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Department/Unit:Child and Adolescent Psychiatry

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The effectiveness of PTSD treatment for adolescents in the juvenile justice system: A systematic review

Baetz, Carly Lyn; Branson, Christopher Edward; Weinberger, Emily; Rose, Raquel E; Petkova, Eva; Horwitz, Sarah McCue; Hoagwood, Kimberly Eaton
OBJECTIVE:The objective of this study was to systematically review existing empirical evidence on the effectiveness of trauma-specific treatment for justice-involved adolescents and evaluate the impact of the interventions on the reduction of posttraumatic stress disorder (PTSD) symptoms, co-occurring mental health symptoms, and juvenile justice-related outcomes. METHOD/METHODS:A systematic literature search was conducted using a four-step process. Studies were included if they used a manualized, trauma-specific treatment with at least one control or comparison group and a sample comprised exclusively of justice-involved adolescents. RESULTS:In total, 1,699 unique records were identified, and 56 full-text articles were reviewed, of which 7 met the criteria for inclusion. Trauma-specific interventions led to a decrease in PTSD symptoms compared with a control group in four of seven studies, and two studies also demonstrated a reduction in trauma-related depressive symptoms. Finally, juvenile justice-related outcomes were measured in only four studies, with one study finding moderately reduced rates of delinquent behavior and recidivism following trauma-specific treatment. CONCLUSIONS:The results from this systematic review suggest that trauma-specific treatment interventions have promising effects for justice-involved adolescents. However, the results reveal a dearth of quality intervention research for treating youths with histories of trauma in the justice system. Significant gaps in the literature are highlighted, and suggestions for future directions are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
PMID: 34410809
ISSN: 1942-969x
CID: 5069842

Parenting style history in predicting harsh parenting and child abuse risk across the transition to parenthood: Role of gender

Morgan, Casie H; Pu, Doris F; Rodriguez, Christina M
BACKGROUND:Intergenerational transmission of abuse processes imply that individuals abused as children are more likely to abuse their own children when they become parents, with similar intergenerational patterns observed for parenting styles. OBJECTIVE:The present study addresses an important gap in the literature regarding the intergenerational cycle, investigating how perceived parenting style history predicts mothers' and fathers' child abuse risk across the transition to parenthood, with particular attention to the role of gender by comparing cross-gender and same-gender grandparent-parent dyads. PARTICIPANTS AND METHODS:The sample is drawn from a four-wave longitudinal study that enrolled 203 families beginning the final trimester of mothers' pregnancy until children were four years old. Parents responded to measures on parenting style history received from both their mothers and fathers as well as measures of their own child abuse risk, parent-child aggression, and personal parenting style. RESULTS:Mothers demonstrated more same-gender effects, whereas fathers demonstrated more cross-gender effects-both patterns supportive of a tendency to follow maternal influences when considering child abuse risk. With regards to behavior, both mothers' and fathers' reports of parent-children aggression were most influenced by perceived harsh parenting received from their fathers. CONCLUSIONS:Future development of parenting interventions could be more individualized to the participating parent's reported personal history of parenting style and gender.
PMCID:8993540
PMID: 35276532
ISSN: 1873-7757
CID: 5401382

Adjunctive antidepressants for the acute treatment of bipolar depression: A systematic review and meta-analysis

Hu, Yuliang; Zhang, Huijuan; Wang, Hongyan; Wang, Chris; Kung, Simon; Li, Chunbo
BACKGROUND:The depressive phase of bipolar disorder causes significant functional impairment and disease burden. The efficacy and safety of antidepressants in the treatment of bipolar depression has long been a subject of debate. AIMS:To synthesize evidence of the effectiveness, risk of mood switching, and tolerability of adjunctive antidepressants in acute bipolar depression compared to using mood stabilizers or antipsychotics alone. METHOD:Multiple databases were searched for randomized controlled trials, including open label and double-blinded, for patients ages 18 or older with acute bipolar depression, comparing efficacy and adverse events in those who used adjunctive antidepressants versus without. Risk of bias and outcomes were assessed using the Cochrane Risk of Bias Tool. This study has PROSPERO registration CRD42016037701. RESULTS:Nineteen studies met inclusion criteria. Adjunctive antidepressants showed no significant effect on improving response rate (RR=1.10, 95%CI: 0.98-1.23). Subgroup analysis showed that adjunctive antidepressants with antipsychotics had a small but significantly better response rate compared to antipsychotics alone, which was not seen with adjunctive antidepressants with mood stabilizers. However, that finding was limited by studies predominantly using olanzapine as the antipsychotic medication. Adjunctive antidepressants had no clinically significant impact (but a small statistically significant impact) on improving depressive symptoms (SMD=-0.13, 95%CI: -0.24 to -0.02). There was no association with increased mood switch (RR=0.97, 95%CI: 0.68-1.39) and there was an association with lower dropout due to inefficacy (RR=0.66, 95%CI: 0.45∼0.98). CONCLUSIONS:There is no evidence of adjunctive antidepressants clinically improving response rate or depressive symptoms for acute bipolar depression. They are well tolerated, without increasing the risk of short-term mood switch.
PMID: 35248807
ISSN: 1872-7123
CID: 5345062

