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Clinical Neuropsychiatry Oct 2023Internalizing and externalizing disorders are developmentally complex entities with multifactorial pathogenesis. The findings from recent research on the transdiagnostic...
OBJECTIVE
Internalizing and externalizing disorders are developmentally complex entities with multifactorial pathogenesis. The findings from recent research on the transdiagnostic responsibility of self-regulation and rumination suggest that their deficits underlie all psychiatric disorders in adults, and yet only a small number of studies have been conducted on the population of adolescents.
METHOD
The clinical study included 162 adolescents, divided into two clinical groups, treated in the Department of Child and Adolescent Psychiatry in Hospital. The first clinical group consisted of 91 adolescents with internalizing mental disorders, with the second clinical group consisting of 71 adolescents with externalizing mental disorders. They had been referred for psychodiagnostic assessment after their first psychiatric examination, and were diagnosed according to the International Classification of Diseases (ICD-)10 criteria, the diagnoses confirmed through structured clinical interviews. They additionally met the inclusion and exclusion criteria for participating in this study.
RESULTS
The results suggest that self-regulation significantly and negatively predicted symptoms of mental disorder in both clinical groups, and rumination significantly predicted symptoms of anxiety and depression in the group of adolescents suffering from internalizing disorders.
CONCLUSIONS
The findings emphasize the importance of maladaptive self-regulation as a transdiagnostic factor underlying various forms of psychopathology in adolescents, and the importance of rumination as a unique transdiagnostic process related to different disorders in the internalizing dimension.
PubMed: 38089740
DOI: 10.36131/cnfioritieditore20230503 -
Behavior Analysis in Practice Dec 2023Rumination is defined as repeated regurgitation of food, not attributed to other medical conditions. Some individuals with autism or other developmental disabilities...
Rumination is defined as repeated regurgitation of food, not attributed to other medical conditions. Some individuals with autism or other developmental disabilities engage in rumination, and it can lead to multiple health issues. Previous research demonstrated that noncontingent presentation of chewing gum could be an effective treatment for reducing ruminations. The current study evaluated the effects of noncontingent chewing gum and contingent gum on rumination of an adolescent boy with autism and the results suggest that both treatments were effective, but contingent gum resulted in the lowest rate of rumination. • Rumination can cause multiple health issues including malnutrition, weight loss, esophagitis, tooth decay, and abnormal gastrointestinal symptoms. • Rumination in individuals with autism is often automatically maintained. • Continuous noncontingent gum and contingent gum may be viable treatments for rumination. • Contingent gum may be a more practical intervention for rumination relative to continuous noncontingent gum.
PubMed: 38076745
DOI: 10.1007/s40617-023-00801-4 -
Neuroscience and Biobehavioral Reviews Jan 2024Prior studies reported mixed effects of the COVID-19 pandemic on the mental health of children and adolescents with ADHD, but they were mainly cross-sectional and... (Review)
Review
Prior studies reported mixed effects of the COVID-19 pandemic on the mental health of children and adolescents with ADHD, but they were mainly cross-sectional and without controls. To clarify the impact, we searched Web of Science, EMBASE, Medline, and PsychINFO until 18/11/2023 and conducted a systematic review of controlled longitudinal cohort studies (Prospero: CRD42022308166). The Newcastle-Ottawa scale was used to assess quality. We identified 6 studies. Worsening of mental health symptoms was more evident in ADHD or control group according to symptom considered and context. However, those with ADHD had more persistent elevated symptoms and remained an at-risk population. Sleep problems deteriorated more significantly in those with ADHD. Lower pre-COVID emotion regulation skills and greater rumination were associated with worse mental health outcomes, and longer screen time with poorer sleep. Quality was rated as low in most studies, mainly due to self-report outcome measures and no information on attrition rates. Despite these limitations, results suggest a predominantly negative impact on youths with ADHD and may guide clinical practice and policy.
Topics: Child; Humans; Adolescent; Attention Deficit Disorder with Hyperactivity; Mental Health; COVID-19; Longitudinal Studies; Pandemics; Cross-Sectional Studies; Cohort Studies
PubMed: 38065419
DOI: 10.1016/j.neubiorev.2023.105502 -
Children (Basel, Switzerland) Oct 2023Previous studies suggest that subjective distress in children with functional neurological disorder (FND) is associated with stress-system dysregulation and modulates...
