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Hutten JC, van Horn JE, Hoppenbrouwers SS, Ziermans TB, Geurts HM. Neuropsychological assessment of aggressive offenders: a Delphi consensus study. Front Psychol 2024; 15:1328839. [PMID: 38464622 PMCID: PMC10922935 DOI: 10.3389/fpsyg.2024.1328839] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
Objective This study explores the intricate relationship between cognitive functioning and aggression, with a specific focus on individuals prone to reactive or proactive aggression. The purpose of the study was to identify important neuropsychological constructs and suitable tests for comprehending and addressing aggression. Methods An international panel of 32 forensic neuropsychology experts participated in this three-round Delphi study consisting of iterative online questionnaires. The experts rated the importance of constructs based on the Research Domain Criteria (RDoC) framework. Subsequently, they suggested tests that can be used to assess these constructs and rated their suitability. Results The panel identified the RDoC domains Negative Valence Systems, Social Processes, Cognitive Systems and Positive Valence Systems as most important in understanding aggression. Notably, the results underscore the significance of Positive Valence Systems in proactive aggression and Negative Valence Systems in reactive aggression. The panel suggested a diverse array of 223 different tests, although they noted that not every RDoC construct can be effectively measured through a neuropsychological test. The added value of a multimodal assessment strategy is discussed. Conclusions This research advances our understanding of the RDoC constructs related to aggression and provides valuable insights for assessment strategies. Rather than suggesting a fixed set of tests, our study takes a flexible approach by presenting a top-3 list for each construct. This approach allows for tailored assessment to meet specific clinical or research needs. An important limitation is the predominantly Dutch composition of the expert panel, despite extensive efforts to diversify.
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Affiliation(s)
- Juliette C. Hutten
- De Waag (Outpatient Forensic Mental Health Clinic), Forensic Care Specialists, Utrecht, Netherlands
- Brain and Cognition, Department of Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Joan E. van Horn
- De Waag (Outpatient Forensic Mental Health Clinic), Forensic Care Specialists, Utrecht, Netherlands
| | - Sylco S. Hoppenbrouwers
- De Waag (Outpatient Forensic Mental Health Clinic), Forensic Care Specialists, Utrecht, Netherlands
| | - Tim B. Ziermans
- Brain and Cognition, Department of Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Hilde M. Geurts
- Brain and Cognition, Department of Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands
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2
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Jaya ES, Wüsten C, Alizadeh BZ, van Amelsvoort T, Bartels-Velthuis AA, van Beveren NJ, Bruggeman R, Cahn W, de Haan L, Delespaul P, Luykx JJ, Myin-Germeys I, Kahn RS, Schirmbeck F, Simons CJP, van Haren NE, van Os J, van Winkel R, Fonseca-Pedrero E, Peters E, Verdoux H, Woodward TS, Ziermans TB, Lincoln TM. Comparing psychotic experiences in low-and-middle-income-countries and high-income-countries with a focus on measurement invariance. Psychol Med 2022; 52:1509-1516. [PMID: 33023691 DOI: 10.1017/s0033291720003323] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The prevalence of psychotic experiences (PEs) is higher in low-and-middle-income-countries (LAMIC) than in high-income countries (HIC). Here, we examine whether this effect is explicable by measurement bias. METHODS A community sample from 13 countries (N = 7141) was used to examine the measurement invariance (MI) of a frequently used self-report measure of PEs, the Community Assessment of Psychic Experiences (CAPE), in LAMIC (n = 2472) and HIC (n = 4669). The CAPE measures positive (e.g. hallucinations), negative (e.g. avolition) and depressive symptoms. MI analyses were conducted with multiple-group confirmatory factor analyses. RESULTS MI analyses showed similarities in the structure and understanding of the CAPE factors between LAMIC and HIC. Partial scalar invariance was found, allowing for latent score comparisons. Residual invariance was not found, indicating that sum score comparisons are biased. A comparison of latent scores before and after MI adjustment showed both overestimation (e.g. avolition, d = 0.03 into d = -0.42) and underestimation (e.g. magical thinking, d = -0.03 into d = 0.33) of PE in LAMIC relative to HIC. After adjusting the CAPE for MI, participants from LAMIC reported significantly higher levels on most CAPE factors but a significantly lower level of avolition. CONCLUSION Previous studies using sum scores to compare differences across countries are likely to be biased. The direction of the bias involves both over- and underestimation of PEs in LAMIC compared to HIC. Nevertheless, the study confirms the basic finding that PEs are more frequent in LAMIC than in HIC.
