Neural substrates of trait impulsivity, anhedonia, and irritability: Mechanisms of heterotypic comorbidity between externalizing disorders and unipolar depression

2016 ◽  
Vol 28 (4pt1) ◽  
pp. 1177-1208 ◽  
Author(s):  
Aimee Zisner ◽  
Theodore P. Beauchaine
Keyword(s):  
Depressive Disorders ◽  
Unipolar Depression ◽  
Neural Substrates ◽  
Externalizing Disorders ◽  
Mesolimbic Dopamine ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Trait Impulsivity ◽  
Spectrum Disorders ◽  
Internalizing And Externalizing

AbstractTrait impulsivity, which is often defined as a strong preference for immediate over delayed rewards and results in behaviors that are socially inappropriate, maladaptive, and short-sighted, is a predisposing vulnerability to all externalizing spectrum disorders. In contrast, anhedonia is characterized by chronically low motivation and reduced capacity to experience pleasure, and is common to depressive disorders. Although externalizing and depressive disorders have virtually nonoverlapping diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, heterotypic comorbidity between them is common. Here, we review common neural substrates of trait impulsivity, anhedonia, and irritability, which include both low tonic mesolimbic dopamine activity and low phasic mesolimbic dopamine responding to incentives during reward anticipation and associative learning. We also consider how other neural networks, including bottom-up emotion generation systems and top-down emotion regulation systems, interact with mesolimbic dysfunction to result in alternative manifestations of psychiatric illness. Finally, we present a model that emphasizes a translational, transdiagnostic approach to understanding externalizing/depression comorbidity. This model should refine ways in which internalizing and externalizing disorders are studied, classified, and treated.

Electroencephalogram Abnormalities and Epilepsy in Autism Spectrum Disorders: Clinical and Electroencephalogram Findings

2021 ◽  
Author(s):  
Fatma Hanci ◽  
Sevim Türay ◽  
Yusuf Öztürk ◽  
Nimet Kabakus
Keyword(s):  
Autism Spectrum Disorders ◽  
Febrile Convulsion ◽  
Autism Spectrum ◽  
Clinical Findings ◽  
Seizure Type ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Epileptic Discharges ◽  
Spectrum Disorders ◽  
Electroencephalogram Eeg

AbstractIt has been known for several decades that epilepsy and autism spectrum disorders (ASD) are related to each other. Epilepsy frequently accompanies ASD. The purpose of this study was to investigate relationship between clinical and electroencephalogram (EEG) findings in ASD patients and to identify EEG characteristics that may create a disposition to epilepsy in ASD by examining differences in clinical and EEG findings between patients diagnosed with ASD without epilepsy and ASD with epilepsy. A total of 102 patients aged 2 to 18 years and diagnosed with ASD based on Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria between January 2017 and June 2019 were included in the study. Patients were assigned into two groups: (1) ASD with epilepsy and (2) ASD without epilepsy. Clinical findings were retrieved from patients' files, and EEG findings from first EEG records in the EEG laboratory at the time of diagnosis. EEG findings were defined as central, parietal, frontal, temporal, or generalized, depending on the location of rhythmic discharges. The incidence of epilepsy in our ASD patients was 33.7% and that of febrile convulsion was 4%. Generalized motor seizures were the most common seizure type. Epileptic discharges most commonly derived from the central and frontal regions. These abnormalities, especially frontal and central rhythmic discharges, may represent a precursor for the development of epilepsy in ASD patients.

Prevalence of Premenstrial Disphoric Disorder Associated Factors among Students of Tabor Secondary and Preparatory School in Hawassa City, Ethiopia Cross Sectional

2020 ◽  
Author(s):  
Mulugeta Gobena Tadesse ◽  
Dereje Dirago Dire ◽  
Yacob Yacob Abraham
Keyword(s):  
Associated Factors ◽  
Depressive Disorders ◽  
Premenstrual Dysphoric Disorder ◽  
Emotional Symptoms ◽  
Cross Sectional ◽  
Preparatory School ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
History Of ◽  
Menstruating Women

Abstract Background: Premenstrual dysphoric disorder (PMDD)-is a severe and disabling form of premenstrual Syndrome affecting 3-8% of menstruating women. The disorder consists of a cluster of affective, behavioral and somatic symptoms that recur monthly during the luteal phase the menstrual cycle. Premenstrual dysphoric disorder (PMDD) was added to the list of depressive disorders in the diagnostic and statistical manual of mental disorders in 2013. The exact pathogenesis of the disorder is still unclear.Objective: To assess the prevalence of PMDD and its associated factors among students of Hawassa tabor secondary and preparatory school.Method: A cross sectional institutional based was conducted among 351 randomly selected female students of Hawassa tabor school. Data was collected by three students were facilitate the works with closed ended structured questionnaire and they was trained on how to collect the data. The collected data was entered, analyzed and cleaned by SPS.Results: prevalence of premenstrual dysphoric disorder in this study was 76.9%. Of each symptom is more than ninety present or 324 (92.3%) respondents can’t have experience unpleasant physical or emotional symptoms peculiar to the five days before the onset of menses & 27(7.7%) participants have show the symptoms. Among those 26 (7.4%) have present for the past ≥3 consecutive cycles. 46 (13.1%) have family history of such symptoms.Conclusions: These findings have implications for both women and medical providers, who should be aware that PMS symptoms are prevalent and often distressing, yet also understand that the severity of symptoms may remit over time.

Neuroanatomy of Obsessive Compulsive and Related Disorders

2012 ◽  
Author(s):  
David Mataix-Cols ◽  
Odile A. van den Heuvel
Keyword(s):  
Neural Systems ◽  
Future Research ◽  
Affective Neuroscience ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Symptom Dimensions ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
Psychiatric Conditions ◽  
Spectrum Disorders

Obsessive-compulsive disorder (OCD) shares features and often co-occurs with other anxiety disorders, as well as with other psychiatric conditions classified elsewhere in the Diagnostic and Statistical Manual (DSM-IV), the so-called “OCD spectrum disorders.” Neurobiologically, it is unclear how all these disorders relate to one another. The picture is further complicated by the clinical heterogeneity of OCD. This chapter will review the literature on the common and distinct neural correlates of OCD vis-à-vis other anxiety and “OCD spectrum” disorders. Furthermore, the question of whether partially distinct neural systems subserve the different symptom dimensions of OCD will be examined. Particular attention will be paid to hoarding, which is emerging as a distinct entity from OCD. Finally, new insights from cognitive and affective neuroscience will be reviewed before concluding with a summary and recommendations for future research.

Internalizing–externalizing comorbidity and regional brain volumes in the ABCD study

2021 ◽  
Vol 33 (5) ◽  
pp. 1620-1633
Author(s):  
Elana Schettini ◽  
Sylia Wilson ◽  
Theodore P. Beauchaine
Keyword(s):  
Unipolar Depression ◽  
Externalizing Disorders ◽  
Mood States ◽  
Anterior Cingulate ◽  
Research Domain Criteria ◽  
Brain Volumes ◽  
Regional Brain ◽  
Main Effects ◽  
Internalizing And Externalizing ◽  
Research Domain

AbstractDespite nonoverlapping diagnostic criteria, internalizing and externalizing disorders show substantial comorbidity. This comorbidity is attributable, at least in part, to transdiagnostic neuroaffective mechanisms. Both unipolar depression and externalizing disorders are characterized by structural and functional compromises in the striatum and its projections to the anterior cingulate cortex (ACC) and other frontal regions. Smaller volumes and dampened reward responding in these regions are associated with anhedonia and irritability – mood states that cut across the internalizing and externalizing spectra. In contrast, smaller amygdala volumes and dampened amygdala function differentiate externalizing disorders from internalizing disorders. Little is known, however, about associations between internalizing–externalizing comorbidity and brain volumes in these regions, or whether such patterns differ by sex. Using a transdiagnostic, research domain criteria (RDoC)-informed approach, we evaluate associations between heterotypic (Internalizing × Externalizing) symptom interactions and striatal, amygdalar, and ACC volumes among participants in the Adolescent Brain Cognitive Development study (N = 6,971, mean age 9.9 years, 51.6% female). Heterotypic symptoms were associated with ACC volumes for both sexes, over and above the main effects of internalizing and externalizing alone. However, heterotypic comorbidity was associated with larger ACC volumes for girls, but with smaller ACC volumes for boys. These findings suggest a need for further studies and transdiagnostic assessment by sex.

The Clenching-Grinding Spectrum and Fear Circuitry Disorders: Clinical Insights from the Neuroscience/Paleoanthropology Interface

CNS Spectrums ◽  
2005 ◽  
Vol 10 (4) ◽  
pp. 311-318 ◽  
Author(s):  
H. Stefan Bracha ◽  
Tyler C. Ralston ◽  
Andrew E. Williams ◽  
Jennifer M. Yamashita ◽  
Adam S. Bracha
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Mental Disorders ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Homo Sapiens ◽  
Chronic Fatigue ◽  
Self Report ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Spectrum Disorders

AbstractThis review discusses the clenching-grinding spectrum from the neuropsychiatric/neuroevolutionary perspective. In neuropsychiatry, signs of jaw clenching may be a useful objective marker for detecting or substantiating a self-report of current subjective emotional distress. Similarly, accelerated tooth wear may be an objective clinical sign for detecting, or substantiating, long-lasting anxiety. Clenching-grinding behaviors affect at least 8% of the population. We argue that during the early paleolithic environment of evolutionary adaptedness, jaw clenching was an adaptive trait because it rapidly strengthened the masseter and temporalis muscles, enabling a stronger, deeper and therefore more lethal bite in expectation of conflict(warfare)with conspecifics. Similarly, sharper incisors produced by teeth grinding may have served as weaponry during early human combat. We posit that alleles predisposing to fear-induced clenching-grinding were evolutionarily conserved in the human clade (lineage) since they remained adaptive for anatomically and mitochondrially modern humans (Homo sapiens) well into the mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain, craniomaxillofacial musculoskeletal pain, temporomandibular disorders, oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders are linked. A 2003 Cochrane meta-analysis concluded that dental procedures for the above spectrum disorders are not evidence based. There is a need for early detection of clenching-grinding in anxiety disorder clinics and for research into science-based interventions. Finally, research needs to examine the possible utility of incorporating physical signs intoDiagnostic and Statistical Manual of Mental Disorders, Fifth Editionposttraumatic stress disorder diagnostic criteria. One of the diagnostic criterion that may need to undergo a revision inDiagnostic and Statistical Manual of Mental Disorders, Fifth Editionis Criterion D (persistent fear-circuitry activation not present before the trauma). Grinding-induced incisor wear, and clenching-induced palpable masseter tenderness may be examples of such objective physical signs of persistent fear-circuitry activation (posttraumatic stress disorder Criterion D).

The Underlying Nature and Structure of the Emotional Disorders

2017 ◽  
pp. 1-22
Author(s):  
David Watson ◽  
Michael W. O’Hara
Keyword(s):  
Emotional Disorders ◽  
Depressive Disorders ◽  
Prevalence Rates ◽  
Obsessive Compulsive ◽  
Specific Symptom ◽  
Statistical Manual ◽  
Symptom Dimensions ◽  
Diagnostic And Statistical Manual ◽  
Alternative Approach ◽  
Low Prevalence

This chapter examines the nature and structure of the emotional disorders, which include five adjacent diagnostic classes within the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders: bipolar and related disorders, depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, and trauma- and stressor-related disorders. It reviews the pervasive problem of comorbidity—that is, the co-occurrence of two or more disorders within the same person—that characterizes these disorders, and it discusses several influential models (including the tripartite model and the integrative hierarchical model) that have been developed to account for these data. It then examines several problems associated with diagnosis-based approaches to psychopathology; these include hierarchical exclusion rules, low prevalence rates, diagnostic unreliability, and the heterogeneity of many disorders. Finally, it proposes an alternative approach to studying psychopathology, namely, examining the specific symptom dimensions that make up the major syndromes within the emotional disorders.

Incompleteness and Harm Avoidance in OCD

2017 ◽  
Author(s):  
Stefano Pallanti ◽  
Jennifer Barnes ◽  
Christopher Pittenger ◽  
Jane Eisen
Keyword(s):  
Neural Substrates ◽  
Harm Avoidance ◽  
Substantial Fraction ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Not Just Right Experiences ◽  
Core Features

Obsessive-compulsive disorder (OCD) has been traditionally linked with the motivational dimension of harm avoidance (HA). However, there is increasing evidence for the involvement of a second core dimension, referred to as Incompleteness (INC) or “not just right experiences” (NJREs), in a substantial fraction of patients. INC-driven compulsions are typically driven by feelings of discomfort or tension, rather than by anxiety. Appreciation of the importance of INC in OCD is one of the factors that motivated the movement of OCD out of the Anxiety Disorders chapter and into its own grouping in the latest edition of the Diagnostic and Statistical Manual (DSM-5). Both dimensions seem to contribute to OCD symptomatology, thus representing core features underlying the disorder. In this chapter, the differential roles and neural substrates of HA and INC are discussed, together with the consequent theoretical and clinical implications.

scholarly journals The diagnosis and management of depression in the era of the DSM-5

2018 ◽  
Vol 60 (1) ◽  
pp. 22-28
Author(s):  
Eileen Thomas ◽  
S Seedat
Keyword(s):  
Public Health ◽  
Mental Disorders ◽  
Clinical Characteristics ◽  
Depressive Disorders ◽  
Health Needs ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dsm Iv ◽  
The Individual

Depressive disorders comprise a range of conditions that can be viewed along many dimensions. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) introduced several changes to the chapter on depressive disorders largely informed by advances in neuroscience, clinical and public health needs and difficulties identified with the previous DSM-IV classification system and criteria. Clinical characteristics vary across depressive disorders, as do the corresponding treatments. Pharmacotherapy and psychotherapy should be tailored to the individual patient.

Conceptualization of psychosis in psychiatric nosology

2020 ◽  
pp. 3-11
Author(s):  
Matcheri S. Keshavan ◽  
John Torous ◽  
Rajiv Tandon
Keyword(s):  
Statistical Manual ◽  
Classification Schemes ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Digital Phenotyping ◽  
Novel Approaches ◽  
Spectrum Disorders ◽  
Definition Of ◽  
Research Domain ◽  
Current Standards

The definition of psychotic spectrum disorders such as schizophrenia has evolved with changing nosology and scientific advancements over the last 200 years. Understanding both the historical evolution of the concept and recent changes reflected in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) and the National Institute of Health’s (NIH) Research Domain Criteria (RDOC) framework is critical for informing current efforts to further update and refine the nosology of psychotic spectrum disorders. This chapter offers an overview of past classification schemes, current standards, and novel approaches to further improve the validity of these definitions through use of biomarkers, reverse nosologies, and digital phenotyping tools like smartphones and sensors.

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