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... >1.0-4.0, >4.0 mg), average maternal anxiety (Beck Anxiety Inventory), 15 depression (Beck Depression Inventory-2), 16 and perceived stress (Perceived Stress Scale-14) 17 during pregnancy and/or after birth through the child's 4.5-year-old visit, and average maternal sleep quality (Pittsburgh Sleep Quality Index) 18 during pregnancy and/or postpartum. Additional potential risk factors for children of WWE on ASM included maximum third-trimester ASM dose, ASM group (monotherapy vs polytherapy), ASM category (lamotrigine monotherapy, levetiracetam monotherapy, other monotherapy, lamotrigine + levetiracetam polytherapy, or other polytherapy), and specific ASM. ...
Background and objectives:
Neurodevelopmental effects of fetal antiseizure medication (ASM) exposure on creativity and executive functions are poorly understood. We previously found fetal valproate exposure to adversely affect measures of creativity and executive functions. In this study, we examine fetal exposure of newer ASMs on these functions in children of women with epilepsy (WWE) compared with children of healthy women (HW).
Methods:
The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational cohort study of WWE and HW enrolled in pregnancy and their offsprings. This report examines blindly assessed creativity and executive functions in 4.5-year-old children of WWE vs HW. In addition, exposure-dependent ASM effects during the third trimester were examined in children of WWE, using a ratio of maximum observed ASM concentrations and ratio of defined daily dose (ratio DDD). For polytherapy, ratios were summed across ASMs. Linear regression models adjusted for multiple potential confounding factors were conducted for all analyses. The primary outcome for 4.5-year-old children was the Torrance Test of Creative Thinking-Figural Creativity Index. Secondary outcomes included the Global Executive Composite Score from the Behavior Rating Inventory of Executive Function-Preschool Version and subscales and other indexes of both measures.
Results:
The primary analysis included 251 children of WWE and 73 of HW. No differences in creativity or executive function were found between children of WWE vs HW. No ASM exposure-dependent effects were found for the creativity measures, but exposure-dependent effects for executive function were present for ratio ASM concentration and ratio DDD.
Discussion:
Our findings at 4.5 years show no differences in creative thinking between children of WWE vs HW (-3.2 [-9.0 to 2.7], p = 0.286) or associations with fetal exposure to ASMs (-2.6 [-11.0 to 5.7], p = 0.530). Secondary analyses revealed fetal exposure-dependent effects for executive function in children of WWE (7.0 [2.9-11.2], p = 0.001), which are most marked for levetiracetam (12.9 [4.2-21.6], p = 0.004). Our findings suggest that even for relatively safe ASMs, dosing needs to be adjusted to concentrations that prevent seizures, but balance risks to the fetus that high concentrations may pose.
Trial registration information:
The study is registered at ClinicalTrials.gov as NCT01730170.
... Indicators were selected based on prior studies validating the ANA domains incentive salience and negative emotionality [42][43][44]. Specifically, these indicators included items assessing perception of urges to drink [Penn Alcohol Craving Scale (PACS) [45] total score and Alcohol Dependence Scale (ADS) [46] item #18: "Do you almost constantly think about drinking alcohol?" and item #25:"After taking one or two drinks, can you usually stop?"] and negative affect and associated consequences [Beck Depression Inventory (BDI-II) [47] total score, Beck Anxiety Inventory (BAI) [48] total score, and Alcohol Use Disorder Identification Test (AUDIT) [49] item #7: "How often Early life stress. ELS was measured using the ACE Questionnaire, which was developed based on the original ACE study [2]. ...
Early life stress (ELS) increases risk for psychiatric illness, including alcohol use disorder (AUD). Researchers have hypothesized that individuals with and without a history of ELS who have the same primary DSM-5 diagnosis are clinically and biologically distinct. While there is strong support for this hypothesis in the context of mood disorders, the hypothesis remains largely untested in the context of AUD. This study investigated the impact of ELS on the neuroclinical phenomenology and inflammatory profile of individuals with AUD. Treatment-seeking adults with AUD ( N = 163) completed the Adverse Childhood Experiences (ACE) Questionnaire and phenotypic battery as part of a pharmacotherapy trial for AUD (NCT03594435). Participants were classified as having “no-ELS,” (ACE = 0) “moderate-ELS,” (ACE = 1, 2 or 3) or “high-ELS” (ACE = 4 + ). The Addictions Neuroclinical Assessment domains incentive salience and negative emotionality were derived and used to assess the neuroclinical phenomenology of AUD. We tested (1) cumulative ELS as a predictor of ANA domains and (2) ELS group differences in ANA domains. A subset of participants ( N = 98) provided blood samples for a biomarker of peripheral inflammation (C-reactive protein; CRP); analyses were repeated with CRP as the outcome variable. Greater ELS predicted higher negative emotionality and elevated CRP, but not incentive salience. The high-ELS group exhibited greater negative emotionality compared with the no-ELS and moderate-ELS groups, with no difference between the latter two groups. The high-ELS group exhibited elevated CRP compared with the no/moderate-ELS group. Findings suggest that high-ELS exposure is associated with a unique AUD neuroclinical presentation marked by greater negative emotionality, and inflammatory profile characterized by elevated peripheral CRP.
... Measures from NIDA's Data Harmonization projects, specifically PhenX Toolkit [70], will be included. Assessments will take approximately 1 h and include [71,72] will be assessed in addition to any changes in syndemic factors such as social determinants of health (e.g., employment, housing, food insecurity, incarceration) and mood (e.g., PHQ-9 [73], BAI [74]). We will use the EuroQol 5D (EQ-5D) to measure health-related quality of life [75,76]. ...
Background
People who inject drugs (PWID) remain a high priority population under the federal Ending the HIV Epidemic initiative with 11% of new HIV infections attributable to injection drug use. There is a critical need for innovative, efficacious, scalable, and community-driven models of healthcare in non-stigmatizing settings for PWID. We seek to test a Comprehensive-TeleHarm Reduction (C-THR) intervention for HIV prevention services delivered via a syringe services program (SSP).
Methods
The CHARIOT trial is a hybrid type I effectiveness-implementation study using a parallel two-arm randomized controlled trial design. Participants (i.e., PWID; n = 350) will be recruited from a syringe services program (SSP) in Miami, Florida. Participants will be randomized to receive either C-THR or non-SSP clinic referral and patient navigation. The objectives are: (1) to determine if the C-THR intervention increases engagement in HIV prevention (i.e., HIV pre-exposure prophylaxis; PrEP or medications for opioid use disorder; MOUD) compared to non-SSP clinic referral and patient navigation, (2) to examine the long-term effectiveness and cost-effectiveness of the C-THR intervention, and (3) to assess the barriers and facilitators to implementation and sustainment of the C-THR intervention. The co-primary outcomes are PrEP or MOUD engagement across follow-up at 3, 6, 9 and 12 months. For PrEP, engagement is confirmed by tenofovir on dried blood spot or cabotegravir injection within the previous 8 weeks. For MOUD, engagement is defined as screening positive for norbuprenorphine or methadone on urine drug screen; or naltrexone or buprenorphine injection within the previous 4 weeks. Secondary outcomes include PrEP adherence, engagement in HCV treatment and sustained virologic response, and treatment of sexually transmitted infections. The short and long term cost-effectiveness analyses and mixed-methods implementation evaluation will provide compelling data on the sustainability and possible impact of C-THR on comprehensive HIV prevention delivered via SSPs.
