Psychological Medicine最新文献

{"title":"Discussing the concept of substance-induced psychosis (SIP)","authors":"Jørgen G. Bramness, Carsten Hjorthøj, Solja Niemelä, Heidi Taipale, Eline Borger Rognli","doi":"10.1017/s0033291724001442","DOIUrl":"https://doi.org/10.1017/s0033291724001442","url":null,"abstract":"Substance-induced psychosis (SIP) is characterized by both substance use and a psychotic state, and it is assumed that the first causes the latter. In ICD-10 the diagnosis is categorized as and grouped together with substance use disorders, and to a large extent also treated as such in the health care system. Though criticism of the diagnostic construct of SIP dates back several decades, numerous large and high-quality studies have been published during the past 5–10 years that substantiate and amplify this critique. The way we understand SIP and even how we name it is of major importance for treatment and it has judicial consequences. It has been demonstrated that substance use alone is not sufficient to cause psychosis, and that other risk factors besides substance use are at play. These are risk factors that are also known to be associated with schizophrenia spectrum disorders. Furthermore, register-based studies from several different countries find that a large proportion, around one in four, of those who are initially diagnosed with an SIP over time are subsequently diagnosed with a schizophrenia spectrum disorder. This scoping review discusses the construct validity of SIP considering recent evidence. We challenge the immanent causal assumption in SIP, and advocate that the condition shares many features with the schizophrenia spectrum disorders. In conclusion, we argue that SIP just as well could be considered a first-episode psychotic disorder in patients with substance use.","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of depression treatment on health behaviors and cardiovascular risk factors in primary care patients with depression and elevated cardiovascular risk: data from the eIMPACT trial","authors":"Matthew D. Schuiling, Aubrey L. Shell, Christopher M. Callahan, John I. Nurnberger, Krysha L. MacDonald, Robert V. Considine, Wei Wu, Adam T. Hirsh, Christopher A. Crawford, Michelle K. Williams, Timothy C. Lipuma, Samir K. Gupta, Richard J. Kovacs, Bruce L. Rollman, Jesse C. Stewart","doi":"10.1017/s0033291724001429","DOIUrl":"https://doi.org/10.1017/s0033291724001429","url":null,"abstract":"Background Depression is an independent risk factor for cardiovascular disease (CVD), but it is unknown if successful depression treatment reduces CVD risk. Methods Using eIMPACT trial data, we examined the effect of modernized collaborative care for depression on indicators of CVD risk. A total of 216 primary care patients with depression and elevated CVD risk were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed over 12 months. Incident CVD events were tracked over four years using a statewide health information exchange. Results The intervention group exhibited greater improvement in depressive symptoms (<jats:italic>p</jats:italic> &lt; 0.01) and sleep quality (<jats:italic>p &lt;</jats:italic> 0.01) than the usual care group, but there was no intervention effect on systolic blood pressure (<jats:italic>p</jats:italic> = 0.36), low-density lipoprotein cholesterol (<jats:italic>p</jats:italic> = 0.38), high-density lipoprotein cholesterol (<jats:italic>p</jats:italic> = 0.79), triglycerides (<jats:italic>p</jats:italic> = 0.76), CVD prevention medication adherence (<jats:italic>p</jats:italic> = 0.64), or sedentary behavior (<jats:italic>p</jats:italic> = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (<jats:italic>p</jats:italic> = 0.02). The likelihood of an incident CVD event did not differ between the intervention (13/107, 12.1%) and usual care (9/109, 8.3%) groups (<jats:italic>p</jats:italic> = 0.39). Conclusions Successful depression treatment alone is not sufficient to lower the heightened CVD risk of people with depression. Alternative approaches are needed. Trial Registration: ClinicalTrials.gov Identifier: NCT02458690","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural activation changes following attention bias modification treatment or a selective serotonin reuptake inhibitor for social anxiety disorder","authors":"Omer Azriel, Gal Arad, Niv Tik, Mark Weiser, Miki Bloch, Eddie Garber, Amit Lazarov, Daniel S. Pine, Ido Tavor, Yair Bar-Haim","doi":"10.1017/s0033291724001521","DOIUrl":"https://doi.org/10.1017/s0033291724001521","url":null,"abstract":"Background Delineation of changes in neural function associated with novel and established treatments for social anxiety disorder (SAD) can advance treatment development. We examined such changes following selective serotonin reuptake inhibitor (SSRI) and attention bias modification (ABM) variant – gaze-contingent music reward therapy (GC-MRT), a first-line and an