A description of the development of an innovative multi-component long COVID treatment program based on central sensitization with preliminary patient satisfaction data

OBJECTIVE

Estimates of the prevalence of Long COVID in the United States or worldwide are imprecise, but millions of people are thought to be affected. No effective treatment exists for the often devastating symptoms of Long COVID. Central Sensitization has been postulated as a causal/explanatory mechanism for developing Long COVID. No treatment to date has targeted Central Sensitization. The present cross-sectional study describes the first 140 patients treated in a multi-component treatment program that targets Central Sensitization to reduce symptom burden, improve functioning, and lower the psychological distress observed in these patients.

METHODS

140 patients diagnosed with Long COVID after an extensive medical evaluation were assessed for function, depression, and pain catastrophizing using questionnaires and patient satisfaction measures after completion of a 16-h Cognitive Behavioral Therapy treatment program focused on Central Sensitization.

RESULTS

Upon admission, patients diagnosed with Long COVID were significantly impaired in their ability to function due to their symptoms. Further, 70% of the patients were depressed. Pain catastrophizing was observed in up to 20% of patients.

CONCLUSION

Patient satisfaction measures were high for the sample at the end of the treatment program suggesting that a multicomponent treatment program targeting Central Sensitization is acceptable to patients. Further research is needed to explore the effectiveness and durability of this treatment approach.

Hub disruption in HIV disease and cocaine use: A connectomics analysis of brain function

BACKGROUND

Cocaine use (CU) is prevalent in people with HIV (PWH). Both conditions are linked to changes in cognitive functioning and neural network topology. The current study utilizes graph theory to investigate functional connectomics associated with HIV and CU, focusing on disruption of densely connected nodes called hubs.

METHODS

Resting state functional magnetic resonance imaging (fMRI) from 206 adults (ages 22-55 years) were analyzed. A HIV x CU factorial design was implemented with participants in four groups: HIV+CU (n= 41), HIV only (n= 88), CU only (n= 36), and controls (n= 41). Functional connectomes were constructed, and thresholded graph metrics were calculated. Network centrality metrics - betweenness centrality (BC), participation coefficient (PC), and within module degree (WD) - were quantified into hub disruption indices (HDI). For each index, a 2×2 ANCOVA was performed controlling for education.

RESULTS

Participants were 68 % male and 74 % African-American with a mean age of 44.4 years. HIV and CU were associated with hub disruption in all three indices. Interactions were significant for HDI-PC and HDI-WD, such that HIV disease was associated with greater hub disruption among participants without CU, but not among participants with CU. Overall, lower global cognitive functioning was associated with greater hub disruption on all three indices.

CONCLUSIONS

Widespread hub disruption was evident in HIV disease and CU, highlighting topological reorganization in both diseases with neurocognitive effects. Hub-related measures inform functional connectivity disruptions in HIV disease and CU, particularly with respect to changes in network topology throughout the connectome.

AI-enhanced analysis of naturalistic social interactions characterizes interaffective impairments in schizophrenia

Social deficits in schizophrenia have been attributed to an impaired attunement to mutual interaction, or "interaffectivity". While impairments in emotion recognition and facial expressivity in schizophrenia have been consistently reported, findings on mimicry and social synchrony are inconsistent, and previous studies have often lacked ecological validity. To investigate interaffective behavior in dyadic interactions in a real-world-like setting, 20 individuals with schizophrenia and 20 without mental disorder played a cooperative board game with a previously unacquainted healthy control participant. Facial expression analysis was conducted using Affectiva Emotion AI in iMotions 9.3. The contingency and state space distribution of emotional facial expressions was assessed using Mangold INTERACT. Psychotic symptoms, subjective stress, affectivity and game experience were evaluated through questionnaires. Due to a considerable between-group age difference, age-adjusted ANCOVA was performed. Overall, despite an unchanged subjective experience of the social interaction, individuals with schizophrenia exhibited reduced responsiveness to positive affective stimuli. Subjective game experience did not differ between groups. Descriptively, facial expressions in schizophrenia were generally more negative, with increased sadness and decreased joy. Facial mimicry was impaired specifically regarding joyful expressions in schizophrenia, which correlated with blunted affect as measured by the SANS. Dyadic interactions involving persons with schizophrenia were less attracted toward mutual joyful affective states. Only unadjusted for age, in the absence of emotional stimuli from their interaction partner, individuals with schizophrenia showed more angry and sad expressions. These impairments in interaffective processes may contribute to social dysfunction in schizophrenia and provide new avenues for future research.

A network analysis of positive psychosocial factors and indication of suboptimal HIV care outcomes among Black women living with HIV

Black women living with HIV (BWLWH) face barriers that impact health outcomes. However, positive psychosocial indicators may influence HIV care outcomes. Among this cross-sectional study of 119 BWLWH, a network analysis was utilized to examine relationships between positive psychosocial factors and HIV-related health outcomes. A preliminary polychoric analysis was conducted to examine correlations between the variables, and the network analyzed connections between resilience, self-efficacy, self-esteem, perceived social support, religious coping, post-traumatic growth, and an indicator variable for suboptimal HIV care outcomes (low medication adherence, detectable viral load, and missed HIV-related health visits) and determined the centrality measures within the network. Seven significant associations were found among the factors: self-efficacy and self-esteem, post-traumatic growth and resilience, post-traumatic growth and self-efficacy, post-traumatic growth and religious coping, perceived social support and resilience, self-esteem and resilience, self-esteem and perceived social support (bootstrapped 95% CI did not contain zero). Self-efficacy was the strongest indicator associated with the other factors. Although not statistically significant, the indicator for suboptimal HIV care outcomes was negatively associated with perceived social support and religious coping. Future interventions incorporating self-efficacy may be beneficial to the overall well-being of Black women.

Trajectories of craving in the course of pharmacotherapy trials for methamphetamine use disorder

AIMS

The aim of this study was to measure trajectories of craving for methamphetamine during the course of pharmacotherapy trials for methamphetamine use disorder.

DESIGN, SETTING AND PARTICIPANTS

Craving trajectories were identified using Group-Based Trajectory Modeling. The association of craving trajectories with drug use trajectories was examined using a dual trajectory model. Association of craving trajectories with other health and social outcomes was also examined. The study used pooled data from five randomized controlled pharmacotherapy trials for methamphetamine use disorder. A total of 866 adults with methamphetamine use disorder participated in randomized controlled pharmacotherapy trials.

MEASUREMENT

Craving was assessed weekly using the Brief Substance Craving Scale. Drug use was assessed using urine toxicology. Alcohol- and drug-related problems, as well as psychiatric, medical, legal, employment and relationship problems, were measured using the Addiction Severity Index.

FINDINGS

A three-trajectory model with high, medium and low craving trajectories was selected as the most parsimonious model. Craving trajectories were associated with methamphetamine use trajectories in the course of trial; 88.4% of those in the high craving trajectory group had a consistently high frequency of methamphetamine use compared with 18.7% of those in the low craving group. High craving was also associated with less improvement in most other outcomes and higher rate of dropout from treatment. In turn, low craving was associated with a rapidly decreasing frequency of methamphetamine use, greater improvement in most other outcomes and a lower rate of dropout. Participants on modafinil daily and ondansetron 1 mg twice daily were less likely to be in the high craving group compared with those on placebo.

CONCLUSIONS

Trajectories of methamphetamine craving in the course of clinical trials for methamphetamine use disorder appear to be both highly variable and strongly associated with greater frequency of drug use, other drug-related outcomes and dropout from trials. Two medications, modafinil daily and ondansetron at a dose of 1 mg two times daily, appear to be associated with greater reduction in craving in the course of treatment compared with placebo. A decrease in methamphetamine craving shows promise as an early indicator of recovery from methamphetamine use disorder.

Network structure of symptomatology of adult attention-deficit hyperactivity disorder in patients with mood disorders

Patients with mood disorders commonly manifest comorbid psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated ADHD symptoms in this population. The current study aimed to explore the network structure of ADHD symptomology and identify central symptoms in patients with mood disorders. The Korean version of the Adult ADHD Self-Report Scale was used to assess the overall ADHD symptoms in 1,086 individuals diagnosed with mood disorders (major depressive disorder [n = 373], bipolar I disorder [n = 314], and bipolar II disorder [n = 399]). We used exploratory graph analysis to detect the number of communities, and the network structure was analyzed using regularized partial correlation models. We identified the central ADHD symptom using centrality indices. Network comparison tests were conducted with different subgroups of patients with mood disorders, including three mood diagnosis groups, between the patients who met the diagnostic criteria for ADHD [ADHD-suspected, n = 259] in their self-report and the others [ADHD-non-suspected, n = 827], and groups with high [n = 503] versus low [n = 252] levels of depressive state. The network analysis detected four communities: disorganization, agitation/restlessness, hyperactivity/impulsivity, and inattention. The centrality indices indicated that "feeling restless" was the core ADHD symptom. The result was replicated in the subgroup analyses within our clinically diverse population of mood disorders, encompassing three presentations: Patients with suspected ADHD, patients without suspected ADHD, and patients with a high depressive state. Our findings reveal that "feeling restless" is the central ADHD symptom. The treatment intervention for "feeling restless" may thus play a pivotal role in tackling ADHD symptoms in adult patients with mood disorders.

