Generalized Anxiety Disorder and Social Anxiety Disorder in Youth: Are They Distinguishable?

The current study was designed to examine diagnostic validity of social anxiety disorder (SOC) and generalized anxiety disorder (GAD) in youth, and implications of comorbidity of the disorders for nosology. Children (n = 130) with SOC, GAD, or both disorders (COMORBID) and their parents were administered diagnostic interviews and self-report measures. Confirmatory factor analyses (CFAs) and ANOVAs were performed for the three groups (SOC, GAD, COMORBID). Second-order CFAs for both parent and child informants suggested that SOC and GAD are two specific facets of a general anxiety factor. ANOVA analyses revealed the two pure groups differed only on parent-reported SOC symptoms and GAD worry symptoms, as hypothesized. COMORBID children had higher scores than SOC group on parent-reported GAD symptoms, worry, and behavioral inhibition, and COMORBID children had higher scores than GAD group on parent-reported SOC symptoms and social anxiety. Results may have implications for assessment of GAD and SOC.     

Motivation for Youth’s Treatment Scale (MYTS): A New Tool for Measuring Motivation Among Youths and Their Caregivers

Treatment motivation can be important for treatment adherence and outcomes, yet few measures of motivation are available for youths in mental health settings. These authors describe the psychometric properties of the motivation for youth's treatment scale (MYTS), an 8-item measure with forms for youths and caregivers that assesses their problem recognition and treatment readiness. Results indicate that the MYTS offers practitioners and researchers a brief, psychometrically sound tool for assessing treatment motivation of youths and their caregivers. Multivariate analyses of clinical and non-clinical characteristics of youths and caregivers show that youths' symptom severity consistently predicts treatment motivation for both groups. However, the strain of caring for the youth adds significantly to caregivers' recognition of the youth's troubles. While caregiver and youth motivations correlate, their agreement is low. Caregivers are nearly always more treatment motivated than youths. The authors discuss the implications of their findings for measurement, treatment planning, and future research.     

Impact of Type of Intervention on Youth Reoffending: Are Gender and Risk Level Involved?

The objective of this study was to analyse the impact of the type of intervention on youth reoffending. Moreover, the possible influence that the offender's gender and level of risk could have on this relationship was also explored. Juvenile offenders from four different types of educational interventions participated in the study (N = 210): victim–offender mediation (VOM) as a diversion procedure, and case closure, reprimand, and community service as dispositions. Aged between 14-18 years, they were assessed by means of the Youth Level of Service/Case Management Inventory (YLS/CMI). Recidivism rates were evaluated as the number of new records in a follow-up period of 24 months. Results of this study showed that type of intervention (diversion versus dispositions) had no apparent effect on youth recidivism. Furthermore, an important aspect to consider in youth assessment was the different impact that risk level had on boys’ and girls’ recidivism.     

The renin-angiotensin system,mood, and suicide: Are there associations?

Available evidence points to a possible role of the renin-angiotensin system (RAS) in the pathophysiology of mood disorders and suicide. We carried out a critical analysis of literature data regarding this role, with a focus on the proposed association between RAS dysfunction and suicidal behavior. Epidemiological, genetic, and biochemical findings are described, and the pathophysiological hypothesis aiming at explaining the possible relationship between RAS and suicide are discussed. Available findings do support the involvement of the RAS in the neurobiology of suicide, although the exact mechanisms underlying this involvement are still unknown.     

Are freezing of gait (FOG) and panic related?

We studied 109 consecutive patients who were unselected for freezing of gait (FOG), anxiety, depression, or panic attacks. All patients completed a panic assessment, the Hamilton Anxiety Scale and the Hamilton Depression Scale. Patients were divided into those with FOG or no FOG based on their answer to the FOG question on the Activities of Daily Living part of the UPDRS. Patients with FOG were more disabled, had more "wearing off", dyskinesia, leg dystonia, and postural instability. They were also more anxious and more likely to panic. FOG, in many patients, is increased by anxiety and panic.     

Brief Report: Are ADHD Traits Dissociable from the Autistic Profile? Links Between Cognition and Behaviour

Reports of co-morbid symptoms of ADHD in children with ASD have increased. This research sought to identify ADHD-related behaviours in a sample of children with ASD, and their relationship with the ASD triad of impairments and related cognitive impairments. Children with ASD (n = 55) completed a comprehensive cognitive assessment whilst a semi-structured parental interview (3Di) provided information on ASD and ADHD symptoms. Co-morbid presentation of ADHD traits in these participants was associated with reports of more ASD related behaviours. Inhibitory control performance was directly related only to the ADHD symptom of impulsive behaviour. In contrast, while there was a relationship between social difficulties associated with ASD and theory of mind ability, there was no such relationship with behaviours relating to ADHD.     

Are speech-evoked auditory brainstem response (speech-ABR) outcomes influenced by ethnicity?

