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1.
Artigo em Inglês | MEDLINE | ID: mdl-38832960

RESUMO

CU traits, characterized by shallow affect, lack of fear, and absence of remorse, have been moderately associated with childhood maltreatment in a recent meta-analysis. However, the potential impact of brain structures remains undetermined. This paper examines the relationship between callous-unemotional (CU) traits, childhood maltreatment, and amygdala volumes. In this study, we used a region-of-interest (ROI) analysis to explore the interaction between the volumes of the amygdala, childhood maltreatment, and the manifestation of CU traits in adolescents diagnosed with conduct disorder (CD, N = 67), along with a comparison group of healthy-control youths (HCs, N = 89). The ROI analysis revealed no significant group differences in the bilateral amygdalar volumes. Significant positive correlation was discovered between all forms of child maltreatment (except for physical neglect) and CU traits across subjects. But the interaction of physical abuse and amygdala volumes was only significant within CD patients. Notably, a sensitivity analysis suggested that gender significantly influences these findings. These results contribute critical insights into the etiology of CU traits, emphasizing the need for customized clinical assessment tools and intervention strategies.

2.
Eur Child Adolesc Psychiatry ; 32(1): 193-203, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34635947

RESUMO

There may be distinct conduct disorder (CD) etiologies and neural morphologies in adolescents with high callous unemotional (CU) traits versus low CU traits. Here, we employed surface-based morphometry methods to investigate morphological differences in adolescents diagnosed with CD [42 with high CU traits (CD-HCU) and 40 with low CU traits (CD-LCU)] and healthy controls (HCs, N = 115) in China. Whole-brain analyses revealed significantly increased cortical surface area (SA) in the left inferior temporal cortex and the right precuneus, but decreased SA in the left superior temporal cortex in the CD-LCU group, compared with the HC group. There were no significant cortical SA differences between the CD-HCU and the HC groups. Compared to the CD-HCU group, the CD-LCU group had a greater cortical thickness (CT) in the left rostral middle frontal cortex. Region-of-interest analyses revealed significant group differences in the right hippocampus, with CD-HCU group having lower right hippocampal volumes than HCs. We did not detect significant group differences in the amygdalar volume, however, the right amygdalar volume was found to be a significant moderator of the correlation between CU traits and the proactive aggression in CD patients. The present results suggested that the manifestations of CD differ between those with high CU traits versus low CU traits, and underscore the importance of sample characteristics in understanding the neural substrates of CD.


Assuntos
Transtorno da Conduta , Humanos , Adolescente , Transtorno da Conduta/diagnóstico por imagem , Transtorno da Conduta/psicologia , Imageamento por Ressonância Magnética/métodos , Tonsila do Cerebelo/diagnóstico por imagem , Encéfalo , Emoções
3.
Bipolar Disord ; 24(4): 400-411, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34606159

RESUMO

BACKGROUND: Recently, functional homotopy (FH) architecture, defined as robust functional connectivity (FC) between homotopic regions, has been frequently reported to be altered in MDD patients (MDDs) but with divergent locations. METHODS: In this study, we obtained resting-state functional magnetic resonance imaging (R-fMRI) data from 1004 MDDs (mean age, 33.88 years; age range, 18-60 years) and 898 matched healthy controls (HCs) from an aggregated dataset from 20 centers in China. We focused on interhemispheric function integration in MDDs and its correlation with clinical characteristics using voxel-mirrored homotopic connectivity (VMHC) devised to inquire about FH patterns. RESULTS: As compared with HCs, MDDs showed decreased VMHC in visual, motor, somatosensory, limbic, angular gyrus, and cerebellum, particularly in posterior cingulate gyrus/precuneus (PCC/PCu) (false discovery rate [FDR] q < 0.002, z = -7.07). Further analysis observed that the reduction in SMG and insula was more prominent with age, of which SMG reflected such age-related change in males instead of females. Besides, the reduction in MTG was found to be a male-special abnormal pattern in MDDs. VMHC alterations were markedly related to episode type and illness severity. The higher Hamilton Depression Rating Scale score, the more apparent VMHC reduction in the primary visual cortex. First-episode MDDs revealed stronger VMHC reduction in PCu relative to recurrent MDDs. CONCLUSIONS: We confirmed a significant VMHC reduction in MDDs in broad areas, especially in PCC/PCu. This reduction was affected by gender, age, episode type, and illness severity. These findings suggest that the depressive brain tends to disconnect information exchange across hemispheres.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Adolescente , Adulto , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
Depress Anxiety ; 39(12): 845-857, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36329675

