Faculty Bibliography

BACKGROUND:The obesity epidemic in the United States affects not only adults, but children and adolescents. SOURCES OF MATERIAL/UNASSIGNED:An extensive review of the literature including 85 articles has been completed with the aim of providing the most current definitions and recommendations for this chronic condition. ABSTACT OF FINDINGS/UNASSIGNED:This article reviews the definition of pediatric obesity, the increasing prevalence of obesity in children and adolescents, genetic and environmental risk factors, as well as the unique aspects and implications of this condition and its associated comorbidities for this population in comparison to adults. Current management recommendations are also discussed which include Intensive Health Behavioral and Lifestyle Treatment (IHBLT), metabolic surgery, and pharmacologic therapy including glucago-like peptide-1 receptor agonists (GLP-1RAs). CONCLUSION/CONCLUSIONS:Childhood obesity is a unique condition in its progression and management requirements, and should be approached with a focus on prevention as well as on the high-risk individual.

BACKGROUND/UNASSIGNED:Autism spectrum disorder (ASD) shows significant clinical variability, likely due to a combination of genetic and environmental factors. Preterm birth is a known risk factor for ASD, occurring in approximately 13% of diagnosed individuals. While genetic factors contribute to preterm birth in the general population, the relationship between genetic variation, preterm birth, and ASD heterogeneity remains unclear. METHODS/UNASSIGNED:We investigated the genetic factors associated with preterm birth in 31,947 autistic individuals using data from the SPARK (Simons Foundation Powering Autism Research for Knowledge) sample. We conducted 3 ancestry-specific genome-wide association studies for African/African American, admixed American, and non-Finnish European ancestries, followed by a meta-analysis of 3308 preterm cases and 28,639 controls using METAL. Functional mapping and gene-based analyses were performed using FUMA, and genetic correlations were estimated using LDSC and Popcorn. Polygenic risk scores (PRSs) were computed with BridgePRS, using PRS of preterm birth in the general population. RESULTS/UNASSIGNED:Our study identified ancestry-specific genetic loci associated with preterm birth in ASD cases. Although the meta-analysis results were not statistically significant, the estimated single nucleotide polymorphism heritability was 14%, indicating a meaningful contribution of common genetic variants. Across ancestry groups, preterm birth status was not significantly associated with PRSs for any psychiatric or medical conditions analyzed. However, polygenic liability to preterm birth in the general population was linked to several congenital anomalies after multiple testing adjustments. CONCLUSIONS/UNASSIGNED:These findings highlight the importance of diverse ancestries and early-life exposures in understanding ASD heterogeneity. Future research should replicate these findings in larger samples and explore rare variants associated with preterm birth to better understand the relationship between gestational duration and clinical and genetic differences in ASD.

Evidence from rodent studies highlights the mother as a safety cue that regulates fear and biology. However, when infant rats are exposed to rough maternal care (i.e., threat), their brains show atypical patterns of activity in response to maternal cues. In humans, childhood adversity (i.e., international adoption, involvement with Child Protective Services) is also associated with differential neural responses to caregiver cues. However, to date, no studies have tested the hypothesis that childhood adversity characterized by threat (e.g., physical abuse, domestic violence) influences neural responses to caregiver cues in children, as suggested by the rodent literature. This study investigates associations between threat experiences and neural responses to caregiver cues in young children using fMRI. The sample included 148 young children (52.02% Male; M_age = 6.45 years). Across the entire sample, children demonstrated heightened recruitment in regions associated with salience detection, visual processing, and social cognition in response to caregiver cues (relative to stranger cues). Moreover, threat experiences were associated with greater recruitment of the insula in response to caregiver cues (relative to stranger cues), even when controlling for deprivation experiences. The present findings contribute to a growing field of research linking childhood adversity to brain function, suggesting that experiences of threat may disrupt how children process caregiver cues at the neural level. Moreover, these results are in line with rodent studies that underscore threat as a potential disruptor of dyadic interaction between children and their caregivers. SUMMARY: Children demonstrate widespread brain activation in response to caregiver cues. Threat experiences are linked to heightened activation of the insula, a region implicated in salience detection and primary visceral processing, in response to caregiver cues. These findings suggest that caregiver cue processing might be a mechanism through which threat impacts the caregiver-child relationship, leading to cascading effects on mental health.

