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The results of recent surveys that show high levels of symptoms of anxiety and depression have generated widespread concern about the mental health of US youth. Although such increases and their causes require immediate action, these symptoms alone do not indicate an epidemic of mental disorders in the US because they do not reflect mental disorders that are characterized by protracted duration and educational or social impairment. Unfortunately, there are no recent comparable data on the full range of common mental disorders. (e.g., Anxiety, Attention Deficit Hyperactivity Disorder, Major Depression, etc.) in nationally representative samples of US youth to provide a baseline for the reported increased distress in recent surveys. Therefore, we must rely on indirect information derived from surveys of subsets of symptoms and behaviors or of restricted age groups, and web-based samples with unknown biases and limited generalizability. This editorial describes how the findings from a recent report of prevalence of mental disorders in 9–10-year-old youths from the ABCD study can contribute to the national profile of mental disorders in youth. We highlight the need to address the lack of systematic data on youth emotional and behavioral disorders in the US through concerted efforts to coordinate the multi-agency sources of data on youth mental health. This will require harmonization of sampling and methods, informed application of internet-based tools based on systematic sampling and non-probability sampling methods and promotion of efforts to bridge the gap between population-based research and interventions at both the societal and individual levels. [ABSTRACT FROM AUTHOR]

Functional brain hubs are key integrative regions in brain networks. Recently, brain hubs identified through resting-state fMRI have emerged as interesting targets to increase understanding of the relationships between large-scale functional networks and psychopathology. However, few studies have directly addressed the replicability and consistency of the hub regions identified and their association with symptoms. Here, we used the eigenvector centrality (EVC) measure obtained from graph analysis of two large, independent population-based samples of children and adolescents (7–15 years old; total N = 652; 341 subjects for site 1 and 311 for site 2) to evaluate the replicability of hub identification. Subsequently, we tested the association between replicable hub regions and psychiatric symptoms. We identified a set of hubs consisting of the anterior medial prefrontal cortex and inferior parietal lobule/intraparietal sulcus (IPL/IPS). Moreover, lower EVC values in the right IPS were associated with psychiatric symptoms in both samples. Thus, low centrality of the IPS was a replicable sign of potential vulnerability to mental disorders in children. The identification of critical and replicable hubs in functional cortical networks in children and adolescents can foster understanding of the mechanisms underlying mental disorders. [ABSTRACT FROM AUTHOR]

This multilevel meta-analysis examined the effects of geographical and economic factors on worldwide childhood maltreatment estimates measured by the Childhood Trauma Questionnaire (CTQ) short-form. The primary outcome extracted was continuous scores on the CTQ subscales – emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect – and total score. Geographical, economical and methodological variables were extracted for use as covariates in meta-regression models. A literature search identified 288 studies suitable for the CTQ total score analysis ( N = 59,692) and 189 studies suitable for maltreatment subtype analysis ( N = 44,832). We found that Europe and Asia were associated with lower CTQ estimates while South America presented the highest estimates among continents. Specifically, studies from China, Netherlands and United Kingdom presented the lowest maltreatment estimates. Furthermore, high-income countries presented lower CTQ physical neglect estimates in comparison to low- or middle-income countries, while per-capita gross domestic product of countries was negatively associated with childhood physical neglect estimates. Despite the influence of methodological covariates, these findings indicate that geographical and economic factors could influence variations of childhood maltreatment estimates around the world, particularly when assessed by a structured standardized questionnaire. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate if a polymorphism in the NR3C2 gene moderates the association between childhood trauma on serum levels of brain derived neurothrophic factor (sBDNF). sBDNF was used here as a general marker of alteration in brain function. This is a community cross sectional study comprising 90 adolescents (54 with anxiety disorders). DNA was extracted from saliva in order to genotype the MR-2G/C (rs2070951) polymorphism using real time PCR. Blood was collected for sBDNF Elisa immunoassay. The Childhood Trauma Questionnaire (CTQ) was used to evaluate childhood abuse and neglect. Main effects and gene environment interactions were tested using linear regression models. Anxiety disorders were not associated with the MR-2G/C polymorphism or with sBDNF levels, but the number of C alleles of the MR-2G/C polymorphism was significantly associated with higher sBDNF levels (b = 8.008; p-value = 0.001). Subjects with intermediate and high exposure to physical neglect showed higher sBDNF levels if compared to subjects non-exposed (b = 11.955; p = 0.004 and b = 16.186; p = 0.009, respectively). In addition, we detected a significant physical neglect by MR-2G/C C allele interaction on sBDNF levels (p = 0.005), meaning that intermediate and high exposure to childhood neglect were only associated with increased sBDNF levels in subjects with the CC genotype, but not in subjects with other genotypes. Our findings suggest that genetic variants in NR3C2 gene may partially explain plastic brain vulnerability to traumatic events. Further studies are needed to investigate the moderating effects of NR3C2 gene in more specific markers of alteration in brain function. [ABSTRACT FROM AUTHOR]

