Det biologiske grunnlaget for kognitiv kontroll : en studie med hjernemorfometri, diffusion tensor imaging og error-related negativity

Bakgrunn: Kognitive kontrollfunksjoner involverer vidt distribuerte nevrale nettverk i hjernen. Disse består av differensierte kortikale områder samt fiberbanene som forbinder dem. Det har ikke vært studert hvordan variasjon i kortikal tykkelse og integriteten til underliggende hvitsubstans kan predikere kognitiv funksjon. I denne studien ble hjernemorfometri og hvitsubstansintegritet brukt for å predikere kognitive kontrollfunksjoner, operasjonalisert både ved hjelp av hendelsesrelaterte potensialer (ERP) og nevropsykologiske atferdstester. Metode: En gruppe middelaldrende friske deltakere (n = 105, alder = 40-60 år) gjennomgikk strukturell magnetisk resonanstomografi (MRI), diffusion tensor imaging (DTI), en ERP-oppgave som utløste event-related negativity (ERN) ved gale responser og sju nevropsykologiske tester relatert til tre ulike kontrollfunksjoner: inhibisjon, oppdatering og skifting. ERN-amplityde og skårer på de tre kontrolldimensjonene ble korrelert med kortikal tykkelse og fraksjonell anisotropi (FA) kalkulert fra DTI-opptakene. Resultater: De tre kognitive kontrolldimensjonene viste lave interkorrelasjoner, og ingen korrelasjon med ERN, noe som indikerer at de reflekterer ulike funksjoner. Analyser av sammenhengen mellom mål på kognitiv kontroll og kortikal tykkelse avdekket effekter i spesifikke områder av hjernebarken. ERN korrelerte negativt med tykkelse bilateralt i anterior cingulate, og viste en opphopning av voksler som korrelerte positivt med konnektivitet i den underliggende hvitsubstansen. Inhibisjon korrelerte positivt med tykkelse medialt frontalt i venstre hemisfære, og viste opphopning av voksler med negative korrelasjoner med konnektivitet i cingulum. Skifting korrelerte negativt med tykkelse temporalt og frontalt, og viste opphopning av voksler med positive korrelasjoner med konnektivitet i forceps frontalis og occipitalis. Oppdatering korrelerte negativt med tykkelse dorsolateralt frontalt og positivt med global konnektivitet. Konklusjon: Konvergerende evidens fra ulike metoder indikerer at kognitive kontrollfunksjoner i ulik grad er sensitive for makro- og mikroanatomisk variasjon i hjernestruktur hos friske personer. Effektene var imidlertid ikke sterke, og retningen på flere av sammenhengene var overraskende. Det diskuteres generelt i hvilken grad strukturelle variabler kan forventes å predikere variasjon i kognitive kontrollfunksjoner hos friske deltakere, og det mulige nevrobiologiske grunnlaget for slike sammenhenger

Short report: COVID-19-related anxiety is associated with mental health problems among adults with rare disorders

Background For adults with rare disorders, COVID-19 can be more severe and deadlier. This may lead to anxiety about COVID-19 among adults with rare disorders, including worries about being infected. COVID-19 anxiety is linked with mental health problems in the general population. Aims To examine the levels of mental health problems and COVID-19 anxiety, and their association, among adults with rare disorders. Methods and procedures Adults with rare disorders (N = 58, Mage = 45.2 years, SD = 12.7, 69.0% females, 31.0% males) answered standardized mental health and COVID-19 anxiety questionnaires online. Their scores were compared with samples without rare disorders. Outcomes and results Mental health problems were higher than in a sample without rare disorders (effect size d = 1.14), as was COVID-19 anxiety (effect size d = 0.53). COVID-19 anxiety correlated significantly with mental health problems (r = .46). Controlling for age, gender, and work status, COVID-19 anxiety explained 16.1% of the variance in mental health problems (ΔR2 = .161, p = .001). Conclusions and implications COVID-19 anxiety is higher than norms and associated with mental health problems for adults with rare disorders. During the pandemic, clinicians are recommended to assess COVID-19 anxiety for patients with rare disorders.publishedVersio

Exposure Quality in Cognitive Behavioral Treatment for Youth Anxiety Disorders—Predictors and Associations with Outcomes

To optimize cognitive behavioral therapy (CBT) outcomes for anxiety disorders in youth, more knowledge is needed about how specific CBT components work. Exposure to feared situations is an effective CBT component. However, there is little observation-based empirical research on how exposure relates to outcomes and other clinical variables. In a randomized controlled community clinic trial for youth with anxiety disorders, observers reliably rated exposure quality for 68 youths aged 8 to 15 years based on 118 videotaped sessions. The treatment program was the manual-based FRIENDS program. Three exposure quality elements (preparation, post-processing, and parent contribution to exposure) were examined in relation to pre-treatment demographic and clinical variables, outcomes, and youth- and therapist-rated alliance using multilevel hierarchical regression models. The outcomes were diagnostic recovery, clinical severity and anxiety symptoms change from pre- to post-treatment and one-year follow-up, and treatment dropout. The results showed that parent contribution to exposure was higher for boys and younger children. Parent contribution to exposure, but no other exposure element, was associated with a larger likelihood of diagnostic recovery and larger clinical severity reduction at one-year follow-up. Exposure quality was unrelated to outcomes at post-treatment, dropout, or alliance. We conclude that enhancing parent contribution to exposure during treatment could improve long-term outcomes after CBT for youth anxiety disorders. Exposure elements should be observed in larger samples to further examine their potential role for CBT outcomes.publishedVersio

Deviations from normative brain white and gray matter structure are associated with psychopathology in youth

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Parental internalizing symptoms as predictors of anxiety symptoms in clinic-referred children

Background: Mothers’ and fathers’ internalizing symptoms may influence children’s anxiety symptoms differently. Objective: To explore the relationship between parental internalizing symptoms and children’s anxiety symptoms in a clinical sample of children with anxiety disorders. Method: The sample was recruited through community mental health clinics for a randomized controlled anxiety treatment trial. At pre-intervention, children (n = 182), mothers (n = 165), and fathers (n = 72) reported children’s anxiety symptoms. Mothers and fathers also reported their own internalizing symptoms. The children were aged 8 to 15 years (Mage = 11.5 years, SD = 2.1, 52.2% girls) and all had a diagnosis of separation anxiety, social phobia, and/or generalized anxiety disorder. We examined parental internalizing symptoms as predictors of child anxiety symptoms in multiple regression models. Results: Both mother and father rated internalizing symptoms predicted children’s self-rated anxiety levels (adj. R2 = 22.0%). Mother-rated internalizing symptoms predicted mother-rated anxiety symptoms in children (adj. R2 = 7.0%). Father-rated internalizing symptoms did not predict father-rated anxiety in children. Conclusions: Clinicians should incorporate parental level of internalizing symptoms in their case conceptualizations