Crying and Attachment Style: The Role of Romantic Relationships

Crying is an attachment behavior that functions to elicit support from others (Nelson, 1998); the context in which the crying occurs is important in understanding whether it is adaptive or maladaptive (Hendriks & Vingerhoets, 2006). However, very little research has examined whether and how attachment style is associated with adult crying, and if this association might vary by an individual’s relationship status. Using a sample of 305 first-year college students and a series of hierarchical regressions, we examined the moderating effect of relationship status on the associations between attachment style (measured using the Revised Experiences in Close Relationships Scale; Fraley, Waller, & Brennan, 2000) and crying frequency and tendency. We found that attachment anxiety was positively associated with both crying frequency and tendency, whereas attachment avoidance was negatively associated with crying tendency. However, we found moderation effects only in the case of attachment avoidance; specifically, we found that attachment avoidance was associated with a lower frequency of crying and tendency to cry only for those individuals involved in romantic relationships. Attachment anxiety, on the other hand, was associated with greater crying frequency and tendency regardless of relationship status. These results demonstrate not only that crying may act as an attachment behavior, but also that the activation or deactivation of this particular attachment behavior may be dependent on the existence of a romantic attachment figure

Psychometric properties of the Ndetei–Othieno–Kathuku (NOK) Scale: A mental health assessment tool for an African setting

Background: Research suggests that psychiatric conditions in children and adolescents are highly debilitating, with sparse resources for assessment and treatment in low- and middle-income countries (LMICs). Objectives: The primary aim of this study was to evaluate the reliability, validity, and latent factor structure of an ethnographically-grounded assessment instrument for detecting common mental health complaints among rural Kenyan children and adolescents. Methods: The Ndetei–Othieno–Kathuku Scale (NOK) was delivered to 2 282 children aged 10 to 18 years old. Exploratory factor analysis identified four latent factors. This structure was confirmed in subsequent confirmatory factor analyses. External validity was explored by investigating associations among NOK factors and Youth Self-Report DSM-oriented scales. Results: Findings suggest the NOK possesses good internal reliability and a four-factor latent structure corresponding to depression, anxiety, somatic complaints, and a mixed factor. Significant associations ranging from small to medium effect sizes were noted between NOK factors and YSR DSM-oriented scales. Conclusions: Exploratory findings suggest that the NOK possesses adequate psychometric properties among this population. This ethnographically-grounded instrument may be uniquely suited to screening for mental health complaints among Kenyan children and adolescents

Enhancing Discovery of Genetic Variants for Posttraumatic Stress Disorder Through Integration of Quantitative Phenotypes and Trauma Exposure Information

