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  Subjects -> PSYCHOLOGY (Total: 873 journals)
Showing 1 - 174 of 174 Journals sorted alphabetically
Acción Psicológica     Open Access   (Followers: 2)
Acta Colombiana de Psicología     Open Access   (Followers: 4)
Acta Comportamentalia     Open Access   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Psychologica     Hybrid Journal   (Followers: 22)
Activités     Open Access   (Followers: 1)
Actualidades en Psicologia     Open Access   (Followers: 1)
Ad verba Liberorum : Journal of Linguistics & Pedagogy & Psychology     Open Access   (Followers: 8)
Addictive Behaviors Reports     Open Access   (Followers: 5)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 20)
ADHD Report The     Full-text available via subscription   (Followers: 6)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 40)
Advances in Mental Health     Hybrid Journal   (Followers: 69)
Advances in Physiotherapy     Hybrid Journal   (Followers: 51)
Advances in Psychology     Full-text available via subscription   (Followers: 58)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29)
African Journal of Cross-Cultural Psychology and Sport Facilitation     Full-text available via subscription   (Followers: 3)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 394)
Aggressive Behavior     Hybrid Journal   (Followers: 15)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 33)
Ágora - studies in psychoanalytic theory     Open Access   (Followers: 3)
Aletheia     Open Access   (Followers: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 15)
American Imago     Full-text available via subscription   (Followers: 3)
American Journal of Applied Psychology     Open Access   (Followers: 34)
American Journal of Community Psychology     Hybrid Journal   (Followers: 24)
American Journal of Health Behavior     Full-text available via subscription   (Followers: 23)
American Journal of Orthopsychiatry     Hybrid Journal   (Followers: 4)
American Journal of Psychoanalysis     Hybrid Journal   (Followers: 21)
American Psychologist     Full-text available via subscription   (Followers: 172)
Anales de Psicología     Open Access   (Followers: 2)
Análise Psicológica     Open Access   (Followers: 1)
Análisis y Modificación de Conducta     Open Access   (Followers: 2)
Analysis     Full-text available via subscription   (Followers: 4)
Annual Review of Clinical Psychology     Full-text available via subscription   (Followers: 66)
Annual Review of Organizational Psychology and Organizational Behavior     Full-text available via subscription   (Followers: 27)
Annual Review of Psychology     Full-text available via subscription   (Followers: 211)
Anuario de Psicología / The UB Journal of Psychology     Open Access   (Followers: 1)
Anuario de Psicología Jurídica     Open Access   (Followers: 1)
Anxiety, Stress & Coping: An International Journal     Hybrid Journal   (Followers: 22)
Applied and Preventive Psychology     Hybrid Journal   (Followers: 13)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 67)
Applied Neuropsychology : Adult     Hybrid Journal   (Followers: 32)
Applied Neuropsychology : Child     Hybrid Journal   (Followers: 18)
Applied Psychological Measurement     Hybrid Journal   (Followers: 17)
Applied Psychology     Hybrid Journal   (Followers: 137)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 48)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 7)
Archive for the Psychology of Religion / Archiv für Religionspychologie     Hybrid Journal   (Followers: 17)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 27)
Archives of Scientific Psychology     Open Access   (Followers: 4)
Arquivos Brasileiros de Psicologia     Open Access   (Followers: 1)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 3)
Asian American Journal of Psychology     Full-text available via subscription   (Followers: 5)
Asian Journal of Business Ethics     Hybrid Journal   (Followers: 7)
Assessment     Hybrid Journal   (Followers: 10)
At-Tajdid : Jurnal Ilmu Tarbiyah     Open Access   (Followers: 2)
Attachment: New Directions in Psychotherapy and Relational Psychoanalysis     Full-text available via subscription   (Followers: 16)
Attention, Perception & Psychophysics     Full-text available via subscription   (Followers: 10)
Australian and Aotearoa New Zealand Psychodrama Association Journal     Full-text available via subscription  
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 6)
Australian Journal of Psychology     Hybrid Journal   (Followers: 17)
Australian Psychologist     Hybrid Journal   (Followers: 11)
Autism Research     Hybrid Journal   (Followers: 31)
Autism Research and Treatment     Open Access   (Followers: 29)
Autism's Own     Open Access  
Autism-Open Access     Open Access   (Followers: 5)
Avaliação Psicológica     Open Access  
Avances en Psicologia Latinoamericana     Open Access   (Followers: 1)
Aviation Psychology and Applied Human Factors     Hybrid Journal   (Followers: 19)
Balint Journal     Hybrid Journal   (Followers: 3)
Barbaroi     Open Access  
Basic and Applied Social Psychology     Hybrid Journal   (Followers: 34)
Behavior Analysis in Practice     Full-text available via subscription   (Followers: 6)
Behavior Analysis: Research and Practice     Full-text available via subscription   (Followers: 2)
Behavior Analyst     Hybrid Journal   (Followers: 3)
Behavior Modification     Hybrid Journal   (Followers: 10)
Behavior Research Methods     Hybrid Journal   (Followers: 18)
Behavior Therapy     Hybrid Journal   (Followers: 45)
Behavioral Development Bulletin     Full-text available via subscription  
Behavioral Interventions     Hybrid Journal   (Followers: 8)
Behavioral Neuroscience     Full-text available via subscription   (Followers: 52)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 23)
Behavioral Sleep Medicine     Hybrid Journal   (Followers: 6)
Behaviour     Hybrid Journal   (Followers: 12)
Behaviour Research and Therapy     Hybrid Journal   (Followers: 17)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 121)
Behavioural Processes     Hybrid Journal   (Followers: 7)
Biofeedback     Hybrid Journal   (Followers: 4)
BioPsychoSocial Medicine     Open Access   (Followers: 6)
BMC Psychology     Open Access   (Followers: 16)
Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice     Hybrid Journal   (Followers: 9)
Boletim Academia Paulista de Psicologia     Open Access  
Boletim de Psicologia     Open Access  
Brain Informatics     Open Access   (Followers: 1)
British Journal of Clinical Psychology     Full-text available via subscription   (Followers: 127)
British Journal of Developmental Psychology     Full-text available via subscription   (Followers: 36)
British Journal of Educational Psychology     Hybrid Journal   (Followers: 32)
British Journal of Health Psychology     Full-text available via subscription   (Followers: 42)
British Journal of Mathematical and Statistical Psychology     Full-text available via subscription   (Followers: 21)
British Journal of Psychology     Full-text available via subscription   (Followers: 58)
British Journal of Psychotherapy     Hybrid Journal   (Followers: 65)
British Journal of Social Psychology     Full-text available via subscription   (Followers: 33)
Burnout Research     Open Access   (Followers: 7)
Cadernos de psicanálise (Rio de Janeiro)     Open Access  
Cadernos de Psicologia Social do Trabalho     Open Access  
Canadian Art Therapy Association     Hybrid Journal  
Canadian Journal of Behavioural Science     Full-text available via subscription   (Followers: 5)
Canadian Journal of Experimental Psychology     Full-text available via subscription   (Followers: 12)
Canadian Psychology / Psychologie canadienne     Full-text available via subscription   (Followers: 11)
Case Studies in Sport and Exercise Psychology     Hybrid Journal  
Cendekia : Jurnal Kependidikan dan Kemasyarakatan     Open Access  
Child Development Perspectives     Hybrid Journal   (Followers: 27)
Child Development Research     Open Access   (Followers: 14)
Ciencia Cognitiva     Open Access   (Followers: 2)
Ciencia e Interculturalidad     Open Access  
Ciências & Cognição     Open Access  
Ciencias Psicológicas     Open Access  
Clínica y Salud     Open Access  
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Practice in Pediatric Psychology     Full-text available via subscription   (Followers: 10)
Clinical Psychological Science     Hybrid Journal   (Followers: 11)
Clinical Psychologist     Hybrid Journal   (Followers: 16)
Clinical Psychology & Psychotherapy     Hybrid Journal   (Followers: 67)
Clinical Psychology and Special Education     Open Access   (Followers: 1)
Clinical Psychology Review     Hybrid Journal   (Followers: 33)
Clinical Psychology: Science and Practice     Hybrid Journal   (Followers: 21)
Clinical Schizophrenia & Related Psychoses     Full-text available via subscription   (Followers: 8)
Coaching Psykologi - The Danish Journal of Coaching Psychology     Open Access   (Followers: 1)
Cogent Psychology     Open Access  
Cógito     Open Access  
Cognition & Emotion     Hybrid Journal   (Followers: 35)
Cognitive Behaviour Therapy     Hybrid Journal   (Followers: 14)
Cognitive Neuropsychology     Hybrid Journal   (Followers: 27)
Cognitive Psychology     Hybrid Journal   (Followers: 61)
Cognitive Research : Principles and Implications     Open Access  
Consciousness and Cognition     Hybrid Journal   (Followers: 26)
Construção Psicopedagógica     Open Access  
Consulting Psychology Journal : Practice and Research     Full-text available via subscription   (Followers: 3)
Contagion : Journal of Violence, Mimesis, and Culture     Full-text available via subscription   (Followers: 8)
Contemporary Educational Psychology     Hybrid Journal   (Followers: 22)
Contemporary School Psychology     Hybrid Journal   (Followers: 4)
Contextos Clínicos     Open Access  
Counseling Outcome Research and Evaluation     Hybrid Journal   (Followers: 10)
Counseling Psychologist     Hybrid Journal   (Followers: 14)
Counseling Psychology and Psychotherapy     Open Access   (Followers: 7)
Counselling and Psychotherapy Research : Linking research with practice     Hybrid Journal   (Followers: 21)
Counselling and Values     Hybrid Journal   (Followers: 2)
Counselling Psychology Quarterly     Hybrid Journal   (Followers: 10)
Couple and Family Psychoanalysis     Full-text available via subscription   (Followers: 1)
Couple and Family Psychology : Research and Practice     Full-text available via subscription   (Followers: 4)
Creativity Research Journal     Hybrid Journal   (Followers: 20)
Creativity. Theories - Research - Applications     Open Access   (Followers: 1)
Criminal Justice Ethics     Hybrid Journal   (Followers: 8)
Cuadernos de Neuropsicología     Open Access   (Followers: 1)
Cuadernos de Psicologia del Deporte     Open Access  
Cuadernos de Psicopedagogía     Open Access  
Cultural Diversity and Ethnic Minority Psychology     Full-text available via subscription   (Followers: 12)
Cultural-Historical Psychology     Open Access  
Culturas Psi     Open Access  
Culture and Brain     Hybrid Journal   (Followers: 4)
Current Addiction Reports     Hybrid Journal   (Followers: 10)
Current Behavioral Neuroscience Reports     Hybrid Journal   (Followers: 2)
Current Directions In Psychological Science     Hybrid Journal   (Followers: 48)
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Current Opinion in Psychology     Hybrid Journal   (Followers: 4)
Current Psychological Research     Hybrid Journal   (Followers: 14)
Current Psychology     Hybrid Journal   (Followers: 15)
Current psychology letters     Open Access   (Followers: 2)
Current Research in Psychology     Open Access   (Followers: 21)
Cyberpsychology, Behavior, and Social Networking     Hybrid Journal   (Followers: 14)
Decision     Full-text available via subscription   (Followers: 2)
Depression and Anxiety     Hybrid Journal   (Followers: 14)
Depression Research and Treatment     Open Access   (Followers: 13)
Developmental Cognitive Neuroscience     Open Access   (Followers: 16)
Developmental Neuropsychology     Hybrid Journal   (Followers: 15)
Developmental Psychobiology     Hybrid Journal   (Followers: 9)
Developmental Psychology     Full-text available via subscription   (Followers: 45)
Diagnostica     Hybrid Journal   (Followers: 2)
Dialectica     Hybrid Journal   (Followers: 1)
Discourse     Full-text available via subscription   (Followers: 9)
Diversitas: Perspectivas en Psicologia     Open Access  
Drama Therapy Review     Hybrid Journal   (Followers: 1)
Dreaming     Full-text available via subscription   (Followers: 11)
Drogues, santé et société     Full-text available via subscription  
Dynamics of Asymmetric Conflict: Pathways toward terrorism and genocide     Hybrid Journal   (Followers: 12)
Ecopsychology     Hybrid Journal   (Followers: 6)
ECOS - Estudos Contemporâneos da Subjetividade     Open Access  
Educational Psychology Review     Hybrid Journal   (Followers: 26)
Educational Psychology: An International Journal of Experimental Educational Psychology     Hybrid Journal   (Followers: 46)
Educazione sentimentale     Full-text available via subscription  
Electronic Journal of Research in Educational Psychology     Open Access   (Followers: 6)
Elpis - Czasopismo Teologiczne Katedry Teologii Prawosławnej Uniwersytetu w Białymstoku     Open Access  
Emotion     Full-text available via subscription   (Followers: 32)
Emotion Review     Hybrid Journal   (Followers: 17)
En-Claves del pensamiento     Open Access   (Followers: 1)
Enseñanza e Investigacion en Psicologia     Open Access  
Epiphany     Open Access   (Followers: 3)
Escritos de Psicología : Psychological Writings     Open Access   (Followers: 2)