Discussion
The CHARIOT trial will be the first to our knowledge to test the efficacy of an innovative, peer-led telehealth intervention with PWID at risk for HIV delivered via an SSP. This innovative healthcare model seeks to transform the way PWID access care by bypassing the traditional healthcare system, reducing multi-level barriers to care, and meeting PWID where they are.
Trial Registration : ClinicalTrials.gov NCT05897099. Trial registry name: Comprehensive HIV and Harm Prevention Via Telehealth (CHARIOT). Registration date: 06/12/2023.
... A systematic review of 27 cohort studies in 2021 found no association between ABO blood types and major depressive disorder [15]. By contrast, research conducted in the USA reported that individuals with blood type O have a higher risk of developing PPD [16]. ...
Background
Postpartum depression (PPD) is a form of depression that can occur after childbirth and is characterized by feelings of sadness. It is a common psychological problem that affects women and children. This study aimed to assess the association between PPD and risk factors, such as delivery mode, ABO blood group, and passive smoking in Saudi Arabia.
Methods
PPD was assessed in this cross-sectional using an Arabic version of the Edinburgh postnatal depression scale through an online questionnaire distributed to women in Saudi Arabia between January and March 2022. The data were analyzed using SPSS version 26 (IBM Corp., Armonk, NY).
Results
A total of 354 postpartum women completed the questionnaire within six weeks of giving birth. Their mean age and BMI were 30.1±6.78 years and 25.98±5.84 kg/m², respectively. PPD occurred in 56.2% of the participants. Elective cesarean section and operative vaginal delivery were associated with the presence of PPD symptoms in 17.6% and 7% of the women, respectively. The majority of those with third and fourth degrees and those who had instrumental assisted delivery had postpartum depression and this was statistically significant (p=0.017). About 26.6% of the participants were exposed to passive smoking, and 21.9% of them developed PPD. However, it was not statistically significant. Moreover, women with PPD were more likely to have blood type O+, followed by A+. Demographic factors did not show a significant correlation with developing PPD except for age (p=0.01), those who developed PPD were much younger on average than those who did not develop PPD (29.28±6.61 years vs. 31.15±6.86 years).
Conclusion
A significant association was found between PPD and the type of delivery. The association between PPD and passive smoking, ABO blood groups was insignificant. However, women who developed PPD were younger on average than those who did not develop PPD.
... Cognitive anxiety has been broadly described as the "negative expectations, worries, and concerns about oneself, the situation at hand, and potential consequences". In contradistinction, somatic anxiety has been associated with "the perception of one's physiological arousal" [87]. Cognitive anxiety has been frequently associated with expressions like "fear of the worst happening", "terrified", and "fear of losing control" whereas somatic anxiety emphasizes the interoceptive and autonomic sequalae of embodied states; including shortness of breath, pounding heart, dizziness, sweating, numbness, unsteadiness, feeling hot, and a feeling of choking [88][89][90][91][92][93]. ...
Functional neuroimaging research on anxiety has traditionally focused on brain networks associated with the psychological aspects of anxiety. Here, instead, we target the somatic aspects of anxiety. Motivated by the growing appreciation that top-down cortical processing plays a crucial role in perception and action, we used resting-state functional MRI data from the Human Connectome Project and Dynamic Causal Modeling (DCM) to characterize effective connectivity among hierarchically organized regions in the exteroceptive, interoceptive, and motor cortices. In people with high (fear-related) somatic arousal, top-down effective connectivity was enhanced in all three networks: an observation that corroborates well with the phenomenology of anxiety. The anxiety-associated changes in connectivity were sufficiently reliable to predict whether a new participant has mild or severe somatic anxiety. Interestingly, the increase in top-down connections to sensorimotor cortex were not associated with fear affect scores, thus establishing the (relative) dissociation between somatic and cognitive dimensions of anxiety. Overall, enhanced top-down effective connectivity in sensorimotor cortices emerges as a promising and quantifiable candidate marker of trait somatic anxiety.
... Interviews were conducted by a trained research assistant or study physician. All participants were additionally assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) [39], Beck Anxiety Inventory (BAI) [40], Young Mania Rating Scale (YMRS) [41], and Columbia-Suicide Severity Rating Scale [42]. ...
Posterior fossa arachnoid cysts (PFACs) are rare congenital abnormalities observed in 0.3 to 1.7% of the population and are traditionally thought to be benign. While conducting a neuroimaging study investigating cerebellar structure in bipolar disorder, we observed a higher incidence of PFACs in bipolar patients (5 of 75; 6.6%) compared to the neuronormative control group (1 of 54; 1.8%). In this report, we detail the cases of the five patients with bipolar disorder who presented with PFACs. Additionally, we compare neuropsychiatric measures and cerebellar volumes of these patients to neuronormative controls and bipolar controls (those with bipolar disorder without neuroanatomical abnormalities). Our findings suggest that patients with bipolar disorder who also present with PFACs may have a milder symptom constellation relative to patients with bipolar disorder and no neuroanatomical abnormalities. Furthermore, our observations align with prior literature suggesting an association between PFACs and psychiatric symptoms that warrants further study. While acknowledging sample size limitations, our primary aim in the present work is to highlight a connection between PFACs and BD-associated symptoms and encourage further study of cerebellar abnormalities in psychiatry.
... The total BAI scale score in FU9 was used to control for current anxiety severity. The reliability and validity of the BAI are well established (Beck et al., 1988;Beck & Streer, 1993). Cronbach's Alpha in the current sample is 0.94. ...
Background
Adults with a history of childhood maltreatment are more likely to experience distrust, feel distant from others, and develop an insecure attachment style which may also affect relationship quality. Furthermore, childhood maltreatment has been linked to several mental health problems; including, depression, anxiety, and alcohol dependance severity, that are also known to relationship quality.
Objective
The current study was designed to investigate to what extent childhood maltreatment is associated with adult insecure attachment and intimate relationships and whether this association is mediated by psychopathology.
Participants and Method
In a study comprised of 2035 adults aged 18–65, we investigated whether childhood maltreatment was associated with insecure adult attachment styles and the quality of intimate relationships and whether this was mediated by depression, anxiety, and alcohol dependence severity (based on repeated assessments of the Inventory of Depressive Symptomatology-Self Report, Beck Anxiety Index, and Alcohol Use Disorders Identification Test respectively).
Results
The path model showed an acceptable fit, RMSEA = 0.05, and suggested full mediation of the association of childhood maltreatment with quality of intimate relationships by depression severity and a) anxious attachment (β = −4.0 ∗ 10⁻²; 95% CI = −5.5 ∗ 10⁻², −2.7 ∗ 10⁻²) and b) avoidant attachment (β = −7.2 ∗ 10⁻²; 95% CI = −9.6 ∗ 10⁻², −4.9 ∗ 10⁻²). Anxiety and alcohol dependence severity were not significant mediators. Conclusions: Childhood maltreatment is associated with a lower quality of intimate relationships, which is fully mediated by depression severity and insecure attachment styles.
... Beck Anxiety Inventory (BAI) The BAI (Beck & Steer, 1990) is a self-report questionnaire developed to assess the severity of anxiety symptoms. The scale includes 21 items rated on a range from zero to three, with a maximum score of 63. ...
