8,413 research outputs found

    The Implications, Magnitude, and Development of Traumatic Brain Injury for Individuals Undergoing Treatment for Opioid Use Disorder

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    There is an established bidirectional relation between substance use and traumatic brain injuries (TBIs). Despite the high rate of prescribing opioids for pain management following a TBI and the epidemic of opioid use disorder (OUD) in the United States, scarce research has specifically analyzed the association between TBI and OUD. In a series of three interrelated manuscripts, the present study will first examine the prevalence and features of TBIs among persons seeking treatment for OUD. Next, the present study will evaluate the association between TBI and indicators of risky health behaviors and OUD severity, including the risk of overdose and polysubstance use. The predictive ability of symptoms of posttraumatic stress disorder, anxiety, impulsivity, depression, and chronic pain on odds of having had a TBI will also be calculated. Last, a systematic review will be conducted to provide comprehensive guidelines for effective methods of tailoring OUD treatment to mitigate the effects of TBI on treatment outcomes. Altogether, the findings will aid in the understanding of the development of TBI for persons with OUD, provide insight into common clinical complexities for patients with OUD and TBI, and offer guidance on how best to tailor interventions to increase substance use treatment efficacy for persons with TBI

    Using neurobiological measures to predict and assess trauma-focused psychotherapy outcome in youth with posttraumatic stress disorder

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    In this thesis we examined different predictive neurobiological measures of traumafocused psychotherapy response and investigated the biological mechanisms underlying trauma-focused psychotherapy response in youth with PTSD. Our results suggest that activity of the major neuroendocrine stress response systems and brain functional connectivity before treatment are indeed associated with trauma-focused treatment response. Moreover, trauma-focused psychotherapy response seems to be related to longitudinal changes in autonomic nervous system activity during stress and brain structure. Together, these findings improve our understanding of the relationship between neurobiological measures and traumafocused psychotherapy response in youth with PTSD. However, these insights have currently limited to no clinical value because the current state of evidence does not support implementation of neurobiological biomarkers for treatment selection and necessary trials of (augmentation) treatments targeting neurobiological mechanisms related to treatment response have not been performed yet. The way forward now, is to perform individual prediction studies in less heterogeneous patient samples and to perform developmentally informed long-term studies examining (neuro) developmental trajectories related to PTSD and treatment response. These studies are necessary to address whether neurobiological measures can eventually improve treatment outcome and reduce the burden of PTSD in affected youth

    A neuroimaging investigation of bipolar disorder and the neurocognitive effects of 5-HT7 antagonists

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    Bipolar disorder is a psychiatric disorder characterised by pathological mood states, but there is growing recognition of the role of cognitive impairment and dysfunction of emotional processes, which has a profound impact on quality of life. Many people with bipolar disorders exhibit brain volume impairment associated with cognitive dysfunction and an increased risk of dementia. In this thesis, I conducted a systematic review to understand the relationships between mood disorders and the 5-HT7 receptor. The 5-HT7 receptor is related to depression and anxiety, but the relationship between 5-HT7 and mania remains unclear; in addition, sleep and memory were also related to the 5-HT7 receptor. Followed by these findings, in the next two chapters, I examined the effects of 5-HT7 antagonists, using JNJ-18038683, on emotional and cognitive functioning, as well as their neural substrates. I then reported on neuroimaging investigations examining the effects of 5-HT7 antagonists on emotional processing and cognitive function in healthy volunteers to gain insight into their potential mode of action and utility for bipolar disorder. In fMRI analyses, the drug acted on 5-HT7 receptors potentially improving cognitive performance by modulating the function of the Cognitive Control Network in healthy controls. In the above-mentioned chapters, I gained a better understanding of the 5-HT7 antagonist, JNJ-18038683, and the putative promising effects for pharmacological treatments. However, the approach taken has some limitations, including a small sample size, potential participant bias, and a lack of systematic control of medication dose and duration of administration. In addition, in Chapter 5, I explored the brain basis of bipolar disorder and its links to cognitive and emotional dysfunction using a new ‘brain age’ approach. Individuals with bipolar disorder were found to have increased brain age compared to healthy controls. I hope that these findings can be applied to pharmacological treatment for individuals with bipolar disorder, ultimately allowing patients to benefit from the drug in the future

    Outline for an externalist psychiatry (1): or, how to realise the biopsychosocial model

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    The biopsychosocial model in psychiatry has come under fire for being too vague to be of any practical use in the clinic. For many, its central flaw consists in lack of scientific validity and philosophical coherence: the model never specified how biological, psychological and social factors causally integrate with one another. Recently, advances in the cognitive sciences have made great strides towards meeting this very ‘integration challenge’. The paper begins by illustrating how enactivist and predictive processing frameworks propose converging accounts of biopsychosocial integration that are far superior to those of previous theories. It argues, however, that the main problem of implementing the biopsychosocial model has less to do with integration than with the lack of a social aetiology. Psychiatric practice leans heavily towards ‘bio’ and ‘psycho’ approaches, without an equally developed set of explanatory and therapeutic resources for dealing with the ‘social’ dimension of illness. This leaves psychiatry essentially internalist in orientation. As illustrated most poignantly by conditions such as functional neurological disorders, internalism comes with the risks of stigma and the curtailment of therapeutic possibilities. The paper argues that the answer to the failings of the biopsychosocial model lies in combining the integration challenge with the development of an ‘externalist psychiatry’, which casts both causes and treatment of psychiatric illness onto the social environment. The following two papers explore the conditions that might make this idea a reality

