Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Addict Biol ; : e12885, 2020 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-32135572

RESUMO

Two of the most commonly used substances by adolescents in the United States are cannabis and alcohol. Cannabis use disorder (CUD) and alcohol use disorder (AUD) are associated with impairments in decision-making processes. One mechanism for impaired decision-making in these individuals is thought to be an inability to adequately represent future events during decision-making. In the current study involving 112 adolescents, we used a comparative optimism task to examine the relationship between relative severity of CUD/AUD (as indexed by the CUD/AUD Identification Tests [CUDIT/AUDIT]) and atypical function within neural systems underlying affect-based neural represenation future events. Greater CUDIT scores were negatively related to responses within subgenual anterior and posterior cingulate cortex when processing high-intensity potential future positive and negative events. There was also a particularly marked negative relationship between CUD symptoms and blood oxygen level-dependent (BOLD) responses within visual and premotor cortices to high-intensity, negatively valenced potential future events. However, AUD symptom severity was not associated with dysfunction within these brain regions. These data indicate that relative risk/severity of CUD is associated with reduced responsiveness to future high-intensity events. This may impair decision-making where future significant consequences should guide response choice.

2.
Psychiatry Res Neuroimaging ; 292: 62-71, 2019 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-31541926

RESUMO

Despite extensive behavioral evidence of impairments in face processing and expression recognition in adults with alcohol or cannabis use disorders (AUD/CUD), neuroimaging findings have been inconsistent. Moreover, relatively little work has examined the relationship of AUD or CUD symptoms with face or expression processing within adolescents. Given the high prevalence of alcohol and cannabis use during adolescence, understanding how these usage behaviors interact with neural mechanisms supporting face and expression processing could have important implications for youth social and emotional functioning. In this study, adolescents (N = 104) responded to morphed fearful and happy expressions during fMRI and their level of AUD and/or CUD symptoms were related to the BOLD response data. We found that AUD and CUD symptom severity were both negatively related to responses to faces generally. However, whereas this relationship was shown for AUD within ventromedial prefrontal cortex and lingual gyrus, it was shown for CUD within rostromedial prefrontal cortex including anterior cingulate cortex. Additionally, AUD symptom levels were associated with differential responses within medial temporal pole and inferior parietal lobule as a function of expression. These results have potential implications for understanding the social and emotional functioning of adolescents with AUD and CUD symptoms.

3.
J Trauma Stress ; 32(5): 753-763, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31441982

RESUMO

Trauma screening is an important element for providing trauma-informed services to youth in residential care. Unfortunately, lack of time and resources may deter clinicians from conducting trauma screening at intake. This study tested the psychometric properties of the Brief Trauma Symptom Screen for Youth (BTSSY), which could be used during intake into residential care. Participants included 572 youth, ages 10-18 years (M = 14.28 years, SD = 2.31), of whom 58.9% were boys, 78.7% were Caucasian, 51.7% were youth receiving services in residential care, 15.6% were youth with clinical needs, and 32.7% were typically developing youth from the local community. Participants completed the BTSSY; other questionnaires of psychopathology, childhood maltreatment, and symptomology of posttraumatic stress disorder (PTSD); and diagnostic interviews, which were conducted by licensed psychiatrists. The total BTSSY score had a good composite reliability (CR) of .80 and was valid based on a significant positive correlation, r = .64, with the UCLA PTSD-Reaction Index. The BTSSY score was also fair, area under the curve = .75, at detecting a diagnosis of PTSD from a psychiatrist. Significant group differences in the BTSSY scores were found between youth with a diagnosis of PTSD and the other two groups, with moderate-to-large effect sizes, ds = 0.73-1.22. Preliminary results indicated the BTSSY may be a useful screening tool for identifying youth at residential care intake who may need additional assessment for PTSD. Limitations and implications for future research and practice are discussed.

