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Vrijsen JN, Grafton B, Koster EHW, Lau J, Wittekind CE, Bar-Haim Y, Becker ES, Brotman MA, Joormann J, Lazarov A, MacLeod C, Manning V, Pettit JW, Rinck M, Salemink E, Woud ML, Hallion LS, Wiers RW. Towards implementation of cognitive bias modification in mental health care: State of the science, best practices, and ways forward. Behav Res Ther 2024; 179:104557. [PMID: 38797055 DOI: 10.1016/j.brat.2024.104557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/17/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
Cognitive bias modification (CBM) has evolved from an experimental method testing cognitive mechanisms of psychopathology to a promising tool for accessible digital mental health care. While we are still discovering the conditions under which clinically relevant effects occur, the dire need for accessible, effective, and low-cost mental health tools underscores the need for implementation where such tools are available. Providing our expert opinion as Association for Cognitive Bias Modification members, we first discuss the readiness of different CBM approaches for clinical implementation, then discuss key considerations with regard to implementation. Evidence is robust for approach bias modification as an adjunctive intervention for alcohol use disorders and interpretation bias modification as a stand-alone intervention for anxiety disorders. Theoretical predictions regarding the mechanisms by which bias and symptom change occur await further testing. We propose that CBM interventions with demonstrated efficacy should be provided to the targeted populations. To facilitate this, we set a research agenda based on implementation frameworks, which includes feasibility and acceptability testing, co-creation with end-users, and collaboration with industry partners.
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Affiliation(s)
- Janna N Vrijsen
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, the Netherlands.
| | - Ben Grafton
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia
| | - Ernst H W Koster
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Jennifer Lau
- Youth Resilience Unit, Queen Mary University of London, UK
| | - Charlotte E Wittekind
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Germany
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv-Yafo, Israel; School of Neuroscience, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, Conneticut, USA
| | - Amit Lazarov
- School of Neuroscience, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Colin MacLeod
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Jeremy W Pettit
- Department of Psychology and Center for Children and Families, Florida International University, Miami, FL, USA
| | - Mike Rinck
- Emotion and Development Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Elske Salemink
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, the Netherlands
| | - Marcella L Woud
- Clinical Psychology and Experimental Psychopathology, Georg-Elias-Mueller-Institute of Psychology, University of Göttingen, Göttingen, Germany; Mental Health Research and Treatment Center, Ruhr-University Bochum, Bochum, Germany
| | | | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, and Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
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Miranda O, Kiehl SM, Qi X, Brannock MD, Kosten T, Ryan ND, Kirisci L, Wang Y, Wang L. Enhancing post-traumatic stress disorder patient assessment: leveraging natural language processing for research of domain criteria identification using electronic medical records. BMC Med Inform Decis Mak 2024; 24:154. [PMID: 38835009 PMCID: PMC11151516 DOI: 10.1186/s12911-024-02554-8] [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] [Received: 03/06/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Extracting research of domain criteria (RDoC) from high-risk populations like those with post-traumatic stress disorder (PTSD) is crucial for positive mental health improvements and policy enhancements. The intricacies of collecting, integrating, and effectively leveraging clinical notes for this purpose introduce complexities. METHODS In our study, we created a natural language processing (NLP) workflow to analyze electronic medical record (EMR) data and identify and extract research of domain criteria using a pre-trained transformer-based natural language model, all-mpnet-base-v2. We subsequently built dictionaries from 100,000 clinical notes and analyzed 5.67 million clinical notes from 38,807 PTSD patients from the University of Pittsburgh Medical Center. Subsequently, we showcased the significance of our approach by extracting and visualizing RDoC information in two use cases: (i) across multiple patient populations and (ii) throughout various disease trajectories. RESULTS The sentence transformer model demonstrated high F1 macro scores across all RDoC domains, achieving the highest performance with a cosine similarity threshold value of 0.3. This ensured an F1 score of at least 80% across all RDoC domains. The study revealed consistent reductions in all six RDoC domains among PTSD patients after psychotherapy. We found that 60.6% of PTSD women have at least one abnormal instance of the six RDoC domains as compared to PTSD men (51.3%), with 45.1% of PTSD women with higher levels of sensorimotor disturbances compared to men (41.3%). We also found that 57.3% of PTSD patients have at least one abnormal instance of the six RDoC domains based on our records. Also, veterans had the higher abnormalities of negative and positive valence systems (60% and 51.9% of veterans respectively) compared to non-veterans (59.1% and 49.2% respectively). The domains following first diagnoses of PTSD were associated with heightened cue reactivity to trauma, suicide, alcohol, and substance consumption. CONCLUSIONS The findings provide initial insights into RDoC functioning in different populations and disease trajectories. Natural language processing proves valuable for capturing real-time, context dependent RDoC instances from extensive clinical notes.
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Affiliation(s)
- Oshin Miranda
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | | | - Xiguang Qi
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | | | - Thomas Kosten
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Neal David Ryan
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Levent Kirisci
- University of Pittsburgh School of Pharmacy, Pittsburgh, PA, 15213, USA
| | - Yanshan Wang
- University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA, 15213, USA
| | - LiRong Wang
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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All K, Chawarska K, Macari SL. Early executive functioning predicts externalizing problems in neurodiverse preschoolers. Autism Res 2024; 17:1053-1065. [PMID: 38476104 DOI: 10.1002/aur.3109] [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] [Received: 07/05/2023] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
Children with autism spectrum disorder (ASD) often exhibit externalizing problems, which have been linked with increased anxiety and depression, peer rejection, and parental stress. Identification of early predictors of externalizing behaviors in autism will facilitate identification of vulnerable children and implementation of early preventative interventions. There is ample evidence that executive functioning, social functioning, and temperament are predictive of later externalizing problems in general populations, but less is known about these relations in ASD and other neurodiverse populations, particularly in the early preschool years. To address this gap, we assessed the relations between executive functioning, social functioning, and temperament at age 3 and externalizing problems at age 5 in a sample of neurodiverse children with ASD and other neurodevelopmental disorders and delays. Analyses revealed that severity of early executive functioning impairment predicted increased externalizing problems. Severity of social autism symptoms moderated this relationship such that the effect of executive functioning on externalizing problems decreased as autism symptoms increased. These findings suggest that executive functioning is an important target for identifying and developing interventions for vulnerable children and underscore the necessity of considering severity of autism symptoms when researching the development of externalizing problems in children with neurodevelopmental disorders.
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Affiliation(s)
- Katherine All
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Suzanne L Macari
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Keidel K, Lu X, Suzuki S, Murawski C, Ettinger U. Association of temporal discounting with transdiagnostic symptom dimensions. NPJ MENTAL HEALTH RESEARCH 2024; 3:13. [PMID: 38627606 PMCID: PMC11021403 DOI: 10.1038/s44184-024-00060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/15/2024] [Indexed: 04/19/2024]
Abstract
Temporal discounting (TD), the tendency to devalue future rewards as a function of delay until receipt, is aberrant in many mental disorders. Identifying symptom patterns and transdiagnostic dimensions associated with TD could elucidate mechanisms responsible for clinically impaired decision-making and facilitate identifying intervention targets. Here, we tested in a general population sample (N = 731) the extent to which TD was related to different symptom patterns and whether effects of time framing (dates/delay units) and monetary magnitude (large/small) had particularly strong effects in people scoring higher on specific symptom patterns. Analyses revealed that TD was related to symptom patterns loading on anxious-depression and inattention-impulsivity-overactivity dimensions. Moreover, TD was lower in the date than the delay version and with higher magnitudes, especially in people scoring higher on the inattention-impulsivity-overactivity dimension. Overall, this study provides evidence for TD as a transdiagnostic process across affective and impulsivity-related dimensions. Future studies should test framing interventions in clinical populations characterized by impulsivity.Preregistration: This research was preregistered at https://osf.io/fg9sc .
