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ObjectiveKnowledge regarding the long-term psychological adjustment of parents to children with prenatal diagnosis of congenital malformation is scarce. The aim of this study is to examine traumatic stress trajectories, resilience, and relationship satisfaction among parents to children with prenatal diagnosis of a congenital malformation, and to compare this to a sample of non-affected parents.MethodsA prospective longitudinal cohort study was conducted at a tertiary perinatal referral center. Ninety-three mothers and 80 fathers who received a diagnosis of fetal anomaly during obstetric ultrasound examination (study group), and 110 mothers and 98 fathers with normal ultrasound findings (comparison group), reported their traumatic stress at four timepoints during pregnancy (T1–T4), 6 weeks after birth (T5), and 10–12 years after birth (T6). Resilience and relationship satisfaction was reported at 10–12 years after birth.ResultsParents to children with a congenital malformation experienced significantly elevated traumatic stress levels over time, compared with parents of children without congenital malformation. The difference between groups was largest acutely after diagnosis and remained significant 10–12 years after the birth of the child. Resilience and relationship satisfaction levels were similar in both groups.ConclusionsDespite experiencing high levels of traumatic stress over time, parents to children with a congenital malformation reported resilience and relationship satisfaction at similar levels to non-affected parents. This suggests that despite ongoing long-term distress, parents are still able to maintain positive psychological coping resources.

Public Health Significance Both the amount of caffeine people consume and their response to caffeine is heritable. A modest proportion of the genetic influences underlying caffeine use and response is shared with personality and personality disorder traits. Our main aim was to estimate the extent of overlapping etiology between caffeine consumption and response and normative and pathological personality. Linear mixed-effects models were used to identify normative personality domains and personality disorder (PD) traits for inclusion in multivariate twin analyses together with individual caffeine related measures. Data were obtained from Norwegian adult twins in a face-to-face interview conducted in 1999-2004 as part of a population-based study of mental health and through self-report in 2010-2011 and 2015-2017. Personality disorder data was available for 2,793 twins, normative personality for 3,889 twins, and caffeine for 3,862 twins (mean age 43.0 years). Normative personality was assessed using the self-reported Big Five Inventory, PD traits were assessed by the Structured Interview for DSM-IV Personality, and caffeine consumption, toxicity, tolerance, and withdrawal were assessed through a self-report questionnaire developed at the Norwegian Institute of Public Health. Caffeine measures were found to be moderately heritable, h(2) = 30.1%-45.0%. All normative personality domains and four PD traits, antisocial, borderline, dependent and paranoid, were significantly associated with at least one caffeine variable. A small proportion of variance in caffeine consumption was attributable to genetic factors shared with normative personality (1.3%) and personality disorders (11.4%). A modest proportion of variance in caffeine tolerance and toxicity was attributable to genetic factors shared with both normative personality (26.9%, 24.8%) and personality disorders (21.0%, 36.0%). The present study found caffeine consumption and response to be heritable and provides evidence that a small to-modest proportion of this genetic etiology is shared with both normative and pathological personality.

The structure of wellbeing has been debated for millennia. Dominant conceptualisations, such as the hedonic and eudaimonic models, emphasise different constituents of the wellbeing construct. Some previous studies have suggested that the underlying structure of wellbeing may consist of one or a few general wellbeing factors. We conducted three studies to advance knowledge on the structure of wellbeing comprising more than 21,500 individuals, includinga genetically informative twin sample. In Study 1, we used hierarchical exploratory factor analysis to identify wellbeing factors in a population-based sample of Norwegian adults. In Study 2, we used confirmatory factor analysis to examine the model fit of the identified factor model in an independent sample. In Study 3, we used biometric models to examine genetic and environmental influences on general wellbeing factors. We identified six wellbeing factors which all loaded on a single higher-order factor. This higher-order factor may represent a general “happiness factor”, i.e., a h-factor, akin to the p-factor in psychopathology research. The identified factor model had excellent fit in an independent sample. All wellbeing factors showed moderate genetic and substantial nonsharedenvironmental influence, with heritability estimates ranging from 26-40%. Heritability was highest for the higher-order general happiness factor. Our findings yield novel insights into the structure of wellbeing and genetic and environmental influences on general wellbeing factors, with implications for wellbeing and mental health research, including genetically informative studies.

One of the most robust findings in political psychology is that political and prejudicial attitudes are predicted by right-wing authoritarianism (RWA), social dominance orientation (SDO), and some of the Big Five personality traits. An unresolved question is whether RWA and SDO form a functional package of traits that is independent of common personality variation, or whether they are fully underpinned by it. We use genetically informative data from a sample of 1987 Norwegian twins to shed light on this question, revealing that RWA and SDO are moderately phenotypically correlated, but highly genetically correlated. This suggests that there is a general, heritable hierarchical motive that manifests in terms of RWA and/or SDO depending on environmental factors. Consistent with this, RWA and SDO share a larger genetic substrate with political attitudes that support monopolizing resources and territory for one’s own group (e.g., deporting an ethnic minority) than do Big Five personality traits, while at the same time exhibiting some genetic overlap with two of these personality traits. Overall, these results suggest that Big Five personality traits are not sufficient for explaining prejudicial political attitudes and that the covariation of hierarchy-related traits with political attitudes is best explained by genetic overlap, not common socialization as assumed by key theories in social and political psychology, such as the dual-process model of prejudice.

The current study addresses the potentially dynamic relationship between employees’ personality and their working conditions. A six-year full-panel longitudinal study of employed individuals was us...

Understanding whether co-occurrent internalizing difficulties (ID) and aggression in early childhood convey increased risk for later mental health problems is important for theoretical and clinical purposes. To investigate this, mothers from the Norwegian Mother, Father and Child Cohort Study (MoBa) reported on child ID and aggression at ages 3 (n=54,644; 26,750 girls) and 5 (n=38,177; 18,794 girls); depressive, anxiety, conduct-related, and opposition-defiant symptoms at age 8. Using ID and aggression, four profiles emerged: low-symptom/normative; primarily internalizing; primarily aggressive; co-occurrent. The “co-occurrent” group exhibited highest levels of depressive, anxiety and opposition-defiant symptoms at 8 years. The heterogeneity between early manifestation of ID and aggression, and specific type of later mental health symptoms supports a shared aetiology between internalizing and externalizing difficulties.