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Affiliation(s)
- Edo S Jaya
- Psychosis Studies Research Group, Faculty of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Caroline Wüsten
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
| | - Behrooz Z Alizadeh
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Therese van Amelsvoort
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Agna A Bartels-Velthuis
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Nico J van Beveren
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Antes Center for Mental Health Care, Rotterdam, The Netherlands
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Richard Bruggeman
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Wiepke Cahn
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Altrecht, General Mental Health Care, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Philippe Delespaul
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Jurjen J Luykx
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Inez Myin-Germeys
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Rene S Kahn
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Frederike Schirmbeck
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Claudia J P Simons
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
- GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Neeltje E van Haren
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Jim van Os
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| | - Ruud van Winkel
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
- Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, La Rioja, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Hélène Verdoux
- University Bordeaux, U1219 Bordeaux Population Health Research Center, Bordeaux, France
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Tim B Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
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Ziermans TB, Schirmbeck F, Oosterwijk F, Geurts HM, de Haan L. Autistic traits in psychotic disorders: prevalence, familial risk, and impact on social functioning. Psychol Med 2021; 51:1704-1713. [PMID: 32151297 PMCID: PMC8327624 DOI: 10.1017/s0033291720000458] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prevalence estimates of autistic traits in individuals with psychotic disorders (PD) vary greatly and it is unclear whether individuals with a familial risk (FR) for psychosis have an increased propensity to display autistic traits. Furthermore, it is unknown whether the presence of comorbid autism traits disproportionally affects the cognitive and behavioral aspects of social functioning in PD. METHODS In total, 504 individuals with PD, 587 unaffected siblings with FR, and 337 typical comparison (TC) individuals (16-50 years) were included. Autistic and psychotic traits were measured with the Autism Spectrum Quotient (AQ) and the Community Assessment of Psychic Experiences (CAPE). Social cognition was assessed with the Picture Sequencing Task (PST) and social behavior with the Social Functioning Scale (SFS). RESULTS For PD 6.5% scored above AQ clinical cut-off (⩾32), 1.0% for FR, and 1.2% for TC. After accounting for age, sex, and IQ, the PD group showed significantly more autistic traits and alterations in social behavior and cognition, while FR and TC only displayed marginal differences. Within the PD group autistic traits were a robust predictor of social behavior and there were no interactions with positive psychotic symptoms. CONCLUSIONS Levels of autistic traits are substantially elevated in PD and have a profoundly negative association with social functioning. In contrast, autistic traits above the clinical cut-off are not elevated in those with FR, and only marginally on a dimensional level. These findings warrant specific clinical guidelines for psychotic patients who present themselves with autistic comorbidity to help address their social needs.
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Affiliation(s)
- Tim B. Ziermans
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Hilde M. Geurts
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
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4
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Sasson NJ, Pinkham AE, Ziermans TB. Editorial: Neurobiology and Cognition Across the Autism-Psychosis Spectrum. Front Psychiatry 2021; 12:654246. [PMID: 33643102 PMCID: PMC7902763 DOI: 10.3389/fpsyt.2021.654246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Noah J Sasson
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Amy E Pinkham
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Tim B Ziermans
- Department of Psychology, Social and Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands
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5
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de Nooij L, Harris MA, Hawkins EL, Clarke TK, Shen X, Chan SWY, Ziermans TB, McIntosh AM, Whalley HC. Longitudinal trajectories of brain age in young individuals at familial risk of mood disorder from the Scottish Bipolar Family Study. Wellcome Open Res 2020; 4:206. [PMID: 32954013 PMCID: PMC7479500 DOI: 10.12688/wellcomeopenres.15617.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Within young individuals, mood disorder onset may be related to changes in trajectory of brain structure development. To date, however, longitudinal prospective studies remain scarce and show partly contradictory findings, with a lack of emphasis on changes at the level of global brain patterns. Cross-sectional adult studies have applied such methods and show that mood disorders are associated with accelerated brain aging. Currently, it remains unclear whether young individuals show differential brain structure aging trajectories associated with onset of mood disorder and/or presence of familial risk. Methods: Participants included young individuals (15-30 years, 53%F) from the prospective longitudinal Scottish Bipolar Family Study with and without close family history of mood disorder. All were well at time of recruitment. Implementing a structural MRI-based brain age prediction model, we globally assessed individual trajectories of age-related structural change using the difference between predicted brain age and chronological age (brain-predicted age difference (brain-PAD)) at baseline and at 2-year follow-up. Based on follow-up clinical assessment, individuals were categorised into three groups: (i) controls who remained well (C-well, n = 93), (ii) high familial risk who remained well (HR-well, n = 74) and (iii) high familial risk who developed a mood disorder (HR-MD, n = 35). Results: At baseline, brain-PAD was comparable between groups. Results showed statistically significant negative trajectories of brain-PAD between baseline and follow-up for HR-MD versus C-well ( β = -0.60, p corrected < 0.001) and HR-well ( β = -0.36, p corrected = 0.02), with a potential intermediate trajectory for HR-well ( β = -0.24 years, p corrected = 0.06). Conclusions: These preliminary findings suggest that within young individuals, onset of mood disorder and familial risk may be associated with a deceleration in brain structure aging trajectories. Extended longitudinal research will need to corroborate findings of emerging maturational lags in relation to mood disorder risk and onset.