RESUMO

BACKGROUND: In the last decade, suicidality has been increasingly theorized as a distinct phenomenon from major depressive disorder (MDD), with unique psychological and neural mechanisms, rather than being mostly a severe symptom of MDD. Although decision-making biases have been widely reported in suicide attempters with MDD, little is known regarding what components of these biases can be distinguished from depressiveness itself. METHODS: Ninety-three patients with current MDD (40 with suicide attempts [SA group] and 53 without suicide attempts [NS group]) and 65 healthy controls (HCs) completed psychometric assessments and the balloon analog risk task (BART). To analyze and compare decision-making components among the three groups, we applied a five-parameter Bayesian computational modeling. RESULTS: Psychological assessments showed that the SA group had greater suicidal ideation and psychological pain avoidance than the NS group. Computational modeling showed that both MDD groups had higher risk preference and lower ability to learn and adapt from within-task observations than HCs, without differences between the SA and NS patient groups. The SA group also had higher loss aversion than the NS and HC groups, which had similar loss aversion. CONCLUSIONS: Our BART and computational modeling findings suggest that psychological pain avoidance and loss aversion may be important suicide risk factor that are distinguishable from depression illness itself.


Assuntos
Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/psicologia , Tentativa de Suicídio/psicologia , Teorema de Bayes , Ideação Suicida , Viés , Simulação por Computador , Dor
5.
Depress Anxiety ; 39(4): 296-306, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35072959

RESUMO

BACKGROUND: Emerging evidence has highlighted the moderating effect of childhood maltreatment (CM) in shaping neurobiological abnormalities in major depressive disorder (MDD). However, whether neural mechanisms underlying stress sensitivity in MDD are affected by the history of CM is unclear. METHODS: Two hundred and thirteen medication-free female participants were recruited for a functional magnetic resonance imaging study assessing the effects of psychosocial stress on neural responses. The Montreal Imaging Stress Task was administrated to 44 female MDD patients with CM (MDD/CM), 32 female MDD patients without CM (MDD/noCM), 43 female healthy controls (HCs) with CM (HC/CM), and 94 female HCs without CM (HC/noCM). A CM (CM, noCM) × diagnosis (MDD, HC) whole-brain voxel-wise analysis was run to assess putative group differences in neural stress responses. RESULTS: A significant CM × Diagnosis interaction emerged in the medial prefrontal cortex (mPFC). Bonferroni-corrected simple effects analysis clarified that (1) the MDD/CM group had less mPFC deactivation than the HC/CM group, (2) the MDD/noCM group exhibited greater mPFC deactivation than the HC/noCM group, and (3) the MDD/CM group exhibited less mPFC deactivation relative to the MDD/noCM group. In addition, the mPFC-seed psychophysiological interaction analysis revealed that individuals in the CM groups had significantly greater stress-related mPFC-left superior frontal gyrus and mPFC-right posterior cerebellum connectivity relative to the noCM groups. CONCLUSIONS: Findings highlight distinct neural abnormalities in MDD depending on prior CM history, particularly potentiated stress-related mPFC recruitment among MDD individuals reporting CM. Moreover, CM history was generally associated with the disruption in functional connectivity centered on the mPFC.


