Faculty Bibliography

BACKGROUND:The United States Preventive Services Task Force recommends that clinicians provide or refer pregnant and postpartum women who are at an increased risk of perinatal depression to counseling interventions. However, this prevention goal requires effective interventions that reach women at risk of, but before, the development of a depressive disorder. OBJECTIVE:We describe a pilot efficacy trial of a novel dyadic intervention to prevent common maternal mental health disorders, that is, Practical Resources for Effective Postpartum Parenting, in a sample of women at risk of maternal mental health disorders based on poverty status. We hypothesized that Practical Resources for Effective Postpartum Parenting compared with enhanced treatment as usual would reduce symptoms of maternal mental health disorders after birth. STUDY DESIGN/METHODS:A total of 60 pregnant women who were recruited from obstetrical practices at Columbia University Irving Medical Center were randomized to the Practical Resources for Effective Postpartum Parenting (n=30) or enhanced treatment as usual (n=30) intervention. The Edinburgh Postnatal Depression Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Patient Health Questionnaire were used to compare maternal mood at 6 weeks, 10 weeks, and 16 weeks after delivery. RESULTS:At 6 weeks after delivery, women randomized to Practical Resources for Effective Postpartum Parenting had lower mean Edinburgh Postnatal Depression scores (P=.018), lower mean Hamilton Depression scores (P<.001), and lower mean Hamilton Anxiety scores (P=.041); however, the incidence of postpartum mental disorders did not differ by treatment group. CONCLUSION/CONCLUSIONS:The Practical Resources for Effective Postpartum Parenting, which is an intervention integrated within obstetrical care, improves subclinical symptomology for at-risk dyads at a crucial time in the early postpartum period; however, our study did not detect reductions in the incidence of postpartum mental disorders.

The corpus callosum serves as a crucial organization for understanding the information integration between the two hemispheres. Our previous study explored the functional connectivity between the corpus callosum and white-matter functional networks (WM-FNs), but the corresponding physical connectivity remains unknown. The current study uses the resting-state fMRI of Human Connectome Project data to identify ten WM-FNs in 108 healthy subjects, and then independently maps the structural and functional connectivity between the corpus callosum and above WM-FNs using the diffusion tensor images (DTI) tractography and resting-state functional connectivity (RSFC). Our results demonstrated that the structural and functional connectivity between the human corpus callosum and WM-FNs have the following high overall correspondence: orbitofrontal WM-FN, DTI map = 89% and RSFC map = 92%; sensorimotor middle WM-FN, DTI map = 47% and RSFC map = 77%; deep WM-FN, DTI map = 50% and RSFC map = 79%; posterior corona radiata WM-FN, DTI map = 82% and RSFC map = 73%. These findings reinforce the notion that the corpus callosum has unique spatial distribution patterns connecting to distinct WM-FNs. However, important differences between the structural and functional connectivity mapping results were also observed, which demonstrated a synergy between DTI tractography and RSFC toward better understanding the information integration of primary and higher-order functional systems in the human brain.

OBJECTIVE/UNASSIGNED:To synthesize the evidence on the efficacy of ADHD teacher training interventions for teachers' ADHD knowledge and reducing pupils' ADHD-type behaviors. METHOD/UNASSIGNED:Six electronic databases were systematically searched up to 14/04/20. Meta-analyses were performed to pool standardized mean differences (SMD). RESULTS/UNASSIGNED:29 studies were included in the systematic review, and 22 meta-analyzed. SMD for teacher knowledge within subjects at post-test and follow-up was 1.96 (95% confidence interval = 1.48, 2.43) and ‒1.21 (-2.02, -0.41) respectively. Between subjects analyses at post-test showed SMD = 1.56 (0.52, 2.59), with insufficient data at follow-up. At post-test, SMD for pupils' behavior within and between subjects was 0.78 (0.37, 1.18), and 0.71 (-0.11, 1.52), respectively. Medium-to-high risk of bias was found in all but one study. CONCLUSION/UNASSIGNED:ADHD teacher training programs may be effective in initially improving ADHD teachers' knowledge. There is inconsistent evidence for their efficacy to reduce students' ADHD-type behaviors.