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Journal Cover Depression and Anxiety
  [SJR: 2.491]   [H-I: 85]   [14 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1091-4269 - ISSN (Online) 1520-6394
   Published by John Wiley and Sons Homepage  [1583 journals]
  • Atypical depression and double depression predict new-onset cardiovascular
           disease in U.S. adults
    • Authors: Stephanie M. Case; Manisha Sawhney, Jesse C. Stewart
      Abstract: BACKGROUNDAlthough depression is a risk factor for cardiovascular disease (CVD), it is unknown whether this risk varies across depressive disorder subtypes. Thus, we investigated atypical major depressive disorder (MDD) and double depression as predictors of new-onset CVD in a nationally representative sample of U.S. adults.METHODSProspective data from 28,726 adults initially free of CVD who participated in Wave 1 (2001–2002) and Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Lifetime depressive disorder subtypes (Wave 1) and incident CVD (Wave 2) were determined by structured interviews.RESULTSWe identified 1,116 incident CVD cases. In demographics adjusted models, the atypical MDD group had a higher odds of incident CVD than the no depression history (OR = 2.19, 95% CI: 1.71–2.81, P 
      PubDate: 2017-06-22T12:40:21.369156-05:
      DOI: 10.1002/da.22666
       
  • Is cannabis treatment for anxiety, mood, and related disorders ready for
           prime time'
    • Authors: Jasmine Turna; Beth Patterson, Michael Ameringen
      Abstract: Anxiety and related disorders are the most common mental conditions affecting the North American population. Despite their established efficacy, first-line antidepressant treatments are associated with significant side effects, leading many afflicted individuals to seek alternative treatments. Cannabis is commonly viewed as a natural alternative for a variety of medical and mental health conditions. Currently, anxiety ranks among the top five medical symptoms for which North Americans report using medical marijuana. However, upon careful review of the extant treatment literature, the anxiolytic effects of cannabis in clinical populations are surprisingly not well-documented. The effects of cannabis on anxiety and mood symptoms have been examined in healthy populations and in several small studies of synthetic cannabinoid agents but there are currently no studies which have examined the effects of the cannabis plant on anxiety and related disorders. In light of the rapidly shifting landscape regarding the legalization of cannabis for medical and recreational purposes, it is important to highlight the significant disconnect between the scientific literature, public opinion, and related policies. The aim of this article is to provide a comprehensive review of the current cannabis treatment literature, and to identify the potential for cannabis to be used as a therapeutic intervention for anxiety, mood, and related disorders. Searches of five electronic databases were conducted (PubMed, MEDLINE, Web of Science, PsychINFO, and Google Scholar), with the most recent in February 2017. The effects of cannabis on healthy populations and clinical psychiatric samples will be discussed, focusing primarily on anxiety and mood disorders.
      PubDate: 2017-06-21T11:22:07.856509-05:
      DOI: 10.1002/da.22664
       
  • Maternal depression and bullying victimization among adolescents: Results
           from the 2004 Pelotas cohort study
    • Authors: Catarina Machado Azeredo; Iná S. Santos, Aluísio J. D. Barros, Fernando C. Barros, Alicia Matijasevich
      Abstract: BackgroundMaternal depression impacts on several detrimental outcomes during a child's life course, and could increase their risk of victimization. This longitudinal study examined the association between antenatal maternal depression, postnatal trajectories, and current maternal depression and offspring bullying victimization at 11 years.MethodsWe included 3,441 11-year-old adolescents from the 2004 Pelotas Cohort Study. Antenatal maternal depression, postnatal trajectories, and current maternal depression data were assessed during the follow-up waves. Bullying victimization was self-reported by the adolescents. We used ordinal logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CIs), for the association between maternal depression and offspring bullying victimization.ResultsThe most prevalent type of bullying was verbal victimization (37.9%). We observed a positive association between antenatal maternal depression, postnatal trajectories, and current maternal depression and physical bullying victimization. Maternal mood symptoms during pregnancy were associated with physical (OR = 1.30, 95%CI = 1.11–1.53), verbal (OR = 1.29, 95%CI = 1.12–1.49), and any victimization (OR = 1.22, 95%CI = 1.05–1.41). Severe current maternal depression was associated with physical (OR = 1.34, 95%CI = 1.10–1.62), social manipulation (OR = 1.29, 95%CI = 1.08–1.53), attacks on property (OR = 1.30, 95%CI = 1.08–1.57) and any victimization (OR = 1.32, 95%CI = 1.12–1.56). Regarding maternal depression trajectories, the “chronic-high” group was associated with higher risk of social manipulation, attacks on property and any victimization, than the “low” group.ConclusionsOur results strengthen the evidence of association between maternal depression and offspring bullying victimization, and physical victimization appears to be the main component. Further studies are warranted to confirm our findings and to elucidate the theoretical pathways for this longitudinal association.
      PubDate: 2017-06-20T13:17:40.68489-05:0
      DOI: 10.1002/da.22662
       
  • Increased neural response to social rejection in major depression
    • Authors: Poornima Kumar; Gordon D Waiter, Magda Dubois, Maarten Milders, Ian Reid, J Douglas Steele
      Abstract: BackgroundBeing a part of community is critical for survival and individuals with major depressive disorder (MDD) have a greater sensitivity to interpersonal stress that makes them vulnerable to future episodes. Social rejection is a critical risk factor for depression and it is said to increase interpersonal stress and thereby impairing social functioning. It is therefore critical to understand the neural correlates of social rejection in MDD.MethodsTo this end, we scanned 15 medicated MDD and 17 healthy individuals during a modified cyberball passing game, where participants were exposed to increasing levels of social exclusion. Neural responses to increasing social exclusion were investigated and compared between groups.ResultsWe showed that compared to controls, MDD individuals exhibited greater amygdala, insula, and ventrolateral prefrontal cortex activation to increasing social exclusion and this correlated negatively with hedonic tone and self-esteem scores across all participants.ConclusionsThese preliminary results support the hypothesis that depression is associated with hyperactive response to social rejection. These findings highlight the importance of studying social interactions in depression, as they often lead to social withdrawal and isolation.
      PubDate: 2017-06-20T13:17:30.622188-05:
      DOI: 10.1002/da.22665
       
  • Genetic variants in 5-HTTLPR, BDNF, HTR1A, COMT, and FKBP5 and risk for
           treated depression after cancer diagnosis
    • Authors: Nis P. Suppli; Jens D. Bukh, Terrie E. Moffitt, Avshalom Caspi, Christoffer Johansen, Anne Tjønneland, Lars V. Kessing, Susanne O. Dalton
      Abstract: BackgroundThe role of gene–environment interactions in the pathogenesis of depression is unclear. Previous studies addressed vulnerability for depression after childhood adversity and stressful life events among carriers of numerous specific genetic variants; however, the importance of individual genetic variants, the environmental exposures with which they interact, and the magnitude of the risk conveyed by these interactions remain elusive.MethodsWe included 7,320 people with a first primary cancer identified in the prospective Diet, Cancer and Health study in an exposed-only cohort study. The mean age of the individuals was 68 years (5th, 95th percentiles: 58, 78) at cancer diagnosis. Using Cox regression models and cumulative incidence plots, we analyzed the associations between genetic variants in 5-HTTLPR, BDNF, HTR1A, COMT, and FKBP5 and use of antidepressants as well as hospital contact for depression after diagnosis of cancer.ResultsOverall, we observed no statistically significant associations, with nonsignificant hazard ratio estimates for use of antidepressants of 0.95–1.07.ConclusionsThis study of elderly people indicates that it is unlikely that the investigated genetic variants are clinically relevantly associated with depression after diagnosis of cancer. The mechanisms for gene–environment interactions in younger individuals are probably different, and we advise caution in extrapolating our results to early life stress. However, conclusion from the present study might be generalizable to elderly persons exposed to other stressful life events.
      PubDate: 2017-06-07T08:16:20.645894-05:
      DOI: 10.1002/da.22660
       