4.
JAMA Netw Open ; 2(5): e194604, 2019 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-31125109

RESUMO

Importance: Childhood maltreatment is associated with serious developmental consequences that may be different depending on the form of maltreatment. However, relatively little research has investigated this issue despite implications for understanding the development of psychiatric disorders after maltreatment. Objective: To determine the association of childhood maltreatment and potential differential associations of childhood abuse or neglect with neural responsiveness within regions of the brain implicated in emotional responding and response control. Design, Setting, and Participants: In this cross-sectional study, participants aged 10 to 18 years with varying levels of prior maltreatment as indexed by the Childhood Trauma Questionnaire (CTQ) were recruited from a residential care facility and the surrounding community. Blood oxygen level-dependent response data were analyzed via 2 analyses of covariance that examined 2 (sex) × 3 (task condition [view, congruent, incongruent]) × 3 (valence [negative, neutral, positive]) with Blom-transformed covariates: (1) total CTQ score; and (2) abuse and neglect subscores. Data were collected from April 1, 2016, to June 30, 2018. Data analyses occurred from June 10, 2018, to October 31, 2018. Main Outcomes and Measures: Blood oxygenation level-dependent signals in response to an Affective Stroop task were measured via functional magnetic resonance imaging. Results: The sample included 116 youths (mean [SD] age, 15.0 [2.2] years; 70 [60.3%] male). Fifteen participants reported no prior maltreatment. The remaining 101 participants (87.1%) reported at least some prior maltreatment, and 55 (54.5%) reported significant maltreatment, ie, total CTQ scores were greater than the validated CTQ score threshold of 40. There were significant total CTQ score × task condition associations within the bilateral postcentral gyrus, left precentral gyrus, midcingulate cortex, middle temporal gyrus, and superior temporal gyrus (left postcentral gyrus: F = 11.73; partial η2 = 0.14; right postcentral and precentral gyrus: F = 9.81; partial η2 = 0.10; midcingulate cortex: F = 12.76; partial η2 = 0.12; middle temporal gyrus: F = 13.24; partial η2 = 0.10; superior temporal gyrus: F = 10.33; partial η2 = 0.11). In all examined regions of the brain, increased maltreatment was associated with decreased differential responsiveness to incongruent task trials compared with view trials (left postcentral gyrus: r = -0.34; 95% CI, -0.17 to -0.51; right postcentral and precentral gyrus: r = -0.31; 95% CI, -0.14 to -0.49; midcingulate cortex: r = -0.36; 95% CI, -0.18 to -0.53; middle temporal gyrus: r = -0.35; 95% CI, -0.17 to -0.52; superior temporal gyrus: r = -0.37; 95% CI, -0.20 to -0.55). These interactions were particularly associated with level of abuse rather than neglect. A second analysis of covariance revealed significant abuse × task condition (but not neglect × task) interactions within the midcingulate cortex (F = 13.96; partial η2 = 0.11), right postcentral gyrus and inferior parietal lobule (F = 15.21; partial η2 = 0.12), left postcentral and precentral gyri (F = 11.16; partial η2 = 0.12), and rostromedial frontal cortex (F = 10.36; partial η2 = 0.08)). In all examined regions of the brain, increased abuse was associated with decreased differential responsiveness to incongruent task trials compared with view trials (midcingulate cortex: partial r = -0.33; P < .001; right postcentral gyrus and inferior parietal lobule: partial r = -0.41; P < .001; left postcentral and precentral gyri: partial r = -0.40; P < .001; and rostromedial frontal cortex: partial r = -0.40; P < .001). Conclusions and Relevance: These data document associations of different forms of childhood maltreatment with atypical neural response. This suggests that forms of maltreatment may differentially influence the development of psychiatric pathology.


