Publications by authors named "Randy P Auerbach"

126 Publications

Neurophysiological predictors of gaze-contingent music reward therapy among adults with social anxiety disorder.

J Psychiatr Res 2021 Sep 2;143:155-162. Epub 2021 Sep 2.

Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA. Electronic address:

Social anxiety disorder (SAD) is associated with fear of negative evaluation and heightened performance monitoring. The best-established treatments help only a subset of patients, and there are no well-established predictors of treatment response. The current study investigated whether individual differences in processing errors might predict response to gaze-contingent music reward therapy (GC-MRT). At baseline, healthy control subjects (HC; n = 20) and adults with SAD (n = 29), ages 19-43 years, completed the Flanker Task while electroencephalography (EEG) data were recorded. SAD participants then received up to 12 sessions over 8 weeks of GC-MRT, designed to train participants' attention away from threatening and toward neutral faces. Clinical assessments were completed 9- (post-treatment) and 20-weeks (follow-up) after initiating the treatment. At baseline, compared to HC, SAD performed the task more accurately and exhibited increased error-related negativity (ERN) and delta power to error commission. After controlling for age and baseline symptoms, more negative ERN and increased frontal midline theta (FMT) predicted reduced self-reported social anxiety symptoms at post-treatment, and FMT also predicted clinician-rated and self-reported symptom reduction at the follow-up assessment. Hypervigilance to error is characteristic of SAD and warrants further research as a predictor of treatment response for GC-MRT.
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http://dx.doi.org/10.1016/j.jpsychires.2021.09.022DOI Listing
September 2021

Neurophysiological predictors of gaze-contingent music reward therapy among adults with social anxiety disorder.

J Psychiatr Res 2021 Sep 2;143:155-162. Epub 2021 Sep 2.

Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA. Electronic address:

Social anxiety disorder (SAD) is associated with fear of negative evaluation and heightened performance monitoring. The best-established treatments help only a subset of patients, and there are no well-established predictors of treatment response. The current study investigated whether individual differences in processing errors might predict response to gaze-contingent music reward therapy (GC-MRT). At baseline, healthy control subjects (HC; n = 20) and adults with SAD (n = 29), ages 19-43 years, completed the Flanker Task while electroencephalography (EEG) data were recorded. SAD participants then received up to 12 sessions over 8 weeks of GC-MRT, designed to train participants' attention away from threatening and toward neutral faces. Clinical assessments were completed 9- (post-treatment) and 20-weeks (follow-up) after initiating the treatment. At baseline, compared to HC, SAD performed the task more accurately and exhibited increased error-related negativity (ERN) and delta power to error commission. After controlling for age and baseline symptoms, more negative ERN and increased frontal midline theta (FMT) predicted reduced self-reported social anxiety symptoms at post-treatment, and FMT also predicted clinician-rated and self-reported symptom reduction at the follow-up assessment. Hypervigilance to error is characteristic of SAD and warrants further research as a predictor of treatment response for GC-MRT.
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http://dx.doi.org/10.1016/j.jpsychires.2021.09.022DOI Listing
September 2021

Resting posterior alpha power and adolescent major depressive disorder.

J Psychiatr Res 2021 09 8;141:233-240. Epub 2021 Jul 8.

Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, USA. Electronic address:

For several decades, resting electroencephalogram (EEG) alpha oscillations have been used to characterize neurophysiological alterations related to major depressive disorder. Prior research has generally focused on frontal alpha power and asymmetry despite resting alpha being maximal over posterior electrode sites. Research in depressed adults has shown evidence of hemispheric asymmetry for posterior alpha power, however, the resting posterior alpha-depression link among adolescents remains unclear. To clarify the role of posterior alpha among depressed adolescents, the current study acquired eyes-closed 128-channel resting EEG data from 13 to 18 year-old depressed (n = 31) and healthy (n = 35) female adolescents. Results indicated a significant group by hemisphere interaction, as depressed adolescents exhibited significantly larger posterior alpha (i.e., lower brain activity) over the right versus left hemisphere, whereas healthy adolescents showed no hemispheric differences. Relatively greater alpha over the right versus left hemisphere correlated with depression symptoms, anhedonia symptoms, rumination, and self-criticism. Further, depressed adolescents had reduced overall posterior alpha compared to healthy youth; though, no associations with symptoms and related traits emerged. Resting posterior alpha may be a promising neurophysiological index of adolescent depression, and more broadly, may relate to risk factors characterized by enhanced perseveration.
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http://dx.doi.org/10.1016/j.jpsychires.2021.07.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364881PMC
September 2021

Resting posterior alpha power and adolescent major depressive disorder.

J Psychiatr Res 2021 09 8;141:233-240. Epub 2021 Jul 8.

Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, USA. Electronic address:

For several decades, resting electroencephalogram (EEG) alpha oscillations have been used to characterize neurophysiological alterations related to major depressive disorder. Prior research has generally focused on frontal alpha power and asymmetry despite resting alpha being maximal over posterior electrode sites. Research in depressed adults has shown evidence of hemispheric asymmetry for posterior alpha power, however, the resting posterior alpha-depression link among adolescents remains unclear. To clarify the role of posterior alpha among depressed adolescents, the current study acquired eyes-closed 128-channel resting EEG data from 13 to 18 year-old depressed (n = 31) and healthy (n = 35) female adolescents. Results indicated a significant group by hemisphere interaction, as depressed adolescents exhibited significantly larger posterior alpha (i.e., lower brain activity) over the right versus left hemisphere, whereas healthy adolescents showed no hemispheric differences. Relatively greater alpha over the right versus left hemisphere correlated with depression symptoms, anhedonia symptoms, rumination, and self-criticism. Further, depressed adolescents had reduced overall posterior alpha compared to healthy youth; though, no associations with symptoms and related traits emerged. Resting posterior alpha may be a promising neurophysiological index of adolescent depression, and more broadly, may relate to risk factors characterized by enhanced perseveration.
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http://dx.doi.org/10.1016/j.jpsychires.2021.07.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364881PMC
September 2021

Resting posterior alpha power and adolescent major depressive disorder.

J Psychiatr Res 2021 09 8;141:233-240. Epub 2021 Jul 8.

Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, USA. Electronic address:

For several decades, resting electroencephalogram (EEG) alpha oscillations have been used to characterize neurophysiological alterations related to major depressive disorder. Prior research has generally focused on frontal alpha power and asymmetry despite resting alpha being maximal over posterior electrode sites. Research in depressed adults has shown evidence of hemispheric asymmetry for posterior alpha power, however, the resting posterior alpha-depression link among adolescents remains unclear. To clarify the role of posterior alpha among depressed adolescents, the current study acquired eyes-closed 128-channel resting EEG data from 13 to 18 year-old depressed (n = 31) and healthy (n = 35) female adolescents. Results indicated a significant group by hemisphere interaction, as depressed adolescents exhibited significantly larger posterior alpha (i.e., lower brain activity) over the right versus left hemisphere, whereas healthy adolescents showed no hemispheric differences. Relatively greater alpha over the right versus left hemisphere correlated with depression symptoms, anhedonia symptoms, rumination, and self-criticism. Further, depressed adolescents had reduced overall posterior alpha compared to healthy youth; though, no associations with symptoms and related traits emerged. Resting posterior alpha may be a promising neurophysiological index of adolescent depression, and more broadly, may relate to risk factors characterized by enhanced perseveration.
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http://dx.doi.org/10.1016/j.jpsychires.2021.07.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364881PMC
September 2021

Reward-Related Neural Circuitry in Depressed and Anxious Adolescents: A Human Connectome Project.

J Am Acad Child Adolesc Psychiatry 2021 Jun 5. Epub 2021 Jun 5.

Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Harvard Medical School, Boston, Massachusetts.

Objective: Although depression and anxiety often have distinct etiologies, they frequently co-occur in adolescence. Recent initiatives have underscored the importance of developing new ways of classifying mental illness based on underlying neural dimensions that cut across traditional diagnostic boundaries. Accordingly, the aim of the study was to clarify reward-related neural circuitry that may characterize depressed-anxious youth.

Method: The Boston Adolescent Neuroimaging of Depression and Anxiety Human Connectome Project tested group differences regarding subcortical volume and nucleus accumbens activation during an incentive processing task among 14- to 17-year-old adolescents presenting with a primary depressive and/or anxiety disorder (n = 129) or no lifetime history of mental disorders (n = 64). In addition, multimodal modeling examined predictors of depression and anxiety symptom change over a 6-month follow-up period.

Results: Our findings highlighted considerable convergence. Relative to healthy youth, depressed-anxious adolescents exhibited reduced nucleus accumbens volume and activation following reward receipt. These findings remained when removing all medicated participants (∼59% of depressed-anxious youth). Subgroup analyses comparing anxious-only, depressed-anxious, and healthy youth also were largely consistent. Multimodal modeling showed that only structural alterations predicted depressive symptoms over time.

Conclusion: Multimodal findings highlight alterations within nucleus accumbens structure and function that characterize depressed-anxious adolescents. In the current hypothesis-driven analyses, however, only reduced nucleus accumbens volume predicted depressive symptoms over time. An important next step will be to clarify why structural alterations have an impact on reward-related processes and associated symptoms.
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http://dx.doi.org/10.1016/j.jaac.2021.04.014DOI Listing
June 2021

Social Feedback Valence Differentially Modulates the Reward Positivity, P300, and Late Positive Potential.

J Psychophysiol 2020 Oct 23;34(4):255-267. Epub 2019 Oct 23.

Department of Psychology, University of Illinois at Chicago.

Abnormal social or reward processing is associated with several mental disorders. Although most studies examining reward processing have focused on monetary rewards, recent research also has tested neural reactivity to social rewards (e.g., positive social feedback). However, the majority of these studies only include two feedback valences (e.g., acceptance, rejection). Yet, social evaluation is rarely binary (positive vs. negative) and people often give 'on the fence' or neutral evaluations of others. Processing of this type of social feedback may be ambiguous and impacted by factors such as psychopathology, self-esteem, and prior experiences of rejection. Thus, the present study probed the reward positivity (RewP), P300, and late positive potential (LPP) following acceptance, rejection, and "one the fence" [between acceptance and rejection] feedback in undergraduate students ( = 45). Results indicated that the RewP showed more positive amplitudes following acceptance compared to both rejection and "on the fence" feedback, and the RewP was larger (i.e., more positive) following rejection relative to "on the fence" feedback. In contrast, the P300 did not differ between rejection and "on the fence" feedback, and both were reduced compared to acceptance. The LPP was blunted in response to rejection relative to acceptance and "on the fence" feedback (which did not differ from each other). Exploratory analyses demonstrated that greater self-reported rejection sensitivity was associated with a reduced LPP to acceptance. Taken together, these findings suggest that the neural systems underlying the RewP, P300, and LPP may evaluate "on the fence" social feedback differently, and that individuals high on rejection sensitivity may exhibit reduced attention toward and elaborative processing of social acceptance.
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http://dx.doi.org/10.1027/0269-8803/a000253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011565PMC
October 2020

Social Feedback Valence Differentially Modulates the Reward Positivity, P300, and Late Positive Potential.

J Psychophysiol 2020 Oct 23;34(4):255-267. Epub 2019 Oct 23.

Department of Psychology, University of Illinois at Chicago.

Abnormal social or reward processing is associated with several mental disorders. Although most studies examining reward processing have focused on monetary rewards, recent research also has tested neural reactivity to social rewards (e.g., positive social feedback). However, the majority of these studies only include two feedback valences (e.g., acceptance, rejection). Yet, social evaluation is rarely binary (positive vs. negative) and people often give 'on the fence' or neutral evaluations of others. Processing of this type of social feedback may be ambiguous and impacted by factors such as psychopathology, self-esteem, and prior experiences of rejection. Thus, the present study probed the reward positivity (RewP), P300, and late positive potential (LPP) following acceptance, rejection, and "one the fence" [between acceptance and rejection] feedback in undergraduate students ( = 45). Results indicated that the RewP showed more positive amplitudes following acceptance compared to both rejection and "on the fence" feedback, and the RewP was larger (i.e., more positive) following rejection relative to "on the fence" feedback. In contrast, the P300 did not differ between rejection and "on the fence" feedback, and both were reduced compared to acceptance. The LPP was blunted in response to rejection relative to acceptance and "on the fence" feedback (which did not differ from each other). Exploratory analyses demonstrated that greater self-reported rejection sensitivity was associated with a reduced LPP to acceptance. Taken together, these findings suggest that the neural systems underlying the RewP, P300, and LPP may evaluate "on the fence" social feedback differently, and that individuals high on rejection sensitivity may exhibit reduced attention toward and elaborative processing of social acceptance.
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http://dx.doi.org/10.1027/0269-8803/a000253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011565PMC
October 2020

Investigating the effect of COVID-19 dissemination on symptoms of anxiety and depression among university students.

BJPsych Open 2021 Mar 19;7(2):e69. Epub 2021 Mar 19.

School of Population and Public Health, University of British Columbia, Canada.

Background: Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations, such as university students, is needed as communities prepare for future waves.

Aims: To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students.

Method: This trend study analysed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks, through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as 'knowing someone who tested positive for COVID-19', which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression.

Results: Of 1388 respondents (adjusted response rate of 50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11-percentage-point increase in the probability of 30-day anxiety symptoms (s.e. 0.05, P ≤ 0.05), moderated by gender, with a significant interaction of the exposure and being female (coefficient -20, s.e. 0.09, P ≤ 0.05). No association was found with depressive symptoms.

Conclusions: Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly among men. Most students reported coping well, but additional support is needed for an emotionally overwhelmed minority who report being unable to access help.
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http://dx.doi.org/10.1192/bjo.2021.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058823PMC
March 2021

Investigating the effect of COVID-19 dissemination on symptoms of anxiety and depression among university students.

BJPsych Open 2021 Mar 19;7(2):e69. Epub 2021 Mar 19.

School of Population and Public Health, University of British Columbia, Canada.

Background: Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations, such as university students, is needed as communities prepare for future waves.

Aims: To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students.

Method: This trend study analysed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks, through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as 'knowing someone who tested positive for COVID-19', which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression.

Results: Of 1388 respondents (adjusted response rate of 50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11-percentage-point increase in the probability of 30-day anxiety symptoms (s.e. 0.05, P ≤ 0.05), moderated by gender, with a significant interaction of the exposure and being female (coefficient -20, s.e. 0.09, P ≤ 0.05). No association was found with depressive symptoms.

Conclusions: Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly among men. Most students reported coping well, but additional support is needed for an emotionally overwhelmed minority who report being unable to access help.
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http://dx.doi.org/10.1192/bjo.2021.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058823PMC
March 2021

Depression risk factors and affect dynamics: An experience sampling study.

J Psychiatr Res 2021 03 7;135:68-75. Epub 2021 Jan 7.

Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA. Electronic address:

Affect dynamics reflect individual differences in how emotional information is processed, and may provide insights into how depressive episodes develop. To extend prior studies that examined affect dynamics in currently depressed individuals, the present study tested in 68 non-depressed young adults whether three well-established risk factors for major depressive disorder (MDD) - (a) past episodes of MDD, (b) family history of MDD, and (c) reduced neurophysiological responses to reward - predicted mean levels, instability, or inertia (i.e., inflexibility) of positive affect (PA) and/or negative affect (NA). Momentary PA and NA were assessed up to 6 times per day for 14 days (mean number of surveys completed = 45.89). MDD history and family history of MDD were assessed via semi-structured interview, and neurophysiological responses to reward were indexed using the Reward Positivity, an event-related potential related to depression. After adjusting for current depressive symptoms, results indicated that (a) past episodes of MDD predicted higher mean levels of NA, (b) family history of MDD predicted greater PA inertia, and (c) blunted reactivity to reward predicted greater NA inertia. Collectively, these results suggest that elevated mean levels of NA and inflexibility of PA and NA may be potential mechanisms that confer risk for depression.
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http://dx.doi.org/10.1016/j.jpsychires.2021.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914176PMC
March 2021

Depression risk factors and affect dynamics: An experience sampling study.

J Psychiatr Res 2021 03 7;135:68-75. Epub 2021 Jan 7.

Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA. Electronic address:

Affect dynamics reflect individual differences in how emotional information is processed, and may provide insights into how depressive episodes develop. To extend prior studies that examined affect dynamics in currently depressed individuals, the present study tested in 68 non-depressed young adults whether three well-established risk factors for major depressive disorder (MDD) - (a) past episodes of MDD, (b) family history of MDD, and (c) reduced neurophysiological responses to reward - predicted mean levels, instability, or inertia (i.e., inflexibility) of positive affect (PA) and/or negative affect (NA). Momentary PA and NA were assessed up to 6 times per day for 14 days (mean number of surveys completed = 45.89). MDD history and family history of MDD were assessed via semi-structured interview, and neurophysiological responses to reward were indexed using the Reward Positivity, an event-related potential related to depression. After adjusting for current depressive symptoms, results indicated that (a) past episodes of MDD predicted higher mean levels of NA, (b) family history of MDD predicted greater PA inertia, and (c) blunted reactivity to reward predicted greater NA inertia. Collectively, these results suggest that elevated mean levels of NA and inflexibility of PA and NA may be potential mechanisms that confer risk for depression.
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http://dx.doi.org/10.1016/j.jpsychires.2021.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914176PMC
March 2021

Depression risk factors and affect dynamics: An experience sampling study.

J Psychiatr Res 2021 03 7;135:68-75. Epub 2021 Jan 7.

Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA. Electronic address:

Affect dynamics reflect individual differences in how emotional information is processed, and may provide insights into how depressive episodes develop. To extend prior studies that examined affect dynamics in currently depressed individuals, the present study tested in 68 non-depressed young adults whether three well-established risk factors for major depressive disorder (MDD) - (a) past episodes of MDD, (b) family history of MDD, and (c) reduced neurophysiological responses to reward - predicted mean levels, instability, or inertia (i.e., inflexibility) of positive affect (PA) and/or negative affect (NA). Momentary PA and NA were assessed up to 6 times per day for 14 days (mean number of surveys completed = 45.89). MDD history and family history of MDD were assessed via semi-structured interview, and neurophysiological responses to reward were indexed using the Reward Positivity, an event-related potential related to depression. After adjusting for current depressive symptoms, results indicated that (a) past episodes of MDD predicted higher mean levels of NA, (b) family history of MDD predicted greater PA inertia, and (c) blunted reactivity to reward predicted greater NA inertia. Collectively, these results suggest that elevated mean levels of NA and inflexibility of PA and NA may be potential mechanisms that confer risk for depression.
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http://dx.doi.org/10.1016/j.jpsychires.2021.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914176PMC
March 2021

Functional Alterations in Cerebellar Functional Connectivity in Anxiety Disorders.

Cerebellum 2021 Jun 18;20(3):392-401. Epub 2020 Nov 18.

Department of Psychology, ISEC 672D, Northeastern University, Boston, MA, 02115, USA.

Adolescents with anxiety disorders exhibit excessive emotional and somatic arousal. Neuroimaging studies have shown abnormal cerebral cortical activation and connectivity in this patient population. The specific role of cerebellar output circuitry, specifically the dentate nuclei (DN), in adolescent anxiety disorders remains largely unexplored. Resting-state functional connectivity analyses have parcellated the DN, the major output nuclei of the cerebellum, into three functional territories (FTs) that include default-mode, salience-motor, and visual networks. The objective of this study was to understand whether FTs of the DN are implicated in adolescent anxiety disorders. Forty-one adolescents (mean age 15.19 ± 0.82, 26 females) with one or more anxiety disorders and 55 age- and gender-matched healthy controls completed resting-state fMRI scans and a self-report survey on anxiety symptoms. Seed-to-voxel functional connectivity analyses were performed using the FTs from DN parcellation. Brain connectivity metrics were then correlated with State-Trait Anxiety Inventory (STAI) measures within each group. Adolescents with an anxiety disorder showed significant hyperconnectivity between salience-motor DN FT and cerebral cortical salience-motor regions compared to controls. Salience-motor FT connectivity with cerebral cortical sensorimotor regions was significantly correlated with STAI-trait scores in HC (R = 0.41). Here, we report DN functional connectivity differences in adolescents diagnosed with anxiety, as well as in HC with variable degrees of anxiety traits. These observations highlight the relevance of DN as a potential clinical and sub-clinical marker of anxiety.
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http://dx.doi.org/10.1007/s12311-020-01213-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213597PMC
June 2021

Reward Functioning Abnormalities in Adolescents at High Familial Risk for Depressive Disorders.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 03 6;6(3):270-279. Epub 2020 Sep 6.

Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

Background: A parental history of major depressive disorder (MDD) is an established risk factor for MDD in youth, and clarifying the mechanisms related to familial risk transmission is critical. Aberrant reward processing is a promising biomarker of MDD risk; accordingly, the aim of this study was to test behavioral measures of reward responsiveness and underlying frontostriatal resting activity in healthy adolescents both with (high-risk) and without (low-risk) a maternal history of MDD.

Methods: Low-risk and high-risk 12- to 14-year-old adolescents completed a probabilistic reward task (n = 74 low-risk, n = 27 high-risk) and a resting-state functional magnetic resonance imaging scan (n = 61 low-risk, n = 25 high-risk). Group differences in response bias toward reward and resting ventral striatal and medial prefrontal cortex (mPFC) fractional amplitude of low-frequency fluctuations (fALFFs) were examined. Computational modeling was applied to dissociate reward sensitivity from learning rate.

Results: High-risk adolescents showed a blunted response bias compared with low-risk adolescents. Computational modeling analyses revealed that relative to low-risk adolescents, high-risk adolescents exhibited reduced reward sensitivity but similar learning rate. Although there were no group differences in ventral striatal and mPFC fALFFs, groups differed in their relationships between mPFC fALFFs and response bias. Specifically, among high-risk adolescents, higher mPFC fALFFs correlated with a blunted response bias, whereas there was no fALFFs-response bias relationship among low-risk youths.

Conclusions: High-risk adolescents exhibit reward functioning impairments, which are associated with mPFC fALFFs. The blunted response bias-mPFC fALFFs association may reflect an excessive mPFC-mediated suppression of reward-driven behavior, which may potentiate MDD risk.
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http://dx.doi.org/10.1016/j.bpsc.2020.08.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936004PMC
March 2021

Neurophysiological responses to safety signals and the role of cardiac vagal control.

Behav Brain Res 2021 01 22;396:112914. Epub 2020 Sep 22.

Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA.

Background: Deficits in safety signal learning are well-established in fear-related disorders (e.g., PTSD, phobias). The current study used a fear conditioning paradigm to test associations among eye blink startle and event-related brain potential (ERP) latency measures of safety signal learning, as well as the role of cardiac vagal control (a measure of top-down inhibition necessary for safety learning).

Methods: Participants were 49 trauma-exposed women ages 17 to 28 years. Eyeblink startle response and ERP amplitudes/latencies were derived for conditioned stimuli associated (CS+) and not associated (CS-) with an aversive unconditioned stimulus. ERPs included the P100 and late positive potential (LPP), which index early visual processing and sustained emotional encoding, respectively. Cardiac vagal control was assessed with resting heart rate variability (HRV).

Results: P100 and LPP latencies for the CS- (safety signal stimulus) were significantly negatively associated with startle to the CS-, but not the CS + . LPP CS- latencies were significantly negatively associated with PTSD Intrusion scores, and this relationship was moderated by vagal control, such that the effect was only present among those with low HRV.

Conclusions: ERP-based markers of safety signal learning were associated with startle response to the CS- (but not CS+) and PTSD symptoms, indicating that these markers may have relevance for fear-related disorders. Cardiac vagal control indexed by HRV is a moderating factor in these associations and may be relevant to safety signal learning.
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http://dx.doi.org/10.1016/j.bbr.2020.112914DOI Listing
January 2021

Reward-Related Neural Predictors and Mechanisms of Symptom Change in Cognitive Behavioral Therapy for Depressed Adolescent Girls.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 01 23;6(1):39-49. Epub 2020 Jul 23.

Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts.

Background: Approximately half of depressed adolescents fail to respond to cognitive behavioral therapy (CBT). Given the variability in response, it is important to identify pretreatment characteristics that predict prognosis. Knowledge of which depressed adolescents are likely to exhibit a positive versus poor outcome to CBT may have important clinical implications (e.g., informing treatment recommendations). Emerging evidence suggests that neural reward responsiveness represents one promising predictor.

Methods: Adolescents with major depressive disorder (n = 36) received CBT and completed a reward task at 3 time points (pretreatment, midtreatment and posttreatment) while 128-channel electroencephalographic data were acquired. Healthy control participants (n = 29) completed the same task at 3 corresponding time points. Analyses focused on event-related potentials linked to 2 stages of neural processing: initial response to rewards (reward positivity) and later, elaborative processing (late positive potential). Moreover, time-frequency analyses decomposed the reward positivity into 2 constituent components: reward-related delta and loss-related theta activity.

Results: Multilevel modeling revealed that greater pretreatment reward responsiveness, as measured by the late positive potential to rewards, predicted greater depressive symptom change. In addition, a group × condition × time interaction emerged for theta activity to losses, reflecting normalization of theta power in the group with major depressive disorder from baseline to posttreatment.

Conclusions: An event-related potential measure of sustained (late positive potential)-but not initial (reward positivity)-reward responsiveness predicted symptom improvement, which may help inform which depressed adolescents are most likely to benefit from CBT. In addition to alleviating depression, successful CBT may attenuate underlying neural (theta) hypersensitivity to negative outcomes in depressed youths.
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http://dx.doi.org/10.1016/j.bpsc.2020.07.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796984PMC
January 2021

Prevalence of 12-month mental and substance use disorders in sexual minority college students in Mexico.

Soc Psychiatry Psychiatr Epidemiol 2021 Feb 4;56(2):247-257. Epub 2020 Sep 4.

Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.

Purpose: Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender.

Method: The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender.

Results: Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder.

Conclusion: These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.
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http://dx.doi.org/10.1007/s00127-020-01943-4DOI Listing
February 2021

Sources of Stress and Their Associations With Mental Disorders Among College Students: Results of the World Health Organization World Mental Health Surveys International College Student Initiative.

Front Psychol 2020 30;11:1759. Epub 2020 Jul 30.

Department of Health Care Policy, Harvard Medical School, Boston, MA, United States.

The college years are stressful for many students. Identifying the sources of stress and their relative importance in leading to clinically significant emotional problems may assist in the development of targeted stress management interventions. The current report examines the distribution and associations of perceived stress across major life areas with 12-month prevalence of common mental disorders in a cross-national sample of first-year college students. The 20,842 respondents were from 24 universities in 9 countries that participated in the World Health Organization World Mental Health International College Student Initiative. Logistic regression analysis examined associations of current perceived stress in six life areas (financial situation, health, love life, relationships with family, relationships at work/school, problems experienced by loved ones) with six types of 12-month mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Population attributable risk proportions (PARPs) were calculated to estimate the upper-bound potential effects of interventions focused on perceived stress in reducing prevalence of mental disorders. The majority of students (93.7%) reported at least some stress in at least one of the six areas. A significant dose-response association was found between extent of stress in each life area and increased odds of at least one of the six disorders. The multivariable models that included all stress measures were significant for all disorders ( = 20.6-70.6, < 0.001). Interpretation of PARPs as representing causal effects of stresses on disorders suggests that up to 46.9-80.0% of 12-month disorder prevalence might be eliminated if stress prevention interventions were developed to block the associations of stress with these disorders.
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http://dx.doi.org/10.3389/fpsyg.2020.01759DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406671PMC
July 2020

Sources of Stress and Their Associations With Mental Disorders Among College Students: Results of the World Health Organization World Mental Health Surveys International College Student Initiative.

Front Psychol 2020 30;11:1759. Epub 2020 Jul 30.

Department of Health Care Policy, Harvard Medical School, Boston, MA, United States.

The college years are stressful for many students. Identifying the sources of stress and their relative importance in leading to clinically significant emotional problems may assist in the development of targeted stress management interventions. The current report examines the distribution and associations of perceived stress across major life areas with 12-month prevalence of common mental disorders in a cross-national sample of first-year college students. The 20,842 respondents were from 24 universities in 9 countries that participated in the World Health Organization World Mental Health International College Student Initiative. Logistic regression analysis examined associations of current perceived stress in six life areas (financial situation, health, love life, relationships with family, relationships at work/school, problems experienced by loved ones) with six types of 12-month mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Population attributable risk proportions (PARPs) were calculated to estimate the upper-bound potential effects of interventions focused on perceived stress in reducing prevalence of mental disorders. The majority of students (93.7%) reported at least some stress in at least one of the six areas. A significant dose-response association was found between extent of stress in each life area and increased odds of at least one of the six disorders. The multivariable models that included all stress measures were significant for all disorders ( = 20.6-70.6, < 0.001). Interpretation of PARPs as representing causal effects of stresses on disorders suggests that up to 46.9-80.0% of 12-month disorder prevalence might be eliminated if stress prevention interventions were developed to block the associations of stress with these disorders.
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http://dx.doi.org/10.3389/fpsyg.2020.01759DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406671PMC
July 2020

Psychological interventions to improve sleep in college students: A meta-analysis of randomized controlled trials.

J Sleep Res 2021 02 16;30(1):e13097. Epub 2020 Jul 16.

Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Sleep disturbances and insomnia are common in college students, and reduce their quality of life and academic performance. The aim of this meta-analysis was to evaluate the efficacy of psychological interventions aimed at improving sleep in college students. A meta-analysis was conducted with 10 randomized controlled trials with passive control conditions (N = 2,408). The overall mean effect size (Hedges' g) of all sleep-related outcomes within each trial was moderate to large (g = 0.61; 95% confidence interval: 0.41-0.81; numbers-needed-to-treat = 3). Effect sizes for global measures of sleep disturbances were g = 0.79; 95% confidence interval: 0.52-1.06; and for sleep-onset latency g = 0.65; 95% confidence interval: 0.36-0.94. The follow-up analyses revealed an effect size of g = 0.56; 95% confidence interval: 0.45-0.66 for the combined sleep-related outcomes based on three studies. No significant covariates were identified. These results should be interpreted cautiously due to an overall substantial risk of bias, and in particular with regard to blinding of participants and personnel. Nevertheless, they provide evidence that psychological interventions for improving sleep are efficacious among college students. Further research should explore long-term effects and potential moderators of treatment efficacy in college students.
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http://dx.doi.org/10.1111/jsr.13097DOI Listing
February 2021

Mental disorders in Spanish university students: Prevalence, age-of-onset, severe role impairment and mental health treatment.

J Affect Disord 2020 08 11;273:604-613. Epub 2020 May 11.

Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain. Electronic address:

Background: The university period carries risk for onset of common mental disorders. Epidemiological knowledge on mental disorders among Spanish university students is limited.

Aims: To estimate lifetime and 12-month prevalence, persistence and age-of-onset of mental disorders among Spanish first-year university students, as well as associated role impairment and mental health treatment use.

Methods: First-year university students (N=2,118; 55.4% female; mean age=18.8 years) from five Spanish universities completed a web-based survey, screening possible DSM-IV mental disorders (major depressive episode(MDE), mania/hypomania, generalized anxiety disorder(GAD), panic disorder(PD), alcohol abuse/dependence(AUD), drug abuse/dependence(DUD), and adult attention-deficit/hyperactivity disorder(ADHD)). Role impairment and treatment associated with mental disorders were assessed.

Results: Lifetime and 12-month prevalence of any possible mental disorder was 41.3%(SE=1.08) and 35.7%(SE=1.05), respectively. Persistence (i.e., ratio of 12-month to lifetime prevalence) was 86.4%(SE=1.58). Median age-of-onset was 14 for adult ADHD, 15 for mood disorders and AUD, and 16 for anxiety disorders and DUD. One third (29.2%) of 12-month disorders were associated with role impairment. Twelve-month PD (OR=4.0;95%CI=1.9-8.5) had the highest odds for role impairment. Only 12.6% of students with 12-month disorder received any mental health treatment. Twelve-month treatment was the highest among those students with 12-month GAD (OR=7.4;95%CI=3.7-14.8).

Limitations: The assessment of mental disorders was based on self-reports. Cross-sectional nature of the data prevents causal associations.

Conclusion: One third of Spanish university students report a common mental disorder in the past year, and one third of those report severe role impairment. Only one out of eight students with 12-month mental disorders receives mental health treatment.
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http://dx.doi.org/10.1016/j.jad.2020.04.050DOI Listing
August 2020

Image acquisition and quality assurance in the Boston Adolescent Neuroimaging of Depression and Anxiety study.

Neuroimage Clin 2020 19;26:102242. Epub 2020 Mar 19.

Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address:

The Connectomes Related to Human Diseases (CRHD) initiative was developed with the Human Connectome Project (HCP) to provide high-resolution, open-access, multi-modal MRI data to better understand the neural correlates of human disease. Here, we present an introduction to a CRHD project, the Boston Adolescent Neuroimaging of Depression and Anxiety (BANDA) study, which is collecting multimodal neuroimaging, clinical, and neuropsychological data from 225 adolescents (ages 14-17), 150 of whom are expected to have a diagnosis of depression and/or anxiety. Our transdiagnostic recruitment approach samples the full spectrum of depressed/anxious symptoms and their comorbidity, consistent with NIMH Research Domain Criteria (RDoC). We focused on an age range that is critical for brain development and for the onset of mental illness. This project sought to harmonize imaging sequences, hardware, and functional tasks with other HCP studies, although some changes were made to canonical HCP methods to accommodate our study population and questions. We present a thorough overview of our imaging sequences, hardware, and scanning protocol. We detail similarities and differences between this study and other HCP studies. We evaluate structural-, diffusion-, and functional-image-quality measures that may be influenced by clinical factors (e.g., disorder, symptomatology). Signal-to-noise and motion estimates from the first 140 adolescents suggest minimal influence of clinical factors on image quality. We anticipate enrollment of an additional 85 participants, most of whom are expected to have a diagnosis of anxiety and/or depression. Clinical and neuropsychological data from the first 140 participants are currently freely available through the National Institute of Mental Health Data Archive (NDA).
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http://dx.doi.org/10.1016/j.nicl.2020.102242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184183PMC
February 2021

The importance of physical and mental health in explaining health-related academic role impairment among college students.

J Psychiatr Res 2020 04 29;123:54-61. Epub 2020 Jan 29.

Department of Health Care Policy, Harvard Medical School, Boston, USA. Electronic address:

Research consistently documents high rates of mental health problems among college students and strong associations of these problems with academic role impairment. Less is known, though, about prevalence and effects of physical health problems in relation to mental health problems. The current report investigates this by examining associations of summary physical and mental health scores from the widely-used Short-Form 12 (SF-12) Health Survey with self-reported academic role functioning in a self-report survey of 3,855 first-year students from five universities in the northeastern United States (US; mean age 18.5; 53.0% female). The mean SF-12 physical component summary (PCS) score (55.1) was half a standard deviation above the benchmark US adult population mean. The mean SF-12 mental component summary (MCS) score (38.2) was more than a full standard deviation below the US adult population mean. Two-thirds of students (67.1%) reported at least mild and 10.5% severe health-related academic role impairment on a modified version of the Sheehan Disability Scale. Both PCS and MCS scores were significantly and inversely related to these impairment scores, but with nonlinearities and interactions and much stronger associations involving MCS than PCS. Simulation suggests that an intervention that improved the mental health of all students with scores below the MCS median to be at the median would result in a 61.3% reduction in the proportion of students who experienced severe health-related academic role impairment. Although low-cost scalable interventions exist to address student mental health problems, pragmatic trials are needed to evaluate the effectiveness of these interventions in reducing academic role impairment.
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http://dx.doi.org/10.1016/j.jpsychires.2020.01.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047531PMC
April 2020

The importance of physical and mental health in explaining health-related academic role impairment among college students.

J Psychiatr Res 2020 04 29;123:54-61. Epub 2020 Jan 29.

Department of Health Care Policy, Harvard Medical School, Boston, USA. Electronic address:

Research consistently documents high rates of mental health problems among college students and strong associations of these problems with academic role impairment. Less is known, though, about prevalence and effects of physical health problems in relation to mental health problems. The current report investigates this by examining associations of summary physical and mental health scores from the widely-used Short-Form 12 (SF-12) Health Survey with self-reported academic role functioning in a self-report survey of 3,855 first-year students from five universities in the northeastern United States (US; mean age 18.5; 53.0% female). The mean SF-12 physical component summary (PCS) score (55.1) was half a standard deviation above the benchmark US adult population mean. The mean SF-12 mental component summary (MCS) score (38.2) was more than a full standard deviation below the US adult population mean. Two-thirds of students (67.1%) reported at least mild and 10.5% severe health-related academic role impairment on a modified version of the Sheehan Disability Scale. Both PCS and MCS scores were significantly and inversely related to these impairment scores, but with nonlinearities and interactions and much stronger associations involving MCS than PCS. Simulation suggests that an intervention that improved the mental health of all students with scores below the MCS median to be at the median would result in a 61.3% reduction in the proportion of students who experienced severe health-related academic role impairment. Although low-cost scalable interventions exist to address student mental health problems, pragmatic trials are needed to evaluate the effectiveness of these interventions in reducing academic role impairment.
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http://dx.doi.org/10.1016/j.jpsychires.2020.01.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047531PMC
April 2020

Prevention of eating disorders at universities: A systematic review and meta-analysis.

Int J Eat Disord 2020 06 14;53(6):813-833. Epub 2020 Jan 14.

Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Background: Eating problems are highly prevalent among young adults. Universities could be an optimal setting to prevent the onset of eating disorders through psychological intervention. As part of the World Mental Health-International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of eating disorder prevention programs targeting university students.

Method: A systematic literature search of bibliographical databases (CENTRAL, MEDLINE, PsycINFO) for randomized trials comparing psychological preventive interventions for eating disorders targeting university students with psychoeducation or inactive controls was performed on October 22, 2019.

Results: Twenty-seven studies were included. Thirteen (48.1%) were rated to have a low risk of bias. The relative risk of developing a subthreshold or full-blown eating disorder was incidence rate ratio = 0.62 (95% CI [0.44, 0.87], n = 8, numbers-needed-to-treat [NNT] = 26.08; standardized clinical interviews only), indicating a 38% decrease in incidence in the intervention groups compared to controls. Small to moderate between-group effects at posttest were found on eating disorder symptoms (g = 0.35, 95% CI [0.24, 0.46], NNT = 5.10, n = 26), dieting (g = 0.43, 95% CI [0.29, 0.57], NNT = 4.17, n = 21), body dissatisfaction (g = 0.40, 95% CI [0.27, 0.53], NNT = 4.48, n = 25), drive for thinness (g = 0.43, 95% CI [0.27, 0.59], NNT = 4.23, n = 12), weight concerns (g = 0.33, 95% CI [0.10, 0.57], NNT = 5.35, n = 13), and affective symptoms (g = 0.27, 95% CI [0.15, 0.38], NNT = 6.70, n = 18). The effects on bulimia nervosa symptoms were not significant. Heterogeneity was moderate across comparisons.

Discussion: Eating disorder prevention on campus can have significant, small-to-moderate effects on eating disorder symptoms and risk factors. Results also suggest that the prevention of subthreshold and full-syndrome eating disorders is feasible using such interventions. More research is needed to identify ways to motivate students to use preventive eating disorder interventions.

Antecedentes: Los trastornos de la conducta alimentaria son altamente prevalentes entre los adultos jóvenes. Las universidades podrían ser un entorno óptimo para prevenir la aparición de trastornos alimentarios a través de la intervención psicológica. Como parte de la iniciativa World Mental Health-International College Student, esta revisión sistemática y meta-análisis sintetiza datos sobre la eficacia de los programas de prevención de trastornos alimentarios dirigidos a estudiantes universitarios. MÉTODO: Una búsqueda bibliográfica sistemática de datos bibliográficas (CENTRAL, MEDLINE, PsycINFO) para ensayos aleatorios que comparaban intervenciones preventivas psicológicas para trastornos alimentarios dirigidos a estudiantes universitarios con psicoeducación o controles inactivos fue realizada hasta el 22 de octubre de 2019.

Resultados: Se incluyeron 27 estudios. Trece (48,1%) fueron calificados como de bajo riesgo de sesgo. El riesgo relativo de desarrollar un trastorno de la conducta alimentaria subclínico (parcial) o completo fue IRR = 0.62 (95% CI [0.44, 0.87], n = 8, NNT = 26.08; sólo entrevistas clínicas estandarizadas), lo que indica una disminución del 38% en la incidencia en los grupos de intervención en comparación con los controles. Se encontraron efectos pequeños a moderados entre los grupos en la post-prueba en los síntomas del trastorno alimentario (g = 0.35, 95% CI [0.24, 0.46], NNT = 5.10, n = 26), dieta (g = 0.43, 95% CI [0.29, 0.57], NNT = 4.17, n = 21), insatisfacción corporal (g = 0.40, 95% CI [0.27, 0.53], NNT = 4.48, n = 25), impulso por delgadez (g = 0.43, 95% CI [0.27, 0.59], NNT = 4.23, n = 12), problemas de peso (g = 0.33, 95% CI [0.10, 0.57], NNT = 5.35, n = 13) y síntomas afectivos (g = 0.27, 95% CI [0.15, 0.38], NNT = 6.70, n = 18). Los efectos sobre los síntomas de la bulimia nervosa no fueron significativos. La heterogeneidad fue moderada en las comparaciones. DISCUSIÓN: La prevención de los trastornos de la conducta alimentaria en el campus universitario puede tener efectos significativos, de pequeños a moderados, sobre los síntomas del trastorno alimentario y los factores de riesgo. Los resultados también sugieren que la prevención de los trastornos alimentarios subclínicos o parciales y síndromes completos es factible utilizando tales intervenciones. Se necesita más investigación para identificar formas de motivar a los estudiantes a usar intervenciones preventivas para los trastornos de la conducta alimentaria.
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http://dx.doi.org/10.1002/eat.23224DOI Listing
June 2020

Binge eating and purging in first-year college students: Prevalence, psychiatric comorbidity, and academic performance.

Int J Eat Disord 2020 03 23;53(3):339-348. Epub 2019 Dec 23.

Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.

Background: Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12-month prevalence of BPB among college first-year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning.

Methods: Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross-sectionally assessed 12-month BPB and mental health problems among college first-year students (n = 4,889; response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage "AYP" [0-100%] and academic failure) were obtained from administrative records at the end of the academic year.

Results: Twelve-month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4-18.4). Multivariate models showed associations with non-suicidal self-injury, post-traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (-4.1 to -11.2% range) and elevated odds of academic year failure (ORs = 1.4-4.2).

Conclusions: BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first-year students. Further study is needed to examine the causal dynamics underlying these associations.
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http://dx.doi.org/10.1002/eat.23211DOI Listing
March 2020

Binge eating and purging in first-year college students: Prevalence, psychiatric comorbidity, and academic performance.

Int J Eat Disord 2020 03 23;53(3):339-348. Epub 2019 Dec 23.

Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.

Background: Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12-month prevalence of BPB among college first-year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning.

Methods: Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross-sectionally assessed 12-month BPB and mental health problems among college first-year students (n = 4,889; response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage "AYP" [0-100%] and academic failure) were obtained from administrative records at the end of the academic year.

Results: Twelve-month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4-18.4). Multivariate models showed associations with non-suicidal self-injury, post-traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (-4.1 to -11.2% range) and elevated odds of academic year failure (ORs = 1.4-4.2).

Conclusions: BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first-year students. Further study is needed to examine the causal dynamics underlying these associations.
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http://dx.doi.org/10.1002/eat.23211DOI Listing
March 2020

Delineating the social valuation network in adolescents.

Soc Cogn Affect Neurosci 2019 11;14(11):1159-1166

Department of Psychiatry, Columbia University, New York, NY, 10032, USA, and.

Adolescents strive for peer approval, and an increased sensitivity to peers' opinions is normative. However, among vulnerable adolescents, peer evaluation can be detrimental, contributing to affective disorders. It is, therefore, critical to improve our understanding of neural underpinnings of peer evaluation. Prior research has investigated averaged neural responses to peer acceptance or rejection, neglecting to probe trial-by-trial computations that mirror real-time updating of daily activities. In non-social decision-making, a common neural valuation system centered on the medial prefrontal cortex (mPFC) has emerged, which evaluates different reward types on a common scale to guide choices. However, it is unclear whether the mPFC also tracks complex social scenarios involving peer feedback. To address this gap, we acquired fMRI data from 55 healthy adolescents during the Chatroom Task, which probes peer evaluation, and implemented a computational approach to characterize trial-by-trial social value, thereby allowing us to interrogate the neural correlates of social value. Consistent with our hypothesis, social value signals were encoded in the mPFC. Interestingly, analyses also revealed a wider social-specific valuation network including the precuneus and amygdala. Understanding how adolescents make social decisions and neural markers associated with it, may, ultimately, help us clarify promising targets for intervention.
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http://dx.doi.org/10.1093/scan/nsz086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057279PMC
November 2019

Brain Volume Abnormalities in Youth at High Risk for Depression: Adolescent Brain and Cognitive Development Study.

J Am Acad Child Adolesc Psychiatry 2020 10 18;59(10):1178-1188. Epub 2019 Oct 18.

Columbia University, New York; New York State Psychiatric Institute, New York; Division of Clinical Developmental Neuroscience, Sackler Institute, New York. Electronic address:

Objective: Children of parents with depression are two to three times more likely to develop major depressive disorder than children without parental history; however, subcortical brain volume abnormalities characterizing major depressive disorder risk remain unclear. The Adolescent Brain and Cognitive Development (ABCD) Study provides an opportunity to identify subcortical differences associated with parental depressive history.

Method: Structural magnetic resonance data were acquired from 9- and 10-year-old children (N = 11,876; release 1.1, n = 4,521; release 2.0.1, n = 7,355). Approximately one-third of the children had a parental depressive history, providing sufficient power to test differences in subcortical brain volume between low- and high-risk youths. Children from release 1.1 were examined as a discovery sample, and we sought to replicate effects in release 2.0.1. Secondary analyses tested group differences in the prevalence of depressive disorders and clarified whether subcortical brain differences were present in youths with a lifetime depressive disorder history.

Results: Parental depressive history was related to smaller right putamen volume in the discovery (release 1.1; d = -0.10) and replication (release 2.0.1; d = -0.10) samples. However, in release 1.1, this effect was driven by maternal depressive history (d = -0.14), whereas in release 2.0.1, paternal depressive history showed a stronger relationship with putamen volume (d = -0.09). Furthermore, high-risk children exhibited a near twofold greater occurrence of depressive disorders relative to low-risk youths (maternal history odds ratio =1.99; paternal history odds ratio = 1.45), but youths with a lifetime depressive history did not exhibit significant subcortical abnormalities.

Conclusion: A parental depressive history was associated with smaller putamen volume, which may affect reward learning processes that confer increased risk for major depressive disorder.
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http://dx.doi.org/10.1016/j.jaac.2019.09.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7165045PMC
October 2020
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