Recently, we found adults who received digital bibliotherapy featuring lived-experience narratives related to suicidal thoughts and behaviors reported lower suicidal thoughts, mediated by increased social connectedness and optimism. This study aimed to identify characteristics of narratives associated with decreased suicidal thinking and increased social connectedness and optimism. 1532 users of a social media platform responded to surveys before and after reading narratives. Mixed-methods content analysis and clustered multidimensional scaling tested whether clusters that shared narrative characteristics were related to suicidal thoughts, social connectedness and optimism. We identified three narrative clusters: Cluster 1: “Encouraging Readers to Live,” Cluster 2: “Sharing Personal Stories,” and Cluster 3: “Detailed Accounts.” Clusters 2 and 3 were associated with greatest reduction in suicidal thoughts, Cluster 2 with the greatest increase in social connectedness, and Cluster 3 with the greatest increase in optimism. Results suggest the optimal narratives for reducing suicidal thoughts are personal, detailed accounts.

Background Military Servicemembers and Veterans are at elevated risk for suicide, but rarely self-identify to their leaders or clinicians regarding their experience of suicidal thoughts. We developed an algorithm to identify posts containing suicide-related content on a military-specific social media platform.Methods Publicly-shared social media posts (n = 8449) from a military-specific social media platform were reviewed and labeled by our team for the presence/absence of suicidal thoughts and behaviors and used to train several machine learning models to identify such posts.Results The best performing model was a deep learning (RoBERTa) model that incorporated post text and metadata and detected the presence of suicidal posts with relatively high sensitivity (0.85), specificity (0.96), precision (0.64), F1 score (0.73), and an area under the precision-recall curve of 0.84. Compared to non-suicidal posts, suicidal posts were more likely to contain explicit mentions of suicide, descriptions of risk factors (e.g. depression, PTSD) and help-seeking, and first-person singular pronouns.Conclusions Our results demonstrate the feasibility and potential promise of using social media posts to identify at-risk Servicemembers and Veterans. Future work will use this approach to deliver targeted interventions to social media users at risk for suicide.

Functional connections in the brain are frequently represented by weighted networks, with nodes representing locations in the brain and edges representing the strength of connectivity between these locations. One challenge in analyzing such data is that inference at the individual edge level is not particularly biologically meaningful; interpretation is more useful at the level of so-called functional systems or groups of nodes and connections between them; this is often called "graph-aware" inference in the neuroimaging literature. However, pooling over functional regions leads to significant loss of information and lower accuracy. Another challenge is correlation among edge weights within a subject which makes inference based on independence assumptions unreliable. We address both of these challenges with a linear mixed effects model, which accounts for functional systems and for edge dependence, while still modeling individual edge weights to avoid loss of information. The model allows for comparing two populations, such as patients and healthy controls, both at the functional regions level and at individual edge level, leading to biologically meaningful interpretations. We fit this model to resting state fMRI data on schizophrenic patients and healthy controls, obtaining interpretable results consistent with the schizophrenia literature.

After selection with the Group LASSO (or generalized variants such as the overlapping, sparse, or standardized Group LASSO), inference for the selected parameters is unreliable in the absence of adjustments for selection bias. In the penalized Gaussian regression setup, existing approaches provide adjustments for selection events that can be expressed as linear inequalities in the data variables. Such a representation, however, fails to hold for selection with the Group LASSO and substantially obstructs the scope of subsequent post-selective inference. Key questions of inferential interest -- for example, inference for the effects of selected variables on the outcome -- remain unanswered. In the present paper, we develop a consistent, post-selective, Bayesian method to address the existing gaps by deriving a likelihood adjustment factor and an approximation thereof that eliminates bias from the selection of groups. Experiments on simulated data and data from the Human Connectome Project demonstrate that our method recovers the effects of parameters within the selected groups while paying only a small price for bias adjustment.