Objective: Suicidal ideation and depressive symptoms are often interrelated in clinical settings. Insecure attachment may be a risk factor for suicidal ideation in depressed adolescents. To our knowledge, this study is the first to examine the association between self-reported insecure attachment styles to both parents and suicidal ideation in a clinical sample of adolescents with depression. Methods: Fifty clinically depressed adolescents (13-17 years, 84% girls) completed self-reported measures of suicidal ideation, depressive symptoms, and attachment style to parents. Results: There was a statistically significant bivariate association between higher levels of attachment anxiety in relation to mothers and fathers and higher levels of suicidal ideation. When attachments to both parents were included in the same multivariate model, only attachment anxiety to the mother was significantly associated with the level of suicidal ideation. Self-reported depressive symptoms remained significantly associated with the level of suicidal ideation in all analyses. Younger adolescents with attachment anxiety reported higher levels of suicidal ideation than older adolescents. Conclusion: Conclusions about directionality and causality of associations between insecure attachment and suicidal ideation are limited due to the cross-sectional design. Our findings suggest that attachment anxiety in relation to the mother and father is associated with increased levels of suicidal ideation. Implication of these findings for treatment selection is discussed.

Hopelessness is an important symptom of adolescent depression, being associated with both risk of suicide and poor treatment response, but predictors of hopelessness are understudied. Conflict with parents is common in adolescent depression, but parents and adolescents often disagree when reporting conflict severity. Discrepancy in reporting may be an indicator of the parent–adolescent dyad lacking a shared representation of the state of their relationship. This could make conflicts seem unresolvable to the adolescent, leading to expectations of persistent stress and lack of support, increasing hopelessness. This study employed latent difference scores, ordinal regression and cross-validation to evaluate the hypothesis that discrepancy in report of parent–adolescent conflict would predict hopelessness among depressed adolescents. Parents reporting less conflict than the adolescent was associated with increased adolescent hopelessness, giving preliminary support to the hypothesis.

Siblings of children with chronic disorders are at increased risk of experiencing family communication problems and poorer mental health. We assessed initial feasibility, acceptability, and outcomes of SIBS; a manual-based group intervention for siblings and parents of children with chronic disorders, aiming to improve parent-sibling communication and sibling mental health. Ninety-nine siblings aged 8–16 years (M = 11.5 years, SD = 2.0; 54.5% girls) and parents (63.6% mothers) of children with chronic disorders participated in three separate group sessions for siblings and parents and two joint sessions with integrated sibling-parent dialogues. We assessed participant satisfaction post-intervention and checked for group leader manual adherence. We measured the following outcomes at baseline, three, and six months post-intervention in an open trial: (1) parent-sibling communication quality; (2) sibling emotional and behavioral problems; (3) sibling adaptation to the disorder; and (4) sibling disorder knowledge. Using growth curve modeling, we found significant improvement in parent-sibling communication quality (p = 0.001), emotional and behavioral problems (p = 0.009), adaptation to the disorder (p = 0.003), and disorder knowledge (p = 0.000) from baseline to follow-up (effect sizes d = 0.22 to 0.64). Improvement in sibling-reported emotional and behavioral problems and adaptation to the disorder was partly explained by communication quality. User satisfaction was high and manual adherence was good. Our evaluation yields support for the SIBS intervention, with initial evidence of acceptability, feasibility, and beneficial outcomes. Our study suggests targeting parent-sibling communication may be a beneficial way of improving siblings’ mental health.

Introduction - The detection of a fetal anomaly during routine obstetric ultrasound is a potentially traumatic experience. The aim of this study is to examine longitudinally the impact of diagnosis of fetal anomaly on symptoms of depression and traumatic stress among mothers and fathers, and to examine how variations in psychological adjustment relate to diagnostic severity and prognostic ambiguity. Material and methods - In this prospective observational study conducted at a tertiary perinatal referral center, 81 mothers and 69 fathers with ultrasound findings of fetal anomaly completed the Edinburgh Postnatal Depression Scale (EPDS) and Impact of Events Scale (IES) at four time points in pregnancy (T1–T4) and 6 weeks after birth (T5). We compared this with depression and traumatic stress in a sample of non-affected parents (n = 110 mothers, 98 fathers). Results - Linear mixed effects models indicated that parents who received a diagnosis of fetal anomaly experienced higher levels of depression and traumatic stress over time, compared with non-affected parents. Depression: mean difference mothers = 4.46 ± 0.47, fathers = 2.80 ± 0.42. Traumatic stress: mean difference mothers = 20.04 ± 2.13, fathers = 12.66 ± 1.74. Parents with a more severe diagnosis experienced elevated symptoms compared with parents with a less severe diagnosis. Among mothers, prognostic ambiguity and changes in the anticipated diagnosis after birth were also associated with increased distress, regardless of whether the change was for the better or worse. Conclusions - Diagnosis of fetal anomaly increases risk of depression and traumatic stress in expectant mothers and fathers, both acutely and over time.