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Affiliation(s)
- Laura de Nooij
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Emma L. Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Stella W. Y. Chan
- Section of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Tim B. Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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6
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de Nooij L, Harris MA, Hawkins EL, Clarke TK, Shen X, Chan SWY, Ziermans TB, McIntosh AM, Whalley HC. Longitudinal trajectories of brain age in young individuals at familial risk of mood disorder from the Scottish Bipolar Family Study. Wellcome Open Res 2020; 4:206. [PMID: 32954013 PMCID: PMC7479500 DOI: 10.12688/wellcomeopenres.15617.2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 11/14/2023] Open
Abstract
Background: Within young individuals, mood disorder onset may be related to changes in trajectory of brain structure development. To date, however, longitudinal prospective studies remain scarce and show partly contradictory findings, with a lack of emphasis on changes at the level of global brain patterns. Cross-sectional adult studies have applied such methods and show that mood disorders are associated with accelerated brain ageing. Currently, it remains unclear whether young individuals show differential brain structure aging trajectories associated with onset of mood disorder and/or presence of familial risk. Methods: Participants included young individuals (15-30 years, 53%F) from the prospective longitudinal Scottish Bipolar Family Study with and without close family history of mood disorder. All were well at time of recruitment. Implementing a structural MRI-based brain age prediction model, we globally assessed individual trajectories of age-related structural change using the difference between predicted brain age and chronological age (brain-predicted age difference (brain-PAD)) at baseline and at 2-year follow-up. Based on follow-up clinical assessment, individuals were categorised into three groups: (i) controls who remained well (C-well, n = 93), (ii) high familial risk who remained well (HR-well, n = 74) and (iii) high familial risk who developed a mood disorder (HR-MD, n = 35). Results: At baseline, brain-PAD was comparable between groups. Results showed statistically significant negative trajectories of brain-PAD between baseline and follow-up for HR-MD versus C-well ( β = -0.60, p corrected < 0.001) and HR-well ( β = -0.36, p corrected = 0.02), with a potential intermediate trajectory for HR-well ( β = -0.24 years, p corrected = 0.06). Conclusions: These preliminary findings suggest that within young individuals, onset of mood disorder and familial risk may be associated with a deceleration in brain structure aging trajectories. Extended longitudinal research will need to corroborate findings of emerging maturational lags in relation to mood disorder risk and onset.
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Affiliation(s)
- Laura de Nooij
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Emma L. Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Stella W. Y. Chan
- Section of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Tim B. Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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7
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de Nooij L, Harris MA, Hawkins EL, Clarke TK, Shen X, Chan SWY, Ziermans TB, McIntosh AM, Whalley HC. Longitudinal trajectories of brain age in young individuals at familial risk of mood disorder. Wellcome Open Res 2019; 4:206. [PMID: 32954013 PMCID: PMC7479500 DOI: 10.12688/wellcomeopenres.15617.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2019] [Indexed: 11/14/2023] Open
Abstract
Background: Within young individuals, mood disorder onset may be related to changes in trajectory of brain structure development. To date, however, longitudinal prospective studies remain scarce and show partly contradictory findings, with a lack of emphasis on changes at the level of global brain patterns. Cross-sectional adult studies have applied such methods and show that mood disorders are associated with accelerated brain ageing. Currently, it remains unclear whether young individuals show differential brain structure ageing trajectories associated with onset of mood disorder and/or presence of familial risk. Methods: Participants included young individuals (15-30 years, 53%F) from the prospective longitudinal Scottish Bipolar Family Study with and without close family history of mood disorder. All were well at time of recruitment. Implementing a structural MRI-based brain age prediction model, we globally assessed individual trajectories of age-related structural change using the difference between predicted brain age and chronological age (brain-predicted age difference (brain-PAD)) at baseline and at 2-year follow-up. Based on follow-up clinical assessment, individuals were categorised into three groups: (i) controls who remained well (C-well, n = 93), (ii) high familial risk who remained well (HR-well, n = 74) and (iii) high familial risk who developed a mood disorder (HR-MD, n = 35). Results: At baseline, brain-PAD was comparable between groups. Results showed statistically significant negative trajectories of brain-PAD between baseline and follow-up for HR-MD versus C-well ( β = -0.60, p corrected < 0.001) and HR-well ( β = -0.36, p corrected = 0.02), with a potential intermediate trajectory for HR-well ( β = -0.24 years, p corrected = 0.06). Conclusions: These preliminary findings suggest that within young individuals, onset of mood disorder and familial risk may be associated with a deceleration in brain structure ageing trajectories. Extended longitudinal research will need to corroborate findings of emerging maturational lags in relation to mood disorder risk and onset.
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Affiliation(s)
- Laura de Nooij
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Emma L. Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Stella W. Y. Chan
- Section of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Tim B. Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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8
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Spruijt AM, Dekker MC, Ziermans TB, Swaab H. Educating parents to improve parent-child interactions: Fostering the development of attentional control and executive functioning. Br J Educ Psychol 2019; 90 Suppl 1:158-175. [PMID: 31392719 PMCID: PMC7380015 DOI: 10.1111/bjep.12312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 09/05/2018] [Revised: 07/01/2019] [Indexed: 11/28/2022]
Abstract
Background Parent–child interaction is essential in the development of attentional control (AC) and executive functioning (EF). Educating parents in AC and EF development may help them to respond more adaptively to their child's developmental needs. Aim This study aimed to investigate whether parents can be educated to improve interactions with their child through a compact psycho‐educational programme that focuses on fostering the development of AC and EF. Sample Parents and their children in a low‐risk sample of four‐ to eight‐year‐olds were randomly assigned to either the educational programme condition (N = 34) or the control condition (N = 36). Methods Parental supportive presence and intrusiveness were observed during home visits, and children's performance‐based AC and EF were assessed before and after the four‐session programme. Result Parents in the educational programme improved significantly in support (ηp2 = .19) and intrusiveness (ηp2 = .09) compared to controls. There was no short‐term programme mediation effect on child AC and EF through parental support and intrusiveness. This study showed, however, that parents who improved after the educational programme had children who improved on AC and EF. Conclusion Parent–child interaction can be enhanced in a low‐risk sample of four‐ to eight‐year‐olds using a compact educational group programme within the school community. Future studies should aim at examining variations in programme responsiveness and assessing associations between parent–child interaction and AC and EF over time.