    Athletes with Eating Disorders: Analysis of Their Clinical Characteristics, Psychopathology and Response to Treatment

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    Eating disorders (ED) have frequently been described among athletes. However, their specific features and therapy responses are lacking in the literature. The aims of this article were to compare clinical, psychopathological and personality traits between ED patients who were professional athletes (ED-A) with those who were not (ED-NA) and to explore differences in response to treatment. The sample comprised n = 104 patients with ED (n = 52 ED-A and n = 52 matched ED-NA) diagnosed according to DSM-5 criteria. Evaluation consisted of a semi-structured face-to-face clinical interview conducted by expert clinicians and a psychometric battery. Treatment outcome was evaluated when the treatment program ended. ED-A patients showed less body dissatisfaction and psychological distress. No differences were found in treatment outcome among the groups. Within the ED-A group, those participants who performed individual sport activities and aesthetic sports presented higher eating psychopathology, more general psychopathology, differential personality traits and poor therapy outcome. Individual and aesthetic sports presented more severity and worse prognosis. Although usual treatment for ED might be similarly effective in ED-A and ED-NA, it might be important to develop preventive and early detection programs involving sports physicians and psychologists, coaches and family throughout the entire athletic career and afterwards


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    Population aging is a prominent demographic challenge. Older adults face increased risks of sleep dysfunctions, depression, and cognitive impairments due to physical, biological, and psychological factors associated with aging. These behavioral issues elevate safety risks at home, which necessitates the transition to assisted living facilities. Extensive research highlights the influence of healthcare environmental design, particularly related to architectural lighting impacts on residents' well-being and quality of life. To optimize older adults' health and well-being, it is essential to consider both the visual and non-visual effects of architectural lighting. Visual impacts include parameters related to task performance and visual acuity, while non-visual impacts may include outcomes such as circadian rhythm regulation, sleep quality, mood enhancement, and cognitive performance, thereby emphasizing the importance of implementing a holistic conceptual approach to human-centric lighting in indoor environments.While existing gerontology studies have primarily focused on light-level attributes, such as radiant flux, illuminance, and equivalent melanopic lux, there has been limited exploration of spectral and spatial pattern parameters in indoor lighting. The primary objective of this research is to investigate the impact of both quantitative and qualitative aspects of lighting design, including spatial layout characteristics such as uniformity, direction, centrality, and spectral attributes like correlated color temperature (CCT), on the visual perception, preference, mood, cognitive performance, and overall well-being of older adults in assisted living facilities. The study employed a multi-method approach across three main research phases. In phase I, a Q-sort survey involving 60 participants assessed the impact of diverse spatial light patterns on visual perception and preference. In phase II, a within-subject design evaluated the cognitive performance of 32 older adults in similar lighting scenarios within real and virtual environments. Lastly, in phase III, the study examined the relationship between spatial and spectral light patterns and cognitive performance through virtual reality testing with 32 participants. Results revealed significant effects of different spatial light patterns on older adults' environmental impressions, including visual preference, stress levels, and cognitive performance. Uniform and indirect lighting were preferred, with no substantial differences between peripheral and central spatial arrangements of light layers. Non-uniform lighting induced a relaxed impression, while uniform lighting heightened perceived stress. Furthermore, the study demonstrated the suitability of virtual reality environments (VR) for assessing cognitive performance and subjective perception. The findings underscore the substantial influence of spatial and spectral light patterns on the cognitive performance of older adults in assisted living facilities. This research contributes to the understanding of the visual and non-visual effects of human-centric lighting on the well-being of older adults. By considering spatial and spectral light attributes, designers can enhance cognitive function, reduce impairments, and cultivate healthier and more efficient living environments

    The ins and outs of open-angle Glaucoma:drugs, diet, and defecation

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    Glaucoma is the leading cause of irreversible blindness and second leading cause of blindness. The primary aim of this thesis is to provide insight into the role of systemic effectsin the pathophysiology of OAG.<br/

    Water-soluble vitamin insufficiency, deficiency and supplementation in children and adolescents with a psychiatric disorder: a systematic review and meta-analysis

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    Nutrition is fundamental for brain development, but relatively little is known about water-soluble vitamin (WSV) levels and the effect of supplementation on psychiatry symptoms in children and adolescents (CAD) with psychiatric disorders. Our team systematically reviewed all studies concerning WSV abnormalities or supplementation in CAD with any psychiatric disorder. We searched for original studies published between 1990 and 15/05/2020 which were not based on retrospective chart review and which included WSV blood level measurements or investigated the effect of WSV supplementation on psychiatric symptoms in psychiatric patients aged 18 or under. Forty-two articles were included, 69% of which (N = 29) examined Autism Spectrum Disorders (ASD), with most of these assessing folate or vitamin B12 supplementation (N = 22, 75.9% of ASD studies). Meta-analyses showed significantly lower vitamin B12 levels in ASD and ADHD patients vs. healthy controls (HC), while folate levels were higher in ADHD patients vs. HC. Most of the studies (9/10, 90%) showed a decrease in symptoms as measured by clinical scales after supplementation. There was significant heterogeneity between the studies, however many found different types of vitamin abnormalities in CAD with psychiatric disorders
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