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Brown B, Nguyen LT, Morales I, Cardinale EM, Tseng WL, McKay CC, Kircanski K, Brotman MA, Pine DS, Leibenluft E, Linke JO. Associations Between Neighborhood Resources and Youth's Response to Reward Omission in a Task Modeling Negatively Biased Environments. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00253-3. [PMID: 38763411 DOI: 10.1016/j.jaac.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/05/2024] [Accepted: 05/10/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE Neighborhoods provide essential resources (e.g., education, safe housing, green space) that influence neurodevelopment and mental health. However, we need a clearer understanding of the mechanisms mediating these relationships. Limited access to neighborhood resources may hinder youth from achieving their goals and, over time, shape their behavioral and neurobiological response to negatively biased environments blocking goals/ rewards. METHOD To test this hypothesis, 211 youth (∼ 13.0 years, 48% boys, 62% identifying as white, 75% with a psychiatric disorder diagnosis) performed a task during functional magnetic resonance imaging. Initially, rewards depended on performance (unbiased condition), but later, rewards were randomly withheld under the pretense that youth did not perform adequately (negatively biased condition), a manipulation that elicits frustration, sadness, and a broad response in neural networks. We investigated associations between the Childhood Opportunity Index (COI), which quantifies access to youth-relevant neighborhood features in one metric, and the multimodal response to the negatively biased condition, controlling for age, sex, medication, and psychopathology. RESULTS Youth from less-resourced neighborhoods responded with less anger (p<.001, marginal R2=.42) and more sadness (p<.001, marginal R2=.46) to the negatively biased condition than youth from well-resourced neighborhoods. On the neurobiological level, lower COI scores were associated with a more localized processing mode (p=.039, marginal R2=.076), reduced connectivity between the somato-motor-salience and the control network (p=.041, marginal R2=.040), and fewer provincial hubs in the somatic-motor-salience, control, and default mode networks (all pFWE<.05). CONCLUSION The present study adds to a growing literature documenting how inequity may affect the brain and emotions in youth. Future work should test whether findings generalize to more diverse samples and explore effects on neurodevelopmental trajectories and emerging mood disorders during adolescence.
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Filippi CA, Winkler AM, Kanel D, Elison JT, Hardiman H, Sylvester C, Pine DS, Fox NA. Neural correlates of novelty-evoked distress in 4-month-old infants: A synthetic cohort study. Biol Psychiatry Cogn Neurosci Neuroimaging 2024:S2451-9022(24)00107-1. [PMID: 38641209 DOI: 10.1016/j.bpsc.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Observational assessments of infant temperament have provided unparalleled insight into prediction of risk for social anxiety. Yet, it is challenging to administer and score these assessments alongside high-quality infant neuroimaging data. The current study aims to identify infant resting state functional connectivity (rsFC) associated with both parent-report and observed behavioral estimates of infant novelty-evoked distress. METHODS Using data from the Origins of Infant Temperament (OIT) study which includes deep phenotyping of infant temperament, we identified parent-report measures that were associated with observed novelty-evoked distress. These parent-report measures were then summarized into a composite score used for imaging analysis. Our infant MRI sample was a "synthetic cohort", harmonizing data from two fMRI studies of 4-month-old infants (OIT and Baby Connectome Project [BCP]; n=101) both of which included parent-reported temperament. Brain-behavior associations were evaluated using "enrichment," a statistical approach that quantifies the clustering of brain-behavior associations within network pairs. RESULTS Results demonstrated that parent-report composites of novelty-evoked distress were significantly associated with three network pairs: Dorsal Attention-Salience/Ventral Attention, Dorsal Attention-Default, and Dorsal Attention-Control. These network pairs demonstrated negative associations with novelty-evoked distress-indicating that less connectivity between these network pairs was associated with greater novelty-evoked distress. Additional analyses demonstrated that Dorsal Attention -Control network connectivity was associated with observed novelty-evoked distress in the OIT sample (n=38). CONCLUSION Overall, this work is broadly consistent with existing work and implicates dorsal attention network connectivity in novelty-evoked distress. This study provides novel data on the neural basis of infant novelty-evoked distress.
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Affiliation(s)
- Courtney A Filippi
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, New York, 10016.
| | - Anderson M Winkler
- Division of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, Texas, 78520
| | - Dana Kanel
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, 20892; Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, 20742
| | - Jed T Elison
- Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, 55455
| | - Hannah Hardiman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, 20892; Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, 20742
| | - Chad Sylvester
- Departments of Psychiatry, Radiology, and the Taylor Family Institute for Innovative Research, Washington University, St. Louis, Missouri, 63110
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, 20892
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, 20742
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Aggarwal N, Tromp DPM, Blackford JU, Pine DS, Roseboom PH, Williams LE, Kalin NH. Sex-Specific Distributed White Matter Microarchitectural Alterations in Preadolescent Youths With Anxiety Disorders: A Mega-Analytic Study. Am J Psychiatry 2024; 181:299-309. [PMID: 38476042 DOI: 10.1176/appi.ajp.20221048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Anxiety disorders are among the most common psychiatric disorders in youths and emerge during childhood. This is also a period of rapid white matter (WM) development, which is critical for efficient neuronal communication. Previous work in preadolescent children with anxiety disorders demonstrated anxiety disorder-related reductions in WM microstructural integrity (fractional anisotropy [FA]) in the uncinate fasciculus (UF), the major WM tract facilitating prefrontal cortical-limbic structural connectivity. Importantly, this association was found only in boys with anxiety disorders. To confirm this finding and more comprehensively understand WM changes in childhood anxiety, this mega-analytic study characterizes WM alterations related to anxiety disorders and sex in the largest sample of preadolescent children to date. METHODS Diffusion tensor imaging data from published studies of preadolescent children with anxiety disorders and healthy volunteers (ages 8-12) (N=198) were combined with a new data set (N=97) for a total sample of 165 children with anxiety disorders and 132 healthy volunteers. Children with anxiety disorders met DSM-5 criteria for current generalized, separation, and/or social anxiety disorder. Analyses of tractography and voxel-wise data assessed between-group differences (anxiety disorder vs. healthy volunteer), effects of sex, and their interaction. RESULTS Tract-based and voxel-wise analyses confirmed a significant reduction in UF FA in boys but not girls with anxiety disorders. Results also demonstrated other significant widespread anxiety disorder-related WM alterations specifically in boys, including in multiple commissural, association, projection, and brainstem regions. CONCLUSIONS In addition to confirming male-specific anxiety disorder-related reductions in UF FA, the results demonstrate that anxiety disorders in boys and not girls are associated with broadly distributed WM alterations across the brain. These findings support further studies focused on understanding the extent to which WM alterations in boys with anxiety disorders are involved in pathophysiological processes that mediate anxiety disorders. The findings also suggest the possibility that WM microarchitecture could serve as a novel treatment target for childhood anxiety disorders.
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Affiliation(s)
- Nakul Aggarwal
- Department of Psychiatry, University of Wisconsin-Madison (Aggarwal, Tromp, Roseboom, Williams, Kalin); Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha (Blackford); Section on Developmental and Affective Neuroscience, NIMH, Bethesda, Md. (Pine)
| | - Do P M Tromp
- Department of Psychiatry, University of Wisconsin-Madison (Aggarwal, Tromp, Roseboom, Williams, Kalin); Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha (Blackford); Section on Developmental and Affective Neuroscience, NIMH, Bethesda, Md. (Pine)
| | - Jennifer U Blackford
- Department of Psychiatry, University of Wisconsin-Madison (Aggarwal, Tromp, Roseboom, Williams, Kalin); Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha (Blackford); Section on Developmental and Affective Neuroscience, NIMH, Bethesda, Md. (Pine)
| | - Daniel S Pine
- Department of Psychiatry, University of Wisconsin-Madison (Aggarwal, Tromp, Roseboom, Williams, Kalin); Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha (Blackford); Section on Developmental and Affective Neuroscience, NIMH, Bethesda, Md. (Pine)
| | - Patrick H Roseboom
- Department of Psychiatry, University of Wisconsin-Madison (Aggarwal, Tromp, Roseboom, Williams, Kalin); Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha (Blackford); Section on Developmental and Affective Neuroscience, NIMH, Bethesda, Md. (Pine)
| | - Lisa E Williams
- Department of Psychiatry, University of Wisconsin-Madison (Aggarwal, Tromp, Roseboom, Williams, Kalin); Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha (Blackford); Section on Developmental and Affective Neuroscience, NIMH, Bethesda, Md. (Pine)
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin-Madison (Aggarwal, Tromp, Roseboom, Williams, Kalin); Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha (Blackford); Section on Developmental and Affective Neuroscience, NIMH, Bethesda, Md. (Pine)
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Leibenluft E, Allen LE, Althoff RR, Brotman MA, Burke JD, Carlson GA, Dickstein DP, Dougherty LR, Evans SC, Kircanski K, Klein DN, Malone EP, Mazefsky CA, Nigg J, Perlman SB, Pine DS, Roy AK, Salum GA, Shakeshaft A, Silver J, Stoddard J, Thapar A, Tseng WL, Vidal-Ribas P, Wakschlag LS, Stringaris A. Irritability in Youths: A Critical Integrative Review. Am J Psychiatry 2024; 181:275-290. [PMID: 38419494 DOI: 10.1176/appi.ajp.20230256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Irritability, defined as proneness to anger that may impair an individual's functioning, is common in youths. There has been a recent upsurge in relevant research. The authors combine systematic and narrative review approaches to integrate the latest clinical and translational findings and provide suggestions for addressing research gaps. Clinicians and researchers should assess irritability routinely, and specific assessment tools are now available. Informant effects are prominent, are stable, and vary by age and gender. The prevalence of irritability is particularly high among individuals with attention deficit hyperactivity disorder, autism spectrum disorder, and mood and anxiety disorders. Irritability is associated with impairment and suicidality risk independent of co-occurring diagnoses. Developmental trajectories of irritability (which may begin early in life) have been identified and are differentially associated with clinical outcomes. Youth irritability is associated with increased risk of anxiety, depression, behavioral problems, and suicidality later in life. Irritability is moderately heritable, and genetic associations differ based on age and comorbid illnesses. Parent management training is effective for treating psychological problems related to irritability, but its efficacy in treating irritability should be tested rigorously, as should novel mechanism-informed interventions (e.g., those targeting exposure to frustration). Associations between irritability and suicidality and the impact of cultural context are important, underresearched topics. Analyses of large, diverse longitudinal samples that extend into adulthood are needed. Data from both animal and human research indicate that aberrant responses to frustration and threat are central to the pathophysiology of irritability, revealing important translational opportunities.
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Affiliation(s)
- Ellen Leibenluft
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Laura E Allen
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Robert R Althoff
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Melissa A Brotman
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Jeffrey D Burke
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Gabrielle A Carlson
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Daniel P Dickstein
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Lea R Dougherty
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Spencer C Evans
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Katharina Kircanski
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Daniel N Klein
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Eleanor P Malone
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Carla A Mazefsky
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Joel Nigg
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Susan B Perlman
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Daniel S Pine
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Amy Krain Roy
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Giovanni A Salum
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Amy Shakeshaft
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Jamilah Silver
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Joel Stoddard
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Anita Thapar
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Wan-Ling Tseng
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Pablo Vidal-Ribas
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Lauren S Wakschlag
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Argyris Stringaris
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
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Cardinale EM, Bezek J, Siegal O, Freitag GF, Subar A, Khosravi P, Mallidi A, Peterson O, Morales I, Haller SP, Filippi C, Lee K, Brotman MA, Leibenluft E, Pine DS, Linke JO, Kircanski K. Multivariate Assessment of Inhibitory Control in Youth: Links With Psychopathology and Brain Function. Psychol Sci 2024; 35:376-389. [PMID: 38446868 DOI: 10.1177/09567976241231574] [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: 03/08/2024] Open
Abstract
Inhibitory control is central to many theories of cognitive and brain development, and impairments in inhibitory control are posited to underlie developmental psychopathology. In this study, we tested the possibility of shared versus unique associations between inhibitory control and three common symptom dimensions in youth psychopathology: attention-deficit/hyperactivity disorder (ADHD), anxiety, and irritability. We quantified inhibitory control using four different experimental tasks to estimate a latent variable in 246 youth (8-18 years old) with varying symptom types and levels. Participants were recruited from the Washington, D.C., metro region. Results of structural equation modeling integrating a bifactor model of psychopathology revealed that inhibitory control predicted a shared or general psychopathology dimension, but not ADHD-specific, anxiety-specific, or irritability-specific dimensions. Inhibitory control also showed a significant, selective association with global efficiency in a frontoparietal control network delineated during resting-state functional magnetic resonance imaging. These results support performance-based inhibitory control linked to resting-state brain function as an important predictor of comorbidity in youth psychopathology.