Assuntos
Maus-Tratos Infantis , Transtorno Depressivo Maior , Criança , Depressão , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Córtex Pré-Frontal
6.
Proc Natl Acad Sci U S A ; 116(18): 9078-9083, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-30979801

RESUMO

Major depressive disorder (MDD) is common and disabling, but its neuropathophysiology remains unclear. Most studies of functional brain networks in MDD have had limited statistical power and data analysis approaches have varied widely. The REST-meta-MDD Project of resting-state fMRI (R-fMRI) addresses these issues. Twenty-five research groups in China established the REST-meta-MDD Consortium by contributing R-fMRI data from 1,300 patients with MDD and 1,128 normal controls (NCs). Data were preprocessed locally with a standardized protocol before aggregated group analyses. We focused on functional connectivity (FC) within the default mode network (DMN), frequently reported to be increased in MDD. Instead, we found decreased DMN FC when we compared 848 patients with MDD to 794 NCs from 17 sites after data exclusion. We found FC reduction only in recurrent MDD, not in first-episode drug-naïve MDD. Decreased DMN FC was associated with medication usage but not with MDD duration. DMN FC was also positively related to symptom severity but only in recurrent MDD. Exploratory analyses also revealed alterations in FC of visual, sensory-motor, and dorsal attention networks in MDD. We confirmed the key role of DMN in MDD but found reduced rather than increased FC within the DMN. Future studies should test whether decreased DMN FC mediates response to treatment. All R-fMRI indices of data contributed by the REST-meta-MDD consortium are being shared publicly via the R-fMRI Maps Project.


Assuntos
Encéfalo/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Mapeamento Encefálico/métodos , China , Conectoma/métodos , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/metabolismo , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Vias Neurais/fisiopatologia , Descanso/fisiologia
7.
Eur Child Adolesc Psychiatry ; 31(4): 601-613, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33398650

RESUMO

Childhood maltreatment (CM) poses a serious risk to the physical, emotional and psychological well-being of children, and can advance the development of maladaptive behaviors, including conduct disorder (CD). CD involves repetitive, persistent violations of others' basic rights and societal norms. Little is known about whether and how CM influences the neural mechanisms underlying CD, and CD-characteristic neuroanatomical changes have not yet been defined in a structural magnetic resonance imaging (sMRI) study. Here, we used voxel-based morphometry (VBM) and surface-based morphometry (SBM) to investigate the influence of the CD diagnosis and CM on the brain in 96 boys diagnosed with CD (62 with CM) and 86 typically developing (TD) boys (46 with CM). The participants were 12-17 years of age. Compared to the CM- CD group, the CM+ CD group had structural gray matter (GM) alterations in the fronto-limbic regions, including the left amygdala, right posterior cingulate cortex (PCC), right putamen, right dorsolateral prefrontal cortex (dlPFC) and right anterior cingulate cortex (ACC). We also found boys with CD exhibited increased GM volume in bilateral dorsomedial prefrontal cortex (dmPFC), as well as decreased GM volume and decreased gyrification in the left superior temporal gyrus (STG) relative to TD boys. Regional GM volume correlated with aggression and conduct problem severity in the CD group, suggesting that the GM changes may contribute to increased aggression and conduct problems in boys with CD who have suffered CM. In conclusion, these results demonstrate previously unreported CM-associated distinct brain structural changes among CD-diagnosed boys.


Assuntos
Maus-Tratos Infantis , Transtorno da Conduta , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Córtex Cerebral/patologia , Criança , Transtorno da Conduta/diagnóstico por imagem , Transtorno da Conduta/patologia , Feminino , Substância Cinzenta/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/patologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-35704134

RESUMO

Aggression is a core feature of conduct disorder (CD), but the motivation, execution of aggression may vary. A deeper understanding of the neural substrates of aggressive behaviours is critical for effective clinical intervention. Seventy-six Boys with CD (50 with impulsive aggression (I-CD) and 26 with premeditated aggression (P-CD)) and 69 healthy controls (HCs) underwent a structural MRI scan and behavioural assessments. Whole-brain analyses revealed that, compared to HCs, the I-CD group showed significant cortical thinning in the right frontal cortex, while the P-CD group demonstrated significant folding deficits in the bilateral superior parietal cortex. Both types of aggression negatively correlated with the left amygdala volume, albeit in different ways. The present results demonstrated that the complex nature of aggression relies on differentiated anatomical substrates, highlighting the importance of exploring differential circuit-targeted interventions for CD patients.

