Substance P at the nexus of mind and body in chronic inflammation and affective disorders

For decades, research has demonstrated that chronic diseases characterized by dysregulation of inflammation are particularly susceptible to exacerbation by stress and emotion. Likewise, rates of depression and anxiety are overrepresented in individuals suffering from chronic inflammatory disease. In recent years, substance P has been implicated in both the pathophysiology of inflammatory disease and the pathophysiology of depression and anxiety by 2 parallel fields of study. This review integrates the literature from these 2 parallel fields and examines the possibility that substance P dysregulation may be a point of convergence underlying the overlap of chronic inflammatory disease and mood and anxiety disorders. First, the involvement of substance P in peripheral inflammation and in the immune events associated with chronic inflammatory disease is discussed, with a focus on inflammatory bowel disease and asthma. Next, the function of substance P in the communication of peripheral inflammation to the brain is considered. Finally, to complete the bidirectional loop of brain-immune interactions, substance P expression in anxiety and depression as well as its potential role in the neural regulation of peripheral inflammation is reviewed.     

白细胞介素-1在病态行为中的作用及其机制

白细胞介素－1（interleukin-1,IL-1）是介导神经－免疫活动的关键分子,在应激状态时出现IL-1活性增强,注射IL-1可以引发病态行为。外周释放的IL-1通过快通路和慢通路作用于大脑进而引发病态行为,快通路是指局部的初级传入神经将信息传入大脑,慢通路是指IL-1从环脑室器官和脉络从扩散进入大脑。     

Infectious and immune factors in the pathogenesis of neurodevelopmental disorders: epidemiology, hypotheses, and animal models

Both genetic and environmental factors contribute to the pathogenesis of a wide variety of neurodevelopmental disorders, including autism, mental retardation, and schizophrenia. Some heritable disorders approach 100% penetrance; nonetheless, even in these disorders, subtle aspects of clinical disease expression may be influenced by the environment. In other disorders with genetic influences, exogenous factors, and the timepoint(s) during nervous system development at which they are introduced, modulate expression of disease. Elucidation of the mechanisms guiding this intricate interplay between host response genes, environmental agents, and the neurodevelopmental context within which these interactions occur, is necessary to understand the continuum of clinical outcomes. This chapter will review the evidence that infectious and immune factors may contribute to the pathogenesis of neurodevelopmental disorders, describe an animal model of neurodevelopmental disorders based upon viral infection, identify processes by which neural circuitry may be compromised, and outline areas for future research.     

The relevance of recent developments in classical conditioning to understanding the etiology and maintenance of anxiety disorders

Current etiological models of anxiety disorders emphasize both internal diatheses, or risk factors, and external stressors as important in the development and maintenance of clinical anxiety. Although considerable evidence suggests personality, genetic, and environmental variables are important to these diathesis-stress interactions, this general approach could be greatly enriched by incorporating recent developments in experimental research on fear and anxiety learning. In this article, we attempt to integrate the experimental literature on fear/anxiety learning and the psychopathology literature on clinical anxiety, identify areas of inconsistency, and recommend directions for future research. First, we provide an overview of contemporary models of anxiety disorders involving fear/anxiety learning. Next, we review the literature on individual differences in associative learning among anxious and non-anxious individuals. We also examine additional possible sources of individual differences in the learning of both fear and anxiety, and indicate where possible parallels may be drawn. Finally, we discuss recent developments in basic experimental research on fear conditioning and anxiety, with particular attention to research on contextual learning, and indicate the relevance of these findings to anxiety disorders.     

Clinical issues in the assessment of adolescent alcohol and other drug use

Clinicians working with adolescents are routinely faced with the issue that alcohol and other drug (AOD) involvement may be part of the clinical picture either as a primary problem or a contributing factor to other problems or disorders. Fortunately, assessment research in this area has produced several behaviorally oriented and psychometrically sound tools from which to choose for problem identification, referral and treatment of youth suspected of AOD abuse. The aim of this paper is to provide an overview of several issues related to the clinical utility of such assessment tools.     