The Temperament and Personality Questionnaire (T&P) is a flexible tool for assessing personality styles in depression. To investigate its reliability and validity, a sample of 399 depressed outpatients was investigated. Confirmatory Factor Analysis (CFA) was performed to test seven hierarchically organized models. The validity of the hierarchical structure was assessed using correlations among the observed factor scores for each model. External validation was performed using structural equation models for quality of life (QOL) and severity of depression (DEP). Internal consistency was high for all of seven models. CFA indicated proper goodness fit for models from two to four factors. Correlations among factors from all models overall gave support to the hierarchically organized structure, except for perfectionism not being encompassed by the construct of introversion. Associations among T&P factors and both QOL and DEP showed the expected relationships, with resilient personality styles decreasing quality of life and increasing state depression levels, while disordered personality styles showed the converse associations. The T&P showed high reliability and construct validity for Brazilian depressive patients, replicating and extending the results from original studies. The T&P is a flexible instrument assessing personality in depressive patients and might help to further disentangle its vast heterogeneity. [ABSTRACT FROM AUTHOR]

Background The investigation of neurodevelopment during late childhood and pre-adolescence has recently attracted a great deal of interest in the field of neuroimaging. One promising topic in this field is the formation of brain networks in healthy subjects. The integration between neural modules characterizes the ability of the network to process information globally. Although many fMRI-based neurodevelopment studies can be found in the literature, the analyses of very large samples (on the order of hundreds of subjects) that focus on the late childhood/pre-adolescence period and resting state fMRI are scarce, and most studies have focused solely on North American and European populations. Aims In this study, we present a descriptive investigation of the developmental formation of the Default Mode Network and the Control Network based on a Brazilian, cross-sectional community sample of 447 typically developing subjects aged 7-15 years old. Methods Resting state fMRI data were acquired using two MRI systems from the same manufacturer using the same acquisition parameters. We estimated the age effects on the strength of the links (between brain regions) and the network features (graph descriptors: degree and eigenvector centrality). Results Our findings showed an increase in the antero-posterior connectivity in both studied networks during brain development. The graph analyses showed an increase in centrality with age for most regions in the Default Mode Network and the dorsal anterior and posterior cingulate, the right anterior insula and the left posterior temporal cortex in the Control Network. Conclusion We conclude that the period of 7-15 years of age is crucial for the development of both the Default Mode and Control networks, with integration between the posterior and anterior neuronal modules and an increase in the centrality measures of the hub regions. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to define the latent structure of parent-reported manic symptoms and their association with functional impairment and familial risk in a community sample of Brazilian children. Method: We screened for manic symptoms in a community sample of 2,512 children 6 to 12 years of age. Parents of children with "episodes of going abnormally high" completed a detailed mania section (n = 479; 19.1%). Confirmatory factor analysis (CFA) tested a solution with "Under-Control (UC)" and "Exuberant (EX)" dimensions, investigating the severity (threshold) and factor loading of each symptom. We also used latent class analysis (LCA) to evaluate the latent categorical structure of manic symptoms. Associations of these latent constructs with psychiatric comorbidity, psychosocial impairment, and family history of psychopathology were tested. Results: The 2-dimensional model fit the data well. Only the UC dimension was associated with psychiatric morbidity, psychosocial impairment, and a family history of mania, depression, or suicide attempts. Both UC and EX items discriminated subjects with "episodes of going abnormally high," but EX items lay at the mild end of the severity spectrum, whereas UC items lay at the severe end. The LCA yielded a small group of children with high levels of manic symptoms and a distinct profile of psychiatric comorbidity and impairment ("high-symptom group"). Conclusion: In a large, community-based sample, we found a 2-dimensional latent structure for parent-reported manic symptoms in youth, and demonstrated familial associations between the UC dimension and affective disorders. Both UC and EX items are clinically useful, but their contributions vary with symptom severity. [ABSTRACT FROM AUTHOR]