9.
J Clin Psychol ; 78(4): 671-691, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34542183

RESUMO

OBJECTIVE: Predicting suicide is notoriously difficult and complex, but a serious public health issue. An innovative approach utilizing machine learning (ML) that incorporates features of psychological mechanisms and decision-making characteristics related to suicidality could create an improved model for identifying suicide risk in patients with major depressive disorder (MDD). METHOD: Forty-four patients with MDD and past suicide attempts (MDD_SA, N = 44); 48 patients with MDD but without past suicide attempts (MDD_NS, N = 48-42 of whom with suicide ideation [MDD_SI, N = 42]), and healthy controls (HCs, N = 51) completed seven psychometric assessments including the Three-dimensional Psychological Pain Scale (TDPPS), and one behavioral assessment, the Balloon Analogue Risk Task (BART). Descriptive statistics, group comparisons, logistic regressions, and ML were used to explore and compare the groups and generate predictors of suicidal acts. RESULTS: MDD_SA and MDD_NS differed in TDPPS total score, pain arousal and avoidance subscale scores, suicidal ideation scores, and relevant decision-making indicators in BART. Logistic regression tests linked suicide attempts to psychological pain avoidance and a risk decision-making indicator. The resultant key ML model distinguished MDD_SA/MDD_NS with 88.2% accuracy. The model could also distinguish MDD_SA/MDD_SI with 81.25% accuracy. The ML model using hopelessness could classify MDD_SI/HC with 94.4% accuracy. CONCLUSION: ML analyses showed that motivation to avoid intolerable psychological pain, coupled with impaired decision-making bias toward under-valuing life's worth are highly predictive of suicide attempts. Analyses also demonstrated that suicidal ideation and attempts differed in potential mechanisms, as suicidal ideation was more related to hopelessness. ML algorithms show useful promises as a predictive instrument.


Assuntos
Transtorno Depressivo Maior , Transtorno Depressivo Maior/psicologia , Humanos , Aprendizado de Máquina , Dor/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia
10.
BMC Psychiatry ; 21(1): 463, 2021 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556088

RESUMO

BACKGROUND: The Center for Epidemiologic Studies Depression scale (CESD) was widely used for screening of depressive symptoms. The purpose of the current study was to investigate the factor structure and measurement invariance of the CESD across genders and groups in a sample of Chinese undergraduates and clinical patients. METHODS: Participants included 3093 undergraduates from the Hunan province and 336 patients from psychological clinics. The structure of the CESD scale was analyzed by confirmatory factor analysis (CFA). Multiple sets of CFAs were used to test measurement invariance across genders among undergraduates and clinical patients. Internal consistency reliability was also evaluated. RESULTS: The five-factor model achieved satisfactory fit (in the undergraduate sample: WLSMVχ2 = 1662.385, df = 160, CFI = 0.973, TLI = 0.968, RMSEA = 0.055; in the clinical patients: WLSMVχ2 = 502.089, df = 160, CFI = 0.962, TLI = 0.955, RMSEA = 0.072). The measurement invariance of the five-factor model across genders was supported fully assuming different degrees of invariance. The CESD also showed acceptable internal consistency. CONCLUSION: Due to its sound structure and measurement invariance, the five-factor model of the CESD is best suited for testing in Chinese mainland college students and clinical patients.


Assuntos
Depressão , Estudantes , China/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Estudos Epidemiológicos , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes
11.
BMC Psychiatry ; 21(1): 378, 2021 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-34320935

RESUMO

BACKGROUND: A motivation dimension of the core psychiatric symptom anhedonia additional has been suggested. The Temporal Experience of Pleasure Scale (TEPS) has been reported to assess anticipatory and consummatory pleasure separately in multiple factor-structure models. This study explored the factor structure of a Chinese version of the 18-item TEPS and further explored the measurement invariance of the TEPS across sex and clinical status (non-clinical, psychiatric). METHODS: Best-fit factor structure of the TEPS was examined in a non-clinical cohort of 7410 undergraduates, randomized into sample 1 (N = 3755) for exploratory factor analysis (EFA) and sample 2 (N = 3663) for confirmatory factor analysis (CFA). Additionally, serial CFA was conducted to evaluate measurement invariance across sex and between clinical (N = 313) and non-clinical (N = 341) samples. RESULTS: EFA supported a new four-factor structure with a motivation component, based on the original two-factor model (consummatory pleasure with/without motivation drive, anticipatory pleasure with/without motivation drive). CFA confirmed the four-factor model as the best-fit structure and revealed a second-order hierarchy in non-clinical and clinical samples. Full scalar invariance was observed across clinical and non-clinical samples and across sex in the clinical sample; only partial scalar invariance was observed across sex in the non-clinical sample. CONCLUSIONS: A four-factor structured TEPS can assess motivation-driving dimensions of anticipatory and consummatory pleasure, consistent with the recently advanced multidimensional structure of anhedonia. CFA and measurement invariance results support application of the TEPS for assessing motivation aspects of anhedonia.


