Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities

The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6–16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects.     

Trends in suicidality amid the economic crisis in Greece

For the decade 2000–2010, suicidal rates appear to be both low and stable in Greece and unrelated to the socioeconomic environment. It is highly possible that the recent crisis caused a significant increase in dysphoria, stress, depression and maybe suicidal ideation in the general population, but completed suicides do not seem to have increased so far. Measures are needed to make sure there will be no increase in completed suicides in the near future, since historically, periods of socioeconomic instability might be related to increased suicidality. Community interventions reduce stigma and enhance help-seeking. However, only those including the creation of social support networks are essential in the fight against suicidality.     

Safety signal identification for COVID-19 bivalent booster vaccination using tree-based scan statistics in the Vaccine Safety Datalink

BackgroundTraditional active vaccine safety monitoring involves pre-specifying health outcomes and biologically plausible outcome-specific time windows of concern, limiting the adverse events that can be evaluated. In this study, we used tree-based scan statistics to look broadly for >60,000 possible adverse events after bivalent COVID-19 vaccination.MethodsVaccine Safety Datalink enrollees aged ≥5 years receiving Moderna or Pfizer-BioNTech bivalent COVID-19 vaccine through November 2022 were followed for 56 days post-vaccination. Incident diagnoses in inpatient or emergency department settings were analyzed for clustering within the hierarchical ICD-10-CM diagnosis code “tree” and temporally within post-vaccination follow-up. The conditional self-controlled tree-temporal scan statistic was used, conditioning on total number of cases of each diagnosis and total number of cases of any diagnosis occurring during the scanning risk window across the entire tree. P = 0.01 was the pre-specified cut-off for statistical significance.ResultsAnalysis included 352,509 doses of Moderna and 979,189 doses of Pfizer-BioNTech bivalent vaccines. After Moderna vaccination, no statistically significant clusters were found. After Pfizer-BioNTech, there were clusters of unspecified adverse events (Days 1–3, p = 0.0001–0.0007), influenza (Days 35–56, p = 0.0001), cough (Days 44–55, p = 0.0002), and COVID-19 (Days 52–56, p = 0.0004).ConclusionsFor Pfizer-BioNTech only, we detected clusters of: (1) unspecified adverse effects, as have been observed in other vaccine studies using this method, and (2) respiratory disease toward the end of follow-up. The respiratory clusters were likely due to overlap of follow-up with the spread of respiratory syncytial virus, influenza, and COVID-19, i.e., confounding by seasonality. The untargeted nature of the method and its inherent adjustment for the many diagnoses and risk intervals evaluated are unique advantages. Limitations include susceptibility to time-varying confounding, lower statistical power for assessing risks of specific outcomes than in traditional studies targeting fewer outcomes, and the possibility of missing adverse events not strongly clustered in time or within the “tree.”     

Spontaneous neural differentiation of stem cells in culture of human olfactory epithelium

We studied differentiation of stem cells in dissociated cultures of olfactory epithelium. Staining with anti-nestin antibodies revealed stem cells in the primary monolayer culture of the olfactory epithelium from adult human. Proliferation of these cells during culturing in serum-containing medium in the presence of nerve growth factors FGF2 and NGF led to the formation of neurospheres freely floating in the medium or attached to the substrate. Further long-term culturing and cloning of dissociated cells from these neurospheres in media not containing nerve growth factors led to spontaneous neural differentiation of the olfactory epithelium stem cells. The cells with phenotypic signs of differentiated neurons were stained with antibodies against β-tubulin and neurospecific enolase. Differentiated neurons formed diffuse and spatially organized neuronal networks. We hypothesized that factors triggering neural differentiation of olfactory epithelium stem cells are produced by astrocytes present in these cultures. __________ Translated from Kletochnye Tehnologii v Biologii i Medicine, No. 4, pp. 183–188, October, 2007     

Anxiety Sensitivity Prospectively Predicts Increased Acute Posttraumatic Stress and Related Symptoms After Sexual Assault

