Showing papers in "Psychiatry Research-neuroimaging in 2016"
TL;DR: The review of controlled studies of the use of Virtual Reality in psychological treatment confirms the effectiveness of VRT compared to treatment as usual, and shows similar effectiveness when VRT is compared to conventional treatments.
Abstract: The aim of this paper is to provide a review of controlled studies of the use of Virtual Reality in psychological treatment (VRT). Medline, PsychInfo, Embase and Web of Science were searched. Only studies comparing immersive virtual reality to a control condition were included. The search resulted in 1180 articles published between 2012 and 2015, of these, 24 were controlled studies. The reviewed studies confirm the effectiveness of VRT compared to treatment as usual, and show similar effectiveness when VRT is compared to conventional treatments. Current developments and future research are discussed.
292 citations
TL;DR: Evaluated screening tools for depression and anxiety in an Arabic-speaking Lebanese psychiatric outpatient sample showed that the PHQ-9 is sensitive but not specific at capturing depressive symptoms when compared to clinician diagnoses whereas the GAD-7 was neither nor specific at capture anxiety symptoms.
Abstract: The Patient Health Questionnaire - 9 (PHQ-9) and Generalized Anxiety Disorder - 7 (GAD-7) are short screening measures used in medical and community settings to assess depression and anxiety severity. The aim of this study is to translate the screening tools into Arabic and evaluate their psychometric properties in an Arabic-speaking Lebanese psychiatric outpatient sample. The patients completed the questionnaires, among others, prior to being evaluated by a clinical psychiatrist or psychologist. The scales' internal consistency and factor structure were measured and convergent and discriminant validity were established by comparing the scores with clinical diagnoses and the Psychiatric Diagnostic Screening Questionnaire - MDD subset (PDSQ - MDD). Results showed that the PHQ-9 and GAD-7 are reliable screening tools for depression and anxiety and their factor structures replicated those reported in the literature. Sensitivity and specificity analyses showed that the PHQ-9 is sensitive but not specific at capturing depressive symptoms when compared to clinician diagnoses whereas the GAD-7 was neither sensitive nor specific at capturing anxiety symptoms. The implications of these findings are discussed in reference to the scales themselves and the cultural specificity of the Lebanese population.
205 citations
TL;DR: It is suggested that parent, both mothers and fathers, of children with different type of NDDs should be provided with interventions and resources to empower them with the knowledge and skills to reduce their stress and to enhance their quality of life.
Abstract: In recent years, studies have shown that parents of children with Neurodevelopmental Disorders (NDDs) experience more parenting stress than parents of typically developing children, but the relation between the type of disorders and parenting stress is far from clear. The purpose of this study was to compare the parenting stress experienced by parents of 239 children with Specific Learning Disorders (SpLD), Language Disorders (LD), Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and typical development (TD). Parents of children with NDDs experience more parenting stress than those of children who have TD. Although, parents of children with ASD or ADHD report the most high scores of parenting stress, also the parents of children with SpLD or LD report higher parental stress compared with parent of children without NDDs. Another interesting finding was that IQ level or emotional and behavioral problems are associated with the higher levels of parenting stress. This study suggest that parent, both mothers and fathers, of children with different type of NDDs should be provided with interventions and resources to empower them with the knowledge and skills to reduce their stress and to enhance their quality of life.
167 citations
TL;DR: Stigmatization of mental illness is poorly understood due to a lack of research and methodological discrepancies between existing studies, and there was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling.
Abstract: One in ten children and adolescents suffer with mental health difficulties at any given time, yet less than one third seek treatment. Untreated mental illness predisposes to longstanding individual difficulties and presents a great public health burden. Large scale initiatives to reduce stigmatization of mental illness, identified as a key deterrent to treatment, have been disappointing. This indicates the need for a clearer understanding of the stigmatizing processes faced by young people, so that more effective interventions are employed. A systematic review of the literature, assessing public stigma and self-stigma (i.e. internalized public stigma) specifically in children and adolescents with mental health difficulties (YP-MHD), was conducted. Forty-two studies were identified, confirming that stigmatization of YP-MHD is a universal and disabling problem, present amongst both children and adults. There was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling. Self-stigmatization led to more secrecy and an avoidance of interventions. The findings confirm that stigmatization of mental illness is poorly understood due to a lack of research and methodological discrepancies between existing studies. Implications for the findings are discussed, and suggestions made for future research.
162 citations
TL;DR: The definition of AAO for ED may be crucial for planning treatment modalities, with specific consideration of their clinical history and course.
Abstract: Age at onset (AAO) of eating disorders has classically been described in adolescence. We analyzed data from 806 subjects with anorexia nervosa (AN) or bulimia nervosa (BN) and performed a normal distribution admixture analysis to determine their AAO. No significant differences were found concerning the AAO functions of AN and BN subjects. Both groups had a mean AAO of about 18 years. Most of the subjects with AN (75.3%) and BN (83.3%) belonged to the early onset group. The definition of AAO for ED may be crucial for planning treatment modalities, with specific consideration of their clinical history and course.
140 citations
TL;DR: According to the results, online searches for suicide-related terms in Italy are more likely to be linked to factors other than suicidiality such as personal interest and suicide bereavement.
Abstract: People seeking information and news regarding suicide are likely to use the Internet. However, evidence of the relationship between suicide-related search volumes and national suicide-rates in different countries can be strikingly different. We aimed to investigate the relationship between suicide-rates and Google suicide-related search volumes in the Italian population (2008–2012) using the Italian mortality database that provided monthly national data concerning suicides (2008–2012). Moreover, this study aimed to identify future trends of national suicide rates on the basis of the results we obtained concerning the period 2013-14. Google Trends provided data of online monthly search-volumes of the term “suicide”, “commit suicide” and “how to commit suicide” in Google Search and Google News (2008–2014). Google Search volumes for the term “suicide” lags suicide by three months (ρ=0.482, p-value
121 citations
TL;DR: The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL, and exercise can be considered as a therapeutic strategy to improve physical and psychological domains and overallQoL of people with depression.
Abstract: Exercise has established efficacy as an antidepressant in people with depression. However, few meta-analyses have assessed the effects of exercise across different domains of Quality of Life (QoL) in people with depression. Furthermore, there has been no previous meta-analysis of control group response in relation to QoL in exercise trials for depression. Randomized Clinical Trials(RCTs) were initially identified from a Cochrane review, and those including QoL assessments were included in the analysis. Search of major electronic databases were conducted to identify RCTs that compared the exercise effects on QoL versus control condition in people with depression. A random effects meta-analysis was employed to evaluate the Standardized Mean Difference (SMD). Six RCTs were included. Exercise significantly improved physical and psychological domains and overall QoL. Effects on social relationship and environment domains were not significant. No significant control group response was found for any domain or overall QoL. Exercise can be considered as a therapeutic strategy to improve physical and psychological domains and overall QoL of people with depression, with no effect evident across the social and environmental domains. The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL.
116 citations
TL;DR: There is no convincing evidence that peripheral ADH or OT might be reliable biomarkers in psychiatric disorders, and the lack of significant results was associated with high methodological heterogeneity, low quality of the studies, small sample size, and scarce reliability of the methods used in previous studies.
Abstract: A large array of studies have investigated peripheral oxytocin (OT) and vasopressin (ADH) as potential biomarkers of psychiatric disorders, with highly conflicting and heterogenous findings. We searched Web of KnowledgeSM and Scopus® for English original articles investigating OT and/or ADH levels in different biological fluids (plasma/serum, saliva, urine and cerebrospinal fluid) across several psychiatric disorders. Sixty-four studies were included. We conducted 19 preliminary meta-analyses addressing OT alterations in plasma/serum, saliva, urine and cerebrospinal fluid of 7 psychiatric disorders and ADH alterations in plasma/serum, saliva, urine and cerebrospinal fluid of 6 psychiatric disorders compared to controls. Hedge's g was used as effect size measure, together with heterogeneity analyses, test of publication biases and quality control. None of them (except serum OT in anorexia nervosa) revealed significant differences. There is no convincing evidence that peripheral ADH or OT might be reliable biomarkers in psychiatric disorders. However, the lack of significant results was associated with high methodological heterogeneity, low quality of the studies, small sample size, and scarce reliability of the methods used in previous studies, which need to be validated and standardized.
113 citations
TL;DR: An umbrella review indicates that exercise is safe and efficacious in reducing depressive symptoms in older people and should be considered as a core intervention in the multidisciplinary treatment of older adults experiencing depression.