Assuntos
Prazer , Universidades , China , Humanos , Psicometria , Reprodutibilidade dos Testes , Estudantes
12.
BMC Psychiatry ; 21(1): 107, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33596861

RESUMO

BACKGROUND: The Personality Inventory for DSM-5 Brief Form (PID-5-BF) is a 25-item measuring tool evaluating maladaptive personality traits for the diagnosis of personality disorders(PDs). As a promising scale, its impressive psychometric properties have been verified in some countries, however, there have been no studies about the utility of the PID-5-BF in Chinese settings. The current study aimed to explore the maladaptive personality factor model which was culturally adapted to China and to examine psychometric properties of the PID-5-BF among Chinese undergraduate students and clinical patients. METHODS: Seven thousand one hundred fifty-five undergraduate students and 451 clinical patients completed the Chinese version of the PID-5-BF. Two hundered twenty-eight students were chosen randomly for test-retest reliability at a 4-week interval. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to discover the most suitable factor structure in China, measurement invariance(MI), internal consistency, and external validity were also calculated. RESULTS: The theoretical five-factor model was acceptable, but the exploratory six-factor model was more applicable in both samples (Undergraduate sample: CFI = 0.905, TLI = 0.888, RMSEA = 0.044, SRMR = 0.039; Clinical sample: CFI = 0.904, TLI = 0.886, RMSEA = 0.047, SRMR = 0.060). In the Chinese six-factor model, the Negative Affect domain was divided into two factors and the new factor was named "Interpersonal Relationships", which was in line with the Big-Six Personality model in Chinese. Measurement invariance across non-clinical and clinical sample was established (configural, weak, strong MI, and partial strict MI). Aside from acceptable internal consistency (Undergraduate sample: alpha = 0.84, MIC = 0.21; Clinical sample: alpha = 0.86, MIC = 0.19) and test-retest reliability(0.73), the correlation between the 25-item PID-5-BF and the 220-item PID-5 was significant(p < 0.01). The six PDs measured by Personality diagnostic questionnaire-4+ (PDQ-4+) were associated with and predicted by expected domains of PID-5-BF. CONCLUSIONS: Both the theoretical five-factor model and the exploratory six-factor model of the PID-5-BF were acceptable to the Chinese population. The five-factor model could allow for comparison and integration with other work on the original theoretical model. However, the Chinese six-factor structure may be more culturally informed in East Asian settings. In sum, the PID-5-BF is a convenient and useful screening tool for personality disorders.


Assuntos
Estudantes , China , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Inventário de Personalidade , Psicometria , Reprodutibilidade dos Testes
13.
BMC Psychiatry ; 20(1): 529, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33167901

