Mikael Julius Sømhovd

Experience with psychological trauma is overrepresented among substance use disorder (SUD) patients. SUDs may also be a risk factor for violent behaviors, suicidal ideation and suicide. This study proposes a link between these phenomena. Based on data from the EuropASI clinical interview of 137 SUD inpatients we computed a composite variable of trauma experience from being abused. We report descriptive data and cross tabulated problems controlling violent behavior, suicidal ideation or suicide attempts variables with trauma experience. Hypothesizing an association between experienced trauma and the outcome variables. We also examined the correlation between three outcome variables in inpatients. Our data suggested high incidents of experienced psychological trauma in the sample (66.7%). Chi-square tests suggested a significant difference in controlling violent behavior, suicidal ideation and suicide attempts, dependent on trauma experience. Spearman Roh correlations suggested asscociations between suicdal ideation and suicide attempts, and suicdal ideation and problems controlling violent behavior, but not with suicide attempts. Our data suggests that past trauma is a risk factor for violent and suicidal behaviors in the SUD population. Based on our findings we propose that former trauma should be considered in risk assessments and help guide treatment interventions.

Substance use disorder (SUD) can lead to cognitive impairment. The objective of our study is to investigate differences in cognitive impairment between psychostimulant users and opioid users after ...

Patients entering substance use disorder treatment perceive the quality of life as low and have high levels of psychological distress. Some suffer from impaired cognitive functioning. The prevalence of traumatic experiences is high. We aimed to determine whether there had been improvements from admission to discharge and explore the relationships between the improvements and experiences of traumatic abuse. We recruited 138 inpatients from long-term treatment for substance use disorders in Norway. 98 participants completed the questionnaires on quality of life, psychological distress, and cognitive functioning at admission and discharge. We found significant improvements in quality of life and cognitive functioning, and the psychological distress decreased from admission to discharge. Patients with experiences of traumatic abuse improved less in cognitive functioning. Measurements of quality of life, psychological distress, and cognitive functioning may be useful to assess improvements during treatment. Health providers must be aware of the high prevalence of mild cognitive impairment and psychological distress, and low quality of life in patients at admission to treatment. Patients with experiences of traumatic abuse improved less in cognitive functioning and treatment should target this, as it could hinder drop-out and enhance the success of substance use disorder treatment.

Objective: Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with substance use disorders and has some overlapping symptoms with mild cognitive impairment, including executive functions. We wanted to investigate whether patients with ADHD have an excess risk of mild cognitive impairment–like symptoms, as defined by the Montreal Cognitive Assessment (MoCA). Second, we assessed the impact of ADHD medication on the dichotomized MoCA for patients with ADHD. Methods: The participants in this study were 129 inpatients at seven treatment clinics in Norway. All were screened with the MoCA. We calculated relative risk estimates (RR) for scoring in the mild cognitive impairment range (< 26) for those having ADHD. Finally, we calculated the RR for the patients within the ADHD group who were taking medication. Results: Of the 129 participants included in the analyses, 38 (29.5%) scored below the MoCA threshold (< 26), and 24 (18.6%) had ADHD that was diagnosed before or during the inpatient treatment. Of the 105 participants without ADHD, 31 (29.5%) scored below the threshold. Seven (29.2%) of those with ADHD scored below the threshold. The risk of scoring in the mild cognitive impairment range for those with and without ADHD was equal (RR = 0.98). Of the 24 patients with ADHD, 9 (37.5%) were taking medication at the time of testing. One of the patients taking medication scored below the threshold compared to six of those not taking medication. This suggests a 72% lower risk of mild cognitive impairment–like symptoms when taking medication (RR = 0.28); however, the effect was not significant. Conclusions: We revealed no excess risk of mild cognitive impairment–like symptoms for the ADHD group. However, within the ADHD group, there was a possible lower risk of mild cognitive impairment–like symptoms for patients taking medication. These results suggest that there may be a confounding overlap of symptoms between ADHD and cognitive function screens that necessitates adequate assessment and treatment of ADHD before screening or measuring cognitive function.