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Affiliation(s)
- Elise M Cardinale
- Department of Psychology, The Catholic University of America
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | | | - Olivia Siegal
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Gabrielle F Freitag
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Anni Subar
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine
| | - Parmis Khosravi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Ajitha Mallidi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Olivia Peterson
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Isaac Morales
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Simone P Haller
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | | | - Kyunghun Lee
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
| | | | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD
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6
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McKay CC, Scheinberg B, Xu EP, Kircanski K, Pine DS, Brotman MA, Leibenluft E, Linke JO. Modeling Shared and Specific Variances of Irritability, Inattention, and Hyperactivity Yields Novel Insights Into White Matter Perturbations. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00108-4. [PMID: 38452811 DOI: 10.1016/j.jaac.2024.02.010] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/16/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Irritability, inattention, and hyperactivity, which are common presentations of childhood psychopathology, have been associated with perturbed white matter microstructure. However, similar tracts have been implicated across these phenotypes; such non-specificity could be rooted in their high co-occurrence. To address this problem, we use a bifactor approach parsing unique and shared components of irritability, inattention, and hyperactivity, which we then relate to white matter microstructure. METHOD We developed a bifactor model based on the Conners Comprehensive Behavioral Rating Scale in a sample of youth with no psychiatric diagnosis or a primary diagnosis of attention-deficit/hyperactivity disorder or disruptive mood dysregulation disorder (n = 521). We applied the model to an independent yet sociodemographically and clinically comparable sample (n = 152), in which we tested associations between latent variables and fractional anisotropy (FA). RESULTS The bifactor model fit well (comparative fit index = 0.99; root mean square error of approximation = 0.07). The shared factor was positively associated with an independent measure of impulsivity (ρS = 0.88, pFDR < .001) and negatively related to whole-brain FA (r = -0.20), as well as FA of the corticospinal tract (all pFWE < .05). FA increased with age and deviation from this curve, indicating that altered white matter maturation was associated with the hyperactivity-specific factor (r = -0.16, pFWE < .05). Inattention-specific and irritability-specific factors were not linked to FA. CONCLUSION Perturbed white matter microstructure may represent a shared neurobiological mechanism of irritability, inattention, and hyperactivity related to heightened impulsivity. Furthermore, hyperactivity might be uniquely associated with a delay in white matter maturation.
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Affiliation(s)
- Cameron C McKay
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Brooke Scheinberg
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellie P Xu
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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7
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Archer C, Meza-Cervera T, Scheinberg B, Kircanski K, Brotman MA, Pine DS, Leibenluft E, Linke JO. Irritability, Negative Life Events and the Course of Anxiety and Depressive Symptoms in a Clinical Sample of Youth: A Longitudinal Study. JAACAP Open 2024; 2:45-54. [PMID: 38699439 PMCID: PMC11062628 DOI: 10.1016/j.jaacop.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Objective Irritability, the tendency to react with anger, and the experience of negative life events (NLE) have independently been associated with the emergence of anxiety and depression. Here, we investigate how irritability and cumulative effects of NLE interactively predict the course of anxiety and depression in the context of common psychiatric disorders. Method 432 youth with no psychiatric diagnosis, or a diagnosis of an anxiety disorder, Attention-Deficit/ Hyperactivity Disorder (ADHD), or Disruptive Mood Dysregulation Disorder (DMDD), participated in this study. At baseline, we assessed NLE, parent and youth reports of irritability and anxiety, and youth reports of depression. Symptoms were annually reassessed for up to four years. Results In youth without psychiatric diagnoses but with elevated baseline irritability, the presence of NLE predicted decreasing anxiety, while the absence of NLE predicted increasing anxiety. In youth with an anxiety disorder, elevated baseline irritability predicted decreasing anxiety independent of NLE, while a large cumulative effect of NLE predicted increasing depression. NLE predicted persisting mild anxiety in ADHD and persisting mild depressive symptoms in DMDD. Conclusion Our findings suggest that, particularly in non-referred samples, NLE might moderate the relationship between irritability and future anxiety such that irritability/ anger in the context of NLE can positively affect the course of anxiety. Future work replicating this finding while repeatedly measuring NLE and rigorously controlling for potentially confounding effects of treatment, is warranted.
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Affiliation(s)
- Camille Archer
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Tatiana Meza-Cervera
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Brooke Scheinberg
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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Zugman A, Winkler AM, Qamar P, Pine DS. Current and Future Approaches to Pediatric Anxiety Disorder Treatment. Am J Psychiatry 2024; 181:189-200. [PMID: 38425255 DOI: 10.1176/appi.ajp.20231037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
This overview critically appraises the literature on the treatment of pediatric anxiety disorders. The two established treatments for these conditions comprise cognitive-behavioral therapy (CBT) and antidepressant medications. Many youths receiving these treatments fail to achieve remission, which creates a need for new treatments. After summarizing the literature on CBT and currently available medications, the authors describe research that lays a foundation for improvements in the treatment of pediatric anxiety disorders. This foundation leverages neuroscientific investigations, also described in the overview, which provide insights on mechanisms of successful treatment.
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Affiliation(s)
- Andre Zugman
- Section on Development and Affective Neuroscience, Emotion and Development Branch, NIMH, Bethesda, Md. (Zugman, Winkler, Qamar, Pine); Division of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville (Winkler)
| | - Anderson M Winkler
- Section on Development and Affective Neuroscience, Emotion and Development Branch, NIMH, Bethesda, Md. (Zugman, Winkler, Qamar, Pine); Division of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville (Winkler)
| | - Purnima Qamar
- Section on Development and Affective Neuroscience, Emotion and Development Branch, NIMH, Bethesda, Md. (Zugman, Winkler, Qamar, Pine); Division of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville (Winkler)
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, NIMH, Bethesda, Md. (Zugman, Winkler, Qamar, Pine); Division of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville (Winkler)
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9
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Meigs JM, Kiderman M, Kircanski K, Cardinale EM, Pine DS, Leibenluft E, Brotman MA, Naim R. Sleepless nights, sour moods: daily sleep-irritability links in a pediatric clinical sample. J Child Psychol Psychiatry 2024. [PMID: 38355141 DOI: 10.1111/jcpp.13959] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Sleep, or a lack thereof, is strongly related to mood dysregulation. Although considerable research uses symptom scales to examine this relation, few studies use longitudinal, real-time methods focused on pediatric irritability. This study leveraged an ecological momentary assessment (EMA) protocol, assessing bidirectional associations between momentary irritability symptoms and daily sleep duration in a transdiagnostic pediatric sample enriched for irritability. METHODS A total of N = 125 youth (Mage = 12.58 years, SD = 2.56 years; 74% male; 68.8% White) completed digital, in vivo surveys three times a day for 7 days. For a subset of youth, their parents also completed the EMA protocol. Trait irritability was measured using youth-, parent-, and clinician-report to test its potential moderating effect on the association between sleep duration and momentary irritability. RESULTS Results from multilevel modeling dynamically linked sleep to irritability. Specifically, according to youth- and parent-report, decreased sleep duration was associated with increased morning irritability (bs ≤ -.09, ps < .049). A bidirectional association between parent-reported nightly sleep duration and anger was found-increased evening anger related to decreased nightly sleep duration, and decreased sleep duration related to increased morning anger (bs ≤ -.17, ps < .019). Trait irritability moderated this association, which was stronger for more irritable youth (b = -.03, p < .027). CONCLUSIONS This study adds to the literature and suggests sleep-irritability dynamics as a potential treatment target.
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Affiliation(s)
- Jennifer M Meigs
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Miryam Kiderman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Elise M Cardinale
- Psychology Department, The Catholic University of America, Washington, DC, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Reut Naim
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
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10
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Klein Z, Shner-Livne G, Danon-Kraun S, Ginat-Frolich R, Pine DS, Shechner T. Enhanced late positive potential to conditioned threat cue during delayed extinction in anxious youth. J Child Psychol Psychiatry 2024; 65:215-228. [PMID: 37157184 DOI: 10.1111/jcpp.13814] [Citation(s) in RCA: 1] [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] [Accepted: 03/14/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Deficits in threat learning relate to anxiety symptoms. Since several anxiety disorders arise in adolescence, impaired adolescent threat learning could contribute to adolescent changes in risk for anxiety. This study compared threat learning among anxious and non-anxious youth using self-reports, peripheral psychophysiology measures, and event-related potentials. Because exposure therapy, the first-line treatment for anxiety disorders, is largely based on principles of extinction learning, the study also examined the link between extinction learning and treatment outcomes among anxious youth. METHODS Clinically anxious (n = 28) and non-anxious (n = 33) youth completed differential threat acquisition and immediate extinction. They returned to the lab a week later to complete a threat generalization test and a delayed extinction task. Following these two experimental visits, anxious youth received exposure therapy for 12 weeks. RESULTS Anxious as compared to non-anxious youth demonstrated elevated cognitive and physiological responses across acquisition and immediate extinction learning, as well as greater threat generalization. In addition, anxious youth showed enhanced late positive potential response to the conditioned threat cue compared to the safety cue during delayed extinction. Finally, aberrant neural response during delayed extinction was associated with poorer treatment outcomes. CONCLUSIONS The study emphasizes differences between anxious and non-anxious youth in threat learning processes and provides preliminary support for a link between neural processing during delayed extinction and exposure-based treatment outcome in pediatric anxiety.
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Affiliation(s)
- Zohar Klein
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Gil Shner-Livne
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Shani Danon-Kraun
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Rivkah Ginat-Frolich
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Daniel S Pine
- National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Tomer Shechner
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
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11
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Zugman A, Ringlein GV, Finn ES, Lewis KM, Berman E, Silverman WK, Lebowitz ER, Pine DS, Winkler AM. Brain Functional Connectivity and Anatomical Features as Predictors of Cognitive Behavioral Therapy Outcome for Anxiety in Youths. medRxiv 2024:2024.01.29.24301959. [PMID: 38352528 PMCID: PMC10862993 DOI: 10.1101/2024.01.29.24301959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Background Because pediatric anxiety disorders precede the onset of many other problems, successful prediction of response to the first-line treatment, cognitive-behavioral therapy (CBT), could have major impact. However, existing clinical models are weakly predictive. The current study evaluates whether structural and resting-state functional magnetic resonance imaging can predict post-CBT anxiety symptoms. Methods Two datasets were studied: (A) one consisted of n=54 subjects with an anxiety diagnosis, who received 12 weeks of CBT, and (B) one consisted of n=15 subjects treated for 8 weeks. Connectome Predictive Modeling (CPM) was used to predict treatment response, as assessed with the PARS; additionally we investigated models using anatomical features, instead of functional connectivity. The main analysis included network edges positively correlated with treatment outcome, and age, sex, and baseline anxiety severity as predictors. Results from alternative models and analyses also are presented. Model assessments utilized 1000 bootstraps, resulting in a 95% CI for R2, r and mean absolute error (MAE). Outcomes The main model showed a mean absolute error of approximately 3.5 (95%CI: [3.1-3.8]) points a R2 of 0.08 [-0.14 - 0.26] and r of 0.38 [0.24 - 0.511]. When testing this model in the left-out sample (B) the results were similar, with a MAE of 3.4 [2.8 - 4.7], R2-0.65 [-2.29 - 0.16] and r of 0.4 [0.24 - 0.54]. The anatomical metrics showed a similar pattern, where models rendered overall low R2. Interpretation The analysis showed that models based on earlier promising results failed to predict clinical outcomes. Despite the small sample size, the current study does not support extensive use of CPM to predict outcome in pediatric anxiety.
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Affiliation(s)
- Andre Zugman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Grace V. Ringlein
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Emily S. Finn
- Psychological and Brain Sciences, Dartmouth College, 3 Maynard St, Hanover, NH, 03755, USA
| | - Krystal M. Lewis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Erin Berman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Wendy K. Silverman
- Child Study Center, Yale University, 230 South Frontage Rd., New Haven, CT 06520, USA
| | - Eli R. Lebowitz
- Child Study Center, Yale University, 230 South Frontage Rd., New Haven, CT 06520, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Anderson M. Winkler
- Division of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, 1 West University Blvd, Brownsville, TX 78520, USA
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12
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Amelio P, Antonacci C, Khosravi P, Haller S, Kircanski K, Berman E, Cullins L, Lewis K, Davis M, Engel C, Towbin K, Stringaris A, Pine DS. Evaluating the development and well-being assessment (DAWBA) in pediatric anxiety and depression. Child Adolesc Psychiatry Ment Health 2024; 18:12. [PMID: 38245769 PMCID: PMC10800067 DOI: 10.1186/s13034-023-00696-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/19/2023] [Indexed: 01/22/2024] Open
Abstract
Enhancing screening practices and developing scalable diagnostic tools are imperative in response to the increasing prevalence of youth mental health challenges. Structured lay psychiatric interviews have emerged as one such promising tool. However, there remains limited research evaluating structured psychiatric interviews, specifically their characterization of internalizing disorders in treatment-seeking youth. This study evaluates the relationship between the Development and Well-Being Assessment (DAWBA), a structured psychiatric interview, and established measures of pediatric anxiety and depression, including the Screen for Child Anxiety Related Disorders (SCARED), the Pediatric Anxiety Rating Scale (PARS), and the Mood and Feelings Questionnaire (MFQ). The study comprised two independent clinical samples of treatment-seeking youth: sample one included 55 youth with anxiety and 29 healthy volunteers (HV), while sample two included 127 youth with Major Depressive Disorder and 73 HVs. We examined the association between the DAWBA band scores, indicating predicted risk for diagnosis, the SCARED and PARS (sample one), and the MFQ (sample two). An exploratory analysis was conducted in a subset of participants to test whether DAWBA band scores predicted the change in anxiety symptoms (SCARED, PARS) across a 12-week course of cognitive behavioral therapy. The results revealed that the DAWBA significantly predicted the SCARED, PARS and MFQ measures at baseline; however, it did not predict changes in anxiety symptoms across treatment. These findings suggest that the DAWBA may be a helpful screening tool for indexing anxiety and depression in treatment-seeking youth but is not especially predictive of longitudinal trajectories in symptomatology across psychotherapy.
