by
Danijela Piskulic;
Lu Liu;
Kristin S. Cadenhead;
Tyrone D. Cannon;
Barbara A. Cornblatt;
Thomas H. McGlashan;
Diana O. Perkins;
Larry J. Seidman;
Ming T. Tsuang;
Elaine Walker;
Scott W. Woods;
Carrie E. Bearden;
Daniel H. Mathalon;
Jean Addington
Deficits in social cognition are well established in schizophrenia and have been observed prior to the illness onset. Compared to healthy controls (HCs), individuals at clinical high risk of psychosis (CHR) are said to show deficits in social cognition similar to those observed in patients experiencing a first episode of psychosis. These deficits have been observed in several domains of social cognition, such as theory of mind (ToM), emotion perception and social perception. In the current study, the stability of three domains of social cognition (ToM, social perception and facial emotion perception) was assessed over time along and their association with both clinical symptoms and the later development of psychosis. Six hundred and seventy-five CHR individuals and 264 HC participants completed four tests of social cognition at baseline. Of those, 160 CHR and 155 HC participants completed assessments at all three time points (baseline, 1 year and 2 years) as part of their participation in the North American Prodrome Longitudinal Study. The CHR group performed poorer on all tests of social cognition across all time points compared to HCs. Social cognition was not associated with attenuated positive symptoms at any time point in the study. CHR individuals who developed a psychotic disorder during the course of the study did not differ in social cognition compared to those who did not develop psychosis. This longitudinal study demonstrated mild to moderate, but persistent ToM and social perception impairments in those at CHR for psychosis compared to HCs.
Objective:To compare neurodevelopmental outcomes in postnatal growth-restricted infants born <29 weeks with and without postnatal head-sparing (PHS).Study Design:We analyzed developmental outcomes at 2 years of age among postnatally growth-restricted infants with and without head-sparing. The primary outcome was Bayley III cognitive composite score; secondary outcomes included Bayley III motor composite score, moderate/severe cerebral palsy, gross motor functional classification scale level≥2, and presence or absence of neurodevelopmental impairment (NDI).Results:Of 1098 infants evaluated at 18 to 22 months, 658 were postnatally growth restricted, of whom 301 had head-sparing. In the multivariate model including independent risk factors for poor growth and poor developmental outcome, infants with head-sparing had higher adjusted motor composite scores (mean difference 4.65, P<0.01), but no differences in other neurodevelopmental outcomes.Conclusion:PHS is associated with improved neurodevelopmental outcome in extremely preterm infants, specifically Bayley III motor scores, but whether beneficial effects of PHS persist later in life is unknown.
Background
Attitudes and knowledge about suicide may influence psychiatrists’ management of suicidal patients but there has been little research about this issue in China.
Methods
We used the Scale of Public Attitudes about Suicide (SPAS) – a 47-item scale developed and validated in China – to assess knowledge about suicide and seven specific attitudes about suicide in a sample of 187 psychiatrists from six psychiatric hospitals in Shanghai. The results were compared to those of 548 urban community members (assessed in a previous study).
Results
Compared to urban community members, psychiatrists were more likely to believe that suicide can be prevented and that suicide is an important social problem but they had more stigmatizing beliefs about suicidal individuals and felt less empathy for them. The belief that suicide can be prevented was more common among female psychiatrists than male psychiatrists but male psychiatrists felt more empathy for suicidal individuals. Only 37% of the psychiatrists correctly agreed that talking about suicide-related issues with an individual would not precipitate suicidal behavior and only 41% correctly agreed that those who state that they intend to kill themselves may actually do so.
Conclusions
Many psychiatrists in Shanghai harbor negative attitudes about suicidal individuals and are concerned that directly addressing the issue with patients will increase the risk of suicide. Demographic factors, educational status and work experience are associated with psychiatrists’ attitudes about suicide and, thus, need to be considered when training psychiatrists about suicide prevention.
Background
The Duke University Religion Index (DUREL) is a widely-used 5-item scale assessing religiosity.
Aim
Assess the internal consistency, reliability, and factor structure of the revised Chinese version of DUREL.
Methods
Using probability proportionate to size (PPS) methods we randomly identified 3981 households with eligible occupants in 20 primary sampling sites in Ningxia Hui Autonomous Region, a province in northwest China in which 34% of the population are Muslims of the Hui ethnic group. In 3054 households a screening interview was completed and an adult family member was randomly selected; 2425 respondents completed the survey (including the DUREL) and 188 randomly selected individuals repeated the survey an average of 2.5 days later.
Results
The internal consistency (Cronbach’s α) of the 5 items in the full sample was 0.90; it ranged from 0.70 to 0.90 in various subgroups of subjects stratified by ethnicity, urban versus rural residence, and above versus below median education. The test-retest reliability (intraclass correlation coefficient) for the total score in the full sample was 0.87; it ranged from 0.63 to 0.90 in the different subgroups of subjects. Exploratory factor analysis in a random half of the sample identified a single factor (eigen value=4.21) that explained 84% of the total variance. Confirmatory factor analysis in the second half of the sample confirmed the unidimensional model; the model fit measures of the one-factor model using the 5 item scores as observed variables were acceptable (comparative fit index [CFI] and Tucker-Lewis index [TLI]>0.99; root mean square error of approximation [RMSEA]=0.105; χ2 =70.49, df=5), but the model fit improved after adding the correlation between items 1 and 2 (that assess organized and personal religious activities, respectively) as a sixth observed variable(CFI and TLI>0.99; RMSEA=0.046; χ2 =14.32, df=4).
