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Department/Unit:Child and Adolescent Psychiatry

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Loneliness, Social Isolation, and Suicidal Ideation and Attempt Among Adolescents Living with HIV: A Cross-Sectional Study in Masaka, Uganda

Atwebembere, Raymond; Nakasujja, Noeline; Mugisha, James; Ssewamala, Fred; Mckay, Mary
One in six people are aged 10-19 years. Adolescence is a unique and formative time. Physical, emotional, and social changes, including exposure to poverty, abuse, or violence, can make adolescents vulnerable to mental health problems. Protecting adolescents from adversity, promoting socio-emotional learning and psychological well-being, and ensuring access to mental healthcare are critical for their health and well-being during adolescence and adulthood. Globally, it is estimated that 1 in 7 (14%) 10-19 year-olds experience mental health conditions (1), yet these remain largely unrecognized and untreated. Adolescents with mental health conditions are particularly vulnerable to social exclusion, discrimination, stigma (affecting readiness to seek help), educational difficulties, risk-taking behaviors, physical ill-health, and human rights violations.
PMCID:12533749
PMID: 41112956
ISSN: 2196-8799
CID: 6047392

Brain morphometry of toddlers with language delay: An exploratory study

Filippi, Courtney A; Smith, Elizabeth; Redcay, Elizabeth; Hazlett, Heather; Thompson, Lauren; Manwaring, Stacy S; D'Souza, Precilla; Thurm, Audrey
While studies have documented neural correlates of language delay in toddlers with developmental conditions, those at genetic risk for language delay, and those born premature, no studies have examined neural correlates in toddlers exhibiting early language delay without known etiology. This study examines brain morphometry in toddlers with and without early language delay. To do so, we collected magnetic resonance imaging on toddlers with language delay (LD; n=7, Mage=19.67 months, 3 female, 2 Hispanic, 4 non-caucasian) and a typically developing (TD; n=17, Mage=22.73 months, 8 female, 2 Hispanic, 3 non-caucasian) comparison group. Exploratory analyses examined group differences in total brain volume, cortical thickness, and cortical surface area using both a whole-brain and region of interest (Broca's and Wernicke's areas) approach. Results showed no gross brain anatomical differences between groups. However, there were group differences in cortical surface area in the temporal cortex (including Wernicke's area and left middle temporal gyrus, hedges' g= -.35) and Broca's area thickness. Results are reported using multiple analytic methods, age matching, and exclusion of children later diagnosed with autism. While this exploratory study has a limited sample size, it provides novel findings that can be utilized to guide hypothesis-driven imaging studies on toddler language delay.
PMCID:12714334
PMID: 41426947
ISSN: 1522-7227
CID: 6041832

Brain plasticity underlying acquisition of new organizational skills in children: A Rashomon analysis

Martinez Agulleiro, Luis; Deng, Bowen; Gallagher, Richard; Abikoff, Howard B; Yoncheva, Yuliya; Robinson, Lauren; Conlon, Greta; Haroon, Maleeha; Yan, Chao-Gan; Di Martino, Adriana; Zhao, Yihong; Castellanos, F Xavier
OBJECTIVE/UNASSIGNED:We used resting-state functional magnetic resonance imaging to identify changes in brain functional connectivity (FC) associated with Organizational Skills Training (OST). METHOD/UNASSIGNED:In an open, waitlist-controlled, randomized clinical trial (NCT04108273), 51 children aged 8-12 years with deficient organizational skills were assigned to immediate tele-health OST treatment (twice weekly, 10 weeks) or waitlist. We obtained Children's Organizational Skills Scale-Parent version (COSS-P) scores and examined FC changes between dorsal anterior cingulate cortex (dACC) and preregistered subcortical anterior ventral striatum (aVS) regions-of-interest. RESULTS/UNASSIGNED: < 0.05). Analyses were then performed with two additional analytic pipelines, neither of which detected any significant effects. CONCLUSION/UNASSIGNED:Although improvements in organizational deficits were associated with increased FC within a circuit linking dACC and the default mode network region of the aVS in one analysis, the direction was the opposite of predicted and results did not replicate. Thus, we highlight the tentativeness of our findings; we have de-identified all the data and made it available for investigators to examine and to combine with other datasets in mega- and meta-analyses. Future studies should also include alternative control conditions and larger samples. CLINICAL TRIAL REGISTRATION/UNASSIGNED:https://clinicaltrials.gov/study/NCT04108273?cond=NCT04108273&rank=1.
PMCID:12723142
PMID: 41446359
ISSN: 2813-1193
CID: 6042012

