Pub Date : 2017-12-05DOI: 10.1080/20017022.2017.1407192
Wencke Chodan, F. Hässler, O. Reis
ABSTRACT Objective: Sexual abuse is reported to be more prevalent among children with intellectual disabilities (ID), which emphasizes the need for preventive measures to be taken. The few studies on prevention programmes show methodical weaknesses, such as small sample sizes, a lack of a control group, or invalid outcome measures. This study aims to develop and evaluate a sexual abuse prevention programme that is tailored to the needs of girls with ID and that eliminates many of these weaknesses. Method: The study will enrol 120 girls aged 8–12 with mild ID recruited at special schools. After block randomization, the effects of the prevention programme will be examined in a controlled four-time follow-up design. Preventive skills will be assessed in terms of individual changes in measures of knowledge, verbal reports of anticipated behaviour, role plays, and in situ probes. In situ probes will assess participants’ behaviour in a realistic setting, with participants being unaware of the evaluation. All assessments will be videotaped and rated by blind raters. Discussion: This study will be the first randomized controlled trial on the effectiveness of a prevention programme for girls with ID using valid outcome measures with a large sample. It will meet the criteria established for evaluation studies of prevention.
{"title":"A randomized controlled trial on the effectiveness of a sexual abuse prevention programme for girls with intellectual disabilities: study protocol","authors":"Wencke Chodan, F. Hässler, O. Reis","doi":"10.1080/20017022.2017.1407192","DOIUrl":"https://doi.org/10.1080/20017022.2017.1407192","url":null,"abstract":"ABSTRACT Objective: Sexual abuse is reported to be more prevalent among children with intellectual disabilities (ID), which emphasizes the need for preventive measures to be taken. The few studies on prevention programmes show methodical weaknesses, such as small sample sizes, a lack of a control group, or invalid outcome measures. This study aims to develop and evaluate a sexual abuse prevention programme that is tailored to the needs of girls with ID and that eliminates many of these weaknesses. Method: The study will enrol 120 girls aged 8–12 with mild ID recruited at special schools. After block randomization, the effects of the prevention programme will be examined in a controlled four-time follow-up design. Preventive skills will be assessed in terms of individual changes in measures of knowledge, verbal reports of anticipated behaviour, role plays, and in situ probes. In situ probes will assess participants’ behaviour in a realistic setting, with participants being unaware of the evaluation. All assessments will be videotaped and rated by blind raters. Discussion: This study will be the first randomized controlled trial on the effectiveness of a prevention programme for girls with ID using valid outcome measures with a large sample. It will meet the criteria established for evaluation studies of prevention.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20017022.2017.1407192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46634299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-21DOI: 10.1080/20017022.2017.1309879
L. Newman, F. Judd, A. Komiti
ABSTRACT This paper aims is to examine the neurodevelopmental and psychosocial outcomes of infants born to mothers with antenatal anxiety and determine whether perinatal interventions can mitigate the negative effects of maternal anxiety.
{"title":"Developmental implications of maternal antenatal anxiety mechanisms and approaches to intervention","authors":"L. Newman, F. Judd, A. Komiti","doi":"10.1080/20017022.2017.1309879","DOIUrl":"https://doi.org/10.1080/20017022.2017.1309879","url":null,"abstract":"ABSTRACT This paper aims is to examine the neurodevelopmental and psychosocial outcomes of infants born to mothers with antenatal anxiety and determine whether perinatal interventions can mitigate the negative effects of maternal anxiety.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20017022.2017.1309879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46415801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neurological soft signs (NSS), minor and subtle neurological abnormalities in sensory integration and motor performance that are not part of a properly defined neurological syndrome, have been consistently observed in patients with schizophrenia. The prevalence estimates of NSS in patients with schizophrenia have been reported to be higher than in healthy subjects. Current evidence suggests that NSS are an integral part of the disease and cannot be fully explained by the exposure to antipsychotic medication, as they are already present in treatment-naïve patients. NSS have been associated with cardinal features of the disorder such as cognitive impairment, psychopathological severity, or functional outcome. The increased prevalence of NSS and/or related motor precursors has been described at different stages of development (infancy, childhood, adolescence) in those subjects who later developed schizophrenia. Evidence from family and twin studies indicates that genetic factors play an important role in the emergence of NSS, and some authors have already suggested that such neurological anomalies are suitable endophenotypes for schizophrenia. Some genetic association studies based on a candidate gene approach have already reported the association of genetic variants with the severity of NSS. This non-systematic review describes the potential relevance of NSS 1) in the understanding of schizophrenia as a neurodevelopmental disorder, 2) as outcome predictors, 3) as biological markers during several stages of development, and 4) as a candidate (endo)phenotype for genetic analyses. Likewise, the possibilities afforded by the advances in high-throughput techniques in genomic analysis are also discussed.
