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Multiple pathway models propose that attention deficit hyperactivity disorder (ADHD) arises from dysfunction in separate systems comprised of a "cool" or cognitive pathway versus a "hot" or emotional/reward pathway. Interactions between these pathways and the degree of maturation may further determine functional outcomes for adolescents ranging from those diagnosed with ADHD to typical development (TD). We used a latent profile analysis on rating scales and behavioral task performance assessing emotion, irritability, impulsivity, risk-taking, future orientation, and processing speed (PS) to identify subgroups of TD adolescents and adolescents with ADHD (N = 152) based on the hot and cool pathway model. We identified four classes: 1) High-Complex Challenges; 2) Moderate-Mixed Challenges; 3) Non-Emotive Impulsivity; and 4) High Regulation and Control. A multiple pathway model of ADHD is supported with classes differing in degree of emotional lability and irritability, types of impulsivity, and ability to use future consequences to modulate impulsivity and PS. The classes differed regarding functional behavior, with the High-Complex class demonstrating the most severe functional challenges in academic-related functioning. The Moderate-Mixed class also displayed significant functional challenges but with moderate emotional lability and irritability ratings. The Non-Emotive Impulsivity class exhibited low emotionality and low irritability, yet high impulsivity with limited negative functional consequences, and was composed of a mix of ADHD and TD adolescents. Differences between classes suggest ADHD symptomatology may represent both categorical and dimensional differences. Precision health interventions may be more effective in addressing the specific challenges associated with the classes rather than a one-size-fits-all approach to treating ADHD.

People with dyslexia, a neurodevelopmental disorder of reading, are highly attuned to the emotional world. Compared with their typically developing peers, children with dyslexia exhibit greater autonomic nervous system reactivity and facial behaviour to emotion‐ and empathy‐inducing film clips. Affective symptoms, such as anxiety, are also more common in children with dyslexia than in those without. Here, we investigated whether the startle response, an automatic reaction that lies at the interface of emotion and reflex, is elevated in dyslexia. We measured facial behaviour, electrodermal reactivity (a sympathetic nervous system measure) and emotional experience in response to a 100 ms, 105 dB unanticipated acoustic startle task in 30 children with dyslexia and 20 comparison children without dyslexia (aged 7–13) who were matched on age, sex and nonverbal reasoning. Our results indicated that the children with dyslexia had greater total facial behaviour and electrodermal reactivity to the acoustic startle task than the children without dyslexia. Across the sample, greater electrodermal reactivity during the startle predicted greater parent‐reported anxiety symptoms. These findings contribute to an emerging picture of heightened emotional reactivity in dyslexia and suggest accentuated sympathetic nervous system reactivity may contribute to the elevated anxiety that is often seen in this population. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, a high-uncertainty situation, presents an ideal opportunity to examine how trait intolerance of uncertainty (IU) and situation-specific IU relate to each other and to mental health outcomes. The current longitudinal study examined the unique associations of trait and COVID-specific IU with general distress (anxiety and depression) and pandemic-specific concerns (pandemic stress and vaccine worry). A community sample of Florida adults (N = 2152) was surveyed online at three timepoints. They completed measures of trait IU at Wave 1 (April–May 2020) and COVID-specific IU at Wave 2 (May–June 2020). At Wave 3 (December–February 2021), they reported symptoms of depression, anxiety, pandemic stress, and vaccine worry. We used structural equation modeling to test our overall model. Trait IU significantly predicted later COVID-specific IU, however there was no significant effect of trait IU on any outcome measure after accounting for COVID-specific IU. Notably, COVID-specific IU fully mediated the relationship between trait IU and all four symptom measures. There were several limitations of the current study, including the use of a community sample and high participant attrition. Results suggest that COVID-specific IU predicts mental health outcomes over and above trait IU, extending the existing literature. These findings indicate that uncertainty may be more aversive when it is related to specific distressing situations, providing guidance for developing more specific and individualized interventions. Idiographic treatments which target situation-specific IU may be more efficacious in reducing affective symptoms and related stress during the COVID-19 pandemic or other similar events. • Intolerance of uncertainty (IU) involves both trait and situation-specific components. • The COVID-19 pandemic is an ideal opportunity to test this theoretical model of IU. • Trait IU and COVID-specific IU appear to be related but distinct constructs. • COVID-specific IU mediated the relationship between trait IU and affective symptoms. • Situation-specific IU may be an important treatment target to consider. [ABSTRACT FROM AUTHOR]

Introduction: Moyamoya disease (MMD) is a life-threatening condition characterized by stenosis of intracranial arteries. Despite the frequency and the impact of psychiatric symptoms on the long-term prognosis and quality of life of MMD patients, no systematic review on this topic exists. Methods: This systematic review and meta-analysis included 41 studies (29 being case reports), from PubMed, Scopus, Embase until 27/3/2023, on MMD patients exhibiting psychiatric symptoms. Results: Despite a fair average quality of the articles, quantitative synthesis through logistic regression was possible only for case reports, due to heterogeneity between the other studies. Psychosis, the most frequent psychiatric symptom reported in case reports, was more frequent in MMD patients with left hemisphere involvement. Neurological symptoms occurrence increased the odds of MMD diagnosis preceding psychiatric symptoms. Psychiatric symptoms are highly prevalent in MMD patients and are relatively often the only presenting symptoms. Discussion: We discuss the diagnostic, therapeutic, and prognostic implications of recognizing and characterizing specific psychiatric symptoms in MMD, outlining preliminary guidelines for targeted pharmacological and psychotherapeutic interventions. Lastly, we outline future research and clinical perspectives, striving to enhance the oft-overlooked psychiatric care for MMD patients and to ameliorate their long-term outcome. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023406303. [ABSTRACT FROM AUTHOR]

We aimed to reveal interrelationships between alexithymia, catastrophic thinking, sensory processing patterns, and dental anxiety among 460 participants who were registrants of a Japanese research company. Measures used were the Modified Dental Anxiety Scale, the Adult Sensory Profile, the Pain Catastrophizing Scale, and the 20‐item Toronto Alexithymia Scale. The interrelationships among the constructs were analyzed using structural equation modeling, adjusting for age, gender, and negative dental treatment experience. Data from 428 participants were used in the analyses. Sensory sensitivity and pain catastrophizing were independently associated with anticipatory and treatment‐related dental anxiety, while difficulty identifying feelings was not. In the mediation model, sensory sensitivity and pain catastrophizing served as full mediators between difficulty identifying feelings and the dimensions of dental anxiety (indirect effects were between 0.13 and 0.15). The strength of the associations was 0.55 from difficulty identifying feelings to both pain catastrophizing and sensory sensitivity, and between 0.24 and 0.26 to anticipatory and treatment‐related dental anxiety. The association between trait‐like phenomena, such as alexithymia, and dental anxiety may be mediated by neurophysiological and cognitive factors such as sensory sensitivity and pain catastrophizing. These findings could be crucial for new and innovative interventions for managing dental anxiety. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Felt presence (FP) is a phenomenon that might appear in individuals with mental and neurological disorders as well as those without any specific morbidity. Some studies have indicated that FP is closely related to psychotic symptomatology. Yet, the mechanisms underlying its occurrence remain largely unknown. The present study aimed to disentangle as to whether FP is associated with widely known risk factors of psychosis. Data from three independent samples of non-clinical young adults were analyzed. Self-reports were administered to assess psychopathological symptoms (samples 1 – 3), neurodevelopmental risk factors for psychosis (sample 1), social defeat components (sample 2), childhood trauma and loneliness (sample 3). A total of 4782 individuals were surveyed across all three samples. Unadjusted analyses showed that the following factors are associated with higher odds of FP: obstetric complications, childhood trauma, non-right handedness, a lower education level, unemployment, minority status, humiliation, perceived constraints, and loneliness. However, only minority status and a lower level of education were associated with higher odds of FP after adjustment for other psychopathological symptoms, age, and gender. Importantly, hallucination-like experiences across all recorded modalities and paranoia were associated with higher odds of FP in all samples. Depressive symptoms were weakly associated with FP in two samples. Findings from the present study suggest that the majority of known risk factors for psychosis contribute to the emergence of FP through the effects on psychotic experiences. Low educational attainment and minority status might be the only risk factors independently contributing to the emergence of FP.

