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Chapter 5 - New Perspectives in Eating Disorders
- Edited by Andrea Fiorillo, University of Campania “L. Vanvitelli”, Naples, Peter Falkai, Ludwig-Maximilians-Universität München, Philip Gorwood, Sainte-Anne Hospital, Paris
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- Mental Health Research and Practice
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- 01 February 2024
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- 08 February 2024, pp 68-88
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Summary
Eating disorders (ED) are complex psychiatric disorders associated with high morbidity and mortality. Medical complications are relatively frequent and may involve all organs and systems, and although most remit when a regular food intake and/or a normal body weight are resumed, others are severe enough to cause the death of the individual. Despite this relevance for public health, there is no conclusive knowledge about their etiopathogenesis. Current diagnostic criteria are unable to address all clinical presentations of these syndromes, since they are focused on eating-related psychopathology and miss the presence of general psychopathological symptoms, which have been shown to have a central role in the disorders. Moreover, although social processes and connection with others have been recognized to be a cornerstone of clinical recovery, they are rarely considered in the therapeutic planning. This chapter reviews the recent literature on emerging issues related to the etiopathogenetic risk factors, focusing especially on reward processes. Psychopathology and diagnostic problems are addressed through the illustration of new methodological approaches such as the network analysis and the staging model. Finally, we consider the impact of an ED on interpersonal functioning of close others, parents, partners, and siblings of the individual with an ED.
1 Social Brain Network Connectivity Relates to Social and Adaptive Outcomes Following Pediatric Traumatic Brain Injury
- Katherine A Billetdeaux, Whitney Mattson, Eric Nelson, Brianna Laney, Kathryn Vannatta, William A Cunningham, Elisabeth A Wilde, Keith Yeates, Kristen R Hoskinson
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 509-510
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Objective:
Traumatic brain injury (TBI) is a prevalent cause of long-term morbidity in children and adolescents and can lead to persistent difficulties with social and behavioral function. TBI may impact brain structures that support social cognition, social perception, and day-to-day social interactions—termed the social brain network (SBN). We examined differences in links among the SBN and regions of interest from other neural networks thought to support social outcomes, i.e., the default mode network (DMN) and salience network (SN). Furthermore, we examined how differences in co-activation among the SBN and these other key networks were associated with ratings of social and day-to-day adaptive outcomes.
Participants and Methods:Participants included children and adolescents with moderate to severe TBI (msTBI; n=11, Mage=11.78, 6 male), complicated-mild TBI (cmTBI; n=12, Mage=12.59, 9 male), and orthopedic injury (OI; n=22, Mage=11.69, 15 male). Participants underwent resting-state functional MRI on a 3Tesla Siemens Prisma scanner. Parents rated their child’s social and adaptive function on the Child Behavior Checklist (CBCL) and Adaptive Behavior Assessment System-Third Edition (ABAS-3). Resting-state connectivity was assessed using the CONN Toolbox, including preprocessing, denoising, and alignment to the participants’ processed T1 MPRAGE sequence followed by seed-to-voxel analysis using a SBN mask and targeted regions of interest within the DMN and SN. Individual-level r-to-z correlations were extracted from resulting clusters of co-activation with the SBN mask and exported into SPSSv28.0 for integration with behavioral data.
Results:One-way ANOVAs used to examine group differences in social and adaptive outcome revealed significant group differences in CBCL Social Competence (F=4.49, p=.019) and all composite scores on the ABAS-3 (Fs=3.78 to 5.17, ps=.031 to .010). In each domain, children with msTBI were rated as having elevated difficulties relative to cmTBI or OI, whereas cmTBI and OI groups did not differ. Connectivity also differed significantly between groups, with children with OI demonstrating greater connectivity between the SBN and the anterior cingulate cortex of the SN (t=5.19, p(FDR)<.0001) and posterior cingulate cortex of the DMN (f=4.30, p(FDR)<.001) than children with msTBI. Children with cmTBI also showed greater connectivity between the SBN and left temporal pole of the DMN (t=7.45, p(FDR)<.000001) than children with msTBI. Degree of connectivity between the SBN and posterior cingulate was significantly positively correlated across all domains of adaptive function (rs=.451 to .504, ps=.010 to .003), whereas degree of connectivity between the SBN and left temporal pole was strongly positively related to Social Competence (a=.633, p=.006) and conceptual adaptive skills on the ABAS (A=.437, p=.037).
Conclusions:Our findings provide insights into the neural substrates of social and adaptive morbidity after pediatric TBI, particularly msTBI, by linking alterations in connectivity among the SBN, DMN, and SN with measures of social and adaptive outcome. While the posterior cingulate was broadly associated with adaptive outcome, the temporal pole was particularly strongly associated with social competence. This may reflect the diverse functions and high degree of interconnectivity of the posterior cingulate, which contributes to various cognitive and attentional processes, relative to the strong amygdala/limbic connections of the temporal pole.
56 Outcome Probability Task: Association with Safety Behaviors and Avenues for Future Imaging Research
- Madeline A. Rech, Page L. Anderson
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- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 927-928
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Objective:
Probability bias—overestimation of the likelihood that feared social outcomes will occur—is a mechanism targeted for symptom reduction in cognitive behavioral therapy for social anxiety. Safety behaviors (i.e., the conscious and unconscious actions taken to reduce discomfort in feared social situations) are related to cognitive biases and can be manipulated to reduce probability bias. The purpose of this research was to test the hypothesis that scores from a newly developed computer task to measure probability bias, the Outcome Probability Task (OPT; Draheim & Anderson, 2022) would be associated with self-reported safety behaviors during a speech task.
