The extramural Research Unit on Anxiety and Stress Disorders was established by the Medical Research Council in 1997. The Unit has worked towards obtaining status as a cross-University Centre, with key unit researchers now located at the University of Stellenbosch, as well as the University of Cape Town (UCT), and at Northwest University. Prof Dan J. Stein, head of the Department of Psychiatry and Mental Health at UCT, is director of the Unit. Priority has been given to establishing a unit focusing on anxiety disorders, including PTSD, fostering a multi-disciplinary biopsychosocial approach to the anxiety disorders, promoting increased awareness of the anxiety disorders in the community, and finally, ensuring capacity building of clinical and research skills in students and staff. In 2017 the name of the unit was changed to the SU/UCT MRC Unit on Risk and Resilience in Mental Disorders. Students, post-doctoral fellows and any others should contact the Unit if interested in our work: tel nr: 021 938 9229; Prof Dan J. Stein: Dan.Stein@uct.ac.za; Prof Christine Lochner: cl2@sun.ac.za.

Projek 1

Stellenbosch Universiteit is besig met breinskandering-navorsing oor sosiale angssteuring (SAS)

 Wat behels hierdie navorsingsprojek? U het dalk al van neurale netwerke gehoor. ‘Neurale netwerke’ verwys na die manier waarop verskillende dele van die brein saamwerk om spesifieke dinge te doen. Verskillende areas in die brein is byvoorbeeld betrokke by die verstaan van wat ’n mens met sy oë sien. Al dié areas is saam bekend as die ‘visuele netwerk’. ʼn Ander netwerk is dalk betrokke by die manier waarop sosiale situasies verstaan word – bv. die identifisering van ander mense se emosies terwyl jy by ʼn partytjie met hulle praat. Ons vermoed dat hierdie ‘sosiale netwerk’ anders is in mense met SAS en ons wil dit ondersoek. Ons wil ook sien watter effek behandeling van SAS op hierdie netwerk het.

Hoe word die studie gedoen? Ons beplan om twee tipes breinskandering te doen (om die netwerk te bestudeer) asook toetse van sosiale funksie in pasiënte met en sonder SAS. Vir mense met SAS sal ons dieselfde toetse na ’n kursus van behandeling (moklobemied) herhaal om te sien of daar enige verandering was.

Ons benodig vrywilligers met SAS om deel te neem. Met uitsluiting van die aanvanklike (siftings-) besoek, sal SAS vrywilligers 8 studie-besoeke (oor ʼn tydperk van 9 weke) moet bywoon, terwyl vrywilligers sonder SAS 4 studie-besoeke (oor ʼn tydperk van 1-2 weke) moet bywoon. Vrywilligers sal vir hulle kos en reiskoste vergoed word.

Die projek is reeds sedert 2015 aan die gang en vorder fluks.

Kwalifiseer ek? Vir verskeie redes moet u voldoen aan al die onderstaande kriteria om aan die studie deel te neem:

• Ouer as 18 jaar
• Vlot in Engels (vraelyste en video’s is slegs in Engels beskikbaar)
• Regshandig (linkshandige persone se brein is anders)
• Nie swanger of borsvoed nie
• Geen ander psigiatriese toestande (bv. depressie, skisofrenie) behalwe SAS nie (SAS deelnemers)
• Geen beduidende psigiatriese toestande nie (gesonde vrywilligers)
• Nie tans op enige medikasie vir ‘n psigiatriese toestand nie, of is bereid om medikasie tydelik te onderbreek om aan die studie deel te neem.
• Geen vorige of huidige mediese toestande wat die brein direk beïnvloed nie, (bv. vorige kopbesering met bewussynsverlies of breinoperasies), geen metaal-inplantings in die skedel, geen suikersiekte (diabetes) nie
• In staat om in ‘n breinskandeerder stil te lê vir tot ‘n uur op ‘n slag

Indien u belangstel (óf as ‘n SAS deelnemer óf as ‘n gesonde vrywilliger), kontak asseblief Prof Christine Lochner (cl2@sun.ac.za ): Tel: 021 – 938 9179

Stellenbosch University is conducting neuroimaging research in social anxiety disorder (SAD)

Brain imaging research in the past has largely been focused on looking at regional differences in activity in the brain. So for example, researchers demonstrated that in the brains of people with SAD, there might be more activity in the amygdala (a part of the brain involved in anxiety) than would be expected in people without the disorder. While this work remains important, such regional differences only represent part of the picture!