Anorexia nervosa (AN) usually emerges in adolescence when important changes occur in cognitive, emotional, and social processes. Mentalizing, alexithymia, and impulsiveness represent key dimensions for the understanding and interpretation of psychological difficulties in AN. The outbreak of the COVID-19 pandemic has impacted adolescents with AN, showing a worsening of the disease. The main aims of the present paper are (1) to compare adolescents with AN before and during the COVID-19 pandemic and (2) to explore the relationship between mentalizing, alexithymia, impulsiveness, and psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. One hundred and ninety-six AN female adolescents (N = 94 before COVID-19; N = 102 during COVID-19) participated in this study. The results show that adolescents with AN during the COVID-19 pandemic had a more impaired functioning profile than the before COVID-19 group. Mentalizing, alexithymia, and impulsiveness had a predictive role on psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. In conclusion, our data reveal that the COVID-19 pandemic has likely represented a stress condition that affects mental health; worsening the severity of adolescents with AN clinical condition. Lastly, predictive patterns suggest the existence of a link between difficulties in the ability to face the problems of the present time using effective strategies and the severity of psychological symptoms.

Abstract Background Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are more likely than cisgender heterosexuals to experience mental, physical, and sexual health issues. A promising contemporary strategy to address the issue of affective symptoms in sexual and gender minorities (SGM) is psychosocial intervention. Objective To systematically evaluate the effect of psychosocial interventions on the improvement of affective symptoms in SGM, and to provide a reference for the implementation of effective psychological interventions for SGM with affective symptoms. Methods Between the date of database construction until December 10, 2022, a computerized search of the English-language literature published both nationally and worldwide was done. 8 literature databases and 3 additional gray databases were searched. We gathered randomized controlled trials that used psychological interventions for SGM. To evaluate risk bias in included papers in accordance with Cochrane cooperation criteria, we used Review Manager 5.4 software. In conjunction with post-test and follow-up data, mean differences were standardized using Stata 12.0 software. Subgroup analysis was used to investigate the cause of heterogeneity. The study was conducted strictly in accordance with PRISMA guidelines, and it was registered on the PROSPERO platform (CRD42023408610). Results This review covered 18 research, and 14 studies were included in the meta-analysis. A total of 1194 study cases, including 706 cases from the control group and 488 cases from the experimental group, were included in these investigations. Compared to the control group, the psychosocial intervention group had significantly lower levels of depression (standardized mean difference (SMD) = -0.17;95% CI = [-0.30, -0.04]; p = 0.012) and anxiety (SMD = -0.22; 95% CI = [-0.41, -0.04]; p = 0.01), but no significant differences were found for distress (SMD = -0.19; 95% CI = [-0.45,0.07]; p = 0.021). Conclusion According to this study, psychosocial interventions helped lessen the symptoms of depression and anxiety in SGM but had no significant effect on their psychological distress. To assess the impact of psychological intervention on SGM, more randomized controlled trials with larger sample sizes and numerous follow-up times should be done.

Introduction: Psychological factors might play a role in the onset and exacerbation of cardiovascular disease. This study aimed to determine the relationship between Alexithymia and Emotional Maturity with the mediation of Attachment Styles among cardiovascular patients in Zanjan, Iran.Methods: The present study has a descriptive-correlational design. The statistical population of this study encompassed a range of 670 patients with cardiovascular diseases who were referred to the Cardiology Clinic of Ayatollah Mousavi Hospital in Zanjan from March and August 2019. The sample size was estimated to be 244 people using Cochran formula. Data collection tools included Hazen and Shaver’s standard adult attachment style questionnaire, Toronto’s ataxia, and Singh and Bhargava questionnaires. The Pearson correlation coefficient and multiple regression analyses were done using SPSS 24 software.Results: There was a positive correlation between alexithymia with emotional instability (r=0.14, P

Objective: The aim of this study was to explore the relationship between affective disturbances and aberrant salience in the context of childhood trauma, attachment, and mentalization in an analogue study. Methods: Using a cross‐sectional design, an online community sample completed self‐report measures of key variables. Structural equation modelling was used to test childhood trauma's influence on aberrant salience via a set of intermediate risk factors (depression, negative schizotypy, and insecure attachment). These intermediate risk factors were assumed to lead to the proximal risk factors of aberrant salience (i.e., disorganized schizotypy and disorganized attachment) depending on the vulnerability of mentalizing capacity to elevated stress. Results: The sample (N = 1263) was 78% female and aged between 18 and 35 years. The tested models closely fitted the observed data, revealing significant pathways from childhood trauma to aberrant salience via the hypothesized pathways. The direct effect of childhood trauma on aberrant salience was significant. Conclusion: Findings suggest that the pathway to aberrant salience may be characterized by disorganization of self‐state and intersubjectivity as a function of diminishment in mentalizing ability. This may relate to changes in attachment organization and socio‐cognitive capacity, which could constitute possible risk factors signalling development of aberrant salience. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive behavioural therapies (CBTs) are a standard of care for treatment of many 'hidden symptoms' in people with MS (PwMS), such as stress, depression, and fatigue. However, these interventions can vary widely in formatting and may not be tailored for PwMS. To optimize CBTs for MS, understanding the experiences of PwMS and clinicians is essential. This systematic review and meta-aggregation synthesizes existing qualitative data on stakeholder perspectives of CBTs for PwMS. Methods: Systematic searches across five major electronic databases were conducted. Studies reporting qualitative data were identified. Two reviewers performed screening, quality assessment, data extraction, and certainty of evidence assessments. Meta-aggregation was performed as per the Joanna Briggs Institute approach, entailing qualitative data extraction, developing categories, and synthesizing overall findings. Results: Twenty-eight studies were included in this review, comprising data from 653 PwMS and 47 clinicians. In the meta-aggregation, 122 qualitative results were extracted and grouped into nine categories. Categories were then combined into six synthesized findings: (1) setting the context–life with MS, (2) reasons for participating in CBTs, (3) acceptability of and experiences with participating in CBTs, (4) perceived benefits of CBTs, (5) perceived challenges with CBTs, and (6) suggestions to improve CBTs for PwMS. Conclusions: A range of benefits including psychological, social, and lifestyle improvements were reported, but varied based on the design of the CBT intervention. Future CBT interventions should be tailored to participant needs, delivered in group settings, offer online options, and be delivered by a trained facilitator familiar with MS. Further exploration of the ideal CBT design for PwMS, as well as engagement with caregivers and clinicians treating MS, is warranted. [ABSTRACT FROM AUTHOR]

