A randomized controlled trial of a bidirectional cultural adaptation of cognitive behavior therapy for children and adolescents with anxiety disorders.

BACKGROUND: Cognitive behavior therapy (CBT) programs with ethnic and cultural sensitivity are scarce. This study was the first randomized controlled trial of cognitive behavior therapy for children and adolescents with anxiety disorders using bidirectional cultural adaptation. METHODS: The Japanese Anxiety Children/Adolescents Cognitive Behavior Therapy program (JACA-CBT) was developed based on existing evidence-based CBT for anxious youth and optimized through feedback from clinicians in the indigenous cultural group. Fifty-one children and adolescents aged 8-15 with anxiety disorders were randomly allocated to either a cognitive behavioral treatment (CBT: 122.08 days, SD = 48.15) or a wait-list control condition (WLC: 70.00 days, SD = 11.01). Participants were assessed at pre-treatment and post-treatment as well as 3 and 6 months after completion of treatment (92.88 days, SD = 17.72 and 189.42 days, SD = 25.06) using a diagnostic interview, self-report measures of anxiety, depression, cognitive errors, and a parent-report measure of anxiety. RESULTS: A significant difference was found between the CBT and WLC at post-treatment, specifically 50% of participants in the treatment condition were free from their principal diagnoses compared to 12% in the wait-list condition, χ2 (1, N = 51) = 8.55, η2 = 0.17, p < .01. In addition, participants in the treatment condition showed significant improvement in clinical severity and child-self reported depression, F (1, 49) = 12.38, p < .001, F (1, 47.60) = 5.95, p < .05. At post-treatment, Hedge's g between the conditions was large for clinical severity, 1.00 (95% CI = 0.42-1.58), and moderate for the self-report anxiety scale, 0.43 (0.19-1.04), two depression scales, 0.39 (0.22-1.00), 0.48 (0.14-1.09), and the cognitive errors scale, 0.38 (0.24-0.99). Finally, significant improvements in diagnostic status were evident at the 3 and 6-month follow-up assessments when combining the CBT and WLC, ps < .001. CONCLUSION: The current results support the transportability of CBT and the efficacy of a bidirectional, culturally adapted cognitive behavior therapy in an underrepresented population.

Cognitive behavioural therapy for Japanese children and adolescents with anxiety disorders: a pilot study.

BACKGROUND: Thirty-three Japanese children and adolescents diagnosed with an anxiety disorder participated in individual or group Cognitive Behaviour Therapy (CBT) that was modelled after evidence-based intervention programs developed in Western countries. METHOD: The treatment consisted of: (a) building rapport and education; (b) identifying emotions and recognizing cognitive self-talk; (c) challenging anxious self-talk; (d) developing an anxiety hierarchy and in vivo exposures; and (e) planning for future challenges. RESULTS: Three months following treatment, 20 of the 33 children and adolescents (60.91%) no longer met criteria for their principal anxiety disorders and 16 (48.48%) were free from all anxiety disorders. Self-reported anxiety, depression, and cognitive errors also decreased significantly from pre- to post-treatment and these gains were maintained at 3-month follow-up. For the most part, similar outcomes were found in both the group and individual formats of CBT. CONCLUSIONS: This study provides preliminary support for the transportability of CBT in both an individual and group format to Japan.

Habituation in prepulse inhibition is affected by a polymorphism on the NMDA receptor 2B subunit gene (GRIN2B).

OBJECTIVES: To identify the reliable connectivity between causal genes or variants with an abnormality expressed in a certain endophenotype has been viewed as a crucial step in unraveling the etiology of schizophrenia because of the considerable heterogeneity in this disorder. METHODS: According to this practical and scientific demand, we aimed to investigate the relationship between seven top-ranked variants in the SZgene database [120-bpTR in DRD4, rs1801028 and rs6277 in DRD2, rs1019385 (T200G) in GRIN2B, rs1800532 in TPH1, rs1801133 (C677T) in MTHFR, rs2619528 (P1765) in DTNBP1] and prepulse inhibition (PPI) and habituation after acoustic stimulus (HAB). RESULTS: Both PPI and HAB were decreased significantly in patients with schizophrenia. In addition, we observed a significant effect of GRIN2B (human NMDA receptor 2B subunit gene, NR2B) genotype on HAB (P<0.05, not corrected). CONCLUSION: Although these findings need to be replicated in other samples, an underlying mechanism of impaired biological reaction may be influenced by NMDA hypofunctioning in schizophrenia.

Frontal activity during the digit symbol substitution test determined by multichannel near-infrared spectroscopy.

BACKGROUND: The digit symbol substitution test (DSST) is a clinically useful and widely accepted tool for the detection of various psychiatric disorders. Investigating neural activity during the DSST is useful when considering the relationship between the poor performance on the DSST and neurocognitive deficits. However, obtaining reliable functional imaging of the neural mechanisms associated with this test is challenging due to motion artifacts. AIMS: To circumvent this problem, we examined frontal lobe activity during the DSST using multichannel near-infrared spectroscopy, a noninvasive functional imaging technique that does not interfere with the DSST procedure. METHODS: Twenty-five healthy volunteers were enrolled in this study. Changes in the concentration of oxygenated hemoglobin (oxyHb) during the DSST were determined bilaterally in 52 measurement points (channels) on the frontal area. RESULTS: We found significant increases in oxyHb in more than 70% of the channels, with the intensity of the increase being more pronounced in the left hemisphere. Several channels showed significant positive correlations between changes in oxyHb and DSST performance. Some of the channels with a significant increase in oxyHb during the DSST did not show a correlation with the DSST performance. CONCLUSIONS: Our findings indicate that the DSST could prove useful as a frontal lobe stimulating task. Further examinations of DSST/near-infrared spectroscopy analyses of neural mechanisms in patients with psychiatric and neurological diseases are necessary to assess its effectiveness in clinical practice for the evaluation of neuropsychopathology.

Memory dysfunction in caudate infarction caused by Heubner's recurring artery occlusion.

We report five cases with caudate infarction due to Heubner's recurring artery occlusion, in which we conducted detailed memory examinations in terms of explicit memory and implicit memory. We performed the auditory verbal learning test as explicit memory tasks, and motor and cognitive procedural memory tasks, developed by Komori, as implicit memory tasks. Comparing normal control subjects with patients with left caudate infarction due to Heubner's recurring artery occlusion demonstrated lower scores on both declarative and motor procedural memory tasks. These results suggest that the left caudate nucleus may be related with both declarative memory and procedural memory.

Word familiarity influences word-stem completion in amnesic patients.

The effect of familiarity to word-stem completion priming in amnesic patients was studied. A smaller priming effect of low familiarity of words in amnesic patients indicated that the process of lexical access may be involved in word-stem completion in amnesic patients.

Monozygotic twin cases of the agenesis of the corpus callosum with schizophrenic disorder.

We report the identical monozygotic twin cases of agenesis of the corpus callosum that demonstrated schizophrenic disorder. Patients were 26-year-old twin brothers and both cases were diagnosed as having schizophrenia using DSM-III-R diagnostic criteria. On magnetic resonance imagings both cases demonstrated the total agenesis of the corpus callosum and the anterior commissure was hypertrophic. We speculated that the developmental disturbance of the corpus callosum might be related to the cause of the psychiatric disorders in the present cases.