Person: Auerbach, Randy
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Auerbach
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Randy
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Auerbach, Randy
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Publication The impact of lifetime suicidality on academic performance in college freshmen(Elsevier BV, 2015) Mortier, Philippe; Demyttenaere, K.; Auerbach, Randy; Green, J.G.; Kessler, Ronald; Kiekens, G.; Nock, Matthew; Bruffaerts, R.Background While suicidal thoughts and behaviors (STB) among college students are common, the associations between STB and academic performance are not well understood. Methods As part of the World Mental Health Surveys International College Student project, web-based self-reported STB of KU Leuven (Leuven, Belgium) incoming freshmen (N=4921; response rate=65.4%) was collected, as well as academic year percentage (AYP), and the departments to which students belong. Single- and multilevel multivariate analyses were conducted, adjusted for gender, age, parental educational level, and comorbid lifetime emotional problems. Results Lifetime suicide plan and attempt upon college entrance were associated with significant decreases in AYP (3.6% and 7.9%, respectively). A significant interaction was found with average departmental AYP, with STB more strongly associated with reduced AYP in departments with lower than higher average AYP. Limitations Limited sample size precluded further investigation of interactions between department-level and student-level variables. No information was available on freshman secondary school academic performance. Conclusions Lifetime STB has a strong negative association with academic performance in college. Our study suggests a potential role for the college environment as target for treatment and prevention interventions.Publication Predicting suicide attempts in depressed adolescents: Clarifying the role of disinhibition and childhood sexual abuse(Elsevier BV, 2015) Stewart, Jeremy G; Kim, Judy C.; Esposito, Erika C.; Gold, Joseph; Nock, Matthew; Auerbach, RandyBackground Suicide is the second leading cause of death among adolescents, and depressed youth are six times more likely to make suicide attempts as compared to non-depressed adolescents. The present study examined the unique and interactive effects of two well-established correlates of suicidality – childhood sexual abuse (CSA) and disinhibition – in predicting suicide attempts among depressed adolescents. Method Participants were 163 adolescents (125 females) aged 13 to 18 (M = 15.60, SD = 1.27) diagnosed with Major Depressive Disorder (n = 95, 58.3%) and/or Dysthymia (n = 69, 42.3%) recruited from an acute residential treatment service. Participants completed interviews assessing psychopathology and suicidality, self-report measures of depressive symptoms and CSA, and a computerized disinhibition task. Results Consistent with hypotheses, CSA moderated the association between disinhibition and adolescents' report of their past year and lifetime suicide attempts. Specifically, higher disinhibition was associated with a greater likelihood of having made a suicide attempt among adolescents with a history of CSA, but not among those without. The same pattern of results held in analyses of suicide attempt frequency. Limitations Primary findings were based on observational, cross-sectional data, and therefore, causal relationships cannot be inferred. The gender imbalance in the sample precluded stratifying our analyses by gender. CSA was ascertained by self-report; replication of the results with more objective measures is warranted. Conclusions Our findings indicate that CSA and disinhibition may work together to predict elevated suicide risk, and these results have implications for early identification efforts in youth at high risk for suicide.Publication Adolescent nonsuicidal self-injury: Examining the role of child abuse, comorbidity, and disinhibition(Elsevier BV, 2014) Auerbach, Randy; Kim, Judy C.; Chango, Joanna M; Spiro, Westley J.; Cha, Christine; Gold, Joseph; Esterman, Michael; Nock, MatthewThe purpose of the study is to examine how several well-known correlates of nonsuicidal self-injury (NSSI) might work together to contribute to the occurrence of this behavior. Specifically, we examined models including child abuse, psychiatric comorbidity, and disinhibition, testing how these factors may work together to lead to NSSI in the past month. Participants (n=194; 144 female; age 13–18 years) were recruited from a short-term, acute adolescent residential unit. Within 48 hours of admission to the hospital participants completed structured clinical interviews assessing mental disorders and patterns of NSSI. Following the interviews, participants completed a self-report questionnaire assessing childhood abuse and a computerized continuous performance task. Consistent with study hypotheses, results revealed that the association between child abuse and NSSI is partially mediated by comorbidity. Although disinhibition is associated with comorbidity, contrary to our hypothesis, disinhibition does not mediate the relation between child abuse and NSSI. Collectively, these findings provide new information about how comorbidity may increase risk for NSSI, and critically, discuss the potential importance of creating targeted programs to reduce the prevalence of child abuse.Publication Mental disorders among college students in the World Health Organization World Mental Health Surveys(Cambridge University Press (CUP), 2016) Auerbach, Randy; Alonso, Jose; Axinn, W. G.; Cuijpers, P.; Ebert, D. D.; Green, J. G.; Hwang, Irving; Kessler, Ronald; Liu, Howard; Mortier, Philippe; Nock, Matthew; Pinder-Amaker, Stephanie; Sampson, Nancy; Aguilar-Gaxiola, S.; Al-Hamzawi, A.; Andrade, L. H.; Benjet, C.; Caldas-de-Almeida, J. M.; Demyttenaere, K.; Florescu, S.; de Girolamo, G.; Gureje, O.; Haro, J. M.; Karam, E. G.; Kiejna, A.; Kovess-Masfety, V.; Lee, S.; McGrath, J. J.; O, S.; Pennell, B.