Objectives
Mindfulness-based cognitive therapy (MBCT) has shown some efficacy for patients with anxiety disorders. However, most of available studies suffer from important methodological shortcomings, including the lack of adequate control groups and of follow-up measures. The present study aims to compare MBCT with an active psycho-educational and introductory cognitive behavioural therapy (CBT) control group designed to match as much as possible the MBCT program but excluding mindfulness meditation practice for the treatment of patients with generalized anxiety disorder and panic disorder who did not achieve remission following at least 8 weeks of adequate pharmacological treatment.Methods
Out of 112 screened patients, 52 were randomized to receive MBCT or psycho-education for 8 weeks and were prospectively followed for 26 weeks. The severity of anxiety symptoms was assessed with the Beck Anxiety Inventory (BAI) and the Penn State Worry Questionnaire (PSWQ). Measures of depression, mindfulness and quality of life were also included (Beck Depression Inventory-II; Five Facet Mindfulness Questionnaire; Psychological General Well Being Index). All assessments were performed at baseline, 4, 8, 17 and 26 weeks.ResultsBAI and PSWQ showed higher improvements, which were particularly evident over the long-term period, in the MBCT group than in the psycho-education group.Conclusions
Although limited by a small sample size, the results of this study suggest the superiority of MBCT over an active psycho-educational and introductory CBT control group for non-remitted patients with anxiety disorders.
... Foi aplicado o BAI, (BECK et al., 1988), que descreve o desenvolvimento do instrumento e fornece informações sobre suas propriedades psicométricas. Trata-se de uma escala construída com base em vários instrumentos de autorrelato, usado no Center for Cognitive Therapy para medir aspectos da ansiedade (BECK e STEER, 1993), dos quais foram selecionados os itens que passaram a compor o inventário (CUNHA, 2001). ...
... The third most frequently used was the Color Trails Test (D'Elia et al., 1996;9%) that was also normed within the NeSBHIS battery. Mood/Personality (N = 83) The most frequently used mood/personality domain measure was the Beck Depression Inventory-II (Beck et al., 1996;20%), followed by the MMPI-2 (Butcher et al., 1989)/MMPI-2-RF (Tellegen et al., 2003;18%), and the Beck Anxiety Inventory (Beck, 1993;16%). All three were used primarily with English language norms. ...
Objective
To identify the Spanish language neuropsychological tests most frequently used in the evaluation of Hispanic Americans/Latino/as/x across eight neuropsychological domains. To compare these with previously surveyed most frequently used English language tests in the US/Canada. To describe the norms used with Spanish language tests.
Method
An anonymous, uncompensated, 12-min survey was emailed to 169 members of the American Academy of Clinical Neuropsychology, Hispanic Neuropsychological Society, and National Academy of Neuropsychology who self-identified as providing neuropsychological evaluations in Spanish via organizational websites.
Results
The response rate was 36%. Respondents were all licensed U.S. psychologists with the majority fluent in Spanish, conducting less than half their evaluations in Spanish. There was an overlap between the versions of the three most frequently used Spanish versus English neuropsychological tests, but it varied by domain with 3/3 similar for visual–spatial/visuoconstructional skills and sensory/motor functioning domains and 2/3 similar for all other domains except memory (0/3). English language norm use predominated within the mood/personality and sensory/motor functioning domains. In all other domains, Spanish language norms collected in the continental US were preferred to those from foreign Spanish-speaking countries. The most frequently used foreign norms were from Mexico.
Conclusion
Except for the memory domain, there was a sizeable overlap between the three most frequently used Spanish and English language neuropsychological tests in the US. Spanish language tests are primarily interpreted with Spanish norms collected in the continental US except within the mood/personality and sensory/motor functioning domains where English language norms predominate.
Introduction
Emerging evidence supports mindfulness as a potential psychotherapy for post-traumatic stress disorder (PTSD). Individuals with subthreshold PTSD experience significant impairment in their daily life and functioning due to PTSD symptoms, despite not meeting the full diagnostic criteria for PTSD in DSM-5. Mindfulness skills, including non-judgmental acceptance, attentional control and openness to experiences may help alleviate PTSD symptoms by targeting characteristics such as intensified memory processing, dysregulated hyperarousal, avoidance, and thought suppression. This trial aims to test the effects of mindfulness-based cognitive therapy (MBCT) when compared to an active control.
Method and analysis
This 1:1 randomised controlled trial will enroll 160 participants with PTSD symptoms in 2 arms (MBCT vs. Seeking Safety), with both interventions consisting of 8 weekly sessions lasting 2 h each week and led by certified instructors. Assessments will be conducted at baseline (T0), post-intervention (T1), and 3 months post-intervention (T2), with the primary outcome being PTSD symptoms measured by the PTSD checklist for DSM-5 (PCL-5) at T1. Secondary outcomes include depression, anxiety, attention, experimental avoidance, rumination, mindfulness, and coping skills. Both intention-to-treat and per-protocol analyses will be performed. Mediation analysis will investigate whether attention, experimental avoidance, and rumination mediate the effect of mindfulness on PTSD symptoms.
Discussion
The proposed study will assess the effectiveness of MBCT in improving PTSD symptoms. The findings are anticipated to have implications for various areas of healthcare and contribute to the enhancement of existing intervention guidelines for PTSD.
Trial registration number
ChiCTR2200061863.
Background
Information on the quality of life of people hospitalised with COVID-19 is important, both in assessing the burden of disease and the cost-effectiveness of treatments. However, there were potential barriers to collecting such evidence.
Objective
To review the existing evidence on quality of life for people hospitalised with COVID-19, with a focus on the amount of evidence available and methods used.
Design
A scoping review with systematic searches.
Results
A total of 35 papers were selected for data extraction. The most common study type was economic evaluation ( N = 13), followed by cross-sectional ( N = 10). All economic evaluations used published utility values for other conditions to represent COVID-19 inpatients’ quality of life. The most popular quality-of-life survey measure was the Pittsburgh Sleep Quality Index ( N = 8). There were 12 studies that used a mental health-related survey and 12 that used a sleep-related survey. Five studies used EQ-5D, but only one collected responses from people in the acute phase of COVID-19. Studies reported a negative impact on quality of life for people hospitalised with COVID-19, although many studies did not include a formal comparison group.
Limitations
Although it used systematic searches, this was not a full systematic review.
Conclusion
Quality-of-life data were collected from people hospitalised with COVID-19 from relatively early in the pandemic. However, there was a lack of consensus as to what survey measures to use, and few studies used generic health measures. Economic evaluations for COVID-19 treatments did not use utilities collected from people with COVID-19. In future health crises, researchers should be vigilant for opportunities to collect quality-of-life data from hospitalised patients but should try to co-ordinate as well as ensuring generic health measures are used more.
Funding
This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132254.
Objectives
University students are regarded as the backbone of society, and their mental health during a pandemic may have a substantial impact on their performance and life outcomes. The purpose of this study was to assess university students’ mental health, specifically depression, anxiety, and stress, during Lebanon’s extended COVID-19 pandemic, as well as the sociodemographic factors and lifestyle practices associated with it.
Methods
An online anonymous survey assessed the rates of mental health problems during COVID-19, controlling for socio-demographics and other lifestyle practices, in 329 undergraduate and graduate university students. Instruments utilized were the Patient Health Questionnaire (PHQ-9) for depression, the Beck Anxiety Inventory (21-BAI) for anxiety, and the Perceived Stress Scale (PSS-10) for stress. The study employed descriptive statistics and multiple logistic regression models to analyze the association between depression, anxiety, and stress with sociodemographic and lifestyle factors. Results were evaluated using adjusted odds ratios and confidence intervals, with a significance level of 0.05.
Results
Moderate to severe rates of depression, anxiety and stress among students were reported by 75.9%, 72.2%, and 89.3%, respectively. The odds of anxiety and stress were higher among women compared to men. Students who used private counseling services had higher odds of anxiety and stress than those who did not. Overall rated health was a major predictor of depression and anxiety, with the "poor" and "fair" overall-reported health groups having higher odds than the "Excellent" group. When compared to those who did not smoke, students who increased their smoking intake had higher odds of depression, anxiety and stress. Students who reduced their alcohol consumption had lower odds of anxiety compared to those who did not consume alcohol. Students who reduced their physical activity had higher odds than those who increased it. Finally, students who slept fewer than seven hours daily had higher odds of depression than those who slept seven to nine hours.
