Describing Callous Unemotional Traits and Stressful Life Event Trajectories: Differences on Risk Factors and Mental Health Outcomes from the Age of 3 to 10

Callous Unemotional (CU) traits are associated with different environmental risk factors, such as negative stressful life events (SLE). The most common studied SLE associated with CU trait has been childhood maltreatment, but less is known about how other SLE impact the development of CU traits. Therefore, this work examines risk factors, personal factors (executive functioning), and mental health outcomes associated with the trajectories of Callous Unemotional (CU) traits and Stressful Life Events (SLE) in a community sample of children. A cohort of 377 preschoolers were followed up between ages 3 and 10. Several risk factors and outcomes for three trajectory groups (high CU/SLE; high CU/low SLE; and the reference group with low CU/SLE) were analyzed by using multiple post-hoc comparisons. We hypothesized that children with high CU/SLE would face more contextual risk factors, more executive functioning difficulties and more mental health problems than children with high CU/low SLE or the reference group. At the age of 3, children who showed high CU/SLE faced more early contextual adversity, including socioeconomic difficulties and maternal antisocial behavior than the other groups of children. At the age of 10, children with high CU/SLE presented more peer problems and higher psychopathology symptoms than the reference group, but no differences on mental health outcomes in comparison to the high CU/low SLE group. These results have potential implications for clinical practice and studies attempting to identify different CU subtypes in children. (AU)

La impulsividad y su asociación con la inclinación de la frente / Impulsivity and its association with the slant of the forehead

Avances en embriología, genética o neuroimagen, están ayudando a discernir posibles correlaciones entre estructuras del rostro, cerebro y personalidad. Una conducta que ha sido objeto de numerosas investigaciones es la impulsiva, de la que han surgido distintas conceptualizaciones con cierta controversia etiológica. En el presente trabajo estudiamos si el rostro refleja de manera objetiva el nivel de impulsividad. Para ello, se utilizó en población adulta (N=33), la dimensión Búsqueda de Novedad del Inventario de Temperamento y Carácter-Revisado de Cloninger, la Escala de Impulsividad de Barratt (BIS-11) y la Escala de Impulsividad Estado (EIE). En el rostro se midió el grado de inclinación de la frente hacia atrás, resultando una asociación positiva con las 3 puntuaciones psicométricas. Tres jueces evaluaron visualmente el nivel de inclinación de la frente. Se obtuvo un alto acuerdo entre ellos, así como una alta correlación con la medida objetiva de inclinación. Aunque la muestra es reducida, los datos ofrecen una aproximación al objetivo de estudio.

Advances in embryology, genetics and neuroimaging are helping to discern possible correlations between facial structures, brain and personality. A behavior that has been the subject of much research is impulsiveness,where different conceptualizations have arisen with some etiological controversy. Objectifying the possibility of different levels of impulsivity in the face is studied.Foran adult sample (N =33),the Novelty Seeking dimension of Temperament and Character-Revised by Cloninger,the Barratt Impulsiveness Scale (BIS-11) and Impulsiveness Scale State (EIE) were used. In the forehead the degree of inclination front to back was measured, resulting in a positive association with the 3 psychometric scores. Three judges evaluated the level of inclination of the forehead, resulting in a high reliability and a high correlation with the objective measurement of inclination. Although the sample is small, the data provides an objective approach to the study of the variable analyzed.

Spanish adaptation of the Markova and Berrios Insight scale.

INTRODUCTION: The aim of this study was to adapt the Markova and Berrios Insight scale in Spanish and to analyze its psychometric properties and relationships to the severity of the psychotic symptoms. METHODOLOGY: A translation-backtranslation of the original scale was elaborated and a panel of professionals participated to assess conceptual equivalence and naturality. This is a 30-item self-administered scale with response options Yes/No. A total of 170 psychotic patients were assessed according to DSM-IV-TR diagnostic criteria. Confirmatory factor analysis validated the structure originally proposed. Internal consistency was evaluated using Cronbach's Alpha Coefficient and the Intraclass Correlation Coefficient (ICC). We calculated the association between variables with Spearman's rank correlation coefficient. RESULTS: The 4-factors structure originally proposed by Markova and Berrios was verified. Cronbach's alpha coefficient value for the whole scale was 0.824, indicating good internal consistency. The ICC value was 0.855. There were no statistically significant relationships between severity of psychotic symptoms and the lack of insight. CONCLUSIONS: The Spanish adaptation of the Markova and Berrios Insight Scale has good internal and external reliability. It is simple and easy to perform and very sensitive to change.

