Clinical Interview Research Articles

Influence of Stress Factors on the Development of Post-Traumatic Stress Disorder in Children: Risk Factors

In the current conditions of the ongoing war in Ukraine, which began in February 2022, Ukrainian children might develop post-traumatic stress disorder (PTSD) due to stress factors caused by the conflict between Ukraine and Russian-backed separatist forces, along with the Russian military. In particular, the relationship between reduced emotional intelligence and the development of post-traumatic stress disorder in children has become more relevant. This study aimed to assess structural and cognitive changes in children with PTSD and their relationship to depression, anxiety, and event segmentation. The study methods included clinical interviews (CAPS-CA-5 scale), neuropsychological tests (short-term and long-term memory tests), self-assessment questionnaires (standardised CDI, RCADS and SCAS-Child scales), and a single-shotMRI. The results showed that patients with post-traumatic stress disorder had reduced hippocampal volume (p=0.018) and the volume of cingulate cortex isthmus (p=0.026). Diffusion in the cerebellum-hippocampal tract was reduced (p=0.014). The level of depression was positively correlated with hippocampal volume (r=0.32, p=0.021) and anxiety with the volume of cingulate cortex isthmus (r=0.26, p=0.048). These results emphasise the importance of the relationship between structural changes and levels of depression and anxiety in patients with PTSD. Prospects for further research are based on the study of the long-term effects of psychotherapeutic interventions aimed at improving cognitive function in patients with posttraumatic stress disorder.

The psychosocial impacts of the 15 March terrorist attack on the Christchurch Muslim community: A descriptive, cross-sectional assessment.

On 15 March 2019, a white supremacist terrorist carried out sequential attacks on two mosques in Christchurch, New Zealand during Friday prayers. This resulted in the loss of 51 lives, 40 others sustained gunshot injuries, and there were approximately 250 survivors. This study aimed to evaluate the impacts on community members, assess clinical needs, facilitate access to appropriate interventions and provide insights into working with a traumatised and diverse population. This cross-sectional study used semi-structured clinical interviews and self-report measures to assess social and demographic factors, mental health disorders and well-being for adult Muslims 11-32 months post-attack. A total of 189 participants completed assessments. The sample was diverse, representing 34 different ethnicities and participant proximity to the attack was complex, with personal and familial exposures. Elevated levels of psychological distress and psychopathology were found with 38% of participants reporting moderate/severe psychological distress on the Kessler-10, 39% reporting post-traumatic stress disorder on the post-traumatic stress disorder checklist-5, and 40% reporting poor well-being or possible depression on the World Health Organization-5 Well Being Index. Secondary stressors were also documented, as well as high scores for post-traumatic growth and the importance of faith. This study provides valuable insights into the repercussions of the Christchurch mosque attack on the affected community, describing the complexity of exposure and the substantial burden of morbidity experienced. It also highlights the high levels of social connectedness and the role of faith in promoting positive outcomes in the recovery process for this population.

Characterization of pain and somatization and its relationship with psychopathology in early onset psychosis

BackgroundEarly onset psychosis (EOP) frequently presents with a severe clinical phenotype and poor long-term prognosis. Clinical experience suggests that individuals with EOP have abnormal pain and somatosensory processing, yet relative to adult-onset psychosis, pain and somatic sensory processing in EOP have rarely been studied. MethodsThe history of two characteristic patients is described to illustrate clinical presentations of pain in EOP patients. Furthermore, 31 patients with EOP were studied with self-reported questionnaires informing on pain severity, pain catastrophizing, central sensitization, and somatization. Structured clinical interviews were administered to confirm Diagnostic and Statistical Manual of Mental Disorders-5 EOP diagnosis and the patient's dimensions of psychopathology were measured by the Brief Psychiatric Rating Scale (BPRS). ResultsOut of 31 EOP patients, 22 reported distressing pain, where higher pain severity corresponded with greater BPRS total and affectivity and resistance subscale scores. The degree of psychopathology was associated (N = 31; p < 0.05, FDR-corrected) with the magnitude of pain catastrophizing, central sensitization, and somatization. Multivariate analysis revealed relationships (N = 31; p < 0.05, FDR-corrected) between BPRS subscale (negative symptoms and activation) scores with somatization severity. The observed associations occurred independent of antipsychotic medication usage as quantified by chlorpromazine equivalent doses. ConclusionsPain and somatosensory symptoms could be a frequent cause of distress in patients with EOP and their severity associated with the degree of psychopathology. Future studies should determine if treating pain and somatic symptoms in EOP patients can lead to better control of psychosis as well as improve quality of life.

Psychotic symptoms in Chinese adolescent patients with major depressive disorder: prevalence and related endocrine clinical factors

ObjectiveMajor depressive disorder (MDD) is often accompanied by psychotic symptoms. However, few studies have examined the relationship between psychotic symptoms and endocrine factors in adolescent patients with MDD. Therefore, this study aimed to investigate the prevalence and related endocrine clinical factors of psychotic symptoms in Chinese adolescent patients with MDD.MethodsIn total, 601 patients (aged 12–18) with MDD were recruited. The Patient Health Questionnaire – 9 items (PHQ – 9) was utilized for assessing depressive symptoms. Psychotic symptoms were assessed through clinical interviews. Prolactin (PRL), thyroid-stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), and free thyroxine (FT4) were also measured.ResultsThe incidence of psychotic symptoms in adolescent patients with MDD was 22.6%. The findings demonstrated that age, self-harming behavior, PHQ-9 score, FT4, and normalized PRL were independently associated with psychotic symptoms in patients with MDD (All p < 0.05).ConclusionsPRL and FT4 levels are more likely to be abnormally elevated in major depressive adolescents with psychotic symptoms. Prolactin and thyroid hormones in patients with MDD should be paid more attention.

Mental Health and Social Correlates of Reincarceration of Youths as Adults.

The rise in the U.S. prison population over the past 40 years has heightened scrutiny of the incarceration of children and adolescents. Correlates of later reincarceration in this group, especially correlates relating to psychiatric and substance use disorders, are understudied in the U.S. population. We aimed to establish the prevalence and correlates of the reincarceration as adults of people incarcerated before age 18. Data were derived from clinical interviews and from validated diagnostic and psychometric instruments. They were obtained as part of a cross-sectional representative survey of the civilian U.S. population, the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). We identified 1,543 adults (4.3% of the NESARC sample) who had been incarcerated before they were 18. Of these, 55.9 percent had subsequently been incarcerated as adults. In addition to variables that have been repeatedly identified in criminological research (less education, past antisocial behavior, and parental imprisonment), substance use disorder, bipolar disorder, and longer childhood incarceration were independently associated with incarceration as an adult. The possibility that psychiatric treatment could reduce reincarceration in this group warrants longitudinal and experimental research.

Facial image analysis for automated suicide risk detection with deep neural networks

Accurately assessing suicide risk is a critical concern in mental health care. Traditional methods, which often rely on self-reporting and clinical interviews, are limited by their subjective nature and may overlook non-verbal cues. This study introduces an innovative approach to suicide risk assessment using facial image analysis. The Suicidal Visual Indicators Prediction (SVIP) Framework leverages EfficientNetb0 and ResNet architectures, enhanced through Bayesian optimization techniques, to detect nuanced facial expressions indicating mental state. The models’ interpretability is improved using GRADCAM, Occlusion Sensitivity, and LIME, which highlight significant facial regions for predictions. Using datasets DB1 and DB2, which consist of full and cropped facial images from social media profiles of individuals with known suicide outcomes, the method achieved 67.93% accuracy with EfficientNetb0 on DB1 and up to 76.6% accuracy with a Bayesian-optimized Support Vector Machine model using ResNet18 features on DB2. This approach provides a less intrusive, accessible alternative to video-based methods and demonstrates the substantial potential for early detection and intervention in mental health care.

Current clinical practice of prurigo nodularis in Japan: A cross-sectional web-survey among dermatologists.