Conclusion
Our findings indicate a national student mental health crisis, with exceptionally high rates of moderate to severe depression, anxiety, and stress. Factors such as gender, university program, overall rated health, importance of religion in daily decisions, private counseling, smoking cigarettes, alcohol consumption, physical activity, and sleeping, were all found to have an impact on mental health outcomes. Our study highlights the need for university administrators and mental health professionals to consider targeted mental health programming for students, particularly for women and those with poor or fair overall perceived health.
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved ones, so as to inform a specialized intervention. 31 adults living with NMOSD and 22 caregivers of people with NMOSD in the United States and Canada, recruited from NMOSD patient advocacy groups, social media groups, and through word of mouth from other participants, completed a battery of standardized self-report measures of anxiety, depression, trauma, cognitive fusion, valued living, and coping styles. Semi-structured focus group sessions were conducted via HIPAA-compliant Zoom with 31 patients, and separate focus groups were conducted with 22 caregivers. A subset of these samples, comprised of 16 patients and 11 caregivers, participated in individual semi-structured interviews, prioritizing inclusion of diverse perspectives. Descriptive statistics and bivariate correlations were run on quantitative self-report data using SPSS [Version 28.0.1]; data were stored in REDCap. Reflexive thematic analysis was employed regarding qualitative individual interview data. The majority of patients reported experiencing anxiety, depression, cognitive fusion, over-controlled coping, and lack of values-based living. Caregivers also reported heightened anxiety, cognitive fusion, and over-controlled coping, although they did not endorse clinically significant depression. Patient and caregiver degree of anxiety and of overcontrolled coping were both strongly positively correlated, likely affecting how both parties manage NMOSD-related stressors, both individually and as a dyad. Patients reported more anxiety, depression, psychological inflexibility, and lack of values-based living, compared with caregivers. Patient and caregiver narrative themes included mistrust of medical professionals, lack of support immediately following diagnosis, changes in relationships, deviation from values-based living, internalization of feelings, and avoidant coping strategies to manage the psychological burden of NMOSD. A novel mental health intervention targeting the specific psychological burden of life with NMOSD is proposed.
Psychiatric disorders are the most common comorbidities in patients with multiple sclerosis (MS) and show higher prevalences compared to the general population. The most frequently observed disorders include depressive and anxiety disorders, bipolar disorders, and psychotic conditions. Overall, it has been found that despite specific and partially validated diagnostic tools, psychiatric comorbidities in MS are often underdiagnosed and undertreated. Controlled clinical studies on the efficacy of psychopharmacological treatment addressed only depressive disorders in MS. Due to the multifactorial nature of psychiatric disorders, differentiating between coincidences, comorbidities, medication-induced, or organically caused disorders (e.g., a psychiatric relapse) is complex. The assessment and treatment of psychiatric comorbidities in MS are clinically relevant, frequently challenging, and require an interdisciplinary approach.
Objective
The uncinate fasciculus (UF) has been implicated previously in contributing to the pathophysiology of functional (nonepileptic) seizures (FS). FS are frequently preceded by adverse life events (ALEs) and present with comorbid psychiatric symptoms, yet neurobiological correlates of these factors remain unclear. To address this gap, using advanced diffusion magnetic resonance imaging (dMRI), UF tracts in a large cohort of patients with FS and pre‐existing traumatic brain injury (TBI + FS) were compared to those in patients with TBI without FS (TBI‐only). We hypothesized that dMRI measures in UF structural connectivity would reveal UF differences when controlling for TBI status. Partial correlation tests assessed the potential relationships with psychiatric symptom severity measures.
Methods
Participants with TBI‐only (N = 46) and TBI + FS (N = 55) completed a series of symptom questionnaires and MRI scanning. Deterministic tractography via diffusion spectrum imaging (DSI) was implemented in DSI studio (https://dsi‐studio.labsolver.org) with q‐space diffeomorphic reconstruction (QSDR), streamline production, and manual segmentation to assess bilateral UF integrity. Fractional anisotropy (FA), radial diffusivity (RD), streamline counts, and their respective asymmetry indices (AIs) served as estimates of white matter integrity.
Results
Compared to TBI‐only, TBI + FS participants demonstrated decreased left hemisphere FA and RD asymmetry index (AI) for UF tracts (both p < .05, false discovery rate [FDR] corrected). Additionally, TBI + FS reported higher symptom severity in depression, anxiety, and PTSD measures (all p < .01). Correlation tests comparing UF white matter integrity differences to psychiatric symptom severity failed to reach criteria for significance (all p > .05, FDR corrected).
Significance
In a large, well‐characterized sample, participants with FS had decreased white matter health after controlling for the history of TBI. Planned follow‐up analysis found no evidence to suggest that UF connectivity measures are a feature of group differences in mood or anxiety comorbidities for FS. These findings suggest that frontolimbic structural connectivity may play a role in FS symptomology, after accounting for prior ALEs and comorbid psychopathology severity.
Artificial Intelligence (AI) has been widely utilized in automated journalism writing and broadcasting in recent years. However, few systematic studies have been conducted on the differences in brain activation between human and artificial voices in newscasts. This paper aims to investigate the psychophysiological effects of the media in Chinese contexts when different agents (AI or human) broadcast different types (emotional/neutral) of news. Comparing the electrophysiological data of the participants’ EEG while listening to different newscast agents revealed that brain activity responses were greater when listening to a human newscast than to an AI voice newscast. And β bands in left posterior temporal lobe were significantly different, suggesting that participants’ brain were better at processing, comprehending auditory information, and storing working memory when listening to a human reporter than when listening to a voice generated by AI. Moreover, the ERP results and the interaction effect of content valence and agent voice demonstrated that the human voice generated greater cognitive effect, which may reflect participants’ trust in the credibility and fluency of the human voice news. This study demonstrates the importance of further research into cognitive effects of AI journalism.
Background
Insomnia disorder (ID), one of the most common psychophysiological disorders, can cause a serious burden on the individual's work and academic performance. Cognitive dysfunction often exists in patients with insomnia, which negatively affects their living quality. Inhibitory control (IC), as a vital cognitive function, allows individuals to suppress attention, behavior, or thoughts that are irrelevant to the task, so as to effectively adapt to the current goal. The earlier studies on the inhibitory control of insomnia patients predominantly used subjective scales for evaluation and that can have drawbacks because they don't provide an objective assessment.
Methods
In order to investigate the inhibitory control function of insomniacs, this research subdivides inhibitory control into response inhibition and conflict inhibition. The response inhibition and conflict inhibition capacities of insomniacs were evaluated using the two-choice oddball task and the color-word stroop task, and accordingly the association between insomnia disorder and inhibitory control capacity as well as its cognitive neural mechanism was able to be examined.
Results
Behavioral results finding, insomniacs conducted the two-choice oddball test and the color-word stroop task with lower accuracy and slower reaction times when compared to healthy sleepers. ERP results finding, when performing the two-choice oddball task, the P3 amplitude of the insomniacs was significantly lower than that of healthy sleepers while there was no significant difference between the two groups' N2 amplitudes. At the same time, when completing the color-word stroop task, the insomniacs' N450 amplitude was significantly lower than that of healthy sleepers.