Participants and Methods:Participants (N=90) included diverse students from a university in a southern, metropolitan area. Individuals reported an average age of 20.74 (SD=3.57) and self-identified as 'Woman’ (69%), 'Man’ (30%), 'Transgender’ (1%), or 'Non-binary/Agender’ (1%), and 'African American or Black’ (52%), 'Asian or Asian American’ (19%), 'White’ (16%), 'Multi-racial’ (7%), 'Hispanic or Latine’ (5%), or 'Middle Eastern’ (1%). Participants viewed social images and imagined themselves in the scenarios, then rated the likelihood that they would be negatively evaluated on a 0-100% scale (higher ratings indicate greater probability bias), gave a speech, and completed a standardized self-report measure of safety behaviors to rate how often they engaged in avoidant safety behaviors during the speech.
Results:Results from a linear regression indicated that OPT scores (ß=.43) were positively associated with self-reported safety behaviors during a speech task, R2 = .19, F(1, 88) = 20.02, p < .001, 95% CI [0.170, 0.443].
Conclusions:Negatively biased expectations about fear-relevant social situations—measured by a digital imagery task, the OPT—may contribute to increased engagement in avoidant safety behaviors during a speech task among a convenience sample. Outcome probability bias has previously only been measured through self-report, and the OPT is a promising new measure to multi-modally assess this aspect of social cognition. This task could be used along with imaging techniques to better understand the functional brain activity involved in outcome probability bias. Future studies could explore how activity in the orbitofrontal cortex, which is associated with the anticipation of negative outcomes, relates to responses on the OPT. If there is a connection, this brain region could be an indicator of improvement following intervention, such as cognitive behavioral therapy, for probability biases involved in social anxiety.
80 The Association between Periodontal Disease and Self-Reported Cognitive and Functional Decline at Age 60 in a Large, Multicultural Cohort Study
- Jessie Himmelstern, John R Warren, Eric Grodsky, Chandra Muller, Emily Lybbert, Adam Brickman, Jennifer Manly, Ryan Demmer
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- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 383-384
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Objective:
We assess the association between self-reported history of periodontal disease diagnosis with self-reported cognitive and functional decline at age ∼60. We also investigate (1) the roles of social background, demographic characteristics, education, and adolescent test scores in confounding that association and (2) the role of cardiovascular disease in mediating that association.
Participants and Methods:We use data from a nationally representative sample of 13,525 people who participated in the 2021 wave of the High School & Beyond (HSB) cohort study. HSB began in 1980 with a nationally-representative sample of American 10th and 12th grade students; these students have been followed up on six occasions since 1980, yielding extraordinary and prospectively-collected life course data on all key measures for a large, multicultural sample.
In 2021, HSB sample members were evaluated with neuropsychological tests that evaluated list learning and memory, semantic and letter fluency, and working memory. They were also asked to self-report memory and functional decline using the AD8, using a cutoff of 2 or more items for significant concerns. Mild Cognitive Impairment will be identified using an algorithm validated in a similar sample of middle aged participants.
Sample members were also asked in 2021 whether a medical professional had ever diagnosed them with periodontal disease; those responding affirmatively were then asked the years in which they started and stopped having periodontal disease.
Measures of social and economic background; demographic characteristics; and educational contexts, opportunities, and attainments were measured prospectively—and in great detail—in the surveys administered in the 1980s. Critically, almost all sample members completed a series of cognitive tasks during adolescence, allowing us to address a key set of confounders in the relationship between periodontal disease and MCI. Markers of cardiovascular disease were measured in both 2013 and 2021.
We estimate logistic regression models predicting significant cognitive and functional concerns as a function of periodontal disease history; we also estimate models that account for confounders, including social background, demographic characteristics, education, and cognitive skills during adolescence; finally, we estimate models that account for the mediating role of cardiovascular disease. All models account for the clustered sampling design of HSB and employ sampling weights to account for HSB’s complex sampling design and selective attrition from the panel.
Results:About 15% of the cohort has been diagnosed with periodontal disease, and nearly one in five had significant cognitive and functional concerns.
People with a history of periodontal disease were more likely to report significant cognitive and functional concerns. This association remains substantive and statistically significant after adjusting for confounders. All else equal, the odds of people with a history of periodontal disease having an AD8 score of 2 or higher were about 60% greater than the odds of those not reporting periodontal disease. Very little of this association can be attributed to cardiovascular disease as a mediating pathway.
Conclusions:People with a history of periodontal disease are at greatly elevated risk of self-reported cognitive and functional concerns at age ∼60. This supports evidence— never before collected at this scale in a long-term, representative cohort study—that oral pathogens may contribute to cognitive well-being over the life course.
