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Department/Unit:Child and Adolescent Psychiatry

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Integration of clinical decision support systems into pediatric subspecialty care

Urban, Tamaki Hosoda; Counts, Nathaniel; Lois, Becky Hashim; Risser, Heather Jill
ORIGINAL:0015384
ISSN: 2169-4826
CID: 5069932

Guanfacine as a Treatment for Posttraumatic Stress Disorder in an Adolescent Female

Anderson, Jeffrey; Wang, Chang; Zaidi, Arifa; Rice, Timothy; Coffey, Barbara J
PMID: 32551846
ISSN: 1557-8992
CID: 4968962

What Is the Health and Well-Being Burden for Parents Living With a Child With ADHD in the United Kingdom?

Peasgood, Tessa; Bhardwaj, Anupam; Brazier, John E; Biggs, Katie; Coghill, David; Daley, David; Cooper, Cindy L; De Silva, Cyril; Harpin, Val; Hodgkins, Paul; Nadkarni, Amulya; Setyawan, Juliana; Sonuga-Barke, Edmund J S
Objective: To explore the burden associated with childhood ADHD in a large observational study. Methods: We recruited familes with at least one child (6-18 years) with ADHD via 15 NHS trusts in the UK, and collected data from all family members. We made careful adjustments to ensure a like-for-like comparison with two different control groups, and explored the impact of controlling for a positive parental/carer ADHD screen, employment, and relationship status. Results: We found significant negative impacts of childhood ADHD on parents'/carers' hours and quality of sleep, satisfaction with leisure time, and health-related quality of life (measured by the EuroQol-5D [EQ-5D]). We found a decrement in life satisfaction, mental well-being (as measured by the Short-Warwick Edinburgh Mental Well-Being Scale [S-WEMWBS]), and satisfaction with intimate relationships, but this was not always robust across the different control groups. We did not find any decrement in satisfaction with health, self-reported health status, or satisfaction with income. Conclusion: The study quantifies the impact on the health and well-being of parents living with a child with ADHD using a survey of families attending ADHD clinics in the United Kingdom.
PMID: 32552265
ISSN: 1557-1246
CID: 4484952

Telepsychiatry and healthcare access inequities during the COVID-19 pandemic [Letter]

Ramalho, Rodrigo; Adiukwu, Frances; Gashi Bytyçi, Drita; El Hayek, Samer; Gonzalez-Diaz, Jairo M; Larnaout, Amine; Grandinetti, Paolo; Kundadak, Ganesh Kudva; Nofal, Marwa; Pereira-Sanchez, Victor; Pinto da Costa, Mariana; Ransing, Ramdas; Schuh Teixeira, Andre Luiz; Shalbafan, Mohammadreza; Soler-Vidal, Joan; Syarif, Zulvia; Orsolini, Laura
PMCID:7296313
PMID: 32585636
ISSN: 1876-2026
CID: 4493512

Subcortical Brain Volume, Regional Cortical Thickness, and Cortical Surface Area Across Disorders: Findings From the ENIGMA ADHD, ASD, and OCD Working Groups

