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Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)
... According to AAIDD (The American Association on Intellectual and Developmental Dissabilities), mental retardation has limitations both in intellectual function and adaptive behavior, which is shown by limitations in conceptual, social and practical adaptive abilities (Hallahan, Kauffman, & Pullen, 2012). The American Psychiatric Association (2000) classifies mental retardation into four categories , namely 1) mild mental retardation ( IQ 50-55 maximum 70 ), can be taught academically and requires little supervision in adaptive behavior , 2) moderate mental retardation ( IQ 35-40 to 50) -55 ), able to be trained for adaptive behavior and the ability to read and write simple , 3) severe mental retardation , requires total care assistance in adaptive behavior even requires protection from danger throughout his life , and 4 ) very severe or severe mental retardation ( IQ below 20-25), requires full protection from those around him. Based on the above categories, the categories of mental retardation that can still be developed for adaptive behavior are mild and moderate mental retardation. ...
... MENTARI's Guide (Teaching Skilled Children of Indonesian Joints). This guide includes materials such as knowledge related to mental retardation, skills that can be taught to mentally retarded children, problems that usually occur when bathing, how to solve problems, choosing when to teach bath skills, steps to teach bath skills and tips on choosing rewards (gifts) for children (Association, 2000;Martin, G., & Pear, 2003;Narayan, J., & Kutty, 2001;Narayan, 2007;Peshawaria, R, & Venkatesan, 1992). This guide is equipped with pictures to make it easier for mothers to understand the material. ...
... The knowledge test is prepared based on the material contained in the guide (Association, 2000;Martin, G., & Pear, 2003;Narayan, J., & Kutty, 2001;Narayan, 2007;Peshawaria, R, & Venkatesan, 1992) which includes 7 materials, namely related knowledge mental retardation, skills that can be taught to mentally retarded children, problems that usually occur when bathing, how to solve problems, choosing when to teach bath skills, steps to teach bathing skills and tips on choosing rewards (gifts) for children . ...
Bathing skill was an important skill that should be possessed by intellectual disability children so that they become independent. The result of preliminary study indicates that mothers of the intellectual disability did not have knowledge and skills in teaching children’s bathing skill so they often help their children to take a bath. Based on the matter, it requires a guide to improve mothers’ knowledge and skill in teaching bath skill for intellectual disability children. This research is aimed to perform the validation of MENTARI guide through content validation with professional judgment and empirical validation which uses one-group pretest-posttest. Wilcoxon’s Signed Rank Test was utilized to test the score difference between knowledge and skill of teaching intellectual disability children to take a bath themselves. Nine mothers who have intellectual disability children become the participants. The research result indicates that MENTARI guide was contently and empirically valid. The guide has also satisfying content validity (Aiken’s V= 0,80-0.98). The data analysis which utilizes Wilcoxon’s Signed Rank Test indicates that there was an increase of score of bathing teaching knowledge and skill with Z =-2,670 and p<0.05 for knowledge score and Z value = 2,670 and p< 0.05 for bathing teaching skill score.
... Depression can be defined as a situation in which the enjoyment and motivation of living decreases or is completely lost, a deep sadness and grief, feelings of anger, regret and guilt about past experiences, a pessimistic perception of the future, and a desire to die and commit suicide. In other words, depression; difficulty in thinking and concentrating, difficulty in memory, constant sadness and grief, feeling emptiness with anxiety, increase in nervous reactions, tendency to blame other individuals, change in appetite, questioning one's own worth with a sense of worthlessness, decreased interest in recreational activities and Decreased enjoyment of enjoyable activities, increased thoughts about death, increased smoking, coronary heart problems, difficulty in motivation (APA, 2000). ...
... The common features of the definitions are that it is an individual-specific experience due to pressure, expectation or threat, and that the person's perception of competence is negatively affected. In this context, the common features of the definition of stress are as follows (APA, 2000); feelings of guilt, irritability, grief, anger, sleep disturbance, change in appetite and weight, difficulty concentrating when making decisions, negative thoughts, difficulty in attention, not feeling peaceful, having problems with other individuals, and difficulties in communication. ...
In this study, it is aimed to examine the relationship between emotional reactivity, depression, anxiety and stress in elite athletes, considering that psychological qualities such as emotional reactivity and anxiety observed in athletes due to the heavy preparation conditions inherent in sports and the recent breaks in sports may increase the risk of psycho-social disorders. In this descriptive study, the relational survey model was used. The study group of the research consisted of a total of 209 elite level athletes, 59 women and 150 men, in different branches. As a data collection tool; “Emotional Responsiveness Scale” and “Turkish Short Form of Depression Anxiety Stress Scale (Dass 21)” were used. As a result of the study, there were significant differences between the emotional reactivity and depression, anxiety, and stress levels of the athletes involved in team sports compared to the athletes involved in individual sports, according to the sports branch. However, it has been determined that there is a positive and highly significant relationship between the emotional reactivity of the athletes and their depression, anxiety, and stress levels. As a result, considering the strong relationship between emotional reactivity and psychological adjustment skills, it is important to take protective measures in both social and professional lives of athletes for this concept, as an increase in the level of emotional reactivity may have positive relations with some psychological adjustment skills.Keywords: Anxiety, Depression, Elite Athlete, Emotional Reactivity, Stress
... [15][16][17][18][19][20] In particular, pediatric neurologists often have insufficient training in the management of depression and anxiety, and yet are required to act as primary mental health care providers. [21][22][23][24][25][26][27][28] The Psychiatric Pediatric Issues Task Force (TF), established in 2018, is a liaison between the Pediatric and the Psychiatry Commissions of the International League Against Epilepsy (ILAE). The TF involved experts from all ILAE world regions. ...
The Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy (ILAE) aimed to develop recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy. The Task Force conducted a systematic review and identified two studies that assessed the accuracy of four screening measures for depression and anxiety symptoms compared with a psychiatric interview. Nine studies met the eligibility criteria for treatment of anxiety and depressive disorders or symptoms. The risk of bias and certainty of evidence were assessed. The evidence generated by this review followed by consensus where evidence was missing generated 47 recommendations. Those with a high level of agreement (≥80%) are summarized. Diagnosis: (1) Universal screening for anxiety and depression is recommended. Closer surveillance is recommended for children after 12 years, at higher risk (e.g., suicide‐related behavior), with subthreshold symptoms, and experiencing seizure worsening or therapeutic modifications. (2) Multiple sources of ascertainment and a formal screening are recommended. Clinical interviews are recommended whenever possible. The healthcare provider must always explain that symptom recognition is essential to optimize treatment outcomes and reduce morbidity. (3) Questioning about the relationship between symptoms of anxiety or depression with seizure worsening/control and behavioral adverse effects of antiseizure medications is recommended. Treatment: (1) An individualized treatment plan is recommended. (2) For mild depression, active monitoring must be considered. (3) Referral to a mental health care provider must be considered for moderate to severe depression and anxiety. (4) Clinical care pathways must be developed. (5) Psychosocial interventions must be tailored and age‐appropriate. (6) Healthcare providers must monitor children with epilepsy who are prescribed antidepressants, considering symptoms and functioning that may not improve simultaneously. (7) Caregiver education is essential to ensure treatment adherence. (8) A shared‐care model involving all healthcare providers is recommended for children and adolescents with epilepsy and mental health disorders. We identified clinical decisions in the management of depression and anxiety that lack solid evidence and provide consensus‐based guidance to address the care of children and adolescents with epilepsy.
... Twenty-two early-course / drug-naïve or drug-free, and thirty chronic / medicated schizophrenia patients, attending the clinical services of the National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, participated in this study. Trained psychiatrists ascertained the diagnosis of schizophrenia as per DSM-IV TR (Association, 2010) in patient participants using Mini International Neuropsychiatric Interview (Sheehan et al., 1998) Experienced psychiatrist (GVS/JCN) independently re-affirmed the diagnosis for each patient. Thirty-six unaffected first-degree relatives of schizophrenia patients also consented to take part in this study. ...
... CN individuals were defined as individuals without MCI or dementia and with clinical dementia rating (CDR) global score of 0. MCI was defined as having CDR score of 0.5 and meeting core clinical criteria for diagnosis of MCI on the National Institute on Aging and Alzheimer's Association (NIA-AA) guideline [22]. AD dementia was defined as meeting the criteria for dementia on the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV-TR) [23] and the NIA-AA criteria for probable AD [24]. All participants with AD dementia had CDR score of 0.5 or 1. ...
Background
Growing evidence suggests that not only cerebrovascular disease but also Alzheimer’s disease (AD) pathological process itself cause cerebral white matter degeneration, resulting in white matter hyperintensities (WMHs). Some preclinical evidence also indicates that white matter degeneration may precede or affect the development of AD pathology. This study aimed to clarify the direction of influence between in vivo AD pathologies, particularly beta-amyloid (Aβ) and tau deposition, and WMHs through longitudinal approach.
Methods
Total 282 older adults including cognitively normal and cognitively impaired individuals were recruited from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE) cohort. The participants underwent comprehensive clinical and neuropsychological assessment, [¹¹C] Pittsburgh Compound B PET for measuring Aβ deposition, [¹⁸F] AV-1451 PET for measuring tau deposition, and MRI scans with fluid-attenuated inversion recovery image for measuring WMH volume. The relationships between Aβ or tau deposition and WMH volume were examined using multiple linear regression analysis. In this analysis, baseline Aβ or tau were used as independent variables, and change of WMH volume over 2 years was used as dependent variable to examine the effect of AD pathology on increase of WMH volume. Additionally, we set baseline WMH volume as independent variable and longitudinal change of Aβ or tau deposition for 2 years as dependent variables to investigate whether WMH volume could precede AD pathologies.
Results
Baseline Aβ deposition, but not tau deposition, had significant positive association with longitudinal change of WMH volume over 2 years. Baseline WMH volume was not related with any of longitudinal change of Aβ or tau deposition for 2 years. We also found a significant interaction effect between baseline Aβ deposition and sex on longitudinal change of WMH volume. Subsequent subgroup analyses showed that high baseline Aβ deposition was associated with increase of WMH volume over 2 years in female, but not in male.
Conclusions
Our findings suggest that Aβ deposition accelerates cerebral WMHs, particularly in female, whereas white matter degeneration appears not influence on longitudinal Aβ increase. The results also did not support any direction of influence between tau deposition and WMHs.
... Exclusion criteria:(1) patients with mental disorders diagnosed by a physician according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, TR) [31]; (2) inability to communicate orally; and (3) presence of other life-threatening comorbidities, such as malignant tumors, cardiorespiratory failure, and severe infection. ...
Background
Primary caregivers of hemodialysis patients suffer from varying degrees of stress from their patients. Caring for hemodialysis patients can expose caregivers to many problems, leading to an increased burden of care and even impacting the quality of care. The purpose of our study was to examine whether family resilience could be a mediating variable moderating the relationship between patient coping styles and caregiver burden.
Methods
The study was a cross-sectional and descriptive-analytical study that interviewed 173 pairs of hemodialysis patients and their caregivers at a blood purification center in a public hospital in China. The Brief Coping Styles Scale (Chinese version) was used to assess individuals’ coping styles for disease and treatment. From the caregiver’s perspective, the Family Resilience Assessment Scale (Chinese version) was used to understand the resilience of families, and the Zarit Caregiver Burden Scale was used to capture the caregiver’s subjective experience of burden. Statistical analyses were conducted using SPSS version 23 and Amos version 26 to analyze the relationships between variables to examine for correlation and construct mediated effects models.
Results
Coping styles showed a significant positive correlation with family resilience (r = 0.347, P < 0.01) and a negative correlation with caregiver burden (r = -0.379, P < 0.01). A significant negative correlation was found between family resilience and caregiver burden (r = -0.503, P < 0.01). In the mediation model, patient coping styles directly impacted caregiver burden significantly (95% CI [-0.372, -0.058]), and coping styles indirectly impacted caregiver burden by family resilience in a significant way (95% CI [-0.275, -0.098]).
Conclusions
Patient coping styles directly affect caregiver burden. Family resilience is a mediating variable between patients’ coping styles and the burden on caregivers.
... The assessment questionnaire for ADHD (a version of the ADHD Rating Scale-IV; DuPaul, Power, Anastopoulos, & Reid, 1998) included 18 items based on the symptoms listed in the Diagnostic and Statistical Manual of MentalDisorders(Nomenclature, Statistics, & Association, 2008) for ADHD diagnosis. ...
... La dislexia es definida por el DSM IV como "una dificultad del aprendizaje que tiene un origen neurológico, se caracteriza por dificultades en el correcto o fluido reconocimiento de palabras y por un deletreo y habilidades decodificadoras pobres a pesar de una adecuada inteligencia, instrucción y habilidades sensoriales" (13). En la Guía General sobre Dislexia (10) se indica que los estudiantes que sufren dislexia presentan problemas tanto de precisión como de velocidad lectora, según la guía, "ello les limita en cuanto a la cantidad de recursos cognitivos que pueden utilizar para realizar una lectura comprensiva del nivel que se exige en la escuela" (14) La dislexia persiste a lo largo de toda la vida de los individuos. ...
El objetivo de esta comunicación es reflexionar, desde la lingüística clínica, en torno a cómo los estudiantes con dislexia han afrontado los retos y dificultades que implica la lectura de textos científicos y académicos durante la formación universitaria. La lectura en la universidad tiene un mayor nivel de complejidad, se caracteriza por el uso del discurso referido, por el dominio de los géneros discursivos propios de cada área del saber y por el uso de un léxico especializado. A través del análisis de experiencias de profesionales con dislexia y de las consideraciones de investigadores sobre el tema, se concluye que es necesario promover ejercicios de investigación interdisciplinar con el objetivo de ayudar al estudiante disléxico a superar los retos de la educación universitaria.
... Participants diagnosed with PTSD in response to a threat to life trauma (Criterion A) were excluded from the analysis (n = 4). Clinically significant PTSS were defined as meeting Criteria B1 (intrusive memories), at minimum two symptoms of avoidance of stimuli and numbing (Criterion C), and at least two symptoms of increased arousal (Criterion D), with a duration of more than one month (Criterion E) and symptoms causing significant distress and/or impairment (Criterion F; [34]). The inclusion criterion for the original SAD group was a primary diagnosis of SAD, and a diagnosis of OCD was an exclusion criterion. ...
Cognitive theories of post-traumatic stress disorder (PTSD) feature appraisal of trauma as a critical factor in the development and maintenance of the disorder. Here we explored appraisals of social trauma (severe rejection or humiliation). Participants were outpatients with social anxiety disorder (SAD) and clinically significant PTSD symptoms (PTSS) after social trauma (n = 15); two clinical control groups of either SAD (n = 32) or obsessive-compulsive disorder (OCD; n = 13); and a control group with no diagnoses (n = 38). Measures included a clinical interview to assess social trauma and related open-ended appraisals and the Posttraumatic Cognitions Inventory (PTCI). Raters blind to group assignment performed content analyses of appraisals. Results showed that the PTSS group scored significantly higher than either clinical group on the PTCI SELF subscale. Only the SELF subscale predicted a diagnosis of both PTSS and SAD. All but one PTSS participant reported primarily negative beliefs about their social trauma, and the most common categories were flawed self and others are critical or cruel. Post-traumatic appraisals implicated in the course of PTSD are significant in how individuals respond to social trauma, with negative self-cognitions linked to both PTSS and SAD.
... suspected of ASD; and annual linkage to the Norwegian Patient Register (NPR) [14]. Cases were defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) [15] criteria. Children diagnosed at the ABC Study Clinic were assessed by clinical psychologists and child psychiatrists using standardized diagnostic instruments including the Autism Diagnostic Interview-Revised (ADI-R) [16] and the Autism Diagnostic Observation Schedule (ADOS) [17] and tests of intellectual and adaptive functioning and language capacity. ...
The discovery of prenatal and neonatal molecular biomarkers has the potential to yield insights into autism spectrum disorder (ASD) and facilitate early diagnosis. We characterized metabolomic profiles in ASD using plasma samples collected in the Norwegian Autism Birth Cohort from mothers at weeks 17–21 gestation (maternal mid-gestation, MMG, n = 408) and from children on the day of birth (cord blood, CB, n = 418). We analyzed associations using sex-stratified adjusted logistic regression models with Bayesian analyses. Chemical enrichment analyses (ChemRICH) were performed to determine altered chemical clusters. We also employed machine learning algorithms to assess the utility of metabolomics as ASD biomarkers. We identified ASD associations with a variety of chemical compounds including arachidonic acid, glutamate, and glutamine, and metabolite clusters including hydroxy eicospentaenoic acids, phosphatidylcholines, and ceramides in MMG and CB plasma that are consistent with inflammation, disruption of membrane integrity, and impaired neurotransmission and neurotoxicity. Girls with ASD have disruption of ether/non-ether phospholipid balance in the MMG plasma that is similar to that found in other neurodevelopmental disorders. ASD boys in the CB analyses had the highest number of dysregulated chemical clusters. Machine learning classifiers distinguished ASD cases from controls with area under the receiver operating characteristic (AUROC) values ranging from 0.710 to 0.853. Predictive performance was better in CB analyses than in MMG. These findings may provide new insights into the sex-specific differences in ASD and have implications for discovery of biomarkers that may enable early detection and intervention.
... Module (SCID-SAM) [72]. The SCID-SAM is a clinical interview used to assess whether participants meet criteria for any SUD (alcohol-, cannabis-, stimulant-, hallucinogen-, opioid use disorders) listed in the DSM-IV [71]. Trained raters coded the presence of DSM-IV symptoms of substance abuse and dependence on a three-point scale (0 = not present, 1 = subthreshold, 2 = present). ...
The aim of the current study was to examine the effects of length of abstinence on decision-making (impulsive choice) and response inhibition (impulsive action) in former opiate users (OU). Participants included 45 OU in early remission [0-12 months of abstinence], 68 OU in sustained remission [>12 months of abstinence], and 68 control participants. Decision-making was assessed with the Iowa Gambling Task (IGT), the Cambridge Gambling Task (CGT), and the Monetary Choice Questionnaire (MCQ). Response inhibition was examined with the Stop Signal Task (SST), and the Go/No-Go Task (GNG). Results revealed group differences in decision-making under risk (CGT) and ambiguity (IGT), where control participants displayed better decision-making compared to OU in early remission. Both groups of former OU were also characterized by higher discounting of delayed rewards (MCQ). Regression analyses revealed minimal effects of length of abstinence on performance on decision-making tasks and no effects on delay discounting. In addition, both OU groups showed reduced action inhibition (GNG) relative to controls and there were no group differences in action cancellation (SST). Length of abstinence had no effect on response inhibition. Overall, our findings suggest that neurocognitive function may not fully recover even with protracted abstinence, which should be addressed by relapse prevention and cognitive remediation programs for OU.
... Participants diagnosed with PTSD in response to a threat to life trauma (Criterion A) were excluded from the analysis (n = 4). Clinically significant PTSS were defined as meeting Criteria B1 (intrusive memories), at minimum two symptoms of avoidance of stimuli and numbing (Criterion C), and at least two symptoms of increased arousal (Criterion D), with a duration of more than one month (Criterion E) and symptoms causing significant distress and/or impairment (Criterion F; [34]). The inclusion criterion for the original SAD group was a primary diagnosis of SAD, and a diagnosis of OCD was an exclusion criterion. ...
... Autis juga diartikan sebagai gangguan perkembangan yang parah dimana sebelum anak berusia 3 tahun gejalanya sudah mulai tampak, bahkan mampu diketahui pada minggu pertama kehidupan. Gangguan tersebut mencakup gangguan interaksi sosial, komunikasi, terdapat tingkah laku stereotipe, serta minat dan aktivitas yang terbatas (Association, 2000). ...
One of the characteristics of children with autism or Autism Spectrum Disorder (ASD) has emotional disorders. This is in accordance with what happened at SD Plus Al-Ghifari. By applying murottal Al-Qur’an therapy which is indirectly able to make children calmer in learning. This study aims to determine the process and effect of murottal Al-Qur’an therapy on emotional disturbances in autistic children. The study methods field research with three data collection techniques, namely observation, interviews, and documentation conducted at SD Plus Al-Ghifari Bandung. According to the helper at SD Plus Al-Ghifari after receiving the murottal Al-Qur’an treatment, the students were able to be calmer and able to follow the instructions from the helper. Al-Qur’an murottal therapy is able to affect emotional disturbances in children with ASD.
... Current and lifetime diagnostic status was confirmed with Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I), 32 the official diagnostic tool for the diagnostic and statistical manual of psychiatric disorders. 1 The duration of the SCID-I is 30-90 minutes. Demographic data included age, gender, family history, the age of BD onset, duration time for diagnosis, and the number of affective episodes. ...
Introduction
Chronic stress has been linked to the pathophysiology of bipolar disorder (BD); however, the underlying mechanism remains unclear. In BD patients, hypothalamic-pituitary-adrenal (HPA) axis activity is associated with stress. This study aimed to examine the relationship between HPA axis activity and BD symptoms in various clinical states, as well as how personality influences the process.
Methods
This study investigated the differences in HPA axis activity among four BD states. We enrolled 813 BD patients in an 8-week longitudinal study to examine the relationship between HPA axis activity and symptom trajectories using dynamic temporal warping (DTW) analysis and an unsupervised machine learning technique. Furthermore, using mediation analyses, the relationship between the HPA axis, personality, and BD symptoms was investigated.
Results
Analysis of variance (ANOVA) analysis showed that glucocorticoid cortisol (CORT) and adrenocorticotropin (ACTH) did not differ significantly among the four clinical states of BD. The DTW integrating clustering analysis revealed that the two clusters were optimal, with cluster 1 characterized by severe manic symptoms, which then improved, and cluster 2, characterized by milder manic severity, which also improved. The two clusters showed different ACTH levels (t = 2.289, p = 0.022), and logistic regression analysis revealed a slight positive association between ACTH levels and cluster 1. Furthermore, the mediation analysis indicated that ACTH influences curative efficacy via conscientiousness (βc =0.103, p=0.001).
Discussion
In conclusion, we found that a higher level of ACTH is associated with severe manic symptoms, indicating a chronic stress response in BD patients. Additionally, the ACTH levels affect short-term BD curative efficacy via the mediation of conscientiousness, providing a psychotherapeutic strategy direction for BD.
... Major depressive disorder (MDD) and bipolar disorder (BD) are two major kinds of (mood) disorders [1]. The clinical differences between these syndromes, i.e., depression and mania vs only depression, indicate differences in their respective pathogenesis. ...
We investigated for the first time the proteomic profiles both in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) of major depressive disorder (MDD) and bipolar disorder (BD) patients. Cryostat sections of DLPFC and ACC of MDD and BD patients with their respective well-matched controls were used for study. Proteins were quantified by tandem mass tag and high-performance liquid chromatography-mass spectrometry system. Gene Ontology terms and functional cluster alteration were analyzed through bioinformatic analysis. Over 3000 proteins were accurately quantified, with more than 100 protein expressions identified as significantly changed in these two brain areas of MDD and BD patients as compared to their respective controls. These include OGDH, SDHA and COX5B in the DLPFC in MDD patients; PFN1, HSP90AA1 and PDCD6IP in the ACC of MDD patients; DBN1, DBNL and MYH9 in the DLPFC in BD patients. Impressively, depending on brain area and distinct diseases, the most notable change we found in the DLPFC of MDD was ‘suppressed energy metabolism’; in the ACC of MDD it was ‘suppressed tissue remodeling and suppressed immune response’; and in the DLPFC of BD it was differentiated ‘suppressed tissue remodeling and suppressed neuronal projection’. In summary, there are distinct proteomic changes in different brain areas of the same mood disorder, and in the same brain area between MDD and BD patients, which strengthens the distinct pathogeneses and thus treatment targets.
... Diagnostic assessment: Current and lifetime psychiatric disorders were evaluated with the Spanish version (Ulloa et al., 2006) [32] of the Kiddie-Schedule for Affective Disorders and Schizophrenia Interview [33]. The K-SADS-PL is a semi-structured interview developed to diagnose children and adolescents using DSM-IV [34] Axis I diagnoses. Diagnoses were adapted to DSM-5 [35]. ...
Purpose
The aim of the study was to examine the relationship between personality traits of parents and their daughters with AN by case-control study.
Method
50 adolescent girls with anorexia nervosa (AN) and both parents were measured with the Temperament and Character Inventory Revised (TCI-R), the Eating Disorder Inventory-2 (EDI-2) was used to assess eating symptoms.
Results
The results were compared with matched 50 controls girls without pathology (CG) and their parents. AN group and adolescent of CG did not differ in personality traits. Mothers and fathers in AN group showed significant differences in temperamental and character traits compared to mothers and fathers in CG. Both parents in AN group showed similar levels in personality traits. Regarding to correlations between personality traits in mothers and their daughters in the AN group, complementary relationships were found in mothers harm avoidance and daughters cooperativeness and fantasy, while in fathers and daughters associations between reward dependence, persistence and self-directedness. The only scale that discriminated between the two groups was drive for thinness between AN-G and CG (classification: 74.7%).
Conclusion
Evaluating and knowing the different personality traits in adolescents, mothers and fathers at the onset of AN will allow improvements in the intervention in the early phases.
Level of evidence
III: evidence obtained from well-designed case–control study.
... Individuals with gender dysphoria (GD) receiving gender-affirming hormone therapy (GHT) represent a unique cohort to investigate the direct effects of sex hormones on human brain structure. As described in the 5 th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), GD is defined as an incongruence between the biological sex assigned at birth and the experienced gender later in life (42). GHT basically involves the long-term administration of an estrogen and a type of androgen blocker in transgender women (TW), whereas the masculinization of transgender men (TM) can be supported by testosterone treatment (43). ...
MAO-A catalyzes the oxidative degradation of monoamines and is thus implicated in sex-specific neuroplastic processes that influence gray matter (GM) density (GMD) and microstructure (GMM). Given the exact monitoring of plasma hormone levels and sex steroid intake, transgender individuals undergoing gender-affirming hormone therapy (GHT) represent a valuable cohort to potentially investigate sex steroid-induced changes of GM and concomitant MAO-A density. Here, we investigated the effects of long-term GHT over a median time period of 4.5 months on GMD and GMM as well as MAO-A distribution volume. To this end, 20 cisgender women, 11 cisgender men, 20 transgender women and 10 transgender men underwent two MRI scans in a longitudinal design. PET scans using [ ¹¹ C]harmine were performed before each MRI session in a subset of 35 individuals. GM changes determined by diffusion weighted imaging (DWI) metrics for GMM and voxel based morphometry (VBM) for GMD were estimated using repeated measures ANOVA. Regions showing significant changes of both GMM and GMD were used for the subsequent analysis of MAO-A density. These involved the fusiform gyrus, rolandic operculum, inferior occipital cortex, middle and anterior cingulum, bilateral insula, cerebellum and the lingual gyrus (post-hoc tests: p FWE+Bonferroni < 0.025). In terms of MAO-A distribution volume, no significant effects were found. Additionally, the sexual desire inventory (SDI) was applied to assess GHT-induced changes in sexual desire, showing an increase of SDI scores among transmen. Changes in the GMD of the bilateral insula showed a moderate correlation to SDI scores (rho = −0.62, p Bonferroni = 0.047). The present results are indicative of a reliable influence of gender-affirming hormone therapy on 1) GMD and GMM following an interregional pattern and 2) sexual desire specifically among transmen.
Highlights
Gender-affirming hormone therapy led to significant changes in gray matter density and microstructure in various brain regions
Gray matter changes found after gender-affirming hormone therapy were not reflected by monoamone oxidase A density changes in the brain.
Masculinizing gender-affirming hormone therapy resulted in increased sexual desire in transgender men.
... Table 4 lists several values of accuracy in the literature, including those presented in this work. [74]. The participants were literate and without cognitive delays, which did not compromise the application of the game during the experiments. ...
Autism spectrum disorder refers to a neurodevelopmental disorders characterized by repetitive behavior patterns, impaired social interaction, and impaired verbal and nonverbal communication. The ability to recognize mental states from facial expressions plays an important role in both social interaction and interpersonal communication. Thus, in recent years, several proposals have been presented, aiming to contribute to the improvement of emotional skills in order to improve social interaction. In this paper, a game is presented to support the development of emotional skills in people with autism spectrum disorder. The software used helps to develop the ability to recognize and express six basic emotions: joy, sadness, anger, disgust, surprise, and fear. Based on the theory of facial action coding systems and digital image processing techniques, it is possible to detect facial expressions and classify them into one of the six basic emotions. Experiments were performed using four public domain image databases (CK+, FER2013, RAF-DB, and MMI) and a group of children with autism spectrum disorder for evaluating the existing emotional skills. The results showed that the proposed software contributed to improvement of the skills of detection and recognition of the basic emotions in individuals with autism spectrum disorder.
... PMDD was defined as late luteal phase dysphoric disorder in The Diagnostic and Statistical Manual of Mental Disorders third edition (DSM-III-R); later this term was changed to a premenstrual dysphoric disorder in DSM-IV (3,4) and located in the depressive disorders section in DSM-V (5). ...
Zusammenfassung
Nach der Reform des § 64 StGB muss für eine Unterbringungsanordnung – neben weiteren Anordnungskriterien – ein „Hang“ vorliegen, welcher eine Substanzkonsumstörung erfordert, „infolge derer eine dauernde und schwerwiegende Beeinträchtigung der Lebensgestaltung, der Gesundheit, der Arbeits- oder Leistungsfähigkeit eingetreten ist und fortdauert“. Der Hangbegriff stellt einen juristischen Terminus dar. Eine mögliche Brücke zur psychiatrischen Operationalisierung dieses Hangbegriffs kann die Global Assessment of Functioning (GAF) Scale darstellen. Ziele dieser Studie waren es, Maßregelvollzugspatienten anhand ihrer Werte in der GAF-Skala zu kategorisieren und zu prüfen, ob ihre Substanzkonsumstörung und damit einhergehende Einschränkung im Funktionsniveau die Anforderungen des aktuellen Hangbegriffs weiterhin erfüllen. Ein möglicher Klientelwandel soll abgebildet werden. Die Studie untersuchte 222 männliche Maßregelvollzugspatienten. Basierend auf ihrem GAF-Wert wurden 3 Outcome-Gruppen gebildet und diese mittels Chi²- und t-Tests auf Unterschiede hin untersucht. Die Ergebnisse verdeutlichten, dass, basierend auf dem GAF-Wert, 78,4 % der untersuchten Patienten wahrscheinlich auch zukünftig das Hangkriterium gemäß § 64 StGB erfüllen werden. Bei 48 Patienten (21,6 %) konnten keine schwerwiegenden Einschränkungen in ihrer psychosozialen Funktionsfähigkeit festgestellt werden, sodass bei ihnen zukünftig kein Hang gemäß § 64 StGB zu bejahen wäre. Diese 48 Patienten waren u. a. signifikant häufiger voll schuldfähig, aufgrund eines BtMG-Indexdelikts untergebracht, hatten höhere Bildungsabschlüsse, wiesen häufiger eine Substanzkonsumstörung bezüglich Kokain oder Cannabis auf und verfügten über weniger strafrechtliche Voreintragungen. Aufgrund der Ergebnisse dieser Studie kann von einem Rückgang der Unterbringungsanordnungen von etwa einem Fünftel ausgegangen werden.
Personality Disorders (PD) are linked to several highly detrimental outcomes and are highly prevalent in developed and developing countries. PD prevalence estimates may exceed 20% in the general population. Specifically, screening measures typically found percentages ranging from 40 to 54%. Although studies in a few developed countries were published, we could not find any study conducted in Brazil screening for PDs in the general population. Our study aimed to screen for PDs in a large Brazilian community sample, also examining differences by biological sex, age, education level, and region of residence. Using a Google Forms link, 8,108 participants from all 26 Brazilian states completed the Dimensional Clinical Personality Inventory – screening version (IDCP-SV). We found that women, individuals aged 18–39, those with high school or postgraduate education, and those from the Midwest region of Brazil had the highest rates of positive PD screening. Overall, 63.5% of participants screened positive for PD, a rate much higher than expected. We discuss possible alternative explanations for this unexpected finding. Our is the first study of its kind in Brazil, and our findings provide essential insight into PD prevalence and distribution in the country. Our findings have implications for clinical practice and public health interventions targeting PDs. Further research is needed to confirm our results and explore potential explanations for the high prevalence of PDs in Brazil.
Opioid use is widespread throughout the intensive care unit. Opioids are prescribed for analgesia and/or sedation to tolerate mechanical ventilation, but both undertreating pain and overusing opioids can lead to considerable adverse effects in critically ill patients. Clinicians must consider many factors when administering opioids in critical illness, including patients’ history of chronic pain and outpatient opioid use, pain associated with their acute diagnoses, surgery, and invasive procedures, as well as tolerance of mechanical ventilation. Underutilization of opioids may yield unmanaged pain, which may manifest as post-traumatic stress disorder in ICU survivors. Aggressive weaning of opioids may risk iatrogenic opioid withdrawal. Conversely, evidence is growing that supports potential harms from opioid use in critical illness, including new persistent opioid use and new chronic pain diagnoses after discharge. This chapter provides a comprehensive review of the risks and benefits of opioid use in the ICU.
The aim of this research is to evaluate the impact of educational management strategies and policies on the level of incidence and intensity and measure student, teacher and parent perceptions of the effectiveness of elementary school management in dealing with bullying; The research method used is descriptive qualitative; The data collection techniques used were observation, interviews and documentation; Data analysis used with Miles and Humbermen's theory is how to collect data, reduce data, present data, and draw conclusions; Data validity checking techniques using source and technique triangulation; The subjects in this research were the principal, head of curriculum, class teachers, and students; According to the results of this research, 1) Evaluation of the impact of the strategies that emerged included: religious learning strategies, teacher strategies through social care character education, collaboration strategies between teachers and parents in the form of parenting and school principal policies in dealing with bullying, so that students become more accustomed to and discipline in behavior at school and minimizing bullying behavior. 2) Measuring teachers' perceptions, namely acting decisively, anti-bullying campaigns, anti-bullying mentoring, classical and individual guidance, friendly attitudes, and providing instructions and understanding to students. Then the perception of parents is that disgraceful actions are carried out continuously, so that parents have the right to communicate well with teachers and actively involve themselves with their children, so that many perceptions are discussed in the solution to cases of bullying behavior
Although older adults with HIV are at high risk for mild neurocognitive disorders, a subset experience successful cognitive aging (SCA). HIV is associated with an increased risk of vascular depression (VasDep), which can affect cognitive and daily functioning. The current study examined whether VasDep impedes SCA among older adults with HIV. 136 persons with HIV aged 50 years and older were classified as either SCA+ (n = 37) or SCA- (n = 99) based on a battery of demographically adjusted neurocognitive tests and self-reported cognitive symptoms. Participants were also stratified on the presence of vascular disease (e.g., hypertension) and current depression as determined by the Composite International Diagnostic Interview and the Depression/Dejection scale of the Profile of Mood States. A Cochran-Armitage test revealed a significant additive effect of vascular disease and depression on SCA in this sample of older adults with HIV (z = 4.13, p <.0001). Individuals with VasDep had the lowest frequency of SCA+ (0%), which differed significantly from the group with only vascular disease (30%, OR = 0.04, CI = 0.002,0.68)) and the group with neither vascular disease nor depression (47% OR = 0.02, CI = 0.33,0.001). Findings were not confounded by demographics, HIV disease severity, or other psychiatric and medical factors (ps > 0.05). These data suggest that presence of VasDep may be a barrier to SCA in older adults with HIV disease. Prospective, longitudinal studies with neuroimaging-based operationalizations of VasDep are needed to further clarify this risk factor’s role in the maintenance of cognitive and brain health in persons with HIV disease.
Despite the importance of understanding how intelligence is ingrained in the function and structure of the brain in some neurological disorders, the alterations of intelligence‐associated neurological factors in atypical neurodevelopmental disorders, such as attention deficit/hyperactivity disorder (ADHD), are limited. Therefore, we aimed to explore the relationship between the brain functional and morphological characteristics and the intellectual performance of 139 patients with ADHD. Resting‐state functional and T1‐weighted structural magnetic resonance imaging (MRI) data and intellectual‐performance data of the patients were collected. The MRI data were preprocessed to extract four indicators characterizing the participants' brain features: fractional amplitude of low‐frequency fluctuation, regional homogeneity, and gray and white matter volumes. Then, we used a two‐layer feature‐selection method with support vector regression models based on three kernel functions to predict the verbal and performance intelligent quotients of the patients, along with ten fold cross‐validation to evaluate the models' predictive performance. All models showed good performance; the correlation coefficients between the predicted and observed values for each predictive phenotypic variable were >0.41, with statistical significance. The brain features that could best predict the intellectual performance of the patients were concentrated in the superior and inferior frontal gyrus of the prefrontal areas, the angular gyrus and precuneus of the parietal lobe, the inferior and middle temporal gyrus of the temporal lobe, and part of the cerebellar regions. Thus, the voxel‐based brain‐feature indicators could adequately predict the intellectual performance of patients with ADHD, providing a foundation for future neuroimaging studies of this disorder.
Objectives
This study aims to understand the statistical significance of the associations between diagnoses and symptoms based on simulations that have been used to understand the interpretability of mental illness diagnoses.
Methods
The symptoms for the diagnosis of major depressive episodes, dysthymic disorder, and manic episodes were extracted from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR, American Psychiatric Association, Philadelphia, Pennsylvania). Without real-world symptom data, we simulated populations using various combinations of symptom prevalence and correlations. Assuming symptoms occurred with similar prevalence and correlations, for each combination of symptom prevalence (0.05, 0.1, 0.3, 0.5, and 0.7) and correlation (0, 0.1, 0.4, 0.7, and 0.9), 100 cohorts with 10,000 individuals were randomly created. Diagnoses were made according to the DSM-IV-TR criteria. The associations between the diagnoses and their input symptoms were quantified with odds ratios and correlation coefficients. P-values from 100 cohorts for each combination of symptom prevalence and correlation were summarized.
Results
Three mental illness diagnoses were not significantly correlated with their own symptoms in all simulations, particularly when symptoms were not correlated, except for the symptom in the major criteria of major depressive episodes or dysthymic disorder. The symptoms for the diagnosis of major depressive episodes and dysthymic disorder were significantly correlated with these two diagnoses in some simulations, assuming 0.1, 0.4, 0.7, or 0.9 symptom correlations, except for one symptom. The overlap in the input symptoms for the diagnosis of major depressive episodes and dysthymic disorder also leads to significant correlations between these two diagnoses, assuming 0.1, 0.4, 0.7, and 0.9 correlations between input symptoms. Manic episodes are not significantly associated with the input symptoms of major depressive episodes and dysthymic disorder.
Conclusion
There are challenges to establish the causation between psychiatric symptoms and mental illness diagnoses. There is insufficient prevalence and incidence data to show all psychiatric symptoms exist or can be observed in patients. The diagnostic accuracy of symptoms to detect a disease cause is far from perfect. Assuming the symptoms of three mood disorders may present in patients, three diagnoses are not significantly associated with all psychiatric symptoms used to diagnose them. The diagnostic criteria of the three diagnoses have not been designed to guarantee significant associations between symptoms and diagnoses. Because statistical associations are important for making causal inferences, there may be a lack of causation between diagnoses and symptoms. Previous research has identified factors that lead to insignificant associations between diagnoses and symptoms, including biases due to data processing and a lack of epidemiological evidence to support the design of mental illness diagnostic criteria.
Specific Learning Disorder (SLD) affects the acquisition of reading, writing and mathematics skills, with a prevalence rate of around 5% in school-age children. In the Brazilian context, there is a shortage of scales for the SLD symptoms screening. Therefore, this study aimed to generate the items and present evidences of validity and reliability of the Escala de Avaliação do Transtorno Específico da Aprendizagem (ESATA), a Likert-type scale developed for 2nd to 5th grade teachers. 80 items related to the domains of reading, written expression and mathematics were developed. Theoretical and empirical analyses were performed. After the expert panel review, 76 items presented a Content Validity Index (CVI) ranging from 0.86 to 1, with a total CVI = 0.98. The semantic analysis showed the items were easily understood. The Exploratory Factor Analysis (EFA) performed based on data collected from 308 2nd to 5th grade teachers, from 19 Brazilian states, showed a better fit of the data in a bifactorial structure, the first factor called Reading and Writing, with loads ranging from. 44 to .89, and the second factor called Mathematics, with loads ranging from .57 to .94. Both factors explained 58% of the variance. Cronbach’s α for the full scale was .99, indicating excellent reliability of ESATA with 74 items.
This naturalistic study investigated the effects of an 8-week mindfulness-based cognitive therapy (MBCT) group intervention on attention. Eighteen participants completed the attentional network test (ANT) during an EEG recording. All measures were repeated before, following, and 3 months after MBCT. Clinical improvements were found at post-test and follow-up. Reaction times significantly decreased from baseline to follow-up with consistently high accuracy. However, ANT scores did not change. Recording sessions had no effect on cue- or target-related event-related potentials (ERP). However, event-related spectral perturbation (ERSP) results revealed that from baseline to follow-up, congruent targets needed fewer attentional resources. Information processing needed for conflict resolution decreased between baseline and follow-up. No converging results regarding clinical improvements and changes in behavioral and ERP measures of ANT were found. ERSP analysis demonstrated that congruent attentional tasks needed less cortical processing at follow-up. Further research that includes data from controls is needed to rule out possible training effects on the measured data.
Speech communication depends on accurate perception and identification of speech sounds, which vary across talkers and word or sentence contexts. The ability to map this variable input onto discrete speech sound representations relies on categorization. Recent research and theoretical models implicate the procedural learning system in the ability to learn novel speech and non-speech categories. This connection is particularly intriguing because several language disorders that demonstrate linguistic impairments are proposed to stem from procedural learning and memory dysfunction. One such disorder, Developmental Language Disorder (DLD), affects 7.5% of children and persists into adulthood. While DLD is associated with general linguistic impairments, it is not yet clear how fundamental perceptual and cognitive processes supporting language are impacted, such as the ability to learn novel auditory categories. We examined auditory category learning in children with DLD and typically developed (TD) children using two well-matched nonspeech auditory category learning challenges to draw upon presumed procedural (information-integration) versus declarative (rule-based) learning systems. We observed impaired information-integration category learning and intact rule-based category learning in the DLD group. Quantitative model-based analyses revealed reduced use of, and slower shifting to, optimal procedural-based strategies in DLD and slower shifting to but similarly efficient use of optimal hypothesis-testing strategies. The dissociation is consistent with the Procedural Deficit Hypothesis of language disorders and supports the theoretical distinction of multiple category learning systems. These findings demonstrate that highly controlled experimental tasks assessing perceptual and cognitive abilities can relate to real-world challenges facing individuals with DLD in forming stable linguistic representations.
Background:
An increasing amount of clinical evidence of acupuncture's effect on protracted opioid abstinence syndrome (POAS) has emerged in recent years. The aim of this study was to evaluating the evidence of efficacy of acupuncture for POAS. clinical and scientific research work.
Methods:
Four English-language databases (PubMed, Medline, Embase, Cochrane Libraries) and three Chinese-language databases (CNKI, WanFang and VIP Libraries) were searched, with coverage from database inception to March 31, 2022. Randomized clinical trials (RCTs) evaluating the effects of acupuncture and acupuncture-related therapies for prophylaxis or treatment of POAS were included. Data were screened and extracted independently according to pre-set tabular formats. RCT quality was assessed using risk of bias tool in the Cochrane Collaboration. The primary outcome was opiate withdrawal scale. The secondary outcomes are depression, anxiety for assessing protracted symptoms. The scores on the above scales are proportional to the severity of the symptoms.
Results:
Twenty-eight trials met the inclusion criteria and provided data for the meta-analysis. A total of only 3 studies (11%) were judged to be low-risk overall due to various biases in them. Acupuncture-related therapy showed statistical differences in improving protracted withdrawal symptom scores compared with sham acupuncture (5 studies, Standard mean difference (SMD), -1.85, 95% CI [-3.21, -0.50], P = 0.007), western medicine(7 studies, SMD, -0.72, 95% CI [-1.22, -0.21], P = 0.005)and no treatment(3 studies, SMD,-2.26, 95% CI [-3.82, -0.69], P = 0.005)with high heterogeneity.
Conclusions:
Acupuncture maybe safe and effective in relieving POAS individuals' protracted withdrawal symptoms. However, the results of our review should be interpreted with caution because of the high risk of bias of the included trials.
Study registration:
The protocol of this review has been registered at PROSPERO (CRD42022335505).
Background:
MicroRNAs (miRNAs) and circulating cell-free mitochondrial DNA (ccf-mtDNA) have attracted interest as biological markers of affective disorders. In response to stress, it is known that miRNAs in mitochondria diffuse out of the cytoplasm alongside mtDNA; however, this process has not yet been identified. We hypothesized that miRNAs derived from specific cell nuclei cause mitochondrial damage and mtDNA fragmentation under MDD-associated stress conditions.
Methods:
A comprehensive analysis of the plasma miRNA levels and quantification of the plasma ccf-mtDNA copy number were performed in 69 patients with depression to determine correlations and identify genes and pathways interacting with miRNAs. The patients were randomly assigned to receive either selective serotonin reuptake inhibitors (SSRI) or mirtazapine. Their therapeutic efficacy over four weeks was evaluated in relation to miRNAs correlated with ccf-mtDNA copy number.
Results:
The expression levels of the five miRNAs showed a significant positive correlation with the ccf-mtDNA copy number after correcting for multiple testing. These miRNAs are involved in gene expression related to thyroid hormone synthesis, the Hippo signaling pathway, vasopressin-regulated water reabsorption, and lysine degradation. Of these five miRNAs, miR-6068 and miR-4708-3p were significantly associated with the SSRI and mirtazapine treatment outcomes, respectively.
Limitations:
This study did not show comparison with a healthy group.
Conclusions:
The expression levels of specific miRNAs were associated with ccf-mtDNA copy number in untreated depressed patients; moreover, these miRNAs were linked to antidepressant treatment outcomes. These findings are expected to lead to the elucidation of new pathological mechanism of depression.
OBJECTIVES:The aim of this study was to determine the readmission rates of Acute and Transient Psychotic Disorders (ATPD) who were admitted for the first time in the National Center of Mental Health from January to December 2012.
METHODOLOGY: This study used the retrospective cohort method. Patients included in the study were admitted for the first time with a diagnosis of Acute and Transient Psychotic Disorders (ATPD) during the period of January to December 2012. The source of data involved the chart review during the first admission and the subsequent admission. Patients who were readmitted beyond one year from time of admission were excluded.
RESULTS:Results showed that 25 out of 204 (12.26%) patients diagnosed with an ATPD were readmitted within one year. The most common diagnosis of ATPD upon admission were: Acute Schizophrenia-Like Psychotic Disorder (n=95), Other Schizophrenia (n=90) and Acute Polymorphic Psychotic Disorder (n=19). ATPD's with the highest 1 year readmission rates were Acute Polymorphic Psychotic Disorder (3/19),Other Schizophrenia (13/90) and Acute Schizophrenia-Like Psychotic Disorder(9/95).Those that were readmitted had a different discharge diagnosis in their second admission.The three most common diagnosis upon readmission were Undifferentiated Schizophrenia (36%), Bipolar Affective Disorder, current episode manic, with psychotic symptoms (24%) and Other Schizophrenia (12%). Acute Schizophrenia-Like Psychotic Disorder were mostly readmitted as Bipolar Affective Disorder in 44% of patients; Acute Polymorphic Psychotic Disorder (APPD) were readmitted as another ATPD (66.6%); and Other Schizophrenia was diagnosed as Undifferentiated Schizophrenia (54%).
CONCLUSION:Only a small percentage of patients with ATPD were readmitted one year from admission and those who were readmitted revealed that they may have actually been suffering from or developed another more chronic psychotic disorder.
Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting social and communicative skills, including narrative ability, namely the description of real-life or fictive accounts of temporally and causally related events. With this study, we aimed to determine whether a communicative-pragmatic training, i.e., the version for adolescents of the Cognitive-Pragmatic Treatment, is effective in improving the narrative skills of 16 verbally fluent adolescents with ASD. We used a multilevel approach to assess pre-and post-training narrative production skills. Discourse analysis focused on micro-(i.e., mean length of utterance, complete sentences, omissions of morphosyntactic information) and mac-rolinguistic measures (i.e., cohesion, coherence errors, lexical informativeness). Results revealed a significant improvement in mean length of utterance and complete sentences and a decrease in cohesion errors. No significant change was found in the other narrative measures investigated. Our findings suggest that a pragmatically oriented training may be useful in improving grammatical efficiency in narrative production.
Background:
Attention deficit hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder, and the prevalence of ADHD among Korean children has attained about 8.5%. Various genetic factors can contribute to the etiology of the disease. Synaptophysin (SYP) regulates neurotransmitter release and synaptic plasticity. According to previous studies, several genetic polymorphisms on SYP were risk factors for ADHD.
Objective:
We investigated the effect of the SYP gene polymorphisms (rs2293945 and rs3817678) on ADHD in Korean children.
Methods:
In this study, we examined the case-control study in 150 ADHD cases and 322 controls. The genotyping of SYP gene polymorphisms was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).
Results:
Significant associations in the genotype and genetic models of SYP rs2293945 polymorphism between girls with ADHD and control girls were found. The girls with ADHD having the C/T genotype were significantly associated with ADHD. In the dominant model of rs3817678, C/T + T/T genotypes were significantly associated with ADHD. The haplotype analyses showed significant associations from haplotypes of rs2293945 T-rs3817678 G and rs2293945 C-rs3817678 A.
Conclusion:
Our results imply that the SYP rs2293945 C/T polymorphism in female participants may provide a possible effect on the genetic etiology of ADHD.
The current study examined factorial invariance of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) and the Depression Anxiety Stress Scales-21 (DASS-21) using a convenience sample of 434 adults surveyed though Amazon Mechanical Turk. Participants were sorted into two groups based on their score on the Autism-Spectrum Quotient. Results indicated that the CESD-R did not demonstrate configural invariance. The DASS-21 demonstrated evidence of scalar invariance, indicating cross-group equality in factor loadings and factor intercepts. Findings suggest that the DASS-21 measures symptoms of depression, anxiety, and stress consistently across individuals with high and low levels of ASD-related traits, whereas the CESD-R may not be valid when assessing symptoms of depression in those with a high level of ASD-related traits.
Background: Specifying early developmental differences among neurodevelopmental disorders with distinct etiologies but similar clinical phenotypes is critical to improving early identification and tailored intervention during the first years of life. Recent studies have uncovered important differences between infants with fragile X syndrome (FXS) and infants with familial history (FH) of autism spectrum disorder (ASD) who go on to develop autism themselves (FH-ASD), including differences in brain development and behavioral symptomology. However, there have been no studies investigating differential developmental skill profiles in FXS and FH-ASD infants.
Methods: The current study contrasted longitudinal trajectories of verbal (expressive and receptive language) and nonverbal (gross and fine motor, visual reception) skills in infants with FXS and FH-ASD infants, compared to typically developing controls and FH infants who did not develop ASD (FH-nonASD).
Results: Infants with FXS showed delays in developmental composite scores compared to FH-ASD (and FH-nonASD and control) infants as early as 6 months of age. At 12 months an ordinal pattern was established between groups on all domains tested, such that controls > FH-nonASD > FH-ASD > FXS. This pattern persisted through 24 months.
Conclusions: Our results demonstrate detectable delays by 6 months in FXS, whereas FH-ASD infants were indistinguishable from typically developing infants until 12 months. This highlights an earlier onset of global cognitive delays in FXS and, conversely, a protracted period of more subtly emerging delays in FH-ASD. Divergent neural and cognitive development in infancy between FXS and FH-ASD add to our understanding of important distinctions in the development and behavioral phenotype of these two groups.
Relating learned information to similar yet new scenarios, transfer of learning, is a key characteristic of expert reasoning in many fields including medicine. Psychological research indicates that transfer of learning is enhanced via active retrieval strategies. For diagnostic reasoning, this finding suggests that actively retrieving diagnostic information about patient cases could improve the ability to engage in transfer of learning to later diagnostic decisions. To test this hypothesis, we conducted an experiment in which two groups of undergraduate student participants learned symptom lists of simplified psychiatric diagnoses (e.g., Schizophrenia; Mania). Next, one group received written patient cases and actively retrieved the cases from memory and the other group read these written cases twice, engaging in a passive rehearsal learning strategy. Both groups then diagnosed test cases that had two equally valid diagnoses-one supported by "familiar" symptoms described in learned patient cases, and one by novel symptom descriptions. While all participants were more likely to assign higher diagnostic probability to those supported by the familiar symptoms, this effect was significantly larger for participants that engaged in active retrieval compared to passive rehearsal. There were also significant differences in performance across the given diagnoses, potentially due to differences in established knowledge of the disorders. To test this prediction, Experiment 2 compared performance on the described experiment between a participant group that received the standard diagnostic labels to a group that received fictional diagnostic labels, nonsense words designed to remove prior knowledge with each diagnosis. As predicted, there was no effect of diagnosis on task performance for the fictional label group. These results provide new insight on the impact of learning strategy and prior knowledge in fostering transfer of learning, potentially contributing to expert development in medicine.
Disruptive, impulse-control, and conduct disorders is a new category under DSM-5 classification system. These disorders originate in childhood and often continue into adulthood. There is a strong association between these disorders and intellectual disabilities (ID). They include conduct disorder, oppositional defiant disorder which is a less severe form of conduct disorder, and intermittent explosive disorder, which was part of impulse control disorder in previous DSM classifications. However, by definition many of these disorders have to show an intention behind the behaviour, which is not easy to determine, particularly among those who have severe and profound ID. Other impulse control disorders include pyromania, kleptomania, gambling disorder, compulsive sexual behaviour disorder, trichotillomania, and excoriation disorder. Body-focussed repetitive behaviour, on the other hand, includes stereotyped movement disorder and self-injurious behaviour. The aetiology of these disorders is complex and often is the outcome of an interaction between internal factors within the person and external factors such as the environment. Management of these behaviours is often difficult, therefore, requires input from a multitude of professionals with relevant and specific skills to provide a person-centred assessment and management. The ultimate aim should be to improve the quality of life of the person with ID and their family members.KeywordsIntellectual disabilitiesImpulse control disorderConduct disorderOppositional defiant disorderIntermittent explosive disorderCompulsive sexual behaviour disorderBody-focussed repetitive behaviourStereotypePerson-centred assessmentMultidisciplinary management
Attention deficit hyperactivity disorder (ADHD) is characterised by inattention or hyperactivity/ impulsivity or both. The onset of ADHD is in childhood, but in a proportion of cases some symptoms continue into adulthood. There is a strong association among ADHD, intellectual disability (ID), problem behaviour, and autism spectrum disorder (ASD). The prevalence of ADHD in persons with ID and ASD is significantly higher than the general population, ranging between 10% and 28%. It might be difficult to diagnose ADHD in persons with ID and low-functioning ASD. The stringent use of categorical diagnostic criteria might limit the identification of the disorder since some criteria may not be applicable, particularly for those with more severe cognitive and communication impairments. Observation of a person’s distractibility that is not consistent with their developmental level may help when considering the symptom of inattention in an individual with ID, while hyperactivity and impulsivity are better indicated by fidgeting most of the time, appearing ‘on the go’, and being unable to remain seated for a long time and to wait for one’s turn, which can often lead to verbal or physical aggression, irritability, mood fluctuations, or self-harming behaviour.Although ADHD in the non-ID population is a widely researched area, the lack of high-quality research in ADHD in ID has been a barrier to the advancement of treatment in this patient group, with most studies having named ID as an exclusion criterion. Drug treatment such as psychostimulants like methylphenidate along with psychosocial interventions is effective in a high proportion of cases to improve ADHD symptoms. In people with ID, the overall effect size of psychostimulants is smaller than that reported in the general population, while the adverse effect profile is similar in both populations.KeywordsAttention deficit hyperactivity disorderADHDPsychostimulantsMethylphenidateIntellectual disabilitiesChildrenAdults
The biopsychosocial formulation is foundational to case conceptualization in functional movement disorder and related functional neurological conditions. In this chapter, a practical approach to the development of a patient-centered biopsychosocial model in patients with functional movement disorder is put forth, highlighting roles for predisposing vulnerabilities, acute precipitants and perpetuating factors. The use of this approach underscores that “one size does not fit all” in contextualizing the development and maintenance of functional neurological symptoms in a given patient. Notably, a well-constructed biopsychosocial formulation is an important step in identifying potential treatment targets. Furthermore, the biopsychosocial formulation can be used to contextualize why a given patient may not be optimally responding to treatment.KeywordsFunctional movement disorderFunctional neurological disorderBiopsychosocialNeuropsychiatry
Sleep disorders affect an individuals’ mental and physical health leading to impairment in the level of perceived life satisfaction. Most common sleep disorders, that is, insomnia, obstructive sleep apnoea and restless leg syndrome, have been found to impair physical, social and psychological well-being leading to impairment in quality of life (QOL) as compared to healthy population. An improvement in QOL has also been observed with certain treatment modalities for these disorders. This chapter discusses effects of sleep disorders and their treatment on QOL of an individual.KeywordsSleep disordersQuality of lifeSatisfactionWell-being
The rising prevalence of gambling disorder (GD) among women has awakened considerable interest in the study of therapeutic outcomes in females. This study aimed to explore profiles of women seeking treatment for GD based on a set of indicators including sociodemographic features, personality traits, clinical state at baseline, and cognitive behavioral therapy (CBT) outcomes. Two-step clustering, an agglomerative hierarchical classification system, was applied to a sample of n = 163 women of ages ranging from 20 to 73 years-old, consecutively attended to by a clinical unit specialized in the treatment of G. Three mutually exclusive clusters were identified. Cluster C1 (n = 67, 41.1%) included the highest proportion of married, occupationally active patients within the highest social status index. This cluster was characterized by medium GD severity levels, the best psychopathological functioning, and the highest mean in the self-directedness trait. C1 registered 0% dropouts and only 14.9% relapse. Cluster C2 (n = 63; 38.7%) was characterized by the lowest GD severity, medium scores for psychopathological measures and a high risk of dropout during CBT. Cluster C3 (n = 33; 20.2%) registered the highest GD severity, the worst psychopathological state, the lowest self-directedness level and the highest harm-avoidance level, as well as the highest risk of relapse. These results provide new evidence regarding the heterogeneity of women diagnosed with GD and treated with CBT, based on the profile at pre- and post-treatment. Person-centered treatments should include specific strategies aimed at increasing self-esteem, emotional regulation capacities and self-control of GD women.
The prime question concerns the reason psychiatry exists as a medical specialty. This could only be justified with the existence of mental conditions that need diagnosis and treatment in the way medicine conceptualizes and treats. If there is no such thing as mental disorder or disease and essentially we are dealing with a sociocultural or psychological phenomenon, psychiatry is not only mistaken, but indeed it could be harmful. So, the core question is “do mental disorders exist as medical issues that require diagnosis and treatment?”
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