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Affiliation(s)
- Andrea M Spruijt
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Marielle C Dekker
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands
| | - Tim B Ziermans
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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9
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Spruijt AM, Dekker MC, Ziermans TB, Swaab H. Linking Parenting and Social Competence in School-Aged Boys and Girls: Differential Socialization, Diathesis-Stress, or Differential Susceptibility? Front Psychol 2019; 9:2789. [PMID: 30697182 PMCID: PMC6340968 DOI: 10.3389/fpsyg.2018.02789] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 04/25/2018] [Accepted: 12/31/2018] [Indexed: 11/15/2022] Open
Abstract
Girls generally demonstrate superior skill levels in social competence compared to boys. The exact relations of parenting with these gender differences are currently unclear. Gender differences may occur due to exposure to different parenting strategies (differential socialization model) or due to a different impact of similar parenting strategies for boys and girls (differential susceptibility and diathesis-stress model). Objective: In this study we assessed both hypotheses using a multi-method multi-informant approach. We investigated (1) to what extent different parenting strategies mediate the relation between gender and social competence and (2) whether gender and age moderate the relation between parenting strategies and social competence. Design: Parenting strategies were observed during home visits and social competence was assessed using parent and teacher questionnaires and performance-based neurocognitive tasks (N = 98, aged 4 to 8). Results: (1) Parenting strategies did not mediate the relation between gender and social competence. (2) Gender moderated the association between parental questioning style and children’s level of social competence: parents asking fewer questions was associated with poorer social cognitive skills in boys only. Parental supportive presence and intrusiveness were related to aspects of social competence irrespective of gender. Age moderated the relation between parenting and aspects of social competence, though in various (unexpected) directions. Conclusion: Our findings do not support the differential socialization hypothesis and provide partial evidence for a diathesis-stress model as an explanation for parental influence on gender differences in social competence.
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Affiliation(s)
- Andrea M Spruijt
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Marielle C Dekker
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Tim B Ziermans
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
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Wüsten C, Schlier B, Jaya ES, Fonseca-Pedrero E, Peters E, Verdoux H, Woodward TS, Ziermans TB, Lincoln TM. Psychotic Experiences and Related Distress: A Cross-national Comparison and Network Analysis Based on 7141 Participants From 13 Countries. Schizophr Bull 2018; 44:1185-1194. [PMID: 29982814 PMCID: PMC6192474 DOI: 10.1093/schbul/sby087] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Psychotic experiences (PEs) are common in the general population but do not necessarily reflect a risk status if they occur in relative isolation or are not distressing. Emerging evidence suggests that PEs might be experienced as more benign for individuals from collectivistic low- and middle-income countries (LAMIC) compared with individualistic high-income countries (HIC). The aim of this study was to determine whether: (1) self-reported PEs are less distressing in community samples from LAMIC than from HIC; (2) the network of PEs is significantly less connected in a sample from LAMIC than from HIC. Adults from 8 HIC (n = 4669) and 5 LAMIC (n = 2472) were compared. The lifetime frequency of PEs and related distress were assessed with the Community Assessment of Psychic Experiences. We analyzed the associations of PEs with distress and country type. The interconnection of PEs was visualized by a network analysis and tested for differences in global connection strengths. The average endorsement rates of PEs were significantly higher in LAMIC than in HIC (χ2 = 1772.87, P < .01, Φcramer = 0.50). There was a universal positive correlation between higher frequency of PEs and more distress, but the distress levels controlled for frequency were significantly higher in HIC (R2 = 0.11; b = 0.26; SE = 0.01; T = 17.68; P < .001). Moreover, the network of PEs was significantly less connected in LAMIC (S = 0.40, P < .05). The findings indicate that PEs are of less clinical relevance in LAMIC compared with HIC. The universal use of current high-risk criteria might thus not be adequate without consideration of associated distress and cultural values.