Boedhoe, Premika S W; van Rooij, Daan; Hoogman, Martine; Twisk, Jos W R; Schmaal, Lianne; Abe, Yoshinari; Alonso, Pino; Ameis, Stephanie H; Anikin, Anatoly; Anticevic, Alan; Arango, Celso; Arnold, Paul D; Asherson, Philip; Assogna, Francesca; Auzias, Guillaume; Banaschewski, Tobias; Baranov, Alexander; Batistuzzo, Marcelo C; Baumeister, Sarah; Baur-Streubel, Ramona; Behrmann, Marlene; Bellgrove, Mark A; Benedetti, Francesco; Beucke, Jan C; Biederman, Joseph; Bollettini, Irene; Bose, Anushree; Bralten, Janita; Bramati, Ivanei E; Brandeis, Daniel; Brem, Silvia; Brennan, Brian P; Busatto, Geraldo F; Calderoni, Sara; Calvo, Anna; Calvo, Rosa; Castellanos, Francisco X; Cercignani, Mara; Chaim-Avancini, Tiffany M; Chantiluke, Kaylita C; Cheng, Yuqi; Cho, Kang Ik K; Christakou, Anastasia; Coghill, David; Conzelmann, Annette; Cubillo, Ana I; Dale, Anders M; Dallaspezia, Sara; Daly, Eileen; Denys, Damiaan; Deruelle, Christine; Di Martino, Adriana; Dinstein, Ilan; Doyle, Alysa E; Durston, Sarah; Earl, Eric A; Ecker, Christine; Ehrlich, Stefan; Ely, Benjamin A; Epstein, Jeffrey N; Ethofer, Thomas; Fair, Damien A; Fallgatter, Andreas J; Faraone, Stephen V; Fedor, Jennifer; Feng, Xin; Feusner, Jamie D; Fitzgerald, Jackie; Fitzgerald, Kate D; Fouche, Jean-Paul; Freitag, Christine M; Fridgeirsson, Egill A; Frodl, Thomas; Gabel, Matt C; Gallagher, Louise; Gogberashvili, Tinatin; Gori, Ilaria; Gruner, Patricia; Gürsel, Deniz A; Haar, Shlomi; Haavik, Jan; Hall, Geoffrey B; Harrison, Neil A; Hartman, Catharina A; Heslenfeld, Dirk J; Hirano, Yoshiyuki; Hoekstra, Pieter J; Hoexter, Marcelo Q; Hohmann, Sarah; Høvik, Marie F; Hu, Hao; Huyser, Chaim; Jahanshad, Neda; Jalbrzikowski, Maria; James, Anthony; Janssen, Joost; Jaspers-Fayer, Fern; Jernigan, Terry L; Kapilushniy, Dmitry; Kardatzki, Bernd; Karkashadze, Georgii; Kathmann, Norbert; Kaufmann, Christian; Kelly, Clare; Khadka, Sabin; King, Joseph A; Koch, Kathrin; Kohls, Gregor; Kohls, Kerstin; Kuno, Masaru; Kuntsi, Jonna; Kvale, Gerd; Kwon, Jun Soo; Lázaro, Luisa; Lera-Miguel, Sara; Lesch, Klaus-Peter; Hoekstra, Liesbeth; Liu, Yanni; Lochner, Christine; Louza, Mario R; Luna, Beatriz; Lundervold, Astri J; Malpas, Charles B; Marques, Paulo; Marsh, Rachel; Martínez-Zalacaín, Ignacio; Mataix-Cols, David; Mattos, Paulo; McCarthy, Hazel; McGrath, Jane; Mehta, Mitul A; Menchón, José M; Mennes, Maarten; Martinho, Mauricio Moller; Moreira, Pedro S; Morer, Astrid; Morgado, Pedro; Muratori, Filippo; Murphy, Clodagh M; Murphy, Declan G M; Nakagawa, Akiko; Nakamae, Takashi; Nakao, Tomohiro; Namazova-Baranova, Leyla; Narayanaswamy, Janardhanan C; Nicolau, Rosa; Nigg, Joel T; Novotny, Stephanie E; Nurmi, Erika L; Weiss, Eileen Oberwelland; O'Gorman Tuura, Ruth L; O'Hearn, Kirsten; O'Neill, Joseph; Oosterlaan, Jaap; Oranje, Bob; Paloyelis, Yannis; Parellada, Mara; Pauli, Paul; Perriello, Chris; Piacentini, John; Piras, Fabrizio; Piras, Federica; Plessen, Kerstin J; Puig, Olga; Ramos-Quiroga, J Antoni; Reddy, Y C Janardhan; Reif, Andreas; Reneman, Liesbeth; Retico, Alessandra; Rosa, Pedro G P; Rubia, Katya; Rus, Oana Georgiana; Sakai, Yuki; Schrantee, Anouk; Schwarz, Lena; Schweren, Lizanne J S; Seitz, Jochen; Shaw, Philip; Shook, Devon; Silk, Tim J; Simpson, H Blair; Skokauskas, Norbert; Soliva Vila, Juan Carlos; Solovieva, Anastasia; Soreni, Noam; Soriano-Mas, Carles; Spalletta, Gianfranco; Stern, Emily R; Stevens, Michael C; Stewart, S Evelyn; Sudre, Gustavo; Szeszko, Philip R; Tamm, Leanne; Taylor, Margot J; Tolin, David F; Tosetti, Michela; Tovar-Moll, Fernanda; Tsuchiyagaito, Aki; van Erp, Theo G M; van Wingen, Guido A; Vance, Alasdair; Venkatasubramanian, Ganesan; Vilarroya, Oscar; Vives-Gilabert, Yolanda; von Polier, Georg G; Walitza, Susanne; Wallace, Gregory L; Wang, Zhen; Wolfers, Thomas; Yoncheva, Yuliya N; Yun, Je-Yeon; Zanetti, Marcus V; Zhou, Fengfeng; Ziegler, Georg C; Zierhut, Kathrin C; Zwiers, Marcel P; Thompson, Paul M; Stein, Dan J; Buitelaar, Jan; Franke, Barbara; van den Heuvel, Odile A
OBJECTIVE:Attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and obsessive-compulsive disorder (OCD) are common neurodevelopmental disorders that frequently co-occur. The authors sought to directly compare these disorders using structural brain imaging data from ENIGMA consortium data. METHODS:-weighted whole-brain MRI data from healthy control subjects (N=5,827) and from patients with ADHD (N=2,271), ASD (N=1,777), and OCD (N=2,323) from 151 cohorts worldwide were analyzed using standardized processing protocols. The authors examined subcortical volume, cortical thickness, and cortical surface area differences within a mega-analytical framework, pooling measures extracted from each cohort. Analyses were performed separately for children, adolescents, and adults, using linear mixed-effects models adjusting for age, sex, and site (and intracranial volume for subcortical and surface area measures). RESULTS:No shared differences were found among all three disorders, and shared differences between any two disorders did not survive correction for multiple comparisons. Children with ADHD compared with those with OCD had smaller hippocampal volumes, possibly influenced by IQ. Children and adolescents with ADHD also had smaller intracranial volume than control subjects and those with OCD or ASD. Adults with ASD showed thicker frontal cortices compared with adult control subjects and other clinical groups. No OCD-specific differences were observed across different age groups and surface area differences among all disorders in childhood and adulthood. CONCLUSIONS:The study findings suggest robust but subtle differences across different age groups among ADHD, ASD, and OCD. ADHD-specific intracranial volume and hippocampal differences in children and adolescents, and ASD-specific cortical thickness differences in the frontal cortex in adults, support previous work emphasizing structural brain differences in these disorders.
PMID: 32539527
ISSN: 1535-7228
CID: 4484542

