Tze-Chun Tang

Randomized study of school-based intensive interpersonal psychotherapy for depressed adolescents with suicidal risk and parasuicide behaviors

Aim:  The aim of the present study was to examine the intervention effects of intensive interpersonal psychotherapy for depressed adolescents with suicidal risk (IPT‐A‐IN) by comparison with treatment as usual (TAU) at schools.

Association between school bullying levels/types and mental health problems among Taiwanese adolescents

BACKGROUND Few studies have compared the risks of mental health problems among the adolescents with different levels and different types of bullying involvement experiences. METHOD Bullying involvement in 6,406 adolescents was determined through use of the Chinese version of the School Bullying Experience Questionnaire. Data were collected regarding the mental health problems, including depression, suicidality, insomnia, general anxiety, social phobia, alcohol abuse, inattention, and hyperactivity/impulsivity. The association between experiences of bullying involvement and mental health problems was examined. The risk of mental health problems was compared among those with different levels/types of bullying involvement. RESULTS The results found that being a victim of any type of bullying and being a perpetrator of passive bullying were significantly associated with all kinds of mental health problems, and being a perpetrator of active bullying was significantly associated with all kinds of mental health problems except for general anxiety. Victims or perpetrators of both passive and active bullying had a greater risk of some dimensions of mental health problems than those involved in only passive or active bullying. Differences in the risk of mental health problems were also found among adolescents involved in different types of bullying. CONCLUSIONS This difference in comorbid mental health problems should be taken into consideration when assessing adolescents involved in different levels/types of bullying.

Posttraumatic stress disorder in adolescents after Typhoon Morakot-associated mudslides.

The aims of this study were to examine prevalence rate of post-traumatic stress disorder (PTSD), its associated factors and co-occurring psychological problems in a group of displaced adolescents 3 months following Typhoon Morakot in Taiwan. The relationship of trauma dimension and PTSD was also explored. A total of 271 adolescents who had been evacuated from their homes participated in this school-based survey. Adolescents were interviewed using the Mini-International Neuropsychiatric Interview for Children and Adolescents. Subjects themselves completed the following questionnaires: an inventory of exposure experiences to Typhoon Morakot, the Chinese version of Impact of Events Scale-Revised, the Center for Epidemiological Studies Depression Scale, and the Family APGAR Index. Teachers completed the Teachers Report Form in the Achenbach system of Empirically Bases Assessment. Results revealed that the prevalence of PTSD related to Typhoon Morakot was 25.8%. Adolescents who were female, had PTSD related to previous traumatic events before Typhoon Morakot, had more exposure experiences, were physically injured, or had family member in same household died or seriously injured were more likely to have the diagnoses of PTSD. Meanwhile, adolescents with PTSD had more severe depression, internalizing, externalizing, social, thought, and attention problems than those without PTSD. Our findings indicate that specialized trauma services are needed for these youngsters to lessen prolonged vulnerabilities.

Cue-induced positive motivational implicit response in young adults with Internet gaming addiction

This study evaluated the positive motivational implicit response to Internet gaming cues (i.e., screenshots of popular online games) to identify potential mechanisms of dyscontrolled Internet use in young adults with Internet gaming addiction (IGA). The final analysis included 64 young adults with IGA and 71 control subjects. The subjects completed the implicit association task to test their reaction to congruent pairing (Internet gaming screenshot paired with liked words) and incongruent pairing (Internet gaming screenshot paired with disliked words). The results demonstrated that, compared to the control group, the IGA group reacted faster to congruent pairing. It suggests that the IGA group had a positive motivational implicit response to screenshots of online games. Implicit cognition is an important mechanism of dyscontrolled substance use, such as alcohol dependence. This result suggests that implicit cognition might also be associated with dyscontrolled online gaming. The findings also demonstrate the important role of implicit cognition in dyscontrolled Internet use in young adults with IGA.

Association between Types of Involvement in School Bullying and Different Dimensions of Anxiety Symptoms and the Moderating Effects of Age and Gender in Taiwanese Adolescents.

OBJECTIVE The aims of this cross-sectional study were to examine the associations of various types of school bullying involvement experiences with different dimensions of anxiety symptoms on the Multidimensional Anxiety Scale for Children (MASC) and to examine the moderating effects of gender and age on the associations in Taiwanese adolescent students aged at 11-18. METHOD Involvement in passive and physical bullying and belongings snatch and multiple dimensions of anxiety symptoms in 5537 adolescents were determined through use of the self-reported Chinese version of the School Bullying Experience Questionnaire (C-SBEQ) and the Taiwanese version of the MASC, respectively. The associations between four types of bullying involvement and four dimensions of anxiety symptoms and the moderating effects of gender and age were examined using linear mixed model analysis. RESULTS The results indicated that except for the non-significant association between victimization by verbal and relational bullying and harm avoidance, both victims of verbal and relational bullying and physical bullying and belongings snatch reported more severe anxiety symptoms on all four dimensions of MASC-T than non-bullied subjects. While the perpetrators of verbal and relational bullying reported more severe physical symptoms and social anxiety than did non-perpetrators of verbal and relational bullying, the perpetrators of physical bullying and belongings snatch reported less harm avoidance, social anxiety and separation/panic than did non-perpetrators of physical bullying and belongings snatch. Perpetrator-victims of verbal and relational bullying showed more physical symptoms than those who were pure victims or perpetrators of verbal and relational bullying. Perpetrator-victims of physical bullying and belongings snatch had more social anxiety than those who were pure victims or perpetrators. This study also found that gender and age had the moderating effect on the association between some forms of bullying involvement and some dimensions of anxiety symptoms. CONCLUSIONS The results of this study support the necessity to apply the multi-dimensional scale to evaluate anxiety symptoms in adolescents who are involved in bullying and to take the different directions of association into consideration when developing prevention and intervention programs.

