Cognitive-behavioral therapy for generalized anxiety.
Authors: Borza L Abstract As a form of therapy, cognitive behavioral therapy (CBT) is more than a mere "toolbox." CBT allows us to better understand how the human mind is functioning because it is based on neuroscience and experimental and scientific psychology. At the beginning, the Diagnostic and Statistical Manual of Mental Disorders (DSM) was "nontheoretical," but nowadays (the most recent version being DSM-5), it is increasingly based on CBT paradigms (with the insertion of important notions such as cognitions and behaviors). This Brief Report presents what we currently know about generaliz...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neuroinflammation: new vistas for neuropsychiatric research.
Authors: Thibaut F Abstract In psychiatric diseases such as mood disorders or schizophrenia, the inflammatory response system is activated. Microglia has gradually emerged as a key interface between stress-related signals and neuroimnune consequences of stress, with stressors leading to elevated microglial activity. PMID: 28566942 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Affective immunology: where emotions and the immune response converge.
Authors: D'Acquisto F Abstract Affect and emotion are defined as "an essential part of the process of an organism's interaction with stimuli." Similar to affect, the immune response is the "tool" the body uses to interact with the external environment. Thanks to the emotional and immunological response, we learn to distinguish between what we like and what we do not like, to counteract a broad range of challenges, and to adjust to the environment we are living in. Recent compelling evidence has shown that the emotional and immunological systems share more than a similarity of functions. This rev...
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

In immune defense: redefining the role of the immune system in chronic disease.
Authors: Rubinow KB, Rubinow DR Abstract The recognition of altered immune system function in many chronic disease states has proven to be a pivotal advance in biomedical research over the past decade. For many metabolic and mood disorders, this altered immune activity has been characterized as inflammation, with the attendant assumption that the immune response is aberrant. However, accumulating evidence challenges this assumption and suggests that the immune system may be mounting adaptive responses to chronic stressors. Further, the inordinate complexity of immune function renders a simplistic, binary model inca...
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Inflammation: opportunities for treatment stratification among individuals diagnosed with mood disorders.
This article also briefly reviews novel and repurposed agents that are capable of targeting the innate immune inflammatory system and possibly correcting an abnormal immune/inflammatory milieu (eg, infliximab). PMID: 28566945 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A multispecies approach for understanding neuroimmune mechanisms of stress.
Authors: Deak T, Kudinova A, Lovelock DF, Gibb BE, Hennessy MB Abstract The relationship between stress challenges and adverse health outcomes, particularly for the development of affective disorders, is now well established. The highly conserved neuroimmune mechanisms through which responses to stressors are transcribed into effects on males and females have recently garnered much attention from researchers and clinicians alike. The use of animal models, from mice to guinea pigs to primates, has greatly increased our understanding of these mechanisms on the molecular, cellular, and behavioral levels, and research ...
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Immunological aspects of the treatment of depression and schizophrenia.
Authors: Müller N Abstract Schizophrenia and major depression (MD) have been associated with immune system dysfunction. One example of this is the altered level of cytokines-important inflammatory mediators-in blood, and a proinflammatory immune state has been described in some subgroups of patients. A knock to the immune system in early life might trigger a life-long increased immune reactivity, and infections and autoimmune disorders are now known to be risk factors for development of schizophrenia and MD. Pro- and anti-inflammatory cytokines mediate indoleamine 2,3-dioxygenase activity; this enzyme drives m...
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Clinical and autoimmune features of a patient with autism spectrum disorder seropositive for anti-NMDA-receptor autoantibody.
Authors: Gréa H, Scheid I, Gaman A, Rogemond V, Gillet S, Honnorat J, Bolognani F, Czech C, Bouquet C, Toledano E, Bouvard M, Delorme R, Groc L, Leboyer M Abstract Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by dysfunctions in social interactions resulting from a complex interplay between immunogenetic and environmental risk factors. Autoimmunity has been proposed as a major etiological component of ASD. Whether specific autoantibodies directed against brain targets are involved in ASD remains an open question. Here, we identified within a cohort an ASD patient with multiple...
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The potential role of neuroinflammation and transcription factors in Parkinson disease.