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Affiliation(s)
- Caroline Wüsten
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
| | - Björn Schlier
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
| | - Edo S Jaya
- Psychosis Studies Research Group, Faculty of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, La Rioja, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Hélène Verdoux
- Univ. Bordeaux, U1219 Bordeaux Population Health Research Center, Bordeaux, France
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Tim B Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
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Spruijt AM, Dekker MC, Ziermans TB, Swaab H. Attentional control and executive functioning in school-aged children: Linking self-regulation and parenting strategies. J Exp Child Psychol 2018; 166:340-359. [DOI: 10.1016/j.jecp.2017.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 08/18/2017] [Accepted: 09/01/2017] [Indexed: 10/18/2022]
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Abstract
BACKGROUND Autism is generally associated with poor functional outcome but little is known about predictors of quality of life, especially during early adulthood. This study was conducted to assess subjective quality of life during early adulthood in high-functioning autism spectrum disorder and its relation with self-regulating abilities. Individuals with high-functioning autism spectrum disorder who progressed into post-secondary higher education ( N = 75) were compared to a typical peer control group ( N = 28) based on behavioral self-report questionnaires. The results indicated that individuals with high-functioning autism spectrum disorder reported significantly lower subjective quality of life than typical controls ( p < 0.001, effect size ( d) = 1.84). In addition, individuals with high-functioning autism spectrum disorder reported more problems with emotion processing ( p < 0.05, effect size ( d) = 0.79) and daily executive functioning ( p < 0.001, effect size ( d) = 1.29) than controls. A higher level of executive functioning problems was related to lower quality of life in the high-functioning autism spectrum disorder group, but no significant relation between level of emotion processing and subjective quality of life became apparent in the regression analysis. Our findings show that even in high-functioning young adults with autism, executive functioning, emotion processing, and subjective quality of life are low compared to typically developing peers. Furthermore, these results emphasize the importance of targeting executive functioning problems in individuals with autism to improve subjective quality of life.
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Affiliation(s)
- Renee R Dijkhuis
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
| | - Tim B Ziermans
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
| | - Sophie Van Rijn
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
| | - Wouter G Staal
- Karakter Universitair Centrum, The Netherlands
- Radboud Universitair Medisch Centrum, The Netherlands
| | - Hanna Swaab
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
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Dekker MC, Ziermans TB, Spruijt AM, Swaab H. Cognitive, Parent and Teacher Rating Measures of Executive Functioning: Shared and Unique Influences on School Achievement. Front Psychol 2017; 8:48. [PMID: 28194121 PMCID: PMC5276999 DOI: 10.3389/fpsyg.2017.00048] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/09/2017] [Indexed: 12/13/2022] Open
Abstract
Very little is known about the relative influence of cognitive performance-based executive functioning (EF) measures and behavioral EF ratings in explaining differences in children's school achievement. This study examined the shared and unique influence of these different EF measures on math and spelling outcome for a sample of 84 first and second graders. Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF), and children were tested with computer-based performance tests from the Amsterdam Neuropsychological Tasks (ANT). Mixed-model hierarchical regression analyses, including intelligence level and age, showed that cognitive performance and teacher's ratings of working memory and shifting concurrently explained differences in spelling. However, teacher's behavioral EF ratings did not explain any additional variance in math outcome above cognitive EF performance. Parent's behavioral EF ratings did not add any unique information for either outcome measure. This study provides support for the ecological validity of performance- and teacher rating-based EF measures, and shows that both measures could have a complementary role in identifying EF processes underlying spelling achievement problems. The early identification of strengths and weaknesses of a child's working memory and shifting capabilities, might help teachers to broaden their range of remedial intervention options to optimize school achievement.
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Affiliation(s)
- Marielle C. Dekker
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden UniversityLeiden, Netherlands
| | - Tim B. Ziermans
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden UniversityLeiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden UniversityLeiden, Netherlands
| | - Andrea M. Spruijt
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden UniversityLeiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden UniversityLeiden, Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden UniversityLeiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden UniversityLeiden, Netherlands
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Dekker MC, Ziermans TB, Swaab H. The impact of behavioural executive functioning and intelligence on math abilities in children with intellectual disabilities. J Intellect Disabil Res 2016; 60:1086-1096. [PMID: 27028315 DOI: 10.1111/jir.12276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/05/2016] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Little is known about the role of behavioural executive functioning (EF) skills and level of intelligence (IQ) on math abilities in children with mild to borderline intellectual disabilities. METHOD Teachers of 63 children attending a school for special education (age: 10 to 13 years; IQ: 50 to 85) filled out a Behaviour Rating Inventory for Executive Function for each student. Furthermore, students took a standardised national composite math test and a specific math test on measurement and time problems. Information on level of intelligence was gathered through school records. Multiple regression analyses were performed to test direct, moderating and mediating effects of EF and IQ on math performance. RESULTS Behavioural problems with working memory and flexibility had a direct negative effect on math outcome, while concurrently, level of intelligence had a positive effect. The effect of IQ on math skills was moderated by problems with inhibition: in children with a clinical level of inhibition problems, there was no effect of level of intelligence on math performance. CONCLUSIONS Findings suggest that in students with mild to borderline intellectual disabilities and math difficulties, it is important to address their strengths and weaknesses with respect to EF and adjust instruction and remedial intervention accordingly.
