The relationship between childhood trauma and Internet gaming disorder among college students: A structural equation model

open access journalBackground The aim of this study was to investigate the mechanisms of Internet gaming disorder (IGD) and the associated interaction effects of childhood trauma, depression and anxiety in college students. Methods Participants were enrolled full-time as freshmen at a University in the Hunan province, China. All participants reported their socio-demographic characteristics and undertook a standardized assessment on childhood trauma, anxiety, depression and IGD. The effect of childhood trauma on university students' internet gaming behaviour mediated by anxiety and depression was analysed using structural equation modelling (SEM) using R 3.6.1. Results In total, 922 freshmen participated in the study, with an approximately even male-to-female ratio. A mediation model with anxiety and depression as the mediators between childhood trauma and internet gaming behaviour allowing anxiety and depression to be correlated was tested using SEM. The SEM analysis revealed that a standardised total effect of childhood trauma on Internet gaming was 0.18, (Z = 5.60, 95% CI [0.02, 0.05], P < 0.001), with the direct effects of childhood trauma on Internet gaming being 0.11 (Z = 3.41, 95% CI [0.01, 0.03], P = 0.001), and the indirect effects being 0.02 (Z = 2.32, 95% CI [0.00, 0.01], P = 0.020) in the pathway of childhood trauma-depression-internet gaming; and 0.05 (Z = 3.67, 95% CI [0.00, 0.02], P < 0.001) in the pathway of childhood trauma-anxiety-Internet gaming. In addition, the two mediators anxiety and depression were significantly correlated (r = 0.50, Z = 13.54, 95% CI [3.50, 5.05], P < 0.001). Conclusions The study revealed that childhood trauma had a significant impact on adolescents' Internet gaming behaviours among college students. Anxiety and depression both significantly mediated the relationship between childhood trauma and internet gaming and augmented its negative influence. Discussion of the need to understand the subtypes of childhood traumatic experience in relationship to addictive behaviours is included

Neural responses to facial emotions and subsequent clinical outcomes in difficult-to-treat depression

Background: Amygdala and dorsal anterior cingulate cortex responses to facial emotions have shown promise in predicting treatment response in medication-free major depressive disorder (MDD). Here, we examined their role in the pathophysiology of clinical outcomes in more chronic, difficult-to-treat forms of MDD.Methods: Forty-five people with current MDD who had not responded to ≥2 serotonergic antidepressants (n=42, meeting pre-defined fMRI minimum quality thresholds) were enrolled and followed up over four months of standard primary care. Prior to medication review, subliminal facial emotion fMRI was used to extract blood-oxygen level-dependent effects for sad vs. happy faces from two pre-registered a priori defined regions: bilateral amygdala and dorsal/pregenual anterior cingulate cortex. Clinical outcome was the percentage change on the self-reported Quick Inventory of Depressive Symptomatology (16-item).Results: We corroborated our pre-registered hypothesis (NCT04342299) that lower bilateral amygdala activation for sad vs. happy faces predicted favourable clinical outcomes (rs[38]=.40, p=.01). In contrast, there was no effect for dorsal/pregenual anterior cingulate cortex activation (rs[38]=.18, p=.29), nor when using voxel-based whole-brain analyses (voxel-based Family-Wise Error-corrected p&lt;.05). Predictive effects were mainly driven by the right amygdala whose response to happy faces was reduced in patients with higher anxiety levels.Conclusions: We confirmed the prediction that a lower amygdala response to negative vs. positive facial expressions might be an adaptive neural signature, which predicts subsequent symptom improvement also in difficult-to-treat MDD. Anxiety reduced adaptive amygdala responses

Self-blame-selective hyper-connectivity between anterior temporal and subgenual cortices predicts prognosis in major depressive disorder

Background: Self-blame-related fMRI measures were shown to predict subsequent recurrence in remitted major depressive disorder (MDD). Their role in current MDD, however, is unknown. We hypothesised that these neural signatures reflect a highly recurrent but remitting course of MDD and therefore predict favourable outcomes over a four-month follow-up period in current MDD. Methods: Forty-five participants with current MDD and non-responders to at least two serotonergic antidepressants, were encouraged to optimise their medication and followed up after receiving four months of primary care treatment-as-usual. Prior to their medication review, participants completed an fMRI paradigm in which they viewed self- and other-blame emotion-evoking statements. Thirty-nine participants met pre-defined fMRI data minimum quality thresholds. Psychophysiological interaction analysis was used to determine baseline connectivity of the right superior anterior temporal lobe (RSATL), with an a priori BA25 region-of-interest for self-blaming vs other-blaming emotions, using Quick Inventory of Depressive Symptomatology (16-item) percentage change as a covariate. Results: We corroborated our pre-registered hypothesis that a favourable clinical outcome was associated with higher self-blame-selective RSATL-BA25 connectivity (Family-Wise Error-corrected p <.05 over the a priori BA25 region-of-interest; rs(34) = −0.47, p =.005). This generalised to the sample including participants with suboptimal fMRI quality (rs(39) = −0.32, p =.05). Conclusions: This study shows that neural signatures of overgeneralised self-blame are relevant for prognostic stratification of current treatment-resistant MDD. Future studies need to confirm whether this neural signature indeed represents a trait-like feature of a fully remitting subtype of MDD, or whether it is also modulated by depressive state and related to treatment effects