  • There is an app for that! The current state of mobile applications (apps)
           for DSM-5 obsessive-compulsive disorder, posttraumatic stress disorder,
           anxiety and mood disorders
    • Authors: Michael Ameringen; Jasmine Turna, Zahra Khalesi, Katrina Pullia, Beth Patterson
      Abstract: Mental health apps are viewed as a promising modality to extend the reach of mental health care beyond the clinic. They do so by providing a means of assessment, tracking, and treatment through a smartphone. Given that nearly 2/3 of the American population owns a smartphone, mental health apps offer the possibility of overcoming treatment barriers such as geographic location or financial barriers. Unfortunately, the excitement surrounding mental health apps may be premature as the current supporting literature regarding their efficacy is limited. The app marketplace is littered with apps claiming to treat or assess symptoms, but even those created by reputable organizations or those incorporating components of evidence-based treatments have not yet been validated in terms of their efficacy. This review aims to provide a comprehensive review of the current state of the mental health app literature by examining published reports of apps designed for DSM-5 anxiety and mood disorders, OCD, and PTSD. The breadth of apps reviewed includes those oriented around assessment, symptom tracking, and treatment as well as “multipurpose” apps, which incorporate several of these components. This review will also present some of the most popular mental health apps which may have clinical utility and could be prescribed to clients. While we discuss many potential benefits of mental health apps, we focus on a number of issues that the current state of the app literature presents. Overall there is a significant disconnect between app developers, the scientific community and health care, leaving the utility of existing apps questionable.
      PubDate: 2017-06-01T05:05:38.770172-05:
      DOI: 10.1002/da.22657
       
  • Internet-based guided self-help for posttraumatic stress disorder (PTSD):
           Randomized controlled trial
    • Authors: Catrin E. Lewis; Daniel Farewell, Vicky Groves, Neil J. Kitchiner, Neil P. Roberts, Tracey Vick, Jonathan I. Bisson
      Abstract: BackgroundThere are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD.MethodsForty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment.ResultsPosttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h.ConclusionsInternet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy.
      PubDate: 2017-05-29T11:40:26.990249-05:
      DOI: 10.1002/da.22645
       
  • Clinical and neurobiological effects of aerobic exercise in dental phobia:
           A randomized controlled trial
    • Authors: Brigitt L. Lindenberger; Jens Plag, Sarah Schumacher, Katharina Gaudlitz, Sophie Bischoff, Thomas Bobbert, Fernando Dimeo, Moritz B. Petzold, Clemens Kirschbaum, Zsuzsa Dudás, Andreas Ströhle
      Abstract: BackgroundPhysical activity has shown to be effective in anxiety disorders. For specific phobia, no studies are available that systematically examined the effects of an aerobic exercise intervention on phobic fear within a randomized-controlled design. Therefore, we investigated the acute effect of a standardized aerobic training on clinical symptoms of dental phobia as well as on stress-related neurobiological markers.MethodsWithin a crossover design, 30 patients with dental phobia (mean age: 34.1 years; mean score of the Dental Anxiety Scale: 18.8) underwent two minor dental interventions separated by 7 days. Dental treatment was performed after 30 min of physical activity at either 20% VO2 max (control) or 70% VO2 max (intervention), respectively. To control for habituation, patients were randomly assigned to one of the two conditions prior to the first intervention. Moreover, saliva samples were collected at five times in order to determine changes in salivary cortisol (sC) and alpha-amylase (sAA) due to treatment.ResultsIn comparison to baseline, aerobic exercise within 70% VO2 max significantly reduced clinical anxiety and sC concentrations before, during, and after the dental treatment. In contrast, the control condition led to decreased sAA levels at different time points of measurement. Habituation occurred at the second study day, independent of the order.ConclusionsOur study provides evidence for an effect of moderate–intense exercise on clinical symptoms and sC in patients with dental phobia. Therefore, acute aerobic exercise might be a simple and low-cost intervention to reduce disorder-specific phobic fear.
      PubDate: 2017-05-26T12:45:24.968345-05:
      DOI: 10.1002/da.22659
       
  • Uncertainty increases neural indices of attention in obsessive-compulsive
           disorder
    • Authors: Raoul Dieterich; Tanja Endrass, Norbert Kathmann
      Abstract: BackgroundPatients with obsessive-compulsive disorder (OCD) experience abnormally high levels of uncertainty, and unpredictability is evaluated negatively and not well tolerated. The current study examined neural correlates of attentional processing in response to experimentally induced uncertainty in OCD.MethodsTwenty-four OCD patients and 24 healthy controls performed a task where neutral and negative pictures were preceded by a cue, either being predictive (certain condition) or nonpredictive (uncertain condition) of subsequent picture valence. We examined prepicture anticipatory attention through α (∼8–12 Hz) suppression, and attentional allocation during picture presentation with the P1, N1, P2, N2, and late positive potential (LPP) of the event-related potential. Additionally, we tested how clinical measures related to these attentional markers.ResultsSubjectively, patients overestimated the frequency of negative pictures after nonpredictive cues. Patients, but not controls, showed upper α(10–12 Hz) suppression after nonpredictive and predictive negative cues relative to predictive neutral cues. Only patients showed increased P2 and decreased N2 amplitudes for pictures after nonpredictive cues, and, whereas both groups showed increased LPP amplitudes for pictures after nonpredictive cues, this modulation was more pronounced in OCD during the early LPP (
      PubDate: 2017-05-25T12:25:26.694345-05:
      DOI: 10.1002/da.22655
       
  • Cognitive enhancing effects of rTMS administered to the prefrontal cortex
           in patients with depression: A systematic review and meta-analysis of
           individual task effects
    • Authors: Donel M. Martin; Shawn M. McClintock, Jane J. Forster, Tin Yan Lo, Colleen K. Loo
      Abstract: BackgroundRepetitive transcranial magnetic stimulation (rTMS) is an approved therapeutic treatment of major depressive disorder and has increasing clinical use throughout the world. However, it remains unclear whether an rTMS course for depression may also produce cognitive enhancement. In a recent meta-analysis of sham-controlled randomized controlled studies (RCTs) conducted in patients with neuropsychiatric conditions, no evidence was found for generalized cognitive enhancing effects across cognitive domains with active compared to sham rTMS. Notwithstanding, there remains the possibility of cognitive effects following an rTMS course that are more highly specific, for example, in specific clinical conditions, or at the individual task level. This study aimed to determine whether a therapeutic rTMS course in patients with depression is associated with cognitive enhancing effects at the task level.MethodsA systematic review and meta-analysis of outcomes on individual neuropsychological tasks from sham-controlled RCTs where an rTMS course was administered to the dorsolateral prefrontal cortex (DLPFC) in patients with depression.ResultsEighteen studies met the inclusion criteria. Active rTMS treatment showed no specific enhancing effects on the majority of cognitive tasks. Modest effect size improvements with active compared to sham rTMS treatment were found for performance on the Trail Making Test Parts A (g = 0.28, 95% CI = 0.06–0.50) and B (g = 0.26, 95% CI = 0.06–0.47).ConclusionA therapeutic rTMS course administered to the prefrontal cortex for depression may produce modest cognitive enhancing effects specific to psychomotor speed, visual scanning, and set-shifting ability.
      PubDate: 2017-05-24T11:30:27.915514-05:
      DOI: 10.1002/da.22658
       
  • The experience sampling method as an mHealth tool to support
           self-monitoring, self-insight, and personalized health care in clinical
           practice
    • Authors: Jim Os; Simone Verhagen, Anne Marsman, Frenk Peeters, Maarten Bak, Machteld Marcelis, Marjan Drukker, Ulrich Reininghaus, Nele Jacobs, Tineke Lataster, Claudia Simons, , Richel Lousberg, Sinan Gülöksüz, Carsten Leue, Peter C. Groot, Wolfgang Viechtbauer, Philippe Delespaul
      Abstract: BackgroundThe experience sampling method (ESM) builds an intensive time series of experiences and contexts in the flow of daily life, typically consisting of around 70 reports, collected at 8–10 random time points per day over a period of up to 10 days.MethodsWith the advent of widespread smartphone use, ESM can be used in routine clinical practice. Multiple examples of ESM data collections across different patient groups and settings are shown and discussed, varying from an ESM evaluation of a 6-week randomized trial of mindfulness, to a twin study on emotion dynamics in daily life.ResultsResearch shows that ESM-based self-monitoring and feedback can enhance resilience by strengthening the capacity to use natural rewards. Personalized trajectories of starting or stopping medication can be more easily initiated and predicted if sensitive feedback data are available in real time. In addition, personalized trajectories of symptoms, cognitive abilities, symptoms impacting on other symptoms, the capacity of the dynamic system of mental health to “bounce back” from disturbance, and patterns of environmental reactivity yield uniquely personal data to support shared decision making and prediction in clinical practice. Finally, ESM makes it possible to develop insight into previous implicit patterns of thought, experience, and behavior, particularly if rapid personalized feedback is available.ConclusionsESM enhances clinical practice and research. It is empowering, providing co-ownership of the process of diagnosis, treatment evaluation, and routine outcome measurement. Blended care, based on a mix of face-to-face and ESM-based outside-the-office treatment, may reduce costs and improve outcomes.
      PubDate: 2017-05-23T12:00:35.654148-05:
      DOI: 10.1002/da.22647
       
  • Are there sensitive periods when child maltreatment substantially elevates
           suicide risk' Results from a nationally representative sample of
           adolescents
    • Authors: Stephanie H. Gomez; Jenny Tse, Yan Wang, Brianna Turner, Alexander J. Millner, Matthew K. Nock, Erin C. Dunn
      Abstract: BackgroundAlthough child maltreatment is a well documented risk factor for suicidal behavior, little is known about whether the timing of child maltreatment differentially associates with risk of suicidal ideation, suicide plans, or suicide attempts. The goal of this study was to examine whether a first exposure to physical or sexual abuse during specific developmental periods significantly elevated risk for suicidal behavior in adolescents.MethodsData came from the National Comorbidity Survey Adolescent Supplement, a population-based sample of US adolescents aged 13–18 years old (n = 9,272). Using discrete time survival analysis, we assessed the association between timing of first abuse (early childhood: ages 0–5; middle childhood: ages 6–10; adolescence: ages 11–18) and suicidal ideation, plans, and attempts.ResultsExposure to either physical or sexual abuse increased the odds of reporting suicidal ideation (odds ratio [OR] = 5.06 and OR = 3.56, respectively), plans (OR = 3.63 and OR = 3.58, respectively), and attempts (OR = 5.80 and OR = 4.21, respectively), even after controlling for sociodemographic covariates and psychiatric disorders. However, the timing of physical and sexual abuse exposure was unassociated with suicidal behavior (all P values>.05).ConclusionsExposure to child maltreatment is strongly associated with the risk for adolescent suicidal behaviors, though this association did not vary based on the timing of first exposure. These findings suggest that prevention efforts should be implemented throughout early development and target all children, regardless of when they were first exposed.
      PubDate: 2017-05-23T12:00:23.860154-05:
      DOI: 10.1002/da.22650
       
