Effects of transcranial direct current stimulation in children and young people with psychiatric disorders: a systematic review.

Transcranial direct current stimulation (tDCS) has demonstrated benefits in adults with various psychiatric disorders, but its clinical utility in children and young people (CYP) remains unclear. This PRISMA systematic review used published and ongoing studies to examine the effects of tDCS on disorder-specific symptoms, mood and neurocognition in CYP with psychiatric disorders. We searched Medline via PubMed, Embase, PsychINFO via OVID, and Clinicaltrials.gov up to December 2022. Eligible studies involved multiple session (i.e., treatment) tDCS in CYP (≤ 25 years old) with psychiatric disorders. Two independent raters assessed the eligibility of studies and extracted data using a custom-built form. Of 33 eligible studies (participant N = 517), the majority (n = 27) reported an improvement in at least one outcome measure of disorder-specific symptoms. Few studies (n = 13) examined tDCS effects on mood and/or neurocognition, but findings were mainly positive. Overall, tDCS was well tolerated with minimal side effects. Of 11 eligible ongoing studies, many are sham-controlled RCTs (n = 9) with better blinding techniques and a larger estimated participant enrolment (M = 79.7; range 15-172) than published studies. Although encouraging, the evidence to date is insufficient to firmly conclude that tDCS can improve clinical symptoms, mood, or cognition in CYP with psychiatric disorders. Ongoing studies appear of improved methodological quality; however, future studies should broaden outcome measures to more comprehensively assess the effects of tDCS and develop dosage guidance (i.e., treatment regimens). [Abstract copyright: © 2023. The Author(s).

Effects of Education and Media Framing on Genetic Knowledge and Attitudes

Genetic education is paramount to continued genetic advances, as well as for beneficial use of the outcomes of such advances. However, a large body of literature suggests that the public’s genetic literacy remains inadequate. Previous research has found a positive relationship between educational level and genetic literacy. The current research explores this in 2 samples of UK students: school (A-Level) and undergraduates. A between groups ANOVA revealed a significant difference in genetic literacy scores between the educational levels. The current study further explored genetic literacy of Psychology undergraduates, as psychologists are likely to play a key role in the genomic era, for example contributing to genomic research and providing genetic counselling. Results revealed low genetic literacy in Psychology undergraduate students, highlighting the need for genetic education improvements. To this end, experimental manipulations were conducted to investigate the effects of media framing and feedback on views of genetic determinism and knowledge calibration. A between groups ANOVA showed no significant difference between high and low determinism media framing. The knowledge calibration findings suggested that participants were underconfident in their genetic knowledge. No correlation was found between knowledge and perceived knowledge (confidence) in the group of participants who received feedback. In contrast, a positive correlation between knowledge and confidence was found in the no-feedback condition. Future research is needed to build on these findings

Treatment response in child anxiety is differentially related to the form of maternal anxiety disorder

An examination was made of the extent to which maternal anxiety predicted response to treatment of children presenting with an anxiety disorder. In a sample of 55 children referred to a local NHS CAMH service for treatment of an anxiety disorder, systematic mental state interview assessment was made of both mothers and children, and both completed self-report questionnaires to assess aspects of anxiety, both immediately before the children received treatment and following treatment. Children of mothers with anxiety disorder overall responded less well to treatment than children of mothers with no anxiety disorder. There was some diagnostic specificity in this in that children of mothers with GAD did as well in treatment as children whose mothers had no anxiety, whereas children of mothers with social phobia did poorly. The outcome for children with anxiety appears to be related to the presence and nature of maternal anxiety. It would seem prudent that treatment of children with anxiety involves assessment of maternal anxiety. It is important to establish in systematic investigation whether treatment of maternal anxiety improves the outcome for child anxiety

A randomised controlled feasibility trial of intermittent theta burst stimulation with an open longer-term follow-up for young people with persistent anorexia nervosa (RaISE):Study protocol

OBJECTIVE: We present the protocol of a feasibility randomised controlled trial (RCT) of intermittent theta burst stimulation (iTBS) for young people with anorexia nervosa (AN). Effective first-line psychological therapies exist for young people with AN, but little is known about how to treat those who do not respond. Non-invasive neuromodulation, such as iTBS, could address unmet treatment needs by targeting neurocircuitry associated with the development and/or maintenance of AN.DESIGN: Sixty-six young people (aged 13-30 years) with persistent AN will be randomly allocated to receive 20 sessions of real or sham iTBS over the left dorsolateral prefrontal cortex in addition to their usual treatment. Outcomes will be measured at baseline, post-treatment (1-month post-randomisation) and 4-months post-randomisation (when unblinding will occur). Additional open follow-ups will be conducted at 12- and 24-months post-randomisation. The primary feasibility outcome is the proportion of participants retained in the study at 4-months. Secondary outcomes include AN symptomatology, other psychopathology, quality of life, service utilisation, neurocognitive processes, and neuroimaging measures.DISCUSSION: Findings will inform the development of a future large-scale RCT. They will also provide exploratory data on treatment efficacy, and neural and neurocognitive predictors and correlates of treatment response to iTBS in AN.</p

Characterising illness stages and recovery trajectories of eating disorders in young people via remote measurement technology (STORY):A multi-centre prospective cohort study protocol

Background: Eating disorders (EDs) are serious, often chronic, conditions associated with pronounced morbidity, mortality, and dysfunction increasingly affecting young people worldwide. Illness progression, stages and recovery trajectories of EDs are still poorly characterised. The STORY study dynamically and longitudinally assesses young people with different EDs (restricting; bingeing/bulimic presentations) and illness durations (earlier; later stages) compared to healthy controls. Remote measurement technology (RMT) with active and passive sensing is used to advance understanding of the heterogeneity of earlier and more progressed clinical presentations and predictors of recovery or relapse. Methods: STORY follows 720 young people aged 16–25 with EDs and 120 healthy controls for 12 months. Online self-report questionnaires regularly assess ED symptoms, psychiatric comorbidities, quality of life, and socioeconomic environment. Additional ongoing monitoring using multi-parametric RMT via smartphones and wearable smart rings (‘Ōura ring’) unobtrusively measures individuals’ daily behaviour and physiology (e.g., Bluetooth connections, sleep, autonomic arousal). A subgroup of participants completes additional in-person cognitive and neuroimaging assessments at study-baseline and after 12 months. Discussion: By leveraging these large-scale longitudinal data from participants across ED diagnoses and illness durations, the STORY study seeks to elucidate potential biopsychosocial predictors of outcome, their interplay with developmental and socioemotional changes, and barriers and facilitators of recovery. STORY holds the promise of providing actionable findings that can be translated into clinical practice by informing the development of both early intervention and personalised treatment that is tailored to illness stage and individual circumstances, ultimately disrupting the long-term burden of EDs on individuals and their families.</p

Primate social cognition: uniquely primate, uniquely social, or just unique?

Primates undoubtedly have impressive abilities in perceiving, recognising, understanding and interpreting other individuals, their ranks and relationships; they learn rapidly in social situations, employ both deceptive and cooperative tactics to manipulate companions, and distinguish others’ knowledge from ignorance. Some evidence suggests that great apes recognize the cognitive basis of manipulative tactics and have a deeper appreciation of intention and cooperation than monkeys; and only great apes among primates show any understanding of the concept of self. None of these abilities is unique to primates, however. We distinguish (1) a package of quantitative advantages in social sophistication, evident in several broad mammalian taxa, in which neocortical enlargement is associated with social group size; from (2) a qualitative difference in understanding found in several distantly related but large-brained species, including great apes, some corvids, and perhaps elephants, dolphins, and domestic dogs. Convergence of similar abilities in widely divergent taxa should enable their cognitive basis and evolutionary origins to be determined. Cortical enlargement seems to have been evolutionarily selected by social challenges, although it confers intellectual benefits in other domains also; most likely the mechanism is more efficient memory. The taxonomic distribution of qualitatively special social skills does not point to an evolutionary origin in social challenges, and may be more closely linked to a need to acquire novel ways of dealing with the physical world; but at present research on this question remains in its infancy. In the case of great apes, their ability to learn new manual routines by parsing action components may also account for their qualitatively different social skills, suggesting that any strict partition of physical and social cognition is likely to be misleading