Large Multinational Sample Research Articles

Cross-Cultural Comparison of the Strengths and Difficulties Self-Report Questionnaire in 12 Asian and European Countries.

The self-report Strengths and Difficulties Questionnaire (SDQ) is widely used globally; hence, the validity of the intergroup comparisons is essential. This study examined the structure of the self-report SDQ in a large multinational adolescent sample, tested its measurement invariance across genders and countries, and compared youth mental health in 12 European and Asian countries. This study is part of the Eurasian Child Mental Health Study (EACMHS), a cross-cultural research study of child and adolescent well-being and mental health in 12 Asian and European countries. The sample (N= 26,306) came from a cross-sectional school-based survey of adolescents. Confirmatory factor analysis was used to assess a common measurement model for the self-report SDQ and the measurement invariance of the model across gender and country. Fit indices in the total sample, in each gender, and in each of the 12 countries separately supported the use of the first-order 3-factor model (without the reverse-coded items) as a common measurement model for the self-report SDQ. Measurement invariance analyses provided good support for configural, metric, and scalar invariance across gender; however, metric invariance across countries was not supported. There were significant gender main effects for all SDQ subscales except for hyperactivity/inattention. Culture had significant main effects and moderated the magnitude of gender differences in all subscales. The present findings support the use of the correlated 3-factor model comprising the positive dimension of prosocial behavior and 2 broad groupings of internalizing and externalizing problems, without the reverse-coded problem items, as a common measurement model for the self-report SDQ internationally.

Improving quality of life in the elderly: hearing loss treatment with cochlear implants

BackgroundHearing loss impacts health-related quality of life and general well-being and was identified in a Lancet report as one of the largest potentially modifiable factors for the prevention of age-related dementia. There is a lack of robust data on how cochlear implant treatment in the elderly impacts quality of life. The primary objective was to measure the change in health utility following cochlear implantation in individuals aged ≥ 60 years.MethodsThis study uniquely prospectively recruited a large multinational sample of 100 older adults (mean age 71.7 (SD7.6) range 60–91 years) with severe to profound hearing loss. In a repeated-measures design, pre and post implant outcome measures were analysed using mixed-effect models. Health utility was assessed with the Health Utilities Index Mark III (HUI3). Subjects were divided into groups of 60–64, 65–74 and 75 + years.ResultsAt 18 months post implant, the mean HUI3 score improved by 0.13 (95%CI: 0.07–0.18 p < 0.001). There was no statistically significant difference in the HUI3 between age groups (F[2,9228] = 0.53, p = 0.59). The De Jong Loneliness scale reduced by an average of 0.61 (95%CI: 0.25–0.97 p < 0.014) and the Lawton Instrumental Activities of Daily Living Scale improved on average (1.25, 95%CI: 0.85–1.65 p < 0.001). Hearing Handicap Inventory for the Elderly Screening reduced by an average of 8.7 (95%CI: 6.7–10.8, p < 0.001) from a significant to mild-moderate hearing handicap. Age was not a statistically significant factor for any of the other measures (p > 0.20). At baseline 90% of participants had no or mild depression and there was no change in mean depression scores after implant. Categories of Auditory perception scale showed that all subjects achieved a level of speech sound discrimination without lip reading post implantation (level 4) and at least 50% could use the telephone with a known speaker.ConclusionsBetter hearing improved individuals’ quality of life, ability to communicate verbally and their ability to function independently. They felt less lonely and less handicapped by their hearing loss. Benefits were independent of age group. Cochlear implants should be considered as a routine treatment option for those over 60 years with bilateral severe to profound hearing loss.Trial RegistrationClinicalTrials.gov (http://www.clinicaltrials.gov/), 7 March 2017, NCT03072862.

Social and emotional determinants of parental reflective functioning in a multinational sample.