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Affiliation(s)
- M C Dekker
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands.
| | - T B Ziermans
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - H Swaab
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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de Wit S, Ziermans TB, Nieuwenhuis M, Schothorst PF, van Engeland H, Kahn RS, Durston S, Schnack HG. Individual prediction of long-term outcome in adolescents at ultra-high risk for psychosis: Applying machine learning techniques to brain imaging data. Hum Brain Mapp 2016; 38:704-714. [PMID: 27699911 DOI: 10.1002/hbm.23410] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 11/11/2022] Open
Abstract
An important focus of studies of individuals at ultra-high risk (UHR) for psychosis has been to identify biomarkers to predict which individuals will transition to psychosis. However, the majority of individuals will prove to be resilient and go on to experience remission of their symptoms and function well. The aim of this study was to investigate the possibility of using structural MRI measures collected in UHR adolescents at baseline to quantitatively predict their long-term clinical outcome and level of functioning. We included 64 UHR individuals and 62 typically developing adolescents (12-18 years old at recruitment). At six-year follow-up, we determined resilience for 43 UHR individuals. Support Vector Regression analyses were performed to predict long-term functional and clinical outcome from baseline MRI measures on a continuous scale, instead of the more typical binary classification. This led to predictive correlations of baseline MR measures with level of functioning, and negative and disorganization symptoms. The highest correlation (r = 0.42) was found between baseline subcortical volumes and long-term level of functioning. In conclusion, our results show that structural MRI data can be used to quantitatively predict long-term functional and clinical outcome in UHR individuals with medium effect size, suggesting that there may be scope for predicting outcome at the individual level. Moreover, we recommend classifying individual outcome on a continuous scale, enabling the assessment of different functional and clinical scales separately without the need to set a threshold. Hum Brain Mapp 38:704-714, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sanne de Wit
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Tim B Ziermans
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - M Nieuwenhuis
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Patricia F Schothorst
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Herman van Engeland
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - René S Kahn
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Sarah Durston
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Hugo G Schnack
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, the Netherlands
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16
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de Wit S, Wierenga LM, Oranje B, Ziermans TB, Schothorst PF, van Engeland H, Kahn RS, Durston S. Brain development in adolescents at ultra-high risk for psychosis: Longitudinal changes related to resilience. Neuroimage Clin 2016; 12:542-549. [PMID: 27672558 PMCID: PMC5030366 DOI: 10.1016/j.nicl.2016.08.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 07/01/2016] [Accepted: 08/12/2016] [Indexed: 01/21/2023]
Abstract
Background The main focus of studies of individuals at ultra-high risk for psychosis (UHR) has been on identifying brain changes in those individuals who will develop psychosis. However, longitudinal studies have shown that up to half of UHR individuals are resilient, with symptomatic remission and good functioning at follow-up. Yet little is known about brain development in resilient individuals. Therefore, the aim of this study was to investigate differences in brain development between resilient and non-resilient individuals. Methods A six-year longitudinal structural MRI study was performed with up to three scans per individual. The final sample consisted of 48 UHR individuals and 48 typically developing controls with a total of 225 MRI-scans, aged 12–20 years at the time of the first MRI-scan and matched for age, gender and number of follow-up scans. At six-year follow-up, 35 UHR individuals were divided in resilient (good functional outcome) and non-resilient (poor functional outcome) subgroups, defined by the modified Global Assessment of Functioning. The main outcome measures were developmental changes in MR-based measures of cortical and subcortical anatomy. Results We found widespread differences in volume of frontal, temporal and parietal cortex between resilient and non-resilient individuals. These were already present at baseline and remained stable over development (12–24 years). Furthermore, there were differences in the development of cortical surface area in frontal regions including cingulate gyrus. Conclusions Developmental differences may reflect compensatory neural mechanisms, where better functioning in resilient individuals leads to less tissue loss over development. Is brain development different between resilient and non-resilient UHR individuals? We performed a longitudinal MRI study with up to three scans per individual. Resilience was defined by functional outcome at 6-year follow-up. Widespread differences were found, primarily in volume and cortical surface area. Developmental differences may reflect compensatory neural mechanisms.
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Affiliation(s)
- Sanne de Wit
- NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Corresponding author at: NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, HP A01.126 (B01.108), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.NICHE labDepartment of PsychiatryUniversity Medical Center UtrechtBrain Center Rudolf MagnusHP A01.126 (B01.108)Heidelberglaan 100Utrecht3584 CXThe Netherlands
| | - Lara M. Wierenga
- NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Bob Oranje
- NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Tim B. Ziermans
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Patricia F. Schothorst
- NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Herman van Engeland
- NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - René S. Kahn
- NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Sarah Durston
- NICHE lab, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
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Therman S, Ziermans TB. Confirmatory factor analysis of psychotic-like experiences in a general population sample. Psychiatry Res 2016; 235:197-9. [PMID: 26738980 DOI: 10.1016/j.psychres.2015.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 05/26/2015] [Revised: 10/16/2015] [Accepted: 12/15/2015] [Indexed: 11/16/2022]
Abstract
Psychotic-like experiences (PLEs) are sub-psychotic expressions of the psychosis continuum. Several studies have suggested multifactorial models, including a bifactor model, of the putative PLEs assessed with the popular Community Assessment of Psychic Experiences (CAPE) questionnaire. Our confirmatory results in a gender-balanced population of adolescents and young adults support a three-factor Paranoia-Delusions-Hallucinations structure of PLEs, which excludes Grandiosity and Common Paranormal Beliefs. The best latent models achieved excellent fit when taking the categorical nature of the responses into consideration.