Funding Information: This work was supported by the National Institute of Mental Health / U.S. Army Medical Research and Development Command (Grant No. R01MH106595 [to CMN, IL, MBS, KJRe, and KCK], National Institutes of Health (Grant No. 5U01MH109539 to the Psychiatric Genomics Consortium ), and Brain & Behavior Research Foundation (Young Investigator Grant [to KWC]). Genotyping of samples was provided in part through the Stanley Center for Psychiatric Genetics at the Broad Institute supported by Cohen Veterans Bioscience . Statistical analyses were carried out on the LISA/Genetic Cluster Computer ( https://userinfo.surfsara.nl/systems/lisa ) hosted by SURFsara. This research has been conducted using the UK Biobank resource (Application No. 41209). This work would have not been possible without the financial support provided by Cohen Veterans Bioscience, the Stanley Center for Psychiatric Genetics at the Broad Institute, and One Mind. Funding Information: MBS has in the past 3 years received consulting income from Actelion, Acadia Pharmaceuticals, Aptinyx, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and has stock options in Oxeia Biopharmaceuticals and Epivario. In the past 3 years, NPD has held a part-time paid position at Cohen Veterans Bioscience, has been a consultant for Sunovion Pharmaceuticals, and is on the scientific advisory board for Sentio Solutions for unrelated work. In the past 3 years, KJRe has been a consultant for Datastat, Inc., RallyPoint Networks, Inc., Sage Pharmaceuticals, and Takeda. JLM-K has received funding and a speaking fee from COMPASS Pathways. MU has been a consultant for System Analytic. HRK is a member of the Dicerna scientific advisory board and a member of the American Society of Clinical Psychopharmacology Alcohol Clinical Trials Initiative, which during the past 3 years was supported by Alkermes, Amygdala Neurosciences, Arbor Pharmaceuticals, Dicerna, Ethypharm, Indivior, Lundbeck, Mitsubishi, and Otsuka. HRK and JG are named as inventors on Patent Cooperative Treaty patent application number 15/878,640, entitled “Genotype-guided dosing of opioid agonists,” filed January 24, 2018. RP and JG are paid for their editorial work on the journal Complex Psychiatry. OAA is a consultant to HealthLytix. All other authors report no biomedical financial interests or potential conflicts of interest. Funding Information: This work was supported by the National Institute of Mental Health/ U.S. Army Medical Research and Development Command (Grant No. R01MH106595 [to CMN, IL, MBS, KJRe, and KCK], National Institutes of Health (Grant No. 5U01MH109539 to the Psychiatric Genomics Consortium), and Brain & Behavior Research Foundation (Young Investigator Grant [to KWC]). Genotyping of samples was provided in part through the Stanley Center for Psychiatric Genetics at the Broad Institute supported by Cohen Veterans Bioscience. Statistical analyses were carried out on the LISA/Genetic Cluster Computer (https://userinfo.surfsara.nl/systems/lisa) hosted by SURFsara. This research has been conducted using the UK Biobank resource (Application No. 41209). This work would have not been possible without the financial support provided by Cohen Veterans Bioscience, the Stanley Center for Psychiatric Genetics at the Broad Institute, and One Mind. This material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting true views of the U.S. Department of the Army or the Department of Defense. We thank the investigators who comprise the PGC-PTSD working group and especially the more than 206,000 research participants worldwide who shared their life experiences and biological samples with PGC-PTSD investigators. We thank Mark Zervas for his critical input. Full acknowledgments are in Supplement 1. MBS has in the past 3 years received consulting income from Actelion, Acadia Pharmaceuticals, Aptinyx, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and has stock options in Oxeia Biopharmaceuticals and Epivario. In the past 3 years, NPD has held a part-time paid position at Cohen Veterans Bioscience, has been a consultant for Sunovion Pharmaceuticals, and is on the scientific advisory board for Sentio Solutions for unrelated work. In the past 3 years, KJRe has been a consultant for Datastat, Inc. RallyPoint Networks, Inc. Sage Pharmaceuticals, and Takeda. JLM-K has received funding and a speaking fee from COMPASS Pathways. MU has been a consultant for System Analytic. HRK is a member of the Dicerna scientific advisory board and a member of the American Society of Clinical Psychopharmacology Alcohol Clinical Trials Initiative, which during the past 3 years was supported by Alkermes, Amygdala Neurosciences, Arbor Pharmaceuticals, Dicerna, Ethypharm, Indivior, Lundbeck, Mitsubishi, and Otsuka. HRK and JG are named as inventors on Patent Cooperative Treaty patent application number 15/878,640, entitled ?Genotype-guided dosing of opioid agonists,? filed January 24, 2018. RP and JG are paid for their editorial work on the journal Complex Psychiatry. OAA is a consultant to HealthLytix. All other authors report no biomedical financial interests or potential conflicts of interest. Publisher Copyright: © 2021 Society of Biological PsychiatryBackground: Posttraumatic stress disorder (PTSD) is heritable and a potential consequence of exposure to traumatic stress. Evidence suggests that a quantitative approach to PTSD phenotype measurement and incorporation of lifetime trauma exposure (LTE) information could enhance the discovery power of PTSD genome-wide association studies (GWASs). Methods: A GWAS on PTSD symptoms was performed in 51 cohorts followed by a fixed-effects meta-analysis (N = 182,199 European ancestry participants). A GWAS of LTE burden was performed in the UK Biobank cohort (N = 132,988). Genetic correlations were evaluated with linkage disequilibrium score regression. Multivariate analysis was performed using Multi-Trait Analysis of GWAS. Functional mapping and annotation of leading loci was performed with FUMA. Replication was evaluated using the Million Veteran Program GWAS of PTSD total symptoms. Results: GWASs of PTSD symptoms and LTE burden identified 5 and 6 independent genome-wide significant loci, respectively. There was a 72% genetic correlation between PTSD and LTE. PTSD and LTE showed largely similar patterns of genetic correlation with other traits, albeit with some distinctions. Adjusting PTSD for LTE reduced PTSD heritability by 31%. Multivariate analysis of PTSD and LTE increased the effective sample size of the PTSD GWAS by 20% and identified 4 additional loci. Four of these 9 PTSD loci were independently replicated in the Million Veteran Program. Conclusions: Through using a quantitative trait measure of PTSD, we identified novel risk loci not previously identified using prior case-control analyses. PTSD and LTE have a high genetic overlap that can be leveraged to increase discovery power through multivariate methods.publishersversionpublishe

Development of the crying proneness scale: Associations among crying proneness, empathy, attachment, and age

Crying is a unique form of human emotional expression that is associated with both positive and negative evocative antecedents. This article investigates the psychometric properties of a newly developed Crying Proneness Scale by examining the factor structure, test–retest reliability, and theoretically hypothesized relationships with empathy, attachment, age, and gender. Based on an analysis of data provided by a Dutch panel (Time 1: N = 4,916, Time 2: N = 4,874), exploratory and confirmatory factor analyses suggest that crying proneness is a multidimensional construct best characterized by four factors called attachment tears, societal tears, sentimental/moral tears, and compassionate tears. Test–retest reliability of the scale was adequate and associations with age, gender, empathy, and attachment demonstrated expected relations. Results suggest that this scale can be used to measure crying proneness, and that it will be useful in future studies that aim to gain a better understanding of normal and pathological socioemotional development

Childhood autism spectrum disorder: insights from a tertiary hospital cohort in Kenya

Introduction: Autism Spectrum Disorder (ASD) is characterized by impairments in behavior, social communication and interaction. There have been little data on ASD from sub-Saharan Africa (SSA) describing clinical characteristics in large cohorts of patients. Preliminary studies reported a high male sex ratio, excess of non-verbal cases, possible infectious etiologies and comorbidities e.g. epilepsy. Objectives: To describe the clinical characteristics of children diagnosed with ASD in an African context. Methodology: This cohort study used a retrospective medical chart review which identified 116 (7%) children diagnosed with ASD according to DSM-5 criteria. From a total of 1,711 medical records consisting of physical files and electronic databases from Twenty-seven (23%) children self-referred while 89 (77%) referred by other medical practitioners and attended a pediatric neurology clinic at Aga Khan University Hospital in Nairobi, Kenya, between 2011 and 2016. Results: The median age at presentation was 3 years with speech delay as the most common reason for presentation enventhouh most of them were 6 years and below. Expressive language delay was observed in 90% of the respondents. (60%) who obtained imaging had normal MRI brain findings. Only 44% and 34% of the children had access to speech and occupational therapy respectively. 53% in the study were first-borns in their families. Epilepsy and ADHD were the most prevalent co-morbidities. Males (94, 81.1%) were more than females (22, 18.9%) at a ratio of 4.3:1. Conclusion And Recommendations: An early median age at presentation and preponderance of male gender was observed as lack of awareness and stigma identified as contributing factors for therapy. Access to speech therapy and other interventions to scale-up to cub intellectual disability and epilepsy. A prospective study would help determine outcomes following appropriate interventions from 1 to 23 years old

Psychological resilience: an update on definitions, a critical appraisal, and research recommendations

Background: The ability to resist adverse outcomes, or demonstrate resilience after exposure to trauma is a thriving field of study. Yet ongoing debate persists regarding definitions of resilience, generalizability of the extant literature, neurobiological correlates, and a consensus research agenda. Objectives: To address these pressing questions, Drs. Christy Denckla and Karestan Koenen (co-chairs) convened a multidisciplinary panel including Drs. Dante Cicchetti, Laura Kubzansky, Soraya Seedat, Martin Teicher, and David Williams at the 2019 annual meeting of the International Society for Traumatic Stress Studies (ISTSS). Questions included (1) how have definitions of resilience evolved, (2) what are the best approaches to capture the complexity of resilience processes, and (3) what are the most important areas for future research? Methods: The proceedings of this panel are summarized in this report, and prominent themes are synthesized and integrated. Results: While different definitions emerged, all shared a focus on conceptualizing resilience at multiple levels, from the biological to the social structural level, a focus on the dynamic nature of resilience, and a move away from conceptualizing resilience as only an individual trait. Critical areas for future research included 1) focused efforts to improve assessment that has international and cross-cultural validity, 2) developing within-study designs that employ more intensive phenotyping strategies, 3) examining outcomes across multiple levels and domains, and 4) integrating conceptualizations of resilience from the individual-level to the larger social context at the population health level. Conclusion: Increasingly sophisticated and nuanced conceptual frameworks, coupled with research leveraging advances in genetics, molecular biology, increased computational capacity, and larger, more diverse datasets suggest that the next decade of research could bring significant breakthroughs

Cross-country variations in the reporting of psychotic symptoms among sub-Saharan African adults: A psychometric evaluation of the Psychosis Screening Questionnaire

Background: Self-reporting of psychotic symptoms varies significantly between cultures and ethnic groups. Yet, limited validated screening instruments are available to capture such differences in the African continent. Methodology: Among 9,059 individuals participating as controls in a multi-country case-control study of the genetic causes of psychosis, we evaluated the psychometric properties of the Psychosis Screening Questionnaire (PSQ). We applied multi-group confirmatory factor analysis and item response theory to assess item parameters. Results: The overall positive endorsement of at least one item assessing psychotic symptoms on the PSQ was 9.7%, with variability among countries (Uganda 13.7%, South Africa 11%, Kenya 10.2%, and Ethiopia 2.8%). A unidimensional model demonstrated good fit for the PSQ (root mean square error of approximation = 0.009; comparative fit index = 0.997; and Tucker-Lewis Index = 0.995). Hypomania had the weakest association with single latent factor (standardized factor loading 0.62). Sequential multi-group confirmatory factor analysis demonstrated that PSQ items were measured in equivalent ways across the four countries. PSQ items gave more information at higher levels of psychosis, with hypomania giving the least discriminating information. Limitations: Participants were recruited from general medical facilities, so findings may not be generalizable to the general population. Conclusion: The PSQ demonstrated a unidimensional factor structure in these samples. Items were measured equivalently across all study settings, suggesting that differences in prevalence of psychotic symptoms between countries were less likely to represent measurement artifact. The PSQ is more reliable in screening for psychosis in individuals with higher degrees of psychotic experiences-hypomania excluded-and might decrease the false-positive rate from mild nonspecific psychotic experiences

Psychometric properties of the Ndetei–Othieno–Kathuku (NOK) Scale: A mental health assessment tool for an African setting

Background: Research suggests that psychiatric conditions in children and adolescents are highly debilitating, with sparse resources for assessment and treatment in low- and middle-income countries (LMICs). Objectives: The primary aim of this study was to evaluate the reliability, validity, and latent factor structure of an ethnographically-grounded assessment instrument for detecting common mental health complaints among rural Kenyan children and adolescents. Methods: The Ndetei–Othieno–Kathuku Scale (NOK) was delivered to 2 282 children aged 10 to 18 years old. Exploratory factor analysis identified four latent factors. This structure was confirmed in subsequent confirmatory factor analyses. External validity was explored by investigating associations among NOK factors and Youth Self-Report DSM-oriented scales. Results: Findings suggest the NOK possesses good internal reliability and a four-factor latent structure corresponding to depression, anxiety, somatic complaints, and a mixed factor. Significant associations ranging from small to medium effect sizes were noted between NOK factors and YSR DSM-oriented scales. Conclusions: Exploratory findings suggest that the NOK possesses adequate psychometric properties among this population. This ethnographically-grounded instrument may be uniquely suited to screening for mental health complaints among Kenyan children and adolescents

Cross-cultural equivalence of the Kessler Psychological Distress Scale (K10) across four African countries in a multi-national study of adults

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all.Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional model with correlated errors was tested for equivalence across study countries using confirmatory factor analyses and the alignment optimization method. Results displayed 30 % noninvariance (i.e., variation) for both intercepts and factor loadings across all countries. Monte Carlo simulations showed a correlation of 0.998, a good replication of population values, indicating minimal noninvariance, or variation. Items “so nervous,” “lack of energy/effortful tasks,” and “tired” were consistently equivalent for intercepts and factor loadings, respectively. However, items “depressed” and “so depressed” consistently differed across study countries (R2 = 0) for intercepts and factor loadings for both items.The K10 scale likely functions equivalently across the four countries for most items, except “depressed” and “so depressed.” Differences in K10 items were more common in Kenya and Ethiopia, suggesting cultural context may influence the interpretation of some items and the potential need for cultural adaptations in these countries