Diseases of despair in early adulthood: The complex role of social relationships.

"Diseases of despair," most prominently depressive and substance-related problems, diminish the prospects of many young adults, especially those with lower levels of education. Yet many young adults in that situation avoid these problems. Close relationships are thought to be a key factor underpinning risk and resilience among this group. To examine this premise, this study explored links, beyond potential confounders assessed in adolescence, between strengths and strains in the social domain and markers of despair in the early and mid-20s in a Canadian sample overrepresenting youth without postsecondary credentials (N = 543, 52% male, 23% non-White). Having a good general ability to maintain supportive relationships was associated with fewer depressive and substance-related symptoms. Furthermore, support and less strain in relationships with parents and friends were associated with fewer depressive symptoms in the early and mid-20s, while for romantic relationships, associations with depressive symptoms became more consistent and robust in the mid-20s. Therefore, support and strains in romantic relationships gradually gained prominence as a determinant of depressive symptoms as youth advanced in adulthood. For substance-related problems, significant associations emerged for strains in friendships only, in both the early and mid-20s. These results suggest that multiple aspects of relationships pose a risk for or protect from the development of diseases of despair in early adulthood and that their relative importance changes depending on outcomes and developmental timing. Thus, facilitating meaningful social connections and reducing the prevalence and impact of relationship strains might contribute to preventing diseases of despair among youth with lower educational attainment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perception of social inclusion/exclusion and response inhibition in adolescents with past suicide attempt: a multidomain task-based fMRI study.

The occurrence of suicidal behaviors increases during adolescence. Hypersensitivity to negative social signals and deficits in cognitive control are putative mechanisms of suicidal behaviors, which necessitate confirmation in youths. Multidomain functional neuroimaging could enhance the identification of patients at suicidal risk beyond standard clinical measures. Three groups of adolescents (N = 96; 78% females, age = 11.6-18.1) were included: patients with depressive disorders and previous suicide attempts (SA, n = 29); patient controls with depressive disorders but without any suicide attempt history (PC, n = 35); and healthy controls (HC, n = 32). We scanned participants with 3T-MRI during social inclusion/exclusion (Cyberball Game) and response inhibition (Go-NoGo) tasks. Neural activation was indexed by the blood-oxygenation-level dependent (BOLD) of the hemodynamic response during three conditions in the Cyberball Game ("Control condition", "Social Inclusion", and "Social Exclusion"), and two conditions in Go-NoGo task ("Go" and "NoGo" blocks). ANCOVA-style analysis identified group effects across three whole-brain contrasts: 1) NoGo vs. Go, 2) Social inclusion vs. control condition, 3) Social exclusion vs. control condition. We found that SA had lower activation in the left insula during social inclusion vs. control condition compared to PC and HC. Moreover, SA compared to PC had higher activity in the right middle prefrontal gyrus during social exclusion vs. control condition, and in bilateral precentral gyri during NoGo vs. Go conditions. Task-related behavioral and self-report measures (Self-reported emotional reactivity in the Cyberball Game, response times and number of errors in the Go-NoGo Task) did not discriminate groups. In conclusion, adolescent suicidal behaviors are likely associated with neural alterations related to the processing of social perception and response inhibition. Further research, involving prospective designs and diverse cohorts of patients, is necessary to explore the potential of neuroimaging as a tool in understanding the emergence and progression of suicidal behaviors.

Trajectories of Goth Music Preferences in Adolescence and Psychological Adjustment in Adulthood.

Non-mainstream rock music preferences, like goth, are linked to psychological difficulties in adolescence and emerging adulthood. This study explored the persistence of these difficulties into adulthood, while considering gender moderation. From ages 15 to 22, 364 participants (59% female) annually indicated their preference for goth music. Their mental health and well-being were evaluated at age 30 and at ages 13-14 as a control. A latent class growth analysis on their goth preference revealed two trajectories: lower (non-fans; 77%) and higher (fans; 23%). Gender moderation analysis showed that only males on the higher trajectory reported lower well-being and poorer mental health at age 30. Male goth music fans, most likely attracted to this cultural expression of their difficulties, may face increased psychological challenges as adults due to societal gender norms and growing marginalization. This study indeed suggests that an extended affinity for goth music during adolescence and emerging adulthood indicates long-term psychological adjustment challenges among adult male fans.