Background: Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are more likely than cisgender heterosexuals to experience mental, physical, and sexual health issues. A promising contemporary strategy to address the issue of affective symptoms in sexual and gender minorities (SGM) is psychosocial intervention. Objective: To systematically evaluate the effect of psychosocial interventions on the improvement of affective symptoms in SGM, and to provide a reference for the implementation of effective psychological interventions for SGM with affective symptoms. Methods: Between the date of database construction until December 10, 2022, a computerized search of the English-language literature published both nationally and worldwide was done. 8 literature databases and 3 additional gray databases were searched. We gathered randomized controlled trials that used psychological interventions for SGM. To evaluate risk bias in included papers in accordance with Cochrane cooperation criteria, we used Review Manager 5.4 software. In conjunction with post-test and follow-up data, mean differences were standardized using Stata 12.0 software. Subgroup analysis was used to investigate the cause of heterogeneity. The study was conducted strictly in accordance with PRISMA guidelines, and it was registered on the PROSPERO platform (CRD42023408610). Results: This review covered 18 research, and 14 studies were included in the meta-analysis. A total of 1194 study cases, including 706 cases from the control group and 488 cases from the experimental group, were included in these investigations. Compared to the control group, the psychosocial intervention group had significantly lower levels of depression (standardized mean difference (SMD) = -0.17;95% CI = [-0.30, -0.04]; p = 0.012) and anxiety (SMD = -0.22; 95% CI = [-0.41, -0.04]; p = 0.01), but no significant differences were found for distress (SMD = -0.19; 95% CI = [-0.45,0.07]; p = 0.021). Conclusion: According to this study, psychosocial interventions helped lessen the symptoms of depression and anxiety in SGM but had no significant effect on their psychological distress. To assess the impact of psychological intervention on SGM, more randomized controlled trials with larger sample sizes and numerous follow-up times should be done. [ABSTRACT FROM AUTHOR]

Introduction: Psychological factors might play a role in the onset and exacerbation of cardiovascular disease. This study aimed to determine the relationship between Alexithymia and Emotional Maturity with the mediation of Attachment Styles among cardiovascular patients in Zanjan, Iran. Methods: The present study has a descriptive-correlational design. The statistical population of this study encompassed a range of 670 patients with cardiovascular diseases who were referred to the Cardiology Clinic of Ayatollah Mousavi Hospital in Zanjan from March and August 2019. The sample size was estimated to be 244 people using Cochran formula. Data collection tools included Hazen and Shaver’s standard adult attachment style questionnaire, Toronto’s ataxia, and Singh and Bhargava questionnaires. The Pearson correlation coefficient and multiple regression analyses were done using SPSS 24 software. Results: There was a positive correlation between alexithymia with emotional instability (r=0.14, P<0.01), personality decay (r=0.36, P<0.01), and emotional maturity (r=0.38, P<0.01). The results of multiple regression analysis showed that emotional instability (P=0.009), personality decay (P=0.016), and emotional immaturity (P=0.009) significantly predicted secure style. Additionally, difficulty in describing emotions significantly predicted avoidant style (P=0.034). Emotional maturity (P=0.006) and difficulty recognizing emotions (P=0.009) also significantly predicted ambivalent style. Conclusion: Personality traits and emotional alexithymia can be used as indicators for predicting attachment styles and social behaviors, and specifically, lack of emotional stability, personality disintegration, and emotional alexithymia can predict secure and ambivalent styles to some extent. Also, difficulty in describing emotions and emotional immaturity have the ability to predict the avoidant style. These results can help to better understand individual behaviors and design solutions to improve behavior.. [ABSTRACT FROM AUTHOR]

Introduction: In the early years of schooling, factors such as being far from parents for 5 hours, academic and social demands can be stressful for children and provide the conditions for creating or intensify some mental disorders. Therefore, it is important to investigate the prevalence of emotional-behavioral disorders and their related factors at this age. Aim: The purpose of the present study was to investigate the prevalence of emotional-behavioral disorders with and without comorbidity in children aged 6 to 8 years, and also to predict the severity of these disorders based on the mother's reaction to the child's negative emotions. Method: The research method was descriptive-analytical. The population included all the first and second grade primary school students of Malayer city in the academic year 2017-2018, and 454 people were selected by cluster sampling method. In order to collect data, the Child's Behavior Checklist (2002) and the Child's Reaction to Negative Emotions Questionnaire (1990) were used. Data were analyzed through SPSS version 22 software and stepwise linear regression model was employed. Results: The findings of the present study revealed that, the pure prevalence of emotional and behavioral disorders in these children was 8.6% and prevalence with comorbidity of these disorders was 7.3%. In addition, mother's reactions to children's negative emotions could predict the severity of children's emotional-behavioral problems (P=0.001). Conclusion: In the age range of 6 to 8, the comorbidity of emotional and behavioral disorders of these children is high and the mother's supportive or unsupportive reactions to the child's negative emotions play a significant role in it, so it is suggested that child psychologists and psychiatrists pay special attention to these findings in diagnostic interviews and treatment strategies.

BackgroundGold-standard psychological and pharmacological treatments for bulimic-spectrum eating disorders only result in remission for around 50% of patients; patients with affective lability and impulsivity represent a subgroup with particularly poor outcomes. Both dialectical behavior therapy (DBT), a treatment for emotion dysregulation, and lamotrigine, a mood stabilizer, have demonstrated promise for targeting affective lability and impulsivity; however, data exploring the combination of these interventions remain limited.ObjectiveWe followed a group of women with recurrent dysregulated eating behaviors (N = 62) throughout intensive DBT treatment and compared the symptom trajectory of those prescribed lamotrigine (n = 28) and those who were not (n = 34).MethodParticipants completed surveys every 2 weeks throughout treatment.ResultsGroup analyses suggested that all participants self-reported decreases in emotional reactivity, negative urgency, and symptoms of borderline personality disorder (BPD). The lamotrigine group reported greater elevations in BPD symptoms at baseline, but demonstrated steeper decreases in emotion and behavioral dysregulation than the non-matched comparison group. Within-subject analyses suggested that within the lamotrigine group, subjects reported greater decreases in symptoms following prescription of lamotrigine.ConclusionsFindings provide initial data suggesting that lamotrigine could be useful as an adjunctive treatment for patients with affective lability and impulsivity.Level of evidenceIV, time series without randomization.

ObjectivesThis study aims to test the psychometric proprieties of the Reflective Functioning Questionnaire (RFQ) applied to younger (13-16 years) and older (17-20 years) Italian adolescents examining (1) the factorial structure of RFQ; (2) its invariance across age and sex; (3) correlations between RFQ subscale scores, as well as the associations of the RFQ with (4) psychological problems and alexithymia dimensions.MethodsA cross-sectional study was conducted with 593 adolescents between the ages of 13 and 20 years old recruited from the community within Italy. These participants completed the RFQ, Symptom Checklist-90, and Toronto Alexithymia Scale.ResultsThe two-factor structure of the RFQ was confirmed. However, higher internal consistency of RFQ was obtained by removing two items that seemed problematic within this sample. Using a six-item version of RFQ, the two-factor structure was invariant across adolescent age and sex. Significant correlations among RFQ subscale scores, and between RFQ subscales with both psychological problems and alexithymia dimensions were found.ConclusionsPreliminary results reveal a short version of RFQ (six-item) is a suitable measure to assess mentalizing in adolescents in the Italian context.