Anxiety sensitivity is a potential risk factor for posttraumatic stress symptoms (PTSS) and has been hypothesized to contribute to PTSS development. However, few prospective studies have evaluated whether anxiety sensitivity predicts PTSS. In a subsample of 48 women sexual assault survivors enrolled as part of a larger prospective observational study, elevated anxiety sensitivity measured via a brief assessment 1 week after experiencing a sexual assault was concurrently associated with PTSS at 1 week and prospectively predicted PTSS 6 weeks after the event, with small-to-medium effect sizes, η²_p = .10, even after covarying for trauma history. Heightened anxiety sensitivity at 1-week postevent also interacted with time to predict anxiety and depression both before and after sexual assault, with medium-to-large effect sizes, η_p² = .21– .24. This is consistent with research linking anxiety sensitivity to PTSS, but this was the first prospective study of which we are aware to demonstrate that anxiety sensitivity in the acute posttrauma period predicts PTSS among women who have recently experienced sexual assault. Future research should use the full Anxiety Sensitivity Index to replicate findings in a larger sample and explore whether targeting anxiety sensitivity could mitigate the development of PTSS in this vulnerable population.     

Misperceptions of Facial Emotions Among Youth Aged 9–14 Years Who Present Multiple Antecedents of Schizophrenia

Similar to adults with schizophrenia, youth at high risk for developing schizophrenia present difficulties in recognizing emotions in faces. These difficulties might index vulnerability for schizophrenia and play a role in the development of the illness. Facial emotion recognition (FER) impairments have been implicated in declining social functioning during the prodromal phase of illness and are thus a potential target for early intervention efforts. This study examined 9- to 14-year-old children: 34 children who presented a triad of well-replicated antecedents of schizophrenia (ASz), including motor and/or speech delays, clinically relevant internalizing and/or externalizing problems, and psychotic-like experiences (PLEs), and 34 typically developing (TD) children who presented none of these antecedents. An established FER task (ER40) was used to assess correct recognition of happy, sad, angry, fearful, and neutral expressions, and facial emotion misperception responses were made for each emotion type. Relative to TD children, ASz children presented an overall impairment in FER. Further, ASz children misattributed neutral expressions to face displaying other emotions and also more often mislabeled a neutral expression as sad compared with healthy peers. The inability to accurately discriminate subtle differences in facial emotion and the misinterpretation of neutral expressions as sad may contribute to the initiation and/or persistence of PLEs. Interventions that are effective in teaching adults to recognize emotions in faces could potentially benefit children presenting with antecedents of schizophrenia.Key words: emotion recognition, high risk, child and adolescent psychopathology, social functioning, psychotic-like experiencesPeople with schizophrenia display a marked impairment in recognizing emotions in the faces of others, particularly anger, sadness, and fear, and less difficulty recognizing happy expressions.^1,2 Facial emotion recognition (FER) difficulties are associated with poor social functioning³ and have implications for the development, course, and outcome of the disorder.⁴ Yet, interventions to improve FER performance (eg, Training of Affect Recognition)⁵ can reduce these deficits and elicit generalized improvement in other social cognitive domains.⁶FER impairments are apparent not only among individuals with chronic schizophrenia (for review see Kohler et al 2010)² but also among individuals experiencing a first episode of psychosis^7,8 and among unaffected adolescent (though only for neutral facial expressions)⁹ and adult first-degree relatives of individuals with schizophrenia.¹⁰ Thus, abnormalities in FER are present at illness onset and may also index vulnerabil ity for schizophrenia. Prospective studies following individuals at elevated risk for developing schizophrenia are needed to determine the extent to which impairments of FER precede illness and represent potential targets for early intervention. Among symptomatic, help-seeking individuals meeting ultra-high risk (UHR) criteria for psychosis,^7,8,11–13 evidence for FER impairments is mixed. Two studies reported FER impairments relative to healthy participants,^7,11 while another study indicated specific difficulties in correctly identifying neutral expressions.¹³ A study of a large British birth cohort comprising 5267 children reported no association between FER at 8 years and subclinical psychotic symptoms at 12 years.¹⁴ By contrast, a recent cross-sectional study of 748 children aged 10–13 years indicated that those reporting psychotic-like experiences (PLEs) on questionnaires were poorer at recognizing facial emotional expressions, primarily sadness.¹⁵ Unfortunately, as with many previous FER studies, no information was provided about the nature of the facial emotion misperceptions committed when processing facial expressions. Though PLEs in childhood are significantly associated with later psychotic illness,^16,17 they are also associated with an increased risk of anxiety disorders¹⁶ and other psychiatric disorders including affective disorders, drug use disorders, and personality disorders,¹⁸ albeit to a lesser extent. Thus, PLEs constitute a relatively nonspecific marker of risk for subsequent psychiatric disorders. Further, cross-sectional data from the general population indicate significant comorbidity of PLEs with emotional and behavioral problems,^19,20 implying that the observed relationship between PLEs and FER reported by Roddy et al¹⁵ might reflect the presence of unreported internalizing and/or externalizing psychopathology.To better characterize the nature of FER associated with schizophrenia, several studies have examined facial emotion misperceptions. Relative to healthy adults, individuals with schizophrenia more often mislabel negative emotions to faces displaying no or neutral expressions.^21,22 Adolescent relatives of individuals with schizophrenia, compared with adolescents from healthy families, also more often incorrectly label neutral expressions as displaying negative emotions, predominantly mislabeling them as sad.⁹ Among individuals with schizophrenia, and individuals at high risk for psychosis,²³ functional imaging has revealed hyperactivation of the amygdala during the processing of neutral expressions, which could reflect emotional salience being assigned to neutral stimuli.²⁴ It has been suggested that the tendency to misinterpret neutral facial expressions as displaying emotion may contribute to the development of positive symptoms in schizophrenia.²³ Previous research indicates that facial emotion misperceptions might constitute the cognitive mechanism contributing to the social impairment that characterizes UHR samples¹³ and is a critical component to understanding FER difficulties in samples at risk for schizophrenia.Until recently, there has been no practical method for identifying children who are at elevated risk for schizophrenia. Despite the high heritability of schizophrenia, only approximately one-third of individuals with schizophrenia have a first- or second-degree relative with the illness. Consequently, a positive family history identifies only a subset of children who will develop the illness.²⁵ Prospective investigations of birth cohorts have demonstrated consistently that, by middle childhood, individuals who later developed schizophrenia presented delays in motor and language development; disturbances in social, emotional, and behavioral functioning; and PLEs.¹⁷ Based on this evidence, we developed questionnaires, to be completed by children aged 9–12 years and their primary caregiver, to identify children who present a triad of these replicated antecedents of schizophrenia (ASz).^26,27 We defined ASz to include (1) early speech and/or motor developmental delays/abnormalities; (2) social, emotional, and/or behavioral problems in the clinical range; and (3) PLEs. It is thought that the identification of children who present multiple antecedents of schizophrenia that have been replicated in prospective longitudinal studies will offer greater sensitivity and specificity for later development of schizophrenia than any one antecedent.We are currently following the development of ASz children to determine the specificity and sensitivity of the triad of antecedents for later schizophrenia development. We anticipate that some ASz children will develop schizophrenia and spectrum disorders, some will develop other disorders, and others will remain healthy. In the interim, our investigations have shown that ASz children, compared with typically developing (TD) children who present no antecedents and no family history of schizophrenia or a spectrum disorder, are characterized by features observed among adults with schizophrenia including (1) deficits in performance on standardized intelligence and neuropsychological tests of executive function and memory,²⁸ (2) dyskinetic movement abnormalities,²⁹ (3) reduction in the amplitude of the error-related negativity event-related potential component generated in the anterior cingulate that indexes internal monitoring of behavior,³⁰ and (4) structural brain abnormalities in the superior/middle temporal gyri.³¹ Further, among children aged 9–12 years, two-thirds (69%) of those presenting with the triad of antecedents report distress and/or functional impairment associated with their PLEs.²⁷This study sought to determine whether ASz children present FER difficulties similar to those reported among individuals with schizophrenia and at-risk youth, after accounting for intelligence quotient (IQ) differences between ASz and TD groups,²⁸ which may contribute to FER performance. The study examined overall performance on FER tasks, as well as the specific nature of facial emotion misperceptions. We hypothesized that ASz children would be less accurate than TD children in identifying emotions in facial expressions and that they would more often mislabel neutral faces with other emotion expressions. In particular, we anticipated that ASz children would misidentify neutral expressions as sad, as was reported in a study of youth with family histories of schizophrenia using the same FER task.⁹