emerging treatments for SAD. Methods Eighty-one patients with SAD were allocated to 12-week treatments of either SSRI or GC-MRT, or waitlist (<jats:italic>n</jats:italic>s = 22, 29, and 30, respectively). Baseline and post-treatment functional magnetic resonance imaging (fMRI) data were collected during a social-threat processing task, in which attention was directed toward and away from threat/neutral faces. Results Patients who received GC-MRT or SSRI showed greater clinical improvement relative to patients in waitlist. Compared to waitlist patients, treated patients showed greater activation increase in the right inferior frontal gyrus and anterior cingulate cortex when instructed to attend toward social threats and away from neutral stimuli. An additional anterior cingulate cortex cluster differentiated between the two active groups. Activation in this region increased in ABM and decreased in SSRI. In the ABM group, symptom change was positively correlated with neural activation change in the dorsolateral prefrontal cortex. Conclusions Brain function measures show both shared and treatment-specific changes following ABM and SSRI treatments for SAD, highlighting the multiple pathways through which the two treatments might work. Treatment-specific neural responses suggest that patients with SAD who do not fully benefit from SSRI or ABM may potentially benefit from the alternative treatment, or from a combination of the two. Trial Registration: ClinicalTrials.gov, Identifier: NCT03346239. <jats:uri xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://clinicaltrials.gov/ct2/show/NCT03346239\">https://clinicaltrials.gov/ct2/show/NCT03346239</jats:uri>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting suicide risk among U.S. servicemembers and veterans: a deep learning approach using social media data.","authors":"Kelly L Zuromski, Daniel M Low, Noah C Jones, Richard Kuzma, Daniel Kessler, Liutong Zhou, Erik K Kastman, Jonathan Epstein, Carlos Madden, Satrajit S Ghosh, David Gowel, Matthew K Nock","doi":"10.1017/S0033291724001557","DOIUrl":"https://doi.org/10.1017/S0033291724001557","url":null,"abstract":"<p><strong>Background: </strong>Military Servicemembers and Veterans are at elevated risk for suicide, but rarely self-identify to their leaders or clinicians regarding their experience of suicidal thoughts. We developed an algorithm to identify posts containing suicide-related content on a military-specific social media platform.</p><p><strong>Methods: </strong>Publicly-shared social media posts (<i>n</i> = 8449) from a military-specific social media platform were reviewed and labeled by our team for the presence/absence of suicidal thoughts and behaviors and used to train several machine learning models to identify such posts.</p><p><strong>Results: </strong>The best performing model was a deep learning (RoBERTa) model that incorporated post text and metadata and detected the presence of suicidal posts with relatively high sensitivity (0.85), specificity (0.96), precision (0.64), F1 score (0.73), and an area under the precision-recall curve of 0.84. Compared to non-suicidal posts, suicidal posts were more likely to contain explicit mentions of suicide, descriptions of risk factors (e.g. depression, PTSD) and help-seeking, and first-person singular pronouns.</p><p><strong>Conclusions: </strong>Our results demonstrate the feasibility and potential promise of using social media posts to identify at-risk Servicemembers and Veterans. Future work will use this approach to deliver targeted interventions to social media users at risk for suicide.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experience sampling methodology as a digital clinical tool for more person-centered mental health care: an implementation research agenda.","authors":"Inez Myin-Germeys, Anita Schick, Thomas Ganslandt, Michal Hajdúk, Anton Heretik, Ine Van Hoyweghen, Glenn Kiekens, Georgia Koppe, Luca Marelli, Iveta Nagyova, Jeroen Weermeijer, Michel Wensing, Maria Wolters, Joanne Beames, Manuela de Allegri, Simona di Folco, Daniel Durstewitz, Zuzana Katreniaková, Elisa Lievevrouw, Hoa Nguyen, Jan Pecenak, Islay Barne, Rafael Bonnier, Manuel Brenner, Natália Čavojská, Daniel Dancik, Adam Kurilla, Erica Niebauer, Koraima Sotomayor-Enriquez, Julia Schulte-Strathaus, Lena de Thurah, Lotte Uyttebroek, Matthias Schwannauer, Ulrich Reininghaus","doi":"10.1017/S0033291724001454","DOIUrl":"https://doi.org/10.1017/S0033291724001454","url":null,"abstract":"<p><p>This position paper by the international IMMERSE consortium reviews the evidence of a digital mental health solution based on Experience Sampling Methodology (ESM) for advancing person-centered mental health care and outlines a research agenda for implementing innovative digital mental health tools into routine clinical practice. ESM is a structured diary technique recording real-time self-report data about the current mental state using a mobile application. We will review how ESM may contribute to (1) service user engagement and empowerment, (2) self-management and recovery, (3) goal direction in clinical assessment and management of care, and (4) shared decision-making. However, despite the evidence demonstrating the value of ESM-based approaches in enhancing person-centered mental health care, it is hardly integrated into clinical practice. Therefore, we propose a global research agenda for implementing ESM in routine mental health care addressing six key challenges: (1) the motivation and ability of service users to adhere to the ESM monitoring, reporting and feedback, (2) the motivation and competence of clinicians in routine healthcare delivery settings to integrate ESM in the workflow, (3) the technical requirements and (4) governance requirements for integrating these data in the clinical workflow, (5) the financial and competence related resources related to IT-infrastructure and clinician time, and (6) implementation studies that build the evidence-base. While focused on ESM, the research agenda holds broader implications for implementing digital innovations in mental health. This paper calls for a shift in focus from developing new digital interventions to overcoming implementation barriers, essential for achieving a true transformation toward person-centered care in mental health.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of emotional facial expressions in aggression and psychopathy.","authors":"Timo Stein, Nina Gehrer, Aiste Jusyte, Jonathan Scheeff, Michael Schönenberg","doi":"10.1017/S0033291724001417","DOIUrl":"10.1017/S0033291724001417","url":null,"abstract":"<p><strong>Background: </strong>Altered affective state recognition is assumed to be a root cause of aggressive behavior, a hallmark of psychopathologies such as psychopathy and antisocial personality disorder. However, the two most influential models make markedly different predictions regarding the underlying mechanism. According to the integrated emotion system theory (IES), aggression reflects impaired processing of social distress cues such as fearful faces. In contrast, the hostile attribution bias (HAB) model explains aggression with a bias to interpret ambiguous expressions as angry.</p><p><strong>Methods: </strong>In a set of four experiments, we measured processing of fearful and angry facial expressions (compared to neutral and other expressions) in a sample of 65 male imprisoned violent offenders rated using the Hare Psychopathy Checklist-Revised (PCL-R, Hare, R. D. (1991). <i>The psychopathy checklist-revised</i>. Toronto, ON: Multi-Health Systems) and in 60 age-matched control participants.</p><p><strong>Results: </strong>There was no evidence for a fear deficit in violent offenders or for an association of psychopathy or aggression with impaired processing of fearful faces. Similarly, there was no evidence for a perceptual bias for angry faces linked to psychopathy or aggression. However, using highly ambiguous stimuli and requiring explicit labeling of emotions, violent offenders showed a categorization bias for anger and this anger bias correlated with self-reported trait aggression (but not with psychopathy).</p><p><strong>Conclusions: </strong>These results add to a growing literature casting doubt on the notion that fear processing is impaired in aggressive individuals and in psychopathy and provide support for the idea that aggression is related to a hostile attribution bias that emerges from later cognitive, post-perceptual processing stages.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of cognitive flexibility and its implications for mental health disorders.","authors":"Ke Tong, Xinchen Fu, Natalie P Hoo, Lee Kean Mun, Chrysoula Vassiliu, Christelle Langley, Barbara J Sahakian, Victoria Leong","doi":"10.1017/S0033291724001508","DOIUrl":"10.1017/S0033291724001508","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-modal assessment of self-knowledge in adolescents with non-suicidal self-injury: a research domains criteria (RDoC) study.","authors":"Michelle Thai, Zeynep Başgöze, Melinda Westlund Schreiner, Donovan J Roediger, Chloe A Falke, Bryon A Mueller, Mark B Fiecas, Karina Quevedo, Jennifer H Pfeifer, Bonnie Klimes-Dougan, Kathryn R Cullen","doi":"10.1017/S0033291724001399","DOIUrl":"https://doi.org/10.1017/S0033291724001399","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a critical period for brain development, consolidation of self-understanding, and onset of non-suicidal self-injury (NSSI). This study evaluated the RDoC (Research Domain Criteria) sub-construct of Self-Knowledge in relation to adolescent NSSI using multiple units of analysis.</p><p><strong>Methods: </strong>One hundred and sixty-four adolescents assigned female at birth (AFAB), ages 12-16 years with and without a history of NSSI entered a study involving clinical assessment and magnetic resonance imaging (MRI), including structural, resting-state functional MRI (fMRI), and fMRI during a self-evaluation task. For imaging analyses, we used an <i>a priori</i> defined Self Network (anterior cingulate, orbitofrontal, and posterior cingulate cortices; precuneus). We first examined interrelationships among multi-level Self variables. We then evaluated the individual relationships between NSSI severity and multi-level Self variables (self-report, behavior, multi-modal brain Self Network measures), then conducted model testing and multiple regression to test how Self variables (together) predicted NSSI severity.</p><p><strong>Results: </strong>Cross-correlations revealed key links between self-reported global self-worth and self-evaluation task behavior. Individually, greater NSSI severity correlated with lower global self-worth, more frequent and faster negative self-evaluations, lower anterior Self Network activation during self-evaluation, and lower anterior and posterior Self Network resting-state connectivity. Multiple regression analysis revealed the model including multi-level Self variables explained NSSI better than a covariate-only model; the strongest predictive variables included self-worth, self-evaluation task behavior, and resting-state connectivity.</p><p><strong>Conclusions: </strong>Disruptions in Self-Knowledge across multiple levels of analysis relate to NSSI in adolescents. Findings suggest potential neurobiological treatment targets, potentially enhancing neuroplasticity in Self systems to facilitate greater flexibility (more frequently positive) of self-views in AFAB adolescents.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The course of children's mental health symptoms during and beyond the COVID-19 pandemic.","authors":"Joanne L Park, Brae Anne McArthur, André Plamondon, Jackson M A Hewitt, Nicole Racine, Sheila McDonald, Suzanne Tough, Sheri Madigan","doi":"10.1017/S0033291724001491","DOIUrl":"10.1017/S0033291724001491","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic is associated with increases in child mental health problems, but the persistence of these changes in the post-pandemic era remains uncertain. Additionally, it is unclear whether changes in mental health problems during the pandemic exceed the anticipated increases as children age. This study controls for the linear effect of age in 1399 children, investigating the course of child-reported anxiety, depression, hyperactivity, and inattention symptoms during and after the pandemic, and identifies risk and protective factors that predict these mental health trajectories.</p><p><strong>Methods: </strong>Children (51% male; ages 9-11 at the first timepoint) provided mental health ratings at three pandemic timepoints (July-August 2020; March-April 2021; November 2021-January 2022) and one post-pandemic timepoint (January-July 2023). Mothers reported pre-pandemic mental health (2017-2019) and socio-demographic factors. Children reported socio-demographic factors, risk (e.g. screen time, sleep), and resilience (e.g. optimism) factors during the first timepoint.</p><p><strong>Results: </strong>Average mental health symptoms increased over time, with more children exceeding clinical cut-offs for poor mental health at each subsequent pandemic timepoint. Growth curve modeling, adjusting for age-related effects, revealed a curvilinear course of mental health symptoms across all domains. Examination of risk and protective factors revealed that pre-existing mental health symptoms and optimism were associated with the course of symptoms.</p><p><strong>Conclusions: </strong>After considering age effects, children's mental health follows a curvilinear pattern over time, suggesting an initial decline followed by a rising trend in symptoms post-COVID. These findings underscore the continued need for additional resources and timely, evidence-based mental health prevention and intervention for children.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in fear learning as a mechanism linking childhood exposure to violence with PTSD symptoms: a longitudinal study.","authors":"Laura Machlin, Margaret A Sheridan, Lucy A Lurie, Steven W Kasparek, Stephanie Gyuri Kim, Matthew Peverill, John McClellan France, Madeline M Robertson, Tanja Jovanovic, Liliana J Lengua, Katie A McLaughlin","doi":"10.1017/S0033291724001569","DOIUrl":"https://doi.org/10.1017/S0033291724001569","url":null,"abstract":"<p><strong>Background: </strong>Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth.</p><p><strong>Methods: </strong>The sample includes 170 youths aged 10-13 years (<i>M =</i> 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later.</p><p><strong>Results: </strong>Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS-) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms.</p><p><strong>Conclusions: </strong>Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}