17 Emotional and Instrumental Support as Protective Factors in Cognitive Aging Among Black and Hispanic/Latinx Older Adults
- Emily P Morris, A. Zarina Kraal, Shellie-Anne Levy, Franchesca Arias, Ruijia Chen, Dominika Seblova, Marcia P. Jimenez, Mateo Farina, Zvinka Zlatar, Marianne Chanti-Ketterl, Yi Lor, Evan Fletcher, Jennifer J. Manly, Maria Glymour
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 330-331
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Objective:
Social support may protect against Alzheimer’s disease and related dementias (ADRD), potentially through emotional or instrumental support elements. Black and Hispanic/Latinx older adults bear a disproportionate burden of ADRD. However, independent effects of emotional and instrumental support on cognition, a primary indicator of ADRD risk, are largely understudied in these groups. Guided by the differential vulnerability hypothesis – the theoretical framework which posits that systemic racism disadvantages Black and Hispanic/Latinx individuals’ health – we hypothesize that emotional and instrumental support may be particularly important to protect against worse cognition for Black and Hispanic/Latinx older adults, who often have fewer resources due to these inequalities (e.g., wealth, educational opportunities) to otherwise maintain health. Using the NIH Toolbox Emotion Module measures of emotional (e.g., the extent to which individuals can rely on others in challenging times) and instrumental support (e.g., the extent to which individuals can rely on others for assistance in daily activities), we aimed to identify positive social support factors (i.e., emotional and instrumental support) that may protect against ADRD risk (i.e., longitudinal executive function and memory performance) among Black and Hispanic/Latinx older adults.
Participants and Methods:Participants were 362 Black and 265 Hispanic/Latinx adults aged 65-89 (63% female, average age=75) from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study who completed baseline and up to two additional waves of assessments (every 1.5 years), including questionnaires, neuropsychological evaluations, and the NIH toolbox. Predictors included baseline covariates (i.e., age, language of test administration, gender, education, income, self-rated health) and NIH toolbox emotional and instrumental support variables. Outcomes were baseline and longitudinal memory (visual and verbal episodic memory) and executive functioning (verbal fluency and working memory) composites from the Spanish and English Neuropsychological Assessment Scales (SENAS). Latent growth curve models were conducted separately in Black and Hispanic/Latinx participants to estimate effects of emotional and instrumental support on baseline cognition and subsequent change in each domain.
Results:Black participants reported greater emotional support. There were no group differences in levels of instrumental support. Greater instrumental support was associated with better initial memory (standardized β= .194, 95%CI: [.063, .325]) among Black participants but not among Hispanic/Latinx participants. In Hispanic/Latinx participants, greater emotional support was associated with better initial executive functioning (standardized β= .215, 95%CI: [.079, .350]. Emotional support was not associated with either cognitive domain in Black participants. There were no associations between emotional or instrumental support on cognitive change in either group.
Conclusions:Results point to differences between Black and Hispanic/Latinx older adults in the impact of specific aspects of social support on different cognitive domains. Positive associations between instrumental support and baseline memory in Black participants and between emotional support and executive functioning in Hispanic/Latinx participants suggest unique cognitive consequences of social support across groups. Differences in the role of specific types of social supports may be useful in identifying intervention targets specifically for Black and Hispanic/Latinx older adults, who are disproportionately affected by ADRD. Future research will examine these constructs using multiple group models to test these associations more rigorously.
43 Evaluating the Relationship Between Social Support, Executive Function, and Communicative Effectiveness
- Molly Split, Jessica L Saurman, Amy Rodriguez, Felicia C Goldstein, Kayci L Vickers
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- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 251-252
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Objective:
Research suggests greater perceived social support is associated with better general cognitive function in community-dwelling older adults. While these findings expand our understanding of the role of social support in healthy aging, further work is needed to investigate the role of social support in mild cognitive impairment (MCI). Of particular interest is the relationship between executive function (EF), communicative effectiveness, and social support, as these are common areas of decline and are likely to impact one’s ability to meaningfully interact with others. The present study aimed to evaluate the association between perceived social support, EF, and communicative effectiveness. We hypothesize better EF performance and communicative effectiveness would be associated with higher levels of perceived social support in older adults with MCI.
Participants and Methods:One hundred and twenty-one older adults with MCI were included in the current study. All participants were enrolled in Charles and Harriett Schaffer Cognitive Empowerment Program (CEP) at Emory University, a comprehensive lifestyle program for individuals diagnosed with MCI and their care partners. Upon CEP enrollment, participants completed self-report questionnaires, including the Multidimensional Scale of Perceived Social Support (MSPSS), the Communicative Effectiveness Index (CETI), and EF assessments including Letter Fluency (phonemic fluency), Digit Span Backward (working memory), and the Test of Practical Judgment (decision making). Additionally, a subset of participants completed the written Trail Making Test - Part B (set-shifting; n = 63). Pearson bivariate correlations were utilized to explore the relationship between MSPSS, CETI, and EF performance.
Results:Higher levels of perceived social support were significantly associated with communicative effectiveness (r = .210, p = .021), such that participants who endorsed having more social support also reported greater confidence in their communicative effectiveness. Perceived social support was associated with better working memory performance (r = .342, p < .001), phonemic fluency output (r = .261, p = .041), and shorter time to complete TMT-B (r = -.244, p = .052), indicating individuals with higher perceived social support demonstrated better EF abilities. Finally, greater confidence in communicative effectiveness was associated with better performances in working memory (r = .274; p = .008), phonemic fluency output (r = .213; p = .020) and decision making (r =.192; p = .044), suggesting stronger working memory, phonemic fluency, and practical decision-making abilities support better communicative effectiveness. There was no association between social support and practical decision-making abilities (r = .146, p = .129).