Sex-dependent astrocyte reactivity: Unveiling chronic stress-induced morphological changes across multiple brain regions

Chronic stress is a major precursor to various neuropsychiatric disorders and is linked with increased inflammation in the brain. However, the bidirectional association between inflammation and chronic stress has yet to be fully understood. Astrocytes are one of the key inflammatory regulators in the brain, and the morphological change in reactive astrocytes serves as an important indicator of inflammation. In this study, we evaluated the sex-specific astrocyte response to chronic stress or systemic inflammation in key brain regions associated with mood disorders. We conducted the unpredictable chronic mild stress (UCMS) paradigm to model chronic stress, or lipopolysaccharide (LPS) injection to model systemic inflammation. To evaluate stress-induced morphological changes in astrocyte complexity, we measured GFAP fluorescent intensity for astrocyte expression, branch bifurcation by quantifying branch points and terminal points, branch arborization by conducting Sholl analysis, and calculated the ramification index. Our analysis indicated that chronic stress-induced morphological changes in astrocytes in all brain regions investigated. The effects of chronic stress were region and sex specific. Notably, females had greater stress or inflammation-induced astrocyte activation in the hypothalamus (HYPO), CA1, CA3, and amygdala (AMY) than males. These findings indicate that chronic stress induces astrocyte activation that may drive sex and region-specific effects in females, potentially contributing to sex-dependent mechanisms of disease.

The Associations Between Attachment Insecurity and Compulsive Sexual Behavior Disorder or Problematic Pornography Use: The Mediating Role of Emotion Regulation Difficulties

Compulsive sexual behavior disorder (CSBD) was previously considered an attachment disorder, while emotion dysregulation was thought to potentially be a key characteristic of it. However, this theoretical model was not tested in previous empirical research. In our cross-sectional study, we tested whether emotional regulation (ER) difficulties can be adopted as an explanatory mechanism for the relationships between attachment avoidance and anxiety, as well as CSBD and its most prevalent behavioral presentation-problematic pornography use (PPU). Participants (n = 1002; Mage = 50.49 years, SD = 13.32; men: 50.2%) completed an online survey regarding the investigated variables. In mediation analyses, attachment avoidance and anxiety were treated as simultaneous predictors, ER difficulties as a mediating variable, with CSBD/PPU severity as dependent variables. Emotion regulation difficulties and attachment anxiety had a direct positive effect on both CSBD and PPU. The direct effect of attachment avoidance on PPU was non-significant, and significant for CSBD depending on the measure used. Moreover, all the relationships between both insecure attachment dimensions and CSBD/PPU symptom severity were at least partially mediated by ER difficulties. Our results corroborate the theoretical claim that ER difficulties may be a useful framework for explaining the impact of attachment insecurity on CSBD/PPU. Theoretical and practical implications of the findings are discussed.

Comparing the Clique Percolation algorithm to other overlapping community detection algorithms in psychological networks: A Monte Carlo simulation study

In psychological networks, one limitation of the most used community detection algorithms is that they can only assign each node (symptom) to a unique community, without being able to identify overlapping symptoms. The clique percolation (CP) is an algorithm that identifies overlapping symptoms but its performance has not been evaluated in psychological networks. In this study, we compare the CP with model parameters chosen based on fuzzy modularity (CPMod) with two other alternatives, the ratio of the two largest communities (CPRat), and entropy (CPEnt). We evaluate their performance to: (1) identify the correct number of latent factors (i.e., communities); and (2) identify the observed variables with substantive (and equally sized) cross-loadings (i.e., overlapping symptoms). We carried out simulations under 972 conditions (3x2x2x3x3x3x3): (1) data categories (continuous, polytomous and dichotomous); (2) number of factors (two and four); (3) number of observed variables per factor (four and eight); (4) factor correlations (0.0, 0.5, and 0.7); (5) size of primary factor loadings (0.40, 0.55, and 0.70); (6) proportion of observed variables with substantive cross-loadings (0.0%, 12.5%, and 25.0%); and (7) sample size (300, 500, and 1000). Performance was evaluated through the Omega index, Mean Bias Error (MBE), Mean Absolute Error (MAE), sensitivity, specificity, and mean number of isolated nodes. We also evaluated two other methods, Exploratory Factor Analysis and the Walktrap algorithm modified to consider overlap (EFA-Ov and Walk-Ov, respectively). The Walk-Ov displayed the best performance across most conditions and is the recommended option to identify communities with overlapping symptoms in psychological networks.

Use of Machine Learning Algorithms Based on Text, Audio, and Video Data in the Prediction of Anxiety and Posttraumatic Stress in General and Clinical Populations: A Systematic Review

Research in machine learning (ML) algorithms using natural behavior (i.e., text, audio, and video data) suggests that these techniques could contribute to personalization in psychology and psychiatry. However, a systematic review of the current state of the art is missing. Moreover, individual studies often target ML experts who may overlook potential clinical implications of their findings. In a narrative accessible to mental health professionals, we present a systematic review conducted in 5 psychology and 2 computer science databases. We included 128 studies that assessed the predictive power of ML algorithms using text, audio, and/or video data in the prediction of anxiety and posttraumatic stress disorder. Most studies (n = 87) were aimed at predicting anxiety, while the remainder (n = 41) focused on posttraumatic stress disorder. They were mostly published since 2019 in computer science journals and tested algorithms using text (n = 72) as opposed to audio or video. Studies focused mainly on general populations (n = 92) and less on laboratory experiments (n = 23) or clinical populations (n = 13). Methodological quality varied, as did reported metrics of the predictive power, hampering comparison across studies. Two-thirds of studies, which focused on both disorders, reported acceptable to very good predictive power (including high-quality studies only). The results of 33 studies were uninterpretable, mainly due to missing information. Research into ML algorithms using natural behavior is in its infancy but shows potential to contribute to diagnostics of mental disorders, such as anxiety and posttraumatic stress disorder, in the future if standardization of methods, reporting of results, and research in clinical populations are improved.

Gray matter volumetric correlates of the polygenic risk of depression: A study of the Human Connectome Project data

Genetic factors confer risks for depression. Understanding the neural endophenotypes, including brain morphometrics, of genetic predisposition to depression would help in unraveling the pathophysiology of depression. We employed voxel-based morphometry (VBM) to examine how gray matter volumes (GMVs) were correlated with the polygenic risk score (PRS) for depression in 993 young adults of the Human Connectome Project. The phenotype of depression was quantified with a DSM-oriented scale of the Achenbach Adult Self-Report. The PRS for depression was computed for each subject using the Psychiatric Genomics Association Study as the base sample. In multiple regression with age, sex, race, drinking severity, and total intracranial volume as covariates, regional GMVs in positive correlation with the PRS were observed in bilateral hippocampi and right gyrus rectus. Regional GMVs in negative correlation with the PRS were observed in a wide swath of brain regions, including bilateral frontal and temporal lobes, anterior cingulate cortex, thalamus, lingual gyri, cerebellum, and the left postcentral gyrus, cuneus, and parahippocampal gyrus. We also found sex difference in anterior cingulate volumes in manifesting the genetic risk of depression. In addition, the GMV of the right cerebellum crus I partially mediated the link from PRS to depression severity. These findings add to the literature by highlighting 1) a more diverse pattern of the volumetric markers of depression, with most regions showing lower but others higher GMVs in association with the genetic risks of depression, and 2) the cerebellar GMV as a genetically informed neural phenotype of depression, in neurotypical individuals.

Reviewing explore/exploit decision-making as a transdiagnostic target for psychosis, depression, and anxiety

In many everyday decisions, individuals choose between trialling something novel or something they know well. Deciding when to try a new option or stick with an option that is already known to you, known as the "explore/exploit" dilemma, is an important feature of cognition that characterises a range of decision-making contexts encountered by humans. Recent evidence has suggested preferences in explore/exploit biases are associated with psychopathology, although this has typically been examined within individual disorders. The current review examined whether explore/exploit decision-making represents a promising transdiagnostic target for psychosis, depression, and anxiety. A systematic search of academic databases was conducted, yielding a total of 29 studies. Studies examining psychosis were mostly consistent in showing that individuals with psychosis explored more compared with individuals without psychosis. The literature on anxiety and depression was more heterogenous; some studies found that anxiety and depression were associated with more exploration, whereas other studies demonstrated reduced exploration in anxiety and depression. However, examining a subset of studies that employed case-control methods, there was some evidence that both anxiety and depression also were associated with increased exploration. Due to the heterogeneity across the literature, we suggest that there is insufficient evidence to conclude whether explore/exploit decision-making is a transdiagnostic target for psychosis, depression, and anxiety. However, alongside our advisory groups of lived experience advisors, we suggest that this context of decision-making is a promising candidate that merits further investigation using well-powered, longitudinal designs. Such work also should examine whether biases in explore/exploit choices are amenable to intervention.

