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Elster EM, Pauli R, Baumann S, De Brito SA, Fairchild G, Freitag CM, Konrad K, Roessner V, Brazil IA, Lockwood PL, Kohls G. Impaired Punishment Learning in Conduct Disorder. J Am Acad Child Adolesc Psychiatry 2024; 63:454-463. [PMID: 37414274 DOI: 10.1016/j.jaac.2023.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/22/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE Conduct disorder (CD) has been associated with deficits in the use of punishment to guide reinforcement learning (RL) and decision making. This may explain the poorly planned and often impulsive antisocial and aggressive behavior in affected youths. Here, we used a computational modeling approach to examine differences in RL abilities between CD youths and typically developing controls (TDCs). Specifically, we tested 2 competing hypotheses that RL deficits in CD reflect either reward dominance (also known as reward hypersensitivity) or punishment insensitivity (also known as punishment hyposensitivity). METHOD The study included 92 CD youths and 130 TDCs (aged 9-18 years, 48% girls) who completed a probabilistic RL task with reward, punishment, and neutral contingencies. Using computational modeling, we investigated the extent to which the 2 groups differed in their learning abilities to obtain reward and/or to avoid punishment. RESULTS RL model comparisons showed that a model with separate learning rates per contingency explained behavioral performance best. Importantly, CD youths showed lower learning rates than TDCs specifically for punishment, whereas learning rates for reward and neutral contingencies did not differ. Moreover, callous-unemotional (CU) traits did not correlate with learning rates in CD. CONCLUSION CD youths have a highly selective impairment in probabilistic punishment learning, regardless of their CU traits, whereas reward learning appears to be intact. In summary, our data suggest punishment insensitivity rather than reward dominance in CD. Clinically, the use of punishment-based intervention techniques to achieve effective discipline in patients with CD may be a less helpful strategy than reward-based techniques.
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Affiliation(s)
| | - Ruth Pauli
- University of Birmingham, Birmingham, United Kingdom
| | | | | | | | - Christine M Freitag
- University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kerstin Konrad
- University Hospital RWTH Aachen, Aachen, Germany; RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | | | | | - Patricia L Lockwood
- University of Birmingham, Birmingham, United Kingdom; University of Oxford, Oxford, United Kingdom
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Koerner S, Staginnus M, Cornwell H, Smaragdi A, González-Madruga K, Pauli R, Rogers JC, Gao Y, Chester S, Townend S, Bernhard A, Martinelli A, Kohls G, Raschle NM, Konrad K, Stadler C, Freitag CM, De Brito SA, Fairchild G. Does the Relationship between Age and Brain Structure Differ in Youth with Conduct Disorder? Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01178-w. [PMID: 38557727 DOI: 10.1007/s10802-024-01178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
Conduct disorder (CD) is characterised by persistent antisocial and aggressive behaviour and typically emerges in childhood or adolescence. Although several authors have proposed that CD is a neurodevelopmental disorder, very little evidence is available about brain development in this condition. Structural brain alterations have been observed in CD, and some indirect evidence for delayed brain maturation has been reported. However, no detailed analysis of age-related changes in brain structure in youth with CD has been conducted. Using cross-sectional MRI data, this study aimed to explore differences in brain maturation in youth with CD versus healthy controls to provide further understanding of the neurodevelopmental processes underlying CD. 291 CD cases (153 males) and 379 healthy controls (160 males) aged 9-18 years (Mage = 14.4) were selected from the European multisite FemNAT-CD study. Structural MRI scans were analysed using surface-based morphometry followed by application of the ENIGMA quality control protocols. An atlas-based approach was used to investigate group differences and test for group-by-age and group-by-age-by-sex interactions in cortical thickness, surface area and subcortical volumes. Relative to healthy controls, the CD group showed lower surface area across frontal, temporal and parietal regions as well as lower total surface area. No significant group-by-age or group-by-age-by-sex interactions were observed on any brain structure measure. These findings suggest that CD is associated with lower surface area across multiple cortical regions, but do not support the idea that CD is associated with delayed brain maturation, at least within the age bracket considered here.
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Affiliation(s)
- Sarah Koerner
- Department of Psychology, University of Bath, Bath, UK
| | | | | | | | | | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Jack C Rogers
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Yidian Gao
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Sally Chester
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
- School of Psychology, Fresenius University of Applied Sciences, Frankfurt, Germany
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Medical Faculty, TU Dresden, Dresden, Germany
| | - Nora Maria Raschle
- Jacobs Center for Productive Youth Development at the University of Zurich, Zurich, Switzerland
- Neuroscience Centre Zurich (ZNZ), University and ETH Zurich, Zurich, Switzerland
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- JARA- Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
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Diaconu B, Kohls G, Rogers JC, Pauli R, Cornwell H, Bernhard A, Martinelli A, Ackermann K, Fann N, Fernandez-Rivas A, Gonzalez-Torres MA, Gonzalez de Artaza-Lavesa M, Hervas A, Stadler C, Konrad K, Freitag CM, Fairchild G, Rotshtein P, De Brito SA. Emotion processing in maltreated boys and girls: Evidence for latent vulnerability. Eur Child Adolesc Psychiatry 2023; 32:2523-2536. [PMID: 36738328 PMCID: PMC10682268 DOI: 10.1007/s00787-022-02132-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/14/2022] [Indexed: 02/05/2023]
Abstract
Evidence of alterations in emotion processing in maltreated youth has been hypothesized to reflect latent vulnerability for psychopathology. However, previous studies have not systematically examined the influence of psychopathology on the results. Here, we examined emotion recognition and learning in youth who differed in terms of presence vs. absence of maltreatment and psychopathology and tested for potential sex effects. Maltreatment and psychopathology were assessed in 828 youth (514 females) aged 9-18 years using diagnostic interviews and self- and parent-report questionnaires. Emotion recognition was assessed via identification of morphed facial expressions of six universal emotions. For emotion learning, reward and punishment values were assigned to novel stimuli and participants had to learn to correctly respond/withhold response to stimuli to maximize points. A three-way interaction of maltreatment by psychopathology by emotion indicated that when psychopathology was low, maltreated youth were less accurate than non-maltreated youth for happy, fear and disgust. A three-way interaction of sex, maltreatment and emotion indicated that maltreated girls and boys were impaired for fear, but girls showed an impairment for happy, while boys for disgust. There were no effects of maltreatment, psychopathology, or sex on reward learning. However, a two-way interaction between sex and maltreatment showed that maltreated girls were worse at learning from punishment relative to non-maltreated girls, while maltreated boys were better than non-maltreated boys. The study provides the first clear evidence of latent-vulnerability in emotion recognition in maltreated youth and suggests that girls and boys might be characterized by distinct profiles of emotion recognition and learning following maltreatment.
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Affiliation(s)
- Bianca Diaconu
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Jack C Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
- School of Psychology, Fresenius University of Applied Sciences, Frankfurt am Main, Germany
| | - Katharina Ackermann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Nikola Fann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | | | | | - Amaia Hervas
- University Hospital Mutua Terrassa, Barcelona, Spain
- Global Institute of Neurodevelopment Integrated Care (IGAIN), Barcelona, Spain
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Juelich, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | - Pia Rotshtein
- Neuroimaging Research Unit, University of Haifa, Haifa, Israel
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
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Pinchess C, Pauli R, Tully J. Knowledge and attitudes about conduct disorder of professionals working with young people: The influence of occupation and direct and indirect experience. PLoS One 2023; 18:e0292271. [PMID: 37768972 PMCID: PMC10538712 DOI: 10.1371/journal.pone.0292271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Knowledge and attitudes of professionals both pose a potential barrier to diagnosis and treatment of mental disorders. However, knowledge and attitudes about conduct disorder in professionals working with young people are poorly understood. Little is known about the impact of occupation, direct and indirect (training and education) experience, or the interrelationship between knowledge and attitudes. METHODS We conducted an online survey of 58 participants, including Psychology Staff, Teaching Staff, Care Staff, and Other Non-Clinical Staff. A questionnaire comprising three subscales (causes, treatments, and characteristics) measured knowledge. A thermometer scale measured global attitudes. Open-ended response measures were used to measure four attitude components: stereotypic beliefs (about characteristics), symbolic beliefs (about the holder's traditions), affect, and past behaviour. Primary analysis explored the impact of occupation, direct experience, and indirect experience on outcome measures. A secondary exploratory analysis was conducted to explore the relationship between knowledge and attitudes. RESULTS Psychology Staff had significantly more favourable global attitudes (F = 0.49, p = 0.01) and symbolic beliefs (F = 0.57, p = 0.02) towards those with conduct disorder than Teaching Staff; there were no other significant group differences in attitudes. Psychology staff had more knowledge about conduct disorder than other groups, though the differences were not significant. Direct and indirect experience were associated with greater knowledge (direct: d = 0.97, p = 0.002; indirect d = 0.86, p = 0.004) and favourable global attitudes (direct: d = 1.12, p < 0.001; indirect: d = 0.68, p = 0.02). Secondary exploratory analyses revealed significant positive correlations between: all knowledge variables with global attitudes; total knowledge with past behaviour; and affect and knowledge of causes with past behaviour. CONCLUSIONS Psychology-based staff may have more favourable attitudes towards children with conduct disorder than teachers, primarily due to direct and indirect experience with the disorder. Our sample may have been too small to detect overall or within-group effects of knowledge or attitudes, however exploratory analyses showing a positive correlation between knowledge and attitudes suggest education may be critical in supporting teachers and other groups in their approaches to this challenging group of young people.
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Affiliation(s)
- Chloe Pinchess
- Centre for Forensic and Family Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Clayfields House, Nottinghamshire County Council, Nottingham, United Kingdom
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - John Tully
- Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Nottinghamshire Healthcare NHS Trust, Nottingham, United Kingdom
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Pauli R, Brazil IA, Kohls G, Klein-Flügge MC, Rogers JC, Dikeos D, Dochnal R, Fairchild G, Fernández-Rivas A, Herpertz-Dahlmann B, Hervas A, Konrad K, Popma A, Stadler C, Freitag CM, De Brito SA, Lockwood PL. Action initiation and punishment learning differ from childhood to adolescence while reward learning remains stable. Nat Commun 2023; 14:5689. [PMID: 37709750 PMCID: PMC10502052 DOI: 10.1038/s41467-023-41124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/24/2023] [Indexed: 09/16/2023] Open
Abstract
Theoretical and empirical accounts suggest that adolescence is associated with heightened reward learning and impulsivity. Experimental tasks and computational models that can dissociate reward learning from the tendency to initiate actions impulsively (action initiation bias) are thus critical to characterise the mechanisms that drive developmental differences. However, existing work has rarely quantified both learning ability and action initiation, or it has relied on small samples. Here, using computational modelling of a learning task collected from a large sample (N = 742, 9-18 years, 11 countries), we test differences in reward and punishment learning and action initiation from childhood to adolescence. Computational modelling reveals that whilst punishment learning rates increase with age, reward learning remains stable. In parallel, action initiation biases decrease with age. Results are similar when considering pubertal stage instead of chronological age. We conclude that heightened reward responsivity in adolescence can reflect differences in action initiation rather than enhanced reward learning.