Conclusions:The current findings demonstrate a link between higher levels of social support, communicative effectiveness, and EF abilities, particularly in the subdomains of working memory, phonemic fluency, and set-shifting. This link suggests individuals with stronger EF abilities may have greater communicative effectiveness and, in turn, may be better able to maintain social relationships and garner social support. Future research is needed to evaluate the causality in this relationship, as it remains possible those with stronger social support networks maintain communicative effectiveness and EF for longer. Thus, further evaluation of the mechanism(s) underlying the relationships between social support, EF, and communicative effectiveness is needed.
44 Develop A Social Perception Test: The Psychometric Properties of Child's version Reading the Mind in the Eyes Test in Taiwan
- Wen-Yi Huang, Chia-Chen Chao, Nai-Wen Guo
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 831-832
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Objective:
Expertise in social perception, defined as the ability to decode another person's mental states based on basic behavioral signals (Allison et al., 2000; Beauchamp et al., 2008). The Reading the Mind in the Eyes Test (RMET) is a social-perception task of theory of mind (ToM, Meinhardt-Injac et al., 2020) and used to test different clinical disorders, like autism spectrum disorders (ASD, Peñuelas-Calvo et al., 2019). RMET has been used to demonstrate gender, cultural, genetic, and personality trait influences on ToM and elucidate its neurobiological mechanisms (Adams et al., 2010). In Taiwan, there has few sensitive tools to evaluate children's social perception, thus the purpose of this study is to examine psychometric properties of child's version of RMET in Taiwan (RMET-C-TW) and cross-cultural comparisons.
Participants and Methods:RMET-C (Baron-Cohen et al., 2001) was used to assess mental state/emotion recognition (Vellante et al., 2013). It consists of photographs of the eye regions of 28 faces. Participants were asked to make a choice between four words presented, choose the one that best described for feel or think. One point was given to each correctly response. RMET-C-TW was double-translation of words to ensure cultural applicability in Taiwan. This study included both a normative sample and criteria sample. The normative sample consisted of 769 (385 male, 384 female) 3 to 9 grades students from northern Taiwan. The normative sample completed both the RMET-C-TW and Chinese Vocabulary Test (CVT) in groups at their own schools, the CVT was to ensure that participants had sufficient vocabulary skills to understand the options provided in REMT-C-TW. The criteria sample were collected from 46 matched, school-aged children with ASD (age mean = 10.52, SD = 1.62; IQ = 108.39, SD = 11.75), and normally developing controls (age mean = 10.66, SD=1.68; IQ = 109.70, SD = 12.12). These two groups were administered the (1) WISC-III (2) CVT (3) RMET-C-TW and (4) ToM Test.
Results:The results showed that RMET-C-TW had acceptable test-retest reliability and internal consistency (test-retest reliability = .71, Cronbach α= .40). There were significant gender and age difference in the performance of RMET-C-TW, example female, older participants performed better. Item analysis showed 93% of items in the RMET-C-TW had cross- cultural consistency in the distribution of respondents' choices. In criteria sample, the control group's RMET-C-TW scores significantly better than ASD group. Physician diagnosis (r = .49, p < .01) and high-order ToM's scores (r = .33, p < .01) were significantly associated with RMET-C-TW scores.
Conclusions:RMET-C-TW has acceptable reliability and good developmental validity (age-related growth) in three to nine grades, and future can be extended to different age and clinicians to understand the development of social perception. Therefore, RMET-C-TW can be used as an initial screening and cross-cultural tool for ASD. In addition, EF is divided into cold and hot, and hot EF makes a unique contribution to ToM in ASD (Kouklari et al., 2017), thus this tool may also be used in the future to understand the association of hot EF with social perception.
69 Executively-Mediated Language Skills are Related to Performance-Based Social Functioning across the Psychosis-Spectrum
- Kaley Angers, Julie A. Suhr, Aubrey Moe
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 853-854
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Objective:
Social impairment is observed across psychotic-spectrum disorders (PSDs). Prior work demonstrates that neurocognition may account for social impairment in chronic PSDs. Concerning specific neurocognitive facets, there is support for a relationship between language/verbal performance and social outcomes in chronic PSDs. However, few studies have investigated this relationship in at-risk and early intervention samples, despite the clinical importance in these populations. The present study aimed to identify whether language is related to social functioning across the psychosis-spectrum, utilizing a sample comprised of individuals low in schizotypal personality traits, at-risk for psychosis (high in schizotypal traits), and those who recently experienced a first episode of psychosis (FEP). As an exploratory analysis and guided by findings from general studies of neurocognition and functional outcomes in the chronic PSD literature, we also investigated potential mediating mechanisms (i.e, negative traits; social cognition). We hypothesized that language is related to social functioning, and language is indirectly related to social functioning through negative traits and social cognition.
Participants and Methods:We recruited 42 participants low in schizotypal traits and 44 high in schizotypal traits from undergraduate courses, and 15 FEP individuals were recruited from an early psychosis intervention center. On average, participants were 21.55 (4.39) years old and completed 14 (1.57) years of education. A majority were female (62%) and White (82%). Participants completed the Schizotypal Personality Questionnaire – Brief Revised Updated, which was used to categorize the schizotypy groups and sum negative traits; and measures of language/verbal ability (Similarities, Proverbs Test, semantic fluency, Digit Span), social cognition (Hinting Task, Affect Naming), and examiner-rated (Global functioning [GF]: Social) and performance-based social functioning (Social Skills Performance Assessment; SSPA). We also measured verbal processing speed and COVID-19 distress as covariates. Standardized scores were used for neurocognitive variables, and we used raw scores for most other variables. We utilized hierarchical linear regression models to examine whether specific language/verbal skills accounted for unique variance in examiner-rated and performance-based social functioning. For our exploratory analyses, we created averaged z-scores for language, social cognition, and social functioning and then, employed PROCESS Macro Model 4 to examine whether negative traits or social cognition were significant mediators in two separate mediation models.