Prior ex vivo histological postmortem studies of autism spectrum disorder (ASD) have shown gray matter microstructural abnormalities, however, in vivo examination of gray matter microstructure in ASD has remained scarce due to the relative lack of non-invasive methods to assess it. The aim of this work was to evaluate the feasibility of employing diffusional kurtosis imaging (DKI) to describe gray matter abnormalities in ASD in vivo. DKI data were examined for 16 male participants with a diagnosis of ASD and IQ>80 and 17 age- and IQ-matched male typically developing (TD) young adults 18-25 years old. Mean (MK), axial (AK), radial (RK) kurtosis and mean diffusivity (MD) metrics were calculated for lobar and sub-lobar regions of interest. Significantly decreased MK, RK, and MD were found in ASD compared to TD participants in the frontal and temporal lobes and several sub-lobar regions previously associated with ASD pathology. In ASD participants, decreased kurtosis in gray matter ROIs correlated with increased repetitive and restricted behaviors and poor social interaction symptoms. Decreased kurtosis in ASD may reflect a pathology associated with a less restrictive microstructural environment such as decreased neuronal density and size, atypically sized cortical columns, or limited dendritic arborizations.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adolescents are more likely to report suicidality and worse mental health than their heterosexual peers. We conducted a systematic review to examine the relationship between positive school climate and suicidality and mental health among LGBTQ adolescents. We searched the literature using PubMed, PsycINFO, and CINAHL. Six studies met inclusion criteria, and all had low to moderate risks of bias. Results indicate that LGBTQ students in schools with more positive school climates were at lower risk of suicidality and reported fewer depressive symptoms compared to students in less positive school climates. Being at the forefront of health in schools, school nurses have the opportunity to advocate for changes in school environments that promote positive mental health for all youth, including LGBTQ adolescents.

What is the role of errors in infants' acquisition of basic skills such as walking, skills that require immense amounts of practice to become flexible and generative? Do infants change their behaviors based on negative feedback from errors, as suggested by "reinforcement learning" in artificial intelligence, or do errors go largely unmarked so that learning relies on positive feedback? We used falling as a model system to examine the impact of errors in infant development. We examined fall severity based on parent reports of prior falls and videos of 563 falls incurred by 138 13- to 19-month-old infants during free play in a laboratory playroom. Parent reports of notable falls were limited to 33% of infants and medical attention was limited to 2% of infants. Video-recorded falls were typically low-impact events. After falling during free play in the laboratory, infants rarely fussed (4% of falls), caregivers rarely showed concern (8% of falls), and infants were back at play within seconds. Impact forces were mitigated by infants' effective reactive behaviors, quick arrest of the fall before torso or head impact, and small body size. Moreover, falling did not alter infants' subsequent behavior. Infants were not deterred from locomotion or from interacting with the objects and elevations implicated in their falls. We propose that a system which discounts the impact of errors in early stages of development encourages infants to practice basic skills such as walking to the point of mastery.