Previous studies suggest that subjective distress in children with functional neurological disorder (FND) is associated with stress-system dysregulation and modulates aberrant changes in neural networks. The current study documents illness-promoting psychological processes in 76 children with FND (60 girls and 16 boys, aged 10.00-17.08 years) admitted to the Mind-Body Program. The children completed a comprehensive family assessment and self-report measures, and they worked with the clinical team to identify psychological processes during their inpatient admission. A total of 47 healthy controls (35 girls and 12 boys, aged 8.58-17.92 years) also completed self-report measures, but were not assessed for illness-promoting psychological processes. Children with FND (vs. controls) reported higher levels of subjective distress (total DASS score, (104.24) = 12.18; ˂ 0.001) and more adverse childhood experiences across their lifespans (total ELSQ score, (88.57) = 9.38; ˂ 0.001). Illness-promoting psychological processes were identified in all children with FND. Most common were the following: chronic worries about schoolwork, friendships, or parental wellbeing ( = 64; 84.2%); attention to symptoms ( = 61; 80.3%); feeling sad ( = 58; 76.3%); experiencing a low sense of control (helplessness) in relation to symptoms ( = 44; 57.9%); pushing difficult thoughts out of mind ( = 44; 57.9%); self-critical rumination ( = 42; 55.3%); negative/catastrophic-symptom expectations ( = 40; 52.6%); avoidance of activities ( = 38; 50%); intrusive thoughts/feelings/memories associated with adverse events ( = 38, 50%); and pushing difficult feelings out of mind ( = 37; 48.7%). In children with FND-disabled enough to be admitted for inpatient treatment-illness-promoting psychological processes are part of the clinical presentation. They contribute to the child's ongoing sense of subjective distress, and if not addressed can maintain the illness process. A range of clinical interventions used to address illness-promoting psychological processes are discussed, along with illustrative vignettes.
PubMed: 38002815
DOI: 10.3390/children10111724 -
Veterinarni Medicina Sep 2023Jejunal haemorrhage syndrome (JHS) is a sporadic and fatal enterotoxaemic disease in dairy cows associated with acute development and poor prognosis despite...
Jejunal haemorrhage syndrome (JHS) is a sporadic and fatal enterotoxaemic disease in dairy cows associated with acute development and poor prognosis despite treatment. A 5-year-old Holstein cow with no reported pregnancy, three calving numbers, and 303 days in milk presented with hypothermia, discomfort, and inappetence. Anaemia, dehydration, faeces with blood clots, and absence of rumen and bowel movements were observed. We identified the presence of neutrophilia, hyperglycaemia, hypoproteinaemia, azotaemia, hyperlactatemia, hypocalcaemia, hypermagnesemia, hypokalaemia, and hypochloraemia through blood analyses. Necropsy and histopathologic examination revealed a dilated bluish-purple jejunum, blood clots within the jejunum, neutrophil infiltration into the submucosa of the jejunum, and vascular necrosis. Retrospective examination revealed extraordinary patterns of rumination time, activity, rumen mobility, and rumen temperature using biosensors and decreased milk yield. The abnormalities in the affected cow were detected before recognition by farm workers. To the best of our knowledge, this is the first report to examine data from biosensors in a cow with JHS. Our findings suggest that using biometric data may help understand the development of JHS.
PubMed: 37981941
DOI: 10.17221/73/2023-VETMED -
PloS One 2023With the widespread use of smartphones, many people spend much time on smartphones for shopping, learning, socializing, and so on, which can affect an individual's...
With the widespread use of smartphones, many people spend much time on smartphones for shopping, learning, socializing, and so on, which can affect an individual's mental health and work performance. Especially, individual perceived conflict at work may increase their social anxiety and thus raise the risk of their smartphone addiction. This study collected data from 577 corporate employees in China through convenience sampling to explain the influence mechanism of work conflict on smartphone addiction and to verify the moderating role of rumination. Statistical results show that relationship conflicts, task conflicts, and process conflicts positively affect smartphone addiction by enhancing social anxiety. Moreover, rumination positively moderates the relationship between work conflict and smartphone addiction. People with high rumination are more likely to escape reality due to conflict at work, which further enhances their smartphone addiction behaviors. Our study suggests that a relatively harmonious working atmosphere should be established within organizations, especially for employees with rumination. Work conflict is a predisposing factor for social anxiety and smartphone addiction in individuals with high rumination.