Conclusion
The Chinese version of the DUREL is a reliable and valid measure of religiosity that can be used to assess the relationship of religiosity/spirituality to physical and psychological wellbeing in Chinese respondents. As suggested by other authors, our factor analysis results indicate that the overall score is the best measure derived from the scale, not the three dimensional scores recommended by the original authors.
Background
Suicide rates in rural China are two-fold to three-fold those in urban China but the reasons for this large difference remain unclear.
Aim
Assess the characteristics and risk factors of medically serious suicide attempts in rural China.
Methods
A comprehensive 2 to 3 hour structured interview was administered by psychiatrists to 297 medically serious suicide attempters (defined as those who remained in hospital for 6 hours or longer) treated in the emergency room of the People's Hospital of Yuncheng County in Shandong Province and, separately, to their accompanying co-resident family members. A parallel interview was administered to control subjects matched for age and gender from the same village who had never made a suicide attempt and to their co-resident family members. Risk factors for attempted suicide were identified using Cox regression models.
Results
Among the 297 suicide attempters, 74% were female, 78% were farmers, their mean (sd) age was 33.2 (14.6) years, their mean length of formal schooling was 4.8 (3.1) years, 80% had attempted suicide by ingesting pesticides, 57% reported considering suicide for five minutes or less before acting, 76% had a score of less than 50 (range, 0 to 100) on the planning subscale of the Suicide Intent Scale, 11% had made prior attempts, and only 38% met DSM-IV criteria for a current mental disorder. After controlling for gender, age, location of residence and prior suicide attempt (in the matched analysis), risk factors identified in the multivariate analysis included a low level of education, having relatives or associates with prior suicidal behavior, experiencing four or more negative life events in the prior year, a low quality of life and low family cohesion over the prior month, high depressive symptom scores over the prior two weeks, and (only assessed in a subsample) high impulsivity and aggression.
Conclusion
Many of the medically treated suicide attempts in rural China are low-intent attempts by the ingestion of pesticides in persons who do not meet criteria of a mental disorder but have high levels of impulsiveness and aggression. This profile is different from that seen in high-income countries so it will require a different approach to the prevention of suicidal behavior, an approach that is less focused on the identification and treatment of mental disorders and more focused on limiting access to agricultural poisons and training impulsive individuals about self-regulation of their emotions and behaviors.
Psychosocial stress, including stress resulting from racial discrimination (RD), has been associated with elevated depressive symptoms. However, individuals vary in their reactivity to stress, with some variability resulting from genetic differences. Specifically, genetic variation within the linked promoter region of the serotonin transporter gene (5-HTTLPR) is related to heightened reactivity to emotional environmental cues. Likewise, variations within this region may interact with stressful life events (e.g., discrimination) to influence depressive symptoms, but this has not been empirically examined in prior studies. The objective of this study was to examine whether variation in the 5-HTTLPR gene interacts with RD to predict depressive symptoms among a sample of African-American adolescent females. Participants were 304 African-American adolescent females enrolled in a sexually transmitted disease prevention trial. Participants completed a baseline survey assessing psychosocial factors including RD (low vs. high) and depressive symptomatology (low vs. high) and provided a saliva sample for genotyping the risk polymorphism 5-HTTLPR (s allele present vs. not present). In a logistic regression model adjusting for psychosocial correlates of depressive symptoms, an interaction between RD and 5-HTTLPR group was significantly associated with depressive symptomatology (AOR = 3.79, 95% CI: 1.20-11.98, p = 0.02). Follow-up tests found that high RD was significantly associated with greater odds of high depressive symptoms only for participants with the s allele. RD and 5-HTTLPR status interact to differentially impact depressive symptoms among African-American adolescent females. Efforts to decrease depression among minority youth should include interventions which address RD and strengthen factors (e.g., coping, emotion regulation, building support systems) which protect youth from the psychological costs of discrimination.
Accumulating evidence suggests that males outperform females on mental rotation tasks as early as infancy. Sex differences in object preference have also been shown to emerge early in development and precede sex-typed play in childhood. Although research with adults and older children is suggestive of a relationship between play preferences and visuospatial abilities, including mental rotation, little is known about the developmental origins of this relationship. The present study compared mental rotation ability and object preference in 6- to 13-month-old infants. We used a novel paradigm to examine individual differences in infants’ mental rotation abilities as well as their differential preference for one of two sex-typed objects. A sex difference was found on both tasks, with boys showing an advantage in performance on the mental rotation task and exhibiting greater visual attention to the male-typed object (i.e., a toy truck) than to the female-typed object (i.e., a doll) in comparison to girls. Moreover, we found a relation between mental rotation and object preference that varied by sex. Greater visual interest in the male-typed object was related to greater mental rotation performance in boys, but not in girls. Possible explanations related to perceptual biases, prenatal androgen exposure, and experiential influences for this sex difference are discussed.