Results:Controlling for verbal processing speed and COVID-19 distress, language accounted for a significant portion of variance in SSPA performance, p = .008, ΔR2 = .12. Specifically, better Proverbs Test performance was uniquely associated with better SSPA performance, β = .33, p = .002. Controlling for study covariates, language was unrelated to GF: Social ratings, p = .31, ΔR2 = .038. In exploratory analyses, language was significantly indirectly related to social functioning through social cognition, β = .15, SE = .04, 95% CI [.04, .27], but not through negative traits, β = .08, SE = .06, 95% CI [-.001, .17].
Conclusions:Our findings suggest that executively-mediated language tasks (e.g., Proverbs Test) and social cognition may be beneficial treatment targets for social impairment. Limitations include generalizability of the present findings, small FEP sample, and cross-sectional design. Future work should replicate these findings in longitudinal models.
54 Exploring the Impact of Stria Terminalis Connectivity and Family Income on Depressive Symptoms Throughout Development
- Sophie I Leib, Whitney I Mattson, Eric E Nelson, Young Jin Kim, Kristen R Hoskinson
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- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 463-464
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Objective:
The stria terminalis (ST) is a white matter tract with connections to limbic and autonomic brain structures that is implicated in affective functioning. Recent works suggests that ST functional integrity and connectivity is associated with faster responses to emotional cues (Dzafic et al., 2019) and may be influenced by environmental factors including socioeconomic status (SES) and childhood adversity (Banihashemi et al., 2020). The role of the ST in the experience of more daily affective experiences, such as depressive symptoms, remains unexplored. Therefore, the present study examined the role of the ST and SES, as assessed by household income, in the relationship between age and depressive symptoms in typically developing children and adolescents.
Participants and Methods:Participants include 64 typically developing children and adolescents age 8-21 (Mage=13.27, SD=3.15) who participated in an ongoing study of development of neurocognitive and social-cognitive skills. Participants completed imaging on a 3Tesla MR Siemens PRISMA scanner. Tractography was executed via ENIGMA tract-based spatial statistics to quantify WM integrity and provided values for mean fractional anisotropy (mFA) of the ST. Depressive symptoms were measured with the Behavior Assessment Scale for Children-Third Edition (BASC-3) parent report scale, and annual family income was obtained per parent report. Mediation and moderation analyses were conducted using Process version 4.1 (Hayes, 2022) in SPSS version 28. As depression symptoms are often higher in early adolescence than later, we examined the indirect effect of age on depressive symptoms through ST mFA and evaluated this relationship at different levels of family income.
Results:Age was associated with lower levels of depressive symptoms (b=-.98, t=-2.18, p<.05), whereas greater right ST mFA was associated with higher levels of depressive symptoms (b=42.05, t=2.50, p<.05). Right ST mFA explained significant variance in the relationship between age and parent-reported depression (ab=.13, 95% CI [.02, .29]). The conditional indirect effect of family income was significant for children with annual family incomes between 25-50k (effect=.16, 95% CI [.01, .38]) and 75-100k (effect=.13, 95% CI [.001, .31]), but not for 100k+ (effect=.11, 95% CI [-.05, .33]).
Conclusions:The present study revealed a significant, positive relationship between white matter integrity in the right ST and parent-reported depressive symptoms in healthy children and young adults. Finding extend on prior work implicating the ST in threat responsivity (Dzafic et al., 2019). Moreover,results suggest the role of the ST in the relationship between age and depression depends on level of family income, such that ST mFA explains more variance at lower income levels, and is no longer significant for children from families with income greater than 100k. These findings support the notion that environmental stressors (such as lower family income) may strengthen ST pathways via activity-dependent plasticity and repeated, coordinated activation (Rinaman et al., 2011). Future studies should examine these brain-behavior associations, as they may replicate in a larger sample, with more nuanced indicators of environmental stress.
45 The Impact of Loneliness on Amyloid Burden, Cerebrovascular Disease, Neurodegeneration, and Memory Performance in a Community-Based Sample of Older Adults
- Bayardo E Lacayo, Clarissa Morales, Aine Montgomery, Kiana Chan, Stephanie Cosentino, Adam M Brickman, Jennifer Manly, Nicole Schupf, Richard Mayeux, Patrick Lao
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 455-456
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Objective:
The current research framework recommends using biomarkers to further understand Alzheimer’s disease (AD) pathogenesis, including other contributing factors like cerebrovascular disease. In longitudinal studies of people with neuropathological examination after death, baseline loneliness was associated with lower cognition, faster cognitive decline, and future AD risk, independent of AD pathology. Examination of memory impairment along with AD and cerebrovascular biomarkers, could aid risk reduction efforts earlier in the lifecourse and among populations with more exposure to loneliness. We hypothesized that loneliness is associated with amyloid, vascular, and neurodegeneration biomarkers; with worse memory; and that loneliness increases the susceptibility to biomarker-related memory impairment.
Participants and Methods:A subset of cognitively unimpaired older adults with available amyloid PET, vascular MRI (white matter hyperintensity volume, WMH), structural MRI (cortical thickness in AD signature regions), neuropsychological testing (memory factor score), dichotomized loneliness data (one item from CES-D), and relevant medical data were drawn from the community-based Washington Heights-Inwood Columbia Aging Project (WHICAP; n=169; covariates included age=81±6 years; 63% women; 49/31/20% Non-Hispanic Black/Non-Hispanic White/Hispanic; education=13±4 years; 32% APOE-e4 carriers). General linear models in the overall sample and stratified by race and ethnicity tested the association between loneliness and AD and cerebrovascular biomarkers, loneliness and memory, and the interaction of loneliness and biomarkers on memory, adjusting for covariates.
Results:Loneliness was endorsed in 18% of participants, marginally associated with older age (2.1 [-0.2, 4.4], p=0.08), was more likely in those with untreated diabetes (13/0.1% lonely/not lonely, p=0.001), associated with lower cortical thickness (-0.05 [-0.09, -0.02], p=0.01), and associated with lower memory (0.3 [-0.6, -0.001], p=0.05). In Non-Hispanic White participants, loneliness was associated with greater WMH volume (0.5 [0.07, 0.82], p=0.03), while in Hispanic participants, loneliness was associated with lower cortical thickness (-0.16 [-0.24, -0.08], p=0.0006). In Non-Hispanic Black participants, loneliness was associated with lower memory (-13 [-26, -0.5], p=0.05), and the association between lower cortical thickness and lower memory was stronger in those that endorse loneliness (5 [0.2, 10], p=0.05). In Hispanic participants, loneliness was associated with higher memory (13 [4, 22], p=0.009), but the association between higher amyloid burden and lower memory was stronger in those that endorse loneliness (-12 [-20, -4], p=0.006); further, loneliness was marginally associated with lower memory (-0.7 [-1.4, 0.1], p=0.09), independently of WMH.
Conclusions:Associations between loneliness and biomarkers may relate to health seeking behavior, reported as treatment status for diabetes, for cerebrovascular burden and general neurodegeneration, but might be more complex for amyloid. The degree to which loneliness increased the susceptibility to amyloid and neurodegeneration-related, but not cerebrovascular-related, memory impairment, specifically, may suggest that domains beyond memory should be considered. Future work should be longitudinal to disentangle the effects of loneliness from related constructs like depression and anxiety, incorporate other AD biomarkers such as hyperphosphorylated tau, and incorporate biological mechanisms (e.g., stress, inflammation) into models of loneliness and AD pathogenesis. Older adults from all backgrounds may be more susceptible to loneliness, which was associated with lower memory; culturally-humble, social support-based interventions may reduce the risk of cognitive impairment.
81 Occupation Complexity Mediates the Association between Education and Self-Reported Cognitive and Functional Decline in 60-Year-Olds
- Jessie Himmelstern, John R Warren, Eric Grodsky, Chandra Muller, Koit Hung, Adam Brickman, Jennifer Manly
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 384-385
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Objective:
We ask about the degree to which the association between (1) the quantity and quality of people’s education and (2) midlife self-reported concerns about cognition and daily function is mediated by occupational complexity. The overarching hypothesis is that amount and quality of education provides people with access to better jobs, including jobs that are more cognitively complex. Occupational complexity, in turn, may be protective against cognitive impairment. If true, this means that part of the poorly-understood connection between education and cognitive impairment can be attributed to occupational complexity.
Participants and Methods:We use data from a nationally representative sample of 13,525 people who participated in the 2021 wave of the High School & Beyond (HSB) cohort study. HSB began in 1980 with a nationally-representative sample of American 10th and 12th grade students; these students have been followed up on six occasions since 1980, yielding extraordinary and prospectively-collected life course data on all key measures for a large, multicultural sample.
In 2021, HSB sample members were evaluated with neuropsychological tests that evaluated list learning and memory, semantic and letter fluency, and working memory. They were also asked to self-report memory and functional decline using the AD8, using a cutoff of 2 or more items for significant concerns. Mild Cognitive Impairment will be identified using an algorithm validated in a similar sample of middle aged participants.
HSB surveys gathered information about sample members’ labor force activities in every survey between 1980 and 2021, including information sufficient to code verbatim reports of occupations to the standards of the 2010 Standard Occupational Classification. We have linked these codes for sample members’ 2013 and 2021 occupations to the O*Net database, which includes extensive information about the cognitive complexity (and other attributes) of every occupation.
Measures of key confounders—including social and economic background; demographic characteristics; educational contexts, opportunities, and attainments that are associated with labor force outcomes; adolescent achievement test scores; and aspects of midlife occupations besides complexity (e.g., how well they pay)—were measured prospectively and in great detail in the surveys administered between the 1980s and 2021.
We estimate logistic regression models predicting significant cognitive and functional concerns as a function of educational contexts, opportunities, and outcomes; we also estimate models that account for the confounders listed above. Our main focus is on coefficients for education in models that do and do not include occupational complexity as a mediator. All models account for the clustered sampling design of HSB and use sampling weights to account for HSB’s complex sampling design and selective attrition from the panel.
Results:Nearly one in five cohort members had significant cognitive and functional concerns; rates are lower for non-Latinx Whites and for better educated people. Associations between educational contexts, opportunities, and outcomes (including attainment) are robust, even after adjusting for confounders.
Between one quarter and one third of the conditional association between education and self-reported cognitive and functional concerns can be attributed to occupational complexity.
Conclusions:Occupational complexity is an important pathway through which more and better education protects people from concerns about cognitive and functional decline at about age 60.
34 Neurocomputational Mechanisms of Social Reward Processing in Combat-Exposed Veterans
- Alex F. Skupny, Danielle N. Dun, Katia M. Harle, Alan N. Simmons
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 823-824
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Objective:
Combat exposure is associated with higher rates of depressive symptoms, including anhedonia (i.e., a reduced ability to seek and experience rewards) and feelings of social disconnectedness. While these symptoms are commonly documented in combat-exposed Veterans following deployment, the cognitive mechanisms underlying this pathology is less well understood. Computational modeling can provides detailed mechanistic insights into complex cognition, which may be particularly useful to understand how social reward processing is altered following combat exposure. Here, we use a Bayesian learning model framework to address this question.
Participants and Methods:Thirty-three Operation Enduring Freedom (OEF)/ Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) Veterans (25 Male, 8 Female) between the ages of 18-65 years old (M = 41.61, SD = 10.49) participated in this study. In both classic/monetary and social reward conditions, participants completed a 2-arm bandit task, in which they must choose on each trial between two options (i.e., slot machine vs social partner) with unknown reward rates. While they received monetary outcomes in the classic condition, participants received compliments from different fictitious partners in the social condition. We first compared a learning-independent Win-stay/Lose-shift (WSLS) heuristic and either a Rescorla-Wagner Q-learning or a Bayesian learning model (Dynamic Belief Model/DBM) paired with a Softmax reward maximization policy. DBM+Softmax provided the best fit of the data for most participants (31/33). Individual DBM parameters of prior reward expectation, reward learning (i.e., perceived stability of reward rates), and Softmax reward maximization were estimated and compared across conditions.
Results:Participants did not differ in their reward learning parameters across monetary and social conditions (t(30)= -0.70, p = 0.490), suggesting similar perception of reward stability in both modalities. However, higher Bayesian prior mean (i.e., initial belief of reward rate; t(30)= -2.31, p = 0.028, d=0.42) and greater reward maximization (i.e., Softmax parameter; t(30)= -2.26, p = 0.031, d=0.41) were observed in response to social vs monetary rewards. In the social reward condition, higher self-reported social connectedness was associated with greater model fit of our DBM model (i.e., smaller Bayesian Information Criterion/BIC; r = -0.38, p = 0.041). In this condition, those expecting higher reward rates when initiating reward exploration (those with higher DBM prior mean) endorsed lower self-esteem (Spearman's ρ = -0.43, p = 0.078) and lower positive affect (ρ = -0.32, p = 0.078).
Conclusions:A Bayesian learning modeling framework can characterize mechanistic differences in the processing of social vs non-social reward among combat-exposed Veterans. Individuals with higher social connectedness were more model-based in their performance, consistent with the notion that they are more likely to estimate and anticipate how much social peers have to offer. Combat-exposed individuals with lower self-esteem and positive affect appear to have higher initial expectations of reward from unknown partners, which could reflect greater need for mood and/or self-esteem repair in those individuals. Overall, Bayesian modeling of social reward behavior provides a useful quantitative framework to predict clinically relevant construct of functional outcomes in military populations.
11 - Family and Social Processes in Recovery from Alcohol Use Disorder
- from Part II - Meso Level
- Edited by Jalie A. Tucker, University of Florida, Katie Witkiewitz, University of New Mexico
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- Book:
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Published online:
- 23 December 2021
- Print publication:
- 06 January 2022, pp 200-217
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Summary
Family and social processes play a critical role in the development, maintenance, and recovery from alcohol use disorder (AUD). Individuals with AUD tend to have few social supports in place, and poor social supports can further exacerbate AUD symptoms. Positive social supports, however, can play a key role in AUD recovery and improving psychosocial functioning. This chapter reviews literature from multiple disciplines to identify key family and social processes in AUD and AUD recovery. The role of family and social processes in AUD development and maintenance is reviewed to identify potential targets for future intervention efforts. The various ways in which different forms of social support can contribute to recovery are also discussed. The chapter concludes with directions for future clinical practice and research.
Advancing the RDoC initiative through the assessment of caregiver social processes
- Lucy S. King, Virginia C. Salo, Autumn Kujawa, Kathryn L. Humphreys
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- Journal:
- Development and Psychopathology / Volume 33 / Issue 5 / December 2021
- Published online by Cambridge University Press:
- 27 July 2021, pp. 1648-1664
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The relationships infants and young children have with their caregivers are fundamental to their survival and well-being. Theorists and researchers across disciplines have attempted to describe and assess the variation in these relationships, leading to a general acceptance that caregiving is critical to understanding child functioning, including developmental psychopathology. At the same time, we lack consensus on how to assess these fundamental relationships. In the present paper, we first review research documenting the importance of the caregiver–child relationship in understanding environmental risk for psychopathology. Second, we propose that the National Institute of Mental Health's Research Domain Criteria (RDoC) initiative provides a useful framework for extending the study of children's risk for psychopathology by assessing their caregivers’ social processes. Third, we describe the units of analysis for caregiver social processes, documenting how the specific subconstructs in the domain of social processes are relevant to the goal of enhancing knowledge of developmental psychopathology. Lastly, we highlight how past research can inform new directions in the study of caregiving and the parent–child relationship through this innovative extension of the RDoC initiative.