BACKGROUND:The COVID-19 pandemic exacerbated challenges faced by pregnant women, introducing new risks and intensifying existing disparities, particularly among those routinely experiencing race- and ethnicity-based discrimination. It remains unclear how the pandemic affected perceptions of perinatal quality of care (QoC). OBJECTIVES/OBJECTIVE:To explore mothers' experiences of pregnancy, birth, and the early postpartum period during the early COVID-19 pandemic, attending to both health care encounters and to the broader structural and social forces shaping those experiences. DESIGN/METHODS:The COVID-19 Mother Baby Outcomes (COMBO) Initiative is a longitudinal, prospective cohort study investigating maternal-child outcomes among women from a predominantly low socioeconomic status, Latinx community in New York City who delivered during the pandemic. This qualitative substudy analyzed a subset of participants using modified grounded theory. METHODS:Semi-structured interviews explored perinatal and pandemic experiences, perceptions of inequitable or poor treatment, and protective factors among 64 participants purposively sampled from the parent cohort. Analysis focused on 48 transcripts highlighting discrimination-related themes, which were transcribed and systematically coded using both inductive and deductive approaches. RESULTS:phenomenon. CONCLUSION/CONCLUSIONS:Giving birth during the pandemic worsened perceptions of perinatal QoC, with discrimination compounding negative experiences. Findings underscore the link between care quality and trust in medical institutions, highlighting the need for evidence-based crisis protocols that both reduce unnecessary risk while preserving patient agency, particularly for marginalized populations. The pandemic exposed longstanding structural inequities, presenting an opportunity to address these patient-level manifestations and strengthen support for populations facing systemic barriers.

Individuals with severe mental illness (SMI) face significantly reduced life expectancy, mainly driven by natural causes such as cardiovascular disease, pulmonary disease, cancer, and stroke. Although medical care has advanced, the mortality gap between individuals with SMI and the general population has continued to expand in many countries over recent decades. This disparity is exacerbated by systemic healthcare inequities, fragmented healthcare, insufficient use of preventive measures, and the burden of multimorbidity. This paper proposes six actionable strategies to reduce the excess mortality associated with SMI by integrating physical healthcare into psychiatric services. Across all recommendations, we explicitly embed lifestyle interventions, especially structured physical activity given its comparatively stronger evidence base in SMI, alongside sleep and nutrition support delivered through pragmatic, accessible programs. First, psychoeducation should be expanded to include physical health literacy. Second, structured smoking cessation programs must be implemented. Third, early identification and management of obesity, including pharmacological interventions, should be prioritized. Fourth, hypertension should be routinely screened and treated within psychiatric settings. Fifth, dyslipidaemia and diabetes require systematic monitoring and timely initiation of statins, metformin and GLP-1 receptor agonists. Sixth, these interventions must be delivered through integrated care models that ensure continuity, optimal self-management, and long-term outcome monitoring. Together, these six approaches offer a framework to narrow the mortality gap between people with SMI and the general population, as well as support a shift toward holistic, person-centered care. We synthesise the evidence on physical health disparities in SMI and provide practical, evidence-based recommendations for psychiatric settings. Together, these strategies offer a feasible, person-centered framework to improve health outcomes and reduce premature mortality in individuals with SMI.