Parental reflective functioning refers to parents' capacity to consider their child's internal experiences and is associated with secure parent-child attachment, sensitive parenting behavior, and positive child socioemotional development. However, research into determinants of parental reflective functioning in large diverse samples has been scarce. Therefore, using a large multinational sample and longitudinal design, we aimed to: (a) identify sociodemographic determinants of parental reflective functioning; (b) investigate whether parental emotion regulation is a psychological determinant of parental reflective functioning; and (c) assess whether child negative affect, parent stress, and child age moderate longitudinal associations between parent emotion regulation and parental reflective functioning. Data were two time points of the Child and Parent Emotion Study following 2,208 parents (68% female) of a child aged 0-10 years residing in English-speaking countries. Parent emotion dysregulation, parent male cisgender status, speaking a language other than English, younger parent age, and older child age were associated with lower parental reflective functioning 12 months later, as indicated by higher levels of prementalizing. Child negative affect moderated the association between parent emotion dysregulation and parental reflective functioning, whereas child age and parent stress did not. Specifically, parent difficulty controlling impulses when distressed was associated with higher levels of prementalizing modes of reflective functioning only when child negative affect was moderate-to-high. The interplay between parent emotion dysregulation and child negative affect highlights the importance of considering both parent and child characteristics in intervention planning and suggests that personalizing parenting support according to these characteristics may be beneficial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cause we are living in a Machiavellian world, and I am a Machiavellian major: Machiavellianism and academic major choice

Students from diverse academic majors differ in their personalities. However, the study of the association between Machiavellianism (i.e., desire for power, status, and social dominance) and educational choices (i.e., academic major choices) that lay a path toward occupations that allow for those outcomes has been largely ignored. Using a large multinational sample of 35,025 participants across 50 majors, we found overall support for a significant association between Machiavellianism and academic major choice. We break down the results by sex and provide a cross-country comparison.

Paranoid beliefs and conspiracy mentality are associated with different forms of mistrust: A three-nation study.

Paranoia and conspiracy are terms typically used interchangeably. However, although the underlying content of these types of beliefs might be similar (e.g., seeing others as powerful and threatening), recent research suggests that these constructs differ in important ways. One important feature shared by both constructs is excessive mistrust but this aspect might play different roles in each belief system. In this study we explored the strength of associations of different trust predictors (i.e., trust in institutions, trust in sources of information, perceptual trust, and interpersonal trust) between conspiracy mentality and paranoid beliefs. We tested this association in a large representative multinational sample (United Kingdom n = 2025; Spain n = 1951; and Ireland n = 1041). Confirmatory factor analysis supported a two-factor model of conspiracy and paranoid beliefs in each nation sample. Path and equality of constraints analysis revealed that paranoia was more strongly associated with perceptual mistrust (bias towards mistrusting unfamiliar faces) whereas conspiracy was more strongly associated with mistrust in political institutions. Although interpersonal mistrust and trust in social sources of information were associated significantly with conspiracy their association with paranoid beliefs was stronger. These findings clarify the role of different trust processes in both belief systems. Limitations of this study are discussed.

The prosociality of married people: Evidence from a large multinational sample.

Single people are more likely to die from COVID-19. Here we study whether this higher death rate could be partly explained by differences in compliance with protective health measures against COVID-19 between single and married people, and the drivers of this marital compliance gap. Data collected from 46,450 respondents in 67 countries reveal that married people are more likely to comply with protective measures than single people. This marital gap in compliance is higher for men (approximately 5%) than for women (approximately 2%). These results are robust across a large range of countries and independent of country level differences with respect to culture, values or infection rates. Prosocial characteristics linked to morality and social belonging explain more than 38% of the marital gap, while individual risk perceptions play a minor role. These findings help explain single people’s and particularly single men’s greater vulnerability to COVID-19, which in turn can be leveraged to improve the effectiveness of international public policy campaigns aimed at promoting protective health measures.

Explaining the Occupational Structure of Depressive Symptoms: Precarious Work and Social Marginality across European Countries.

The idea that socioeconomic differences are a “fundamental cause” of health and well-being is the basis for large volumes of research. However, one of the challenges in this area is that of linking socioeconomic positions to etiological mechanisms in theoretically informative ways. The situation is doubly challenging because the expression and meaning of socioeconomic positions and the mechanisms they activate change over time. Focusing on depression and applying mediation analysis to data from a large multinational sample from European countries, we find strong support for a three-stage model where occupational differences are largely mediated by exposure to precarious work, which itself is mediated by social marginality. The model is largely robust across welfare state regimes. Ultimately, the research extends fundamental cause perspectives by highlighting connections between “old” and “new” dimensions of socioeconomic status and the social and social psychological sequelae that connect them to psychological well-being.

Do Pornography Use and Masturbation Frequency Play a Role in Delayed/Inhibited Ejaculation during Partnered Sex? A Comprehensive and Detailed Analysis

The role of masturbation frequency and pornography use on sexual response during partnered sex has been controversial, the result of mixed and inconsistent findings. However, studies investigating this relationship have often suffered from methodological shortcomings. We investigated the role of masturbation frequency and pornography use on both the occurrence and severity of delayed/inhibited ejaculation (DE), an increasingly common sexual problem among men. We did so in a large (nonclinical) multinational sample of cisgender men (N = 2332; mean age = 40.3, SE = 0.31) within a multivariate context that relied on multiple (and, when possible, standardized) assessments of sexual dysfunctions while controlling for possible confounding variables. Results indicated a weak, inconsistent, and sometimes absent association between the frequency of pornography use and DE symptomology and/or severity. In contrast, both poorer erectile functioning and anxiety/depression represented consistent and strong predictors of DE and, to a lesser extent, DE severity. Other factors, including relationship satisfaction, sexual interest, and masturbation frequency, were significantly though moderately to weakly associated with DE. In conclusion, associations (or sometimes lack thereof) between masturbation frequency, pornography use, and delayed ejaculation are more clearly understood when analyzed in a multivariate context that controls for possible confounding effects.

The Prosociality of Married People: Evidence from a Large Multinational Sample

The Prosociality of Married People: Evidence from a Large Multinational Sample

Risk factors associated with postpartum depressive symptoms: A multinational study

ObjectiveTo evaluate the association between maternal age, parity, gestational number (singleton vs twin), newborn gender and self-reported postpartum depressive symptoms (PDS) in a large multinational sample using survey data from a digital telephone application. MethodsWomen using the Flo app answered a survey (available in 10 languages) from January 2018 to April 2020. A survey question asking about emotional state was used to determine the presence of PDS. Chi-squared statistics were used to compare groups. A weighted mean prevalence was calculated based upon the socioeconomic status and reproductive population of each country in 2020. ResultsOver a million women from 138 countries participated. Of all respondents, 9.4% endorsed PDS. The weighted mean prevalence of PDS was 11%. We found that PDS decreased with advancing age. First-time mothers reported higher rates of PDS. Twin births were associated with a higher symptom burden than singleton births and mothers of twins in the oldest age group reported the greatest burden. We did not find a clinically significant difference in rates of PDS between mothers of singleton girls and boys. ConclusionsTo our knowledge, this study is the first to examine risk factors for postpartum symptoms using the same survey across a large international population. These results can further research and clinical aims to identify and treat maternal depression more effectively. LimitationsData was aggregated, thereby limiting analysis of individual associations. The survey was self-report and not diagnostic for postpartum depression. Generalizability of risks of postpartum depression should be approached with caution.

Change, Correlates, and Structure of Personality Across Adulthood

Personality is both stable and changing across the lifespan. However, many questions remain about the factors that account for individual differences in change, the consequences of personality for life outcomes, and how best to assess personality at different points in the lifespan. First, Olivia Atherton will discuss research on the development of the Big Five personality traits from young adulthood to midlife with a sample of Mexican-origin individuals, as well as sociodemographic and cultural predictors of personality change in this population. Second, Bill Chopik uses data from 90 countries to examine the consistency of age differences in positive personality traits in the second half of life, from midlife to old age, as well as how cultural characteristics moderate the terminal decline in positive personality traits. Third, Emorie Beck will present research demonstrating that personality traits from the Big Five to beyond are robustly associated with a number of key life events across countries, decades, sociodemographic moderators, and even when controlling for selection bias. Finally, Josh Jackson uses network psychometric techniques to examine coherence and differentiation among indicators of the Big Five from 14 to 85 in a large multinational sample, tracking age differences with consequences for the assessment of personality traits in older adulthood. We will conclude with a panel discussion of emerging issues in personality change, prediction, and assessment across adulthood, with each speaker providing unique experience and insight into the study of each area.