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Affiliation(s)
- Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
| | - Inti A Brazil
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU, Dresden, Germany
| | - Miriam C Klein-Flügge
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Jack C Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Dimitris Dikeos
- Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Roberta Dochnal
- Faculty of Medicine, Child and Adolescent Psychiatry, Department of the Child Health Center, Szeged University, Szeged, Hungary
| | | | | | - Beate Herpertz-Dahlmann
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Amaia Hervas
- University Hospital Mutua Terrassa, Barcelona, Spain
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Jülich, Jülich, Germany
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, Netherlands
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Patricia L Lockwood
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK.
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.
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Staginnus M, Cornwell H, Toschi N, Oosterling M, Paradysz M, Smaragdi A, González-Madruga K, Pauli R, Rogers JC, Bernhard A, Martinelli A, Kohls G, Raschle NM, Konrad K, Stadler C, Freitag CM, De Brito SA, Fairchild G. Testing the Ecophenotype Model: Cortical Structure Alterations in Conduct Disorder With Versus Without Childhood Maltreatment. Biol Psychiatry Cogn Neurosci Neuroimaging 2023:S2451-9022(22)00347-0. [PMID: 36925341 DOI: 10.1016/j.bpsc.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/16/2022] [Accepted: 12/19/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Childhood maltreatment is common in youths with conduct disorder (CD), and both CD and maltreatment have been linked to neuroanatomical alterations. Nonetheless, our understanding of the contribution of maltreatment to the neuroanatomical alterations observed in CD remains limited. We tested the applicability of the ecophenotype model to CD, which holds that maltreatment-related psychopathology is (neurobiologically) distinct from psychopathology without maltreatment. METHODS Surface-based morphometry was used to investigate cortical volume, thickness, surface area, and gyrification in a mixed-sex sample of participants with CD (n = 114) and healthy control subjects (HCs) (n = 146), ages 9 to 18 years. Using vertexwise general linear models adjusted for sex, age, total intracranial volume, and site, the control group was compared with the overall CD group and the CD subgroups with (n = 49) versus without (n = 65) maltreatment (assessed by the Children's Bad Experiences interview). These subgroups were also directly compared. RESULTS The overall CD group showed lower cortical thickness in the right inferior frontal gyrus. CD youths with a history of maltreatment showed more widespread structural alterations relative to HCs, comprising lower thickness, volume, and gyrification in inferior and middle frontal regions. Conversely, CD youths with no history of maltreatment only showed greater left superior temporal gyrus folding relative to HCs. When contrasting the CD subgroups, those with maltreatment displayed lower right superior temporal gyrus volume, right precentral gyrus surface area, and gyrification in frontal, temporal, and parietal regions. CONCLUSIONS Consistent with the ecophenotype model, findings indicated that CD youths with versus without maltreatment differ neurobiologically. This highlights the importance of considering maltreatment history in neuroimaging studies of CD and other disorders.
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Affiliation(s)
| | - Harriet Cornwell
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy; Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, Massachusetts
| | | | - Michal Paradysz
- Department of Psychology, University of Bath, Bath, United Kingdom
| | | | | | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Jack C Rogers
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; School of Psychology, Fresenius University of Applied Sciences, Frankfurt, Germany
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany; Department of Child and Adolescent Psychiatry, Medical Faculty, TU Dresden, Dresden, Germany
| | - Nora Maria Raschle
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany; JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Graeme Fairchild
- Department of Psychology, University of Bath, Bath, United Kingdom
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7
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Konrad K, Kohls G, Baumann S, Bernhard A, Martinelli A, Ackermann K, Smaragdi A, Gonzalez-Madruga K, Wells A, Rogers JC, Pauli R, Clanton R, Baker R, Kersten L, Prätzlich M, Oldenhof H, Jansen L, Kleeven A, Bigorra A, Hervas A, Kerexeta-Lizeaga I, Sesma-Pardo E, Angel Gonzalez-Torres M, Siklósi R, Dochnal R, Kalogerakis Z, Pirlympou M, Papadakos L, Cornwell H, Scharke W, Dikeos D, Fernández-Rivas A, Popma A, Stadler C, Herpertz-Dahlmann B, De Brito SA, Fairchild G, Freitag CM. Sex differences in psychiatric comorbidity and clinical presentation in youths with conduct disorder. J Child Psychol Psychiatry 2022; 63:218-228. [PMID: 34008879 DOI: 10.1111/jcpp.13428] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Conduct disorder (CD) rarely occurs alone but is typically accompanied by comorbid psychiatric disorders, which complicates the clinical presentation and treatment of affected youths. The aim of this study was to investigate sex differences in comorbidity pattern in CD and to systematically explore the 'gender paradox' and 'delayed-onset pathway' hypotheses of female CD. METHODS As part of the FemNAT-CD multisite study, semistructured clinical interviews and rating scales were used to perform a comprehensive phenotypic characterization of 454 girls and 295 boys with CD (9-18 years), compared to 864 sex- and age-matched typically developing controls. RESULTS Girls with CD exhibited higher rates of current major depression, anxiety disorders, post-traumatic stress disorder and borderline personality disorder, whereas boys with CD had higher rates of current attention-deficit/hyperactivity disorder. In line with the 'gender paradox' hypothesis, relative to boys, girls with CD showed significantly more lifetime psychiatric comorbidities (incl. Alcohol Use Disorder), which were accompanied by more severe CD symptoms. Female and male youths with CD also differed significantly in their CD symptom profiles and distribution of age-of-onset subtypes of CD (i.e. fewer girls with childhood-onset CD). In line with the 'delayed-onset pathway' hypothesis, girls with adolescent-onset CD showed similar levels of dimensional psychopathology like boys with childhood-onset CD, while boys with adolescent-onset CD had the lowest levels of internalizing psychopathology. CONCLUSIONS Within the largest study of CD in girls performed to date, we found compelling evidence for sex differences in comorbidity patterns and clinical presentation of CD. Our findings further support aspects of the 'gender paradox' and 'delayed-onset pathway' hypotheses by showing that girls with CD had higher rates of comorbid lifetime mental disorders and functional impairments, and they usually developed CD during adolescence. These novel data on sex-specific clinical profiles of CD will be critical in informing intervention and prevention programmes.
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Affiliation(s)
- Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.,JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Juelich, Germany
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Sarah Baumann
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Katharina Ackermann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Areti Smaragdi
- Centre of Addiction and Mental Health, Toronto, ON, Canada
| | | | - Amy Wells
- School of Psychology, Cardiff University, Cardiff, Wales, UK
| | - Jack C Rogers
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Roberta Clanton
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Rosalind Baker
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Linda Kersten
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Martin Prätzlich
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Helena Oldenhof
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Lucres Jansen
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Anneke Kleeven
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Aitana Bigorra
- Child and Adolescent Mental Health Service, University Hospital Mutua Terrassa, Barcelona, Spain
| | - Amaia Hervas
- Child and Adolescent Mental Health Service, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | - Eva Sesma-Pardo
- Psychiatric Service, Basurto University Hospital, Bilbao, Spain
| | | | - Réka Siklósi
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Roberta Dochnal
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Zacharias Kalogerakis
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Mara Pirlympou
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Papadakos
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Wolfgang Scharke
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.,Cognitive and Experimental Psychology, Institute of Psychology, RWTH Aachen University, Aachen, Germany
| | - Dimitris Dikeos
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Arne Popma
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Christina Stadler
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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8
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Farrow E, Chiocchetti AG, Rogers JC, Pauli R, Raschle NM, Gonzalez-Madruga K, Smaragdi A, Martinelli A, Kohls G, Stadler C, Konrad K, Fairchild G, Freitag CM, Chechlacz M, De Brito SA. Correction: SLC25A24 gene methylation and gray matter volume in females with and without conduct disorder: an exploratory epigenetic neuroimaging study. Transl Psychiatry 2021; 11:553. [PMID: 34716293 PMCID: PMC8556356 DOI: 10.1038/s41398-021-01643-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Elizabeth Farrow
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
| | - Andreas G. Chiocchetti
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jack C. Rogers
- grid.6572.60000 0004 1936 7486School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Ruth Pauli
- grid.6572.60000 0004 1936 7486School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Nora M. Raschle
- grid.7400.30000 0004 1937 0650Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Karen Gonzalez-Madruga
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, King’s College London, London, UK
| | | | - Anne Martinelli
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gregor Kohls
- grid.1957.a0000 0001 0728 696XRWTH Aachen University, Aachen, Germany
| | | | - Kerstin Konrad
- grid.1957.a0000 0001 0728 696XRWTH Aachen University, Aachen, Germany
| | - Graeme Fairchild
- grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, Bath, UK
| | - Christine M. Freitag
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Magdalena Chechlacz
- grid.6572.60000 0004 1936 7486School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Stephane A. De Brito
- grid.6572.60000 0004 1936 7486School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
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9
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Pauli R, Kohls G, Tino P, Rogers JC, Baumann S, Ackermann K, Bernhard A, Martinelli A, Jansen L, Oldenhof H, Gonzalez-Madruga K, Smaragdi A, Gonzalez-Torres MA, Kerexeta-Lizeaga I, Boonmann C, Kersten L, Bigorra A, Hervas A, Stadler C, Fernandez-Rivas A, Popma A, Konrad K, Herpertz-Dahlmann B, Fairchild G, Freitag CM, Rotshtein P, De Brito SA. Machine learning classification of conduct disorder with high versus low levels of callous-unemotional traits based on facial emotion recognition abilities. Eur Child Adolesc Psychiatry 2021; 32:589-600. [PMID: 34661765 PMCID: PMC10115711 DOI: 10.1007/s00787-021-01893-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022]
Abstract
Conduct disorder (CD) with high levels of callous-unemotional traits (CD/HCU) has been theoretically linked to specific difficulties with fear and sadness recognition, in contrast to CD with low levels of callous-unemotional traits (CD/LCU). However, experimental evidence for this distinction is mixed, and it is unclear whether these difficulties are a reliable marker of CD/HCU compared to CD/LCU. In a large sample (N = 1263, 9-18 years), we combined univariate analyses and machine learning classifiers to investigate whether CD/HCU is associated with disproportionate difficulties with fear and sadness recognition over other emotions, and whether such difficulties are a reliable individual-level marker of CD/HCU. We observed similar emotion recognition abilities in CD/HCU and CD/LCU. The CD/HCU group underperformed relative to typically developing (TD) youths, but difficulties were not specific to fear or sadness. Classifiers did not distinguish between youths with CD/HCU versus CD/LCU (52% accuracy), although youths with CD/HCU and CD/LCU were reliably distinguished from TD youths (64% and 60%, respectively). In the subset of classifiers that performed well for youths with CD/HCU, fear and sadness were the most relevant emotions for distinguishing them from youths with CD/LCU and TD youths, respectively. We conclude that non-specific emotion recognition difficulties are common in CD/HCU, but are not reliable individual-level markers of CD/HCU versus CD/LCU. These findings highlight that a reduced ability to recognise facial expressions of distress should not be assumed to be a core feature of CD/HCU.