Discussion
The above findings suggest that in response inhibition tasks, insomniacs may have weaker motor inhibition abilities, and similarly perform weaker conflict monitoring abilities in conflict inhibition tasks, which indicates that insomniacs' inhibitory control is impaired compared to that of healthy sleepers. This study thus relates to the finding at the electrophysiological level that there is a certain correlation between insomnia and a decline in inhibitory control ability, which may suggest that improving inhibitory control function in patients with insomnia is a clinically significant and worthwhile area of adjuvant treatment.
Background
The diminished executive control along with cue-reactivity has been suggested to play an important role in addiction. Hear rate variability (HRV), which is related to the autonomic nervous system, is a useful biomarker that can reflect cognitive-emotional responses to stimuli. In this study, Internet gaming disorder (IGD) subjects’ autonomic response to gaming-related cues was evaluated by measuring HRV changes in exposure to gaming situation. We investigated whether this HRV reactivity can significantly classify the categorical classification according to the severity of IGD.
Methods
The present study included 70 subjects and classified them into 4 classes (normal, mild, moderate and severe) according to their IGD severity. We measured HRV for 5 min after the start of their preferred Internet game to reflect the autonomic response upon exposure to gaming. The neural parameters of deep learning model were trained using time-frequency parameters of HRV. Using the Class Activation Mapping (CAM) algorithm, we analyzed whether the deep learning model could predict the severity classification of IGD and which areas of the time-frequency series were mainly involved.
Results
The trained deep learning model showed an accuracy of 95.10% and F-1 scores of 0.995 (normal), 0.994 (mild), 0.995 (moderate), and 0.999 (severe) for the four classes of IGD severity classification. As a result of checking the input of the deep learning model using the CAM algorithm, the high frequency (HF)-HRV was related to the severity classification of IGD. In the case of severe IGD, low frequency (LF)-HRV as well as HF-HRV were identified as regions of interest in the deep learning model.
Conclusion
In a deep learning model using the time-frequency HRV data, a significant predictor of IGD severity classification was parasympathetic tone reactivity when exposed to gaming situations. The reactivity of the sympathetic tone for the gaming situation could predict only the severe group of IGD. This study suggests that the autonomic response to the game-related cues can reflect the addiction status to the game.
Background
Unilateral and bilateral peripheral vestibular hypofunction (UVH and BVH) often complains of dizziness, gaze, and balance disturbances. There is a lack of evidence on exercise intervention in UVH and BVH patients. To investigate the effect of an eight-week supervised multicomponent exercise program in people suffering from UVH or BVH in comparison with a control group doing conventional vestibular rehabilitation at home.
Methods
This longitudinal, controlled, randomized, prospective, single-blinded, two-arm, parallel intervention study will include 66 adults (≥18 years old) with chronic UVH or BVH. Participants will be randomly assigned to an exercise intervention group or an attention control group. Participants will be assessed at baseline, after a two-month intervention period, and after a six-month follow-up. The primary variable will be the balance, measured by the dynamic posturography sensory organization test and the Modified Dynamic Gait Index test. Secondary outcome variables will include cardiorespiratory fitness (peak cardiopulmonary exercise test), body composition (bioimpedance and anthropometric variables), physical activity level and sleep quality (accelerometry), health-related quality of life (Dizziness Handicap Inventory questionnaire), emotional state (Beck Depression and Anxiety Inventory questionnaires), and blood pressure monitoring.
Discussion
This study will try to answer whether in people with UVH/BVH, an adjuvant program of multicomponent exercise will help the prognosis of this population.
Trial registration
ClinicalTrials.gov, identifier [NCT05192564]. Verification date: April 2023.
Background:
The neurodevelopmental effects of fetal exposure to most antiseizure medications are unclear. We aimed to investigate the effects of fetal exposure to commonly used antiseizure medications on neuropsychological outcomes at age 3 years.
Methods:
The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a prospective, observational, multicentre cohort study at 20 specialty epilepsy centres in the USA. We have investigated pregnancy outcomes in women (aged 14-45 years) with and without epilepsy who were enrolled during pregnancy (≤20 weeks' gestational age), and their children. The primary outcome for children at age 3 years was a blindly assessed Verbal Index score, which was calculated by averaging scores on the Naming Vocabulary and Verbal Comprehension subtests of Differential Ability Scales-II, Expressive Communication and Auditory Comprehension subscales of Preschool Language Scale-5, and Peabody Picture Vocabulary Test-4. Children of women with and without epilepsy were compared, and the associations of medication exposures to outcomes in exposed children were assessed. The MONEAD study is registered with ClinicalTrials.gov, NCT0730170, and is ongoing.
Findings:
Between Dec 19, 2012, and Jan 13, 2016, 456 pregnant women (351 with epilepsy and 105 without epilepsy) were enrolled into the study. 345 children were born to women with epilepsy and 106 children were born to women without epilepsy. Verbal Index scores at age 3 years did not differ for children of women with epilepsy (n=284; adjusted least-square mean 102·7, 95% CI 101·4 to 103·9) versus those without epilepsy (n=87; 102·3, 99·8 to 104·7). Significant risk factors for reduced Verbal Index scores included maternal intelligence quotient, maternal education, post-birth anxiety, gestational age at enrolment, child's sex, and child's ethnicity. For Verbal Index scores, antiseizure medication exposure effects were not seen for maximum third trimester blood concentrations (n=258; adjusted parameter estimate -2·9, 95% CI -6·7 to 1·0). However, in secondary analyses, exposure-dependent effects were present on multiple cognitive measures, which varied by medication.
Interpretation:
We found no difference in neurodevelopmental outcomes between children with fetal exposure to newer antiseizure medications compared with unexposed children. However, some exposure-dependent antiseizure medication effects were seen in secondary analyses. The adverse effects of maternal post-birth anxiety emphasise the importance of screening mothers during pregnancy and postpartum and implementing interventions. Additional studies are needed to clarify the exposure-dependent effects.
Funding:
National Institutes of Health, National Institute of Neurological Disorders and Stroke, and National Institute of Child Health and Development.
Pilipinx Americans (PA) make up the third largest sub-Asian American group, yet continue to be disproportionately understudied in the social sciences. Subsequently, very little is known about the bio-psycho-social-spiritual (BPSS) factors that may impact their well-being. Recognizing the social, political, and historical conditions that impact PA is critical for understanding their well-being. Specifically, over 300 years of Spanish and U.S. American colonization of the Philippines have had profound and lasting impacts on Pilipinx and PA. Pilipinx scholars argue that Pilipinx have internalized the effects of colonial violence resulting in the development and intergenerational transmission of colonial mentality (CM). This study aims to build from the vital research on CM by answering the following research question: What is the relationship between CM and BPSS factors of well-being among PA? The literature search included 11 databases, gray literature, and consultations with content experts. Two reviewers independently assessed eligibility for inclusion, and information on CM measurement, sample, outcomes, and study design was extracted. The search strategy and selection criteria yielded 15 studies. Within the collective sample of 5,052 PA, significant relationships were found between CM and depression/self-esteem/body dissatisfaction, mental health help seeking, ethnic identity development, acculturation, and enculturation. CM is one form of internalized racism unique to PA. This systematic review indicated that CM has the potential to impact the BPSS well-being of PA. Recommendations for indigenizing practice and grounding future research in anticoloniality are provided, specifically through the restoration of kapwa, a core Pilipinx cultural value.