Canonical Correlation Analysis (CCA) is a method for analyzing pairs of random vectors; it learns a sequence of paired linear transformations such that the resultant canonical variates are maximally correlated within pairs while uncorrelated across pairs. CCA outputs both canonical correlations as well as the canonical directions which define the transformations. While inference for canonical correlations is well developed, conducting inference for canonical directions is more challenging and not well-studied, but is key to interpretability. We propose a computational bootstrap method (combootcca) for inference on CCA directions. We conduct thorough simulation studies that range from simple and well-controlled to complex but realistic and validate the statistical properties of combootcca while comparing it to several competitors. We also apply the combootcca method to a brain imaging dataset and discover linked patterns in brain connectivity and behavioral scores.

We consider the setting where many networks are observed on a common node set, and each observation comprises edge weights of a network, covariates observed at each node, and an overall response. The goal is to use the edge weights and node covariates to predict the response while identifying an interpretable set of predictive features. Our motivating application is neuroimaging, where edge weights encode functional connectivity measured between brain regions, node covariates encode task activations at each brain region, and the response is disease status or score on a behavioral task. We propose an approach that constructs feature groups based on assumed community structure (naturally occurring in neuroimaging applications). We propose two feature grouping schemes that incorporate both edge weights and node covariates, and we derive algorithms for optimization using an overlapping group LASSO penalty. Empirical results on synthetic data show that our method, relative to competing approaches, has similar or improved prediction error along with superior support recovery, enabling a more interpretable and potentially more accurate understanding of the underlying process. We also apply the method to neuroimaging data from the Human Connectome Project. Our approach is widely applicable in neuroimaging where interpretability is highly desired.

Background Interest in developing machine learning models that use electronic health record data to predict patients’ risk of suicidal behavior has recently proliferated. However, whether and how such models might be implemented and useful in clinical practice remain unknown. To ultimately make automated suicide risk–prediction models useful in practice, and thus better prevent patient suicides, it is critical to partner with key stakeholders, including the frontline providers who will be using such tools, at each stage of the implementation process. Objective The aim of this focus group study is to inform ongoing and future efforts to deploy suicide risk–prediction models in clinical practice. The specific goals are to better understand hospital providers’ current practices for assessing and managing suicide risk; determine providers’ perspectives on using automated suicide risk–prediction models in practice; and identify barriers, facilitators, recommendations, and factors to consider. Methods We conducted 10 two-hour focus groups with a total of 40 providers from psychiatry, internal medicine and primary care, emergency medicine, and obstetrics and gynecology departments within an urban academic medical center. Audio recordings of open-ended group discussions were transcribed and coded for relevant and recurrent themes by 2 independent study staff members. All coded text was reviewed and discrepancies were resolved in consensus meetings with doctoral-level staff. Results Although most providers reported using standardized suicide risk assessment tools in their clinical practices, existing tools were commonly described as unhelpful and providers indicated dissatisfaction with current suicide risk assessment methods. Overall, providers’ general attitudes toward the practical use of automated suicide risk–prediction models and corresponding clinical decision support tools were positive. Providers were especially interested in the potential to identify high-risk patients who might be missed by traditional screening methods. Some expressed skepticism about the potential usefulness of these models in routine care; specific barriers included concerns about liability, alert fatigue, and increased demand on the health care system. Key facilitators included presenting specific patient-level features contributing to risk scores, emphasizing changes in risk over time, and developing systematic clinical workflows and provider training. Participants also recommended considering risk-prediction windows, timing of alerts, who will have access to model predictions, and variability across treatment settings. Conclusions Providers were dissatisfied with current suicide risk assessment methods and were open to the use of a machine learning–based risk-prediction system to inform clinical decision-making. They also raised multiple concerns about potential barriers to the usefulness of this approach and suggested several possible facilitators. Future efforts in this area will benefit from incorporating systematic qualitative feedback from providers, patients, administrators, and payers on the use of these new approaches in routine care, especially given the complex, sensitive, and unfortunately still stigmatized nature of suicide risk.