Abstract: Late-life depression is a growing public health concern. Exercise may be of added value but the literature remains equivocal. We conducted a systematic overview of meta-analyses and an exploratory pooled analysis of previous meta-analyses to determine the effect of exercise on depression in older adults. Two independent researchers searched Pubmed, CINAHL, Cochrane Plus, PsycArticles, and PsycInfo for meta-analyses on exercise in late-life depression. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument. We pooled effect sizes from previous meta-analyses of randomized controlled trials to determine the effect of exercise on depression in older adults. The systematic review yielded 3 meta-analyses. In total, 16 unique cohorts of 1487 participants were included. The quality of the three included meta-analyses was considered as "moderate" according to AMSTAR scores. No serious adverse events were reported. Compared to controls (n=583), those exercising (n=541) significantly reduced depressive symptoms. Our umbrella review indicates that exercise is safe and efficacious in reducing depressive symptoms in older people. Since exercise has many other known health benefits, it should be considered as a core intervention in the multidisciplinary treatment of older adults experiencing depression.
106 citations
TL;DR: Examining the unique sensory processing patterns of individuals with major affective disorders and their relationship with psychiatric symptomatology revealed that depression and anxious/cyclothymic affective temperaments were predicted by sensory sensory/avoiding.
Abstract: Previous studies highlighted the involvement of sensory perception in emotional processes. However, the role of extreme sensory processing patterns expressed in hyper- or hyposensitivity was not thoroughly considered. The present study, in real life conditions, examined the unique sensory processing patterns of individuals with major affective disorders and their relationship with psychiatric symptomatology. The sample consisted of 105 participants with major affective conditions ranging in age from 20 to 84 years (mean=56.7±14.6). All participants completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A), the second version of the Beck Depression Inventory (BDI-II), and Adolescent/Adult Sensory Profile (AASP). Sensory sensitivity/avoiding hypersensitivity patterns and low registration (a hyposensitivity pattern) were prevalent among our sample as compared to normative data. About seventy percent of the sample showed lower seeking tendency. Stepwise regression analyses revealed that depression and anxious/cyclothymic affective temperaments were predicted by sensory sensory/avoiding. Anxious and irritable affective temperaments were predicted by low registration. Hyperthymic affective temperament and lower severity of depression were predicted by sensation seeking. Hyposensitivity or hypersensitivity may be "trait" markers of individuals with major affective disorders. Interventions should refer to the individual unique sensory profiles and their behavioral and functional impact in the context of real life.
105 citations
TL;DR: Support is provided for an abbreviated measure of the PCL-5 as an alternative to the 20-item total scale of PTSD symptoms derived from the PTSD Checklist for DSM-5 (PCL-5).
Abstract: Posttraumatic stress disorder (PTSD) is a significant public health concern associated with marked impairment across the lifespan. Exposure to traumatic events alone, however, is insufficient to determine if an individual has PTSD. PTSD is a heterogeneous diagnosis such that assessment of all 20 symptoms is problematic in time-limited treatment settings. Brief assessment tools that identify those at risk for PTSD and measure symptom severity are needed to improve access to care and assess treatment response. The present study evaluated abbreviated measures of PTSD symptoms derived from the PTSD Checklist for DSM-5 (PCL-5) – a 20-item validated measure of PTSD symptoms – across two studies. In the first, using a community sample of adults exposed to a traumatic event, 4-and 8-item versions of the PCL-5 were identified that were highly correlated with the full PCL-5. In the second, using a sample of combat veterans, the 4-and 8-item measures had comparable diagnostic utility to the total-scale PCL-5. These results provide support for an abbreviated measure of the PCL-5 as an alternative to the 20-item total scale.
TL;DR: This study is an important first step in elucidating patterns of neural connectivity associated with unique symptoms of arousal/interoception, emotional processing, and awareness of bodily states, in PTSD and its dissociative subtype.
Abstract: The insula and amygdala are implicated in the pathophysiology of posttraumatic stress disorder (PTSD), where both have been shown to be hyper/hypoactive in non-dissociative (PTSD-DS) and dissociative subtype (PTSD+DS) PTSD patients, respectively, during symptom provocation. However, the functional connectivity between individual insula subregions and the amygdala has not been investigated in persons with PTSD, with or without the dissociative subtype. We examined insula subregion (anterior, mid, and posterior) functional connectivity with the bilateral amygdala using a region-of-interest seed-based approach via PickAtlas and SPM8. Resting-state fMRI was conducted with (n=61) PTSD patients (n=44 PTSD-DS; n=17 PTSD+DS), and (n=40) age-matched healthy controls. When compared to controls, the PTSD-DS group displayed increased insula connectivity (bilateral anterior, bilateral mid, and left posterior) to basolateral amygdala clusters in both hemispheres, and the PTSD+DS group displayed increased insula connectivity (bilateral anterior, left mid, and left posterior) to the left basolateral amygdala complex. Moreover, as compared to PTSD-DS, increased insula subregion connectivity (bilateral anterior, left mid, and right posterior) to the left basolateral amygdala was found in PTSD+DS. Depersonalization/derealization symptoms and PTSD symptom severity correlated with insula subregion connectivity to the basolateral amygdala within PTSD patients. This study is an important first step in elucidating patterns of neural connectivity associated with unique symptoms of arousal/interoception, emotional processing, and awareness of bodily states, in PTSD and its dissociative subtype.