Alternation of psychological resilience may moderate mentalization toward mental health conditions from macro- and microstructure aspects

OBJECTIVE

We aim to investigate the interplay between mentalization, brain microstructure, and psychological resilience as potential protective factors against mental illness.

METHOD

Four hundred and twenty-six participants (mean age 40.12±16.95; 202 males, 224 females), without psychiatric or neurological history, completed assessments: Dissociative Process Scale (DPS), Peace of Mind (PoM), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Resilience Scale for Adults (RSA), and Magnetic Resonance Imaging (MRI) structures with selected regions of interest, and Diffusion Tensor Imaging (DTI) maps from various tracts in the right hemisphere and connection to the frontal areas, including anterior thalamic radiation (ATR), Cingulum (hippocampus) (CH), Corticospinal tract (CST), Superior longitudinal fasciculus (SLF), Inferior fronto-occipital fasciculus (IFOF), and Uncinate fasciculus (UF) were analyzed.

RESULTS

Two clusters, representing hypomentalization (HypoM) and hypermentalization (HyperM), were identified based on DPS, CPSS, and RFQ responses. One-way ANOVA showed no significant age or gender differences between clusters. The HypoM group exhibited lower PoM scores, higher BDI and BAI scores, and lower RSA scores (ps< 0.05). Structural brain metric comparison showed significant differences in GMV in the right caudal middle frontal gyrus (rcMFG), right superior frontal gyrus (rsFG), and right frontal pole (rFP) between groups. In addition, the HyperM individuals with a higher risk of depression and a higher ratio of intrapersonal to interpersonal factors of resilience were found with reduced GMV on the rcMFG. Additionally, analyses of DTI metrics revealed significant differences between two groups in rATR and rSLF in terms of fractional anisotropy (FA) values; rATR, rCST, rUF, rSLF, rCH and rIFOF in terms of mean diffusivity (MD) values, and radial diffusivity (RD) (corrected p = 0.05). Moreover, the positive correlation between different domains of resilience and white matter (WM) integrity implied further enhancement of intrapersonal or interpersonal resilience factors that are different for people with different mentalization.

CONCLUSIONS

The findings underscore the importance of considering both intrapersonal and interpersonal factors in understanding the interactions between psychological resilience and mental health conditions relevant to brain mechanisms.

Neonatal Nucleus Accumbens Microstructure Modulates Individual Susceptibility to Preconception Maternal Stress in Relation to Externalizing Behaviors

OBJECTIVE

Maternal stress influences in utero brain development and is a modifiable risk factor for offspring psychopathologies. Reward circuitry dysfunction underlies various internalizing and externalizing psychopathologies. This study examined (1) the association between maternal stress and microstructural characteristics of the neonatal nucleus accumbens (NAcc), a major node of the reward circuitry, and (2) whether neonatal NAcc microstructure modulates individual susceptibility to maternal stress in relation to childhood behavioral problems.

METHOD

K-means longitudinal cluster analysis was performed to determine trajectories of maternal stress measures (Perceived Stress Scale [PSS], hair cortisol) from preconception to the third trimester. Neonatal NAcc microstructural measures (orientation density index [ODI] and intracellular volume fraction [ICVF]) were compared across trajectories. We then examined the interaction between maternal stress and neonatal NAcc microstructure on child internalizing and externalizing behaviors, assessed between ages 3 and 4 years.

RESULTS

Two trajectories of maternal stress magnitude ("low"/"high") were identified for both PSS (n = 287) and hair cortisol (n = 336). Right neonatal NAcc ODI (rNAcc-ODI) was significantly lower in "low" relative to "high" PSS trajectories (n = 77, p = .04). PSS at preconception had the strongest association with rNAcc-ODI (r = 0.293, p = .029). No differences in NAcc microstructure were found between hair cortisol trajectories. A significant interaction between preconception PSS and rNAcc-ODI on externalizing behavior was observed (n = 47, p = .047).

CONCLUSION

Our study showed that the preconception period contributes to in utero NAcc development, and that NAcc microstructure modulates individual susceptibility to preconception maternal stress in relation to externalizing problems.

PLAIN LANGUAGE SUMMARY

In the S-PRESTO population-based cohort study conducted in Singapore with 351 women and their children, higher levels of maternal perceived stress within the year before pregnancy were associated with increased dendritic complexity within offsprings' nucleus accumbens, indicative of a more advanced developmental profile. Variations in right nucleus accumbens microstructure significantly modulated the association between maternal perceived stress at preconception and externalizing behaviors in early childhood. Study findings suggest that maternal stress in the preconception period accelerates in-utero nucleus accumbens development, leading to differential risk to externalizing problems in later childhood.

From willpower to strategies: Existing insights and outstanding issues in self-control strategy use in daily life

This paper focuses on recent advances in research on strategies that support self-control in everyday life. No one strategy or set of strategies appears to be effective at all times and in all situations. To understand effective self-control, we must expand our understanding of how strategies fit the situation and the person. To this end, we propose researching unexplored aspects of situations, how self-control strategies develop in the first place, and the role of emotion regulation in self-control strategy effectiveness. We also highlight methodological blind spots and offer ways to correct them and introduce new methodological approaches to best capture self-control strategies in everyday life.

Associations between sleep duration trajectories and risk of cardio-metabolic disease among middle-aged and older Chinese adults

BACKGROUND

The association of a single time-point measure of sleep duration with cardio-metabolic disease has been extensively studied, but few studies have focused on the impact of sleep duration trajectory. This study aims to model the sleep duration trajectory as predictors for the subsequent development of cardio-metabolic disease.

METHODS

This study recruited a notably large population (n = 9883) of subjects aged at least 45 years from the China Health and Retirement Longitudinal Study (CHARLS), who participated in sequential surveys conducted in 2011, 2013, 2015, and 2018. Sleep duration trajectories were plotted using data of night sleep duration recorded at intervals from 2011 to 2015 by latent class trajectory model. The onset of cardio-metabolic diseases from 2015 to 2018 were confirmed and then the risk of different sleep duration trajectories on incident cardio-metabolic disease was examined using cox proportional hazards regression model.

RESULTS

We identified four sleep duration trajectories. Compared to the normal-stable trajectory, the short-stable trajectory was significantly associated with higher risk of incident stroke (hazard ratio [HR], 1.32; 95 % confidence interval [CI], 1.02 to 1.70), dyslipidemia (HR, 1.22; 95%CI, 1.01 to 1.49), and diabetes (HR, 1.42; 95%CI, 1.13 to 1.78) within three years of follow-up, and the short-increasing trajectory predicted a higher risk of incident stroke (HR, 2.38; 95%CI, 1.25 to 4.55).

CONCLUSIONS

Short sleep trajectory could increase the risk of incident stroke, dyslipidemia, and diabetes, and an increasing sleep trajectory was associated with increased risk of incident stroke among middle-aged and older Chinese adults.

Aberrant inhibitory control as a transdiagnostic dimension of mental disorders - A meta-analysis of the antisaccade task in different psychiatric populations

This meta-analysis examined inhibitory control performance in the antisaccade task across mental disorders. Following PRISMA guidelines, we analyzed data from k = 146 studies (n = 13,807 participants) on antisaccade performance. Effect sizes were estimated using random-effects models and restricted maximum-likelihood estimation, with robustness tests for study heterogeneity and publication bias. Most disorders displayed elevated error rates, with schizophrenia showing the greatest impairments, followed by autism spectrum disorder, bipolar disorder and attention deficit hyperactivity disorder. Small to medium impairments were also found in eating disorders, major depressive disorder, obsessive-compulsive disorder and substance use disorder. Results were robust against corrections for publication bias and largely unaffected by confounding variables. Prolonged latencies were observed in schizophrenia, attention deficit hyperactivity disorder, bipolar disorder and obsessive compulsive disorder, with smaller and less robust effect sizes. Results indicate inhibitory control deficits in the antisaccade task across mental disorders, especially evident for error rates. While present in most disorders, results imply varying degrees of impairments, ranging from small to large in effect sizes, with largest impairments in schizophrenia.