Interpersonal Emotion Regulation: A Review of Social and Developmental Components
- Abigail L. Barthel, Aleena Hay, Stacey N. Doan, Stefan G. Hofmann
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- Journal:
- Behaviour Change / Volume 35 / Issue 4 / December 2018
- Published online by Cambridge University Press:
- 18 October 2018, pp. 203-216
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A staple theme in clinical psychology, emotion regulation, or the ability to manage one's emotions, is directly linked with personal wellbeing and the ability to effectively navigate the social world. Until recently, this concept has been limited to a focus on intrapersonal processes, such as suppression. Less emphasis has been placed on developmental, social, and cultural aspects of emotion regulation. We argue here that as social beings, our engagement in emotion regulation may often occur interpersonally, with trusted others helping us to regulate our emotions. This review will highlight recent research on interpersonal emotion regulation processes.
Network Approaches to Understand Individual Differences in Brain Connectivity: Opportunities for Personality Neuroscience
- Steven H. Tompson, Emily B. Falk, Jean M. Vettel, Danielle S. Bassett
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- Journal:
- Personality Neuroscience / Volume 1 / 2018
- Published online by Cambridge University Press:
- 02 July 2018, e5
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Over the past decade, advances in the interdisciplinary field of network science have provided a framework for understanding the intrinsic structure and function of human brain networks. A particularly fruitful area of this work has focused on patterns of functional connectivity derived from noninvasive neuroimaging techniques such as functional magnetic resonance imaging. An important subset of these efforts has bridged the computational approaches of network science with the rich empirical data and biological hypotheses of neuroscience, and this research has begun to identify features of brain networks that explain individual differences in social, emotional, and cognitive functioning. The most common approach estimates connections assuming a single configuration of edges that is stable across the experimental session. In the literature, this is referred to as a static network approach, and researchers measure static brain networks while a subject is either at rest or performing a cognitively demanding task. Research on social and emotional functioning has primarily focused on linking static brain networks with individual differences, but recent advances have extended this work to examine temporal fluctuations in dynamic brain networks. Mounting evidence suggests that both the strength and flexibility of time-evolving brain networks influence individual differences in executive function, attention, working memory, and learning. In this review, we first examine the current evidence for brain networks involved in cognitive functioning. Then we review some preliminary evidence linking static network properties to individual differences in social and emotional functioning. We then discuss the applicability of emerging dynamic network methods for examining individual differences in social and emotional functioning. We close with an outline of important frontiers at the intersection between network science and neuroscience that will enhance our understanding of the neurobiological underpinnings of social behavior.
27 - Consequences of Managed Care for Mental Health Providers
- from Part III - Mental Health Systems and Policy
- Edited by Teresa L. Scheid, University of North Carolina, Charlotte, Tony N. Brown, Vanderbilt University, Tennessee
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- Book:
- A Handbook for the Study of Mental Health
- Published online:
- 05 June 2012
- Print publication:
- 16 November 2009, pp 529-547
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Summary
This chapter focuses on mental health utilization, commonly referred to as help-seeking. It focuses on the social processes involved in responding to mental health problems and if, when, and how individuals receive care from a wide range of people in the community-their friends and family, physicians, mental health specialists, alternative healers, the clergy, Web sites, and life coaches. The chapter considers how the fiscal and organizational arrangements seen with changes in the American health care system, particularly the expansion and more recent contraction of stringent managed care strategies, affect how mental health care services are allocated and what this means for people and professionals responding to illness. In the Network-Episode Model (NEM), individuals are seen as pragmatic users with commonsense knowledge and cultural routines who seek out and respond to others when psychiatric symptoms or unusual behavior occurs.
4 - Conceptualising the social world
- from Part I - Theoretical and conceptual foundations
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- By Dana March, Department of Epidemiology Mailman School of Public Health, Columbia University, Presbyterian Hospital, 722 West 168th Street, New York, NY, USA, Craig Morgan, Section of Social and Cultural Psychiatry Health Service and Population Research Department Box 33, Institute of Psychiatry De Crespigny Park, London, UK, Michaeline Bresnahan, Department of Epidemiology Mailman, School of Public Health, Columbia University, Presbyterian Hospital, 722 West 168th Street, New York, NY, USA, Ezra Susser, Department of Epidemiology Mailman School of Public Health, Columbia University, Presbyterian Hospital, 722 West 168th Street, New York, NY, USA
- Edited by Craig Morgan, Kwame McKenzie, University College London, Paul Fearon
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- Book:
- Society and Psychosis
- Published online:
- 07 December 2009
- Print publication:
- 20 March 2008, pp 41-57
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Summary
Conceptualising the social world is a critical first step in attempting to understand the aetiological role of social factors. This chapter draws on ideas developed in a previous era to suggest a theoretically informed rubric for conceptualising components of the social world to make them amenable to investigation, the focus being specifically on aetiology. The ecological notion of aetiology held by Faris and Dunham and their contemporaries eventually gave way to a focus on what they termed constitutional factors. The chapter addresses the necessity of considering distinctions between processes and conditions, levels of organisation and place and time. Care must be taken to guard against two common inferential mistakes involving multiple levels of organisation. The ecological fallacy is familiar to most investigators. The equally important converse fallacy, sometimes referred to as the atomistic fallacy, is less familiar. It results from comparing individuals and inferring causation at the group level.