Objectives Accumulating evidence has revealed that dental anxiety is robustly associated with dental care-related pain and discomfort, but also with the personality trait of neuroticism (i.e. the relatively stable disposition to experience the world as distressing, threatening and unsafe). However, there is a near absence of research on these risk factors in samples for which genetic information is available. With the aim of arriving at a more refined understanding of dental anxiety, this twin cohort study assessed genetic and environmental influences on neuroticism, dental care-related pain and dental anxiety, and the relation between these phenotypes. Methods Participants were recruited from the Norwegian Twin Registry, and data collections were carried out in 1992–98 (Time 1) and 2011 (Time 2). Well-validated questionnaires were used to assess the study variables, including Corah's Dental Anxiety Scale, the Numerical Pain Rating Scale, the NEO Personality Inventory Revised (Time 2) and Eysenck's Personality Questionnaire (Time 1). Pearson correlation analysis and generalized estimating equations (GEE) were used to investigate phenotypic associations. Analyses of genetic and environmental influences were performed using Cholesky modelling. Results A total of 746 monozygotic (MZ) and 770 dizygotic (DZ) twins in the age group of 50–65 participated in the study. Moderate estimates of heritability for dental anxiety (0.29), treatment-related pain (0.24) and neuroticism (0.45–0.54) were found. Cholesky modelling showed furthermore that neuroticism assessed at Time 1 and Time 2 was related to dental anxiety and pain via both genetic and individual-specific environmental pathways, albeit not very strongly. The particularly high phenotypic correlation observed between dental care-related pain and anxiety (r = .68) was explained by both overlapping genetic and individual-specific environmental influences (the genetic and environmental correlations were .84 and .63 respectively). Conclusions The findings provide deeper insight into the aetiology of dental anxiety and confirm that while it is strongly linked to treatment-related pain experiences, this relation is to a considerable degree independent of general negative affectivity/neuroticism.

Schools are well positioned for large scale promotion of mental health among young people. We tested the MindPower program delivered universally in the classroom to strengthen self-efficacy, self-esteem, and quality of life in high school students. We used a cluster randomized two-groups delayed intervention design. Participants where 1,673 out of 2,384 students, aged 15–16 years, in all the 110 first year high school classes in a county in Norway, randomized into two intervention groups, IG1 and IG2. IG1 started with MindPower. IG2 waited for four months to participate. Seven repeated measures were conducted with Rosenberg Self-esteem Scale (short version), General Perceived Self-Efficacy Scale (short version), and Warwick Edinburg Mental Wellbeing Scale. Self-efficacy level was compared to scores from a large comparable population study, locally and nationally (UngData). Mixed model analyses adjusted for cluster effects showed no significant increase in the three measures from start to five to nine months follow up. Self-efficacy level was approximately the same as the one found in UngData. The universal implementation in schools was a great challenge and attrition was comprehensive. MindPower did not strengthen students’ levels of self-efficacy, self-esteem, and quality of life, partly because the initial levels were already high (ceiling effect). In spite of careful preparations, fidelity was low and attrition high. Results should therefore be interpreted with caution. Learning points in implementing and conducting class based universal mental health programs in high school are discussed comprehensively. ClinicalTrials.gov: NCT03647826. The 27.08.2018. Retrospectively registered.

The evolved attachment system maintains proximity and care-giving behavior between parents and offspring, in a way that is argued to shape people’s mental models of how relationships work, resulting in secure, anxious or avoidant interpersonal styles. Several theorists have suggested that the attachment system is closely connected to orientations and behaviors in social and political domains, such that the latter are grounded in the same set of familial experiences as are the different attachment styles. We use a large sample of Norwegian twins (N = 1987) to assess the relationship between attachment styles and two key ideological orientations, right-wing authoritarianism (RWA) and social dominance orientation (SDO), and the role of genetic and environmental influences therein. We also consider the relationship of both sets of traits with the interpersonal orientations of trust and altruism. Results indicate no shared environmental overlap between attachment and ideology, nor even between the two attachment styles or between the two ideological traits, challenging conventional wisdom in developmental, social, and political psychology. Rather, evidence supports two functionally distinct systems, one for navigating intimate relationships and one for navigating social hierarchies, with genetic overlap between traits within each system, and two distinct genetic linkages to trust and altruism. We argue for further genetically informed research in other settings to elucidate the etiology and dynamics of these core aspects of our social and political nature.

Conflict with parents is common among depressed adolescents, interferes with treatment, and may increase risk of recurrence. Parental depressive symptoms have been shown to predict conflict with adolescent children, but an important role for different kinds of parental interpersonal problems, as described by interpersonal circumplex, is also plausible. This study compared parental interpersonal problems to parental depressive symptoms as predictors of parent-adolescent conflict reported by a depressed adolescent child, using multilevel linear regression, leave-one-out cross-validation and model stacking (N = 100 parents, 57 mothers and 43 fathers, of 60 different adolescents). Cross-validation and model stacking showed that including parental interpersonal problems contributes to accurate predictions. Parents reporting more interpersonal problems related to excessive dominance or submissiveness was associated with increased or decreased conflict, respectively. Parental depressive symptoms were found to be negatively associated with parent-adolescent conflict only in father-adolescent relationships. Electronic supplementary material The online version of this article (doi:10.1007/s10578-020-00955-0) contains supplementary material, which is available to authorized users.

Self-selection into prospective cohort studies and loss to follow-up can cause biased exposure-outcome association estimates. Previous investigations illustrated that such biases can be small in large prospective cohort studies. The structural approach to selection bias shows that general statements about bias are not possible for studies that investigate multiple exposures and outcomes, and that inverse probability of participation weighting (IPPW) but not adjustment for participation predictors generally reduces bias from self-selection and loss to follow-up. We propose to substantiate assumptions in structural models of selection bias through calculation of genetic correlations coefficients between participation predictors, outcome, and exposure, and to estimate a lower bound for bias due to self-selection and loss to follow-up by comparing effect estimates from IPP weighted and unweighted analyses. This study used data from the Norwegian Mother and Child Cohort Study and the Medical Birth Registry of Norway. Using the example of risk factors for ADHD, we find that genetic correlations between participation predictors, exposures, and outcome suggest the presence of bias. The comparison of exposure-outcome associations from regressions with and without IPPW revealed meaningful deviations. Assessment of selection bias for entire multi-exposure multi-outcome cohort studies is not possible. Instead, it has to be assessed and controlled on a case-by-case basis.