Assuntos
Encéfalo/fisiopatologia , Maus-Tratos Infantis/psicologia , Função Executiva/fisiologia , Adolescente , Encéfalo/diagnóstico por imagem , Criança , Estudos Transversais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Oxigênio/sangue , Desempenho Psicomotor , Inquéritos e Questionários
5.
Dev Cogn Neurosci ; 36: 100618, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30710868

RESUMO

Alcohol and cannabis are two of the most commonly used substances by adolescents and are associated with adverse medical and psychiatric outcomes. These adverse psychiatric outcomes may reflect the negative impact of alcohol and/or cannabis abuse on neural systems mediating reward and/or error detection. However, work indicative of this has mostly been conducted in adults with Alcohol and/or Cannabis Use Disorder (i.e., AUD and CUD), with relatively little work in adolescent patients. Furthermore, of the work that has been conducted in adolescents, groups were based on categorical diagnoses of AUD and/or CUD, so the relationship between AUD and/or CUD symptom severity in adolescents and neural dysfunction is unclear. We used a Monetary Incentive Delay (MID) task to examine the relationship between AUDIT and/or CUDIT scores and functional integrity of neuro-circuitries mediating reward processing and error detection within 150 adolescents. Our findings indicate that AUDIT score is negatively related to activity in reward processing neuro-circuitry in adolescents. However, CUDIT score is negatively related to activity in brain regions involved in error detection. Each of these relationships reflected a medium effect size (Partial-η2 0.09-0.14). These data suggest differential impacts of AUD and CUD on reward versus error detection neuro-circuitries within the adolescent brain.


Assuntos
Alcoolismo/complicações , Encéfalo/fisiopatologia , Imagem por Ressonância Magnética/métodos , Abuso de Maconha/complicações , Adolescente , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Abuso de Maconha/psicologia , Recompensa
6.
Neuroimage Clin ; 21: 101677, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30682530

RESUMO

BACKGROUND: The functional significance of the impairment shown by patients with ADHD on response inhibition tasks is unclear. Dysfunctional behavioral and BOLD responses to rare no-go cues might reflect disruption of response inhibition (mediating withholding the response) or selective attention (identifying the rare cue). However, a factorial go/no-go design (involving high and low frequency go and no-go stimuli) can disentangle these possibilities. METHODS: Eighty youths [22 female, mean age = 13.70 (SD = 2.21), mean IQ = 104.65 (SD = 13.00); 49 with diagnosed ADHD] completed the factorial go/no-go task while undergoing fMRI. RESULTS: There was a significant response type-by-ADHD symptom severity interaction within the left anterior insula cortex; increasing ADHD symptom severity was associated with decreased recruitment of this region to no-go cues irrespective of cue frequency. There was also a significant frequency-by-ADHD symptom severity interaction within the left superior frontal gyrus. ADHD symptom severity showed a quadratic relationship with responsiveness to low frequency cues (irrespective of whether these cues were go or no-go); within this region, at lower levels of symptom severity, increasing severity was associated with increased BOLD responses but at higher levels of symptom severity, decreasing BOLD responses. CONCLUSION: The current study reveals two separable forms of dysfunction that together probably contribute to the impairments shown by patients with ADHD on go/no-go tasks.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Atenção/fisiologia , Desempenho Psicomotor/fisiologia , Adolescente , Mapeamento Encefálico , Córtex Cerebral/fisiopatologia , Criança , Função Executiva/fisiologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Córtex Pré-Frontal/fisiopatologia , Tempo de Reação/fisiologia
7.
Neuroimage Clin ; 19: 782-792, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29988822

RESUMO

Alcohol and cannabis are two substances that are commonly abused by adolescents in the United States and which, when abused, are associated with negative medical and psychiatric outcomes across the lifespan. These negative psychiatric outcomes may reflect the detrimental impact of substance abuse on neural systems mediating emotion processing and executive attention. However, work indicative of this has mostly been conducted either in animal models or adults with Alcohol and/or Cannabis Use Disorder (AUD/CUD). Little work has been conducted in adolescent patients. In this study, we used the Affective Stroop task to examine the relationship in 82 adolescents between AUD and/or CUD symptom severity and the functional integrity of neural systems mediating emotional processing and executive attention. We found that AUD symptom severity was positively related to amygdala responsiveness to emotional stimuli and negatively related to responsiveness within regions implicated in executive attention and response control (i.e., dorsolateral prefrontal cortex, anterior cingulate cortex, precuneus) as a function of task performance. In contrast, CUD symptom severity was unrelated to amygdala responsiveness but positively related to responsiveness within regions including precuneus, posterior cingulate cortex, and inferior parietal lobule as a function of task performance. These data suggest differential impacts of alcohol and cannabis abuse on the adolescent brain.


Assuntos
Alcoolismo/diagnóstico por imagem , Atenção/fisiologia , Encéfalo/diagnóstico por imagem , Emoções/fisiologia , Função Executiva/fisiologia , Abuso de Maconha/diagnóstico por imagem , Rede Nervosa/diagnóstico por imagem , Adolescente , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Abuso de Maconha/psicologia , Testes Neuropsicológicos , Índice de Gravidade de Doença
8.
Psychol Med ; 48(15): 2541-2549, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29428004

RESUMO

BACKGROUND: Previous work has shown that amygdala responsiveness to fearful expressions is inversely related to level of callous-unemotional (CU) traits (i.e. reduced guilt and empathy) in youth with conduct problems. However, some research has suggested that the relationship between pathophysiology and CU traits may be different in those youth with significant prior trauma exposure. METHODS: In experiment 1, 72 youth with varying levels of disruptive behavior and trauma exposure performed a gender discrimination task while viewing morphed fear expressions (0, 50, 100, 150 fear) and Blood Oxygenation Level Dependent responses were recorded. In experiment 2, 66 of these youth performed the Social Goals Task, which measures self-reports of the importance of specific social goals to the participant in provoking social situations. RESULTS: In experiment 1, a significant CU traits-by-trauma exposure interaction was observed within right amygdala; fear intensity-modulated amygdala responses negatively predicted CU traits for those youth with low levels of trauma but positively predicted CU traits for those with high levels of trauma. In experiment 2, a bootstrapped model revealed that the indirect effect of fear intensity amygdala response on social goal importance through CU traits is moderated by prior trauma exposure. CONCLUSIONS: This study, while exploratory, indicates that the pathophysiology associated with CU traits differs in youth as a function of prior trauma exposure. These data suggest that prior trauma exposure should be considered when evaluating potential interventions for youth with high CU traits.


Assuntos
Sintomas Afetivos/fisiopatologia , Tonsila do Cerebelo/fisiopatologia , Transtorno da Conduta/fisiopatologia , Empatia/fisiologia , Medo/fisiologia , Neuroimagem Funcional/métodos , Relações Interpessoais , Trauma Psicológico/fisiopatologia , Comportamento Social , Percepção Social , Adolescente , Sintomas Afetivos/diagnóstico por imagem , Tonsila do Cerebelo/diagnóstico por imagem , Criança , Transtorno da Conduta/diagnóstico por imagem , Expressão Facial , Reconhecimento Facial/fisiologia , Feminino , Metas , Humanos , Imagem por Ressonância Magnética , Masculino , Trauma Psicológico/diagnóstico por imagem
9.
Psychiatry Res Neuroimaging ; 257: 17-24, 2016 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-27716545

RESUMO

Individuals with substance abuse (SA) histories show impairment in the computations necessary for decision-making, including expected value (EV) and prediction error (PE). Neuroimaging findings, however, have been inconsistent. Sixteen youth with (SApositive) and 29 youth without (SAnegative) substance abuse histories completed a passive avoidance task while undergoing functional MRI. The groups did not significantly differ on age, gender composition or IQ. Behavioral results indicated that SApositive youth showed significantly less learning than SAnegative youth over the task. SApositive youth show problems representing EV information when attempting to avoid sub-optimal choices in bilateral inferior frontal gyrus and striatum. Furthermore, SApositive youth showed a significantly increased differential response to reward versus punishment feedback modulated by PE in posterior cingulate cortex relative to SAnegative youth. Disrupted decision-making is likely to exacerbate SA as a failure to represent EV during the avoidance of sub-optimal choices is likely to increase the likelihood of SA. With respect to the representation of PE, future work will be needed to clarify the impact of different substances on the neural systems underpinning PE representation. Moreover, interaction of age/development and substance abuse on PE signaling will need to be explored.


Assuntos
Encéfalo/fisiopatologia , Tomada de Decisões/fisiologia , Recompensa , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adolescente , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Punição , Transtornos Relacionados ao Uso de Substâncias/diagnóstico por imagem
10.
J Child Psychol Psychiatry ; 57(8): 938-46, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27062170

RESUMO

BACKGROUND: Previous work has shown that patients with conduct problems (CP) show impairments in reinforcement-based decision-making. However, studies with patients have not previously demonstrated any relationships between impairment in any of the neurocomputations underpinning reinforcement-based decision-making and specific symptom sets [e.g. level of CP and/or callous-unemotional (CU) traits]. METHODS: Seventy-two youths [20 female, mean age = 13.81 (SD = 2.14), mean IQ = 102.34 (SD = 10.99)] from a residential treatment program and the community completed a passive avoidance task while undergoing functional MRI. RESULTS: Greater levels of CP were associated with poorer task performance. Reduced representation of expected values (EV) when making avoidance responses within bilateral anterior insula cortex/inferior frontal gyrus (AIC/iFG) and striatum was associated with greater levels of CP but not CU traits. CONCLUSIONS: The current data indicate that difficulties in the use of value information to motivate decisions to avoid suboptimal choices are associated with increased levels of CP (though not severity of CU traits). Moreover, they account for the behavioral deficits observed during reinforcement-based decision-making in youth with CP. In short, an individual's relative failure to utilize value information within AIC/iFG to avoid bad choices is associated with elevated levels of CP.


Assuntos
Córtex Cerebral/fisiopatologia , Transtorno da Conduta/fisiopatologia , Tomada de Decisões/fisiologia , Neostriado/fisiopatologia , Desempenho Psicomotor/fisiologia , Adolescente , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino
12.
Am J Psychiatry ; 170(3): 315-23, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23450288

RESUMO

OBJECTIVE: Youths with disruptive behavior disorders, including conduct disorder and oppositional defiant disorder, show major impairments in reinforcement-based decision making. However, the neural basis of these difficulties remains poorly understood. This partly reflects previous failures to differentiate responses during decision making and feedback processing and to take advantage of computational model-based functional MRI (fMRI). METHOD: Participants were 38 community youths ages 10-18 (20 had disruptive behavior disorders, and 18 were healthy comparison youths). Model-based fMRI was used to assess the computational processes involved in decision making and feedback processing in the ventromedial prefrontal cortex, insula, and caudate. RESULTS: Youths with disruptive behavior disorders showed reduced use of expected value information within the ventromedial prefrontal cortex when choosing to respond and within the anterior insula when choosing not to respond. In addition, they showed reduced responsiveness to positive prediction errors and increased responsiveness to negative prediction errors within the caudate during feedback. CONCLUSIONS: This study is the first to determine impairments in the use of expected value within the ventromedial prefrontal cortex and insula during choice and in prediction error-signaling within the caudate during feedback in youths with disruptive behavior disorders.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Atenção/fisiologia , Aprendizagem da Esquiva/fisiologia , Núcleo Caudado/fisiopatologia , Córtex Cerebral/fisiopatologia , Tomada de Decisões/fisiologia , Retroalimentação Psicológica/fisiologia , Interpretação de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Motivação/fisiologia , Córtex Pré-Frontal/fisiopatologia , Recompensa , Adolescente , Aprendizagem por Associação/fisiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Mapeamento Encefálico , Criança , Feminino , Humanos , Masculino , Vias Neurais/fisiopatologia , Reconhecimento Visual de Modelos/fisiologia
13.
J Child Psychol Psychiatry ; 54(5): 575-81, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-22934662