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Affiliation(s)
- Kristof Keidel
- Department of Psychology, University of Bonn, Bonn, Germany
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Xiaping Lu
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Shinsuke Suzuki
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
- Faculty of Social Data Science, Hitotsubashi University, Tokyo, Japan
- HIAS Brain Research Center, Hitotsubashi University, Tokyo, Japan
| | - Carsten Murawski
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Bonn, Germany.
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Castro Ribeiro T, García Pagès E, Ballester L, Vilagut G, García Mieres H, Suárez Aragonès V, Amigo F, Bailón R, Mortier P, Pérez Sola V, Serrano-Blanco A, Alonso J, Aguiló J. Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study. JMIR Res Protoc 2024; 13:e51298. [PMID: 38551647 PMCID: PMC11015365 DOI: 10.2196/51298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/22/2023] [Accepted: 01/11/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress. OBJECTIVE This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress. METHODS This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed. RESULTS Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024. CONCLUSIONS This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies. TRIAL REGISTRATION OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51298.
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Affiliation(s)
- Thais Castro Ribeiro
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Departament of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Bellaterra, Spain
| | - Esther García Pagès
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Departament of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Bellaterra, Spain
| | - Laura Ballester
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Gemma Vilagut
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Helena García Mieres
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Víctor Suárez Aragonès
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Franco Amigo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Raquel Bailón
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Philippe Mortier
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Víctor Pérez Sola
- CIBER en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
- Neurosciences Research Group, Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Antoni Serrano-Blanco
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jordi Alonso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jordi Aguiló
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Departament of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Bellaterra, Spain
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Quah SKL, Jo B, Geniesse C, Uddin LQ, Mumford JA, Barch DM, Fair DA, Gotlib IH, Poldrack RA, Saggar M. A Data-Driven Latent Variable Approach to Validating the Research Domain Criteria Framework. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.31.577486. [PMID: 38559071 PMCID: PMC10979851 DOI: 10.1101/2024.01.31.577486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Despite the widespread use of the Research Domain Criteria (RDoC) framework in psychiatry and neuroscience, recent studies suggest that the RDoC is insufficiently specific or excessively broad relative to the underlying brain circuitry it seeks to elucidate. To address these concerns of the RDoC framework, our study employed a latent variable approach, specifically utilizing bifactor analysis. We examined a total of 84 whole-brain task-based fMRI (tfMRI) activation maps from 19 studies with a total of 6,192 participants. Within this set of 84 maps, a curated subset of 37 maps with a balanced representation of RDoC domains constituted the training set of our analysis, and the remaining held-out maps formed the internal validation set. External validation was performed with 36 peak coordinate activation maps from Neurosynth, using terms of RDoC constructs as seeds for topic meta-analysis. Our results indicate that a bifactor model with a task-general domain and splitting the cognitive systems domain into sub-domains better fits the current corpus of tfMRI data than the current RDoC framework. Our data-driven validation supports revising the RDoC framework to accurately reflect underlying brain circuitry.
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Affiliation(s)
- S K L Quah
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - B Jo
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - C Geniesse
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - L Q Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, CA USA
| | - J A Mumford
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - D M Barch
- Departments of Psychological & Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St Louis, MO, USA
| | - D A Fair
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - I H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - R A Poldrack
- Department of Psychology, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - M Saggar
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
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Fram NR, Alviar C, Lense MD. What scholarship on social timing and autism can learn from each other: A Comment on "The evolution of social timing" by Laura Verga, Sonja A. Kotz, and Andrea Ravignani. Phys Life Rev 2024; 48:19-21. [PMID: 38061249 DOI: 10.1016/j.plrev.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Noah R Fram
- Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center.
| | - Camila Alviar
- Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center
| | - Miriam D Lense
- Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center; Vanderbilt Kennedy Center, Vanderbilt University Medical Center
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8
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Duda JM, Fineberg SK, Deng W, Ma Y, Everaert J, Cannon TD, Joormann J. Borderline personality disorder features are associated with inflexible social interpretations. J Affect Disord 2024; 348:78-87. [PMID: 38110156 DOI: 10.1016/j.jad.2023.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is thought to involve aberrant social learning, including impaired revision of social interpretations with new evidence (social interpretation inflexibility). However, this topic has received little empirical attention outside of specific literatures, such as moral inference or behavioral economics. Further, the contribution of comorbid depression to BPD-related interpretation inflexibility has not yet been assessed. METHODS In two independent samples (Study 1: N = 213; Study 2: N = 210, oversampled for BPD features), we assessed the associations between BPD symptoms, depressive symptoms, and task-based measures of social interpretation flexibility. RESULTS We found that BPD symptoms, particularly volatility of identity and relationships, were associated with less revision of social interpretations with both positive and negative evidence. Meanwhile, depressive symptoms were associated with a pattern of less revision of social interpretations with positive versus negative information. LIMITATIONS The use of cross-sectional, crowdsourced samples limits causal interpretations. Translation to clinical populations should be assessed in future studies. CONCLUSIONS Results suggest that inflexible social interpretations across valences may be a feature of BPD-related pathology, and could be connected to symptoms involving volatility in social contexts. Future studies should investigate whether treatments geared toward increasing the flexibility of social interpretations are effective in treating BPD symptoms, especially those involving interpersonal difficulties.
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Affiliation(s)
- Jessica M Duda
- Department of Psychology, Yale University, New Haven, CT, USA.
| | - Sarah K Fineberg
- Department of Psychiatry, Yale University, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
| | - Wisteria Deng
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Yvette Ma
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Jonas Everaert
- Department of Medical and Clinical Psychology, Tilburg University, the Netherlands; Research Group of Quantitative Psychology and Individual Differences, KU, Leuven, Belgium
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
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Pickersgill M. Stalling or oiling the engines of diagnosis? Shifting perspectives on the DSM and categorical diagnosis in psychiatry. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:132-151. [PMID: 37329240 DOI: 10.1111/1467-9566.13682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/22/2023] [Indexed: 06/18/2023]
Abstract
Diagnosis in psychiatry and its precursors has long attracted debate and dissent. Attempts to discipline professional praxis are associated especially with the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM). In this article, I explore how social actors with the institutional power to contribute in important ways to shaping psychiatric contexts construct the problems with and purposes of the DSM and of diagnosis in psychiatry. I suggest that despite common assumptions that influential psychiatrists and related stakeholders uncritically adopt the DSM and other tools of categorical diagnosis, their relationship with these is rather more nuanced, ambivalent, and even fraught. However, I will also show that critiques can themselves be folded into particular styles of psychiatric thought in ways that do little to impact wider concerns about biomedicalisation and pharmaceuticalisation-and might even further accelerate these processes. Moreover, since professional critiques of the DSM often underscore its ubiquity and entrenchment, when positioned against implicit or explicit justifications of the ongoing use of this text they might inadvertently contribute to a 'discourse of inevitability'-acting to 'oil' rather than 'stall' what Annemarie Jutel terms the 'engines of diagnosis'.