BackgroundCan the structure of genetic and environmental influences on normative personality traits (NPTs), abnormal personality traits (APTs), and DSM-IV criteria for personality disorders (PD) fit a high or low congruence model positing, respectively, close or more limited etiologic continuity?MethodExploratory factor analysis was applied to transformed correlation matrices from Cholesky twin decompositions obtained in OpenMx. In 2801 adult twins from the Norwegian Institute of Public Health Twin Panel, NPTs and APTs were assessed by self-report using the Big Five Inventory (BFI) and PID-5-Norwegian Brief Form (PID-5-NBF), respectively. PDs were assessed at interview using the Structured Interview for DSM-IV Personality (SIDP-IV).ResultsThe best model yielded three genetic and three unique environmental factors. Genetic factors were dominated, respectively, by (i) high loadings on nearly all PDs and NPT/APT neuroticism and compulsivity, (ii) negative loadings on NPT agreeableness/conscientiousness and positive loadings on APT/PD measures of antisocial traits, and (iii) negative loadings on NPT extraversion and histrionic PD, and positive loadings on APT detachment and schizoid/avoidant PD. Unique environmental factors were dominated, by (i) high loadings on all PDs, (ii) high loadings on all APT dimensions and NPT neuroticism, and (iii) negative loadings on NPT extraversion and positive loadings on NPT detachment/avoidant PD.ConclusionsTwo genetic and one environmental common factor were consistent with a high congruence model while one genetic and two environmental factors were more supportive of a low congruence model. The relationship between genetic and environmental influences on personality assessed by NPTs, APTs, and PDs is complex and does not fit easily into a low or high congruence model.

Background The previous decades have shown increased symptoms of depression and anxiety among adolescents. To promote mental health and reduce mental illness, the government of Norway has, as in other countries, pledged that all schools must incorporate life-skills education. We report results from an evaluation of MindPower, a modification of the Coping With Depression (CWD) course, delivered universally in the classroom to secondary high school students, aged 15–16 years, in one county in Norway. The aim of the study was to evaluate the effect of MindPower on symptoms of depression and anxiety. Methods We utilized a two-groups` delayed intervention design where 110 first year high school classes were randomized into one of two intervention groups (IG1 and IG2). IG1 participated in MindPower while IG2 served as a control group for four months until the intervention started also in this group. IG1 and IG2 responded to questionnaires before and after the eight weeks course, at the start of the first and the second booster session, and at the five months follow up. Questionnaires, including online versions of the Hopkins Symptom Checklist (SCL-8) and the Reynolds Adolescent Depression Scale (RADS-2:SF), were administered to 1673 out of a total of 2384 students. SCL-levels were also compared with those from a large population study (UngData). Results According to mixed model analyses, SCL-8 and RADS-2:SF showed significant baseline differences between IG1 and IG2. In IG1 and IG2, both SCL-8 and RADS-2:SF showed a small but significant increase in mean scores throughout the study period, with markedly lower mean scores among boys. The SCL-levels were first lower for both girls and boys and then after the completion of MindPower the SCL-levels, equal to the SCL-levels in UngData. Conclusions No effects of the intervention were found. This large universal school-based trial suffered from considerable drop-out of participants. Experiences from implementation and evaluation of universal mental health promotion and preventive school interventions are thoroughly discussed, including, preparation, resources, support, time, realistic expectations, teacher selection and training, implementation, research designs and more. Several empirically based, practical advices are presented. Clinical Trial registration 27/08/2018. Registration number NCT03647826.

BackgroundMajor Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent–child relationship.ObjectiveTo study the effectiveness of ABFT compared with treatment as usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.MethodSixty adolescents (86.7% girls), aged 13–18 years (M = 14.9, SD = 1.35), with MDD referred to two CAMHS were randomized to 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were assessed by blinded evaluators at baseline and post-treatment with the Hamilton Depression Scale (HAMD). Self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms were assessed at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks. Analyses were performed according to intent-to-treat principles.ResultsAt post-treatment, clinician-rated remission rates on the HAMD (5% in ABFT and 3.33% in TAU,p = 1, OR = 1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2,N = 60] = 0.06,p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority (63.3%) of adolescents were still in the clinical range after 16 weeks of treatment.ConclusionABFT was not superior to TAU. Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. Findings must be viewed in the context of the study’s small sample size, missing data, and implementation challenges. Continued efforts to improve treatment for MDD in outpatient clinics are warranted. Future research should examine moderators of and mechanisms for individual differences to treatment response, as well as the feasibility and cost-effectiveness of implementing treatment models which may require extensive training and expertise to yield clinically meaningful improvements in non-research settings.Trial registrationClinicaltrials.gov identifier: NCT01830088https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1Date of registration: April 12, 2013

Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship.Objective: To study the effectiveness of ABFT compared with treatment as usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents (86.7% girls), aged 13-18 years (M = 14.9, SD = 1.35), with MDD referred to two CAMHS were randomized to 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were assessed by blinded evaluators at baseline and post-treatment with the Hamilton Depression Scale (HAMD). Self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms were assessed at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks. Analyses were performed according to intent-to-treat principles.Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority (63.3 %) of adolescents were still in the clinical range after 16 weeks of treatment.Conclusion: ABFT was not superior to TAU. Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. Findings must be viewed in the context of the study’s small sample size, missing data, and implementation challenges. Continued efforts to improve treatment for MDD in outpatient clinics are warranted . Future research should examine moderators of and mechanisms for individual differences to treatment response, as well as the feasibility and cost-effectiveness of implementing treatment models which may require extensive training and expertise to yield clinically meaningful improvements in non-research settings.Trial Registration: Clinicaltrials.gov identifier: NCT01830088https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013

The authors wish to make the following correction to their paper [...]

Background While self-reported post-traumatic growth (PTG) has been documented after a wide variety of potentially traumatic experiences, we need more knowledge on the mechanisms behind PTG to gain a better understanding of this phenomenon. Objective We aimed to investigate the hypothesized mechanism of perceived event centrality as a mediator on the pathway between peritraumatic reactions and later PTG. Method In total, 204 survivors of the 2011 massacre on Utøya island, participated 4–5 months (T1), 14–15 months (T2), and 30–32 months (T3) post-terror. We applied counterfactually based causal mediation analysis to explore the potential mediating role of survivors’ perceived centrality (T2) in linking their peritraumatic reactions (T1) and self-reported PTG (T3). Results The vast majority of the survivors reported experiencing some positive changes post-terror, and we found a positive, significant association between survivor’s peritraumatic reactions, perceived event centrality and self-reported growth. However, we did not find that centrality significantly mediated the longitudinal association between peritraumatic reactions and later PTG. Conclusion Reports of PTG are common post-terror, and peritraumatic reactions and perceptions of centrality may help explain individual differences in trauma survivors’ level of PTG. Perceived event centrality about one year post-trauma does not appear to explain the relationship between initial reactions to trauma and subsequent PTG.

Antisocial (ASPD) and borderline (BPD) personality disorders (PDs) are associated with increased risk for substance use. They are "specific" risk factors among PDs in that they withstand adjusting for the other PDs, whereas the reverse does not hold. Specificity is a classic sign of causation. This empirical work addresses 3 further problems that can undermine causal inferences in personality and substance-use research: hierarchical nature of etiologic factors in psychiatry, imperfectly operationalized PD criteria, and possible genetic or environmental confounding, as seen in lack of "etiologic continuity." We used exploratory structural equation bifactor modeling and biometric models to mitigate these problems. The participants were Norwegian adult twins of ages 19-36 years (N = 2,801). Criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), PDs were assessed using a structured interview. General substance-use risk was indicated by World Health Organization Composite International Diagnostic Interviewed alcohol use disorder and illicit drug use, and by self-reported regular smoking. A general risk factor for all criteria of both ASPD and BPD was the strongest individual correlate of general substance use and showed etiologic continuity, though just 3 specific PD criteria could predict substance use to the same extent. The findings indicate that a broad latent factor for both ASPD and BPD may be a specific and a genetically and environmentally unconfounded risk factor for substance use. Substance-use treatment research might benefit from attending to transdiagnostic models of ASPD, BPD, and related behavioral disinhibition. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

While it is well-established that education and Right Wing Authoritarianism (RWA) are quite strongly negatively correlated, it is still unclear why this is the case. There could be causal effects between these variables, in one or both directions, which can be either direct or mediated. And there could also be confounding third variables influencing their association. Using a sample of 320 monozygotic- and 312 dizygotic twin pairs, we were able to control for confounding influences from both genes and the family-environment, increasing our ability to infer causal effects. Furthermore, we investigate the roles of perceived Socio-Economic Status (SES) in both childhood and adulthood; SES in childhood could be a confound between education and RWA, and SES in adulthood could be a mediator. We explore these hypotheses with ACE-β models, which extend the logic of discordant twin designs into a structural equation framework. Our results are consistent with a causal effect of education to reduce RWA. SES in adulthood did not mediate this effect. We find that the negative correlation between RWA and education is further amplified by confounding influences, mostly from the family environment, which are partly associated with SES.

Moral judgments may be driven by both principled and opportunistic motivations. Being morally principled is to consistently adhere to a single set of rules about morality and justice. Opportunistic morality rather involves selectively enforcing rules when they are beneficial to one’s interests. These two kinds of motivations sometimes pull in the same direction, other times not. Prior studies on moral motivations have mostly focused on principled morality. Opportunistic morality, along with its phenotypic and genetic correlates, remains largely unexamined. Here, utilizing a sample from the Norwegian Twin Registry, consisting of 312 monozygotic-and 298 dizygotic twin pairs (N = 1220), we measure people’s propensity to react to injustice as victims, observers, beneficiaries, and perpetrators of injustice, using the Justice Sensitivity scale. Our genetically informative sample allows a biometric modeling approach that provides increased stringency in inferring latent psychological traits. We find evidence for two substantially heritable traits explaining correlations between Justice Sensitivity facets, which we interpret as aprincipled justice sensitivity(h2= .45) leading to increased sensitivity to injustices of all categories, and anopportunistic justice sensitivity(h2= .69) associated with increased victim sensitivity and a decreased propensity to feel guilt from being a perpetrator. These heritable justice traits share a genetic substrate with broad strategies for cooperation (as measured by altruism and trust) and for selectively benefitting oneself over the adaptive interests of others (as measured by social dominance orientation and support for monopolizing territory and resources), and differ genetically and phenotypically from Big Five personality traits.

This study examined the development in cognition, work, and social functioning in a group of fully recovered first-episode schizophrenia (FES) patients across six-eight years and inspected whether changes in outcome were similar when individuals were off medication as when they were on medication.Ten out of 28 participants were identified as fully recovered by the eighth follow-up. Assessments were conducted yearly, apart from the first year, when assessments were conducted every six months. Cognition was assessed with MATRICS Consensus Cognitive Battery. Functional outcomes were obtained through Global functioning: Social and Global functioning: Role. Information from semistructured interviews were also gathered. Data were analyzed with linear multilevel models.There were steady improvements in cognition, social, and role functioning among the patients, but the changes were significantly larger when individuals were off antipsychotic medications than on medications for processing speed and work functioning. T-tests showed that unmedicated participants were not healthier than medicated participants at baseline. The most common reason for discontinuing medication treatment was negative side effects. Instead, many of the participants highlighted the use of active coping mechanisms for maintaining recovery.The findings challenge some of the views about medication treatment of FES patients. For a subgroup of FES patients, continuous medication treatment is not necessary for maintaining low levels of symptoms. These patients show sustained good functioning once fully recovered. Due to a small sample size, these results may not be generalized to the general FES population and need to be replicated with studies of larger sample sizes.