Functional connectivity research is a recent method of brain analysis that allows scientists to examine how multiple, widespread connections in the brain result in these regional differences in activity. Groups of these connections form what are known as ‘neural networks’ and several of such networks have so far been detected. There is some evidence that one network in the brain (called the default mode network) may play a role in how social information is processed (social information includes our perceptions and thoughts about other people and how they perceive us).

We are interested in networks in the brains of SAD sufferers and whether they differ from those without the disorder. We want to investigate whether network differences can be linked to how people with SAD process social information. We also want to see the effect of treatment (using an established treatment for SAD – moclobemide) on these networks.

The project has been ongoing since 2015, and is progressing well.

All participants undergo two types of brain scan (FDG PET/CT and fMRI) and a series of psychological tests. SAD volunteers then receive an 8-9 week course of moclobemide followed by repeat testing and scanning. Excluding the initial (screening) visit, SAD participants attend 8 study visits over the course of 9 weeks, while healthy volunteers (without SAD) attend 4 study visits over the course of 1-2 weeks. Participants are reimbursed for their food and travel costs.

Eligibility criteria:

• Between the ages of 18 and 55
• Fluent in English (the psychological tests are only available in English)
• Right-handed (left-handed people’s brains are different)
• Not pregnant or breastfeeding
• No dominant psychiatric conditions other than Social Anxiety Disorder (SAD participants)
• No significant psychiatric conditions at all (volunteers without SAD)
• Not currently on any medications for a psychiatric condition, or willing to temporarily interrupt medications to participate in the study.
• A few other medications might interfere with the study: the study doctor will check this provided you meet the other criteria.
• No previous or current medical conditions that directly affect the brain, (including previous head injury with loss of consciousness or brain surgery), no metal implants in the skull, no diabetes (affects the scan)
• Able to lie still in a scanner for up to an hour at a time

If you suspect you have SAD or have been diagnosed with SAD and are interested in taking part in the study; or if you are willing to volunteer as a healthy control (without SAD), please contact Prof Christine Lochner (cl2@sun.ac.za ): Tel: 021 – 938 9179

Project 2

‘n Projek oor dobbelsteuring en metamfetamien (“tik-“) gebruiksteuring

Ly u aan dobbelsteuring of gebruik u gereeld “tik”? U kan deelneem aan ‘n belangrike nuwe navorsingsprojek by die MRC Unit on Risk and Resilience in Mental Disorders by die Universiteite van Stellenbosch en Kaapstad.

Die projek dek verskeie aspekte van hierdie toestande, insluitend die simptome en erns daarvan, die impak op persone se lewenskwaliteit, en sluit ook ondersoeke na die genetiese onderbou en die struktuur en werking van sekere brein-areas wat betrokke kan wees by hierdie toestande in.

Kwalifiseer ek? Vir verskeie redes moet u voldoen aan al die onderstaande kriteria om aan die studie deel te neem:

• Tussen 18 en 65 jaar oud
• Vlot in Engels (vraelyste en video’s is slegs in Engels beskikbaar)
• Regshandig
• Verkieslik nie tans op enige psigiatriese medikasie nie, of is bereid om medikasie tydelik te onderbreek om aan die studie deel te neem.
• Voldoen aan ʼn diagnose van dobbelsteuring of metamfetamien (“tik-“) gebruiksteuring

3 sessies:

1) ‘n Volledige siftings- en diagnostiese onderhoud, met selfrapporteringsvraelyste en die trek van bloed vir genetiese analise.

2) Indien iemand kwalifiseer om deel te neem, word ‘n breinskandering gedoen.

3) Voltooiing van ‘n aantal rekenaar-gebaseerde en papier-en-pen take.