Speechlessness forms a psychological concept that describes non-speaking or silence in different situations. Speechlessness occurs in particular during emotional stress. The Cologne Questionnaire on Speechlessness (ger.: Kölner Fragebogen zur Sprachlosigkeit) is an instrument for measuring speechlessness as a function of emotional perception and processing in situations of emotional stress or existing emotional dysregulation. The questionnaire was developed in theoretical proximity to the constructs of alexithymia and expressive suppression. Item selection was performed on a first line sample of N = 307 individuals of a normal population. Acquisition of an exploratory model to classify the phenomenon was conducted within four samples in clinical and non-clinical settings. Validation of the factorial structure was performed using an overarching dataset (N = 1293) consisting of all samples. The results of a confirmatory factor analysis (CFA) indicated the best model fit (χ2 (df, 146) = 953.856; p <.001; Tucker-Lewis-Index =.891; Comparative Fit Index =.916; Root Mean Square Error of Approximation =.065; p <.001; N = 1293) with a four-factorial structure of the questionnaire. Both the overall acceptable validity and reliability recommend the application of KFS on individuals of the normal population as well as clinical subgroups. In addition, the questionnaire can also be used in the context of research on the regulation of emotions. [ABSTRACT FROM AUTHOR]

Background: Sexual abuse and bullying are associated with poor mental health in adulthood. We previously established a clear relationship between bullying and symptoms of psychosis. Similarly, we would expect sexual abuse to be linked to the emergence of psychotic symptoms, through effects on negative affect. Method: We analysed English data from the Adult Psychiatric Morbidity Surveys, carried out in 2007 (N = 5954) and 2014 (N = 5946), based on representative national samples living in private households. We used probabilistic graphical models represented by directed acyclic graphs (DAGs). We obtained measures of persecutory ideation and auditory hallucinosis from the Psychosis Screening Questionnaire, and identified affective symptoms using the Clinical Interview Schedule. We included cannabis consumption and sex as they may determine the relationship between symptoms. We constrained incoming edges to sexual abuse and bullying to respect temporality. Results: In the DAG analyses, contrary to our expectations, paranoia appeared early in the cascade of relationships, close to the abuse variables, and generally lying upstream of affective symptoms. Paranoia was consistently directly antecedent to hallucinations, but also indirectly so, via non-psychotic symptoms. Hallucinosis was also the endpoint of pathways involving non-psychotic symptoms. Conclusions: Via worry, sexual abuse and bullying appear to drive a range of affective symptoms, and in some people, these may encourage the emergence of hallucinations. The link between adverse experiences and paranoia is much more direct. These findings have implications for managing distressing outcomes. In particular, worry may be a salient target for intervention in psychosis. [ABSTRACT FROM AUTHOR]

Introduction: In the early years of schooling, factors such as being far from parents for 5 hours, academic and social demands can be stressful for children and provide the conditions for creating or intensify some mental disorders. Therefore, it is important to investigate the prevalence of emotional-behavioral disorders and their related factors at this age. Aim: The purpose of the present study was to investigate the prevalence of emotional-behavioral disorders with and without comorbidity in children aged 6 to 8 years, and also to predict the severity of these disorders based on the mother's reaction to the child's negative emotions. Method: The research method was descriptive-analytical. The population included all the first and second grade primary school students of Malayer city in the academic year 2017-2018, and 454 people were selected by cluster sampling method. In order to collect data, the Child's Behavior Checklist (2002) and the Child's Reaction to Negative Emotions Questionnaire (1990) were used. Data were analyzed through SPSS version 22 software and stepwise linear regression model was employed. Results: The findings of the present study revealed that, the pure prevalence of emotional and behavioral disorders in these children was 8.6% and prevalence with comorbidity of these disorders was 7.3%. In addition, mother's reactions to children's negative emotions could predict the severity of children's emotional-behavioral problems (P=0.001). Conclusion: In the age range of 6 to 8, the comorbidity of emotional and behavioral disorders of these children is high and the mother's supportive or unsupportive reactions to the child's negative emotions play a significant role in it, so it is suggested that child psychologists and psychiatrists pay special attention to these findings in diagnostic interviews and treatment strategies. [ABSTRACT FROM AUTHOR]

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To investigate the association between neuropsychiatric symptoms (NPS) and nutritional status, and explore their shared regulatory brain regions on the Alzheimer’s disease (AD) continuum. Design: A longitudinal, observational cohort study. Setting: Data were collected from the Chinese Imaging, Biomarkers, and Lifestyle study between June 1, 2021 and December 31, 2022. Participants: Overall, 432 patients on the AD continuum, including amnestic mild cognitive impairment and AD dementia, were assessed at baseline, and only 165 patients completed the (10.37 ± 6.08) months’ follow-up. Measurements: The Mini-Nutritional Assessment (MNA) and Neuropsychiatric Inventory (NPI) were used to evaluate nutritional status and NPS, respectively. The corrected cerebral blood flow (cCBF) measured by pseudo-continuous arterial spin labeling of the dietary nutrition-related brain regions was analyzed. The association between the NPS at baseline and subsequent change in nutritional status and the association between the changes in the severity of NPS and nutritional status were examined using generalized linear mixed models. Results: Increased cCBF in the left putamen was associated with malnutrition, general NPS, affective symptoms, and hyperactivity (P < 0.05). The presence of general NPS (β = −1.317, P = 0.003), affective symptoms (β = −1.887, P < 0.001), and appetite/eating disorders (β = −1.714, P < 0.001) at baseline were associated with a decline in the MNA scores during follow-up. The higher scores of general NPI (β = −0.048), affective symptoms (β = −0.181), and appetite/eating disorders (β = −0.416; all P < 0.001) were longitudinally associated with lower MNA scores after adjusting for confounding factors. Conclusions: We found that baseline NPS were predictors of a decline in nutritional status on the AD continuum. The worse the severity of affective symptoms and appetite/eating disorders, the poorer the nutritional status. Furthermore, abnormal perfusion of the putamen may regulate the association between malnutrition and NPS, which suggests their potentially common neural regulatory basis.

IntroductionMoyamoya disease (MMD) is a life-threatening condition characterized by stenosis of intracranial arteries. Despite the frequency and the impact of psychiatric symptoms on the long-term prognosis and quality of life of MMD patients, no systematic review on this topic exists.MethodsThis systematic review and meta-analysis included 41 studies (29 being case reports), from PubMed, Scopus, Embase until 27/3/2023, on MMD patients exhibiting psychiatric symptoms.ResultsDespite a fair average quality of the articles, quantitative synthesis through logistic regression was possible only for case reports, due to heterogeneity between the other studies. Psychosis, the most frequent psychiatric symptom reported in case reports, was more frequent in MMD patients with left hemisphere involvement. Neurological symptoms occurrence increased the odds of MMD diagnosis preceding psychiatric symptoms. Psychiatric symptoms are highly prevalent in MMD patients and are relatively often the only presenting symptoms.DiscussionWe discuss the diagnostic, therapeutic, and prognostic implications of recognizing and characterizing specific psychiatric symptoms in MMD, outlining preliminary guidelines for targeted pharmacological and psychotherapeutic interventions. Lastly, we outline future research and clinical perspectives, striving to enhance the oft-overlooked psychiatric care for MMD patients and to ameliorate their long-term outcome.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023406303.

Oppositional Defiant Disorder (ODD) is characterized by a recurrent pattern of angry/irritable emotional lability, argumentative/defiant behavior, and vindictiveness. Previous studies indicated that ODD typically might originate within a maladaptive family environment, or was at least maintained within such an environment. As such, the present review summarized pertinent research from the last 20 years that focused on the pathways connecting family risk factors to the development of child ODD symptoms. A systematic search of electronic databases was completed in August 2020, resulting in the inclusion of 62 studies in the review. The review established a multi-level framework to describe the mechanisms underlying the pathway from familial factors to ODD psychopathological symptoms: (a) the system level that is affected by the family's socioeconomic status and family dysfunction; (b) the dyadic level that is affected by conflict within the marital dyad and parent-child interactions; and (c) the individual level that is affected by parent and child factors. Additionally, from the perspective of family systems theory, we pay special attention to the interactions among and between the various levels of the pathway (moderation and mediation) that might be associated with the occurrence and severity of ODD symptoms. Considering future prevention and intervention efforts, this three-level model emphasizes the necessity of focusing on familial risk factors at multiple levels and the mechanisms underlying the proposed pathways.

