Michael Kaess

Striatal cerebral blood flow, executive functioning, and fronto-striatal functional connectivity in clinical high risk for psychosis

BACKGROUNDnPatients at clinical high risk (CHR) for psychosis exhibit increased striatal cerebral blood flow (CBF) during the resting state and impaired cognitive function. However, the relation between CBF and cognitive impairment is unknown. We therefore studied the association between striatal CBF and executive functioning and evaluated the functional connectivity (FC) between dorsal striatum and the frontal cortex in CHR.nnnMETHODSnIn total, 47 participants [29 with CHR, 18 matched clinical controls (CC)] were assessed for ultra-high-risk criteria and basic symptoms and were tested for executive functioning using the trail making test-B (TMT-B). Resting state mean CBF and FC were calculated from arterial spin labeling 3T MRI data.nnnRESULTSnStriatal CBF was highest in CHR patients with TMT-B deficits and was significantly higher than that in CC with and without TMT-B impairment. Further, a significantly lower CBF FC between the dorsal striatum and the anterior cingulate cortex was revealed in CHR.nnnCONCLUSIONSnOur study suggests that higher striatal CBF might represent focal pathology in CHR and is associated with disrupted cingulo-striatal FC and executive dysfunctions.

Bi-directional longitudinal associations between different types of bullying victimization, suicide ideation/attempts, and depression among a large sample of European adolescents

BACKGROUNDnThe association between bullying victimization and depression, suicide ideation and suicide attempts has been studied mainly in cross-sectional studies. This study aims to test the bidirectional effect and the chronicity versus sporadic effect of physical, verbal, and relational bullying victimization on suicidal ideation/attempts and depression.nnnMETHODSnLongitudinal assessments with an interval of 3- and 12-months were performed within a sample of 2,933 adolescents (56.1% females; mean age 14.78, SDxa0=xa0.89) from 10 European countries, participating in the Saving and Empowering Young Lives in Europe (SEYLE) school-based multicenter control sample. Multilevel Structural Equation Models were used, controlling for sociodemographic variables. Victimization was considered chronic when a student was victimized in the first two time points and sporadic when it was reported only at one point but not in another.nnnRESULTSnBidirectional prospective association between all types of victimization and depression were found. Among participants, who reported victimization once (but not twice), physical victimization, but not verbal and relational, was associated with later suicidal ideation and attempts. Chronic victimization of any type increased likelihood for later depression compared with sporadic and no-victimization. Chronic relational victimization increased the likelihood of later suicidal ideation, and chronic physical victimization increased the likelihood for suicidal attempts.nnnCONCLUSIONSnThe results support the bidirectional effect of victimization and depression and indicate that there are complex longitudinal associations between victimization and suicidal ideation/attempts. Physical victimization may especially carry effect on suicidal risk over time. Interventions should focus on victimization as a cause of distress but also aim to prevent vulnerable adolescents from becoming targets of victimization.

Bullying: peer-to-peer maltreatment with severe consequences for child and adolescent mental health

In the past decades, research on the development of mental disorders has increasingly set a strong focus on the identification and investigation of environmental risk factors. Ideally, such risk factors can be used as potential targets for prevention. Among the most important factors that may either positively or negatively influence an individual’s environment are interpersonal experiences and relationships. Without a doubt, childhood maltreatment (mostly comprised of childhood experiences of abuse and neglect) is among the most important environmental risk factor for the development of mental-health problems including internalizing and externalizing psychopathology, posttraumatic stress disorder, and personality disorders [1] as well as suicidal behavior [2]. In addition, other adverse childhood experiences such as parental loss or parental maladjustment have been identified as risk factors that contribute in an additive manner to the development of psychopathology [3]. Common to all the risk factors mentioned above is that they commonly refer to adult–child relationships, and focus less on the relationship among peers. Peer relationships, however, play an important role in children’s and adolescents’ lives, and the importance of peer relationships steadily rises with increasing age. Similar to adult–child relationships, the quality of peer relationships may heavily impact mental health. This is particularly true for severely abusive or neglectful peer relationships that can also be labeled as “bullying”. Bullying is defined as repeated negative actions over a prolonged period, performed by a single individual or group and carried out in direct or indirect form. Key criteria of bullying are the harmful intent of the perpetrator as well as an existing imbalance of power between victim and perpetrator [4]. Thus, bullying is a man-made, intentional aggression, which is consistent with the defining features of maltreatment or abuse. The large-scale study “Health Behaviour in School-Aged Children”, which collected data from more than 200,000 adolescents in 40 European countries, reported bullying rates ranging from 7 to 40% dependent on the country. Overall, 26.9% of the participants were affected by bullying, as either victims or perpetrators, or both (so-called bully/victims). The overall number of individuals who had experienced bullying victimization was 16.2% [5]. Most bullying happens in schools; however, cyberbullying has received increased public and academic attention due to its novelty and potential additive impact and harm. Recent research, however, concluded that cyberbullying creates few new victims, but is mainly a new tool to harm victims already bullied by traditional means [6]. Nonetheless, cyberbullying may extend the reach of bullying beyond the school gate and may be even less visible and controllable for adults who might be able to intervene. Another social space that has long been neglected as a place for bullying is the family where bullying often occurs among siblings (so-called sibling bullying) [7]. Consistent with other experiences of maltreatment, the distress and suffering caused by bullying is enormous. Bullying shows strong associations with both non-suicidal selfinjury [8, 9] and suicidal behavior [8, 10]. For example, prospective studies revealed elevated odds for emotional disorders [11] and personality disorders [12] among those who were bullied. Overall, previous victims of school bullying were found to be at higher risk for poor general health and lower educational achievement [13, 14]. At the 17th International Congress of European Society of Child and Adolescent Psychiatry (ESCAP) 2017 in Geneva/Switzerland, Professor Dieter Wolke gave an impressive lecture entitled “Peers and siblings matter for mental health: long-term consequences of bullying.” In this * Michael Kaess Michael.Kaess@upd.ch

Impact of Maternal Early Life Maltreatment and Maternal History of Depression on Child Psychopathology: Mediating Role of Maternal Sensitivity?

The study addresses the impact of maternal early life maltreatment (ELM) and maternal history of depression (HoD) on offspring’s mental health. Maternal sensitivity was examined as a potential mediator explaining the relationship between maternal ELM, maternal HoD and child psychopathology. Participants were 194 mothers with and without HoD and/or ELM as well as their children between 5 and 12xa0years. Maternal sensitivity was assessed using the Emotional Availability Scales. Parent and teacher ratings were utilized to assess child psychopathology. Path analyses showed an indirect effect of maternal HoD on parents’ ratings of child psychopathology with maternal sensitivity as mediating variable. In contrast, maternal ELM was directly linked to teachers’ ratings of child psychopathology; this effect was not mediated by maternal sensitivity. Our results indicate that the impact of maternal HoD, maternal ELM, and maternal sensitivity on offspring psychopathology might vary depending on the context in which child psychopathology is assessed.