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Affiliation(s)
- Martyn Pickersgill
- Centre for Biomedicine, Self and Society, Usher Institute, The University of Edinburgh, Edinburgh, UK
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10
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Kirkham R, Kooijman L, Albertella L, Myles D, Yücel M, Rotaru K. Immersive Virtual Reality-Based Methods for Assessing Executive Functioning: Systematic Review. JMIR Serious Games 2024; 12:e50282. [PMID: 38407958 DOI: 10.2196/50282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/26/2023] [Accepted: 12/29/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Neuropsychological assessments traditionally include tests of executive functioning (EF) because of its critical role in daily activities and link to mental disorders. Established traditional EF assessments, although robust, lack ecological validity and are limited to single cognitive processes. These methods, which are suitable for clinical populations, are less informative regarding EF in healthy individuals. With these limitations in mind, immersive virtual reality (VR)-based assessments of EF have garnered interest because of their potential to increase test sensitivity, ecological validity, and neuropsychological assessment accessibility. OBJECTIVE This systematic review aims to explore the literature on immersive VR assessments of EF focusing on (1) EF components being assessed, (2) how these assessments are validated, and (3) strategies for monitoring potential adverse (cybersickness) and beneficial (immersion) effects. METHODS EBSCOhost, Scopus, and Web of Science were searched in July 2022 using keywords that reflected the main themes of VR, neuropsychological tests, and EF. Articles had to be peer-reviewed manuscripts written in English and published after 2013 that detailed empirical, clinical, or proof-of-concept studies in which a virtual environment using a head-mounted display was used to assess EF in an adult population. A tabular synthesis method was used in which validation details from each study, including comparative assessments and scores, were systematically organized in a table. The results were summed and qualitatively analyzed to provide a comprehensive overview of the findings. RESULTS The search retrieved 555 unique articles, of which 19 (3.4%) met the inclusion criteria. The reviewed studies encompassed EF and associated higher-order cognitive functions such as inhibitory control, cognitive flexibility, working memory, planning, and attention. VR assessments commonly underwent validation against gold-standard traditional tasks. However, discrepancies were observed, with some studies lacking reported a priori planned correlations, omitting detailed descriptions of the EF constructs evaluated using the VR paradigms, and frequently reporting incomplete results. Notably, only 4 of the 19 (21%) studies evaluated cybersickness, and 5 of the 19 (26%) studies included user experience assessments. CONCLUSIONS Although it acknowledges the potential of VR paradigms for assessing EF, the evidence has limitations. The methodological and psychometric properties of the included studies were inconsistently addressed, raising concerns about their validity and reliability. Infrequent monitoring of adverse effects such as cybersickness and considerable variability in sample sizes may limit interpretation and hinder psychometric evaluation. Several recommendations are proposed to improve the theory and practice of immersive VR assessments of EF. Future studies should explore the integration of biosensors with VR systems and the capabilities of VR in the context of spatial navigation assessments. Despite considerable promise, the systematic and validated implementation of VR assessments is essential for ensuring their practical utility in real-world applications.
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Affiliation(s)
- Rebecca Kirkham
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Lars Kooijman
- Institute for Intelligent Systems Research and Innovation, Deakin University, Geelong, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Dan Myles
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Murat Yücel
- Queensland Institute of Medical Research Berghofer Medical Research Institute, Herston, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Kristian Rotaru
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- Monash Business School, Monash University, Caufield, Australia
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11
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Miranda O, Kiehl S, Qi X, Ryan ND, Kirisci L, Brannock MD, Kosten T, Wang Y, Wang L. Enhancing post-traumatic stress disorder patient assessment: Leveraging Natural Language Processing for Research of Domain Criteria Identification using electronic medical records. RESEARCH SQUARE 2024:rs.3.rs-3973337. [PMID: 38464073 PMCID: PMC10925404 DOI: 10.21203/rs.3.rs-3973337/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Extracting research of domain criteria (RDoC) from high-risk populations like those with post-traumatic stress disorder (PTSD) is crucial for positive mental health improvements and policy enhancements. The intricacies of collecting, integrating, and effectively leveraging clinical notes for this purpose introduce complexities. Methods In our study, we created an NLP workflow to analyze electronic medical record (EMR) data, and identify and extract research of domain criteria using a pre-trained transformer-based natural language model, allmpnet-base-v2. We subsequently built dictionaries from 100,000 clinical notes and analyzed 5.67 million clinical notes from 38,807 PTSD patients from the University of Pittsburgh Medical Center. Subsequently, we showcased the significance of our approach by extracting and visualizing RDoC information in two use cases: (i) across multiple patient populations and (ii) throughout various disease trajectories. Results The sentence transformer model demonstrated superior F1 macro scores across all RDoC domains, achieving the highest performance with a cosine similarity threshold value of 0.3. This ensured an F1 score of at least 80% across all RDoC domains. The study revealed consistent reductions in all six RDoC domains among PTSD patients after psychotherapy. Women had the highest abnormalities of sensorimotor systems, while veterans had the highest abnormalities of negative and positive valence systems. The domains following first diagnoses of PTSD were associated with heightened cue reactivity to trauma, suicide, alcohol, and substance consumption. Conclusions The findings provide initial insights into RDoC functioning in different populations and disease trajectories. Natural language processing proves valuable for capturing real-time, context dependent RDoC instances from extensive clinical notes.
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12
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Burback L, Yap S, Purdon SE, Abba-Aji A, O’Shea K, Brémault-Phillips S, Greenshaw AJ, Winkler O. Randomized controlled trial investigating web-based, therapist delivered eye movement desensitization and reprocessing for adults with suicidal ideation. Front Psychiatry 2024; 15:1361086. [PMID: 38435978 PMCID: PMC10904458 DOI: 10.3389/fpsyt.2024.1361086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Promising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition. Methods This randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989). Results Forty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group. Conclusion Study results provide promising preliminary evidence that web-based EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results. Clinical Trial Registration https://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&rank=1, identifier NCT04181047.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
| | - Sidney Yap
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Scot E. Purdon
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Adam Abba-Aji
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
| | - Katie O’Shea
- Eye Movement Desensitization and Reprocessing International Association, Austin, TX, United States
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Olga Winkler
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
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13
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Bird BM, Levitt EE, Stewart SH, Wanklyn SG, Meyer EC, Murphy JG, McDevitt-Murphy ME, MacKillop J. Posttraumatic stress and delay discounting: a meta-analytic review. Psychol Med 2024; 54:437-446. [PMID: 37947238 DOI: 10.1017/s0033291723003069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Delay discounting-the extent to which individuals show a preference for smaller immediate rewards over larger delayed rewards-has been proposed as a transdiagnostic neurocognitive process across mental health conditions, but its examination in relation to posttraumatic stress disorder (PTSD) is comparatively recent. To assess the aggregated evidence for elevated delay discounting in relation to posttraumatic stress, we conducted a meta-analysis on existing empirical literature. Bibliographic searches identified 209 candidate articles, of which 13 articles with 14 independent effect sizes were eligible for meta-analysis, reflecting a combined sample size of N = 6897. Individual study designs included case-control (e.g. examination of differences in delay discounting between individuals with and without PTSD) and continuous association studies (e.g. relationship between posttraumatic stress symptom severity and delay discounting). In a combined analysis of all studies, the overall relationship was a small but statistically significant positive association between posttraumatic stress and delay discounting (r = .135, p < .0001). The same relationship was statistically significant for continuous association studies (r = .092, p = .027) and case-control designs (r = .179, p < .001). Evidence of publication bias was minimal. The included studies were limited in that many did not concurrently incorporate other psychiatric conditions in the analyses, leaving the specificity of the relationship to posttraumatic stress less clear. Nonetheless, these findings are broadly consistent with previous meta-analyses of delayed reward discounting in relation to other mental health conditions and provide further evidence for the transdiagnostic utility of this construct.
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Affiliation(s)
- Brian M Bird
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Emily E Levitt
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Department of Psychology, Neuroscience, & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sonya G Wanklyn
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
| | - Eric C Meyer
- Department of Counseling and Behavioral Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | | | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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14
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Long Y, Dickey L, Pegg S, Argiros A, Venanzi L, Dao A, Kujawa A. Interpersonal Trauma Effects on Adolescent Depression: The Moderating Role of Neurophysiological Responses to Positive Interpersonal Images. Res Child Adolesc Psychopathol 2024; 52:195-206. [PMID: 37707698 PMCID: PMC10843025 DOI: 10.1007/s10802-023-01118-0] [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: 08/25/2023] [Indexed: 09/15/2023]
Abstract
Trauma exposure is associated with a heightened risk for depression and such risk is thought to vary based on the type of traumatic events (e.g., interpersonal, including abuse and domestic violence, or non-interpersonal, including accidents or natural disasters). Depression is often accompanied by altered emotional reactivity, and the late positive potential (LPP) serves as a reliable neurophysiological measure of sustained attention towards emotional stimuli, raising questions regarding the role of the LPP in moderating trauma effects on depression. We conducted a cross-sectional study of 201 adolescents aged 14-17 years (61.2% female) who were oversampled for current depression and elevated risk of depression based on maternal history. Clinical interviews were conducted to assess diagnoses and lifetime trauma exposure, and participants reported on current depressive symptoms. Electroencephalogram (EEG) was continuously recorded while participants completed a previously validated interpersonal emotional images task. Cumulative trauma (CT) and interpersonal trauma (IPT) were both associated with greater depressive symptoms, but non-interpersonal trauma (NIPT) was not significantly related to depressive symptoms. The association between IPT and depressive symptoms was moderated by the LPP to positive interpersonal images, such that IPT-exposed adolescents with blunted neural responses to such images showed the greatest symptoms. This result was specific to IPT, and the LPP to threatening interpersonal images did not significantly moderate the effects of IPT on depressive symptoms. These findings highlight the unique effects of interpersonal trauma on depressive symptoms and elucidate a potential vulnerability linking trauma exposure to depression risk among adolescents.
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Affiliation(s)
- Yinru Long
- Department of Psychology and Human Development, Vanderbilt University Peabody College, 230 Appleton Place, Nashville, TN, 37203-5721, United States of America.
| | - Lindsay Dickey
- Department of Psychology and Human Development, Vanderbilt University Peabody College, 230 Appleton Place, Nashville, TN, 37203-5721, United States of America
| | - Samantha Pegg
- Department of Psychology and Human Development, Vanderbilt University Peabody College, 230 Appleton Place, Nashville, TN, 37203-5721, United States of America
| | - Alexandra Argiros
- Department of Psychology and Human Development, Vanderbilt University Peabody College, 230 Appleton Place, Nashville, TN, 37203-5721, United States of America
| | - Lisa Venanzi
- Department of Psychology and Human Development, Vanderbilt University Peabody College, 230 Appleton Place, Nashville, TN, 37203-5721, United States of America
| | - Anh Dao
- Department of Psychology and Human Development, Vanderbilt University Peabody College, 230 Appleton Place, Nashville, TN, 37203-5721, United States of America
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University Peabody College, 230 Appleton Place, Nashville, TN, 37203-5721, United States of America
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15
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Stark R, Walter B, Bengesser I, Kramer D, Muhl C, Tahmassebi N, Khatib S, Storz F, Markert C, Golder S. Reply on "Why compulsive sexual behavior is not a form of addiction like drug addiction". Sex Med 2024; 12:qfae007. [PMID: 38450255 PMCID: PMC10915578 DOI: 10.1093/sexmed/qfae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Rudolf Stark
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, 35394, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, 35394, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, 35032/35394, Germany
| | - Bertram Walter
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, 35394, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, 35032/35394, Germany
| | | | | | | | | | - Said Khatib
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, 35394, Germany
| | - Florian Storz
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, 35394, Germany
| | - Charlotte Markert
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, 35394, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, 35394, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, 35032/35394, Germany
| | - Sarah Golder
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, 35394, Germany
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Widge AS. Closing the loop in psychiatric deep brain stimulation: physiology, psychometrics, and plasticity. Neuropsychopharmacology 2024; 49:138-149. [PMID: 37415081 PMCID: PMC10700701 DOI: 10.1038/s41386-023-01643-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/28/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023]
Abstract
Deep brain stimulation (DBS) is an invasive approach to precise modulation of psychiatrically relevant circuits. Although it has impressive results in open-label psychiatric trials, DBS has also struggled to scale to and pass through multi-center randomized trials. This contrasts with Parkinson disease, where DBS is an established therapy treating thousands of patients annually. The core difference between these clinical applications is the difficulty of proving target engagement, and of leveraging the wide range of possible settings (parameters) that can be programmed in a given patient's DBS. In Parkinson's, patients' symptoms change rapidly and visibly when the stimulator is tuned to the correct parameters. In psychiatry, those same changes take days to weeks, limiting a clinician's ability to explore parameter space and identify patient-specific optimal settings. I review new approaches to psychiatric target engagement, with an emphasis on major depressive disorder (MDD). Specifically, I argue that better engagement may come by focusing on the root causes of psychiatric illness: dysfunction in specific, measurable cognitive functions and in the connectivity and synchrony of distributed brain circuits. I overview recent progress in both those domains, and how it may relate to other technologies discussed in companion articles in this issue.
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Affiliation(s)
- Alik S Widge
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
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17
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Ortega LA, Aragon-Carvajal DM, Cortes-Corso KT, Forero-Castillo F. Early developmental risks for tobacco addiction: A probabilistic epigenesis framework. Neurosci Biobehav Rev 2024; 156:105499. [PMID: 38056543 DOI: 10.1016/j.neubiorev.2023.105499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/23/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
Considerable progress has been made in elucidating the relationships between early life psychobiological and environmental risk factors and the development of tobacco addiction. However, a comprehensive understanding of the heterogeneity in tobacco addiction phenotypes requires integrating research findings. The probabilistic epigenesis meta-theory offers a valuable framework for this integration, considering systemic, multilevel, developmental, and evolutionary perspectives. In this paper, we critically review relevant research on early developmental risks associated with tobacco addiction and highlight the integrative heuristic value of the probabilistic epigenesis framework for this research. For this, we propose a four-level systems approach as an initial step towards integration, analyzing complex interactions among different levels of influence. Additionally, we explore a coaction approach to examine key interactions between early risk factors. Moreover, we introduce developmental pathways to understand interindividual differences in tobacco addiction risk during development. This integrative approach holds promise for advancing our understanding of tobacco addiction etiology and informing potentially effective intervention strategies.
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Affiliation(s)
- Leonardo A Ortega
- Facultad de Psicologia, Fundacion Universitaria Konrad Lorenz, Colombia.
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18
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Goodman ML, Lee M, Springer A, Schick V, Vaughan E, Markham C, Gitari S, Mukiri F. Sleep disturbance as a precursor to anxiety, depression, and PTSD among rural Kenyans: A cross-lagged panel analysis from a rural Kenyan interventional cohort. J Sleep Res 2023:e14119. [PMID: 38083983 PMCID: PMC11164828 DOI: 10.1111/jsr.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/06/2023] [Accepted: 11/22/2023] [Indexed: 05/01/2024]
Abstract
Sleep quality is essential to biopsychosocial functioning, yet there remains limited longitudinal research on sleep and mental or social well-being within low- or middle-income countries. This study utilised longitudinal cohort data from a community-based empowerment programme in Meru County, Kenya to assess cross-lagged correlations between sleep disturbance, social support, symptoms of depression, anxiety, and posttraumatic stress. Participants (n = 373; 92% women; age range 18-86 years) who reported more sleep disturbance at T1 reported significantly more symptoms of depression, anxiety, and PTSD, and significantly less social support at T2 (average 11 weeks later), controlling for all within-time correlations across measures, within-measure correlations across time, and sociodemographic background characteristics. The findings are consistent with research across high-income countries, underscoring the need for more contextualised research into sleep behaviours across low- and middle-income countries. The findings may inform interventions to increase mental and social well-being within Kenya.