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Affiliation(s)
- Sebastian Therman
- Department of Health, National Institute of Health and Welfare, Helsinki, Finland; Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands.
| | - Tim B Ziermans
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
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de Wit S, Schothorst PF, Oranje B, Ziermans TB, Durston S, Kahn RS. Adolescents at ultra-high risk for psychosis: long-term outcome of individuals who recover from their at-risk state. Eur Neuropsychopharmacol 2014; 24:865-73. [PMID: 24636460 DOI: 10.1016/j.euroneuro.2014.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 12/22/2013] [Revised: 02/10/2014] [Accepted: 02/11/2014] [Indexed: 11/19/2022]
Abstract
Studies of individuals at ultra-high risk (UHR) for psychosis have mostly reported on long-term outcome of those individuals who develop psychosis compared to those who do not. However, these studies show that a large number of UHR individuals no longer meet criteria for UHR at follow-up. Therefore, this study aimed to investigate functioning at 6-year follow-up in remitted individuals, and to explore the course of their clinical symptoms. Forty-four UHR adolescents completed extensive clinical assessments at baseline and participated in long-term follow-up approximately six years later. UHR adolescents who had either converted to psychosis or who still met UHR criteria (n=26) at follow-up were compared to individuals who had remitted from their UHR status (n=18) on clinical and psychosocial variables. Results show that more than 40% of UHR individuals had fully remitted from their UHR status. At six-year follow-up, remitted individuals had improved clinically on most symptoms. The course of their symptoms showed that the most substantial reduction in positive symptoms occurred within the first two years, while improvements in general, mood and anxiety symptoms occurred at a later stage. Baseline socio-demographic characteristics and clinical symptoms did not distinguish between remitters and non-remitters. Although remitters no longer met criteria for UHR, they did meet diagnostic criteria for a wide range of psychiatric disorders. Our findings suggest that, when related to long-term outcome, UHR criteria capture non-specific psychotic symptoms rather than risk for psychosis per se and relate more to general psychopathology.
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Affiliation(s)
- S de Wit
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands.
| | - P F Schothorst
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - B Oranje
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - T B Ziermans
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
| | - S Durston
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - R S Kahn
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
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Ziermans TB. Working memory capacity and psychotic-like experiences in a general population sample of adolescents and young adults. Front Psychiatry 2013; 4:161. [PMID: 24348432 PMCID: PMC3847810 DOI: 10.3389/fpsyt.2013.00161] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 10/24/2013] [Accepted: 11/20/2013] [Indexed: 01/13/2023] Open
Abstract
Working memory (WM) impairment is a common feature in individuals with schizophrenia and high-risk for psychosis and a promising target for early intervention strategies. However, it is unclear to what extent WM impairment parallels specific behavioral symptoms along the psychosis continuum. To address this issue, the current study investigated the relation of WM capacity with psychotic-like experiences (PLEs) in a large Swedish population sample (N = 1012) of adolescents and young adults (M = 24.4 years, range 12-35). WM was assessed with two online computer tasks: a task where participants had to identify and remember the location of an odd shape and a task of remembering and following instructions. PLE scores were derived from a translated symptom questionnaire (Community Assessment of Psychic Experiences), which includes positive, negative, and depressive symptom scales. Positive and negative symptom scales were further subdivided into symptom clusters based on factor analyses. The results showed that low WM capacity was modestly associated with increased reports of bizarre experiences (BE) and depressive symptoms, after controlling for age, gender, and global symptom scores. Interestingly, when analyses were repeated for separate age groups, low WM was exclusively associated with a higher frequency of BE for young adults (20-27 years) and with depressive symptoms for older adults (28-35 years). These findings suggest that specific PLEs can be indicative of reduced WM capacity in early adulthood, which in turn may reflect an increased risk for psychosis and a greater need for targeted intervention. In contrast, during adolescence individual differences in cognitive development may influence the strength of the relationships and thereby mask potential vulnerabilities for psychopathology.
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Affiliation(s)
- Tim B Ziermans
- Department of Clinical Child and Adolescent Studies, Leiden University , Leiden , Netherlands ; Department of Neuroscience, Karolinska Institutet, Stockholm Brain Institute , Stockholm , Sweden
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Ziermans TB, Schothorst PF, Schnack HG, Koolschijn PCMP, Kahn RS, van Engeland H, Durston S. Progressive structural brain changes during development of psychosis. Schizophr Bull 2012; 38:519-30. [PMID: 20929968 PMCID: PMC3329986 DOI: 10.1093/schbul/sbq113] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Ultra-high risk (UHR) for psychosis has been associated with widespread structural brain changes in young adults. The onset of these changes and their subsequent progression over time are not well understood. METHODS Rate of brain change over time was investigated in 43 adolescents at UHR for psychosis compared with 30 healthy controls. Brain volumes (total brain, gray matter, white matter [WM], cerebellum, and ventricles), cortical thickness, and voxel-based morphometry were measured at baseline and at follow-up (2 y after baseline) and compared between UHR individuals and controls. Post hoc analyses were done for UHR individuals who became psychotic (N = 8) and those who did not (N = 35). RESULTS UHR individuals showed a smaller increase in cerebral WM over time than controls and more cortical thinning in the left middle temporal gyrus. Post hoc, a more pronounced decrease over time in total brain and WM volume was found for UHR individuals who became psychotic relative to controls and a greater decrease in total brain volume than individuals who were not psychotic. Furthermore, UHR individuals with subsequent psychosis displayed more thinning than controls in widespread areas in the left anterior cingulate, precuneus, and temporo-parieto-occipital area. Volume loss in the individuals who developed psychosis could not be attributed to medication use. CONCLUSION The development of psychosis during adolescence is associated with progressive structural brain changes around the time of onset. These changes cannot be attributed to (antipsychotic) medication use and are therefore likely to reflect a pathophysiological process related to clinical manifestation of psychosis.
