Distress tolerance is linked with substance use motivations and problems in young adults across four continents.

INTRODUCTION: People low in trait distress tolerance are at higher risk for harmful patterns of substance use. Some evidence suggests that maladaptive motives for substance use account for this correlation. However, the generality of these associations remains in doubt because virtually all available data come from North American samples. METHOD: Using data from 7 countries (total N = 5858; U.S., Argentina, Uruguay, Spain, South Africa, Canada, and England), we examined distress tolerance's association with alcohol- and cannabis-related problems in young adults. On an exploratory basis, we examined how distress tolerance related to different substance-use motivations. RESULTS: We found that distress tolerance was inversely related to problematic alcohol and cannabis use (rs = -0.14 and - 0.13). There was notable variation across countries in the magnitude of these effects, particularly for cannabis-related problems. Additionally, exploratory analyses revealed statistically significant (cross-sectional) indirect effects of distress tolerance on substance-related problems via substance-use motivations related to neutralizing negative emotions. CONCLUSIONS: Distress tolerance's role in substance-use problems appears to generalize beyond North America, although effect sizes were generally small and varied notably across geographical regions. Distress tolerance's connection with negative reinforcement processes (e.g., coping motives) warrants attention as a possible mediator of its association with problematic substance use.

Defining distress tolerance in a structural model of Big Five personality domains.

OBJECTIVE: Distress tolerance (DT)-willingness to face internal discomforts-has a fuzzy boundary with neuroticism (low emotional stability), raising questions about its independent role in models of personality and mental health. METHOD: We investigated DT's overlap with neuroticism and other Big Five factors in a structural model of personality and personality disorder features in samples of university students (N = 1025), emotional disorder patients (N = 225), and substance-use patients (N = 210). RESULTS: In exploratory factor analyses, we found that DT indicators clustered with neuroticism and were essentially unrelated to other Big Five domains. Big Five personality dimensions collectively explained approximately 40%-70% of variation in DT, across different samples and methods of quantifying shared variance. CONCLUSIONS: We conclude that DT and neuroticism are near neighbors in empirical space and speculate that much of the observed correlation between DT and mental health outcomes in the literature may be carried by shared neuroticism variance. We suggest that clearer distinctions between the two constructs in empirical research could improve our understanding of DT's unique role in the development and treatment of psychopathology.

Childhood Traumatic Experiences and Negative Alcohol-Related Consequences in Adulthood: A Cross-Cultural Examination of Distress Tolerance and Drinking to Cope.

Background: Prior research has established that Adverse Childhood Experiences (ACEs) predict harmful alcohol use outcomes. However, underlying mechanisms that could explain these associations are less clear. The present study examined if ACEs are indirectly related to alcohol negative consequences through their associations with distress tolerance and drinking to cope. Method: A sample of 3,763 (71.9% female) college students who drink alcohol from seven countries (U.S., Argentina, Canada, Uruguay, Spain, South Africa, and England) completed online surveys. Path analysis was performed within the whole sample testing the serial unique associations between ACEs→distress tolerance→drinking to cope→negative alcohol-related consequences. Multi-group analysis was performed to determine if the proposed pathways were invariant across gender and countries. Results: Both distress tolerance and drinking to cope uniquely accounted for the relationship between ACEs and negative alcohol-related consequences. Additionally, a significant double-mediation effect was found illustrating that a higher endorsement of ACEs was associated with lower distress tolerance, which in turn was associated with higher drinking to cope, which in turn was associated with more negative alcohol-related consequences. These effects were invariant across countries and gender groups. Conclusions: These findings provide support for the relevance of distress tolerance and coping motives as potential factors in linking ACEs to problematic alcohol use across nations. Our data are consistent with the idea that intervening on distress tolerance and drinking motives could mitigate downstream alcohol-related consequences related to ACEs in college student populations around the world.

Utility of the Brief Young Adult Alcohol Consequences Questionnaire to Identify College Students At-Risk for Alcohol Related Problems: Relative Operating Characteristics across Seven Countries.

