Cognitive Behavioral Symptoms Research Articles

Posttraumatic stress disorder (PTSD) in a sample of patients evaluated for acute coronary syndrome: A factor analysis of the PTSD checklist for DSM-5 (PCL-5)

The PCL-5 is a psychometrically sound measure of Post-Traumatic Stress Disorder (PTSD) symptoms. Although the scale is commonly applied to past external traumas (e.g., combat, assault), PTSD symptoms have also been assessed about potentially life-threatening cardiovascular events that represent ongoing internal threats. To date, there is a paucity of studies that have examined the updated scale factor structure for PTSD in patients with suspected acute coronary syndromes (ACS). MethodsExploratory and confirmatory factor analyses (EFA, CFA) were conducted using PCL-5 data completed by 830 patients enrolled in the REactions to Acute Care and Hospitalization (REACH) study, an observational cohort study of patients recruited from the emergency department during evaluation for ACS. Follow-up measurement invariance tests were conducted on pre-selected models and on the best-fitting model identified by EFA to evaluate invariance across diagnosis (confirmed v. rule-out ACS), sex, and language. ResultsThe EFA identified a two-factor model with “Memories of Trauma” (MT) and “Cognitive Behavioral Symptoms” (CBS) factors offering a balanced fit and interpretability. In CFAs, the Anhedonia CFA model performed the best overall. Measurement invariance tests supported strong invariance across confirmed and ruled-out ACS, male and female sex, and English and Spanish language for all models. LimitationsOnly 34 % of the sample was diagnosed with ACS at discharge, which limits generalizability. ConclusionOur study contributes to the understanding of PTSD in the context of internal traumatic reminders and may guide future research and clinical practice by informing intervention targets to improve health and well-being after suspected ACS.

Network Analysis of Cognitive-Behavioral Symptom Connectivity in OCD Subtypes: Evaluating SSRI Treatment Response and Resistance

Network Analysis of Cognitive-Behavioral Symptom Connectivity in OCD Subtypes: Evaluating SSRI Treatment Response and Resistance

Clinicopathological correlates in the frontotemporal lobar degeneration-motor neuron disease spectrum.

Amyotrophic lateral sclerosis (ALS) is a devastating motor neuron disease (MND) that shares a common clinical, genetic and pathologic spectrum with frontotemporal dementia (FTD). It is highly heterogeneous in its presentation and features. Up to 50% of patients with MND develop cognitive-behavioural symptoms during the course of the disease, meeting criteria for FTD in 10%-15% of cases. In the absence of a precise biomarker, neuropathology is still a valuable tool to understand disease nosology, reach a definite diagnostic confirmation and help define specific subgroups of patients with common phenotypic, genetic and biomarker profiles. However, few neuropathological series have been published, and the frequency of frontotemporal lobar degeneration (FTLD) in MND is difficult to estimate. In this work we describe a large clinicopathological series of MND patients, analysing the frequency of concurrent FTLD changes and trying to define specific subgroups of patients based on their clinical, genetic and pathological characteristics. We performed an observational, retrospective, multicentre case study. We included all cases meeting neuropathological criteria for MND from the Neurological Tissue Bank of the FRCB-IDIBAPS-Hospital Clínic Barcelona Biobank between 1994 and 2022, regardless of their last clinical diagnosis. While brain donation is encouraged in all patients, it is performed in very few, and representativeness of the cohort might not be precise for all patients with MND. We retrospectively reviewed clinical and neuropathological data and describe the main clinical, genetic and pathogenic features, comparing neuropathologic groups between MND with and without FTLD changes and aiming to define specific subgroups. We included brain samples from 124 patients, 44 of whom (35.5%) had FTLD neuropathologic features (i.e. FTLD-MND). Pathologic TDP-43 aggregates were present in 93.6% of the cohort and were more extensive (higher Brettschneider stage) in those with concurrent FTLD (P < 0.001). Motor symptom onset was more frequent in the bulbar region in FTLD-MND cases than in those with isolated MND (P = 0.023), with no differences in survival. We observed a better clinicopathological correlation in the MND group than in the FTLD-MND group (93.8% versus 61.4%; P < 0.001). Pathogenic genetic variants were more common in the FTLD-MND group, especially C9orf72. We describe a frequency of FTLD of 35.5% in our series of neuropathologically confirmed cases of MND. The FTLD-MND spectrum is highly heterogeneous in all aspects, especially in patients with FTLD, in whom it is particularly difficult to define specific subgroups. In the absence of definite biomarkers, neuropathology remains a valuable tool for a definite diagnosis, increasing our knowledge in disease nosology.