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Affiliation(s)
- Tim B Ziermans
- Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, the Netherlands.
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Ziermans TB, Schothorst PF, Sprong M, Magnée MJCM, van Engeland H, Kemner C. Reduced prepulse inhibition as an early vulnerability marker of the psychosis prodrome in adolescence. Schizophr Res 2012; 134:10-5. [PMID: 22085828 DOI: 10.1016/j.schres.2011.10.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 10/04/2011] [Accepted: 10/20/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND The onset of psychosis is thought to be preceded by neurodevelopmental changes in the brain. However, the timing and nature of these changes have not been established. The aim of the present study was to determine whether three "classic" neurophysiological markers of schizophrenia are also characteristic of young adolescents (12-18 years) at ultra-high risk for psychosis (UHR). METHODS 63 young UHR individuals and 68 typically developing, age-, sex- and IQ-matched controls were recruited for neurophysiological assessment. Data for P50 suppression, prepulse inhibition (PPI) and smooth pursuit eye movements (SPEM) were gathered and compared. RESULTS UHR individuals showed reduced PPI compared to controls, which became more pronounced when controls were directly compared to medication-naive UHR individuals (N=39). There were no group differences in P50 or SPEM measures. CONCLUSIONS These results suggest that PPI is a relatively early vulnerability marker, while changes in other neurophysiological measures may only be detected or affected later during the illness course. Antipsychotic and antidepressant medication may aid in elevating PPI levels and potentially have a neuroprotective effect.
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Affiliation(s)
- Tim B Ziermans
- Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
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Ziermans TB, Schothorst PF, Sprong M, van Engeland H. Transition and remission in adolescents at ultra-high risk for psychosis. Schizophr Res 2011; 126:58-64. [PMID: 21095104 DOI: 10.1016/j.schres.2010.10.022] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 10/21/2010] [Accepted: 10/24/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Future success of early intervention initiatives to prevent the onset of psychosis will rely on the validity of methods to predict clinical outcome. Proper identification is particularly essential for young adolescents, as psychotic-like symptoms are often transitory during this period and mislabeling can lead to early stigmatization and unnecessary treatment. This article presents results from a prospective, naturalistic 2-year follow-up study of a cohort of young adolescents putatively at ultra-high risk (UHR) for psychosis. METHODS Seventy-two adolescents between 12 and 18years were recruited, fulfilling either UHR criteria or the basic symptom-based criterion cognitive disturbances (COGDIS). Incidence of transition as well as the remission rate from UHR status was calculated. Individuals who made a transition (UHR-P) were compared to those who did not (UHR-NP) and to those who remitted (UHR-R) on socio-demographic and clinical characteristics. RESULTS Fifty-seven UHR individuals completed the 2-year follow-up assessment. The confirmed transition rate was 15.6% and 35.3% still met UHR criteria. The remaining 49.1% had remitted from an initial UHR status. The UHR subgroups did not differ on socio-demographic or clinical variables at baseline. CONCLUSIONS Half of young adolescents meeting UHR criteria continue to experience prodromal or psychotic symptoms after 2 years. However, they are at least three times more likely to have remitted from their UHR status than to have made a transition to psychosis. In addition, baseline characteristics are not indicative of clinical outcome at follow-up. Our results emphasize the need for further improvement and stratification of relative risk factors for psychosis.
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Affiliation(s)
- Tim B Ziermans
- Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands.
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Ziermans TB, Durston S, Sprong M, Nederveen H, van Haren NEM, Schnack HG, Lahuis BE, Schothorst PF, van Engeland H. No evidence for structural brain changes in young adolescents at ultra high risk for psychosis. Schizophr Res 2009; 112:1-6. [PMID: 19419840 DOI: 10.1016/j.schres.2009.04.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 04/07/2009] [Accepted: 04/12/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The onset of psychosis is thought to be preceded by neurodevelopmental changes in the brain. However, the timing of these changes has not been established. We investigated structural brain changes in a sample of young adolescents (12-18 years) at ultra high-risk for psychosis (UHR). METHODS Structural MRI data from young UHR subjects (n=54) and typically developing, matched controls (n=54) were acquired with a 1.5 Tesla scanner and compared. RESULTS None of the measures differed between UHR subjects and controls. CONCLUSIONS Our results do not support the presence of gross neuroanatomical changes in young UHR subjects. This suggests that early changes are too subtle to detect with conventional imaging techniques. Therefore, changes observed in older cohorts may only onset later developmentally or occur secondary to prodromal symptoms.
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Affiliation(s)
- Tim B Ziermans
- Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, the Netherlands.
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