Faculty Bibliography

BACKGROUND:The objective of this study is to gain new insights into the relationship between clinical signs and age at diagnosis. METHOD:We utilize a new, large, online survey of 1743 parents of children diagnosed with ASD, and use multiple statistical approaches. These include regression analysis, factor analysis, and machine learning (regression tree). RESULTS:We find that clinical signs that most strongly predict early diagnosis are not necessarily specific to autism, but rather those that initiate the process that eventually leads to an ASD diagnosis. Given the high correlations between symptoms, only a few signs are found to be important in predicting early diagnosis. For several clinical signs we find that their presence and intensity are positively correlated with delayed diagnosis (e.g., tantrums and aggression). Even though our data are drawn from parents' retrospective accounts, we provide evidence that parental recall bias and/or hindsight bias did not play a significant role in shaping our results. CONCLUSION:In the subset of children without early deficits in communication, diagnosis is delayed, and this might be improved if more attention will be given to clinical signs that are not necessarily considered as ASD symptoms. Our findings also suggest that careful attention should be paid to children showing excessive tantrums or aggression, as these behaviors may interfere with an early ASD diagnoses.

During mammalian evolution, primate neocortex expanded, shifting hippocampal functional networks away from primary sensory cortices, towards association cortices. Reflecting this rerouting, human resting hippocampal functional networks preferentially include higher association cortices, while those in rodents retained primary sensory cortices. Research on human visual, auditory and somatosensory systems shows evidence of this rerouting. Olfaction, however, is unique among sensory systems in its relative structural conservation throughout mammalian evolution, and it is unknown whether human primary olfactory cortex was subject to the same rerouting. We combined functional neuroimaging and intracranial electrophysiology to directly compare hippocampal functional networks across human sensory systems. We show that human primary olfactory cortex-including the anterior olfactory nucleus, olfactory tubercle and piriform cortex-has stronger functional connectivity with hippocampal networks at rest, compared to other sensory systems. This suggests that unlike other sensory systems, olfactory-hippocampal connectivity may have been retained in mammalian evolution. We further show that olfactory-hippocampal connectivity oscillates with nasal breathing. Our findings suggest olfaction might provide insight into how memory and cognition depend on hippocampal interactions.

OBJECTIVES/UNASSIGNED:The global crisis of COVID-19 and its consequential strict public health measures placed around the world have impacted mental health. New scales and tools have been developed to measure these mental health effects. This narrative review assesses the psychometric properties of these scales and tools and methodological aspects of their development. METHODS/UNASSIGNED:PubMed, PubMed Central, and Google Scholar were searched for articles published from 15 May 2020 to 15 August 2020. This search used three groups of terms ("tool" OR "scale" AND "mental" OR "psychological"; AND "COVID-19" OR "coronavirus"). The identified scales were further evaluated for their psychometric properties and methodological aspects of their development. RESULTS/UNASSIGNED:= 12) have demonstrated their robust psychometric properties, some methodological concerns are noteworthy. Most of the scales were validated using internet-based surveys, and detailed descriptions of the mode of administration, sampling process, response rates, and augmentation strategies were missing. CONCLUSIONS/UNASSIGNED:The heterogeneous and inadequate reporting of methods adopted to evaluate the psychometric properties of the identified scales can limit their utility in clinical and research settings. We suggest developing guidelines and checklists to improve the design and testing, and result in reporting of online-administered scales to assess the mental health effects of the COVID-19 pandemic.

Childhood and adolescence psychiatric disorders affect subsequent stages; early diagnosis of these disorders, such as attention-deficit/hyperactivity disorder (ADHD), is necessary. There is no reliable and valid diagnostic interview for ADHD in Asian Persian or Farsi speaking countries. The DSM 5-based version of the interview was sent to the 14 child and adolescent and general psychiatrists to ensure the validity of the ADHD section of the PAPA interview through an online website. Out of 59 health centers, 15 centers were selected via systematic random sampling. Three hundred children participated in the study. ADHD questions of the PAPA had the power to differentiate, with a sensitivity of 0.92, a specificity of 0.01. It had positive diagnostic value = 95.83 %, negative diagnostic value = 98.91 %, negative correlation ratio = 0.12, overall diagnostic accuracy = 98.67 % and diagnostic chance ratio = 2085.35. ADHD questions of the PAPA diagnostic interview can diagnose ADHD in preschool as a reliable tool based on DSM-5.