Associations between perceived discrimination experiences, treatment adherence self-efficacy, and depressive symptoms among people living with HIV in the Southern United States

This study examined associations between perceived discrimination, treatment adherence self-efficacy, and depressive symptoms among people living with HIV (PLHIV) in the Southern United States. Cross-sectional survey data were collected from 402 PLHIV who self-reported on interpersonal discrimination experiences based on HIV status, sexuality, gender, income, and living condition. Participants also reported on adherence self-efficacy and depressive symptoms. We employed K-means clustering to identify groups based on discrimination experiences, and logistic regressions to examine group differences on adherence self-efficacy and depressive symptoms. Results suggested three groups: a cluster with high perceived discrimination across all identities/conditions (n = 41; 11%; Cluster 1); a cluster with high perceived discrimination based on HIV status, income, and living condition (n = 49; 13%; Cluster 2); and a cluster with low perceived discrimination across all identities/conditions (n = 288; 76%; Cluster 3). Compared to Cluster 3, Cluster 1 and 2 had 2.22 times (p = .037) and 3.98 times (p<.001) greater odds of reporting depressive symptoms. Compared to Cluster 3, Cluster 2 had 3.40 times (p = .003) greater odds of reporting lower adherence self-efficacy. Findings demonstrate the need for individual-level support for PLHIV with discrimination histories, and broader efforts to end the stigma, discrimination, and marginalization of PLHIV based on HIV status and other characteristics.

Different activation in dorsolateral prefrontal cortex between anxious depression and non-anxious depression during an autobiographical memory task: A fNIRS study

OBJECTIVE

Using functional near-infrared spectroscopy (fNIRS) previous studies have found that activation differences in the dorsolateral prefrontal cortex (DLPFC) during an autobiographical memory task (AMT) under the condition of different emotional valences may be neurophysiological markers of depression and different depression subtypes. Additionally, compared with non-anxious depression, anxious depression presents abnormal hemodynamic activation in the DLPFC. This study aimed to use fNIRS to investigate hemodynamic activation in the DLPFC of depression patients with and without anxiety during AMT triggered by different emotional valence stimuli.

METHODS

We recruited 194 patients with depression (91 with non-anxious depression, 103 with anxious depression) and 110 healthy controls from Chinese college students. A 53-channel fNIRS was used to detect cerebral hemodynamic differences in the three groups during AMT.

RESULTS

The results showed that: (1) the activation of oxy-Hb in the left DLPFC was significantly higher under positive emotional valence than under negative emotional valence for healthy controls and patients with non-anxious depression, while there was no significant difference between positive and negative emotional valence observed in response to anxious depression; and (2) Oxy-Hb activation under negative emotional valence was significantly higher in the anxious depression group than in the non-anxious depression group.

CONCLUSIONS

This study revealed that the hemodynamic hyperactivation of negative emotional valence in the left DLPFC may be due to the neurophysiological differences between anxious and non-anxious patients with depression.

Shared and distinct aberrations in frontal-striatal system functional patterns among patients with irritable bowel syndrome and major depressive disorder

BACKGROUND

Considering the high comorbidity, shared risk factors, and genetic pathways between irritable bowel syndrome (IBS) and major depressive disorder (MDD), we hypothesized that there would be both shared and disorder-specific alterations in brain function.

METHODS

A total of 39 IBS patients, 39 MDD patients, and 40 healthy controls (HCs) were enrolled and matched for sex, age, and educational level. All subjects underwent resting-state functional MRI. The clinical variables of anxiety, depression, gastrointestinal symptoms and alexithymia were recorded. The 12 subregions of the striatum were employed as seeds to assess their functional connectivity (FC) with every voxel throughout the whole brain.

RESULTS

Compared to HC, IBS and MDD patients exhibited aberrant frontal-striatal circuitry. We observed a common decrease in FC between the dorsal striatum and regions of the hippocampus, sensorimotor cortex, and prefrontal cortex (PFC) in both IBS and MDD patients. Patients with IBS exhibited disorder-specific decreases in FC within the striatum, along with reduced connectivity between the ventral striatum and sensorimotor cortex. In contrast, MDD patients showed disorder-specific hyperconnectivity in the medial PFC-limbic system. Receiver operating characteristic curve analysis showed that frontal-striatal FC values could serve as transdiagnostic markers of IBS and MDD. Within the IBS group, striatal connectivity was not only negatively associated with weekly abdominal pain days but also negatively correlated with the levels of anxiety and alexithymia.

CONCLUSIONS

This exploratory analysis indicated that patients with IBS and MDD exhibited both shared and disorder-specific frontal-striatal circuit impairments, potentially explaining both comorbidity and distinct phenotypes.

Geofencing in location-based behavioral research: Methodology, challenges, and implementation

This manuscript presents a novel geofencing method in behavioral research. Geofencing, built upon geolocation technology, constitutes virtual fences around specific locations. Every time a participant crosses the virtual border around the geofenced area, an event can be triggered on a smartphone, e.g., the participant may be asked to complete a survey. The geofencing method can alleviate the problems of constant location tracking, such as recording sensitive geolocation information and battery drain. In scenarios where locations for geofencing are determined by participants (e.g., home, workplace), no location data need to be transferred to the researcher, so this method can ensure privacy and anonymity. Given the widespread use of smartphones and mobile Internet, geofencing has become a feasible tool in studying human behavior and cognition outside of the laboratory. The method can help advance theoretical and applied psychological science at a new frontier of context-aware research. At the same time, there is a lack of guidance on how and when geofencing can be applied in research. This manuscript aims to fill the gap and ease the adoption of the geofencing method. We describe the current challenges and implementations in geofencing and present three empirical studies in which we evaluated the geofencing method using the Samply application, a tool for mobile experience sampling research. The studies show that sensitivity and precision of geofencing were affected by the type of event, location radius, environment, operating system, and user behavior. Potential implications and recommendations for behavioral research are discussed.

A new sample-size planning approach for person-specific VAR(1) studies: Predictive accuracy analysis

Researchers increasingly study short-term dynamic processes that evolve within single individuals using N = 1 studies. The processes of interest are typically captured by fitting a VAR(1) model to the resulting data. A crucial question is how to perform sample-size planning and thus decide on the number of measurement occasions that are needed. The most popular approach is to perform a power analysis, which focuses on detecting the effects of interest. We argue that performing sample-size planning based on out-of-sample predictive accuracy yields additional important information regarding potential overfitting of the model. Predictive accuracy quantifies how well the estimated VAR(1) model will allow predicting unseen data from the same individual. We propose a new simulation-based sample-size planning method called predictive accuracy analysis (PAA), and an associated Shiny app. This approach makes use of a novel predictive accuracy metric that accounts for the multivariate nature of the prediction problem. We showcase how the values of the different VAR(1) model parameters impact power and predictive accuracy-based sample-size recommendations using simulated data sets and real data applications. The range of recommended sample sizes is smaller for predictive accuracy analysis than for power analysis.

The Association Between Prenatal Maternal Stress and Adolescent Affective Outcomes is Mediated by Childhood Maltreatment and Adolescent Behavioral Inhibition System Sensitivity

Prenatal maternal stress is linked to offspring outcomes; however, there is little research on adolescents, behavioral, transdiagnostic outcomes, or the mechanisms through which relations operate. We examined, in N = 268 adolescents (Mage = 15.31 years; SD = 1.063; 57.8% boys) whether prenatal maternal stress is associated with adolescent affective outcomes; whether this association is mediated, serially, by childhood home atmosphere and adolescent behavioral inhibition system (BIS) sensitivity; and whether mediational effects are moderated by adolescent attention-deficit/hyperactivity disorder or maternal internalizing symptomology. Prenatal maternal daily stress and major life events were associated with adolescent outcomes through childhood negative atmosphere/neglect and BIS sensitivity, with no evidence of moderation. Results have implications regarding the effect of prenatal maternal stress on offspring outcomes and regarding corresponding sensitive periods.

Association of social gatherings and physical exercise with depressive symptoms among middle-aged and older adults during the COVID-19 pandemic

Strict social isolation and physical distancing measures implemented during the COVID-19 pandemic had significant implications for the psychological well-being of middle-aged and older adults. This study aimed to investigate factors associated with depressive symptoms during the pandemic period among individuals who reported no significant depressive symptoms before the pandemic. Individuals from the Korean Longitudinal Study of Aging without a previous report of significant depressive symptoms across Waves 6 (2016) and 7 (2018) were investigated for the development of depressive symptoms in Wave 8 (2020). The multivariable logistic regression results revealed that both men and women who participated in social gatherings and physical exercise less than once a week were associated with an increase in the likelihood of depressive symptoms (odds ratio [OR] 2.88; 95% confidence interval [CI] 1.80-4.61 and OR 2.61; 95% CI 1.64-4.15, respectively for men and OR 2.58; 95% CI 1.80-3.70 and OR 1.51; 95% CI 1.02-2.23, respectively for women). In addition, unmarried men (OR 2.38; 95% CI 1.37-4.14) and women with one chronic disease (OR 1.98; 95% CI 1.14-3.43) or two or more chronic diseases (OR 2.28; 95% CI 1.31-3.99) reported a significant increase in the likelihood of depressive symptoms. Regular social gatherings and physical exercise were identified as key factors in mitigating depressive symptoms among middle-aged and older adults. The findings can inform the development of public health strategies that promote regular social interactions and physical activity to enhance the psychological resilience and overall well-being of middle-aged and older adults in the endemic era.

