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Hamididin RM, El Keshky MES. Does the dark triad predict intention to commit corrupt acts? The mediating role of financial anxiety among Saudi students. Australian Journal of Psychology 2023. [DOI: 10.1080/00049530.2023.2177498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
- Radeah Mohammed Hamididin
- Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mogeda El Sayed El Keshky
- Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Psychology, Faculty of Arts, Assiut University, Assiut, Egypt
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Stevenson A, Beltran M, Misra S, Ametaj AA, Bronkhorst A, Gelaye B, Koenen KC, Pretorius A, Stein DJ, Zingela Z. Trauma exposure and psychometric properties of the life events checklist among adults in South Africa. Eur J Psychotraumatol 2023; 14. [PMID: 37052114 PMCID: PMC9901439 DOI: 10.1080/20008066.2023.2172257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Trauma exposure is widespread and linked to chronic physical and mental health conditions including posttraumatic stress disorder. However, there are major gaps in our knowledge of trauma exposure in Africa and on the validity of instruments to assess potentially life-threatening trauma exposure.Objective: The Life Events Checklist for the DSM-5 (LEC-5) is a free, widely used questionnaire to assess traumatic events that can be associated with psychopathology. As part of a case-control study on risk factors for psychosis spectrum disorders, we used the LEC-5 to examine the frequency of traumatic events and to assess the questionnaire's factor structure in South Africa (N = 6,765).Method: The prevalence of traumatic events was measured by individual items on the LEC-5 across the study sample, by case-control status, and by sex. Cumulative trauma burden was calculated by grouping items into 0, 1, 2, 3, and ≥4 traumatic event types. Psychometric properties of the LEC-5 were assessed through exploratory and confirmatory factor analyses.Results: More than 92% of the study sample reported experiencing ≥1 traumatic event; 38.7% reported experiencing ≥4 traumatic event types. The most endorsed item was physical assault (65.0%), followed by assault with a weapon (50.2%). Almost 94% of cases reported ≥1 traumatic event compared to 90.5% of controls (p < .001) and 94% of male participants reported ≥1 traumatic event compared to 89.5% of female participants (p < .001). Exploratory factor analysis revealed a 6-factor model. Confirmatory factor analyses of three models found that a 7-factor model based on the South African Stress and Health survey was the best fit (standardized root mean square residual of 0.024, root mean square error of approximation of 0.029, comparative fit index of 0.910).Conclusion: Participants reported very high exposure to traumatic events. The LEC-5 has good psychometric priorities and is adequate for capturing trauma exposure in South Africa.
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Mou NL, Lei WK, Balaji S, Contractor AA, Latkin CA, Hall BJ. The association between posttraumatic disorder symptoms and addictive behaviours in Macao within a sample of female Filipino migrant workers: a network analysis. Eur J Psychotraumatol 2023; 14. [PMID: 37052088 PMCID: PMC9987736 DOI: 10.1080/20008066.2023.2178764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Background: Filipino migrant workers in Macao are vulnerable to posttraumatic stress disorder (PTSD) symptoms and addictive behaviours due to trauma histories, postmigration stressors, and access to alcohol and gambling venues. While PTSD addiction comorbidity is well-established in the existing literature, such research among migrant workers is lacking.Objective: The current study investigated differential relations between PTSD symptoms and addictive behaviours in a polytrauma exposed sample of Filipino domestic workers in Macao (SAR), China.Methods: Data were collected from 1375 Filipino migrant workers; data from a subsample of 1200 participants who reported an index traumatic event and PTSD symptoms were used in the analyses. Participants responded to the PTSD Checklist for DSM-5, gambling disorder symptoms checklist from DSM-5, and The Alcohol Use Disorders Identification Test. We estimated a regularized partial correlation network structure of PTSD symptoms and addictive behaviours employing graphical LASSO and extended Bayesian information criterion.Results: PTSD symptoms of arousal and negative emotions had bridge connections with gambling disorder symptoms; while PTSD symptoms of arousal, restricted affect, negative emotions, and emotional reactivity had bridge connections with alcohol misuse.Conclusions: PTSD's arousal and negative emotion symptoms were common in the networks of PTSD and addictive behaviours, while PTSD's restricted affect and emotional reactivity symptoms were unique to the network of PTSD and alcohol misuse. Treatment of the comorbidity of PTSD and addictive behaviours may yield optimal effects when tailored to these symptoms.