Deelname is gratis en persoonlike inligting sal streng vertroulik hanteer word.

Dit is nie ‘n behandelingstudie nie. Indien u belangstel in behandeling, sal opsies bespreek kan word en ‘n verwysing kan gereël word.

Vir meer inligting, kontak:

Prof Christine Lochner, tel: 021 – 938 9179, e-pos: cl2@sun.ac.za

Dr Samantha Brooks, tel: 021 – 4045427, e-pos: drsamanthabrooks@gmail.com

A project on gambling disorder and methamphetamine (“tik”) use disorder (MUD)

Do you suffer from gambling disorder (also known as compulsive or pathological gambling) or do you use methamphetamine (“tik”) regularly? You can take part in an important new study on these conditions that is conducted by the MRC Unit on Risk and Resilience in Mental Disorders at the Universities of Stellenbosch and Cape Town.

The study covers many aspects of these conditions – symptoms, illness severity and impact on the quality of life, while also looking at genetics and the structure of certain brain regions that are implicated.

Gambling disorder (GD) is characterized by the inability to resist gambling despite severe disruption to work, social and family life. Individuals with GD may continually chase their losses, hide their behaviour, tell lies about where they go, how much they spend or owe, accumulate debt, or even resort to theft or fraud to continue gambling. There is no single known cause of GD, but there is evidence suggesting involvement of both genetic and environmental factors.

“Tik” is highly addictive and one of the most common drugs used in the Western Cape. Chronic tik abusers show symptoms that can include violent behaviour, anxiety, confusion and sleep disturbances. They can also display a number of psychotic features, including paranoia, “hearing voices” (auditory hallucinations), mood disturbances and disturbed thinking (i.e. “delusions”, e.g. the sensation of insects creeping on the skin, called “formication”). MUD is also accompanied by functional and molecular changes in the brain.

 Eligibility criteria:

• Should be between 18 and 65 years old
• Right-handed
• Diagnosed with or suspect they have one of the above conditions
• Preferably not be on any chronic psychiatric medication at the time of participation

 What does participation involve?

3 sessions:

1) Undergoing a screening interview and diagnostic assessment, filling out of self-report questionnaires and taking a blood sample for genetic analysis.

2) If suitable for the study, participants undergo brain scanning during the next session.

3) Completion of a number of computerized and paper-and-pen brain tasks.

 Participation is cost-free.

This is not a treatment study. However, if you are interested in treatment, options will be discussed with you, and referral arranged.

 If you want more information or want to participate, please contact:

Prof Christine Lochner, tel: 021 – 938 9179, e-mail: cl2@sun.ac.za

Dr Samantha Brooks: e-mail: drsamanthabrooks@gmail.com

Projek 3

‘n Projek oor obsessief-kompulsiewe steuring (OKS) en haar-uittreksteuring (trichotillomanie)

Navorsers van die MRC Unit on Risk and Resilience in Mental Disorders, by die Universiteite van Stellenbosch en Kaapstad is steeds op soek na vrywilligers om deel te neem in ‘n kliniese, genetiese brein-beelding studie oor OKS en haar-uittreksteuring (trichotillomanie).

Drie “tipes” vrywilligers word benodig vir deelname:

1. Regshandige persone (tussen die ouderdomme 18 en 65 jaar) gediagnoseer met OKS;
2. Regshandige persone (tussen die ouderdomme 18 en 65 jaar) gediagnoseer met haar-uittreksteuring (trichotillomanie);
3. Gesonde regshandige eerste-graad familie (tussen die ouderdomme 18 en 65 jaar) van persone gediagnoseer met OKS.

Deelname behels bywoning van 3 sessies. Die eerste sessie bestaan uit ‘n onderhoud, die invul van vraelyste en die neem van’ n bloedmonster vir genetiese analise.

Indien die persoon kwalifiseer, sal die daaropvolgende twee sessies ‘n breinskandering en ‘n aantal neurosielkundige take op ‘n rekenaar insluit.

Die studie sluit nie behandeling in nie maar verwysings kan op versoek gereël word.

Deelnemer-inligting sal vertroulik gehou word.