  • Latent structure of negative valence measures in childhood
    • Authors: Minyoung Lee; Steven H. Aggen, Dever M. Carney, Shannon Hahn, Elizabeth Moroney, Laura Machlin, Melissa A. Brotman, Kenneth E. Towbin, Ellen Leibenluft, Daniel S. Pine, Roxann Roberson-Nay, John M. Hettema
      Abstract: BackgroundInternalizing disorders (IDs), consisting of the syndromes of anxiety and depression, are common, debilitating conditions often having onsets in adolescence. Scientists have developed dimensional self-report instruments that assess putative negative valence system (NVS) trait-like constructs as complimentary phenotypes to clinical symptoms. These include various measures that index temperamental predispositions to IDs and correlate with neural substrates of fear, anxiety, and affective regulation. This study sought to elucidate the overarching structure of putative NVS traits and their relationship to early manifestations of ID symptomatology.MethodsThe sample consisted of 768 juvenile twin subjects ages 9–13. Together with ID symptoms, extant validated instruments were chosen to assess a broad spectrum of NVS traits: anxiety sensitivity, irritability, fearfulness, behavioral activation and inhibition, and neuroticism and extraversion. Exploratory and confirmatory factor analyses (EFA/CFA) were used to investigate the latent structure of the associations among these different constructs and ID symptoms. Bifactor modeling in addition to standard correlated-factor analytic approaches were applied.ResultsFactor analyses produced a primary tripartite solution comprising anxiety/fear, dysphoria, and positive affect among all these measures. Competing DSM-like correlated factors and an RDoC-like NVS bifactor structure provided similar fit to these data.ConclusionsOur findings support the conceptual organization of a tripartite latent internalizing domain in developing children. This structure includes both clinical symptoms and a variety of self-report dimensional traits currently in use by investigators. These various constructs are, therefore, most informatively investigated using an inclusive, integrated approach.
      PubDate: 2017-05-22T12:35:25.351342-05:
      DOI: 10.1002/da.22656
       
  • Anxiety: There is an app for that. A systematic review of anxiety apps
    • Authors: Madalina Sucala; Pim Cuijpers, Frederick Muench, Roxana Cardoș, Radu Soflau, Anca Dobrean, Patriciu Achimas-Cadariu, Daniel David
      Abstract: BackgroundSmartphones and mobile devices have become ubiquitous, and with the rapid advance of technology, the number of health applications (apps) that are available for consumers on these devices is constantly growing. In particular, there has been a recent proliferation of anxiety apps. However, there has been no review of the quality or content of these anxiety apps and little is known about their purpose, the features they contain, and their empirical support. The goal of this systematic review was to assess the commercially available anxiety apps.MethodsA list of anxiety apps was collected in January 2017, using the Power Search function of iTunes and Google Play. Of 5,078 identified apps, 52 met our inclusion criteria (i.e., being defined as an anxiety/worry relief app, and offering psychological techniques aimed primarily at reducing anxiety) and were further reviewed.ResultsThe majority (67.3%) of the currently available anxiety apps were found to lack the involvement of health care professionals in their development, and very few (3.8%) of them have been rigorously tested.ConclusionsAt the moment, although anxiety apps have the potential to enhance access to mental health care, there is a marked discrepancy between the wealth of commercially available apps, and the paucity of data regarding their efficacy and effectiveness. Although the great promise of apps is their ability to increasing access to evidence-based mental health, the field is not quite there yet and the full potential of apps for treating anxiety has yet to be exploited.
      PubDate: 2017-05-15T10:30:32.697859-05:
      DOI: 10.1002/da.22654
       
  • The efficacy of benzodiazepines as acute anxiolytics in children: A
           meta-analysis
    • Authors: Heide Kuang; Jessica A. Johnson, Jilian M. Mulqueen, Michael H. Bloch
      Abstract: ObjectiveCurrent practice guidelines do not recommend benzodiazepines for acute management of anxiety disorders in pediatric patients. However, in procedural settings, benzodiazepines are commonly used to relieve acute preprocedural stress. This meta-analysis examines the efficacy and tolerability of benzodiazepines as short-term anxiolytics in children.MethodPubMed was searched for randomized controlled trials assessing the efficacy of benzodiazepines as short-term anxiolytics in pediatric patients. Twenty-one trials involving 1,416 participants were included. A fixed effects model was used to examine the standardized mean difference of improvement in anxiety levels compared to control conditions. In stratified subgroup and meta-regression, the effect of the specific agent, dose, timing, and setting of benzodiazepine treatment was examined.ResultsA significant benefit was seen for benzodiazepines compared to control (standardized mean difference = 0.71 [95% confidence interval, 0.60–0.82], k = 24, z = 12.7, P < .001). There was also funnel plot asymmetry in this meta-analysis, suggesting some evidence of publication bias. Moderator analyses found that when benzodiazepines were used in dental or nonoperating room procedures, they were more effective than when they were used in operating room procedures (test for subgroup differences Q2 = 6.34, P = .04). Tolerability analysis revealed there was no significant difference in the risk of developing irritability or behavioral changes between benzodiazepine and control groups.ConclusionsBenzodiazepines are effective and well-tolerated when used as short-term anxiolytics in procedural settings for pediatric patients. Further research is needed to determine whether benzodiazepines are effective in pediatric anxiety disorders.
      PubDate: 2017-05-15T10:30:26.663561-05:
      DOI: 10.1002/da.22643
       
  • Perceiving social pressure not to feel negative predicts depressive
           symptoms in daily life
    • Authors: Egon Dejonckheere; Brock Bastian, Eiko I. Fried, Sean C. Murphy, Peter Kuppens
      Abstract: BackgroundWestern societies often overemphasize the pursuit of happiness, and regard negative feelings such as sadness or anxiety as maladaptive and unwanted. Despite this emphasis on happiness, the amount of people suffering from depressive complaints is remarkably high. To explain this apparent paradox, we examined whether experiencing social pressure not to feel sad or anxious could in fact contribute to depressive symptoms.MethodsA sample of individuals (n = 112) with elevated depression scores (Patient Health Questionnaire [PHQ-9] ≥ 10) took part in an online daily diary study in which they rated their depressive symptoms and perceived social pressure not to feel depressed or anxious for 30 consecutive days. Using multilevel VAR models, we investigated the temporal relation between this perceived social pressure and depressive symptoms to determine directionality.ResultsPrimary analyses consistently indicated that experiencing social pressure predicts increases in both overall severity scores and most individual symptoms of depression, but not vice versa. A set of secondary analyses, in which we adopted a network perspective on depression, confirmed these findings. Using this approach, centrality analysis revealed that perceived social pressure not to feel negative plays an instigating role in depression, reflected by the high out- and low instrength centrality of this pressure in the various depression networks.ConclusionsTogether, these findings indicate how perceived societal norms may contribute to depression, hinting at a possible malignant consequence of society's denouncement of negative emotions. Clinical implications are discussed.
      PubDate: 2017-05-12T11:25:47.18961-05:0
      DOI: 10.1002/da.22653
       
  • Posttraumatic stress disorder symptom severity is associated with reduced
           default mode network connectivity in individuals with elevated genetic
           risk for psychopathology
    • Authors: Danielle R. Miller; Mark W. Logue, Erika J. Wolf, Hannah Maniates, Meghan E. Robinson, Jasmeet P. Hayes, Annjanette Stone, Steven Schichman, Regina E. McGlinchey, William P. Milberg, Mark W. Miller
      Abstract: BackgroundAccumulating evidence suggests that posttraumatic stress disorder (PTSD) is associated with disrupted default mode network (DMN) connectivity, but findings across studies have not been uniform. Individual differences in relevant genes may account for some of the reported variability in the relationship between DMN connectivity and PTSD. In this study, we investigated this possibility using genome-wide association study (GWAS) derived polygenic risk scores (PRSs) for relevant psychiatric traits. We hypothesized that the association between PTSD and DMN connectivity would be moderated by genetic risk for one or more psychiatric traits such that individuals with elevated polygenic risk for psychopathology and severe PTSD would exhibit disrupted DMN connectivity.MethodsParticipants were 156 white, non-Hispanic veterans of the wars in Iraq and Afghanistan who were genotyped and underwent resting state functional magnetic resonance imaging and clinical assessment. PRSs for neuroticism, anxiety, major depressive disorder, and cross-disorder risk (based on five psychiatric disorders) were calculated using summary statistics from published large-scale consortia-based GWASs.ResultsCross-disorder polygenic risk influenced the relationship between DMN connectivity and PTSD symptom severity such that individuals at greater genetic risk showed a significant negative association between PTSD symptom severity and connectivity between the posterior cingulate cortex and right middle temporal gyrus. Polygenic risk for neuroticism, anxiety, and major depressive disorder did not influence DMN connectivity directly or through an interaction with PTSD.ConclusionsFindings illustrate the potential power of genome-wide PRSs to advance understanding of the relationship between PTSD and DMN connectivity, a putative neural endophenotype of the disorder.
      PubDate: 2017-05-11T11:25:31.990381-05:
      DOI: 10.1002/da.22633
       
  • Ecological momentary interventions for depression and anxiety
    • Authors: Stephen M. Schueller; Adrian Aguilera, David C. Mohr
      Abstract: Ecological momentary interventions (EMIs) are becoming more popular and more powerful resources for the treatment and prevention of depression and anxiety due to advances in technological capacity and analytic sophistication. Previous work has demonstrated that EMIs can be effective at reducing symptoms of depression and anxiety as well as related outcomes of stress and at increasing positive psychological functioning. In this review, we highlight the differences between EMIs and other forms of treatment due to the nature of EMIs to be deeply integrated into the fabric of people's day-to-day lives. EMIs require unique considerations in their design, deployment, and evaluation. Furthermore, given that EMIs have been advanced by changes in technologies and that the use of behavioral intervention technologies for mental health has been increasing, we discuss how technologies and analytics might usher in a new era of EMIs. Future EMIs might reduce user burden and increase intervention personalization and sophistication by leveraging digital sensors and advances in natural language processing and machine learning. Thus, although current EMIs are effective, the EMIs of the future might be more engaging, responsive, and adaptable to different people and different contexts.
      PubDate: 2017-05-11T11:25:24.766643-05:
      DOI: 10.1002/da.22649
       
  • Predictors of PTSD 40 years after combat: Findings from the National
           Vietnam Veterans longitudinal study
    • Authors: Maria M. Steenkamp; William E. Schlenger, Nida Corry, Clare Henn-Haase, Meng Qian, Meng Li, Danny Horesh, Karen-Inge Karstoft, Christianna Williams, Chia-Lin Ho, Arieh Shalev, Richard Kulka, Charles Marmar
      Abstract: BackgroundFew studies have longitudinally examined predictors of posttraumatic stress disorder (PTSD) in a nationally representative sample of US veterans. We examined predictors of warzone-related PTSD over a 25-year span using data from the National Vietnam Veterans Longitudinal Study (NVVLS).MethodsThe NVVLS is a follow-up study of Vietnam theater veterans (N = 699) previously assessed in the National Vietnam Veterans Readjustment Study (NVVRS), a large national-probability study conducted in the late 1980s. We examined the ability of 22 premilitary, warzone, and postmilitary variables to predict current warzone-related PTSD symptom severity and PTSD symptom change in male theater veterans participating in the NVVLS. Data included a self-report Health Questionnaire survey and a computer-assisted telephone Health Interview Survey. Primary outcomes were self-reported PTSD symptoms assessed by the PTSD Checklist for DSM-5 (PCL 5) and Mississippi PTSD Scale (M-PTSD).ResultsPredictors of current PTSD symptoms most robust in hierarchical multivariable models were African-American race, lower education level, negative homecoming reception, lower current social support, and greater past-year stress. PTSD symptoms remained largely stable over time, and symptom exacerbation was predicted by African-American race, lower education level, younger age at entry into Vietnam, greater combat exposure, lower current social support, and greater past-year stressors.ConclusionsFindings confirm the robustness of a select set of risk factors for warzone-related PTSD, establishing that these factors can predict PTSD symptom severity and symptom change up to 40 years postdeployment.
      PubDate: 2017-05-10T10:35:40.826931-05:
      DOI: 10.1002/da.22628
       