Does social defeat cause negative symptoms? A prospective study in a multi-national community sample

Psychological models of the consequences of ostracism (i.e. being socially excluded and ignored) and negative symptoms in schizophrenia suggest that repeatedly experiencing ostracism can lead to elevated levels of amotivation, anhedonia, and asociality (i.e. negative symptoms).We tested this assumption in a prospective study, following up a large multi-national community sample from Germany, Indonesia, and the United States (N = 962) every four months over one year. At each of the four assessment points (T0 – T3), participants rated their recent ostracism experiences and negative symptoms.Using cross-lagged panel analyses we found a) that negative symptoms and experiences of ostracism were significantly associated in each of the four assessment points, b) that ostracism predicted negative symptoms over time (T2 to T3), and c) that negative symptoms increased ostracism (T0 to T1).The results are in line with the social defeat model of negative symptoms and suggest a bi-directional longitudinal relationship between ostracism and negative symptoms. Moving forward, it will therefore be important to gain an understanding of potential moderators involved in the mechanism.

Sexual Response Differs during Partnered Sex and Masturbation in Men With and Without Sexual Dysfunction: Implications for Treatment

BackgroundIt is unclear whether men who experience sexual difficulty during partnered sex experience similar difficulty during masturbation. AimTo determine whether sexual functionality and dysfunctionality were similar or different during masturbation vs partnered sex. MethodsWe compared sexual responsivity during masturbation vs partnered sex in a multinational sample of 4,209 men with and without a sexual dysfunction to determine whether dysfunctionality was greater, less, or about the same during these 2 types of sexual activity. OutcomesConsistently lower impairment of sexual function was found during masturbation compared with partnered sex for all 3 sexual problems assessed: erectile dysfunction, premature ejaculation, and delayed ejaculation. Clinical TranslationThese findings reiterate the potential value of assessing sexual responsivity during masturbation as well as melding masturbation strategies with couples therapy in order to attenuate impaired response during partnered sex. Strength & LimitationsAlthough this study provides the first empirical evidence based on a large multinational sample indicating that sexual functionality is consistently higher during masturbation than partnered sex, it does not provide an empirically-derived explanation for this difference. ConclusionUnderstanding a man's response potential during masturbation may be important to improving sexual response during partnered sex, with the need for more targeted research that more directly evaluates the use of such strategies in the treatment of men's sexual problems.Rowland DL, Hamilton BD, Bacys KR et al. Sexual Response Differs during Partnered Sex and Masturbation in Men With and Without Sexual Dysfunction: Implications for Treatment. J Sex Med 2021;18:1835–1842.

A multi-national test on self-reported compliance with COVID-19 public health measures: The role of individual age and gender demographics and countries’ developmental status

Rationale/objectiveThe COVID-19 pandemic has brought far-reaching consequences on individual and societal levels. Social distancing and physical hygiene constitute effective public health measures to limit the spread of the virus. This study investigated age and gender demographics, in tandem with national levels of human development, as crucial factors influencing self-reported compliance with COVID-19-related public health measures. MethodsThe present study leveraged a large multi-national sample that ranged across the adult lifespan (18–100 years) and comprised 45,772 women and men from 66 countries/territories. Data were collected in Spring (2020) during the earlier phase of the COVID-19 pandemic. Self-reports of compliance with two public health measures (spatial distancing and physical hygiene) were assessed via online survey. Human Development Index (HDI), developed by the United Nations Development Program, was used as a proxy of a country's achievement in key dimensions of human development. ResultsOlder age, female gender, and lower HDI were independently associated with greater self-reported compliance. A significant three-way interaction further revealed that self-reported compliance was lowest in young males from well-developed countries, while highest among females across all ages from less-developed countries. ConclusionThe study offers an integration of individual-level and country-level demographic predictors of self-reported compliance and allows for robust testing in a large multi-national adult lifespan sample for enhanced generalizability. The results highlight the potential of data-driven, tailored (i.e., towards specific demographics, countries) health campaigns and public policies in the fight against a global pandemic.