西方家庭影响进食障碍的研究述评

家庭是进食障碍发展过程中一个重要的影响因素。已有众多西方学者采用各种方法对进食障碍和家庭之间的关系进行了研究。从时间发展脉络来看, Minuchin等学者首先对此进行了经典临床研究; 随后有众多量化研究出现, 对此可以依据不同的测量水平、研究变量和被试视角进行梳理; 近些年, 有学者采用质化研究方法重新对此进行探讨。进食障碍家庭研究的发展趋势表现出：重视本土化研究、对家庭做多水平的探讨、兼顾家庭结构和家庭变化过程。     

Neuropsychopharmacologic treatment of depression and other neuropsychiatric disorders in HIV-infected individuals

How can neuropsychiatric disorders and syndromes be underdiagnosed and inadequately treated in individuals infected with human immunodeficiency virus? Depression in particular is among the most prevalent diagnoses and there is a solid foundation of data from controlled clinical studies that has begun to examine the efficacy of various antidepressants in HIV-infected persons. This article summarizes essential findings pertaining to the use of psychotropic medications to treat depression and other neuropsychiatric disorders in the context of immunodeficiency. This includes discussion of clinically significant treatment considerations (eg, efficacy, side effects, drug-drug interactions) derived from the existing literature. Taken together, there is compelling evidence that psychopharmacologic intervention can improve the quality of life of mentally ill HIV-infected individuals.     

Obsessive-compulsive disorder: boundary issues

The boundaries between obsessive-compulsive disorder (OCD) and other neuropsychiatric disorders remain unresolved and may well differ from one disorder to another. Endophenotypes are heritable, quantitative traits hypothesized to more closely represent genetic risk for complex polygenic mental disorders than overt symptoms and behaviors. They may have a role in identifying how closely these disorders are associated with another and with other mental disorders with which they share major comorbidity. This review maps the nosological relationships of OCD to other neuropsychiatric disorders, using OCD as the prototype disorder and endophenotype markers, such as cognitive, imaging, and molecular data as well as results from demographic, comorbidity, family, and treatment studies. Despite high comorbidity rates, emerging evidence suggests substantial endophenotypic differences between OCD and anxiety disorders, depression, schizophrenia, and addictions, though comparative data is lacking and the picture is far from clear. On the other hand, strong relationships between OCD, Tourette syndrome, body dysmorphic disorder, hypochondriasis, grooming disorders, obsessive-compulsive personality disorder, and pediatric autoimmune neuropsychiatric disorders associated with streptococcus are likely. Studies designed to delineate the cause, consequences, and common factors are a challenging but essential goal for future research in this area.     

Cluster A Personality Disorders: Schizotypal,Schizoid and Paranoid Personality Disorders in Childhood and Adolescence

Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors. The DSM-IV-TR describes personality disorders as representing stable and enduring patterns of maladaptive traits, and much of what is understood about Cluster A personality disorders in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area.     

Social Neuroscience: Progress and Implications for Mental Health

ABSTRACT— Social neuroscience is a new, interdisciplinary field devoted to understanding how biological systems implement social processes and behavior. Social neuroscience capitalizes on biological concepts and methods to inform and refine theories of social behavior, and it uses social and behavioral constructs and data to inform and refine theories of neural organization and function. We focus here on the progress and potential of social neuroscience in the area of mental health. Research in social neuroscience has grown dramatically in recent years. Among the most active areas of research we found are brain-imaging studies in normal children and adults; animal models of social behavior; studies of stroke patients; imaging studies of psychiatric patients; and research on social determinants of peripheral neural, neuroendocrine, and immunological processes. We also found that these areas of research are proceeding along largely independent trajectories. Our goals in this article are to review the development of this field, examine some currently promising approaches, identify obstacles and opportunities for future advances and integration, and consider how this research can inform work on the diagnosis and treatment of mental disorders.     

