Does behavioural parent training reduce internalising symptoms (or not) among children with externalising problems? Systematic review and meta-analysis.

Behaviour parent training (BPT) is known to effectively reduce child externalising problems. However, evidence for BPT to have secondary benefits for reducing internalising symptoms remains unclear. To address this, electronic databases (PsycINFO, MEDLINE, EMBASE, CINAHL, and SCOPUS) were systematically searched for studies examining internalising outcomes from BPT among children aged 2-12 years with clinically elevated externalizing problems. Outcomes for internalising problems following BPT were analysed by meta-analysis. Of 9105 studies identified, 24 studies met the eligibility criteria. Results from meta-analysis demonstrated a significant small treatment effect size (g = - 0.41) for reducing internalising symptoms immediately after treatment. Studies showed moderate heterogeneity (I2 = 44%). Moderation analyses indicated that the overall treatment effect was robust against variations in treatment and study design characteristics. However, a review of individual study methods indicate that these results are limited by significant heterogeneity and limitations in clinical assessment. Overall, the results suggest that BPT programmes for reducing externalising problems have the potential to improve internalising outcomes, but that there is limited information to determine the reliability of these effects, highlighting the need for further investigation.

Transdiagnosis of alcohol use and psychopathologies: A systematic review.

Multiple diagnoses are the rule in Mental Health and alcohol use disorder (AUD) is a psychopathology with many comorbidities, requiring interventions that consider common factors, which means using a transdiagnostic perspective. This study aimed to identify in the scientific literature the main common transdiagnostic factors that link AUD to other psychopathologies in people over 18 years of age. A systematic review of the literature was carried out in the portals of the databases Pubmed, PsychINFO and CAPES. 37 articles were selected for analysis, which resulted in 25 transdiagnostic factors linked to AUD and to several other related disorders and health conditions. The results emphasize the variety of disorders and health conditions related to AUD, which highlights the importance of transdiagnostic factors for these conditions as targets for both scientific research and therapeutic interventions for this population.

Multi-modal hallucinations across diagnoses: What relationships do they have with voice-related distress?

BACKGROUND: Research into hallucinatory experiences has focused primarily upon hallucinations within the auditory modality, to the relative neglect of other modalities. Furthermore, the exploration of auditory hallucinations (or 'voices') has focused primarily upon the experiences of people with a diagnosis of psychosis. The presence of multi-modal hallucinations may have implications across diagnoses for levels of distress, formulation and the targeting of psychological interventions. METHODS: This study presents a cross-sectional analysis of observational data from the PREFER survey (N = 335). Linear regression was used to explore the relationships between voice-related distress and the presence, number, type and timing of multi-modal hallucinations. RESULTS: Simple relationships were not found between distress and the presence of hallucinations in visual, tactile, olfactory or gustatory modalities, or in the number of modalities experienced. When considering the degree to which another modality hallucination was experienced simultaneously with voices, there was some evidence that the degree of co-occurrence with visual hallucinations was predictive of distress. CONCLUSIONS: The co-occurrence of voices with visual hallucinations may be associated with relatively greater distress, but not consistently, and the association between multimodal hallucinations and clinical impact appear complex and potentially variable from individual to individual. Further study of associated variables such as perceived voice power may further illuminate these relationships.

Categorical and Dimensional Deficits in Hippocampal Subfields Among Schizophrenia, Obsessive-Compulsive Disorder, Bipolar Disorder, and Major Depressive Disorder.