{"title":"Neurological soft signs in patients with schizophrenia: current knowledge and future perspectives in the post-genomics era","authors":"S. Papiol, M. Fatjó-Vilas, T. Schulze","doi":"10.3402/tdp.v4.30071","DOIUrl":"https://doi.org/10.3402/tdp.v4.30071","url":null,"abstract":"Neurological soft signs (NSS), minor and subtle neurological abnormalities in sensory integration and motor performance that are not part of a properly defined neurological syndrome, have been consistently observed in patients with schizophrenia. The prevalence estimates of NSS in patients with schizophrenia have been reported to be higher than in healthy subjects. Current evidence suggests that NSS are an integral part of the disease and cannot be fully explained by the exposure to antipsychotic medication, as they are already present in treatment-naïve patients. NSS have been associated with cardinal features of the disorder such as cognitive impairment, psychopathological severity, or functional outcome. The increased prevalence of NSS and/or related motor precursors has been described at different stages of development (infancy, childhood, adolescence) in those subjects who later developed schizophrenia. Evidence from family and twin studies indicates that genetic factors play an important role in the emergence of NSS, and some authors have already suggested that such neurological anomalies are suitable endophenotypes for schizophrenia. Some genetic association studies based on a candidate gene approach have already reported the association of genetic variants with the severity of NSS. This non-systematic review describes the potential relevance of NSS 1) in the understanding of schizophrenia as a neurodevelopmental disorder, 2) as outcome predictors, 3) as biological markers during several stages of development, and 4) as a candidate (endo)phenotype for genetic analyses. Likewise, the possibilities afforded by the advances in high-throughput techniques in genomic analysis are also discussed.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v4.30071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69951227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Knospe, T. J. Gaber, Peter Aretz, J. Wong, F. Zepf
Background Neurofeedback (NF) is a physiological method that enables a subject to learn how to regulate his or her own brain activity. NF can be used as an alternative treatment for symptoms of attention deficit hyperactivity disorder (ADHD) via improved cortical self-regulation of brain potentials known to be related to ADHD symptoms such as changed attentional control, impulsive behaviours, and hyperactivity. However, no detailed teaching resources or tutorials are available to date, which allow a thorough teaching approach covering the technical aspects of electroencephalography (EEG)-based NF administration. Methods To allow a flexible and easily accessible online resource for teaching the administration of NF, an online teaching module was developed (NF-eTutorial). Specifically, this online tutorial module was developed for one of the most commonly used NF systems (TheraPrax EEG-neurofeedback device, NeuroConn, Ilmenau, Germany) currently available. The NF-eTutorial was implemented and made available to medical students who were interested in NF administration via the eMedia Skills lab of RWTH Aachen University (www.emedia-medizin.rwth-aachen.de/). Furthermore, this tutorial was also used as a resource to educate clinicians, patients, and carers about NF. This short article aims to present the development and specific features of the newly developed NF-eTutorial resource in a brief and descriptive manner. Results The NF-eTutorial comprises the following components: 1) Basic introduction (overview and information on using NF in patients with ADHD, outline of the training schedule, and basic scientific information on NF); 2) Correct handling of the electrodes (electrode and skin preparation, positioning of the electrodes, linking the system to the amplifier of the NF system, disconnecting the electrodes, and cleaning and storing of the electrodes); 3) Using the NF device (detailed guide to specific technical settings); 4) Explanation of specific tasks of the patient when engaging in NF training; 5) Aspects of NF training (checklists and training protocols that can assist the use of NF as a therapeutic application); and 6) Aspects of signal quality (step-by-step guide to troubleshooting and artefact correction). Summary The NF-eTutorial is the first web-based platform that allows access to detailed and practical information on the administration of EEG-based NF. Future research and development should focus on the practical use of such NF-related web-based tutorials with regard to the administration of NF by different groups of trainers, such as professionals, allied health staff and also lay people. This in turn will facilitate high-quality NF training for young patients with ADHD in non-clinical environments such as home and school.
{"title":"A web-based teaching module on the administration of EEG-based neurofeedback for the treatment of ADHD","authors":"E. Knospe, T. J. Gaber, Peter Aretz, J. Wong, F. Zepf","doi":"10.3402/tdp.v4.30339","DOIUrl":"https://doi.org/10.3402/tdp.v4.30339","url":null,"abstract":"Background Neurofeedback (NF) is a physiological method that enables a subject to learn how to regulate his or her own brain activity. NF can be used as an alternative treatment for symptoms of attention deficit hyperactivity disorder (ADHD) via improved cortical self-regulation of brain potentials known to be related to ADHD symptoms such as changed attentional control, impulsive behaviours, and hyperactivity. However, no detailed teaching resources or tutorials are available to date, which allow a thorough teaching approach covering the technical aspects of electroencephalography (EEG)-based NF administration. Methods To allow a flexible and easily accessible online resource for teaching the administration of NF, an online teaching module was developed (NF-eTutorial). Specifically, this online tutorial module was developed for one of the most commonly used NF systems (TheraPrax EEG-neurofeedback device, NeuroConn, Ilmenau, Germany) currently available. The NF-eTutorial was implemented and made available to medical students who were interested in NF administration via the eMedia Skills lab of RWTH Aachen University (www.emedia-medizin.rwth-aachen.de/). Furthermore, this tutorial was also used as a resource to educate clinicians, patients, and carers about NF. This short article aims to present the development and specific features of the newly developed NF-eTutorial resource in a brief and descriptive manner. Results The NF-eTutorial comprises the following components: 1) Basic introduction (overview and information on using NF in patients with ADHD, outline of the training schedule, and basic scientific information on NF); 2) Correct handling of the electrodes (electrode and skin preparation, positioning of the electrodes, linking the system to the amplifier of the NF system, disconnecting the electrodes, and cleaning and storing of the electrodes); 3) Using the NF device (detailed guide to specific technical settings); 4) Explanation of specific tasks of the patient when engaging in NF training; 5) Aspects of NF training (checklists and training protocols that can assist the use of NF as a therapeutic application); and 6) Aspects of signal quality (step-by-step guide to troubleshooting and artefact correction). Summary The NF-eTutorial is the first web-based platform that allows access to detailed and practical information on the administration of EEG-based NF. Future research and development should focus on the practical use of such NF-related web-based tutorials with regard to the administration of NF by different groups of trainers, such as professionals, allied health staff and also lay people. This in turn will facilitate high-quality NF training for young patients with ADHD in non-clinical environments such as home and school.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v4.30339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69950897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John Hasslinger, S. Sirviö, S. Berggren, Lynnea Myers, Oskar Flygare, K. Tammimies, S. Bölte
Today, the treatment for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) is predominantly pharmacological. However, not all individuals respond to medication or some may experience problematic side effects. In addition, the compliance and treatment fidelity to medication is sometimes limited; thus, effective non-pharmacological treatment options are desirable. Neurocognitive training (NCT) methods such neurofeedback (NF) and working memory (WMt) have shown efficacy treating the primary symptoms of ADHD in non-blinded trials. Still, larger, comparative, blinded, pragmatic randomized controlled trials (RCTs) are needed to ensure the efficacy and effectiveness of these methods, and to identify an optimal training variant. Furthermore, little is known about predictors of treatment response to NCTs, such as genetic variants. In this article, we present the protocol of a pragmatic RCT for three NCT methods: slow cortical potential (SCP) training and live z-score (LZS) training (two NF variants), and working memory training (WMt). These are evaluated against each other and a waiting list control/treatment as usual group. In a clinical outpatient setting, 200 children and adolescents with ADHD aged 9–17 years with common comorbidities are randomized to either one of the treatment groups or the waiting list control group (n=50/group). The treatment groups (SCP/LZS/WMt) receive a total of 25 highly frequent training sessions (5/week for 5 weeks). A comprehensive assessment comprising ADHD core symptoms, psychopathology, neuropsychology, neurophysiology, quality of life, and health-related measures are collected pre- and post-treatment and at a 6-month follow-up. Primary outcomes are blinded teacher and unblinded parent ratings and self-ratings on the Conners 3 for ADHD. We expect that participants receiving NCT will exhibit improved core ADHD symptomatology compared with waiting list controls. Moreover, we hypothesize that the type of NCT (i.e. SCP, LZS, WMt) and participant characteristics (e.g. genetic predisposition, age, IQ, gender, verbal skills, and comorbidity) will predict patterns of treatment effects on the various outcomes.
