Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Child and Adolescent Psychiatry
Total Results:
11211
Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms
In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4<OR<10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.
PMID: 33367502
ISSN: 1464-3553
CID: 4731482
Family Processes and Mental Health among Children and Caregivers in a Family Strengthening Program
Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b = 0.034, SE = 0.01, p < 0.001), child ODD (b = 0.053, SE = 0.02, p < 0.01), and caregiver depression (b = 0.049, SE = 0.02, p < 0.01). Family rules significantly related to caregiver depression (b = 0.228, SE = 0.11, p < 0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective.
SCOPUS:85110549956
ISSN: 1062-1024
CID: 4964342
An Equine-Assisted Therapy for Youth with Mild to Moderate Anxiety: Manual Development and Fidelity
Childhood anxiety is common, yet approximately half of youth do not receive treatment due to stigma, mistrust of the mental health service system, extensive wait lists for services and provider shortages. Alternative models and modes of treatment are needed. This paper describes the development of an alternative treatment that incorporates cognitive behavioral components for anxiety into an adaptive/therapeutic riding program delivered by certified riding instructors in a horse stable that offers horseback riding and therapeutic horsemanship programs. Using PracticeWise®, a well-established database of evidence-based mental health practices for youth, we identified five therapeutic elements that are the most commonly examined in rigorous research for childhood anxiety, and integrated them into a manualized program of adaptive riding sessions. Excellent fidelity to the intervention (98.7% mean score) and high inter-rater reliability (k = 0.92) were achieved. This approach has implications for expanding access to and engagement in adaptive/therapeutic riding interventions.
SCOPUS:85108806607
ISSN: 1062-1024
CID: 4962732
Duality of Smell: Route-dependent Effects on Olfactory Perception and Language
Olfactory research in humans has largely focused on odors perceived via sniffing, orthonasal olfaction, while odors perceived from the mouth, retronasal olfaction, are less well understood. Prior work on retronasally presented odors involve animal models and focus mainly on odor sensitivity, but little is known about retronasal olfactory perception and cognition in humans. In this study, we compared orthonasal and retronasal odor presentation routes to investigate differences in odor descriptions and evaluations. Thirty-six individuals participated in a within-subjects study using twelve odors (varying in pleasantness and edibility) in perceptual and semantic tasks. Orthonasal presentation was associated with a better ability to identify odors, and with more concrete (and source-based) language. Exploratory analyses revealed that while orthonasal odors were described with words that had visual associations, retronasal odors were described with words that had interoceptive associations. Interestingly, these route-dependent differences in descriptor usage were not explained by differences in sensitivity and intensity, suggesting instead a cognitive and linguistic processing difference between odors presented orthonasally and retronasally. Our results indicate that olfaction is in fact a dual sense, in which the routes change the perception of an odor.
PMID: 34007980
ISSN: 1464-3553
CID: 4905272
A Meta-Analysis Investigating the Association Between Metacognition and Math Performance in Adolescence
Poor math and numeracy skills are associated with a range of adverse outcomes, including reduced employability and poorer physical and mental health. Research has increasingly focused on understanding factors associated with the improvement of math skills in school. This systematic literature review and meta-analysis investigated the association between metacognition and math performance in adolescence (11"“16-year-olds). A systematic search of electronic databases and grey literature (to 04.01.2020) highlighted 31 studies. The quantitative synthesis of 74 effect sizes from 29 of these studies (30 independent populations) indicated a significantly positive correlation between metacognition and math performance in adolescence (r =.37, 95% CI = [.29,.44], p <.001). There was significant heterogeneity between studies. Consideration of online (versus offline) measures of metacognition and more complex (versus simple) measures of math performance, and their combination, was associated with larger effect sizes; however, heterogeneity remained high for all analyses.
SCOPUS:85109316840
ISSN: 1040-726x
CID: 4963432
Friendly Faces: Characteristics of Children and Adolescents With Repeat Visits to a Specialized Child Psychiatric Emergency Program
OBJECTIVES/OBJECTIVE:Pediatric mental health emergency department (ED) visits continue to rise with 19% to 62% of youth presenting to the ED ultimately returning for a mental health-related complaint. To better understand the needs of children returning to the ED, this study examines the clinical, demographic, and environmental factors associated with revisits to a dedicated child psychiatric ED. METHODS:Clinical factors, home environment, and mental health service utilization of 885 children presenting to a dedicated child psychiatric ED over a 1-year period were abstracted by retrospective chart review. Bivariate analyses comparing demographic and clinical characteristics for children with and without revisits and a multivariable logistic regression were performed. RESULTS:Of the children presenting to the ED, 186 (21.0%) had at least 1 revisit in the subsequent 180 days. Thirty-one percent of initial visits presented as urgent, 55% presented as emergent. Children presenting with more severe symptoms at their initial visit were more likely to return within 6 months. Female gender, suicidal and disruptive behavioral symptomatology, and a diagnosis of oppositional defiant disorder were associated with repeat visits. Children with mental health system involvement were more likely to have revisits than those who were "treatment naive." CONCLUSIONS:Revisits to the ED are driven by both clinical factors, including severity and psychosocial complexity, and barriers to accessing services. Addressing the problem of return ED visits will require the development of a robust mental health service system that is accessible to children and families of all socioeconomic levels.
PMID: 29438124
ISSN: 1535-1815
CID: 2956152
Primary Open-Angle Glaucoma Preferred Practice Pattern
EMBASE:636933376
ISSN: 1549-4713
CID: 5136422
Peer models for families involved in the child welfare system: a systematic review
This systematic review aimed to synthesize the research of peer mentor models for families involved in the child welfare system. Twelve studies were examined. Most interventions targeted birth parents to facilitate reunification and support the family, with outcomes being mainly favorable particularly for engagement in treatment and reunification outcomes. However, few studies employed rigorous research designs, suggesting several avenues for future practice and research such as advancing the rigor of the evidence and collaborating with peers to provide comprehensive services and enhance family outcomes.
SCOPUS:85118456749
ISSN: 1554-8732
CID: 5058152
9/11 Twenty Years On: Fractured Identities; Fear of the Other; Forging a New Path for Our Children Introduction to the Section
This is an introduction to a collection of papers that commemorates the twentieth anniversary of 9/11. The nature of the content of the papers which follow is spurred by reflections on this anniversary from a number of domains: child and adult psychoanalysis; the healing arts of theater; the parent-child treatment of Afghani and Iraqi asylum-seeking families; the Law of the Mother and siblingships; the changes occurring in psychoanalytic views of secularism; and the confrontation of racial prejudice and othering in the workplace and its repercussions upon the self. Concepts of splitting, the bearing of ambivalence, and the capacity to reflect and resist fragmentation are illuminated.
SCOPUS:85116542930
ISSN: 0079-7308
CID: 5055702
Virtual Histology of Cortical Thickness and Shared Neurobiology in 6 Psychiatric Disorders
Importance/UNASSIGNED:Large-scale neuroimaging studies have revealed group differences in cortical thickness across many psychiatric disorders. The underlying neurobiology behind these differences is not well understood. Objective/UNASSIGNED:To determine neurobiologic correlates of group differences in cortical thickness between cases and controls in 6 disorders: attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and schizophrenia. Design, Setting, and Participants/UNASSIGNED:Profiles of group differences in cortical thickness between cases and controls were generated using T1-weighted magnetic resonance images. Similarity between interregional profiles of cell-specific gene expression and those in the group differences in cortical thickness were investigated in each disorder. Next, principal component analysis was used to reveal a shared profile of group difference in thickness across the disorders. Analysis for gene coexpression, clustering, and enrichment for genes associated with these disorders were conducted. Data analysis was conducted between June and December 2019. The analysis included 145 cohorts across 6 psychiatric disorders drawn from the ENIGMA consortium. The numbers of cases and controls in each of the 6 disorders were as follows: ADHD: 1814 and 1602; ASD: 1748 and 1770; BD: 1547 and 3405; MDD: 2658 and 3572; OCD: 2266 and 2007; and schizophrenia: 2688 and 3244. Main Outcomes and Measures/UNASSIGNED:Interregional profiles of group difference in cortical thickness between cases and controls. Results/UNASSIGNED:A total of 12 721 cases and 15 600 controls, ranging from ages 2 to 89 years, were included in this study. Interregional profiles of group differences in cortical thickness for each of the 6 psychiatric disorders were associated with profiles of gene expression specific to pyramidal (CA1) cells, astrocytes (except for BD), and microglia (except for OCD); collectively, gene-expression profiles of the 3 cell types explain between 25% and 54% of variance in interregional profiles of group differences in cortical thickness. Principal component analysis revealed a shared profile of difference in cortical thickness across the 6 disorders (48% variance explained); interregional profile of this principal component 1 was associated with that of the pyramidal-cell gene expression (explaining 56% of interregional variation). Coexpression analyses of these genes revealed 2 clusters: (1) a prenatal cluster enriched with genes involved in neurodevelopmental (axon guidance) processes and (2) a postnatal cluster enriched with genes involved in synaptic activity and plasticity-related processes. These clusters were enriched with genes associated with all 6 psychiatric disorders. Conclusions and Relevance/UNASSIGNED:In this study, shared neurobiologic processes were associated with differences in cortical thickness across multiple psychiatric disorders. These processes implicate a common role of prenatal development and postnatal functioning of the cerebral cortex in these disorders.
PMCID:7450410
PMID: 32857118
ISSN: 2168-6238
CID: 4650132