Dissemination Strategies to Accelerate the Policy Impact of Children's Mental Health Services Research

Purtle, Jonathan; Nelson, Katherine L; Bruns, Eric J; Hoagwood, Kimberly E
The United States is in the midst of a children's mental health crisis, with rates of depression, anxiety, and suicide increasing precipitously. Evidence produced by children's mental health services research can help address this crisis by informing public policy decisions about service delivery, system design, and investments in the social determinants of mental health. Unfortunately, the policy impact of children's mental health services research is limited because evidence often fails to reach policy makers, be responsive to their needs, resonate with their worldview, or reflect the contexts in which they make decisions. Dissemination strategies-defined as the development and targeted distribution of messages and materials about research evidence pertaining to a specific issue or intervention-can help address these challenges. Yet, limited integrated guidance exists to inform the design of such strategies. This article addresses this need by synthesizing the results of empirical studies to provide guidance about how to enhance the dissemination of children's mental health services research to policy makers. The article provides four recommendations about the content of policy maker-focused dissemination materials, discusses how strategic framing and message tailoring can increase the chances that evidence is persuasive to policy makers, and highlights strategies to ensure that evidence reaches policy makers.
PMID: 32517640
ISSN: 1557-9700
CID: 4489592

The Differential Effect of Anxiety and ADHD Symptoms on Inhibitory Control and Sustained Attention for Threat Stimuli: A Go/No-Go Eye-Movement Study