{"title":"A comparative randomized controlled pragmatic trial of neurofeedback and working memory training for children with attention-deficit/hyperactivity disorder: protocol","authors":"John Hasslinger, S. Sirviö, S. Berggren, Lynnea Myers, Oskar Flygare, K. Tammimies, S. Bölte","doi":"10.3402/tdp.v4.30556","DOIUrl":"https://doi.org/10.3402/tdp.v4.30556","url":null,"abstract":"Today, the treatment for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) is predominantly pharmacological. However, not all individuals respond to medication or some may experience problematic side effects. In addition, the compliance and treatment fidelity to medication is sometimes limited; thus, effective non-pharmacological treatment options are desirable. Neurocognitive training (NCT) methods such neurofeedback (NF) and working memory (WMt) have shown efficacy treating the primary symptoms of ADHD in non-blinded trials. Still, larger, comparative, blinded, pragmatic randomized controlled trials (RCTs) are needed to ensure the efficacy and effectiveness of these methods, and to identify an optimal training variant. Furthermore, little is known about predictors of treatment response to NCTs, such as genetic variants. In this article, we present the protocol of a pragmatic RCT for three NCT methods: slow cortical potential (SCP) training and live z-score (LZS) training (two NF variants), and working memory training (WMt). These are evaluated against each other and a waiting list control/treatment as usual group. In a clinical outpatient setting, 200 children and adolescents with ADHD aged 9–17 years with common comorbidities are randomized to either one of the treatment groups or the waiting list control group (n=50/group). The treatment groups (SCP/LZS/WMt) receive a total of 25 highly frequent training sessions (5/week for 5 weeks). A comprehensive assessment comprising ADHD core symptoms, psychopathology, neuropsychology, neurophysiology, quality of life, and health-related measures are collected pre- and post-treatment and at a 6-month follow-up. Primary outcomes are blinded teacher and unblinded parent ratings and self-ratings on the Conners 3 for ADHD. We expect that participants receiving NCT will exhibit improved core ADHD symptomatology compared with waiting list controls. Moreover, we hypothesize that the type of NCT (i.e. SCP, LZS, WMt) and participant characteristics (e.g. genetic predisposition, age, IQ, gender, verbal skills, and comorbidity) will predict patterns of treatment effects on the various outcomes.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v4.30556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69951139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background In the last decade, the prescription of atypical antipsychotics in minors, by all specialists, has increased. The use has been both licensed and ‘off-label’, with the aim of targeting different symptoms and clinical conditions. However, most research around safety and efficacy of these pharmacological agents has been conducted in adults and with repeated calls for such research in minors in vain. Objectives This survey aims to describe current prescribing practices in a ‘real-world’ scenario and to compare the results with existing research to evaluate lessons learnt. Methods The survey consisted of a semi-structured questionnaire that aimed to evaluate the current practices of Child and Adolescent Mental Health Services (CAMHS) prescribers. A total of 31 questionnaires sent out yielded 24 completed returns (77.41%). A literature search yielded articles that described prescribing trends over the last decade. The results from the survey were compared with the existing literature. Results The commonest indication for using atypical antipsychotics in minors was psychosis (75%). Other indications included reduced behavioural control (50%), tic disorders (37.5%), ADHD and anxiety disorders. Atypical antipsychotics were the commonest first-line medications for managing behavioural control with Risperidone (54%) being the most preferred agent. Second-line medications included Quetiapine (7%) and Olanzapine (15%). Doses were lower for managing behavioural control, and atypical antipsychotics were trialled for up to 8 weeks, and with duration of treatment extending up to 9 months. When such medications were used for non-psychotic presentations, most common target symptoms were aggression (85%), agitation (54%) and anxiety (54%). Most prescribers reported peer/expert opinion and their own clinical experience as evidence base for their use and clinical practice. Conclusions In the investigated sample, atypical antipsychotics continue to be used as first-line medications for psychotic and non-psychotic psychiatric presentations in minors, despite an absence of clear evidence comparable to the adult literature, and also despite repeated calls for in-depth research in this particular population. Although the present survey was conducted amongst psychiatrists, this has implications for all prescribers in children and adolescents, regardless of their specialty.
{"title":"Atypical antipsychotic prescribing patterns amongst Child and Adolescent Mental Health Services clinicians in a defined National Health Service Trust","authors":"P. Rao, F. Zepf, I. Chakrabarti, P. Sigalas","doi":"10.3402/tdp.v4.28537","DOIUrl":"https://doi.org/10.3402/tdp.v4.28537","url":null,"abstract":"Background In the last decade, the prescription of atypical antipsychotics in minors, by all specialists, has increased. The use has been both licensed and ‘off-label’, with the aim of targeting different symptoms and clinical conditions. However, most research around safety and efficacy of these pharmacological agents has been conducted in adults and with repeated calls for such research in minors in vain. Objectives This survey aims to describe current prescribing practices in a ‘real-world’ scenario and to compare the results with existing research to evaluate lessons learnt. Methods The survey consisted of a semi-structured questionnaire that aimed to evaluate the current practices of Child and Adolescent Mental Health Services (CAMHS) prescribers. A total of 31 questionnaires sent out yielded 24 completed returns (77.41%). A literature search yielded articles that described prescribing trends over the last decade. The results from the survey were compared with the existing literature. Results The commonest indication for using atypical antipsychotics in minors was psychosis (75%). Other indications included reduced behavioural control (50%), tic disorders (37.5%), ADHD and anxiety disorders. Atypical antipsychotics were the commonest first-line medications for managing behavioural control with Risperidone (54%) being the most preferred agent. Second-line medications included Quetiapine (7%) and Olanzapine (15%). Doses were lower for managing behavioural control, and atypical antipsychotics were trialled for up to 8 weeks, and with duration of treatment extending up to 9 months. When such medications were used for non-psychotic presentations, most common target symptoms were aggression (85%), agitation (54%) and anxiety (54%). Most prescribers reported peer/expert opinion and their own clinical experience as evidence base for their use and clinical practice. Conclusions In the investigated sample, atypical antipsychotics continue to be used as first-line medications for psychotic and non-psychotic psychiatric presentations in minors, despite an absence of clear evidence comparable to the adult literature, and also despite repeated calls for in-depth research in this particular population. Although the present survey was conducted amongst psychiatrists, this has implications for all prescribers in children and adolescents, regardless of their specialty.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v4.28537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69951022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antiphospholipid syndrome (APS) has been implicated in a range of neuropsychiatric presentations. However, there is a paucity of systematic studies on APS in psychiatry. This paper reports the clinical manifestations of APS that are relevant to psychiatrists. The aspects of APS pathogenesis, diagnosis, and treatment presented in this paper are based on a literature review. Treatment-resistant and atypical psychiatric illnesses, severe cognitive dysfunction, migraines, transient ischaemic attacks, and thromboembolic episodes, along with characteristic skin manifestations are the common clinical features of this syndrome. Antiphospholipid antibodies (aPL) may have a causal role in the development of some neuropsychiatric conditions. The existing criteria of APS may not apply to psychiatric patients, which may result in the underdiagnosis of APS in psychiatry. There is no evidence-based guidance available for the treatment of APS in patients with psychiatric symptoms. The treatment of APS with antithrombotic agents in case reports has been reported to yield dramatic improvements in complex and treatment-resistant cases. The possibility of a causal role of aPL in high-morbidity conditions, such as psychosis, depression, and dementia, requires the psychiatrist to be vigilant to the occurrence of this syndrome. There is an urgent need to conduct studies that elucidate the role of aPL in psychiatric presentations, identify patient characteristics, and consider whether new criteria with greater applicability in psychiatry are needed.