Effective Treatment for Mental Disorders in Children and Adolescents

As pressure increases for the demonstration of effective treatment for children with mental disorders, it is essential that the field has an understanding of the evidence base. To address this aim, the authors searched the published literature for effective interventions for children and adolescents and organized this review as follows: (1) prevention; (2) traditional forms of treatment, namely outpatient therapy, partial hospitalization, inpatient treatment, and psychopharmacology; (3) intensive comprehensive community-based interventions including case management, home-based treatment, therapeutic foster care, and therapeutic group homes; (4) crisis and support services; and (5) treatment for two prevalent disorders, major depressive disorder and attention-deficit hyperactivity disorder. Strong evidence was found for the treatment of attention-deficit hyperactivity disorder, depression, anxiety, and disruptive behavior disorders. Guidance from the field relevant to moving the evidence-based interventions into real-world clinical practice and further strengthening the research base will also need to address change in policy and clinical training.     

Ways to independence

Much research attests to the beneficial effects of equine interventions on physical development and ability. However, less is known about the possible psychological benefits of horse activities, such as therapeutic riding or interactions with horses. Although there is public consensus that horses can have psychological benefits, it is an under-researched area and conclusions are largely based on anecdotal data. The little empirical evidence that is available about the efficacy of equine-assisted interventions on psychological outcomes tends to be mixed and is often difficult to interpret due to the lack of rigorous research designs. The purpose of this review was to examine the current state of the literature regarding the psychological effects of equine-assisted interventions, and to make recommendations for future research. Findings from this review suggest that equine-assisted interventions hold much promise, particularly in terms of child/adolescent social and behavioural issues, and perhaps adult affective disorders. However, the current state of the literature does not allow us to definitively conclude that equine-assisted interventions are efficacious. Well-designed randomised controlled trials are greatly needed in this area, as it is an appreciation of the need to standardise and document equine-assisted interventions and outcomes in future research.     

Psychosocial risk factors, natural immunity, and cancer progression: Implications for intervention

One of the more important and emerging fields in which psychologists collaborate with other disciplines is psychoimmunology. Centuries of clinical anecdote and decades of psychosomatic hypotheses have gained credibility in the eyes of the medical establishment—and many patients—by the systematic investigation of mechanisms potentially explaining how events intrapsychic and interpersonal could affect physical disease processes. The central nervous system is connected with the immune system by both neuronal and endocrinological pathways. The immune system has been found to mediate the organism’s response to aberrations of its own normal functions, as well as to invading organisms from without. AIDS, arthritis, asthma, lupus, and herpes are some of the illnesses in which research is demonstrating important relationships among psychosocial and immunological factors and disease course. In this article, we first discuss the immunological apparatus in order to provide a base for subsequent discussions of the effects of stress on immune function. Then we discuss malignant diseases and current evidence that disease course is related to both psychosocial stressors and immune function. We next discuss a model of these interactions, and finally we talk about interventions incorporating psychosocial factors aimed at influencing immune status and, thus, disease course.     

Psychosomatische Aspekte des Diabetes mellitus

The term “diabetes mellitus” describes a group of endocrinological diseases characterised by hyperglycemia. The treatment is demanding for patients in terms of self-management and self-responsibility, and some patients need not only medical but psychological support as well. This article reviews essential psychological aspects of diabetes, starting with factors affecting adherence to diabetes treatment. The main part describes epidemiology and interactions between anxiety disorders, eating disorders and depression in patients with diabetes. Treatment recommendations are derived from current knowledge in accordance with evidence-based treatment guidelines.     

Partner Enabling of Substance Use Disorders: Critical Review and Future Directions

Substance use disorders affect not only the identified client but significant others as well. Dyadic and family dysfunction is typically associated with a family member's alcohol or drug abuse. One area of research interest based on clinical conceptions of these families is that of partner support or coping in response to the addiction. Female partners of male alcoholics have received much of this clinical and research attention, and have alternatively been labeled as codependents, co-alcoholics, or enablers. Broadening the therapeutic emphasis beyond the impaired individual underscores the systemic notion that a loved one's addiction necessarily affects spouses and partners, and that partner responses may in turn affect drinking or drug behaviors. The present article contrasts the enabling and codependency constructs, reviews empirical studies of enabling, and offers a conceptualization of partner responses to addiction that could enhance future research efforts and clinical applications in this area.     