Computational models mimic important concepts inherent to brain function and the relationships among these concepts in a mathematical form.1 These models offer a suitable approach to quantitatively explore properties of complex systems across levels of investigation. Therefore, these models may be well suited to linking molecular, cellular, circuits, cognition, and behavior in psychiatry.2 Although some progress has been made in applying such models for understanding other mental disorders,2,3 their role in uncovering the cognitive mechanisms underpinning disruptive mood dysregulation disorder (DMDD) has not previously been explored in the medical literature. In fact, very little is known about the neurocognitive correlates of DMDD in children. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of the present study was to test the ability of adolescents with a current anxiety diagnosis to recognize facial affective expressions, compared to those without an anxiety disorder. Methods: Forty cases and 27 controls were selected from a larger cross sectional community sample of adolescents, aged from 10 to 17 years old. Adolescent’s facial recognition of six human emotions (sadness, anger, disgust, happy, surprise and fear) and neutral faces was assessed through a facial labeling test using Ekman’s Pictures of Facial Affect (POFA). Results: Adolescents with anxiety disorders had a higher mean number of errors in angry faces as compared to controls: 3.1 (SD=1.13) vs. 2.5 (SD=2.5), OR=1.72 (CI95% 1.02 to 2.89; p =0.040). However, they named neutral faces more accurately than adolescents without anxiety diagnosis: 15% of cases vs. 37.1% of controls presented at least one error in neutral faces, OR=3.46 (CI95% 1.02 to 11.7; p =0.047). No differences were found considering other human emotions or on the distribution of errors in each emotional face between the groups. Conclusion: Our findings support an anxiety-mediated influence on the recognition of facial expressions in adolescence. These difficulty in recognizing angry faces and more accuracy in naming neutral faces may lead to misinterpretation of social clues and can explain some aspects of the impairment in social interactions in adolescents with anxiety disorders. [Copyright &y& Elsevier]

Abstract: Different lines of evidence support BDNF as a candidate gene in mood and anxiety modulation. More recently, the Met allele of the BDNF Val66Met polymorphism has been implicated in anxiety in animal models and anxiety-traits in humans. The aim of this study is to evaluate the a priori hypothesis that the association between anxiety disorders and Val66Met polymorphism at the BDNF gene would be replicated in a community sample of children and adolescents. 240 subjects from a total sample of 2457 children and adolescents aged 10–17 years from the public schools in the catchment area of the primary care unit of a university hospital participated in this case-control study and were assessed for psychopathology using the K-SADS-PL. A sample of saliva was collected for DNA analysis of Val66Met polymorphism. BDNF was the single gene evaluated in this sample. We found a significant association between carrying one copy of the Met allele and higher chance of anxiety disorders in children and adolescents. The association remained positive even after the adjustment for potential confounders (228 subjects; OR=3.53 (CI95% 1.77–7.06; p <0.001)). Our results support the a priori hypothesis of an association between anxiety and the polymorphism Val66Met. To our knowledge, this is the first study documenting a potential role of this polymorphism in a community sample of anxious children and adolescents. [Copyright &y& Elsevier]