BACKGROUND: The hippocampus is a core region of interest for all major mental disorders, and its subfields implement distinctive functions. It is unclear whether the mental disorders exhibit common patterns of hippocampal impairments, and we lack knowledge on whether and how hippocampal subfields represent deficit spectra across mental disorders. METHODS: Using brain images of 1123 individuals scanned on a single magnetic resonance imaging scanner, we examined the commonality, specificity, and symptom associations of the volume of hippocampal subfields across patients with schizophrenia, patients with obsessive-compulsive disorder, patients with bipolar disorder, patients with major depressive disorder, and healthy control subjects. We further performed a transdiagnostic analysis of the individual variability of the volume of hippocampal subfields to reflect cross-disease gradients in the hippocampus. RESULTS: We found common and disease-specific abnormalities in a few hippocampal fields and identified 2 reliable transdiagnostic factors in the hippocampal subfields, each reflecting a spectrum of mental disorders. The plane spanned by the 2 most reliable factors provided a clearer view of hippocampal volume abnormality spectra among the major mental disorders. In addition, functional and genetic enrichment analyses supported the different roles of the 2 hippocampal factors in mental disorders. CONCLUSIONS: The volume of hippocampal subfields reflected some commonality and specificity among the 3 major mental disorders. We propose a new pathophysiological dimensional view of the hippocampus, reflecting at least 2 spectra of mental disorders, suggesting multivariate links among the diseases. This work highlights the value of the complementary categorical and dimensional views of the hippocampal deficits in mental disorders.

Transdiagnostic considerations of mental health for the post-COVID era: Lessons from the first surge of the pandemic.

BACKGROUND: The Coronavirus disease 19 (COVID-19)-related psychiatric burden partly results from prolonged social stress world-wide. Studies have examined the psychiatric impact of COVID-19 on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) and International Classification of Diseases 11th Revision (ICD-11) categories, implicating multiple diagnoses, complicating clinical management. AIM: To verify whether COVID-19-related psychopathology spans multiple DSM-5 and ICD-11 diagnoses, but not in a random pattern. Consequently, empirical analysis of the multiple associated symptoms will better describe COVID-19-related psychopathology. METHODS: We conducted a bi-national study during the first surge of the pandemic: an Italian sample (n = 21217, studied March-April 2020); and three representative longitudinal samples from Israel (n = 1276, 1189, and 1432 respectively, studied May-July 2020). Data in Italy were collected by a national internet-based survey with an initially approached sample of about one million persons and in Israel by the Israeli Central Bureau of Statistics using probability-based national representative sampling. Data analysis focused on the frequency and patterns of reported multiple mental health symptoms. RESULTS: Combinations with all symptoms were more prevalent than combinations with fewer symptoms, with no majorities-minorities differences in both countries, demonstrating the generalizability of the transdiagnostic pattern of mental health issues in both nations. A history of previous mental disorder (Italian study) and an increase in symptom prevalence over time (Israel study) were associated with an increased number of symptoms. Conclusions: Based on finding correlated symptom diversity spanning conventional diagnostic categories, we suggest that the pattern of mental health issues associated with the COVID-19 pandemic is transdiagnostic. CONCLUSION: The findings have implications for improving prevention and treatment of COVID-19 related psychopathology and for post-pandemic times in conditions resulting from multiplicity of stressors with mixed symptomatology in the clinical picture.

Charting the neural circuits disruption in inhibitory control and its subcomponents across psychiatric disorders: A neuroimaging meta-analysis.

BACKGROUND: Inhibitory control, comprising cognitive inhibition and response inhibition, showed consistent deficits among several major psychiatric disorders. We aim to identify the trans-diagnostic convergence of neuroimaging abnormalities underlying inhibitory control across psychiatric disorders. METHODS: Inhibitory control tasks neuroimaging, including functional magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography articles published in PubMed and Web of Science before April 2020 comparing healthy controls with patients with several psychiatric disorders were searched. RESULTS: 146 experiments on 2653 patients with different disorders and 2764 control participants were included. Coordinates of case-control differences coded by diagnosis and inhibitory control components were analyzed using activation likelihood estimation. A robust trans-diagnostic pattern of aberrant brain activation in the bilateral cingulate gyri extending to medial frontal gyri, right insula, bilateral lentiform nuclei, right inferior frontal gyrus, right precuneus extending to inferior parietal lobule, and right supplementary motor area were detected. Frontostriatal pathways are the commonly disrupted neural circuits in the inhibitory control across psychiatric disorders. Furthermore, Patients showed aberrant activation in the dorsal frontal inhibitory system in cognitive inhibition, while in the frontostriatal system in response inhibition across disorders. CONCLUSION: Consistent with the Research Domain Criteria initiative, current findings show that psychiatric disorders may be productively formulated as a phenotype of trans-diagnostic neurocircuit disruption. Our results provide new insights for future research into mental disorders with inhibition-related dysfunctions.