Trajectories of self-kindness, common humanity, and mindfulness during the COVID-19 pandemic: A person-oriented multi-trajectory approach.

The COVID-19 pandemic has produced unprecedented changes in the lives of many people. Although research has documented associations between concerns related to COVID-19 and poor mental health indicators, fewer studies have focused on positive factors that could help people better cope with this stressful social context. To fill this gap, the present research investigated the trajectories of self-compassion facets in times of dramatic social change. Using a longitudinal research design, we described the trajectories of self-kindness, common humanity, and mindfulness during the first eight months of the COVID-19 pandemic, in a representative sample of Canadian adults (N = 3617). Relying on a multi-trajectory group-based approach, we identified clusters of individuals following persistently low (4.0%), moderate-low (39.3%), moderate-high (46.7%), and high (10.0%) levels of self-kindness, common humanity, and mindfulness. Interestingly, we found that compassionate self-responding trajectories were mainly stable over time with minor fluctuations for some groups of individuals, in line with the epidemiological situation. In terms of covariates, we observed that older women were more likely to follow trajectories of high compassionate self-responding, as compared to the other age and gender groups. In terms of mental health indicators, we demonstrated that trajectory groups with high levels of compassionate self-responding were associated with greater life satisfaction, more happiness, better sleep quality, higher sleep quantity, and fewer negative emotions, as compared to lower trajectory groups. The results supported the idea that self-compassion during the COVID-19 pandemic could have favored better mental health indicators and could possibly be promoted as a psychological intervention in the general population.

Trajectories of health behaviors during the COVID-19 pandemic: a longitudinal analysis of handwashing, mask wearing, social contact limitations, and physical distancing.

AIM: This study aimed to investigate the associations between health behavior adherence and psychological factors during the COVID-19 pandemic, with a particular focus on identifying trajectories of handwashing, mask wearing, social contact limitations, and physical distancing. METHODS: We employed a multi-trajectory group-based approach to analyze data from 6026 Belgian residents, including 60% women, with an average age of 52.65. Data were collected over six waves spanning from April 2021 to December 2021. RESULTS: Participants were categorized into trajectory groups based on persistently low (11.9%), moderate-low (20.9%), moderate-high (39.1%), and high (28.1%) levels of adherence to the specified health behaviors. Our findings indicate a declining trend in health behavior adherence over the study period. Additionally, we observed that females, older individuals, and those with prior COVID-19 infection had a higher likelihood of belonging to trajectory groups characterized by the highest levels of health behavior adherence. Similarly, individuals with positive vaccination intentions, a heightened perception of consequences, and increased health anxiety demonstrated greater adherence to health behaviors over time. Furthermore, our investigation into the relationship between health behaviors and mental health revealed that participants in trajectory groups with higher levels of adherence to social contact limitations and physical distancing reported increased feelings of loneliness and decreased life satisfaction. CONCLUSIONS: The COVID-19 pandemic has reshaped our lives, and while vaccines have marked progress, maintaining health behaviors is crucial for virus prevention. To address potential mental health challenges from sanitary measures, policies and communication should promote health behaviors while acknowledging their psychological impact.

How level of understanding and type of used sources relate to adherence to COVID-19 public health measures in Canada.

Previous studies have highlighted the importance of promoting health literacy and minimizing misinformation to encourage higher adherence to key public health measures during the COVID-19 pandemic. This study explores how one's self-reported understanding of information and types of sources used to get information regarding COVID-19 can hinder adherence to public health measures implemented by the Canadian government. Data was collected following a longitudinal design of 11 time points for April 2020 to April 2021. The sub-sample used for this study included 2659 Canadians who completed the survey for at least four time points. Using Latent Class Growth Analysis, we modelled typical trajectories of adherence to three key public health measures: staying home, social distancing and mask wearing. Overall, a lower level of understanding was associated with lower adherence trajectories to public health measures, and vice-versa. Adjusted odds ratio (AOR) showed that the higher the level of understanding, the higher were the chances of following a high adherence trajectory. The type of used sources also showed a significant statistical association with adherence trajectories for social distancing and staying home (AOR: between 1.1 and 3.4). These results are discussed considering future policy implications.

Heterogeneity in the Course of Suicidal Ideation and its Relation to Suicide Attempts in First-Episode Psychosis: A 5-Year Prospective Study.

OBJECTIVES: Although the risk of suicide is high in first-episode psychosis (FEP), little is known about the course of suicidal ideation and its relation to suicide attempts. Therefore, we aimed to identify 5-year trajectories of suicidal ideation and associated factors in FEP and compare how suicide attempts were distributed across these identified trajectories. METHOD: This 5-year prospective study assessed suicidal ideation, suicide attempts and potentially associated factors through research interviews, chart review and coroners' reports in 382 FEP patients [mean age = 23.53 (SD = 3.61)] admitted to 2 5-year early psychosis services in Montreal, Canada. Trajectories were identified using a semiparametric mixture model, and associated factors with multinomial logistic regression. RESULTS: Three suicidal ideation trajectories were identified: low and decreasing (n = 325, 85.08%); early decline, then increasing (n = 30, 7.85%), and persistent suicidal ideation (n = 27, 7.07%). Suicidal ideation prior to admission (OR = 2.85, 95% CI, 1.23 to 6.63, P < 0.05) and cocaine use disorder (OR = 6.78, 95% CI, 1.08 to 42.75, P < 0.05) were associated with the early decline, then increasing suicidal ideation trajectory. Persons with prior suicide ideation (OR = 4.33, 95% CI, 1.66 to 11.29, P < 0.05) and attempts (OR = 8.18, 95% CI, 2.39 to 27.97, P < 0.001) and alcohol use disorder (OR = 3.63, 95% CI, 1.4 to 9.42, P < 0.05) were more likely to belong to the persistent suicidal ideation trajectory, and to attempt suicide during follow-up. CONCLUSIONS: Our study highlights heterogeneity in the course of suicidal ideation over 5 years and the importance of ongoing assessment of suicidal risk in FEP patients, particularly for patients who persistently report suicidal ideation, as they are likelier to engage in suicide attempts. Patients with factors associated with increasing or persistent suicidal ideation trajectories should be targeted for suicide prevention interventions from the early phase of follow-up. Given the small number of persons in these trajectories and the wide CIs for some factors, larger studies are however needed to further characterize who belongs in each group.

COVID-19, economic threat and identity status: Stability and change in prejudice against Chinese people within the Canadian population.

Objectives: Previous studies found a general increase in prejudice against Chinese people during the first months of the pandemic. The present study aims to consider inter-individual heterogeneity in stability and change regarding prejudice involving Chinese people during the pandemic. The first objective is to identify and describe different trajectories of prejudice over a seven-month period during the pandemic. The second and third objectives are to test the association between trajectory group membership and antecedent variables such as: socio-demographic factors (i.e., age, gender, political affiliation) and two psychological mechanisms, namely economic threat and global citizenship identification. Methods: A representative Canadian sample (N = 3,617) according to age, gender and province of residence, was recruited for a 10-wave survey starting from April 2020 to December 2020. First, a group-based modeling approach was used to identify trajectories of prejudice. Second, a multinomial logistic regression model was used to test associations between membership in trajectories and antecedents. Results: Four trajectories were identified. The first three trajectories have a low (71.4% of the sample), high (18.5%) or very high (5.3%) level of prejudice against Chinese people which is relatively stable over time. The fourth trajectory (4.9%) reports low levels of prejudice in favor of Chinese people which become more positive throughout 2020. Regarding socio-demographic factors: gender is not associated with trajectory group membership, younger people are more likely to follow the trajectory in favor of Chinese people and conservatives are more likely to follow the highest trajectories against Chinese people. Regarding some psychological mechanisms: personal but not collective economic threat is associated with the trajectory in favor of Chinese people. Finally, the highest levels of prejudice are found when the strategy of identification is more local rather than global. Conclusion: The present study shows that Canadians differ in terms of both their level and change in prejudice against Chinese people throughout the pandemic with some socio-demographic groups being more likely than others to be associated with prejudice. The results also suggest that a promising way to tackle the major social issue of prejudice is to highlight a vision of the world where individuals are all "global citizens" facing the same challenge.