Manoli, Athina; Liversedge, Simon P; Sonuga-Barke, Edmund J S; Hadwin, Julie A
Objective: This study examined the synergistic effects of ADHD and anxiety symptoms on attention and inhibitory control depending on the emotional content of the stimuli. Method: Fifty-four typically developing individuals (27 children/adolescents and 27 adults) completed an eye-movement based emotional Go/No-Go task, using centrally presented (happy, angry) faces and neutral/symbolic stimuli. Sustained attention was measured through saccade latencies and saccadic omission errors (Go trials), and inhibitory control through saccadic commission errors (No-Go trials). ADHD and anxiety were assessed dimensionally. Results: Elevated ADHD symptoms were associated with more commission errors and slower saccade latencies for angry (vs. happy) faces. In contrast, angry faces were linked to faster saccade onsets when anxiety symptoms were high, and this effect prevailed when both anxiety and ADHD symptoms were high. Conclusion: Social threat impacted performance in individuals with sub-clinical anxiety and ADHD differently. The effects of anxiety on threat processing prevailed when both symptoms were high.
PMID: 32513052
ISSN: 1557-1246
CID: 4478032

Thoughtful feelings

LeDoux, Joseph E
In this My Word, Joseph LeDoux describes how his four-decade career exploring how non-conscious processes involving the amygdala detect and respond to danger has contributed to the 'amygdala fear center' meme, a view he does not endorse. The conscious experience of fear, he tells us here, is not wired into the amygdala, but is instead a cognitively assembled understanding that you are in harm's way based on non-conscious memories, schemas, and mental models.
PMID: 32516605
ISSN: 1879-0445
CID: 4489572

Prediction of social behavior in autism spectrum disorders: Explicit versus implicit social cognition

Keifer, Cara M; Mikami, Amori Yee; Morris, James P; Libsack, Erin J; Lerner, Matthew D
LAY ABSTRACT/UNASSIGNED:Difficulties with social communication and interaction are a hallmark feature of autism spectrum disorder. These difficulties may be the result of problems with explicit social cognition (effortful and largely conscious processes) such as learning and recalling social norms or rules. Alternatively, social deficits may stem from problems with implicit social cognition (rapid and largely unconscious processes) such as the efficient integration of social information. The goal of this study was to determine how problems in explicit and implicit social cognition relate to social behavior in 34 youth with autism spectrum disorder. We measured aspects of implicit and explicit social cognition abilities in the laboratory using behavioral, cognitive, and brain (electrophysiological) measures. We then used those measures to predict "real-world" social behavior as reported by parents, clinicians, and independent observers. Results showed that overall better aspects of implicit and explicit social cognition predicted more competent social behavior. In addition, the ability to fluidly integrate social information (implicit social cognition) was more frequently related to competent social behavior that merely knowing what to do in social situations (explicit social cognition). These findings may help with the development of interventions focusing on improving social deficits.
PMID: 32484000
ISSN: 1461-7005
CID: 4468882

Expanding attention-deficit/hyperactivity disorder service provision in urban socioeconomically disadvantaged communities: A pilot study

Chacko, Anil; Hopkins, Karen; Acri, Mary; Mendelsohn, Alan; Dreyer, Benard
Objective: Access to evidence-based psychosocial interventions for the treatment of attention-deficit/hyperactivity disorder (ADHD) is a challenge in urban, socioeconomically disadvantaged communities. Approaches that leverage existing but underdeveloped workforces and connects these with well-established settings that treat ADHD offers an opportunity to address this barrier. This pilot study focused on a preliminary test of the potential utility of paraprofessional-delivered behavioral parent training (BPT) to parents of children with ADHD being treated in a developmental behavioral pediatric practice. Method: In an open clinical trial of 7 families, Family Peer Advocate paraprofessionals delivered BPT to parents of children with ADHD. Parent reports of their child's ADHD symptoms/ oppositional defiant behaviors and functional impairment were assessed before, weekly during BPT, and immediately after BPT. Parents report of their positive and negative parenting behaviors were assessed before and immediately after BPT. Results: Findings demonstrated that participation in BPT was associated with improvements in child-and parent-level outcomes, with moderate to large effects across outcomes. Conclusions: Integrating existing service systems with oversight through pediatric psychologists offers opportunities to efficiently utilize resources, thereby increasing access to evidence-based interventions for ADHD in urban, socioeconomically disadvantaged communities. This study advances the scope of paraprofessional involvement in formal pediatric settings. In addition, it highlights the potential effectiveness of peer-to-peer delivered services.
SCOPUS:85086863575
ISSN: 2169-4826
CID: 4509962