Aim: To compare anxiety symptoms in adolescents born extremely prematurely to term‐born controls.Methods: We had 96 preterm‐born adolescents and 40 term‐born controls from Denmark, and their mothers score the adolescents on the Revised Children Anxiety and Depression scale. We analysed group differences, cross‐informant correlations and relative risks for elevated anxiety symptoms.Results: Self‐reported anxiety symptoms did not significantly differ, although the upper confidence limit (95% CI: −3.3 to 5.1) supported an odds ratio of 2 for the preterm‐born participants. Mothers of the preterm‐born participants reported higher social anxiety symptoms than did mothers of controls (51.7 versus 46.8, p = 0.001). The relative risk for being above a threshold indicating distressing anxiety was small from self‐reports (1.39; p = 0.60). From mother‐reports, the relative risk was noticeable but not significant (4.58; p = 0.14). Cross‐informant scores correlated significant for total anxiety and social anxiety for the preterm‐born (rτ = 0.2, p = 0.001; rτ = 0.3, p ≤ 0.001).Conclusions: Self‐reports did not clearly indicate more anxiety in the preterm group, although confidence intervals supported a possible twofold increase. Mother‐ and self‐reports correlated only for the preterm group, which may indicate increased sensitivity for their children's symptoms.

The metacognitive model has increased our understanding of the development and maintenance of generalized anxiety disorders in adults. It states that the combination of positive and negative beliefs about worry creates and sustains anxiety. A recent review argues that the model can be applied to children, but empirical support is lacking. The aim of the 2 presented studies was to explore the applicability of the model in a childhood sample. The first study employed a Danish community sample of youth (n = 587) ages 7 to 17 and investigated the relationship between metacognitions, worry and anxiety. Two multiple regression analyses were performed using worry and metacognitive processes as outcome variables. The second study sampled Danish children ages 7 to 12, and compared the metacognitions of children with a GAD diagnosis (n = 22) to children with a non-GAD anxiety diagnosis (n = 19) and nonanxious children (n = 14). In Study 1, metacognitive processes accounted for an additional 14% of the variance in worry, beyond age, gender, and anxiety, and an extra 11% of the variance in anxiety beyond age, gender, and worry. The Negative Beliefs about Worry scale emerged as the strongest predictor of worry and a stronger predictor of anxiety than the other metacognitive processes and age. In Study 2, children with GAD have significantly higher levels of deleterious metacognitions than anxious children without GAD and nonanxious children. The results offer partial support for the downward extension of the metacognitive model of generalized anxiety disorders to children.

Theoretical models of anxiety have been developed in adult populations. The applicability of these models in child samples has been assessed using downward extensions of the questionnaires developed to assess the proposed theoretical mechanisms. This poses a challenge, as children are still in the process of developing the skills that are being assessed. Psychometrically sound assessment tools are therefore needed for this developing population, in order to ensure the early detection of mechanisms leading to anxiety disorders in children. This study examined if metacognitions, which play a key role in generalized anxiety disorder (GAD) in adults, can also be reliably assessed in childhood. The study investigated the psychometric properties of the 30-item Metacognitions Questionnaire for Children (MCQ-C₃₀; Gerlach, Adam, Marschke, & Melfsen, 2008) in a national sample of 974 children and adolescents (538 girls) ages 9-17 years. Confirmatory factor analysis supported the 5-factor subscale structure and a 2nd-order total scale factor, which corresponds with previous versions of the scale. MCQ-C₃₀ expectedly correlated significantly with anxiety symptoms and worry. Structural equation modeling revealed that both obsessive-compulsive disorder and generalized anxiety disorder symptoms regressed significantly onto the MCQ-C₃₀. We fitted separate models for children and adolescents, and no noticeable differences are suggested between the models. Female gender was, expectedly, associated with increased levels of general metacognitions. This gender effect was mediated by level of anxiety. Overall, the MCQ-C₃₀ exhibited acceptable psychometric properties in our community sample of children ages 9-17 years. Future studies should investigate the psychometric properties of the instrument in clinical samples and samples of younger children.