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Serur Y, Fuhrmann N, Russo O, Green T. Irritability in children with RASopathies, insights into emotional dysregulation and social impairment. Eur Child Adolesc Psychiatry 2025:10.1007/s00787-025-02767-w. [PMID: 40459753 DOI: 10.1007/s00787-025-02767-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 05/26/2025] [Indexed: 06/11/2025]
Affiliation(s)
- Yaffa Serur
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral Science, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA, 94305-5717, USA.
| | - Naomi Fuhrmann
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral Science, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA, 94305-5717, USA
| | - Odeya Russo
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral Science, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA, 94305-5717, USA
| | - Tamar Green
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral Science, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA, 94305-5717, USA
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Ayala-Aldana N, Pinar-Martí A, Ruiz-Rivera M, Fernández-Barrés S, Romaguera D, Casanova-Mollà J, Solà-Valls N, Julvez J. Original article: adolescent dietary patterns derived using principal component analysis and neuropsychological functions: a cross-sectional analysis of Walnuts Smart Snack cohort. Eur Child Adolesc Psychiatry 2025; 34:1569-1578. [PMID: 39292245 PMCID: PMC12122558 DOI: 10.1007/s00787-024-02577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 08/28/2024] [Indexed: 09/19/2024]
Abstract
A balanced diet is relevant for neuropsychological functioning. We aimed to analyze the association between dietary patterns and neuropsychological outcomes in a sample of healthy adolescents of the Walnuts Smart Snack (WSS) cohort from Barcelona city. We performed principal components analysis (PCA) to determine dietary patterns in the adolescent sample using a food frequency questionnaire (60 items). Multiple linear regression models were performed to analyze the association between PCA dietary patterns with neuropsychological outcomes: Strengths and Difficulties (SDQ) externalizing and internalizing scores, Attention Network Test (ANT) Impulsivity Index and Emotional Recognition Task (ERT) scores. We additionally adjusted the models for child sex, age, body mass index (BMI), physical activity and maternal education. Six dietary patterns were identified in PCA analyses. "low consumption of calorie-dense foods" dietary pattern had a negative association (protective) with the both SDQ outcomes (p value < 0.001) and "Nuts" dietary pattern showed a negative (protective) association with impulsivity index( β 1 = -24.60, 95% CI = -36.80, -12.41, p value < 0.001). Overall, our main results suggest that healthy dietary patterns, including higher intakes of "nuts" and a preference of "low consumption of calorie-dense foods" dietary patterns, could provide a beneficial association with neuropsychological functions during the adolescence period. The associations may include improvements of externalizing and internalizing problem symptoms, and impulsivity.
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Affiliation(s)
- Nicolas Ayala-Aldana
- Clinical and Epidemiological Neuroscience (NeuroÈ̇pia), Institut d'Investigació̇ Sanità̇ria Pere Virgili (IISPV), Reus, Spain.
- ISGlobal, Barcelona, Spain.
- University of Barcelona, Catalonia Barcelona, Spain.
| | - Ariadna Pinar-Martí
- Clinical and Epidemiological Neuroscience (NeuroÈ̇pia), Institut d'Investigació̇ Sanità̇ria Pere Virgili (IISPV), Reus, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Catalonia Barcelona, Spain
| | - Marina Ruiz-Rivera
- Clinical and Epidemiological Neuroscience (NeuroÈ̇pia), Institut d'Investigació̇ Sanità̇ria Pere Virgili (IISPV), Reus, Spain
- ISGlobal, Barcelona, Spain
| | | | - Dora Romaguera
- ISGlobal, Barcelona, Spain
- Institut d'Investigació Sanitaria Illes Balears (IdISBa), Palma, Spain
- CIBER Fisiopatologí̇a de la Obesidad y Nutrició̇n (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Casanova-Mollà
- Clinical and Epidemiological Neuroscience (NeuroÈ̇pia), Institut d'Investigació̇ Sanità̇ria Pere Virgili (IISPV), Reus, Spain
- Salut Sant Joan Reus - Baix Camp, Reus, Spain
| | - Nuria Solà-Valls
- Clinical and Epidemiological Neuroscience (NeuroÈ̇pia), Institut d'Investigació̇ Sanità̇ria Pere Virgili (IISPV), Reus, Spain
- Salut Sant Joan Reus - Baix Camp, Reus, Spain
| | - Jordi Julvez
- Clinical and Epidemiological Neuroscience (NeuroÈ̇pia), Institut d'Investigació̇ Sanità̇ria Pere Virgili (IISPV), Reus, Spain.
- ISGlobal, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Catalonia Barcelona, Spain.
- CIBER Fisiopatologí̇a de la Obesidad y Nutrició̇n (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Human Nutrition Unit, Reus, Spain.
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Soler-Gutiérrez AM, Sánchez-Carmona AJ, Albert J, Hinojosa JA, Cortese S, Bellato A, Mayas J. Emotion processing difficulties in ADHD: a Bayesian meta-analysis study. Eur Child Adolesc Psychiatry 2025:10.1007/s00787-025-02647-3. [PMID: 39853403 DOI: 10.1007/s00787-025-02647-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 01/09/2025] [Indexed: 01/26/2025]
Abstract
We investigated whether there is an emotional processing deficit in ADHD and whether this only applies to specific emotional categories. In this PRISMA-compliant systematic review based on a pre-registered protocol ( https://osf.io/egp7d ), we searched MEDLINE, PsycINFO, ERIC, Scopus and Web of Science databases until 3rd December 2023, to identify empirical studies comparing emotional processing in individuals meeting DSM (version III to 5-TR) or ICD (version 9 or 10) criteria for Attention Deficit/Hyperactivity Disorder (ADHD) and in a non-psychiatric control group. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Eighty studies were included and meta-analysed (encompassing 6191 participants and 465 observations). Bayesian meta-analyses were conducted to compare individuals with ADHD and non-psychiatric controls on overall emotional processing measures (meta-analysis 1) and across emotional categories (meta-analysis 2). The type of stimulus employed, outcome measurement reported, age, sex, and medication status were analysed as moderators. We found poorer performance in both overall emotion processing (g = - 0.65) and across emotional categories (anger g = - 0.37; disgust g = - 0.24; fear g = - 0.37; sadness g = - 0.34; surprise g = - 0.26; happiness/positive g = - 0.31; negative g = - 0.20; neutral g = - 0.25) for individuals with ADHD compared to non-psychiatric controls. Scales items and accuracy outcome being the most effective moderators in detecting such differences. No effects of age, sex, or medication status were found. Overall, these results show that impaired emotional processing is a relevant feature of ADHD and suggest that it should be systematically assessed in clinical practice.
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Affiliation(s)
- Ana-María Soler-Gutiérrez
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Despacho 2.36 bis, Calle Juan del Rosal, 10, 28040, Madrid, Spain
- Escuela Internacional de Doctorado de la UNED (EIDUNED), Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Jacobo Albert
- Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - José Antonio Hinojosa
- Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain
- Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, Madrid, Spain
| | - Samuele Cortese
- School of Psychology, University of Southampton, Southampton, UK
- Centre for Innovation in Mental Health, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, Università degli Studi di Bari "Aldo Moro", Bari, Italy
| | - Alessio Bellato
- School of Psychology, University of Southampton, Southampton, UK
- Centre for Innovation in Mental Health, University of Southampton, Southampton, UK
- Institute for Life Sciences, University of Southampton, Southampton, UK
- School of Psychology, University of Nottingham, Semenyih, Malaysia
- Mind and Neurodevelopment (MiND) Research Group, University of Nottingham, Semenyih, Malaysia
| | - Julia Mayas
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Despacho 2.36 bis, Calle Juan del Rosal, 10, 28040, Madrid, Spain.
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Serur Y, Fuhrman N, Russo O, Green T. Irritability in Children with Rasopathies, Insights into Emotional Dysregulation and Social Skills Impairments. RESEARCH SQUARE 2024:rs.3.rs-5428038. [PMID: 39764141 PMCID: PMC11702823 DOI: 10.21203/rs.3.rs-5428038/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2025]
Abstract
Rasopathies, including Noonan Syndrome (NS) and Neurofibromatosis type 1 (NF1), are developmental disorders caused by germline mutations in genes of the RAS/mitogen-activated protein kinase pathway (RAS-MAPK). This study investigates irritability, a highly prevalent transdiagnostic construct, in children with Rasopathies and the impact of Rasopathy status on the associations between irritability, emotional dysregulation-related disorders, and social skills impairments. The sample comprise 174 children aged 4-17 (age mean = 9.49; 98 females), including 113 children with Rasopathies (NS n = 85, NF1 n = 28) and 61 age-sex-matched typically developed (TD) children. We used parent questionnaires (CBCL, SRS) to assess irritability, symptoms of ADHD, defiance, anxiety/depression, and social skills impairments while controlling for cognitive measures (IQ). Children with Rasopathies exhibited higher irritability than TD children (mean difference = 1.09; p < 0.001). Children with NS showed a weaker association between irritability and ADHD symptoms compared to TD children (p = .032, ηp 2 = .03) and a stronger association between irritability and social skills impairments compared to both TD (p = .033, ηp 2 = .03), and NF1 groups (p = .009, ηp 2 = .06). We present novel and clinically significant findings showing high irritability in children with Rasopathies. Our study provides syndrome-specific results, suggesting differences in the mechanisms involved in irritability, ADHD, and social processes in children with NS and NF1. In essence, children with Rasopathies showed a highly irritable profile associated with ADHD symptoms and social skills impairments, with a significantly stronger association between irritability and social processes in NS. Our results suggest that developing prevention and treatments targeting irritability can distinctly affect the trajectories of neurodevelopmental disorders in children with Rasopathies.
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Elvin OM, Modecki KL, Waters AM. An Expanded Conceptual Framework for Understanding Irritability in Childhood: The Role of Cognitive Control Processes. Clin Child Fam Psychol Rev 2024; 27:381-406. [PMID: 38856946 PMCID: PMC11222227 DOI: 10.1007/s10567-024-00489-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/11/2024]
Abstract
Children prone to irritability experience significant functional impairments and internalising and externalising problems. Contemporary models have sought to elucidate the underlying mechanisms in irritability, such as aberrant threat and reward biases to improve interventions. However, the cognitive control processes that underlie threat (e.g., attention towards threats) and reward (e.g., attention towards reward-related cues) biases and the factors which influence the differential activation of positive and negative valence systems and thus leading to maladaptive activation of cognitive control processes (i.e., proactive and reactive control) are unclear. Thus, we aim to integrate extant theoretical and empirical research to elucidate the cognitive control processes underlying threat and reward processing that contribute to irritability in middle childhood and provide a guiding framework for future research and treatment. We propose an expanded conceptual framework of irritability that includes broad intraindividual and environmental vulnerability factors and propose proximal 'setting' factors that activate the negative valence and positive valence systems and proactive and reactive cognitive control processes which underpin the expression and progression of irritability. We consider the implications of this expanded conceptualisation of irritability and provide suggestions for future research.
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Affiliation(s)
- Olivia M Elvin
- School of Applied Psychology, Griffith University, Mount Gravatt Campus, Brisbane, QLD, Australia.
| | - Kathryn L Modecki
- Centre for Mental Health and School of Applied Psychology, Griffith University, Mount Gravatt Campus, Brisbane, QLD, Australia
- School of Psychological Science, University of Western Australia & Telethon Kids Institute, Perth, Australia
| | - Allison M Waters
- Centre for Mental Health and School of Applied Psychology, Griffith University, Mount Gravatt Campus, Brisbane, QLD, Australia.
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Chen Y, Ma Y, Fan X, Lyu J, Yang R. Facial expression recognition ability and its neuropsychological mechanisms in children with attention deficit and hyperactive disorder. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024; 53:254-260. [PMID: 38650447 PMCID: PMC11057990 DOI: 10.3724/zdxbyxb-2023-0390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/17/2024] [Indexed: 04/25/2024]
Abstract
Attention deficit and hyperactive disorder (ADHD) is a chronic neurodevelopmental disorder characterized by inattention, hyperactivity-impulsivity, and working memory deficits. Social dysfunction is one of the major challenges faced by children with ADHD. It has been found that children with ADHD can't perform as well as typically developing children on facial expression recognition (FER) tasks. Generally, children with ADHD have some difficulties in FER, while some studies suggest that they have no significant differences in accuracy of specific emotion recognition compared with typically developing children. The neuropsychological mechanisms underlying these difficulties are as follows. First, neuroanatomically. Compared to typically developing children, children with ADHD show smaller gray matter volume and surface area in the amygdala and medial prefrontal cortex regions, as well as reduced density and volume of axons/cells in certain frontal white matter fiber tracts. Second, neurophysiologically. Children with ADHD exhibit increased slow-wave activity in their electroencephalogram, and event-related potential studies reveal abnormalities in emotional regulation and responses to angry faces when facing facial stimuli. Third, psychologically. Psychosocial stressors may influence FER abilities in children with ADHD, and sleep deprivation in ADHD children may significantly increase their recognition threshold for negative expressions such as sadness and anger. This article reviews research progress over the past three years on FER abilities of children with ADHD, analyzing the FER deficit in children with ADHD from three dimensions: neuroanatomy, neurophysiology and psychology, aiming to provide new perspectives for further research and clinical treatment of ADHD.
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Affiliation(s)
- Yi Chen
- Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Ye Ma
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Xiaoli Fan
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jiamin Lyu
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Rongwang Yang
- Department of Psychology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
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