P.026 Frontal cognitive-behavioural deficits in patients with anti-leucine-rich glioma-inactivated protein 1 antibody encephalitis

Background: Cognitive impairment is a common manifestation of anti-LGI1 encephalitis and is typically defined as prominent memory deficits. We frequently encounter frontal cognitive-behavioural deficits when evaluating these patients, but this has yet to be well described in the literature. Methods: Patients with anti-LGI1 encephalitis were retrospectively identified from three tertiary centres in Toronto, Ontario between 2013 and 2022. Their medical records were evaluated and frontal features were categorized based on diagnostic criteria for behavioural variant frontotemporal dementia (bvFTD). Results: Nineteen patients were identified (median age 60 years [range 18–84]; 10 [52.6%] male). Eighteen (94.7%) had frontal cognitive-behavioural symptoms. Two developed these symptoms during treatment with steroids and were excluded from further analysis. The remaining 16 presented with behavioural disinhibition (n=13), apathy or inertia (n=6), perseverative, stereotyped or compulsive/ritualistic behaviours (n=6), hyperorality and dietary changes (n=4), a neuropsychological profile with predominant deficits in executive tasks (n=4), and loss of sympathy or empathy (n=4). Nine (47.3%) met diagnostic criteria for possible bvFTD. Anterograde memory impairment was common (n=14). Of the 16 patients with frontal features, 6 had faciobrachial dystonic seizures. Conclusions: Patients with anti-LGI1 encephalitis exhibit frontal cognitive-behavioural symptoms in addition to memory impairment. Clinicians should consider anti-LGI1 encephalitis in the differential diagnosis of bvFTD.

Frontal cognitive-behavioural deficits in patients with anti-leucine-rich glioma-inactivated protein 1 antibody encephalitis (S22.004)

<h3>Objective:</h3> To determine the prevalence of a frontal cognitive-behavioural phenotype in patients with anti-leucine-rich glioma-inactivated protein 1 (LGI1) encephalitis. <h3>Background:</h3> Cognitive impairment is a common manifestation of anti-LGI1 encephalitis and is typically defined as prominent memory deficits. We frequently encounter frontal cognitive-behavioural deficits when evaluating these patients, but this has yet to be well described in the literature. <h3>Design/Methods:</h3> We retrospectively identified patients from three tertiary centres in Toronto, Ontario who were diagnosed with anti-LGI1 encephalitis between October 2013 and September 2022. Patient electronic medical records were evaluated for cognitive features and frontal features were categorized based on the diagnostic criteria for behavioural variant frontotemporal dementia (bvFTD). <h3>Results:</h3> Fifteen patients were identified (median age 65 years [range 18–84]; 8 [53.3%] male). Fourteen (93.3%) patients had cognitive symptoms that localized to the frontal lobe. Two developed these symptoms during treatment with steroids and were therefore excluded from further analysis. The remaining 12 patients presented with behavioural disinhibition (n=11), apathy or inertia (n=5), perseverative, stereotyped or compulsive/ritualistic behaviours (n=4), hyperorality and dietary changes (n=4), a neuropsychological profile with predominant deficits in executive tasks (n=4), and loss of sympathy or empathy (n=1). Seven (46.7%) met diagnostic criteria for possible bvFTD. Of these, 3 had significant functional decline and none had neuroimaging findings consistent with bvFTD. Anterograde memory impairment was common (n=11), and patients also presented with language deficits (n=3) and difficulties with spatial navigation (n=3). Of the 12 patients with frontal symptoms, only 5 had faciobrachial dystonic seizures. <h3>Conclusions:</h3> Patients with anti-LGI1 encephalitis can exhibit frontal cognitive-behavioural symptoms in addition to memory impairment, and screening for these features on clinical assessment may help to identify the diagnosis. Clinicians should also consider anti-LGI1 encephalitis in the differential diagnosis of bvFTD. <b>Disclosure:</b> Dr. Lee has nothing to disclose. Dr. Climans has nothing to disclose. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Parabon Nanolabs. The institution of Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for DynaMed (EBSCO Health). Dr. Day has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Barrow Law. Dr. Day has stock in ANI Pharmaceuticals. The institution of Dr. Day has received research support from National Institutes of Health / NIA. The institution of Dr. Day has received research support from Chan Zuckerberg Initiative. The institution of Dr. Day has received research support from Alzheimer’s Association. The institution of Dr. Day has received research support from National Institutes of Health / NINDS. The institution of Dr. Day has received research support from Horizon Therapeutics. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with American Academy of Neurology. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development (CME) with PeerView, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Continuing Education, Inc. Dr. Day has a non-compensated relationship as a Clinical Director with AntiNMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities. Dr. Hebert has nothing to disclose. Dr. Lapointe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Ramos has nothing to disclose. The institution of Dr. Steriade has received research support from NIH. The institution of Dr. Steriade has received research support from Dorris Duke Fund to Retain Clinician Scientists. Dr. Wennberg has nothing to disclose. Dr. Muccilli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Muccilli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Muccilli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Tang-Wai has nothing to disclose.

Association of Intrinsic Functional Brain Network and Longitudinal Development of Cognitive Behavioral Symptoms in Young Girls With Fragile X Syndrome

BackgroundFragile X syndrome (FXS) is an X chromosome–linked genetic disorder characterized by increased risk for behavioral, social, and neurocognitive deficits. Because males express a more severe phenotype than females, research has focused largely on identifying neural abnormalities in all-male or both-sex populations with FXS. Therefore, very little is known about the neural alterations that contribute to cognitive behavioral symptoms in females with FXS. This cross-sectional study aimed to elucidate the large-scale resting-state brain networks associated with the multidomain cognitive behavioral phenotype in girls with FXS. MethodsWe recruited 38 girls with full-mutation FXS (11.58 ± 3.15 years) and 32 girls without FXS (11.66 ± 2.27 years). Both groups were matched on age, verbal IQ, and multidomain cognitive behavioral symptoms. Resting-state functional magnetic resonance imaging data were collected. ResultsCompared with the control group, girls with FXS showed significantly greater resting-state functional connectivity of the default mode network, lower nodal strength at the right middle temporal gyrus, stronger nodal strength at the left caudate, and higher global efficiency of the default mode network. These aberrant brain network characteristics map directly onto the cognitive behavioral symptoms commonly observed in girls with FXS. An exploratory analysis suggested that brain network patterns at a prior time point (time 1) were predictive of the longitudinal development of participants’ multidomain cognitive behavioral symptoms. ConclusionsThese findings represent the first examination of large-scale brain network alterations in a large sample of girls with FXS, expanding our knowledge of potential neural mechanisms underlying the development of cognitive behavioral symptoms in girls with FXS.

Latent disconnectome prediction of long-term cognitive-behavioural symptoms in stroke.

Stroke significantly impacts the quality of life. However, the long-term cognitive evolution in stroke is poorly predictable at the individual level. There is an urgent need to better predict long-term symptoms based on acute clinical neuroimaging data. Previous works have demonstrated a strong relationship between the location of white matter disconnections and clinical symptoms. However, rendering the entire space of possible disconnection-deficit associations optimally surveyable will allow for a systematic association between brain disconnections and cognitive-behavioural measures at the individual level. Here we present the most comprehensive framework, a composite morphospace of white matter disconnections (disconnectome) to predict neuropsychological scores 1 year after stroke. Linking the latent disconnectome morphospace to neuropsychological outcomes yields biological insights that are available as the first comprehensive atlas of disconnectome-deficit relations across 86 scores-a Neuropsychological White Matter Atlas. Our novel predictive framework, the Disconnectome Symptoms Discoverer, achieved better predictivity performances than six other models, including functional disconnection, lesion topology and volume modelling. Out-of-sample prediction derived from this atlas presented a mean absolute error below 20% and allowed personalize neuropsychological predictions. Prediction on an external cohort achieved an R2 = 0.201 for semantic fluency. In addition, training and testing were replicated on two external cohorts achieving an R2 = 0.18 for visuospatial performance. This framework is available as an interactive web application (http://disconnectomestudio.bcblab.com) to provide the foundations for a new and practical approach to modelling cognition in stroke. We hope our atlas and web application will help to reduce the burden of cognitive deficits on patients, their families and wider society while also helping to tailor future personalized treatment programmes and discover new targets for treatments. We expect our framework's range of assessments and predictive power to increase even further through future crowdsourcing.