OBJECTIVE:Suicide is a major public health concern in the United States, but few effective and scalable interventions exist to help those with suicidal thoughts. We hypothesized that reading first-person narratives about working through suicidal thoughts would reduce the desire to die among adults and that this effect would be mediated by increased perceived shared experience and optimism.METHOD:Using a randomized waitlist-controlled trial, we tested the effect of digital narrative-based bibliotherapy among 528 adults visiting a social media platform dedicated to providing mental health support. Participants were randomized to either a treatment condition (n = 266), in which they read one suicide narrative per day for 14 days or to a waitlist control condition (n = 262). The primary outcome was a measure of desire to die assessed daily for the 14-day trial period and at 2-week follow-up.RESULTS:Participants in the treatment condition reported lower desire to die than participants in the control condition during the 14-day trial period (β = -0.26, p = .001) and at 2-week follow-up (t = -2.82, p = .005). Increased perceived shared experience (indirect effect b = -0.55, p < .001) and optimism (indirect effect b = -0.85, p < .001) mediated the effect of treatment on desire to die.CONCLUSIONS:Digital narrative-based bibliotherapy may be an effective intervention for those at risk for suicide, and may work in part by increasing feelings of perceived shared experience and optimism. Future research is needed to test the generalizability of these results to other platforms, groups, and conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

There are strong cultural norms for how emotions are expressed, yet little is known about cultural variations in preschoolers' outward displays and regulation of disappointment. Chinese, Japanese, and American preschoolers' (N = 150) displays of emotion to an undesired gift were coded across both social and nonsocial contexts in a "disappointing gift" paradigm. Generalized estimating equations revealed that, regardless of culture, when children received a disappointing gift, they showed more positive expressions of emotion ("fake smile") in social contexts (in the presence of unfamiliar and familiar examiners) relative to when they were alone, suggesting that preschool-aged children are able to mask their disappointment with positive displays. However, children's emotion expressions varied across both cultures and contexts. American children were more positively and negatively expressive than Japanese children and were more negatively expressive than Chinese children. Chinese and Japanese preschoolers verbally reported more negative emotions but showed more neutral expressions than American preschoolers when receiving the disappointing gift. In addition, across different contexts of the task, there were subtle differences in how Chinese and Japanese children regulated their emotional expressions, with Chinese children showing similar levels of neutral expressions (e.g., "poker face") across different contexts in the task. Thus, our findings highlight the importance of understanding cultural meanings and practices underlying emotion development during early childhood. (C) 2020 Elsevier Inc. All rights reserved.

Background: Interest in developing machine learning algorithms that use electronic health record data to predict patients’ risk of suicidal behavior has recently proliferated. Whether and how such models might be implemented and useful in clinical practice, however, remains unknown. In order to ultimately make automated suicide risk prediction algorithms useful in practice, and thus better prevent patient suicides, it is critical to partner with key stakeholders (including the frontline providers who will be using such tools) at each stage of the implementation process.Objective: The aim of this focus group study was to inform ongoing and future efforts to deploy suicide risk prediction models in clinical practice. The specific goals were to better understand hospital providers’ current practices for assessing and managing suicide risk; determine providers’ perspectives on using automated suicide risk prediction algorithms; and identify barriers, facilitators, recommendations, and factors to consider for initiatives in this area. Methods: We conducted 10 two-hour focus groups with a total of 40 providers from psychiatry, internal medicine and primary care, emergency medicine, and obstetrics and gynecology departments within an urban academic medical center. Audio recordings of open-ended group discussions were transcribed and coded for relevant and recurrent themes by two independent study staff members. All coded text was reviewed and discrepancies resolved in consensus meetings with doctoral-level staff. Results: Though most providers reported using standardized suicide risk assessment tools in their clinical practices, existing tools were commonly described as unhelpful and providers indicated dissatisfaction with current suicide risk assessment methods. Overall, providers’ general attitudes toward the practical use of automated suicide risk prediction models and corresponding clinical decision support tools were positive. Providers were especially interested in the potential to identify high-risk patients who might be missed by traditional screening methods. Some expressed skepticism about the potential usefulness of these models in routine care; specific barriers included concerns about liability, alert fatigue, and increased demand on the healthcare system. Key facilitators included presenting specific patient-level features contributing to risk scores, emphasizing changes in risk over time, and developing systematic clinical workflows and provider trainings. Participants also recommended considering risk-prediction windows, timing of alerts, who will have access to model predictions, and variability across treatment settings.Conclusions: Providers were dissatisfied with current suicide risk assessment methods and open to the use of a machine learning-based risk prediction system to inform clinical decision-making. They also raised multiple concerns about potential barriers to the usefulness of this approach and suggested several possible facilitators. Future efforts in this area will benefit from incorporating systematic qualitative feedback from providers, patients, administrators, and payers on the use of new methods in routine care, especially given the complex, sensitive, and unfortunately still stigmatized nature of suicide risk.

