Neurodevelopmental and other psychiatric disorders in 22q11.2 deletion syndrome from childhood to adult age: Prospective longitudinal study of 100 individuals.
22q11.2 deletion syndrome
behavior
follow up
neurodevelopmental
phenotype
psychiatric
Journal
American journal of medical genetics. Part C, Seminars in medical genetics
ISSN: 1552-4876
Titre abrégé: Am J Med Genet C Semin Med Genet
Pays: United States
ID NLM: 101235745
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
10
05
2023
accepted:
11
05
2023
medline:
22
6
2023
pubmed:
30
5
2023
entrez:
30
5
2023
Statut:
ppublish
Résumé
The 22q11.2 deletion syndrome (22q11.2DS), affects physical as well as cognitive and emotional functioning with increased risk for psychiatric and behavioral problems. This longitudinal study of 79 individuals (18-50 years) with 22q11.2DS investigated neurodevelopmental (NDD) and psychiatric disorders in adulthood, evaluated the stability of childhood diagnoses over time, and examined associations between clinical characteristics in childhood/adolescence and diagnostic outcome in adult age. Examination using validated instruments for cognitive, psychiatric, and global functional problems in the context of an in-depth clinical evaluation found adult age stability of NDD diagnoses made in childhood, however, rates increased at follow-up. Rates of anxiety, mood, and psychotic disorders were high, with a majority meeting diagnostic criteria for one or more psychiatric disorder. The rate of psychotic disorders was much lower compared to many other studies. Variability in functioning at follow-up was primarily associated with intellectual ability at T1. The findings obtained highlight the increased risk of NDD and psychiatric problems and of cognitive impairment and reduced levels of global functioning over time. Results emphasize the importance of clinical follow-up to enable appropriate support for the promotion of optimal health along with a need for future research on effective interventions and treatment strategies.
Identifiants
pubmed: 37248687
doi: 10.1002/ajmg.c.32052
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
172-182Informations de copyright
© 2023 The Authors. American Journal of Medical Genetics Part C: Seminars in Medical Genetics published by Wiley Periodicals LLC.
Références
Achenbach, T. M. (1991). Manual for the child Behavior checklist/4-18 and 1991 profile.
APA. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). American Psychiatric Association.
Baker, K. D., & Skuse, D. H. (2005). Adolescents and young adults with 22q11 deletion syndrome: Psychopathology in an at-risk group. The British Journal of Psychiatry, 186, 115-120. https://doi.org/10.1192/bjp.186.2.115
Bartik, L. E., Hughes, S. S., Tracy, M., Feldt, M. M., Zhang, L., Arganbright, J., & Kaye, A. (2022). 22q11.2 duplications: Expanding the clinical presentation. American Journal of Medical Genetics. Part A, 188(3), 779-787. https://doi.org/10.1002/ajmg.a.62577
Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: A systematic review and meta-regression. Psychological Medicine, 43(5), 897-910. https://doi.org/10.1017/S003329171200147X
Bhattarai, D., McGinn, D. E., Crowley, T. B., Giunta, V., Gaiser, K., Zackai, E. H., Emanuel, B. S., Heimall, J., Jyonouchi, S., Lee, J., Sun, D., McDonald-McGinn, D. M., & Sullivan, K. E. (2023). Immunologic, molecular, and clinical profile of patients with chromosome 22q11.2 duplications. Journal of Clinical Immunology, 43, 794-807. https://doi.org/10.1007/s10875-023-01443-5