Digital media and mental health in adolescent athletes

Although digital media are increasingly important for adolescent athletes, few studies explore their influence on mental health in this population. This study aimed to examine this relationship in 591 German adolescent athletes (aged 12–19 years) from 42 different sports. Longer daily social media usage was connected to increased negative affect and dysfunctional eating patterns. Similar results were found for cognitive-behavioral symptoms of excessive media usage and mental health. Structural equation modeling revealed these relationships were mediated by social comparison and quality of sleep. Higher athletic performance level was related to increased social comparison, but not to quality of sleep, negative affect, and dysfunctional eating. The negative relationship between excessive media usage and sleep was stronger in competitive and elite than in recreational athletes. Results imply digital media should receive attention when aiming to improve mental health in athletes. Relevant targets for future intervention could be social comparison and sleep.

Modulatory effects of Nigella sativa l. oil on the hippocampus of dizocilpine-induced schizophrenia in BALB/c MICE

IntroductionSchizophrenia is a neuropsychiatric disorder characterised by positive, negative and cognitive behavioral symptoms. Despite years of research, the need for suitable therapy remains elusive. Nigella sativa oil (NSO) is a medicinal plant notable for its dietary, neuroprotective and anti-inflammatory properties. However, there is paucity of information on its neuroprotective potentials in schizophrenia.ObjectivesThis study was designed to investigate the modulatory effects of NSO on the hippocampus of dizocilpine-induced schizophrenia in mice.MethodsSixty 14-weeks old male BALB/c mice (23-25g) were divided into five groups (n=12); control (normal saline, 1 mL/kg), NSO (1 mL/kg), dizocilpine-control (0.5 mg/kg) all for 7 days, while NSO (1 mL/kg for 7 days) + dizocilpine (0.5 mg/kg, for another 7 days) for preventive measure, and dizocilpine (0.5 mg/kg for 7 days) + NSO (1 mL/kg for another 7 days) for reversal. Dizocilpine and NSO were administered intraperitoneally and orally, respectively. Open field box was used for stereotypic popping. Animals were euthanised after behavioral studies, and harvested brains were weighed. Hippocampal glutamate was determined spectrophotometrically. Neuronal arrangement, sizes and densities were determined in perfused brain tissues using haematoxylin and eosin stain. Dendritic arborisations were assessed using Golgi stain. Metabotropic glutamate receptor-II (mGluR-2) and Glia Fibrilliary Acidic Protein (GFAP) were evaluated immunohistochemically. Data were analysed using descriptive statistics and ANOVA at α0.05.ResultsStereotypic popping was observed in dizocilpine-control but not in the preventive and reversal NSO-treated animals. The NSO increased glutamate levels in the reversal (0.19±0.00 μM/μg tissue) but not in the preventive (0.18±0.00 μM/μg tissue) groups relative to dizocilpine-control (0.18±0.00 μM/μg tissue). Hippocampal neuronal density was significantly increased by dizocilpine (21.25±1.11neurons/100μm2) but modulated by NSO in the preventive (17.25±0.51 neurons/100μm2) and reversal groups (12.00±0.71 neurons/100μm2). Significant neuronal de-arborisation that occurred in the dizocilpine-control (989.90±253.9 μm2/2.5mm2area) was inhibited by NSO in the preventive (1678±370.90 μm2/2.5mm2area) and reversal (1639±314.80 μm2/2.5mm2area) treatments. Compared to dizocilpine-control (4219±127.3 ODU), NSO increased mGluR-2 expression in the preventive (4945±17.00 ODU) and reversal (4116±24.97 ODU) groups. The GFAP expression in NSO-treated animals relative to dizocilpine-control (5510±38.45 ODU) was significantly reduced in the preventive (4945±17.00 ODU) and reversal (4116±24.97 ODU) measures.ConclusionsNigella sativa oil mitigated schizophrenic symptoms induced by dizocilpine in mice via modulation of hippocampal glutamate, metabotropic glutamate receptor–II upregulation, astrogliosis inhibition and neuroprotective mechanisms.Disclosure of InterestNone Declared

