Web-based Self-help for Preventing Mental Health Problems in Universities: Comparing Acceptance and Commitment Training to Mental Health Education

OBJECTIVE: This study sought to test the feasibility of a web-based Acceptance and Commitment Training (ACT) prototype prevention program called ACT on College Life (ACT-CL). METHOD: A sample of 234 university students was randomized to either the ACT-CL website or a mental health education (MHE) website. RESULTS: Findings indicated a lower level of user engagement and satisfaction ratings with the prototype of ACT-CL than the MHE website. There were no significant differences between conditions on outcome measures at post or follow-up. However, statistical trends suggested the MHE condition actually led to greater remission of severe symptoms than the ACT-CL condition among those with severe symptoms at baseline. There were no differences between conditions on ACT process of change measures. Changes in psychological flexibility were predictive of changes in mental health across conditions, but relations dissipated over time. Furthermore, greater engagement in some components of ACT-CL predicted improvements in psychological flexibility, though not on mental health outcomes. CONCLUSIONS: The effects of the ACT-CL program on mental health outcomes and ACT process measures were largely equivalent to those of an education website, although there was a lower level of program engagement with ACT-CL. Findings are discussed in the context of feasibility issues and lessons learned for program revisions

Comorbidity Between Major Depression and Alcohol Use Disorder From Adolescence to Adulthood

Background—Limited information exists regarding the long-term development of comorbidity between Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD; abuse/dependence). Using a representative prospective study, we examine multiple aspects pertaining to MDD+AUD comorbidity, with a focus on the relation between disorders across periods (adolescence, early adulthood, adulthood) and cumulative impairments by age 30. Method—816 participants were diagnostically interviewed at ages 16, 17, 24, and 30. Results—Rates of comorbid MDD+AUD were low in adolescence (2%), but increased in early adulthood (10%) and adulthood (7%). Rates of cumulative comorbidity were elevated (21%). Most individuals with a history of MDD or AUD had the other disorder, except for women with MDD. Prospectively, adolescent AUD predicted early adult MDD, while early adult MDD predicted adult AUD. Compared to pure disorders, MDD+AUD was associated with higher risk of alcohol dependence, suicide attempt, lower global functioning, and life dissatisfaction. Conclusions—Lifetime rates of comorbid MDD+AUD were considerably higher than in crosssectional studies. Comorbidity was partly explained by bidirectional and developmentally-specific associations and predicted selected rather than generalized impairments. Clinically, our findings emphasize the need to always carefully assess comorbidity in patients with MDD or AUD, taking into account concurrency and developmental timing

Adolescent suicide attempts and adult adjustment

Background: Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were asso- ciated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (objective 1) and whether these impairments were better accounted for by concurrent adolescent confounders (objective 2). Method: Eight hundred and sixteen adolescents were assessed using interviews and question- naires at four time points from adolescence to adulthood. We examined whether lifetime suicide attempts in adolescence (by T2, mean age 17) predicted adult out- comes (by T4, mean age 30) using linear and logistic regressions in unadjusted models (objective 1) and adjusting for sociodemographic background, adolescent psychopathology, and family risk factors (objective 2). Results: In unadjusted analyses, adolescent suicide attempts predicted poorer adjustment on all outcomes, except those related to social role status. After adjustment, adolescent attempts remained predictive of axis I and II psychopathology (anxiety disorder, antisocial and borderline personality disorder symptoms), global and social adjustment, risky sex, and psychiatric treatment utilization. However, adolescent attempts no longer predicted most adult outcomes, notably suicide attempts and major depressive disorder. Secondary analyses indicated that associations did not differ by sex and attempt characteristics (intent, lethality, recurrence). Conclusions: Adolescent suicide attempters are at high risk of protracted and wide-ranging im- pairments, regardless of the characteristics of their attempt. Although attempts specifically predict (and possibly influence) several outcomes, results suggest that most impairments reflect the confounding contributions of other individual and family problems or vulnerabilites in adolescent attempters

Examining psychological inflexibility as a transdiagnostic process across psychological disorders

The current cross-sectional study examined psychological inflexibility, a process in which behavior is rigidly guided by psychological reactions rather than direct contingencies or personal values, as a transdiagnostic process relevant to a range of depressive, anxiety, substance use and eating disorders. A sample of 972 first-year college students between 17 and 20 years of age completed self-report measures of psychological inflexibility and psychological distress as well as a structured diagnostic interview. Psychological inflexibility was significantly higher across a range of current and lifetime depressive and anxiety disorders as well as lifetime history of eating disorders, relative to students with no disorder, even after controlling for general psychological distress. Findings were mixed for substance use disorders, with a more consistent pattern for lifetime history than for current disorders. Psychological inflexibility was also related to having comorbid depressive, anxiety, and substance use disorders relative to only having one of these diagnoses. Results are discussed in relation to research on psychological inflexibility as a transdiagnostic pathological process and target for interventions

Recombinant Incretin-Secreting Microbe Improves Metabolic Dysfunction in High-Fat Diet Fed Rodents

peer-reviewedThe gut hormone glucagon-like peptide (GLP)-1 and its analogues represent a new generation of anti-diabetic drugs, which have also demonstrated propensity to modulate host lipid metabolism. Despite this, drugs of this nature are currently limited to intramuscular administration routes due to intestinal degradation. The aim of this study was to design a recombinant microbial delivery vector for a GLP-1 analogue and assess the efficacy of the therapeutic in improving host glucose, lipid and cholesterol metabolism in diet induced obese rodents. Diet-induced obese animals received either Lactobacillus paracasei NFBC 338 transformed to express a long-acting analogue of GLP-1 or the isogenic control microbe which solely harbored the pNZ44 plasmid. Short-term GLP-1 microbe intervention in rats reduced serum low-density lipoprotein cholesterol, triglycerides and triglyceride-rich lipoprotein cholesterol substantially. Conversely, extended GLP-1 microbe intervention improved glucose-dependent insulin secretion, glucose metabolism and cholesterol metabolism, compared to the high-fat control group. Interestingly, the microbe significantly attenuated the adiposity associated with the model and altered the serum lipidome, independently of GLP-1 secretion. These data indicate that recombinant incretin-secreting microbes may offer a novel and safe means of managing cholesterol metabolism and diet induced dyslipidaemia, as well as insulin sensitivity in metabolic dysfunction

Negative Life Events and Substance Use Moderate Cognitive Behavioral Adolescent Depression Prevention Intervention

Abstract. Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n ¼ 173) in which adolescents (M age ¼ 15.5, SD ¼ 1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Results imply that high-risk adolescents with either high rates of major life stress or initial substance use may require specialized depression prevention efforts

A comparison of magnetic resonance imaging and neuropsychological examination in the diagnostic distinction of Alzheimer’s disease and behavioral variant frontotemporal dementia

The clinical distinction between Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) remains challenging and largely dependent on the experience of the clinician. This study investigates whether objective machine learning algorithms using supportive neuroimaging and neuropsychological clinical features can aid the distinction between both diseases. Retrospective neuroimaging and neuropsychological data of 166 participants (54 AD; 55 bvFTD; 57 healthy controls) was analyzed via a Naïve Bayes classification model. A subgroup of patients (n = 22) had pathologically-confirmed diagnoses. Results show that a combination of gray matter atrophy and neuropsychological features allowed a correct classification of 61.47% of cases at clinical presentation. More importantly, there was a clear dissociation between imaging and neuropsychological features, with the latter having the greater diagnostic accuracy (respectively 51.38 vs. 62.39%). These findings indicate that, at presentation, machine learning classification of bvFTD and AD is mostly based on cognitive and not imaging features. This clearly highlights the urgent need to develop better biomarkers for both diseases, but also emphasizes the value of machine learning in determining the predictive diagnostic features in neurodegeneration

A Comprehensive Resource for Induced Pluripotent Stem Cells from Patients with Primary Tauopathies.

Primary tauopathies are characterized neuropathologically by inclusions containing abnormal forms of the microtubule-associated protein tau (MAPT) and clinically by diverse neuropsychiatric, cognitive, and motor impairments. Autosomal dominant mutations in the MAPT gene cause heterogeneous forms of frontotemporal lobar degeneration with tauopathy (FTLD-Tau). Common and rare variants in the MAPT gene increase the risk for sporadic FTLD-Tau, including progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). We generated a collection of fibroblasts from 140 MAPT mutation/risk variant carriers, PSP, CBD, and cognitively normal controls; 31 induced pluripotent stem cell (iPSC) lines from MAPT mutation carriers, non-carrier family members, and autopsy-confirmed PSP patients; 33 genome engineered iPSCs that were corrected or mutagenized; and forebrain neural progenitor cells (NPCs). Here, we present a resource of fibroblasts, iPSCs, and NPCs with comprehensive clinical histories that can be accessed by the scientific community for disease modeling and development of novel therapeutics for tauopathies