Cognitive behavior therapy for autistic adolescents, awareness and care for my autistic traits program: a multicenter randomized controlled trial

BACKGROUND: Autistic people demonstrate focused interests, sensitivity to sensory stimulation, and, compared with the general population, differences in social communication and interaction. We examined whether a combination of the Awareness and Care for My Autistic Traits (ACAT) program and treatment-as-usual is more effective than only treatment-as-usual in increasing the understanding of autistic attributes, reducing treatment stigma, and improving mental health and social adaptation among autistic adolescents and their parents/guardians. METHODS: Forty-nine adolescents and their parents/guardians were randomly assigned to either a combination of ACAT and treatment-as-usual or only treatment-as-usual. The combined group received six weekly 100-minute ACAT sessions, while the treatment-as-usual group received no additional intervention. The primary outcome was the change in understanding of autistic attributes (Autism Knowledge Quiz-Child), administered from pre- to post-intervention. The secondary outcomes included the change in Autism Knowledge Quiz-Parent, reduced treatment stigma, and improved mental health and social adaptation among autistic adolescents and their parents/guardians. A primary outcome measure scale was scored by assessors who were blind to the group assignment. RESULTS: The combined group (both autistic adolescents and their parents/guardians) showed an increase in Autism Knowledge Quiz scores compared to those in the treatment-as-usual group. Autistic adolescents in the combined group also demonstrated a decrease in treatment-related stigma and an improvement in general mental health compared to those in the treatment-as-usual group, while there were no group differences in the change in social adaptation. For parents/guardians, there were no group differences in the change in treatment-related stigma, general mental health, adaptive skills, or attitudes toward their children. CONCLUSIONS: The ACAT program could be an effective treatment modality to increase the understanding of autistic attributes among both autistic adolescents and their parents/guardians. The ACAT program positively affects self-understanding, reduces treatment stigma, and stabilizes behavioral issues for autistic adolescents as a part of mental health measures, but it does not effectively reduce treatment barriers or improve mental health for parents/guardians. Further research should consider whether additional support for parents/guardians could be beneficial. TRIAL REGISTRATION: The study was registered in UMIN (UMIN000029851, 06/01/2018)

Methyl donor-deficient diet during development can affect fear and anxiety in adulthood in C57BL/6J mice.

DNA methylation is one of the essential factors in the control of gene expression. Folic acid, methionine and choline (methyl donors)--all nutrients related to one-carbon metabolism--are known as important mediators of DNA methylation. A previous study has shown that long-term administration of a diet lacking in methyl donors caused global DNA hypermethylation in the brain (Pogribny et al., 2008). However, no study has investigated the effects of a diet lacking in methyl donors during the developmental period on emotional behaviors such as fear and anxiety-like behavior in association with gene expressions in the brain. In addition, it has not been elucidated whether a diet supplemented with methyl donors later in life can reverse these changes. Therefore, we examined the effects of methyl donor deficiency during the developmental period on fear memory acquisition/extinction and anxiety-like behavior, and the relevant gene expressions in the hippocampus in juvenile (6-wk) and adult (12-wk) mice. We found that juvenile mice fed a methyl-donor-deficient diet had impaired fear memory acquisition along with decreases in the gene expressions of Dnmt3a and Dnmt3b. In addition, reduced anxiety-like behavior with decreased gene expressions of Grin2b and Gabar2 was observed in both the methyl-donor-deficient group and the body-weight-matched food-restriction group. After being fed a diet supplemented with methyl donors ad libitum, adult mice reversed the alteration of gene expression of Dnmt3a, Dnmt3b, Grin2b and Gabar2, but anxiety-like behavior became elevated. In addition, impaired fear-memory formation was observed in the adult mice fed the methyl-donor-deficient diet during the developmental period. Our study suggested that developmental alterations in the one-carbon metabolic pathway in the brain could have effects on emotional behavior and memory formation that last into adulthood

Changes in self-regulation-related prefrontal activities in eating disorders: a near infrared spectroscopy study.

OBJECTIVE: The aim of this study is to clarify the symptomatology of the eating disorders examining the prefrontal function and activity associated with self-regulation among participants with or without eating disorders. METHODS: Ten patients with anorexia nervosa, fourteen with bulimia nervosa, and fourteen healthy control participants performed two cognitive tasks assessing self-regulatory functions, an auditorily distracted word fluency task and a rock-paper-scissors task under the measurements on prefrontal oxyhemoglobin concentration with near infrared spectroscopy. The psychiatric symptoms of patient groups were assessed with several questionnaires. RESULTS: Patients with bulimia nervosa showed decreased performances and prefrontal hyper activation patterns. Prefrontal activities showed a moderate negative correlation with task performances not in the patient groups but only in the healthy participants. The prefrontal activities of the patient groups showed positive correlations with some symptom scale aspects. CONCLUSIONS: The decreased cognitive abilities and characteristic prefrontal activation patterns associated with self-regulatory functions were shown in patients with bulimia nervosa, which correlated with their symptoms. These findings suggest inefficient prefrontal self-regulatory function of bulimia nervosa that associate with its symptoms

Measurement of work-related psychological injury with depressive symptoms

Abstract Objective This study aimed to measure the level of psychological injury caused by work-related stress as well as the severity of depression among workers. Method First, we conducted an online survey and recruited 500 workers diagnosed with depression or adjustment disorder to investigate what type of stress they experienced within six months before onset. Second, we conducted another online survey and recruited 767 participants who experienced some form of work-related stress. All the participants were classified into four groups by whether or not they were diagnosed with depression and whether or not they quit their jobs due to work-related stress. We used the Impact of Event Scale-Revised (IES-R) to measure psychological injury caused by work-related stressful events and the Patient Health Questionnaire (PHQ)-9 to assess the severity of depression. Results In study 1, 62.4% of workers diagnosed with depression or adjustment disorder experienced work-related stress within six months before onset. In study 2, the IES-R mean scores were 40.7 (SD = 23.1) for Group A (workers with depression and quit their jobs) and 36.67 (SD = 23.4) for Group B (workers with depression but stayed at their jobs), with both exceeding the cut-off point (24/25) of PTSD (Post-Traumatic Stress Disorder), while the mean score of Group C (workers who did not have depression but quit their jobs because of work-related stress) was 20.74 (SD = 21.2), and it was 13.89 (SD = 17.4) for Group D (workers who had work-related stress but stayed at their jobs), with both of them below the cut-off point of PTSD. The total scores of IES-R of Group A and Group B were significantly higher than those of Group C and Group D(p < 0.001). There was a significant positive correlation between the scores of IES-R and PHQ-9 for all four groups (r = 0.708). Conclusions This study suggests that it is necessary to measure not only depressive symptoms but also the level of psychological injury resulting from stressful events in the workplace to assess workers with depression

Comparison of brain activity between motor imagery and mental rotation of the hand tasks: a functional magnetic resonance imaging study

Motor imagery (MI) has been considered effective in learning and practicing movements in many fields. However, when evaluating the effectiveness of this technique, the examiner has no way of assessing the participant\u27s motor imagery process. As an alternative, we have been exploring a mental body-part rotation task, in which the examiner can estimate the participant\u27s motivation and ability to sustain attention through the scored results. In this study, we aimed to investigate the possible application of a mental rotation (MRot) task and used fMRI to compare the brain activity during the MRot task with that during an MI task in healthy volunteers. Increased blood oxygenation level-dependent signals were observed bilaterally in the premotor areas and supplementary motor area during performance of both MI and MRot tasks. Our findings suggest that MRot could be an alternative to MI

The effects of FMCD on locomotor activity and anxiety-like and risk-assessment behavior.

<p>(A) Locomotor activity during elevated plus maze in juvenile mice (Control, n = 10; FMCD, n = 9; FR, n = 8). (B) Anxiety-like behavior during elevated plus maze in juvenile mice. (C) Risk-assessment behavior during elevated plus maze in juvenile mice. (D) Locomotor activity during elevated plus maze in adult mice (Control, n = 9; FMCD, n = 8; FR, n = 8). (E) Anxiety-like behavior during elevated plus maze in adult mice. (F) Data on risk assessment behavior during elevated plus maze in adult mice. The data represent the means ± SEMs. * and ** indicate <i>p</i><0.05 and <i>p</i><0.01, respectively, Control vs. FMCD.</p

The effects of FMCD on gene expressions in the dorsal hippocampus in juvenile mice.

<p>(A) Gene expressions of <i>Grin1</i>, <i>Grin2a</i> and <i>Grin2b</i> (Control, n = 5; FMCD, n = 5; FR, n = 5). (B) Gene expressions of <i>Gabra1</i>, <i>Gabra2</i> and <i>Gabra3</i> (Control, n = 5; FMCD, n = 5; FR, n = 5). The data represent the means ± SEMs. * and ** indicate <i>p</i><0.05 and <i>p</i><0.01, respectively, Control vs. FMCD. # and ## indicate <i>p</i><0.05 and <i>p</i><0.01, respectively, Control vs. FR.</p

The effects of FMCD on contextual fear conditioning and memory test.

<p>(A) %Freezing during contextual fear conditioning in juvenile mice (Control, n = 10; FMCD, n = 10; FR, n = 10). (B) %Freezing during memory test in juvenile mice. (C) %Freezing during contextual fear conditioning in adult mice (Control, n = 9; FMCD, n = 10; FR, n = 10). (D) %Freezing during memory test in adult mice. The data represent the means ± SEMs. * and ** indicate <i>p</i><0.05 and <i>p</i><0.01, respectively, Control vs. FMCD. ## indicates <i>p</i><0.01, Control vs. FR. † and †† indicate <i>p</i><0.05 and p<0.01, respectively, FMCD vs. FR.</p

The effects of FMCD on the expression of DNA methyltransferases.

<p>Expressions of (A) <i>Dnmt1</i>, (B) <i>Dnmt3a and</i> (C) <i>Dnmt3b</i> in the dorsal hippocampus in juvenile (left) and adult mice (right). The data represent the means ± SEMs (Control, n = 5; FMCD, n = 5; FR, n = 5). * and ** indicate <i>p</i><0.05 and <i>p</i><0.01, respectively, Control vs. FMCD.</p