Prurigo nodularis (PN) is a chronic inflammatory skin disease associated with intense pruritic nodules. The unclear patho-etiological mechanisms of PN cause difficulty in disease management; and there is a paucity of information on the current diagnosis and treatment options for PN in Japan. To describe the current management from a dermatologists' perspective we conducted a web-based survey (UMIN Clinical Trial Registry UMIN000047643) in 2022 among dermatologists from a Japanese commercially available physician panel, who had seen at least one patient with PN within the last 3 months. The survey included 117 dermatologists. The dermatologists diagnosed PN mainly by confirming clinical signs and patient interviews, while to assess the severity of PN, the number of pruritic nodules and the degree of itching were primarily utilized. Topical corticosteroids and antihistamines were the most used drugs, as recommended in the current guidelines on the diagnosis and treatment of prurigo. Dermatologists' treatment satisfaction decreased with increasing assumed severity of PN; almost 65% dermatologists were not satisfied with the treatment of severe PN. These results suggest the need of more effective medications and diagnostic tools for better management of PN in Japan.

The role of impulsivity and binge eating in outpatients with overweight or obesity: an EEG temporal discounting study

BackgroundBinge eating (BE) is associated with a range of cognitive control deficits related to impulsivity, including lower response inhibition, preference for immediate gratification, and maladaptive decision-making. The aim was to investigate whether impulsivity and BE may interact with the decision process and underlying brain activity in outpatients with overweight or obesity who are starting a treatment to achieve weight loss.MethodsA sample of 26 treatment-seeking outpatients with overweight or obesity was evaluated for impulsivity, BE, and temporal discounting rates. Impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11), according to which two groups were composed: high BIS and low BIS; BE was assessed with the eating disorders module of the Structured Clinical Interview for DSM5—Research Version, according to which two groups were composed: with (BE group) or without BE (NBE group). Changes in subjective value of rewards were measured with the Temporal Discounting Task (TDt) where participants had to choice between sooner but smaller vs. later but larger monetary rewards. These choices were made in two differently delayed conditions (“Now” and “Not-now”). Brain rhythms were recorded through high-density electroencephalogram (hd-EEG) during the TDt.ResultsPatients with BE reported more impulsive tendencies and perceived sooner rewards as more gratifying when both options were delayed (Not-now condition, p = 0.02). The reward choice in the TDt was accompanied by a general EEG alpha band desynchronization in parietal areas observed without differences between experimental conditions and patients groups. No effects were observed within the Now condition or in the other EEG bands.ConclusionsThe tendency to favor immediate rewards may constitute an obstacle to adhering to treatment plans and achieving weight loss goals for outpatients with overweight or obesity. Clinicians are therefore encouraged to include psychological factors, such as impulsivity and dysfunctional eating behaviors, when designing weight loss programs. By addressing these psychological aspects, clinicians can better support patients in overcoming barriers to adherence and achieving sustainable weight loss.Trial registrationThis study was approved by the Ethics Committee of the Department of Psychological, Health, and Territorial Sciences of the University G. d’Annunzio of Chieti-Pescara (Prot. n. 254 of 03/14/2017).

Early Intervention after Rape to prevent post-traumatic stress symptoms (the EIR-study): an internal pilot study of a randomized controlled trial

BackgroundRape is one of the trauma incidents with the highest risk of subsequent post-traumatic stress disorder. Early interventions, such as prolonged exposure therapy (PE), have shown promise in preventing PTSD following a sexual assault. The primary objective of this internal pilot trial was to examine the feasibility of the EIR study protocol, which used modified prolonged exposure therapy (mPE) as a preventive intervention after rape.MethodsThis parallel two-arm clinical pilot study involved three sexual assault centers (SACs) in Trondheim, Oslo, and Vestfold, with data collected between June 2022 and March 2023. Women seeking assistance at one of these three SACs within 72 h after rape or attempted rape received acute medical treatment and forensic examinations. Women who wanted further psychosocial treatment were, if eligible and consenting, recruited to complete baseline assessments and a clinical interview before being randomized to one of two study arms. The intervention group prescribed up to five sessions of modified PE (mPE) in addition to treatment as usual (TAU), starting within the first 14 days after the rape incident, followed by weekly sessions. The other group received TAU.The present pilot evaluation is based on 22 participants, i.e., nine mPE + TAU and 13 TAU alone. Primary outcomes were predefined progression criteria regarding recruitment, retention, intervention implementation, a harm reporting system, and applying biological measurements and actigraphy.ResultsDuring the 6-month recruitment period, 235 women visited the three SACs. After eligibility screening and consent, 22 (9.4%) women were randomized. Three months later, 14 (63.6%) participants completed the final assessments. Intervention implementation was successful using trained SAC personnel to deliver mPE. The harm reporting system was used according to the study’s plan, and adverse and serious adverse events were detected during the trial. The biological measurements and actigraphy had substantial missing data but were still considered usable for statistical analyses.ConclusionIt may be feasible to conduct a full-scale RCT of early intervention after rape by comparing mPE + TAU to TAU alone. Minor design refinements were made to the protocol to enhance the main study outcome.Trial registrationClinicalTrials.gov Identifier: NCT05489133. Registered on 15 July 2022, retrospectively.

Odor identification dysfunction in late-life depression with suicidal ideation

BackgroundSuicide is more prevalent among older adults compared to younger individuals. Late-life depression (LLD) poses the highest risk for suicide. However, early recognition of suicidal ideation is challenging. Dysfunction in odor identification (OI), a characteristic of LLD, may hold potential for early identification of suicidal ideation. This study aims to compare OI between LLD patients with suicidal ideation (LLD-S) and LLD patients without suicidal ideation (LLD-NS), and examine its relationship with cognitive function. MethodsA total of 262 LLD-NS patients, 63 LLD-S patients, and 316 healthy normal older adults (HOAs) underwent OI testing, standardized clinical interviews, and comprehensive neuropsychological assessments. Results(1) LLD-S patients exhibited lower OI scores and poorer cognitive performance (including global cognition, information processing speed, memory, language, executive function, and visuospatial ability) compared to LLD-NS patients and HOAs. (2) There were interactive effects between suicidal ideation and OI dysfunction, leading to lower scores in information processing speed and visuospatial ability. (3) OI dysfunction mediated the differences in cognition between the LLD-NS and LLD-S groups. LimitationsThe present study was a cross-sectional design. ConclusionsLLD-S patients had worse odor identification than LLD-NS patients and HOAs, suggesting that OI testing could be a valuable approach for identifying suicidal ideation in LLD and screening for suicide risk. The presence of both OI impairment and suicidal ideation was associated with poorer cognitive performance in LLD.

An Item Response Theory Analysis of the Psychosis Screening Questionnaire in Ethiopia.

Few psychosis screening instruments have been tested for use in Africa, yet appropriate tools can increase the detection of self-reported psychotic symptoms, improve the detection of psychosis and impact its prognosis. The construct validity and factor structure of Psychosis Screening Questionnaire (PSQ) were tested with confirmatory factor analysis (CFA) and item response theory (IRT) in a sample of 1928 Ethiopian adults without any history of psychosis. We tested a unidimensional model with and without an item on mania. For IRT, unidimensional latent structure one-parameter logistic (1PL) and two-parameter (2PL) logistic models were tested and compared for relative fit using a likelihood-ratio test. The prevalence of lifetime positive screens was 2.8% in an Ethiopian sample of adults from a general medical setting. A unidimensional model demonstrated good fit for the PSQ, (CFI = 0.993, TLI = 0.986 and RMSEA = 0.025). For IRT, a 2PL model was the best fitting one. IRT tests of item difficulty and discrimination parameters showed that paranoia had the highest discrimination and lowest difficulty ( ), likely to be endorsed at low levels of psychotic features. Thought insertion had the highest item difficulty ( ). Overall, the measure captures the psychosis construct at higher levels of the latent trait and may be suited for detecting moderate to severe levels of psychosis. The PSQ is found to have good construct validity in screening for psychosis among Ethiopian adults. Future studies may focus on the diagnostic validity of the PSQ comparing it with a structured clinical interview.