Background: It is important to identify students who would benefit from early interventions to reduce harmful drinking patterns and associated consequences. the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) could be particularly useful as a screening tool in university settings. Objectives. The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Objectives: The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Methods: A sample of 6382 students (mean age=20.28, SD=3.75, 72.2% females) from seven countries (i.e., U.S., Canada, South-Africa, Spain, Argentina, Uruguay, England) completed the B-YAACQ, the AUDIT and different measures of alcohol use. Results: ROC analyses suggested that a cutoff score of 5 maximized the YAACQ's discrimination utility to differentiate between students at low versus moderate/high risk in the total sample and across countries (except in Canada, where the cutoff was 4). In addition, a cutoff of 7 differentiated between students at low/moderate versus high risk in the total sample, while cutoffs of 10, 9, 8 and 7 differentiate between students at low/moderate versus high risk in Uruguay, U.S and Spain (10), Argentina (9), England (8), and Canada and South-Africa (7), respectively. Students classified at the three risk levels (i.e., low, moderate and high) differed in age (i.e., a younger age was associated with higher risk) and drinking patters (i.e., higher drinking frequency, quantity, binge drinking and AUDIT and B-YAACQ scores in the higher risk groups). Conclusions: This study suggest that the B-YAACQ is a useful tool to identify college students at-risk for experiencing problematic patterns of alcohol use.

The Hierarchical Taxonomy of Psychopathology (HiTOP) in psychiatric practice and research.

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Higher order compulsivity versus grooming dimensions as treatment targets for the DSM-5 obsessive-compulsive and related disorders.

BACKGROUND: Transdiagnostic definitions of obsessive-compulsive and related disorders (OCRDs) may represent useful treatment targets. The current study sought to characterize higher order dimensions underpinning the OCRDs in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition, and examine their course during treatment. METHODS: Adult patients (N = 407) completed measures of OCRDs, depression, and worry before and after intensive/residential treatment for OCRDs. Structural equation modeling was used to examine the comorbidity structure and temporal course of the symptoms. RESULTS: Covariation of the symptoms was best represented by three dimensions: distress (depression and worry), compulsivity (obsessive-compulsive disorder, hoarding, and body dysmorphia), and grooming (hair pulling and skin picking). Latent change score modeling revealed significant reduction in the means of all three dimensions across treatment (Cohen's ds = -1.04, -0.62, and -0.23 for distress, compulsivity, and grooming, respectively). There was a strong correlation between change in compulsivity and grooming (r = .67) and change in compulsivity and distress (r = .80), but a small correlation between change in grooming and distress (r = .35). CONCLUSIONS: The results indicate that OCRDs are underpinned by higher order compulsivity and grooming dimensions that differ in their association with distress. The results further suggest that the two dimensions may reflect promising intervention targets suitable for transdiagnostic treatment protocols.

Nonhuman primates learn adjacent dependencies but fail to learn nonadjacent dependencies in a statistical learning task with a salient cue.

There is ample evidence that humans and nonhuman animals can learn complex statistical regularities presented within various types of input. However, humans outperform their nonhuman primate counterparts when it comes to recognizing relationships that exist across one or several intervening stimuli (nonadjacent dependencies). This is especially true when the two elements in the dependency do not share any perceptual similarity (arbitrary associations). In the present study, we investigated whether manipulating the saliency of the predictive stimulus would enhance nonadjacent dependency learning in nonhuman primates. Rhesus macaques and tufted capuchins engaged in a computerized signal detection task that included sequences that were random in nature, included an adjacent dependency, or included a nonadjacent dependency. We manipulated the saliency of the predictive stimulus, such that the predictor jittered in place on the screen in some grammar blocks, as well as the transitional probability (the likelihood of the stimulus preceding the target to accurately predict the target's appearance) from block to block. Some monkeys evidenced learning of adjacent dependencies by faster response times to targets that followed a predictive stimulus compared to targets that were not preceded by a predictor. However, consistent with the body of evidence that indicates that nonhuman animals' statistical learning mechanisms are not at the same level of sophistication as humans', there was no evidence that monkeys learned nonadjacent dependencies of arbitrary associations, even when the salient cue was present.

The Hierarchical Taxonomy of Psychopathology (HiTOP): A Quantitative Nosology Based on Consensus of Evidence.

Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.

Visual Sequence Repetition Learning is Not Impaired in Signing DHH Children.