The purpose of the study was to determine the moderating role of baseline levels of attention-deficit/hyperactivity disorder symptoms on parent- and child-level outcomes following the Caring in Chaos behavioral parent training intervention at immediate post-intervention and follow-up assessment. One-hundred sixty-one children between the ages of 3-9 (Mean age = 7.6; 73% male) with parental concerns of attention-deficit/hyperactivity disorder were randomly assigned to the Caring in Chaos behavioral parent training intervention, a task-shifted intervention delivered by a volunteer workforce across 12 community-based settings in Denmark, or to a wait-list control condition. Parent report of parenting behavior, sense of competence, stress, depressive symptoms as well as child attention-deficit/hyperactivity disorder symptoms and child noncompliance were collected at baseline, immediate post-intervention and at follow-up assessment points. Analyses indicated no moderating effect of baseline attention-deficit/hyperactivity disorder symptoms on parent- and child-outcomes, with no to large effects at post-treatment with maintenance of effects at follow-up assessment. The results of these analyses suggest that the Caring in Chaos behavioral parent training intervention can be utilized with young children with varying levels of attention-deficit/hyperactivity disorder symptoms. These findings further support that community-based interventions delivered by nonprofessionals may serve as a beneficial option to increase availability and access to behavioral parent training for the treatment of attention-deficit/hyperactivity disorder.HighlightsCommunity-based BPT programs delivered by volunteers are a feasible alternative to commercial interventions.Homegrown interventions can improve access to treatments that typically require extensive cost and time.Baseline ADHD symptoms did not moderate parent and child outcomes of the Caring in Chaos intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

The prevalence of mental health problems among children (ages 0-21) in the United States remains unacceptably high and, post-COVID-19, is expected to increase dramatically. Decades of psychological knowledge about effective treatments should inform the delivery of better services. Dissemination and implementation (D&I) science has been heralded as a solution to the persistent problem of poor quality services and has, to some extent, improved our understanding of the contexts of delivery systems that implement effective practices. However, there are few studies demonstrating clear, population-level impacts of psychological interventions on children. Momentum is growing among communities, cities, states, and some federal agencies to build "health in all policies" to address broad familial, social, and economic factors known to affect children's healthy development and mental health. These health policy initiatives offer a rare opportunity to repurpose D&I science, shifting it from a primary focus on evidence-based practice implementation, to a focus on policy development and implementation to support child and family health and well-being. This shift is critical as states develop policy responses to address the health and mental health impacts of the COVID-19 pandemic on already-vulnerable families. We provide a typology for building research on D&I and children's mental health policy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background/UNASSIGNED:Post-COVID syndrome is increasingly recognized by the medical community but has not been studied exclusively in young adults. This preliminary report investigates the prevalence and features of protracted symptoms in non-hospitalized university students who experienced mild-to-moderate acute illness. Methods/UNASSIGNED:148 students completed an online study to earn research credit for class. Data from COVID-19 positive participants with symptoms ≥28 days (N=22) were compared to those who fully recovered (N=21) and those not diagnosed with COVID-19 (N=58). Results/UNASSIGNED:51% of participants who contracted COVID-19 (N=43) experienced symptoms ≥28 days and were classified as having post-COVID syndrome; all but one (96%) were female. During acute illness the post-COVID group, compared to those who fully recovered, experienced significantly more chest pain (64% vs 14%; P=.002), fatigue (86% vs 48%; P=.009), fever (82% vs 48%; P=.02), olfactory impairment (82% vs 52%; P=.04), headaches (32% vs 5%; P<.05), and diarrhea (32% vs 5%; P<.05). Compared to those not diagnosed with COVID-19, the post-COVID syndrome group more frequently experienced exercise intolerance (43% vs. 0%; P<.001), dyspnea (43% vs. 0%; P<.001), chest pain (31% vs 7%; P=.002), olfactory impairment (19% vs 0%; P=.004), lymphadenopathy (19% vs 0%; P=.004), gustatory impairment (14% vs 0%; P=.02), and appetite loss (36% vs 14%; P=.02). Interpretation/UNASSIGNED:Our results contradict the perception that this "yet to be defined" post-COVID syndrome predominantly affects middle-aged adults and suggest that exercise intolerance, dyspnea, chest pain, chemosensory impairment, lymphadenopathy, rhinitis, and appetite loss may differentiate post-COVID syndrome from general symptoms of pandemic, age, and academic related stress. These findings are also consistent with previous reports that females are more vulnerable to this post viral syndrome. Large-scale population-based studies are essential to discerning the magnitude and characterization of post-COVID syndrome in young adults as well as more diverse populations.