Effects of Psilocybin on Religious and Spiritual Attitudes and Behaviors in Clergy from Various Major World Religions

Griffiths, Roland R; Jesse, Robert; Richards, William A; Johnson, Matthew W; Sepeda, Nathan D; Bossis, Anthony P; Ross, Stephen
BACKGROUND/UNASSIGNED:Although historical writings, anthropological accounts, and experimental studies document associations between psilocybin use and religion, no prospective experimental study has investigated how the effects of psilocybin are experienced and interpreted by religious clergy. This exploratory study evaluated the overall safety and the acute and enduring effects of psilocybin in clergy. METHODS/UNASSIGNED:= 16) at 6 months after screening using self-report measures. The effects of psilocybin were also assessed on session days and 4 and 16 months after the second psilocybin session in the 24 participants who completed both sessions. RESULTS/UNASSIGNED:The primary outcome assessment at 6 months after screening showed that, compared with the delayed control group, participants who had received psilocybin reported significantly greater positive changes in their religious practices, attitudes about their religion, and effectiveness as a religious leader, as well as in their non-religious attitudes, moods, and behavior. Follow-up assessments showed that positive changes in religious and non-religious attitudes and behavior were sustained through 16 months after the second psilocybin session. At that time, participants rated at least one of their psilocybin experiences to be among the top five most spiritually significant (96%), profoundly sacred (92%), psychologically insightful (83%), and psychologically meaningful (79%) of their lives. Furthermore, 42% rated one of their experiences to be the single most profound of their lifetime. At 16-months follow-up, most (79%) strongly endorsed that the experiences had positive effects on their religious practices (e.g., prayer or meditation) and their daily sense of the sacred, and most (71%) reported positive changes in their appreciation of religious traditions other than their own. Although no serious adverse events were reported, 46% rated a psilocybin experience as among the top five most psychologically challenging of their lives. CONCLUSIONS/UNASSIGNED:In this population of clergy, psilocybin administration was safe and increased multiple domains of overall psychological well-being including positive changes in religious attitudes and behavior as well as their vocation as a religious leader. The study was limited by a waitlist control design, homogenous sample, and the use of some unvalidated outcome measures. Further research with more rigorous control conditions and diverse samples is needed.
PMCID:13000417
PMID: 41869007
ISSN: 2831-4433
CID: 6017792

The role of allostatic load in adverse pregnancy outcomes: a multisystem, developmental perspective

Costello, Lauren A; Banker, Sarah M; Morales, Santiago; Barber, Maria; Hockett, Christine; McCormack, Lacey; Rauth, Virginia A; Elliott, Amy J; Shuffrey, Lauren C
Allostatic load provides a valuable framework for examining how cumulative stress impacts multiple physiological systems simultaneously, making it a powerful tool for understanding the mechanisms through which stress contributes to adverse pregnancy outcomes. This multisystem perspective is especially important during pregnancy, a period characterized by heightened vulnerability to stress and significant physiological changes that can themselves contribute to allostatic load. Although the impact of allostatic load during pregnancy is well documented, the mechanisms and moderators involved by trimester remain unclear, particularly given wide variation in social, cultural, and structural determinants of maternal health worldwide. In this review, we discuss the progress that has been made over the past two decades in studying prenatal allostatic load and describe the clinical implications of this by highlighting sensitive periods of interest throughout gestation. Despite these advances, key questions remain regarding the intergenerational transmission of risk, the specificity of findings to the pregnancy period, and the role of factors that often accompany elevated allostatic load, such as poor sleep, limited social support, systemic inequities, and comorbid mental or physical health conditions, which may manifest differently across global contexts. Most existing studies have been conducted in high-income settings, yet the burden of adverse pregnancy outcomes is greatest in low- and middle-income countries, where structural, environmental, and social stressors are pervasive. Expanding this framework to include diverse global contexts is essential for understanding how social inequities and chronic stressors shape maternal physiology worldwide. We discuss these issues and offer directions for future research, including the goal of developing a standardized metric for measuring allostatic load - one that we believe will advance the field's understanding of how prenatal allostatic load markers by trimester relate to maternal and infant outcomes.
PMCID:12824014
PMID: 41586415
ISSN: 2673-5059
CID: 6003032