Abstract: The aim of this study was to evaluate the psychometric properties of the Brazilian-Portuguese version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large community sample of Brazilian children and adolescents. A total of 2410 students completed the 41-item Brazilian-Portuguese version of the SCARED. The one-factor and the five-factor structure of the SCARED fit this sample well. However, the five-factor model had a significantly better fit than the one-factor model and an adequate fit for age and gender subgroups. Anxiety symptoms in Brazilian youth were reported at a moderate-high level as compared to other studies. Females were found to score significantly higher on the total score and on all of the subscales as compared to the males. The total score and each of the five factors for both children and adolescents showed good internal consistency, test–retest and construct validity. According to our findings the Brazilian-Portuguese version of the SCARED is a reliable and valid instrument to assess anxiety in Brazilian children and adolescents. [Copyright &y& Elsevier]

Abstract: Objective: The aim of this study is to evaluate the association between HTR1A, HTR2A and the 5-HTTLPR in panic disorder (PD) patients and controls. In addition, this study also aims to evaluate the interaction between these genes and two environmental factors previously associated with PD: childhood trauma and parental bonding. Methods: This is a case–control candidate gene association study (107 PD patients and 125 controls). Genes were analyzed using a gene-based test in PLINK followed by single marker association tests and haplotype test only for genes that reached experiment-wide significance in the gene-based test in order to minimize multiple testing. Logistic regression was used to test the relationships between genotype in the additive model, trauma, optimal paternal parenting and optimal maternal parenting and their interactions. Results: Only HTR1A was associated with PD in gene-based test after correction for multiple tests (p corrected =0.027) and one HTR1A haplotype comprising four SNPs was associated with PD (p corrected =0.032). In the interaction analysis, no significant gene–environment interaction was found with the genes evaluated. Conclusion: This study reinforces the association between HTR1A and PD. No major evidence of gene–environment interaction in PD with parenting or trauma was found. Further studies are necessary in order to confirm these findings. [ABSTRACT FROM AUTHOR]

The article presents a study focusing on the association between migration and the prevalence of psychiatric disorders in childhood and adolescence. Topics include worldwide migration flows determined according to movements of the world population as measured by the World Bank since 1960, which classified countries as isolated, emitter, receiver, and transit and the prevalence mental disorder found to be higher for emitter and receiver countries compared with transit and isolated countries.

Abstract: Objective: The purpose of the study is to compare the personality traits assessed with the Temperament and Character Inventory (TCI) between patients with panic disorder (PD) and a control group in a Brazilian sample. Methods: One hundred thirty-five patients with PD paired according to sex and age with 135 controls without any psychiatric disorders were assessed with the Mini International Neuropsychiatric Interview (MINI), a structured interview. Temperament and character were assessed with the TCI. Results: Consistently, patients with PD presented higher scores on the harm avoidance (HA) temperament scale (23.20 ± 5.41 vs 15.21 ± 4.92; P < .001) and lower scores on the self-directedness (SD) (27.81 ± 7.25 vs 35.16 ± 5.47; P < .001) if compared to the control group and has been associated independently from other TCI scales and confounders with PD. The multivariate logistic model containing HA and SD explains 38.6% to 51.4% of the differences between PD and controls. Conclusions: Harm avoidance could be a good candidate to be heritable because it appears to be a consistent finding across current literature in anxious and depressed patients independent of their cultural context. Also, SD seems to be a key character characteristic of PD patients. The dimensional assessment is an interesting alternative for understanding the relationship between the psychobiologic bases of temperament and character and is highly related to the development of psychiatric syndromes. [Copyright &y& Elsevier]

An abstract of the article "Looking at Both Ends of the Social Aptitude Dimension" by Giovanni Salum is presented.

Burnout syndrome (BS) has been classified as an independent 'work-related phenomenon', however, there is still an important discussion on whether BS is a unique clinical construct due to the overlapping symptoms with other domains of negative affect such as symptoms of depression, anxiety, and irritability. Thus, we investigated the common and dissociable aspects between BS and domains of negative affect such as depression, anxiety, and irritability through a cross-sectional study with 3428 essential service professionals from a national project during the COVID-19 pandemic. Participants were assessed with Burnout Assessment Tool (BAT) and the Patient-Reported Outcomes Measurement Information System (PROMIS) scales to assess the severity of depression, anxiety, and irritability. The discriminability between the constructs was investigated using correlation tests, Bifactor Exploratory Structural Equation Modeling Bifactor (ESEM), and network analyzes. The mean correlation among the four subscales of BAT-12 was stronger with each other than with depression, anxiety, and irritability. Both ESEM and network analysis, despite showing shared characteristics, clearly delineated that Burnout domains were dissociable from other domains of negative affect. Our findings corroborate the ICD-11 strategy to include BS as a separate entity that cannot be fully explained by variance accounted for by other domains. • The most widespread definition of burnout contributes to the persistent discussion about its overlap with depression. • In the covid-19 pandemic, essential service workers were exposed to risky situations for symptoms related to negative affects. • The association of burnout with symptoms of anxiety and depression does not invalidate the existence of burnout. [ABSTRACT FROM AUTHOR]