Maximizing the reach of universal child sexual abuse prevention: Protocol for an equivalence trial

Background

Child sexual abuse (CSA) affects 1 in 5 girls and 1 in 12 boys before age 18. Universal school-based prevention programs are an effective and cost-efficient method of teaching students an array of personal safety skills. However, the programmatic reach of universal school-based programs is limited by the inherent reliance on the school infrastructure and a dearth of available alternative delivery modalities.

Methods

The design for this study will use a rigorous cluster randomized design (N = 180 classrooms) to determine the equivalence of two delivery modalities of Safe Touches: as usual vs. modified. The as usual workshop will be delivered by two facilitators with live puppet skits (n = 90). Whereas, the modified workshop will be delivered by one facilitator using prerecorded skit videos (n = 90). We will determine the equivalence by measuring concept learning acquisition preworkshop to immediate postworkshop (Aim 1) and retention at 3-months postworkshop (Aim 2) among students in classrooms that receive the as usual or modified workshops. To conclude equivalence, it is imperative to also examine factors that may impact future dissemination and implementation, specifically program adoption among school personnel and implementation fidelity between the two modalities (Aim 3).

Conclusion

Study findings will inform the ongoing development of effective CSA prevention programs and policy decisions regarding the sustainable integration of such programs within schools.

Clinical trial registration

NCT06195852.

A study of somatization symptoms and low-frequency amplitude fluctuations of emotional memory in adolescent depression

Studies have revealed that somatization symptoms are associated with emotional memory in adolescents with depressive disorders. This study investigated somatization symptoms and emotional memory among adolescents with depressive disorders using low-frequency amplitude fluctuations (ALFF). Participants were categorized into the somatization symptoms (FSS) group, non-FSS group and healthy control group (HC). The correctness of negative picture re-recognition was higher in the FFS and HC group than in the non-FSS group. The right superior occipital gyrus and right inferior temporal gyrus were significantly larger in the FSS group than those in the non-FSS and HC groups. Additionally, the ALFF in the superior occipital and inferior temporal gyrus were positively correlated with CSI score. Furthermore, the ALFF values in the temporal region positively correlated with correct negative image re-recognition. The negative image re-recognition rate was positively correlated with the ALFF in the left and right middle occipital gyri. These findings indicated that somatization symptoms in adolescent depression are associated with the superior occipital gyrus and inferior temporal gyrus. Notably, somatization symptoms play a role in memory bias within depressive disorders, with middle occipital and inferior temporal gyri potentially serving as significant brain regions.

Microbiota-gut-brain axis in perioperative neurocognitive and depressive disorders: Pathogenesis to treatment

An increasing number of people undergo anesthesia and surgery. Perioperative neurocognitive and depressive disorders are common central nervous system complications with similar pathogeneses. These conditions pose a deleterious threat to human health and a significant societal burden. In recent years, numerous studies have focused on the role of the gut microbiota and its metabolites in the central nervous system via the gut-brain axis. Its involvement in perioperative neurocognitive and depressive disorders has attracted considerable attention. This review aimed to elucidate the role of the gut microbiota and its metabolites in the pathogenesis of perioperative neurocognitive and depressive disorders, as well as the value of targeted interventions and treatments.

Investigating the association between symptoms and functional activity in brain regions in schizophrenia: A cross-sectional fmri-based neuroimaging study

Schizophrenia is a persistent neurological disorder profoundly affecting cognitive, emotional, and behavioral functions, prominently characterized by delusions, hallucinations, disordered speech, and abnormal motor activity. These symptoms often present diagnostic challenges due to their overlap with other forms of psychosis. Therefore, the implementation of automated diagnostic methodologies is imperative. This research leverages Functional Magnetic Resonance Imaging (fMRI), a neuroimaging modality capable of delineating functional activations across diverse brain regions. Furthermore, the utilization of evolving machine learning techniques for fMRI data analysis has significantly progressive. Here, our study stands as a novel attempt, focusing on the comprehensive assessment of both classical and atypical symptoms of schizophrenia. We aim to uncover associated changes in brain functional activity. Our study encompasses two distinct fMRI datasets (1.5T and 3T), each comprising 34 schizophrenia patients for the 1.5T dataset and 25 schizophrenia patients for the 3T dataset, along with an equal number of healthy controls. Machine learning algorithms are applied to assess data subsets, enabling an in-depth evaluation of the current functional condition concerning symptom impact. The identified voxels contribute to determining the brain regions most influenced by each symptom, as quantified by symptom intensity. This rigorous approach has yielded various new findings while maintaining an impressive classification accuracy rate of 97 %. By elucidating variations in activation patterns across multiple brain regions in individuals with schizophrenia, this study contributes to the understanding of functional brain changes associated with the disorder. The insights gained may inform differential clinical interventions and provide a means of assessing symptom severity accurately, offering new avenues for the management of schizophrenia.

Mechanisms Linking Physical Activity With Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review

INTRODUCTION

Physical activity (PA) is a promising way to improve mental health in children and adolescents with neurodevelopmental disorders (NDDs). However, the underlying mechanisms remain unclear. The current review aimed to explore the potential neurobiological, psychosocial, and behavioral mechanisms between PA interventions and mental health in children and adolescents with NDDs.

METHODS

Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC were searched from inception to June 2023. Randomized controlled trials/quasi-experimental designs applying PA interventions and reporting at least one mental health outcome and at least one potential mechanism in children and adolescents with NDDs were included. The best evidence synthesis rating system was adopted to determine the strength and consistency of potential mechanisms and was performed in 2024.

RESULTS

In total, 45 studies were included, 29 of which were randomized controlled trials and 16 were quasi-experimental, with a total of 1,751 participants. According to the best evidence synthesis rating system, neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms were the frequently examined and consistent mechanisms through which PA affected mental health in children and adolescents with NDDs. However, evidence regarding P3 latency, beta activity, and physical self-concept was insufficient.

DISCUSSION

Future PA interventions could consider neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms. Alternatively, PA can be developed as an adjunctive approach with interventions that specifically focus on these mechanisms to enhance mental health in children and adolescents with NDDs.

Clinical predictors of suicidal ideation, suicide attempts and suicide death in depressive disorder: a systematic review and meta-analysis

Patients with depressive disorders are especially prone to suicide risk. Among the clinical predictors of suicidality, those specifically related to depressive disorders have not been accurately detailed. Our aim was to conduct a systematic review and meta-analysis of studies reporting longitudinal predictors of suicidal ideation, suicide attempts and suicide death within depression, including diagnostic subtypes, symptoms, clinical course, and assessment scales. A systematic search of the literature between 2001 and 2022 identified 4422 references, among which 19 studies providing 45 different predictors of suicidality met the inclusion criteria. Random effects meta-analyses were performed for 22 predictors, three for suicidal ideation, eleven for suicide attempts and eight for suicide death. Heterogeneity and publication bias were inspected through I2 tests and Egger's tests respectively. Meta-analysis results showed that severity of hopelessness predicted suicidal ideation and suicide attempts. History of suicide attempts, suicidal ideation, severe depression, and psychotic symptoms predicted subsequent suicide attempts and suicide death. Time to full remission and sleep disturbances were also found as relevant predictors of future suicide behaviours. This review specifies which predictors of suicidality within the clinical features of depression will help clinicians and policy makers to better prevent suicide risk in patients with depressive disorders. Further longitudinal studies are needed to reliably assess the predictive ability of our results and to analyse other possible clinical predictors to prevent suicidality, especially with regard to suicidal ideation.