TL;DR: The findings suggest that individuals with AN have a disordered, CT-based affective touch system, which may be linked to their weakened interoceptive perception and distorted body representation.
Abstract: Anorexia nervosa (AN) is a disorder characterized by restricted eating, fears of gaining weight, and body image distortions. The etiology remains unknown; however impairments in social cognition and reward circuits contribute to the onset and maintenance of the disorder. One possibility is that AN is associated with reduced perceived pleasantness during social interactions. We therefore examined the perception of interpersonal, ‘affective touch’ and its social modulation in AN. We measured the perceived pleasantness of light, dynamic stroking touches applied to the forearm of 25 AN patients and 30 healthy controls using C Tactile (CT) afferents-optimal (3 cm/s) and non-optimal (18 cm/s) velocities, while simultaneously displaying images of faces showing rejecting, neutral and accepting expressions. CT-optimal touch, but not CT non-optimal touch, elicited significantly lower pleasantness ratings in AN patients compared with healthy controls. Pleasantness ratings were modulated by facial expressions in both groups in a similar fashion; namely, presenting socially accepting faces increased the perception of touch pleasantness more than neutral and rejecting faces. Our findings suggest that individuals with AN have a disordered, CT-based affective touch system. This impairment may be linked to their weakened interoceptive perception and distorted body representation.
TL;DR: The findings add to the extant literature attesting to the relevance of alexithymia and emotion dysregulation for understanding aggression, and providing concrete recommendation for the treatment and prevention of aggressive tendencies.
Abstract: There is a need to better understand the antecedent of aggressive behaviors in order to tailor treatments and reduce the associated damage to the others and the self. Possible mechanisms underlying aggression are poor emotional awareness and emotion dysregulation, as well as impulsivity. Here, we examined the relationships among alexithymia, emotion dysregulation, impulsivity and aggression, comparing a mixed psychiatric sample (N=257) and a community sample (N=617). The clinical sample reported greater levels of alexithymia, emotion dysregulation, trait impulsivity and aggression, than the community sample. Furthermore, in the community sample, emotion dysregulation and impulsivity mediated the relationship (i.e., accounted for the shared variance) between alexithymia and aggression. In the clinical sample, only emotion dysregulation explained the alexithymia-aggression link. In particular, specific dimensions of the emotion dysregulation (i.e., Negative Urgency) and impulsivity constructs (i.e., cognitive and motor impulsivity) played a unique role in explaining these associations. Finally, controlling for depressive symptoms reduced some of the findings involving impulsivity to nonsignificant results. Overall, our findings add to the extant literature attesting to the relevance of alexithymia and emotion dysregulation for understanding aggression, and providing concrete recommendation for the treatment and prevention of aggressive tendencies.
TL;DR: Support is provided for a neural formulation in which the SN plays a primary role in contributing to negative cognitive biases in MDD by examining the affective consequences of training depressed persons to down-regulate response of SN nodes to negative material.
Abstract: Neural models of major depressive disorder (MDD) posit that over-response of components of the brain's salience network (SN) to negative stimuli plays a crucial role in the pathophysiology of MDD. In the present proof-of-concept study, we tested this formulation directly by examining the affective consequences of training depressed persons to down-regulate response of SN nodes to negative material. Ten participants in the real neurofeedback group saw, and attempted to learn to down-regulate, activity from an empirically identified node of the SN. Ten other participants engaged in an equivalent procedure with the exception that they saw SN-node neurofeedback indices from participants in the real neurofeedback group. Before and after scanning, all participants completed tasks assessing emotional responses to negative scenes and to negative and positive self-descriptive adjectives. Compared to participants in the sham-neurofeedback group, from pre- to post-training, participants in the real-neurofeedback group showed a greater decrease in SN-node response to negative stimuli, a greater decrease in self-reported emotional response to negative scenes, and a greater decrease in self-reported emotional response to negative self-descriptive adjectives. Our findings provide support for a neural formulation in which the SN plays a primary role in contributing to negative cognitive biases in MDD.