The auditory scaffolding hypothesis states that early experience with sound underpins the development of domain-general sequence processing abilities, supported by studies observing impaired sequence processing in deaf or hard-of-hearing (DHH) children. To test this hypothesis, we administered a sequence processing task to 77 DHH children who use American Sign Language (ASL) and 23 hearing monolingual children aged 7-12 years and found no performance difference between them after controlling for age and nonverbal intelligence. Additionally, neither spoken language comprehension scores nor hearing loss levels predicted sequence processing scores in the DHH group, whereas ASL comprehension scores did. Our results do not indicate sequence processing deficits in DHH children and do not support the auditory scaffolding hypothesis; instead, these findings suggest that factors related to experience with and/or proficiency in an accessible language during development may be more important determinants of sequence processing abilities.

Les progrès dans la réalisation de la classification quantitative de la psychopathologie.

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.

Distinct neural networks for detecting violations of adjacent versus nonadjacent sequential dependencies: An fMRI study.

The ability to learn and process sequential dependencies is essential for language acquisition and other cognitive domains. Recent studies suggest that the learning of adjacent (e.g., "A-B") versus nonadjacent (e.g., "A-X-B") dependencies have different cognitive demands, but the neural correlates accompanying such processing are currently underspecified. We developed a sequential learning task in which sequences of printed nonsense syllables containing both adjacent and nonadjacent dependencies were presented. After incidentally learning these grammatical sequences, twenty-one healthy adults (age M = 22.1, 12 females) made familiarity judgments about novel grammatical sequences and ungrammatical sequences containing violations of the adjacent or nonadjacent structure while in a 3T MRI scanner. Violations of adjacent dependencies were associated with increased BOLD activation in both posterior (lateral occipital and angular gyrus) as well as frontal regions (e.g., medial frontal gyrus, inferior frontal gyrus). Initial results indicated no regions showing significant BOLD activations for the violations of nonadjacent dependencies. However, when using a less stringent cluster threshold, exploratory analyses revealed that violations of nonadjacent dependencies were associated with increased activation in subcallosal cortex, paracingulate cortex, and anterior cingulate cortex (ACC). Finally, when directly comparing the adjacent condition to the nonadjacent condition, we found significantly greater levels of activation for the right superior lateral occipital cortex (BA 19) for the adjacent relative to nonadjacent condition. In sum, the detection of violations of adjacent and nonadjacent dependencies appear to involve distinct neural networks, with perceptual brain regions mediating the processing of adjacent but not nonadjacent dependencies. These results are consistent with recent proposals that statistical-sequential learning is not a unified construct but depends on the interaction of multiple neurocognitive mechanisms acting together.

Double Dissociation of Auditory Attention Span and Visual Attention in Long-Term Survivors of Childhood Cerebellar Tumor: A Deterministic Tractography Study of the Cerebellar-Frontal and the Superior Longitudinal Fasciculus Pathways.

OBJECTIVE: Right cerebellar-left frontal (RC-LF) white matter integrity (WMI) has been associated with working memory. However, prior studies have employed measures of working memory that include processing speed and attention. We examined the relationships between the RC-LF WMI and processing speed, attention, and working memory to clarify the relationship of RC-LF WMI with a specific cognitive function. Right superior longitudinal fasciculus II (SLF II) WMI and visual attention were included as a negative control tract and task to demonstrate a double dissociation. METHODS: Adult survivors of childhood brain tumors [n = 29, age: M = 22 years (SD = 5), 45% female] and demographically matched controls were recruited (n = 29). Tests of auditory attention span, working memory, and visual attention served as cognitive measures. Participants completed a 3-T MRI diffusion-weighted imaging scan. Fractional anisotropy (FA) and radial diffusivity (RD) served as WMI measures. Partial correlations between WMI and cognitive scores included controlling for type of treatment. RESULTS: A correlational double dissociation was found. RC-LF WMI was associated with auditory attention (FA: r = .42, p = .03; RD: r = -.50, p = .01) and was not associated with visual attention (FA: r = -.11, p = .59; RD: r = -.11, p = .57). SLF II FA WMI was associated with visual attention (FA: r = .44, p = .02; RD: r = -.17, p = .40) and was not associated with auditory attention (FA: r = .24, p = .22; RD: r = -.10, p = .62). CONCLUSIONS: The results show that RC-LF WMI is associated with auditory attention span rather than working memory per se and provides evidence for a specificity based on the correlational double dissociation.