{"title":"Antiphospholipid antibodies as biomarkers in psychiatry: review of psychiatric manifestations in antiphospholipid syndrome","authors":"Sanil Rege, C. Mackworth-Young","doi":"10.3402/tdp.v3.25452","DOIUrl":"https://doi.org/10.3402/tdp.v3.25452","url":null,"abstract":"Antiphospholipid syndrome (APS) has been implicated in a range of neuropsychiatric presentations. However, there is a paucity of systematic studies on APS in psychiatry. This paper reports the clinical manifestations of APS that are relevant to psychiatrists. The aspects of APS pathogenesis, diagnosis, and treatment presented in this paper are based on a literature review. Treatment-resistant and atypical psychiatric illnesses, severe cognitive dysfunction, migraines, transient ischaemic attacks, and thromboembolic episodes, along with characteristic skin manifestations are the common clinical features of this syndrome. Antiphospholipid antibodies (aPL) may have a causal role in the development of some neuropsychiatric conditions. The existing criteria of APS may not apply to psychiatric patients, which may result in the underdiagnosis of APS in psychiatry. There is no evidence-based guidance available for the treatment of APS in patients with psychiatric symptoms. The treatment of APS with antithrombotic agents in case reports has been reported to yield dramatic improvements in complex and treatment-resistant cases. The possibility of a causal role of aPL in high-morbidity conditions, such as psychosis, depression, and dementia, requires the psychiatrist to be vigilant to the occurrence of this syndrome. There is an urgent need to conduct studies that elucidate the role of aPL in psychiatric presentations, identify patient characteristics, and consider whether new criteria with greater applicability in psychiatry are needed.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v3.25452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69950361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Frey, Lucy Malinowska, Katherine Harley, L. Salhi, Somya Iqbal, Sarika Sharma, C. McCabe
Background Anhedonia, the loss of pleasure in usually enjoyable activities, is a central feature of major depressive disorder (MDD). The aim of the present study was to examine whether young people at a familial risk of depression display signs of anticipatory, motivational or consummatory anhedonia, which would indicate that these deficits may be trait markers for MDD. Methods The study was completed by 22 participants with a family history of depression (FH+) and 21 controls (HC). Anticipatory anhedonia was assessed by asking participants to rate their anticipated liking of pleasant and unpleasant foods which they imagined tasting when cued with images of the foods. Motivational anhedonia was measured by requiring participants to perform key presses to obtain pleasant chocolate taste rewards or to avoid unpleasant apple tastes. Additionally, physical consummatory anhedonia was examined by instructing participants to rate the pleasantness of the acquired tastes. Moreover, social consummatory anhedonia was investigated by asking participants to make preference-based choices between neutral facial expressions, genuine smiles, and polite smiles. Results It was found that the FH+ group’s anticipated liking of unpleasant foods was significantly lower than that of the control group. By contrast, no group differences in the pleasantness ratings of the actually experienced tastes or in the amount of performed key presses were observed. However, controls preferred genuine smiles over neutral expressions more often than they preferred polite smiles over neutral expressions, while this pattern was not seen in the FH+ group. Conclusion These findings suggest that FH+ individuals demonstrate an altered anticipatory response to negative stimuli and show signs of social consummatory anhedonia, which may be trait markers for depression.