Personality traits and change in depression status at 18 months: Findings from a British Psychiatric Morbidity Survey

BackgroundDepression is a common mental disorder, yet it shows low remission rates. The available evidence on personality traits as factors associated with the course of depression has common methodological limitations. Identifying personality traits linked with depression can improve understanding of the course of illness. Therefore, we aimed to investigate personality traits that are associated with the course of depression over 18 months. Methodslongitudinal data of 2366 Adult Psychiatric Morbidity Survey respondents were analysed. Assessments were applied at two-time points (baseline) and follow-up (about 18 months later). We assessed the total score on the screening questionnaire from the Structured Clinical Interview (SCID-II) for the dependent, obsessive-compulsive, and borderline personalities. Depression was measured using the revised Clinical Interview Schedule (CIS-R) version. ResultsAn increase of one score on the borderline personality scale at baseline increased the odds of experiencing persistent depression by 1.50 times (OR = 1.50, 95 % CI [1.22–1.86]), depression onset by 1.30 times (OR = 1.30, 95 % CI [1.14–1.50]), and recovery by 1.52 times (OR = 1.52, 95 % CI [1.35–1.70]), comparing to no depression group. Elevated scores of dependent personality traits significantly predicted depression persistence (OR = 1.95, 95 % CI [1.52–2.49]). An increase of one score on the obsessive-compulsive personality scale increases the odds of depression onset by 1.21 times (OR = 1.21, 95 % CI [1.04–1.39]). LimitationsThe APMS survey defined depression statuses in a limited sense, which may affect the generalisability of these results. ConclusionThe present study confirms previous findings and contributes evidence suggesting that personality dysfunctions worsen depression outcomes.

Clinician Perspectives on Palliative Care for Older Adults With Serious Mental Illnesses: A Multisite Qualitative Study

ObjectivesApproximately 5.5% of the population live with serious mental illnesses (SMI). Older adults with SMI experience a high burden of serious medical illnesses and disparities in advance care planning, symptom management, and caregiver support. The objectives of this study are to explore interdisciplinary clinician perspectives on the palliative care needs of older adults with SMI and serious medical illnesses. Design, setting, and participantsThis qualitative study utilized thematic analysis of semi-structured interviews of interdisciplinary clinicians practicing palliative care, geriatrics, or geriatric/consultation-liaison psychiatry at four hospitals within an urban health system. MeasurementsThemes related to care of older adults with serious mental illness and serious medical illness with respect to clinician experiences, challenges in care, and opportunities to improve care. ResultsThe authors interviewed 45 clinicians. Major themes identified were: (1) Current paradigms of palliative care do not meet the needs of patients with SMI; (2) Clinicians are motivated to care for this population but require more training and interdisciplinary practice; (3) There is a need for structural integration of psychiatric and palliative care services. ConclusionsThe study underscores the inadequacy of current palliative care models in meeting the unique needs of older adults with SMI. Models of integrated psychiatric and serious illness care and enhanced training are needed to improve the delivery of palliative care. Integrated care models and workforce development at the interface of serious illness care and psychiatric have the potential to improve outcomes for this vulnerable population.

How Do We Better Serve Excluded Populations When Delivering Digital Health Technology? Inclusion Evaluation of a Digital Musculoskeletal Self-Management Solution.