Topics: Humans; Internet Addiction Disorder; Behavior, Addictive; Smartphone; Social Behavior; Learning
PubMed: 37956132
DOI: 10.1371/journal.pone.0287669 -
Journal of Eating Disorders Nov 2023Recent research suggests that individuals with eating disorders (EDs) report elevated anhedonia, or loss of pleasure. Although individuals with avoidant/restrictive food...
BACKGROUND
Recent research suggests that individuals with eating disorders (EDs) report elevated anhedonia, or loss of pleasure. Although individuals with avoidant/restrictive food intake disorder (ARFID) often express that they do not look forward to eating, it is unclear whether they experience lower pleasure than those without EDs. Thus, identifying whether individuals with ARFID experience anhedonia may yield important insights that inform clinical conceptualization and treatment.
METHODS
A sample of 71 participants ages 10-23 with full and subthreshold ARFID and 33 healthy controls (HCs) completed the Pica, ARFID, and Rumination Disorder Interview, a diagnostic interview to assess ARFID profile severity (lack of interest in food, sensory sensitivity, fear of aversive consequences) and the Temporal Experience of Pleasure Scale (TEPS), a self-report measure of consummatory and anticipatory pleasure. Statistical analyses were performed using the full TEPS and also the TEPS with food-related items removed.
RESULTS
The ARFID group reported significantly lower anticipatory and consummatory pleasure compared to HCs, but these differences were no longer significant after controlling for depression, nor after removing food items from the TEPS. Within the ARFID sample, greater ARFID severity was associated with lower anticipatory pleasure across analyses, and greater endorsement of the lack of interest in food profile was related to lower anticipatory pleasure. ARFID severity was also associated with lower consummatory pleasure using the full TEPS, but this relationship was no longer significant with food items removed.
CONCLUSIONS
These results provide initial evidence for lower pleasure before potentially pleasurable events in individuals with more severe ARFID, particularly those with the lack of interest phenotype. Our findings also suggest that depression is likely to contribute low pleasure in this population. Future research should seek to further characterize how dimensions of pleasure relate to the maintenance and treatment of ARFID symptoms.
PubMed: 37950288
DOI: 10.1186/s40337-023-00921-w -
MedRxiv : the Preprint Server For... Oct 2023Rumination is a transdiagnostic problem that is common in major depressive disorder (MDD). Rumination Focused Cognitive Behavioral Therapy (RF-CBT) explicitly targets...
BACKGROUND
Rumination is a transdiagnostic problem that is common in major depressive disorder (MDD). Rumination Focused Cognitive Behavioral Therapy (RF-CBT) explicitly targets the ruminative habit. This study examined changes in brain activation during a rumination induction task in adolescents with remitted MDD following RF-CBT. We also evaluated the reliability of the rumination task among adolescents who received treatment as usual (TAU).
METHOD
Fifty-five adolescents ages 14-17 completed a self-relevant rumination induction fMRI task and were then randomized to either RF-CBT (n = 30) or TAU (n = 25). Participants completed the task a second time either following 10-14 sessions of RF-CBT or the equivalent time delay for the TAU group. We assessed activation change in the RF-CBT group using paired-samples t-tests and reliability by calculating intraclass correlation coefficients (ICCs) of five rumination-related ROIs during each of three blocks for the TAU and RF-CBT groups separately (Rumination Instruction, Rumination Prompt, and Distraction).
RESULTS
Following treatment, participants in the RF-CBT group demonstrated an increase in activation of the left precuneus during Rumination Instruction and the left angular and superior temporal gyri during Rumination Prompt ( < .01). The TAU group demonstrated fair to excellent reliability ( = .52, range = .27-.86) across most ROIs and task blocks. In contrast, the RF-CBT group demonstrated poor reliability across most ROIs and task blocks ( = .21, range = -.19-.69).
CONCLUSION
RF-CBT appears to lead to rumination-related brain change. We demonstrated that the rumination induction task has fair to excellent reliability among individuals who do not receive an intervention that explicitly targets the ruminative habit, whereas reliability of this task is largely poor in the context of RF-CBT. This has meaningful implications in longitudinal and intervention studies, particularly when conceptualizing it as an important target for intervention. It also suggests one of many possible mechanisms for why fMRI test-retest reliability can be low that appears unrelated to the methodology itself.
PubMed: 37873244
DOI: 10.1101/2023.10.09.23296759 -
BMC Psychiatry Oct 2023Adolescence is characterized by a heightened vulnerability for Major Depressive Disorder (MDD) onset, and currently, treatments are only effective for roughly half of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Adolescence is characterized by a heightened vulnerability for Major Depressive Disorder (MDD) onset, and currently, treatments are only effective for roughly half of adolescents with MDD. Accordingly, novel interventions are urgently needed. This study aims to establish mindfulness-based real-time fMRI neurofeedback (mbNF) as a non-invasive approach to downregulate the default mode network (DMN) in order to decrease ruminatory processes and depressive symptoms.