Initial risk factors, self-compassion trajectories, and well-being outcomes during the COVID-19 pandemic: A person-centered approach.

Introduction: We investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic. Methods: A large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020-April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction). Results and Discussion: Four risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.

Brain cortical and subcortical morphology in adolescents with depression and a history of suicide attempt.

Background: Suicidal behaviours are a major source of mortality and morbidity among adolescents. Given the maturational changes that occur in cortical and subcortical structures during adolescence, we tested whether atypical brain structural measurements were associated with a history of suicide attempt. Methods: We assessed 3 groups of adolescents (n = 92; 79% female, mean age 15.9 years, range 11.6-18.1 years): patients with a depressive disorder and a history of suicide attempt (n = 28); patient controls, who had a depressive disorder but no history of suicide attempt (n = 34); and healthy controls (n = 30). We derived regional cortical thickness and surface area, and subcortical volumes, from T1-weighted anatomic MRI scans acquired at 3 T. Results: We found significant group differences in surface area in the prefrontal, temporal and parietal regions, as well as in the volume of several subcortical nuclei (pFDR ≤ 0.05), but not in cortical thickness. Post hoc analyses indicated that morphological alterations primarily differentiated patients with a history of suicide attempt from healthy controls, but not from patient controls. However, patients with a history of suicide attempt exhibited positive correlations between age and cortical thickness in the temporal cortices and right insula, and between age and right putamen volume (i.e., thicker regional cortex and larger subcortical volumes with age). These correlations were negative in both patient controls and healthy controls (i.e., thinner regional cortex and smaller subcortical volumes). Limitations: Sample sizes, cross-sectional findings and psychiatric heterogeneity were limitations of this study. Conclusion: Macroscopic structural differences in several brain regions differentiated adolescents with a history of suicide attempt from healthy controls, but not from patient controls. However, adolescents with a history of suicide attempt may present with atypical maturation of specific cortical and subcortical regions that might contribute to the risk of suicidal behaviour.

A person-centered approach to studying associations between psychosocial vulnerability factors and adolescent depressive symptoms and suicidal ideation in a Canadian longitudinal sample.

This study used a person-centered approach to identify subgroups of adolescents who are at risk for depression and suicidal ideation. Latent class analysis was first applied to 1,290 adolescents from a Canadian cohort study in order to identify latent vulnerability subtypes based on 18 psychosocial vulnerability factors. Logistic regression analyses were conducted to study the associations between class membership and depressive symptoms and suicidal ideation 2 years later. The moderating role of sex in the associations between latent classes and depressive symptoms was explored. Five latent classes were identified: Low Vulnerability (42%), Substance Use Only (13%), Moderate Vulnerability (28%), Conduct Problems (8%) and High Vulnerability (9%). Compared with the Low Vulnerability class, the probabilities of presenting depressive symptoms were higher for the Substance Use Only class, OR = 1.93, 95% CI [1.21, 3.06], the Moderate Vulnerability class, OR = 2.96, 95% CI [2.09, 4.20], the Conduct Problems class, OR = 3.03, 95% CI [1.84, 4.98], and the High Vulnerability class, OR = 5.4, 95% CI [3.42, 8.53]. Furthermore, interaction effects with sex were identified in relation to depressive symptoms only. The probability of presenting suicidal ideation was higher only for the High Vulnerability class, OR = 4.51, 95% CI [2.41, 8.43]. This study highlights the importance of a person-centered perspective that considers both vulnerability subtypes and sex because these associations are complex rather than linear or additive.

Decision-making and cognitive control in adolescent suicidal behaviors: a qualitative systematic review of the literature.

Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive variables and adolescent suicidal behaviors. The online search strategy identified 17 neurocognitive studies examining either cognitive control or decision-making processes in adolescents with past suicidal behaviors. Several studies have reported that adolescents with a history of suicidal behaviors present neuropsychological differences in the cognitive control (using Go/NoGo, suicide Stroop Test, continuous performance test, suicide/death Implicit Association Test), and decision-making (Iowa Gambling Task, Cambridge Gambling Task, cost computation, delay discounting, loss aversion tasks) domains. Due to a lack of replication or conflicting findings, our systematic review suggests that no firm conclusion can be drawn as to whether altered decision-making or poor cognitive control contribute to adolescent suicidal behaviors. However, these results collectively suggest that further research is warranted. Limitations included scarcity of longitudinal studies and a lack of homogeneity in study designs, which precluded quantitative analysis. We propose remediating ways to continue neuropsychological investigations of suicide risk in adolescence, which could lead to the identification of novel therapeutic targets and predictive markers, enabling early intervention in suicidal youth.

Longitudinal interplay between gambling participation and substance use during late adolescence: A genetically-informed study.

Substance use and gambling participation during adolescence are correlated, both concurrently and over time. It is unclear, however, whether this association can be explained by common underlying genetic vulnerabilities or environmental factors. The present study explored the concurrent and longitudinal associations between substance use and gambling participation and their genetic and environmental underpinnings by late adolescence. Participants were 373 pairs of monozygotic and dizygotic twins. Self-reports of substance use and gambling participation were collected at Ages 17 and 19 years. Results showed concurrent associations between substance use and gambling participation as well as a small, but significant unidirectional longitudinal association over time from substance use to gambling participation. Common genetic factors largely accounted for the concurrent associations at Ages 17 and 19, as well as for the unidirectional longitudinal association between substance use and gambling participation. Substance use and gambling participation share a common genetic component that account for most of their concurrent and longitudinal links during late adolescence. However, these behaviors are also influenced by specific environmental factors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Gender Differences in Adolescents' Exposure to Stressful Life Events and Differential Links to Impaired School Functioning.

Gender differences in exposure and reactivity to specific stressful life events (SLE) contribute to explaining adolescent boys' and girls' differential susceptibility to common adjustment difficulties like depression and behavioral problems. However, it is unclear whether these gender differences are also relevant to understanding another key marker of adolescent maladjustment: high school dropout. A state-of-the-art interview protocol was used to assess recent SLE in a sample of academically vulnerable Canadian adolescents (N = 545, 52% boys). The sample was comprised of three groups in approximately equal proportions: 1) students who had recently dropped out; 2) matched students at risk of dropping out but who persevered nevertheless; and 3) "normative" students with an average level of risk. When SLE of all types were considered together, overall exposure was similar for adolescent boys and girls, and the SLE-dropout association did not vary as a function of gender. However, gender differences emerged for specific events. Boys were especially exposed to SLE related to performance (e.g., school failure, suspension) and conflicts with authority figures (e.g., with teachers or the police), whereas girls were particularly exposed to SLE involving relationship problems with family members, peers, or romantic partners. In terms of specific SLE-dropout associations, one consistent result emerged, showing that performance/authority-related SLE were significantly associated with dropout only among boys. It therefore seems that considering gendered exposure and sensitivity to SLE is important for understanding the emergence of educational difficulties with long-ranging consequences for future health and well-being.

Sexual Aggressors Against Women's Sexual Lives: A Latent Class Analysis.

This study investigated the day-to-day deviant and nondeviant sexuality of a sample of Canadian sexual aggressors against women ( N = 160). Using latent class analysis, three latent classes were identified: internalized deviant (ID), low sexual problem (LSP), and hypersexual deviant (HD). Following the latent class analysis, the developmental, physiological, cognitive, and criminological correlates of these lifestyles were analyzed. ID ( n = 31) aggressors were characterized by sexual dissatisfaction, sexual deviance, and a bland sexual life. LSP ( n = 116) aggressors were characterized by the absence of sexual deviance or hypersexuality. HD ( n = 13) aggressors were characterized by hypersexuality and sexual deviance. Our exploratory study suggests that the day-to-day nondeviant and deviant sexual life of sexual aggressors against women appear to affect their modus operandi. Furthermore, the adult sexual lifestyles of sexual aggressors against women appear to be extensions of their adolescent sexual lifestyles. The results of this study thus suggest avenues for research-notably, the specific influence of sexual behaviours and internalized psychosexual problems on modus operandi-that could improve the clinical management of sexual aggressors against women.