-E.; Scott, K.; ten Have, M.; Torres, Y.; Zaslavsky, Alan; Zarkov, Z.; Bruffaerts, R.Background Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Methods The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1,572) and nonstudents in the same age range (18–22; n = 4,178), including nonstudents who recently left college without graduating (n = 702) based on surveys in 21 countries (4 low/lower-middle income, 5 upper middle-income, 1 lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioural and substance disorders were assessed with the Composite International Diagnostic Interview. Results One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders. 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.Publication Integrating Spirituality Into Cognitive Behavioral Therapy in an Acute Psychiatric Setting: A Pilot Study(Springer Publishing Company, 2011) Rosmarin, David; Auerbach, Randy; Bigda-Peyton, Joseph S.; Bjorgvinsson, Throstur; Levendusky, PhilipResults from national studies in the United States suggest that spiritually integrated psycho- therapy may be desired by and beneficial for a specific subset of patients. However, protocols to facilitate these aims within the context of evidence-based psychosocial treatments are few, and, consequently, the availability of spiritually integrated cognitive behavioral therapy (CBT) is limited. This article describes the development and implementation of a brief (50-minute), stand-alone Spirituality & CBT group piloted in an acute psychiatric setting. This novel treat- ment includes (a) psychoeducation about the relevance of spirituality to psychiatric symptoms, (b) the integration of spiritual beliefs into cognitive restructuring, and (c) the use of spiritual exercises in behavioral activation and self-care. We further report results from a brief survey of 45 patients regarding the perceived relevance of spirituality to symptoms and treatment and their subjective experiences in the group.Publication Predictive models for suicidal thoughts and behaviors among Spanish University students: rationale and methods of the UNIVERSAL (University & mental health) project(BioMed Central, 2016) Blasco, Maria Jesús; Castellví, Pere; Almenara, José; Lagares, Carolina; Roca, Miquel; Sesé, Albert; Piqueras, José Antonio; Soto-Sanz, Victoria; Rodríguez-Marín, Jesús; Echeburúa, Enrique; Gabilondo, Andrea; Cebrià, Ana Isabel; Miranda-Mendizábal, Andrea; Vilagut, Gemma; Bruffaerts, Ronny; Auerbach, Randy; Kessler, Ronald; Alonso, JordiBackground: Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain. Methods: An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models. Discussion The study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.Publication Cognitive Vulnerability to Major Depression: View from the Intrinsic Network and Cross-network Interactions(Lippincott Williams & Wilkins, 2016) Wang, Xiang; Ongur, Dost; Auerbach, Randy; Yao, ShuqiaoAbstract Although it is generally accepted that cognitive factors contribute to the pathogenesis of major depressive disorder (MDD), there are missing links between behavioral and biological models of depression. Nevertheless, research employing neuroimaging technologies has elucidated some of the neurobiological mechanisms related to cognitive-vulnerability factors, especially from a whole-brain, dynamic perspective. In this review, we integrate well-established cognitive-vulnerability factors for MDD and corresponding neural mechanisms in intrinsic networks using a dual-process framework. We propose that the dynamic alteration and imbalance among the intrinsic networks, both in the resting-state and the rest-task transition stages, contribute to the development of cognitive vulnerability and MDD. Specifically, we propose that abnormally increased resting-state default mode network (DMN) activity and connectivity (mainly in anterior DMN regions) contribute to the development of cognitive vulnerability. Furthermore, when subjects confront negative stimuli in the period of rest-to-task transition, the following three kinds of aberrant network interactions have been identified as facilitators of vulnerability and dysphoric mood, each through a different cognitive mechanism: DMN dominance over the central executive network (CEN), an impaired salience network–mediated switching between the DMN and CEN, and ineffective CEN modulation of the DMN. This focus on interrelated networks and brain-activity changes between rest and task states provides a neural-system perspective for