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Department/Unit:Child and Adolescent Psychiatry

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Identifying the Medical Lethality of Suicide Attempts Using Network Analysis and Deep Learning: Nationwide Study

Kim, Bora; Kim, Younghoon; Park, C Hyung Keun; Rhee, Sang Jin; Kim, Young Shin; Leventhal, Bennett L; Ahn, Yong Min; Paik, Hyojung
BACKGROUND:Suicide is one of the leading causes of death among young and middle-aged people. However, little is understood about the behaviors leading up to actual suicide attempts and whether these behaviors are specific to the nature of suicide attempts. OBJECTIVE:The goal of this study was to examine the clusters of behaviors antecedent to suicide attempts to determine if they could be used to assess the potential lethality of the attempt. To accomplish this goal, we developed a deep learning model using the relationships among behaviors antecedent to suicide attempts and the attempts themselves. METHODS:This study used data from the Korea National Suicide Survey. We identified 1112 individuals who attempted suicide and completed a psychiatric evaluation in the emergency room. The 15-item Beck Suicide Intent Scale (SIS) was used for assessing antecedent behaviors, and the medical outcomes of the suicide attempts were measured by assessing lethality with the Columbia Suicide Severity Rating Scale (C-SSRS; lethal suicide attempt >3 and nonlethal attempt ≤3). RESULTS:Using scores from the SIS, individuals who had lethal and nonlethal attempts comprised two different network nodes with the edges representing the relationships among nodes. Among the antecedent behaviors, the conception of a method's lethality predicted suicidal behaviors with severe medical outcomes. The vectorized relationship values among the elements of antecedent behaviors in our deep learning model (E-GONet) increased performances, such as F1 and area under the precision-recall gain curve (AUPRG), for identifying lethal attempts (up to 3% for F1 and 32% for AUPRG), as compared with other models (mean F1: 0.81 for E-GONet, 0.78 for linear regression, and 0.80 for random forest; mean AUPRG: 0.73 for E-GONet, 0.41 for linear regression, and 0.69 for random forest). CONCLUSIONS:The relationships among behaviors antecedent to suicide attempts can be used to understand the suicidal intent of individuals and help identify the lethality of potential suicide attempts. Such a model may be useful in prioritizing cases for preventive intervention.
PMID: 32673253
ISSN: 2291-9694
CID: 4528362

Functional linear regression model with randomly censored data: Predicting conversion time to Alzheimer's disease

Yang, Seong J.; Shin, Hyejin; Lee, Sang Han; Lee, Seokho
ISI:000539101800008
ISSN: 0167-9473
CID: 4525122

Exposure therapy for generalized anxiety disorder in children and adolescents

Chapter by: Davis, Jordan P; Palitz, Sophie A; Norris, Lesley A; Phillips, Katherine E; Crane, Margaret E; Kendall, Philip C
in: Exposure Therapy for Children with Anxiety and OCD : Clinician's Guide to Integrated Treatment by Peris, TS; et al [Eds]
[S.l.] : Academic Press, 2020
pp. 221-243
ISBN:
CID: 4521402

Smell-based memory training: Evidence of olfactory learning and transfer to the visual domain

Olofsson, Jonas K; Ekström, Ingrid; Lindström, Joanna; Syrjänen, Elmeri; Stigsdotter-Neely, Anna; Nyberg, Lars; Jonsson, Sara; Larsson, Maria
Human and non-human animal research converge to suggest that the sense of smell, olfaction, has a high level of plasticity and is intimately associated with visual-spatial orientation and memory encoding networks. We investigated whether olfactory memory training would lead to transfer to an untrained visual memory task, as well as untrained olfactory tasks. We devised a memory intervention to compare transfer effects generated by olfactory and non-olfactory (visual) memory training. Adult participants were randomly assigned to daily memory training for about 40 days with either olfactory or visual tasks, that had a similar difficulty level. Results showed that while visual training did not produce transfer to the olfactory memory task, olfactory training produced transfer to the untrained visual memory task. Olfactory training also improved participants' performance on odor discrimination and naming tasks, such that they reached the same performance level as a high-performing group of wine professionals. Our results indicate that the olfactory system is highly responsive to training, and we speculate that the sense of smell may facilitate transfer of learning to other sensory domains. Further research is however needed in order to replicate and extend our findings.
PMID: 32645143
ISSN: 1464-3553
CID: 4518662