Individuals with internalizing psychopathologies (IPs) demonstrate a negativity bias in emotion and self-related processing that contributes to negative interpretation of neutral information. However, most neuroimaging studies of emotional experience in IPs do not specifically investigate reactivity to neutral stimuli. Thus, little is known about the neural processes underlying emotional experience for neutral stimuli and how those processes may differ between groups and during neutral versus negative stimuli. To address this gap, we asked: (1) does neural reactivity to neutral and negative stimuli differ between IPs and control groups in brain regions associated with emotional and self-referential processing, and (2) does neural activity during neutral condition relate to clinical symptoms? Adults with IPs (n = 103) and healthy volunteers (HVs; n = 40) completed a well-validated fMRI task probing neural responses to neutral and negative images. A flexible factorial model revealed a significant group-by-condition interaction, such that individuals with IPs had less precuneus activation during the neutral condition relative to HVs. In IPs, precuneus activation during the neutral condition was negatively correlated with depression symptom severity. Individuals with IPs demonstrate abnormal precuneus reactivity to neutral stimuli that is associated with depression symptoms. This may reflect altered default mode network activity and/or self-referential processing in IPs.
Objective:
This review will explore the impact of educational and psychological interventions on educational, social, behavioral, and mental health outcomes in students with autism spectrum disorder in tertiary education.
Introduction:
This systematic review will inform a new guideline on support for students with autism spectrum disorder in the tertiary education environment. These students face multiple educational, behavioral, social, and health-related problems that require effective interventions.
Inclusion criteria:
Participants are students with autism spectrum disorder in a tertiary education study program. Educational and psychological interventions will be included, such as accommodations, meta-cognitive and self-regulation training, psychological counseling, social skills training, and peer-mentoring/academic coaching. The comparator will be standard care. The study outcomes will include academic drop-out rates and evaluations, learning skills, social skills and social engagement, behavior, mental health (including anxiety, stress, and depression), and employment after graduation. This review will consider quantitative studies only.
Methods:
A 3-step search strategy will be used to find both published and unpublished studies in MEDLINE, CINAHL, APA PsycINFO, SocINDEX, Web of Science, Clinical Trials, ProQuest Dissertations and Theses, Open Dissertations, ERIC, WHO ICRTP, and Google Scholar. There will be no date or language limitations. All stages of article screening, critical appraisal, and data extraction will be conducted by 2 independent reviewers with the resolution of any disagreements done via consensus or through a senior reviewer. If possible, the included studies will be pooled using meta-analysis. The degree of certainty of the evidence will be assessed according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Systematic review registration number:
PROSPERO CRD42022323554.
Providers working with families of autistic children have a shared responsibility to ensure access to culturally responsive and linguistically appropriate services for Latino caregivers. Acceptance and Commitment Therapy (ACT) is a promising intervention for Autism parents. However, research on ACT for Latino caregivers is absent. This small pilot study indicated that a brief, group-based, culturally adapted ACT protocol may enhance the wellbeing of Latino mothers. The 2-day intervention was associated with significant reductions in anxiety, depression and psychological inflexibility for all parents, with medium to large effect sizes. Methodological factors significantly limit conclusions, however, the study offers the foundation for a program of research centered on the promotion of thriving in Latino families with autistic children, and how to best integrate guidelines for culturally adapted practice with CBS approaches. The study also highlights the importance of centering social justice as a key component of what it means to be effective contextual behavioral scientists and the need for systemic action to address current barriers to care for Latino families.
Background
Pain can have a significant impact on an individual's life, as it has both cognitive and affective consequences. However, our understanding of how pain affects social cognition is limited. Previous studies have shown that pain, as an alarm stimulus, can disrupt cognitive processing when focal attention is required, but whether pain also affects task-irrelevant perceptual processing is unclear.
Methods
We examined the effect of laboratory-induced pain on event-related potentials (ERPs) to neutral, sad, and happy faces before, during, and after a cold pressor pain. ERPs reflecting different stages of visual processing (P1, N170, and P2) were analyzed.
Results
Pain decreased the P1 amplitude for happy faces and increased the N170 amplitude for happy and sad faces compared to the pre-pain phase. The effect of pain on N170 was also observed in the post-pain phase. The P2 component was not affected by pain.
Conclusions
Our results suggest that pain alters both featural (P1) and structural face-sensitive (N170) visual encoding of emotional faces, even when the faces are irrelevant to the task. While the effect of pain on initial feature encoding seemed to be disruptive and specific to happy faces, later processing stages showed long-lasting and increased activity for both sad and happy emotional faces.
Significance
The observed alterations in face perception due to pain may have consequences for real-life interactions, as fast and automatic encoding of facial emotions is important for social interactions.
Objectives
The pandemic has greatly impacted people’s lives and mental health. Therefore, it is now especially important to help people maintain good mental health. The positive effects of mindfulness-based practices on mental health have been demonstrated previously. However, no consensus has yet been reached on the potential mechanisms of mindfulness. This study adopted the two-component model of mindfulness to explain the relationships between fear of COVID-19, and mental health. We proposed the following hypothetical model: (1) fear of COVID-19 could affect orientation to experience; (2) orientation to experience could affect mental health. Directly; (3) fear of COVID-19 could mental health directly; (4) orientation to experience could be a mediator between fear of COVID-19 and mental health.
Methods
We conducted an online survey in the present study. Three hundred and forty-four respondents were recruited to participate in the present study. After informed consent, they completed the questionnaires on the websites. The participants were asked to complete a questionnaire including the Beck Depression Inventory-II, Beck Anxiety Inventory, the Taiwan version of the Five Facet Mindfulness Questionnaire, and the Fear of COVID-19 Scale. Descriptive analysis and structural equation modeling were used to analyze the data and examine the goodness-of-fit indices.
Results
Our results not only showed orientation to experience playing as a mediator between fear of COVID-19 and mental health; but also confirmed the roles of nonjudgment and nonreactivity in regulating emotions.
Conclusion
Experimentation and longitudinal study could be applied to examine the roles of nonjudgment and nonreactivity in the future.
The COVID-19 pandemic has forced many throughout the world to isolate themselves from their respective communities to stop the spread of disease. Although this form of distancing can prevent the contraction of a virus, it results in social isolation and physical inactivity. Consequently, our communities have become heavily reliant on digital solutions to foster social connection and increase physical activity when forced to isolate. Dance is a multidimensional form of physical activity that includes sensory, motor, cognitive, rhythmic, creative, and social elements. Long-term, interventional studies in dance have shown positive effects on both mental and social health; however, little has been done to examine the acute effects and no studies to date have explored the relationship between the affective state and social outcomes of dance. We examined the hypothesis that online dance is associated with improvements in affective state and social connection during a time of social isolation, namely, the COVID-19 crisis. Healthy adults (age ≥ 18; n = 47) engaged in a single session of 60 min of self-selected online dance, completing a series of validated self-reported questionnaires before and after class. We found that online dance was associated with improvements in affective state as measured by increased positive affect and self-esteem and decreased negative affect and depressive symptoms. Additionally, online dance was associated with improvements in social and community connectedness. Further, we found that those who experienced the largest increases in self-esteem and decreases in negative affect demonstrated the largest gains in social connectivity. Although in-person dance classes may be optimal for formalized dance training, online dance instruction offers an accessible platform that can provide mental and social health benefits during the COVID-19 social isolation crisis. We conclude that through online dance, individuals can experience a connection between the body, mind, and community.
This client study presents the work of a trainee therapist with a client experiencing PTSD. Rather than a focus on outcome, this case seeks to highlight the real-life challenges imbued in applying theory to practice for both the trainee and the client. This case has encouraged the authors to conclude that in addition to a knowledge of the literature, and practitioner skill, courage, and good faith are also fundamental to the application of the scientist practitioner metaphor.
We have chosen to present this case to illustrate how empirical research and reports of practice-based methods with proven effective results may be used to address a discrete psychological problem. Despite incorporating this approach within the context of the therapeutic relationship, it is a focus on an established treatment procedure that is outside the primary therapist’s usual orientation that produced results for the client in the current case. This case touches on therapist anxiety and issues of good faith in the literature (reported efficacy) in the face of significant client distress, arising as a consequence of the treatment protocol. Although this case study was conceptualised and written collaboratively, it is expressed from the perspective of the first author.
Parents of children with diagnoses of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) may experience significant psychological distress related to their child’s severe and relapsing illness and challenges with the traumatic nature of its treatment. No manualized or studied psychological interventions specifically for parents of youth with PANS have existed prior to this study. In this pilot study, we assessed the feasibility, satisfaction, and treatment fidelity of a brief 9-session group therapy intervention for parents based on principles of trauma-focused cognitive behavior therapy (CBT). We hypothesized that, if initially elevated, symptoms of depression, anxiety, and trauma would decrease and participants’ utilization of positive coping mechanisms would increase post-intervention. We adapted an existing evidence-based group intervention developed for parents of children with premature infants to target sources of stress and coping in parents of children with PANS. Ten parents participated in the study. The 9-session intervention used a combination of techniques that included cognitive restructuring, coping skills, self-care, and a trauma narrative to address psychological stress, trust, grief, and unwanted emotions. Outcome measures included parental symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD), as well as rating of parental satisfaction with the intervention. The treatment was feasible and deliverable with high fidelity. The intervention was rated as useful and satisfactory by parents (overall average usefulness of 4.54 and satisfaction of 4.71 out of 5.0). Elevated symptoms of PTSD and depression decreased with large effect sizes (Cohen’s d = 1.42 and Cohen’s d = 1.38, respectively). Participating parents demonstrated significantly more active coping and acceptance behaviors and stances. A brief 9-session group therapy intervention based on principles of trauma-focused CBT was found to be effective in reducing symptoms of psychological distress in parents of children with PANS.
Currently, the identification of stroke patients with an increased suicide risk is mainly based on self‐report questionnaires, and this method suffers from a lack of objectivity. This study developed and validated a suicide ideation (SI) prediction model using clinical data and identified SI predictors. Significant variables were selected through traditional statistical analysis based on retrospective data of 385 stroke patients; the data were collected from October 2012 to March 2014. The data were then applied to three boosting models (Xgboost, CatBoost, and LGBM) to identify the comparative and best performing models. Demographic variables that showed significant differences between the two groups were age, onset, type, socioeconomic, and education level. Additionally, functional variables also showed a significant difference with regard to ADL and emotion (p < 0.05). The CatBoost model (0.900) showed higher performance than the other two models; and depression, anxiety, self-efficacy, and rehabilitation motivation were found to have high importance. Negative emotions such as depression and anxiety showed a positive relationship with SI and rehabilitation motivation and self-efficacy displayed an inverse relationship with SI. Machine learning-based SI models could augment SI prevention by helping rehabilitation and medical professionals identify high-risk stroke patients in need of SI prevention intervention.
Neurodevelopmental disorders, specifically intellectual disability (ID) and autism spectrum disorder (ASD), and psychopathy are completely separate and distinct diagnoses/conditions. Despite their drastic differences at the surface level, symptoms and behaviors associated with neurodevelopmental disorders and/or psychopathy are embedded in the very fabric of the individuals’ life and significantly impacts their daily functioning. Lower intelligence and adaptive functioning deficits are symptoms of ID and intelligence quotient is seen as unchangeable due to the organic nature of ID. Social interaction deficits and engaging in repetitive behaviors are symptoms of ASD and significantly impair the individuals’ ability to engage with others and their community. Lastly, psychopathic traits are deeply ingrained in the individuals’ personality. This chapter explores the relationship between ID and psychopathy and ASD and psychopathy. More specifically, this chapter will provide an overview of each diagnosis/condition, assessment information for each diagnosis/condition, information on various comorbid relationships, and outline prominent interventions.KeywordsPsychopathyNeurodevelopmental disordersIntellectual disabilityMental retardationAutism Spectrum disorderApplied behavior analysisCognitive-behavioral therapyPerson-centered active support
Background
Cognitive biases are recognized as important treatment targets for reducing symptoms associated with severe mental disorders. Although cognitive biases have been linked to symptoms in most studies, few studies have looked at such biases transdiagnostically. The Cognitive Bias Questionnaire for psychosis (CBQp) is a self-reported questionnaire that assesses cognitive biases amongst individuals with a psychotic disorder, as well as individuals with other severe mental disorders. The current study aims to validate a French version of the CBQp and to explore transdiagnostic cognitive biases in individuals with psychotic disorders, individuals with depression, and in healthy controls.
Methods
The CBQp was translated into French following a protocol based on international standards. Discriminant validity and internal consistency were determined for total score and each subscale score. Confirmatory factor analyses were performed to test construct validity. Finally, cluster analyses were conducted to investigate cognitive biases across diagnostic groups.
Results
Our results were similar to those of the original authors, with the one-factor solution (assessment of a general thinking bias) being the strongest, but the two-factor solution (assessing biases within two themes relating to psychosis) and the five-factor solution (assessment of multiple distinct biases) being clinically more interesting. A six-cluster solution emerged, suggesting that individuals with similar diagnoses score differently on all cognitive biases, and that individuals with different diagnoses might have similar cognitive biases.
Conclusions
The current findings support the validity of the French translation of the CBQp. Our cluster analyses overall support the transdiagnostic presence of cognitive biases.
Objective
Assess the incidence and factors associated with major depressive episodes (MDE) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared to healthy pregnant women (HPW) and to non-pregnant women with epilepsy (NPWWE) in comparable timeframes.
Background
Previous studies have reported higher rates of postpartum depression in women with epilepsy compared to women without epilepsy. However, the incidence of MDE using a structured interview during pregnancy and postpartum has not been directly compared to control groups, and the comparison of depression and anxiety symptoms and the role of associated factors remain ambiguous.
Design
/Methods. The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a multicenter NIH-funded prospective observational parallel-group cohort study of PWWE and their children. This report examines mood disorders. Unlike prior epilepsy pregnancy studies, the Structured Clinical Interview for DSM-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory (BDI), Edinburg Postnatal Depression Scale (EPDS)) and anxiety (Beck Anxiety Inventory (BAI)) were also assessed along with multiple clinical factors.
Results
The study included PWWE (n=331) and HPW (n=102) during pregnancy and postpartum, and NPWWE (n=102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE, and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE, and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms.
Conclusions
Although SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed, and symptomatic patients should be offered treatment.
The study is registered at clinicaltrials.gov as NCT01730170 .
Human anxiety is a grave mental health concern that needs to be addressed in the appropriate manner in order to develop a healthy society. In this study, an objective human anxiety assessment framework is developed by using physiological signals of electroencephalography (EEG) and recorded in response to exposure therapy. The EEG signals of twenty-three subjects from an existing database called “A Database for Anxious States which is based on a Psychological Stimulation (DASPS)” are used for anxiety quantification into two and four levels. The EEG signals are pre-processed using appropriate noise filtering techniques to remove unwanted ocular and muscular artifacts. Channel selection is performed to select the significantly different electrodes using statistical analysis techniques for binary and four-level classification of human anxiety, respectively. Features are extracted from the data of selected EEG channels in the frequency domain. Frequency band selection is applied to select the appropriate combination of EEG frequency bands, which in this study are theta and beta bands. Feature selection is applied to the features of the selected EEG frequency bands. Finally, the selected subset of features from the appropriate frequency bands of the statistically significant EEG channels were classified using multiple machine learning algorithms. An accuracy of 94.90% and 92.74% is attained for two and four-level anxiety classification using a random forest classifier with 9 and 10 features, respectively. The proposed state anxiety classification framework outperforms the existing anxiety detection framework in terms of accuracy with a smaller number of features which reduces the computational complexity of the algorithm.