A pilot study examining roles of cognitions and affect between positive memory processing and posttraumatic stress disorder symptom severity

Contractor, Ateka A; Caldas, Stephanie V; Banducci, Anne N; Armour, Cherie
PMID: 33734770
ISSN: 1942-969x
CID: 5344812

Black Youth Suicide: Investigation of Current Trends and Precipitating Circumstances

Sheftall, Arielle H; Vakil, Fatima; Ruch, Donna A; Boyd, Rhonda C; Lindsey, Michael A; Bridge, Jeffrey A
OBJECTIVE:Suicide among Black youth is a significant public health concern, yet research investigating the epidemiology of suicide in this population is limited. This study examines current trends and precipitating circumstances of suicide by sex and age group in Black youth 5 to 17 years of age, using 2 national databases. METHOD/METHODS:Data from the Web-based Injury Statistics Query and Reporting System (WISQARS) and the National Violent Death Reporting System (NVDRS) were used to investigate trends and precipitating circumstances of Black youth suicide from 2003 to 2017. We hypothesized suicide rates would increase over time for both sexes and all age groups (5-11, 12-14, and 15-17 years), and precipitating circumstances would differ by sex and age group. Trend analyses were conducted using Joinpoint regression software, version 4.8.0.01 (Surveillance Research Program, National Cancer Institute). Sex and age group comparisons of characteristics and precipitating circumstances were conducted using standard univariate statistical tests. RESULTS:From 2003 to 2017, Black youth experienced a significant upward trend in suicide with the largest annual percentage change in the 15- to 17-year age group and among girls (4.9% and 6.6%, respectively). Mental health problems, relationship problems, interpersonal trauma and life stressors, and prior suicidal thoughts/behavior were the most common clinical characteristics and precipitating circumstances, with several varying by sex and age group. CONCLUSION/CONCLUSIONS:Increases in Black youth suicide calls for the prioritization of research aimed at identifying specific risk and protective factors as well as developmental mechanisms associated with Black youth suicidal behavior. To implement effective suicide prevention programming, understanding targets for intervention is necessary.
PMID: 34509592
ISSN: 1527-5418
CID: 5030932

Flexibility in action: Development of locomotion under overhead barriers

Rachwani, Jaya; Herzberg, Orit; Kaplan, Brianna E; Comalli, David M; O'Grady, Sinclaire; Adolph, Karen E
Behavioral flexibility-the ability to tailor motor actions to changing body-environment relations-is critical for functional movement. Navigating the everyday environment requires the ability to generate a wide repertoire of actions, select the appropriate action for the current situation, and implement it quickly and accurately. We used a new, adjustable barrier paradigm to assess flexibility of motor actions in 20 17-month-old (eight girls, 12 boys) and 14 13-month-old (seven girls, eight boys) walking infants and a comparative sample of 14 adults (eight women, six men). Most participants were White, non-Hispanic, and middle class. Participants navigated under barriers normalized to their standing height (overhead, eye, chest, hip, and knee heights). Decreases in barrier height required lower postures for passage. Every participant altered their initial walking posture according to barrier height for every trial, and all but two 13-month-olds found solutions for passage. Compared to infants, adults displayed a wider variety of strategies (squat-walking, half-kneeling, etc.), found more appropriate solutions based on barrier height (ducked at eye height and low crawled at knee height), and implemented their solutions more quickly (within 4 s) and accurately (without bumping their heads against the barrier). Infants frequently crawled even when the barrier height did not warrant a low posture, displayed multiple postural shifts prior to passage and thus took longer to go, and often bumped their heads. Infants' improvements were related to age and walking experience. Thus, development of flexibility likely involves the contributions of multiple domains-motor, perception, and cognition-that facilitate strategy selection and implementation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
PMCID:9050859
PMID: 35311311
ISSN: 1939-0599
CID: 5387672

Cognitive, social, and behavioral manifestations of the co-occurrence of autism spectrum disorder and attention-deficit/hyperactivity disorder: A systematic review

Rosello, Rocio; Martinez-Raga, Jose; Mira, Alvaro; Pastor, Juan Carlos; Solmi, Marco; Cortese, Samuele
This work aimed to review recent research on the characteristics of individuals who have both autism spectrum disorder and attention-deficit/hyperactivity disorder due to their high co-occurrence. Thirty-four studies were analyzed and main findings summarized in two content domains focusing on areas that could enhance our understanding of the cognitive and behavioral characteristics of individuals with autism spectrum disorder + attention-deficit/hyperactivity disorder (ASD+). Most of the results suggested that ASD+ is a co-occurring condition associated with more severe impairments in cognitive functioning, adaptive behavior, and increased likelihood to present more emotional/behavioral problems. These results will be helpful to provide improved care plans for individuals with both attention-deficit/hyperactivity disorder and autism spectrum disorder.
PMID: 34961363
ISSN: 1461-7005
CID: 5470372