Inhibitory control and negative emotional processing in psychopathy and antisocial personality disorder

The field of personality disorders has had a long-standing interest in understanding interactions between emotion and inhibitory control, as well as neurophysiological indices of these processes. More work in particular is needed to clarify differential deficits in offenders with antisocial personality disorder (APD) who differ on psychopathic traits, as APD and psychopathy are considered separate, albeit related, syndromes. Evidence of distinct neurobiological processing in these disorders would have implications for etiology-based personality disorder taxonomies in future psychiatric classification systems. To inform this area of research, we recorded event-related brain potentials during an emotional-linguistic Go/No-Go task to examine modulation of negative emotional processing by inhibitory control in three groups: psychopathy (n = 14), APD (n = 16), and control (n = 15). In control offenders, inhibitory control demands (No-Go vs. Go) modulated frontal-P3 amplitude to negative emotional words, indicating appropriate prioritization of inhibition over emotional processing. In contrast, the psychopathic group showed blunted processing of negative emotional words regardless of inhibitory control demands, consistent with research on emotional deficits in psychopathy. Finally, the APD group demonstrated enhanced processing of negative emotion words in both Go and No-Go trials, suggesting a failure to modulate negative emotional processing when inhibitory control is required. Implications for emotion-cognition interactions and putative etiological processes in these personality disorders are discussed.     

Additive factor method applied to psychopathology with special reference to childhood hyperactivity

A review is made of available studies using the Additive Factor Method (AFM) in clinical research. The paper argues that by using the AFM in studies of psychological dysfunctioning a major contribution can be made: first, in preventing spurious findings, second, distinguishing between group differences with and without information processing deficits, and third, by identifying fundamental processes which may be impaired. This may offer psychodiagnostics an empirical basis on which to define disorders. This paper reviews studies contributing to this endeavour. It further raises the question of how to interpret clinical research, which is conducted in the tradition of information processing but not within the frame of reference of the AFM. It is suggested that such research is useful and complementary to that conducted using the AFM. Further, it is suggested that the role of energetical factors in clinical disorders and in their treatment is an important area for future experimental clinical research.     

The Dual Value of the Web: Risks and Benefits of the Use of the Internet in Disorders with A Self-Destructive Component in Adolescents and Young Adults

Eating disorders (ED) and non-suicidal self-injury (NSSI) present common aspects and factors which contribute to their onset and development. The last decade has seen an increasing circulation of online materials and interactions connected to ED and NSSI. There is a general agreement among mental health clinicians and researchers that this kind of online content involves serious risks, such as normalization and reinforcement of unhealthy behaviors, alongside with some benefits, like receiving peer support and validation. The aim of this paper is to offer an overview of major research contributions on this topic. After describing common aspects between these disorders, we analyze data concerning the usage of harm-advocating websites on internet and the characteristics of users. Furthermore, we define and explore the contents of both pro-ED and NSSI websites, and we extensively inspect risks and benefits of the exposure to these online content. Finally, we present clinical guidelines for assessment, intervention and prevention, particularly focusing on family interventions. Due to the rapidity of changes when technology is involved, the research on this topic is far from being concluded; more in-depth studies are needed, not only to explore long term effects of the use of the websites described, but also to investigate new alarming tendencies such as the diffusion of websites challenging self-destructive behaviors.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

A developmental approach to violence, hostile attributions, and paranoid thinking in adolescence

Research within the area of paranoid thinking has focused primarily on adults and has only recently looked at the effects during the critical life stage of adolescence, with even less research in the context of the juvenile justice system. This article aims to explore the relationship between antisocial behaviour in adolescence and the development of paranoid thinking, set within wider contexts that surround the juvenile justice system. The information presented is drawn from both the current research and the clinical experiences of those working in adolescent forensic psychiatry services. The relationships with other disorders such as conduct disorder, ADHD, PTSD, and depression are also explored.