Journal of psychiatry and brain science最新文献

Pain is regulated by circadian rhythms. Daily fluctuations in pain thresholds are observed in health and disease. Disruptions to the circadian and pain systems may initiate a detrimental feedback loop between the two systems. The relationship between the pain and circadian systems is briefly reviewed to highlight a perspective on the need to consider disrupted circadian rhythms in the treatment of pain.

Significant advances in pharmacological treatments for mental illness and addiction will require abandoning old monoaminergic theories of psychiatric disorders and traditionally narrow approaches to how we conduct treatment research. Reframing our efforts with a view on integrative treatments that target core neural network function and plasticity may provide new approaches for lifting patients out of chronic psychiatric symptom sets and addiction. For example, we discuss new treatments that target brain glutamate systems at key transition points within longitudinal courses of care that integrate several treatment modalities. A reconsideration of what our novel and already available medications are intended to achieve and how and when we deliver them for patients with complex illness trajectories could be the key to unlocking new advances in general and addiction psychiatry.

Very little research has prioritized girls with ADHD, despite accumulating evidence showing that girls with ADHD experience broader and more severe peer dysfunction relative to boys with ADHD. Attention to identifying the neural mechanisms underlying the peer difficulties of girls with ADHD is critical in order to develop targeted intervention strategies to improve peer functioning. New efforts to address the peer dysfunction of girls with ADHD are discussed.

Emerging research suggests mindfulness-based therapies positively impact adults with autism spectrum disorder (ASD). However, questions concerning intervention active ingredients, the breadth and duration of impact, and psychological and neural mechanisms of change remain. Here we discuss what is known about mindfulness-based therapies in adults with ASD and offer suggestions for future research.

More than 21 million people globally are refugees. More than half of these (>10 million) are children, representing a highly vulnerable population. Most children experience high levels of trauma exposure, including war trauma, as well as substantial migration- and resettlement-related stress. These exposures confer risk for mental health problems, including posttraumatic stress disorder (PTSD), but their relative contributions have not been fully explicated. These effects may be modulated by the developmental timing of trauma and stress exposure: childhood trauma and stress are broadly linked to worse health outcomes across the lifespan, but the developmental specificity of these effects remains uncertain. Refugee children typically experience the trauma leading up to displacement (e.g., civil war) which often lasts for decades, and for some, followed by resettlement. Longitudinal studies that follow children through this process can provide unique insight into how these experiences of trauma, displacement, and resettlement during development impact mechanisms of risk and resilience. They can also elucidate how environmental and physiological factors may modulate the effects of trauma and stress. The present study includes two groups of families (parents and their 7- to 17-year-old children): (1) Syrian and Iraqi refugee families who experienced war-zone trauma before resettling in the United States in ~2016, and (2) Arab immigrant families who did not experience war-zone trauma prior to resettlement in the United States in ~2016. We assessed symptoms of anxiety, depression, and PTSD in refugee and immigrant children and parents. Skin conductance responses, a measure of autonomic response, saliva samples for genetic and epigenetic analyses, and information about social and environmental context, including family structure, resources, and neighborhood quality, were also collected. Refugee participants provided data at three time points spanning ~3 years following resettlement in the United States: Wave 1, within 1 month of resettlement, Wave 2, 12-24 months post resettlement, and Wave 3 planned for 24-36 months resettlement. Immigrant participants will provide data once, within 3-5 years after immigration, matching the age of Wave 1. This comparison group enables us to compare mental health and biomarkers between refugees and immigrants. Results of these comparative analyses will provide insight into the impact of war trauma versus other types of trauma and adversity on biomarkers of child mental health outcomes. Results from the longitudinal analyses will address refugee mental health trajectories over time, and, in children, across development. Initial data from Wave 1 showed high levels of anxiety in refugee children, as well as high levels of PTSD symptoms and anxiety in their parents. Together, results from these comparative and longitudinal analyses will provide insight into multiple aspects of trauma and stress exposure in refugees an

Early detection and intervention with young people at clinical high risk (CHR) for psychosis is critical for prevention efforts focused on altering the trajectory of psychosis. Early CHR research largely focused on validating clinical interviews for detecting at-risk individuals; however, this approach has limitations related to: (1) specificity (i.e., only 20% of CHR individuals convert to psychosis) and (2) the expertise and training needed to administer these interviews is limited. The purpose of our study is to develop the computerized assessment of psychosis risk (CAPR) battery, consisting of behavioral tasks that require minimal training to administer, can be administered online, and are tied to the neurobiological systems and computational mechanisms implicated in psychosis. The aims of our study are as follows: (1A) to develop a psychosis-risk calculator through the application of machine learning (ML) methods to the measures from the CAPR battery, (1B) evaluate group differences on the risk calculator score and test the hypothesis that the risk calculator score of the CHR group will differ from help-seeking and healthy controls, (1C) evaluate how baseline CAPR battery performance relates to symptomatic outcome two years later (i.e., conversion and symptomatic worsening). These aims will be explored in 500 CHR participants, 500 help-seeking individuals, and 500 healthy controls across the study sites. This project will provide a next-generation CHR battery, tied to illness mechanisms and powered by cutting-edge computational methods that can be used to facilitate the earliest possible detection of psychosis risk.

Depression, non-suicidal self-injury (NSSI), and suicidal thoughts and behaviors (STB) often emerge during adolescence. Despite considerable overlap in clinical presentation, risk factors, and implicated neurobiology, there is also evidence for divergence in terms of precursors, correlates, and outcomes. The complex interrelationships amongst these three clinical domains require considering both shared and divergent patterns of risk for depression, NSSI, and STB; a clearer understanding of these developmental trajectories will be needed to guide optimization and tailoring of early interventions.

Despite substantial suicide prevention efforts, US suicide rates continue to climb, currently reaching about 14 per 100,000 individuals. Suicidal behavior has been linked to neurobiological, neurocognitive and behavioral factors; however, integrative, multi-modal studies are rare. Furthermore, prospective studies, crucial to understanding future risk factors, have focused on a single predictor and a single outcome, implying that suicidal behavior is homogeneous. But recent research shows suicidal behavior is complex and heterogeneous, with the possible existence of subtypes. The present report describes a project testing a model that posits two putative subtypes, using a prospective, multi-model design. The subtypes differ in regard to the patterns of suicidal ideation and underlying mechanisms. One hundred subjects diagnosed with a Major Depressive episode, half of whom have attempted suicide in the past, are enrolled and followed for two years, notably the highest risk period for suicidal behavior. Baseline assessments include a clinical assessment, neurocognitive and behavioral tasks, Ecological Momentary Assessments (EMA), PET imaging, and a cognitive emotion regulation task in the MRI scanner. The follow-up assessment includes a clinical assessment and EMA. The study findings have the potential to pave the way for a clearer understanding of suicidal ideation and behaviors and to improve our ability to treat those at risk for suicide by developing tailored approaches that will allow for more accurate pharmacological and psychosocial interventions.