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Affiliation(s)
- Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.,Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU, Dresden, Germany
| | - Peter Tino
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - Jack C Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Sarah Baumann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Katharina Ackermann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany.,Faculty of Education, Hamburg University, Hamburg, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Lucres Jansen
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Helena Oldenhof
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Karen Gonzalez-Madruga
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | | | | | | | - Cyril Boonmann
- Department of Child and Adolescent Psychiatry, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Linda Kersten
- Department of Child and Adolescent Psychiatry, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | | | - Amaia Hervas
- University Hospital Mutua Terrassa, Barcelona, Spain
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | | | - Arne Popma
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.,JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Pia Rotshtein
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
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10
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Farrow E, Chiocchetti AG, Rogers JC, Pauli R, Raschle NM, Gonzalez-Madruga K, Smaragdi A, Martinelli A, Kohls G, Stadler C, Konrad K, Fairchild G, Freitag CM, Chechlacz M, De Brito SA. SLC25A24 gene methylation and gray matter volume in females with and without conduct disorder: an exploratory epigenetic neuroimaging study. Transl Psychiatry 2021; 11:492. [PMID: 34561420 PMCID: PMC8463588 DOI: 10.1038/s41398-021-01609-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/29/2021] [Accepted: 09/02/2021] [Indexed: 11/09/2022] Open
Abstract
Conduct disorder (CD), a psychiatric disorder characterized by a repetitive pattern of antisocial behaviors, results from a complex interplay between genetic and environmental factors. The clinical presentation of CD varies both according to the individual's sex and level of callous-unemotional (CU) traits, but it remains unclear how genetic and environmental factors interact at the molecular level to produce these differences. Emerging evidence in males implicates methylation of genes associated with socio-affective processes. Here, we combined an epigenome-wide association study with structural neuroimaging in 51 females with CD and 59 typically developing (TD) females to examine DNA methylation in relation to CD, CU traits, and gray matter volume (GMV). We demonstrate an inverse pattern of correlation between CU traits and methylation of a chromosome 1 region in CD females (positive) as compared to TD females (negative). The identified region spans exon 1 of the SLC25A24 gene, central to energy metabolism due to its role in mitochondrial function. Increased SLC25A24 methylation was also related to lower GMV in multiple brain regions in the overall cohort. These included the superior frontal gyrus, prefrontal cortex, and supramarginal gyrus, secondary visual cortex and ventral posterior cingulate cortex, which are regions that have previously been implicated in CD and CU traits. While our findings are preliminary and need to be replicated in larger samples, they provide novel evidence that CU traits in females are associated with methylation levels in a fundamentally different way in CD and TD, which in turn may relate to observable variations in GMV across the brain.
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Affiliation(s)
- Elizabeth Farrow
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
| | - Andreas G. Chiocchetti
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jack C. Rogers
- grid.6572.60000 0004 1936 7486School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Ruth Pauli
- grid.6572.60000 0004 1936 7486School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Nora M. Raschle
- grid.7400.30000 0004 1937 0650Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | | | | | - Anne Martinelli
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gregor Kohls
- grid.1957.a0000 0001 0728 696XRWTH Aachen University, Aachen, Germany
| | | | - Kerstin Konrad
- grid.1957.a0000 0001 0728 696XRWTH Aachen University, Aachen, Germany
| | - Graeme Fairchild
- grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, Bath, UK
| | - Christine M. Freitag
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Magdalena Chechlacz
- grid.6572.60000 0004 1936 7486School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Stephane A. De Brito
- grid.6572.60000 0004 1936 7486School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
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11
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Metrebian N, Weaver T, Goldsmith K, Pilling S, Hellier J, Pickles A, Shearer J, Byford S, Mitcheson L, Bijral P, Bogdan N, Bowden-Jones O, Day E, Dunn J, Glasper A, Finch E, Forshall S, Akhtar S, Bajaria J, Bennett C, Bishop E, Charles V, Davey C, Desai R, Goodfellow C, Haque F, Little N, McKechnie H, Mosler F, Morris J, Mutz J, Pauli R, Poovendran D, Phillips E, Strang J. Using a pragmatically adapted, low-cost contingency management intervention to promote heroin abstinence in individuals undergoing treatment for heroin use disorder in UK drug services (PRAISE): a cluster randomised trial. BMJ Open 2021; 11:e046371. [PMID: 34210725 PMCID: PMC8252884 DOI: 10.1136/bmjopen-2020-046371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Most individuals treated for heroin use disorder receive opioid agonist treatment (OAT)(methadone or buprenorphine). However, OAT is associated with high attrition and persistent, occasional heroin use. There is some evidence for the effectiveness of contingency management (CM), a behavioural intervention involving modest financial incentives, in encouraging drug abstinence when applied adjunctively with OAT. UK drug services have a minimal track record of applying CM and limited resources to implement it. We assessed a CM intervention pragmatically adapted for ease of implementation in UK drug services to promote heroin abstinence among individuals receiving OAT. DESIGN Cluster randomised controlled trial. SETTING AND PARTICIPANTS 552 adults with heroin use disorder (target 660) enrolled from 34 clusters (drug treatment clinics) in England between November 2012 and October 2015. INTERVENTIONS Clusters were randomly allocated 1:1:1 to OAT plus 12× weekly appointments with: (1) CM targeted at opiate abstinence at appointments (CM Abstinence); (2) CM targeted at on-time attendance at appointments (CM Attendance); or (3) no CM (treatment as usual; TAU). Modifications included monitoring behaviour weekly and fixed incentives schedule. MEASUREMENTS Primary outcome: heroin abstinence measured by heroin-free urines (weeks 9-12). SECONDARY OUTCOMES heroin abstinence 12 weeks after discontinuation of CM (weeks 21-24); attendance; self-reported drug use, physical and mental health. RESULTS CM Attendance was superior to TAU in encouraging heroin abstinence. Odds of a heroin-negative urine in weeks 9-12 was statistically significantly greater in CM Attendance compared with TAU (OR=2.1; 95% CI 1.1 to 3.9; p=0.030). CM Abstinence was not superior to TAU (OR=1.6; 95% CI 0.9 to 3.0; p=0.146) or CM Attendance (OR=1.3; 95% CI 0.7 to 2.4; p=0.438) (not statistically significant differences). Reductions in heroin use were not sustained at 21-24 weeks. No differences between groups in self-reported heroin use. CONCLUSIONS A pragmatically adapted CM intervention for routine use in UK drug services was moderately effective in encouraging heroin abstinence compared with no CM only when targeted at attendance. CM targeted at abstinence was not effective. TRIAL REGISTRATION NUMBER ISRCTN 01591254.
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Affiliation(s)
- Nicola Metrebian
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Tim Weaver
- Department of Mental Health & Social Work, Middlesex University, London, UK
| | - Kimberley Goldsmith
- Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Stephen Pilling
- Centre for Outcomes, Research and Effectiveness, University College London, London, UK
| | - Jennifer Hellier
- Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Andrew Pickles
- Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - James Shearer
- Health Services and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Sarah Byford
- Health Services and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Luke Mitcheson
- Addictions, South London and Maudsley NHS Foundation Trust, London, UK
| | - Prun Bijral
- Management Offices, Change Grow Live, Manchester, UK
| | - Nadine Bogdan
- Sankey House, Essex Partnership University NHS Foundation Trust, Pitsea,Essex, UK
| | - Owen Bowden-Jones
- Addictions and Substance Misuse, Central and North West London NHS Foundation Trust, London, UK
| | - Edward Day
- Addiction Services, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - John Dunn
- Drugs and Alcohol Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Anthony Glasper
- Substancce Misuse Service, Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Emily Finch
- Addictions, South London and Maudsley NHS Foundation Trust, London, UK
| | - Sam Forshall
- Drug and Alcohol Services, Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, UK
| | - Shabana Akhtar
- Addiction Services, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Jalpa Bajaria
- Sankey House, Essex Partnership University NHS Foundation Trust, Pitsea,Essex, UK
| | - Carmel Bennett
- Addiction Services, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Elizabeth Bishop
- Centre for Outcomes, Research and Effectiveness, University College London, London, UK
| | - Vikki Charles
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Clare Davey
- Drug and Alcohol Services, Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, UK
| | - Roopal Desai
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Claire Goodfellow
- Centre for Outcomes, Research and Effectiveness, University College London, London, UK
| | - Farjana Haque
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nicholas Little
- Centre for Outcomes, Research and Effectiveness, University College London, London, UK
| | - Hortencia McKechnie
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Centre for Mental Health, Imperial College London, London, UK
| | - Franziska Mosler
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Jo Morris
- Drug and Alcohol Services, Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, UK
| | - Julian Mutz
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Ruth Pauli
- Addiction Services, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | | | - Elizabeth Phillips
- Sankey House, Essex Partnership University NHS Foundation Trust, Pitsea,Essex, UK
| | - John Strang
- Addictions, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Addictions, South London and Maudsley NHS Foundation Trust, London, UK
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12
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Abstract
Providing long-term care for a family member diagnosed with a Prolonged Disorder of Consciousness (PDoC) can have a significant impact on the lives of family caregivers. This scoping review aimed to explore the current literature investigating the impact of caring for a person in a PDoC on family caregivers’ Quality of Life (QOL), as categorized using the WHOQOL-BREF model. We observed that articles employing quantitative methodologies mostly reported QOL outcomes relating to negative feelings, thinking, learning, memory and concentration, and personal relationships. Articles employing qualitative methodologies mostly reported QOL outcomes relating to negative feelings, personal relationships, positive feelings, and health and social care accessibility and quality. A descriptive content analysis of the QOL outcomes highlighted the limitations of the current literature base in representing the complexities of the experiences of family members providing care for a person in a PDoC. To provide valuable and personalized support to caregivers, without pathologizing or medicalizing their distress, it is vital to characterize more accurately the contextual subtleties of each person’s situation.