BACKGROUND:Developmental assets provide a framework for optimizing development among adolescents but have not been studied in adolescents with chronic illness and comorbid depression, which is a group at risk for poor health outcomes. YouTube postings provide valuable insights to understand this understudied population. OBJECTIVE:This study aims to explore asset development from the perspectives of adolescents and young adults (AYAs) with chronic illness and comorbid depression. METHODS:YouTube was searched using 12 chronic illnesses (eg, diabetes) coupled with "depression" as keywords. Videos were included if they were uploaded by AYAs aged between 11 and 29 years and discussed living with chronic illness and depression during adolescence. Video transcripts were coded deductively for 40 internal and external assets that constitute the Developmental Assets Framework. Categories not captured by deductive coding were identified using conventional content analysis. Categories and their respective assets were labeled as being discussed either negatively or positively. RESULTS:In total, 31 videos from 16 AYAs met the inclusion criteria. A total of 7 asset categories, support, constructive use of time, boundaries and expectations (external assets), identity, commitment to learning, positive values, and social competence (internal assets), reflecting 25 (13 internal; 12 external) assets, were discussed. Internal assets, particularly relating to identity, were commonly discussed by AYAs either in a negative way or fluctuated between positive and negative perspectives. CONCLUSIONS:In this sample of AYAs with chronic illness and comorbid depression, internal assets were commonly discussed in a negative way. Future research is needed to better understand how assets develop and if the Developmental Assets Framework adequately represents the experiences of this population.

OBJECTIVE:The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief neuropsychological battery that has been validated in the assessment of dementia and other clinical populations. The current study examines the utility of the RBANS in patients with epilepsy. METHODS:Ninety-eight patients with epilepsy completed the RBANS as part of a more comprehensive neuropsychological evaluation. Performance on the RBANS was evaluated for patients with a diagnosis of temporal lobe epilepsy (TLE; n = 51) and other epilepsy patients (non-TLE, n = 47) in comparison to published norms. Multivariate analysis of variance compared group performances on RBANS indices. Rates of impairment were also compared across groups using cutoff scores of ≤1.0 and ≤1.5 standard deviations below the normative mean. Exploratory hierarchical regressions were used to examine the relations between epilepsy severity factors (i.e., age of onset, disease duration, and number of antiepileptic drugs [AEDs]) and RBANS performance. RESULTS:TLE and non-TLE patients performed below the normative sample across all RBANS indices. Those with TLE performed worse than non-TLE patients on the Immediate and Delayed Memory indices and exhibited higher rates of general cognitive impairment. Number of AEDs was the only epilepsy severity factor that significantly predicted RBANS total performance, accounting for 14% of the variance. CONCLUSIONS:These findings suggest that the RBANS has utility in evaluating cognition in patients with epilepsy and can differentiate TLE and non-TLE patients. Additionally, number of AEDs appears to be associated with global cognitive performance in adults with epilepsy.

BACKGROUND:Longitudinal studies of many health behaviors often rely on infrequent self-report assessments. The measurement of psychoactive substance use among youth is expected to improve with more frequent mobile assessments, which can reduce recall bias. Researchers have used mobile devices for longitudinal research, but studies that last years and assess youth continuously at a fine-grained, temporal level (eg, weekly) are rare. A tailored mobile app (mNCANDA [mobile National Consortium on Alcohol and Neurodevelopment in Adolescence]) and a brief assessment protocol were designed specifically to provide a feasible platform to elicit responses to health behavior assessments in longitudinal studies, including NCANDA (National Consortium on Alcohol and Neurodevelopment in Adolescence). OBJECTIVE:This study aimed to determine whether an acceptable mobile app system could provide repeatable and valid assessment of youth's health behaviors in different developmental stages over extended follow-up. METHODS:Participants were recruited (n=534; aged 17-28 years) from a larger longitudinal study of neurodevelopment. Participants used mNCANDA to register reports of their behaviors for up to 18 months. Response rates as a function of time measured using mNCANDA and participant age were modeled using generalized estimating equations to evaluate response rate stability and age effects. Substance use reports captured using mNCANDA were compared with responses from standardized interviews to assess concurrent validity. Reactivity was assessed by evaluating patterns of change in substance use after participants initiated weekly reports via mNCANDA. Quantitative feedback about the app was obtained from the participants. Qualitative interviews were conducted with a subset of participants who used the app for at least one month to obtain feedback on user experience, user-derived explanations of some quantitative results, and suggestions for system improvements. RESULTS:The mNCANDA protocol adherence was high (mean response rate 82%, SD 27%) and stable over time across all age groups. The median time to complete each assessment was 51 s (mean response time 1.14, SD 1.03 min). Comparisons between mNCANDA and interview self-reports on recent (previous 30 days) alcohol and cannabis use days demonstrate close agreement (eg, within 1 day of reported use) for most observations. Models used to identify reactivity failed to detect changes in substance use patterns subsequent to enrolling in mNCANDA app assessments (P>.39). Most participants (64/76, 84%) across the age range reported finding the mNCANDA system acceptable. Participants provided recommendations for improving the system (eg, tailoring signaling times). CONCLUSIONS:mNCANDA provides a feasible, multi-year, continuous, fine-grained (eg, weekly) assessment of health behaviors designed to minimize respondent burden and provides acceptable regimes for long-term self-reporting of health behaviors. Fine-grained characterization of variability in behaviors over relatively long periods (eg, up to 18 months) may, through the use of mNCANDA, improve our understanding of the relationship between substance use exposure and neurocognitive development.

Childhood maltreatment (CM) is a known risk factor for adolescent pregnancy. Sleep disturbances and psychological distress, both common negative sequelae of CM, often co-occur during pregnancy, although directionality remains unclear. Furthermore, little is known about how CM affects sleep-distress associations during pregnancy. In pregnant adolescents, we examined: (a) whether there are significant predictive associations from CM to sleep quality and distress and (b) bidirectional influences of distress and sleep quality. Healthy pregnant adolescents (n = 204) were recruited before or during the 2nd trimester. CM was assessed at enrollment; sleep quality and distress were assessed in the 2nd and 3rd trimesters. Hypotheses were tested using path analysis. Findings revealed that CM was associated with worse 2nd trimester sleep quality and distress (β = .19, p < .05 for sleep; β = .30, p < .001 for distress). Higher levels of 2nd trimester distress were associated with lower 3rd trimester sleep quality (β = .19, p < .05). Findings provide novel information about (a) associations from CM to prenatal mood and sleep in pregnant adolescents, and (b) sleep-distress directionality over the course of pregnancy. These results have implications for better understanding the ways in which CM potentially exerts influences later in life, and for targeting interventions to address physical and mental health during pregnancy.

Attention and salience processing have been linked to the intrinsic between- and within-network dynamics of large-scale networks engaged in internal (default network [DN]) and external attention allocation (dorsal attention network [DAN] and salience network [SN]). The central oxytocin (OXT) system appears ideally organized to modulate widely distributed neural systems and to regulate the switch between internal attention and salient stimuli in the environment. The current randomized placebo (PLC)-controlled between-subject pharmacological resting-state fMRI study in N = 187 (OXT, n = 94; PLC, n = 93; single-dose intranasal administration) healthy male and female participants employed an independent component analysis approach to determine the modulatory effects of OXT on the within- and between-network dynamics of the DAN–SN–DN triple network system. OXT increased the functional integration between subsystems within SN and DN and increased functional segregation of the DN with both attentional control networks (SN and DAN). Whereas no sex differences were observed, OXT effects on the DN–SN interaction were modulated by autistic traits. Together, the findings suggest that OXT may facilitate efficient attention allocation by modulating the intrinsic functional dynamics between DN components and large-scale networks involved in external attentional demands (SN and DAN)./UNASSIGNED/: