Publications by authors named "Patrick W L Leung"

Article Synopsis
  • The study examines how to best measure the general factor of psychopathology using various statistical models on data from youth ratings in 24 societies.
  • Four models were tested: principal axis, hierarchical factor, bifactor, and a simple Total Problem score, analyzing data from over 25,000 youth ages 11-18.
  • Findings show that all models yielded similar results, suggesting that the simplest approach (the Total Problem score) is recommended for evaluating youth psychopathology in both clinical and research settings.
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Background: Video feedback is a technique used in cognitive therapy for social anxiety disorder (CT-SAD) to update patients' negative self-perceptions of how they appear to others. Clients are supported to watch video of themselves engaging in social interactions. While typically undertaken in session with a therapist, this study aimed to investigate the effectiveness of remotely delivered video feedback embedded within an Internet-based cognitive therapy program (iCT-SAD).

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Background: It has been argued that what differentiates delusional ideation from full-blown delusions (indicating need for care) is not the number of beliefs, but the experiential dimensions such as conviction, distress, and preoccupation. However, how these dimensions evolve over time and affect outcomes is under-researched. While delusional conviction and distress are associated with reasoning biases and worry respectively in clinical samples, how these processes predict trajectories of delusional dimensions in the general population remains unclear.

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  • Schizophrenia (SCZ) is a complex mental health disorder influenced by genetic factors, with studies revealing a gap in understanding due to undetected medium-sized structural variants (SVs).
  • The research aimed to identify these SVs in families with chronic SCZ characterized by severe negative symptoms and cognitive deficits.
  • By using advanced third-generation sequencing techniques, the study discovered 88 SVs associated with 79 genes, linking them to important brain functions and development pathways, which could help explain some aspects of the heritability of SCZ.
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  • The study investigates how the COVID-19 pandemic impacted sleep patterns among children and adolescents in Hong Kong, addressing a knowledge gap left by previous studies that focused only on the early months of the pandemic.
  • Utilizing a cross-sectional design, researchers recruited a total of 1,233 primary and secondary school students and compared their sleep data before and during the pandemic, accounting for various factors such as age, sex, and household income.
  • Findings reveal that students pre-COVID experienced longer sleep latency on both school and nonschool days, with low household income linked to later bedtimes and sleep onset, highlighting the pandemic's ongoing adverse effects on youth sleep health and the role of socioeconomic factors.
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The current study aimed at testing and developing alternative short versions of autism spectrum quotient (AQ-10) (adult [self-report], adult [parent-report], adolescent, and child versions) for use in Hong Kong. First, the various versions of AQ-10 developed in the United Kingdom (the AQ-10-UK) were applied to Hong Kong Chinese samples and demonstrated satisfactory discriminative power (AUCs 0.77-0.

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Introduction: Loneliness is a negative experience arising from a mismatch between perceived and actual social relationships. Several dimensions of loneliness have been suggested, namely intimate, relational and collective loneliness. Loneliness has been linked to poorer mental health, with its co-occurrence with depression, social anxiety, and paranoia most widely reported.

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School-based mental health support services allow children and adolescents easy access to services without requirement of traveling to clinics and hospitals. We describe a School Mental Health Support Scheme (SMHSS) piloted in Hong Kong and discuss the challenges and learnings from the experience. This conceptual paper argues that accessibility is not the only advantage of such services.

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Emerging evidence of an altered gut microbiome in autism spectrum disorder (ASD) suggests a pathomechanism through the gut-brain axis despite the inconsistent microbiome profile reported across studies. One of the knowledge gaps in the existing ASD microbiota studies is the lack of systematic exploration of the role of comorbid functional gastrointestinal disorder (FGID) in the association of ASD and altered gut microbiome. Consequently, 92 ASD and 112 age-matched typically developing (TD) boys were profiled on general psychopathology, FGID status by Rome IV classification, and gut microbiota using 16S ribosomal RNA amplicon sequencing at the V4 hypervariable region.

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Background: Research is needed to determine the extent to which internet-delivered psychological therapies are effective when delivered in countries and cultures outside of where they were developed.

Objective: This waitlist-controlled study evaluated the efficacy of a UK-developed, therapist-guided internet Cognitive Therapy programme for Social Anxiety Disorder (iCT-SAD) when delivered in Hong Kong by local therapists.

Methods: Patients were randomized to iCT-SAD (n = 22) or a waitlist control group (n = 22).

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Article Synopsis
  • Social functioning is a crucial area of difficulty for individuals with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), and this review uses a social information-processing model to analyze the differences in their social deficits.* -
  • Both disorders demonstrate challenges at each step of social information-processing, but ASD's issues stem from problems with understanding social cues, while ADHD's difficulties are linked to inattention and impulsivity that disrupt social interactions.* -
  • The review suggests specific intervention strategies targeting the six steps of social information-processing for both ASD and ADHD, and highlights the need for future research to better understand the social impairments associated with these conditions.*
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A bifactor model with a general (p) factor reflecting shared variance and specific factors reflecting additional variance in individual symptoms has been introduced to explain common co-occurrence among anxiety, depression and schizotypy. However, longitudinal evidence is lacking and the validity of bifactor modeling is debatable. The current study aimed to examine the presence of the p factor together with specific factors in accounting for relationships between anxiety, depression and schizotypy both cross-sectionally and longitudinally, and to investigate the relationship between these factors and rumination.

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Problem: The debate on whether psychiatric symptoms are universal and to what extent they are affected by culture is generally divided between the universalist and relativist approaches.

Methods: This study compared Achenbach/Rescorla's model and Weisz's model of youth self-report in 2521 Chinese adolescents (mean age = 12 years). Indigenous exploratory factor analyses were conducted to explore the factor structure of youth self-report (YSR), and the derived models were tested with confirmatory factor analysis.

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Children with autism commonly suffer from comorbid functional gastrointestinal disorders (FGID) and anxiety. The raised prevalence of both conditions in autism suggests complex reciprocal relationships, which are seldom explored in non-treatment-seeking FGID. The relationships between subtypes of FGID and anxiety are also unclear.

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This study examines the psychometric properties of the Autism Diagnostic Interview-Revised (ADI-R) in the context of DSM-5 in a sample of Chinese children. Using re-mapped ADI-R items and algorithms matched to DSM-5 criteria, and administering to children with autism spectrum disorder (ASD) with and without intellectual disability, attention-deficit hyperactivity disorder, and typically developing, it evidenced high sensitivity and specificity. However, similar to DSM-IV algorithm, the DSM-5 algorithms were better at classifying ASD among children with intellectual disability than among those without intellectual disability.

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Article Synopsis
  • Recent research shows a strong link between ADHD and autism spectrum disorder (ASD), suggesting shared genetic factors may contribute to their high occurrence together.
  • The study included 298 boys with ADHD, 134 with ASD, and 109 with both, along with control groups of typically developing boys.
  • Findings indicated that three specific genetic markers (SNPs) showed significant associations with both disorders, hinting at potential common genetic influences that may explain their comorbidity.
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Purpose Of The Research: Cortico-striatal functional connectivity has been implicated in the neuropathology of schizophrenia. However, the longitudinal relationship between the cortico-striatal connectivity and schizotypy remains unknown. We examined the resting-state fMRI connectivity in 27 individuals with a high level of schizotypy and 20 individuals with a low level of schizotypy at baseline and 18 months later.

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Background: To cope with the rising demand for psychological treatment, evidence-based low-intensity cognitive behavioural therapy (LiCBT) delivered by trained para-professionals was introduced internationally.

Aims: This pilot study aimed at examining the effectiveness of LiCBT in Hong Kong.

Method: This study was of an uncontrolled pre- and post-treatment design, testing LiCBT at a local community mental health centre in Hong Kong.

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There has been increasing interest in transdiagnostic cognitive-behavioral therapy (CBT), which is more cost efficient yet yields similar effect sizes when compared to disorder-specific CBT. The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders was adapted for Hong Kong Chinese adults with common mental disorders, such as depression and anxiety. It was piloted in community settings and delivered in a group format.

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Purpose: Gastrointestinal symptoms in individuals with autism spectrum disorder may constitute a subgroup with complex gut-brain interactions underlying the pathogenesis. This study examined the prevalence of gastrointestinal symptoms in a sample of Chinese children with autism spectrum disorder, as well as the factors related to them.

Participants And Methods: The participants included a clinic sample of 107 children with autism spectrum disorder and 249 gender- and age-matched typically developing community children.

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The Autism-Spectrum Quotient-Adult (AQ-Adult) is a screening tool for adults with autism spectrum disorder (ASD). The present study examined the psychometric properties of the Chinese self- and parent-report versions of the AQ-Adult in Hong Kong (AQ-Adult-HK). Participants included adults with ASD (n = 27) and community controls (n = 345).

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Recent studies have shown that worry and related negative metacognitions are characteristic in generalized anxiety and paranoia respectively. However, most of these studies did not take into account common co-occurrence of anxiety and paranoia, and longitudinal modelling of the role of worry and metacognitions on the development of anxiety and paranoia is rare. The current study aimed at examining the bidirectional longitudinal relationship between anxiety and paranoia, as well as the importance of worry and metacognitions in the development of these symptoms.

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There is growing evidence supporting the individual associations of maternal occupation and maternal education with children's behavioral outcomes. However, few studies have linked these factors together in a mediation model. The current study is the first to examine the mediating effect of maternal occupational skillfulness on the relationship between the length of maternal education and preschool children's behavioral outcomes in the Chinese context.

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Schizotypal personality (SP) traits have been found to be correlated with autistic traits, obsessive-compulsive traits, depressive symptoms and anxiety symptoms. However, the overall pattern of the relationship remains unclear. The purpose of this study was to investigate the network structure between SP traits and other subclinical features (symptoms or traits) and test the replicability of these relationships.

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This study examined the epidemiology of trauma exposure (TE) and posttraumatic stress disorder (PTSD) among community-dwelling Chinese adults in Hong Kong. Multistage stratification sampling design was used, and 5,377 participants were included. In Phase 1, TE, probable PTSD (p-PTSD), and psychiatric comorbid conditions were examined.

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