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Affiliation(s)
- Amy Chinner
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Ruth Pauli
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Damian Cruse
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
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13
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O’Donnell A, Pauli R, Banellis L, Sokoliuk R, Hayton T, Sturman S, Veenith T, Yakoub KM, Belli A, Chennu S, Cruse D. The prognostic value of resting-state EEG in acute post-traumatic unresponsive states. Brain Commun 2021; 3:fcab017. [PMID: 33855295 PMCID: PMC8023635 DOI: 10.1093/braincomms/fcab017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 11/27/2022] Open
Abstract
Accurate early prognostication is vital for appropriate long-term care decisions after traumatic brain injury. While measures of resting-state EEG oscillations and their network properties, derived from graph theory, have been shown to provide clinically useful information regarding diagnosis and recovery in patients with chronic disorders of consciousness, little is known about the value of these network measures when calculated from a standard clinical low-density EEG in the acute phase post-injury. To investigate this link, we first validated a set of measures of oscillatory network features between high-density and low-density resting-state EEG in healthy individuals, thus ensuring accurate estimation of underlying cortical function in clinical recordings from patients. Next, we investigated the relationship between these features and the clinical picture and outcome of a group of 18 patients in acute post-traumatic unresponsive states who were not following commands 2 days+ after sedation hold. While the complexity of the alpha network, as indexed by the standard deviation of the participation coefficients, was significantly related to the patients' clinical picture at the time of EEG, no network features were significantly related to outcome at 3 or 6 months post-injury. Rather, mean relative alpha power across all electrodes improved the accuracy of outcome prediction at 3 months relative to clinical features alone. These results highlight the link between the alpha rhythm and clinical signs of consciousness and suggest the potential for simple measures of resting-state EEG band power to provide a coarse snapshot of brain health for stratification of patients for rehabilitation, therapy and assessments of both covert and overt cognition.
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Affiliation(s)
- Alice O’Donnell
- Birmingham Medical School, University of Birmingham, Edgbaston B15 2TT, UK
- Centre for Human Brain Health, University of Birmingham, Edgbaston B15 2TT, UK
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
| | - Ruth Pauli
- Centre for Human Brain Health, University of Birmingham, Edgbaston B15 2TT, UK
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
| | - Leah Banellis
- Centre for Human Brain Health, University of Birmingham, Edgbaston B15 2TT, UK
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
| | - Rodika Sokoliuk
- Centre for Human Brain Health, University of Birmingham, Edgbaston B15 2TT, UK
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
| | - Tom Hayton
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Birmingham B15 2TH, UK
| | - Steve Sturman
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Birmingham B15 2TH, UK
| | - Tonny Veenith
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Birmingham B15 2TH, UK
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Edgbaston B15 2TT, UK
| | - Kamal M Yakoub
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Birmingham B15 2TH, UK
| | - Antonio Belli
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Birmingham B15 2TH, UK
| | - Srivas Chennu
- School of Computing, University of Kent, Canterbury CT2 7NZ, UK
| | - Damian Cruse
- Centre for Human Brain Health, University of Birmingham, Edgbaston B15 2TT, UK
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
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14
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Pauli R, O'Donnell A, Cruse D. Resting-State Electroencephalography for Prognosis in Disorders of Consciousness Following Traumatic Brain Injury. Front Neurol 2020; 11:586945. [PMID: 33343491 PMCID: PMC7746866 DOI: 10.3389/fneur.2020.586945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
Although the majority of patients recover consciousness after a traumatic brain injury (TBI), a minority develop a prolonged disorder of consciousness, which may never fully resolve. For these patients, accurate prognostication is essential to treatment decisions and long-term care planning. In this review, we evaluate the use of resting-state electroencephalography (EEG) as a prognostic measure in disorders of consciousness following TBI. We highlight that routine clinical EEG recordings have prognostic utility in the short to medium term. In particular, measures of alpha power and variability are indicative of relatively better functional outcomes within the first year post-TBI. This is hypothesized to reflect intact thalamocortical loops, and thus the potential for recovery of consciousness even in the apparent absence of current consciousness. However, there is a lack of research into the use of resting-state EEG for predicting longer-term recovery following TBI. We conclude that, given the potential for patients to demonstrate improvements in consciousness and functional capacity even years after TBI, a research focus on EEG-augmented prognostication in very long-term disorders of consciousness is now required.
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Affiliation(s)
- Ruth Pauli
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
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15
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Oldenhof H, Jansen L, Ackermann K, Baker R, Batchelor M, Baumann S, Bernhard A, Clanton R, Dochnal R, Fehlbaum LV, Fernandez-Rivas A, Goergen S, Gonzalez de Artaza-Lavesa M, Gonzalez-Madruga K, Gonzalez-Torres MA, Gundlach M, Lotte van der Hoeven M, Kalogerakis Z, Kapornai K, Kieser M, Konsta A, Martinelli A, Pauli R, Rogers J, Smaragdi A, Sesma-Pardo E, Siklósi R, Steppan M, Tsiakoulia F, Vermeiren R, Vriends N, Werner M, Herpertz-Dahlmann B, Kohls G, De Brito S, Konrad K, Stadler C, Fairchild G, Freitag CM, Popma A. Psychophysiological responses to sadness in girls and boys with conduct disorder. J Abnorm Psychol 2020; 131:314-326. [PMID: 33180540 DOI: 10.1037/abn0000524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reduced responsiveness to emotions is hypothesized to contribute to the development of conduct disorder (CD) in children and adolescents. Accordingly, blunted psychophysiological responses to emotions have been observed in boys with CD, but this has never been tested in girls. Therefore, this study compared psychophysiological responses to sadness in girls and boys with and without CD, and different clinical phenotypes of CD: with versus without limited prosocial emotions (LPE), and with versus without comorbid internalizing disorders (INT). Nine-hundred and 27 girls (427 CD, 500 controls) and 519 boys (266 CD, 253 controls) aged 9-18 years participated. Psychophysiological responses were measured while participants watched two validated sad film clips, specifically: heart rate (HR), respiratory sinus arrhythmia (RSA; indexing parasympathetic activity), preejection period (PEP; indexing sympathetic activity). Girls and boys with CD showed larger HR responses to sadness than controls. This effect was rendered nonsignificant, however, after controlling for covariates. We observed aberrant RSA responses to sadness in CD compared with controls. Similarly, we found a significant positive association between RSA responsivity and antisocial behavior when assessed dimensionally. The effects were very small, though. Results were similar for boys and girls. We found no evidence for emotional underresponsiveness in CD in the largest psychophysiological study to date in this field. More research is needed to explore whether this is specific to sadness or generalizes to other emotions. Furthermore, we recommend that studies on emotion processing in CD assess different physiological measures to help disentangle CD-related effects on sympathetic and parasympathetic activity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Katharina Ackermann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | | | - Sarah Baumann
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | | | | | | | - Réka Siklósi
- Department of Pediatrics, Child and Adolescent Psychiatry
| | | | | | | | | | - Marleen Werner
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging
| | | | | | | | - Kerstin Konrad
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging
| | | | | | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | - Arne Popma
- Department of Child and Adolescent Psychiatry
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16
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Gao Y, Jiang Y, Ming Q, Zhang J, Ma R, Wu Q, Dong D, Guo X, Liu M, Wang X, Situ W, Pauli R, Yao S. Gray Matter Changes in the Orbitofrontal-Paralimbic Cortex in Male Youths With Non-comorbid Conduct Disorder. Front Psychol 2020; 11:843. [PMID: 32435221 PMCID: PMC7218112 DOI: 10.3389/fpsyg.2020.00843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 04/06/2020] [Indexed: 11/29/2022] Open
Abstract
Conduct disorder is one of the most common developmental psychiatric disorders which is characterized by persistent aggressive and antisocial behaviors during childhood or adolescence. Previous neuroimaging studies have investigated the neural correlates underlying CD and demonstrated several constructive findings. However, Individuals with CD are at high risk for comorbidities, which might give rise to the inconsistencies of existed findings. It remains unclear which neuroanatomical abnormalities are specifically related to CD without comorbidities. Using structural magnetic resonance imaging (sMRI) data of 69 CD and 69 typically developing (TD) male youths (aged 14–17 years), the present study aims at investigating gray matter volume alterations of non-comorbid CD (i.e., not comorbid with attention deficit hyperactivity disorder, substance abuse disorder, anxiety or depression). We also examined how regional gray matter volumes were related to callous-unemotional (CU) traits and conduct problems in the CD group. The whole-brain analysis revealed decreased gray matter volumes in the right pre-postcentral cortex, supramarginal gyrus and right putamen in CD youths compared with TD youths. The region-of-interest analyses showed increased gray matter volumes in the superior temporal gyrus (STG) and right orbitofrontal cortex (OFC) in CD youths. Correlation analysis found that gray matter volume in the left amygdala was negatively correlated with CU traits in CD participants. These results demonstrated that gray matter volume in the orbitofrontal-paralimbic cortex, including OFC, STG and amygdala, might characterize the male youths with non-comorbid CD and might contribute to different severe forms and trajectories of CD.
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Affiliation(s)
- Yidian Gao
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Yali Jiang
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Qingsen Ming
- Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jibiao Zhang
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Ren Ma
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Qiong Wu
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Daifeng Dong
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Xiao Guo
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Mingli Liu
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Xiang Wang
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Weijun Situ
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Shuqiao Yao
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
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17
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Kohls G, Baumann S, Gundlach M, Scharke W, Bernhard A, Martinelli A, Ackermann K, Kersten L, Prätzlich M, Oldenhof H, Jansen L, van den Boogaard L, Smaragdi A, Gonzalez-Madruga K, Cornwell H, Rogers JC, Pauli R, Clanton R, Baker R, Bigorra A, Kerexeta-Lizeaga I, Sesma-Pardo E, Aguirregomoscorta-Menéndez F, Siklósi R, Dochnal R, Kalogerakis Z, Pirlympou M, Papadakos L, Dikeos D, Hervas A, Herpertz-Dahlmann B, Fernández-Rivas A, Popma A, Stadler C, De Brito SA, Blair JR, Freitag CM, Fairchild G, Konrad K. Investigating Sex Differences in Emotion Recognition, Learning, and Regulation Among Youths With Conduct Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:263-273. [PMID: 31026574 DOI: 10.1016/j.jaac.2019.04.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/27/2019] [Accepted: 04/17/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Conduct disorder (CD) is a serious neurodevelopmental disorder marked by notably higher prevalence rates for boys than girls. Converging evidence suggests that CD is associated with impairments in emotion recognition, learning, and regulation. However, it is not known whether there are sex differences in the relationship between CD and emotion dysfunction. Prior studies on emotion functioning in CD have so far been underpowered for investigating sex differences. Therefore, our primary aim was to characterize emotion processing skills in a large sample of girls and boys with CD compared to typically developing controls (TDCs) using a comprehensive neuropsychological test battery. METHOD We included 542 youths with CD (317 girls) and 710 TDCs (479 girls), 9 to 18 years of age, from a European multisite study (FemNAT-CD). Participants completed three experimental tasks assessing emotion recognition, learning, and regulation, respectively. Data were analyzed to test for effects of group and sex, and group-by-sex interactions, while controlling for potentially confounding factors. RESULTS Relative to TDCs, youths with CD showed impaired emotion recognition (that was related to more physical and proactive aggression, and higher CU traits), emotional learning (specifically from punishment), and emotion regulation. Boys and girls with CD, however, displayed similar impairments in emotion processing. CONCLUSION This study provides compelling evidence for a relationship between CD and deficient neurocognitive functioning across three emotional domains that have previously been linked to CD etiology. However, there was no support for sex-specific profiles of emotion dysfunction, suggesting that current neurocognitive models of CD apply equally to both sexes.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Martin Prätzlich
- Psychiatric University Clinics and University of Basel, Switzerland
| | | | - Lucres Jansen
- VU University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Roberta Clanton
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Rosalind Baker
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Aitana Bigorra
- Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | - Eva Sesma-Pardo
- Psychiatric Service, Basurto University Hospital, Bilbao, Spain
| | | | - Réka Siklósi
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Roberta Dochnal
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | | | | | | | | | - Amaia Hervas
- Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | | | - Arne Popma
- VU University Medical Center, Amsterdam, The Netherlands
| | | | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE
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18
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Kohls G, Fairchild G, Bernhard A, Martinelli A, Smaragdi A, Gonzalez-Madruga K, Wells A, Rogers JC, Pauli R, Oldenhof H, Jansen L, van Rhijn A, Kersten L, Alfano J, Baumann S, Herpertz-Dahlmann B, Vetro A, Lazaratou H, Hervas A, Fernández-Rivas A, Popma A, Stadler C, De Brito SA, Freitag CM, Konrad K. Neuropsychological Subgroups of Emotion Processing in Youths With Conduct Disorder. Front Psychiatry 2020; 11:585052. [PMID: 33414731 PMCID: PMC7783416 DOI: 10.3389/fpsyt.2020.585052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
Background: At the group level, youths with conduct disorder (CD) show deficient emotion processing across various tasks compared to typically developing controls (TDC). But little is known about neuropsychological subgroups within the CD population, the clinical correlates of emotion processing deficits [for instance, with regard to the presence or absence of the DSM-5 Limited Prosocial Emotions (LPE) specifier], and associated risk factors. Methods: 542 children and adolescents with CD (317 girls) and 710 TDCs (479 girls), aged 9-18 years, were included from the FemNAT-CD multisite study. All participants completed three neuropsychological tasks assessing emotion recognition, emotion learning, and emotion regulation. We used a self-report measure of callous-unemotional traits to create a proxy for the LPE specifier. Results: Relative to TDCs, youths with CD as a group performed worse in all three emotion domains. But using clinically based cut-off scores, we found poor emotion recognition skills in only 23% of the participants with CD, followed by emotion regulation deficits in 18%, and emotion learning deficits in 13% of the CD group. Critically, the majority of youths with CD (~56%) did not demonstrate any meaningful neuropsychological deficit, and only a very small proportion showed pervasive deficits across all three domains (~1%). Further analyses indicate that established DSM-5 subtypes of CD are not tightly linked to neurocognitive deficits in one particular emotion domain over another (i.e., emotion recognition deficits in CD+LPE vs. emotion regulation deficits in CD-LPE). Conclusions: Findings from this large-scale data set suggest substantial neuropsychological diversity in emotion processing in the CD population and, consequently, only a subgroup of youths with CD are likely to benefit from additional behavioral interventions specifically targeting emotion processing mechanisms.
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Affiliation(s)
- Gregor Kohls
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany
| | - Graeme Fairchild
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Areti Smaragdi
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Amy Wells
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Jack C Rogers
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Helena Oldenhof
- Department of Child and Adolescent Psychiatry, Amsterdam Public Health - Mental Health, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lucres Jansen
- Department of Child and Adolescent Psychiatry, Amsterdam Public Health - Mental Health, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Arthur van Rhijn
- Department of Child and Adolescent Psychiatry, Amsterdam Public Health - Mental Health, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Linda Kersten
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Janine Alfano
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Sarah Baumann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Agnes Vetro
- Child and Adolescent Psychiatry Department, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Helen Lazaratou
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Amaia Hervas
- Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | - Arne Popma
- Department of Child and Adolescent Psychiatry, Amsterdam Public Health - Mental Health, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Christina Stadler
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Kerstin Konrad
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany.,JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Juelich, Juelich, Germany
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19
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Rogers JC, Gonzalez-Madruga K, Kohls G, Baker RH, Clanton RL, Pauli R, Birch P, Chowdhury AI, Kirchner M, Andersson JLR, Smaragdi A, Puzzo I, Baumann S, Raschle NM, Fehlbaum LV, Menks WM, Steppan M, Stadler C, Konrad K, Freitag CM, Fairchild G, De Brito SA. White Matter Microstructure in Youths With Conduct Disorder: Effects of Sex and Variation in Callous Traits. J Am Acad Child Adolesc Psychiatry 2019; 58:1184-1196. [PMID: 31028899 DOI: 10.1016/j.jaac.2019.02.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 02/11/2019] [Accepted: 03/28/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Studies using diffusion tensor imaging (DTI) to investigate white matter (WM) microstructure in youths with conduct disorder (CD) have reported disparate findings. We investigated WM alterations in a large sample of youths with CD, and examined the influence of sex and callous-unemotional (CU) traits. METHOD DTI data were acquired from 124 youths with CD (59 female) and 174 typically developing (TD) youths (103 female) 9 to 18 years of age. Tract-based spatial statistics tested for effects of diagnosis and sex-by-diagnosis interactions. Associations with CD symptoms, CU traits, a task measuring impulsivity, and the impact of comorbidity, and age- and puberty-related effects were examined. RESULTS Youths with CD exhibited higher axial diffusivity in the corpus callosum and lower radial diffusivity and mean diffusivity in the anterior thalamic radiation relative to TD youths. Female and male youths with CD exhibited opposite changes in the left hemisphere within the internal capsule, fornix, posterior thalamic radiation, and uncinate fasciculus. Within the CD group, CD symptoms and callous traits exerted opposing influences on corpus callosum axial diffusivity, with callous traits identified as the unique clinical feature predicting higher axial diffusivity and lower radial diffusivity within the corpus callosum and anterior thalamic radiation, respectively. In an exploratory analysis, corpus callosum axial diffusivity partially mediated the association between callous traits and impulsive responses to emotional faces. Results were not influenced by symptoms of comorbid disorders, and no age- or puberty-related interactions were observed. CONCLUSION WM alterations within the corpus callosum represent a reliable neuroimaging marker of CD. Sex and callous traits are important factors to consider when examining WM in CD.
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Affiliation(s)
| | | | - Gregor Kohls
- Child Neuropsychology Section, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany
| | | | | | - Ruth Pauli
- School of Psychology, University of Birmingham, UK
| | | | - Alimul I Chowdhury
- School of Psychology, University of Birmingham, UK; Medical Physics Department, University Hospitals Birmingham, NHS Foundation Trust, UK
| | - Marietta Kirchner
- Institute of Medical Biometry and Informatics, University of Heidelberg, Germany
| | | | | | | | - Sarah Baumann
- Child Neuropsychology Section, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany
| | | | | | | | | | | | - Kerstin Konrad
- Child Neuropsychology Section, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany
| | - Christine M Freitag
- University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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20
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Gao Y, Rogers JC, Pauli R, Clanton R, Baker R, Birch P, Ferreira L, Brown A, Freitag CM, Fairchild G, Rotshtein P, De Brito SA. Neural correlates of theory of mind in typically-developing youth: Influence of sex, age and callous-unemotional traits. Sci Rep 2019; 9:16216. [PMID: 31700004 PMCID: PMC6838181 DOI: 10.1038/s41598-019-52261-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 10/03/2019] [Indexed: 12/30/2022] Open
Abstract
Theory of mind (ToM), or the ability to infer and predict the intentions, thoughts and beliefs of others, involves cognitive perspective taking (cognitive ToM/cToM) and understanding emotions (affective ToM/aToM). While behavioral evidence indicates that ToM is influenced by sex and age, no study has examined the influence of these variables on the neural correlates of cToM and aToM in late childhood/adolescence. Using fMRI with 35 typically-developing youths (aged 9-18 years, 12 males), we investigated the influence of sex and age on the neural correlates of cToM and aToM. We also examined how callous-unemotional traits, indexing a lack of empathy, were related to brain responses during aToM. Across both conditions, we found convergent activity in ToM network regions, such as superior temporal sulcus/temporoparietal junction (TPJ) and precuneus across males and females, but males recruited the left TPJ significantly more than females during cToM. During aToM, age was negatively correlated with brain responses in frontal, temporal and posterior midline regions, while callous-unemotional traits were positively correlated with right anterior insula responses. These results provide the first evidence in youth that sex influences the neural correlates of cToM, while age and callous-unemotional traits are specifically related to brain responses during aToM.