Working memory deficit in premenstrual dysphoric disorder and its associations with difficulty in concentrating and irritability

OBJECTIVE This study evaluates working memory deficit among women with premenstrual dysphoric disorder (PMDD) and whether such a deficit and its premenstrual aggravation is associated with difficulty in concentrating, irritability, and impaired daily function or not. METHOD Sixty women with PMDD (PMDD group) and 60 women without PMDD (control group) completed the assessment. Severity of irritability, difficulty concentrating, total symptoms, and functional impairment of PMDD were evaluated by the Premenstrual Symptoms Screening Tool. All participants performed N2 and N3 back tasks to assess working memory in both luteal and follicular phases. RESULTS The PMDD group had significantly poorer performance on N2 and N3 back tasks than the control group did in the luteal phase but not in the follicular phase. Compared to the control group, the PMDD group also exhibited more deterioration in performance of N3 back task in the luteal phase. Performance of N2 and N3 back tasks in luteal phase was significantly associated with irritability, symptom severity, and functional impairment by PMDD. CONCLUSIONS Working memory deficit is aggravated in the luteal phase among women with PMDD. Appropriate interventions are needed to prevent negative consequences of working memory deficit.

The Chinese version of the Severity of Dependence Scale as a screening tool for benzodiazepine dependence in Taiwan

The development of an instrument to estimate the incidence, characteristics, and risk factors of benzodiazepine (BZD) dependence broadly in Taiwan is an important task. This study assessed the validity of the Chinese version of the Severity of Dependence Scale (SDS[Ch]) among regular BZD users in Taiwan (n = 228). A positive correlation was shown between SDS[Ch] and Mini‐International Neuropsychiatric Interview diagnosed of BZD dependence. Thirty‐six percent of the users received a Mini‐International Neuropsychiatric Interview diagnosis of current BZD dependence. The dependent users tended to be divorced/widowed; not schizophrenic; and have higher SDS[Ch] scores, a longer duration of use, and multiple‐BZD use. The SDS[Ch] for BZD dependence was shown to have high diagnostic utility (area under the receiver operating characteristic curve = 0.779), a sensitivity of 80.5%, and a specificity of 85.7%, with a cutoff point of 7. The findings support that the SDS[Ch] is a valid brief self‐reported questionnaire for the assessment of BZD dependence among chronic users in Taiwan.

The effects of aerobic exercise on cognition in schizophrenia: A 3-month follow-up study

Aerobic exercise (AE) has been shown to improve cognition in patients with schizophrenia. However, it remains unclear whether these exercise-induced cognitive benefits persist beyond the training period. Accordingly, the present study sought to examine the immediate and maintenance effects of AE on a wide range of cognitive functions in 75 schizophrenia patients randomized to 12 weeks of either moderate-intensity treadmill exercise or stretching and toning exercise that served as a control. Participants completed assessments of neurocognition and cardiovascular fitness at pretest, posttest, and 3-month follow-up. The results showed that the AE group outperformed the controls on processing speed and attention at the end of intervention. The two groups did not differ significantly in any cognitive outcome measured at follow-up; however, improvement over time was noted in certain cognitive domains in AE group. The average effect sizes at follow-up were 0.53 and 0.35 for AE and control groups, respectively. There were no significant between-group differences in aerobic fitness at posttest and follow-up, and that fitness level was not related to changes in cognitive performance. These findings provide preliminary evidence for a trend towards beneficial effects of physical activity on cognition over a short follow-up period in favor of AE.

The Associations between Suicidal Ideation and Attempt and Anxiety Symptoms and the Demographic, Psychological, and Social Moderators in Taiwanese Adolescents

The objectives of this study were to examine the associations between suicidal ideation and attempt and anxiety symptoms and the moderators in 5,027 Taiwanese adolescents. The associations between suicidal ideation and attempt and anxiety symptoms on the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T) were examined using logistic regression analysis. The moderating effects of demographic (gender and age), psychological (problematic alcohol use, severe depressive symptoms, and low self-esteem), and social factors (bullying victimization, and low family function) on the associations were examined. Adolescents who had anxiety symptoms were more likely to have suicidal ideation and attempt than those who did not have anxiety symptoms. Bullying victimization had a moderating effect on the association between suicidal ideation and anxiety symptoms. Assessment of suicidal ideation and attempt should be routine practice among adolescents who present with anxiety symptoms.

One-year follow up of PTSD and depression in elderly aboriginal people in Taiwan after Typhoon Morakot

This paper describes a 1‐year follow‐up of post‐traumatic stress disorder (PTSD) symptomatology and depression in an elderly minority population who experienced Typhoon Morakot in Taiwan.