RESUMO

BACKGROUND: The presence of a large cavum septum pellucidum (CSP) has been previously associated with antisocial behavior/psychopathic traits in an adult community sample. AIMS: The current study investigated the relationship between a large CSP and symptom severity in disruptive behavior disorders (DBD; conduct disorder and oppositional defiant disorder). METHOD: Structural MRI scans of youth with DBDs (N = 32) and healthy comparison youth (N = 27) were examined for the presence of a large CSP and if this was related to symptom severity. RESULTS: Replicating previous results, a large CSP was associated with DBD diagnosis, proactive aggression, and level of psychopathic traits in youth. However, the presence of a large CSP was unrelated to aggression or psychopathic traits within the DBD sample. CONCLUSIONS: Early brain mal-development may increase the risk of a DBD diagnosis, but does not mark a particularly severe form of DBD within patients receiving these diagnoses.


Assuntos
Transtorno da Personalidade Antissocial/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtorno da Conduta/diagnóstico , Empatia/fisiologia , Interpretação de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Septo Pelúcido/patologia , Agressão/fisiologia , Transtorno da Personalidade Antissocial/fisiopatologia , Transtorno da Personalidade Antissocial/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno da Conduta/fisiopatologia , Transtorno da Conduta/psicologia , Humanos , Tamanho do Órgão/fisiologia , Determinação da Personalidade/estatística & dados numéricos , Inventário de Personalidade/estatística & dados numéricos , Psicometria , Valores de Referência , Fatores de Risco , Septo Pelúcido/fisiopatologia , Estatística como Assunto
14.
Psychiatry Res ; 202(3): 239-44, 2012 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-22819939

RESUMO

Youths with conduct disorder or oppositional defiant disorder and psychopathic traits (CD/ODD+PT) are at high risk of adult antisocial behavior and psychopathy. Neuroimaging studies demonstrate functional abnormalities in orbitofrontal cortex and the amygdala in both youths and adults with psychopathic traits. Diffusion tensor imaging in psychopathic adults demonstrates disrupted structural connectivity between these regions (uncinate fasiculus). The current study examined whether functional neural abnormalities present in youths with CD/ODD+PT are associated with similar white matter abnormalities. Youths with CD/ODD+PT and comparison participants completed 3.0 T diffusion tensor scans and functional magnetic resonance imaging scans. Diffusion tensor imaging did not reveal disruption in structural connections within the uncinate fasiculus or other white matter tracts in youths with CD/ODD+PT, despite the demonstration of disrupted amygdala-prefrontal functional connectivity in these youths. These results suggest that disrupted amygdala-frontal white matter connectivity as measured by fractional anisotropy is less sensitive than imaging measurements of functional perturbations in youths with psychopathic traits. If white matter tracts are intact in youths with this disorder, childhood may provide a critical window for intervention and treatment, before significant structural brain abnormalities solidify.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/patologia , Mapeamento Encefálico , Transtorno da Conduta/patologia , Sistema Límbico/patologia , Fibras Nervosas Mielinizadas/patologia , Adolescente , Análise de Variância , Anisotropia , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/patologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Estudos de Casos e Controles , Criança , Transtorno da Conduta/complicações , Imagem de Tensor de Difusão , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Escalas de Graduação Psiquiátrica
15.
Dev Psychopathol ; 24(3): 1105-16, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22781874

RESUMO

Using behavioral and blood oxygen level dependent (BOLD) response indices through functional magnetic resonance imaging (fMRI), the current study investigated whether youths with disruptive behavior disorders (conduct disorder and oppositional defiant disorder) plus psychopathic traits (DBD + PT) show aberrant sensitivity to eye gaze information generally and/or whether they show particular insensitivity to eye gaze information in the context of fearful expressions. The participants were 36 children and adolescents (ages 10-17 years); 17 had DBD + PT and 19 were healthy comparison subjects. Participants performed a spatial attention paradigm where spatial attention was cued by eye gaze in faces displaying fearful, angry, or neutral affect. Eye gaze sensitivity was indexed both behaviorally and as BOLD response. There were no group differences in behavioral response: both groups showed significantly faster responses if the target was in the congruent spatial direction indicated by eye gaze. Neither group showed a Congruence × Emotion interaction; neither group showed an advantage from the displayer's emotional expression behaviorally. However, the BOLD response revealed a significant Group × Congruence × Emotion interaction. The comparison youth showed increased activity within the dorsal endogenous orienting network (superior parietal lobule and inferior parietal sulcus) for fearful congruent relative to incongruent trials relative to the youth with DBD + PT. The results are discussed with reference to current models of DBD + PT and possible treatment innovations.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Atenção/fisiologia , Transtorno da Conduta/fisiopatologia , Medo/fisiologia , Rede Nervosa/fisiopatologia , Lobo Parietal/fisiopatologia , Adolescente , Mapeamento Encefálico , Criança , Expressão Facial , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Comportamento Impulsivo/fisiopatologia , Imagem por Ressonância Magnética , Masculino
17.
Am J Psychiatry ; 169(7): 750-8, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22456823

RESUMO

OBJECTIVE: Amygdala dysfunction has been reported to exist in youths and adults with psychopathic traits. However, there has been disagreement as to whether this dysfunction reflects a primary emotional deficit or is secondary to atypical attentional control. The authors examined the validity of the contrasting predictions. METHOD: Participants were 15 children and adolescents (ages 10­17 years) with both disruptive behavior disorders and psychopathic traits and 17 healthy comparison youths. Functional MRI was used to assess the response of the amygdala and regions implicated in top-down attentional control (the dorsomedial and lateral frontal cortices) to emotional expression under conditions of high and low attentional load. RESULTS: Relative to youths with disruptive behavior disorders and psychopathic traits, healthy comparison subjects showed a significantly greater increase in the typical amygdala response to fearful expressions under low relative to high attentional load conditions. There was also a selective inverse relationship between the response to fearful expressions under low attentional load and the callous-unemotional component (but not the narcissism or impulsivity component) of psychopathic traits. In contrast, the two groups did not differ in the significant recruitment of the dorsomedial and lateral frontal cortices as a function of attentional load. CONCLUSIONS: Youths with disruptive behavior disorders and psychopathic traits showed reduced amygdala responses to fearful expressions under low attentional load but no indications of increased recruitment of regions implicated in top-down attentional control. These findings suggest that the emotional deficit observed in youths with disruptive behavior disorders and psychopathic traits is primary and not secondary to increased top-down attention to nonemotional stimulus features.


Assuntos
Comportamento do Adolescente/fisiologia , Tonsila do Cerebelo/fisiopatologia , Transtorno da Personalidade Antissocial/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Atenção/fisiologia , Emoções/fisiologia , Neuroimagem Funcional/psicologia , Adolescente , Transtorno da Personalidade Antissocial/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Estudos de Casos e Controles , Criança , Expressão Facial , Feminino , Lobo Frontal/fisiopatologia , Neuroimagem Funcional/métodos , Humanos , Imagem por Ressonância Magnética/métodos , Imagem por Ressonância Magnética/psicologia , Masculino , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Desempenho Psicomotor/fisiologia
18.
Acad Psychiatry ; 32(5): 377-85, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18945976

RESUMO

OBJECTIVE: Previous studies indicate declining interest in child and adolescent psychiatry (CAP) as a career choice during psychiatry residency training. Programs have developed integrated training in psychiatry and CAP as a means to address the workforce shortage in CAP, but little is known about the number or nature of these training tracks. METHODS: A survey was conducted among all program directors of Accreditation Council for Graduate Medical Education (ACGME) accredited CAP residency training programs in the United States. Those reporting integrated training with their affiliated psychiatry training programs were contacted for in-depth interview. Integrated research programs were not included in this survey. RESULTS: Of the 115 ACGME accredited CAP programs at the time of the survey, 93 responded and 33 of those indicated having some form of integrated training in psychiatry and CAP. Only seven programs identified residents in integrated training in the first year of residency. CONCLUSION: There is no consensus regarding a definition of integrated psychiatry and CAP training. Even though integrated training may provide opportunities for recruitment and retention of child and adolescent psychiatrists, few programs currently offer fully integrated training. This article describes several potential models for integrated training tracks, identifying factors to consider when developing such pathways.


Assuntos
Psiquiatria do Adolescente/educação , Psiquiatria Infantil/educação , Currículo , Ensino/métodos , Adolescente , Criança , Humanos
19.
Am J Psychiatry ; 160(6): 1172-4, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12777278

RESUMO

OBJECTIVE: The authors examined facial expression recognition in adolescents with mood and anxiety disorders. METHOD: Standard facial emotion identification tests were given to youth with bipolar disorder (N=11) or DSM-IV anxiety disorders (N=10) and a group of healthy comparison subjects (N=25). RESULTS: Relative to the anxiety disorder and healthy comparison groups, the subjects with bipolar disorder made more emotion recognition errors when presented with faces of children. Unlike the anxious and comparison subjects, bipolar disorder youth were prone to misidentify faces as angry. No differences in emotion recognition errors were seen when the adolescents were presented with adult faces. CONCLUSIONS: A bias to misinterpret the facial expressions of peers as angry may characterize youth with bipolar disorder but not youth with anxiety disorders. This bias may relate to social impairment in youth with bipolar disorder.


Assuntos
Transtornos de Ansiedade/diagnóstico , Transtorno Bipolar/diagnóstico , Expressão Facial , Adolescente , Fatores Etários , Ira , Transtornos de Ansiedade/psicologia , Transtorno Bipolar/psicologia , Diagnóstico Diferencial , Emoções , Face , Humanos , Masculino , Grupo Associado , Percepção Social
20.
J Am Acad Child Adolesc Psychiatry ; 42(4): 406-14, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12649627

RESUMO

OBJECTIVE: To identify the obstacles and special challenges-ethical, practical, scientific, and regulatory-faced by investigators who attempt to conduct psychopharmacological studies in preschoolers. METHOD: In a workshop held at the 47th Annual Meeting of the American Academy of Child and Adolescent Psychiatry, featuring interactive sessions designed to elicit discussion of the theory and feasibility of research in this young population, several key domains were identified: diagnosis and assessment, ethics, research design, special considerations for preschoolers, regulatory/industry issues, and education/training. RESULTS: A Pediatric Psychopharmacology Initiative is needed to consolidate recommendations from this and other workshops and current federal, research, and regulatory committees. A scholarly review and a guide for institutional review boards and investigators should be prepared on issues related to preschoolers. Developmental specialists provide valuable expertise that can strengthen studies of pediatric psychopharmacology. "N of 1" case studies can provide valuable information to clinicians. Only preschoolers with severe symptoms that occur in several interpersonal contexts should be entered into trials. Indications for the study of symptom complexes (e.g., aggression) rather than specific diagnoses should be examined and considered for regulatory activities. Psychopharmacology practice parameters for preschoolers are needed. CONCLUSIONS: With preschoolers being increasingly treated with psychopharmacological agents, the need for investigations to address the safety and efficacy of these medications is becoming a central issue for researchers from many disciplines.


Assuntos
Psiquiatria Infantil/normas , Ensaios Clínicos como Assunto/normas , Transtornos Mentais/tratamento farmacológico , Psicotrópicos/uso terapêutico , Pesquisa/normas , Adolescente , Criança , Pré-Escolar , Guias como Assunto , Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA