Conspiracy beliefs and COVID-19 guideline adherence in adolescent psychiatric outpatients: the predictive role of adverse childhood experiences.

BACKGROUND: Conspiracy beliefs have become widespread throughout the COVID-19 pandemic. Previous studies have shown that endorsing conspiracy beliefs leads to lower protective guideline adherence (i.e., wearing face masks), posing a threat to public health measures. The current study expands this research across the lifespan, i.e., in a sample of adolescents with mental health problems. Here, we investigated the association between conspiracy beliefs and guideline adherence while also exploring the predictors of conspiracy beliefs. METHODS: N = 93 adolescent psychiatric outpatients (57% female, mean age: 15.8) were assessed using anonymous paper-pencil questionnaires. Endorsement of generic and COVID-19 conspiracy beliefs was assessed, in addition to items measuring adherence to protective guidelines and mental health (stress, depressive symptoms, emotional/behavioral problems, and adverse childhood experiences). Multiple regressions and supervised machine learning (conditional random forests) were used for analyses. RESULTS: Fourteen percent of our sample fully endorsed at least one COVID-19 conspiracy theory, while protective guidelines adherence was relatively high (M = 4.92, on a scale from 1 to 7). The endorsement of COVID-19 conspiracy beliefs-but not of generic conspiracy beliefs-was associated with lower guideline adherence (ß = - 0.32, 95% CI - 0.53 to - 0.11, p < .001). Conditional random forests suggested that adverse childhood experiences and peer and conduct problems were relevant predictors of both conspiracy belief categories. CONCLUSION: While a significant proportion of our sample of adolescents in psychiatric treatment endorsed conspiracy beliefs, the majority did not. Furthermore, and to some degree, contrary to public perception, we found that adolescents show relatively good adherence to public health measures-even while experiencing a high degree of mental distress. The predictive value of adverse childhood experiences and peer/conduct problems for conspiracy beliefs might be explained by compensatory mechanisms to ensure the safety, structure, and inclusion that conspiracies provide.

Balancing the brain of offenders with psychopathy? Resting state EEG and electrodermal activity after a pilot study of brain self-regulation training.

Although investigation of the brains of criminals began quite early in the history of psychophysiological research, little is known about brain plasticity of offenders with psychopathy. Building on our preliminary study reporting successful brain self-regulation using slow cortical potential (SCP) neurofeedback in offenders with psychopathy, we investigated the central nervous and autonomic peripheral changes occurring after brain self-regulation in a group of severe male offenders with psychopathy. Regarding the central nervous system, an overall suppression of the psychopathic overrepresentation of slow frequency bands was found, such as delta and theta band activity, after EEG neurofeedback. In addition, an increase in alpha band activity could be observed after the SCP self-regulation training. Electrodermal activity adaptively changed according to the regulation task, and this flexibility improved over training time. The results of this study point towards a constructive learning process and plasticity in neural and peripheral measures of offenders with psychopathy.

[Review about psychopharmaceuticals for the use in children and adolescents with a respective license in Austria]. / Review über Psychopharmaka mit Zulassung in Österreich für die Anwendung an Kindern und/oder Jugendlichen.

Given an indication for pharmacological treatment, prescribers can only draw from a rather limited number of substances with a label for the treatment of children and adolescents suffering from psychiatric disorders. In order to capture the currently available substances with such a label in Austria and to thus provide one element of informed patient education, the Austrian medicinal product index of the Austrian Federal Office for Safety in Health Care has been systematically searched. The resulting tables are being presented.

[Guideline for off-label use of psychotropic drugs in children and adolescents]. / Leitlinie zum "Off-Label-Use" von Psychopharmaka im Kindes- und Jugendalter.

Off-label use is the practice of prescribing pharmaceuticals for an unapproved indication or in an unapproved age group, unapproved dose or unapproved form of administration. Many psychotropic drugs are not put through the rigorous formal process required to officially approve the drug for use in children and adolescents. If no approved drugs are available for a specific indication, child psychiatrists have to decide, whether to utilize the corresponding product authorized for adults, or not to treat with drugs. In many cases non-treatment would not be in line with the legal and moral duty to care and would be assessed as a breach of statutory duty of care in a liability proceeding. Off-label use of drugs requests extended obligation to inform because of enlarged needs of information of patients and parents. The present guideline makes recommendations for child and adolescent psychiatrists of the principle of the obligation to care as well as legal and moral considerations.

[Pharmacotherapy of attention-deficit/hyperactivity disorder (ADHD) and comorbid disorders]. / Medikamentöse Behandlung von Aufmerksamkeitsdefizit- Hyperaktivitätssyndrom (ADHS) und komorbiden Störungen.

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed disorders in child and adolescent psychiatry. Patients with ADHD show increased risk for comorbid psychiatric disorders such as mood disorders, anxiety disorders, tic disorders and disruptive behavior disorders. Using criteria and methods of evidence-based medicine, in this paper possible algorithms for ADHD and comorbid disorders are presented. In conclusion, these algorithms aim to support health care professionals and can serve as guideline in decision making in pharmacotherapy. Stimulants are first-line medication treatment of ADHD without comorbid disorder. In co-existing aggression, major depressive disorder and tic disorder treatment with stimulants should be initialized at first. Only in case of unchanged persistence of comorbid symptoms specific pharmacological therapy should be combined. In comorbid anxiety disorders atomoxetine can be used as first-line treatment.

[Autocastration of a young schizophrenic man]. / Selbstkastration eines psychotischen Patienten - Eine entwicklungspsychopathologische Betrachtung.

OBJECTIVE: Self-mutilation of the genitals in man is a rare phenomenon mainly occurring in young males. The importance of conflicts about the male role, difficulties with the male identification in childhood and feeling of guilt for sexual offences are discussed in the literature. The influence of developmental crisis on this symbolic form of automutilation will be discussed in our case report. METHOD: We present a case of a young schizophrenic man whose illness started in adolescence. He committed genital automutilation already in early adolescence, as a young male he autocastrated himself. DISCUSSION: We demonstrate the connection of specific problems of development in adolescence and psychopathology. Autocastration will be discussed as a "psychotic" solution of the adolescent conflict of dependence. CONCLUSIONS: Developmental conflicts may be important pathoplastic factors who may lead to severe psychopathology and misbehavior. Additionally to a psychopharmacological treatment a specific adolescent- and conflictoriented psychotherapy for solving the developmental conflicts in young schizophrenic patients should be established.

Tension-type headache in different age groups at two headache centers.

At two headache centers, one for children and adolescents and the other for adults, we investigated patients aged 5-80 years with episodic or chronic tension-type headache to evaluate the relation between age and headache characteristics as well as analgesics intake. We found an increasing headache frequency and duration, an increasing variability of the headache location, and an increasing frequency of nausea with increasing age. All other headache features did not depend on age. Additionally, our study revealed a marked increase of analgesics use in adults compared to children and adolescents. In conclusion, children, adolescents, and adults referred for tension-type headache show minor differences in some headache features, but a marked change of analgesics intake. The different headache symptoms may be causally related to age, but an influence of medication or other factors must also be considered.