Personalized brain circuit scores identify clinically distinct biotypes in depression and anxiety.

There is an urgent need to derive quantitative measures based on coherent neurobiological dysfunctions or 'biotypes' to enable stratification of patients with depression and anxiety. We used task-free and task-evoked data from a standardized functional magnetic resonance imaging protocol conducted across multiple studies in patients with depression and anxiety when treatment free (n = 801) and after randomization to pharmacotherapy or behavioral therapy (n = 250). From these patients, we derived personalized and interpretable scores of brain circuit dysfunction grounded in a theoretical taxonomy. Participants were subdivided into six biotypes defined by distinct profiles of intrinsic task-free functional connectivity within the default mode, salience and frontoparietal attention circuits, and of activation and connectivity within frontal and subcortical regions elicited by emotional and cognitive tasks. The six biotypes showed consistency with our theoretical taxonomy and were distinguished by symptoms, behavioral performance on general and emotional cognitive computerized tests, and response to pharmacotherapy as well as behavioral therapy. Our results provide a new, theory-driven, clinically validated and interpretable quantitative method to parse the biological heterogeneity of depression and anxiety. Thus, they represent a promising approach to advance precision clinical care in psychiatry.

Examining Early Adolescent Positive and Negative Social Technology Behaviors and Well-being During the COVID-19 Pandemic.

Public concerns of how frequently adolescents used screens during the pandemic shutdowns fueled the need to research whether these behaviors were conducive or detrimental to their wellbeing. The aims of this longitudinal survey study of 586 middle school students in the Northeast U.S. were to examine (a) changes in positive and negative social technology behaviors prior to the coronavirus disease (COVID-19) pandemic (fall 2019) compared to during the pandemic (fall 2020) including any differences by subgroups and (b) whether changes in social technology behaviors were associated with wellbeing outcomes and any moderating factors. We found that during this time period, there were significant increases in frequency of checking social media, social technology use before bedtime, and problematic internet use. Students also experienced significant increases in social anxiety, loneliness, and depressive symptoms, but also increased strategies of coping when stressed. By following our preregistered analytical plan, each research aim was addressed within a multilevel modeling framework with time nested within students. We found extremely small effects of social technology behaviors associated with wellbeing, such as online support seeking being related to strategies when coping with stress. Though we found statistically significant effects, none of the findings met our effect size criteria (i.e., effect of ≥.05). Overall, we did not find any strong support that the changes in wellbeing that adolescents experienced during the COVID-19 social distancing was meaningfully related to their social technology use, which is counter to the popular assumption that adolescent wellbeing is intricately tied to their social technology use.