The spectrum of neuropsychiatric phenomena observed in amyotrophic lateral sclerosis (ALS) is wide and not fully understood. Disorders of laughter and crying stand among the most common manifestations. The aim of this study is to report the results of an educational consensus organized by the Brazilian Academy of Neurology to evaluate the definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in ALS patients. Twelve members of the Brazilian Academy of Neurology - considered to be experts in the field - were recruited to answer 12 questions about the subject. After exchanging revisions, a first draft was prepared. A face-to-face meeting was held in Fortaleza, Brazil on 9.23.22 to discuss it. The revised version was subsequently emailed to all members of the ALS Scientific Department from the Brazilian Academy of Neurology and the final revised version submitted for publication. The prevalence of pseudobulbar affect/pathological laughter and crying (PBA/PLC) in ALS patients from 15 combined studies and 3906 patients was 27.4% (N = 1070), ranging from 11.4% to 71%. Bulbar onset is a risk factor but there are limited studies evaluating the differences in prevalence among the different motor neuron diseases subtypes, including patients with and without frontotemporal dementia. Antidepressants and a combination of dextromethorphan and quinidine (not available in Brazil) are possible therapeutic options. This group of panelists acknowledge the multiple gaps in the current literature and reinforces the need for further studies.

Abstract Background Neuropsychiatric symptoms (NPS) are prevalent in the early clinical stages of Alzheimer’s disease (AD) according to proxy-based instruments. Little is known about which NPS clinicians report and whether their judgment aligns with proxy-based instruments. We used natural language processing (NLP) to classify NPS in electronic health records (EHRs) to estimate the reporting of NPS in symptomatic AD at the memory clinic according to clinicians. Next, we compared NPS as reported in EHRs and NPS reported by caregivers on the Neuropsychiatric Inventory (NPI). Methods Two academic memory clinic cohorts were used: the Amsterdam UMC (n = 3001) and the Erasmus MC (n = 646). Patients included in these cohorts had MCI, AD dementia, or mixed AD/VaD dementia. Ten trained clinicians annotated 13 types of NPS in a randomly selected training set of n = 500 EHRs from the Amsterdam UMC cohort and in a test set of n = 250 EHRs from the Erasmus MC cohort. For each NPS, a generalized linear classifier was trained and internally and externally validated. Prevalence estimates of NPS were adjusted for the imperfect sensitivity and specificity of each classifier. Intra-individual comparison of the NPS classified in EHRs and NPS reported on the NPI were conducted in a subsample (59%). Results Internal validation performance of the classifiers was excellent (AUC range: 0.81–0.91), but external validation performance decreased (AUC range: 0.51–0.93). NPS were prevalent in EHRs from the Amsterdam UMC, especially apathy (adjusted prevalence = 69.4%), anxiety (adjusted prevalence = 53.7%), aberrant motor behavior (adjusted prevalence = 47.5%), irritability (adjusted prevalence = 42.6%), and depression (adjusted prevalence = 38.5%). The ranking of NPS was similar for EHRs from the Erasmus MC, although not all classifiers obtained valid prevalence estimates due to low specificity. In both cohorts, there was minimal agreement between NPS classified in the EHRs and NPS reported on the NPI (all kappa coefficients

Background Schizophrenia is a debilitating disorder making it a challenge for clinicians to manage its heterogeneous symptom profile. Antipsychotics remain the main modality of its treatment. However, some symptoms persist after an optimal dose of antipsychotics. The affective and cognitive symptoms need a holistic approach for resolution. Biofeedback is a noninvasive procedure showing its effectiveness in various mental illnesses. Integration of biofeedback adjunctive to medications can help in attaining treatment goals in schizophrenia. Objectives It is to determine the role of biofeedback as an adjunctive therapy technique to traditional pharmacotherapy in patients with schizophrenia in improving affective symptoms. Methodology Sixty patients diagnosed with schizophrenia were selected for the study after fulfilling the inclusion and exclusion criteria. Patients were allotted to either the test group or control group by alternate allocation method. All patients were titrated to an optimal fixed dose of antipsychotic medications during 1st week of allotment to study. Biofeedback therapy was given 3 sessions per week for 3 weeks to patients in the test group. Positive and negative syndrome scale (PANSS) was applied for all patients at baseline. Hamilton Anxiety Rating Scale (HAM-A) and Calgary Depression Scale for Schizophrenia (CDSS) were applied at baseline and after 4 weeks to measure anxiety and depressive symptoms respectively. After 4 weeks the results were compared between both groups using statistical analysis. Conclusion The outcome of the study found that biofeedback therapy is effective in reducing anxiety and depressive symptoms in patients receiving biofeedback therapy compared to those who did not receive it. Recommendation Further studies in a larger cohort are needed to formulate sound and consistent conclusions.

Objective: Here, we examine whether the dynamics of the four dimensions of the circumplex model of affect assessed by ecological momentary assessment (EMA) differ among those with bipolar disorder (BD) and major depressive disorder (MDD). Methods: Participants aged 11–85 years (n = 362) reported momentary sad, anxious, active, and energetic dimensional states four times per day for 2 weeks. Individuals with lifetime mood disorder subtypes of bipolar‐I, bipolar‐II, and MDD derived from a semistructured clinical interview were compared to each other and to controls without a lifetime history of psychiatric disorders. Random effects from individual means, inertias, innovation (residual) variances, and cross‐lags across the four affective dimensions simultaneously were derived from multivariate dynamic structural equation models. Results: All mood disorder subtypes were associated with higher levels of sad and anxious mood and lower energy than controls. Those with bipolar‐I had lower average activation, and lower energy that was independent of activation, compared to MDD or controls. However, increases in activation were more likely to perpetuate in those with bipolar‐I. Bipolar‐II was characterized by higher lability of sad and anxious mood compared to bipolar‐I and controls but not MDD. Compared to BD and controls, those with MDD exhibited cross‐augmentation of sadness and anxiety, and sadness blunted energy. Conclusion: Bipolar‐I is more strongly characterized by activation and energy than sad and anxious mood. This distinction has potential implications for both specificity of intervention targets and differential pathways underlying these dynamic affective systems. Confirmation of the longer term stability and generalizability of these findings in future studies is necessary. [ABSTRACT FROM AUTHOR]

Background: The Odor Awareness Scale (OAS) is a questionnaire that assesses individual differences in awareness of odors in the surrounding environment, which has been shown to be associated with affective symptoms in recent researches. To further research, A Chinese version of the OAS needs to be introduced. Objective: To investigate the factor structure and validate the psychometric properties of the OAS. Methods: A total of 978 participants from college were randomly allocated into two groups for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. Additionally, the study entailed item analysis and scrutinized internal consistency reliability, test-retest reliability, and concurrent validity. Testretest reliability was assessed by having 214 participants complete the OAS twice at a one-week interval. Concurrent validity was measured using the Body Odor Sniffing Questionnaire (BOSQ), the Generalized Anxiety Disorder Scale (GAD-7), and the Toronto Alexithymia Scale (TAS-20). Results: EFA identified three factors that best fit the data: odor sensitivity, odor impact, and odor attention. CFA validated a second-order factor model, yielding good fit indices: χ² / Df = 2.326, RMSEA = 0.052, CFI = 0.911, TLI = 0.900, SRMR = 0.053. The final version of the OAS comprised 27 items and exhibited a commendable internal consistency reliability (Cronbach's α = 0.913), and a good test-retest reliability, as evidenced by the high Pearson correlation coefficient (r = 0.940) and intraclass correlation coefficient (ICC = 0.940). The OAS was significantly correlated with BOSQ (r = 0.416), GAD-7 (r = 0.155), and TAS-20 (r = -0.081). Conclusion: The Chinese version of the OAS demonstrated robust reliability and validity, rendering it a valuable instrument for evaluating odor awareness in the Chinese population. [ABSTRACT FROM AUTHOR]

