Previous research examining the diversity and inclusion of editorial review boards has revealed that the participation of women in editorial boards of major medical journals is extremely underrepresented. One analysis of women on editorial boards of major medical journals found that only 15.9% of the major medical journals that were investigated had editors in chief that were women. Also, less than one fifth of all editorial board members were women (Amrein et al, 2011).

Despite high rates of trauma-related disorders among individuals with early psychosis, no clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders exist to date. Indeed, the routine exclusion of individuals with past and current psychosis from participation in trauma research and practice has limited the accumulation of research that could support such clinical practice guidelines. While preliminary research evidence suggests that traditional, evidence-based treatments for trauma-related disorders can be safely and effectively employed to reduce symptoms of posttraumatic stress and chronic psychosis, it remains unclear whether such treatments are appropriate for individuals in the early stages of psychotic illness. Clinical experts (N = 118) representing 121 early psychosis programs across 28 states were surveyed using the expert consensus method. Forty-nine clinical experts responded and reached consensus on 46 of 49 expert consensus items related to the treatment of comorbid early psychosis and trauma-related disorders. Conjoint or family therapy and individual therapy were rated as treatment approaches of choice. Anxiety or stress management and psychoeducation were rated as treatment interventions of choice for addressing both trauma symptoms and psychotic symptoms. In addition, case management was rated as a treatment intervention of choice for addressing psychotic symptoms. No consensus was reached on expert consensus items regarding the appropriateness of a parallel treatment approach exposure interventions for addressing psychotic symptoms, or sensorimotor or movement interventions for addressing trauma symptoms. In areas where expert consensus exists and is supported by current research, preliminary clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders are offered. In areas where expert consensus does not exist, recommendations for future research are offered. The results of this study are intended to serve as a launching point for scientists and practitioners interested in advancing appropriate treatment for high-risk and underserved individuals with comorbid early psychosis and trauma-related disorders.

Background

Motivational impairment associated with deficits in processing the anticipation of future reward is hypothesized to be a cardinal feature of schizophrenia spectrum disorders (SZ). Evidence from short-term follow-up (6-week post-treatment) studies suggests that these deficits may improve or be reversed with treatment, although longer-term outcomes are unknown. Here we examined the one-year trajectory of functional activation in brain circuitry associated with reward anticipation in people with recent onset SZ who participated in coordinated specialty care (CSC) treatment, hypothesizing normalization of brain response mirroring previous short-term findings in first-episode individuals.

Method

Blood oxygen level-dependent (BOLD) response in the dorsal anterior cingulate cortex, anterior insula, and ventral striatum (VS) associated with reward anticipation during the Incentivized Control Engagement Task (ICE-T) was analyzed in a baseline sample of 49 healthy controls (HCs) and 52 demographically matched people with SZ, with follow-up data available for 35 HCs and 17 people with SZ.

Results

In agreement with our hypothesis, significant time × diagnosis interactions were observed across all regions, in which reward anticipation-associated BOLD response increased in SZ to above baseline HC levels at follow-up. Increased VS activation was associated with decreased reality distortion symptoms over the follow-up period. Baseline reward anticipation-associated BOLD response in the right anterior insula was associated with improvement in reality distortion symptoms.

Conclusions

These findings suggest that functional deficits in reward anticipation may be reversed after one year of CSC in recent onset participants with SZ, and that this improvement is associated with reduced positive symptoms in the illness.

Cognitive impairment, particularly in the domain of cognitive control, is characteristic of schizophrenia (SZ) spectrum and bipolar disorders (BDs). The longitudinal trajectory of these impairments, however, remains unclear. Indeed, some studies have observed degeneration and others stability or even improvement over time in these illnesses. Here we examined the longitudinal stability of the AX-Continuous Performance Task (AX-CPT), a cognitive control task, in 52 patients with recent-onset SZ (<2 years from first study measurement), 20 patients with recent-onset BD Type I with psychotic features, and 70 healthy control subjects. Subjects performed the AX-CPT at 2 time points separated by an average of 365 days (range 270-620). Previously identified deficits in cognitive control were replicated in both patient groups. No effects of time or interactions between time and diagnosis were observed. Intraclass correlation coefficients also suggested AX-CPT performance was stable across time for all diagnostic groups. Although performance was stable on average, a positive association was noted between change in cognitive control and change in disorganization symptom severity across patient groups. In conclusion, the present findings suggest that deficits in cognitive control are present in both disorders and stable over the early course of psychotic illness. No evidence was observed for progression or deterioration of cognitive control or differential recovery in SZ compared to BD. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Psychosis is conceptualized in a neurodevelopmental vulnerability-stress framework, and childhood trauma is one environmental factor that can lead to psychotic symptoms and the development of psychotic disorders. Higher rates of trauma are associated with higher psychosis risk and greater symptom frequency and severity, resulting in increased hospitalization rates and demand on outpatient primary care and mental health services. Despite an estimated 70% of individuals in the early stages of psychosis reporting a history of experiencing traumatic events, trauma effects (post-traumatic anxiety or depressive symptoms) are often overlooked in psychosis treatment and current interventions typically do not target commonly comorbid post-traumatic stress symptoms. We presented a protocol for Trauma-Integrated Cognitive Behavioral Therapy for Psychosis (TI-CBTp), an approach to treating post-traumatic stress symptoms in the context of early psychosis care. We provided a brief summary of TI-CBTp as implemented in the context of Coordinated Specialty Care and presented preliminary data supporting the use of TI-CBTp in early psychosis care. The preliminary results suggest that individuals with comorbid psychosis and post-traumatic stress symptoms can be appropriately and safely treated using TI-CBTp within Coordinated Specialty Care.

