-dependent chronic adversities were present for anxious children compared to controls. Findings suggest that parents contribute to an increased frequency of chronic adversities but not negative life events prior to their child's most recent onset of anxiety. Furthermore, increased child exposure to parent-dependent chronic adversities was related to parental history of mental disorder.
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Affiliation(s)
- Jennifer L Allen
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, UK.
| | - Seija Sandberg
- Mental Health Sciences Unit, University College London, London, UK
| | - Celine Y Chhoa
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, UK
| | - Tom Fearn
- Department of Statistical Science, University College London, London, UK
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
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49
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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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50
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Meyer A. A biomarker of anxiety in children and adolescents: A review focusing on the error-related negativity (ERN) and anxiety across development. Dev Cogn Neurosci 2017; 27:58-68. [PMID: 28818707 PMCID: PMC6987910 DOI: 10.1016/j.dcn.2017.08.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 12/16/2022] Open
Abstract
Background Anxiety disorders are the most common form of psychopathology and often begin early in development. Therefore, there is interest in identifying neural biomarkers that characterize pathways leading to anxiety disorders early in the course of development. A substantial amount of work focuses on the error-related negativity (ERN) as a biomarker of anxiety. While two previous reviews have focused on the relationship of the ERN and anxiety in adults, no previous review has focused on this issue in children and adolescents. Results and conclusions Overall, 22 studies were included in the current review. A number of patterns emerged, including: 1.) The ERN is enhanced in clinically anxious children at all ages (6–18 years old), regardless of the task used to measure the ERN. 2.) Studies focusing on anxiety symptoms and temperamental fear suggest that the relationship between the ERN and normative anxiety may change across development. 3.) The ERN can predict the onset of anxiety disorders across different developmental periods. 4.) The ERN relates to other markers of risk for anxiety (e.g., aversive startle potentiation) in children and adolescents.
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Affiliation(s)
- Alexandria Meyer
- Department of Psychology, Florida State University, 1107 W Call St., Tallahassee, FL 32303, United States.
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