Criterion A of the AMPD in HiTOP.

The categorical model of personality disorder classification in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013 ) is highly and fundamentally problematic. Proposed for DSM-5 and provided within Section III (for Emerging Measures and Models) was the Alternative Model of Personality Disorder (AMPD) classification, consisting of Criterion A (self-interpersonal deficits) and Criterion B (maladaptive personality traits). A proposed alternative to the DSM-5 more generally is an empirically based dimensional organization of psychopathology identified as the Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017 ). HiTOP currently includes, at the highest level, a general factor of psychopathology. Further down are the five domains of detachment, antagonistic externalizing, disinhibited externalizing, thought disorder, and internalizing (along with a provisional sixth somatoform dimension) that align with Criterion B. The purpose of this article is to discuss the potential inclusion and placement of the self-interpersonal deficits of the DSM-5 Section III Criterion A within HiTOP.

Visual sequential processing and language ability in children who are deaf or hard of hearing.

This study investigated the role of sequential processing in spoken language outcomes for children who are deaf or hard of hearing (DHH), ages 5;3-11;4, by comparing them to children with typical hearing (TH), ages 6;3-9;7, on sequential learning and memory tasks involving easily nameable and difficult-to-name visual stimuli. Children who are DHH performed more poorly on easily nameable sequencing tasks, which positively predicted receptive vocabulary scores. Results suggest sequential learning and memory may underlie delayed language skills of many children who are DHH. Implications for language development in children who are DHH are discussed.

Transdiagnostic pathways from early social stress to psychopathology: a 20-year prospective study.

BACKGROUND: Adverse family environments confer susceptibility to virtually all psychiatric problems. This study evaluated two possible models to explain this diversity of associations. Stressful family circumstances during childhood could either activate general, transdiagnostic liabilities to mental disorder or promote numerous disorder-specific liabilities. METHODS: We recruited a high-risk sample of 815 mother-offspring pairs and assessed social stressors in the family context prospectively from the perinatal period through offspring age 5. We factor analyzed offspring mental disorder diagnoses at age 20 to parse transdiagnostic and disorder-specific dimensions of psychopathology. RESULTS: Structural analyses revealed nearly equivalent prospective effects of early family stress on overarching Internalizing (ß = .30) and Externalizing (ß = .29) dimensions. In contrast, there was no evidence of disorder-specific effects. CONCLUSIONS: Social stressors early in life activate transdiagnostic, and not disorder-specific, liabilities to psychopathology. A focus on higher-order dimensions of psychopathology could accelerate etiological research and intervention efforts for stress-linked mental disorders.

Visual artificial grammar learning by rhesus macaques (Macaca mulatta): exploring the role of grammar complexity and sequence length.

Humans and nonhuman primates can learn about the organization of stimuli in the environment using implicit sequential pattern learning capabilities. However, most previous artificial grammar learning studies with nonhuman primates have involved relatively simple grammars and short input sequences. The goal in the current experiments was to assess the learning capabilities of monkeys on an artificial grammar-learning task that was more complex than most others previously used with nonhumans. Three experiments were conducted using a joystick-based, symmetrical-response serial reaction time task in which two monkeys were exposed to grammar-generated sequences at sequence lengths of four in Experiment 1, six in Experiment 2, and eight in Experiment 3. Over time, the monkeys came to respond faster to the sequences generated from the artificial grammar compared to random versions. In a subsequent generalization phase, subjects generalized their knowledge to novel sequences, responding significantly faster to novel instances of sequences produced using the familiar grammar compared to those constructed using an unfamiliar grammar. These results reveal that rhesus monkeys can learn and generalize the statistical structure inherent in an artificial grammar that is as complex as some used with humans, for sequences up to eight items long. These findings are discussed in relation to whether or not rhesus macaques and other primate species possess implicit sequence learning abilities that are similar to those that humans draw upon to learn natural language grammar.

Evaluating dimensional models of psychopathology in outpatients diagnosed with emotional disorders: A cautionary tale.

BACKGROUND: Mental disorders cluster together systematically. Through factor analysis of disorder comorbidity, investigators are establishing the latent dimensions that underlie the development of related syndromes. However, these dimensions have not been validated across diverse patient samples, in which comorbidity patterns vary widely. METHOD: We assessed 4,928 outpatients seeking treatment for emotional disorders with a semistructured diagnostic interview. This was the largest patient sample as yet for an evaluation of the latent structure of mental disorders. We compared several competing dimensional models of common mental disorders via confirmatory factor analysis. RESULTS: The hypothesized confirmatory factor model-anchored by internalizing and externalizing spectra-fit the diagnostic data poorly. Neither a one-factor model, reflecting a unitary liability to all mental disorders, nor a three-factor model, wherein the internalizing dimension bifurcated into distress and fear subfactors, fit appreciably better. CONCLUSIONS: These data provide novel evidence that the internalizing and externalizing spectra are not structurally sound in all clinical contexts. We speculate about the causes of model misfit and advise additional research into the generalizability-with respect to sample, input data, developmental stage, and more-of dimensional models of mental disorder.

PATHOLOGICAL PERSONALITY TRAITS AND THE NATURALISTIC COURSE OF INTERNALIZING DISORDERS AMONG HIGH-RISK YOUNG ADULTS.

BACKGROUND: A personality disorder diagnosis signals a negative prognosis for depressive and anxiety disorders, but the precise abnormal personality traits that determine the temporal course of internalizing psychopathology are unknown. In the present study, we examined prospective associations between abnormal personality traits and the onset and recurrence of internalizing disorders. METHODS: A sample of 371 young adults at high risk for internalizing problems completed the Schedule for Nonadaptive and Adaptive Personality-Second Edition--a measure of 12 abnormal personality traits and three temperament dimensions (i.e., Negative Temperament, Positive Temperament, Disinhibition vs. Control)--and underwent annual diagnostic interviews over 4 years of follow-up. RESULTS: In multivariate survival analyses, Negative Temperament was a robust predictor of both new onsets and recurrences of internalizing disorder. Further, the Dependency and Self-Harm abnormal personality dimensions emerged as independent predictors of new onsets and recurrences, respectively, of internalizing disorders after statistically adjusting for variation in temperament. CONCLUSIONS: Our findings suggest that abnormal personality traits and temperament dimensions have complementary effects on the trajectory of internalizing pathology during young adulthood. In assessment and treatment settings, targeting the abnormal personality and temperament dimensions with the greatest prognostic value stands to improve the early detection of enduring internalizing psychopathology.

Heparan sulfotransferases Hs6st1 and Hs2st keep Erk in check for mouse corpus callosum development.

The corpus callosum (CC) connects the left and right cerebral hemispheres in mammals and its development requires intercellular communication at the telencephalic midline mediated by signaling proteins. Heparan sulfate (HS) is a sulfated polysaccharide that decorates cell surface and extracellular matrix proteins and regulates the biological activity of numerous signaling proteins via sugar-protein interactions. HS is subject to regulated enzymatic sulfation and desulfation and an attractive, although not proven, hypothesis is that the biological activity of HS is regulated by a sugar sulfate code. Mutant mouse embryos lacking the heparan sulfotransferases Hs2st or Hs6st1 have severe CC phenotypes and form Probst bundles of noncrossing axons flanking large tangles of midline glial processes. Here, we identify a precocious accumulation of Sox9-expressing glial cells in the indusium griseum region and a corresponding depletion at the glial wedge associated with the formation of Probst bundles along the rostrocaudal axis in both mutants. Molecularly, we found a surprising hyperactivation of Erk signaling in Hs2st(-/-) (2-fold) and Hs6st1(-/-) (6-fold) embryonic telencephalon that was most striking at the midline, where Erk signaling is lowest in wild-types, and a 2-fold increase in Fgf8 protein levels in Hs6st1(-/-) embryos that could underpin Erk hyperactivation and excessive glial movement to the indusium griseum. The tightly linked Hs6st1(-/-) CC glial and axonal phenotypes can be rescued by genetic or pharmacological suppression of Fgf8/Erk axis components. Overall, our data fit a model in which Hs2st and Hs6st1 normally generate conditions conducive to CC development by generating an HS-containing environment that keeps Erk signaling in check.