Psychiatric symptoms and syndromes transcending diagnostic boundaries in Indian multiplex families: The cohort of ADBS study.

Syndromes of schizophrenia, bipolar disorder, obsessive-compulsive disorder, substance use disorders and Alzheimer's dementia are highly heritable. About 10-20% of subjects have another affected first degree relative (FDR), and thus represent a 'greater' genetic susceptibility. We screened 3583 families to identify 481 families with multiple affected members, assessed 1406 individuals in person, and collected information systematically about other relatives. Within the selected families, a third of all FDRs were affected with serious mental illness. Although similar diagnoses aggregated within families, 62% of the families also had members with other syndromes. Moreover, 15% of affected individuals met criteria for co-occurrence of two or more syndromes, across their lifetime. Using dimensional assessments, we detected a range of symptom clusters in both affected and unaffected individuals, and across diagnostic categories. Our findings suggest that in multiplex families, there is considerable heterogeneity of clinical syndromes, as well as sub-threshold symptoms. These families would help provide an opportunity for further research using both genetic analyses and biomarkers.

La regulación emocional como categoría transdiagnóstica a través de los problemas clínicos: un estudio narrativo

Introducción: En el proceso diagnóstico de los trastornos psicológicos, podemos encontrar características comunes a diferentes problemas, pudiendo explicar variedad de dificultades clínicas y comorbilidades desde esta categoría transversal, lo cual ha sido llamada transdiagnóstico. Siendo la regulación emocional una variable transdiagnóstica que se define como la capacidad de la persona de hacer uso de recursos o habilidades para modular la respuesta conductual producida posteriormente a la experimentación de una emoción de moderada a elevada intensidad. Objetivo: Explicar el impacto de la variable regulación emocional en la teoría y práctica clínica a través de una mirada transdiagnóstica. Discusión: El término transdiagnóstico nace por una serie de inconvenientes en su fundamentación y práctica, siendo estás: la insatisfacción por los modelos tradicionales como la Clasificación Internacional de las Enfermedades y Trastornos relacionados con la Salud Mental (CIE-10) y Manual Diagnóstico y Estadístico de Trastornos Mentales (DSM-5), la comorbilidad y el riego de la medicalización. Por eso, este modelo propone comprender los procesos causales básicos comunes entre distintos trastornos o grupos de estos. Para tocar el tema de regulación emocional se debe hablar de las emociones. Estás son adaptativas para las personas. Sin embargo, pueden transformarse en problemáticas si se responde de forma automática bajo el nivel emocional, ya que interfiere con objetivos y bienestar personal. Todos los seres humanos contamos con procesos reguladores de la emoción, es decir, somos capaces de decidir cómo responder ante la aparición de una emoción. Ello es llamado regulación emocional, la cual se vuelve efectiva cuando se adapta el contexto y a los metas a largo plazo. Esta forma de responder es un producto personal aprendido que depende de las contingencias y las reglas que la comunidad verbal de referencia haya organizado a lo largo de la historia personal; por lo que, a veces, puede ser destructiva en la medida que su aplicación rígida y, muchas veces evitativa, impide a la persona construir una vida con sentido. La investigación reciente demuestra que una cantidad importante de diagnósticos clínicos en salud mental podría ser explicada por los problemas en la regulación emocional, entre los cuales hemos destacado los trastornos de ansiedad, depresivos, el trastorno límite de la personalidad, los trastornos por uso de sustancias y los trastornos de la conducta alimentaria. Conclusión: Los procesos transdiagnósticos se ven cada vez más valorados debido a las variadas teorías explicativas que aparecen en estos últimos años. Generando tratamientos enfocados al déficit de habilidades en regulación emocional, todo con el fin de mejorar la calidad de vida de los consultantes. Cabe agregar que al revisar toda esta literatura podemos concluir que es posible conceptualizar y explicar los trastornos psicológicos desde el déficit de regulación emocional. Sobre todo, desde los puntos biológicos, contextuales y teniendo en cuenta los aprendizajes para su mantenimiento.