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Babicola L, Mancini C, Riccelli C, Di Segni M, Passeri A, Municchi D, D'Addario SL, Andolina D, Cifani C, Cabib S, Ventura R. A mouse model of the 3-hit effects of stress: Genotype controls the effects of life adversities in females. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110842. [PMID: 37611651 DOI: 10.1016/j.pnpbp.2023.110842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023]
Abstract
Helplessness is a dysfunctional coping response to stressors associated with different psychiatric conditions. The present study tested the hypothesis that early and adult adversities cumulate to produce helplessness depending on the genotype (3-hit hypothesis of psychopathology). To this aim, we evaluated whether Chronic Unpredictable Stress (CUS) differently affected coping and mesoaccumbens dopamine (DA) responses to stress challenge by adult mice of the C57BL/6J (B6) and DBA/2J (D2) inbred strains depending on early life experience (Repeated Cross Fostering, RCF). Three weeks of CUS increased the helplessness expressed in the Forced Swimming Test (FST) and the Tail Suspension Test by RCF-exposed female mice of the D2 strain. Moreover, female D2 mice with both RCF and CUS experiences showed inhibition of the stress-induced extracellular DA outflow in the Nucleus Accumbens, as measured by in vivo microdialysis, during and after FST. RCF-exposed B6 mice, instead, showed reduced helplessness and increased mesoaccumbens DA release. The present results support genotype-dependent additive effects of early experiences and adult adversities on behavioral and neural responses to stress by female mice. To our knowledge, this is the first report of a 3-hit effect in an animal model. Finally, the comparative analyses of behavioral and neural phenotypes expressed by B6 and D2 mice suggest some translationally relevant hypotheses of genetic risk factors for psychiatric disorders.
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Affiliation(s)
- Lucy Babicola
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Camilla Mancini
- University of Camerino, School of Pharmacy, Pharmacology Unit, Camerino, Italy
| | - Cristina Riccelli
- Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Matteo Di Segni
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Alice Passeri
- Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Diana Municchi
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | | | - Diego Andolina
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy
| | - Carlo Cifani
- University of Camerino, School of Pharmacy, Pharmacology Unit, Camerino, Italy
| | - Simona Cabib
- IRCCS Fondazione Santa Lucia, Rome, Italy; Dept. of Psychology and Center "Daniel Bovet", Sapienza University, Rome 00184, Italy.
| | - Rossella Ventura
- IRCCS Fondazione Santa Lucia, Rome, Italy; IRCCS San Raffaele, Rome, Italy.
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Wang Z, van Bruggen R, Sandini T, Hagen EV, Li XM, Zhang Y. Wistar-Kyoto rats and chronically stressed Wistar rats present similar depression- and anxiety-like behaviors but different corticosterone and endocannabinoid system modulation. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110825. [PMID: 37437836 DOI: 10.1016/j.pnpbp.2023.110825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/14/2023]
Abstract
The interplay of social, psychological, and biological stresses can trigger mental health conditions such as major depressive disorder (MDD), adjustment disorder, and posttraumatic stress disorder (PTSD). The endocannabinoid system (ECS), comprising endocannabinoids and cannabinoid receptors, is the critical pathway that mediates responses to stress stimuli. This study aimed to investigate the ECS's impact on responding to chronic social instability stress (SIS). Wistar (WIS) rats and an endogenously depressed rat model, Wistar-Kyoto (WKY), were used to evaluate depression- and anxiety-like behavioral responses, cognitive function, hormone levels, and ECS function. The animals in the stress group (WIS-STS and WKY-STS) were exposed to TMT (predator odor) for 10 mins (two exposures in total: one in light cycle and one in dark cycle) and daily roommate changes (30 days in total), while the control group (CTL) rats were exposed to a sham odor stimulus (distilled water) and did not undergo roommate changes. The results in the open field test suggest that WKY rats had significantly lower locomotor activity than WIS rats. In contrast, WKY rats and chronically stressed WIS rats presented similar depression- and anxiety-like behaviors and impaired cognitive function in the elevated plus maze, forced swimming test, and novel objective recognition test. However, chronic SIS did not exacerbate these behavioral changes in WKY rats. ELISA and Western blot analysis indicated that chronic SIS did not induce further upregulation of endocannabinoids and CB1R downregulation in WKY rats compared to WIS rats. In addition, the Luminex assay revealed that WKY rats showed a higher resilience on the HPA-axis modulation towards chronic SIS, distinguished by the hyperactivity of the HPA-axis modulation in WIS rats. Overall, the study revealed that the chronic SIS animal model (stressed WIS rats) and an animal model of endogenous depression (WKY rats) can generate similar behavioral changes in anxious behavior, behavioral despair, and cognitive impairment. Both animal models present hyperactivity of the ACTH modulation and ECS activity, while WKY rats are more resilient on CORT modulation towards chronic SIS.
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Affiliation(s)
- Zitong Wang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Rebekah van Bruggen
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Thaisa Sandini
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ethan V Hagen
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
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Cattarinussi G, Di Giorgio A, Moretti F, Bondi E, Sambataro F. Dynamic functional connectivity in schizophrenia and bipolar disorder: A review of the evidence and associations with psychopathological features. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110827. [PMID: 37473954 DOI: 10.1016/j.pnpbp.2023.110827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/05/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
Alterations of functional network connectivity have been implicated in the pathophysiology of schizophrenia (SCZ) and bipolar disorder (BD). Recent studies also suggest that the temporal dynamics of functional connectivity (dFC) can be altered in these disorders. Here, we summarized the existing literature on dFC in SCZ and BD, and their association with psychopathological and cognitive features. We systematically searched PubMed, Web of Science, and Scopus for studies investigating dFC in SCZ and BD and identified 77 studies. Our findings support a general model of dysconnectivity of dFC in SCZ, whereas a heterogeneous picture arose in BD. Although dFC alterations are more severe and widespread in SCZ compared to BD, dysfunctions of a triple network system underlying goal-directed behavior and sensory-motor networks were present in both disorders. Furthermore, in SCZ, positive and negative symptoms were associated with abnormal dFC. Implications for understanding the pathophysiology of disorders, the role of neurotransmitters, and treatments on dFC are discussed. The lack of standards for dFC metrics, replication studies, and the use of small samples represent major limitations for the field.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy
| | - Annabella Di Giorgio
- Department of Mental Health and Addictions, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Federica Moretti
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Emi Bondi
- Department of Mental Health and Addictions, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy.
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Zhu H, Zhang Y, Duan Y, Pei K, Tu S, Chen Y, Cai H. Pharmacokinetic evaluation of Sinisan containing vinegar-processed products in depressive rats, a comprehensive perspective of 'individual herb, herb-pair, and herbal formula'. J Ethnopharmacol 2023; 317:116817. [PMID: 37343654 DOI: 10.1016/j.jep.2023.116817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/09/2023] [Accepted: 06/17/2023] [Indexed: 06/23/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE As a classical formula for the treatment of depression, the clinical application of vinegar-processed products of Bupleuri Radix (Bupleurum chinense DC., BR) and Paeoniae Radix Alba (Paeonia lactiflora Pall., PRA) contained in Sinisan (SNS) is still controversial. AIM OF THE STUDY Three levels of 'individual herb, herb-pair, and herbal formula' were employed to investigate whether and how the processing of main drugs affected the active constituents of pharmacokinetics in SNS, as well as their impacts on the hepatic CYP450 enzyme. MATERIALS AND METHODS Rats were subjected to construct a chronic unpredictable mild stimulation (CUMS) model. A rapid and sensitive ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS/MS) analytical method was developed and validated for simultaneously quantitative evaluation of thirteen potential active compounds of SNS in depressive rat plasma, and successfully applied to a holistic comparison of pharmacokinetics. The differences in pharmacokinetic parameters based on three different forms of drug composition from BR and PRA before and after vinegar-processing were compared. Meanwhile, qRT-PCR and Western Blot were utilized to explore the metabolic activity of three isoforms of CYP450 enzyme scattered in the livers of depressive rats. RESULTS The characteristic pharmacokinetics profiles of thirteen representative constituents in CUMS rats were influenced by vinegar-processing of BR and PRA and/or the compatibility. In detail, there were significant differences in the Cmax, AUC0-24, AUC0-∞, t1/2, and MRT0-24 of most constituents among the three different forms of drug composition from BR and PRA before and after vinegar-processing, with the most obvious changes in six constituents from the adjuvant and mediating guide drugs. And also, the pharmacokinetic parameters of seven constituents from BR and PRA in SNS containing vinegar-processed products obviously changed after compatibility. Additionally, the mRNA and protein levels of CYP1A2, CYP2E1, and CYP3A1 were observed to increase significantly with the processing of BR and PRA and the combination/formulation. CONCLUSIONS In conclusion, SNS containing vinegar-processed products was more conducive to the absorption of most activated constituents compared to the original formula in vivo. The vinegar-processing of BR and PRA and the compatibility co-contribute to the pharmacokinetic variability of active compounds of SNS in CUMS rats, and the extent of contribution varies among drugs, which might be related to the regulation of the hepatic drug metabolizing enzymes. The finding of the investigation could help to better understand how active compounds metabolized in vivo, which might be helpful for guiding the clinical application of SNS containing vinegar-processed products.
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Affiliation(s)
- Hui Zhu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China.
| | - Yating Zhang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China.
| | - Yu Duan
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China.
| | - Ke Pei
- School of Chinese Medicine and Food Engineering, Shanxi University of Chinese Medicine, Jinzhong, 030619, PR China.
| | - Sicong Tu
- Brain & Mind Centre, Faculty of Medicine & Health, The University of Sydney, NSW, 2050, Australia.
| | - Yijing Chen
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China.
| | - Hao Cai
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China.
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Lee MS, Lee JJ, Park S, Kim S, Lee H. Is social support associated with postpartum depression, anxiety and perceived stress among Korean women within the first year postpartum? J Psychosom Obstet Gynaecol 2023; 44:2231629. [PMID: 37428880 DOI: 10.1080/0167482x.2023.2231629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
PURPOSE This study aimed to examine the association between social support, postpartum depression (PPD), anxiety and perceived stress among women within 12 months of childbirth in South Korea. METHODS A cross-sectional, web-based survey was conducted from 21 to 30 September 2022 and included women within 12 months of childbirth in Chungnam Province, South Korea. A total of 1486 participants were included. Multiple linear regression models were used to evaluate the association between social support and mental health. RESULTS In total, 40.0% of the participants had mild to moderate PPD; 12.0%, anxiety symptoms; and 8.2%, perceived severe stress. Social support (from family and significant others) is significantly associated with PPD, anxiety and perceived severe stress. Current maternal health problems, unplanned pregnancy and low household income were risk factors for PPD, anxiety and perceived stress. The increase in the time elapsed after childbirth showed a positive association with PPD and perceived severe stress. CONCLUSIONS Our findings provide insights to identify at-risk mothers and emphasize the importance of social support in families, early screening and continuous monitoring for postpartum women to prevent PPD, anxiety and stress.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
- Department of Psychiatry, College of Medicine, Dankook University, Cheonan, South Korea
- Chungcheongnam-do Mental Health Welfare Center, Hongseong, South Korea
| | - Soyeon Park
- Korea Human Resource Development Institute for Health & Welfare, Seoul, South Korea
| | - Seongju Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Department of Public Health and Healthcare Management, Graduate School, The Catholic University of Korea, Seoul, South Korea
| | - Hooyeon Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Buin E, da Mota Silveira MSV, Pavin EJ. Adaptation and psychometric assessment of the instrument " Partners of Adults with Type 1 Diabetes Distress Scale" in a Brazilian population. PEC Innov 2023; 2:100155. [PMID: 37214537 PMCID: PMC10194356 DOI: 10.1016/j.pecinn.2023.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 04/10/2023] [Accepted: 04/16/2023] [Indexed: 05/24/2023]
Abstract
Objectives To adapt the instrument "Partners of Adults with Type 1 Diabetes Distress Scale" (Partner-DDS) into Brazilian culture, and to evaluate the psychometric characteristics of the adapted version. Methods All the cultural adaptation steps of the measure's instruments were followed. The psychometric properties such as reliability (stability by test-retest; internal consistency), and convergent construct validity were performed. Results Of all 72 partners, 69.4% were male, mean age: 42.69 ± 14.09 years, mean of marriage duration: 14.74 ± 12.41 years, and mean schooling: 11.81 ± 3.91 years.The internal consistency of the instrument (Cronbach Alpha) was 0.90. The intra-class coefficient (stability) was 0.80 (0.72-0.84). The Spearman coefficient (convergent construct validity) between the Partner-DDS scale and the Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) was 0.4273 (p < 0.0002). Conclusions The steps of the instruments' cultural adaptation were appropriately performed. The Brazilian version of the Partner- DDS scale demonstrates reliable psychometric properties for being used in POPWT1D distress evaluation in Brazil. Innovation The cultural adaptation of Partner-DDS scale into Brazilian Portuguese is a helpful innovation to assess the emotional burden in POPWT1D. This tool could be used to provide education and psychological support for this population.
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Affiliation(s)
- Edimariz Buin
- Internal Medicine Postgraduation Program, Faculty of Medical Sciences- University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Mônica Sueli Vilela da Mota Silveira
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences- University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Elizabeth João Pavin
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences- University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
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Gallagher MR, Collins AC, Winer ES. A network analytic investigation of avoidance, dampening, and devaluation of positivity. J Behav Ther Exp Psychiatry 2023; 81:101870. [PMID: 37201468 DOI: 10.1016/j.jbtep.2023.101870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/27/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Reward Devaluation Theory suggests that devaluation of positivity may be integral in understanding depression (Winer & Salem, 2016). Specifically, the anticipatory (e.g., fear of happiness) and responsive (e.g., dampening) behaviors related to the processing of positivity may play a role in the development and maintenance of depression. METHODS The goal of this study was to examine the potential overlap between measures that operationalize positivity avoidance, two Fear of Happiness Scales (Gilbert et al., 2012; Joshanloo, 2013), as well as positivity dampening, measured via the dampening subscale of the Responses to Positive Affect Questionnaire (Feldman et al., 2008). Network and community analyses were employed to examine the extent to which the items of these measures clustered into their parent measures and investigate the dynamic interactions between items. RESULTS The results of the community analysis revealed that the three self-report measures overall clustered into their parent measures, except for the Gilbert et al. (2012) Fear of Happiness Scale, which clustered into two separate communities. The most influential nodes represented the concept that good feelings are often followed by negative outcomes. Additionally, nodes related to the theme of fear of letting oneself become happy emerged as the strongest bridge nodes. LIMITATIONS One limitation of this study is the use of a cross-sectional design; thus, causality cannot be inferred, but the results can guide future longitudinal network designs. CONCLUSIONS These findings demonstrate how anticipatory avoidance and responsive dampening may influence depression, thus providing evidence for unique targets for treatment.
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Affiliation(s)
- Michael R Gallagher
- Department of Psychology, Mississippi State University, Mississippi State, MS, USA.
| | - Amanda C Collins
- Department of Psychology, Mississippi State University, Mississippi State, MS, USA; Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA; Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - E Samuel Winer
- Department of Psychology, The New School for Social Research, New York, NY, USA
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Bathe-Peters R, Priebe K, Schulte S, Meyer K, Schulte-Herbrüggen O, Ülsmann D, Bermpohl F, Schoofs N. The Affect Intolerance Scale (AIS), German version: A validation study in a student and clinical sample of patients with trauma-related disorders. J Behav Ther Exp Psychiatry 2023; 81:101841. [PMID: 36827946 DOI: 10.1016/j.jbtep.2023.101841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 11/24/2022] [Accepted: 02/10/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND AND OBJECTIVES The Affect Intolerance Scale (AIS) assesses two core concepts of emotion regulation: appraisals of negative emotions as threatening and proneness to emotional avoidance. Maladaptive emotion regulation is associated with various psychopathologies. We translated and validated the AIS in a German student and clinical sample of patients with trauma-related disorders. METHODS 340 patients, 161 with post-traumatic stress disorder and 179 with adjustment disorder, and 322 students were enrolled. We employed exploratory and confirmatory factor analyses in a cross-validation design to investigate construct validity, convergent and discriminant validity, and reliability. RESULTS We replicated the originally described two-factor structure in both samples. Cronbach's α was 0.947 in the student and 0.950 in the clinical sample. AIS subscales showed moderate to high correlations with convergent and low correlations with discriminant measures. AIS total scores were significantly larger in the clinical sample, controlled for gender and age. LIMITATIONS This study provides a unified cross-validation model in a clinical and a student sample at the cost of reduced sample sizes. CONCLUSIONS The AIS is a valid measure of affect intolerance with the discriminative ability to distinguish between patients with trauma-related disorders and students. Test redundancy within both sub-constructs of the AIS might lead to biased estimates but allows for increased test precision, rendering the AIS a tool suitable for individual treatment monitoring.
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Affiliation(s)
- Rouven Bathe-Peters
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, CCM, Charitéplatz 1, 10117, Berlin, Germany.
| | - Kathlen Priebe
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, CCM, Berlin, Germany
| | - Sarah Schulte
- Friedrich von Bodelschwingh Clinic for Psychiatry, Psychotherapy and Psychosomatic Medicine, Berlin, Germany
| | - Kristina Meyer
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, CCM, Berlin, Germany
| | - Olaf Schulte-Herbrüggen
- Friedrich von Bodelschwingh Clinic for Psychiatry, Psychotherapy and Psychosomatic Medicine, Berlin, Germany
| | - Dominik Ülsmann
- Friedrich von Bodelschwingh Clinic for Psychiatry, Psychotherapy and Psychosomatic Medicine, Berlin, Germany
| | - Felix Bermpohl
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, CCM, Berlin, Germany
| | - Nikola Schoofs
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, CCM, Berlin, Germany
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van den Berg KC, Voncken M, Hendrickson AT, Di Simplicio M, Regeer EJ, Rops L, Keijsers GPJ. Exploring aspects of self-reported emotional mental imagery in patients with bipolar disorder. J Behav Ther Exp Psychiatry 2023; 81:101861. [PMID: 37182427 DOI: 10.1016/j.jbtep.2023.101861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/28/2023] [Accepted: 04/29/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND AND OBJECTIVES CBT for patients with bipolar disorder has modest effects. Across disorders, mental imagery has been used to update CBT to increase effectiveness. In order to enhance CBT for bipolar disorder with imagery techniques, research is needed into emotional imagery quality and, related appraisals of imagery and their relationships with mood instability and subsequent behaviour in bipolar disorder. METHODS Patients with bipolar disorder (n = 106), unipolar depression (n = 51), creative imagery prone participants (n = 53) and participants without a history of a mood disorder (n = 135) completed the Dutch Imagery Survey (DImS), an online imagery survey, adapted from the Imagery Interview, assessing self-reported emotional imagery aspects. Imagery quality, appraisals and their self-perceived effects on emotion and behaviour were compared between groups. As unexpected differences within the bipolar group appeared, these were additionally explored. RESULTS Imagery appraisals but not imagery quality discriminated between the patient groups and non-patient groups Imagery was perceived as an emotional amplifier in all groups, but this was specifically apparent in bipolar manic and bipolar depressed groups. Only in the bipolar group imagery was experienced to amplify behavioural tendencies. LIMITATIONS Results need to be replicated using a larger sample of patients with BD who are currently manic or depressed. CONCLUSIONS Not only quality of imagery, but especially appraisals associated with imagery are differentiating between imagery prone people with and without mood disorder. Imagery amplifies emotion in all groups, but only in those patients with bipolar disorder currently manic or depressed did this influence behaviour.
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Affiliation(s)
- K C van den Berg
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), the Netherlands; Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands.
| | - M Voncken
- Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands
| | - A T Hendrickson
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands
| | - M Di Simplicio
- Imperial College London, Division of Psychiatry, Department of Brain Sciences, UK
| | - E J Regeer
- Altrecht Institute for Mental Health Care, Utrecht, the Netherlands
| | - L Rops
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), the Netherlands
| | - G P J Keijsers
- Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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Wittekind CE, Schiebel T, Kühn S. Reliability of and associations between cognitive bias measures and response inhibition in smoking. J Behav Ther Exp Psychiatry 2023; 81:101853. [PMID: 36947971 DOI: 10.1016/j.jbtep.2023.101853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 02/06/2023] [Accepted: 03/10/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND AND OBJECTIVE Theoretical models propose that different cognitive biases are caused by a common underlying mechanism (incentive salience/"wanting") and should, therefore, be interrelated. Additionally, stronger impulsive processes should be related to weaker inhibitory abilities. However, these assumptions have hardly been empirically tested and key psychometric information have hardly been reported in samples of smokers. To extent previous research, the present study aimed (1) to estimate the reliability (split-half) of different cognitive bias measures and (2) to investigate associations between attention, approach and associative biases, response inhibition, and smoking-related variables. METHODS Eighty current, non-deprived smokers completed the following tasks in random order: Approach-Avoidance Task (AAT), Stimulus-Response Compatibility Task (SRCT), Implicit-Association Tests (IAT, approach-avoid, valence), Dotprobe Task, Go-/NoGo Task (GNGT). Additionally, different smoking-related variables were assessed. Split-half reliabilities of the different cognitive (bias) measures and correlations between them were calculated. RESULTS Split-half reliabilities of the AAT, the SRCT, and the Dotprobe Task were unacceptable whereas both IATs and the GNGT showed good to excellent reliability. Smoking-approach associations were significantly related to nicotine dependence; however, none of the cognitive bias measures correlated with response inhibition or smoking-related variables. LIMITATIONS Pictorial stimuli were the same across paradigms and might not have been relevant to all participants. CONCLUSIONS This is the first study to investigate the association between different cognitive biases, response inhibition, and smoking-related variables. Although findings are at odds with theoretical assumptions, their interpretation is clearly restricted by the low reliability of the cognitive bias measures.
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Affiliation(s)
- Charlotte E Wittekind
- LMU Munich, Department of Psychology, Clinical Psychology and Psychotherapy, Germany; University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Germany.
| | - Tanja Schiebel
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Germany
| | - Simone Kühn
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Germany; Max Planck Institute for Human Development, Lise Meitner Group for Environmental Neuroscience, Berlin, Germany; Max Planck-UCL Center for Computational Psychiatry and Ageing Research, Berlin, Germany
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Grave J, Madeira N, Morais S, Rodrigues P, Soares SC. Emotional interference and attentional control in schizophrenia-spectrum disorders: The special case of neutral faces. J Behav Ther Exp Psychiatry 2023; 81:101892. [PMID: 37429124 DOI: 10.1016/j.jbtep.2023.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 06/19/2023] [Accepted: 06/25/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Schizophrenia-spectrum disorders (SSD) are characterized by impaired emotion processing and attention. SSD patients are more sensitive to the presence of emotional distractors. But despite growing interest on the emotion-attention interplay, emotional interference in SSD is far from fully understood. Moreover, research to date has not established the link between emotional interference and attentional control in SSD. This study thus aimed to investigate the effects of facial expression and attentional control in SSD, by manipulating perceptual load. METHODS Twenty-two SSD patients and 22 healthy controls performed a target-letter discrimination task with task-irrelevant angry, happy, and neutral faces. Target-letter was presented among homogenous (low load) or heterogenous (high load) distractor-letters. Accuracy and RT were analysed using (generalized) linear mixed-effect models. RESULTS Accuracy was significantly lower in SSD patients than controls, regardless of perceptual load and facial expression. Concerning RT, SSD patients were significantly slower than controls in the presence of neutral faces, but only at high load. No group differences were observed for angry and happy faces. LIMITATIONS Heterogeneity of SSD, small sample size, lack of clinical control group, medication. CONCLUSIONS One possible explanation is that neutral faces captured exogenous attention to a greater extent in SSD, thus challenging attentional control in perceptually demanding conditions. This may reflect abnormal processing of neutral faces in SSD. If replicated, these findings will help to understand the interplay between exogenous attention, attentional control, and emotion processing in SSD, which may unravel the mechanism underlying socioemotional dysfunction in SSD.
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Affiliation(s)
- Joana Grave
- William James Center for Research (WJCR-Aveiro), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Nuno Madeira
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal; Institute of Psychological Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; CIBIT-Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3000-548 Coimbra, Portugal; CACC-Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal
| | - Sofia Morais
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal; Institute of Psychological Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; CIBIT-Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3000-548 Coimbra, Portugal; CACC-Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal
| | - Paulo Rodrigues
- Department of Psychology and Education, University of Beira Interior, Estrada do Sineiro, 6200-209 Covilhã, Portugal
| | - Sandra C Soares
- William James Center for Research (WJCR-Aveiro), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
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Käll A, Andersson G. Knowledge acquisition following internet-based cognitive behavioural therapy for loneliness - A secondary analysis of a randomised controlled trial. J Behav Ther Exp Psychiatry 2023; 81:101872. [PMID: 37209636 DOI: 10.1016/j.jbtep.2023.101872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/21/2023] [Accepted: 05/06/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Knowledge about a condition and how to treat it is part of most cognitive behavioural therapies. This is particularly relevant for self-help treatments such as internet-based CBT, which is commonly delivered in the form of didactic materials. The role of knowledge acquisition in treatment outcomes is an understudied area. The present study sought to investigate knowledge acquisition as part of an ICBT trial targeting loneliness and discern its role in the outcome of treatment. METHODS We used secondary data from a randomised controlled trial of ICBT targeting loneliness with 73 participants. A knowledge test including certainty ratings was constructed and used to investigate whether knowledge increased for the treatment group in comparison to the control group, whether changes in knowledge predicted changes in loneliness during the treatment phase, and how the acquired knowledge related to outcomes at a two-year follow-up. Multiple linear regression models were used to analyse the data. RESULTS The treatment group had significantly higher knowledge scores compared to the waitlist group at posttreatment, both in terms of correct answers (Cohen's d = 0.73) and certainty-weighted sum scores (Cohen's d = 1.20). Acquired knowledge did not predict reductions in loneliness in the short-term, and neither loneliness ratings nor use of treatment techniques in the long-term. LIMITATIONS The sample size was relatively small, which limits the statistical inferences. CONCLUSIONS Knowledge of treatment relevant principles increase as part of the treatment in ICBT for loneliness. This increase was not related to other short- and long-term outcomes.