Billstedt, E., Anckarsater, H., Wallinius, M., & Hofvander, B. (2017). Neurodevelopmental disorders in young violent offenders: Overlap and background characteristics. Psychiatry Research, 252, 234-241. https://doi.org/10.1016/j.psychres.2017.03.004
Billstedt, E., Gillberg, I. C., & Gillberg, C. (2005). Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. Journal of Autism and Developmental Disorders, 35(3), 351-360. https://doi.org/10.1007/s10803-005-3302-5
Blankstein, K. R., Flett, G. L., Hewitt, P. L., & Eng, A. (1993). Dimensions of perfectionism and irrational fears: An examination with the fear survey schedule. Personality and Individual Differences, 15(3), 323-328. https://doi.org/10.1016/0191-8869
Blokland, G. A. M., Grove, J., Chen, C. Y., Cotsapas, C., Tobet, S., Handa, R., St Clair, D., Lencz, T., Mowry, B. J., Periyasamy, S., Cairns, M. J., Tooney, P. A., Wu, J. Q., Kelly, B., Kirov, G., Sullivan, P. F., Corvin, A., Riley, B. P., Esko, T., … Goldstein, J. M. (2022). Sex-dependent shared and nonshared genetic architecture across mood and psychotic disorders. Biological Psychiatry, 91(1), 102-117. https://doi.org/10.1016/j.biopsych.2021.02.972
Botto, L. D., May, K., Fernhoff, P. M., Correa, A., Coleman, K., Rasmussen, S. A., Merritt, R. K., O'Leary, L. A., Wong, L. Y., Elixson, E. M., Mahle, W. T., & Campbell, R. M. (2003). A population-based study of the 22q11.2 deletion: Phenotype, incidence, and contribution to major birth defects in the population. Pediatrics, 112(1 Pt 1), 101-107. https://doi.org/10.1542/peds.112.1.101
Bulzacka, E., Meyers, J. E., Boyer, L., Gloahec, T. L., Fond, G., Szöke, A., Leboyer, M., & Schürhoff, F. (2016). WAIS-IV seven-subtest short form: Validity and clinical use in schizophrenia. Archives of Clinical Neuropsychology, 31(8), 915-925. https://doi.org/10.1093/arclin/acw063
Conners, C. K., Sitarenios, G., Parker, J. D., & Epstein, J. N. (1998). The revised Conners' parent rating scale (CPRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26(4), 257-268. https://doi.org/10.1023/a:1022602400621
Ehlers, S., & Gillberg, C. (1993). The epidemiology of Asperger syndrome. A total population study. Journal of Child Psychology and Psychiatry, 34(8), 1327-1350. https://doi.org/10.1111/j.1469-7610.1993.tb02094.x
Ehlers, S., Gillberg, C., & Wing, L. (1999). A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children. Journal of Autism and Developmental Disorders, 29(2), 129-141. https://doi.org/10.1023/a:1023040610384
Fiksinski, A. M., Breetvelt, E. J., Duijff, S. N., Bassett, A. S., Kahn, R. S., & Vorstman, J. A. S. (2017). Autism Spectrum and psychosis risk in the 22q11.2 deletion syndrome. Findings from a prospective longitudinal study. Schizophrenia Research, 188, 59-62. https://doi.org/10.1016/j.schres.2017.01.032
Fiksinski, A. M., Schneider, M., Murphy, C. M., Armando, M., Vicari, S., Canyelles, J. M., Gothelf, D., Eliez, S., Breetvelt, E. J., Arango, C., & Vorstman, J. A. S. (2018). Understanding the pediatric psychiatric phenotype of 22q11.2 deletion syndrome. American Journal of Medical Genetics. Part A, 176(10), 2182-2191. https://doi.org/10.1002/ajmg.a.40387
Fung, W. L., McEvilly, R., Fong, J., Silversides, C., Chow, E., & Bassett, A. (2010). Elevated prevalence of generalized anxiety disorder in adults with 22q11.2 deletion syndrome. The American Journal of Psychiatry, 167(8), 998. https://doi.org/10.1176/appi.ajp.2010.09101463