TL;DR: The results of this study contribute to the understanding of the role internalized stigma plays in patients with mental illness, and the impact it can have on psychosocial aspects of their lives.
Abstract: This study aimed to: (i) determine the prevalence, socio-demographic and clinical correlates of internalized stigma and (ii) explore the association between internalized stigma and quality of life, general functioning, hope and self-esteem, among a multi-ethnic Asian population of patients with mental disorders. This cross-sectional, survey recruited adult patients (n=280) who were seeking treatment at outpatient and affiliated clinics of the only tertiary psychiatric hospital in Singapore. Internalized stigma was measured using the Internalized Stigma of Mental Illness scale. 43.6% experienced moderate to high internalized stigma. After making adjustments in multiple logistic regression analysis, results revealed there were no significant socio-demographic or clinical correlates relating to internalized stigma. Individual logistic regression models found a negative relationship between quality of life, self-esteem, general functioning and internalized stigma whereby lower scores were associated with higher internalized stigma. In the final regression model, which included all psychosocial variables together, self-esteem was the only variable significantly and negatively associated with internalized stigma. The results of this study contribute to our understanding of the role internalized stigma plays in patients with mental illness, and the impact it can have on psychosocial aspects of their lives.
TL;DR: The presence of food addiction before surgery was not associated with weight loss as measured EBL%.
Abstract: Purposes The objectives of the current study were to determine the prevalence of food addiction in bariatric surgery candidates and whether food addiction is associated with weight loss after bariatric surgery. Methods This prospective observational study was performed on morbidly obese patients who had been found suitable for bariatric surgery. Follow-up was conducted at the 6 and 12 month post-surgery. The Yale Food Addiction Scale (YFAS) was used to determine food addiction. Results One hundred seventy-eight patients were included. Pre-operative food addiction was found in 57.8% of patients. Food addiction prevalence decreased at the 6 and 12 month follow ups, to 7.2% and 13.7% respectively. There were no statistically differences between those with food addiction and those without addiction with regard to weight loss measured as percent of excess BMI at the 12 month follow-up. Conclusion Food addiction as measured by the YFAS decreases significantly after bariatric surgery. The presence of food addiction before surgery was not associated with weight loss as measured EBL%. However, in view of the increase in BMI, 2 years after surgery longer follow up studies are warranted.
TL;DR: This study suggests that repeated intermittent use of R-ketamine is safer than esketamine in the treatment of depression, since it is free of psychotomimetic side effects.
Abstract: Clinical use of the rapid antidepressant drug ketamine is limited, due to psychotomimetic side effects. R-ketamine appears to be a potent, long-lasting and safer antidepressant, relative to S-ketamine (esketamine), since it is free of psychotomimetic side effects. Repeated, intermittent administration of esketamine (10mg/kg, once per week for 8-weeks), but not R-ketamine, caused loss of parvalbumin (PV)-immunoreactivity in the medial prefrontal cortex and hippocampus of mouse brains, regions associated with psychosis. This study suggests that repeated intermittent use of R-ketamine is safer than esketamine in the treatment of depression.
TL;DR: The phenotypic structure of tic, OC, ADHD, and autism symptoms as measured by the YGTSS,Y-BOCS,CAARS and AQ reveals a five factor structure that cuts through the diagnostic categories of GTS patients, and might inform both future genetic and treatment studies.
Abstract: Gilles de la Tourette's syndrome (GTS) is a disorder in which obsessive-compulsive (OC), Attention Deficit Hyperactivity Disorder (ADHD) and autism symptoms occur in up to 60% of patients, suggesting shared etiology. We explored the phenotypic structure of tic, OC, ADHD, and autism symptoms as measured by the YGTSS,Y-BOCS,CAARS and AQ, in 225 GTS patients and 371 family members. First, Confirmatory Factor Analyses (CFA) were performed on the symptom structure of each separate symptom scale. Second, the symptom dimensions derived from each scale were combined in one model, and correlations between them were calculated. Using the correlation matrix, Exploratory Factor Analyses (EFA) were performed on the symptom dimensions across the scales. EFA revealed a five factor structure: tic/aggression/symmetry; OC symptoms/compulsive tics/ numbers and patterns; ADHD symptoms; autism symptoms; and hoarding/inattention symptoms. The results are partly in line with the traditional categorical boundaries of the symptom scales used, and partly reveal a symptom structure that cuts through the diagnostic categories. This phenotypic structure might more closely reflect underlying etiologies than a structure that classically describes GTS patients according to absence or presence of comorbid OCD, ADHD and autism, and might inform both future genetic and treatment studies.