Digital self-management platforms have been proposed as a solution to better support people manage their musculoskeletal (MSK) condition. However, research studies often explicitly exclude people who can't access internet connected devices. An important consideration is that digital exclusion (for people without access to an internet connected device) from these new digital options will worsen already existing inequality and inequity in healthcare. To evaluate the acceptability and potential causes of digital exclusion of the South West London (SWL) MSK self-management app. (1) Explore why some patients are not using the app and any barriers they have. Explore why some clinicians are not prescribing the app. (2) Make recommendations, based on these findings, to improve digital inclusion. An explanatory sequential mixed method service evaluation that consisted of initial questionnaires to identify suitable collaborators, followed by structured interviews of patients and clinicians. Following a comprehensive data analysis, 10 sub-themes were grouped into four main themes: (1) Beliefs: Importance of understanding the role of digital; face to face consultation is still valued and needed. (2) Barriers: Lack of digital literacy; lack of physical examination/contact with a clinician. (3) Enablers: Immediate access to advice and information; perceived better control over health; ease of use; no appointment needed. (4) Solutions: Support and training; greater awareness. As digital health technology develops, strategies must change, requiring deliberate work and investments to improve inclusion. Our findings highlight how digital technology design and delivery can be adapted to address the causes of digital exclusion.

Originalbeiträge (Originals). High Young schema levels predict manualized confrontation therapy outcome in patients with panic disorder / Der Einfluss von Schemata nach Young auf das Therapieergebnis von Patienten mit Panikstörung

The role of schemas is well established in personality disorders. Their influence on therapy outcome of patients with Axis I disorders remains unclear. Therefore, patients with a panic disorder (PD) with/without agoraphobia varying in their expression of early maladaptive schemas were examined regarding therapy outcomes after exposure therapy. In this study, a sample of 216 patients with panic disorder with/without agoraphobia were recruited in a day clinic. After the initial diagnosis with the Structured Clinical Interview, the patients filled out the Young Schema Questionnaire (YSQ-S2), Beck Depression Inventory and Revised Symptom Checklist. Afterwards, they participated in a five-week manualized exposure therapy by Lang et al. (2011). Subjects with high schema scores showed lower therapeutic success rates than subjects with a weaker pattern score. In addition, it was found that high schema levels, especially of schemas regarding impaired autonomy and achievement (YSQ-S2: domain 2), influenced therapy outcome by either predicting more/severe or less/milder anxiety-, phobicrelated and general symptoms after therapy. The results of this study emphasize the role of schemas not only for personality disorders but also for disorders on Axis I. For PD with/without agoraphobia, schemas regarding impaired autonomy and achievement seem to play the most important role regarding the influence on therapy outcome.

How I think about how I feel: Personal beliefs about emotion prospectively predict suicide-related outcomes and depression symptoms

One transdiagnostic process that may be critical to depression and suicidal ideation is beliefs about the nature of one's own emotions, both concurrently and longitudinally. In a sample of community adults (n = 143), we assessed personal emotion beliefs about the degree to which one's own emotions are malleable, unique, and last a long time. There were significant associations between stronger views that one's own emotions were fixed, unique to you, and had a longer duration and higher clinical symptom severity, including higher levels of current suicidal ideation, and less adaptive emotion regulation. Mediation analyses using longitudinal data clarified that the differential engagement in emotion regulation, specifically rumination, represented the link tying specific personal emotion beliefs to clinical symptoms and that, in certain cases, the opposite pathway is also significant – differences in clinical symptoms mediated the relationship between specific personal emotion beliefs and emotion regulation (rumination) longitudinally. Additionally, personal emotion beliefs varied based on depression status, as determined using a semi-structured clinical interview. For example, individuals meeting current criteria for Major Depressive Disorder (MDD) held stronger views that their emotions were unique to them compared to individuals with remitted MDD or no history of MDD. The current study's findings highlight the important role of specific personal emotion beliefs in clinical symptoms concurrently and longitudinally and mechanisms in these relationships. These results could guide future research on interventions to promote more adaptive beliefs about emotion to improve clinical outcomes.

Suicidal thoughts and attempts in a transdiagnostic eating disorder sample: Do diagnostic severity criteria predict risk?