Background
Attention and habituation are two domains known to play key roles in the perception and maintenance of tinnitus. The heterogeneous nature of tinnitus and the methodologies adopted by various studies make it difficult to generalize findings. The current review aims at assessing and synthesizing evidence on the possible roles of attention and habituation in continuous subjective tinnitus.
Methodology
The literature search included five databases (PubMed, Scopus, Web of Sciences, CINAHL and ProQuest) that resulted in 1,293 articles, published by July 2019. Studies on attention and/or habituation in individuals with tinnitus using either behavioural or electrophysiological tests were included in the review after a quality assessment.
Results
Seventeen studies on attention in tinnitus were included in the narrative synthesis. Two meta-analyses were performed to assess the role of attention in tinnitus using a behavioural methodology ( z = 4.06; p < 0.0001) and P300 amplitude ( z = 2.70; p = 0.007) with 531 participants. With respect to habituation, the review indicates the lack of quality articles for habituation inclusion in the narrative synthesis.
Conclusions
The review highlights that selective domains of attention were consistently impaired in individuals with tinnitus. Habituation, on the other hand, needs further exploration.
More older adults are using cannabis for recreational and/or medical purposes, but most studies examining cognitive function and cannabis use do not include older adults. The current small pilot study sought to compare cognitive function and emotional functioning among adults age 60 and older who were regular, primarily recreational cannabis users ( n = 28) and nonusers ( n = 10). A bimodal distribution was observed among cannabis users such that they had either initiated regular use more recently (“short-term” users; ≤7 years, n = 13) or earlier in life (“long-term” users; ≥19 years, n = 15). Nonusers, short-term, and long-term users were not different in depression, anxiety, or emotion regulation, or alcohol use. Nonusers scored significantly higher than long-term users in executive function. Short-term users scored significantly higher than long-term users in executive function, processing speed, and general cognition. Additionally, greater recent cannabis use frequency was negatively associated with working memory. The current findings suggest that short-term recreational cannabis use does not result in differences in cognitive performance compared to nonusers, which may indicate that short-term use is relatively benign in older adults. However, longer duration of use is associated with poorer processing speed and executive functioning, and more recent cannabis use is associated with poorer working memory, which may impact older adults’ overall cognitive functioning.
Background
Alcohol, a known addictive substance, affects the structural properties of the brain. In this study, we explored associations between alcohol use and gray matter properties among firefighters, who are often exposed to significant occupational stress.
Methods
Gray matter volume (GMV) was evaluated using voxel-based morphometry in 287 male firefighters (mean age: 48.8±7.7 years). Firefighters were classified into 32 never-drinkers, 162 non-heavy alcohol users, and 93 heavy alcohol users according to their alcohol consumption. GMV was compared between groups, and the correlations between GMV and alcohol use were investigated. A voxel-wise height threshold of p < 0.001 (uncorrected) was used, with small volume correction applied on cluster level.
Results
Heavy alcohol users had lower GMV in the bilateral thalamus than non-heavy alcohol users or never-drinkers. Heavy alcohol users also showed lower GMV in the left insula, compared to other groups. The higher the alcohol consumption among firefighters, the lower the GMV of the right thalamus.
Conclusions
The results of this study show that heavy alcohol use has an association with lower GMV in several core regions, including the thalamus. When considering the impact of these brain regions on cognitive and behavioral control, our findings suggest a need for concern about heavy alcohol use among firefighters.
ABSTRACT
Introduction
Research has highlighted relationships
between the micro-organisms that inhabit our
gastrointestinal tract (oral and gut microbiota) with host
mood and gastrointestinal functioning. Mental health
disorders and functional gastrointestinal disorders co-occur
at high rates, although the mechanisms underlying these
associations remain unclear. The Bugs and Brains Study
aims to investigate complex relationships between anxiety/
depression and irritable bowel syndrome (IBS) in two ways.
First, its primary component will compare the gut and oral
microbiota in females with anxiety/depression and/or IBS
relative to controls, and investigate underlying physiological,
endocrine and immune factors, as well as associations with
diet and psychosocial factors. In an ancillary component, the
study will also investigate gastrointestinal and mental health
symptoms in a larger sample, and explore relationships with
diet, exercise, oral health, substance use, medical history,
early life adversity and psychosocial factors.
Methods and analysis
The Bugs and Brains Study aims
to recruit 160 females to the primary component: (1) 40
controls; (2) 40 participants with a depressive/anxiety
disorder, but no IBS; (3) 40 participants with IBS, but no
depressive/anxiety disorder and (4) 40 participants with
both depressive/anxiety disorder and IBS. Participation is
completed within 1month, and involves comprehensive
questionnaires, anthropometrics, a diagnostic clinical
interview, collection of two saliva samples, and stool, urine
and hair samples. This study aims to use a systems biology
approach to characterise oral and gut microbial composition
and function using 16S rRNA gene sequencing and nuclear
MR spectroscopy. As part of the ancillary component, it will
collect questionnaire data from 1000 participants aged 18–40
years, capturing mental health, gastrointestinal health, oral
health, diet and psychosocial factors.
Despite their increasing numbers, Saudi Arabian international students in the United States have been the focus of few research studies. We examined acculturative stress among 84 female Saudi Arabian students enrolled in US colleges and universities in the vicinity of Washington, DC. Most participants experienced low levels of depression and anxiety, as measured by the Beck Depression Inventory–II (BDI-II) and the Beck Anxiety Inventory (BAI). Furthermore, smooth acculturation in the United States was strongly related to respondents’ confidence in their English-language competence. Interestingly, English-language proficiency and other sociodemographic variables (e.g., marital status, religiosity) were not related to psychological stress, as measured by the BAI and BDI-II. In contrast, the study found a statistically significant relationship between cultural mistrust and respondents’ psychological stress. We conclude that initiatives sponsoring international student-study in the United States and host universities should provide incoming international students with enhanced support for developing English-language proficiency, as well as a more expansive toolkit for cultural understanding.
Objectives:
Caregivers of persons with neurodegenerative disease have high rates of mental health problems compared to non-caregiving adults. Emotion regulation may play an important role in preserving caregivers' mental health. We examined the associations between caregivers' emotion regulation measured in several ways (ability, habitual use, and self-ratings) and their mental health symptoms.
Method:
Ninety-one caregivers of persons with neurodegenerative disease participated in a laboratory-based assessment of emotion regulation. In two series of tasks, caregivers were given different instructions (no instruction, suppress) regarding altering their emotional behavioral responses to disgusting films and acoustic startle stimuli. Caregivers' emotional behavior was measured via behavioral coding and caregivers rated "how much emotion" they showed during each task. Anxiety, depression, and habitual use of expressive suppression were measured via questionnaires.
Results:
Poor emotion regulation in the disgust suppression condition (i.e., greater emotional behavior) was associated with greater anxiety. Associations were not found for the startle suppression condition, depression, or self-report measures of emotion regulation.
Discussion:
Findings suggest that caregivers who are unable to suppress emotional behavior in response to disgusting stimuli may be at greater risk for anxiety. Given high levels of anxiety in caregivers, it may be useful to evaluate interventions that improve ability to downregulate emotional behavior.
ResearchGate has not been able to resolve any references for this publication.