Online Developmental Science to Foster Innovation, Access, and Impact

Sheskin, Mark; Scott, Kimberly; Mills, Candice M; Bergelson, Elika; Bonawitz, Elizabeth; Spelke, Elizabeth S; Fei-Fei, Li; Keil, Frank C; Gweon, Hyowon; Tenenbaum, Joshua B; Jara-Ettinger, Julian; Adolph, Karen E; Rhodes, Marjorie; Frank, Michael C; Mehr, Samuel A; Schulz, Laura
We propose that developmental cognitive science should invest in an online CRADLE, a Collaboration for Reproducible and Distributed Large-Scale Experiments that crowdsources data from families participating on the internet. Here, we discuss how the field can work together to further expand and unify current prototypes for the benefit of researchers, science, and society.
PMCID:7331515
PMID: 32624386
ISSN: 1879-307x
CID: 4517102

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

Psychoeducation Interventions for Parents and Teachers of Children and Adolescents with ADHD: a Systematic Review of the Literature [Review]

Dahl, Victoria; Ramakrishnan, Amrita; Spears, Angela Page; Jorge, Annlady; Lu, Janice; Bigio, Nina Abraham; Chacko, Anil
ISI:000519705300004
ISSN: 1056-263x
CID: 4511102

An International Examination of the Effectiveness of Functional Family Therapy (FFT) in a Danish Community Sample

Vardanian, Maria Michelle; Scavenius, Christoffer; Granski, Megan; Chacko, Anil
Youth behavior problems have increased in prevalence in Scandinavian countries. Functional Family Therapy (FFT) has been shown to be an effective intervention across diverse populations and international contexts. The current study examines the effectiveness of FFT within a Danish-community sample in a pre-post comparison design and includes 687 families. Observed outcomes included both parent- and/or youth- reported domains of youth behavior, family dysfunction, school attendance and performance, and substance use. Significant improvements were found in youth behavior, family functioning, and school-related outcomes (e.g., like of school and truancy) despite experiencing a 60% attrition rate in our sample postintervention. This study provides evidence for the effectiveness of FFT on a wide scale in a Scandinavian context, adding to previous research that supports the transportability of this intervention.
PMID: 31515824
ISSN: 1752-0606
CID: 4511182

Years of life lost due to the psychosocial consequences of COVID-19 mitigation strategies based on Swiss data

Moser, Dominik A; Glaus, Jennifer; Frangou, Sophia; Schechter, Daniel S
BACKGROUND:The pandemic caused by coronavirus disease 2019 (COVID-19) has forced governments to implement strict social mitigation strategies to reduce the morbidity and mortality from acute infections. These strategies, however, carry a significant risk for mental health, which can lead to increased short-term and long-term mortality and is currently not included in modeling the impact of the pandemic. METHODS:We used years of life lost (YLL) as the main outcome measure, applied to Switzerland as an example. We focused on suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, and social isolation, as these are known to increase YLL in the context of imposed restriction in social contact and freedom of movement. We stipulated a minimum duration of mitigation of 3 months based on current public health plans. RESULTS:The study projects that the average person would suffer 0.205 YLL due to psychosocial consequence of COVID-19 mitigation measures. However, this loss would be entirely borne by 2.1% of the population, who will suffer an average of 9.79 YLL. CONCLUSIONS:The results presented here are likely to underestimate the true impact of the mitigation strategies on YLL. However, they highlight the need for public health models to expand their scope in order to provide better estimates of the risks and benefits of mitigation.
PMCID:7303469
PMID: 32466820
ISSN: 1778-3585
CID: 4510312

Context- and Subgroup-Specific Language Changes in Individuals Who Develop PTSD After Trauma

Todorov, German; Mayilvahanan, Karthikeyan; Cain, Christopher; Cunha, Catarina
Post-traumatic stress disorder (PTSD) is a very common condition with more than 3 million new cases per year in the US alone. The right diagnosis in a timely manner is key to ensuring a prompt treatment that could lead to a full recovery. Unfortunately, avoidance of trauma reminders, social stigma, self-presentation, and self-assessment biases often prevent individuals from seeking timely evaluation, leading to delays in treatment and suboptimal outcomes. Previous studies show that various mental health conditions are associated with distinct patterns of language use. Analyzing language use may also help to avoid response bias in self-reports. In this study, we analyze text data from online forum users, showing that language use differences between PTSD sufferers and controls. In all groups of PTSD sufferers, the usage of singular first-person pronouns was higher and that of plural first-person pronouns was lower than in control groups. However, the analysis of other word categories suggests that subgroups of people with the same mental health disorder (here PTSD) may have salient differences in their language use, particularly in word usage frequencies. Additionally, we show that word usage patterns may vary depending on the type of the text analyzed. Nevertheless, more studies will be needed to increase precision by further examine a variety of text types and different comorbidities. If properly developed, such tools may facilitate earlier PTSD diagnosis, leading to timely support and treatment, which are associated with better outcomes.
PMCID:7243708
PMID: 32499747
ISSN: 1664-1078
CID: 4510722