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Affiliation(s)
| | - Miryoung Lee
- University of Texas Health Science Center – School of Public Health
| | - Andrew Springer
- University of Texas Health Science Center – School of Public Health
| | - Vanessa Schick
- University of Texas Health Science Center – School of Public Health
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19
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Pouyan N, Younesi Sisi F, Kargar A, Scheidegger M, McIntyre RS, Morrow JD. The effects of Lysergic Acid Diethylamide (LSD) on the Positive Valence Systems: A Research Domain Criteria (RDoC)-Informed Systematic Review. CNS Drugs 2023; 37:1027-1063. [PMID: 37999867 PMCID: PMC10703966 DOI: 10.1007/s40263-023-01044-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND AND OBJECTIVES The renewed interest in psychedelic research provides growing evidence of potentially unique effects on various aspects of reward processing systems. Using the Research Domain Criteria (RDoC) framework, as proposed by the National Institute of Mental Health, we aim to synthesize the existing literature concerning the impact of lysergic acid diethylamide (LSD) on the RDoC's Positive Valence Systems (PVS) domain, and to identify potential avenues for further research. METHODS Two LSD-related terms (lysergic acid diethylamide and LSD) and 13 PVS-related terms (reward, happiness, bliss, motivation, reinforcement learning, operant, conditioning, satisfaction, decision making, habit, valence, affect, mood) were used to search electronic databases such as PubMed, Scopus, PsychINFO, and Web of Science for relevant articles. A manual search of the reference list resulted in nine additional articles. After screening, articles and data were evaluated and included based on their relevance to the objective of investigating the effects of LSD on the PVS. Articles and data were excluded if they did not provide information about the PVS, were observational in nature, lacked comparators or reference groups, or were duplicates. A risk of bias assessment was performed using the National Toxicology Program's Office of Health Assessment and Translation (NTP OHAT) risk of bias (RoB) tool. Data from the included articles were collected and structured based on the RDoC bio-behavioral matrix, specifically focusing on the PVS domain and its three constituent constructs: reward responsiveness, reward learning, and reward valuation. RESULTS We reviewed 28 clinical studies with 477 participants. Lysergic acid diethylamide, assessed at self-report (23 studies), molecular (5 studies), circuit (4 studies), and paradigm (3 studies) levels, exhibited dose-dependent mood improvement (20 short-term and 3 long-term studies). The subjective and neural effects of LSD were linked to the 5-HT2A receptor (molecular). Animal studies (14 studies) suggested LSD could mildly reinforce conditioned place preference without aversion and reduce responsiveness to other rewards. Findings on reward learning were inconsistent but hinted at potential associative learning enhancements. Reward valuation measures indicated potential reductions in effort expenditure for other reinforcers. CONCLUSION Our findings are consistent with our previous work, which indicated classical psychedelics, primarily serotonin 2A receptor agonists, enhanced reward responsiveness in healthy individuals and patient populations. Lysergic acid diethylamide exhibits a unique profile in the reward learning and valuation constructs. Using the RDoC-based framework, we identified areas for future research, enhancing our understanding of the impact of LSD on reward processing. However, applying RDoC to psychedelic research faces limitations due to diverse study designs that were not initially RDoC-oriented. Limitations include subjective outcome measure selection aligned with RDoC constructs and potential bias in synthesizing varied studies. Additionally, some human studies were open-label, introducing potential bias compared to randomized, blinded studies.
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Affiliation(s)
- Niloufar Pouyan
- Michigan Psychedelic Center (M-PsyC), and Chronic Pain and Fatigue Research Center (CPFRC), University of Michigan Medical School, Ann Arbor, MI, USA.
- Neuroscience Graduate Program, and Program in Biomedical Sciences (PIBS), University of Michigan Medical School, 1135 Catherine Street, Box 5619, 2960 Taubman Health Science Library, Ann Arbor, MI, USA.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Aracell Zist Darou pharmaceutical, Tehran, Iran.
| | - Farnaz Younesi Sisi
- Yaadmaan Institute for Brain, Cognition and Memory Studies, Tehran, Iran
- Cognitive Neurology and Neuropsychiatry Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Alireza Kargar
- Cognitive Neurology and Neuropsychiatry Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Clinical Pharmacy, School of pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Milan Scheidegger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jonathan D Morrow
- Neuroscience Graduate Program, and Program in Biomedical Sciences (PIBS), University of Michigan Medical School, 1135 Catherine Street, Box 5619, 2960 Taubman Health Science Library, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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20
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Rief W, Hofmann SG, Berg M, Forbes MK, Pizzagalli DA, Zimmermann J, Fried E, Reed GM. Do We Need a Novel Framework for Classifying Psychopathology? A Discussion Paper. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e11699. [PMID: 38357431 PMCID: PMC10863678 DOI: 10.32872/cpe.11699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
Introduction The ICD-11 and DSM-5 are the leading systems for the classification of mental disorders, and their relevance for clinical work and research, as well as their impact for policy making and legal questions, has increased considerably. In recent years, other frameworks have been proposed to supplement or even replace the ICD and the DSM, raising many questions regarding clinical utility, scientific relevance, and, at the core, how best to conceptualize mental disorders. Method As examples of the new approaches that have emerged, here we introduce the Hierarchical Taxonomy of Psychopathology (HiTOP), the Research Domain Criteria (RDoC), systems and network approaches, process-based approaches, as well as a new approach to the classification of personality disorders. Results and Discussion We highlight main distinctions between these classification frameworks, largely related to different priorities and goals, and discuss areas of overlap and potential compatibility. Synergies among these systems may provide promising new avenues for research and clinical practice.
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Affiliation(s)
- Winfried Rief
- Clinical Psychology and Psychotherapy Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Stefan G. Hofmann
- Translational Clinical Psychology Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Max Berg
- Clinical Psychology and Psychotherapy Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Miriam K. Forbes
- School of Psychological Sciences, Australian Hearing Hub, Macquarie University Sydney, Sydney, Australia
| | - Diego A. Pizzagalli
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research & McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | - Eiko Fried
- Clinical Psychology Group, Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Geoffrey M. Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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21
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Stowe ZN. Perinatal Mental Health: Advances and Opportunities. Am J Psychiatry 2023; 180:874-877. [PMID: 38037410 DOI: 10.1176/appi.ajp.20230822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Affiliation(s)
- Zachary N Stowe
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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Pavăl D. The dopamine hypothesis of autism spectrum disorder: A comprehensive analysis of the evidence. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 173:1-42. [PMID: 37993174 DOI: 10.1016/bs.irn.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Despite intensive research into the etiopathogenesis of autism spectrum disorder (ASD), limited progress has been achieved so far. Among the plethora of models seeking to clarify how ASD arises, a coherent dopaminergic model was lacking until recently. In 2017, we provided a theoretical framework that we designated "the dopamine hypothesis of ASD". In the meantime, numerous studies yielded empirical evidence for this model. 4 years later, we provided a second version encompassing a refined and reconceptualized framework that accounted for these novel findings. In this chapter, we will review the evidence backing the previous versions of our model and add the most recent developments to the picture. Along these lines, we intend to lay out a comprehensive analysis of the supporting evidence for the dopamine hypothesis of ASD.
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Affiliation(s)
- Denis Pavăl
- The Romanian Association for Autoimmune Encephalitis, Cluj-Napoca, Romania; Department of Psychiatry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Lewis MW, Webb CA, Kuhn M, Akman E, Jobson SA, Rosso IM. Predicting Fear Extinction in Posttraumatic Stress Disorder. Brain Sci 2023; 13:1131. [PMID: 37626488 PMCID: PMC10452660 DOI: 10.3390/brainsci13081131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Fear extinction is the basis of exposure therapies for posttraumatic stress disorder (PTSD), but half of patients do not improve. Predicting fear extinction in individuals with PTSD may inform personalized exposure therapy development. The participants were 125 trauma-exposed adults (96 female) with a range of PTSD symptoms. Electromyography, electrocardiogram, and skin conductance were recorded at baseline, during dark-enhanced startle, and during fear conditioning and extinction. Using a cross-validated, hold-out sample prediction approach, three penalized regressions and conventional ordinary least squares were trained to predict fear-potentiated startle during extinction using 50 predictor variables (5 clinical, 24 self-reported, and 21 physiological). The predictors, selected by penalized regression algorithms, were included in multivariable regression analyses, while univariate regressions assessed individual predictors. All the penalized regressions outperformed OLS in prediction accuracy and generalizability, as indexed by the lower mean squared error in the training and holdout subsamples. During early extinction, the consistent predictors across all the modeling approaches included dark-enhanced startle, the depersonalization and derealization subscale of the dissociative experiences scale, and the PTSD hyperarousal symptom score. These findings offer novel insights into the modeling approaches and patient characteristics that may reliably predict fear extinction in PTSD. Penalized regression shows promise for identifying symptom-related variables to enhance the predictive modeling accuracy in clinical research.
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Affiliation(s)
- Michael W. Lewis
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Christian A. Webb
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Manuel Kuhn
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Eylül Akman
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Sydney A. Jobson
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Isabelle M. Rosso
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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24
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Cohen BM, Öngür D. The need for evidence-based updating of ICD and DSM models of psychotic and mood disorders. Mol Psychiatry 2023; 28:1836-1838. [PMID: 36697753 DOI: 10.1038/s41380-023-01967-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/09/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Affiliation(s)
- Bruce M Cohen
- Robertson Steele Professor of Psychiatry, Harvard Medical School, Boston, MA, USA.
- President and Psychiatrist in Chief, Emeritus, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA.
| | - Dost Öngür
- William P. and Henry B. Test Professor of Psychiatry, Harvard Medical School, Boston, MA, USA
- Chief, Division of Psychotic Disorders, McLean Hospital, 115 Mill St., Belmont, MA, USA
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25
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Kietzman HW, Gourley SL. How social information impacts action in rodents and humans: the role of the prefrontal cortex and its connections. Neurosci Biobehav Rev 2023; 147:105075. [PMID: 36736847 PMCID: PMC10026261 DOI: 10.1016/j.neubiorev.2023.105075] [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] [Received: 09/04/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
Day-to-day choices often involve social information and can be influenced by prior social experience. When making a decision in a social context, a subject might need to: 1) recognize the other individual or individuals, 2) infer their intentions and emotions, and 3) weigh the values of all outcomes, social and non-social, prior to selecting an action. These elements of social information processing all rely, to some extent, on the medial prefrontal cortex (mPFC). Patients with neuropsychiatric disorders often have disruptions in prefrontal cortical function, likely contributing to deficits in social reasoning and decision making. To better understand these deficits, researchers have turned to rodents, which have revealed prefrontal cortical mechanisms for contending with the complex information processing demands inherent to making decisions in social contexts. Here, we first review literature regarding social decision making, and the information processing underlying it, in humans and patient populations. We then turn to research in rodents, discussing current procedures for studying social decision making, and underlying neural correlates.
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Affiliation(s)
- Henry W Kietzman
- Medical Scientist Training Program, Emory University School of Medicine, USA; Department of Pediatrics, Emory University School of Medicine, USA; Department of Psychiatry, Emory University School of Medicine, USA; Graduate Program in Neuroscience, Emory University, USA; Emory National Primate Research Center, Emory University, 954 Gatewood Rd. NE, Atlanta GA 30329, USA.
| | - Shannon L Gourley
- Department of Pediatrics, Emory University School of Medicine, USA; Department of Psychiatry, Emory University School of Medicine, USA; Graduate Program in Neuroscience, Emory University, USA; Emory National Primate Research Center, Emory University, 954 Gatewood Rd. NE, Atlanta GA 30329, USA; Children's Healthcare of Atlanta, USA.
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26
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Mundy P. Research on social attention in autism and the challenges of the research domain criteria (RDoC) framework. Autism Res 2023; 16:697-712. [PMID: 36932883 DOI: 10.1002/aur.2910] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
The fuzzy nature of categories of psychopathology, such as autism, leads to significant research challenges. Alternatively, focusing research on the study of a common set of important and well-defined psychological constructs across psychiatric conditions may make the fundamental etiological processes of psychopathology easier to discern and treat (Cuthbert, 2022). The development of the research domain criteria (RDoC) framework is designed to guide this new research approach (Insel et al., 2010). However, progress in research may be expected to continually refine and reorganize the understanding of the specifics of these mental processes (Cuthbert & Insel, 2013). Moreover, knowledge gleaned from the study of both normative and atypical development can be mutually informative in the evolution of our understanding of these fundamental processes. A case in point is the study of social attention. This Autism 101 commentary provides an educational summary of research over the last few decades indicates that social attention is major construct in the study of human social-cognitive development, autism and other forms of psychopathology. The commentary also describes how this research can inform the Social Process dimension of the RDoC framework.
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Affiliation(s)
- Peter Mundy
- School of Education, Department of Psychiatry and the MIND Institute, University of California at Davis, Davis, California, USA
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27
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Paul SE, Colbert SM, Gorelik AJ, Hansen IS, Nagella I, Blaydon L, Hornstein A, Johnson EC, Hatoum AS, Baranger DA, Elsayed NM, Barch DM, Bogdan R, Karcher NR. Phenome-wide Investigation of Behavioral, Environmental, and Neural Associations with Cross-Disorder Genetic Liability in Youth of European Ancestry. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.10.23285783. [PMID: 36824847 PMCID: PMC9949197 DOI: 10.1101/2023.02.10.23285783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Etiologic insights into psychopathology may be gained by using hypothesis-free methods to identify associations between genetic risk for broad psychopathology and phenotypes measured during adolescence, including both markers of child psychopathology and intermediate phenotypes such as neural structure that may link genetic risk with outcomes. We conducted a phenome-wide association study (phenotype n=1,269-1,694) of polygenic risk scores (PRS) for broad spectrum psychopathology (i.e., Compulsive, Psychotic, Neurodevelopmental, and Internalizing) in youth of PCA-selected European ancestry (n=5,556; ages 9-13) who completed the baseline and/or two-year follow-up of the ongoing Adolescent Brain Cognitive Development℠ (ABCD) Study. We found that Neurodevelopmental and Internalizing PRS were significantly associated with a host of proximal as well as distal phenotypes (Neurodevelopmental: 187 and 211; Internalizing: 122 and 173 phenotypes at baseline and two-year follow-up, respectively), whereas Compulsive and Psychotic PRS showed zero and one significant associations, respectively, after Bonferroni correction. Neurodevelopmental PRS were further associated with brain structure metrics (e.g., total volume, mean right hemisphere cortical thickness), with only cortical volume indirectly linking Neurodevelopmental PRS to grades in school. Genetic variation influencing risk to psychopathology manifests broadly as behaviors, psychopathology symptoms, and related risk factors in middle childhood and early adolescence.
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Affiliation(s)
- Sarah E. Paul
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - Sarah M.C. Colbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Aaron J. Gorelik
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - Isabella S. Hansen
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - I. Nagella
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - L. Blaydon
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - A. Hornstein
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - Emma C. Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Alexander S. Hatoum
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - David A.A. Baranger
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - Nourhan M. Elsayed
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - Deanna M. Barch
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Department of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO
| | - Nicole R. Karcher
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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28
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Gómez-Carrillo A, Paquin V, Dumas G, Kirmayer LJ. Restoring the missing person to personalized medicine and precision psychiatry. Front Neurosci 2023; 17:1041433. [PMID: 36845417 PMCID: PMC9947537 DOI: 10.3389/fnins.2023.1041433] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023] Open
Abstract
Precision psychiatry has emerged as part of the shift to personalized medicine and builds on frameworks such as the U.S. National Institute of Mental Health Research Domain Criteria (RDoC), multilevel biological "omics" data and, most recently, computational psychiatry. The shift is prompted by the realization that a one-size-fits all approach is inadequate to guide clinical care because people differ in ways that are not captured by broad diagnostic categories. One of the first steps in developing this personalized approach to treatment was the use of genetic markers to guide pharmacotherapeutics based on predictions of pharmacological response or non-response, and the potential risk of adverse drug reactions. Advances in technology have made a greater degree of specificity or precision potentially more attainable. To date, however, the search for precision has largely focused on biological parameters. Psychiatric disorders involve multi-level dynamics that require measures of phenomenological, psychological, behavioral, social structural, and cultural dimensions. This points to the need to develop more fine-grained analyses of experience, self-construal, illness narratives, interpersonal interactional dynamics, and social contexts and determinants of health. In this paper, we review the limitations of precision psychiatry arguing that it cannot reach its goal if it does not include core elements of the processes that give rise to psychopathological states, which include the agency and experience of the person. Drawing from contemporary systems biology, social epidemiology, developmental psychology, and cognitive science, we propose a cultural-ecosocial approach to integrating precision psychiatry with person-centered care.
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Affiliation(s)
- Ana Gómez-Carrillo
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Vincent Paquin
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Guillaume Dumas
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Precision Psychiatry and Social Physiology Laboratory at the CHU Sainte-Justine Research Center, Université de Montréal, Montreal, QC, Canada
- Mila–Quebec Artificial Intelligence Institute, Montreal, QC, Canada
| | - Laurence J. Kirmayer
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
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29
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Kang MJY, Farrand S, Evans A, Chiu WH, Eratne D, Kelso W, Walterfang M, Velakoulis D, Loi SM. Carer burden and behavioral disturbance is similar between younger-onset Alzheimer's disease and behavioral variant frontotemporal dementia. Int Psychogeriatr 2023:1-8. [PMID: 36756758 DOI: 10.1017/s1041610222001259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVES Carer burden is common in younger-onset dementia (YOD), often due to the difficulty of navigating services often designed for older people with dementia. Compared to Alzheimer's disease (AD), the burden is reported to be higher in behavioral variant frontotemporal dementia (bvFTD). However, there is little literature comparing carer burden specifically in YOD. This study hypothesized that carer burden in bvFTD would be higher than in AD. DESIGN Retrospective cross-sectional study. SETTING Tertiary neuropsychiatry service in Victoria, Australia. PARTICIPANTS Patient-carer dyads with YOD. MEASUREMENTS We collected patient data, including behaviors using the Cambridge Behavioral Inventory-Revised (CBI-R). Carer burden was rated using the Zarit Burden Inventory-short version (ZBI-12). Descriptive statistics and Mann-Whitney U tests were used to analyze the data. RESULTS Carers reported high burden (ZBI-12 mean score = 17.2, SD = 10.5), with no significant difference in burden between younger-onset AD and bvFTD. CBI-R stereotypic and motor behaviors, CBI-R everyday skills, and total NUCOG scores differed between the two groups. There was no significant difference in the rest of the CBI-R subcategories, including the behavior-related domains. CONCLUSION Carers of YOD face high burden and are managing significant challenging behaviors. We found no difference in carer burden between younger-onset AD and bvFTD. This could be due to similarities in the two subtypes in terms of abnormal behavior, motivation, and self-care as measured on CBI-R, contrary to previous literature. Clinicians should screen for carer burden and associated factors including behavioral symptoms in YOD syndromes, as they may contribute to carer burden regardless of the type.
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Affiliation(s)
- Matthew J Y Kang
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Sarah Farrand
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Andrew Evans
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Wei-Hsuan Chiu
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Wendy Kelso
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Mark Walterfang
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Samantha M Loi
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
- Melbourne Neuropsychiatry Centre & Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
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30
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Editorial: an emerging field with bright prospects. PERSONALITY NEUROSCIENCE 2023; 6:e1. [PMID: 36843660 PMCID: PMC9947592 DOI: 10.1017/pen.2022.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 02/03/2023]
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31
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Albertella L, Kirkham R, Adler AB, Crampton J, Drummond SPA, Fogarty GJ, Gross JJ, Zaichkowsky L, Andersen JP, Bartone PT, Boga D, Bond JW, Brunyé TT, Campbell MJ, Ciobanu LG, Clark SR, Crane MF, Dietrich A, Doty TJ, Driskell JE, Fahsing I, Fiore SM, Flin R, Funke J, Gatt JM, Hancock PA, Harper C, Heathcote A, Heatown KJ, Helsen WF, Hussey EK, Jackson RC, Khemlani S, Killgore WDS, Kleitman S, Lane AM, Loft S, MacMahon C, Marcora SM, McKenna FP, Meijen C, Moulton V, Moyle GM, Nalivaiko E, O'Connor D, O’Conor D, Patton D, Piccolo MD, Ruiz C, Schücker L, Smith RA, Smith SJR, Sobrino C, Stetz M, Stewart D, Taylor P, Tucker AJ, van Stralen H, Vickers JN, Visser TAW, Walker R, Wiggins MW, Williams AM, Wong L, Aidman E, Yücel M. Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study. Front Psychol 2023; 13:1017675. [PMID: 36755983 PMCID: PMC9901503 DOI: 10.3389/fpsyg.2022.1017675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/02/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure. Methods International experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance. Results Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control-Performance Monitoring; (3) Arousal and Regulatory Systems-Arousal; (4) Cognitive Control-Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control-Response Selection and Inhibition/Suppression; (6) Working memory-Flexible Updating; (7) Working memory-Active Maintenance; (8) Perception and Understanding of Self-Self-knowledge; (9) Working memory-Interference Control, and (10) Expert-suggested-Shifting. Discussion Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.
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Affiliation(s)
- Lucy Albertella
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia,*Correspondence: Lucy Albertella,
| | - Rebecca Kirkham
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Amy B. Adler
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - John Crampton
- APS College of Sport and Exercise Psychologists, Melbourne, VIC, Australia
| | - Sean P. A. Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Gerard J. Fogarty
- School of Psychology and Wellbeing, University of Southern Queensland, Toowoomba, QLD, Australia
| | | | - Leonard Zaichkowsky
- Wheelock College of Education and Human Development, Boston University, Boston, MA, United States
| | | | | | - Danny Boga
- Australian Army Psychology Corps, Canberra, ACT, Australia
| | - Jeffrey W. Bond
- APS College of Sport and Exercise Psychologists, Melbourne, VIC, Australia
| | - Tad T. Brunyé
- U.S. Army DEVCOM Analysis Center, Natick, MA, United States
| | - Mark J. Campbell
- Physical Education & Sport Sciences Department, University of Limerick, Limerick, Ireland
| | - Liliana G. Ciobanu
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Scott R. Clark
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Monique F. Crane
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Arne Dietrich
- Department of Psychology, American University of Beirut, Beirut, Lebanon
| | - Tracy J. Doty
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | | | - Ivar Fahsing
- Norwegian Police University College, Oslo, Norway
| | - Stephen M. Fiore
- Department of Psychology, and Institute of Simulation and Training, University of Central Florida, Orlando, FL, United States
| | - Rhona Flin
- Aberdeen Business School, Robert Gordon University, Aberdeen, United Kingdom
| | - Joachim Funke
- Department of Psychology, Heidelberg University, Heidelberg, Germany
| | - Justine M. Gatt
- School of Psychology, University of New South Wales, Kensington, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia
| | - P. A. Hancock
- Department of Psychology, and Institute of Simulation and Training, University of Central Florida, Orlando, FL, United States
| | - Craig Harper
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Andrew Heathcote
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Kristin J. Heatown
- US Army Research Institute of Environmental Medicine (USARIEM), Natick, MA, United States
| | | | | | - Robin C. Jackson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sangeet Khemlani
- United States Naval Research Laboratory, Washington, DC, United States
| | | | - Sabina Kleitman
- School of Psychology, The University of Sydney, Darlington, NSW, Australia
| | - Andrew M. Lane
- Sport, Physical Activity Research Centre (SPARC), School of Sport, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Shayne Loft
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Clare MacMahon
- School of Allied Health, Human Services, and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Samuele M. Marcora
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Frank P. McKenna
- Department of Psychology, University of Reading, Reading, United Kingdom
| | - Carla Meijen
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, United Kingdom
| | | | - Gene M. Moyle
- Faculty of Creative Industries, Education and Social Justice, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eugene Nalivaiko
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Donna O'Connor
- Sydney School of Education and Social Work, The University of Sydney, Darlington, NSW, Australia
| | | | - Debra Patton
- United States Department of Defense, Washington DC, United States
| | | | - Coleman Ruiz
- Mission Critical Team Institute, Annapolis, MD, United States
| | - Linda Schücker
- Department of Sport Psychology, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | | | - Sarah J. R. Smith
- Defense Science and Technology Laboratory, Salisbury, United Kingdom
| | - Chava Sobrino
- NSW Institute of Sport and Diving, Sydney, NSW, Australia
| | - Melba Stetz
- Independent Practitioner, Grand Ledge, MI, United States
| | | | - Paul Taylor
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Andrew J. Tucker
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | | | - Joan N. Vickers
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Troy A. W Visser
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Rohan Walker
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Mark W. Wiggins
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | | | - Leonard Wong
