bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depressive Symptoms and PANSS Symptom Dimensions in Patients With Predominant Negative Symptom Schizophrenia: A Network Analysis
Authors: Demyttenaere Koen , Anthonis Elizabeth , Acsai Károly , Correll Christoph U. 
Published: April 2022

IntroductionSchizophrenia is a severe psychiatric disorder with a large symptomatic heterogeneity. Moreover, many patients with schizophrenia present with comorbid psychiatric symptoms or disorders. The relation between depressive symptoms and negative symptoms, such as blunted affect, alogia, anhedonia, asociality and avolition, is particularly intriguing. The negative symptoms can be primary or secondary of depression or overlapping with depressive symptoms. The aim of the present network analysis was to better understand the interactions between depressive symptoms and the different symptoms of schizophrenia and to investigate whether negative symptoms and depressive symptoms can be better delineated.MethodsA network analysis on the baseline item scores of the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) from the cariprazine-risperidone study in patients with predominant negative symptoms (PNS) was performed. The connections between all these symptoms (PANSS and CDSS) were investiged: node strength and network centrality were estimated and the Mohr 5-factor model of the PANSS was applied to test the validity of its different symptoms clusters.ResultsAcross 460 patients with schizophrenia and PNS, the most central symptom (largest node strength) was depression (PANSS) followed by depression (CDSS), anxiety, lack of judgment and insight and tension. The PANSS negative symptom cluster together and was only poorly connected with CDSS depresson symptoms. The Mohr 5 factor model was clearly recognized in the overall clustering of symptoms.ConclusionThis network analysis suggests that depression and anxiety symptoms are the most central in this PNS patient population, despite the baseline low depression scores, and that negative symptoms are a clearly independent symptom cluster that can be delineated from depressive symptoms.
Temperament Dimensions and Awakening Cortisol Levels in Attention-Deficit/Hyperactivity Disorder
Authors: Carta Alessandra , Vainieri Isabella , Rommel Anna-Sophie , Zuddas Alessandro , Kuntsi Jonna , Sotgiu Stefano , Adamo Nicoletta 
Published: April 2022

ObjectiveTo investigate whether temperament dimensions, Effortful Control (EC), Surgency-Extraversion (SE), and Negative Affectivity (NA), are associated with attention-deficit/hyperactivity disorder (ADHD) and how they relate to awakening cortisol levels, as a proxy measure of peripheral arousal.MethodsParent-rated temperament and saliva samples were collected from 55 children with ADHD and 65 age-matched controls.ResultsCompared to controls, youths with ADHD showed lower EC, higher NA, and lower awakening cortisol levels but did not differ in SE. Similar findings emerged in dimensional analyses linking temperament traits to inattention and hyperactivity-impulsivity symptoms. The results remained unchanged when controlling for the presence of co-occurring opposition-defiance and anxiety traits, as well as medication status. Temperament dimensions were not associated with cortisol levels.ConclusionsPoor temperamental emotional and cognitive self-regulation showed significant associations with ADHD but did not appear to be linked to the under-arousal typically seen in ADHD.
Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting
Authors: Ahmad Shaikh I. , Shih Emily W. , LeWinn Kaja Z. , Rivera Luisa , Graff J. Carolyn , Mason W. Alex , Karr Catherine J. , Sathyanarayana Sheela , Tylavsky Frances A. , Bush Nicole R. 
Published: April 2022

ObjectiveExperiences of stress and adversity, such as intimate partner violence, confer risk for psychiatric problems across the life span. The effects of these risks are disproportionately borne by women and their offspring—particularly those from communities of color. The prenatal period is an especially vulnerable period of fetal development, during which time women's experiences of stress can have long-lasting implications for offspring mental health. Importantly, there is a lack of focus on women's capacity for resilience and potential postnatal protective factors that might mitigate these intergenerational risks and inform intervention efforts. The present study examined intergenerational associations between women's prenatal stressors and child executive functioning and externalizing problems, testing maternal parenting quality and child sex as moderators, using a large, prospective, sociodemographically diverse cohort.MethodsWe used data from 1,034 mother-child dyads (64% Black, 30% White) from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) pregnancy cohort within the ECHO PATHWAYS consortium. Women's prenatal stressors included stressful life events (pSLE) and intimate partner violence (pIPV). Measures of child psychopathology at age 4–6 included executive functioning and externalizing problems. Parenting behaviors were assessed by trained observers, averaged across two sessions of mother-child interactions. Linear regression models were used to estimate associations between women's prenatal stressors and child psychopathology, adjusting for confounders and assessing moderation effects by maternal parenting quality and child sex.ResultsWomen's exposures to pSLE and pIPV were independently associated with child executive functioning problems and externalizing problems in fully-adjusted models. Maternal parenting quality moderated associations between pSLE and both outcomes, such that higher parenting quality was protective for the associations between women's pSLE and child executive functioning and externalizing problems. No moderation by child sex was found.DiscussionFindings from this large, sociodemographically diverse cohort suggest women's exposures to interpersonal violence and major stressful events—common for women during pregnancy—may prenatally program her child's executive functioning and externalizing problems. Women's capacity to provide high quality parenting can buffer this intergenerational risk. Implications for universal and targeted prevention and early intervention efforts to support women's and children's wellbeing are discussed.
Brain Stimulation for Emotion Regulation in Adolescents With Psychiatric Disorders: Study Protocol for a Clinical-Transdiagnostical, Randomized, Triple-Blinded and Sham-Controlled Neurotherapeutic Trial
Authors: Konicar Lilian , Prillinger Karin , Klöbl Manfred , Lanzenberger Rupert , Antal Andrea , Plener Paul L. 
Published: April 2022

BackgroundAnxiety, conduct and depressive disorders represent three highly prevalent psychiatric conditions in adolescents. A shared underpinning of these disorders is a shortcoming in emotion regulation, connected to the functioning of the ventromedial prefrontal cortex. Thus, an intervention able to target the suggested neural correlate seems to be highly desirable, aiming to hinder a maladaptive development of emotion regulation abilities and chronification of associated psychiatric disorders. As transcranial direct current stimulation (tDCS) was repeatedly demonstrated as a safe and non-invasive method to modulate specific brain activity, research is in demand to evaluate neurotherapeutic applications in adolescents with psychiatric disorders.MethodThis transdiagnostic, randomized, triple-blind and sham-controlled clinical neurostimulation trial primary aims to investigate if emotion regulation abilities are increased after tDCS in adolescents with psychiatric disorders. Secondly, disorder-specific changes in the anxiety, depression or conduct disorder will be investigated, as well as changes in quality of life, and cognitive and emotional functioning after tDCS intervention. We will include 108 adolescents with psychiatric disorders, displaying a substantial deficit in emotion regulation. Of these, one third each has to be primarily diagnosed with a depressive, anxiety or conduct disorder, respectively. Participants will be randomized to the experimental group (n = 54) receiving real anodal tDCS, or to the control group (n = 54) receiving sham tDCS. Brain stimulation will be applied for 20 min on five consecutive days twice targeting the ventromedial prefrontal cortex (vmPFC). Changes in emotion regulation, together with changes in disorder-specific clinical symptoms will be recorded by multi-informant psychological ratings. To inspect changes in behavior and gaze, computerized tasks and an eye tracker system will be used. Changes in brain responses to emotional and cognitive stimuli will be examined with three functional magnetic resonance imaging (fMRI) paradigms. In addition, a resting state MRI will be acquired to investigate possible changes in brain connectivity.DiscussionBy investigating “emotion regulation” as transdiagnostic treatment target, this project is oriented toward the Research Domain Criteria framework with a dimensional view on mental illness. The study aims at investigating the potential of tDCS as non-invasive intervention for depressive, anxiety and conduct disorders in adolescents and broadening the scientific foundation for its clinical application.Clinical Trial RegistrationThe study is ongoing and has been registered in the German Registry of Clinical Trials (DRKS-ID: DRKS00025601X) on the 28.06.2021.
Consumption-Related Health Education Inequality in COVID-19: A Cross-Sectional Study in China
Authors: You Jialu , Zhang Jinhua , Li Ze 
Published: April 2022

BackgroundThe COVID-19 pandemic influences various aspects of society, especially for people with low socioeconomic status. Health education has been proven to be a critical strategy in preventing a pandemic. However, socioeconomic characteristics may limit health education among low socioeconomic status groups. This study explores consumption-related health education inequality and the factors that contribute to this, which are variable across China during COVID-19.MethodsThe 2020 China COVID-19 Survey is a cross-sectional study in China, based on an anonymous online survey from 7,715 samples in 85 cities. It employed machine-learning methods to assess household consumption and other contributing variates associated with health education during the pandemic. Concentration Index (CI) and Horizontal Index (HI) were used to measure consumption-related inequalities in health education, respectively. Moreover, Wagstaff decomposition analysis was employed to identify other contributing variables to health education inequality.ResultsThe result indicates that participants with more education, better income, and positive consumption preferences undertake higher health education during COVID-19. The CI and HI of consumption-health education inequality are 0.0321 (P&lt; 0.001) and 0.0416 (p&lt; 0.001), respectively, which indicates that health education is concentrated in wealthy groups. We adapted Lasso regression to solve issues and omit variables. In terms of other socioeconomic characteristics, Annual Income was also a major contributor to health education inequalities, accounting for 27.1% (P&lt; 0.001). The empirical results also suggests that education, health status, identification residence, and medical health insurance contribute to health education inequality.ConclusionsThe difference in Household consumption, annual income, rural and urban disparity, and private healthcare insurance are critical drivers of health education inequality. The government should pay more attention to promoting health education, and healthcare subside policy among vulnerable people. Significantly to improve awareness of undertaking health education with lower education, rural residential, to enhance confidence in economic recovery and life after COVID-19.
Impact of Poverty on Parent–Child Relationships, Parental Stress, and Parenting Practices
Authors: Ho Laurie Long Kwan , Li William Ho Cheung , Cheung Ankie Tan , Luo Yuanhui , Xia Wei , Chung Joyce Oi Kwan 
Published: April 2022

Objectives:To explore the impact of poverty on parent–child relationships, parental stress and parenting practices.DesignA mixed methods study.SampleFour hundred and eighty five Hong Kong Chinese parents who had children aged 3-6 years, and who were from low-income families. Eleven of these parents were randomly selected for individual semi-structured interviews.MeasurementsA sociodemographic questionnaire, the parent–child relationship score, the Parental Stress Scale and the Perceived Parental Aggression Scale.ResultsThe parents were found to have an impaired relationship with their children. The findings indicated that employment status, parental stress and harsh parenting were significantly associated with parent–child relationships. The qualitative findings revealed that parents from low-income families encountered a wide range of difficulties, which made these parents more likely to experience parental stress, thereby increasing their tendency to adopt harsh parenting practices that undermined parent–child relationships.ConclusionThis study sheds light on the associations between parent–child relationships, parental stress and parenting practices in low-income families. These findings will enhance nurses' understanding of the impact of poverty on parent–child relationships, and highlight the need for nurses to ensure that underprivileged parents and their children receive adequate primary care to prevent the development of psychological problems in this vulnerable group.
A Latent Profile Analysis of Chinese Physicians' Workload Tethered to Paperwork During Outpatient Encounters
Authors: Li Dehe , Hu Yinhuan , Liu Sha , Lu Chuntao , Li Jiayi , Zhou Jinghan , Zhang Yeyan , Lu Shaoyu 
Published: April 2022