Adaptación al castellano de la escala de Insight de Marková y Berrios / Spanish adaptation of the Markova and Berrios Insight scale

Introducción. El objetivo de este estudio fue realizar la adaptación al castellano de la escala de Insight de Markováy Berrios, así como analizar sus propiedades psicométricas y su relación con la gravedad de la sintomatología psicótica. Metodología. Se utilizó un método de traducción-retrotraducción y la participación de un panel de profesionales para valorar equivalencia conceptual y naturalidad. Se trata de una escala de autoaplicación de 30 ítems con opciones de respuesta Sí/No. Fueron valorados 170 pacientes psicóticos según criterios DSM-IV-TR. Mediante análisis factorial confirmatorio se validó la estructura propuesta originalmente. La consistencia interna se evaluó a través del Coeficiente Alfa de Cronbach y el Coeficiente de correlación intraclase (CCI). La asociación entre las variables se analizó con el coeficiente de correlación de Spearman. Resultados. La estructura de 4 factores propuesta originalmente se verifica en gran medida. El valor del Coeficiente alfa de Cronbach para toda la escala fue de 0.824 indicando una buena consistencia interna. El valor del CCI fue de 0.855.No se observaron relaciones estadísticamente significativas entre la gravedad de la sintomatología psicótica y el déficit de insight valorado con la escala de Marková y Berrios. Conclusiones. La versión castellana de la Escala de Insightde Marková y Berrios presenta validez de constructo, buena consistencia interna, buena validez externa, es sencilla ,de fácil aplicación y de fiabilidad temporal (AU)

Introduction. The aim of this study was to adapt the Markova and Berrios Insight scale in Spanish and to analyze its psychometric properties and relationships to the severity of the psychotic symptoms. Methodology. A translation-backtranslation of the original scale was elaborated and a panel of professionals participated to assess conceptual equivalence and naturality. This is a 30-item self-administered scale with response options Yes/No. A total of 170 psychotic patients were assessed according to DSM-IV-TR diagnostic criteria. Confirmatory factor analysis validated the structure originally proposed. Internal consistency was evaluated using Cronbach’s Alpha Coefficient and the Intraclass Correlation Coefficient (ICC).We calculated the association between variables with Spearman’s rank correlation coefficient. Results. The 4-factors structure originally proposed by Markova and Berrios was verified. Cronbach’s alpha coefficient value for the whole scale was 0.824, indicating good internal consistency. The ICC value was 0.855. There were no statistically significant relationships between severity of psychotic symptoms and the lack of insight. Conclusions. The Spanish adaptation of the Markova and Berrios Insight Scale has good internal and external reliability. It is simple and easy to perform and very sensitive to change (AU)

Insight, symptomatic dimensions, and cognition in patients with acute-phase psychosis.

AIMS: This study was designed to evaluate the relationship between insight and the severity of psychotic symptomatology in a sample of patients in an acute phase of psychosis, as well as to analyze the relationship between insight and the symptomatic profile of the patient. In addition, the role of general cognitive abilities in this relationship was explored. METHOD: Cross-sectional observational study of 96 acute psychotic adults. To evaluate psychopathology we used the Positive and Negative Syndrome Scale; for insight, the Scale of Unawareness of Mental Disorder; and for general cognitive abilities, the Screen for Cognitive Impairment in Psychiatry. RESULTS: Insight showed significant and moderate positive correlations with positive and general symptoms but not with negative symptoms. In the subgroup with positive symptomatic profile, awareness of the disorder and of the effects of medication were positively associated with severity of positive and general psychotic symptoms. Awareness of social consequences of the disease was positively associated with positive symptoms. In the subgroup with a negative symptomatic profile, awareness of the disorder and of the effects of medication were positively associated with severity of positive and general psychotic symptoms. In this subgroup, these relationships were significantly affected by general cognitive abilities. CONCLUSIONS: Insight was not related with the severity of negative psychotic symptoms. The symptomatic profile of subjects played an important role in determining the relationship between insight and its dimensions and the severity of psychotic symptoms. Cognitive function moderated these relationships only in the negative symptomatic profile.

Plasma osteopontin levels in multiple sclerosis.

Osteopontin (OPN) is a pleiotropic integrin binding protein with functions in cell-mediated immunity, inflammation, tissue repair, and cell survival. Recent studies have shown that OPN may play an important role in the pathogenesis of experimental autoimmune encephalomyelitis and multiple sclerosis (MS). Here, we investigated the plasma levels of OPN in 221 MS patients and 36 healthy controls using an enzyme-linked immunoassay. The MS group comprised of 71 patients with primary and transitional progressive MS (PP/TP-MS), 35 patients with secondary progressive MS (SPMS), and 115 patients with relapsing-remitting MS (RRMS)[46 patients during clinical remission, 26 patients during relapse, and 43 patients treated with interferon-beta (IFNbeta)]. Levels of OPN in plasma were elevated in SPMS patients compared with healthy controls, RRMS patients in remission, and PP/TP-MS patients. Patients with RRMS during relapse presented higher OPN levels than patients with RRMS during clinical remission. When MS patients were classified based on progression of neurological disability, an inverse relation between levels of OPN and disability progression was observed only in patients with relapsing MS. In RRMS patients receiving therapy with IFNbeta, OPN plasma levels were similar to RRMS patients during remission. These findings suggest that OPN is involved in both acute and chronic disease activity, thus expanding the role of OPN in MS pathogenesis suggested by previous studies. Furthermore, the different profiles of OPN levels found in acute relapses and chronic progression and its apparent lack of influence in primary progressive MS phenotypes raise interesting questions on the actual role of OPN in the pathogenesis of MS.