Social Characteristics and Adherence to Adjuvant Endocrine Therapy in Premenopausal Women With Breast Cancer

PURPOSESocial characteristics, including cohabitation/marital status and socioeconomic position (SEP)-education level, employment status, and income-influence breast cancer prognosis. We investigated the impact of these social characteristics on adherence to adjuvant endocrine therapy (AET) from treatment initiation to 5 years after diagnosis.METHODSWe assembled a nationwide, population-based cohort of premenopausal women diagnosed in Denmark with stage I-III, estrogen receptor-positive breast cancer during 2002-2011. We ascertained prediagnostic social characteristics from national registries. AET adherence was based on information from the Danish Breast Cancer Group and operationalized as (1) adherence trajectories (from group-based trajectory modeling) and (2) early discontinuation. We computed odds ratios (ORs) and associated 95% CI to estimate the association of cohabitation and SEP with AET adherence using multinomial and logistic regression models adjusted according to directed acyclic graphs.RESULTSAmong 4,353 patients, we identified three adherence trajectories-high adherence (57%), slow decline (36%), and rapid decline (6.9%). Compared with cohabiting women, those living alone had higher ORs of slow (1.26 [95% CI, 1.08 to 1.46]) or rapid decline (1.66 [95% CI, 1.27 to 2.18]) versus high adherence. The corresponding ORs for women not working versus employed women were 1.22 (95% CI, 1.02 to 1.45) and 1.76 (95% CI, 1.30 to 2.38). For early discontinuation (17%), the ORs were 1.48 (95% CI, 1.23 to 1.78) for living alone and 1.44 (95% CI, 1.17 to 1.78) for women not working.CONCLUSIONAdherence to AET was lower among women living alone or unemployed than cohabiting or employed women, respectively. These women may benefit from support programs to enhance AET adherence.

Tooth loss from the perspective of studies employing a life course approach: a systematic review

The life course approach scrutinizes factors that shape the development of diseases over time. Tooth loss, which is influenced by social, behavioral and biological factors, can occur at various stages of life and tends to become more prevalent in later years. This systematic review examined the influence of socioeconomic, psychosocial, biological and behavioral adversities in life on the likelihood of tooth loss. Searches were conducted in the Embase, PubMed, Web of Science, Ovid, PsycINFO, Scopus and LILACS databases. Reference management was performed using EndNote online. The risk of bias was appraised using the Newcastle-Ottawa Scale (NOS). The electronic searches yielded 1366 records, 17 of which (13 cohort and four cross-sectional studies) met the inclusion criteria. According to the NOS, all studies had a low risk of bias. Two studies found a link between a lower education and higher incidence of tooth loss and socioeconomic status exerted a significant influence in 47% of the studies. Disadvantaged socioeconomic trajectories and health-related factors, such as smoking, general health perception and oral health behaviors, increased the likelihood of tooth loss. Factors such as dental visits, a history of toothache and exposure to fluoridated water influenced the likelihood of tooth loss. Individuals who experienced adversities in socioeconomic, behavioral and biological aspects throughout their life course were more prone to tooth loss.

Suppressing the Maintenance of Information in Working Memory Alters Long-term Memory Traces

The sensory recruitment hypothesis conceptualizes information in working memory as being activated representations of information in long-term memory. Accordingly, changes made to an item in working memory would be expected to influence its subsequent retention. Here, we tested the hypothesis that suppressing information from working memory, which can reduce short-term access to that information, may also alter its long-term neural representation. We obtained fMRI data (n = 25; 13 female / 12 male participants) while participants completed a working memory removal task with scene images as stimuli, followed by a final surprise recognition test of the examined items. We applied a multivariate pattern analysis to the data to quantify the engagement of suppression on each trial, to track the contents of working memory during suppression, and to assess representational changes afterward. Our analysis confirms previous reports that suppression of information in working memory involves focused attention to target and remove unwanted information. Furthermore, our findings provide new evidence that even a single dose of suppression of an item in working memory can (if engaged with sufficient strength) produce lasting changes in its neural representation, particularly weakening the unique, item-specific features, which leads to forgetting. Our study sheds light on the underlying mechanisms that contribute to the suppression of unwanted thoughts and highlights the dynamic interplay between working memory and long-term memory.

Linking the neural signature of response time variability to Alzheimer's disease pathology and cognitive functioning

Promising evidence has suggested potential links between mind-wandering and Alzheimer's disease (AD). Yet, older adults with diagnosable neurocognitive disorders show reduced meta-awareness, thus questioning the validity of probe-assessed mind-wandering in older adults. In prior work, we employed response time variability as an objective, albeit indirect, marker of mind-wandering to identify patterns of functional connectivity that predicted mind-wandering. In the current study, we evaluated the association of this connectome-based, mind-wandering model with cerebral spinal fluid (CSF) p-tau/Aβ 42 ratio in 289 older adults from the Alzheimer's Disease NeuroImaging Initiative (ADNI). Moreover, we examined if this model was similarly associated with individual differences in composite measures of global cognition, episodic memory, and executive functioning. Edges from the high response time variability model were significantly associated with CSF p-tau/Aβ ratio. Furthermore, connectivity strength within edges associated with high response time variability was negatively associated with global cognition and episodic memory functioning. This study provides the first empirical support for a link between an objective neuromarker of mind-wandering and AD pathophysiology. Given the observed association between mind-wandering and cognitive functioning in older adults, interventions targeted at reducing mind-wandering, particularly before the onset of AD pathogenesis, may make a significant contribution to the prevention of AD-related cognitive decline.

Development of a family-level intervention for families with transgender and/or nonbinary youth: Lessons and recommendations

Family support plays an important role in promoting resilience and health among transgender and/or nonbinary youth (TNBY), but family members often experience barriers to supporting their TNBY, including minority-adjacent stress stemming from exposure to structural stigma and antitransgender legislation. TNBY and their families need effective family-level interventions developed using community-based participatory research (CBPR), which integrates community members (e.g., TNBY, family members, service providers for families with TNBY) into the intervention development process to ensure the resulting intervention is relevant and useful. Informed by findings from the Trans Teen and Family Narratives Project, we used CBPR to develop the Trans Teen and Family Narratives Conversation Toolkit, a family-level intervention designed to educate families about TNBY and facilitate conversations about gender. The toolkit was developed across 1.5 years (June 2019 to January 2021) using four integrated phases: (1) content development: digital storytelling workshop with TNBY; (2) content review: digital storyteller interviews and user focus groups; (3) content development: study team content synthesis and website development; and (4) content review: website review by TNBY, family members, and mental health providers, and intervention refinement. This article outlines the intervention development process, describes strategies employed to navigate challenges encountered along the way, and shares key learnings to inform future CBPR intervention development efforts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association between gut microbiota and postpartum depression: A bidirectional Mendelian randomization study

BACKGROUNDS

Empirical investigations have shown an association between gut microbiota and postpartum depression (PPD); nevertheless, the precise cause-and-effect relationship between these two variables remains ambiguous. This research aimed to examine the possible reciprocal causal relationship between the gut microbiota and PPD.

METHODS

In this work, we used Mendelian randomization (MR) to analyze the relationship between the gut microbiota (n = 18,340) and PPD (n = 67,205). We obtained the relevant SNPs from publicly accessible genome-wide association studies (GWAS). The SNP estimations were combined by the inverse-variance weighted (IVW) method, including sensitivity analyses such as weighted median, MR Egger, and MR Pleiotropy Residual Sum and Outlier (PRESSO).

RESULTS

We have identified strong correlations between six bacterial characteristics and the likelihood of developing PPD. Our research revealed that the genus Ruminococcaceae UCG010, the family Veillonellaceae, and the class Clostridia had a beneficial effect on preventing PPD. The class Alphaproteobacteria, genus Slackia, and order NB1n were found to have a significant negative impact on PPD. The sensitivity studies conducted on these bacterial features consistently confirmed these finding.

LIMITATIONS

It is crucial to acknowledge that our study was conducted just within a European society, which may restrict its applicability to other groups.

CONCLUSIONS

The findings from our MR investigation indicate a potential causal relationship between certain kinds of gut bacteria and PPD. Additional investigation is required to elucidate the influence of gut microbiota on the advancement of PPD.

Exploring the differential impacts of social isolation, loneliness, and their combination on the memory of an aging population: A 6-year longitudinal study of the CLSA

Memory plays a crucial role in cognitive health. Social isolation (SI) and loneliness (LON) are recognized risk factors for global cognition, although their combined effects on memory have been understudied in the literature. This study used three waves of data over six years from the Canadian Longitudinal Study on Aging to examine whether SI and LON are individually and jointly associated with memory in community-dwelling middle-aged and older adults (n = 14,208). LON was assessed with the question: "In the last week, how often did you feel lonely?". SI was measured using an index based on marital/cohabiting status, retirement status, social activity participation, and social network contacts. Memory was evaluated with combined z-scores from two administrations of the Rey Auditory Verbal Learning Test (immediate-recall, delayed-recall). We conducted our analyses using all available data across the three timepoints and retained participants with missing covariate data. Linear mixed models were used to regress combined memory scores onto SI and LON, adjusting for sociodemographic, health, functional ability, and lifestyle variables. Experiencing both SI and LON had the greatest inverse effect on memory (least-squares mean: -0.80 [95 % confidence-interval: -1.22, -0.39]), followed by LON alone (-0.73 [-1.13, -0.34]), then SI alone (-0.69 [-1.09, -0.29]), and lastly by being neither lonely nor isolated (-0.65 [-1.05, -0.25]). Sensitivity analyses confirmed this hierarchy of effects. Policies developed to enhance memory in middle-aged and older adults might achieve greater benefits when targeting the alleviation of both SI and LON rather than one or the other individually.