Background: In the diagnostic process of psychological disorders, we can find common characteristics to different problems, being able to explain a variety of clinical difficulties and comorbidities from this cross-sectional category, which has been called transdiagnostic. Being emotional regulation a transdiagnostic variable that is defined as the ability of the person to make use of resources or skills to modulate the behavioral response produced after experiencing a moderate to high intensity emotion. Objective: To explain the impact of the emotional regulation variable in clinical theory and practice through a transdiagnostic look. Discussion: The term transdiagnosis arises from a series of drawbacks in its foundation and practice, being these: dissatisfaction with traditional models such as the International Classification of Diseases and Disorders related to Mental Health (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders (DSM-5), comorbidity and the risk of medicalization. For this reason, this model proposes to understand the common basic causal processes between different disorders or groups of these. To touch on the subject of emotional regulation, one must talk about emotions. These are adaptive for people. However, they can become problematic if they respond automatically under the emotional level, since it interferes with goals and personal well-being. All human beings have emotion regulatory processes, that is, we are capable of deciding how to respond to the appearance of an emotion. This is called emotional regulation (ER), which becomes effective when the context and long-term goals are adapted. This way of responding is a personal learned product that depends on the contingencies and the rules that the verbal community of reference has organized throughout personal history; so, at times, it can be destructive insofar as its rigid and often avoidant application prevents a person from building a meaningful life. Recent research shows that a significant number of clinical diagnoses in mental health could be explained by problems in emotional regulation, among which we have highlighted anxiety and depressive disorders, borderline personality disorder, and substance use disorders. and eating disorders. Conclusion: Transdiagnostic processes are increasingly valued due to the various explanatory theories that appear in recent years. Generating treatments focused on the deficit of skills in emotional regulation, all in order to improve the quality of life of the consultants. It should be added that when reviewing all this literature we can conclude that it is possible to conceptualize and explain psychological disorders from the deficit of emotional regulation. Especially from the biological and contextual points and taking into account the learning for its maintenance.

Protocolo de Evaluación Transdiagnóstico para Estrés, Ansiedad y Depresión: Un Análisis con Víctimas Colombianas / Protocolo de Avaliação Transdiagnóstica para o Estresse, Ansiedade e Depressão: Uma Análise com as Vítimas Colombianas / Transdiagnostic Evaluation Protocol for Stress, Anxiety and Depression: An Analysis with Colombian Victims

Resumen Siguiendo el modelo transdiagnóstico, se diseñó un protocolo de evaluación para estrés, ansiedad y depresión. Se realizaron dos estudios. El primero fue de tipo instrumental en el cual se estableció la validez de contenido del protocolo a través del juicio de armonía interjueces, con nueve expertos en evaluación transdiagnóstica, quienes evaluaron los aspectos generales, las variables transdiagnósticas incluidas, las problemáticas clínicas e instrumentos propuestos, mediante la técnica Angoff Modificada. Los coeficientes rwg oscilaron entre .33 y .97 valores que indicaron acuerdo entre jueces. Los indicadores de severidad e indulgencia permiten inferir que la evaluación de los expertos fue favorable. En el segundo estudio se compararon las puntuaciones medias obtenidas en la aplicación del protocolo a 15 víctimas del conflicto armado y 73 personas sintomáticas. No se encontraron diferencias estadísticamente significativas entre las medias de las variables transdiagnósticas entre los dos grupos los valores p oscilaron entre .09 y .95, resultados que permiten inferir que la sensitividad ansiosa, intolerancia a la incertidumbre y afecto positivo-negativo, como variables transdiagnósticas pueden ser identificadas mediante el protocolo, independientemente del tipo de diagnóstico o condición de víctima.