  • Nicotine deprivation attenuates panic reactivity in smokers: Findings from
           a placebo-controlled nicotine patch study
    • Authors: Kenneth Abrams; Sam Krimmel, Stacey Johnson, Kate Cieslowski, Helen Strnad, Arielle Melum, Caroline Kryder
      Abstract: BackgroundProspective studies consistently find that smoking is a risk factor for the development of panic disorder (PD). A possible explanation is that nicotine deprivation promotes heightened sensitivity to bodily sensations and/or arterial carbon dioxide (CO2). Abrams et al. (2011) previously found that, in response to a CO2 rebreathing challenge, smokers experiencing more (vs. less) intense nicotine withdrawal had more severe panic symptoms and a stronger urge to escape. However, participants were aware of the last time they smoked, leaving unclear the extent to which fear reactivity was influenced by the pharmacologic effects of nicotine deprivation versus beliefs regarding when nicotine was most recently used. The present study aimed to ascertain whether nicotine deprivation, independent of beliefs regarding recent nicotine use, promotes fear reactivity among smokers.MethodsModerate to heavy smokers without PD (N = 25) participated in a placebo-controlled, double-blind study consisting of two sessions spaced 1 week apart. Participants abstained from nicotine for 2 hr prior to sessions. During one session participants were given a 21 mg nicotine replacement patch and, during the other, a placebo patch, with the order counterbalanced. For both sessions, after a 3-hr absorption period, participants underwent a 10-min CO2 rebreathing challenge.ResultsWearing a nicotine (vs. placebo) patch increased self-reported panic reactivity among participants, but did not significantly affect physiological and behavioral measures of reactivity.ConclusionsIn smokers without a history of PD, nicotine deprivation attenuates subjective panic reactivity. Possible explanations for the contrast between theory and laboratory findings as well as clinical implications are discussed.
      PubDate: 2017-05-10T10:35:37.876433-05:
      DOI: 10.1002/da.22652
       
  • The role of family history of depression and the menopausal transition in
           the development of major depression in midlife women: Study of women's
           health across the nation mental health study (SWAN MHS)
    • Authors: Alicia Colvin; Gale A. Richardson, Jill M. Cyranowski, Ada Youk, Joyce T. Bromberger
      Abstract: BackgroundThis study evaluated whether family history of depression predicts major depression in midlife women above and beyond static risk factors (such as personal history of depression prior to midlife) and risks that may change dynamically across midlife (such as menopausal, psychosocial, and health profiles).MethodsParticipants were 303 African American and Caucasian women (42–52 years at baseline) recruited into the Study of Women's Health across the Nation (SWAN) Mental Health Study (MHS) in Pittsburgh. Major depression was assessed annually with Structured Clinical Interviews for DSM-IV. Family mental health history was collected at the ninth or tenth annual follow-up. Random effects logistic regression was used to assess the relationship between family history of depression and midlife depression, controlling for baseline sociodemographic characteristics and time-varying risk factors.ResultsFamily history of depression was associated with midlife depression after adjusting for participant's history of major depression prior to midlife, trait anxiety and baseline age, and time-varying menopausal status, body mass index, very upsetting life events, and chronic difficulties (OR = 2.24, 95% CI = 1.17–4.29, P = .02). Higher odds of major depression were found when women were late perimenopausal or postmenopausal relative to when they were premenopausal or early perimenopausal (OR = 3.01, 95% CI = 1.76–5.15, P < .0001). However, menopausal status was only associated with major depression among women without a family history.ConclusionsFamily history of depression predicts major depression in midlife women independent of the menopausal transition and other time-varying covariates. Notably, the menopausal transition was associated with increased risk only among women without a family history of depression.
      PubDate: 2017-05-10T10:35:35.1894-05:00
      DOI: 10.1002/da.22651
       
  • Fear learning alterations after traumatic brain injury and their role in
           development of posttraumatic stress symptoms
    • Authors: Daniel E. Glenn; Dean T. Acheson, Mark A. Geyer, Caroline M. Nievergelt, Dewleen G. Baker, Victoria B. Risbrough,
      Abstract: BackgroundIt is unknown how traumatic brain injury (TBI) increases risk for posttraumatic stress disorder (PTSD). One potential mechanism is via alteration of fear-learning processes that could affect responses to trauma memories and cues. We utilized a prospective, longitudinal design to determine if TBI is associated with altered fear learning and extinction, and if fear processing mediates effects of TBI on PTSD symptom change.MethodsEight hundred fifty two active-duty Marines and Navy Corpsmen were assessed before and after deployment. Assessments included TBI history, PTSD symptoms, combat trauma and deployment stress, and a fear-potentiated startle task of fear acquisition and extinction. Startle response and self-reported expectancy and anxiety served as measures of fear conditioning, and PTSD symptoms were measured with the Clinician-Administered PTSD Scale.ResultsIndividuals endorsing “multiple hit” exposure (both deployment TBI and a prior TBI) showed the strongest fear acquisition and highest fear expression compared to groups without multiple hits. Extinction did not differ across groups. Endorsing a deployment TBI was associated with higher anxiety to the fear cue compared to those without deployment TBI. The association of deployment TBI with increased postdeployment PTSD symptoms was mediated by postdeployment fear expression when recent prior-TBI exposure was included as a moderator. TBI associations with increased response to threat cues and PTSD symptoms remained when controlling for deployment trauma and postdeployment PTSD diagnosis.ConclusionsDeployment TBI, and multiple-hit TBI in particular, are associated with increases in conditioned fear learning and expression that may contribute to risk for developing PTSD symptoms.
      PubDate: 2017-05-10T10:35:32.855431-05:
      DOI: 10.1002/da.22642
       
  • New directions for the treatment of depression: Targeting the photic
           regulation of arousal and mood (PRAM) pathway
    • Authors: Hannah E. Bowrey; Morgan H. James, Gary Aston-Jones
      Abstract: Both preclinical and clinical studies demonstrate that depression is strongly associated with reduced light availability, which in turn contributes to decreased function of brain regions that control mood. Here, we review findings that support a critical pathway for the control of mood that depends upon ambient light. We put forward a novel hypothesis, functionally linking retina to locus coeruleus (LC) in depression, and discuss the role of norepinephrine in affective disease. Finally, we discuss how utilizing the chemogenetic tool Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) to precisely control this retina–LC circuit may be used as a novel therapeutic to treat depression.
      PubDate: 2017-05-10T10:35:29.376385-05:
      DOI: 10.1002/da.22635
       
  • Low physical activity as a key differentiating factor in the potential
           high-risk profile for depressive symptoms in older adults
    • Authors: Sofie Holmquist; Sabina Mattsson, Ingrid Schele, Peter Nordström, Anna Nordström
      Abstract: BackgroundThe identification of potential high-risk groups for depression is of importance. The purpose of the present study was to identify high-risk profiles for depressive symptoms in older individuals, with a focus on functional performance.MethodsThe population-based Healthy Ageing Initiative included 2,084 community-dwelling individuals (49% women) aged 70. Explorative cluster analysis was used to group participants according to functional performance level, using measures of basic mobility skills, gait variability, and grip strength. Intercluster differences in depressive symptoms (measured by the Geriatric Depression Scale [GDS]-15), physical activity (PA; measured objectively with the ActiGraph GT3X+), and a rich set of covariates were examined.ResultsThe cluster analysis yielded a seven-cluster solution. One potential high-risk cluster was identified, with overrepresentation of individuals with GDS scores>5 (15.1 vs. 2.7% expected; relative risk = 6.99, P < .001); the prevalence of depressive symptoms was significantly lower in the other clusters (all P < .01). The potential high-risk cluster had significant overrepresentations of obese individuals (39.7 vs. 17.4% expected) and those with type 2 diabetes (24.7 vs. 8.5% expected), and underrepresentation of individuals who fulfilled the World Health Organization's PA recommendations (15.6 vs. 59.1% expected; all P < .01), as well as low levels of functional performance.ConclusionsThe present study provided a potential high-risk profile for depressive symptoms among elderly community-dwelling individuals, which included low levels functional performance combined with low levels of PA. Including PA in medical screening of the elderly may aid in identification of potential high-risk individuals for depressive symptoms.
      PubDate: 2017-05-10T10:35:26.504172-05:
      DOI: 10.1002/da.22638
       
  • Internet and mobile interventions for depression: Opportunities and
           challenges
    • Authors: Pim Cuijpers; Annet Kleiboer, Eirini Karyotaki, Heleen Riper
      Abstract: BackgroundThe Internet offers several new ways of developing, implementing, and disseminating evidence-based interventions for depression.MethodsIn this paper, we narratively synthesized the evidence showing that Internet-based therapies are effective in treating depression.ResultsIn the past decade, a considerable number of psychological treatments have been developed for the treatment of depression and several hundreds of randomized controlled trials have been conducted, showing that these interventions are effective and that there are no major differences in effects between therapies. Several meta-analyses show that Internet-based treatments are also effective in depression. Direct comparisons with face-to-face treatments do not indicate that there are relevant differences between Internet-based and face-to-face treatment formats. The challenge for the near future is to examine how these treatments can be integrated in mental health care. Major opportunities are in preventive services, primary care, specialized mental health care, and in patients with comorbid general medical disorders. New technological innovations through the smartphone, serious gaming, avatars, augmented reality, and virtual reality will give further possibilities to simplify and perhaps increase the effects of treatments.ConclusionsThe Internet offers many possibilities to increase access to evidence-based psychological treatments of depression. New technological may further improve access and, perhaps, the effects of treatments.
      PubDate: 2017-05-04T09:31:04.822289-05:
      DOI: 10.1002/da.22641
       
  • Predicting suicide with the SAD PERSONS scale
    • Authors: Cara Katz; Jason R. Randall, Jitender Sareen, Dan Chateau, Randy Walld, William D. Leslie, JianLi Wang, James M. Bolton
      Abstract: BackgroundSuicide is a major public health issue, and a priority requirement is accurately identifying high-risk individuals. The SAD PERSONS suicide risk assessment scale is widely implemented in clinical settings despite limited supporting evidence. This article aims to determine the ability of the SAD PERSONS scale (SPS) to predict future suicide in the emergency department.MethodsFive thousand four hundred sixty-two consecutive adults were seen by psychiatry consultation teams in two tertiary emergency departments with linkage to population-based administrative data to determine suicide deaths within 6 months, 1, and 5 years.ResultsSeventy-seven (1.4%) individuals died by suicide during the study period. When predicting suicide at 12 months, medium- and high-risk scores on SPS had a sensitivity of 49% and a specificity of 60%; the positive and negative predictive values were 0.9 and 99%, respectively. Half of the suicides at both 6- and 12-month intervals were classified as low risk by SPS at index visit. The area under the curve at 12 months for the Modified SPS was 0.59 (95% confidence interval [CI] range 0.51–0.67). High-risk scores (compared to low risk) were significantly associated with death by suicide over the 5-year study period using the SPS (hazard ratio 2.49; 95% CI 1.34–4.61) and modified version (hazard ratio 2.29; 95% CI 1.24–2.29).ConclusionsAlthough widely used in educational and clinical settings, these findings do not support the use of the SPS and Modified SPS to predict suicide in adults seen by psychiatric services in the emergency department.
      PubDate: 2017-05-04T09:30:55.790991-05:
      DOI: 10.1002/da.22632
       
  • Maternal choline status during pregnancy, but not that of betaine, is
           related to antenatal mental well-being: The growing up in Singapore toward
           healthy outcomes cohort
    • Authors: Linde Lee; Phaik Ling Quah, Seang Mei Saw, Fabian K. P. Yap, Keith M. Godfrey, Yap Seng Chong, Michael J Meaney, Helen Chen, Mary Foong-Fong Chong
      Abstract: BackgroundCholine and betaine status have previously been associated with symptoms of depression. However, the relation of maternal plasma choline and betaine concentrations in pregnancy to peripartum maternal mood is unknown.MethodsMaternal plasma choline and betaine concentrations (μmol/L) were measured at 26–28 weeks gestation in the Growing Up in Singapore Toward healthy Outcomes (GUSTO) mother–offspring cohort. Participants completed the State-Trait Anxiety Inventory (STAI) and Edinburgh Postnatal Depression Scale (EDPS) at 26–28 weeks gestation (n = 949) and at 3 months postnatal (n = 689): higher scores are indicative of more symptoms of anxiety and depression. Multivariate linear regression models were used to estimate the association of choline and betaine with ante- and postnatal mental well-being adjusting for covariates.ResultsMean (SD) antenatal plasma choline and betaine concentrations were 9.2 μmol/L (1.6) and 13.1 μmol/L (2.7), respectively. Plasma choline concentrations were positively associated with antenatal depressive (β = .24 EPDS score [95% CI: 0.05–0.43] per μmol/L] and anxiety symptoms (β = .46 STAI-state score [95% CI: 0.03–0.88] per μmol/L) adjusting for covariates. Plasma betaine concentrations were not associated with antenatal depression or anxiety symptoms. No associations were observed between pregnancy choline or betaine and postnatal mental well-being.ConclusionThis study suggests that higher maternal plasma choline status during pregnancy is associated with more symptoms of antenatal depression and anxiety, whereas plasma betaine concentrations showed no associations. No associations were observed for postnatal mental well-being. Prospective studies are required to replicate these findings and further examine the direction of causality and possible biological mechanisms.
      PubDate: 2017-05-04T09:30:36.310962-05:
      DOI: 10.1002/da.22637
       
  • Less is more: Patient-level meta-analysis reveals paradoxical
           dose-response effects of a computer-based social anxiety intervention
           targeting attentional bias
    • Authors: Rebecca B. Price; Jennie M. Kuckertz, Nader Amir, Yair Bar-Haim, Per Carlbring, Meredith L. Wallace
      Abstract: BackgroundThe past decade of research has seen considerable interest in computer-based approaches designed to directly target cognitive mechanisms of anxiety, such as attention bias modification (ABM).MethodsBy pooling patient-level datasets from randomized controlled trials of ABM that utilized a dot-probe training procedure, we assessed the impact of training "dose" on relevant outcomes among a pooled sample of 693 socially anxious adults.ResultsA paradoxical effect of the number of training trials administered was observed for both posttraining social anxiety symptoms and behavioral attentional bias (AB) toward threat (the target mechanism of ABM). Studies administering a large (>1,280) number of training trials showed no benefit of ABM over control conditions, while those administering fewer training trials showed significant benefit for ABM in reducing social anxiety (P = .02). These moderating effects of dose were not better explained by other examined variables and previously identified moderators, including patient age, training setting (laboratory vs. home), or type of anxiety assessment (clinician vs. self-report).ConclusionsFindings inform the optimal dosing for future dot-probe style ABM applications in both research and clinical settings, and suggest several novel avenues for further research.
      PubDate: 2017-04-28T13:23:02.884652-05:
      DOI: 10.1002/da.22634
       
  • Transdiagnostic neural correlates of affective face processing in anxiety
           and depression
    • Authors: Annmarie MacNamara; Heide Klumpp, Amy E. Kennedy, Scott A. Langenecker, K. Luan Phan
      Abstract: BackgroundIt is unknown whether there are neurobiologic differences between various anxiety and depressive disorders, or whether they are characterized by shared neurobiologic variation that cuts across diagnostic boundaries. For instance, multiple anxiety disorders and depression may be characterized by abnormalities in blood oxygen–level dependent (BOLD) response during the processing of affective scenes and faces. To interrogate the shared or unique nature of these aberrations, research that examines the influence of transdiagnostic, dimensional predictors across multiple diagnoses is needed.MethodsOne hundred ninety-nine individuals, 142 with primary diagnoses of social anxiety disorder (SAD), generalized anxiety disorder (GAD), or major depressive disorder (MDD) and 57 free from psychiatric diagnoses (healthy controls, HCs), performed a face-matching task involving fearful, angry, and happy faces (and geometric shapes) while undergoing functional magnetic resonance imaging.ResultsAcross the three primary diagnoses, anxiety symptom scores were associated with increased Angry > Shapes activation in the bilateral insula, anterior/midcingulate, and dorsolateral prefrontal cortex (dlPFC), while depressive symptoms were associated with reduced dlPFC activation for Angry > Shapes. Patient > HC differences were limited to non a priori regions, and no differences in BOLD activation were observed between diagnostic groups.Conclusions(1) Activation in paralimbic, cingulate, and lateral prefrontal regions in response to angry faces is associated with transdiagnostic anxiety and depressive symptomatology. (2) Anxiety and depressive symptoms may exert opposing influences on lateral prefrontal activation. (3) Abnormal threat processing in GAD, SAD, and MDD may reflect shared neural dysfunction that varies with symptom load.
      PubDate: 2017-04-28T12:17:33.101257-05:
      DOI: 10.1002/da.22631
       
  • Between-visit changes in suicidal ideation and risk of subsequent suicide
           attempt
    • Authors: Gregory E. Simon; Susan M. Shortreed, Eric Johnson, Arne Beck, Karen J. Coleman, Rebecca C. Rossom, Ursula S. Whiteside, Belinda H. Operskalski, Robert B. Penfold
      Abstract: BackgroundWhile clinicians are expected to routinely assess and address suicide risk, existing data provide little guidance regarding the significance of visit-to-visit changes in suicidal ideation.MethodsElectronic health records from four large healthcare systems identified patients completing the Patient Health Questionnaire or PHQ9 at outpatient visits. For patients completing two questionnaires within 90 days, health system records and state vital records were used to identify nonfatal and fatal suicide attempts. Analyses examined how changes in PHQ9 item 9 responses between visits predicted suicide attempt or suicide death over 90 days following the second visit.ResultsAnalyses included 430,701 pairs of item 9 responses for 118,696 patients. Among patients reporting thoughts of death or self-harm “nearly every day” at the first visit, risk of suicide attempt after the second visit ranged from approximately 2.0% among those reporting continued thoughts “nearly every day” down to 0.5% among those reporting a decrease to “not at all.” Among those reporting thoughts of death or self-harm “not at all” at the first visit, risk of suicide attempt following the second visit ranged from approximately 0.2% among those continuing to report such thoughts “not at all” up to 1.2% among those reporting an increase to “nearly every day”.ConclusionsResolution of suicidal ideation between visits does imply a clinically important reduction in short-term risk, but prior suicidal ideation still implies significant residual risk. Onset of suicidal ideation between visits does not imply any special elevation compared to ongoing suicidal ideation. Risk is actually highest for patients repeatedly reporting thoughts of death or self-harm.
      PubDate: 2017-04-25T09:18:29.069758-05:
      DOI: 10.1002/da.22623
       
  • Clinically useful brain imaging for neuropsychiatry: How can we get
           there'
    • Authors: Michael P. Milham; R. Cameron Craddock, Arno Klein
      Abstract: Despite decades of research, visions of transforming neuropsychiatry through the development of brain imaging-based “growth charts” or “lab tests” have remained out of reach. In recent years, there is renewed enthusiasm about the prospect of achieving clinically useful tools capable of aiding the diagnosis and management of neuropsychiatric disorders. The present work explores the basis for this enthusiasm. We assert that there is no single advance that currently has the potential to drive the field of clinical brain imaging forward. Instead, there has been a constellation of advances that, if combined, could lead to the identification of objective brain imaging-based markers of illness. In particular, we focus on advances that are helping to (1) elucidate the research agenda for biological psychiatry (e.g., neuroscience focus, precision medicine), (2) shift research models for clinical brain imaging (e.g., big data exploration, standardization), (3) break down research silos (e.g., open science, calls for reproducibility and transparency), and (4) improve imaging technologies and methods. Although an arduous road remains ahead, these advances are repositioning the brain imaging community for long-term success.
      PubDate: 2017-04-20T12:19:58.433474-05:
      DOI: 10.1002/da.22627
       
  • The feasibility, acceptability, and outcomes of PRIME-D: A novel mobile
           intervention treatment for depression
    • Authors: Danielle A. Schlosser; Timothy R. Campellone, Brandy Truong, Joaquin A. Anguera, Silvia Vergani, Sophia Vinogradov, Patricia Arean
      Abstract: BackgroundDespite decades of research and development, depression has risen from the fifth to the leading cause of disability in the United States. Barriers to progress in the field are (1) poor access to high-quality care; (2) limited mental health workforce; and (3) few providers trained in the delivery of evidence-based treatments (EBTs). Although mobile platforms are being developed to give consumers greater access to high-quality care, too often these tools do not have empirical support for their effectiveness. In this study, we evaluated PRIME-D, a mobile app intervention that uses social networking, goal setting, and a mental health coach to deliver text-based, EBT's to treat mood symptoms and functioning in adults with depression.MethodsThirty-six adults with depression remotely participated in PRIME-D over an 8-week period with a 4-week follow-up, with 83% retained over the 12-week course of thestudy.ResultsOn average, participants logged into the app 5 days/week. Depression scores (PHQ-9) significantly improved over time (over 50% reduction), with coach interactions enhancing these effects. Mood-related disability (Sheehan Disability Scale (SDS)) also significantly decreased over time with participants no longer being impaired by their mood symptoms. Overall use of PRIME-D predicted greater gains in functioning. Improvements in mood and functioning were sustained over the 4-week follow-up.ConclusionsResults suggest that PRIME-D is a feasible, acceptable, and effective intervention for adults with depression and that a mobile service delivery model may address the serious public health problem of poor access to high-quality mental health care.
      PubDate: 2017-04-18T12:06:16.50864-05:0
      DOI: 10.1002/da.22624
       
  • Well-being therapy in depression: New insights into the role of
           psychological well-being in the clinical process
    • Authors: Giovanni A. Fava; Fiammetta Cosci, Jenny Guidi, Elena Tomba
      Abstract: A specific psychotherapeutic strategy for increasing psychological well-being and resilience, well-being therapy (WBT), has been developed and validated in a number of randomized controlled trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continued growth and development, the belief that life is purposeful and meaningful, the possession of quality relations with others, the capacity to manage effectively one's life, and a sense of self-determination. The evidence supporting the use of WBT and its specific contribution when it is combined with other psychotherapeutic techniques is still limited. However, the insights gained by the use of WBT may unravel innovative approaches to assessment and treatment of mood and anxiety disorders, to be confirmed by controlled studies, with particular reference to decreasing vulnerability to relapse and modulating psychological well-being and mood. An important characteristic of WBT is self-observation of psychological well-being associated with specific homework. Such perspective is different from interventions that are labeled as positive but are actually distress oriented. Another important feature of WBT is the assumption that imbalances in well-being and distress may vary from one illness to another and from patient to patient. Customary clinical taxonomy and evaluation do not include psychological well-being, which may demarcate major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same diagnosis.
      PubDate: 2017-04-18T12:06:13.924454-05:
      DOI: 10.1002/da.22629
       
  • Subjective and objective sleep quality modulate emotion regulatory brain
           function in anxiety and depression
    • Authors: Heide Klumpp; Julia Roberts, Mary C. Kapella, Amy E. Kennedy, Anand Kumar, K. Luan Phan
      Abstract: BackgroundDisturbances in emotion regulation and sleep are shared across anxiety and mood disorders. Poor sleep has been shown to impair cognitive processes which may undermine cognitive regulatory function. However, it remains unknown if sleep quality impacts regulatory mechanisms in clinical anxiety and depression.MethodsDuring fMRI, 78 patients with social anxiety disorder, generalized anxiety disorder, and/or major depressive disorder completed a validated emotion regulation task, which involved reappraisal (i.e., decrease negative affect) as compared to viewing aversive images. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and actigraphy, representing subjective and objective measures of sleep, respectively. Regression analysis was conducted with the PSQI and actigraphy sleep efficiency, duration, and wake-after sleep onset variables.ResultsPSQI and actigraphy measures indicated that the majority of patients experienced problematic sleep, however, subjective and objective sleep measures were uncorrelated. Whole-brain voxel-wise regression analysis, controlling for diagnosis, revealed worse self-reported sleep corresponded with less reappraise-related activation in the dorsal anterior cingulate cortex (DACC). The same analysis performed with actigraphy data showed less sleep efficiency positively corresponded with DACC activation. Post-hoc stepwise regression analysis showed these sleep measures predicted DACC activity whereas anxiety and depression symptoms did not.ConclusionsIndividual differences in self-perceived and objective sleep quality differentially modulated the DACC, which is implicated in cognitive reappraisal. Findings suggest neural correlates of emotion regulation tracks different aspects of the sleep experience. Results also indicate sleep disturbance may play a role in the emotion dysregulation observed in anxiety and depressive disorders.
      PubDate: 2017-04-18T12:06:08.973993-05:
      DOI: 10.1002/da.22622
       
  • Meta-analysis of interventions for posttraumatic stress disorder and
           depression in adult survivors of mass violence in low- and middle-income
           countries
    • Authors: Nexhmedin Morina; Mina Malek, Angela Nickerson, Richard A. Bryant
      Abstract: BackgroundMost survivors of mass violence live in low- and middle-income countries (LMICs). We conducted a meta-analysis of randomized controlled psychotherapy trials for adult posttraumatic stress disorder (PTSD) and/or depression in LMICs.MethodsWe included 18 clinical trials (3,058 participants), in which 25 and 18 treatment arms measured symptoms of PTSD and depression, respectively.ResultsActive treatments for PTSD yielded a large aggregated pre–post effect size (g = 1.29; 95% CI = [0.99; 1.59]) and a small to medium effect size at posttreatment when compared to control conditions (g = 0.39; 95% CI = [0.24; 0.55]). Effect sizes were similar for pretreatment versus follow-up (g = 1.75; 95% CI = [1.17; 2.32]) and in comparison to waitlist at follow-up (g = 0.93; 95% CI = [0.56; 1.31]). Active treatments for depression produced large pre–post (g = 1.28; 95% CI = [0.96; 1.61]) and controlled effect sizes (posttreatment, comparison to control conditions, g = 0.86; 95% CI = [0.54; 1.18]).ConclusionsOur findings suggest that psychological interventions can effectively reduce symptoms of PTSD and depression in LMICs. Future research needs to focus on cost-effective interventions that are likely to be disseminated to the large numbers of war survivors in LMICs.
      PubDate: 2017-04-18T12:06:05.741111-05:
      DOI: 10.1002/da.22618
       
  • Targeting memory reconsolidation to prevent the return of fear in patients
           with fear of flying
    • Authors: Jessica L. Maples-Keller; Matthew Price, Tanja Jovanovic, Seth D. Norrholm, Lydia Odenat, Loren Post, Liza Zwiebach, Kathryn Breazeale, Robin Gross, Sae-Jin Kim, Barbara Olasov Rothbaum
      Abstract: BackgroundWhen a memory is recalled, it may again exist in a labile state and stored information becomes amenable to change, a psychobiological process known as reconsolidation. Exposure therapy for anxiety disorders involves accessing a fear memory and modifying it with less fearful information. A preclinical study reported that providing a reminder of a fear memory 10 min prior to extinction training in humans decreased fear up to 1 year later (Schiller et al., 2010). Methods: For this pilot clinical study, we used virtual reality exposure therapy (VRE) for fear of flying (FoF) to determine if using a cue to reactivate the memory of the feared stimulus 10 min prior to exposure sessions leads to fewer anxiety-related behaviors and a more durable response compared to a neutral cue. FoF participants (N = 89) received four sessions of anxiety management training followed by four sessions of VRE. Participants were randomly assigned to receive an FoF cue (reactivation group) or a neutral cue (control group) prior to the VRE sessions. Heart rate (HR) and skin conductance levels (SCLs) were collected during posttreatment and 3-month follow-up assessments as objective markers of fear responding. Results: Treatment was effective and all clinical measures improved equally between groups at posttreatment with maintained gains through follow-ups. Significant differences were identified with regard to HR and SCL indices. Conclusions: These results suggest that memory reactivation prior to exposure therapy did not have an impact on clinical measures but may enhance the effect of exposure therapy at the physiological level.
      PubDate: 2017-04-05T11:03:23.322562-05:
      DOI: 10.1002/da.22626
       
  • History of sexual trauma moderates psychotherapy outcome for posttraumatic
           stress disorder
    • Authors: John C. Markowitz; Yuval Neria, Karina Lovell, Page E. Meter, Eva Petkova
      Abstract: BackgroundModerators of differential psychotherapy outcome for posttraumatic stress disorder (PTSD) are rare, yet have crucial clinical importance. We tested the moderating effects of trauma type for three psychotherapies in 110 unmedicated patients with chronic DSM-IV PTSD.MethodsPatients were randomized to 14 weeks of prolonged exposure (PE, N = 38), interpersonal psychotherapy (IPT, N = 40), or relaxation therapy (RT, N = 32). The Clinician-Administered PTSD Scale (CAPS) was the primary outcome measure. Moderator candidates were trauma type: interpersonal, sexual, physical. We fit a regression model for week 14 CAPS as a function of treatment (a three-level factor), an indicator of trauma type presence/absence, and their interactions, controlling for baseline CAPS, and evaluated potential confounds.ResultsThirty-nine (35%) patients reported sexual, 68 (62%) physical, and 102 (93%) interpersonal trauma. Baseline CAPS scores did not differ by presence/absence of trauma types. Sexual trauma as PTSD criterion A significantly moderated treatment effect: whereas all therapies had similar efficacy among nonsexually-traumatized patients, IPT had greater efficacy among sexually traumatized patients (efficacy difference with and without sexual trauma: IPT vs. PE and IPT vs. RT P’s < .05), specifically in PTSD symptom clusters B and D (P’s < .05).ConclusionsFew studies have assessed effects of varying trauma types on effects of differing psychotherapies. In this exploratory study, sexual trauma moderated PTSD outcomes of three therapies: IPT showed greater benefit for sexually traumatized patients than PE or RT. The IPT focuses on affect to help patients determine trust in their current environments may particularly benefit patients who have suffered sexual assault.
      PubDate: 2017-04-04T10:30:29.771412-05:
      DOI: 10.1002/da.22619
       
  • Associations of childhood bullying victimization with lifetime suicidal
           behaviors among new U.S. Army soldiers
    • Authors: Laura Campbell-Sills; Ronald C. Kessler, Robert J. Ursano, Anthony J. Rosellini, Tracie O. Afifi, Lisa J. Colpe, Steven G. Heeringa, Matthew K. Nock, Nancy A. Sampson, Jitender Sareen, Michael Schoenbaum, Xiaoying Sun, Sonia Jain, Murray B. Stein,
      Abstract: BackgroundPrior studies have documented associations of childhood bullying victimization with suicidal behaviors. However, many failed to adjust for concomitant risk factors and none investigated this relationship in military personnel. This study aimed to estimate independent associations of childhood bullying victimization with suicidal behaviors among U.S. Army soldiers.MethodsSoldiers reporting for basic training completed a cross-sectional survey assessing mental disorders, suicidal behaviors, and childhood adversities including two types of bullying victimization: (1) Physical Assault/Theft and (2) Bullying Comments/Behaviors. Associations of childhood bullying experiences with suicidal behaviors were estimated using discrete-time survival analysis of person–year data from 30,436 soldiers. Models adjusted for sociodemographic factors, childhood maltreatment by adults, and mental disorders.ResultsAfter comprehensive adjustment for other risk factors, more frequent Physical Assault/Theft by peers during childhood was associated with increased odds of lifetime suicidal ideation (adjusted odds ratio [AOR] = 1.18, 95% CI: 1.11–1.26, P < .001) and attempt (AOR = 1.30, 95% CI: 1.13-1.50, P < .001). More frequent Bullying Comments/Behaviors were associated with increased risk of ideation (AOR = 1.30, 95% CI: 1.26-1.35, P < .001), plan (AOR = 1.44, 95% CI: 1.35-1.54, P < .001), attempt (AOR = 1.24, 95% CI: 1.15-1.33, P < .001), and onset of plan among ideators (AOR = 1.09, 95% CI: 1.03-1.15, P = .002). Relative to no bullying victimization, exposure to the most persistent bullying was associated with two- to fourfold increase in risk for suicidal behaviors.ConclusionsChildhood bullying victimization is associated with lifetime suicidal behaviors among new soldiers. Exposure to Bullying Comments/Behaviors during childhood is associated with progression from suicidal ideation to plan. Improved recognition of these relationships may inform risk mitigation interventions for soldiers.
      PubDate: 2017-04-03T09:10:25.286808-05:
      DOI: 10.1002/da.22621
       