Impact of periodontal disease on cognitive disorders, dementia, and depression: a systematic review and meta-analysis

A growing body of research suggested that there was a link between poor periodontal health and systemic diseases, particularly with the early development of cognitive disorders, dementia, and depression. This is especially true in cases of changes in diet, malnutrition, loss of muscular endurance, and abnormal systemic inflammatory response. Our study aimed to determine the extent of these associations to better target the multi-level healthy aging challenge investigating the impact of periodontal disease on cognitive disorders (cognitive impairment and cognitive decline), dementia, and depression. We conducted a comprehensive literature search up to November 2023 using six different electronic databases. Two independent researchers assessed the eligibility of 7363 records against the inclusion criteria and found only 46 records that met the requirements. The study is registered on PROSPERO (CRD42023485688). We generated random effects pooled estimates and 95% confidence intervals (CI) to evaluate whether periodontal disease increased the risk of the investigated outcomes. The quality assessment revealed moderate quality of evidence and risk of bias. Periodontal disease was found to be associated with both cognitive disorders (relative risk (RR) 1.25, 95% CI 1.11-1.40, in the analysis of cross-sectional studies); cognitive impairment (RR 3.01, 95% CI 1.52-5.95 for longitudinal studies, cognitive decline); and dementia (RR 1.22, 95% CI 1.10-1.36). However, no significant increased risk of depression among subjects with periodontal disease was found (RR 1.07, 95% CI 0.95-1.21). Despite the association with two of the three explored outcomes, the available evidence on periodontal diseases and dementia, cognitive disorders, and depression is controversial due to several limitations. Therefore, further investigations involving validated and standardized tools are required.

Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years

OBJECTIVES

Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment.

METHOD

Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately.

RESULTS

Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment.

CONCLUSION

Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.

Regional gray matter changes in steatotic liver disease provide a neurobiological link to depression: A cross-sectional UK Biobank cohort study

BACKGROUND

Steatotic liver disease (SLD) is characterized by excessive accumulation of lipids in the liver. It is associated with elevated risk of hepatic and cardiometabolic diseases, as well as mental disorders such as depression. Previous studies revealed global gray matter reduction in SLD. To investigate a possible shared neurobiology with depression, we examined liver fat-related regional gray matter alterations in SLD and its most significant clinical subgroup metabolic dysfunction-associated steatotic liver disease (MASLD).

METHODS

We analyzed regional cortical thickness and area obtained from brain MRI in 29,051 participants in UK Biobank. Liver fat amount was computed as proton density fat fraction (PDFF) from liver MRI scans. We examined the relationship between brain structure and PDFF, adjusting for sociodemographic, physical, lifestyle, and environmental factors, as well as alcohol intake and a spectrum of cardiometabolic covariates. Finally, we compared patterns of brain alterations in SLD/MASLD and major depressive disorder (MDD) using previously published results.

RESULTS

PDFF-related gray matter alterations were region-specific, involving both increases and decreases in cortical thickness, and increased cortical area. In several regions, PDFF effects on gray matter could also be attributed to cardiometabolic covariates. However, PDFF was consistently associated with lower cortical thickness in middle and superior temporal regions and higher cortical thickness in pericalcarine and right frontal pole regions. PDFF-related alterations for the SLD and the MASLD group correlated with those observed in MDD (Pearson r = 0.45-0.54, p < 0.01).

CONCLUSION

These findings suggest the presence of shared biological mechanisms linking MDD to SLD and MASLD. They might explain the well-known elevated risk of depression in these groups and support early lifestyle interventions and treatment of metabolic risk factors for the successful management of the interconnected diseases depression and SLD/MASLD.

A smartphone app-based mindfulness intervention to enhance recovery from substance use disorders: Protocol for a pilot feasibility randomized controlled trial

Background

Poor long-term recovery outcomes after treatment (e.g., readmission to inpatient treatment) are common among individuals with substance use disorders (SUDs). In-person mindfulness-based treatments (MBTs) are efficacious for SUDs and may improve recovery outcomes. However, existing MBTs for SUD have limited public health reach, and thus scalable delivery methods are needed. A digitally-delivered MBT for SUDs may hold promise.

Methods

We recently developed Mindful Journey, a smartphone app-based adjunctive MBT for improving long-term recovery outcomes. In this paper, we present details on the app and describe the protocol for a single-site pilot feasibility randomized controlled trial of Mindful Journey. In this trial, individuals (n = 34) in an early phase of outpatient treatment for SUDs will be randomized to either treatment-as-usual (TAU) plus Mindful Journey, or TAU only. The trial will focus on testing the feasibility (e.g., engagement) and acceptability of the app (e.g., perceived usability and helpfulness for recovery), as well as feasibility of study procedures (e.g., assessment completion). The trial will incorporate ecological momentary assessment before and after treatment to assess mechanisms in real-time, including mindfulness, craving, difficulties with negative emotion regulation, and savoring. To examine the sensitivity to change of outcomes (substance use, substance-related problems, and psychological distress) and mechanism variables (noted above), we will test within-treatment-condition changes over time.

Discussion

The proposed pilot trial will provide important preliminary data on whether Mindful Journey is feasible and acceptable among individuals with SUDs.

Trial registration

ClinicalTrials.gov NCT05109507.

A tale of two constructs: combined assessment of demoralization and subjective incompetence

Demoralization comprises multiple dimensions. Among them, Subjective Incompetence (SI) is the perception of being incapable of appropriate action in demanding circumstances. SI may be an early sign of demoralization preceding hopelessness, thus we aimed at integrating items related to Subjective Incompetence into the clinical assessment of demoralization. We assessed 414 subjects from the general population with the Demoralization Scale, 24 items (DS24) and the Subjective Incompetence Scale, 12 items (SIS12). We used multiple approaches to detect the optimal number of factors and their item structure, then conducted Bayesian Item Response Theory analyses to study item psychometric properties. Item Response Theory models were used to extrapolate latent severity ratings of clinical dimensions. We modelled the DS24 with five factors (Disheartenment, Sense of Failure, Helplessness, Irritability, Loss of Purpose) and the SIS12 with three (Subjective Incompetence, Inability to plan, Inability to Deal). The more complex IRT model had the best predictive value and helped to identify the items with better discrimination properties across the different dimensions. Twenty items were retained and used to develop the combined Demoralization and Subjective Incompetence Scale (DSIS20), which maintained high correlation with raw and latent trait scores of the longer versions. We combined selected items of the DS24 and the SIS12 to develop the DSIS20, a shorter assessment instrument that includes Subjective Incompetence as well as other clinical dimensions of demoralization. Further study may clarify if DSIS20 may be helpful for the early detection of demoralization.

Non-standard diagnostic assessment reliability in psychiatry: a study in a Brazilian outpatient setting using Kappa

The use of Structured Diagnostic Assessments (SDAs) is a solution for unreliability in psychiatry and the gold standard for diagnosis. However, except for studies between the 50 s and 70 s, reliability without the use of Non-SDAs (NSDA) is seldom tested, especially in non-Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We aim to measure reliability between examiners with NSDAs for psychiatric disorders. We compared diagnostic agreement after clinician change, in an outpatient academic setting. We used inter-rater Kappa measuring 8 diagnostic groups: Depression (DD: F32, F33), Anxiety Related Disorders (ARD: F40-F49, F50-F59), Personality Disorders (PD: F60-F69), Bipolar Disorder (BD: F30, F31, F34.0, F38.1), Organic Mental Disorders (Org: F00-F09), Neurodevelopment Disorders (ND: F70-F99) and Schizophrenia Spectrum Disorders (SSD: F20-F29). Cohen's Kappa measured agreement between groups, and Baphkar's test assessed if any diagnostic group have a higher tendency to change after a new diagnostic assessment. We analyzed 739 reevaluation pairs, from 99 subjects who attended IPUB's outpatient clinic. Overall inter-rater Kappa was moderate, and none of the groups had a different tendency to change. NSDA evaluation was moderately reliable, but the lack of some prevalent hypothesis inside the pairs raised concerns about NSDA sensitivity to some diagnoses. Diagnostic momentum bias (that is, a tendency to keep the last diagnosis observed) may have inflated the observed agreement. This research was approved by IPUB's ethical committee, registered under the CAAE33603220.1.0000.5263, and the UTN-U1111-1260-1212.