Objective: The primary aim of the present study was to separate the direct effect of maternal prenatal depression on offspring ADHD from the passive transmission of genetic liability. Method: A children-of-twins and siblings design including 17,070 extended-family units participating in the Norwegian Mother and Child Cohort Study was used. Self-ratings were obtained from parents using the Symptom Checklist during pregnancy. Maternal ratings using Conner’s Parent Rating Scale were obtained when the children were 5 years of age. Results: Genetic influences were important for explaining similarity between parents and offspring. There was also evidence for a maternal effect after accounting for genetic transmission ( m = 0.06, 95% confidence interval [CI] = [0.02, 0.09]). Conclusion: Our results were consistent with hypotheses suggesting that maternal prenatal depression influences symptoms of ADHD in offspring. However, the effect was weak and a substantial portion of the association could be accounted for by shared genetic influences.

There is uncertainty concerning what the active ingredients in psychotherapy are. The First Experimental Study of Transference interpretations (FEST) was a randomized controlled trial of the effects of transference work (TW) in psychodynamic psychotherapy. Women with low quality of object relations (QOR) showed a large positive effect of transference work, while men with high QOR showed a slight negative effect. The present study aimed to expand the knowledge from the FEST by investigating the therapeutic atmosphere with Structural Analysis of Social Behavior (SASB). Two-way ANOVAs were conducted to investigate differences between SASB cluster scores between subgroups. The therapeutic atmosphere was characterized by Protect&ndash, Trust, Affirm&ndash, Disclose and Control&ndash, Submit. Multilevel modeling was used to assess the relationship between a therapist variable and outcomes for men and women. Contrary to expectations, no significant differences in therapeutic atmosphere between subgroups (with or without TW in women with low QOR and men with high QOR) were observed using the process measure SASB.

The development of individual cognitive domains over time is not yet fully examined in first-episode schizophrenia (FES). This study's objective was to explore the cognitive trajectories of FES-patients (n = 28) and compare them to a pairwise matched healthy control group (n = 28, total n = 56). This study has a multi-assessment design, and includes patient data from seven assessments over six years. Healthy controls were assessed at baseline, after two years and after six years. Cognition was assessed with the MATRICS Consensus Cognitive Battery. Data were analyzed with linear multilevel models. FES-patients scored significantly lower than the control group across all cognitive domains at baseline. Over six years, improvements were seen in attention, verbal learning, processing speed, reasoning/ problem solving, working memory and social cognition. The overall trend points toward a similar cognitive change in both groups. The patient group's improvement in reasoning/ problem solving was significantly larger that the control group, but improvement in working memory was smaller. Cognitive improvements were seen under and after the initial psychosis episode and throughout the recovery process with 45.5% of the patients fully recovered by 6-year follow-up. Cognitive improvements were seen in almost every cognitive domain that is consistently impaired in FES.

Background and aims Individual differences in DSM-IV personality disorders (PDs) are associated with increased prevalence of substance use disorders. Our aims were to determine which combination of PDs trait scores best predict cannabis use (CU) and cannabis use disorder (CUD), and to estimate the size and significance of genetic and environmental risks in PD traits shared with CU and CUD. Design Linear mixed-effects models were used to identify PD traits for inclusion in twin analyses to explore the genetic and environmental associations between the traits and cannabis use. Setting Cross-sectional data were obtained from Norwegian adult twins in a face-to-face interview in 1999-2004 as part of a population-based study of mental health. Participants Subjects were 1419 twins (μage = 28.2 years, range = 19-36) from the Norwegian Institute of Public Health Twin Panel with complete PD and cannabis data. Measurements PD traits were assessed using DSM-IV criteria. Life-time CU and CUD were based on DSM-IV abuse and dependence criteria, including withdrawal and craving. Findings After adjusting for age and sex, antisocial [β = 0.23, 95% confidence interval (CI) = 0.19-0.28] and borderline PDs (β = 0.20, 95% CI = 0.14-0.26) were associated strongly with CU. Antisocial (β = 0.26, 95% CI = 0.21-0.31) and borderline PDs (β = 0.12, 95% CI = 0.06-0.18) were also linked strongly to CUD. Genetic risks in antisocial and borderline PD traits explained 32-60% of the total variance in CU and CUD. Dependent and avoidant PDs explained 11 and 16% of the total variance in CU and CUD, respectively. Conclusions Individual differences in the liability to cannabis use and cannabis use disorder appear to be linked to genetic risks correlated with antisocial and borderline personality disorder traits.

Background and Aims The DSM-IV Personality Disorders (PDs) are comorbid with Alcohol Use Disorder (AUD) and with each other. It remains unclear which PD criteria are most likely to drive onset and recurrence of AUD and which are merely confounded with those criteria. We determine which individual PD criteria predict AUD and the degree of underlying genetic and/or environmental etiology. Design A prospective observational twin study. Setting Norway 1999–2011. Participants Altogether 2528 and 2275 Norwegian adult twins in wave 1 and 2 variable-selection analyses, and 2785 in biometric analyses. Measurements DSM-IV PDs and their 80 criteria were assessed using a structured personal interview, and AUD using WHO's Composite International Diagnostic Interview. Findings In a variable-selection analysis, two PD criteria were associated with AUD even after taking all the other criteria into account: criterion #8 of antisocial PD (childhood conduct disorder) and criterion #4 of borderline PD (self-damaging impulsive behaviors). Adjusting for each other, their respective odds ratios were 3.4 (CI = 2.1–5.4) and 5.0 (CI = 3.3–7.7). Endorsement strength of the criteria was associated with AUD in a dose-response manner and they explained 5.5% of variation in AUD risk—more than the full diagnoses of antisocial and borderline PDs together (0.5%). The association between borderline criterion #4 and AUD 10 years later derived mainly from their overlapping genetic factors, whereas the association between antisocial criterion #8 and AUD 10 years later was due to both genetic and non-genetic factors. Conclusions Conduct disorder and self-harming impulsivity are the foremost risk traits for alcohol use disorder (AUD) among the 80 personality disorder criteria of DSM-IV, predicting AUD better than personality disorder diagnoses. The twin-study analysis suggested that conduct disorder represents a joint genetic and developmental risk for alcohol use disorder and that impulsivity is a genetic risk.

