Student-Athletes’ Views on <Emphasis Type="Italic">APOE</Emphasis> Genotyping for Increased Risk of Poor Recovery after a Traumatic Brain Injury

Use of apolipoprotein E genotyping to personalize the risk of a poor recovery after traumatic brain injury is complicated by the potential for genetic discrimination and the potential to reveal an increased risk for late onset Alzheimer’s disease. We developed a survey to gauge interest in testing among athletes participating in National Collegiate Athletic Association programs. Eight hundred and forty seven student-athletes were surveyed to determine their interest in genetic testing, their willingness to share the results of testing with parents, coaches and physicians, their concerns about privacy and/or discrimination, and their interest in genetic counseling. Nearly three quarters of respondents expressed some level of interest in testing, with the largest number describing themselves as ‘possibly interested’ (54.9 %, n = 463) and a smaller number describing themselves as ‘very interested’ (18.9 %, n = 159). Most student-athletes said that receiving secondary information about their risk for late-onset Alzheimer’s disease made them more likely to test (50.6 %, n = 426) rather than less likely to test (12.4 %, n = 104). Student-athletes were open to apolipoprotein E genotyping and willing to share test results with their parents, coaches and physicians. They did not anticipate that test results would impact their behavior or ability to play. Testing programs may be welcome but should provide clear information as to risks and benefits.     

Antipsychotic dose modulates behavioral and neural responses to feedback during reinforcement learning in schizophrenia

Schizophrenia is characterized by an abnormal dopamine system, and dopamine blockade is the primary mechanism of antipsychotic treatment. Consistent with the known role of dopamine in reward processing, prior research has demonstrated that patients with schizophrenia exhibit impairments in reward-based learning. However, it remains unknown how treatment with antipsychotic medication impacts the behavioral and neural signatures of reinforcement learning in schizophrenia. The goal of this study was to examine whether antipsychotic medication modulates behavioral and neural responses to prediction error coding during reinforcement learning. Patients with schizophrenia completed a reinforcement learning task while undergoing functional magnetic resonance imaging. The task consisted of two separate conditions in which participants accumulated monetary gain or avoided monetary loss. Behavioral results indicated that antipsychotic medication dose was associated with altered behavioral approaches to learning, such that patients taking higher doses of medication showed increased sensitivity to negative reinforcement. Higher doses of antipsychotic medication were also associated with higher learning rates (LRs), suggesting that medication enhanced sensitivity to trial-by-trial feedback. Neuroimaging data demonstrated that antipsychotic dose was related to differences in neural signatures of feedback prediction error during the loss condition. Specifically, patients taking higher doses of medication showed attenuated prediction error responses in the striatum and the medial prefrontal cortex. These findings indicate that antipsychotic medication treatment may influence motivational processes in patients with schizophrenia.     

Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms

ABSTRACT

Fear of positive evaluation (FPE) is experiencing dread during real or potential praise. FPE is associated with social anxiety, but its relation to depressive symptoms is unclear. Anhedonia is a core symptom of depression related to symptoms of anxiety in cross-sectional research. The current study investigated the indirect effect of FPE on depressive symptoms via anhedonia over time. One-hundred ninety-six participants completed three waves of questionnaires over a total timespan of approximately four months via Amazon’s Mechanical Turk, including measures of FPE, depressive symptoms, and anticipatory and consummatory anhedonia. Findings indicated that anticipatory anhedonia at Time 2 mediated the relationship between FPE at Time 1 and depressive symptoms at Time 3. Consummatory anhedonia, however, did not. Each model was contextualised by accounting for prospective covarying relationships, such as depressive symptoms predicting the same symptoms at later waves. The constellation of findings is considered within a reward devaluation framework.     