  • Prevention of insulin resistance in adolescents at risk for type 2
           
    • Authors: Lauren B. Shomaker; Nichole R. Kelly, Rachel M. Radin, Omni L. Cassidy, Lisa M. Shank, Sheila M. Brady, Andrew P. Demidowich, Cara H. Olsen, Kong Y. Chen, Eric Stice, Marian Tanofsky-Kraff, Jack A. Yanovski
      Abstract: BackgroundDepression is associated with poor insulin sensitivity. We evaluated the long-term effects of a cognitive behavioral therapy (CBT) program for prevention of depression on insulin sensitivity in adolescents at risk for type 2 diabetes (T2D) with depressive symptoms.MethodsOne-hundred nineteen adolescent females with overweight/obesity, T2D family history, and mild-to-moderate depressive symptoms were randomized to a 6-week CBT group (n = 61) or 6-week health education (HE) control group (n = 58). At baseline, posttreatment, and 1 year, depressive symptoms were assessed, and whole body insulin sensitivity (WBISI) was estimated from oral glucose tolerance tests. Dual energy X-ray absorptiometry assessed fat mass at baseline and 1 year. Primary outcomes were 1-year changes in depression and insulin sensitivity, adjusting for adiposity and other relevant covariates. Secondary outcomes were fasting and 2-hr insulin and glucose. We also evaluated the moderating effect of baseline depressive symptom severity.ResultsDepressive symptoms decreased in both groups (P < .001). Insulin sensitivity was stable in CBT and HE (ΔWBISI: .1 vs. .3) and did not differ between groups (P = .63). However, among girls with greater (moderate) baseline depressive symptoms (N = 78), those in CBT developed lower 2-hr insulin than those in HE (Δ-16 vs. 16 μIU/mL, P < .05). Additional metabolic benefits of CBT were seen for this subgroup in post hoc analyses of posttreatment to 1-year change.ConclusionsAdolescent females at risk for T2D decreased depressive symptoms and stabilized insulin sensitivity 1 year following brief CBT or HE. Further studies are required to determine if adolescents with moderate depression show metabolic benefits after CBT.
      PubDate: 2017-03-31T16:10:24.821229-05:
      DOI: 10.1002/da.22617
       
  • Ultra-brief behavioral skills trainings for blood injection injury phobia
    • Authors: Alicia E. Meuret; Erica Simon, Lavanya Bhaskara, Thomas Ritz
      Abstract: BackgroundBlood injection injury (BII) phobia is common, with debilitating consequences to the health and well being of many of its sufferers. BII phobia presents with a unique fear response that can involve drops in blood pressure and ultimately fainting. The aim of this study was to provide proof of concept for a line of brief, easy to implement, video-based interventions for reducing phobic avoidance and fears in BII sufferers. One of the interventions was a novel Hypoventilation Respiratory Training (HRT) aimed at reducing the exaggerated ventilation response (hyperventilation) seen in BII phobia. The response has been linked to cerebral vasoconstriction and fainting symptoms.MethodSixty BII patients were randomly assigned to one of three 12-min video-guided trainings: Symptom-Associated Tension (SAT) training, Relaxation Skills Training (RST), or HRT. Experiential and cardiorespiratory activity to phobic stimuli was assessed before and after training.ResultsBoth SAT and HRT resulted in overall greater reductions of phobic fears and symptoms than RST. SAT significantly increased heart rate during exposure, and HRT led to significantly reduced ventilation, increases in PCO2, and elevated blood pressure throughout exposure and recovery. Treatment expectancy was rated equally high across conditions, whereas credibility ratings were highest for HRT.ConclusionsBrief, video-based instructions in muscle tension and normocapnic breathing are effective in reducing BII symptom severity and require minimal time and expertise. HRT may be particularly helpful in reducing fainting caused by cerebral vasoconstriction.
      PubDate: 2017-03-15T06:25:37.522168-05:
      DOI: 10.1002/da.22616
       
  • Mobile assessment of heightened skin conductance in posttraumatic stress
           disorder
    • Authors: Rebecca Hinrichs; Vasiliki Michopoulos, Sterling Winters, Alex O. Rothbaum, Barbara O. Rothbaum, Kerry J. Ressler, Tanja Jovanovic
      Abstract: BackgroundIncreased psychophysiological reactivity is a hallmark intermediate phenotype of posttraumatic stress disorder (PTSD). Individuals with PTSD exhibit greater skin conductance (SC) responses to trauma scripts than trauma survivors without PTSD. However, trauma scripts require time for development and cannot be easily used in a single visit. Thus, there is a need for a low-cost, easy-to-use, SC recording protocol for PTSD assessment.MethodsUsing a mobile device (eSense) connected to a portable tablet computer, we assessed SC reactivity to a standard trauma interview (STI) in 63 participants recruited from Grady Memorial Hospital in Atlanta, GA, approximately 1 year after trauma exposure. SC response (SCR) was calculated by subtracting the SC level (SCL) at the end of the baseline recording from the maximum SCL during the STI.ResultsSCL was significantly higher during the STI compared to baseline (P < .001), and individuals with PTSD showed significantly greater SCR than individuals without PTSD (P = .006). Logistic regression using SCR with PTSD diagnosis as the outcome showed an odds ratio of 1.76 (95% CI: 1.11–2.78). Lastly, higher SCR during the STI was also significantly associated with PTSD symptom total score controlling for demographics and trauma severity (b = 0.42, P = .001).ConclusionsThe current study demonstrated feasibility of the use of a mobile device for assessing psychophysiological reactivity in those with PTSD. The use of this low-cost, easy-to-use mobile device to collect objective physiological data in concert with a STI can be easily disseminated in clinical and research settings.
      PubDate: 2017-02-21T10:41:20.78788-05:0
      DOI: 10.1002/da.22610
       
  • Technology to train the brain: Pushing methodology and treatment in the
           scientific research symposium 2016
    • Authors: Sheila A. M. Rauch
      PubDate: 2017-02-18T11:10:27.6106-05:00
      DOI: 10.1002/da.22611
       
  • Improving late life depression and cognitive control through the use of
           therapeutic video game technology: A proof-of-concept randomized trial
    • Authors: Joaquin A. Anguera; Faith M. Gunning, Patricia A. Areán
      Abstract: BackgroundExisting treatments for depression are known to have only modest effects, are insufficiently targeted, and are inconsistently utilized, particularly in older adults. Indeed, older adults with impaired cognitive control networks tend to demonstrate poor response to a majority of existing depression interventions. Cognitive control interventions delivered using entertainment software have the potential to not only target the underlying cerebral dysfunction associated with depression, but to do so in a manner that is engaging and engenders adherence to treatment protocol.MethodsIn this proof-of-concept trial (Clinicaltrials.gov #: NCT02229188), individuals with late life depression (LLD) (22; 60+ years old) were randomized to either problem solving therapy (PST, n = 10) or a neurobiologically inspired digital platform designed to enhance cognitive control faculties (Project: EVO™, n = 12). Given the overlapping functional neuroanatomy of mood disturbances and executive dysfunction, we explored the impact of an intervention targeting cognitive control abilities, functional disability, and mood in older adults suffering from LLD, and how those outcomes compare to a therapeutic gold standard.ResultsEVO participants demonstrated similar improvements in mood and self-reported function after 4 weeks of treatment to PST participants. The EVO participants also showed generalization to untrained measures of working memory and attention, as well as negativity bias, a finding not evident in the PST condition. Individuals assigned to EVO demonstrated 100% adherence.ConclusionsThis study provides preliminary findings that this therapeutic video game targeting cognitive control deficits may be an efficacious LLD intervention. Future research is needed to confirm these findings.
      PubDate: 2017-01-03T13:00:01.50571-05:0
      DOI: 10.1002/da.22588
       
  • Depression and Anxiety Issue Information
    • Pages: 471 - 477
      PubDate: 2017-06-08T15:19:32.943078-05:
      DOI: 10.1002/da.22565
       
  • From the ADAA President
    • Authors: Karen Lynn Cassiday
      Pages: 478 - 478
      PubDate: 2017-06-08T15:19:34.218284-05:
      DOI: 10.1002/da.22661
       
  • Technology and mental health
    • Authors: Patricia Areán; Pim Cuijpers
      Pages: 479 - 480
      PubDate: 2017-06-08T15:19:31.996965-05:
      DOI: 10.1002/da.22636
       
  • Digital technology and clinical decision making in depression treatment:
           Current findings and future opportunities
    • Authors: Kevin A. Hallgren; Amy M. Bauer, David C. Atkins
      First page: 494
      Abstract: Clinical decision making encompasses a broad set of processes that contribute to the effectiveness of depression treatments. There is emerging interest in using digital technologies to support effective and efficient clinical decision making. In this paper, we provide "snapshots" of research and current directions on ways that digital technologies can support clinical decision making in depression treatment. Practical facets of clinical decision making are reviewed, then research, design, and implementation opportunities where technology can potentially enhance clinical decision making are outlined. Discussions of these opportunities are organized around three established movements designed to enhance clinical decision making for depression treatment, including measurement-based care, integrated care, and personalized medicine. Research, design, and implementation efforts may support clinical decision making for depression by (1) improving tools to incorporate depression symptom data into existing electronic health record systems, (2) enhancing measurement of treatment fidelity and treatment processes, (3) harnessing smartphone and biosensor data to inform clinical decision making, (4) enhancing tools that support communication and care coordination between patients and providers and within provider teams, and (5) leveraging treatment and outcome data from electronic health record systems to support personalized depression treatment. The current climate of rapid changes in both healthcare and digital technologies facilitates an urgent need for research, design, and implementation of digital technologies that explicitly support clinical decision making. Ensuring that such tools are efficient, effective, and usable in frontline treatment settings will be essential for their success and will require engagement of stakeholders from multiple domains.
      PubDate: 2017-04-28T12:17:40.089793-05:
      DOI: 10.1002/da.22640
       
 
 
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