Every day, individuals post suicide notes on social media asking for support, resources, and reasons to live. Some posts receive few comments while others receive many. While prior studies have analyzed whether specific responses are more or less helpful, it is not clear if the quantity of comments received is beneficial in reducing symptoms or in keeping the user engaged with the platform and hence with life. In the present study, we create a large dataset of users' first r/SuicideWatch (SW) posts from Reddit (N=21,274), collect the comments as well as the user's subsequent posts (N=1,615,699) to determine whether they post in SW again in the future. We use propensity score stratification, a causal inference method for observational data, and estimate whether the amount of comments -as a measure of social support- increases or decreases the likelihood of posting again on SW. One hypothesis is that receiving more comments may decrease the likelihood of the user posting in SW in the future, either by reducing symptoms or because comments from untrained peers may be harmful. On the contrary, we find that receiving more comments increases the likelihood a user will post in SW again. We discuss how receiving more comments is helpful, not by permanently relieving symptoms since users make another SW post and their second posts have similar mentions of suicidal ideation, but rather by reinforcing users to seek support and remain engaged with the platform. Furthermore, since receiving only 1 comment -the most common case- decreases the likelihood of posting again by 14% on average depending on the time window, it is important to develop systems that encourage more commenting.

Convergent research identifies a general factor (“P factor”) that confers transdiagnostic risk for psychopathology. Large-scale networks are key organizational units of the human brain. However, studies of altered network connectivity patterns associated with the P factor are limited, especially in early adolescence when most mental disorders are first emerging. We studied 11,875 9- and 10-year olds from the Adolescent Brain and Cognitive Development (ABCD) study, of whom 6593 had high-quality resting-state scans. Network contingency analysis was used to identify altered interconnections associated with the P factor among 16 large-scale networks. These connectivity changes were then further characterized with quadrant analysis that quantified the directionality of P factor effects in relation to neurotypical patterns of positive versus negative connectivity across connections. The results showed that the P factor was associated with altered connectivity across 28 network cells (i.e., sets of connections linking pairs of networks); p PERMUTATION values < 0.05 FDR-corrected for multiple comparisons. Higher P factor scores were associated with hypoconnectivity within default network and hyperconnectivity between default network and multiple control networks. Among connections within these 28 significant cells, the P factor was predominantly associated with “attenuating” effects (67%; p PERMUTATION < 0.0002), i.e., reduced connectivity at neurotypically positive connections and increased connectivity at neurotypically negative connections. These results demonstrate that the general factor of psychopathology produces attenuating changes across multiple networks including default network, involved in spontaneous responses, and control networks involved in cognitive control. Moreover, they clarify mechanisms of transdiagnostic risk for psychopathology and invite further research into developmental causes of distributed attenuated connectivity.