As u meer inligting wil hê, kontak Prof Christine Lochner 021-938 9179, e-pos: cl2@sun.ac.za vir meer inligting.

A project on obsessive-compulsive and hair-pulling disorder (trichotillomania)

This is an important clinical, genetics and brain-imaging study conducted by the MRC Unit on Risk and Resilience in Mental Disorders at Stellenbosch University and UCT in conjunction with researchers at Cambridge University in the UK. The study covers clinical aspects of these disorders – symptoms, illness severity, impact on the quality of your life, treatment history and childhood trauma history, while also looking at genetics and the structure of certain brain regions implicated in these conditions.

 What is obsessive-compulsive disorder (OCD)? In DSM-IV (which is one of the major diagnostic tools used in practice), OCD was categorized as one of the anxiety disorders. In DSM-5 however, OCD now falls under a grouping of obsessive-compulsive and related disorders. OCD is a psychiatric disorder characterized by obsessions and/or compulsions. Obsessions are persistent, “self-generated” (i.e. not delusional or psychotic) thoughts or mental images that are time-consuming, cause significant distress or functional impairment. Compulsions, on the other hand, are repetitive mental (e.g. counting, repeating words) or behavioural (e.g. hand-washing, checking) acts that the person feels obliged to perform in an attempt to reduce the anxiety or distress or to prevent some dreaded event. However, compulsions are not inherently enjoyable, are often extremely time-consuming and do not result in the completion of a useful task.

 What is hair-pulling disorder (HPD)? HPD is also now categorized as an obsessive-compulsive related disorder. It is characterized by recurrent pulling out of one’s hair resulting in hair loss, with repeated attempts to decrease or stop hair-pulling. The hair-pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

 How prevalent are these disorders in SA? OCD, together with other mental disorders like HPD, account for the 2nd largest portion on our national burden of disease after HIV/AIDS. The causality or “working” of these conditions is not yet fully established. It can therefore be argued that it is necessary to do research on disorders such as OCD and HPD, so that the symptomatology and the neurobiological underpinnings can be better understood and that improved treatments can be found.

Who can volunteer?
– Volunteers who are right-handed and aged between 18 and 65 years
– Persons with OCD or HPD
– First-degree relatives of persons diagnosed with OCD
– Healthy controls

 How will it work? Participation involves attendance of 2 sessions, with the first session comprising of a screening interview, filling out of self-report questionnaires and taking a blood sample for genetic analysis. If suitable for brain imaging, participants are scanned during a subsequent session. Participants also complete a number of neuropsychological tasks in the form of computerized games. Participation is cost-free and participant information will be kept confidential.

If you want more information or want to participate, please contact Prof Christine Lochner 021 – 938 9179, e-mail: cl2@sun.ac.za for more information.

Project 4

International Study on Student Health and Wellness

Adolescents and young adults are at increased risk for mental health problems. This includes, but is not limited to, psychopathologies such as anxiety and mood disorders, substance use and sexual and gender identity disorders. Although in many educational institutions treatment and support services are available, not many students access these. Also, although there is scientific knowledge of current risk factors for mental health problems, there is a lack of evidence-based methods for using this knowledge to identify those at risk and refer them to appropriate services.

This research is part of an international study, headed by Professor Bruffaerts, at Leuven University in Belgium.

This is a four-year longitudinal study at SU and UCT, in which we administer a baseline assessment of lifetime history of risk factors for negative outcomes, such as academic-, mental and health problems to university students during their first year, and then collect follow-up data at the start of each subsequent year (academic years 2-4).

Therefore this collaborative, international research project proposes to examine health and wellness of students at participating institutions and aims to utilize an e-survey to identify (i) university students at risk for mental health problems, (ii) disorders and dysfunctional behaviours that should be targeted by prevention and treatment programs, and (iii) types of mental health / wellness services utilized by students.

If you want more information, please contact: Mrs Janine Roos 021 –  938 9229, e-mail: jroos@sun.ac.za   or Prof Christine Lochner 021 – 938 9179, e-mail: cl2@sun.ac.za

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Posted on 22 June 2017 under Our research studies