RESUMO

BACKGROUND: Anhedonia is a core clinical symptom of mental disorders. The Revised Physical Anhedonia Scale (RPAS) and the Revised Social Anhedonia Scale (RSAS) have been applied in clinical and non-clinical samples since 1980s. However, the construct of a unified RPAS&RSAS for comprehensive measurement of anhedonia has never been explored. Therefore, the purpose of our study was to examine the factor structure of the unified RPAS&RSAS among undergraduates and clinical patients. METHODS: A total of 3435 undergraduates from two universities and 294 clinical patients with mental disorders had completed the Chinese version of the RPAS and the RSAS. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were each conducted to reveal the constructs of the RPAS and the RSAS. CFA was used to evaluate first- and second-order models for the unified RPAS&RSAS in undergraduates and clinical patients. The internal consistency and test-retest reliability of the RPAS and the RSAS were also evaluated. RESULTS: EFA and CFA indicated 2-factor structures for RPAS and RSAS, with the factors being defined as anticipatory anhedonia and consummatory anhedonia. The second-order model of the unified RPAS&RSAS in the undergraduates and clinical patients both had satisfactory fit index values (Undergraduate sample: CFI = 0.901, TLI = 0.899, RMSEA = 0.055, SRMR = 0.086; Clinical sample: CFI = 0.922, TLI = 0.911, RMSEA = 0.052, SRMR = 0.078). The psychometric robustness of the RPAS&RSAS were confirmed by high internal consistency and test-retest reliability values. CONCLUSIONS: The unified RPAS&RSAS with a second-order structure was confirmed in both undergraduates and clinical samples in Chinese. The construct of anhedonia was refreshed as covering physical and social domains, and each of them includes both anticipatory and consummatory components.


Assuntos
Anedonia , China , Análise Fatorial , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
14.
Eur Child Adolesc Psychiatry ; 29(4): 479-488, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31264106

RESUMO

Accumulating evidence suggests that neural abnormalities in conduct disorder (CD) may be subject to genetic influences, but few imaging studies have taken genetic variants into consideration. The Val66Met polymorphism of brain-derived neurotrophic factor (BDNF) has emerged as a high-interest genetic variant due to its importance in cortical maturation, and several studies have implicated its involvement in neurodevelopmental disorders. Thus, it is unclear how this polymorphism may influence brain anatomy and aberrant behaviors in CD. A total of 65 male adolescents with CD and 69 gender-, IQ- and socioeconomic status-matched healthy controls (HCs) (age range 13-17 years) were enrolled in this study. Analyses of variance (ANOVAs) were used to assess the main effects of CD diagnosis, BDNF genotype, and diagnosis-genotype interactions on brain anatomy and behaviors. We detected a significant main effect of BDNF genotype on temporal gyrification and antisocial behaviors, but not on CD symptoms. Diagnosis-genotype interactive effects were found for cortical thickness of the superior temporal and adjacent areas. These results suggest that the BDNF Val66Met polymorphism may exert its influence both on neural alterations and delinquent behaviors in CD patients. This initial evidence highlights the importance of elucidating potentially different pathways between BDNF genotype and cortical alterations or delinquent behaviors in CD patients.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/metabolismo , Encéfalo/patologia , Transtorno da Conduta/genética , Polimorfismo Genético/genética , Adolescente , Fator Neurotrófico Derivado do Encéfalo/genética , Feminino , Humanos , Masculino
15.
Psychol Med ; 49(6): 969-979, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29962366

RESUMO

BACKGROUND: Assertive Community Treatment (ACT) is an evidence-based treatment program for people with severe mental illness developed in high-income countries. We report the first randomized controlled trial of ACT in mainland China. METHODS: Sixty outpatients with schizophrenia with severe functional impairments or frequent hospitalizations were randomly assigned to ACT (n = 30) or standard community treatment (n = 30). The severity of symptoms and level of social functioning were assessed at baseline and every 3 months during the 1-year study. The primary outcome was the duration of hospital readmission. Secondary outcomes included a pre-post change in symptom severity, the rates of symptom relapse and gainful employment, social and occupational functioning, and quality of life of family caregivers. RESULTS: Based on a modified intention-to-treat analysis, the outcomes for ACT were significantly better than those of standard community treatment. ACT patients were less likely to be readmitted [3.3% (1/30) v. 25.0% (7/28), Fisher's exact test p = 0.023], had a shorter mean readmission time [2.4 (13.3) v. 30.7 (66.9) days], were less likely to relapse [6.7% (2/30) v. 28.6% (8/28), Fisher's exact test p = 0.038], and had shorter mean time in relapse [3.5 (14.6) v. 34.4 (70.6) days]. The ACT group also had significantly longer times re-employed and greater symptomatic improvement and their caregivers experienced a greater improvement in their quality of life. CONCLUSION: Our results show that culturally adapted ACT is both feasible and effective for individuals with severe schizophrenia in urban China. Replication studies with larger samples and longer duration of follow up are warranted.


