Memory editing from science fiction to clinical practice.

Science fiction notions of altering problematic memories are starting to become reality as techniques emerge through which unique memories can be edited. Here we review memory-editing research with a focus on improving the treatment of psychopathology. Studies highlight two windows of memory vulnerability: initial storage, or consolidation; and re-storage after retrieval, or reconsolidation. Techniques have been identified that can modify memories at each stage, but translating these methods from animal models to humans has been challenging and implementation into clinical therapies has produced inconsistent benefits. The science of memory editing is more complicated and nuanced than fiction, but its rapid development holds promise for future applications.

Longitudinal Research at the Interface of Affective Neuroscience, Developmental Psychopathology, Health and Behavioral Genetics: Findings from the Wisconsin Twin Project.

The Wisconsin Twin Project comprises multiple longitudinal studies that span infancy to early adulthood. We summarize recent papers that show how twin designs with deep phenotyping, including biological measures, can inform questions about phenotypic structure, etiology, comorbidity, heterogeneity, and gene-environment interplay of temperamental constructs and mental and physical health conditions of children and adolescents. The general framework for investigations begins with rich characterization of early temperament and follows with study of experiences and exposures across childhood and adolescence. Many studies incorporate neuroimaging and hormone assays.

[The psychopathology of the Wernicke-Kleist-Leonhard School and its relevance for present-day psychiatry]. / Die Psychopathologie der Wernicke-Kleist-Leonhard Schule und ihre Bedeutung für die aktuelle Psychiatrie.

Historically, the Wernicke-Kleist-Leonhard School represents a countermovement to psychopathology as described by Karl Jaspers and Kurt Schneider. The School aimed to interlink psychopathological and neurobiological aspects. Starting from the model of different functional neuronal systems, each of which can be disturbed in the sense of a hypofunction, hyperfunction, or parafunction, it developed a comprehensive phenomenology of psychopathological symptoms and syndromes that finally culminated in Karl Leonhard's course descriptions. This school of thought can provide important impulses even today. Thus, on the one hand, the neurobiological models can serve as the basis for additional research projects and on the other hand, the psychopathological descriptions of disorders can perhaps also be interpreted in the sense of typological constructs that can contribute to pragmatic clinical decisionmaking.

Detail, dynamics and depth: useful correctives for some current research trends.

Several research trends in contemporary psychiatry would benefit from greater emphasis on detailed assessment, modelling dynamic change, and micro-level analysis. This may assist with clarifying nosological and pathoaetiological issues. We make this case by referring to three areas: psychopathology and nosology; prediction research; and 'big N' data sets.Declaration of interestNone.

Psychiatry and developmental psychopathology: Unifying themes and future directions.

In the past 35 years, developmental psychopathology has grown into a flourishing discipline that shares a scientific agenda with contemporary psychiatry. In this editorial, which introduces the special issue, we describe the history of developmental psychopathology, including core principles that bridge allied disciplines. These include (1) emphasis on interdisciplinary research, (2) elucidation of multicausal pathways to seemingly single disorders (phenocopies), (3) description of divergent multifinal outcomes from common etiological start points (pathoplasticity), and (4) research conducted across multiple levels of analysis spanning genes to environments. Next, we discuss neurodevelopmental models of psychopathology, and provide selected examples. We emphasize differential neuromaturation of subcortical and cortical neural networks and connectivity, and how both acute and protracted environmental insults can compromise neural structure and function. To date, developmental psychopathology has placed greater emphasis than psychiatry on neuromaturational models of mental illness. However, this gap is closing rapidly as advances in technology render etiopathophysiologies of psychopathology more interrogable. We end with suggestions for future interdisciplinary research, including the need to evaluate measurement invariance across development, and to construct more valid assessment methods where indicated.

Future Directions in Sleep and Developmental Psychopathology.

It is critical for psychologists to gain a better understanding about the intersection between sleep and developmental psychopathology. However, while many strive to answer the question of whether sleep causes developmental psychopathology, or vice versa, ultimately the relationship between sleep and developmental psychopathology is complex and dynamic. This article considers future directions in the field of clinical child and adolescent psychology that go beyond this mechanistic question, highlighting areas important to address for clinicians and researchers who strive to better understand how best to serve children and adolescents with developmental psychopathology. Questions are presented about what is normal in terms of sleep across development, the role of individual variability in terms of sleep needs and vulnerability to sleep loss, and how sleep may serve as a risk or resilience factor for developmental psychopathology, concluding with considerations for interventions.

[Is delusion a reasonable scientific term? Reflections on psychopathology in the psychiatry of the twenty-first century]. / Ist Wahn ein sinnvoller wissenschaftlicher Begriff? Eine Reflexion über die Psychopathologie in der Psychiatrie des 21. Jahrhunderts.

Delusion is a central but difficult and controversial term in psychiatry. Similar to the term schizophrenia at the nosological level, the basic questions in the specialty are linked in the debate on delusion at the clinical psychopathological level, beginning with epistemological and methodological aspects up to concrete embodiment of the physician-patient relationship. The text of this article reflects this development from the nineteenth century up to the present day and makes reference to the lively discussion on the future directions of psychiatric research triggered by the research domain criteria (RDoC). Under certain prerequisites, including in particular an extensive understanding of psychopathology, delusion is considered to be a reasonable scientific term, also in the future.

Psychopathology and classification in psychiatry.

INTRODUCTION: The strengths and weaknesses of the 5th edition of the Diagnostic and Statistical Manual of the American Psychiatric Association are considered, and the likely form of the revised version of the International Classification of Disease, due to be released in the future is briefly considered. COMMENTARY: It is argued that there are a number of problems in the checklist approach to diagnosis: there are no points of rarity between common disorders, and that many disorders are rough groupings containing highly heterogeneous syndromes. The tendency to reify these disorders and to view them as independent entities, and to stretch the concept of co-morbidity to cover individuals who satisfy more than one of the diagnostic checklists is seen as being misleading as it gives a false air of precision. CONCLUSION: Two broadly similar solutions are proposed for an alternative approach to common mental disorders.

Commentary: gene by environment interplay and psychopathology--in search of a paradigm.

The articles in this Special Issue (SI) extend research on G×E in multiple ways, showing the growing importance of specifying kinds of G×E models (e.g., bioecological, susceptibility, stress-diathesis), incorporation of sophisticated ways of measuring types of G×E correlations (rGE), checking effects of statistical artifact, exemplifying an impressive range of quantitative and biological methodologies, and pointing to clearly needed next-step studies such as summarizing across many genes in gene sets (Bentley et al.) or in genome-wide pathway based approaches to G×E (Winham & Biernacka) and prediction of clinical outcomes (Rapee et al.). As a group, they document nicely that gene × environment research has come of age. What is the import of this? Does it represent a major new development in our field, or merely an incremental change of a framework that remains fundamentally unchanged?

Stress physiology and developmental psychopathology: past, present, and future.

Research on the hypothalamic-pituitary-adrenocortical (HPA) axis has emerged as a vital area within the field of developmental psychopathology in the past 25 years. Extensive animal research has provided knowledge of the substrates and physiological mechanisms that guide development of stress reactivity and regulation using methods that are not feasible in humans. Recent advances in understanding the anatomy and physiology of the HPA axis in humans and its interactions with other stress-mediating systems, including accurate assessment of salivary cortisol, more sophisticated neuroimaging methods, and a variety of genetic analyses, have led to greater knowledge of how psychological and biological processes impact functioning. A growing body of research on HPA axis regulation and reactivity in relation to psychopathology has drawn increased focus on the prenatal period, infancy, and the pubertal transition as potentially sensitive periods of stress system development in children. Theories such as the allostatic load model have guided research by integrating multiple physiological systems and mechanisms by which stress can affect mental and physical health. However, almost none of the prominent theoretical models in stress physiology are truly developmental, and future work must incorporate how systems interact with the environment across the life span in normal and atypical development. Our theoretical advancement will depend on our ability to integrate biological and psychological models. Researchers are increasingly realizing the importance of communication across disciplinary boundaries in order to understand how experiences influence neurobehavioral development. It is important that knowledge gained over the past 25 years has been translated to prevention and treatment interventions, and we look forward to the dissemination of interventions that promote recovery from adversity.

The R-DoC initiative: science and practice.

A research focus upon dimensions of observable behaviors and neurobiological indices, as outlined in the R-DoC initiative, is likely to enhance our understanding of psychopathology in a number of ways that are outlined in this article. Specific examples include a greater understanding of the mechanisms underlying comorbidity and complexity of symptom manifestation, individual differences in symptom expression, and developmental changes in symptom expression. Furthermore, the R-DoC approach may have treatment implications, including treatment efficacy, and identification of treatment moderators and treatment mediators.

Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?

BACKGROUND: Little is known about changes in the prevalence of psychiatric disorders between childhood and adolescence, and adolescence and adulthood. METHODS: We reviewed papers reporting prevalence rates of psychiatric disorders separately for childhood, adolescence, and early adulthood. Both longitudinal and cross-sectional papers published in the past 15 years were included. RESULTS: About one adolescent in five has a psychiatric disorder. From childhood to adolescence there is an increase in rates of depression, panic disorder, agoraphobia, and substance use disorders (SUD), and a decrease in separation anxiety disorder (SAD) and attention-deficit hyperactivity disorder (ADHD). From adolescence to early adulthood there is a further increase in panic disorder, agoraphobia, and SUD, and a further decrease in SAD and ADHD. Other phobias and disruptive behavior disorders also fall. CONCLUSIONS: Further study of changes in rates of disorder across developmental stages could inform etiological research and guide interventions.

Creativity and psychopathology: a shared vulnerability model.

