Oral Cannabidiol Use in Children With Autism Spectrum Disorder to Treat Related Symptoms and Co-morbidities

Objective: Children with autism spectrum disorder (ASD) commonly exhibit comorbid symptoms such as aggression, hyperactivity and anxiety. Several studies are being conducted worldwide on cannabidiol use in ASD; however, these studies are still ongoing, and data on the effects of its use is very limited. In this study we aimed to report the experience of parents who administer, under supervision, oral cannabinoids to their children with ASD.Methods: After obtaining a license from the Israeli Ministry of Health, parents of children with ASD were instructed by a nurse practitioner how to administer oral drops of cannabidiol oil. Information on comorbid symptoms and safety was prospectively recorded biweekly during follow-up interviews. An independent group of specialists analyzed these data for changes in ASD symptoms and drug safety.Results: 53 children at a median age of 11 (4–22) year received cannabidiol for a median duration of 66 days (30–588). Self-injury and rage attacks (n = 34) improved in 67.6% and worsened in 8.8%. Hyperactivity symptoms (n = 38) improved in 68.4%, did not change in 28.9% and worsened in 2.6%. Sleep problems (n = 21) improved in 71.4% and worsened in 4.7%. Anxiety (n = 17) improved in 47.1% and worsened in 23.5%. Adverse effects, mostly somnolence and change in appetite were mild.Conclusion: Parents’ reports suggest that cannabidiol may improve ASD comorbidity symptoms; however, the long-term effects should be evaluated in large scale studies

Sense of Agency in Clinical High Risk for Psychosis and Psychopathology

This project examines how clinical high risk for psychosis and general psychopathology affect Sense of Agency (SoA) in clinical and general populations. The project uses an VR-based experimental paradigm to assess SoA and semi-structured clinical interviews to assess the participants’ clinical state, attenuated psychotic symptoms and basic self-disturbances. To assess SoA, we use immersive VR to insert a delay in visual feedback of motor action and assess participants' sensitivity to these changes, thus assessing embodied SoA. The experimental paradigm will be administered to three groups: Healthy Controls (HC), individuals at Clinical High Risk (CHR) for psychosis, and Clinical Controls (CC) individuals who suffer from a psychopathology yet do not exhibit attenuated psychotic symptoms. The study's main hypothesis is that impaired SoA and its metacognition are associated with increased attenuated psychotic symptoms. In addition we will examine whether this impairment is unique to psychotic symptoms or general psychopathology. Finally, an exploratory analysis examines how anticipation of performance assessment affects SoA across participants and clinical groups

The scope and nature of prolonged social withdrawal in Israel:An initial quantitative and qualitative investigation

OBJECTIVE: Over the past few decades, prolonged social withdrawal (PSW) among young people has been recognized in several countries. Most research has been quantitative and focused on the characteristics of PSW individuals and their families. Little attention has been given to the valuable perspective of professionals providing service to this population. The purpose of the present study is to identify the characteristics of PSW in Israel, where this phenomenon has not been researched yet. For this initial investigation, the study will utilize a combination of quantitative self-report data from parents of PSW individuals, as well as qualitative data gathered from interviews with mental health professionals who work with this population. METHODS: Quantitative data were derived from records of referrals by parents of 121 PSW individuals, and later categorized into apparent characteristics of PSW. Qualitative data was collected through semi-structured interviews conducted with 19 professionals experienced in treating PSW, and later analyzed in a thematic analysis process. RESULTS: Findings from the quantitative data revealed a majority of males (70%) with an average age of 24.2, with previously diagnosed psychiatric conditions (64%). Findings from the qualitative data exposed frequently reported characteristics of PSW individuals and their families, out of which five themes emerged: Family Dynamics, Psychological Characteristics, Typical Behaviors, Past Difficulties, and Present Challenges. CONCLUSION: This study is the first to identify and report characteristics of PSW in Israel, which are consistent with previous research reported in other countries. The study is highlighting familial characteristics as well as individual ones, while also considering the broader socio-cultural context. These findings draw attention to the importance of notifying the general public, clinicians, researchers, and policymakers in Israel and beyond to the concerning problem of PSW, while contributing to the efforts to develop a map of this barely explored territory

First-hand reports of prolonged social withdrawal:contributing factors, experiences, and change processes