Heterogeneity in the development of proactive and reactive aggression in childhood: Common and specific genetic - environmental factors.

BACKGROUND: Few studies are grounded in a developmental framework to study proactive and reactive aggression. Furthermore, although distinctive correlates, predictors and outcomes have been highlighted, proactive and reactive aggression are substantially correlated. To our knowledge, no empirical study has examined the communality of genetic and environmental underpinning of the development of both subtypes of aggression. The current study investigated the communality and specificity of genetic-environmental factors related to heterogeneity in proactive and reactive aggression's development throughout childhood. METHODS: Participants were 223 monozygotic and 332 dizygotic pairs. Teacher reports of aggression were obtained at 6, 7, 9, 10 and 12 years of age. Joint development of both phenotypes were analyzed through a multivariate latent growth curve model. Set point, differentiation, and genetic maturation/environmental modulation hypotheses were tested using a biometric decomposition of intercepts and slopes. RESULTS: Common genetic factors accounted for 64% of the total variation of proactive and reactive aggression's intercepts. Two other sets of uncorrelated genetic factors accounted for reactive aggression's intercept (17%) on the one hand, and for proactive (43%) and reactive (13%) aggression's slopes on the other. Common shared environmental factors were associated with proactive aggression's intercept (21%) and slope (26%) and uncorrelated shared environmental factors were also associated with reactive aggression's slope (14%). Common nonshared environmental factors explained most of the remaining variability of proactive and reactive aggression slopes. CONCLUSIONS: A genetic differentiation hypothesis common to both phenotypes was supported by common genetic factors associated with the developmental heterogeneity of proactive and reactive aggression in childhood. A genetic maturation hypothesis common to both phenotypes, albeit stronger for proactive aggression, was supported by common genetic factors associated with proactive and reactive aggression slopes. A shared environment set point hypothesis for proactive aggression was supported by shared environmental factors associated with proactive aggression baseline and slope. Although there are many common features to proactive and reactive aggression, the current research underscores the advantages of differentiating them when studying aggression.

Mindfulness-based Intervention in Elementary School Students With Anxiety and Depression: A Series of n-of-1 Trials on Effects and Feasibility.

Mindfulness-based interventions constitute a promising option to address anxiety and depression in elementary school students. This study evaluated the effect of a mindfulness-based intervention on anxiety and depression in elementary school students with a diagnosis of anxiety or depression disorder. A single-subject experimental A-B-A design was used. Participants were three elementary school students from grades three and four, along with their teacher. Anxiety and depression were measured on 10 occasions at baseline, during the intervention, and at follow-up. Primary hypotheses were tested using a univariate single case multilevel modeling strategy and visual analysis. Following intervention, 2 participants reported improvements on anxiety and depression, while their teachers reported deteriorating scores on these variables. Results from this n-of-1 trial design is consistent with other work suggesting caution with regard to the overall impact and efficacy of mindfulness-based interventions as a universal treatment option for youth. Future research is warranted.

Long-Term Metabolic Effects in French-Canadian Children and Adolescents Treated with Second-Generation Antipsychotics in Monotherapy or Polytherapy: A 24-Month Descriptive Retrospective Study.