Evidence for cognitive plasticity during pregnancy via enhanced learning and memory

Callaghan, Bridget; McCormack, Clare; Tottenham, Nim; Monk, Catherine
Human and animal neuroscience studies support the view that plastic shifts occur in the brain during pregnancy that support the emergence of new maternal behaviours. The idea of adaptive plasticity in pregnancy is at odds with the notion of "baby brain", in which pregnant women describe the onset of forgetfulness. While inconsistent evidence for memory deficits during pregnancy has been reported, few studies have investigated spatial associative memory (which is consistently enhanced in studies of pregnant rodents). Moreover, most studies assess domain-general stimuli, which might miss adaptations specific to parent-relevant stimuli. In the present study, we examined the retention of spatial associative memory for parenting-relevant and non-parenting-relevant stimuli across 4-weeks in a sample of women in their third trimester of pregnancy, and compared their performance to a sample of never pregnant women. We demonstrated that relative to never pregnant women, pregnant women exhibited enhanced long-term retention of object-scene-location associations (spatial associative memory), as well as better initial learning about parenting-relevant, relative to non-parenting-relevant, stimuli. Thus, similar to studies in rodents, cognitive improvements were seen during pregnancy in humans, and those improvements were specific to the domain of spatial associative retention, and in the recognition of stimuli relevant to parenting.
PMID: 34985388
ISSN: 1464-0686
CID: 5262532

Using event-related potentials to characterize inhibitory control and self-monitoring across impulsive and compulsive phenotypes: a dimensional approach to OCD

Dhir, Sakshi; Tyler, Kaelasha; Albertella, Lucy; Chamberlain, Samuel R; Teo, Wei-Peng; Yücel, Murat; Segrave, Rebecca A
OBJECTIVE:"Subsyndromal" obsessive-compulsive disorder symptoms (OCDSs) are common and cause impaired psychosocial functioning. OCDSs are better captured by dimensional models of psychopathology, as opposed to categorical diagnoses. However, such dimensional approaches require a deep understanding of the underlying neurocognitive drivers and impulsive and compulsive traits (ie, neurocognitive phenotypes) across symptoms. This study investigated inhibitory control and self-monitoring across impulsivity, compulsivity, and their interaction in individuals (n = 40) experiencing mild-moderate OCDSs. METHODS:EEG recording concurrent with the stop-signal task was used to elicit event-related potentials (ERPs) indexing inhibitory control (ie, N2 and P3) and self-monitoring (ie, error-related negativity and correct-related negativity (CRN): negativity following erroneous or correct responses, respectively). RESULTS:< .05, 95% CI [0.03, 0.19]). CONCLUSION/CONCLUSIONS:The current findings provide evidence for differential, ERP-indexed inhibitory control and self-monitoring profiles across impulsive and compulsive phenotypes in OCDSs.
PMID: 35485847
ISSN: 1092-8529
CID: 5345542

Management of depression during the perinatal period: state of the evidence

Falek, Idan; Acri, Mary; Dominguez, Joanna; Havens, Jennifer; McCord, Mary; Sisco, Sarah; Wilcox, Wendy; Hoagwood, Kimberly
BACKGROUND:Perinatal depression (PND) is a prevalent ailment that affects both the woman and her family. Addressing PND in primary health care, such as pediatrics and obstetric care settings, has been proposed as an effective way to identify and treat women. OBJECTIVE:The purpose of this study is to examine best practices for management of PND in obstetric and pediatric settings, as well as investigate the evidence that supports the guidelines. METHODS:Guidelines were identified through a literature search and discussion with experts in the field of perinatal depression, while evidence was examined through a literature search of reviews and thereafter experimental studies. RESULTS:Twenty-five guidelines, across 17 organizations were retained for analysis. Findings suggest that there is little or varied guidance on the management of PND, as well as a lack of specificity. Treatment was the topic most frequently reported, followed by screening. However best practices vary greatly and often contradict one another. Across all areas, there is inadequate or contrasting evidence to support these guidelines. CONCLUSIONS:Although there was consensus on the key steps in the pathway to care, the review revealed lack of consensus across guidelines on specific issues relating to identification and management of depression during the perinatal period. Clinicians may use these recommendations to guide their practice, but they should be aware of the limitations of the evidence supporting these guidelines and remain alert to new evidence. There is a clear need for researchers and policymakers to prioritize this area in order to develop evidence-based guidelines for managing perinatal depression.
PMCID:9036756
PMID: 35468808
ISSN: 1752-4458
CID: 5217322