Due to its objective nature, auditory brainstem response (ABR) evoked by complex stimuli has been gaining attention lately. The present study aimed to compare the speech-evoked auditory brainstem response (speech-ABR) results between two ethnic groups: Malay and Chinese. In addition, it was also of interest to compare the speech-ABR outcomes obtained from the present study with the published Caucasian data. Thirty healthy male adults (15 Malay and 15 Chinese) were enrolled in this comparative study. Speech syllable/da/presented at 80 dBnHL was used to record speech-ABR waveforms from the right ear of each subject. Amplitudes and latencies of speech-ABR peaks (V, A, C, D, E, F and O), as well as composite onset measures (V/A duration, V/A amplitude and V/A slope) were computed and analyzed. When the two ethnic groups were compared, all speech-ABR results were not statistically different from each other (p > 0.05). When the data from the present study were compared with the published Caucasian data, most of the statistical analyses were significant (p < 0.05). That is, Asian subjects revealed significantly higher peak amplitudes, earlier peak latencies, higher V/A amplitudes and steeper V/A slopes than that of Caucasians. The speech-ABR results between Malay and Chinese were found to be essentially similar due to anatomical similarities. Nevertheless, specific normative data for Asian adults are required as their speech-ABR results are different from that of Caucasian males. This issue should be addressed before it can be applied holistically in multiracial countries.     

Ephemeral New Traces and Evaporated Remote Engrams: A Form of Neocortical Temporal Lobe Amnesia? A Preliminary Case Report

Abstract

We report the case of a patient (GB) with a 2-year history of memory disturbances characterized by forgetting of both recently learned traces and remote information acquired decades before. Forgotten contents involved the episodic aspects of autobiographical and media-mediated information. Moreover, a mild anterograde verbal learning defect was evident. General cognition was normal. In the last months of our observation, GB developed partial complex epilepsy with EEG evidence of a left temporal anterior focus. He never experienced acute transient amnesic episodes. MRI showed normal and symmetrical temporomedial aspects, and a slight ventricular asymmetry with a greater extension of the left ventricle. No brain atrophy was apparent. It is speculated that GB's memory loss is the consequence of a neocortical left temporal lobe dysfunction due to a still obscure underlying degenerative process which produces, as its neurological counterpart, not atrophy, but epilepsy. Temporal epilepsy is cautiously rejected as a crucial determinant of GB's amnesia.     

Neuroprotection against Aβ and glutamate toxicity by melatonin: Are GABA receptors involved?

The beta-amyloid peptide (Abeta) is centrally related to the pathogenesis of Alzheimer's disease (AD). Previous studies have suggested that the neurotoxicity of Abeta may be related to the overactivation of glutamatergic transmission and excitotoxicity, and that blockade of glutamate receptors prevents Abeta-induced cell death. Here, we show that melatonin, a pineal hormone, protects chick retinal neurons in culture against the neurotoxicity of Abeta and glutamate. Right-angle light scattering and thioflavin T fluorescence measurements, as well as light microscopy analysis, indicated that, under our experimental conditions, melatonin had no effect on the aggregation of Abeta. Interestingly, the neuroprotective action of melatonin against the toxicity of Abeta was significantly decreased in the presence of picrotoxin, an antagonist of GABA(A)-like receptors. By itself, picrotoxin had no effect. These results suggest that the neuroprotective effects of melatonin against Abeta neurotoxicity could be at least in part related to a decrease in the excitatory tonus, mediated by activation of GABA receptors and the resulting hyper-polarization of the neurons. Thus, selective pharmacological manipulation of neuronal excitatory/inhibitory tonus could be a potentially interesting new approach in the treatment of AD.     

The Development and Preliminary Psychometric Evaluation of the Theory of Mind Inventory: Self Report—Adult (ToMI:SR-Adult)

This study describes the development and psychometric evaluation of a new self-report measure of social cognition: the Theory of Mind Inventory:Self-report-Adult (ToMI:SR-Adult). Adults with autism (or a suspicion of autism; n?=?111) and typically developing adults (n?=?109) completed a demographic questionnaire and the ToMI:SR-Adult online. Both quantitative and qualitative self-reports of one’s own theory of mind functioning were collected. The ToMI:SR-Adult performed well under all examinations of reliability and validity (internal consistency, accuracy of classification, contrasting-groups). The qualitative data confirmed impressions of validity and revealed that the adults in our sample had high levels of self-insight regarding their own theory of mind. The ToMI:SR-Adult is offered as a promising research and clinical tool for the assessment of social cognition in adults.

     

Brief Report: Are Autistic-Behaviors in Children Related to Prenatal Vitamin Use and Maternal Whole Blood Folate Concentrations?

Prenatal multivitamin/folic acid supplement use may reduce the risk of autism spectrum disorders. We investigated whether 2nd trimester prenatal vitamin use and maternal whole blood folate (WBF) concentrations were associated with Social Responsiveness Scale (SRS) scores at 4–5 years of age in a prospective cohort of 209 mother–child pairs. After confounder adjustment, children born to women taking prenatal vitamins weekly/daily (n = 179) had lower odds of clinically elevated SRS scores (odds ratio 0.26; 95 % confidence interval 0.08, 0.89) than those who rarely/never took them (n = 30). WBF concentrations were not associated with SRS scores. The lack of association between WBF and autistic-behaviors may be due to the timing of biomarker measures relative to critical periods of brain development, confounding, or other modifying factors.     