METHODS
Adolescents (N = 90) with a current diagnosis of MDD ages 13-18-years-old will be randomized in a parallel group, two-arm, superiority trial to receive either 15 or 30 min of mbNF with a 1:1 allocation ratio. Real-time neurofeedback based on activation of the frontoparietal network (FPN) relative to the DMN will be displayed to participants via the movement of a ball on a computer screen while participants practice mindfulness in the scanner. We hypothesize that within-DMN (medial prefrontal cortex [mPFC] with posterior cingulate cortex [PCC]) functional connectivity will be reduced following mbNF (Aim 1: Target Engagement). Additionally, we hypothesize that participants in the 30-min mbNF condition will show greater reductions in within-DMN functional connectivity (Aim 2: Dosing Impact on Target Engagement). Aim 1 will analyze data from all participants as a single-group, and Aim 2 will leverage the randomized assignment to analyze data as a parallel-group trial. Secondary analyses will probe changes in depressive symptoms and rumination.
DISCUSSION
Results of this study will determine whether mbNF reduces functional connectivity within the DMN among adolescents with MDD, and critically, will identify the optimal dosing with respect to DMN modulation as well as reduction in depressive symptoms and rumination.
TRIAL REGISTRATION
This study has been registered with clinicaltrials.gov, most recently updated on July 6, 2023 (trial identifier: NCT05617495).
Topics: Humans; Adolescent; Depressive Disorder, Major; Mindfulness; Magnetic Resonance Imaging; Neurofeedback; Gyrus Cinguli; Brain; Brain Mapping
PubMed: 37848857
DOI: 10.1186/s12888-023-05223-8 -
BMC Psychiatry Oct 2023Research that focused on the mechanisms underlying the relation between school bullying victimization and PTSD ignored the simultaneous effect of emotional and cognitive...
BACKGROUND
Research that focused on the mechanisms underlying the relation between school bullying victimization and PTSD ignored the simultaneous effect of emotional and cognitive factors, which may limit our comprehensive understanding of their roles. Besides, most researchers included non-bullying victims in data analysis, and this may mask the true effect among bullying victims. The present study aimed to explore the relation between bullying victimization and PTSD, and the mediating roles of social anxiety, loneliness, and rumination, after filtering out non-bullying victims.
MATERIALS AND METHODS
In April 2019, we used convenience sampling to recruit 5013 students from Grade 10 and 11 in two high schools in Anhui Province, China. The mean age of these students was 16.77 (SD = 0.92) years. They completed five self-report questionnaires including the Delaware Bullying Victimization Scale-Student Chinese Revision (DBVS-S), the modified PTSD Checklist, the Social Anxiety Scale, the Adolescent Loneliness Scale, and the Rumination Scale. Further, a total of 443 bullying victims were screened out for this study according to the critical score of the DBVS-S.
RESULTS
The results showed that bullying victimization had a direct and positive association with PTSD among adolescents (β = 0.16, 95%CI: 0.046-0.252). Bullying victimization was positively associated with PTSD through increasing adolescents' social anxiety (β = 0.06, 95%CI: 0.017-0.105), as well as through increasing their loneliness (β = 0.16, 95%CI: 0.109-0.215). In addition, bullying victimization was positively associated with PTSD through social anxiety via loneliness (β = 0.04, 95%CI: 0.013-0.067), as well as through loneliness via rumination (β = 0.02, 95%CI: 0.003-0.033). Bullying victimization was also positively associated with PTSD through a three-step path from social anxiety to rumination via loneliness (β = 0.004, 95%CI: 0.001-0.009).
CONCLUSIONS
Social anxiety, loneliness, and rumination have important mediating effects in the relation between bullying victimization and adolescents' PTSD, in which emotional factors (e.g., social anxiety, loneliness) are more crucial than cognitive factors (e.g., rumination). Intervention should pay more attention to timely alleviate victims' emotional problems to reduce the risk of developing PTSD.
Topics: Adolescent; Humans; Bullying; Crime Victims; East Asian People; Emotions; Stress Disorders, Post-Traumatic; Students
PubMed: 37848816
DOI: 10.1186/s12888-023-05212-x