Non-Suicidal Self-Injury Among Male Adjudicated Adolescents: Psychosocial Concerns,Coping Responses,Diagnoses, and Functions

Non-suicidal self-injury (NSSI) refers to self-inflicted physical injury without suicidal intent. NSSI is particularly common in forensic settings and associated with several psychosocial concerns, coping responses, diagnoses, and functions, but little information is available regarding NSSI in adjudicated male adolescents. The present study examined the frequency and types of NSSI among adjudicated male adolescents (n?=?103) and assessed the relationships between NSSI history, psychosocial concerns, coping responses, diagnoses, and functions within this population. Approximately two-thirds (66%) reported NSSI history. Participants with NSSI history reported poorer social adaptation and greater alienation and boredom, aggression, and emotional lability than controls. Youth with high-frequency NSSI were also more likely to utilize emotional discharge as an unhealthy coping response than controls. In addition, participants with high-frequency NSSI were more likely than controls to meet criteria for a mood or anxiety disorder. Function of NSSI primarily surrounded anxiety reduction/affect regulation, punishment, dissociation reduction, and social/sensation-seeking. NSSI appears to be prevalent among male adjudicated youths, and the findings suggest that the relationship between NSSI history, psychosocial concerns, coping responses, and functions is nuanced and could inform more calibrated assessment and treatment strategies.     

Increasing physical activity in children 8 to 12 years old: experiences with VERB Summer Scorecard

Interventions which facilitate physical activity of youth are vital for promoting community health and reducing obesity. This study assessed the results of a community-driven program, VERB Summer Scorecard, as knowledge of exposure to and awareness of community-based interventions for physical activity among youth could inform design and implementation of such interventions. A total of 2,215 youth ages 8 to 12 years responded to a survey about physical activity. Ordinal logistic regression suggested that youth who participated in this program were 1.73 times (95% CI = 1.41, 2.11) more likely to report high physical activity than nonparticipating youth 9 mo. after the intervention's first full-scale application. The program appeared to appeal more to girls than boys. Such results are encouraging for use in communities.     

Experiential avoidance in adolescents with borderline personality disorder: comparison with a non-BPD psychiatric group and healthy controls

ABSTRACT

Previous research has identified experiential avoidance (EA) as related to a host of adolescent internalizing and externalizing problems, as well as borderline personality disorder, suggesting that it is a crosscutting factor for adolescent psychopathology. It remains unclear whether EA differs among adolescents with BPD compared to adolescents with other psychiatric disorders and healthy adolescents. The aims of this study were to 1) examine EA in adolescents with BPD compared to non-BPD inpatient adolescents and healthy adolescents, and 2) to evaluate whether EA has a unique relationship to borderline pathology over and above internalizing and externalizing. Self-report measures of BPD features, EA, and psychopathology were completed by 692 adolescents (64.5% female, M_age= 15.20). This sample included a group of psychiatric inpatient youth (n = 197 BPD; n = 403 non-BPD) and a group of healthy adolescents (n = 92). Results revealed that EA differed significantly across all three groups, with the highest level of EA evidenced in adolescents who had BPD. Furthermore, there was a significant, unique association between BPD symptoms and EA over afnd above internalizing and externalizing pathology. These findings pinpoint EA as an important risk marker and possible target of prevention or intervention for adolescent BPD.     

Enhancing mental health and well-being outcomes for psychotherapy and counselling through idiographic analysis: A four-quadrant approach

Mental health and well-being outcomes in psychotherapy and counselling have largely been studied through the use of standardised nomothetic measurement. A key limitation is that nomothetic measurement and current statistical analyses do not necessarily capture the outcomes of the complicated and individual psychotherapy processes. There is an increased interest in the use of idiographic patient-reported outcome measures (I-PROMs), which are uniquely useful because they may explore areas of importance that are unexplored by nomothetic outcome measures. We argue that to optimise the value of I-PROMs, it is necessary to consider their contribution alongside standardised nomothetic measures. However, there are important considerations with respect to whether or not I-PROMs from different clients, or indeed from the same client, can be meaningfully explored at a team/service level, and alongside standardised nomothetic outcomes. We provide worked examples on real client data to show that delineating four quadrants of analysis is important to explore the breadth of information: (a) individual progress on single items, (b) individual progress by aggregated scores, (c) team/service-level progress by goal item/theme and (d) team/service-level progress by aggregated scores.