The environment and Parkinson's disease: is the nigrostriatal system preferentially targeted by neurotoxins?

Recent epidemiological and experimental studies have renewed interest in the hypothesis that the environment has a role in the pathogenesis of Parkinson's disease (PD). Epidemiological studies have identified protective associations (eg, smoking) as well as adverse risk factors (eg, pesticide exposure) for PD. The concordance rate of PD in pairs of dizygotic twins is similar to that in pairs of monozygotic twins, supporting a role of non-genetic risk factors. New models of selective nigrostriatal damage--such as neurotoxicity induced by rotenone or paraquat--have emphasised that environmental agents may contribute to the neurodegenerative process in PD. Toxins interact, in vitro and in vivo, with alpha-synuclein, an endogenous protein that is implicated in pathology of PD. Similarities between clinical and experimental findings, such as the role of pesticide exposure as a potential environmental risk factor, highlight the importance of a multidisciplinary approach to the aetiology of PD.     

The longitudinal relationship between changes in wellbeing and inflammatory markers: Are associations independent of depression?

ObjectivesThere is a large literature linking inflammation with mental ill health, but a much smaller literature focusing on mental wellbeing. Specifically, it remains unclear whether mental wellbeing is longitudinally and independently associated with inflammation or only via associated changes in mental ill health.MethodsThis study used data from 8780 adults aged 50+ in the English Longitudinal Study of Ageing. Hedonic wellbeing (both positive affect and life satisfaction) and eudemonic wellbeing (self-realisation and control-autonomy) were measured at data collection waves 2 (2004/05), 4 (2008/09) and 6 (20012/13), along with measures of C-reactive protein (CRP), fibrinogen and white blood cells (WBC). Fixed effects modelling was performed to identify the longitudinal relationship between wellbeing and inflammation, adjusting for time-varying mental ill health and other identified confounders.ResultsBoth measured aspects of hedonic wellbeing were associated with lower WBC count, independent of mental ill health. For life satisfaction, this relationship was explained by confounders, whilst for positive affect it persisted. Both measured aspects of eudemonic wellbeing were associated with lower CRP, fibrinogen and WBC, independent of mental ill health. For control-autonomy, this relationship was explained by confounders, whilst for self-realisation it persisted. Results were present in both men and women, although more strongly in men, and were robust to a range of sensitivity analyses.ConclusionsThis study builds on the strong literature showing a relationship between mental ill health and inflammation by showing that there is also an apparently independent relationship between mental wellbeing, in particular eudemonic wellbeing, and inflammation that is unexplained by socio-economic or other time-constant factors and in some instances persists independent of time-varying confounders.     

Are early myoclonic encephalopathy (EME) and the Ohtahara syndrome (EIEE) independent of each other?

BACKGROUND: Early myoclonic encephalopathy (EME) and the Ohtahara syndrome are currently listed as two separate syndromes in the classification of epilepsies. The most prominent differentiating points are the observations that patients with Ohtahara syndrome experience predominantly tonic seizures; their seizures evolve to infantile spasms and the prognosis is often worse than patients with EME. SUMMARY POINTS: We performed a literature review of published cases. Although syndromes may have distinct courses, the differentiation early on may be impossible as both myoclonus and tonic seizures may coexist. There is also an overlap in the etiologies. Tonic seizures are considered a manifestation of brainstem dysfunction and it is possible that this is more prominent in Ohtahara syndrome. To date, there are 17 autopsy cases (12 presumed to be Ohtahara cases and 5 EME). Evidence of hindbrain pathology was present in all. Tonic seizures or tonic posturing was a feature of all cases. We suggest that the two syndromes may represent a continuum and that the prominence of tonic seizures in the Ohtahara syndrome may be an indication of brainstem dysfunction which may play an important role in the subsequent transition to infantile spasms.     

The Relationship Between Change in Therapeutic Alliance Ratings and Improvement in Youth Symptom Severity: Whose Ratings Matter the Most?

This paper presents the psychometric evaluation of brief measures of therapeutic alliance (TA) for youths, clinicians and caregivers and a longitudinal analysis of relationships between changes in TA and changes in youth symptom and functioning severity. Psychometric analyses using methods from Classical Test Theory, Item Response Theory, and Factor Analysis indicate that the measures of TA used in this study offer something new for both practice and research. The measures have variability, sensitivity to change over time, brevity and can be used with multiple parties through parallel forms. The longitudinal analyses, employing hierarchical linear modeling with time-varying covariates, found that TA ratings of the clinician correlated with symptom improvement as rated by the clinician, caregiver and youth. Additional analyses showed that decreases in clinician-rated youth TA was most important in predicting a lower rate of youth improvement. Implications for future research and clinical practice are discussed.