Parents Rate Problematic Video Streaming in Adolescents: Conceptualization and External Assessment of a New Clinical Phenomenon Based on the ICD-11 Criteria of Gaming Disorder.

In recent years, video streaming (VS) increased substantially. Adolescents are at significant risk of presenting problematic VS patterns associated with a spectrum of mental-health difficulties. Because VS platforms rely on similar mechanisms as digital games, the ICD-11 criteria for Gaming Disorder (GD) have been successfully implemented to measure Streaming Disorder (StrD) in adolescents. For proper diagnoses, external rating scales are urgently required in addition to self-reports. The Streaming Disorder Scale for Parents (STREDIS-P) was created and validated in a representative sample of n = 891 adolescent-parent dyads. Mental health problems were assessed with standardized instruments. Confirmatory factor analysis was conducted to examine the underlying factor structure. Cutoff scores were determined using ROC analysis. Accordance between parental and adolescents' self-ratings was calculated. Consistent with the results of previous validation studies for screening instruments assessing similar phenomena based on ICD-11-GD criteria, two factors, cognitive-behavioral symptoms and negative consequences, were confirmed. STREDIS-P demonstrated good to excellent internal consistency, criterion validity, and discriminatory power. Accordance with adolescents' self-ratings was moderate. STREDIS-P is the first screening tool for assessing StrD in adolescents by parental ratings. It is highly relevant for conceptualizing a new phenomenon in clinical routine and academic research.

Gaming Disorder Scale for Parents: Reliability and Validity Study of the Turkish Form.

This study aimed to conduct the validity and reliability study of the Turkish version of the Gaming Disorder Scale for Parents (GADIS-P). In this methodological study, the study sample consisted of 345 parents who had children within the age range of 10-17 years who played digital games. The study data were collected through the Gaming Disorder Scale for Parents, the Scale for Determining Parents' Perceptions of Computer Game Addiction, and the Digital Parenting Attitude Scale. The Cronbach's alpha analysis for reliability, item total correlation analysis, confirmatory and exploratory factor analysis for construct validity, and clustering analysis for identifying gaming disorder according to the scale scores were used. It was determined that the content validity index of the scale was 0.97, that item loads varied between 0.617 and 0.863 according to exploratory factor analysis, and that the scale had good fit indices in the confirmatory factor analysis. The Cronbach's reliability coefficient of the scale was found to be α=0.907, and the item total correlations were determined to be adequate. The criterion validity analysis found a positive and strong correlation with the Scale for Identifying Parents' Perceptions Regarding Digital Game Addiction (r=0.717 p0.001). As a result of the clustering analysis, it was determined that the cut-off value was found as >9 points for "Cognitive Behavioral Symptoms" subscale and as >6 points for "Negative Consequences" subscale. The results obtained show that the Turkish version of the Gaming Disorder Scale for Parents is a valid and reliable measurement tool.

Hybrid-delivered cognitive behavioral symptom management and activity coaching intervention for patients undergoing hematopoietic stem cell transplant: Findings from intervention development and a pilot randomized trial

Objective Develop and pilot test a mobile health (mHealth) cognitive behavioral coping skills training and activity coaching protocol (HCT Symptoms and Steps) for hematopoietic stem cell transplant (HCT) patients. Design Two-phase, mixed methods study. Sample HCT patients and healthcare providers. Methods Phase I was patient (n = 5) and provider (n = 1) focus groups and user testing (N = 5) to develop the HCT Symptoms and Steps protocol. Phase II was a pilot randomized trial (N = 40) to evaluate feasibility, acceptability, and pre-to-post outcomes (e.g., physical disability, pain, fatigue, distress, physical activity, symptom self-efficacy) compared to an education control. Findings Qualitative feedback on symptoms, recruitment strategies, coping skills, and mHealth components (e.g., Fitbit, mobile app) were integrated into the protocol. HCT Symptoms and Steps were feasible and acceptable. Pre-post changes suggest physical disability and activity improved while symptoms (e.g., fatigue, distress) decreased. Conclusions HCT Symptoms and Steps have strong feasibility and acceptability and shows promise for benefits. Larger, fully-powered randomized trials are needed to examine intervention efficacy. Implications HCT Symptoms and Steps may reduce physical disability and improve health outcomes post-transplant. Clinical Trial Registration Number NCT03859765

Genetic investigation of the contribution of body composition to anorexia nervosa in an electronic health record setting

Anorexia nervosa (AN) is a psychiatric disorder defined by anthropometric symptoms, such as low body weight, and cognitive-behavioral symptoms, such as restricted eating, fear of weight gain, and distorted body image. Recent studies have identified a genetic association between AN and metabolic/anthropometric factors, including body mass index (BMI). Although the reported associations may be under pleiotropic genetic influences, they may represent independent risk factors for AN. Here we examined the independent contributions of genetic predisposition to low body weight and polygenic risk (PRS) for AN in a clinical population (Vanderbilt University Medical Center biobank, BioVU). We fitted logistic and linear regression models in a retrospective case-control design (123 AN patients, 615 age-matched controls). We replicated the genetic correlations between PRSBMI and AN (p = 1.12 × 10−3, OR = 0.96), but this correlation disappeared when controlling for lowest BMI (p = 0.84, OR = 1.00). Additionally, we performed a phenome-wide association analysis of the PRSAN and found that the associations with metabolic phenotypes were attenuated when controlling for PRSBMI. These findings suggest that the genetic association between BMI and AN may be a consequence of the weight-related diagnostic criteria for AN and that genetically regulated anthropometric traits (like BMI) may be independent of AN psychopathology. If so, individuals with cognitive-behavioral symptomatology suggestive of AN, but with a higher PRSBMI, may be under-diagnosed given current diagnostic criteria. Furthermore, PRSBMI may serve as an independent risk factor for weight loss and weight gain during recovery.

Ovariectomy-induced hormone deprivation aggravates Aβ1-42 deposition in the basolateral amygdala and cholinergic fiber loss in the cortex but not cognitive behavioral symptoms in a triple transgenic mouse model of Alzheimer's disease.

Alzheimer’s disease is the most common type of dementia, being highly prevalent in elderly women. The advanced progression may be due to decreased hormone synthesis during post-menopause as estradiol and progesterone both have neuroprotective potentials. We aimed to confirm that female hormone depletion aggravates the progression of dementia in a triple transgenic mouse model of Alzheimer’s disease (3xTg-AD). As pathological hallmarks are known to appear in 6-month-old animals, we expected to see disease-like changes in the 4-month-old 3xTg-AD mice only after hormone depletion. Three-month-old female 3xTg-AD mice were compared with their age-matched controls. As a menopause model, ovaries were removed (OVX or Sham surgery). After 1-month recovery, the body composition of the animals was measured by an MRI scan. The cognitive and anxiety parameters were evaluated by different behavioral tests, modeling different aspects (Y-maze, Morris water maze, open-field, social discrimination, elevated plus maze, light–dark box, fox odor, operant conditioning, and conditioned fear test). At the end of the experiment, uterus was collected, amyloid-β accumulation, and the cholinergic system in the brain was examined by immunohistochemistry. The uterus weight decreased, and the body weight increased significantly in the OVX animals. The MRI data showed that the body weight change can be due to fat accumulation. Moreover, OVX increased anxiety in control, but decreased in 3xTg-AD animals, the later genotype being more anxious by default based on the anxiety z-score. In general, 3xTg-AD mice moved less. In relation to cognition, neither the 3xTg-AD genotype nor OVX surgery impaired learning and memory in general. Despite no progression of dementia-like behavior after OVX, at the histological level, OVX aggravated the amyloid-β plaque deposition in the basolateral amygdala and induced early cholinergic neuronal fiber loss in the somatosensory cortex of the transgenic animals. We confirmed that OVX induced menopausal symptoms. Removal of the sexual steroids aggravated the appearance of AD-related alterations in the brain without significantly affecting the behavior. Thus, the OVX in young, 3-month-old 3xTg-AD mice might be a suitable model for testing the effect of new treatment options on structural changes; however, to reveal any beneficial effect on behavior, a later time point might be needed.