Unidimensionality of the Strengths and Vulnerabilities Scales in the Short-Term Assessment of Risk and Treatability (START)

The Short-Term Assessment of Risk and Treatability (START) is a 20-item structured professional judgment instrument for assessing dynamic risk in mental health services. Much of the START research literature examines the relationship between Strengths and Vulnerabilities sub-scale total scores and various adverse outcomes including violence. This assumes that the two sub-scales have the psychometric property of unidimensionality i.e. all the items cluster together as a measure of a single construct. Such assumed unidimensionality is a necessary condition for any analyses based on scale “total score” and the widespread use of scores summated in this way in research studies may obscure more specific clusters of items within each sub-scale. This multinational study examined START assessments (n = 685) conducted in four forensic services in Scandinavia and the UK using principal component analysis. It was found that all but three Strengths items (Substance Use, Social Support and Material Resources) and all but four Vulnerabilities items (Substance Use, Social Support, Material Resources and Self care) loaded >0.5 on the expected component. This indicates a unidimensional structure underlying the START and provides empirical support from a large multinational sample for the widespread use of summated Strengths and Vulnerabilities scores in forensic psychiatric risk research.

S126. THE RELATION OF THE PSYCHOSIS CONTINUUM WITH SCHIZOPHRENIA POLYGENIC RISK SCORE AND CANNABIS USE

BackgroundThere has been much debate about whether research into psychosis should be conducted using symptom dimensions as opposed to diagnostic categories. Indeed, dimensions, like categories, may be practical but arbitrary tools for research and clinical practice; hence, they should not be based on psychometric data only. The aim of this study was to externally validate empirically derived symptom dimensions using combined genetic and environmental data. Specifically, we examined the hypothesis that the continuous multivariate distribution of psychosis is a function of cannabis use and genetic liability to schizophrenia, as summarised by polygenic risk score (SZ-PRS).MethodsAs part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study, we analysed a large multinational sample of First Episode Psychosis patients (FEP) and population controls, with available genotype and psychopathology information. Using item response modelling in Mplus, we estimated a bifactor model of psychotic symptoms in FEP, and of psychotic experiences in controls. Using PRSice, we built SZ-PRS by weighting individuals’ risk variants by the log(odds ratio), where the odds ratio was extracted from the latest summary statistics of Psychiatric Genomic Consortium mega-analyses on schizophrenia. Finally, we used linear regression to test the combined associations of the positive symptom/experience dimensions with SZ-PRS and daily/current cannabis use, separately in FEP and controls, after covarying for 10 ancestry principal components, sex, age, and primary diagnosis.ResultsThe continuous distribution of psychosis was represented by two bi-factor models composed of 1) in FEP, one general psychosis factor and five specific dimensions; 2) in controls, one general psychosis factor and three specific dimensions.Linear regression modelling showed that in 617 FEP, both daily cannabis use (B=0.31; 95%CI 0.11 to 0.52; p=0.002) and SZ-PRS (B=0.22; 95%CI 0.04 to 0.39; p=0.014) were independently associated with the dimension of positive symptoms. Similar results were found in 979 population controls, with a positive association of both current use of cannabis (B=0.26, 95%CI 0.06 to 0.46; p=0.011) and SZ-PRS (B=0.13, 95%CI 0.02 to 0.25; p=0.022) with the dimension of psychotic experiences.DiscussionWe found two factors associated with the latent dimensional structure of psychosis. SZ risk variants and cannabis use independently map onto specific dimensions of positive symptoms, contributing to variation across the psychosis continuum. Our study supports the theory that psychotic experiences in the general population are biologically similar to clinical psychotic symptoms.

Time to Orgasm in Women in a Monogamous Stable Heterosexual Relationship

BackgroundOrgasm in women is a complex phenomenon, and the sparse data about time to orgasm (TitOr) in women are an impediment to the research on this complex phenomenon. AimTo evaluate the stopwatch measured TitOr in women in a monogamous stable heterosexual relationship. MethodsThe study was conducted through web-based and personal interview using a questionnaire, which addressed the issues related to TitOr. Sexually active women older than 18 years and women in a monogamous stable heterosexual relationship were included in the study. Those with comorbidities such as diabetes, hypertension, asthma, psychiatric illness, sexual dysfunction and those with partners with sexual dysfunction were excluded. The participants reported stopwatch measured TitOr after adequate sexual arousal over an 8-week period. The data analysis was performed using GraphPad software (©2018 GraphPad Software, Inc, USA). OutcomesThe outcomes included stopwatch measured average TitOr in women. ResultsThe study period was from October 2017 to September 2018 with a sample size of 645. The mean age of the participants was 30.56 ± 9.36 years. The sample was drawn from 20 countries, with most participants from India, the United Kingdom, the Netherlands, and the United States of America. The mean reported TitOr was 13.41 ± 7.67 minutes (95% confidence interval: 12.76 minutes–14.06 minutes). 17% of the participants had never experienced the orgasm. Penovaginal intercourse was insufficient to reach orgasm in the majority, in whom it was facilitated by certain positions and maneuvers. Clinical ImplicationsThe knowledge of stopwatch measured TitOr in women in real-life setting helps to define, treat, and understand female sexual function/dysfunction better and it also helps to plan treatment of male ejaculatory dysfunction, as reported ejaculatory latency in healthy men is much less than the reported TitOr here. Strengths & limitationsUse of stopwatch to measure TitOr and a large multinational sample are the strength of the study. The absence of a crosscheck mechanism to check the accuracy of the stopwatch measurement is the limitation of the study. ConclusionStopwatch measured average TitOr in the sample of women in our study, who were in a monogamous stable heterosexual relationship, is 13.41 minutes (95% confidence interval: 12.76 minutes–14.06 minutes) and certain maneuvers as well as positions during penovaginal intercourse help achieving orgasm, more often than not.Bhat GS, Shastry A. Time to Orgasm in Women in a Monogamous Stable Heterosexual Relationship. J Sex Med 2020;17:749–760.

Influences of Parental Snacking-Related Attitudes, Behaviours and Nutritional Knowledge on Young Children's Healthy and Unhealthy Snacking: The ToyBox Study.

This study investigated parental influences on preschool children’s healthy and unhealthy snacking in relation to child obesity in a large cross-sectional multinational sample. Parents and 3–5 year-old child dyads (n = 5185) in a kindergarten-based study provided extensive sociodemographic, dietary practice and food intake data. Parental feeding practices that were derived from questionnaires were examined for associations with child healthy and unhealthy snacking in adjusted multilevel models, including child estimated energy expenditure, parental education, and nutritional knowledge. Parental healthy and unhealthy snacking was respectively associated with their children’s snacking (both p < 0.0001). Making healthy snacks available to their children was specifically associated with greater child healthy snack intake (p < 0.0001). Conversely, practices that were related to unhealthy snacking, i.e., being permissive about unhealthy snacking and acceding to child demands for unhealthy snacks, were associated with greater consumption of unhealthy snacks by children, but also less intake of healthy snacks (all p < 0.0001). Parents having more education and greater nutritional knowledge of snack food recommendations had children who ate more healthy snacks (all p < 0.0001) and fewer unhealthy snacks (p = 0.002, p < 0.0001, respectively). In the adjusted models, child obesity was not related to healthy or unhealthy snack intake in these young children. The findings support interventions that address parental practices and distinguish between healthy and unhealthy snacking to influence young children’s dietary patterns.

