Aspects of Self-harm - Cognition, Imaging and Treatability
Region Skane
300 participants
Apr 30, 2021
OBSERVATIONAL
Conditions
Summary
Deliberate self-harm (DSH) is a common symptom in psychiatric disorders. This study aim at increased understanding of parameters associated with DSH with the long term goal to potentially improve and possibly personalise its treatment. In short, the study will characterise cognitive, psychiatric and demographic factors with focus on executive function and will compare results from individuals with DSH, individuals who have ceased DSH as well as psychiatric patients without DSH and individuals who never engaged in DSH. Adequate statistical tests will be used to compare groups. Participants will be interviewed by a trained physician for basic medical history, history of self-harm and treatment for that, demographic data and diagnostic evaluation. Thereafter the participants will undergo standardised neuropsychological testing focusing on emotional response inhibition, decision making and risk taking, attention set shifting, working memory, inhibition and planning. Some participants will redo parts of this testing during fMRI, as well as undergo DTI and volumetry.
Eligibility
Inclusion Criteria17
- Adults 18-65 years.
- Ability to leave informed consent.
- Understands and uses the Swedish language without significant difficulties.
- Psychiatric disorder and ongoing treatment at an adult psychiatric clinic.
- DSH at least five times during the last three months, and DSH at least ten times during at least one year.
- Adults 18-65 years.
- Ability to leave informed consent.
- Understands and uses the Swedish language without significant difficulties.
- Psychiatric disorder and ongoing treatment at an adult psychiatric clinic.
- No DSH during the last three months, but DSH at least ten times during at least one year.
- Adults 18-65 years.
- Ability to leave informed consent.
- Understands and uses the Swedish language without significant difficulties.
- Psychiatric disorder and ongoing treatment at an adult psychiatric clinic.
- Adults 18-65 years.
- Ability to leave informed consent.
- Understands and uses the Swedish language without significant difficulties.
Exclusion Criteria15
- No history of DSH, and/or DSH fewer than five times during the last three months and fewer than ten times during at least one year
- Diagnosis of Intellectual disability
- Diagnosis of chronic psychotic disorder
- Hearing disability, visual impairment or motor disorder that rules out the ability to complete neurocognitive tasks
- Any DSH during the last three months, and/or fewer than ten times during the at least one year
- Diagnosis of Intellectual disability
- Diagnosis of chronic psychotic disorder
- Hearing disability, visual impairment or motor disorder that rules out the ability to complete neurocognitive tasks
- Any DSH during the last three months, and more than two times during lifetime
- Diagnosis of Intellectual disability
- Diagnosis of chronic psychotic disorder
- Hearing disability, visual impairment or motor disorder that rules out the ability to complete neurocognitive tasks
- Diagnosed with any psychiatric disorder
- Any DSH during the last three months, and more than two times during lifetime
- Hearing disability, visual impairment or motor disorder that rules out the ability to complete neurocognitive tasks
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Interventions
Emotional Stop Signal Task (modified version from CANTAB). Outcome Measure is commission and omission errors - higher score (percentage) indicate worse performance.
Functional Magnetic Resonance Imaging (fMRI) Diffusion Tensor Imaging (DTI) Volumetry
Self-reported data on World Health Organizations Disability Assessment Schedule - 36 items self-administered (WHODAS 2.0). Assessing six domains of functional disability in daily life. Each item is rated on a Likert scale ranging from 0-4. Total range 0 - 144. High scores scores indicate more severe disability.
Self-rated personality traits through Personality Inventory for DSM-5 (PID-5). Self-reported scores on domains of personality traits. Higher scores in one domain indicate more pronounced traits in this domain.
The estimate of time where an individual can successfully inhibit their responses 50% of the time.
1. The number of trials for which the outcome was an incorrect response (subject pressed the incorrect button within the response window), calculated across all assessed trials. 2. The total number of times that the subject chose a wrong stimulus - i.e. one incompatible with the current rule, adjustment for every stage that was not reached.
1. The number of times the subject incorrectly revisits a box in which a token has previously been found. Calculated across all assessed four, six and eight token trials. 2. The number of times a subject begins a new search pattem from the same box they started with previously. If they always begin a search from the same starting point, we infer that the subject is employing a planned strategy for finding the tokens. Therefore, a low score indicates high strategy use (1 = they always begin the search from the same box), a high score indicates that they are beginning their searches from many different boxes. Calculated across assessed trials with 6 tokens or more.
1. The number of trials for which the outcome was an incorrect response. 2. The median latency of response (from stimulus appearance to button press). Calculated across all correct, assessed trials. 3. The difference between the median latency of response on the trials that were congruent versus the trials that were incongruent. A positive score indicates that the subject is faster on congruent trials and a negative score indicates that the subject is faster on incongruent trials. A higher incongruency cost indicates that the subjects take longer to process conflicting information. 4. The difference between the median latency of response during assessed blocks in which both rules are used versus assessed blocks in which only a single rule is used. A positive score indicates that the subject responds more slowly during multitasking blocks and indicates a higher cost of managing multiple sources of information.
1. The proportion (0 - 1) of all trials where the subject chose the majority box color. Calculated over all assessed trials from both the ascending and descending conditions in which the number of boxes of each color differed. 2. Risk adjustment is a measure of sensitivity to risk, based on the ability to modify choices in the light of information about the probability of different outcomes and to track the optimal outcome on eaeh trial. The measure is calculated from the average proportion of points that the subject ehose to bet with, taking into aeeount the number of colored boxes in the majority. 3. Allows for the dissociation between risk taking and impulsivity by determining whether subjects simply just place a bet at the first opportunity. Calculated as CGT Risk Taking for all trials from the descending condition minus CGT Risk Taking for all trials from the ascending condition.
Locations(1)
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NCT04905797