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Affiliation(s)
- Yidian Gao
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Jack C Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Roberta Clanton
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Rosalind Baker
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Philippa Birch
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Lisandra Ferreira
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Abigail Brown
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | - Pia Rotshtein
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK. .,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.
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21
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22
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Kohls F, Pauli R, Kohls A. Fallbericht: Ein seltener Fall eines intraduktalen Phylloidestumors der Mamma. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Kohls
- Medizinische Hochschule Hannover, Klinik für Frauenheilkunde und Geburtshilfe, Hannover, Deutschland
| | - R Pauli
- Städtisches Klinikum Brandenburg, Pathologisches Institut, Brandenburg, Deutschland
| | - A Kohls
- Evangelisches Krankenhaus Ludwigsfelde, Klinik für Frauenheilkunde und Geburtshilfe, Ludwigsfelde, Deutschland
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23
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Metrebian N, Weaver T, Pilling S, Hellier J, Byford S, Shearer J, Mitcheson L, Astbury M, Bijral P, Bogdan N, Bowden-Jones O, Day E, Dunn J, Finch E, Forshall S, Glasper A, Morse G, Akhtar S, Bajaria J, Bennett C, Bishop E, Charles V, Davey C, Desai R, Goodfellow C, Haque F, Little N, McKechnie H, Morris J, Mosler F, Mutz J, Pauli R, Poovendran D, Slater E, Strang J. Positive reinforcement targeting abstinence in substance misuse (PRAISe): Study protocol for a Cluster RCT & process evaluation of contingency management. Contemp Clin Trials 2018; 71:124-132. [PMID: 29908336 DOI: 10.1016/j.cct.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 10/14/2022]
Abstract
There are approximately 256,000 heroin and other opiate users in England of whom 155,000 are in treatment for heroin (or opiate) addiction. The majority of people in treatment receive opiate substitution treatment (OST) (methadone and buprenorphine). However, OST suffers from high attrition and persistent heroin use even whilst in treatment. Contingency management (CM) is a psychological intervention based on the principles of operant conditioning. It is delivered as an adjunct to existing evidence based treatments to amplify patient benefit and involves the systematic application of positive reinforcement (financial or material incentives) to promote behaviours consistent with treatment goals. With an international evidence base for CM, NICE recommended that CM be implemented in UK drug treatment settings alongside OST to target attendance and the reduction of illicit drug use. While there was a growing evidence base for CM, there had been no examination of its delivery in UK NHS addiction services. The PRAISe trial evaluates the feasibility, acceptability, clinical and cost effectiveness of CM in UK addiction services. It is a cluster randomised controlled effectiveness trial of CM (praise and financial incentives) targeted at either abstinence from opiates or attendance at treatment sessions versus no CM among individuals receiving OST. The trial includes an economic evaluation which explores the relative costs and cost effectiveness of the two CM intervention strategies compared to TAU and an embedded process evaluation to identify contextual factors and causal mechanisms associated with variations in outcome. This study will inform UK drug treatment policy and practice. Trial registration ISRCTN 01591254.
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Affiliation(s)
- N Metrebian
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
| | - T Weaver
- Imperial College London, London, UK; Middlesex University, London, UK
| | - S Pilling
- University College London, London, UK
| | - J Hellier
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - S Byford
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - J Shearer
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - L Mitcheson
- South London and Maudsley NHS Foundation Trust, London, UK
| | - M Astbury
- Dudley & Walsall Mental Health Partnership Trust, Dudley, UK
| | - P Bijral
- Change, Grow, Live Charity, Management Offices, London, UK
| | - N Bogdan
- South Essex Partnership NHS Foundation Trust, Essex, UK
| | - O Bowden-Jones
- Central and North West London NHS Foundation Trust, London, UK
| | - E Day
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - J Dunn
- Camden & Islington NHS Foundation Trust, London, UK
| | - E Finch
- South London and Maudsley NHS Foundation Trust, London, UK
| | - S Forshall
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - A Glasper
- Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - G Morse
- Turning Point Charity, London, UK
| | - S Akhtar
- Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - J Bajaria
- South Essex Partnership NHS Foundation Trust, Essex, UK
| | - C Bennett
- Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - E Bishop
- University College London, London, UK
| | - V Charles
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - C Davey
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - R Desai
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | | | - F Haque
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - N Little
- University College London, London, UK
| | | | - J Morris
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - F Mosler
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - J Mutz
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - R Pauli
- Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | | | - E Slater
- South Essex Partnership NHS Foundation Trust, Essex, UK
| | - J Strang
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
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Mergel K, Müller C, Pauli R, Ledwon P. Primäres bilaterales Siegelringzellkarzinom des Ovars – ein Fallbericht. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Schümann J, Müller C, Pauli R, Ledwon P. Monströses Cystosarcoma phylloides der Mamma bei einer sehr adipösen Patientin – ein Fallbericht. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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26
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Pauli R, Bowring A, Reynolds R, Chen G, Nichols TE, Maumet C. Exploring fMRI Results Space: 31 Variants of an fMRI Analysis in AFNI, FSL, and SPM. Front Neuroinform 2016; 10:24. [PMID: 27458367 PMCID: PMC4932120 DOI: 10.3389/fninf.2016.00024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 06/22/2016] [Indexed: 11/26/2022] Open
Affiliation(s)
- Ruth Pauli
- Warwick Manufacturing Group, University of Warwick Coventry, UK
| | | | - Richard Reynolds
- Scientific and Statistical Computing Core, National Institute of Mental Health, National Institutes of Health Bethesda, MD, USA
| | - Gang Chen
- Scientific and Statistical Computing Core, National Institute of Mental Health, National Institutes of Health Bethesda, MD, USA
| | - Thomas E Nichols
- Warwick Manufacturing Group, University of WarwickCoventry, UK; Department of Statistics, University of WarwickCoventry, UK
| | - Camille Maumet
- Warwick Manufacturing Group, University of Warwick Coventry, UK
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Mergel K, Müller C, Pauli R, Ledwon P. Monströses Lipoleiomyom des Uterus – Fallbericht. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Weinke S, Ledwon P, Müller C, Pauli R. Akutes Abdomen durch eine Myomnekrose im Wochenbett nach Sectio caesarea – ein Fallbericht. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Rosenthal A, Becker M, Klaman I, Mayr T, Pauli R, Hertel K, Helwig K, Fichtner I, Hoffmann J, Adams H, Hinzmann B. A RNA signature with high sensitivity and specificity discriminating between responder and nonresponder to cetuximab monotherapy in colorectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
We report the case of a 56-year-old female patient with a giant tumor on the left side of the neck, which appeared to be localised outside the large salivary glands. Due to the extensive vascularisation seen on MRI, digital subtraction angiography was performed. To reduce intraoperative bleeding, the vasculature was embolized. The tumor was resected together with the submandibular gland, since a connection between gland and tumor could not be excluded intraoperatively. Histology showed a pleomorphic adenoma with an intact capsule and no indication of malignancy. Pleomorphic adenomas are typical tumors of the salivary glands; however, they can also occur outside the gland. The tumor and its pseudocapsule must be fully resected to prevent recurrence.
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Affiliation(s)
- T Schulz
- Klinik für HNO-Krankheiten, Gesichts und Halschirurgie, Städtisches Klinikum Brandenburg, Brandenburg/Havel, Deutschland.
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Pauli R, Piesker N, Wenzel R, Ebinger M. [Intoxication with cyclopentolate eye drops]. Nervenarzt 2009; 80:967-969. [PMID: 19557378 DOI: 10.1007/s00115-009-2790-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report on an accidental intoxication with cyclopentolate eye drops. A 90-year-old patient became confused and was admitted to the emergency department. His symptoms consisted of disorientation, ataxia, and psychomotor agitation. Similar cases have been described in the literature. With this case report we would like to draw attention to this little known differential diagnosis when confronted with confused patients.
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Affiliation(s)
- R Pauli
- Klinik und Poliklinik für Neurologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin
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32
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Foerster J, Kuerth A, Niederstrasser E, Krautwald E, Pauli R, Paulat R, Eweleit M, Riemekasten G, Worm M. A cold-response index for the assessment of Raynaud's phenomenon. J Dermatol Sci 2006; 45:113-20. [PMID: 17169532 DOI: 10.1016/j.jdermsci.2006.11.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2006] [Revised: 11/03/2006] [Accepted: 11/08/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND Quantification of Raynaud's phenomenon (RP) is a prerequisite in the evaluation of novel therapeutic strategies. Fingertip rewarming in response to local cold provocation has been used in many studies but not been systematically validated. We have previously described the time elapsed before 63% of pre-cooling temperature is reached as a RP activity index. OBJECTIVE A comprehensive evaluation of fingertip rewarming in primary and scleroderma-associated RP. METHODS We defined a cold-response index (CRI) as the log transformation of the 63% rewarming time upon cold challenge. RESULTS The CRI shows high intra-individual reproducibility. The mean CRI values were (mean+/-S.D.): 2.4+/-0.3 in controls (n=53) versus 2.7+/-0.3 in RP (n=50, p<0.0001 versus controls), and 2.7+/-0.3 in scleroderma patients (n=46, p<0.0001). In addition, baseline fingertip temperature was also found to be significantly reduced both in primary as well as scleroderma-associated RP. Kinetic analysis of rewarming temperature curves demonstrates that the CRI is independent of individual rewarming patterns. Finally, the CRI decreases significantly upon a single low-level systemic hyperthermia treatment in scleroderma patients (2.68+/-0.28 before versus 2.45+/-0.33 after, p=0.0003), while the extent of cooling remained unchanged, thus demonstrating sensitivity to change. CONCLUSION Our results provide a solid basis for using the cold-response assay as an endpoint in addition to clinical activity scores in RP treatment trials.
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Affiliation(s)
- John Foerster
- Klinik für Dermatologie, Charité, Charitéplatz 1, 10117 Berlin, Germany.