Psychological resilience, resilient coping, and health behaviors among adults in Puerto Rico after multiple adverse events

Objective: Residents of Puerto Rico have recently experienced multiple adverse events, including hurricanes, earthquakes, and political unrest. Such adversity is associated with worse mental and physical health. Psychological resilience and effective coping may mitigate these relations by fostering positive health behaviors, like consuming a high-quality diet and being physically active. However, empirical evidence for these relationships is limited. Methods: We assessed psychological resilience, resilient coping, and health behaviors among two groups of adults in Puerto Rico, before and during the pandemic, in 2019-2023 (total N = 1,342). Resilience and resilient coping were assessed using the Brief Resilience Scale and Brief Resilient Coping Scale. Diet quality was defined by the Alternate Healthy Eating Index from a food frequency questionnaire. We collected data on sleep, physical activity, alcohol intake, and tobacco use using validated questionnaires. Results: Adjusting for confounders, higher resilience z-scores were associated with being in the highest category of diet quality [OR: 1.25, 95 % CI: 1.04, 1.50]; getting 7-8 h of sleep per night [OR: 1.15, 95 % CI: 1.02,1.30]; and reporting moderate or heavy physical activity (vs. light or sedentary) [OR: 1.17, 95 % CI: 1.02,1.34]. The same patterns were observed for higher resilient coping z-scores, and for categorical measures of resilience and resilient coping. These relationships were stronger among participants interviewed during (vs. before) the COVID-19 pandemic, suggesting that resilience and resilient coping may be particularly relevant during an ongoing stressor. Conclusion: Identifying supportive strategies to cultivate resilience and effective coping mechanisms may contribute to healthier behaviors, particularly in a vulnerable population.

Understanding the relationship between childhood emotional abuse and neglect and psychological distress in pregnant women: the role of prenatal attachment

BACKGROUND

Childhood abuse and neglect pose important risk factors for the development of psychopathology during pregnancy. However, only a few studies have assessed the effects of a specific type of abuse during the perinatal period, namely, psychological maltreatment, which includes emotional abuse and neglect. These studies have found that women who have experienced psychological maltreatment exhibit higher levels of antenatal depressive symptoms and greater difficulties forming attachment with their babies than women who have not experienced this kind of adversity. The aim of this study was to examine how emotional abuse and neglect experiences may favor the occurrence of psychological distress in pregnant women, and whether prenatal attachment might explain this association.

METHODS

Participants comprised 128 Italian pregnant women ranging in age from 21 to 46 years (Mage = 33.4; SD = 6.10). Women responded to the following self-report instruments: CECA.Q and CTQ-SF, for the assessment of psychological maltreatment experiences; MAAS, for the evaluation of prenatal attachment; and PAMA, for the assessment of perinatal psychological distress.

RESULTS

Pearson correlations revealed a positive association between childhood neglect and perinatal psychological distress and a negative association between childhood neglect and prenatal attachment scores. No significant correlations were found for emotional abuse. Perinatal psychological distress was negatively associated with prenatal attachment. Mediation analyses showed significant associations between childhood neglect and the dimensions of perinatal affectivity and prenatal maternal attachment. Prenatal maternal attachment mediated the relationship between neglect and perinatal psychological distress.

CONCLUSIONS

The transition to motherhood is a sensitive period, particularly for women who have experienced abuse and neglect during childhood. These experiences may negatively impact a woman's disposition to emotionally and behaviorally engage in the formation of a bond with their unborn baby. These results may have important prevention and clinical implications and thus warrant further exploration.

Causal effects of smoking, alcohol consumption, and coffee intake on hepatobiliary and pancreatic diseases: A Mendelian randomization study

BACKGROUND

Hepatobiliary and pancreatic diseases, such as cirrhosis, hepatocellular carcinoma, cholelithiasis, and pancreatitis, are major global health challenges. Lifestyle factors like smoking, alcohol consumption, and coffee intake are commonly studied for their health impacts. However, observational studies often face issues with confounding factors and reverse causality, making it difficult to establish causal relationships.

METHODS

This research uses Mendelian randomization (MR) to investigate the causal effects of smoking, alcohol use, and coffee intake on 10 hepatobiliary and pancreatic diseases. Genetic data from the Sequencing Consortium of Alcohol and Nicotine Use (GSCAN) and self-reported GWAS were used to derive instrumental variables (IVs). The outcomes were obtained from the FinnGen and UK Biobank cohorts. Univariable and multivariable MR analyses were conducted to assess the associations.

RESULTS

Genetic predisposition to tobacco use was associated with increased risks of acute pancreatitis, alcoholic hepatitis, chronic pancreatitis, cirrhosis, gallstones, liver cancer, and pancreatic cancer. Alcohol consumption was linked to acute pancreatitis, chronic pancreatitis, alcoholic liver disease, hepatic cancer, and cholangitis. Coffee intake showed minimal associations, with a slight protective effect against non-alcoholic steatohepatitis.

CONCLUSIONS

This study confirms the harmful effects of inhaling tobacco and consuming alcohol on hepatobiliary and pancreatic diseases. It highlights the need for public health strategies to reduce tobacco use and heavy alcohol consumption. Coffee intake showed minimal effects, suggesting further research is needed to understand its relationship with hepatobiliary health.

Who's most at risk? A person-centered approach to understanding the long-term relationship between early social media use and later depression across adolescence

INTRODUCTION

Person-centered analyses examined the relationship between social media use and depression over an 8-year period. The purpose was to examine the varying ways early social media use was associated with the development of depressive symptoms with a hypothesis that social media would not have a uniform association with depressive symptoms across adolescents.

METHODS

Participants included 488 adolescents (52% female), living in the United States, who were surveyed once a year for 8 years (beginning in 2010 when the average age for participants was 13.33 years old).

RESULTS

Longitudinal mixture regression was used to identify classes of adolescents representing unique ways their early social media use was related to the development of depressive symptoms over an 8-year period. Five classes were found representing unique ways social media use was related to depression. Findings suggest social media use does not impact all adolescents in the same way. Social media use was related to increased depression for adolescents with greater parental hostility, peer bullying, anxiety, reactivity to stressors, and lower parental media monitoring. In other instances, social media use was related to less depression or was unrelated to depression.

CONCLUSIONS

By identifying which adolescents may be most at risk from social media use, health providers, schools, and caregivers can tailor interventions to fit the needs of each adolescent.

Pixels and perception: Mapping the association between digital media and psychotic-like experiences in adolescents

INTRODUCTION

Psychotic-like experiences (PLEs) during adolescence can lead to psychotic disorders. Digital media usage has been suggested to link to PLEs, but research is limited on how different types of screen exposure may differentially relate to PLEs over time. This study aimed to examine longitudinal associations between screen usage patterns and PLEs in adolescents.

METHODS

Participants comprised 11,876 adolescents assessed annually from ages 9-12 years as part of the Adolescent Brain Cognitive Development study (ABCD). Screen usage (TV, video games, online video, social media, texting, video chat) and PLEs were assessed via self-report. Longitudinal network analysis models were estimated to examine connections between screen usage types and PLEs across three time points.

RESULTS

Two clusters were formed, including digital media for socializing (e.g., social media/texting/video chat) and digital media for entertainment (e.g., online video/video games/TV). Texting and online video(s) had the highest centrality at each time point, suggesting importance in the network. PLE symptoms of hallucinations and concentration difficulties exhibited higher centrality than other symptoms. Online video and TV were influential bridges between screen usage and PLEs. Network structure significantly differed between ages 9-10 and 10-12 years, but global strength was unchanged over time.

DISCUSSION

Results highlight the importance of understanding the associations between specific screen usage types and PLE symptoms. Texting and online video usage appear most influential in the development of adolescent PLEs over time. Findings can inform targeted interventions to promote healthy screen habits and reduce PLEs in at-risk youth.

Developmental pathways from insomnia to suicidality: A resilience perspective

BACKGROUND

Insomnia has been identified as a potential risk factor for suicidality. However, to date, few studies using the longitudinal-design have examined the underlying mechanism of this relationship. Based on a resilience perspective, this study aimed to investigate the dynamic longitudinal relationships between insomnia, resilience, and suicidality.

METHODS

A total of 5785 freshmen were sampled from a large-scale health-related cohort among Chinese college students. This study spanned six waves, covering the period from 2020 to 2022. Data from T1 to T4 were used because resilience was not measured at baseline (T0) and T5. The cross-lagged panel models and the latent growth curve mediation model were used to examine the longitudinal dynamic relationships between insomnia, resilience, and suicidality.

RESULTS

The results showed that insomnia symptoms and suicidality mutually predicted each other, and resilience played a longitudinal mediating role in linking insomnia symptoms and suicidality.

CONCLUSIONS

Given that resilience served as a mediator in the relation between insomnia symptoms and suicidality, some resilience-oriented prevention and intervention programs will be helpful in reducing the risk of suicide among university students.