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Affiliation(s)
- Anton Käll
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Roca P, Vazquez C, Diez G, McNally RJ. How do mindfulness and compassion programs improve mental health and well-being? The role of attentional processing of emotional information. J Behav Ther Exp Psychiatry 2023; 81:101895. [PMID: 37515955 DOI: 10.1016/j.jbtep.2023.101895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/03/2023] [Accepted: 07/15/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Although the benefits of Meditation-Based Programs are well documented, the mechanisms underlying these benefits have not been fully elucidated. Therefore, we examined whether: (1) formal training in mindfulness and compassion meditation modifies the distribution of attentional resources towards emotional information; and (2) whether changes in attentional processing of emotional information after the meditation programs mediate the improvements in psychological distress, emotion regulation, and well-being. METHODS A sample of 103 participants enrolled in the study: 36 in the mindfulness program (MBSR), 30 in the compassion program (CCT), and 37 in the no-intervention comparison group (CG). The assessment before and after the programs included the completion of an emotional Attentional Blink task (AB) together with self-report measures of psychological distress, emotion regulation, and well-being. RESULTS MBSR and CCT reduced similarly the AB deficit, whereas no changes occurred in the CG. This AB reduction was found for the different emotional and non-emotional stimuli (i.e., negative, positive, and neutral), showing a significant disengagement from first-target emotions and significant accessibility of second-target emotions to consciousness. The effects of both meditation programs on the psychological measures were mediated by changes in the AB and emotion regulation skills. LIMITATIONS Due to our naturalistic design in a real-world community setting, random assignment of participants was not feasible. CONCLUSIONS Meditation may promote more flexible and balanced attention to emotional information, which may be a key transdiagnostic mechanism underlying its benefits on emotional distress and well-being.
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Affiliation(s)
- Pablo Roca
- Faculty of Health Sciences, Universidad Villanueva, Spain; Valencian International University, Valencia, Spain.
| | - Carmelo Vazquez
- School of Psychology, Complutense University of Madrid, Spain
| | - Gustavo Diez
- Nirakara Lab, Complutense University of Madrid, Spain
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Wu Y, Chiu MYL, Wu W, Han S, Wang J. What makes Chinese adolescents "trapped" in severe mental illness? An interactionist perspective on self and identity. Int J Qual Stud Health Well-being 2023; 18:2250093. [PMID: 37652707 PMCID: PMC10478608 DOI: 10.1080/17482631.2023.2250093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
The aim of this study was to explore the self and identity perspectives among Chinese adolescents with severe mental illness (SMI), with a focus on their illness experience and subjective meaning of a formal diagnosis. Thirty-one Chinese adolescents were interviewed and the interview data were analysed strictly according to principles suggested by the constructivist grounded theory approach. Five theoretical codes emerged in this study, including changes of personal values and beliefs, accumulated persistent developmental challenges and personal stresses, ineffective coping strategies and development, symptoms and development of mental illness, and changed perceptions and understandings of self. A proposed model of "The dynamic interactions of Chinese adolescents' identity and mental illness", was constructed and visualized. The results revealed that adolescents' identity formation is a fluctuating and non-linear process, but tends to be predominantly negative. The negative self, as informed by long-term ineffective coping with accumulated persistent developmental challenges and stressful events, develops towards a more serious status of negative identity and contributes to relapse symptoms, although this impact occurs variably with perceived personal characteristics. Besides, some participants who had achieved a state of "Buddha-like numbness" made a conscious decision to live a seemingly normal life while coexisting with their illness. The study also highlighted the positive aspects of identity formation that can arise from the experience of illness, including an enhanced sense of realism and increased empathy. Our findings will imply much the need for person-centred treatment plan and services that take into account of individual situations.
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Affiliation(s)
- Yihan Wu
- School of Social Development, Nanjing Normal University, Nanjing, China
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Marcus Yu Lung Chiu
- School of Health and Wellbeing, University of Bolton, Bolton, UK
- Centre of Mental Health & Society, Bangor University, Wales, UK
- Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Hong Kong
| | - Weiyun Wu
- School of Social Development, Nanjing Normal University, Nanjing, China
| | - Sijia Han
- School of Social Development, Nanjing Normal University, Nanjing, China
| | - Jing Wang
- Affiliated Jianhu Hospital of Nantong University Xinglin College, Yancheng, China
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Tonta KE, Howell J, Boyes M, McEvoy P, Hasking P. An experimental investigation of biased attention in non-suicidal self-injury: The effects of perfectionism and emotional valence on attentional engagement and disengagement. J Behav Ther Exp Psychiatry 2023; 81:101856. [PMID: 36996628 DOI: 10.1016/j.jbtep.2023.101856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [ |