Psychometric properties of the revised children’s anxiety and depression scale (RCADS) for autistic youth without co-occurring intellectual disability

Autistic youth often present with comorbid anxiety and depression yet there is a dearth of validated assessment tools. The Revised Children’s Anxiety and Depression Scale (RCADS) assesses internalizing symptoms but there is little psychometric data in autistic youth. Treatment-seeking autistic youth with anxiety or obsessive-compulsive symptoms (N = 74; age 6–14 years), and caregivers, were administered the RCADS-Parent, RCADS-Child, and assessments of internalizing, externalizing symptoms and social impairment indicative of autism. RCADS-Parent and RCADS-Child total anxiety scores demonstrated excellent internal consistency, and the six subscales demonstrated acceptable-to-good internal consistency. The RCADS-Child and Parent total anxiety scores were weakly correlated, and neither child age nor gender altered the strength of this association. Convergent validity was supported by moderate-to-strong correlations with clinician and parent-reported anxiety symptoms. Support for divergent validity was mixed. Results provide support for the RCADS-Parent and RCADS-Child as reliable, valid measures of internalizing symptoms in autistic youth

Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study protocol

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but \u3e95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, https://www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5000 richly phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity

Tauroursodeoxycholic Acid Protects against the Effects of P-Cresol-Induced Reactive Oxygen Species via the Expression of Cellular Prion Protein

Mesenchymal stem cells (MSCs) could be a promising solution in the treatment of various diseases including chronic kidney disease (CKD). However, endoplasmic reticulum (ER) stress induced by ischemia in the area of application limits the integration and survival of MSCs in patients. In our study, we generated ER stress-induced conditions in MSCs using P-cresol. As P-cresol is a toxic compound accumulated in the body of CKD patients and induces apoptosis and inflammation through reactive oxygen species (ROS), we observed ER stress-induced MSC apoptosis activated by oxidative stress, which in turn resulted from ROS generation. To overcome stress-induced apoptosis, we investigated the protective effects of tauroursodeoxycholic acid (TUDCA), a bile acid, on ER stress in MSCs. In ER stress, TUDCA treatment of MSCs reduced ER stress-associated protein activation, including GRP78, PERK, eIF2α, ATF4, IRE1α, and CHOP. Next, to explore the protective mechanism adopted by TUDCA, TUDCA-mediated cellular prion protein (PrPC) activation was assessed. We confirmed that PrPC expression significantly increased ROS, which was eliminated by superoxide dismutase and catalase in MSCs. These findings suggest that TUDCA protects from inflammation and apoptosis in ER stress via PrPC expression. Our study demonstrates that TUDCA protects MSCs against inflammation and apoptosis in ER stress by PrPC expression in response to P-cresol exposure

Obsessive-Compulsive Disorder Misdiagnosis among Mental Healthcare Providers in Latin America

Mental healthcare professionals often have limited awareness of different obsessive-compulsive disorder (OCD) symptom presentations, which may contribute to years between OCD symptom onset and treatment initiation. While research has identified high rates of OCD misdiagnosis among clinicians from the United States and Canada, research on OCD symptom awareness among healthcare providers in Latin American (LATAM) regions is limited. In this study, LATAM mental healthcare providers (N = 83) provided diagnostic impressions based on five OCD vignettes: three with symptoms centered on taboo thoughts (sexual, harming others, and religion/scrupulosity) and two about contamination or symmetry obsessions. Rates of incorrect (non-OCD) diagnoses were significantly higher for the taboo thoughts vignettes (sexual, 52.7%; harm/aggression, 42.0%; and religious, 34.7%) vs. contamination obsessions (11.0%) and symmetry obsessions (6.9%). The OCD vignette depicting sexual obsessions was often attributed to a paraphilic disorder (36.5%). Bachelor\u27s level clinicians had significantly lower odds of accurately identifying all three vignettes related to taboo thoughts compared to respondents with a graduate degree. Accurate identification of the three taboo vignettes was also associated with first-line psychological treatment recommendations (i.e., cognitive-behavioral therapy) even when controlling for respondents\u27 theoretical orientation. Exposure was rarely mentioned when clinicians were prompted to provide treatment recommendations for each vignette (8-9% of the time for symmetry and contamination vignettes, 5-7% for taboo though vignettes). Like clinicians in the United States and Canada, mental health professionals in LATAM may misidentify OCD symptom presentations, particularly sexual obsessions, highlighting a need for education and training

Characterizing the psychological distress of treatment-seeking youth and adults impacted by Hurricane Harvey

Hurricane Harvey was one of the most destructive hurricanes in U.S. history, resulting in widespread flooding and property damage in the greater Houston-metropolitan area. This study aims to characterize a group of treatment-seeking youth and adults up to 2.5 years following Hurricane Harvey. A total of 154 children, 165 adolescents, and 531 adults who presented to publicly-funded mental health services were assessed on demographics, depressive and anxiety symptomatology, and hurricane impact. Age, sex, race/ethnicity, family/social support, time since the hurricane, and hurricane impact were examined as correlates of depressive and anxiety symptoms at treatment initiation. Overall, participants presented with elevated depressive and anxiety symptoms to the clinic. Greater hurricane impact was correlated with depressive and anxiety symptoms in adults and adolescents, but not in children. In addition, poorer family/social support was linked to greater anxiety in children and higher depression scores in children and adolescents. Adolescent females had higher anxiety and depression than adolescent males. Days since Harvey and anxiety symptoms were negatively associated for adults. Clinical and research implications for psychological distress in the medium-to-long-term post-natural disaster period are discussed. •Treatment-seeking youth and adults reported elevated depressive and anxiety symptoms up to 30 months after Hurricane Harvey.•Greater diasaster impact was associated with more depressive and anxiety symptoms in adults, but not youth.•Further research is warranted to examine factors that affect individuals who do not recover in the post-acute disaster period

Examining the Effectiveness of the Transdiagnostic Unified Protocol for Emotional Disorders Delivered to Youth Following Hurricane Harvey

BackgroundHurricane Harvey struck southeast Texas in August 2017 resulting in widespread destruction and significant emotional distress.ObjectiveWe examined the effectiveness of a transdiagnostic psychotherapeutic intervention delivered to youth with emotional disorders in a large, community health system following this hurricane.MethodsOne hundred forty-nine youth aged 5 to 17 years with a history of hurricane exposure and emotional difficulties received an average of 6.4 (SD = 3.4) psychotherapy sessions using the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents. Youth-caregiver dyads completed measures of disaster exposure and impact at baseline as well as anxiety and depression at baseline and each therapy session. Symptom severity and level of functioning were rated by the clinician. Latent growth curve modeling was used to examine symptom change over time.ResultsChildren and adolescents began treatment with moderate levels of anxiety and depressive symptoms, symptom severity, and difficulties in daily functioning. Anxiety and depressive symptoms and symptom severity declined significantly over the treatment period. Clinician ratings of functionality evidenced significant improvement over time. Older age was correlated with more depressive symptoms at baseline and superior functioning at baseline with fewer completed treatment sessions.ConclusionIn this naturalistic, community-based effectiveness study we found significant improvement on measures of anxiety, depression, symptom severity, and daily functioning. Findings suggest that a transdiagnostic intervention may be effective for addressing a range of emotional concerns in the aftermath of a natural disaster. These results can be used to inform and refine evidence-based interventions that improve the mental health and wellbeing of disaster-exposed youth