Ghaziuddin, M., & Ghaziuddin, N. (2020). Bipolar disorder and psychosis in autism. Child and Adolescent Psychiatric Clinics of North America, 29(3), 433-441. https://doi.org/10.1016/j.chc.2020.02.004
Glantz, M. D., Bharat, C., Degenhardt, L., Sampson, N. A., Scott, K. M., Lim, C. C. W., Al-Hamzawi, A., Alonso, J., Andrade, L. H., Cardoso, G., De Girolamo, G., Gureje, O., He, Y., Hinkov, H., Karam, E. G., Karam, G., Kovess-Masfety, V., Lasebikan, V., Lee, S., … Collaborators, W. H. O. W. M. H. S. (2020). The epidemiology of alcohol use disorders cross-nationally: Findings from the world mental health surveys. Addictive Behaviors, 102, 106128. https://doi.org/10.1016/j.addbeh.2019.106128
Gothelf, D., Feinstein, C., Thompson, T., Gu, E., Penniman, L., van Stone, E., Kwon, H., Eliez, S., & Reiss, A. L. (2007). Risk factors for the emergence of psychotic disorders in adolescents with 22q11.2 deletion syndrome. The American Journal of Psychiatry, 164(4), 663-669. https://doi.org/10.1176/ajp.2007.164.4.663
Gothelf, D., Presburger, G., Zohar, A. H., Burg, M., Nahmani, A., Frydman, M., Shohat, M., Inbar, D., Aviram-Goldring, A., Yeshaya, J., Steinberg, T., Finkelstein, Y., Frisch, A., Weizman, A., & Apter, A. (2004). Obsessive-compulsive disorder in patients with velocardiofacial (22q11 deletion) syndrome. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics, 126B(1), 99-105. https://doi.org/10.1002/ajmg.b.20124
Gothelf, D., Schneider, M., Green, T., Debbane, M., Frisch, A., Glaser, B., Zilkha, H., Schaer, M., Weizman, A., & Eliez, S. (2013). Risk factors and the evolution of psychosis in 22q11.2 deletion syndrome: A longitudinal 2-site study. Journal of the American Academy of Child and Adolescent Psychiatry, 52(11), 1192-1203 e1193. https://doi.org/10.1016/j.jaac.2013.08.008
Grant, B. F., Saha, T. D., Ruan, W. J., Goldstein, R. B., Chou, S. P., Jung, J., Zhang, H., Smith, S. M., Pickering, R. P., Huang, B., & Hasin, D. S. (2016). Epidemiology of DSM-5 drug use disorder: Results from the National Epidemiologic Survey on alcohol and related conditions-III. JAMA Psychiatry, 73(1), 39-47. https://doi.org/10.1001/jamapsychiatry.2015.2132
Grati, F. R., Molina Gomes, D., Ferreira, J. C., Dupont, C., Alesi, V., Gouas, L., Horelli-Kuitunen, N., Choy, K. W., García-Herrero, S., de la Vega, A. G., Piotrowski, K., Genesio, R., Queipo, G., Malvestiti, B., Hervé, B., Benzacken, B., Novelli, A., Vago, P., Piippo, K., … Vialard, F. (2015). Prevalence of recurrent pathogenic microdeletions and microduplications in over 9500 pregnancies. Prenatal Diagnosis, 35(8), 801-809. https://doi.org/10.1002/pd.4613
Green, T., Gothelf, D., Glaser, B., Debbane, M., Frisch, A., Kotler, M., Weizman, A., & Eliez, S. (2009). Psychiatric disorders and intellectual functioning throughout development in velocardiofacial (22q11.2 deletion) syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 48(11), 1060-1068. https://doi.org/10.1097/CHI.0b013e3181b76683
Hoeffding, L. K., Trabjerg, B. B., Olsen, L., Mazin, W., Sparsø, T., Vangkilde, A., Mortensen, P. B., Pedersen, C. B., & Werge, T. (2017). Risk of psychiatric disorders among individuals with the 22q11.2 deletion or duplication: A Danish Nationwide, register-based study. JAMA Psychiatry, 74(3), 282-290. https://doi.org/10.1001/jamapsychiatry.2016.3939