Is recurrence in major depressive disorder related to bipolarity and mixed features? Results from the BRIDGE-II-Mix study

BackgroundCurrent classifications separate Bipolar (BD) from Major Depressive Disorder (MDD) based on polarity rather than recurrence. We aimed to determine bipolar/mixed feature frequency in a large MDD multinational sample with (High-Rec) and without (Low-Rec) >3 recurrences, comparing the two subsamples. MethodsWe measured frequency of bipolarity/hypomanic features during current depressive episodes (MDEs) in 2347 MDD patients from the BRIDGE-II-mix database, comparing High-Rec with Low-Rec. We used Bonferroni-corrected Student's t-test for continuous, and chi-squared test, for categorical variables. Logistic regression estimated the size of the association between clinical characteristics and High-Rec MDD. ResultsCompared to Low-Rec (n = 1084, 46.2%), High-Rec patients (n = 1263, 53.8%) were older, with earlier depressive onset, had more family history of BD, more atypical features, suicide attempts, hospitalisations, and treatment resistance and (hypo)manic switches when treated with antidepressants, higher comorbidity with borderline personality disorder, and more hypomanic symptoms during current MDE, resulting in higher rates of mixed depression according to both DSM-5 and research-based diagnostic (RBDC) criteria. Logistic regression showed age at first symptoms < 30 years, current MDE duration ≤ 1 month, hypomania/mania among first-degree relatives, past suicide attempts, treatment-resistance, antidepressant-induced swings, and atypical, mixed, or psychotic features during MDE to associate with High-Rec. LimitationsNumber of MDEs for defining recurrence was arbitrary; cross-sectionality did not allow assessment of conversion from MDD to BD. ConclusionsHigh-Rec MDD differed from Low-Rec group for several clinical/epidemiological variables, including bipolar/mixed features. Bipolarity specifier and RBDC were more sensitive than DSM-5 criteria in detecting bipolar and mixed features in MDD.

Cortical and Subcortical Brain Morphometry Differences Between Patients With Autism Spectrum Disorder and Healthy Individuals Across the Lifespan: Results From the ENIGMA ASD Working Group.

Neuroimaging studies show structural differences in both cortical and subcortical brain regions in children and adults with autism spectrum disorder (ASD) compared with healthy subjects. Findings are inconsistent, however, and it is unclear how differences develop across the lifespan. The authors investigated brain morphometry differences between individuals with ASD and healthy subjects, cross-sectionally across the lifespan, in a large multinational sample from the Enhancing Neuroimaging Genetics Through Meta-Analysis (ENIGMA) ASD working group. The sample comprised 1,571 patients with ASD and 1,651 healthy control subjects (age range, 2-64 years) from 49 participating sites. MRI scans were preprocessed at individual sites with a harmonized protocol based on a validated automated-segmentation software program. Mega-analyses were used to test for case-control differences in subcortical volumes, cortical thickness, and surface area. Development of brain morphometry over the lifespan was modeled using a fractional polynomial approach. The case-control mega-analysis demonstrated that ASD was associated with smaller subcortical volumes of the pallidum, putamen, amygdala, and nucleus accumbens (effect sizes [Cohen's d], 0.13 to -0.13), as well as increased cortical thickness in the frontal cortex and decreased thickness in the temporal cortex (effect sizes, -0.21 to 0.20). Analyses of age effects indicate that the development of cortical thickness is altered in ASD, with the largest differences occurring around adolescence. No age-by-ASD interactions were observed in the subcortical partitions. The ENIGMA ASD working group provides the largest study of brain morphometry differences in ASD to date, using a well-established, validated, publicly available analysis pipeline. ASD patients showed altered morphometry in the cognitive and affective parts of the striatum, frontal cortex, and temporal cortex. Complex developmental trajectories were observed for the different regions, with a developmental peak around adolescence. These findings suggest an interplay in the abnormal development of the striatal, frontal, and temporal regions in ASD across the lifespan.