Background

Providing early psychosis (EP) individuals with family psychoeducation (FPE) can reduce symptoms and improve clinical outcomes. However, relational memory problems may limit prospective utilization of FPE information. This study examines whether memory for FPE can be improved by testing participants during the initial FPE workshop presentation.

Method

Data were obtained from 20 people with EP and 20 demographically matched healthy comparison subjects (HC). During session one, FPE was presented in small group workshops, with half of the information re-studied twice (re-study condition) and the remaining information tested twice using cued recall tasks (retrieval practice condition). One week later (session two), delayed cued recall was tested for all FPE information. "Testing effects" (i.e., better memory following retrieval practice versus re-study) were examined across all items (standard analysis) and also limited to items successfully retrieved during session one (conditionalized analysis).

Results

HC had better initial recall and learned more over the two retrieval practice trials than EP. However, HC also lost more information than EP over the one-week delay. Both groups produced a significant testing effect. This effect was smaller in EP versus HC across all test items, but did not differ for the conditionalized analysis. Negative symptoms were inversely correlated with delayed cued recall in EP.

Conclusions

EP participants benefit from retrieval practice, with participants with less severe negative symptoms showing the greatest benefit. These results encourage use of memory tests during group psychoeducation to improve subsequent long-term recall of clinically relevant information.

Kraepelinian theory posits that schizophrenia (SZ) is a degenerative disorder that worsens throughout the lifespan. Behavioral studies of cognition have since challenged that viewpoint, particularly in the early phases of illness. Nonetheless, the extent to which cognition remains functionally stable during the early course of illness is unclear, particularly with regard to task-associated connectivity in cognition-related brain networks. In this study, we examined the 1-year stability of the frontoparietal control network during the AX-Continuous Performance Task (AX-CPT) from a new baseline sample of 153 participants scanned at 3T, of which 29 recent onset individuals with SZ and 42 healthy control (HC) participants had follow-up data available for analysis. Among individuals that had both baseline and follow-up data, reduced functional connectivity in SZ was observed between the dorsolateral prefrontal cortex (DLPFC) and superior parietal cortex (SPC) during the high control (B cue) condition. Furthermore, this deficit was stable over time, as no significant time × diagnosis interaction or effects of time were observed and intraclass correlation coefficients were greater than 0.6 in HCs and SZ. Previous 1.5T findings showing stable deficits with no evidence of degeneration in performance or DLPFC activation in an independent SZ sample were replicated. Overall, these results suggest that the neuronal circuitry supporting cognitive control is stably impaired during the early course of illness in SZ across multiple levels of analysis with no evidence of functional decline.

Relatively little is known about associations between peripheral inflammation and neural function in humans. Neuroimaging studies in adults have suggested that elevated peripheral inflammatory markers are associated with altered resting state functional connectivity (rsFC) in several brain networks associated with mood and cognition. Few studies have examined these associations in adolescents, yet scarce data from adolescents point to different networks than adult studies. The current study examined the associations between peripheral inflammation and rsFC in a community sample of adolescents (n = 70; age, 12-15 years; 32 female, 36 male, 2 nonbinary). After blood sampling, an fMRI scan was performed to assess rsFC. Assay for serum inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP), was performed. Results indicated that higher TNF-α was associated with altered rsFC between the right amygdala and left striatum and between the right inferior frontal gyrus and left parietal cortex (p < 0.05 whole-brain corrected). Associations with IL-6 and CRP were not significant. In contrast with findings in adults, inflammation may have unique links with the connectivity of the developing adolescent brain. Results have implications for understanding how peripheral inflammation may influence connectivity during adolescence, when neural networks are undergoing major developmental changes.

Aim

The trauma-psychosis cycle proposes an interactive relationship between impaired developmental and cognitive trajectory, childhood trauma exposure, and increased risk for psychosis. This study explored how childhood trauma (CT) and atypical development (AD) impact clinical course in an early psychosis cohort.

Methods

A retrospective chart review of behavioural and clinical research data was conducted with individuals ages 12 to 40 (N = 508; 72.4% males) evaluated by an early psychosis program.

Results

CT exposure was associated with earlier onset of full threshold psychosis, more hospitalizations, higher ratings of negative symptoms, and increased likelihood of engaging in suicidal behaviour. AD alone was associated with earlier onset of psychosis symptoms, higher ratings of negative symptoms and greater likelihood of engaging in non-suicidal self-injury. The combination of CT and AD was associated with the earliest symptom onset and poorest psychosocial functioning.

Conclusions

The findings contribute to our understanding of heterogeneity in the early psychosis population and highlight the specific risk factors that could be targets in treatment.

This paper describes the SocialVidStim-a database of video stimuli available to the scientific community depicting positive and negative social evaluative and neutral statements. The SocialVidStim comprises 53 diverse individuals reflecting the demographic makeup of the USA, ranging from 9 to 41 years old, saying 20-60 positive and 20-60 negative social evaluative statements (e.g. 'You are a very trustworthy/annoying person'), and 20-60 neutral statements (e.g. 'The sky is blue'), totaling 5793 videos post-production. The SocialVidStim are designed for use in behavioral and functional magetic resonance imaging paradigms, across developmental stages, in diverse populations. This study describes stimuli development and reports initial validity and reliability data on a subset videos (N = 1890) depicting individuals aged 18-41 years. Raters perceive videos as expected: positive videos elicit positively valenced ratings, negative videos elicit negatively valenced ratings and neutral videos are rated as neutral. Test-retest reliability data demonstrate intraclass correlations in the good-to-excellent range for negative and positive videos and the moderate range for neutral videos. We also report small effects on valence and arousal that should be considered during stimuli selection, including match between rater and actor sex and actor believability. The SocialVidStim is a resource for researchers and we offer suggestions for using the SocialVidStim in future research.