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Affiliation(s)
- Paia Amelio
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Chase Antonacci
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Parmis Khosravi
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
| | - Simone Haller
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Erin Berman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Lisa Cullins
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Krystal Lewis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mollie Davis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Chana Engel
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth Towbin
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Argyris Stringaris
- Divisions of Psychiatry and Psychology and Language Science, University College London, London, UK
- National and Kapodistrian University of Athens, Athens, Greece
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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Henry LM, Hansen E, Chimoff J, Pokstis K, Kiderman M, Naim R, Kossowsky J, Byrne ME, Lopez-Guzman S, Kircanski K, Pine DS, Brotman MA. Selecting an Ecological Momentary Assessment Platform: Tutorial for Researchers. J Med Internet Res 2024; 26:e51125. [PMID: 38175682 PMCID: PMC10797510 DOI: 10.2196/51125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/25/2023] [Accepted: 10/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Although ecological momentary assessment (EMA) has been applied in psychological research for decades, delivery methods have evolved with the proliferation of digital technology. Technological advances have engendered opportunities for enhanced accessibility, convenience, measurement precision, and integration with wearable sensors. Notwithstanding, researchers must navigate novel complexities in EMA research design and implementation. OBJECTIVE In this paper, we aimed to provide guidance on platform selection for clinical scientists launching EMA studies. METHODS Our team includes diverse specialties in child and adolescent behavioral and mental health with varying expertise on EMA platforms (eg, users and developers). We (2 research sites) evaluated EMA platforms with the goal of identifying the platform or platforms with the best fit for our research. We created a list of extant EMA platforms; conducted a web-based review; considered institutional security, privacy, and data management requirements; met with developers; and evaluated each of the candidate EMA platforms for 1 week. RESULTS We selected 2 different EMA platforms, rather than a single platform, for use at our 2 research sites. Our results underscore the importance of platform selection driven by individualized and prioritized laboratory needs; there is no single, ideal platform for EMA researchers. In addition, our project generated 11 considerations for researchers in selecting an EMA platform: (1) location; (2) developer involvement; (3) sample characteristics; (4) onboarding; (5) survey design features; (6) sampling scheme and scheduling; (7) viewing results; (8) dashboards; (9) security, privacy, and data management; (10) pricing and cost structure; and (11) future directions. Furthermore, our project yielded a suggested timeline for the EMA platform selection process. CONCLUSIONS This study will guide scientists initiating studies using EMA, an in vivo, real-time research tool with tremendous promise for facilitating advances in psychological assessment and intervention.
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Affiliation(s)
- Lauren M Henry
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Eleanor Hansen
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Justin Chimoff
- Department of Anesthesiology, Critical Care and Pain Medicine Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Kimberly Pokstis
- Department of Anesthesiology, Critical Care and Pain Medicine Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Miryam Kiderman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Reut Naim
- The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care and Pain Medicine Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Meghan E Byrne
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Silvia Lopez-Guzman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, United States
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Valadez EA, Tottenham N, Korom M, Tabachnick AR, Pine DS, Dozier M. A Randomized Controlled Trial of a Parenting Intervention During Infancy Alters Amygdala-Prefrontal Circuitry in Middle Childhood. J Am Acad Child Adolesc Psychiatry 2024; 63:29-38. [PMID: 37385583 PMCID: PMC10751390 DOI: 10.1016/j.jaac.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 04/21/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE Early adverse parenting predicts various negative outcomes, including psychopathology and altered development. Animal work suggests that adverse parenting might change amygdala-prefrontal cortex (PFC) circuitry, but work in humans remains correlational. The present study leveraged data from a randomized controlled trial examining the efficacy of an early parenting intervention targeting parental nurturance and sensitivity (Attachment and Biobehavioral Catch-up [ABC]) to test whether early parenting quality causally affects amygdala-PFC connectivity later in life. METHOD Participants (N = 60, mean age = 10.0 years) included 41 high-risk children whose parents were referred by Child Protective Services and randomly assigned to receive either ABC (n = 21) or a control intervention (n = 20) during the children's infancy and a comparison sample of low-risk children (n = 19). Amygdala-PFC connectivity was assessed via functional magnetic resonance imaging while children viewed fearful and neutral faces. RESULTS Across facial expressions, ABC produced different changes than the control intervention in amygdala-PFC connectivity in response to faces. The ABC group also exhibited greater responses than the control intervention group to faces in areas classically associated with emotion regulation, including the orbitofrontal cortex and right insula. Mediation analysis suggested that the effect of ABC on PFC activation was mediated by the intervention's effect on amygdala-PFC connectivity. CONCLUSION Results provide preliminary causal evidence for the effect of early parenting intervention on amygdala-PFC connectivity and on PFC responses to face viewing. Findings also highlight amygdala-PFC connectivity as a potential mediator of the effects of early parenting intervention on children's emotion regulation development. CLINICAL TRIAL REGISTRATION INFORMATION Intervening Early With Neglected Children; https://clinicaltrials.gov/; NCT02093052. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.
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Affiliation(s)
| | | | | | | | - Daniel S Pine
- National Institute of Mental Health, Bethesda, Maryland
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Hoffmann MS, Pine DS, Georgiades K, Szatmari P, Miguel EC, Pan PM, Gadelha A, Rohde LA, Merikangas KR, Milham MP, Satterthwaite TD, Salum GA. Comparing mental health semi-structured diagnostic interviews and symptom checklists to predict poor life outcomes: an 8-year cohort study from childhood to young adulthood in Brazil. Lancet Glob Health 2024; 12:e79-e89. [PMID: 37980914 PMCID: PMC10716620 DOI: 10.1016/s2214-109x(23)00462-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 03/04/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Semi-structured diagnostic interviews and symptom checklists present similar internal reliability. We aim to investigate whether they differ in predicting poor life outcomes in the transition from childhood to young adulthood. METHODS For this longitudinal study, we used data from the Brazilian High Risk Cohort Study for Childhood Mental Health Conditions. Eligible participants were aged 6-14 years on the day of study enrolment (January to February, 2010) and were enrolled in public schools by a biological parent in Porto Alegre and São Paulo, Brazil. 2511 young people and their caregivers were assessed at baseline in 2010-11, and 1917 were assessed 8 years later (2018-19; 76·3% retention). Clinical thresholds were derived using semi-structured parent-report interview based on the Diagnostic and Statistical Manual of Mental Disorders, according to the Developmental and Well-being Assessment (DAWBA), and clinical scores as defined by the Child Behavior Checklist (CBCL; T-score ≥70 considered positive caseness). At 8 years, participants were assessed for a composite life-threatening outcome (a composite of death, suicide attempts, severe self-harm, psychiatric inpatient admission, or emergency department visits) and a composite poor life chances outcome (a composite of any criminal conviction, substance misuse, or school dropout). We evaluated the accuracy of DAWBA and CBCL to predict these outcomes. Logistic regression models were adjusted for age, sex, race or ethnicity, study site, and socioeconomic class. FINDINGS DAWBA and CBCL had similar sensitivity, specificity, predictive values, and test accuracy for both composite outcomes and their components. Any mental health problem, as classified by DAWBA and CBCL, was independently associated with the composite life-threatening outcome (DAWBA adjusted odds ratio 1·62, 95% CI 1·20-2·18; CBCL 1·66, 1·19-2·30), but only CBCL independently predicted poor life chances (1·56, 1·19-2·04). Participants classified by both approaches did not have higher odds of the life-threatening outcome when compared with participants classified by DAWBA or CBCL alone, nor for the poor life chances outcome when compared with those classified by CBCL alone. INTERPRETATION Classifying children and adolescents based on a semi-structured diagnostic interview was not statistically different to symptom checklist in terms of test accuracy and predictive validity for relevant life outcomes. Classification based on symptom checklist might be a valid alternative to costly and time-consuming methods to identify young people at risk for poor life outcomes. FUNDING Conselho Nacional de Desenvolvimento Científico e Tecnológico; Fundação de Amparo à Pesquisa do Estado de São Paulo; and Medical Research Council, European Research Council. TRANSLATION For the Portuguese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mauricio Scopel Hoffmann
- Department of Neuropsychiatry and Mental Health Epidemiology Group (MHEG), Universidade Federal de Santa Maria, Santa Maria, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
| | - Daniel S Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Universidade de São Paulo, São Paulo, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Michael Peter Milham
- Nathan S Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Child Mind Institute, New York, NY, USA
| | - Theodore Daniel Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Informatics and Neuroimaging Center, Philadelphia, PA, USA
| | - Giovanni Abrahão Salum
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Child Mind Institute, New York, NY, USA
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Azriel O, Arad G, Pine DS, Lazarov A, Bar-Haim Y. Attention bias vs. attention control modification for social anxiety disorder: A randomized controlled trial. J Anxiety Disord 2024; 101:102800. [PMID: 38101253 PMCID: PMC10842890 DOI: 10.1016/j.janxdis.2023.102800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/19/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
Gaze-Contingent Music Reward Therapy (GC-MRT) is an eye-tracking-based attention bias modification protocol for social anxiety disorder (SAD) with established clinical efficacy. However, it remains unclear if improvement following GC-MRT hinges on modification of threat-related attention or on more general enhancement of attention control. Here, 50 patients with SAD were randomly allocated to GC-MRT using either threat faces or shapes. Results indicate comparable reductions in social anxiety and co-morbid depression symptoms in the two conditions. Patients in the shapes condition showed a significant increase in attention control and a reduction in attention to both the trained shapes and threat faces, whereas patients in the faces condition showed a reduction in attention to threat faces only. These findings suggest that enhancement of attention control, independent of valence-specific attention modification, may facilitate reduction in SAD symptoms. Alternative interpretations and clinical implications of the current findings are discussed.
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Affiliation(s)
- Omer Azriel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Gal Arad
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Suarez-Jimenez B, Lazarov A, Zhu X, Zilcha-Mano S, Kim Y, Marino CE, Rjabtsenkov P, Bavdekar SY, Pine DS, Bar-Haim Y, Larson CL, Huggins AA, Terri deRoon-Cassini, Tomas C, Fitzgerald J, Kennis M, Varkevisser T, Geuze E, Quidé Y, El Hage W, Wang X, O’Leary EN, Cotton AS, Xie H, Shih C, Disner SG, Davenport ND, Sponheim SR, Koch SB, Frijling JL, Nawijn L, van Zuiden M, Olff M, Veltman DJ, Gordon EM, May G, Nelson SM, Jia-Richards M, Neria Y, Morey RA. Intrusive Traumatic Re-Experiencing Domain: Functional Connectivity Feature Classification by the ENIGMA PTSD Consortium. Biol Psychiatry Glob Open Sci 2024; 4:299-307. [PMID: 38298781 PMCID: PMC10829610 DOI: 10.1016/j.bpsgos.2023.05.006] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/12/2023] [Accepted: 05/22/2023] [Indexed: 02/02/2024] Open
Abstract
Background Intrusive traumatic re-experiencing domain (ITRED) was recently introduced as a novel perspective on posttraumatic psychopathology, proposing to focus research of posttraumatic stress disorder (PTSD) on the unique symptoms of intrusive and involuntary re-experiencing of the trauma, namely, intrusive memories, nightmares, and flashbacks. The aim of the present study was to explore ITRED from a neural network connectivity perspective. Methods Data were collected from 9 sites taking part in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) PTSD Consortium (n= 584) and included itemized PTSD symptom scores and resting-state functional connectivity (rsFC) data. We assessed the utility of rsFC in classifying PTSD, ITRED-only (no PTSD diagnosis), and trauma-exposed (TE)-only (no PTSD or ITRED) groups using a machine learning approach, examining well-known networks implicated in PTSD. A random forest classification model was built on a training set using cross-validation, and the averaged cross-validation model performance for classification was evaluated using the area under the curve. The model was tested using a fully independent portion of the data (test dataset), and the test area under the curve was evaluated. Results rsFC signatures differentiated TE-only participants from PTSD and ITRED-only participants at about 60% accuracy. Conversely, rsFC signatures did not differentiate PTSD from ITRED-only individuals (45% accuracy). Common features differentiating TE-only participants from PTSD and ITRED-only participants mainly involved default mode network-related pathways. Some unique features, such as connectivity within the frontoparietal network, differentiated TE-only participants from one group (PTSD or ITRED-only) but to a lesser extent from the other group. Conclusions Neural network connectivity supports ITRED as a novel neurobiologically based approach to classifying posttrauma psychopathology.
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Affiliation(s)
- Benjamin Suarez-Jimenez
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Amit Lazarov
- Department of Clinical Psychology, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York
| | - Sigal Zilcha-Mano
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, Israel
| | - Yoojean Kim
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Claire E. Marino
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Pavel Rjabtsenkov
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Shreya Y. Bavdekar
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Daniel S. Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, Maryland
| | - Yair Bar-Haim
- Department of Clinical Psychology, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | | | | | - Mitzy Kennis
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Varkevisser
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yann Quidé
- School of Psychology, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Wissam El Hage
- Unité Mixte de Recherche 1253, Institut National de la Santé et de la Recherche Médicale, Université de Tours, Tours, France
- Centre d'investigation Clinique 1415, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Xin Wang
- University of Toledo, Toledo, Ohio
| | | | | | - Hong Xie
- University of Toledo, Toledo, Ohio
| | | | - Seth G. Disner
- Minneapolis VA Health Care System, Minneapolis, Minnesota
| | | | | | - Saskia B.J. Koch
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Jessie L. Frijling
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Evan M. Gordon
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Geoffery May
- VISN 17 Center of Excellence for Research on Returning War Veterans, U.S. Department of Veterans Affairs, Waco, Texas
| | - Steven M. Nelson
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | | | - Yuval Neria
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York
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Tan E, Zeytinoglu S, Morales S, Buzzell GA, Almas AN, Degnan KA, Chronis-Tuscano A, Henderson H, Pine DS, Fox NA. Social versus non-social behavioral inhibition: Differential prediction from early childhood of long-term psychosocial outcomes. Dev Sci 2024; 27:e13427. [PMID: 37345685 PMCID: PMC10739650 DOI: 10.1111/desc.13427] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 04/14/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
Behavioral inhibition (BI) is a temperamental style characterized by cautious and fearful behaviors in novel situations. The present multi-method, longitudinal study examined whether young children's observed and parent-reported BI in social versus non-social contexts predicts different long-term psychosocial outcomes. Participants (N = 279) were drawn from a longitudinal study of socioemotional development. BI in social contexts ("social BI") was measured via children's observed wariness toward unfamiliar adults and peers at 24 and 36 months and parents' reports of children's social fear/shyness at 24, 36, and 48 months. BI in non-social contexts ("non-social BI") was measured via children's observed fearful responses to masks and novel toys, and parents' reports of children's distress to non-social novelty at 9 months and non-social fear at 48 months. At 15 years, anxiety was assessed via adolescent- and parent-reports, and global internalizing and externalizing problems were assessed via parent-reports. Confirmatory factor analysis showed that a two-factor model fit the BI data significantly better than a single-factor model, providing evidence for the dissociation of BI in social versus non-social contexts. Social BI was uniquely associated with adolescent social anxiety, whereas non-social BI was specifically associated with adolescent separation anxiety. Neither social BI nor non-social BI predicted global internalizing and externalizing problems, providing evidence for the specific relations between BI and anxiety problems. Together, these results suggest that young children's inhibited responses in social versus non-social situations predict different subtypes of anxiety problems in adolescence, highlighting the multifaceted nature of BI and the divergent trajectories of different anxiety problems.