by
David H. Chae;
Sean Clouston;
Mark L. Hatzenbuehler;
Michael Kramer;
Hannah Cooper;
Sacoby M. Wilson;
Seth I. Stephens-Davidowitz;
Robert S. Gold;
Bruce G. Link
Racial disparities in health are well-documented and represent a significant public health concern in the US. Racism-related factors contribute to poorer health and higher mortality rates among Blacks compared to other racial groups. However, methods to measure racism and monitor its associations with health at the population-level have remained elusive. In this study, we investigated the utility of a previously developed Internet search-based proxy of area racism as a predictor of Black mortality rates. Area racism was the proportion of Google searches containing the "N-word" in 196 designated market areas (DMAs). Negative binomial regression models were specified taking into account individual age, sex, year of death, and Census region and adjusted to the 2000 US standard population to examine the association between area racism and Black mortality rates, which were derived from death certificates and mid-year population counts collated by the National Center for Health Statistics (2004-2009). DMAs characterized by a one standard deviation greater level of area racism were associated with an 8.2% increase in the all-cause Black mortality rate, equivalent to over 30,000 deaths annually. The magnitude of this effect was attenuated to 5.7% after adjustment for DMA-level demographic and Black socioeconomic covariates. A model controlling for the White mortality rate was used to further adjust for unmeasured confounders that influence mortality overall in a geographic area, and to examine Black-White disparities in the mortality rate. Area racism remained significantly associated with the allcause Black mortality rate (mortality rate ratio = 1.036; 95% confidence interval = 1.015, 1.057; p = 0.001). Models further examining cause-specific Black mortality rates revealed significant associations with heart disease, cancer, and stroke. These findings are congruent with studies documenting the deleterious impact of racism on health among Blacks. Our study contributes to evidence that racism shapes patterns in mortality and generates racial disparities in health.
Background
Stigmatizing attitude towards HIV/AIDS alongside other factors such as HIV knowledge, substance use, sexual behavior, and involvement in various social activities (e.g., internet use, exposure to media) may be related to likelihood of having HIV counseling and testing (HCT). Thus, we examined these associations among 18–24 year old post-secondary school students in Tbilisi, Georgia.
Methods
We conducted a secondary data analysis of a 2010 cross-sectional survey of 1,879 secondary and post-secondary school students aged 15 to 24 years in Tbilisi, Georgia examining sociodemographics, substance use, sexual behavior, HIV-related knowledge and stigmatizing attitudes, and recreational activities in relation to lifetime HCT. A stratified two-stage cluster sample design was used by the parent study with universities selected with probabilities proportional to their size at the first stage, and with a random selection of students stratified by gender in each of the participating university at the second stage.
Results
The vast majority (95.6%) of participants never received HCT. In the multivariate regression model, significant predictors of lifetime receipt of HCT included being married (p = 0.03), not having HIV stigmatized attitude (p = 0.03), more often reading fiction literature (p = 0.02), more often going out in the evenings (p = 0.03), and more often passing time with friends (p = 0.05).
Conclusions
Intervening on HIV stigmatizing attitudes may be a critical prevention or HCT promotion strategy among youth in Georgia. In order to better inform policy and programs, future research should examine contextual factors in secondary and post-secondary schools that impact HCT among Georgian youth. Specifically, factors impacting differential rates of HCT among males and females, the social stigma and knowledge related to HCT and HIV, and the impact of leisure time activity involvement on HCT should be examined further. In addition, interventions and policies that might impact attitudes toward HIV and HCT should be investigated and considered.
Purpose
Shame and stigma associated with sexually transmitted diseases (STDs) are barriers to adolescents seeking prompt and appropriate diagnosis and treatment. However, little is known about how these constructs are related to STD-protective behaviors, such as condom-protected intercourse. Thus, we prospectively examined the relationship between shame and stigma and condom-use in adolescent females.
Methods
192 African American females age 17.4 ± 1.7 years (range 15-21) were recruited for the study from local teen oriented health clinics. At baseline, participants completed demographic and psychosocial measures (including STD-related shame and stigma), and chart or laboratory confirmed history of STDs was obtained. At six months follow-up, rate of condom-protected intercourse in past 14 days prior to follow-up was assessed. Participants’ baseline shame and stigma scores, prior history of STDs, and select demographic and theoretically important psychosocial variables were entered into a hierarchical linear regression model to predict condom-protected intercourse in the 14 days prior to the 6 month follow-up assessment.
Results
After controlling for variables identified in bivariate correlations, STD-related shame was significantly predictive of condom-protected intercourse in the 14 days prior to follow-up, with higher shame predicting higher rates of condom-protected intercourse.
Conclusions
Future prevention efforts attempting to reduce adolescents’ risks for STDs and HIV may benefit from addressing STD-related shame and stigma in addition to explicitly linking health-promoting behavior changes (condom use) to a decreased likelihood of future infection with STDs.