Assuntos
Serviços Comunitários de Saúde Mental , Esquizofrenia/terapia , Adulto , Idoso , China , Serviços Comunitários de Saúde Mental/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicologia do Esquizofrênico , Resultado do Tratamento
16.
Hum Brain Mapp ; 39(2): 747-757, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29094787

RESUMO

Frontostriatal circuits dysfunction has been implicated in the etiology and psychopathology of patients with schizophrenia (SZ). However, few studies have investigated SZ-related functional connectivity (FC) alterations in discrete frontostriatal circuits and their relationship with pathopsychology in first-episode schizophrenia (FESZ). The goal of this study was to identify dysfunctions in discrete frontostriatal circuits that are associated with key features of FESZ. To this end, a case-control, cross-sectional study was conducted, wherein resting-state (RS) functional magnetic resonance (fMRI) data were collected from 37 treatment-naïve FESZ patients and 29 healthy control (HC) subjects. Seed-based FC analyses were performed by placing six bilateral pairs of seeds within a priori defined subdivisions of the striatum. We observed significantly decreased FC for the FESZ group relative to the HC group [p < .05, family-wise error (FWE)-corrected] in the limbic loop, but not in the sensorimotor or associative loops, of frontostriatal circuitry. Moreover, bilaterally decreased inferior ventral striatum/nucleus accumbens (VSi)-dorsal anterior cingulate cortex (dACC) FC within the limbic loop correlated inversely with overall FESZ symptom severity and the disorganization factor score of PANSS. These findings provide new insight into the role of frontostriatal limbic loop hypoconnectivity in early-stage schizophrenia pathology and suggest potential novel therapeutic targets.


Assuntos
Encéfalo/fisiopatologia , Esquizofrenia/fisiopatologia , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Escalas de Graduação Psiquiátrica , Descanso , Esquizofrenia/diagnóstico por imagem , Adulto Jovem
17.
Eur Child Adolesc Psychiatry ; 27(9): 1159-1169, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29855796

RESUMO

Conduct disorder (CD), a common psychiatric disorder in children and adolescents, is characterized by encroaching upon other rights and violations of age-appropriate social expectations repeatedly and persistently. Individuals with CD often have high aggressiveness and low inhibitory capacity. The monoamine oxidase A (MAOA) gene has long been associated with aggression. Effects of MAOA genotype on inhibitory control have been examined in general population. Several studies had revealed reduced activation in prefrontal areas, especially the anterior cingulate cortex (ACC), in low-expression MAOA (MAOA-L) allele carriers compared to high-expression MAOA (MAOA-H) allele carriers. However, little is known about its genetic risk influences on inhibitory processes in clinical samples. In this study, functional magnetic resonance imaging (fMRI) was administered to a sample of adolescent boys with CD during the performance of a GoStop task, 29 of whom carrying MAOA-L allele and 24 carrying MAOA-H allele. Relative to MAOA-H carriers, MAOA-L carriers in CD showed more pronounced deactivation in the precuneus, supplementary motor area (SMA) and dorsal anterior cingulate cortex (dACC). Deactivation within the default mode network (DMN) and inhibitory-related areas in MAOA-L carriers may be related to compensation for low sensitivity to inhibition and/or an atypical allocation of cognitive resources. The results suggested a possible neural mechanism through which MAOA affects inhibitory processes in a clinical sample.


Assuntos
Transtorno da Conduta/genética , Imageamento por Ressonância Magnética/métodos , Monoaminoxidase/genética , Criança , Feminino , Genótipo , Humanos , Masculino
18.
Psychol Health Med ; 23(1): 58-68, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28475352