TL;DR: Investigating the effects of NSSI, it was found that depressed adolescents with N SSI showed relatively enhanced activation of the medial prefrontal cortex and the ventrolateral prefrontal cortex compared to depressed adolescents without NSSi and also compared to healthy controls.
Abstract: Non-suicidal self-injury (NSSI) is highly prevalent in adolescence and has been suggested as an autonomous diagnosis in the Diagnostic and Statistical Manual (DSM-5). Social rejection is as potential risk-factor for NSSI and depression in adolescence. Objectives of this study were to identify differences in neural processing of social rejection in depressed adolescents with and without co-morbid NSSI and healthy controls. Participants were 28 depressed adolescents (14 with co-morbid NSSI, 79% females) and 15 healthy controls, with an average age of 15.2 years (SD=1.8). Social exclusion was implemented using the Cyberball paradigm 'Cyberball' during functional magnetic resonance imaging (fMRI). All participants reported feelings of social exclusion after fMRI scanning. Investigating the effects of NSSI, we found that depressed adolescents with NSSI showed relatively enhanced activation of the medial prefrontal cortex (mPFC) and the ventrolateral prefrontal cortex (vlPFC) compared to depressed adolescents without NSSI and also compared to healthy controls. Results point towards divergent processing of social exclusion in depressed adolescents with NSSI as compared to adolescents with mere depression in brain regions previously related to the processing of social exclusion. This finding of distinct neurophysiological responses may stimulate further research on individual treatment approaches.
TL;DR: The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) has been validated in general population samples in many countries as mentioned in this paper, particularly for tertiary prevention and mental health promotion.
Abstract: The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) has been validated in general population samples in many countries. Interest in using this measure in clinical populations is growing, particularly for tertiary prevention and mental health promotion. This paper reports validation of the French WEMWBS in healthy and chronic remitted schizophrenia populations. The French WEMWBS was administered to 319 workers, 75 students and 121 patients. For non-patients, self-reported Trait- and State-Anxiety, Mindfulness, Positive and Negative Affect and the General Health Questionnaire were completed. For patients, the Positive and Negative Syndrome Scale, Clinical Global Impression Severity Scale, Birchwood Insight Scale, Social Adjustment Scale, and Global Assessment of Functioning scale were completed. Test-retest reliability and responsiveness to intervention was assessed at 6 months. Whatever the sample, response frequencies showed normal distributions, and internal consistency was good (Cronbach's α). Scree plots of eigenvalues suggested a single factor in the samples. The one-dimensional solution yielded suboptimal fit indices. Construct validity was confirmed. Significant improvement in scores was observed before and after intervention. Test-retest variation was non-significant. Impairment of insight and cognition in the assessed patients implies that attention must be paid before applying WEMWBS to all patients. Nevertheless, WEMWBS proved valid and reliable in a further European population, suggesting transcultural validity for both monitoring and evaluation of interventions in healthy as well as chronic remitted schizophrenia populations.
TL;DR: Patients with schizophrenia have a different personality profile compared with healthy subjects according to the NEO Five-Factor Inventory, a meta-analysis of these personality traits assessed by the NEO-FFI suggests.
Abstract: Personality is one of important factors in the pathogenesis of schizophrenia because it affects patients' symptoms, cognition and social functioning. Several studies have reported specific personality traits in patients with schizophrenia compared with healthy subjects. However, the results were inconsistent among studies. The NEO Five-Factor Inventory (NEO-FFI) measures five personality traits: Neuroticism (N), Extraversion (E), Openness (O), Agreeableness (A) and Conscientiousness (C). Here, we performed a meta-analysis of these personality traits assessed by the NEO-FFI in 460 patients with schizophrenia and 486 healthy subjects from the published literature and investigated possible associations between schizophrenia and these traits. There was no publication bias for any traits. Because we found evidence of significant heterogeneity in all traits among the studies, we applied a random-effect model to perform the meta-analysis. Patients with schizophrenia showed a higher score for N and lower scores for E, O, A and C compared with healthy subjects. The effect sizes of these personality traits ranged from moderate to large. These differences were not affected by possible moderator factors, such as gender distribution and mean age in each study, expect for gender effect for A. These findings suggest that patients with schizophrenia have a different personality profile compared with healthy subjects.
TL;DR: Adolescents with BD had significantly higher spontaneous levels of NF-κB in peripheral blood mononuclear cells, monocyte and lymphocyte populations, and higher plasma levels of IL-1β than healthy controls, and following stimulation with recombinant human TNF-α, participants with BD and MDD both had greater increases in monocytes than controls.
Abstract: Adults with bipolar disorder (BD) and major depressive disorder (MDD) have higher circulating levels of proinflammatory cytokines than healthy controls. However, it is not known whether pediatric-onset patients with BD or MDD show increases in levels of inflammation or activation of nuclear factor kappa B (NF-κB), a key transcription factor in inflammatory signaling. Circulating levels of inflammatory cytokines, as well as spontaneous and stimulated levels of activated NF-κB in total peripheral blood mononuclear cells, monocytes and lymphocytes were measured in adolescents with BD (n=18), MDD (n=13), or no psychiatric history (n=20). Participants had a range of mood symptoms at time of testing. Adolescents with BD had significantly higher spontaneous levels of NF-κB in peripheral blood mononuclear cells, monocyte and lymphocyte populations, and higher plasma levels of IL-1β than healthy controls. Following stimulation with recombinant human TNF-α, participants with BD and MDD both had greater increases in NF-κB in monocytes than controls. Further, greater stimulated increases of NF-κB in monocytes were associated with the current severity of depressive symptoms. The results are limited by the small sample and cross-sectional design. Interventions that target early immunological dysregulation should be examined in relation to long-term outcomes in youth with bipolar and depressive disorders. Clinical Trial registration information: Early Intervention for Youth at Risk for Bipolar Disorder, https://clinicaltrials.gov/ct2/show/NCT01483391.
TL;DR: In patients, loneliness was associated with self-report measures of social cognition, and in controls, loneliness did not rely on the same psychological processes in patients than in controls.
Abstract: Social attachment is a biological and affective need. When this need is not met, people experience loneliness. Loneliness is associated with impaired social cognition, and is a risk factor for broad based morbidity across the adult lifespan even after controlling for multiple factors. However, little is known about loneliness in schizophrenia. Eighty-seven non-depressed individuals with schizophrenia or schizoaffective disorder (including 51 inpatients) and 58 control subjects completed the revised UCLA Loneliness scale. Social cognition was assessed with a self-report questionnaire and a performance-based task. Social trait perception was assessed with a facial task. Comorbid medical diagnoses were available for all inpatients. Patients reported greater loneliness levels than controls, while in- and out-patients did not significantly differ. In patients, loneliness was associated with self-report measures of social cognition. Patients' loneliness scores predicted a diagnosis of drug abuse/dependence, number of drugs used, hypertension and abnormal hemoglobin A1c levels. Patients experienced higher levels of loneliness than controls, independently of their objective social isolation. Loneliness did not rely on the same psychological processes in patients than in controls. Loneliness in schizophrenia is a symptom that deserves more scrutiny, particularly as it relates to the high prevalence of metabolic syndrome in this population.
TL;DR: Subgroups among people confronted with unnatural/violent loss characterized by different symptoms profiles of prolonged grief disorder (PGD) and depression, and socio-demographic, loss-related, and cognitive variables associated with subgroup membership are identified are provided.
Abstract: This study sought to identify (a) subgroups among people confronted with unnatural/violent loss characterized by different symptoms profiles of prolonged grief disorder (PGD) and depression, and (b) socio-demographic, loss-related, and cognitive variables associated with subgroup membership. We used data from 245 individuals confronted with the death of a loved one due to an accident (47.3%), suicide (49%) or homicide (3.7%). Latent class analysis revealed three classes of participants: a resilient-class (25.3%), a predominantly PGD-class (39.2%), and a combined PGD/Depression-class (35.5%). Membership in the resilient-class was predicted by longer time since loss and lower age; membership in the combined class was predicted by lower education. Endorsement of negative cognitions about the self, life, the future, and one's own grief-reactions was lowest in the Resilient-class, intermediate in the PGD-class, and highest in the combined PGD/Depression-class. When all socio-demographic, loss-related, and cognitive variables were included in multinomial regression analyses predicting class-membership, it was found that negative cognitions about one's grief was the only variable predicting membership of the PGD-class. Negative cognitions about the self, life, and grief predicted membership of the combined PGD/Depression-class. These findings provide valuable information for the development of interventions for different subgroups of bereaved individuals confronted with unnatural/violent loss.
TL;DR: Bilateral reduction of both the hippocampus and amygdala in the PTSD group compared to healthy controls is found, and sex diverse MRI studies in PTSD are needed to determine whether sex plays a significant role in the hippocampal effects associated with childhood-onset trauma.
Abstract: We systematically reviewed differences in hippocampal and amygdala volumes between adults with childhood maltreatment-related posttraumatic stress disorder (PTSD) and healthy controls. Using the terms "adults", "MRI", "magnetic resonance imaging", with "posttraumatic stress disorder" "PTSD", "child abuse", and "child maltreatment", we conducted searches on several electronic databases. We identified 10 studies that met our inclusion criteria; 7 of which were included in a meta-analysis of hippocampal volume and 4 that were included in a meta-analysis of amygdala volume. Mean hippocampal and amygdala volumes were used to determine effect sizes. We found bilateral reduction of both the hippocampus and amygdala in the PTSD group compared to healthy controls, with effect sizes of -0.66 and -0.67 for the left and right hippocampus (p<0.00001 and p=0.002) and -1.08 and -1.15 for the left and right amygdala, (p=0.013 and p=0.003), respectively. Confidence intervals were -0.93,-0.39 and -1.26,-0.29 for the left and right hippocampus, respectively. For the amygdala, confidence intervals were -1.92,-0.23 and -1.19, -0.39 for the left and right amygdala. The relatively few studies available for analysis is a limitation. Additionally, sex diverse MRI studies in PTSD are needed to determine whether sex plays a significant role in the hippocampal effects associated with childhood-onset trauma.
TL;DR: These findings represent a preliminary step towards greater clarification of the mechanisms driving suicidal behaviour, and support the utility of basing future research on the Integrated Motivational-Volitional model of suicidal behaviour.
Abstract: Suicidal behaviours are highly complex, multi-determined phenomena. Despite this, historically research has tended to focus on bivariate associations between atheoretical demographic and/or psychiatric factors and suicidal behaviour. The aim of this study was to empirically test the Integrated Motivational-Volitional model of suicidal behaviour using structural equation modeling. Healthy adults (N = 1, 809) completed anonymous self-report surveys. The fit of the proposed model was good, and explained 79% of variance in defeat, 83% of variance in entrapment, 61% of variance in suicidal ideation, and 27% of variance in suicide attempts. All proposed paths were significant except for those between goal re-engagement and two factors of suicide resilience (Internal Protective and External Protective) and suicidal ideation; and impulsivity and discomfort intolerance and suicide attempts. These findings represent a preliminary step towards greater clarification of the mechanisms driving suicidal behaviour, and support the utility of basing future research on the Integrated Motivational–Volitional model of suicidal behaviour.
TL;DR: Investigation of the function of two specific emotion-related skills, emotion expressivity and emotion coping, as potential mediators in the relations between childhood sexual, physical, and emotional abuse and NSSI indicated that poor emotionexpressivity, but not emotion coping), mediated the relation between childhood experiences of emotional abuse.
Abstract: The present study investigated the function of two specific emotion-related skills, emotion expressivity and emotion coping, as potential mediators in the relations between childhood sexual, physical, and emotional abuse and NSSI. A robust body of work supports the role of emotion regulation in nonsuicidal self-injury, but additional research is warranted to tease apart the role of specific emotion regulation deficits as predictors of NSSI. Participants included 95 youth (Mage=14.22, SDage=1.67; 58% female) hospitalized on one of two acute care psychiatric inpatient units. Participants completed self-report questionnaires related to childhood experiences of trauma, current emotion expressivity and coping, and lifetime frequency of NSSI. Path analytic models indicated that only child emotional abuse was directly associated with NSSI when all abuse subtypes were examined simultaneously. Results also indicated that poor emotion expressivity, but not emotion coping, mediated the relation between childhood experiences of emotional abuse and NSSI.
TL;DR: In this article, the authors investigated how problematic Internet use relates to general life satisfaction and distinct facets of everyday life such as job, leisure, and health, using a large sample (N=4852 participants; 51.71% males).
Abstract: The present study investigates, using a large sample (N=4852 participants; 51.71% males), how problematic Internet use (PIU) relates to general life satisfaction and distinct facets of everyday life such as job, leisure, and health. Data on Internet usage was gathered using a short form of the Young Internet Addiction Test. Life satisfaction was measured with standardized items taken from the socioeconomic panel (Germany). Highly significant associations were observed between PIU and the facets of life satisfaction, health and leisure. Of note, these associations between the mentioned facets of life satisfaction and PIU were significantly higher for females compared to males, although the reported total level of PIU was significantly lower for females. This suggests the presence of different thresholds for males and females with respect to negative effects on well-being due to PIU. The current study underlines the importance of including gender as a critical variable when investigating the association between life satisfaction and PIU.