Background: Birthing individuals experience various postpartum symptoms which have been associated with adverse health outcomes. Previous systematic reviews have focused on the examination of individual symptoms and their impact on health, which have limited our understanding of postpartum symptom clusters. Objective: To examine the compositions of symptom clusters, analytic methodologies and predictors of symptom clusters in birthing individuals up to 1 year postpartum. Design: Systematic review. Methods: This systematic review was reported following the PRISMA. Five databases were searched: PubMed, Embase, CINAHL Complete, PsycINFO and Scopus. Two reviewers performed title and abstract and full‐text screening independently. Standard Quality Assessment Criteria were used to assess the articles' qualities. Key information was extracted into evidence table, which was checked for accuracy and completeness. A narrative synthesis was conducted. Results: A total of 30 articles were included. Studies were conducted in 16 countries, mostly in Europe (n = 9) and North America (n = 7). The majority were quantitative (n = 27) and cross‐sectional (n = 27). Factor analysis was the most frequently used analytic methodology (n = 21). All three qualitative studies used grounded theory. Taking into consideration the variations among the studies, stress (n = 15, infant or partner‐related and from other sources), depression (n = 12), somatic (n = 12) and anxiety clusters (n = 10) were most frequently identified. Symptom cluster predictors were examined in less than half of the included studies (n = 13). Among these, most were focused on how individual postpartum symptoms influence symptom clusters. Conclusions: Stress, depression, somatic and anxiety clusters are the most frequently identified postpartum symptom clusters. Future studies should examine the consistency, stability and clinical meaningfulness of these four symptom clusters. Relevance to clinical practice: The identification and management of the four symptom clusters should be of particular interest to clinicians and researchers. No patient or public contribution: This systematic review did not directly involve patient or public contribution to the manuscript. [ABSTRACT FROM AUTHOR]

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Although there is a substantial body of observation research investigating the manner in which reading instruction is provided to students with learning disabilities, there is little research in this area involving students with and at risk for emotional disturbance. The purpose of this investigation was to contribute to the limited corpus of observation studies investigating school-based practice in reading for this student population. In this investigation, 11 teachers from two states were systematically observed while providing reading instruction over the course of the 2017-2018 school year. Participating students were also observed over the course of the year and completed two standardized reading assessments at the beginning and end of this investigation. Teachers were also interviewed to identify contextual factors that promote or impede the provision of high quality reading instruction to this student population. Study findings suggest that teachers are in need of additional training, support, and resources to maximize instructional time. Students in this sample tended to make no or minimal progress in reading and were frequently observed displaying low levels of academic engagement across settings. Implications for school practice and areas for future research are discussed.

Abstract Objective Here, we examine whether the dynamics of the four dimensions of the circumplex model of affect assessed by ecological momentary assessment (EMA) differ among those with bipolar disorder (BD) and major depressive disorder (MDD). Methods Participants aged 11–85 years (n = 362) reported momentary sad, anxious, active, and energetic dimensional states four times per day for 2 weeks. Individuals with lifetime mood disorder subtypes of bipolar‐I, bipolar‐II, and MDD derived from a semistructured clinical interview were compared to each other and to controls without a lifetime history of psychiatric disorders. Random effects from individual means, inertias, innovation (residual) variances, and cross‐lags across the four affective dimensions simultaneously were derived from multivariate dynamic structural equation models. Results All mood disorder subtypes were associated with higher levels of sad and anxious mood and lower energy than controls. Those with bipolar‐I had lower average activation, and lower energy that was independent of activation, compared to MDD or controls. However, increases in activation were more likely to perpetuate in those with bipolar‐I. Bipolar‐II was characterized by higher lability of sad and anxious mood compared to bipolar‐I and controls but not MDD. Compared to BD and controls, those with MDD exhibited cross‐augmentation of sadness and anxiety, and sadness blunted energy. Conclusion Bipolar‐I is more strongly characterized by activation and energy than sad and anxious mood. This distinction has potential implications for both specificity of intervention targets and differential pathways underlying these dynamic affective systems. Confirmation of the longer term stability and generalizability of these findings in future studies is necessary.

Critical COVID-19 disease is accompanied by depletion of plasma tryptophan (TRY) and increases in indoleamine-dioxygenase (IDO)-stimulated production of neuroactive tryptophan catabolites (TRYCATs), including kynurenine (KYN). The TRYCAT pathway has not been studied extensively in association with the physiosomatic and affective symptoms of Long COVID. In the present study, we measured serum TRY, TRYCATs, insulin resistance (using the Homeostatic Model Assessment Index 2-insulin resistance, HOMA2-IR), C-reactive protein (CRP), physiosomatic, depression, and anxiety symptoms in 90 Long COVID patients, 3-10 months after remission of acute infection. We were able to construct an endophenotypic class of severe Long COVID (22% of the patients) with very low TRY and oxygen saturation (SpO2, during acute infection), increased kynurenine, KYN/TRY ratio, CRP, and very high ratings on all symptom domains. One factor could be extracted from physiosomatic symptoms (including chronic fatigue-fibromyalgia), depression, and anxiety symptoms, indicating that all domains are manifestations of the common physio-affective phenome. Three Long COVID biomarkers (CRP, KYN/TRY, and IR) explained around 40% of the variance in the physio-affective phenome. The latter and the KYN/TRY ratio were significantly predicted by peak body temperature (PBT) and lowered SpO2 during acute infection. One validated latent vector could be extracted from the three symptom domains and a composite based on CRP, KYN/TRY, and IR (Long COVID), and PBT and SpO2 (acute COVID-19). In conclusion, the physioaffective phenome of Long COVID is a manifestation of inflammatory responses during acute and Long COVID, and lowered plasma tryptophan and increased kynurenine may contribute to these effects. [ABSTRACT FROM AUTHOR]

Childhood abuse has been widely associated with mental health problems in adulthood and marital quality may be one possible mediator. We examine marital quality as a mediator linking childhood abuse to positive affect, negative affect, emotionally reactivity, and aggression. Using data from Midlife Development in the United States (MIDUS), results of structural equation modeling indicate that the indirect effects from childhood abuse to each of the mental health outcomes were significant. Marital quality may be a source of resilience among adults who were abused in childhood and could be a point of intervention for clinicians. [ABSTRACT FROM AUTHOR]

Background: Neuropsychiatric symptoms (NPS) are prevalent in the early clinical stages of Alzheimer's disease (AD) according to proxy-based instruments. Little is known about which NPS clinicians report and whether their judgment aligns with proxy-based instruments. We used natural language processing (NLP) to classify NPS in electronic health records (EHRs) to estimate the reporting of NPS in symptomatic AD at the memory clinic according to clinicians. Next, we compared NPS as reported in EHRs and NPS reported by caregivers on the Neuropsychiatric Inventory (NPI). Methods: Two academic memory clinic cohorts were used: the Amsterdam UMC (n = 3001) and the Erasmus MC (n = 646). Patients included in these cohorts had MCI, AD dementia, or mixed AD/VaD dementia. Ten trained clinicians annotated 13 types of NPS in a randomly selected training set of n = 500 EHRs from the Amsterdam UMC cohort and in a test set of n = 250 EHRs from the Erasmus MC cohort. For each NPS, a generalized linear classifier was trained and internally and externally validated. Prevalence estimates of NPS were adjusted for the imperfect sensitivity and specificity of each classifier. Intra-individual comparison of the NPS classified in EHRs and NPS reported on the NPI were conducted in a subsample (59%). Results: Internal validation performance of the classifiers was excellent (AUC range: 0.81–0.91), but external validation performance decreased (AUC range: 0.51–0.93). NPS were prevalent in EHRs from the Amsterdam UMC, especially apathy (adjusted prevalence = 69.4%), anxiety (adjusted prevalence = 53.7%), aberrant motor behavior (adjusted prevalence = 47.5%), irritability (adjusted prevalence = 42.6%), and depression (adjusted prevalence = 38.5%). The ranking of NPS was similar for EHRs from the Erasmus MC, although not all classifiers obtained valid prevalence estimates due to low specificity. In both cohorts, there was minimal agreement between NPS classified in the EHRs and NPS reported on the NPI (all kappa coefficients < 0.28), with substantially more reports of NPS in EHRs than on NPI assessments. Conclusions: NLP classifiers performed well in detecting a wide range of NPS in EHRs of patients with symptomatic AD visiting the memory clinic and showed that clinicians frequently reported NPS in these EHRs. Clinicians generally reported more NPS in EHRs than caregivers reported on the NPI. [ABSTRACT FROM AUTHOR]

The use of alcohol and nicotine can negatively impact the course of bipolar disorder (BD), but there is limited knowledge about how symptoms and sleep disturbances are related to concurrent nicotine use and non-pathological use of alcohol. We investigated how nicotine use and non-pathological use of alcohol relates to affective symptoms and sleep disturbances in 453 participants with BD without substance use disorders. Manic symptoms were assessed with the Young Mania Rating Scale, and depressive symptoms with The Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C). Sleep-related questions from IDS-C were used to create proxy variables for sleep disturbances, including Insomnia and Hypersomnia. Multinomial regression analysis was conducted to investigate the associations between nicotine use and sleep disturbances, controlling for possible confounders such as current use of illicit drugs and psychopharmacological treatment. Depressive and manic symptoms were not associated with the concurrent level of alcohol or nicotine use. Individuals with medium and high levels of daily nicotine use had higher risk of insomnia than those without. Non-pathological alcohol use was not associated with sleep disturbances. Sleep disturbances were based on items from the IDS-C questionnaire. We found an elevated risk for insomnia in individuals with BD and medium or high levels of daily nicotine use. We found no association between the level of affective symptoms and the level of use of alcohol or nicotine. The direction of the relationship between nicotine use and insomnia needs clarification, as it is highly relevant for treatment planning. • No association between level of affective symptoms and use of nicotine. • No association between level of affective symptoms and non-pathological alcohol use. • Elevated risk of insomnia in BD individuals using medium or high levels of nicotine. [ABSTRACT FROM AUTHOR]

Background and Objectives: Students with borderline intellectual functioning ("slow learners") underperform in all school subjects. The primary objective of this study was to evaluate the self-perceived anxiety symptoms of slow learners. Its secondary objective was to analyze impact of sociodemographic variables on their symptoms. Settings and Design: Cross-sectional single-arm questionnaire-based study was conducted in the learning disability clinic of a public medical college in Mumbai. Subjects and Methods: One hundred slow learners aged ≥8 to <18 years were recruited by non-probability sampling. Their anxiety symptoms scores were measured using the Screen for Child Anxiety Related Disorders-Child version (SCARED-C) instrument. Statistical Analysis: Multivariate regression analysis was performed for determining the "independent" impact that variables had on the SCARED-C ("individual subscales" and "overall") scores. Results: Symptoms of "separation anxiety" were present in 40%, followed by "social anxiety" in 32%, "generalized anxiety" in 31%, "panic" in 26%, "significant school avoidance" in 24%; and "overall anxiety" in 38% of slow learners. Multivariate analysis revealed that: (i) co-occurring attention-deficit/hyperactivity disorder was significantly associated with having panic symptoms (P = 0.040), and, (ii) studying in a Secondary School Certificate or Higher Secondary Certificate educational board-affiliated school was significantly associated with having symptoms of "generalized anxiety," "social anxiety," and "overall anxiety" (P = 0.009, P = 0.026, and P = 0.046, respectively). Conclusions: Many slow learners in our city have symptoms of anxiety disorders and overall anxiety. There is an urgent need to screen them for anxiety disorders to facilitate their optimum rehabilitation. [ABSTRACT FROM AUTHOR]

Alexithymia is a vulnerability factor for physical and mental illness that can significantly influence the daily function of alcohol-dependent patients. The aim of this study was to examine the indirect effect of obsessive thoughts and compulsive behaviors involving alcohol craving on the relationship between alexithymia, quality of life (QoL) of psychological well-being and health status. Three hundred and eighty-one outpatients (263 males and 118 females) in treatment for alcohol dependence completed self-report measures of alexithymia, alcohol craving, GHQ-28 (QoL-psychological well-being) and SF-36 (QoL-health status). Males scored significantly higher than females on aspects of alexithymia, and females reported significantly higher levels of alcohol craving. Path analysis showed an indirect effect of alcohol craving on the relationship between alexithymia, QoL-psychological well-being and self-reported QoL-health status for males only. The current study provides important new information about impaired self-reported health status and well-being among male alcohol-dependent treatment seekers with alexithymia.

ObjectiveThe aim of this study was to examine whether people who screened positive for depression were more likely to have sought treatment if they had personal knowledge of other individuals with emotional or mental problems or of individuals who have sought treatment for them.MethodsParticipants who screened positive for current major depression (N=239) via an Internet-based depression screening study completed an online survey about seeking treatment for depression.ResultsAfter the authors controlled for social support, stigma, and demographic variables, analyses showed that individuals who personally knew someone with emotional or mental problems either within or outside of their family were more likely to themselves have sought treatment for depression. The same was true for those who personally knew someone-again either within or outside of their family-who had sought treatment for emotional or mental problems.ConclusionsPersonal knowledge of others with emotional problems or who had sought treatment for them may play a role in decisions about one's own treatment.

BackgroundThe relationship between physical and affective symptom clusters in heart failure (HF) is unclear.ObjectivesTo identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups.MethodsThis was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively.ResultsIn this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival.ConclusionCongruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.

Most disaster mental health research focuses on the relationship between disaster exposure and distress, often neglecting its influence on social-emotional health, despite implications for resilience and well-being after the disaster. Following multiple floods in Texas, a sample of 486 youth aged 10-19 years old (M = 13.74 years, SD = 2.57; 52.9% male) completed measures of disaster exposure, life stressors since the disaster, and social-emotional health. Using mixture regression modeling, we examined differences in the relationship between life stressors and social-emotional health across latent classes of disaster exposure (high, moderate, community, and low exposure). After accounting for mean levels of life stressors, the mean levels of social-emotional health did not differ across exposure classes; however, the strength of the relationship between life stressors and social-emotional health did. Youth in the high exposure group had the highest mean level of life stressors since the disaster. Thus, each additional life stressor did not result in changes in social-emotional health, suggesting saturated stress levels. For youth in the moderate and community exposure classes, increases in life stressors did lower social-emotional health, perhaps pushing them into stress overload. For the low exposure group, life stressors did not have an influence. This has implications for postdisaster mental health screening and support, tailored by levels of exposure and attuned to ongoing stressors that may impact long-term social-emotional health. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The purpose of this study was to characterize the association between recent major life events and depressive symptoms during early adulthood, and to determine whether adolescents with chronically low positive affect or persistent sleep disturbance were more vulnerable to the link between stress and depressive symptoms. Adolescents (n = 147; 63.9% female; 33.7% non-Hispanic white) were recruited in 10th-11th grade and re-assessed 2 and 4 years later. At each assessment, adolescents completed measures of positive affect and sleep disturbances. At the final assessment, participants reported on their exposure to major life events in the past 12 months. Exposure to more major life events in the past year was associated with greater depressive symptoms in early adulthood. Chronically low positive affect and persistent sleep disturbances throughout adolescence each independently moderated this relationship. Specifically, only participants reporting low positive affect across the three assessments showed a positive and significant association between major life events and depressive symptoms. Further, only participants reporting sleep disturbances at all three assessments showed a positive and significant association between major life events and depressive symptoms. Chronically low positive affect and persistent sleep disturbances during adolescence may be useful indicators of risk for depression during early adulthood. Further, interventions targeting adolescent sleep disturbances and improving positive affect may be useful in reducing the risk for depression following life stress during this high risk developmental phase.

Background: Alexithymia is a personality trait associated with emotion regulation difficulties. Up to 67% of alcohol-dependent patients in treatment have alexithymia. Objectives: The objective of this study was to investigate the direct and indirect effects of alexithymia, negative mood (stress, anxiety, and depression) and alcohol craving on alcohol dependence severity. Methods: Three hundred and fifty-five outpatients (mean age = 38.70, SD = 11.00, 244 males, range 18-71 years) undergoing Cognitive-Behavioral Therapy for alcohol dependence completed the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS-21), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Use Disorders Identification Test (AUDIT) prior to the first treatment session. Results: Alexithymia had an indirect effect on alcohol dependence severity, via both negative mood and alcohol craving (b = 0.03, seb = 0.008, 95% CI: 0.02-0.05). An indirect effect of negative mood on alcohol dependence via alcohol craving was also observed (b = 0.12, seb = 0.03, 95% CI: 0.07-0.16). Conclusions/importance: Alexithymia worked through negative mood and alcohol craving leading to increased alcohol dependence severity, indicating that craving had an indirect effect on the relationship between alexithymia and alcohol dependence severity. Targeting alcohol craving and negative mood for alcohol-dependent patients with alexithymia seems warranted.

BACKGROUND AND AIMS:We aimed to determine whether a second-order global competence latent factor could be identified as underlying relations between adolescent mental health, social skills, and academic functioning. A secondary aim was to test whether early childhood characteristics predict adolescent global competence. A final aim was to test differences in these models across youth with typical cognitive development (TD) or intellectual disability (ID). METHODS AND PROCEDURES:Participants were 246 youth with TD (n = 148) or ID (n = 98), with assessments from early childhood (3, 4, 5 years) and adolescence (13, 15). These youths' parents and teachers provided measures. A Multiple Indicator, Multiple Causes (MIMIC) model was tested using structural equation modeling, in which parenting, maternal depression, and emotional dysregulation in early childhood were entered as predictors of adolescent global competence. OUTCOMES AND RESULTS:A second-order global competence factor emerged, and was predicted by early childhood variables. The final MIMIC model demonstrated excellent fit. Negative parenting in early childhood predicted lower adolescent global competence for both TD and ID youth. Maternal depression predicted adolescent global competence only for youth with ID, while emotion dysregulation predicted only for youth with TD. CONCLUSIONS AND IMPLICATIONS:Results have implications for longitudinal mechanisms of influence and early intervention targets for specific populations.

PurposeSome features of eating disorders (EDs) are often present in childhood before the onset of the ED. We developed a novel questionnaire to retrospectively capture such childhood traits.MethodsFocus groups were conducted at the University of California-San Diego, USA, and at the University of Turin, Italy. Three focus groups were conducted at each site, interviewing patients and parents to identify those traits that most commonly characterize childhood of patients with EDs. A preliminary version of the Premorbid Childhood Traits Questionnaire (PCT-Q) derived from these focus groups was then administered to 94 consecutive inpatients with an ED and to 286 healthy controls (HCs) at the Turin site. Also, 208 participants' parents were enrolled as well; in fact, the PCT-Q was developed with both a proband and an informant version.ResultsA 37-item final version of the PCT-Q was generated. Reliability analyses suggested acceptability for harm avoidance (HA), social phobia, alexithymia, interoceptive awareness (IA), and food obsessions. Inter-rater reliability ranged from fair to moderate. ED sufferers scored significantly higher than HCs on HA, social phobia, alexithymia, IA, and food obsessions.ConclusionsThese findings support the possibility that premorbid traits contribute to a risk to develop an ED in some individuals.Level of evidenceIII: case-control analytic study.

Depressive and anxious syndromes have been proposed as risk factors and as consequences of Problematic Internet Use (PIU). There has been no study relating affective symptoms in subjects with Problematic Internet Use and those with major depressive and anxious syndromes. In this study, three samples were collected: two from ambulatory clinical settings of the North Lisbon Hospital Centre (1. Centre for PIU and 2. Out-patient psychiatry consultation for adolescents and young adults) and a control group from Faculdade de Medicina da Universidade de Lisboa. Internet use profile and affective psychopathology were assessed and socio-demographic characteristics were controlled. The results revealed that both the PIU group and the clinical group presented significantly higher depression and anxiety scores than the control group while there was no significant difference between them. Also, Problematic Internet Users, similarly to the clinical group, tend to live in less functional families. We speculate that the similitude between samples and yet such different clinical presentations could be explained if Internet acted as a buffer to affective psychopathology. These findings warrant exploring the possibility of PIU as new (and generation biased) psychopathology of depressive or anxious states. [ABSTRACT FROM AUTHOR]

Objectives: The COVID‐19 pandemic presented both serious health threats and economic hardships, which were reflected in increased rates of mood and anxiety symptoms. We examined two separate distress domains, health worries and work distress, as predictors of mood and anxiety symptoms. Additionally, we considered whether these two domains might be uniquely associated with the development of dysfunctional beliefs, as a proposed mechanism to account for increased symptoms during the pandemic. Two separate models were considered to examine if associations remained stable through the first year of the pandemic. Methods: Participants (N = 2152) were a representative sample of Florida adults. They completed online surveys at three waves: Wave 1 (April–May 2020), Wave 2 (May–June 2020), and Wave 3 (December–February 2021). Participants completed measures of COVID‐19 health worry and work distress, anxiety, and depression. They also reported their level of hopelessness and helplessness (indices of dysfunctional beliefs). Results: In an early pandemic model (Wave 1‐Wave 2), health worry directly and indirectly predicted anxiety and depression via dysfunctional beliefs. In contrast, work distress only indirectly predicted both outcomes. In a longer‐term model (Wave 2‐Wave 3), health worry had direct and indirect effects on downstream anxiety but not depression. Pandemic work distress had no effect on depression or dysfunctional beliefs; however, it was associated with less anxiety. Conclusions: Although health worry and work distress predicted later symptoms of anxiety and depression, they appeared to operate through different pathways. These findings provide guidance for the development of more effective interventions to reduce the impact of pandemics. [ABSTRACT FROM AUTHOR]

Background: Although connections between psychotic-like experiences (PLEs) and a series of non-psychotic disorders have been widely explored in previous research, it is unclear whether PLEs could act as a co-occurring psychopathological indicator of multi-dimensional affective symptoms.Methods: A total of 4761 students took part in an online survey which assessed the frequency of PLEs and three types of affective symptoms over lifetime. Binary logistic regression models were used to examine associations between PLEs and each type of affective symptom. Network analysis was conducted to explore the relationship among three subtypes of PLEs - persecutory ideation (PI), bizarre experiences (BEs) and perceptual abnormalities (PAs), and different types of affective symptoms.Results: The results showed that compared with the non-PLEs group, the PLEs group suffered significantly higher risk of experiencing three types of affective symptoms, including manic symptoms [adjusted odds ratio (aOR) 11.50, 95 % confidence interval (CI) (4.59-28.81)], depressive symptoms [aOR 7.28, 95 % CI (4.98-10.66)] and anxiety symptoms [aOR 4.47, 95 % CI (3.10-6.43)]. In the network model, bizarre experiences were the most critical central symptom. Both depressive and anxiety symptoms were most strongly associated with persecutory ideation while manic symptoms were most closely related to bizarre experiences.Limitations: Cross-sectional data and self-reported symptoms.Conclusions: These findings suggest that PLEs are a vital co-occurring indicator of multi-dimensional affective symptoms and show its enormous potential as a target for a host of mental health problems. Further investigation may shed light on the aetiology of the relationship between different subtypes of PLEs and affective symptoms. [ABSTRACT FROM AUTHOR]