Samantha Ely’s research while affiliated with Wayne State University and other places

Objectives The current study investigated the concurrent impact of anxiety and pain catastrophizing on both pain-related impairment (i.e., functional disability, pain-intensity) and on pain-related psychological treatment outcomes in youth with FAPD. Method This is a secondary analysis of data from a psychological treatment study (Aim to Decrease Anxiety and Pain Treatment; ADAPT) for youth with FAPD. Participants completed six weeks of ADAPT (psychological intervention) and treatment as usual or treatment as usual alone. Regressions and analysis of covariance models examined the relationship between baseline pain catastrophizing and anxiety on baseline functional disability and pain intensity, while analysis of covariance models assessed the effect of these baseline psychological factors on pain-related outcomes at post-assessment (8 weeks later) while accounting for group assignment. The effects of ADAPT on post-assessment pain catastrophizing and anxiety, as well as their moderating effects on pain-related outcomes were also explored. Results Results indicated that baseline pain catastrophizing, but not anxiety, predicted baseline functional disability and pain intensity, as well as post-assessment functional disability. Participants in the ADAPT group also demonstrated significantly lower pain catastrophizing at post-assessment. However, there were no moderating effects of post-assessment pain catastrophizing or anxiety on pain-related outcomes. Discussion Findings suggest that assessment of pain catastrophizing is important to better understand pain-related impairment in FAPD.

Objective Pediatric rheumatologic diseases (PRDs) are characterized by high rates of anxiety and depression known to impact health‐related outcomes. We present guidance statements to assess and manage mental health concerns for youth with PRDs in pediatric rheumatology practice. Methods Development of the guidance statements was initiated in 2019 and concluded in November 2023. It included (1) the formation of a task force (including pediatric rheumatologists, pediatric behavioral health providers, patients, and parents) led by two licensed pediatric psychologists and two board‐certified pediatric rheumatologists, (2) iterative drafting of statements and rating of evidence based on the Oxford Centre for Evidence‐Based Medicine levels of evidence, (3) an open comment period followed by revision of statements, (4) a Delphi panel process to attain consensus on the statements, and (5) review by the American College of Rheumatology (ACR) Committee on Quality of Care and refinement of statements to an identified list of those with the strongest empiric evidence for endorsement by the ACR. Results The task force drafted 34 statements for addressing mental health concerns in pediatric rheumatology, including identification, management, and clinic environment/education considerations. After two rounds of Delphi panel voting by a random sample of 76 members of the Childhood Arthritis and Rheumatology Research Alliance, 31 statements attained at least 80% consensus. Eleven of those statements had high empirical support and endorsement and were thus selected as the final guidance statements, including recommendations for depression and anxiety screening in youth aged 12 years and older, management of identified symptoms, and education of patients about mental health. Conclusion It is a goal that these recommendations be used to empower pediatric rheumatology teams to consider how they may better address mental health concerns in their setting and help improve both mental health– and health‐related outcomes for youth with rheumatologic diseases. image

This systematic narrative review examines neuroimaging studies that investigated the neural correlates of mindfulness-based interventions in youth (ages 0–18). We extracted 13 studies with a total of 467 participants aged 5–18 years from the MEDLINE database on February 21st, 2024. These studies included both typically developing youth and those at risk of developing or recovering from neuropsychiatric disorders. Most studies (76.9%) utilized a pre-post intervention design, with resting-state functional magnetic resonance imaging (fMRI) being the most common imaging modality (46.1%), followed by task-based fMRI (38.4%), diffusion-weighted imaging (15.4%), and structural MRI (7.7%). Despite substantial heterogeneity across study designs and findings, several consistent patterns emerged. Resting-state fMRI studies generally reported increased functional connectivity within and between networks, notably involving the salience network, frontoparietal network, and default mode network. Studies using diffusion-weighted imaging indicated enhancements in white matter microstructural properties, supporting overall connectivity improvements. Several task-based fMRI studies identified decreased activation of the default mode network and heightened reactivity of the salience network during or after mindfulness practice, with real-time neurofeedback further amplifying these effects. While preliminary, the reviewed studies suggest that mindfulness interventions may alter both functional and structural connectivity and activity in youth, potentially bolstering self-regulation and cognitive control. Nonetheless, the variability in methodologies and small sample sizes restricts the generalizability of these results. Future research should prioritize larger and more diverse samples, and standardized mindfulness-based interventions to deepen our understanding of the neural mechanisms underlying mindfulness-based interventions in youth and to optimize their efficacy.

Background The endocannabinoid system, which regulates fear- and anxiety-related behaviors, is dysregulated in adults with posttraumatic stress disorder (PTSD), as indicated by higher circulating anandamide (AEA) concentrations. The C385A (rs324420) polymorphism in the fatty acid amide hydrolase (FAAH) gene, which catabolizes AEA, is linked to higher AEA concentrations and greater PTSD symptoms in adults. Given that adolescence is a critical period during which trauma and psychiatric disorders emerge, understanding this relationship in youth is essential. This study examines PTSD symptoms, AEA concentrations, and FAAH genotype in a diverse adolescent sample. Methods This study included 102 Detroit-area adolescents (M ± SD = 13.33 ± 2.21 years, 54.9% female) and their parents/guardians. The sample consisted of 40.2% White Non-Hispanic, 34.3% Black Non-Hispanic, 6.9% White Hispanic, 4.9% Asian/Pacific Islander, and 12.7% Biracial adolescents. Trauma exposure and PTSD symptoms were assessed using the UCLA PTSD Reaction Index for DSM-5. Plasma concentrations of AEA were measured by liquid chromatography-tandem mass spectrometry, and FAAH genotype was determined from saliva samples and high-throughput screening. Results The majority (90%) of adolescents reported trauma exposure, and 20% met PTSD criteria. Higher AEA concentrations were associated with more severe PTSD symptoms (p = 0.009), especially hyperarousal. The FAAH A-allele (present in 52.5% of participants) was associated with higher AEA concentrations (2.11 ± 0.69 pmol/ml, p = 0.013) and greater PTSD severity (22.65 ± 15.931, p = 0.027), particularly those with the reexperiencing cluster, compared to the CC genotype (1.79 ± 0.66 pmol/ml and 15.87 ±+ 13.043, respectively). Conclusion Elevated AEA concentrations and the FAAH A-allele were associated with greater PTSD symptom severity in urban adolescents. These findings suggest endocannabinoid dysregulation may play a role in adolescent PTSD, highlighting the need for further research and targeted interventions.

Objectives Pediatric chronic pain is common and can be detrimental to children’s social, emotional, and school functioning. Non-pharmacological approaches to chronic pain, like cognitive behavioral therapy (CBT) can be effective. Schools could provide children with chronic pain access to these interventions. However, school professionals (i.e. nurses and mental health providers) are seldom trained in CBT, creating a barrier to accessing such help. A seminar was created to introduce CBT strategies for chronic pediatric pain to school professionals. Feasibility, acceptability, and self-reported knowledge gain from the seminar were examined. Methods Two introductory seminars (~2.5 hours each) were held separately for the Michigan Association of School Nurses and the Health Department of Northwest Michigan (n=71 total). The seminar provided an understanding of pain and pain-focused CBT strategies (e.g. activity pacing, positive self-statements, psychoeducation). Fifty-two school nurses, 16 mental health professionals, and three participants (unidentified title) rated program acceptability and self-reported knowledge of CBT before and after training (1=strongly disagree, 5=strongly agree). Results 89.6% of respondents agreed the training was helpful, and 87.5% were interested in additional training. For all questions relating to knowledge of CBT, a mixed model interaction showed a meaningful, increase of at least one point (on a five-point Likert-scale), F (2, 69.83)=3.93, P =0.024. Discussion This study underscores the feasibility and acceptability of training school health providers in CBT for pediatric chronic pain. This project also established key partnerships in Michigan to expand future work in this realm with more comprehensive training and assessment of outcomes.

Air pollution exposure has been associated with adverse cognitive and mental health outcomes in children, adolescents, and adults, although youth may be particularly susceptible given ongoing brain development. However, the neurodevelopmental mechanisms underlying the associations among air pollution, cognition, and mental health remain unclear. We examined the impact of particulate matter (PM2.5) on resting-state functional connectivity (rsFC) of the default mode network (DMN) and three key attention networks: dorsal attention, ventral attention, and cingulo-opercular. Longitudinal changes in rsFC within/between networks were assessed from baseline (9-10 years) to the two-year follow-up (11-12 years) in 10,072 youth (M+SD=9.93+0.63 years; 49% female) from the Adolescent Brain Cognitive Development (ABCD®) study. Annual ambient PM2.5 concentrations from the 2016 calendar year were estimated using hybrid ensemble spatiotemporal models. RsFC was estimated using functional neuroimaging. Linear mixed models were used to test associations between PM2.5 and change in rsFC over time while adjusting for relevant covariates (e.g., age, sex, race/ethnicity, parental education, family income) and other air pollutants (O3, NO2). A PM2.5 x time interaction was significant for within-network rsFC of the DMN such that higher PM2.5 concentrations were associated with a smaller increase in rsFC over time. Further, significant PM2.5 x time interactions were observed for between-network rsFC of the DMN and all three attention networks, with varied directionality. PM2.5 exposure was associated with alterations in the development and equilibrium of the DMN-a network implicated in self-referential processing-and anti-correlated attention networks, which may impact trajectories of cognitive and mental health symptoms across adolescence.