Alcohol use disorder (AUD) and major depressive disorder (MDD) are often comorbid. It is not understood how genetic risk factors for these disorders relate to each other over time and to what degree they are stable. Age-dependent characteristics of the disorders indicate that different genetic factors could be relevant at different stages of life, and MDD may become increasingly correlated with AUD over time. DSM-IV diagnoses of AUD and MDD were assessed by interviews of 2,801 young adult twins between 1999 and 2004 (T1) and 2,284 of the same twins between 2010 and 2011 (T2). Stability, change, and covariation were investigated in longitudinal biometric models. New genetic factors explained 56.4% of the genetic variance in AUD at T2. For MDD, there was full overlap between genetic influences at T1 and T2. Genetic risk factors for MDD were related to AUD, but their association with AUD did not increase over time. Thus, genetic risk factors for AUD, but not MDD, vary with age, suggesting that AUD has age-dependent heritable etiologies. Molecular genetic studies of AUD may therefore benefit from stratifying by age. The new genetic factors in AUD were not related to MDD. Environmental influences on the 2 disorders were correlated in middle, but not in young adulthood. The environmental components for AUD correlated over time (r = .27), but not for MDD. Environmental influences on AUD can have long-lasting effects, and the effects of preventive efforts may be enduring. Environment influences seem to be largely transient. (PsycINFO Database Record

Background A clearer understanding of the etiological overlap between DSM-IV personality disorders (PDs) and alcohol use (AU) and alcohol use disorder (AUD) is needed. To our knowledge, no study has modeled the association between all 10 DSM-IV PDs and lifetime AU and AUD. The aim of the present study is to identify which PDs are most strongly associated with the phenotypic, genetic, and environmental risks of lifetime AU and AUD, and to determine if these associations are stable across time. Methods Participants were Norwegian twins assessed at two waves. At Wave 1, 2801 twins were assessed for all 10 DSM-IV PD criteria, lifetime AU, and DSM-IV AUD criteria. At Wave 2, six of the 10 PDs were again assessed along with AU and AUD among 2393 twins. Univariate and multiple logistic regressions were run. Significant predictors were further analyzed using bivariate twin Cholesky decompositions. Results Borderline and antisocial PD criteria were the strongest predictors of AU and AUD across the two waves. Despite moderate phenotypic and genetic correlations, genetic variation in these PD criteria explained only 4% and 3% of the risks in AU, and 5% to 10% of the risks in AUD criteria, respectively. At Wave 2, these estimates increased to 8% and 23% for AU, and 17% and 33% for AUD. Conclusions Among a large Norwegian twin sample, borderline and antisocial PD criteria were the strongest predictors of the phenotypic and genotypic liability to AU and AUD. This effect remained consistent across time.

Recent work has suggested a high level of congruence between normative personality, most typically represented by the "big five" factors, and abnormal personality traits. In 2,293 Norwegian adult twins ascertained from a population-based registry, the authors evaluated the degree of sharing of genetic and environmental influences on normative personality, assessed by the Big Five Inventory (BFI), and personality disorder traits (PDTs), assessed by the Personality Inventory for DSM-5-Norwegian Brief Form (PID-5-NBF). For four of the five BFI dimensions, the strongest genetic correlation was observed with the expected PID-5-NBF dimension (e.g., neuroticism with negative affectivity [+], conscientiousness with disinhibition [-]). However, neuroticism, conscientiousness, and agreeableness had substantial genetic correlations with other PID-5-NBF dimensions (e.g., neuroticism with compulsivity [+], agreeableness with detachment [-]). Openness had no substantial genetic correlations with any PID-5-NBF dimension. The proportion of genetic risk factors shared in aggregate between the BFI traits and the PID-5-NBF dimensions was quite high for conscientiousness and neuroticism, relatively robust for extraversion and agreeableness, but quite low for openness. Of the six PID-5-NBF dimensions, three (negative affectivity, detachment, and disinhibition) shared, in aggregate, most of their genetic risk factors with normative personality traits. Genetic factors underlying psychoticism, antagonism, and compulsivity were shared to a lesser extent, suggesting that they are influenced by etiological factors not well indexed by the BFI.

Numerous cross-sectional studies have found a positive association between level of event centrality and symptoms of posttraumatic stress disorder (PTSD), but the temporal course of this relationship is unclear. We aimed to investigate the concurrent and longitudinal association between event centrality and symptoms of PTSD in a trauma-exposed sample. In total, 319 survivors of the 2011 massacre on Utøya island, Norway, were interviewed 14 to 15 and 30 to 32 months after the event. A cross-lagged panel model was used to explore the association between event centrality and PTSD symptoms over time. Level of event centrality was significantly associated with concurrent PTSD symptoms at both time points. PTSD symptoms were significantly associated with prospective levels of event centrality but not vice versa. This finding indicates that the degree to which survivors perceive a terrorist attack as central to their identity may be an effect, not a cause, of their PTSD symptoms.

Attachment-Based Family Therapy (ABFT) is the only empirically supported family therapy model designed to treat adolescent depression, including those at risk for suicide, and their families. ABFT aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. To study the effectiveness of ABFT compared with Treatment as Usual (TAU) in reducing suicidal ideation in clinically depressed adolescents. Sixty adolescents (86.7% girls), aged 13 to 18 years ( M = 14.9), with major depressive disorder referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions according to the treatment manual. Suicidal ideation was measured with the Suicidal Ideation Questionnaire-Junior at 4, 6, 8, 10, 12, 14, and 16 weeks. Linear mixed models were fitted to test our hypothesis, time was the only factor to have a significant effect on suicidal ideation t(31.05) = −3.32, p