Kadesjö, B., Janols, L. O., Korkman, M., Mickelsson, K., Strand, G., Trillingsgaard, A., & Gillberg, C. (2004). The FTF (five to fifteen): The development of a parent questionnaire for the assessment of ADHD and comorbid conditions. European Child & Adolescent Psychiatry, 13(Suppl 3), 3-13. https://doi.org/10.1007/s00787-004-3002-2
Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., Howes, M. J., Jin, R., Secnik, K., Spencer, T., Ustun, T. B., & Walters, E. E. (2005). The World Health Organization adult ADHD self-report scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35(2), 245-256. https://doi.org/10.1017/s0033291704002892
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., Wang, P. S., & National Comorbidity Survey, R. (2003). The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). JAMA, 289(23), 3095-3105. https://doi.org/10.1001/jama.289.23.3095
Kincaid, D. L., Doris, M., Shannon, C., & Mulholland, C. (2017). What is the prevalence of autism spectrum disorder and ASD traits in psychosis? A systematic review. Psychiatry Research, 250, 99-105. https://doi.org/10.1016/j.psychres.2017.01.017
Lin, A., Wood, S. J., Nelson, B., Beavan, A., McGorry, P., & Yung, A. R. (2015). Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. The American Journal of Psychiatry, 172(3), 249-258. https://doi.org/10.1176/appi.ajp.2014.13030418
Malecki, S. L., van Mil, S., Graffi, J., Breetvelt, E., Corral, M., Boot, E., Chow, E. W. C., Sanches, M., Verma, A. A., & Bassett, A. S. (2020). A genetic model for multimorbidity in young adults. Genetics in Medicine, 22(1), 132-141. https://doi.org/10.1038/s41436-019-0603-1
McDonald-McGinn, D. M., Sullivan, K. E., Marino, B., Philip, N., Swillen, A., Vorstman, J. A., Zackai, E. H., Emanuel, B. S., Vermeesch, J. R., Morrow, B. E., Scambler, P. J., & Bassett, A. S. (2015). 22q11.2 deletion syndrome. Nature Reviews. Disease Primers, 1, 15071. https://doi.org/10.1038/nrdp.2015.71
McGrath, J., Saha, S., Chant, D., & Welham, J. (2008). Schizophrenia: A concise overview of incidence, prevalence, and mortality. Epidemiologic Reviews, 30, 67-76. https://doi.org/10.1093/epirev/mxn001
Murphy, K. C., Jones, L. A., & Owen, M. J. (1999). High rates of schizophrenia in adults with velo-cardio-facial syndrome. Archives of General Psychiatry, 56(10), 940-945. https://doi.org/10.1001/archpsyc.56.10.940
Niarchou, M., Calkins, M. E., Moore, T. M., Tang, S. X., McDonald-McGinn, D. M., Zackai, E. H., Emanuel, B. S., Gur, R. C., & Gur, R. E. (2018). Attention deficit hyperactivity disorder symptoms and psychosis in 22q11.2 deletion syndrome. Schizophrenia Bulletin, 44(4), 824-833. https://doi.org/10.1093/schbul/sbx113
Niarchou, M., Chawner, S., Fiksinski, A., Vorstman, J. A. S., Maeder, J., Schneider, M., Eliez, S., Armando, M., Pontillo, M., Vicari, S., McDonald-McGinn, D. M., Emanuel, B. S., Zackai, E. H., Bearden, C. E., Shashi, V., Hooper, S. R., Owen, M. J., Gur, R. E., Wray, N. R., … International 22q11.2 Deletion Syndrome Brain and Behavior Consortium. (2019). Attention deficit hyperactivity disorder symptoms as antecedents of later psychotic outcomes in 22q11.2 deletion syndrome. Schizophrenia Research, 204, 320-325. https://doi.org/10.1016/j.schres.2018.07.044
Niarchou, M., Martin, J., Thapar, A., Owen, M. J., & van den Bree, M. B. (2015). The clinical presentation of attention deficit-hyperactivity disorder (ADHD) in children with 22q11.2 deletion syndrome. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics, 168(8), 730-738. https://doi.org/10.1002/ajmg.b.32378