Eating disorders (EDs) are associated with elevated suicide. Low body mass index (BMI) and frequency of purging and binge eating represent severity criteria for EDs and distinguish full-threshold EDs from other specified feeding and eating disorders (OSFED). However, no work has taken a transdiagnostic approach to studying whether severity of these or other features is associated with suicidal ideation (SI) and attempts. We examined diagnostic status, ED features, and SI and attempts in a large, transdiagnostic, community sample of 257 women with EDs and 45 controls without a current or past ED in the United States using the EDs Examination interview and the Structured Clinical Interview for the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). SI and suicide attempts (SA) were elevated in OSFED compared to controls but did not differ between OSFED and full-threshold EDs. Higher BMI predicted increased SI. Number of purging methods, but not frequency, was related to history of SA. Binge episode frequency and size were not significant predictors. OSFED presents with elevated SI and SA, and ED severity criteria that distinguish OSFED from full-threshold EDs do not predict SI or SA. Suicide risk assessments should be implemented universally across EDs in clinical practice.

Eating Behaviors Associated With Suicidal Behaviors and Overall Risk.

Maladaptive eating behaviors remain prevalent in the US population, and a significant percentage of US college students acknowledge engaging in maladaptive eating. Formally defined eating disorders (EDs) have one of the highest mortality rates among all mental illnesses. Suicide risk is substantially elevated among individuals diagnosed with EDs, and even subclinical levels of maladaptive eating behaviors are associated with suicidality. The current study examined associations between specific problematic eating behaviors measured dimensionally (eg, purging, binging, laxative use) and specific suicide-related constructs and behaviors as well as overall suicide risk. College students (N=188; 62% women) completed the Eating Disorder Examination-Questionnaire, a well-established measure of dysfunctional eating, as well as several self-report measures of theoretical components of suicidality, and, finally, a semistructured clinical interview to specify suicide risk category. Results showed a general pattern of moderate and strong associations between the subscales and the overall score of the Eating Disorder Examination-Questionnaire and core suicide constructs of the interpersonal-psychological theory of suicide. Many substantive correlations were found between specific eating behaviors and specific suicide-related behaviors; for example, purging was the highest correlate of overall suicide risk (ρ=0.36). These results are discussed in terms of consistency with the interpersonal-psychological theory of suicide as well as practical implications for intervention.

Digital assessment of nonverbal behaviors forecasts first onset of depression.

Adolescence is marked by a sharp increase in the incidence of depression, especially in females. Identification of risk for depressive disorders (DD) in this key developmental stage can help prevention efforts, mitigating the clinical and public burden of DD. While frequently used in diagnosis, nonverbal behaviors are relatively understudied as risk markers for DD. Digital technology, such as facial recognition, may provide objective, fast, efficient, and cost-effective means of measuring nonverbal behavior. Here, we analyzed video-recorded clinical interviews of 359 never-depressed adolescents females via commercially available facial emotion recognition software. We found that average head and facial movements forecast future first onset of depression (AUC = 0.70) beyond the effects of other established self-report and physiological markers of DD risk. Overall, these findings suggest that digital assessment of nonverbal behaviors may provide a promising risk marker for DD, which could aid in early identification and intervention efforts.

Impaired Emotional Processing in Major Depressive Disorder. Accuracy versus Processing Speed

Depression is one of the most frequent conditions within the general population, ranking among the most burdensome in terms of public health expenses, productivity loss and social costs. The condition has been linked with cognitive deficits that may even continue in remission phases, social cognition being one potentially affected cognitive function. In our study, the Penn’s Emotional Acuity Test included in the CogtestTM battery was used to assess emotion recognition accuracy and processing speed. The Structured Clinical Interview for the Montgomery-Asberg Depression Rating Scale was used to assess the intensity of the symptomatology. A total of 48 depressed individual individuals (65% females), with a mean age of 49.8 ± 10.4 years, and 40 healthy controls (75% females), with a mean age of 35.2 ± 6.9 years were included. As compared to controls, depressive participants recorded significantly less correct answers (9.3 ± 3.8 vs. 11.2 ± 3.6, p = 0.019 – Student’s t test) and slower processing speeds (6795 ± 3366 vs. 4042 ± 1623, p 0.001 – Mann-Whitney U test) in emotion processing. Furthermore, symptom severity significantly influences only processing speed and not accuracy in emotion recognition tasks. Thus, we conclude that depressive individuals have a significant deficit in processing speed and accuracy when identifying the intensity of other peoples’ emotions.