Age of onset for major depressive disorder and its association with symptomatology

BackgroundThe age of onset (AOO) is a key factor for heterogeneity in major depressive disorder (MDD). Looking at the effect of AOO on symptomatology may improve clinical outcomes. This study aims to examine whether and how AOO affects symptomatology using a machine learning approach and latent profile analysis (LPA). MethodsThe study enrolled 915 participants diagnosed with MDD from eight hospitals across China. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale. The relationship between symptom profiles and AOO was explored using Random Forest. The effect of AOO on symptom clusters and subtypes was investigated using multiple linear regression and LPA. A continuous AOO indicator was used to conduct the analyses. ResultsBased on the Random Forest, symptom profiles were closely associated with AOO. The regression model showed that the severity of neurovegetative symptoms was positively associated with AOO (β = 0.18, p < 0.001), and the severity of cognitive-behavioral symptoms was negatively associated with AOO (β = −0.12, p < 0.001). LPA demonstrated that the subgroups characterized by suicide and guilt had earlier onset of depression. The subgroup with the lowest global severity of depression had the latest onset. LimitationsAOO was recalled retrospectively. The relative scarcity of participants with childhood and adolescence onset depression. ConclusionsAOO has an important impact on symptomatology. The findings may enhance clinical evaluations for MDD and assist clinicians in promoting earlier detection and individualized care in vulnerable individuals.

Development of a general purpose cognitive-behavioral symptom taxonomy

Development of a general purpose cognitive-behavioral symptom taxonomy

Psychometric properties of Persian version of depression literacy (D-Lit) questionnaire among general population

BackgroundThe prevalence of depression in society is increasing and there is a need for a suitable tool to assess the health literacy of people in this field. This study was conducted to evaluate the psychometric of the Iranian version of the depression literacy (D-Lit) questionnaire.MethodsThis cross-sectional study was conducted on 845 participants with a proportional stratified sampling method. First, the translation and cultural adaptation of questionnaire was performed. Then, the validity of D-Lit was assessed by face validity, content validity, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). The reliability of D-Lit was assessed by the Cronbach’s alpha coefficient and McDonald omega coefficient.ResultsBased on the results of EFA, 5 factors emerged with eigenvalues of greater than 1, which accounted for 56.30% of the variance. Based on the results of CFA, one question was deleted and the results of goodness fit indexes confirmed the model. Cronbach’s alpha coefficient and McDonald omega coefficient for D-Lit questionnaire were 0.890 and 0.891, respectively. Finally, D-Lit questionnaire with 21 questions and 5 subscales of Knowledge of the psychological symptoms (5 items), Knowledge about the effectiveness of available treatment methods (4 items), Knowledge about cognitive-behavioral symptoms (6 items), Knowledge about taking medications and their side effects (4 items), and Knowledge of the severity of the disease (2 items) were confirmed.ConclusionThe results of this psychometric evaluation confirmed the Persian version of D-Lit questionnaire with 21 questions and 5 subscales is an appropriate tool for measuring people's literacy about depression.

Psychometric properties of the Farsi version of the gaming disorder scale for adolescents (GADIS-A)

BackgroundGaming disorder was added to the 11th version of the international classification of disease by the world health organization in early 2019. Adolescents are the most vulnerable group in this area. Thus, a screening tool for this age range is essential. This study aims to examine the psychometric properties of the gaming disorder scale for adolescents (GADIS-A) in an Iranian male sample.Methods260 male students-7th to 12th grade-from Isfahan city in the academic year 2020–2021 were selected using convenience sampling. The participants responded to the Farsi version of the GADIS-A and problematic online game questionnaire (POGQ). Thirty participants answered the scale again to assess the validity of the retest. Pearson’s correlation analysis, Cronbach’s alpha, and confirmatory factor analysis were used. The data were analyzed by SPSS version 24 and R software packages psych and lavaan.ResultsConfirmatory factor analysis revealed that the two-factor model, which included cognitive-behavioral symptoms and negative consequences, had good fitness indices. The GADIS-A convergent validity is confirmed by the scale’s significant correlation with the POGQ. Cronbach’s alpha coefficient was used to determine the scale’s validity, which was 0.85 for the full scale and 0.70 and 0.75 for two factors. The validity of the retest after two weeks also showed a correlation of 0.88.ConclusionThe Farsi version of the gaming disorder scale for adolescents has a two-factor structure and is valid for use in Iran.

International Classification of Diseases-11-Based External Assessment of Social Media Use Disorder in Adolescents: Development and Validation of the Social Media Use Disorder Scale for Parents.

Social media use disorder (SMUD) is associated with substantial impairments in daily functioning, and adolescents are particularly at risk. The 11th revision of the International Classification of Diseases (ICD-11) criteria of gaming disorder (GD) could be shown to be suitable to describe SMUD in adolescents. Since adolescents' insight might be limited due to young age or symptom denial, it is essential to include their parents in the diagnostic process. The development and validation of a parental scale are, therefore, of great interest to clinicians and scientists. The Social Media Use Disorder Scale for Parents (SOMEDIS-P) was developed by clinical experts and validated in 944 parent-child dyads. Adolescents were 10-17 years old and frequently used social media (SM). Besides SM use times, standardized questionnaires were applied to assess SM use patterns according to ICD-11 and Diagnostic and Statistical Manual of Mental Disorders-5 criteria of (Internet) GD, psychological stress, and depressive symptoms in an online survey. Item structure was investigated by confirmatory factorial analysis. Receiver operating characteristic curve analyses to determine cutoff values and accordance with adolescent self-ratings were computed. A presumed two-factorial structure of SOMEDIS-P could be confirmed describing cognitive-behavioral symptoms and negative consequences. The instrument showed good to excellent internal consistency and criterion validity with moderate to strong correlations, excellent discriminatory characteristics, and moderate accordance with the adolescents' self-ratings. As the first successfully validated tool for the assessment of ICD-11-based SMUD in adolescents by parental judgment, SOMEDIS-P can make an important contribution to reliable SMUD screening in clinical practice and research.

Applying ICD-11 criteria of Gaming Disorder to identify problematic video streaming in adolescents: Conceptualization of a new clinical phenomenon.

Background and aimsInternet video streaming (VS) has become a popular leisure activity among the majority of adolescents, especially under the COVID-19 pandemic. Research on binge watching patterns in adults suggests an addictive potential of VS. To date, no unified conceptualization on problematic VS and no standardized assessment tools for adolescents exist even though they might be especially vulnerable.MethodsSTREDIS-A is based on the ICD-11 criteria of gaming disorder. It was validated in a representative sample of 959 dyads of 10- to 17-year old adolescents with frequent VS and a respective parent using standardized questionnaires on Internet addiction, depressive and anxiety symptoms, insomnia, loneliness, and academic performance in an online survey. Item structure was investigated by factorial analyses. Cutoffs were estimated and latent profile analysis was performed.ResultsThe two-factorial structure of STREDIS-A describes cognitive-behavioral symptoms and negative consequences of VS. Internal consistency and criterion validity were good to excellent. It could excellently discriminate between affected and non-affected adolescents.Discussion and conclusionsThe present study makes a significant contribution to the conceptualization of a new phenomenon. It provides the very first tool to assess streaming disorder in adolescents for clinical and research settings. Clinical validation is highly warranted.