Little is known about the relationship between depression in mothers and problematic gaming in their children. Therefore, we aimed to investigate the potential role of mothers' depression in childhood as a risk factor for problematic gaming in their offspring in late adolescence/young adulthood. We assessed data from 1557 participants on three waves (T0 collected in 2010/2011, T1 in 2013/2014, and T2 in 2018/2019) of a large Brazilian school-based cohort. Mother's depression at T0 was tested as a predictor of problematic gaming at T2 in a logistic regression model. In mediation analyses, we individually assessed internalizing or externalizing disorders at T1 as mediators in this association, with participants' sex being tested as a moderator in both models. Inverse probability weights were used to account for sample attrition at T2. All models were adjusted for maternal and participant-related covariates. Mother's depression at T0 was significantly associated with problematic gaming at T2 (OR = 2.09, p < 0.001) even after adjusting for multiple confounding factors. The presence of any internalizing disorder at T1 was a partial mediator of this relationship, accounting for 8.18% (p = 0.032) of the total effect, while the presence of any externalizing disorder at T1 was not a significant mediator. Participants' sex was not a significant moderator in mediation models. These findings suggest mother's depression in childhood as a risk factor for problematic gaming in later developmental stages, which may be partially mediated by internalizing psychopathology. • Mother's depression at childhood is significantly associated with problematic gaming in late adolescence/young adulthood. • The presence of internalizing disorders at late childhood/early adolescence was a partial mediator of this relationship. • Presence of externalizing disorders at the same developmental period was not a significant mediator of this relationship. • Participants' biological sex was not a significant moderator in mediation models. • These results suggest mother's depression in childhood as a risk factor for problematic gaming in later developmental stages. [ABSTRACT FROM AUTHOR]

The impact of COVID-19 anxiety on mental health and its association with preventive measures is well-established. We aimed to study how COVID-19 anxiety and its dimensions vary over time (16 months) in a sample of individuals (N = 2717) suffering from mental distress in the pandemic context that participated in a randomized clinical trial testing psychosocial interventions in Brazil. Results showed that pandemic anxiety reduced over time. COVID-19 influences fear of others being infected and concerns about mental health being affected by COVID-19 were more significant than the fear of being infected or the physical health influenced by COVID-19. A similar temporal effect was not found for burnout, and this effect was not correlated with the number of COVID-related deaths. Habituation to pandemic anxiety or higher intolerance of uncertainty at the beginning of the pandemic is putative mechanisms for the patterns observed in the data. They might have implications for mental health interventions in the pandemic scenario and motivational strategies for prevention. TRIAL REGISTRATION NUMBER: Plataforma Basil (CAAE: 30608420.5.0000.5327), ClinicalTrials.gov (NCT04632082; November 17, 2020). [ABSTRACT FROM AUTHOR]

Temperament involves stable behavioral and emotional tendencies that differ between individuals, which can be first observed in infancy or early childhood and relate to behavior in many contexts and over many years.1 One of the most rigorously characterized temperament classifications relates to the tendency of individuals to avoid the unfamiliar and to withdraw from unfamiliar people, objects, and unexpected events. This temperament is referred to as behavioral inhibition or inhibited temperament (IT).2 IT is a moderately heritable trait1 that can be measured in multiple species.3 In humans, levels of IT can be quantified from the first year of life through direct behavioral observations or reports by caregivers or teachers. Similar approaches as well as self-report questionnaires on current and/or retrospective levels of IT1 can be used later in life. [ABSTRACT FROM AUTHOR]