Creativity is considered a positive personal trait. However, highly creative people have demonstrated elevated risk for certain forms of psychopathology, including mood disorders, schizophrenia spectrum disorders, and alcoholism. A model of shared vulnerability explains the relation between creativity and psychopathology. This model, supported by recent findings from neuroscience and molecular genetics, suggests that the biological determinants conferring risk for psychopathology interact with protective cognitive factors to enhance creative ideation. Elements of shared vulnerability include cognitive disinhibition (which allows more stimuli into conscious awareness), an attentional style driven by novelty salience, and neural hyperconnectivity that may increase associations among disparate stimuli. These vulnerabilities interact with superior meta-cognitive protective factors, such as high IQ, increased working memory capacity, and enhanced cognitive flexibility, to enlarge the range and depth of stimuli available in conscious awareness to be manipulated and combined to form novel and original ideas.

Time Trends in Psychopathology. A 21-year comparison from Germany.

OBJECTIVE: Time-trend studies are required to learn about children's mental health status in changing societies. Some international studies have already analyzed secular trends over periods of 10 to 25 years, but the results are inconsistent. Our study aims to detect German time trends of psychopathology in children aged 8-11, from the first large Child Behavior Checklist (CBCL)-based study in Marburg/Germany 1987 until the present day (2008). METHOD: Parents filled in the CBCL to report psychopathological symptoms in their children. The school-based samples from the years 1987 and 2008 were matched for sex, age, and socioeconomic status. The matched samples each consists of 212 girls and boys (girls: 50.5 %, boys: 49.5 %). MANCOVAs and ANCOVAs were used to test differences in mean CBCL scale scores. RESULTS: Somatic symptoms showed a significant increase from 1987 to 2008. Similar trends were found for other internalizing symptoms, but did not reach significance. Externalizing symptoms showed no significant increase. Boys showed more aggressive or delinquent behavior and attention problems than girls. The children with the lowest socioeconomic status showed the highest symptom levels in both assessment years. CONCLUSIONS: The increase in somatic problems might be an effect of changes in expected school performance and economic aspects. The overall high rate of psychopathology in children highlights the necessity of effective prevention and intervention programs, particularly regarding families with lower socioeconomic status.

Normality, subjectivity and mental health: A genealogy of Danish psychiatry, 1938-2017.

The increasing prevalence of mental disorders together with the uncertain validity of psychopathological diagnostics challenges psychiatry as the primary home of studying, diagnosing and treating mental health problems and developing mental healthcare. This marks an emerging paradigmatical shift towards 'alternative' mental health perspectives. With the ambition of attending authoritatively in definitory practices, contemporary scholars of psychology, sociology, anthropology and philosophy call for an interdisciplinary approach to mental health, with a predominant focus on the subject. We argue that a paradigmatical shift of mental health requires structural-historical considerations of the foundations upon which subjectivity has been and still is manifested through psychiatry. On this basis, we critically investigate fluctuating psychiatric discourses on subjectivity, normality and pathology. We conducted a genealogical analysis of 13 psychiatric sources (1938-2017) focusing on 'Psychopathy' as a fluctuating diagnosis. We elucidate how subject concepts in psychiatry develop in parallel to subject concepts in society and culture, exemplified through convincing similarities between psychopathic symptoms and neoliberal ideals. Considerations like these, offer scholars valuable bases for mental health research and debate, and also valuable insights to healthcare professionals.

Psyche, soma, and science studies: new directions in the sociology of mental health and illness.

BACKGROUND: With the expanding scope of scientific and technological discourse within psychiatry, social scientists need new theoretical tools to grapple with the complex links between psychiatry, science and society. Benefit may be afforded through engagement with the discipline of science and technology studies (STS), which is concerned explicitly with the relationships between science and society. AIMS: To highlight existing engagements between STS and the sociology of (mental) health, and to encourage researchers to consider ways in which insights from these traditions may be developed further through interdisciplinary debate and analysis. METHODS: Some of the key works in STS and the sociology of mental illness that use the empirical or theoretical writings of the other were reviewed and appraised. RESULTS: Whilst it is clear that some research synthesizing insights from STS and the sociology of mental health exists, this is currently limited. CONCLUSIONS: Sociologists and others concerned with longstanding and emergent issues in mental health might usefully familiarize themselves with some work in STS. A new sociology of psychiatric knowledge production and application represents an important way forward.

The past achievements and future promises of developmental psychopathology: the coming of age of a discipline.

Over the past decades, developmental psychopathology has coalesced into a discipline that has made significant contributions toward the understanding of risk, psychopathology, and resilience in individuals across the life course. The overarching goal of the discipline has been to elucidate the interplay among biological, psychological, and social-contextual aspects of normal and abnormal development. In addition to directing efforts toward bridging fields of study and aiding in elucidating important truths about the processes underlying adaptation and maladaptation, investigators in developmental psychopathology have been equally devoted to developing and evaluating methods for preventing and ameliorating maladaptive and psychopathological outcomes. Increasingly, efforts are being made to conduct investigations at multiple levels of analysis and to translate basic research knowledge into real-world contexts. In this article, the contributions, challenges, and future directions of the field are highlighted.