Authors: Tiwari PC, Pal R Abstract Parkinson disease (PD) is a neurodegenerative disorder characterized by dopaminergic neurons affected by inflammatory processes. Post-mortem analyses of brain and cerebrospinal fluid from PD patients show the accumulation of proinflammatory cytokines, confirming an ongoing neuroinflammation in the affected brain regions. These inflammatory mediators may activate transcription factors-notably nuclear factor κB, Ying-Yang 1 (YY1), fibroblast growth factor 20 (FGF20), and mammalian target of rapamycin (mTOR)-which then regulate downstream signaling pathways that in turn promote...
Source: Dialogues in Clinical Neuroscience - June 2, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The role of sex and gender in neuropsychiatric disorders.
Authors: Thibaut F Abstract The prevalence, age of onset, and clinical symptoms of many neuropsychiatric diseases substantially differ between males and females. Factors influencing the relationships between brain development and function and sex or gender may help us understand the differences between males and females in terms of risk or resilience factors in brain diseases. PMID: 28179806 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sex influences in neurological disorders: case studies and perspectives.
Authors: Clayton JA Abstract Beginning in the late 1980s and early 1990s, scientists and the public alike recognized that, for too long, women had been underrepresented in clinical trials. While much progress was made in the following decades, preclinical research still often ignores sex as a fundamental biological variable. Many neurological disorders, including multiple sclerosis and migraine, show strong sex differences in incidence and disease manifestation. In this commentary, we highlight case studies of neurological disorders affecting men and women to demonstrate the need for more such studies. Research con...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sex differences in the developing brain as a source of inherent risk.
Authors: McCarthy MM Abstract Brain development diverges in males and females in response to androgen production by the fetal testis. This sexual differentiation of the brain occurs during a sensitive window and induces enduring neuroanatomical and physiological changes that profoundly impact behavior. What we know about the contribution of sex chromosomes is still emerging, highlighting the need to integrate multiple factors into understanding sex differences, including the importance of context. The cellular mechanisms are best modeled in rodents and have provided both unifying principles and surprising specifics...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sex in the brain: hormones and sex differences.
Authors: Marrocco J, McEwen BS Abstract Contrary to popular belief, sex hormones act throughout the entire brain of both males and females via both genomic and nongenomic receptors. Many neural and behavioral functions are affected by estrogens, including mood, cognitive function, blood pressure regulation, motor coordination, pain, and opioid sensitivity. Subtle sex differences exist for many of these functions that are developmentally programmed by hormones and by not yet precisely defined genetic factors, including the mitochondrial genome. These sex differences, and responses to sex hormones in brain regions an...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sex-biased cellular signaling: molecular basis for sex differences in neuropsychiatric diseases.
Authors: Valentino RJ, Bangasser DA Abstract The recognition that there are fundamental biological sex differences that extend beyond those that define sexual behavior and reproductive function has inspired the drive toward inclusion of both sexes in research design. This is supported by an underlying clinical rationale that studying both sexes is necessary to elucidate pathophysiology and develop treatments for the entire population. However, at a more basic level, sex differences, like genetic differences, can be exploited to better understand biology. Here, we discuss how sex differences at the molecular level o...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sex differences in addiction.
Authors: Becker JB Abstract Women exhibit more rapid escalation from casual drug taking to addiction, exhibit a greater withdrawal response with abstinence, and tend to exhibit greater vulnerability than men in terms of treatment outcome. In rodents, short-term estradiol intake in female rats enhances acquisition and escalation of drug taking, motivation for drugs of abuse, and relapse-like behaviors. There is also a sex difference in the dopamine response in the nucleus accumbens. Ovariectomized female rats exhibit a smaller initial dopamine increase after cocaine treatment than castrated males. Estradiol treatmen...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Stress-related disorders, pituitary adenylate cyclase-activating peptide (PACAP)ergic system, and sex differences.
Authors: Ramikie TS, Ressler KJ Abstract Trauma-related disorders, such as posttraumatic stress disorder (PTSD) are remarkably common and debilitating, and are often characterized by dysregulated threat responses. Across numerous epidemiological studies, females have been found to have an approximately twofold increased risk for PTSD and other stress-related disorders. Understanding the biological mechanisms of this differential risk is of critical importance. Recent data suggest that the pituitary adenylate cyclase-activating polypeptide (PACAP) pathway is a critical regulator of the stress response across species...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sex differences in the effects of androgens acting in the central nervous system on metabolism.
Authors: Morford J, Mauvais-Jarvis F Abstract One of the most sexually dimorphic aspects of metabolic regulation is the bidirectional modulation of glucose and energy homeostasis by testosterone in males and females. Testosterone deficiency predisposes men to metabolic dysfunction, with excess adiposity, insulin resistance, and type 2 diabetes, whereas androgen excess predisposes women to insulin resistance, adiposity, and type 2 diabetes. This review discusses how testosterone acts in the central nervous system, and especially the hypothalamus, to promote metabolic homeostasis or dysfunction in a sexually dimorphi...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Prenatal stress-immune programming of sex differences in comorbidity of depression and obesity/metabolic syndrome.
Authors: Goldstein JM, Holsen L, Huang G, Hammond BD, James-Todd T, Cherkerzian S, Hale TM, Handa RJ Abstract Major depressive disorder (MDD) is the number one cause of disability worldwide and is comorbid with many chronic diseases, including obesity/metabolic syndrome (MetS). Women have twice as much risk for MDD and comorbidity with obesity/MetS as men, although pathways for understanding this association remain unclear. On the basis of clinical and preclinical studies, we argue that prenatal maternal stress (ie, excess glucocorticoid expression and associated immune responses) that occurs during the sexual diff...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Considering sex and gender in Alzheimer disease and other dementias.
Authors: Podcasy JL, Epperson CN Abstract Suffering related to dementia is multifaceted because cognitive and physical functioning slowly deteriorates. Advanced age and sex, two of the most prominent risk factors for dementia, are not modifiable. Lifestyle factors such as smoking, excessive alcohol use, and poor diet modulate susceptibility to dementia in both males and females. The degree to which the resulting health conditions (eg, obesity, type 2 diabetes, and cardiovascular disease) impact dementia risk varies by sex. Depending on the subtype of dementia, the ratio of male to female prevalence differs. For exa...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sex differences in the psychopharmacological treatment of depression.
Authors: Sramek JJ, Murphy MF, Cutler NR Abstract Although a number of studies have observed that females respond better to serotonergic antidepressants than males and that postmenopausal females have a diminished response to antidepressants compared with younger females, there are also studies that conflict with both of these findings, making any generalizations regarding sex differences difficult to make. Sex variance in antidepressant efficacy and pharmacokinetics profiles have been attributed to sex-based physiological differences, behavioral differences, related disorders, and sex-specific conditions, includin...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The placenta and neurodevelopment: sex differences in prenatal vulnerability.
Authors: Bale TL Abstract Prenatal insults, such as maternal stress, are associated with an increased neurodevelopmental disease risk and impact males significantly more than females, including increased rates of autism, mental retardation, stuttering, dyslexia, and attention deficit/hyperactivity disorder (ADHD). Sex differences in the placenta, which begin with sex chromosomes, are likely to produce sex-specific transplacental signals to the developing brain. Our studies and others have identified X-linked genes that are expressed at higher levels in the female placenta. Through a genome-wide screen after materna...
Source: Dialogues in Clinical Neuroscience - February 13, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

From basic research to personalized medicine.
Authors: Thibaut F Abstract In the future, precision medicine will enable every clinician to tailor treatment and even prevention strategies to an individual's unique characteristics. In order to reach this goal, we need to collect and analyze many different types of data, from many different sources, including symptoms, genomics, and brain circuitry, as well as family dynamics, environmental exposures, and cultural background. PMID: 27757058 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neuropsychiatric genomics in precision medicine: diagnostics, gene discovery, and translation.
Authors: Need AC, Goldstein DB Abstract Only a few years after its development, next-generation sequencing is rapidly becoming an essential part of clinical care for patients with serious neurological conditions, especially in the diagnosis of early-onset and severe presentations. Beyond this diagnostic role, there has been an explosion in definitive gene discovery in a range of neuropsychiatric diseases. This is providing new pointers to underlying disease biology and is beginning to outline a new framework for genetic stratification of neuropsychiatric disease, with clear relevance to both individual treatment op...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Omics approaches to individual variation: modeling networks and the virtual patient.
Authors: Lehrach H Abstract Every human is unique. We differ in our genomes, environment, behavior, disease history, and past and current medical treatment-a complex catalog of differences that often leads to variations in the way each of us responds to a particular therapy. We argue here that true personalization of drug therapies will rely on "virtual patient" models based on a detailed characterization of the individual patient by molecular, imaging, and sensor techniques. The models will be based, wherever possible, on the molecular mechanisms of disease processes and drug action but can also expand t...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Human iPSC-derived neurons and lymphoblastoid cells for personalized medicine research in neuropsychiatric disorders.
Authors: Gurwitz D Abstract The development and clinical implementation of personalized medicine crucially depends on the availability of high-quality human biosamples; animal models, although capable of modeling complex human diseases, cannot reflect the large variation in the human genome, epigenome, transcriptome, proteome, and metabolome. Although the biosamples available from public biobanks that store human tissues and cells may represent the large human diversity for most diseases, these samples are not always sufficient for developing biomarkers for patient-tailored therapies for neuropsychiatric disorders....
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Individual variation in functional brain connectivity: implications for personalized approaches to psychiatric disease.
Authors: Finn ES, Todd Constable R Abstract Functional brain connectivity measured with functional magnetic resonance imaging (fMRI) is a popular technique for investigating neural organization in both healthy subjects and patients with mental illness. Despite a rapidly growing body of literature, however, functional connectivity research has yet to deliver biomarkers that can aid psychiatric diagnosis or prognosis at the single-subject level. One impediment to developing such practical tools has been uncertainty regarding the ratio of intra- to interindividual variability in functional connectivity; in other words...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

An epigenomics approach to individual differences and its translation to neuropsychiatric conditions.
Authors: Sweatt JD, Tamminga CA Abstract This review concerns epigenetic mechanisms and their roles in conferring interindividual differences, especially as related to experientially acquired and genetically driven changes in central nervous system (CNS) function. In addition, the review contains commentary regarding the possible ways in which epigenomic changes may contribute to neuropsychiatric conditions and disorders and ways in which epigenotyping might be cross-correlated with clinical phenotyping in the context of precision medicine. The review begins with a basic description of epigenetic marking in the CNS...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Genomic sequencing in clinical practice: applications, challenges, and opportunities.
Authors: Krier JB, Kalia SS, Green RC Abstract The development of massively parallel sequencing (or next-generation sequencing) has facilitated a rapid implementation of genomic sequencing in clinical medicine. Genomic sequencing (GS) is now an essential tool for evaluating rare disorders, identifying therapeutic targets in neoplasms, and screening for prenatal aneuploidy. Emerging applications, such as GS for preconception carrier screening and predisposition screening in healthy individuals, are being explored in research settings and utilized by members of the public eager to incorporate genomic information into...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Personalized prescribing: a new medical model for clinical implementation of psychotropic drugs.
Authors: Eap CB Abstract The use of pharmacogenetic tests was already being proposed in psychiatry in the early 2000s because genetic factors were known to influence drug pharmacokinetics and pharmacodynamics. However, sufficient levels of evidence to justify routine use have been achieved for only a few tests (eg, major histocompatibility complex, class I, B, allele 1502 [HLA-B*1502] for carbamazepine in epilepsy and bipolar disorders); many findings are too preliminary or, when replicated, of low clinical relevance because of a small effect size. Although drug selection and dose adaptation according to cytochrome...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pharmacogenetic tests for antipsychotic medications: clinical implications and considerations.
Authors: Eum S, Lee AM, Bishop JR Abstract Optimizing antipsychotic pharmacotherapy is often challenging due to significant variability in effectiveness and tolerability. Genetic factors influencing pharmacokinetics and pharmacodynamics may contribute to some of this variability. Research studies have characterized these pharmacogenetic relationships, and some genetic markers are now available as clinical tests. These advances in pharmacogenetics research and test availability have great potential to improve clinical outcomes and quality of life in psychiatric patients. For clinicians considering using pharmacogene...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Transforming big data into computational models for personalized medicine and health care.
Authors: Reza Soroushmehr SM, Najarian K Abstract Health care systems generate a huge volume of different types of data. Due to the complexity and challenges inherent in studying medical information, it is not yet possible to create a comprehensive model capable of considering all the aspects of health care systems. There are different points of view regarding what the most efficient approaches toward utilization of this data would be. In this paper, we describe the potential role of big data approaches in improving health care systems and review the most common challenges facing the utilization of health care big ...
Source: Dialogues in Clinical Neuroscience - October 23, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Digital applications: the future in psychiatry?
Authors: Thibaut F Abstract Digital applications and new mobile technologies can change the nature of the psychiatrist-patient relationship and future clinical practice in terms of diagnosis, follow-up, and treatment, but need to be further studied. This issue explores these new approaches in psychiatry. PMID: 27489451 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The emerging story of emerging technologies in neuropsychiatry.
Authors: Coffey MJ, Coffey CE Abstract The growth of new technologies in health care is exponential, and the impact of such rapid technological innovation on health care delivery is substantial. This review describes two emerging technologies-mobile applications and wearable technologies-and uses a virtual case report to illustrate the impact of currently available technologies on the health care experience of a patient with neuropsychiatric illness. PMID: 27489452 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Issues and developments related to assessing function in serious mental illness.
Authors: Brown MA, Velligan DI Abstract Serious mental illness (SMI) results in functional disability that imposes a significant burden on individuals, caregivers, and society. Development of novel treatments is under way in an effort to improve the illness domains of cognitive impairment and negative symptoms and subsequently to improve functional outcomes. The assessment of functional outcomes in SMI faces a number of challenges, including the proliferation of assessment instruments and the differential prioritization of functional goals among stakeholder groups. Functional assessments relying on self- and inform...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Functional assessment in mental health: lessons from occupational therapy.
Authors: Rogers JC, Holm MB Abstract Occupational therapists have been conducting functional assessments since World War I, and this accumulated experience has taught us several critical lessons. First, a comprehensive profile of a patient's functioning requires multiple assessment methods. Second, assessment content and measurement constructs must change with the times. Third, technology can enhance and extend functional assessment. Fourth, performance-based assessments of everyday activities can also be used to measure body functions/impairments. However, while deconstructing activities into body functions/impair...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neurotechnological assessment of consciousness disorders: five ethical imperatives.
Authors: Evers K Abstract Disorders of consciousness (DOCs) cause great human suffering and material costs for society. Understanding of these disorders has advanced remarkably in recent years, but uncertainty remains with respect to the diagnostic criteria and standards of care. One of the most serious problems concerns misdiagnoses, their impact on medical decision-making, and on patients' well-being. Recent studies use neurotechnology to assess residual consciousness in DOC patients that traditional behavioral diagnostic criteria are unable to detect. The results show an urgent need to strengthen the development...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Mobile technology for mental health assessment.
Authors: Areàn PA, Hoa Ly K, Andersson G Abstract Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional a...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Technology to assess and support self-management in serious mental illness.
Authors: Depp CA, Moore RC, Perivoliotis D, Granholm E Abstract The functional impairment associated with serious mental illness (SMI) places an immense burden on individuals and society, and disability often persists even after efficacious treatment of psychopathologic symptoms. Traditional methods of measuring functioning have limitations, and numerous obstacles reduce the reach and impact of evidence-based interventions developed to improve functioning in SMI. This review describes the potential of technological innovations for overcoming the challenges involved in both functional assessment and intervention in ...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Prevention of suicidal behavior.
Authors: Hegerl U Abstract More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, as well as other factors. In the vast majority of cases, suicidal behavior occurs in the context of psychiatric disorders, depression being the most important one. Improving the treatment of depression, restricting access to lethal means, and avoiding the Werther effect (im...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A review of behavioral tailoring strategies for improving medication adherence in serious mental illness.
Authors: Kreyenbuhl J, Record EJ, Palmer-Bacon J Abstract Nonadherence to psychopharmacological treatments poses a significant challenge to treatment success in individuals with serious mental illness, with upwards of 60% of people not taking their psychiatric medications as prescribed. Nonadherence is associated with adverse outcomes, including exacerbation of psychiatric symptoms, impaired functioning, increased hospitalizations and emergency room use, and increased health care costs. Whereas interventions using psychoeducation or cognitive approaches, such as motivational interviewing, have largely proven ineffe...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Internet interventions for depression: new developments.
Authors: Schröder J, Berger T, Westermann S, Klein JP, Moritz S Abstract A wide range of Internet interventions, mostly grounded in methods of cognitive behavioral therapy, have been developed and tested for several mental disorders. The evidence to date shows that these interventions are effective in reducing symptoms of depression. Metaanalyses report small-to-medium effect sizes when Internet interventions are delivered as stand-alone self-help interventions (d=0.25-0.36), and medium-to-large effect sizes when delivered as therapist-guided interventions (d=0.58-0.78), both compared with usual care. Only a m...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Contributions of mobile technologies to addiction research.
Authors: Swendsen J Abstract Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more a...
Source: Dialogues in Clinical Neuroscience - August 6, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Basal ganglia play a crucial role in decision making.
Authors: Thibaut F Abstract Many studies have suggested that the striatum, located at the interface of the cortico-basal ganglia-thalamic circuit, consists of separate circuits that serve distinct functions It plays an important role in motor planning, value processing, and decision making. PMID: 27069375 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Corticostriatal circuitry.
This article provides an overview of the connections of the cortex to the striatum and their role in integrating information across reward, cognitive, and motor functions. Emphasis is placed on the interface between functional domains within the striatum. PMID: 27069376 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Dopamine reward prediction error coding.
Authors: Schultz W Abstract Reward prediction errors consist of the differences between received and predicted rewards. They are crucial for basic forms of learning about rewards and make us strive for more rewards-an evolutionary beneficial trait. Most dopamine neurons in the midbrain of humans, monkeys, and rodents signal a reward prediction error; they are activated by more reward than predicted (positive prediction error), remain at baseline activity for fully predicted rewards, and show depressed activity with less reward than predicted (negative prediction error). The dopamine signal increases nonlinearly wit...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Habit formation.
Authors: Smith KS, Graybiel AM Abstract Habits, both good ones and bad ones, are pervasive in animal behavior. Important frameworks have been developed to understand habits through psychological and neurobiological studies. This work has given us a rich understanding of brain networks that promote habits, and has also helped us to understand what constitutes a habitual behavior as opposed to a behavior that is more flexible and prospective. Mounting evidence from studies using neural recording methods suggests that habit formation is not a simple process. We review this evidence and take the position that habits co...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Reward and decision processes in the brains of humans and nonhuman primates.
Authors: Sirigu A, Duhamel JR Abstract Choice behavior requires weighing multiple decision variables, such as utility, uncertainty, delay, or effort, that combine to define a subjective value for each considered option or course of action. This capacity is based on prior learning about potential rewards (and punishments) that result from prior actions. When made in a social context, decisions can involve strategic thinking about the intentions of others and about the impact of others' behavior on one's own outcome. Valuation is also influenced by different emotions that serve to adaptively regulate our choices in o...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The involvement of the striatum in decision making.
Authors: Goulet-Kennedy J, Labbe S, Fecteau S Abstract Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the d...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Corticostriatal circuitry in regulating diseases characterized by intrusive thinking.
Authors: Kalivas BC, Kalivas PW Abstract Intrusive thinking triggers clinical symptoms in many neuropsychiatric disorders. Using drug addiction as an exemplar disorder sustained in part by intrusive thinking, we explore studies demonstrating that impairments in corticostriatal circuitry strongly contribute to intrusive thinking. Neuroimaging studies have long implicated this projection in cue-induced craving to use drugs, and preclinical models show that marked changes are produced at corticostriatal synapses in the nucleus accumbens during a relapse episode. We delineate an accumbens microcircuit that mediates cue...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Striatal dopamine, reward, and decision making in schizophrenia.
Authors: Deserno L, Schlagenhauf F, Heinz A Abstract Elevated striatal dopamine function is one of the best-established findings in schizophrenia. In this review, we discuss causes and consequences of this striata! dopamine alteration. We first summarize earlier findings regarding striatal reward processing and anticipation using functional neuroimaging. Secondly, we present a series of recent studies that are exemplary for a particular research approach: a combination of theory-driven reinforcement learning and decision-making tasks in combination with computational modeling and functional neuroimaging. We discuss...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research