Niarchou, M., Zammit, S., van Goozen, S. H., Thapar, A., Tierling, H. M., Owen, M. J., & van den Bree, M. B. (2014). Psychopathology and cognition in children with 22q11.2 deletion syndrome. The British Journal of Psychiatry, 204(1), 46-54. https://doi.org/10.1192/bjp.bp.113.132324
Niklasson, L., Rasmussen, P., Oskarsdottir, S., & Gillberg, C. (2001). Neuropsychiatric disorders in the 22q11 deletion syndrome. Genetics in Medicine, 3(1), 79-84. https://doi.org/10.1097/00125817-200101000-00017
Niklasson, L., Rasmussen, P., Oskarsdottir, S., & Gillberg, C. (2002). Chromosome 22q11 deletion syndrome (CATCH 22): Neuropsychiatric and neuropsychological aspects. Developmental Medicine and Child Neurology, 44(1), 44-50. https://doi.org/10.1017/s0012162201001645
Niklasson, L., Rasmussen, P., Oskarsdóttir, S., & Gillberg, C. (2005). Attention deficits in children with 22q.11 deletion syndrome. Developmental Medicine and Child Neurology, 47(12), 803-807. https://doi.org/10.1017/s0012162205001702
Niklasson, L., Rasmussen, P., Oskarsdottir, S., & Gillberg, C. (2009). Autism, ADHD, mental retardation and behavior problems in 100 individuals with 22q11 deletion syndrome. Research in Developmental Disabilities, 30(4), 763-773. https://doi.org/10.1016/j.ridd.2008.10.007
Oskarsdottir, S., Vujic, M., & Fasth, A. (2004). Incidence and prevalence of the 22q11 deletion syndrome: A population-based study in Western Sweden. Archives of Disease in Childhood, 89(2), 148-151. https://doi.org/10.1136/adc.2003.026880
Posserud, M. B., Lundervold, A. J., & Gillberg, C. (2006). Autistic features in a total population of 7-9-year-old children assessed by the ASSQ (autism Spectrum screening questionnaire). Journal of Child Psychology and Psychiatry, 47(2), 167-175. https://doi.org/10.1111/j.1469-7610.2005.01462.x
Qian, J., Wu, Y., Liu, F., Zhu, Y., Jin, H., Zhang, H., Wan, Y., Li, C., & Yu, D. (2022). An update on the prevalence of eating disorders in the general population: A systematic review and meta-analysis. Eating and Weight Disorders, 27(2), 415-428. https://doi.org/10.1007/s40519-021-01162-z
Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic Advances in Psychopharmacology, 8(9), 251-269. https://doi.org/10.1177/2045125318769235
Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53-63. https://doi.org/10.1038/mp.2008.94
Salk, R. H., Hyde, J. S., & Abramson, L. Y. (2017). Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychological Bulletin, 143(8), 783-822. https://doi.org/10.1037/bul0000102
Schneider, M., Debbané, M., Bassett, A. S., Chow, E. W., Fung, W. L., van den Bree, M., Owen, M., Murphy, K. C., Niarchou, M., Kates, W. R., Antshel, K. M., Fremont, W., McDonald-McGinn, D. M., Gur, R. E., Zackai, E. H., Vorstman, J., Duijff, S. N., Klaassen, P. W., Swillen, A., … Eliez, S. (2014). Psychiatric disorders from childhood to adulthood in 22q11.2 deletion syndrome: Results from the international consortium on brain and Behavior in 22q11.2 deletion syndrome. The American Journal of Psychiatry, 171(6), 627-639. https://doi.org/10.1176/appi.ajp.2013.13070864
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, G. C. (1998). The mini-international neuropsychiatric interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(Suppl 20), quiz 34-57.