metaConvert: an automatic suite for estimation of 11 different effect size measures and flexible conversion across them

Gosling, Corentin J; Cortese, Samuele; Solmi, Marco; Haza, Belen; Vieta, Eduard; Delorme, Richard; Fusar-Poli, Paolo; Radua, Joaquim
A fundamental pillar of science is the estimation of the effect size of associations. However, this task is sometimes difficult and error-prone. To facilitate this process, the R package metaConvert automatically calculates and flexibly converts multiple effect size measures. It applies more than 120 formulas to convert any relevant input data into Cohen's d, Hedges' g, mean difference, odds ratio, risk ratio, incidence rate ratio, correlation coefficient, Fisher's r-to-z transformed correlation coefficient, variability ratio, coefficient of variation ratio, or number needed to treat. Researchers unfamiliar with R can use this software through a browser-based graphical interface (https://metaconvert.org/). We hope this suite will help researchers in the life sciences and other disciplines estimate and convert effect sizes more easily and accurately.
PMCID:12527507
PMID: 41626934
ISSN: 1759-2887
CID: 5999532

Altered Visuomotor Network Dynamics Associated with Freezing of Gait in Parkinson's Disease

Su, Dongning; Ji, Lanxin; Cui, Yusha; Gan, Lu; Ma, Huizi; Liu, Zhu; Duan, Yunyun; Stoessl, A Jon; Zhou, Junhong; Wu, Tao; Liu, Yaou; Feng, Tao
BACKGROUND:Freezing of gait (FOG) is a common gait disorder that often accompanies Parkinson's disease (PD). The current understanding of brain functional organization in FOG was built on the assumption that the functional connectivity (FC) of networks is static, but FC changes dynamically over time. We aimed to characterize the dynamic functional connectivity (DFC) in patients with FOG based on high temporal-resolution functional MRI (fMRI). METHODS:Eighty-seven PD patients, including 29 with FOG and 58 without FOG, and 32 healthy controls underwent resting-state fMRI. Spatial independent component analysis and a sliding-window approach were used to estimate DFC. RESULTS:Four patterns of structured FC 'states' were identified: a frequent and sparsely connected network (State I), a less frequent but highly synchronized network (State IV), and two states with opposite connecting directions between the visual network and the sensorimotor network (positively connected in State II, negatively connected in State III). Compared with the non-FOG group, patients with FOG spent significantly less time in State II and more time in State III. The longer dwell time in State III was correlated with more severe FOG symptoms. The fractional window of State III tended to correlate to visual-spatial and executive dysfunction in FOG. Moreover, fewer transitions between brain states and lower variability in local efficiency were observed in FOG, suggesting a relatively 'rigid' brain. CONCLUSIONS:This study highlights how visuomotor network dynamics are related to the presence and severity of FOG in PD patients, which provides new insights into understanding the pathophysiological mechanisms that underly FOG. © 2025 International Parkinson and Movement Disorder Society.
PMID: 39996352
ISSN: 1531-8257
CID: 5997472

Manifold Learning Uncovers Nonlinear Interactions Between the Adolescent Brain and Environment That Predict Emotional and Behavioral Problems

Busch, Erica L; Conley, May I; Baskin-Sommers, Arielle
BACKGROUND:To progress adolescent mental health research beyond our present achievements-a complex account of brain and environmental risk factors without understanding neurobiological embedding in the environment-we need methods to uncover relationships between the developing brain and real-world environmental experiences. METHODS:We investigated associations between brain function, environments, and emotional and behavioral problems using participants from the Adolescent Brain Cognitive Development (ABCD) Study (n = 2401 female). We applied manifold learning, a promising technique for uncovering latent structure from high-dimensional biomedical data such as functional magnetic resonance imaging. Specifically, we developed exogenous PHATE (potential of heat-diffusion for affinity-based trajectory embedding) (E-PHATE) to model brain-environment interactions. We used E-PHATE embeddings of participants' brain activation during emotional and cognitive processing tasks to predict individual differences in cognition and emotional and behavioral problems both cross-sectionally and longitudinally. RESULTS:E-PHATE embeddings of participants' brain activation and environments at baseline showed moderate-to-large associations with total, externalizing, and internalizing problems at baseline, across several subcortical regions and large-scale cortical networks, compared with the zero-to-small effects achieved by voxelwise data or common low-dimensional embedding methods. E-PHATE embeddings of the brain and environment at baseline were also related to emotional and behavioral problems 2 years later. These longitudinal predictions showed a consistent moderate effect in the frontoparietal and attention networks. CONCLUSIONS:The embedding of the adolescent brain in the environment yields enriched insight into emotional and behavioral problems. Using E-PHATE, we demonstrated how the harmonization of cutting-edge computational methods with longstanding developmental theories advances the detection and prediction of adolescent emotional and behavioral problems.
PMID: 39009136
ISSN: 2451-9030
CID: 5997062

EJSO

Kefleyesus, Amaniel; Bakrin, Naoual; Kepenekian, Vahan; Gerbaud-Coulas, Chloe; Li, Anne; Vassal, Olivia; Eveno, Clarisse; Sgarbura, Olivia; Nelson, Gregg; Bouchard-Fortier, Antoine; Mack, Lloyd; Rivard, Justin; Fagotti, Anna; Kusamura, Shigeki; Robella, Manuela; Piso, Pompiliu; Acs, Miklos; Arias, Fernando; Rau, Beate; Lambert, Laura A.; Wadhwa, Anupama; Polanco, Patricio; Somashekhar, S. P.; Teixeira-Farinha, Hugo; Alyami, Mohammad; Glehen, Olivier; Hubner, Martin
ISI:001502083200001
ISSN: 0748-7983
CID: 5991962

Firesetting Risk Conceptualization, Assessment, and Treatment Recommendations within Youth Psychiatric Acute Care Settings: A Case Study

Sullivan, Paul J; Feder, Michael; Phillips, Victoria; Khan, Ali; Chatterjee, Krishanu; Filton, Beryl; Weis, Rebecca; Stadolnik, Robert
Firesetting behaviors are extremely dangerous not only to the individual but to society as one fire has the potential to destroy property and lead to serious injury or death. Youth firesetting behaviors are often under-assessed in psychiatric care settings intakes due to their relatively low base-rate and only are a part of a practitioner’s conceptualization when these behaviors are part of their presentation to an emergency room. Acute psychiatric care settings are well-equipped to assess and treat many highly dangerous behaviors such as active suicidal and homicidal ideation, as well as non-suicidal self-injury. However, youth firesetting is without a formal and directed plan on how to assess the risk of these behaviors, conceptualize, and intervene effectively. A case study of a 16-year-old multiracial male named “Luis”, who was psychiatrically hospitalized on an adolescent inpatient unit following multiple firesetting behaviors in the community, is used is to show the importance of multiinterdisciplinary collaboration between mental health providers and local fire safety programs. In addition, we will offer several recommendations to providers in the assessment and treatment related to juvenile who fireset
ORIGINAL:7248690
ISSN: 2582-8142
CID: 5986922