Accumulating evidence from neuroimaging studies has implicated widespread disruptions in brain connectivity in autism spectrum disorder (ASD), with altered connectivity patterns reported as early as infancy. However, it remains unexplored whether functional connectivity differences are evident prior to birth in the brain of fetuses who will later exhibit autistic traits in early childhood. In this study, we leveraged a longitudinal sample of 62 children with both quality-assured fetal brain resting-state MRI data and a parent-report measure of autistic traits at age 3 years. Enrichment analysis was employed to identify network pairs significantly correlated with autistic traits. Specificity analysis was conducted by additionally controlling for other childhood psychopathology. Our results demonstrated significant correlations between autistic traits and functional connectivity in the cingulate-left temporal and right prefrontal-left operculum network pairs in both the primary and specificity analyses. Visual network connectivity with prefrontal and opercular regions was also implicated. These network pairs demonstrated positive associations with autistic traits, indicating that stronger connectivity between these network pairs was associated with higher autistic traits. In contrast, weaker cerebellum-right operculum connectivity was associated with higher autistic traits, uniquely in the specificity analysis. This study provides the first in vivo evidence prospectively linking variation in functional network connectivity in the fetal brain to autistic traits in toddlerhood. These findings extend the current understanding of the prenatal brain origins of ASD and highlight the potential of fetal rs-fMRI as a tool to identify neural signatures related to social-emotional development and ASD likelihood.

BACKGROUND:Risky sexual behaviours (RSB) and attention deficit hyperactivity disorder (ADHD) are both major concerns among university students. However, their association remains insufficiently understood. This study aimed to evaluate the relationship between ADHD symptoms and a broad range of RSB in university students. METHODS:A total of 13 085 French students enrolled in the i-Share (Internet-based Students' Health Research Enterprise study (mean age: 20.6 years, SD=2.4) completed self-reported questionnaires assessing ADHD symptoms (Adult Self-Report Scale V.1.1), RSB, sociodemographic characteristics and alcohol and cannabis use. Logistic regression models were used to examine the cross-sectional associations between ADHD symptoms and RSB, adjusting for relevant confounders. RESULTS:A high level of ADHD symptoms was observed in 5.3% of students. In multivariate models, ADHD symptoms were associated with a wide range of RSB, including early first sexual intercourse (adjusted OR (aOR) 1.26; 95% CI 1.06 to 1.51), inconsistent condom use in the last 12 months (aOR 1.26; 95% CI 1.05 to 1.51), diagnosis of a sexually transmitted infection in the last 12 months (aOR 1.60; 95% CI 1.16 to 2.22) and having had multiple sexual partners in the last 12 months (adjusted incidence rate ratio 1.20; 95% CI 1.14 to 1.27). Among female students, ADHD symptoms were associated with lower current use of any form of contraception (aOR 0.59; 95% CI 0.48 to 0.71), and higher odds of having ever used emergency contraception (aOR 1.22; 95% CI 1.02 to 1.47), and having ever had an abortion (aOR 1.77; 95% CI 1.21 to 2.58). CONCLUSIONS:University students with a high level of ADHD symptoms are at increased risk of engaging in a wide range of RSB. Targeted preventive strategies may be particularly beneficial for this population.

BACKGROUND/UNASSIGNED:Sleep deprivation among young adults is a pervasive problem driven by high levels of stress, excessive screen time, disruptive school and living environments, irregular sleep habits, high academic demands, early school start times, and low rates of physical activity. Difficulties with emotion regulation, high rates of anxiety and depression, and poor academic performance are only a few of the struggles faced by sleep deprived young adults. Although sleep apps and wearables are increasingly popular, knowledge of positive sleep health without the proper tools to motivate and instill behavior change can contribute to anxiety and negative cognitions about sleep, which only further fuel the problem. METHODS/UNASSIGNED:In this report we describe a series of undergraduate university curricula, housed within a unique undergraduate department, designed to enhance not only knowledge of sleep, but also associated behavior changes that have been demonstrated to improve sleep, mood, and anxiety among university students. RESULTS/UNASSIGNED:Numerous courses within the Child and Adolescent Mental Health Studies (CAMS) department at New York University address sleep directly, teaching students about the science of sleep and how they can improve their own sleep to enhance overall wellbeing. Our work to date demonstrates that students find these courses desirable and impactful. CONCLUSION/UNASSIGNED:College courses present a unique opportunity to improve the health and wellbeing of young adults by teaching about sleep health. Undergraduate campuses may represent an underutilized locale from which to address population health.