RESUMO

The association between cognitive emotion regulation strategy use and adolescents' risk behavior has long been emphasized. To identify coping profiles of Chinese adolescents having unprotected sex and to examine the characteristics and associations among those subgroups, 541 adolescents (age, 14-19 years) were screened from secondary schools in 10 Chinese cities. By latent profile analysis (LPA), the participants were identified into three latent profiles: the low reaction profile (LRP, N = 70), the medium reaction profile (MRP, N = 369), and the high reaction profile (HRP, N = 102) based on nine subscales of the Cognitive Emotion Regulation Questionnaire (CERQ). By one-way analysis of variance, chi-square tests, and multivariate logistic regression analysis, we found that: the HRP has the highest level of using eight strategies and the lowest unprotected sex, meanwhile the LRP has the lowest level of using nine strategies and the highest unprotected sex among three groups (both p < .05). The low response coping was more prevalent among boys and younger students. It indicates that more active cognitive coping, using both adaptive and maladaptive strategies, may associate with less unprotected sex. The programs of enhancing active copying may be targeted in interventions aiming to reduce adolescent unprotected sex.


Assuntos
Adaptação Psicológica , Cognição , Emoções , Sexo sem Proteção/psicologia , Adolescente , Comportamento do Adolescente/psicologia , China , Feminino , Humanos , Masculino , Assunção de Riscos , Instituições Acadêmicas , Estudantes , Inquéritos e Questionários , Adulto Jovem
19.
BMC Psychiatry ; 17(1): 152, 2017 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-28454569

RESUMO

BACKGROUND: Rumination increases vulnerability to depression, exacerbates and perpetuates negative moods. This study was aimed to examine the psychometric properties of the Chinese version of the 10-item Ruminative Response Scale (RRS-10) in a large undergraduate sample. METHODS: A sample of 5,236 university students finished the RRS and the Center for Epidemiological Studies Depression Scale (CES-D). Confirmatory Factor Analysis (CFA) was performed to examine the two-factor structure and the measurement equivalence of the RRS-10 across gender. The internal consistency, test-retest reliability, correlations among RRS, RRS-10 and CES-D were also explored. In addition, gender difference on rumination and the relationship between rumination and depression were further investigated. RESULTS: The two-factor model of RRS-10 fit the data reasonably and had acceptable internal consistency and test-retest reliability in Chinese undergraduates sample. And the measurement equivalence of the RRS-10 was acceptable across gender in Chinese university students. Findings in respect of latent means and manifest means revealed non-significant gender difference in RRS-10. Besides, participants with high-level rumination had more depressive symptoms than those with low-level rumination. CONCLUSIONS: The Chinese version of the RRS-10 showed good psychometric properties and was measurement invariant across gender in undergraduates.


Assuntos
Depressão/diagnóstico , Estudantes/psicologia , Pensamento , Universidades , Adulto , Povo Asiático/psicologia , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
20.
Eur Child Adolesc Psychiatry ; 26(7): 827-837, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28185093

RESUMO

Functional magnetic resonance imaging (fMRI) studies have revealed abnormal neural activity in several brain regions of adolescents with conduct disorder (CD) performing various tasks. However, little is known about the spontaneous neural activity in people with CD in a resting state. The aims of this study were to investigate CD-associated regional activity abnormalities and to explore the relationship between behavioral impulsivity and regional activity abnormalities. Resting-state fMRI (rs-fMRI) scans were administered to 28 adolescents with CD and 28 age-, gender-, and IQ-matched healthy controls (HCs). The rs-fMRI data were subjected to regional homogeneity (ReHo) analysis. ReHo can demonstrate the temporal synchrony of regional blood oxygen level-dependent signals and reflect the coordination of local neuronal activity facilitating similar goals or representations. Compared to HCs, the CD group showed increased ReHo bilaterally in the insula as well as decreased ReHo in the right inferior parietal lobule, right middle temporal gyrus and right fusiform gyrus, left anterior cerebellum anterior, and right posterior cerebellum. In the CD group, mean ReHo values in the left and the right insula correlated positively with Barratt Impulsivity Scale (BIS) total scores. The results suggest that CD is associated with abnormal intrinsic brain activity, mainly in the cerebellum and temporal-parietal-limbic cortices, regions that are related to emotional and cognitive processing. BIS scores in adolescents with CD may reflect severity of abnormal neuronal synchronization in the insula.


Assuntos
Encéfalo/patologia , Transtorno da Conduta/psicologia , Imageamento por Ressonância Magnética/métodos , Adolescente , Feminino , Humanos , Masculino
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