Alterations in resting-state functional connectivity (rsFC) have been demonstrated in Posttraumatic Stress Disorder (PTSD). However, such reports have primarily focused on adult participants, whereas findings in adolescents with PTSD are mixed and not entirely consistent with the adult literature. Here, we examined rsFC in a non-treatment seeking adolescent sample with posttraumatic stress symptoms (PTSS; n = 59) relative to asymptomatic controls (n = 226). We also examined differences between trauma-exposed and non-exposed control subgroups (TEC n = 73 and Non-TEC n = 153) to examine alterations associated with more general trauma exposure. Finally, we compared the PTSS and TEC groups, to confirm that the reported alterations in PTSS were not driven by trauma exposure. Using a seed-based approach, we examined connectivity of default-mode (DMN) and salience (SN) networks, where alterations have been previously reported. Results suggest that PTSS are associated with less within-DMN connectivity and greater SN-DMN connectivity, as well as altered connectivity with attention regions. Trauma exposure is associated with greater within-SN connectivity. Additionally, we report findings from exploratory connectome-based analysis, which demonstrate a number of topological alterations within DMN in the PTSS group. Overall, our findings replicate prior reports of altered rsFC in PTSD and extend them to non-treatment seeking, trauma-exposed adolescents, who did or did not report PTSS. They specifically highlight SN-DMN desegregation, lower within-DMN and greater within-SN connectivity, as well as altered connectivity with attention regions, in trauma-exposed adolescents. Future research is required to confirm that adolescents with diagnosed PTSD have similar/exacerbated connectivity patterns.

The investigation of brain networks has yielded many insights that have helped to characterise many neurological and psychiatric disorders. In particular, network classification of functional magnetic resonance imaging (fMRI) data is an important tool for the identification of prognostic and diagnostic biomarkers of brain connectivity disorders such as schizophrenia and depression. However, existing generic network classification methods provide no direct information on the underlying molecular mechanisms of the selected functional connectivity features when applied to fMRI data. To address this, we propose a novel fMRI network classification method that incor-porates brain transcriptional data using a user-specified gene set collection (GSC) to construct feature groups for use in classification of brain connectivity data. The use of GSCs are an opportunity to incorporate knowledge of potential molecular mechanisms which may be associated with a disease. The inclusion of transcriptional data yields improved prediction accuracy on publicly available schizophrenia fMRI data for several of the GSCs we consider. We also introduce a post-hoc interpretation framework to provide transcriptional-data-guided biological interpretations for discriminative functional connectivity features identified by existing fMRI network classification methods.

The brain is a complex, multiscale dynamical system composed of many interacting regions. Knowledge of the spatiotemporal organization of these interactions is critical for establishing a solid understanding of the brain’s functional architecture and the relationship between neural dynamics and cognition in health and disease. The possibility of studying these dynamics through careful analysis of neuroimaging data has catalyzed substantial interest in methods that estimate time-resolved fluctuations in functional connectivity (often referred to as “dynamic” or time-varying functional connectivity; TVFC). At the same time, debates have emerged regarding the application of TVFC analyses to resting fMRI data, and about the statistical validity, physiological origins, and cognitive and behavioral relevance of resting TVFC. These and other unresolved issues complicate interpretation of resting TVFC findings and limit the insights that can be gained from this promising new research area. This article brings together scientists with a variety of perspectives on resting TVFC to review the current literature in light of these issues. We introduce core concepts, define key terms, summarize controversies and open questions, and present a forward-looking perspective on how resting TVFC analyses can be rigorously and productively applied to investigate a wide range of questions in cognitive and systems neuroscience.

Methods for supervised principal component analysis (SPCA) aim to incorporate label information into principal component analysis (PCA), so that the extracted features are more useful for a prediction task of interest. Prior work on SPCA has focused primarily on optimizing prediction error, and has neglected the value of maximizing variance explained by the extracted features. We propose a new method for SPCA that addresses both of these objectives jointly, and demonstrate empirically that our approach dominates existing approaches, i.e., outperforms them with respect to both prediction error and variation explained. Our approach accommodates arbitrary supervised learning losses and, through a statistical reformulation, provides a novel low-rank extension of generalized linear models.

Altered functional connectivity (FC) in default-mode (DMN) and salience (SN) networks have been evident in adults with posttraumatic stress disorder (PTSD). However, the validity of these abnormalities in adolescents and to what extent they predict long-term recovery after a traumatic exposure is yet unknown.