Resumo O objetivo deste estudo foi descrever as propriedades de um protocolo para a avaliação do estresse, a ansiedade e a depressão, elaborado segundo o modelo transdiagnóstico. Realizaram-se dois estudos. No primeiro (do tipo instrumental) foram procuradas evidências de validade de conteúdo por meio da estimação da concordância entre juízes. Nove especialistas na área de avaliação transdiagnóstica analisaram as características gerais, as problemáticas clínicas, os instrumentos propostos e as variáveis transdiagnósticas contidas no protocolo, por meio da técnica Angoff modificada. Os coeficientes rwg mostraram uma boa concordância entre os juízes. A análise dos índices de severidade e indulgencia indica que a avaliação dos especialistas foi favorável. No segundo estudo, o protocolo foi aplicado a 15 vítimas do conflito armado e 73 pessoas sintomáticas, e suas pontuações foram comparadas. Não houve diferenças estatisticamente significativas entre os dois grupos quanto às variáveis transdiagnósticas, esses resultados permitem inferir que o protocolo pode ser utilizado para identificar a sensitividade ansiosa, a intolerância à incerteza e o afeto positivo-negativo, como variáveis transdiagnósticas, independentemente do tipo de diagnóstico ou a condição da vítima.

Abstract Two studies were undertaken following the transdiagnostic model, an evaluation protocol for stress, anxiety, and depression was designed. The first one was instrumental, in which the validity of the content of the protocol was established through interjudged harmony judgment, with nine experts in transdiagnostic evaluation, who evaluated the general aspects, the transdiagnostic variables included, the clinical problems, and the instruments proposed, using the modified Angoff technique. The rwg coefficients fluctuated between .33 and .97 showing inter-judge agreement. The indicators of severity and indulgence allowed us to infer that the evaluation of the experts was favorable. In the second study, the average scores obtained in the application of the protocol were compared to 15 victims of the armed conflict and 73 symptomatic people. There were no statistically significant differences between the means of the transdiagnostic variables between the two groups, p-values fluctuated between .09 and .95, this results allow us to infer that anxiety sensitivity, intolerance to uncertainty and positive-negative affect as transdiagnostic variables can be identified by means of the protocol regardless of the type of diagnosis or condition of victim.

Dos décadas de evidencia: hacia un enfoque integrador sobre los efectos de la adversidad y el maltrato infantil en la salud mental / Dues dècades d’evidència: cap a un enfocament integrador sobre els efectes de l’adversitat i del maltractament infantil a la salut mental / Two decades of evidence: towards an integrative approach to the effects of childhood adversity and mal- treatment on mental health

El objetivo de este artículo es recopilar la evidencia actual sobre el impacto del maltrato y laadversidad en la infancia sobre la salud mental, priorizando aquellos trastornos que no han ocupado tradicional-mente un lugar nuclear en la etiología. Se revisan las publicaciones aparecidas en las principales bases de datosen los últimos veinte años. Concluimos con la gran importancia de detectar de forma precoz los antecedentestraumáticos en la atención clínica y la necesidad de implementar intervenciones preventivas efectivas. Primamosla aproximación a los trastornos desde una óptica transdiagnóstica, como un acercamiento más eficiente a larealidad del neurodesarrollo y a la naturaleza, génesis y curso de la psicopatología.(AU)

The aim of this article is to compile the current evidence on the impact of childhoodadversity and maltreatment on mental health, prioritizing those disorders that have not traditionally occupieda central place in the etiology. We review the publications that have appeared in the main databases in the lasttwenty years. We conclude with the great importance of early detection of traumatic antecedents in clinical careand the need to implement effective preventive interventions. We prioritize the approach to disorders from atransdiagnostic perspective, as a more efficient approach to the reality of neurodevelopment and to the nature,genesis and course of psychopathology.(AU)

L’objectiu d’aquest article és recopilar l’evidència actual sobre l’impacte del maltracta-ment i l’adversitat a la infància sobre la salut mental, prioritzant aquells trastorns que no han ocupat tradicional-ment un lloc nuclear a l’etiologia. Es revisen les publicacions aparegudes a les principals bases de dades en elsdarrers vint anys. Concloem amb la gran importància de detectar de manera precoç els antecedents traumàticsa l’atenció clínica i la necessitat d’implementar intervencions preventives efectives. Prioritzem l’aproximació alstrastorns des d’una òptica transdiagnòstica, com un apropament més eficient a la realitat del neurodesenvolu-pament i a la natura, gènesi i curs de la psicopatologia.(AU)