Background Conflict with parents is frequent in adolescent depression, and has been shown to predict poor treatment outcomes. Attachment Based Family Therapy (ABFT) is a manualised treatment for adolescent depression that may be robust to parent-adolescent conflict. Objective To evaluate the hypothesis that parent-adolescent conflict moderates the outcome of Attachment-Based Family Therapy compared with treatment as usual. Methods Data were obtained from a randomised trial comparing 16 weeks of ABFT to treatment as usual, in Norwegian Child and Adolescent Mental Health Services. Sixty adolescents with moderate to severe depression and their parents were recruited. Change in Grid-Hamilton Depression Rating Scale scores from baseline to week 16 was modelled using linear mixed models, and a three-way interaction of time, treatment allocation and a continuous measure of parent-adolescent conflict was fitted to estimate a moderator effect. The moderator model was compared to simpler models using leave-one-out cross-validation. Results Better outcomes were predicted for Attachment-Based Family Therapy at high levels of mother-adolescent conflict, and for treatment as usual at low levels of mother-adolescent conflict, giving preliminary support to the moderator hypothesis. Findings for father-adolescent conflict were mixed. Cross-validation did not clearly support the moderator model over a simple effect of time, indicating that the replicability of these findings is uncertain. Conclusion The results suggest that parent-adolescent conflict should be further studied as a moderator of outcome in Attachment-Based Family Therapy. The trial did not meet its recruitment target and had high attrition, limiting the conclusions that may be drawn.

Environmental light increases acute alertness and is the main regulator of the circadian clock in humans. In turn, circadian processes are strongly associated with inattention and hyperactivity symptoms in both children and adults. Evidence from animal studies suggest that light exposure may affect inattention and hyperactivity related behaviors during critical windows in early development. However, very little is known about the associations between light exposure, rest-activity rhythms and symptoms of inattention and hyperactivity in young children. Our aim was to examine whether the stability in rest-activity rhythms and the dosage, intensity and duration of environmental light were associated with symptoms of inattention and hyperactivity in children between 3 and 6 years of age. The present study used a subsample of the E4Kids Study. Objective measures of light exposure and stability of rest-activity rhythms were collected from 48 preschool children continuously over a period of two weeks. Parental reports of inattention and hyperactivity symptoms were collected concurrently and again 12 months later. Longer durations of light exposure were strongly associated with lower levels of hyperactivity symptoms at baseline (b = −0.64, CI = −0.97; −0.25), but not at follow up. The stability of rest-activity rhythms was associated with hyperactivity symptoms at follow up (b = −0.44, −0.81; −0.08), but not at baseline. Neither the stability of rest-activity rhythms or light exposure were associated with inattention symptoms. We provide the first evidence that the duration and intensity of environmental light exposure is inversely and strongly associated with symptoms of hyperactivity in young children in a naturalistic setting. Potential mechanistic pathways are discussed.

Resume Cette recherche vise a clarifier une controverse concernant la nature de l’influence perturbatrice du contenu emotionnel d’un texte sur les performances en dictee d’enfants de CM2 : Le contenu emotionnel affecte-t-il les performances directement, par un tropisme attentionnel, ou indirectement en induisant un etat emotionnel congruent avec sa valence? Si l’effet perturbateur du contenu emotionnel observe par Cuisinier et al. (2010) a ete replique par Fartoukh et al. (2014), les interpretations de cet effet divergent. Pour demeler cette controverse, le paradigme des deux etudes est repris avec une condition experimentale supplementaire permettant d’examiner l’influence de la joie induite sur les performances a la dictee extraite d’un texte neutre. Bien que l’induction ait modifie l’etat emotionnel des enfants elle n’a pas affecte leurs performances. En revanche le texte joyeux n’a pas modifie leur etat emotionnel mais a perturbe leurs performances. Le rappel libre du texte joyeux etait meilleur que celui du texte neutre. Ces resultats vont dans le sens d’un effet direct du contenu emotionnel du texte.

The Coping With Strain (CWS) course is a modified version of the Coping With Depression (CWD) course. CWD has been shown to reduce depression in several target groups. However, no other study has tested a modified CWD course delivered at the workplace to promote mental health. As mental health problems among employees remain a neglected area in many countries, and initiatives at the workplace often lack documentation of effects, we tested the effects of CWS on self-esteem, self-efficacy and vitality. After advertisement at workplaces, 119 employees were randomized into Intervention Group 1 (IG1), which immediately participated in CWS, or Intervention Group 2 (IG2), which functioned as a control group for six months until its participation in CWS. The follow-up period lasted for four years in both IG1 and IG2. Linear mixed models were fitted to the data. Self-efficacy, self-esteem and vitality increased significantly during the course and showed further significantly elevated levels at the follow-u...

Bidirectional pathways between twin relationship quality and friendship quality were investigated in a large longitudinal twin cohort. We examined negative and positive relationship features in 313 monozygotic (MZ) twins and 238 same-sex dizygotic (DZ) twins from ages 13 to 14 years, using latent structural modeling. Results showed stronger stability of the twin relationship quality compared to friendship quality. Positive features in the sibling relationship were associated with increased positive features in the relationship with the best friend a year later. In contrast, no significant association between negative sibling relationship features and change in negative friendship quality features was found. These findings speak to the important role of the sibling relationship in the development of good quality friendship relations in twins.

Stereopsis is a powerful depth cue for humans, which may also contribute to object recognition. In particular, we surmise that face identification would benefit from the availability of stereoscopic depth cues, since facial perception may be based on three-dimensional (3D) representations. In this study, a virtual reality (VR) headset with integrated eye-tracking was used to present stereoscopic images of faces. As a monoscopic contrast condition, identical images of faces were displayed to the two eyes. We monitored the participants' gaze behavior and pupil diameters while they performed a sample-to-match face identification task. We found that accuracy was superior in the stereoscopic condition compared to the monoscopic condition for frontal and intermediate views, but not profiles. Moreover, pupillary diameters were smaller when identifying stereoscopically seen faces than when viewing them without stereometric cues, which we interpret as lower processing load for the former than the latter conditions. The analysis of gaze showed that participants tended to focus on regions of the face rich in volumetric information, more so in the stereoscopic condition than the monoscopic condition. Together, these findings suggest that a 3D representation of faces may be the natural format used by the visual system when assessing face identity. Stereoscopic information, by providing depth information, assists the construction of robust facial representations in memory.