Abstract Purpose – The purpose of this study is to gain deeper understanding of the experience of PSW and pathways to recover. Prolonged social withdrawal (PSW) among young people has been widely reported; however, the voice of those who withdraw is rarely heard. Illuminating these firsthand experiences is important as the phenomenon becomes widespread, calling for increased attention and creative solutions to promote recovery processes and re-inclusion in society. Design/methodology/approach – This study conducted nine in-depth semi-structured interviews with young people who have been reclusive for 2–19 years and inquired about their perspectives and experiences around times of PSW and beyond. These data were analyzed and categorized according to three main areas: factors contributing to PSW, subjective experiences and general functioning during PSW and processes involved in coming out of PSW. This study presents the main findings and illustrates them using a case of a young man in PSW for 19 years. Findings – The findings reveal that young people may turn to social withdrawal in response to varied personal and familial challenges, and often experience intense loneliness and psychic pain. Attempts to cope and recover from withdrawal involve inner motivation combined with support from significant others and a strong therapeutic alliance with professionals. Originality/value – To the best of the authors’ knowledge, this is the first study to report findings from in-depth interviews with people who spent very long periods in PSW, and accordingly it contributes to the growing body of knowledge on this phenomenon. Based on this unique firsthand perspective, the authors propose potential guidelines for caregivers and mental health professionals trying to help people in PSW to reintegrate into society

Disturbances of the Basic Self and Prodromal Symptoms Among Young Adolescents From the Community:A Pilot Population-Based Study

BACKGROUND AND GOAL: Recent findings have provided preliminary support for the notion that basic self-disturbances (SD) are related to prodromal symptoms among nonpsychotic help-seeking adolescents. As a sizable proportion of adolescents who are at risk do not seek help, this study attempts to assess the extent to which these findings can be generalized to the entire population of adolescents who are at risk for psychosis. METHOD: The concurrent relationship between SD and prodromal symptoms was explored in a sample of 100 non-help-seeking adolescents (age 13–15) from the community. SD were assessed with the Examination of Anomalous Self-Experience (EASE); prodromal symptoms and syndromes were assessed with the Structured Interview for Prodromal Syndromes (SIPS); psychosocial functioning was assessed with the “Social and Role Global Functioning Scales”; and level of distress with the Mood and Anxiety States Questionnaire (MASQ). RESULTS: SD significantly correlated with sub-clinical psychotic symptoms (r = .70, P < .0001). This correlation was significantly stronger than those of SD with mood symptoms and social functioning. Finally, SD was the single best concurrent predictor of prodromal symptoms and syndromes. CONCLUSIONS: These results provide preliminary support for the generalizability of the association between SD and prodromal symptoms for the entire population of adolescents who are clinically at high risk for psychosis. In addition, they further support the notion that this association is both specific and unique

Assessing the Relationship between Sense of Agency, the Bodily-Self and Stress: Four Virtual-Reality Experiments in Healthy Individuals

The bodily-self, our experience of being a body, arises from the interaction of several processes. For example, embodied Sense of Agency (SoA), the feeling of controlling our body&rsquo;s actions, is a fundamental facet of the bodily-self. SoA is disturbed in psychosis, with stress promoting its inception. However, there is little knowledge regarding the relationship between SoA, stress, and other facets of the bodily-self. In four experiments manipulating embodied SoA using a virtual hand (VH), we examined (1) How is embodied SoA related to other facets of the bodily-self?; and (2) How is SoA impacted by stress? We found that increased alteration of the VH significantly decreased subjective ratings of SoA and body ownership (Exp. 1), supporting the close relation between SoA and body ownership. Interoceptive accuracy and SoA were positively correlated (Exp. 3), connecting awareness to one&rsquo;s actions and cardiac signals. Contrary to our expectations, SoA was not related to trait anxiety (Exp. 3), nor did induced stress impair SoA (Exp. 4). Finally, we found a negative correlation between self-reported prodromal symptoms and SoA. These results strongly support the connection between SoA and the bodily-self. Whereas, SoA was not impaired by stress, and weakly related to psychotic symptoms

The Dynamic Boundaries of The Self: Serial Dependence In Embodied Sense of Agency

The feeling of control over one’s actions, termed the Sense of Agency (SoA), delineates one’s experience as an embodied self. Although, this embodied experience is typically perceived as stable over time, recent theoretical accounts highlight the experience-dependent and dynamic nature of the embodied self. In this study we examined how recent experiences modulate SoA (i.e., serial dependence), and disambiguated the unique contributions of previous stimuli and choices on subsequent SoA judgments. In addition, we examined whether these effects persist across different domains of perceptual alteration. We analyzed two independent datasets of the Virtual Hand (VH) task (N = 100 participants) in which a sensorimotor conflict is introduced between the presented visual feedback and the actual movement performed. In Dataset 1, which included only temporal alterations, we found that previous stimuli recalibrate current perception, increasing the likelihood of the current choice to be different than the previous choice. Whereas previous choices induce a repetition bias increasing the likelihood to repeat choices across trials. Thus, previous external stimuli and self-generated choices exert opposing influences on SoA. We replicated these findings in Dataset 2, in which the VH task was tested with alterations in both temporal and spatial domains. In addition, we discovered that previous stimuli from a different perceptual domain exert a recalibration effect similar to stimuli from the same domain. Thus, SoA is constantly shaped by our previous subjective choices and objective stimuli experienced even across different perceptual domains. This highlights how SoA may act as unifying construct organizing our experience of the self over time and across perceptual experiences