BackgroundPhysician dissatisfaction with more time spent on related paperwork but less time available for direct interaction with patients is increasing internationally. Increased physician workload resulting from paperwork might negatively affect their interaction with patients and increase the risk for burnout. This study aimed to investigate the level of physician workload tethered to paperwork during outpatient encounters and explore its latent workload subgroups among Chinese physicians.MethodsA cross-sectional survey was conducted via online questionnaire primarily in 24 hospitals in 6 provinces in Eastern, Central, and Western China from November 2020 to February 2021. The Chinese physician mental workload scale developed by our research team was used for assessment of physician workload tethered to paperwork. Physicians were categorized into different subgroups of workload via latent profile analysis. Multinomial logistic regression was subsequently performed to examine how demographic variables differ among physicians belonging to different subgroups.ResultsA total of 1,934 valid questionnaires were received. Chinese physicians reported medium levels of workload while performing non-physician-patient communication work tasks characterized by paperwork during outpatient encounters. Four latent workload subgroups were identified: “low workload group” (8.8%), “medium workload group” (34.0%), “high workload group” (42.1%) and “very high workload group” (15.1%). Compared with the other latent workload subgroups, physicians belonging to the “very high workload group” were more likely to be younger, married, those who had worse health status, lower educational levels and lower average monthly incomes, those who worked more years in the current institution, more hours per week and longer outpatient hours per week, and those who worked in public general hospitals, tertiary B hospitals and Obstetrics and Gynecology, and saw more than 50 outpatients per day, with more time spent on per patient.ConclusionsThere exit four latent workload subgroups among Chinese physicians tethered to paperwork during outpatient encounters along with great individual variations among these subgroups. The characteristics of the latent “very high workload group” can help permit more targeted guidance for developing interventions with optimized human resource allocation to, in turn, increase the time available for direct interaction with patients, thereby resulting in improved quality of physician-patient interactions and decreased risk for physician burnout.
Muscle Strength Is Associated With Physical Function in Community-Dwelling Older Adults Receiving Home Care. A Cross-Sectional Study
Authors: Bårdstu Hilde Bremseth , Andersen Vidar , Fimland Marius Steiro , Raastad Truls , Saeterbakken Atle Hole 
Published: April 2022

BackgroundHigher maximal- and explosive strength is associated with better physical function among older adults. Although the relationship between isometric maximal strength and physical function has been examined, few studies have included measures of isometric rate of force development (RFD) as a measure of explosive strength. Furthermore, little is known about the oldest old (&gt;80 years), especially individuals who receive home care and use mobility devices. Therefore, the aim of this study was to examine the association between maximal- and explosive muscle strength with physical function in community-dwelling older adults receiving home care.MethodsAn exploratory cross-sectional analysis including 107 (63 females and 43 males) community-dwelling older adults [median age 86 (interquartile range 80–90) years] receiving home care was conducted. Physical function was measured with five times sit-to-stand (5TSTS), timed 8-feet-up-and-go (TUG-8ft), preferred-, and maximal gait speed. Maximal strength was assessed as maximal isometric voluntary contraction (MVC) and explosive strength as RFD of the knee extensors. We used linear regression to examine the associations, with physical function as dependent variables and muscle strength (MVC and RFD) as independent variables.ResultsMVC was significantly associated with 5TSST [standardized regression coefficient β = −0.26 95% CI (−0.45, −0.06)], TUG-8ft [−0.6 (−0.54, −0.17)], preferred gait speed [0.39 (0.22, 0.57)], and maximal gait speed [0.45 (0.27, 0.62)]. RFD was significantly associated with 5TSST [−0.35 (−0.54, −0.17)], TUG-8ft [−0.43 (−0.60, −0.27)], preferred gait speed [0.40 (0.22, 0.57)], and maximal gait speed [0.48 (0.31, 0.66)].ConclusionsHigher maximal- and explosive muscle strength was associated with better physical function in older adults receiving home care. Thus, maintaining and/or improving muscle strength is important for perseverance of physical function into old age and should be a priority.
Manifestation of Generalized Anxiety Disorder and Its Association With Somatic Symptoms Among Occupational and Physical Therapists During the COVID-19 Pandemic
Authors: Alnaser Musaed Z. , Alotaibi Naser , Nadar Mohammed Sh. , Manee Fahad , Alrowayeh Hesham N. 
Published: April 2022

PurposeThe purpose of the study was to examine the level of generalized anxiety disorder among occupational and physical therapists during treatment sessions and its association with somatic symptoms during the COVID-19 pandemic.MethodsA descriptive cross-sectional design was used in this study. Data were collected during the month of April 2021, and the study included occupational and physical therapists who practiced during COVID-19 from March 2020 to March 2021. The generalized anxiety disorder scale (GAD-7) and a modified patient health questionnaire (mPHQ-15) were used to examine self-reported anxiety and somatic symptoms among the study participants. The independent t-test was used to determine differences between groups based on GAD-7 and mPHQ-15 results. Spearman's correlation test and chi-squared test were used to find the relationships between different variables such as anxiety and somatic symptoms.ResultsThe study (n = 98 participants) included 56 occupational and 42 physical therapists. An 84% response rate was achieved. GAD-7 final score was μ = 9.21 ± 5.63 with 27% reporting no anxiety, 14% mild, 38% moderate, and 21% severe. Independent t-tests on GAD-7 scores showed significant differences between therapist specializations [t(96) = −2.256; p = 0.026] and between therapists residing with or without their parents [t(96) = −2.536; p = 0.013]. The mPHQ-15 final score was μ = 9.52 ± 5.54 with 13% reporting no symptoms (n = 13), 20% mild (n = 20), 38% moderate (n = 37), and 29% severe (n = 28). GAD-7 and mPHQ-15 scores were moderately positively correlated [r(96) = 0.569; p &lt;0.000]. The chi-squared test showed a significant association between GAD-7 levels of anxiety and mPHQ-15 levels of somatic symptoms [x2(9, N = 98) = 70.62 p &lt;0.000]. Therapists reported that the quality (76%) and effectiveness (20%) of their rehabilitation services were negatively impacted by the COVID-19 pandemic.ConclusionThe majority of study participants experienced moderate to severe anxiety and associated somatic symptoms. During COVID-19, ongoing psychological counseling of healthcare professionals such as occupational and physical therapists is required to maintain positive mental health. Implications for practice are presented.
Low But Recoverable Markers of Humoral Immune Response to BNT162b2 in Elderly LTCF Residents Five to Seven Months After Two-Dose Vaccination
Authors: Delbrück Marla , Hoehl Sebastian , Toptan Tuna , Schenk Barbara , Grikscheit Katharina , Metzler Melinda , Herrmann Eva , Ciesek Sandra 
Published: April 2022

The immune response is known to wane after vaccination with BNT162b2, but the role of age, morbidity and body composition is not well understood. We conducted a cross-sectional study in long-term care facilities (LTCFs) for the elderly. All study participants had completed two-dose vaccination with BNT162b2 five to 7 months before sample collection. In 298 residents (median age 86 years, range 75–101), anti-SARS-CoV-2 rector binding IgG antibody (anti-RBD-IgG) concentrations were low and inversely correlated with age (mean 51.60 BAU/ml). We compared the results to Health Care Workers (HCW) aged 18–70 years (n = 114, median age: 53 years), who had a higher mean anti-RBD-IgG concentration of 156.99 BAU/ml. Neutralization against the Delta variant was low in both groups (9.5% in LTCF residents and 31.6% in HCWs). The Charlson Comorbidity Index was inversely correlated with anti-RBD-IgG, but not the body mass index (BMI). A control group of 14 LTCF residents with known breakthrough infection had significant higher antibody concentrations (mean 3,199.65 BAU/ml), and 85.7% had detectable neutralization against the Delta variant. Our results demonstrate low but recoverable markers of immunity in LTCF residents five to 7 months after vaccination.