Sarina Volari

All Publications

• A Feasibility Study of a Remotely-Delivered Mindfulness-Based Training for Adolescents During the COVID-19 Pandemic FRONTIERS IN PSYCHIATRY Tymofiyeva, O., Hu, M. Y., Sipes, B. S., Jakary, A., Glidden, D. V., Jariwala, N., Bhandari, S., Parks, K. C., Nguyen, C., Henje, E., Yang, T. T. 2022; 13: 838694

  Abstract

  Social distancing, home confinement, economic challenges, and COVID-19-related illness and deaths during the COVID-19 pandemic can significantly affect mental health in youth. One promising approach to reduce anxiety and depression in adolescents is the neuroscience-based mindfulness intervention Training for Awareness, Resilience, and Action (TARA). The objective of this individually randomized waitlist-controlled trial (RCT) was (1) to test the feasibility of TARA, delivered partially over Zoom, and (2) to assess changes in the emotional wellbeing in healthy adolescents between the ages of 14-18 years old during the COVID-19 pandemic.Twenty-one healthy adolescents were randomized to the TARA intervention or to the waitlist control group in February 2020, just before the start of the pandemic. The TARA group intervention was delivered in person for the first five sessions and remotely over Zoom for the remaining seven sessions due to the pandemic. The participants' acceptability of TARA was assessed weekly using the Child Session Rating Scale (CSRS). The primary outcome was the emotional wellbeing measured using emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) pre/post-TARA. We also explored weekly changes in TARA participants' wellbeing using the Child Outcome Rating Scale (CORS).The overall session rating in TARA participants improved after the switch to Zoom (Cohen's d = 1.2, p = 0.008). The results of the two-way ANOVA showed no statistically significant difference in the change of the SDQ emotional symptoms during the 12 weeks between the TARA group and waitlist-control group (timepoint × group interaction: F = 0.77, p = 0.38). The exploratory analysis using the CORS in the TARA participants showed a significant improvement in their functioning over the weeks of training.Our results support the feasibility of TARA delivered over Zoom. While our primary outcome did not provide support for the improvement of the emotional wellbeing with TARA compared to a passive control group, our exploratory analysis in the intervention group indicated an improved functioning over the weeks of TARA training. The important general positive impact of this study lies in the possibility of offering a neuroscience-based mindfulness intervention remotely to youth living in remote areas and for all youth during pandemic times.

  View details for DOI 10.3389/fpsyt.2022.838694

  View details for Web of Science ID 000803642300001

  View details for PubMedID 35633797

  View details for PubMedCentralID PMC9133427

• Reduced anxiety and changes in amygdala network properties in adolescents with training for awareness, resilience, and action (TARA). NeuroImage. Clinical Tymofiyeva, O., Henje, E., Yuan, J. P., Huang, C., Connolly, C. G., Ho, T. C., Bhandari, S., Parks, K. C., Sipes, B. S., Yang, T. T., Xu, D. 2020; 29: 102521

  Abstract

  Mindfulness-based approaches show promise to improve emotional health in youth and may help treat and prevent adolescent depression and anxiety. However, there is a fundamental gap in understanding the neural reorganization that takes place as a result of such interventions. The Training for Awareness, Resilience, and Action (TARA) program, initially developed for depressed adolescents, uses a framework drawn from neuroscience, mindfulness, yoga, and modern psychotherapeutic techniques to promote emotional health. The goal of this study was to assess the effects of the TARA training on emotional health and structural white matter brain networks in healthy youth. We analyzed data from 23 adolescents who underwent the 12-week TARA training in a controlled within-subject study design and whose brain networks were assessed using diffusion MRI connectomics. Compared to the control time period, adolescents showed a significant decrease in anxiety symptoms with TARA (Cohen's d=-0.961, p=0.006); moreover, the node strength of the Right Amygdala decreased significantly after TARA (Cohen's d=-1.026, p=0.004). Post-hoc analyses indicated that anxiety at baseline before TARA was positively correlated with Right Amygdala node strength (r=0.672, p=0.001). While change in Right Amygdala node strength with TARA was not correlated with change in anxiety (r=0.146, p=0.51), it was associated with change in depression subscale of Anhedonia / Negative Affect (r=0.575, p=0.004, exploratory analysis), possibly due to overlapping constructs captured in our anxiety and depression scales. Our results suggest that increased structural connectivity of Right Amygdala may underlie increased anxiety in adolescents and be lowered through anxiety-reducing training such as TARA. The results of this study contribute to our understanding of the neural mechanisms of TARA and may facilitate neuroscience-based prevention and treatment of adolescent anxiety and depression.

  View details for DOI 10.1016/j.nicl.2020.102521

  View details for PubMedID 33316764

• CHILDHOOD TRAUMA AND AMYGDALA-ORBITOFRONTAL ANATOMICAL CONNECTIVITY IN ADOLESCENTS Tymofiyeva, O., Huang, C., Bhandari, S., Lopez, E., Parks, K., Jariwala, N., Sipes, B., Yang, T. T. ELSEVIER SCIENCE INC. 2020: S140

  View details for DOI 10.1016/j.jaac.2020.08.030

  View details for Web of Science ID 000579844100454

• High levels of mitochondrial DNA are associated with adolescent brain structural hypoconnectivity and increased anxiety but not depression JOURNAL OF AFFECTIVE DISORDERS Tymofiyeva, O., Blom, E., Ho, T. C., Connolly, C. G., Lindqvist, D., Wolkowitz, O. M., Lin, J., LeWinn, K. Z., Sacchet, M. D., Han, L. M., Yuan, J. P., Bhandari, S. P., Xu, D., Yang, T. T. 2018; 232: 283–90

  Abstract

  Adolescent anxiety and depression are highly prevalent psychiatric disorders that are associated with altered molecular and neurocircuit profiles. Recently, increased mitochondrial DNA copy number (mtDNA-cn) has been found to be associated with several psychopathologies in adults, especially anxiety and depression. The associations between mtDNA-cn and anxiety and depression have not, however, been investigated in adolescents. Moreover, to date there have been no studies examining associations between mtDNA-cn and brain network alterations in mood disorders in any age group.The first aim of this study was to compare salivary mtDNA-cn between 49 depressed and/or anxious adolescents and 35 well-matched healthy controls. The second aim of this study was to identify neural correlates of mtDNA-cn derived from diffusion tensor imaging (DTI) and tractography, in the full sample of adolescents.There were no diagnosis-specific alterations in mtDNA-cn. However, there was a positive correlation between mtDNA-cn and levels of anxiety, but not depression, in the full sample of adolescents. A subnetwork of connections largely corresponding to the left fronto-occipital fasciculus had significantly lower fractional anisotropy (FA) values in adolescents with higher than median mtDNA-cn.Undifferentiated analysis of free and intracellular mtDNA and use of DTI-based tractography represent this study's limitations.The results of this study help elucidate the relationships between clinical symptoms, molecular changes, and neurocircuitry alterations in adolescents with and without anxiety and depression, and they suggest that increased mtDNA-cn is associated both with increased anxiety symptoms and with decreased fronto-occipital structural connectivity in this population.

  View details for PubMedID 29500956

  View details for PubMedCentralID PMC5864120