Faculty Bibliography

Mass univariate testing on functional connectivity MRI (fcMRI) data is limited by difficulties achieving experiment-wide significance. Recent work addressing this problem has used enrichment analysis, which aggregates univariate screening statistics for a set of variables into a single enrichment statistic. There have been promising results using this method to explore fcMRI-behavior associations. However, there has not yet been a rigorous examination of the statistical properties of enrichment analysis when applied to fcMRI data. Establishing power for fcMRI enrichment analysis will be important for future neuropsychiatric and cognitive neuroscience study designs that plan to include this method. Here, we use realistic simulation methods, which mimic the covariance structure of fcMRI data, to examine the false positive rate and statistical power of one technique for enrichment analysis, over-representation analysis. We find it can attain high power even for moderate effects and sample sizes, and it strongly outperforms univariate analysis. The false positive rate associated with permutation testing is robust.

The current study investigates the conjoint effect of prenatal Superstorm Sandy stress (SS) and postnatal parenting, as measured by affectionless control (AC), in determining the risk of early childhood psychopathology. The study included 154 children (45.5% males) longitudinally tracked from ages 2-5 years. Maternal AC was assessed using the Parental Bonding Instrument. The prevalence of child diagnostic outcomes (DSM-IV anxiety disorders, phobias, and disruptive behavior disorders) was ascertained by trained clinical interviewers using maternal responses to the Preschool Age Psychiatric Assessment. Children were stratified into four groups by SS and AC status to identify synergistic effects on psychopathology exceeding the risks expected in an additive model. Children exposed to both SS and AC had over 5-fold increased risk of any anxiety disorder, a 12-fold increased risk for disruptive behavior disorders, and a nearly 5-fold increased risk of any disorder relative to the reference group of children with neither exposure. The risks of anxiety, disruptive behavior, and any disorders were synergistically greater than the sum of independent effects of the two stressors, as evident in the synergy index. Evaluation of synergistically increased risks for childhood disorders will help to identify high-risk children, which in turn could inform design of multi-level interventions to mitigate child psychopathology.

BACKGROUND:Numerous studies support the association of exercise training, physical activity (PA) and sedentary behaviour (SB) with both mortality and morbidity outcomes. The results across studies have been inconsistent, and no umbrella reviews have yet been conducted on this topic. METHODS:We conducted an umbrella review of meta-analyses of observational studies by screening articles in PubMed/MEDLINE, EMBASE and Web of Science databases from inception to 30 April 2024. Quality appraisal of each included meta-analysis was done using the AMSTAR 2 tool, with evidence certainty evaluated based on statistical significance, study size, heterogeneity, small-study effects, prediction intervals (PI) and potential biases. RESULTS:Frothy-eight meta-analyses were included (AMSTAR 2 ratings: high 25, moderate 10, low 2 and critically low 11). No evidence was highly suggestive or convincing. Suggestive evidence linked any PA and SB to lower and higher risks of all-cause, cardiovascular and cancer mortality. Suggestive evidence indicated a significant association between self-reported and device-measured total PA (equivalent odds ratio [eOR] 0.78 [0.70-0.86] and eHR = 0.50 [0.38-0.65], respectively), self-reported leisure time PA (eHR = 0.73 [0.66-0.80]), device-measured daily steps (eHR = 0.44 [0.35-0.56]) and aerobic plus resistance training (eHR = 0.60 [0.56-0.64]) with lower all-cause mortality. Weak evidence supported links between self-reported and device-measured SB and higher mortality (eHR = 1.3 [1.22-1.38] and eHR = 2.16 [1.09-4.28], respectively). Suggestive evidence was noted for the association between self-reported leisure time PA (eHR = 0.74 [0.69-0.80]) and resistance training (eHR = 0.82 [0.81-0.84]) with cardiovascular mortality. Suggestive evidence was also found for the association between self-reported leisure time PA (eHR = 0.87 [0.83-0.91]) with cancer mortality. Associations between self-reported running time and mortality from all causes, cardiovascular diseases (CVD) and cancer did not reach statistical significance nor did the association between low skeletal muscle mass and all-cause mortality. Meta-regression analyses showed that physical activity reduces mortality risk, with age reducing the protective effects against all-cause, CVD and cancer mortality. We also found that combined exercise training (aerobic plus resistance) most effectively reduces all-cause and CVD mortality. CONCLUSIONS:Converging evidence supports that physical activity and sedentary behaviour are associated with lower and higher rates of all-cause, cardiovascular and cancer mortality. More high-quality prospective studies are needed for a better understanding of the associations between running time and also TV-viewing time and health-related outcomes.

Trauma-focused psychotherapies for infants, toddlers, and preschoolers comprise a unique subset of child trauma interventions. Given the developmental age range in question, certain characteristics of these therapies differ significantly from those for older children. This study reviews evidence-based, trauma-focused treatments for young children and their caregivers, followed by evidence-based treatments for trauma-vulnerable families with very young children that do not target trauma directly but rather reinforce attachment-related protective factors such as parental sensitivity and reflective functioning. Directions for further research are discussed.

Dyadic assessment is an essential component of understanding a young child's mental health, providing critical information about the contexts within which they live and develop. This article describes how to observe the behaviors of a child and caregiver together, either by systematically reviewing key domains of the dyadic interaction or by using a formal observation procedure. Though challenged by issues of training and time to complete them, cultural responsiveness, and the balance of making them both naturalistic and feasible, dyadic assessments are indispensable. They can provide a foundation and jumping-off point for therapy and healing.

BACKGROUND:It is unknown whether there is a general factor that accounts for the propensity for both physical and mental conditions in different age groups and how it is associated with lifestyle and well-being. METHODS:factor, lifestyles, and well-being was further explored. RESULTS:factor scores significantly correlated with lifestyle and well-being, suggesting healthier lifestyles were associated with a reduced likelihood of physical and mental health comorbidities, which in turn improved well-being. CONCLUSIONS:Contrary to the traditional dichotomy between mental and physical conditions, our study showed a general factor underlying the comorbidity across mental and physical diseases, related to lifestyle and well-being. Our results inform the conceptualization of mental and physical illness as well as future research assessing risk and pathways of disease transmission, intervention, and prevention. Our results also provide a strong rationale for a systematic screening for mental disorders in individuals with physical conditions and vice versa, and for integrated services addressing multimorbidity.

Both psychotherapeutic interventions and pharmacological agents have demonstrated limited efficacy in the treatment of personality disorders (PDs). Emerging evidence suggests that psychedelic therapy, already showing promise in treating various psychiatric conditions commonly comorbid with PDs, may exert therapeutic effects by promoting adaptive changes in personality. Thus, psychedelic therapy could hold potential for addressing core features of PDs through shared mechanisms of personality modulation. Although historical literature and observational studies suggest the potential clinical utility of psychedelics in treating PDs, rigorous research is lacking, and individuals with PDs are often excluded from modern psychedelic therapy trials. In the present review, we first discuss research on the effects of psychedelics in individuals with a PD through the conventional lens of the Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR) categorical model. Next, using the dimensional DSM Alternative Model of Personality Disorders (DSM-AMPD) as a framework, we examine how psychedelics may affect self-functioning, interpersonal functioning, and pathological personality traits. We conclude by discussing the clinical relevance of psychedelic therapy as a treatment for personality pathology, including safety considerations, gaps and limitations, and recommendations for approaching psychedelic therapy within these more complex clinical populations.

This editorial focuses on the seven studies published in the BMJ Mental Health topic collection Advances in Clinical Psychopharmacology in Children and Young People. Collectively, these articles provide evidence that informs key steps in the psychopharmacological management of children and adolescents with mental health or neurodevelopmental conditions. Papers in this collection contribute to strengthen evidence-based psychopharmacological practice. We look forward to further developments in the field, supported by adequate research funding.

OBJECTIVE/UNASSIGNED:This scoping review aims to summarize the current state of research literature on disparities in the care of youth with agitation or aggression in the emergency department (ED), including referral, assessment, diagnosis, use of pharmacologic interventions, and use of restraint and seclusion. METHOD/UNASSIGNED:This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for scoping reviews searching PubMed and PsycINFO databases (May 1, 2013 through May 5, 2023) for studies that reported disparities in the care of youth with agitation or aggression in the pediatric ED. RESULTS/UNASSIGNED:Disparities in the care of youth with agitation or aggression in the ED have been documented for race, sex, age, developmental status, and insurance status. There are no data available on disparities in ED-based care of youth with agitation or aggression based on gender identity and/or presentation, sexual orientation, socioeconomic status (SES), systems involvement (including child welfare, foster care, juvenile justice), or language proficiency. CONCLUSION/UNASSIGNED:Although there are some data on disparities in the care of youth with agitation or aggression the ED documented for race, sex, age, developmental status, and insurance status, further work in this area is needed. Actionable steps to address mental health disparities in the pediatric ED are discussed. STUDY PREREGISTRATION INFORMATION/UNASSIGNED:Disparities in the Care of Youth with Agitation or Aggression in the Emergency Department: A Scoping Review and Clinical Guidance; https://osf.io/eg7tk. DIVERSITY & INCLUSION STATEMENT/UNASSIGNED:One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.