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Rosenberg MJ, Killoran C, Dziadzio L, Chang S, Stone DL, Meck J, Aughton D, Bird LM, Bodurtha J, Cassidy SB, Graham JM, Grix A, Guttmacher AE, Hudgins L, Kozma C, Michaelis RC, Pauli R, Peters KF, Rosenbaum KN, Tifft CJ, Wargowski D, Williams MS, Biesecker LG. Scanning for telomeric deletions and duplications and uniparental disomy using genetic markers in 120 children with malformations. Hum Genet 2001; 109:311-8. [PMID: 11702212 DOI: 10.1007/s004390100559] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2001] [Accepted: 06/05/2001] [Indexed: 10/28/2022]
Abstract
We screened 120 children with sporadic multiple congenital anomalies and either growth or mental retardation for uniparental disomy (UPD) or subtelomeric deletions. The screening used short tandem repeat polymorphisms (STRP) from the subtelomeric regions of 41 chromosome arms. Uninformative marker results were reanalyzed by using the next available marker on that chromosome arm. In total, approximately 25,000 genotypes were generated and analyzed for this study. Subtelomeric deletions of 1 Mb in size were excluded for 27 of 40 chromosome arms. Among the 120 subjects none was found to have UPD, but five subjects (4%, 95% confidence interval 1-9%) were found to have a deletion or duplication of one or more chromosome arms. We conclude that UPD is not a frequent cause of undiagnosed multiple congenital anomaly syndrome. In addition, we determined that 9p and 7q harbor chromosome length variations in the normal population. We conclude that subtelomeric marker analysis is effective for the detection of subtelomeric duplications and deletions, although it is labor intensive. Given a detection rate that is similar to prior studies and the large workload imposed by STRPs, we conclude that STRPs are an effective, but impractical, approach to the determination of segmental aneusomy given current technology.
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Affiliation(s)
- M J Rosenberg
- National Human Genome Research Institute, Genetic Disease Research Branch, 49 Convent Drive, Bethesda, MD 20892, USA.
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Li M, Squire J, Shuman C, Fei YL, Atkin J, Pauli R, Smith A, Nishikawa J, Chitayat D, Weksberg R. Imprinting status of 11p15 genes in Beckwith-Wiedemann syndrome patients with CDKN1C mutations. Genomics 2001; 74:370-6. [PMID: 11414765 DOI: 10.1006/geno.2001.6549] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Beckwith-Wiedemann syndrome (BWS) is an imprinting disorder characterized by somatic overgrowth, congenital malformations, and predisposition to childhood tumors. Aberrant expression of multiple imprinted genes, including H19, IGF2, KCNQ1OT1, and CDKN1C, has been observed in BWS patients. It has been estimated that mutations in CDKN1C occur in 12-17% of BWS patients. We have screened 10 autosomal dominant pedigrees and 65 sporadic BWS cases by PCR/heteroduplex analysis and DNA sequencing and have identified four mutations, two of which were associated with biallelic IGF2 expression and normal H19 and KCNQ1OT1 imprinting. One patient demonstrated phenotypic expression of paternally transmitted mutation in this maternally expressed gene, a second proband is the child of one of a pair of monozygotic twin females who carry the mutation de novo, and a third patient exhibited unusual skeletal changes more commonly found in other overgrowth syndromes. When considered with other studies published to date, this work reveals the frequency of CDKN1C mutations in BWS to be only 4.9%. This is the first report of an analysis of the imprinting status of genes in the 11p15 region where CDKN1C mutations were associated with loss of IGF2 imprinting and maintenance of H19 and KCNQ1OT1 imprinting.
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Affiliation(s)
- M Li
- Division of Clinical and Metabolic Genetics, Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada
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Soutullo A, Verwimp V, Riveros M, Pauli R, Tonarelli G. Design and validation of an ELISA for equine infectious anemia (EIA) diagnosis using synthetic peptides. Vet Microbiol 2001; 79:111-21. [PMID: 11230933 DOI: 10.1016/s0378-1135(00)00352-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Three peptides derived from the equine infectious anemia virus (EIAV) surface proteins were synthesized to design and validate an ELISA for EIA diagnosis. Peptides identified as gp90-I and gp90-II correspond to the N- and C-terminal part of the surface glycoprotein gp90. Peptide gp45-1 overlaps the immunodominant epitope CIERTHVFC of the transmembrane glycoprotein gp45, and includes a hydrophilic chain close to the N-terminal end of this nonapeptide loop. Serum samples from 140 naturally infected horses with EIAV and a panel of 167 non-immune equine sera obtained from non-infected animals were used. Differences in reactivity between positive and negative serum samples were clearly distinguished. Samples considered weak positive to the agar gel immunodiffusion (AGID) test were "true" positive in the ELISA. These results are consistent with the improved sensitivity of the ELISA in comparison with the AGID test. The cyclic peptide that mimics the immunodominant sequence of gp45 showed excellent reactivity, thus suggesting that its functional activity depends significantly on its conformation, since very low reactivity was observed in the linear form of the peptide. The detectability indices of positive and negative sera reached 98% when gp90-II and gp45-I synthetic peptides were used in the same assay, illustrating the high specificity and sensitivity of the assay. Our study represents a first approach for the design of a diagnostic kit, which would allow the rapid analysis of a large numbers of serum samples from horses, and could be applied in endemic areas with different prevalence of infection.
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Affiliation(s)
- A Soutullo
- Laboratorio de Diagnóstico e Investigaciones Agropecuarias, Dirección de Sanidad Animal, Ministerio de Agricultura, Ganadería, Industria y Comercio de Santa Fe, Bv. Pellegrini 3100, 3000, Santa Fe, Argentina.
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Abstract
Certain dopaminergic anti-Parkinson drugs (ergolines) have repeatedly been identified as a cause of pleuropulmonary disease with a focus on serosal cell damage. Recently, a pathogenetic link between ergolines and prior asbestos exposure was suggested, as regards the development of pleural pathology. This report describes a patient with idiopathic Parkinson's disease, who was on a multiple drug regimen including low dose cabergoline. The patient developed a febrile illness with widespread bilateral lung infiltrations nonresponsive to beta-lactam and macrolide antibiotics. Bronchoalveolar lavage and transbronchial lung biopsy showed a "hypersensitivity-like" interstitial lung disease, which cleared almost completely within 2 months after simple drug withdrawal. Circumstantial evidence suggests a so far undescribed adverse lung reaction to cabergoline, devoid of the more usual pleural changes.
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Affiliation(s)
- W Frank
- Klinik III, Fachklinik für Pneumologie, Johanniterkrankenhaus Im Fläming gGmbH, Treuenbrietzen, Germany
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Abstract
Ovarian germ cell cancers are rare malignancies accounting for less than 5% of all ovarian cancers. We present a family in which three closely related women were diagnosed with ovarian germ cell malignancies. This family's cancer history prompted a family history investigation of women treated for ovarian germ cell malignancies in the Gynecologic-Oncology Clinic at the University of Wisconsin. One of the eight patients whose family histories were reviewed had an uncle who had been diagnosed with testicular germ cell cancer. A review found six other previously reported families in which more than one relative had been diagnosed with a malignant ovarian germ cell tumor. Additionally, several cases of families with both males and females diagnosed with germ cell cancers have been documented. The low incidence of ovarian germ cell cancers suggests that multiple occurrences in the same family may not be due to chance. Rather, it is possible that a gene conferring susceptibility to ovarian germ cell cancers, and possibly to germ cell tumors in males as well, is present in at least some of these families.
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Affiliation(s)
- A R Stettner
- Clinical Genetics Center, University of Wisconsin, Madison 53705, USA
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Haitsch R, Frank W, Evers H, Pauli R. [Chylothorax as a complication of sarcoidosis]. Pneumologie 1996; 50:912-4. [PMID: 9091887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This case report features a male patient of 45 years of age presenting with a right sided moderately compressive pleural effusion, that was clearly identified as chylothorax on thoracocentesis. Sarcoidosis with systemic involvement had already been diagnosed in 1995 by a parotid gland biopsy. Thoracoscopy revealed multiple discrete nodules parietally besides a number of more extensive yellowish lesions resembling malignant lymphoma. However visualization of a thoracic duct leakage was not possible. Histologically the biopsies taken represented exclusively non-caseating sarcoidosistype granulomas. Complete and permanent remission of the chylothorax was achieved within only ten days following talcum pleurodesis, alimentary measures and induction of systemic steroid therapy. The etiological classification of this extremely rare complication appears very clear. Pathogenetic and differential therapeutic aspects are discussed against the background of a review of the literature.
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Affiliation(s)
- R Haitsch
- Fachklinik für Lungenkrankheiten und Tuberkulose, Beelitz-Heilstätten
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Abstract
OBJECTIVES - To assess the efficacy of dual film reading in screening mammography with a suitably trained radiographer as the second reader and to determine a suitable decision model for radiographer/radiologist double reading. SETTING - Three breast screening centres in South Thames (West) region. METHODS - Seven radiographers with prior film reading training double read 17 202 screening mammograms with a radiologist. Screening performance of radiographers and radiologists was assessed taking into account interval cancers. The efficacy of radiographer/radiologist double reading was assessed in terms of changes in sensitivity and specificity compared with radiologist single reading. RESULTS - Radiographers yielded equivalent sensitivity but lower specificity than radiologist film readers. The effect of double reading between radiographer/radiologist pairs was an increase in sensitivity of 6-4%, which was achieved at the cost of a 0-6% decrease in specificity. This was reached by a decision system involving radiologists' review of radiographer queries and recall classifications. If all radiographer queries were recalled a large increase in sensitivity would be counterbalanced by an equally large decrease in specificity. CONCLUSIONS - Radiographer/radiologist double reading resulted in similar increases in sensitivity as those previously reported in radiologist double reading studies. Radiologist review of radiographer reported abnormalities is a suitable means by which to limit excess recall.
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Affiliation(s)
- R Pauli
- School of Psychology and Counselling, Roehampton Institute, West Hill, London, United Kingdom
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Pauli R, Hammond S, Cooke J, Ansell J. Radiographers as film readers in screening mammography: an assessment of competence under test and screening conditions. Br J Radiol 1996; 69:10-4. [PMID: 8785616 DOI: 10.1259/0007-1285-69-817-10] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to investigate the potential of radiographers as film readers in screening mammography. Seven radiographers received training in mammogram interpretation at a National Health Service (NHS) Breast Screening Training Centre. Film reading performance was assessed over a period of 1 year after training with test sets of selected screening mammograms. Actual screening performance on contemporary screening mammograms was monitored after training in relation to radiologist decisions and screening outcome. It was found that trained radiographers read mammograms to a standard comparable with that of radiologists. Film reading skills were maintained consistently over the period of this study and transferred to actual screening performance. It was concluded that radiographers could play a useful role as second readers in screening mammography. Training needs have to be assessed in relation to the role the film reading radiographer is to adopt.
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Affiliation(s)
- R Pauli
- School of Psychology and Counselling, Roehampton Institute, London, UK
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Williams MS, Rooney BL, Williams J, Josephson K, Pauli R. Investigation of thermoregulatory characteristics in patients with Prader-Willi syndrome. Am J Med Genet 1994; 49:302-7. [PMID: 8209890 DOI: 10.1002/ajmg.1320490312] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A survey instrument is used to assess temperature regulation characteristics in children with Prader-Willi syndrome (PWS) compared to 3 control groups: sibs of PWS patients (SIB), neurodevelopmentally handicapped children (ND), and age and gender matched well children (WC). Significant differences were found between PWS patients, SIB controls, and WC controls in the prevalence of febrile convulsions, fever-associated symptoms, and temperature less than 94 degrees F. No differences were noted in any variable between the PWS patients and the ND controls, suggesting that these abnormalities are not unique to PWS, but can occur in any neurodevelopmentally handicapped individual, further suggesting these do not necessarily reflect syndrome-specific hypothalamic abnormalities.
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Surina DM, Langhans W, Pauli R, Wenk C. Meal composition affects postprandial fatty acid oxidation. Am J Physiol Regul Integr Comp Physiol 1993. [DOI: 10.1152/ajpregu.1993.265.3.714-r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pages R1065–R1070: D. M. Surina, W. Langhans, R. Pauli, and C. Wenk. “Meal composition affects postprandial fatty acid oxidation.” Results from a similar experiment performed after this article went to press have led the authors to conclude that the β-hydroxybutyrate values reported in this article are unreliable. They are probably skewed by high plasma triglyceride levels. The authors deeply regret this error and request that the readers disregard the related interpretations.
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Abstract
The influence of macronutrient content of a meal on postprandial fatty acid oxidation was investigated in 13 Caucasian males after consumption of a high-fat (HF) breakfast (33% carbohydrate, 52% fat, 15% protein) and after an equicaloric high-carbohydrate (HC) breakfast (78% carbohydrate, 6% fat, 15% protein). The HF breakfast contained short- and medium-chain fatty acids, as well as long-chain fatty acids. Respiratory quotient (RQ) and plasma beta-hydroxybutyrate (BHB) were measured during the 3 h after the meal as indicators of whole body substrate oxidation and hepatic fatty acid oxidation, respectively. Plasma levels of free fatty acids (FFA), triglycerides, glucose, insulin, and lactate were also determined because of their relationship to nutrient utilization. RQ was significantly lower and plasma BHB was higher after the HF breakfast than after the HC breakfast, implying that more fat is burned in general and specifically in the liver after an HF meal. As expected, plasma FFA and triglycerides were higher after the HF meal, and insulin and lactate were higher after the HC meal. In sum, oxidation of ingested fat occurred in response to a single HF meal.
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Affiliation(s)
- D M Surina
- Institute for Animal Sciences, Swiss Federal Institute of Technology, Zurich
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Monath TP, Sabattini MS, Pauli R, Daffner JF, Mitchell CJ, Bowen GS, Cropp CB. Arbovirus investigations in Argentina, 1977-1980. IV. Serologic surveys and sentinel equine program. Am J Trop Med Hyg 1985; 34:966-75. [PMID: 2863991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Serologic surveys of wild and domestic birds, wild mammals, and horses were conducted during arbovirus field studies in Argentina from 1977 through 1980, a non-epizootic interval. The prevalence of neutralizing antibodies to eastern equine encephalitis (EEE) was consistently higher than to western equine encephalitis (WEE) virus in all species and all areas. The presence of antibodies in short-lived avian species and in young unvaccinated horses and the demonstration of seroconversions in horses during the period, indicated that these viruses are either enzootic in, or annually reintroduced into, Argentina. Antibodies to AG80-646, a new subtype of WEE virus isolated in the subtropical north (Chaco Province) from Culex (Melanoconion) mosquitoes, were found in horses and rodents in that region. Antibodies to the TC-83 strain of Venezuelan equine encephalitis (VEE) virus were found in all areas studied. The presence of antibodies in some horses was probably related to vaccination, but the demonstration of seroconversions in sentinel horses and of antibodies in birds and wild mammals indicates active transmission of VEE virus. In 1980 a new enzootic subtype of VEE virus (AG80-663) was isolated from mosquitoes in Chaco; neutralizing antibodies to this virus were prevalent in horses and rodents in this area. Infections with Aura and Una viruses were most common in the subtropical northern provinces. Infection with St. Louis encephalitis was prevalent and widespread, and birds, principally passerine and columbiform species, appear to be the principal hosts. An interesting and unexplained finding was the absence of arbovirus antibodies, in particular SLE antibodies in house sparrows (Passer domesticus). Antibody prevalences in horses exceeded 50% in all areas, and 12% of horses surveyed in Santa Fe Province developed antibody in a 17-month period. Antibodies to other flaviviruses were rare. A high prevalence of immunity to Maguari virus was found in horses; this agent is considered to be a potential equine pathogen. Antibodies to 2 new viruses, Barranqueras and Resistencia, which had been isolated from Cx. (Melanoconion) in Chaco Province, were found in rodents there. Immunity to Gamboa group viruses was prevalent, and birds were implicated as principal hosts.
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Sabattini MS, Monath TP, Mitchell CJ, Daffner JF, Bowen GS, Pauli R, Contigiani MS. Arbovirus investigations in Argentina, 1977-1980. I. Historical aspects and description of study sites. Am J Trop Med Hyg 1985; 34:937-44. [PMID: 4037184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This is the introductory paper to a series on the ecology of arboviruses in Argentina. Epizootics of equine encephalitis have occurred since at least 1908, principally in the Pampa and Espinal biogeographic zones, with significant economic losses; human cases of encephalitis have been rare or absent. Both western equine and eastern equine encephalitis viruses have been isolated from horses during these epizootics, but the mosquitoes responsible for transmission have not been identified. A number of isolations of Venezuelan equine encephalitis (VEE) virus were reported between 1936 and 1958 in Argentina, but the validity of these findings has been seriously questioned. Nevertheless, serological evidence exists for human infections with a member of the VEE virus complex. Serological surveys conducted in the 1960s indicate a high prevalence of infection of humans and domestic animals with St. Louis encephalitis (SLE), and 2 SLE virus strains have been isolated from rodents. Human disease, however, has rarely been associated with SLE infection. Only 7 isolations of other arboviruses have been described (3 of Maguari, 1 of Aura, 2 of Una, and 1 of an untyped Bunyamwera group virus). In 1977, we began longitudinal field studies in Santa Fe Province, the epicenter of previous equine epizootics, and in 1980 we extended these studies to Chaco and Corrientes provinces. The study sites are described in this paper.
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MESH Headings
- Animals
- Arbovirus Infections/epidemiology
- Arbovirus Infections/microbiology
- Arboviruses
- Argentina
- Birds
- Cattle
- Child
- Climate
- Ecology
- Encephalitis Virus, St. Louis
- Encephalitis Virus, Venezuelan Equine
- Encephalitis Virus, Western Equine
- Encephalitis, St. Louis/epidemiology
- Encephalitis, St. Louis/microbiology
- Encephalomyelitis, Equine/epidemiology
- Encephalomyelitis, Equine/microbiology
- Encephalomyelitis, Equine/veterinary
- Encephalomyelitis, Venezuelan Equine/epidemiology
- Encephalomyelitis, Venezuelan Equine/microbiology
- Encephalomyelitis, Venezuelan Equine/veterinary
- Geography
- Horse Diseases/epidemiology
- Horse Diseases/microbiology
- Horses/microbiology
- Humans
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Affiliation(s)
- T. P. Monath
- Division of Vector-Borne Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services, P.O. Box 2087, Fort Collins, Colorado 80522
| | - R. Pauli
- Ministry of Agriculture and Livestock, Sante Fe Province, Santa Fe, Argentina
| | - G. S. Bowen
- Commonwealth of Pennsylvania, Department of Health, Bureau of Epidemiology and Disease Prevention, P.O. Box 90, Room 1006, Harrisburg, Pennsylvania 17108
| | - C. J. Mitchell
- Division of Vector-Borne Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services, P.O. Box 2087, Fort Collins, Colorado 80522
| | - J. F. Daffner
- Institute of Virology, Faculty of Medical Science, University of Cordoba, Estafeta 32, Cordoba, Argentina
| | - C. B. Cropp
- Division of Vector-Borne Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services, P.O. Box 2087, Fort Collins, Colorado 80522
| | - M. S. Sabattini
- Institute of Virology, Faculty of Medical Science, University of Cordoba, Estafeta 32, Cordoba, Argentina
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Sabattini MS, Contigiani MS, Bowen GS, Monath TP, Daffner JF, Mitchell CJ, Pauli R. Arbovirus Investigations in Argentina, 1977–1980. Am J Trop Med Hyg 1985. [DOI: 10.4269/ajtmh.1985.34.937] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- M. S. Sabattini
- Institute of Virology, Faculty of Medical Science, University of Cordoba, Estafeta 32, Cordoba, Argentina
| | - M. S. Contigiani
- Institute of Virology, Faculty of Medical Science, University of Cordoba, Estafeta 32, Cordoba, Argentina
| | - G. S. Bowen
- Commonwealth of Pennsylvania, Department of Health, Bureau of Epidemiology and Disease Prevention, P.O. Box 90, Room 1006, Harrisburg, Pennsylvania 17108
| | - T. P. Monath
- Division of Vector-Borne Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services, P.O. Box 2087, Fort Collins, Colorado 80522
| | - J. F. Daffner
- Institute of Virology, Faculty of Medical Science, University of Cordoba, Estafeta 32, Cordoba, Argentina
| | - C. J. Mitchell
- Division of Vector-Borne Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services, P.O. Box 2087, Fort Collins, Colorado 80522
| | - R. Pauli
- Ministry of Agriculture and Livestock, Santa Fe Province, Santa Fe, Argentina
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