- United States Army War College, Carlisle, PA, United States
| | - Eugene Aidman
- The University of Newcastle, Callaghan, NSW, Australia,Decision Sciences Division, Defense Science and Technology Group, Adelaide, SA, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
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32
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Critical review of RDoC approaches to the study of motivation with animal models: effort valuation/willingness to work. Emerg Top Life Sci 2022; 6:515-528. [PMID: 36218385 DOI: 10.1042/etls20220008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 02/06/2023]
Abstract
The NIMH research domain criteria (RDoC) approach was instigated to refocus mental health research on the neural circuits that mediate psychological functions, with the idea that this would foster an understanding of the neural basis of specific psychiatric dysfunctions (i.e. 'symptoms and circuits') and ultimately facilitate treatment. As a general idea, this attempt to go beyond traditional diagnostic categories and focus on neural circuit dysfunctions related to specific symptoms spanning multiple disorders has many advantages. For example, motivational dysfunctions are present in multiple disorders, including depression, schizophrenia, Parkinson's disease, and other conditions. A critical aspect of motivation is effort valuation/willingness to work, and several clinical studies have identified alterations in effort-based decision making in various patient groups. In parallel, formal animal models focusing on the exertion of effort and effort-based decision making have been developed. This paper reviews the literature on models of effort-based motivational function in the context of a discussion of the RDoC approach, with an emphasis on the dissociable nature of distinct aspects of motivation. For example, conditions associated with depression and schizophrenia blunt the selection of high-effort activities as measured by several tasks in animal models (e.g. lever pressing, barrier climbing, wheel running). Nevertheless, these manipulations also leave fundamental aspects of hedonic reactivity, food motivation, and reinforcement intact. This pattern of effects demonstrates that the general emphasis of the RDoC on the specificity of the neural circuits mediating behavioral pathologies, and the dissociative nature of these dysfunctions, is a valid concept. Nevertheless, the specific placement of effort-related processes as simply a 'sub-construct' of 'reward processing' is empirically and conceptually problematic. Thus, while the RDoC is an excellent general framework for new ways to approach research and therapeutics, it still needs further refinement.
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Maatoug R, Oudin A, Adrien V, Saudreau B, Bonnot O, Millet B, Ferreri F, Mouchabac S, Bourla A. Digital phenotype of mood disorders: A conceptual and critical review. Front Psychiatry 2022; 13:895860. [PMID: 35958638 PMCID: PMC9360315 DOI: 10.3389/fpsyt.2022.895860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mood disorders are commonly diagnosed and staged using clinical features that rely merely on subjective data. The concept of digital phenotyping is based on the idea that collecting real-time markers of human behavior allows us to determine the digital signature of a pathology. This strategy assumes that behaviors are quantifiable from data extracted and analyzed through digital sensors, wearable devices, or smartphones. That concept could bring a shift in the diagnosis of mood disorders, introducing for the first time additional examinations on psychiatric routine care. OBJECTIVE The main objective of this review was to propose a conceptual and critical review of the literature regarding the theoretical and technical principles of the digital phenotypes applied to mood disorders. METHODS We conducted a review of the literature by updating a previous article and querying the PubMed database between February 2017 and November 2021 on titles with relevant keywords regarding digital phenotyping, mood disorders and artificial intelligence. RESULTS Out of 884 articles included for evaluation, 45 articles were taken into account and classified by data source (multimodal, actigraphy, ECG, smartphone use, voice analysis, or body temperature). For depressive episodes, the main finding is a decrease in terms of functional and biological parameters [decrease in activities and walking, decrease in the number of calls and SMS messages, decrease in temperature and heart rate variability (HRV)], while the manic phase produces the reverse phenomenon (increase in activities, number of calls and HRV). CONCLUSION The various studies presented support the potential interest in digital phenotyping to computerize the clinical characteristics of mood disorders.
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Affiliation(s)
- Redwan Maatoug
- Service de Psychiatrie Adulte de la Pitié-Salpêtrière, Institut du Cerveau (ICM), Sorbonne Université, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.,iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France
| | - Antoine Oudin
- Service de Psychiatrie Adulte de la Pitié-Salpêtrière, Institut du Cerveau (ICM), Sorbonne Université, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.,iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France
| | - Vladimir Adrien
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France.,Department of Psychiatry, Sorbonne Université, Hôpital Saint Antoine-Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Bertrand Saudreau
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France.,Département de Psychiatrie de l'Enfant et de l'Adolescent, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Olivier Bonnot
- CHU de Nantes, Department of Child and Adolescent Psychiatry, Nantes, France.,Pays de la Loire Psychology Laboratory, Nantes, France
| | - Bruno Millet
- Service de Psychiatrie Adulte de la Pitié-Salpêtrière, Institut du Cerveau (ICM), Sorbonne Université, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.,iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France
| | - Florian Ferreri
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France.,Department of Psychiatry, Sorbonne Université, Hôpital Saint Antoine-Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Stephane Mouchabac
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France.,Department of Psychiatry, Sorbonne Université, Hôpital Saint Antoine-Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Alexis Bourla
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Paris Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, Paris, France.,Department of Psychiatry, Sorbonne Université, Hôpital Saint Antoine-Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.,INICEA Korian, Paris, France
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A Research Domain Criteria (RDoC)-Guided Dashboard to Review Psilocybin Target Domains: A Systematic Review. CNS Drugs 2022; 36:1031-1047. [PMID: 36097251 PMCID: PMC9550777 DOI: 10.1007/s40263-022-00944-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Preliminary results from randomized controlled studies as well as identified molecular, cellular, and circuit targets of select psychedelics (e.g., psilocybin) suggest that their effects are transdiagnostic. In this review, we exploit the Research Domain Criteria (RDoC) transdiagnostic framework, to synthesize extant literature on psilocybin. OBJECTIVE We aimed to identify RDoC-based effects of psilocybin and vistas for future mechanistic and interventional research. METHODS A systematic search in electronic databases (i.e., PubMed, Scopus, PsycINFO, and Web of Science) performed in January and February 2021 identified English articles published between 1990 and 2020 reporting the effects of psilocybin on mental health measures. Data from included articles were retrieved and organized according to the RDoC bio-behavioral matrix and its constituent six main domains, namely: positive valence systems, negative valence systems, cognitive systems, social processes, sensorimotor systems, and arousal and regulatory systems. RESULTS The preponderance of research with psilocybin has differentially reported beneficial effects on positive valence systems, negative valence system, and social process domains. The data from the included studies support both short-term (23 assessments) and long-term (15 assessments) beneficial effects of psilocybin on the positive valence systems. While 12 of the extracted outcome measures suggest that psilocybin use is associated with increases in the "fear" construct of the negative valence systems domain, 19 findings show no significant effects on this construct, and seven parameters show lowered levels of the "sustained threat" construct in the long term. Thirty-four outcome measures revealed short-term alterations in the social systems' construct namely, "perception and understanding of self," and "social communications" as well as enhancements in "perception and understanding of others" and "affiliation and attachment". The majority of findings related to the cognitive systems' domain reported dyscognitive effects. There have been relatively few studies reporting outcomes of psilocybin on the remaining RDoC domains. Moreover, seven of the included studies suggest the transdiagnostic effects of psilocybin. The dashboard characterization of RDoC outcomes with psilocybin suggests beneficial effects in the measures of reward, threat, and arousal, as well as general social systems. CONCLUSIONS Psilocybin possesses a multi-domain effectiveness. The field would benefit from highly rigorous proof-of-mechanism research to assess the effects of psilocybin using the RDoC framework. The combined effect of psilocybin with psychosocial interventions with RDoC-based outcomes is a priority therapeutic vista.
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