OBJECTIVE:Although there are frequent reports of shared neurofunctional and neurostructural alterations among probands with attention-deficit/hyperactivity disorder (ADHD) and their unaffected siblings, there is little knowledge regarding whether abnormalities in the resting-state functional connectivity of ADHD probands is also expressed in unaffected siblings, or whether this unaffected (but at-risk) cohort manifests distinct patterns. METHOD:We used a multivariate connectome-wide association study examining intrinsic functional connectivity with resting-state functional magnetic resonance imaging (MRI) in a sample (aged 8-17 years) of medication-naive ADHD probands (n = 56), their unaffected siblings (n = 55), and typically developing (TD) youths (n = 106). RESULTS:ADHD probands showed, relative to TD youths, increased connectivity between the default-mode network (DMN) and task-positive networks. Relative to ADHD and TD groups, respectively, unaffected siblings showed increased connectivity within the salience network and reduced connectivity between the DMN and salience network. No shared alterations in functional connectivity among ADHD probands and their unaffected siblings were identified. These findings were largely confirmed by complementary pairwise connectomic comparisons. However, the main connectivity differences between ADHD and unaffected siblings were not replicated in a tightly age- and sex-matched subsample (20 proband-sibling pairs and 60 TD youths). CONCLUSION:Our findings suggest that increased functional segregation related to the attention networks, especially the salience (ventral attention) system, may be a potential feature of at-risk siblings who remain unaffected by ADHD expression. Further replications are needed in other larger and sex-matched samples. CLINICAL TRIAL REGISTRATION INFORMATION:Structural and Functional Connectivity of Frontostriatal and Frontoparietal Networks as Endophenotypes of ADHD; https://clinicaltrials.gov/; NCT01682915.

Alzheimer's disease is considered a disconnection syndrome, motivating the use of brain network measures to detect changes in whole-brain resting state functional connectivity (FC). We investigated changes in FC within and among resting state networks (RSN) across four different stages in the Alzheimer's disease continuum. FC changes were examined in two independent cohorts of individuals (84 and 58 individuals, respectively) each comprising control, subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia groups. For each participant, FC was computed as a matrix of Pearson correlations between pairs of time series from 278 gray matter brain regions. We determined significant differences in FC modular organization with two distinct approaches, network contingency analysis and multiresolution consensus clustering. Network contingency analysis identified RSN sub-blocks that differed significantly across clinical groups. Multiresolution consensus clustering identified differences in the stability of modules across multiple spatial scales. Significant modules were further tested for statistical association with memory and executive function cognitive domain scores. Across both analytic approaches and in both participant cohorts, the findings converged on a pattern of FC that varied systematically with diagnosis within the frontoparietal network (FP) and between the FP network and default mode network (DMN). Disturbances of modular organization were manifest as greater internal coherence of the FP network and stronger coupling between FP and DMN, resulting in less segregation of these two networks. Our findings suggest that the pattern of interactions within and between specific RSNs offers new insight into the functional disruption that occurs across the Alzheimer's disease spectrum.

While statistical analysis of a single network has received a lot of attention in recent years, with a focus on social networks, analysis of a sample of networks presents its own challenges which require a different set of analytic tools. Here we study the problem of classification of networks with labeled nodes, motivated by applications in neuroimaging. Brain networks are constructed from imaging data to represent functional connectivity between regions of the brain, and previous work has shown the potential of such networks to distinguish between various brain disorders, giving rise to a network classification problem. Existing approaches tend to either treat all edge weights as a long vector, ignoring the network structure, or focus on graph topology as represented by summary measures while ignoring the edge weights. Our goal is to design a classification method that uses both the individual edge information and the network structure of the data in a computationally efficient way, and that can produce a parsimonious and interpretable representation of differences in brain connectivity patterns between classes. We propose a graph classification method that uses edge weights as predictors but incorporates the network nature of the data via penalties that promote sparsity in the number of nodes, in addition to the usual sparsity penalties that encourage selection of edges. We implement the method via efficient convex optimization and provide a detailed analysis of data from two fMRI studies of schizophrenia.