Abstract: The serotonin transporter promoter polymorphism (5-HTTLPR) has been investigated regarding its association with neuroticism, which, in its turn, is a personality dimension often found in patients with panic disorder (PD). It has been recently evidenced that the long 5-HTTLPR polymorphism has a genetic variation (Lg), which is related to its lower expression. The objective of this study was to assess the association between the 5-HTTLPR polymorphism in the triallelic system and the neurotic personality traits in patients in PD remission. Sixty-seven Caucasian patients with PD diagnosis according to the DSM-IV-TR assessed with the MINI (mini international neuropsychiatric interview) were included. The MMPI (Minnesota multiphasic personality inventory) was used to assess the personality. The remission of PD symptoms was defined as CGI (clinical global impression) ≤2 and absence of panic attacks. The patients’ genotypes were grouped according to the level of expression: low expression (SS, SLg and LgLg), intermediate expression (SLa, LgLa) and high expression (LaLa). There was no significant deviation from Hardy–Weinberg equilibrium (χ 2 =0.52, d.f.=1, p =0.471). According to the triallelic classification, the distribution of alleles in these patients was as follows: S 58 (43.3%), Lg 17 (12.7%) and La 59 (44.0%). There were no significant differences on the MMPI scales between different genotype classifications and allele analyses. Larger samples are necessary to exclude the less relevant genetic influences on these traits. In addition, other polymorphisms should be considered in the characterization of a heritable phenotype in the PD. [Copyright &y& Elsevier]

Background: Lesbian, Gay, Bisexual, Transgender, Queer, and Asexual (LGBTQA+) youth have a greater chance of experiencing stressful life events when compared to cisgender heterosexual peers, which can lead to mental health problems. We aimed to estimate the prevalence of mental disorders among LGBTQA+ youths from two large cities in Brazil.Methods: Participants were 13-22 years old youths from the 3rd wave of the Brazilian High-Risk Cohort for Psychiatric Disorders (n = 1475). Mental disorders were assessed using the Development and Well-Being Behavior Assessment. Sexual orientation and gender identity were assessed using a self-report confidential questionnaire. Data were analyzed through logistic regressions (adjusting for sociodemographic) using sampling weights to account for attrition and our oversampling high-risk design.Results: 15.18% of the sample described themselves as LGBTQA+. The LGBTQA+ group presented higher rates of anxiety disorders (30.14% vs. 13.37%; OR = 3.37; 95%CI:2.51-4.50), depressive disorders (27.75% vs. 15.34%; OR = 2.17; 95%CI:1.60-2.93) and post-traumatic stress disorder (4.98% vs. 2.25%; OR = 4.20; 95%CI:2.24-7.82), if compared with the cisgender heterosexual group. No difference was found for conduct disorders (2.97% vs. 5.21%; OR = 0.82; 95%CI:0.35-1.65) or attention deficit hyperactivity disorder (5.92% vs. 3.28%; OR = 1.56; 95%CI:0.83-2.79).Limitations: Although recruitment was performed at 57 schools in the two cities, sampling was non-probabilistic and included only urban areas, which might bias prevalence estimates and group comparisons.Conclusions: Our results elucidate the mental health disparities between LGBTQA+ people and cisgender heterosexuals in Brazil. It highlights the need to promote the inclusion of this population in policy formulation and support actions to mitigate the suffering related to sexual orientation and gender identity. [ABSTRACT FROM AUTHOR]

Objective: It is unclear if pediatric executive dysfunction assessed only with cognitive tasks predicts clinically relevant outcomes independently of psychiatric diagnoses. This study tested the stability and validity of a task-based classification of executive function.Method: A total of 2,207 individuals (6-17 years old) from the Brazilian High-Risk Cohort Study participated in this study (1,930 at baseline, 1,532 at follow-up). Executive function was measured using tests of working memory and inhibitory control. Dichotomized age- and sex-standardized performances were used as input in latent class analysis and receiver operating curves to create an executive dysfunction classification (EDC). The study tested EDC's stability over time, association with symptoms, functional impairment, a polymorphism in the CADM2 gene, polygenic risk scores (PRS), and brain structure. Analyses covaried for age, sex, social class, IQ, and psychiatric diagnoses.Results: EDC at baseline predicted itself at follow-up (odds ratio [OR] = 5.11; 95% CI 3.41-7.64). Participants in the EDC reported symptoms spanning several domains of psychopathology and exhibited impairment in multiple settings, including more adverse school events (OR = 2.530; 95% CI 1.838-3.483). Children in the EDC presented higher attention-deficit/hyperactivity disorder and lower educational attainment PRS at baseline; higher schizophrenia PRS at follow-up; and lower chances of presenting a polymorphism in a gene previously linked to high performance in executive function (CADM2 gene). They also exhibited smaller intracranial volumes and smaller bilateral cortical surface areas in several brain regions.Conclusion: Task-based executive dysfunction is associated with several validators, independently of psychiatric diagnoses and intelligence. Further refinement of task-based assessments might generate clinically useful tools. [ABSTRACT FROM AUTHOR]

The associations of anxiety and depression with metabolic syndrome (MetS) are not consistent across studies. Anxiety and depression are highly correlated and traditional methods don't take the structure of this correlation into account. Our aim is to disentangle the relationship of these emotional conditions with MetS, using bifactor models, modelling both general and specific aspects between anxiety and depression. Bifactor models were tested using the baseline data from the Brazilian Longitudinal Study of Adult Health (n = 13,584). Anxiety and depression were accessed with the Clinical Interview Schedule - Revised. MetS was measured through assessment of its continuous components. A bifactor S-1 model better represent the 14 CIS-R indicators, composed by an internalizing factor corresponding to depressive symptoms, anxiety, worry and the shared variance of all remaining CIS-R indicators, and also by residual variance explained by a somatic (e.g., fatigue and pain) and fear (e.g., panic and phobias) specific factors. Internalizing spectrum (β = 0.116; p < 0.001) and the fear specific factor (β = 0.060; p = 0.008) were associated with MetS after adjusting for confounders, whereas somatic specific factor was unlikely to be associated with MetS (β = 0.002; p = 0.934). Anxiety and depression indicators were associated with MetS via a shared internalizing factor and also by a residual fear factor, but not by somatic residual factor. This finding has potential implications about shared biological and behavioral mechanisms that may link emotional conditions with MetS in adults. • Associations of anxiety and depression with metabolic syndrome (MetS) are inconsistent possibly due to high correlation. • Bifactor models can disentangle communalities and specificities from depression and anxiety. • Anxiety and depression can be modelled by an internalizing spectrum and residual fear and somatic specific factors. • Internalizing spectrum and fear are associated with MetS in an adjusted structural equation model. • Symptoms of anxiety and depression may share biological and behavioral mechanisms that are linked with MetS. [ABSTRACT FROM AUTHOR]

Objective: To identify the most appropriate threshold for disruptive mood dysregulation disorder (DMDD) diagnosis and the impact of potential changes in diagnostic rules on prevalence levels in the community.Method: Trained psychologists evaluated 3,562 preadolescents/early adolescents from the 2004 Pelotas Birth Cohort with the Development and Well-Being Behavior Assessment (DAWBA). The clinical threshold was assessed in 3 stages: symptomatic, syndromic, and clinical operationalization. The symptomatic threshold identified the response category in each DAWBA item, which separates normative misbehavior from a clinical indicator. The syndromic threshold identified the number of irritable mood and outbursts needed to capture preadolescents/early adolescents with high symptom levels. Clinical operationalization compared the impact of AND/OR rules for combining irritable mood and outbursts on impairment and levels of psychopathology.Results: At the symptomatic threshold, most irritable mood items were normative in their lowest response categories and clinically significant in their highest response categories. For outbursts, some indicated a symptom even when present at only a mild level, while others did not indicate symptoms at any level. At the syndromic level, a combination of 2 out of 7 irritable mood and 3 out of 8 outburst indicators accurately captured a cluster of individuals with high level of symptoms. Analysis combining irritable mood and outbursts delineated nonoverlapping aspects of DMDD, providing support for the OR rule in clinical operationalization. The best DMDD criteria resulted in a prevalence of 3%.Conclusion: Results provide information for initiatives aiming to provide data-driven and clinically oriented operationalized criteria for DMDD. [ABSTRACT FROM AUTHOR]

Abstract: Genetic variation at the EF-hand domain containing 2 gene (EFHC2) locus has been associated with fear recognition in Turner syndrome. The aim of this study was to examine whether EFHC2 variants are associated with non-syndromic anxiety-related traits [harm avoidance (HA) and behavioral inhibition (BI)] and with panic disorder (PD). Our sample comprised 127 PD patients and 132 controls without psychiatric disorder. We genotyped nine SNPs within the EFHC2 locus and used PLINK to perform association analyses. An intronic SNP (rs1562875) was associated with HA (permuted p =0.031) accounting alone for over 3% of variance in this trait. This same SNP was nominally, but not empirically, associated with BI (r 2 =0.022; nominal p =0.022) and PD (OR=2.64; nominal p =0.009). The same association was found in a subsample of only females. In sum, we observed evidence of association between a variant in EFHC2, a gene previously associated with the processing of fear and social threat, and HA. Larger studies are warranted to confirm this association. [Copyright &y& Elsevier]

Objective: To investigate the effect of relatively younger age on attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis through three population-based cohorts and a meta-analysis.Method: This study included participants of three community-based cohorts in Brazil: 1993 Pelotas Cohort (N = 5,249), 2004 Pelotas Cohort (N = 4,231), and Brazilian High-Risk Study for Psychiatric Disorders (HRC study) (N = 2,511). We analyzed the effect of relatively younger age on ADHD symptoms and diagnosis. For the meta-analysis, we searched MEDLINE, PsycINFO, and Web of Science from inception through December 25, 2018. We selected studies that reported measures of association between relative immaturity and an ADHD diagnosis. We followed the Meta-analysis Of Observational Studies in Epidemiology guidelines. The protocol for meta-analysis is available on PROSPERO (CRD42018099966).Results: In the meta-analysis, we identified 1,799 potentially eligible records, from which 25 studies including 8,076,570 subjects (164,049 ADHD cases) were analyzed with their effect estimates. The summarized relative risk of an ADHD diagnosis was 1.34 (95% CI, 1.26-1.43, p < .001) for children born in the first 4 months of the school year (relatively younger). Heterogeneity was high (I2 = 96.7%). Relative younger age was associated with higher levels of ADHD symptoms in the 1993 Pelotas Cohort (p = .003), 2004 Pelotas Cohort (p = .046), and HRC study (p = .010).Conclusion: Children and adolescents who are relatively younger compared with their classmates have a higher risk of receiving an ADHD diagnosis. Clinicians should consider the developmental level of young children when evaluating ADHD symptoms. [ABSTRACT FROM AUTHOR]

To employ machine learning algorithms to examine patterns of rumination from RDoC perspective and to determine which variables predict high levels of maladaptive rumination across a transdiagnostic sample. Sample of 200 consecutive, consenting outpatient referrals with clinical diagnoses of schizophrenia, schizoaffective, bipolar, depression, anxiety disorders, obsessive compulsive and post-traumatic stress. Machine learning algorithms used a range of variables including sociodemographics, serum levels of immune markers (IL-6, IL-1β, IL-10, TNF-α and CCL11) and BDNF, psychiatric symptoms and disorders, history of suicide and hospitalizations, functionality, medication use and comorbidities. The best model (with recursive feature elimination) included the following variables: socioeconomic status, illness severity, worry, generalized anxiety and depressive symptoms, and current diagnosis of panic disorder. Linear support vector machine learning differentiated individuals with high levels of rumination from those ones with low (AUC = 0.83, sensitivity = 75, specificity = 71). Rumination is known to be associated with poor prognosis in mental health. This study suggests that rumination is a maladaptive coping style associated not only with worry, distress and illness severity, but also with socioeconomic status. Also, rumination demonstrated a specific association with panic disorder. [ABSTRACT FROM AUTHOR]