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Affiliation(s)
- Enda Tan
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
- Neuroscience and Cognitive Science Program, University of Maryland, College Park
| | - Selin Zeytinoglu
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | | | | | - Alisa N. Almas
- School of Population and Public Health, University of British Columbia
| | | | | | | | - Daniel S. Pine
- Emotion and Development Branch, Section on Development and Affective Neuroscience, National Institute of Mental Health
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
- Neuroscience and Cognitive Science Program, University of Maryland, College Park
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Sylvester CM, Luby JL, Pine DS. Novel mechanism-based treatments for pediatric anxiety and depressive disorders. Neuropsychopharmacology 2024; 49:262-275. [PMID: 37608220 PMCID: PMC10700626 DOI: 10.1038/s41386-023-01709-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
Pediatric anxiety and depressive disorders are common, can be highly impairing, and can persist despite the best available treatments. Here, we review research into novel treatments for childhood anxiety and depressive disorders designed to target underlying cognitive, emotional, and neural circuit mechanisms. We highlight three novel treatments lying along a continuum relating to clinical impact of the disorder and the intensity of clinical management required. We review cognitive training, which involves the lowest risk and may be applicable for problems with mild to moderate impact; psychotherapy, which includes a higher level of clinical involvement and may be sufficient for problems with moderate impact; and brain stimulation, which has the highest potential risks and is therefore most appropriate for problems with high impact. For each treatment, we review the specific underlying cognitive, emotional, and brain circuit mechanisms that are being targeted, whether treatments modify those underlying mechanisms, and efficacy in reducing symptoms. We conclude by highlighting future directions, including the importance of work that leverages developmental windows of high brain plasticity to time interventions to the specific epochs in childhood that have the largest and most enduring life-long impact.
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Affiliation(s)
- Chad M Sylvester
- Washington University Department of Psychiatry, St. Louis, MO, USA.
- Washington University Department of Radiology, St. Louis, MO, USA.
| | - Joan L Luby
- Washington University Department of Psychiatry, St. Louis, MO, USA
| | - Daniel S Pine
- National Institute of Mental Health, Emotion and Development Branch, St. Louis, MO, USA
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20
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Liuzzi L, Pine DS, Fox NA, Averbeck BB. Changes in Behavior and Neural Dynamics across Adolescent Development. J Neurosci 2023; 43:8723-8732. [PMID: 37848282 PMCID: PMC10727120 DOI: 10.1523/jneurosci.0462-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/28/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023] Open
Abstract
Adolescence is an important developmental period, during which substantial changes occur in brain function and behavior. Several aspects of executive function, including response inhibition, improve during this period. Correspondingly, structural imaging studies have documented consistent decreases in cortical and subcortical gray matter volume, and postmortem histologic studies have found substantial (∼40%) decreases in excitatory synapses in prefrontal cortex. Recent computational modeling work suggests that the change in synaptic density underlie improvements in task performance. These models also predict changes in neural dynamics related to the depth of attractor basins, where deeper basins can underlie better task performance. In this study, we analyzed task-related neural dynamics in a large cohort of longitudinally followed subjects (male and female) spanning early to late adolescence. We found that age correlated positively with behavioral performance in the Eriksen Flanker task. Older subjects were also characterized by deeper attractor basins around task related evoked EEG potentials during specific cognitive operations. Thus, consistent with computational models examining the effects of excitatory synaptic pruning, older adolescents showed stronger attractor dynamics during task performance.SIGNIFICANCE STATEMENT There are well-documented changes in brain and behavior during adolescent development. However, there are few mechanistic theories that link changes in the brain to changes in behavior. Here, we tested a hypothesis, put forward on the basis of computational modeling, that pruning of excitatory synapses in cortex during adolescence changes neural dynamics. We found, consistent with the hypothesis, that variability around event-related potentials shows faster decay dynamics in older adolescent subjects. The faster decay dynamics are consistent with the hypothesis that synaptic pruning during adolescent development leads to stronger attractor basins in task-related neural activity.
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Affiliation(s)
- Lucrezia Liuzzi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, 20892, MD
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, 20892, MD
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20742
| | - Bruno B Averbeck
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, 20892, MD
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Byrne ME, Bernstein RA, Pine DS, Kircanski K. Ecological Momentary Assessment of Youth Anxiety: Evaluation of Psychometrics for Use in Clinical Trials. J Child Adolesc Psychopharmacol 2023; 33:409-417. [PMID: 38052059 PMCID: PMC10733775 DOI: 10.1089/cap.2023.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Background: Ecological momentary assessment (EMA) captures naturalistic experience in real time and holds promise to improve our understanding and treatment of youth psychopathology. While psychometric evaluation of EMA methods is crucial, particularly for use as a tool in clinical trials, research examining the reliability and validity of EMA items in youth is lacking. Method: This study evaluates EMA responses from 204 child and adolescent participants (M age = 12.54, 60.8% female), including 131 participants with an anxiety disorder and 73 participants with no psychiatric diagnosis. We assessed the within- and between-person variability, internal consistency, test-retest reliability, and convergent and discriminant validity of two EMA items probing anxiety symptoms; one positive affect item served as a comparison. Results: All psychometric properties of the anxiety items were at least satisfactory in youth with anxiety disorders. However, there was restricted variability and poor test-retest reliability in youth with no diagnosis. Discussion: These results might facilitate future clinical trials using EMA to investigate pediatric anxiety. Results also suggest that unique EMA items might be needed to reliably track anxiety in healthy youth. Future work should continue to examine the psychometric properties of EMA protocols before implementation in clinical trials. ClinicalTrials.gov identifier: NCT00018057.
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Affiliation(s)
- Meghan E. Byrne
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Rachel A. Bernstein
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Katharina Kircanski
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
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22
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Shamai-Leshem D, Abend R, Arad G, Azriel O, Chong L, de Jong P, Dykan CDG, Hajcak G, Klawohn J, Meyer A, Neophytou K, Neria Y, Panayiotou G, Schneier F, Soleymani A, Yair N, Pine DS, Bar-Haim Y, Lazarov A. The free-viewing matrix task: A reliable measure of attention allocation in psychopathology. J Anxiety Disord 2023; 100:102789. [PMID: 37949029 DOI: 10.1016/j.janxdis.2023.102789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 09/25/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
Aberrant attention allocation has been implicated in the etiology and maintenance of a range of psychopathologies. However, three decades of research, relying primarily on manual response-time tasks, have been challenged on the grounds of poor reliability of its attention bias indices. Here, in a large, multisite, international study we provide reliability information for a new eye-tracking-based measure of attention allocation and its relation to psychopathology and age. Data from 1567 participants, across a wide range of psychiatric diagnoses and ages, were aggregated from nine sites around the world. Of these, 213 participants also provided retest data. Acceptable overall internal consistency and test-retest reliability were observed among adult participants (Cronbach's alpha = 0.86 and r(213) = 0.89, respectively), as well as across all examined psychopathologies. Youth demonstrated lower internal consistency scores (Cronbach's alpha = 0.65). Finally, the percent dwell time index derived from the task statistically differentiated between healthy participants and participants diagnosed with social anxiety disorder, major depression, and post-traumatic stress disorder. These results potentially address a long-standing reliability crisis in this research field. Aberrant attention allocation patterns in a variety of psychiatric disorders may be targeted with the hope of affecting symptoms. The attention allocation index derived from the matrix task offers reliable means to measure such cognitive target engagement in clinical contexts.
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Affiliation(s)
- Dana Shamai-Leshem
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, USA
| | - Gal Arad
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Omer Azriel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Lyndsey Chong
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Peter de Jong
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | | | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Julia Klawohn
- Department of Psychology, Florida State University, Tallahassee, FL, USA; Department of Medicine, MSB Medical School Berlin, Berlin, Germany
| | - Alexandria Meyer
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - Yuval Neria
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | | | - Franklin Schneier
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Ali Soleymani
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Centre of Education and Learning, Technical University of Delft, Delft, the Netherlands
| | - Noga Yair
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, USA
| | - Yair Bar-Haim
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
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Schwarzlose RF, Filippi CA, Myers MJ, Harper J, Camacho MC, Smyser TA, Rogers CE, Shimony JS, Warner BB, Luby JL, Barch DM, Pine DS, Smyser CD, Fox NA, Sylvester CM. Neonatal neural responses to novelty related to behavioral inhibition at 1 year. Dev Psychol 2023:2024-26488-001. [PMID: 37971828 PMCID: PMC11096262 DOI: 10.1037/dev0001654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Behavioral inhibition (BI), an early-life temperament characterized by vigilant responses to novelty, is a risk factor for anxiety disorders. In this study, we investigated whether differences in neonatal brain responses to infrequent auditory stimuli relate to children's BI at 1 year of age. Using functional magnetic resonance imaging (fMRI), we collected blood-oxygen-level-dependent (BOLD) data from N = 45 full-term, sleeping neonates during an adapted auditory oddball paradigm and measured BI from n = 27 of these children 1 year later using an observational assessment. Whole-brain analyses corrected for multiple comparisons identified 46 neonatal brain regions producing novelty-evoked BOLD responses associated with children's BI scores at 1 year of age. More than half of these regions (n = 24, 52%) were in prefrontal cortex, falling primarily within regions of the default mode or frontoparietal networks or in ventromedial/orbitofrontal regions without network assignments. Hierarchical clustering of the regions based on their patterns of association with BI resulted in two groups with distinct anatomical, network, and response-timing profiles. The first group, located primarily in subcortical and temporal regions, tended to produce larger early oddball responses among infants with lower subsequent BI. The second group, located primarily in prefrontal cortex, produced larger early oddball responses among infants with higher subsequent BI. These results provide preliminary insights into brain regions engaged by novelty in infants that may relate to later BI. The findings may inform understanding of anxiety disorders and guide future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Courtney A Filippi
- Department of Child and Adolescent Psychiatry, New York University School of Medicine
| | - Michael J Myers
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Jennifer Harper
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - M Catalina Camacho
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis
| | - Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Daniel S Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health
| | | | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland
| | - Chad M Sylvester
- Department of Psychiatry, Washington University School of Medicine in St. Louis
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24
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Pine DS. Commentary on the special issue: Leveraging measurement to refine developmental perspectives on psychopathology. Int J Methods Psychiatr Res 2023; 32:e1996. [PMID: 37906502 PMCID: PMC10654816 DOI: 10.1002/mpr.1996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Affiliation(s)
- Daniel S. Pine
- Section on Development and Affective NeuroscienceNational Institute of Mental Health Intramural Research ProgramBethesdaMarylandUSA
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25
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Byrne ME, Tanofsky-Kraff M, Liuzzi L, Holroyd T, Parker MN, Bloomer BF, Nugent A, Brady SM, Yang SB, Turner SA, Pine DS, Yanovski JA. Neural underpinnings of threat bias in relation to loss-of-control eating behaviors among adolescent girls with high weight. Front Psychiatry 2023; 14:1276300. [PMID: 37965354 PMCID: PMC10642175 DOI: 10.3389/fpsyt.2023.1276300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction Loss-of-control (LOC) eating, a key feature of binge-eating disorder, may relate attentional bias (AB) to highly salient interpersonal stimuli. The current pilot study used magnetoencephalography (MEG) to explore neural features of AB to socially threatening cues in adolescent girls with and without LOC-eating. Methods Girls (12-17 years old) with overweight or obesity (BMI >85th percentile) completed an AB measure on an affective dot-probe AB task during MEG and evoked neural responses to angry or happy (vs. neutral) face cues were captured. A laboratory test meal paradigm measured energy intake and macronutrient consumption patterns. Results Girls (N = 34; Mage = 15.5 ± 1.5 years; BMI-z = 1.7 ± 0.4) showed a blunted evoked response to the presentation of angry face compared with neutral face cues in the left dorsolateral prefrontal cortex, a neural region implicated in executive control and regulation processes, during attention deployment (p < 0.01). Compared with those without LOC-eating (N = 21), girls with LOC-eating (N = 13) demonstrated a stronger evoked response to angry faces in the visual cortex during attention deployment (p < 0.001). Visual and cognitive control ROIs had trends suggesting interaction with test meal intake patterns among girls with LOC-eating (ps = 0.01). Discussion These findings suggest that girls with overweight or obesity may fail to adaptively engage neural regions implicated in higher-order executive processes. This difficulty may relate to disinhibited eating patterns that could lead to excess weight gain.
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Affiliation(s)
- Meghan E. Byrne
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Marian Tanofsky-Kraff
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, United States
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, United States
| | - Lucrezia Liuzzi
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Tom Holroyd
- MEG Core Facility, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Megan N. Parker
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, United States
| | - Bess F. Bloomer
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Allison Nugent
- MEG Core Facility, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Sheila M. Brady
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Shanna B. Yang
- Nutrition Department, Clinical Center, NIH, Bethesda, MD, United States
| | - Sara A. Turner
- Nutrition Department, Clinical Center, NIH, Bethesda, MD, United States
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Jack A. Yanovski
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
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26
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Zugman A, Jett L, Antonacci C, Winkler AM, Pine DS. A systematic review and meta-analysis of resting-state fMRI in anxiety disorders: Need for data sharing to move the field forward. J Anxiety Disord 2023; 99:102773. [PMID: 37741177 PMCID: PMC10753861 DOI: 10.1016/j.janxdis.2023.102773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
Anxiety disorders are among the most prevalent psychiatric disorders. Neuroimaging findings remain uncertain, and resting state functional magnetic resonance (rs-fMRI) connectivity is of particular interest since it is a scalable functional imaging modality. Given heterogeneous past findings for rs-fMRI in anxious individuals, we characterize patterns across anxiety disorders by conducting a systematic review and meta-analysis. Studies were included if they contained at the time of scanning both a healthy group and a patient group. Due to insufficient study numbers, the quantitative meta-analysis only included seed-based studies. We performed an activation likelihood estimation (ALE) analysis that compared patients and healthy volunteers. All analyses were corrected for family-wise error with a cluster-level threshold of p < .05. Patients exhibited hypo-connectivity between the amygdala and the medial frontal gyrus, anterior cingulate cortex, and cingulate gyrus. This finding, however, was not robust to potential file-drawer effects. Though limited by strict inclusion criteria, our results highlight the heterogeneous nature of reported findings. This underscores the need for data sharing when attempting to detect reliable patterns of disruption in brain activity across anxiety disorders.
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Affiliation(s)
- André Zugman
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States.
| | - Laura Jett
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Child Emotion Lab, University of Wisconsin, Madison, Madison, WI, United States.
| | - Chase Antonacci
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Department of Psychology, Stanford University, Stanford, CA, United States.
| | - Anderson M Winkler
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Division of Human Genetics, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, Texas, United States.
| | - Daniel S Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States.
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Harrewijn A, Ruiz SG, Abend R, Haller SP, Subar AR, Swetlitz C, Valadez EA, Brotman MA, Chen G, Chronis-Tuscano A, Leibenluft E, Bar-Haim Y, Fox NA, Pine DS. Development of Neural Mechanisms Underlying Threat Processing: Associations With Childhood Social Reticence and Adolescent Anxiety. Biol Psychiatry Glob Open Sci 2023; 3:893-901. [PMID: 37881548 PMCID: PMC10593903 DOI: 10.1016/j.bpsgos.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
Background Social reticence in early childhood is characterized by shy and anxiously avoidant behavior, and it confers risk for pediatric anxiety disorders later in development. Aberrant threat processing may play a critical role in this association between early reticent behavior and later psychopathology. The goal of this longitudinal study is to characterize developmental trajectories of neural mechanisms underlying threat processing and relate these trajectories to associations between early-childhood social reticence and adolescent anxiety. Methods In this 16-year longitudinal study, social reticence was assessed from 2 to 7 years of age; anxiety symptoms and neural mechanisms during the dot-probe task were assessed at 10, 13, and 16 years of age. The sample included 144 participants: 71 children provided data at age 10 (43 girls, meanage = 10.62), 85 at age 13 (46 girls, meanage = 13.25), and 74 at age 16 (36 girls, meanage = 16.27). Results A significant interaction manifested among social reticence, anxiety symptoms, and time, on functional connectivity between the left amygdala and the left dorsolateral prefrontal cortex, voxelwise p < .001, clusterwise familywise error p < .05. Children with high social reticence showed a negative association between amygdala-dorsolateral prefrontal cortex connectivity and anxiety symptoms with age, compared to children with low social reticence, suggesting distinct neurodevelopmental pathways to anxiety. Conclusions These findings were present across all conditions, suggesting task-general effects in potential threat processing. Additionally, the timing of these neurodevelopmental pathways differed for children with high versus low social reticence, which could affect the timing of effective preventive interventions.
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Affiliation(s)
- Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Sonia G. Ruiz
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
- School of Psychology, Reichman University, Herzliya, Israel
| | - Simone P. Haller
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Anni R. Subar
- Department of Psychology, University of Denver, Denver, Colorado
| | | | - Emilio A. Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Gang Chen
- Scientific and Statistical Computing Core, National Institute of Mental Health, Bethesda, Maryland
| | | | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Yair Bar-Haim
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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28
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Drysdale AT, Myers MJ, Harper JC, Guard M, Manhart M, Yu Q, Perino MT, Luby JL, Barch DM, Pine DS, Sylvester CM. A Novel Cognitive Training Program Targets Stimulus-Driven Attention to Alter Symptoms, Behavior, and Neural Circuitry in Pediatric Anxiety Disorders: Pilot Clinical Trial. J Child Adolesc Psychopharmacol 2023; 33:306-315. [PMID: 37669021 PMCID: PMC10616944 DOI: 10.1089/cap.2023.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Objective: Pediatric anxiety disorders are associated with increased stimulus-driven attention (SDA), the involuntary capture of attention by salient stimuli. Increased SDA is linked to increased activity in the right ventrolateral prefrontal cortex (rVLPFC), especially in the portion corresponding to the ventral attention network (VAN). In this study, we present a small clinical trial using a novel attention training program designed to treat pediatric anxiety by decreasing SDA and activity in the rVLPFC. Methods: Children ages 8-12 with anxiety disorders (n = 18) participated in eight sessions of attention training over a 4-week period. At baseline and after completing training, participants completed clinical anxiety measures and a battery of cognitive tasks designed to measure three different aspects of attention: SDA, goal-oriented attention, and threat bias. A subset of participants (n = 12) underwent baseline and post-training neuroimaging while engaged in an SDA task. Brain analyses focused on activity within the rVLPFC. Results: Parent (p < 0.001)-, child (p < 0.002)-, and clinician-rated (p < 0.02) anxiety improved significantly over the course of training. Training significantly altered SDA [F(1,92) = 8.88, corrected p-value (pcor) < 0.012, uncorrected p-value (puncor) < 0.004]. Anxiety improvement correlated with improvements in goal-directed attention [r(10) = 0.60, pcor < 0.12 puncor < 0.04]. Within an area of the rVLPFC corresponding to the cingulo-opercular network (CON), there was a main effect of training [F(1,20) = 6.75, pcor < 0.16, puncor < 0.02], with decreasing signal across training. There was a significant interaction between training and anxiety on this region's activity [F(1,20) = 9.48, pcor < 0.048, puncor < 0.006]. Post hoc testing revealed that post-training activity within this CON area correlated with residual anxiety [r(10) = 0.68, p < 0.02]. Conclusions: SDA and rVLPFC neural activity may be novel therapeutic targets in pediatric anxiety. After undergoing a training paradigm aimed at modifying this aspect of attention and its underlying neural circuitry, patients showed lower anxiety, changes in SDA and goal-oriented attention, and decreased activity in the CON portion of the rVLPFC.
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Affiliation(s)
- Andrew T. Drysdale
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael J. Myers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jennifer C. Harper
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Meg Guard
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Megan Manhart
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Qiongru Yu
- Department of Psychology and San Diego State University, San Diego, California, USA
- Department of Psychiatry, San Diego State University, San Diego, California, USA
| | - Michael T. Perino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joan L. Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Deanna M. Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Psychological and Brain Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Daniel S. Pine
- National Institute of Mental Health, Bethesda, Maryland, USA
| | - Chad M. Sylvester
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Conte S, Richards JE, Fox NA, Valadez EA, McSweeney M, Tan E, Pine DS, Winkler AM, Liuzzi L, Cardinale EM, White LK, Buzzell GA. Multimodal study of the neural sources of error monitoring in adolescents and adults. Psychophysiology 2023; 60:e14336. [PMID: 37212619 PMCID: PMC10524909 DOI: 10.1111/psyp.14336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 05/23/2023]
Abstract
The ability to monitor performance during a goal-directed behavior differs among children and adults in ways that can be measured with several tasks and techniques. As well, recent work has shown that individual differences in error monitoring moderate temperamental risk for anxiety and that this moderation changes with age. We investigated age differences in neural responses linked to performance monitoring using a multimodal approach. The approach combined functional MRI and source localization of event-related potentials (ERPs) in 12-year-old, 15-year-old, and adult participants. Neural generators of two components related to performance and error monitoring, the N2 and ERN, lay within specific areas of fMRI clusters. Whereas correlates of the N2 component appeared similar across age groups, age-related differences manifested in the location of the generators of the ERN component. The dorsal anterior cingulate cortex (dACC) was the predominant source location for the 12-year-old group; this area manifested posteriorly for the 15-year-old and adult groups. A fMRI-based ROI analysis confirmed this pattern of activity. These results suggest that changes in the underlying neural mechanisms are related to developmental changes in performance monitoring.
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Affiliation(s)
- Stefania Conte
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - John E Richards
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Emilio A Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Marco McSweeney
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Enda Tan
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Daniel S Pine
- National Institute of Mental Health, Emotion and Development Branch, Bethesda, Maryland, USA
| | - Anderson M Winkler
- National Institute of Mental Health, Emotion and Development Branch, Bethesda, Maryland, USA
| | - Lucrezia Liuzzi
- National Institute of Mental Health, Emotion and Development Branch, Bethesda, Maryland, USA
| | - Elise M Cardinale
- National Institute of Mental Health, Emotion and Development Branch, Bethesda, Maryland, USA
| | - Lauren K White
- Lifespan Brain Institute of the Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - George A Buzzell
- Florida International University and the Center for Children and Families, Miami, Florida, USA
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30
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Affiliation(s)
- Daniel S Pine
- Ross Center, Washington, D.C.; National Institute of Mental Health, Bethesda, Md
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31
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Rapee RM, Creswell C, Kendall PC, Pine DS, Waters AM. Anxiety disorders in children and adolescents: A summary and overview of the literature. Behav Res Ther 2023; 168:104376. [PMID: 37499294 DOI: 10.1016/j.brat.2023.104376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.
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Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia.
| | - Cathy Creswell
- Departments of Psychiatry and Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip C Kendall
- Department of Psychology, Temple University, Child and Adolescent Anxiety Disorders Clinic, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program (NIMH-IRP), USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Brisbane, Australia
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32
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Chen G, Taylor PA, Reynolds RC, Leibenluft E, Pine DS, Brotman MA, Pagliaccio D, Haller SP. BOLD Response is more than just magnitude: Improving detection sensitivity through capturing hemodynamic profiles. Neuroimage 2023; 277:120224. [PMID: 37327955 PMCID: PMC10527035 DOI: 10.1016/j.neuroimage.2023.120224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/21/2023] [Accepted: 06/11/2023] [Indexed: 06/18/2023] Open
Abstract
Typical fMRI analyses often assume a canonical hemodynamic response function (HRF) that primarily focuses on the peak height of the overshoot, neglecting other morphological aspects. Consequently, reported analyses often reduce the overall response curve to a single scalar value. In this study, we take a data-driven approach to HRF estimation at the whole-brain voxel level, without assuming a response profile at the individual level. We then employ a roughness penalty at the population level to estimate the response curve, aiming to enhance predictive accuracy, inferential efficiency, and cross-study reproducibility. By examining a fast event-related FMRI dataset, we demonstrate the shortcomings and information loss associated with adopting the canonical approach. Furthermore, we address the following key questions: 1) To what extent does the HRF shape vary across different regions, conditions, and participant groups? 2) Does the data-driven approach improve detection sensitivity compared to the canonical approach? 3) Can analyzing the HRF shape help validate the presence of an effect in conjunction with statistical evidence? 4) Does analyzing the HRF shape offer evidence for whole-brain response during a simple task?
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Affiliation(s)
- Gang Chen
- Scientific and Statistical Computing Core, National Institute of Mental Health, USA.
| | - Paul A Taylor
- Scientific and Statistical Computing Core, National Institute of Mental Health, USA
| | - Richard C Reynolds
- Scientific and Statistical Computing Core, National Institute of Mental Health, USA
| | - Ellen Leibenluft
- Neuroscience and Novel Therapeutics Unit, Emotion and Development Branch, National Institute of Mental Health, USA
| | - Daniel S Pine
- Neuroscience and Novel Therapeutics Unit, Emotion and Development Branch, National Institute of Mental Health, USA
| | - Melissa A Brotman
- Neuroscience and Novel Therapeutics Unit, Emotion and Development Branch, National Institute of Mental Health, USA
| | | | - Simone P Haller
- Neuroscience and Novel Therapeutics Unit, Emotion and Development Branch, National Institute of Mental Health, USA
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33
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Ravi S, Havewala M, Kircanski K, Brotman MA, Schneider L, Degnan K, Almas A, Fox N, Pine DS, Leibenluft E, Filippi C. Parenting and childhood irritability: Negative emotion socialization and parental control moderate the development of irritability. Dev Psychopathol 2023; 35:1444-1453. [PMID: 35039102 PMCID: PMC9289071 DOI: 10.1017/s0954579421001346] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 11/06/2022]
Abstract
Irritability, characterized by anger in response to frustration, is normative in childhood. While children typically show a decline in irritability from toddlerhood to school age, elevated irritability throughout childhood may predict later psychopathology. The current study (n = 78) examined associations between trajectories of irritability in early childhood (ages 2-7) and irritability in adolescence (age 12) and tested whether these associations are moderated by parenting behaviors. Results indicate that negative emotion socialization moderated trajectories of irritability - relative to children with low stable irritability, children who exhibited high stable irritability in early childhood and who had parents that exhibited greater negative emotion socialization behaviors had higher irritability in adolescence. Further, negative parental control behavior moderated trajectories of irritability - relative to children with low stable irritability, children who had high decreasing irritability in early childhood and who had parents who exhibited greater negative control behaviors had higher irritability in adolescence. In contrast, positive emotion socialization and control behaviors did not moderate the relations between early childhood irritability and later irritability in adolescence. These results suggest that both irritability in early childhood and negative parenting behaviors may jointly influence irritability in adolescence. The current study underscores the significance of negative parenting behaviors and could inform treatment.
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Affiliation(s)
- Sanjana Ravi
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Mazneen Havewala
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Leslie Schneider
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Kathryn Degnan
- Department of Psychology, Catholic University of America, Washington, DC, USA
| | - Alisa Almas
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Nathan Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Courtney Filippi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
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Tseng WL, Naim R, Chue A, Shaughnessy S, Meigs J, Pine DS, Leibenluft E, Kircanski K, Brotman MA. Network analysis of ecological momentary assessment identifies frustration as a central node in irritability. J Child Psychol Psychiatry 2023; 64:1212-1221. [PMID: 36977629 PMCID: PMC10615387 DOI: 10.1111/jcpp.13794] [Citation(s) in RCA: 1] [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] [Accepted: 02/20/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Irritability presents transdiagnostically, commonly occurring with anxiety and other mood symptoms. However, little is known about the temporal and dynamic interplay among irritability-related clinical phenomena. Using a novel network analytic approach with smartphone-based ecological momentary assessment (EMA), we examined how irritability and other anxiety and mood symptoms were connected. METHODS Sample included 152 youth ages 8-18 years (M ± SD = 12.28 ± 2.53; 69.74% male; 65.79% White) across several diagnostic groups enriched for irritability including disruptive mood dysregulation disorder (n = 34), oppositional defiant disorder (n = 9), attention-deficit/hyperactivity disorder (n = 47), anxiety disorder (n = 29), and healthy comparisons (n = 33). Participants completed EMA on irritability-related constructs and other mood and anxiety symptoms three times a day for 7 days. EMA probed symptoms on two timescales: "since the last prompt" (between-prompt) versus "at the time of the prompt" (momentary). Irritability was also assessed using parent-, child- and clinician-reports (Affective Reactivity Index; ARI), following EMA. Multilevel vector autoregressive (mlVAR) models estimated a temporal, a contemporaneous within-subject and a between-subject network of symptoms, separately for between-prompt and momentary symptoms. RESULTS For between-prompt symptoms, frustration emerged as the most central node in both within- and between-subject networks and predicted more mood changes at the next timepoint in the temporal network. For momentary symptoms, sadness and anger emerged as the most central node in the within- and between-subject network, respectively. While anger was positively related to sadness within individuals and measurement occasions, anger was more broadly positively related to sadness, mood lability, and worry between/across individuals. Finally, mean levels, not variability, of EMA-indexed irritability were strongly related to ARI scores. CONCLUSIONS This study advances current understanding of symptom-level and temporal dynamics of irritability. Results suggest frustration as a potential clinically relevant treatment target. Future experimental work and clinical trials that systematically manipulate irritability-related features (e.g. frustration, unfairness) will elucidate the causal relations among clinical variables.
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Affiliation(s)
- Wan-Ling Tseng
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Reut Naim
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Amanda Chue
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Shannon Shaughnessy
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Jennifer Meigs
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
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35
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Suarez-Jimenez B, Lazarov A, Zhu X, Pine DS, Bar-Haim Y, Neria Y. Attention allocation to negatively-valenced stimuli in PTSD is associated with reward-related neural pathways. Psychol Med 2023; 53:4666-4674. [PMID: 35652602 PMCID: PMC9715854 DOI: 10.1017/s003329172200157x] [Citation(s) in RCA: 1] [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: 10/14/2021] [Revised: 03/13/2022] [Accepted: 05/11/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND In a recent eye-tracking study we found a differential dwell time pattern for negatively-valenced and neutral faces among patients with posttraumatic stress disorder (PTSD), trauma-exposed healthy control (TEHCs), and healthy control (HC) participants. Here, we explored whether these group differences relate to resting-state functional connectivity (rsFC) patterns of brain areas previously linked to both attention processes and PTSD. These encompass the amygdala, dorsal anterior cingulate cortex (dACC), dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC), and nucleus accumbens (NAcc). METHODS Ten minutes magnetic resonance imaging rsFC scans were recorded in 17 PTSD patients, 21 TEHCs, and 16 HCs. Participants then completed a free-viewing eye-tracking task assessing attention allocation outside the scanner. Dwell time on negatively-valenced stimuli (DT%) were assessed relative to functional connectivity in the aforementioned seed regions of interest (amygdala, dACC, dlPFC, vlPFC, and NAcc) to whole-brain voxel-wise rsFC. RESULTS As previously reported, group differences occurred in attention allocation to negative-valence stimuli, with longer dwell time on negatively valence stimuli in the PTSD and TEHC groups than the HC group. Higher DT% correlated with weaker NAcc-orbitofrontal cortex (OFC) connectivity in patients with PTSD. Conversely, a positive association emerged in the HC group between DT% and NAcc-OFC connectivity. CONCLUSIONS While exploratory in nature, present findings may suggest that reward-related brain areas are involved in disengaging attention from negative-valenced stimuli, and possibly in regulating ensuing negative emotions.
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Affiliation(s)
- Benjamin Suarez-Jimenez
- Department of Neuroscience, The Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Amit Lazarov
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Daniel S. Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Yair Bar-Haim
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, New York, NY, USA
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36
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Alon Y, Azriel O, Pine DS, Bar-Haim Y. A randomized controlled trial of supervised remotely-delivered attention bias modification for posttraumatic stress disorder. Psychol Med 2023; 53:3601-3610. [PMID: 35132952 PMCID: PMC10248784 DOI: 10.1017/s003329172200023x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 09/13/2021] [Revised: 01/03/2022] [Accepted: 01/17/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Many individuals with posttraumatic stress disorder (PTSD) have limited access to first-line treatments, warranting the development of remotely-delivered treatments. Attention bias modification (ABM), targeting perturbed threat-related attentional patterns, shows promise when delivered in-person. However, previous studies found ABM to be ineffective when delivered remotely. Randomized clinical trials usually applied two variations of ABM: ABM away from threat or attention control training (ACT) balancing attention between threat-related and neutral stimuli. We tested remotely-delivered ACT/ABM with tighter supervision and video-based interactions that resemble in-clinic protocols. We expected to replicate the results of in-clinic trials, in which ACT outperformed ABM for PTSD. METHODS In this double-blinded, parallel-group randomized controlled trial, 60 patients diagnosed with PTSD were randomized (ABM n = 30; ACT n = 30). Patients performed eight bi-weekly remotely-delivered supervised ABM/ACT sessions. Symptoms were assessed pre- and post-treatment with Clinician-Administered PTSD Scale 5 (CAPS-5) severity score and PTSD diagnosis as the primary outcomes. Current depressive episode, current anxiety-related comorbidity, and time elapsed since the trauma were examined as potential moderators of treatment outcome. RESULTS Significant decrease in CAPS-5 severity scores and PTSD diagnosis was observed following both ACT and ABM with no between-group difference. Patients without depression or whose trauma occurred more recently had greater symptom reduction in the ACT than the ABM group. CONCLUSIONS Contrary to our expectation, symptoms decreased similarly following ACT and ABM. Moderator analyses suggest advantage for ACT in non-depressed patients and patients whose trauma occurred more recently. Further refinements in remotely-delivered ABM/ACT may be needed.
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Affiliation(s)
- Yaron Alon
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Omer Azriel
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Daniel S. Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv-Yafo, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv-Yafo, Israel
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Bach DR, Sporrer J, Abend R, Beckers T, Dunsmoor JE, Fullana MA, Gamer M, Gee DG, Hamm A, Hartley CA, Herringa RJ, Jovanovic T, Kalisch R, Knight DC, Lissek S, Lonsdorf TB, Merz CJ, Milad M, Morriss J, Phelps EA, Pine DS, Olsson A, van Reekum CM, Schiller D. Consensus design of a calibration experiment for human fear conditioning. Neurosci Biobehav Rev 2023; 148:105146. [PMID: 36990370 PMCID: PMC10618407 DOI: 10.1016/j.neubiorev.2023.105146] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
Fear conditioning is a widely used laboratory model to investigate learning, memory, and psychopathology across species. The quantification of learning in this paradigm is heterogeneous in humans and psychometric properties of different quantification methods can be difficult to establish. To overcome this obstacle, calibration is a standard metrological procedure in which well-defined values of a latent variable are generated in an established experimental paradigm. These intended values then serve as validity criterion to rank methods. Here, we develop a calibration protocol for human fear conditioning. Based on a literature review, series of workshops, and survey of N = 96 experts, we propose a calibration experiment and settings for 25 design variables to calibrate the measurement of fear conditioning. Design variables were chosen to be as theory-free as possible and allow wide applicability in different experimental contexts. Besides establishing a specific calibration procedure, the general calibration process we outline may serve as a blueprint for calibration efforts in other subfields of behavioral neuroscience that need measurement refinement.
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Affiliation(s)
- Dominik R Bach
- Wellcome Centre for Human Neuroimaging and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, United Kingdom; Hertz Chair for Artificial Intelligence and Neuroscience, Transdisciplinary Research Area "Life & Health", University of Bonn, Germany.
| | - Juliana Sporrer
- Wellcome Centre for Human Neuroimaging and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, United Kingdom
| | - Rany Abend
- National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Tom Beckers
- KU Leuven, Faculty of Psychology and Educational Sciences/Leuven Brain Institute, Leuven, Belgium
| | - Joseph E Dunsmoor
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, USA
| | - Miquel A Fullana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, & Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - Matthias Gamer
- Julius-Maximilians-University of Würzburg, Department of Psychology, Würzburg, Germany
| | - Dylan G Gee
- Yale University, Department of Psychology, New Haven, CT, USA
| | - Alfons Hamm
- Department of Psychology, University of Greifswald, Germany
| | | | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany; and Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - David C Knight
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA
| | - Shmuel Lissek
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Tina B Lonsdorf
- University Medical Center Hamburg-Eppendorf, Institute of Systems Neuroscience, Hamburg, Germany
| | - Christian J Merz
- Ruhr University Bochum, Faculty of Psychology, Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Bochum, Germany
| | - Mohammed Milad
- Department of Psychiatry and Neuroscience Institute, NYU Grossman School of Medicine, New York, NY, USA; The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Jayne Morriss
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Elizabeth A Phelps
- Department of Psychology, Harvard University, 52 Oxford St., Cambridge, MA, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Andreas Olsson
- Karolinska Institutet, Department of Clinical Neuroscience, Division of Psychology, Stockholm, Sweden
| | - Carien M van Reekum
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Daniela Schiller
- Friedman Brain Institute, Department of Neuroscience, Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
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Mallidi A, Meza-Cervera T, Kircanski K, Stringaris A, Brotman MA, Pine DS, Leibenluft E, Linke JO. Robust caregiver-youth discrepancies in irritability ratings on the affective reactivity index: An investigation of its origins. J Affect Disord 2023; 332:185-193. [PMID: 37030330 PMCID: PMC10170868 DOI: 10.1016/j.jad.2023.03.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/03/2023] [Accepted: 03/29/2023] [Indexed: 04/10/2023]
Abstract
OBJECTIVE The Affective Reactivity Index (ARI) is widely used to assess young people's irritability symptoms, but youth and caregivers often diverge in their assessments. Such informant discrepancy might be rooted in poor psychometric properties, the differential conceptualization of irritability across informants, or reflect sociodemographic and clinical characteristics. We use an out-of-sample replication approach and leverage longitudinal data, available for a subset of the participants, to test these hypotheses. METHOD Across two independent samples (NCohort-1 = 765, 8-21 years; NCohort-2 = 1910, 6-21 years), we investigate the reliability and measurement invariance of the ARI, examine sociodemographic and clinical predictors of discrepant reporting and probe the utility of a bifactor model for cross-informant integration. RESULTS Despite good internal consistency and 6-week-retest-reliability of parent (Cohort-1: α = 0.92, ICC = 0.85; Cohort-2: α = 0.93) and youth forms (Cohort-1: α = 0.88, ICC = 0.78; Cohort-2: α = 0.82), we confirm substantial informant discrepancy in ARI ratings (3 points on a scale from 0 to 12), which is stable over six weeks (ICC = 0.53). Measurement invariance across informants was weak, indicating that parents and youth may interpret ARI items differently. Irritability severity and diagnostic status predicted informant-discrepancy, albeit in opposing directions: higher severity was linked to relative, higher irritability-ratings by youth (Cohort-1: β = -0.06, p < .001; Cohort-2: β = -0.06, p < .001), while diagnoses of Disruptive Mood Dysregulation Disorder (Cohort-1: β = 0.44, p < .001; Cohort-2: β = 0.84, p < .001) and Oppositional Defiant Disorder (Cohort-1: β = 0.41, p < .001; Cohort-2: β = 0.42, p < .001) predicted relative higher irritability-ratings by caregivers. In both datasets, a bifactor model parsing informant-specific from shared irritability-related variance fit the data well (CFI = 0.99, RMSEA = 0.05; N2: CFI = 0.99; RMSEA = 0.04). CONCLUSION Parent and youth ARI reports and their discrepancy are reliable and reflect different interpretations of the scale items; hence they should not be averaged. This finding also suggests that irritability is not a unitary construct. Future work should investigate and model how different aspects of irritability might differ in their impact on the responses of specific informants.
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Affiliation(s)
- Ajitha Mallidi
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Tatiana Meza-Cervera
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Argyris Stringaris
- Divisions of Psychiatry and Psychology and Language Sciences, University College London, United Kingdom
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Julia O Linke
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America.
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Jangraw DC, Keren H, Sun H, Bedder RL, Rutledge RB, Pereira F, Thomas AG, Pine DS, Zheng C, Nielson DM, Stringaris A. A highly replicable decline in mood during rest and simple tasks. Nat Hum Behav 2023; 7:596-610. [PMID: 36849591 PMCID: PMC10192073 DOI: 10.1038/s41562-023-01519-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 01/04/2023] [Indexed: 03/01/2023]
Abstract
Does our mood change as time passes? This question is central to behavioural and affective science, yet it remains largely unexamined. To investigate, we intermixed subjective momentary mood ratings into repetitive psychology paradigms. Here we demonstrate that task and rest periods lowered participants' mood, an effect we call 'Mood Drift Over Time'. This finding was replicated in 19 cohorts totalling 28,482 adult and adolescent participants. The drift was relatively large (-13.8% after 7.3 min of rest, Cohen's d = 0.574) and was consistent across cohorts. Behaviour was also impacted: participants were less likely to gamble in a task that followed a rest period. Importantly, the drift slope was inversely related to reward sensitivity. We show that accounting for time using a linear term significantly improves the fit of a computational model of mood. Our work provides conceptual and methodological reasons for researchers to account for time's effects when studying mood and behaviour.
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Affiliation(s)
- David C Jangraw
- National Institute of Mental Health, Bethesda, MD, USA.
- Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, USA.
| | - Hanna Keren
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Haorui Sun
- Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, USA
| | - Rachel L Bedder
- 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
| | - Robb B Rutledge
- 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
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, USA
| | | | - Adam G Thomas
- National Institute of Mental Health, Bethesda, MD, USA
| | - Daniel S Pine
- National Institute of Mental Health, Bethesda, MD, USA
| | - Charles Zheng
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Argyris Stringaris
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
- Faculty of Brain Sciences, Division of Psychiatry, University College London, London, UK
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40
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Cardinale EM, Bezek J, Morales S, Filippi C, Smith AR, Haller S, Valadez EA, Harrewijn A, Phillips D, Chronis-Tuscano A, Brotman MA, Fox NA, Pine DS, Leibenluft E, Kircanski K. Cross-sectional and Longitudinal Associations of Anxiety and Irritability With Adolescents' Neural Responses to Cognitive Conflict. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:436-444. [PMID: 35358745 PMCID: PMC9764223 DOI: 10.1016/j.bpsc.2022.03.007] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 04/12/2023]
Abstract
BACKGROUND Psychiatric symptoms are commonly comorbid in childhood. The ability to disentangle unique and shared correlates of comorbid symptoms facilitates personalized medicine. Cognitive control is implicated broadly in psychopathology, including in pediatric disorders characterized by anxiety and irritability. To disentangle cognitive control correlates of anxiety versus irritability, the current study leveraged both cross-sectional and longitudinal data from early childhood into adolescence. METHODS For this study, 89 participants were recruited from a large longitudinal research study on early-life temperament to investigate associations of developmental trajectories of anxiety and irritability symptoms (from ages 2 to 15) as well as associations of anxiety and irritability symptoms measured cross-sectionally at age 15 with neural substrates of conflict and error processing assessed at age 15 using the flanker task. RESULTS Results of whole-brain multivariate linear models revealed that anxiety at age 15 was uniquely associated with decreased neural response to conflict across multiple regions implicated in attentional control and conflict adaptation. Conversely, irritability at age 15 was uniquely associated with increased neural response to conflict in regions implicated in response inhibition. Developmental trajectories of anxiety and irritability interacted in relation to neural responses to both error and conflict. CONCLUSIONS Our findings suggest that neural correlates of conflict processing may relate uniquely to anxiety and irritability. Continued cross-symptom research on the neural correlates of cognitive control could stimulate advances in individualized treatment for anxiety and irritability during child and adolescent development.
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Affiliation(s)
| | - Jessica Bezek
- National Institute of Mental Health, Bethesda, Maryland
| | - Santiago Morales
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland; Department of Psychology, University of Southern California, Los Angeles, California
| | | | | | - Simone Haller
- National Institute of Mental Health, Bethesda, Maryland
| | - Emilio A Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | - Anita Harrewijn
- National Institute of Mental Health, Bethesda, Maryland; Department of Clinical Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Andrea Chronis-Tuscano
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | | | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | - Daniel S Pine
- National Institute of Mental Health, Bethesda, Maryland
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Arad G, Azriel O, Pine DS, Lazarov A, Sol O, Weiser M, Garber E, Bloch M, Bar-Haim Y. Attention Bias Modification Treatment Versus a Selective Serotonin Reuptake Inhibitor Or Waiting List Control for Social Anxiety Disorder: A Randomized Clinical Trial. Am J Psychiatry 2023; 180:357-366. [PMID: 36945823 DOI: 10.1176/appi.ajp.20220533] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Social anxiety disorder is common and impairing. The efficacy of pharmacotherapy is moderate, highlighting the need for alternative therapies. This study compared the efficacy of gaze-contingent music reward therapy (GC-MRT), an eye-tracking-based attention bias modification treatment, with a selective serotonin reuptake inhibitor (SSRI) treatment or a waiting list control condition in reducing social anxiety disorder symptoms. Superior clinical effects of similar magnitude were expected for the active treatments relative to the control condition. METHODS Participants were 105 treatment-seeking adults with social anxiety disorder, randomly allocated to 12 weeks of GC-MRT, SSRI, or waiting list control. Mean changes in clinician-rated and self-reported social anxiety symptoms from baseline to mid- and posttreatment assessments were compared between groups using generalized estimating equations. Changes in attentional dwell time on threat were also examined. RESULTS Analysis indicated a significant differential reduction in symptoms between groups. Patients in the GC-MRT and SSRI groups had lower social anxiety scores at the mid- and posttreatment assessments compared with patients in the waiting list group. The efficacy of the active treatments did not differ. Only patients in the GC-MRT group showed reduction in dwell time on threat from baseline to posttreatment assessment. CONCLUSIONS Eye-tracking-based attention bias modification is an acceptable and effective treatment option for social anxiety disorder.
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Affiliation(s)
- Gal Arad
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Omer Azriel
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Daniel S Pine
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Amit Lazarov
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Omer Sol
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Mark Weiser
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Eddie Garber
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Miki Bloch
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
| | - Yair Bar-Haim
- School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch)
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Groenewold NA, Bas-Hoogendam JM, Amod AR, Laansma MA, Van Velzen LS, Aghajani M, Hilbert K, Oh H, Salas R, Jackowski AP, Pan PM, Salum GA, Blair JR, Blair KS, Hirsch J, Pantazatos SP, Schneier FR, Talati A, Roelofs K, Volman I, Blanco-Hinojo L, Cardoner N, Pujol J, Beesdo-Baum K, Ching CRK, Thomopoulos SI, Jansen A, Kircher T, Krug A, Nenadić I, Stein F, Dannlowski U, Grotegerd D, Lemke H, Meinert S, Winter A, Erb M, Kreifelts B, Gong Q, Lui S, Zhu F, Mwangi B, Soares JC, Wu MJ, Bayram A, Canli M, Tükel R, Westenberg PM, Heeren A, Cremers HR, Hofmann D, Straube T, Doruyter AGG, Lochner C, Peterburs J, Van Tol MJ, Gur RE, Kaczkurkin AN, Larsen B, Satterthwaite TD, Filippi CA, Gold AL, Harrewijn A, Zugman A, Bülow R, Grabe HJ, Völzke H, Wittfeld K, Böhnlein J, Dohm K, Kugel H, Schrammen E, Zwanzger P, Leehr EJ, Sindermann L, Ball TM, Fonzo GA, Paulus MP, Simmons A, Stein MB, Klumpp H, Phan KL, Furmark T, Månsson KNT, Manzouri A, Avery SN, Blackford JU, Clauss JA, Feola B, Harper JC, Sylvester CM, Lueken U, Veltman DJ, Winkler AM, Jahanshad N, Pine DS, Thompson PM, Stein DJ, Van der Wee NJA. Volume of subcortical brain regions in social anxiety disorder: mega-analytic results from 37 samples in the ENIGMA-Anxiety Working Group. Mol Psychiatry 2023; 28:1079-1089. [PMID: 36653677 PMCID: PMC10804423 DOI: 10.1038/s41380-022-01933-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/01/2022] [Revised: 10/31/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023]
Abstract
There is limited convergence in neuroimaging investigations into volumes of subcortical brain regions in social anxiety disorder (SAD). The inconsistent findings may arise from variations in methodological approaches across studies, including sample selection based on age and clinical characteristics. The ENIGMA-Anxiety Working Group initiated a global mega-analysis to determine whether differences in subcortical volumes can be detected in adults and adolescents with SAD relative to healthy controls. Volumetric data from 37 international samples with 1115 SAD patients and 2775 controls were obtained from ENIGMA-standardized protocols for image segmentation and quality assurance. Linear mixed-effects analyses were adjusted for comparisons across seven subcortical regions in each hemisphere using family-wise error (FWE)-correction. Mixed-effects d effect sizes were calculated. In the full sample, SAD patients showed smaller bilateral putamen volume than controls (left: d = -0.077, pFWE = 0.037; right: d = -0.104, pFWE = 0.001), and a significant interaction between SAD and age was found for the left putamen (r = -0.034, pFWE = 0.045). Smaller bilateral putamen volumes (left: d = -0.141, pFWE < 0.001; right: d = -0.158, pFWE < 0.001) and larger bilateral pallidum volumes (left: d = 0.129, pFWE = 0.006; right: d = 0.099, pFWE = 0.046) were detected in adult SAD patients relative to controls, but no volumetric differences were apparent in adolescent SAD patients relative to controls. Comorbid anxiety disorders and age of SAD onset were additional determinants of SAD-related volumetric differences in subcortical regions. To conclude, subtle volumetric alterations in subcortical regions in SAD were detected. Heterogeneity in age and clinical characteristics may partly explain inconsistencies in previous findings. The association between alterations in subcortical volumes and SAD illness progression deserves further investigation, especially from adolescence into adulthood.
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Affiliation(s)
- Nynke A Groenewold
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
- South African Medical Research Council (SA-MRC) Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
| | - Janna Marie Bas-Hoogendam
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Alyssa R Amod
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Max A Laansma
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Laura S Van Velzen
- Orygen & Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Moji Aghajani
- Leiden University, Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden, Netherlands
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hyuntaek Oh
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Michael E DeBakey VA Medical Center, Center for Translational Research on Inflammatory Diseases, Houston, TX, USA
| | - Andrea P Jackowski
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Pedro M Pan
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Giovanni A Salum
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Joy Hirsch
- Departments of Psychiatry & Neurobiology, Yale School of Medicine, New Haven, CT, USA
| | - Spiro P Pantazatos
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Franklin R Schneier
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Ardesheer Talati
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Karin Roelofs
- Donders Institute for Brain, Cognition and Behavior, Radboud University Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Inge Volman
- Wellcome Centre for Integrative Neuroimaging Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Narcís Cardoner
- Department of Mental Health, University Hospital Parc Taulí-I3PT, Barcelona, Spain, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psycholog and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christopher R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Andreas Jansen
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University Hospital of Bonn, Bonn, Germany
| | - Igor Nenadić
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Fei Zhu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Benson Mwangi
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mon-Ju Wu
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ali Bayram
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Mesut Canli
- Department of Physiology, Istanbul University, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul University, Istanbul, Turkey
| | - P Michiel Westenberg
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Alexandre Heeren
- Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Henk R Cremers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | | | - Christine Lochner
- SA-MRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Stellenbosch, South Africa
| | - Jutta Peterburs
- Institute of Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Marie-José Van Tol
- Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Bart Larsen
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Courtney A Filippi
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - André Zugman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Harald Kugel
- University Clinic for Radiology, University of Münster, Münster, Germany
| | - Elisabeth Schrammen
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Peter Zwanzger
- KBO-Inn-Salzach-Klinikum, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University of Munich, Munich, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lisa Sindermann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tali M Ball
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Gregory A Fonzo
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | | | - Alan Simmons
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Murray B Stein
- Departments of Psychiatry & School of Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Heide Klumpp
- Departments of Psychology & Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry & Behavioral Health, the Ohio State University, Columbus, OH, USA
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | | | - Suzanne N Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Chad M Sylvester
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC location VUMC, Amsterdam, Netherlands
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Dan J Stein
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SA-MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Nic J A Van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
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Correll CU, Solmi M, Cortese S, Fava M, Højlund M, Kraemer HC, McIntyre RS, Pine DS, Schneider LS, Kane JM. The future of psychopharmacology: a critical appraisal of ongoing phase 2/3 trials, and of some current trends aiming to de-risk trial programmes of novel agents. World Psychiatry 2023; 22:48-74. [PMID: 36640403 PMCID: PMC9840514 DOI: 10.1002/wps.21056] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 01/15/2023] Open
Abstract
Despite considerable progress in pharmacotherapy over the past seven decades, many mental disorders remain insufficiently treated. This situation is in part due to the limited knowledge of the pathophysiology of these disorders and the lack of biological markers to stratify and individualize patient selection, but also to a still restricted number of mechanisms of action being targeted in monotherapy or combination/augmentation treatment, as well as to a variety of challenges threatening the successful development and testing of new drugs. In this paper, we first provide an overview of the most promising drugs with innovative mechanisms of action that are undergoing phase 2 or 3 testing for schizophrenia, bipolar disorder, major depressive disorder, anxiety and trauma-related disorders, substance use disorders, and dementia. Promising repurposing of established medications for new psychiatric indications, as well as variations in the modulation of dopamine, noradrenaline and serotonin receptor functioning, are also considered. We then critically discuss the clinical trial parameters that need to be considered in depth when developing and testing new pharmacological agents for the treatment of mental disorders. Hurdles and perils threatening success of new drug development and testing include inadequacy and imprecision of inclusion/exclusion criteria and ratings, sub-optimally suited clinical trial participants, multiple factors contributing to a large/increasing placebo effect, and problems with statistical analyses. This information should be considered in order to de-risk trial programmes of novel agents or known agents for novel psychiatric indications, increasing their chances of success.