OBJECTIVE: To compare weight and glucose changes of long-term second-generation antipsychotic (SGA) monotherapy versus polytherapy (switching or combining SGAs) in children and adolescents. METHODS: This is a 24-month retrospective study conducted between November 2005 and June 2013. From 147 antipsychotic-naive patients selected (mean age, 12.8 years; 95% confidence interval [CI], 9.8-15.9), 116 (78.9%) received SGA monotherapy and 31 (21.1%) SGA polytherapy for up to 24 months. Height, weight, and fasting glucose (FG) were measured at baseline and 1, 3, 6, 12, and 24 months. Linear mixed-model analysis was used to compare weight, body mass index z score (BMI z score), and glucose changes between the 2 SGA treatment groups, with the repeated factor being the time relative to baseline at 1, 3, 6, 12, and 24 months. RESULTS: Overall, after 24 months of SGA treatment, mean weight increased significantly by 12.8 kg (95% CI, 10.4-15.0), BMI z score by 0.44 (95% CI, 0.21-0.68), and FG levels by 0.29 mmol/L (95% CI, 0.11-0.47). Incidence of overweight/obesity was 22.6%, BMI z score increase over 0.5 was 9.4%, impaired fasting glucose was 9.4%, and type 2 diabetes mellitus was 3.1%. Regarding metabolic effects, no significant difference was found between the subjects taking a single SGA and those exposed to an SGA polytherapy. CONCLUSION: Our study confirms the significant increase of metabolic complications during 24 months of SGA treatment without excluding or confirming a difference between the 2 groups of treatment (mono vs. poly).

Persistence and innovation effects in genetic and environmental factors in negative emotionality during infancy: A twin study.

BACKGROUND: Difficult temperament in infancy is a risk factor for forms of later internalizing and externalizing psychopathology, including depression and anxiety. A better understanding of the roots of difficult temperament requires assessment of its early development with a genetically informative design. The goal of this study was to estimate genetic and environmental contributions to individual differences in infant negative emotionality, their persistence over time and their influences on stability between 5 and 18 months of age. METHOD: Participants were 244 monozygotic and 394 dizygotic twin pairs (49.7% male) recruited from birth. Mothers rated their twins for negative emotionality at 5 and 18 months. Longitudinal analysis of stability and innovation between the two time points was performed in Mplus. RESULTS: There were substantial and similar heritability (approximately 31%) and shared environmental (57.3%) contributions to negative emotionality at both 5 and 18 months. The trait's interindividual stability across time was both genetically- and environmentally- mediated. Evidence of innovative effects (i.e., variance at 18 months independent from variance at 5 months) indicated that negative emotionality is developmentally dynamic and affected by persistent and new genetic and environmental factors at 18 months. CONCLUSIONS: In the first two years of life, ongoing genetic and environmental influences support temperamental negative emotionality but new genetic and environmental factors also indicate dynamic change of those factors across time. A better understanding of the source and timing of factors on temperament in early development, and role of sex, could improve efforts to prevent related psychopathology.

A Longitudinal Empirical Investigation of the Pathways Model of Problem Gambling.

The pathways model of problem gambling suggests the existence of three developmental pathways to problem gambling, each differentiated by a set of predisposing biopsychosocial characteristics: behaviorally conditioned (BC), emotionally vulnerable (EV), and biologically vulnerable (BV) gamblers. This study examined the empirical validity of the Pathways Model among adolescents followed up to early adulthood. A prospective-longitudinal design was used, thus overcoming limitations of past studies that used concurrent or retrospective designs. Two samples were used: (1) a population sample of French-speaking adolescents (N = 1033) living in low socio-economic status (SES) neighborhoods from the Greater Region of Montreal (Quebec, Canada), and (2) a population sample of adolescents (N = 3017), representative of French-speaking students in Quebec. Only participants with at-risk or problem gambling by mid-adolescence or early adulthood were included in the main analysis (n = 180). Latent Profile Analyses were conducted to identify the optimal number of profiles, in accordance with participants' scores on a set of variables prescribed by the Pathways Model and measured during early adolescence: depression, anxiety, impulsivity, hyperactivity, antisocial/aggressive behavior, and drug problems. A four-profile model fit the data best. Three profiles differed from each other in ways consistent with the Pathways Model (i.e., BC, EV, and BV gamblers). A fourth profile emerged, resembling a combination of EV and BV gamblers. Four profiles of at-risk and problem gamblers were identified. Three of these profiles closely resemble those suggested by the Pathways Model.