{"title":"Investigating subtypes of reward processing deficits as trait markers for depression","authors":"A. Frey, Lucy Malinowska, Katherine Harley, L. Salhi, Somya Iqbal, Sarika Sharma, C. McCabe","doi":"10.3402/tdp.v3.27517","DOIUrl":"https://doi.org/10.3402/tdp.v3.27517","url":null,"abstract":"Background Anhedonia, the loss of pleasure in usually enjoyable activities, is a central feature of major depressive disorder (MDD). The aim of the present study was to examine whether young people at a familial risk of depression display signs of anticipatory, motivational or consummatory anhedonia, which would indicate that these deficits may be trait markers for MDD. Methods The study was completed by 22 participants with a family history of depression (FH+) and 21 controls (HC). Anticipatory anhedonia was assessed by asking participants to rate their anticipated liking of pleasant and unpleasant foods which they imagined tasting when cued with images of the foods. Motivational anhedonia was measured by requiring participants to perform key presses to obtain pleasant chocolate taste rewards or to avoid unpleasant apple tastes. Additionally, physical consummatory anhedonia was examined by instructing participants to rate the pleasantness of the acquired tastes. Moreover, social consummatory anhedonia was investigated by asking participants to make preference-based choices between neutral facial expressions, genuine smiles, and polite smiles. Results It was found that the FH+ group’s anticipated liking of unpleasant foods was significantly lower than that of the control group. By contrast, no group differences in the pleasantness ratings of the actually experienced tastes or in the amount of performed key presses were observed. However, controls preferred genuine smiles over neutral expressions more often than they preferred polite smiles over neutral expressions, while this pattern was not seen in the FH+ group. Conclusion These findings suggest that FH+ individuals demonstrate an altered anticipatory response to negative stimuli and show signs of social consummatory anhedonia, which may be trait markers for depression.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v3.27517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69950474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Finger, Sooyeon Byun, Sharon M. Melnick, K. Lyons-Ruth
Objective The present study assessed whether the often reported relation between childhood abuse and the extent of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) features would be mediated by Hostile–Helpless (HH) and/or Unresolved (U) states of mind on the Adult Attachment Interview (AAI). Method One hundred and three young adults from low- to moderate-income families were assessed for HH and U states of mind on the AAI, psychopathology on the SCID I and II, and childhood abuse experiences on three validated measures of abuse. Results As expected, childhood abuse was related to extent of both BPD and ASPD features and to HH states of mind. In addition, BPD and ASPD features were significantly related to HH states of mind on the AAI, and those states of mind mediated the relations between severity of childhood abuse and later BPD and ASPD features. Contrary to predictions, scores for lack of resolution of loss or trauma on the AAI were not found to mediate the relations between childhood abuse and either BPD or ASPD. Conclusions Findings indicate that pervasively contradictory and unintegrated states of mind regarding attachment experiences play an important role in linking past abuse to current personality pathology.
{"title":"Hostile–Helpless states of mind mediate relations between childhood abuse severity and personality disorder features","authors":"B. Finger, Sooyeon Byun, Sharon M. Melnick, K. Lyons-Ruth","doi":"10.3402/tdp.v3.28785","DOIUrl":"https://doi.org/10.3402/tdp.v3.28785","url":null,"abstract":"Objective The present study assessed whether the often reported relation between childhood abuse and the extent of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) features would be mediated by Hostile–Helpless (HH) and/or Unresolved (U) states of mind on the Adult Attachment Interview (AAI). Method One hundred and three young adults from low- to moderate-income families were assessed for HH and U states of mind on the AAI, psychopathology on the SCID I and II, and childhood abuse experiences on three validated measures of abuse. Results As expected, childhood abuse was related to extent of both BPD and ASPD features and to HH states of mind. In addition, BPD and ASPD features were significantly related to HH states of mind on the AAI, and those states of mind mediated the relations between severity of childhood abuse and later BPD and ASPD features. Contrary to predictions, scores for lack of resolution of loss or trauma on the AAI were not found to mediate the relations between childhood abuse and either BPD or ASPD. Conclusions Findings indicate that pervasively contradictory and unintegrated states of mind regarding attachment experiences play an important role in linking past abuse to current personality pathology.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v3.28785","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69950907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Infancy is a critical developmental period involving establishment of the neurological underpinnings of psychological, affective and relational functioning. The integration of findings from developmental and attachment theories and neurodevelopment has contributed to greater understanding of the significance of early relationships and the developmental impact of interactional disturbance. This paper provides an overview of this framework and the implications for infant–caregiver interventions in high-risk dyads.
{"title":"Attachment and early brain development – neuroprotective interventions in infant–caregiver therapy","authors":"L. Newman, C. Sivaratnam, A. Komiti","doi":"10.3402/tdp.v3.28647","DOIUrl":"https://doi.org/10.3402/tdp.v3.28647","url":null,"abstract":"Infancy is a critical developmental period involving establishment of the neurological underpinnings of psychological, affective and relational functioning. The integration of findings from developmental and attachment theories and neurodevelopment has contributed to greater understanding of the significance of early relationships and the developmental impact of interactional disturbance. This paper provides an overview of this framework and the implications for infant–caregiver interventions in high-risk dyads.","PeriodicalId":90753,"journal":{"name":"Translational developmental psychiatry","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/tdp.v3.28647","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69950566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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