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Affiliation(s)
- Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Marco Solmi
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mikkel Højlund
- Department of Public Health, Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Mental Health Services in the Region of Southern Denmark, Department of Psychiatry Aabenraa, Aabenraa, Denmark
| | - Helena C Kraemer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Cupertino, CA, USA
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Daniel S Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Lon S Schneider
- Department of Psychiatry and Behavioral Sciences, and Department of Neurology, Keck School of Medicine, and L. Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - John M Kane
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
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44
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Pettit JW, Rey Y, Marin CE, Bechor M, Lebowitz ER, Vasey MW, Jaccard J, Abend R, Pine DS, Bar-Haim Y, Silverman WK. Attention Training as a Low-Intensity Treatment for Concerning Anxiety in Clinic-Referred Youth. Behav Ther 2023; 54:77-90. [PMID: 36608979 PMCID: PMC9825787 DOI: 10.1016/j.beth.2022.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 10/07/2021] [Revised: 06/27/2022] [Accepted: 07/10/2022] [Indexed: 01/11/2023]
Abstract
Although youth anxiety treatment research has focused largely on severe and impairing anxiety levels, even milder anxiety levels, including levels that do not meet full criteria for a diagnosis, can be impairing and cause for concern. There is a need to develop and test viable treatments for these concerning anxiety levels to improve functioning and reduce distress. We present findings from a randomized controlled efficacy trial of attention bias modification treatment (ABMT) and attention control training (ACT) for youths with concerning anxiety levels. Fifty-three clinic-referred youths (29 boys, M age = 9.3 years, SD age = 2.6) were randomized to either ABMT or ACT. ABMT and ACT consisted of attention-training trials in a dot-probe task presenting angry and neutral faces; probes appeared in the location of neutral faces in 100% of ABMT trials and 50% of ACT trials. Independent evaluators provided youth anxiety severity ratings; youths and parents provided youth anxiety severity and global impairment ratings; and youths completed measures of attention bias to threat and attention control at pretreatment, posttreatment, and 2-month follow-up. In both arms, anxiety severity and global impairment were significantly reduced at posttreatment and follow-up. At follow-up, anxiety severity and global impairment were significantly lower in ACT compared with ABMT. Attention control, but not attention bias to threat, was significantly improved at follow-up in both arms. Changes in attention control and attention focusing were significantly associated with changes in anxiety severity. Findings support the viability of attention training as a low-intensity treatment for youths with concerning anxiety levels, including levels that do not meet full criteria for a diagnosis. Superior anxiety reduction effects in ACT highlight the critical need for mechanistic research on attention training in this population.
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Affiliation(s)
| | | | - Carla E Marin
- Yale Child Study Center, Yale University School of Medicine
| | | | - Eli R Lebowitz
- Yale Child Study Center, Yale University School of Medicine
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45
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Newsome P, Ruiz SG, Gold AL, Pine DS, Abend R. Fear-potentiated startle reveals diminished threat extinction in pathological anxiety. Int J Psychophysiol 2023; 183:81-91. [PMID: 36442665 PMCID: PMC9812922 DOI: 10.1016/j.ijpsycho.2022.11.011] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 10/13/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Major theories propose that perturbed threat learning is central to pathological anxiety, but empirical support is inconsistent. Failures to detect associations with anxiety may reflect limitations in quantifying conditioned responses to anticipated threat, and hinder translation of theory into empirical work. In prior work, we could not detect threat-specific anxiety effects on states of conditioned threat using psychophysiology in a large sample of patients and healthy comparisons. Here, we examine the utility of an alternative fear potentiated startle (FPS) scoring in revealing associations between anxiety and threat conditioning and extinction in this dataset. Secondary analyses further explored associations among conditioned threat responses, subcortical morphometry, and treatment outcomes. METHODS Youths and adults with anxiety disorders and healthy comparisons (n = 306; 178 female participants; 8-50 years) previously completed a well-validated differential threat learning paradigm. FPS and skin conductance response (SCR) quantified psychophysiological responses during threat conditioning and extinction. In this report, we examined normalizing raw FPS scores to intertrial intervals (ITI) to address challenges in more common approaches to FPS scoring which could mask group effects. Secondary analyses examined associations between FPS and subcortical morphometry and with response to exposure-based cognitive behavioral therapy in a subsample of patients. RESULTS Patients and comparisons showed comparable differential threat conditioning using FPS and SCR. While SCR suggested comparable extinction between groups, FPS revealed stronger retention of threat contingency during extinction in individuals with anxiety disorders. Extinction indexed with FPS was not associated with age, morphometry, or anxiety treatment outcome. CONCLUSION ITI-normalized FPS may have utility in detecting difficulties in extinguishing conditioned threat responses in anxiety. These findings provide support for extinction theories of anxiety and encourage continued research on aberrant extinction in pathological anxiety.
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Affiliation(s)
- Philip Newsome
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health, Bethesda, MD, USA
| | - Sonia G Ruiz
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health, Bethesda, MD, USA
| | - Rany Abend
- Baruch Ivcher School of Psychology, Reichman University, Israel.
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46
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Guath M, Kleberg JL, Weis J, Widegren E, Frick M, Möller S, Klevebrant L, Karlsson B, Fällmar D, Mårtensson J, Pine DS, Brocki K, Gingnell M, Frick A. Pupil dilation during negative prediction errors is related to brain choline concentration and depressive symptoms in adolescents. Behav Brain Res 2023; 436:114060. [DOI: 10.1016/j.bbr.2022.114060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 10/15/2022]
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47
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Linke JO, Haller SP, Xu EP, Nguyen LT, Chue AE, Botz-Zapp C, Revzina O, Perlstein S, Ross AJ, Tseng WL, Shaw P, Brotman MA, Pine DS, Gotts SJ, Leibenluft E, Kircanski K. Persistent Frustration-Induced Reconfigurations of Brain Networks Predict Individual Differences in Irritability. J Am Acad Child Adolesc Psychiatry 2022; 62:684-695. [PMID: 36563874 DOI: 10.1016/j.jaac.2022.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/07/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Aberrant responses to frustration are central mechanisms of pediatric irritability, which is a common reason for psychiatric consultation and a risk factor for affective disorders and suicidality. This pilot study aimed to characterize brain network configuration during and after frustration and test whether characteristics of networks formed during or after frustration relate to irritability. METHOD During functional magnetic resonance imaging, a transdiagnostic sample enriched for irritability (N = 66, mean age = 14.0 years, 50% female participants) completed a frustration-induction task flanked by pretask and posttask resting-state scans. We first tested whether and how the organization of brain regions (ie, nodes) into networks (ie, modules) changes during and after frustration. Then, using a train/test/held-out procedure, we aimed to predict past-week irritability from global efficiency (Eglob) (ie, capacity for parallel information processing) of these modules. RESULTS Two modules present in the baseline pretask resting-state scan (one encompassing anterior default mode and temporolimbic regions and one consisting of frontoparietal regions) contributed most to brain circuit reorganization during and after frustration. Only Eglob of modules in the posttask resting-state scans (ie, after frustration) predicted irritability symptoms. Self-reported irritability was predicted by Eglob of a frontotemporal-limbic module. Parent-reported irritability was predicted by Eglob of ventral-prefrontal-subcortical and somatomotor-parietal modules. CONCLUSION These pilot results suggest the importance of the postfrustration recovery period in the pathophysiology of irritability. Eglob in 3 specific posttask modules, involved in emotion processing, reward processing, or motor function, predicted irritability. These findings, if replicated, could represent specific intervention targets for irritability.
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Affiliation(s)
- Julia O Linke
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
| | - Simone P Haller
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellie P Xu
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lynn T Nguyen
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Amanda E Chue
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Christian Botz-Zapp
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Olga Revzina
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Samantha Perlstein
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Andrew J Ross
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Philip Shaw
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, Maryland
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Stephen J Gotts
- Section on Cognitive Neuropsychology, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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48
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Valadez EA, Morales S, Buzzell GA, Troller-Renfree SV, Henderson HA, Chronis-Tuscano A, Pine DS, Fox NA. Development of Proactive Control and Anxiety Among Behaviorally Inhibited Adolescents. J Am Acad Child Adolesc Psychiatry 2022; 61:1466-1475. [PMID: 35490841 PMCID: PMC9613813 DOI: 10.1016/j.jaac.2022.04.012] [Citation(s) in RCA: 3] [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: 07/02/2021] [Revised: 01/26/2022] [Accepted: 04/21/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Behavioral inhibition (BI) is an infant temperament characterized by heightened reactivity and negative affect in response to novel people and situations. BI is among the earliest and strongest predictors of future anxiety problems. However, not all children with a history of BI will manifest anxiety problems. A growing body of evidence suggests that proactive control skills may help buffer youth with BI from future anxiety difficulties; yet, it remains unclear how temperament may interact with the development of cognitive control to influence anxiety risk. The present study tested whether enhancements in proactive control occurring during adolescence may reduce risk for anxiety among youth with a history of BI. METHOD Participants included 185 adolescents (56% female) whose temperament was assessed during toddlerhood. In adolescence, participants completed anxiety assessments and an AX Continuous Performance Test (AX-CPT) to assess cognitive control strategy. Both assessments were administered at age 13 years and again at 15 years. RESULTS Latent change score modeling revealed that, on average, participants increasingly used proactive control strategies and experienced worsening anxiety from age 13-15 years. Early BI was associated with a smaller anxiety increase from 13-15 years, but only among participants whose proactive control skills improved at mean or greater rates. CONCLUSION The present findings suggest that greater proactive control development during adolescence protects youth with high BI from age-related increases in anxiety. Results support a framework that highlights cognitive control as a key moderator of anxiety risk among children with a history of high BI.
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Affiliation(s)
| | | | | | | | | | | | - Daniel S Pine
- National Institute of Mental Health, Bethesda, Maryland
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49
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Khosravi P, Zugman A, Amelio P, Winkler AM, Pine DS. Translating Big Data to Clinical Outcomes in Anxiety: Potential for Multimodal Integration. Curr Psychiatry Rep 2022; 24:841-851. [PMID: 36469202 PMCID: PMC9931491 DOI: 10.1007/s11920-022-01385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE OF THE REVIEW This review describes approaches to research on anxiety that attempt to link neural correlates to treatment response and novel therapies. The review emphasizes pediatric anxiety disorders since most anxiety disorders begin before adulthood. RECENT FINDINGS Recent literature illustrates how current treatments for anxiety manifest diverse relations with a range of neural markers. While some studies demonstrate post-treatment normalization of markers in anxious individuals, others find persistence of group differences. For other markers, which show no pretreatment association with anxiety, the markers nevertheless distinguish treatment-responders from non-responders. Heightened error related negativity represents the risk marker discussed in the most depth; however, limitations in measures related to error responding necessitate multimodal and big-data approaches. Single risk markers show limits as correlates of treatment response. Large-scale, multimodal data analyzed with predictive models may illuminate additional risk markers related to anxiety disorder treatment outcomes. Such work may identify novel targets and eventually guide improvements in treatment response/outcomes.
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Affiliation(s)
- Parmis Khosravi
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA.
| | - André Zugman
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
| | - Paia Amelio
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
| | - Anderson M Winkler
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
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50
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Atlas LY, Dildine TC, Palacios-Barrios EE, Yu Q, Reynolds RC, Banker LA, Grant SS, Pine DS. Instructions and experiential learning have similar impacts on pain and pain-related brain responses but produce dissociations in value-based reversal learning. eLife 2022; 11:73353. [PMID: 36317867 PMCID: PMC9681218 DOI: 10.7554/elife.73353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/25/2022] [Indexed: 11/22/2022] Open
Abstract
Recent data suggest that interactions between systems involved in higher order knowledge and associative learning drive responses during value-based learning. However, it is unknown how these systems impact subjective responses, such as pain. We tested how instructions and reversal learning influence pain and pain-evoked brain activation. Healthy volunteers (n=40) were either instructed about contingencies between cues and aversive outcomes or learned through experience in a paradigm where contingencies reversed three times. We measured predictive cue effects on pain and heat-evoked brain responses using functional magnetic resonance imaging. Predictive cues dynamically modulated pain perception as contingencies changed, regardless of whether participants received contingency instructions. Heat-evoked responses in the insula, anterior cingulate, and other regions updated as contingencies changed, and responses in the prefrontal cortex mediated dynamic cue effects on pain, whereas responses in the brainstem’s rostroventral medulla (RVM) were shaped by initial contingencies throughout the task. Quantitative modeling revealed that expected value was shaped purely by instructions in the Instructed Group, whereas expected value updated dynamically in the Uninstructed Group as a function of error-based learning. These differences were accompanied by dissociations in the neural correlates of value-based learning in the rostral anterior cingulate, thalamus, and posterior insula, among other regions. These results show how predictions dynamically impact subjective pain. Moreover, imaging data delineate three types of networks involved in pain generation and value-based learning: those that respond to initial contingencies, those that update dynamically during feedback-driven learning as contingencies change, and those that are sensitive to instruction. Together, these findings provide multiple points of entry for therapies designs to impact pain.
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Affiliation(s)
- Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health
- National Institute on Drug Abuse, National Institutes of Health
- National Institute of Mental Health, National Institutes of Health
| | - Troy C Dildine
- National Center for Complementary and Integrative Health, National Institutes of Health
- Department of Clinical Neuroscience, Karolinska Institutet
| | | | - Qingbao Yu
- National Center for Complementary and Integrative Health, National Institutes of Health
| | | | - Lauren A Banker
- National Center for Complementary and Integrative Health, National Institutes of Health
| | - Shara S Grant
- National Center for Complementary and Integrative Health, National Institutes of Health
| | - Daniel S Pine
- National Institute of Mental Health, National Institutes of Health
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