future research on cognitive vulnerability and resilience, and may potentially guide the development of new intervention strategies for MDD.Publication Incorporating spiritual beliefs into a cognitive model of worry(Wiley-Blackwell, 2011) Rosmarin, David; Pirutinsky, Steven; Auerbach, Randy; Bjorgvinsson, Throstur; Bigda-Peyton, Joseph; Andersson, Gerhard; Pargament, Kenneth I.; Krumrei, Elizabeth J.Cognitive theory and research have traditionally highlighted the relevance of the core beliefs about oneself, the world, and the future to human emotions. For some individuals, however, core beliefs may also explicitly involve spiritual themes. In this article, we propose a cognitive model of worry, in which positive/negative beliefs about the Divine affect symptoms through the mechanism of intolerance of uncertainty. Using mediation analyses, we found support for our model across two studies, in particular, with regards to negative spiritual beliefs. These findings highlight the importance of assessing for spiritual alongside secular convictions when creating cognitive-behavioral case formulations in the treatment of religious individuals.Publication Mapping anhedonia-specific dysfunction in a transdiagnostic approach: an ALE meta-analysis(Springer US, 2015) Zhang, Bei; Lin, Pan; Shi, Huqing; Ongur, Dost; Auerbach, Randy; Wang, Xiaosheng; Yao, Shuqiao; Wang, XiangAnhedonia is a prominent symptom in neuropsychiatric disorders, most markedly in major depressive disorder (MDD) and schizophrenia (SZ). Emerging evidence indicates an overlap in the neural substrates of anhedonia between MDD and SZ, which supported a transdiagnostic approach. Therefore, we used activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging studies in MDD and SZ to examine the neural bases of three subdomains of anhedonia: consummatory anhedonia, anticipatory anhedonia and emotional processing. ALE analysis focused specifically on MDD or SZ was used later to dissociate specific anhedonia-related neurobiological impairments from potential disease general impairments. ALE results revealed that consummatory anhedonia was associated with decreased activation in ventral basal ganglia areas, while anticipatory anhedonia was associated with more substrates in frontal-striatal networks except the ventral striatum, which included the dorsal anterior cingulate, middle frontal gyrus and medial frontal gyrus. MDD and SZ patients showed similar neurobiological impairments in anticipatory and consummatory anhedonia, but differences in the emotional experience task, which may also involve affective/mood general processing. These results support that anhedonia is characterized by alterations in reward processing and relies on frontal-striatal brain circuitry. The transdiagnostic approach is a promising way to reveal the overall neurobiological framework that contributes to anhedonia and could help to improve targeted treatment strategies. Electronic supplementary material The online version of this article (doi:10.1007/s11682-015-9457-6) contains supplementary material, which is available to authorized users.Publication Development and psychometric properties of the health-risk behavior inventory for Chinese adolescents(BioMed Central, 2012) Wang, Mengcheng; Yi, Jinyao; Cai, Lin; Hu, Muli; Zhu, Xiongzhao; Yao, Shuqiao; Auerbach, RandyBackground: There is a growing body of research investigating adolescent risk behaviors in China, however, a comprehensive measure that evaluates the full spectrum of relevant risk behaviors is lacking. In order to address this important gap, the current study sought to develop and validate a comprehensive tool: the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA). Methods: Adolescents, ages 14–19 years (n = 6,633), were recruited from high schools across 10 cities in mainland China. In addition, a clinical sample, which included 326 adolescents meeting DSM-IV criteria for Conduct Disorder, was used to evaluate predictive validity of the HBICA. Psychometric properties including internal consistency (Cronbach’s alpha), test-retest reliability, convergent validity, and predictive validity were analyzed. Results: Based upon item analysis and exploratory factor analysis, we retained 33 items, and 5 factors explained 51.75% of the total variance: Suicide and Self-Injurious Behaviors (SS), Aggression and Violence (AV), Rule Breaking (RB), Substance Use (SU), and Unprotected Sex (US). Cronbach’s alphas were good, from 0.77 (RB) to 0.86 (US) for boys, and from 0.74 (SD) to 0.83(SS) for girls. The 8 weeks test–retest reliabilities were moderate, ranged from 0.66 (AV) to 0.76 (SD). External validities was strong, with Barratt Impulsiveness Scale-11 was 0.35 (p < 0.01), and with aggressive behavior and rule-breaking behavior subscales of the Youth Self Report were 0.54 (p < 0.01) and 0.68 (p < 0.01), respectively. Predictive validity analysis also provided enough discriminantity, which can distinguish high risky individual effectively (cohen’ d = 0.79 – 2.96). Conclusions: These results provide initial support for the reliability and validity of the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA) as a comprehensive and developmentally appropriate assessment instrument for risk behaviors in Chinese adolescents.