Shprintzen, R. J. (2008). Velo-cardio-facial syndrome: 30 years of study. Developmental Disabilities Research Reviews, 14(1), 3-10. https://doi.org/10.1002/ddrr.2
Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1992). The structured clinical interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry, 49(8), 624-629. https://doi.org/10.1001/archpsyc.1992.01820080032005
Swillen, A., & McDonald-McGinn, D. (2015). Developmental trajectories in 22q11.2 deletion. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 169(2), 172-181. https://doi.org/10.1002/ajmg.c.31435
Swillen, A., Moss, E., & Duijff, S. (2018). Neurodevelopmental outcome in 22q11.2 deletion syndrome and management. American Journal of Medical Genetics. Part A, 176(10), 2160-2166. https://doi.org/10.1002/ajmg.a.38709
Tang, S. X., & Gur, R. E. (2018). Longitudinal perspectives on the psychosis spectrum in 22q11.2 deletion syndrome. American Journal of Medical Genetics. Part A, 176(10), 2192-2202. https://doi.org/10.1002/ajmg.a.38500
The National Board of Health and Welfare. (2019).
Unenge Hallerbäck, M., Lugnegård, T., & Gillberg, C. (2012). Is autism spectrum disorder common in Schizophrenia? Psychiatry Research, 198(1), 12-17. https://doi.org/10.1016/j.psychres.2012.01.016
Ustun, B., Adler, L. A., Rudin, C., Faraone, S. V., Spencer, T. J., Berglund, P., Gruber, M. J., & Kessler, R. C. (2017). The World Health Organization adult attention-deficit/hyperactivity disorder self-report screening scale for DSM-5. JAMA Psychiatry, 74(5), 520-527. https://doi.org/10.1001/jamapsychiatry.2017.0298
Vingerhoets, C., van Oudenaren, M. J. F., Bloemen, O. J. N., Boot, E., van Duin, E. D. A., Evers, L. J. M., Fiksinski, A. M., Breetvelt, E. J., Palmer, L. D., Vergaelen, E., Vogels, A., Meijer, C., Booij, J., de Haan, L., Swillen, A., Vorstman, J. A. S., Bassett, A. S., & van Amelsvoort, T. (2019). Low prevalence of substance use in people with 22q11.2 deletion syndrome. The British Journal of Psychiatry, 215(5), 661-667. https://doi.org/10.1192/bjp.2018.258
Vorstman, J. A., Breetvelt, E. J., Duijff, S. N., Eliez, S., Schneider, M., Jalbrzikowski, M., Armando, M., Vicari, S., Shashi, V., Hooper, S. R., Chow, E. W., Fung, W. L., Butcher, N. J., Young, D. A., McDonald-McGinn, D. M., Vogels, A., van Amelsvoort, T., Gothelf, D., Weinberger, R., … Bassett, A. S. (2015). Cognitive decline preceding the onset of psychosis in patients with 22q11.2 deletion syndrome. JAMA Psychiatry, 72(4), 377-385. https://doi.org/10.1001/jamapsychiatry.2014.2671
Vorstman, J. A., Breetvelt, E. J., Thode, K. I., Chow, E. W., & Bassett, A. S. (2013). Expression of autism spectrum and schizophrenia in patients with a 22q11.2 deletion. Schizophrenia Research, 143(1), 55-59. https://doi.org/10.1016/j.schres.2012.10.010
Wechsler, D. (2008). Wechsler adult intelligence scale-Fourth edition technical and interpretive manual Texas: Psychological corporation ed. Pearson.
Weisman, O., Guri, Y., Gur, R. E., McDonald-McGinn, D. M., Calkins, M. E., Tang, S. X., Emanuel, B., Zackai, E. H., Eliez, S., Schneider, M., Schaer, M., Kates, W. R., Antshel, K. M., Fremont, W., Shashi, V., Hooper, S. R., Armando, M., Vicari, S., Pontillo, M., … Behavior in 22q11.2 Deletion, S. (2017). Subthreshold psychosis in 22q11.2 deletion syndrome: Multisite naturalistic study. Schizophrenia Bulletin, 43(5), 1079-1089. https://doi.org/10.1093/schbul/sbx005
Wolpe, J., & Lang, P. J. (1964). A fear survey schedule for use in behaviour therapy. Behaviour Research and Therapy, 2(1), 27-30. https://doi.org/10.1016/0005-7967