Perceived Exertion and Affect From Tai Chi, Yoga, and Stretching Classes for Elderly Women

Tai Chi, yoga, and stretching regimens are gaining popularity as alternatives to more traditional exercise, but there is scant research regarding participants' perceived exertion and affective responses to these practices. We compared experienced states of perceived exertion, feelings of pleasure/displeasure, and arousal in 70 elderly women enrolled in groups of Tai Chi ( n = 26), yoga ( n = 25), or stretching ( n = 19) classes. Mean rates of perceived exertion, feelings of pleasure, and arousal responses were significantly higher over the time course of all three groups, while the overall mean perceived exertion ( Somewhat Hard on the Borg CR-10 scale) and pleasure responses (∼ Very Good on the Feeling Scale) were similar between them. The circumplex model of affect showed that changes occurred in the high-activation pleasure quadrant (energy on the Felt Arousal Scale). From a practical perspective, the exercise intensity and affective responses elicited during these classes made participants feel good and infused with energy, likely creating a positive memory and reinforcing continued physical activity participation.

The Influence of Question Wording on Interpersonal Trust

Abstract. We aimed to evaluate the impact of two question wordings, one more directive (reference, European Social Survey ) and one less directive (modified version), on self-reported trust. Using a randomly equivalent groups design, young adults ( n = 1,681) from the EPITeen cohort completed one of two questionnaires to evaluate trust. The final score ranged between 0 (lowest) and 30 (highest). Cronbach’s alphas were computed to assess reliability, and invariance tests were conducted to test the equivalence of both versions. Lower levels of interpersonal trust were attained with the reference version [ M ( SD):14.4(5.3) vs. 15.6(4.8); p < .001 and p = .005 for mean and variance comparison]. The reference version had better reliability (α = .742 vs. .686; p = .006). Strict invariance was achieved between the two formats, and similar effects of sociodemographic variables on trust were obtained, independently of the version used. The reference version presented better reliability than the modified one, supporting its ability to measure levels of trust among young adults.

Gender and survival of critically ill patients: results from the FROG-ICU study

Purpose

Few studies analyzed gender-related outcome differences of critically ill patients and found inconsistent results. This study aimed to test the independent association of gender and long-term survival of ICU patients.

Materials and methods

FROG-ICU was a prospective, observational, multi-center cohort designed to investigate the long-term mortality of critically ill adult patients. The primary endpoint of this study was 1-year mortality after ICU admission of women compared to men.

Results

The study included 2087 patients, 726 women and 1361 men. Women and men had similar baseline characteristics, clinical presentation, and disease severity. No significant difference in 1-year mortality was found between women and men (34.9% vs. 37.9%, P = 0.18). After multivariable adjustment, no difference in the hazard of death was observed [HR 0.99 (95% CI 0.77–1.28)]. Similar 1-year survival between women and men was found in a propensity score-matched patient cohort of 506 patients [HR 0.79 (95% CI 0.54–1.14)].

Conclusion

Women constituted one-third of the population of critically ill patients and were unexpectedly similar to men regarding demographic characteristics, clinical presentation, and disease severity and had similar risk of death at 1 year after ICU admission.

Trial registration ClinicalTrials.gov NCT01367093; registered on June 6, 2011.

Electronic supplementary material

The online version of this article (10.1186/s13613-019-0514-y) contains supplementary material, which is available to authorized users.

Examining the Role of Spatial Changes in Bimodal and Uni-Modal To-Be-Ignored Stimuli and How They Affect Short-Term Memory Processes

This study examines the potential vulnerability of short-term memory processes to distraction by spatial changes within to-be-ignored bimodal, vibratory, and auditory stimuli. Participants were asked to recall sequences of serially presented digits or locations of dots while being exposed to to-be-ignored stimuli. On unexpected occasions, the bimodal to-be-ignored sequence, vibratory to-be-ignored sequence, or auditory to-be-ignored sequence changed their spatial origin from one side of the body (e.g., ear and arm, arm only, ear only) to the other. It was expected that the bimodal stimuli would make the spatial change more salient compared to that of the uni-modal stimuli and that this, in turn, would yield an increase in distraction of serial short-term memory in both the verbal and spatial domains. Our results support this assumption as a disruptive effect of the spatial deviant was only observed when presented within the bimodal to-be-ignored sequence: uni-modal to-be-ignored sequences, whether vibratory: or auditory, had no impact on either verbal or spatial short-term memory. Implications for models of attention capture and the potential special attention capturing role of bimodal stimuli are discussed.

The resource group method in severe mental illness: study protocol for a randomized controlled trial and a qualitative multiple case study

BACKGROUND

The resource group method provides a structure to facilitate patients' empowerment and recovery processes, and to systematically engage significant others in treatment and care. A patient chooses members of a resource group (RG) that will work together on fulfilling patients' recovery plan. By adopting shared decision-making processes and stimulating collaboration of different support systems, a broad and continuous support of patients' chosen goals and wishes is preserved and problem solving and communication skills of the RG members are addressed.

OBJECTIVE

The objectives of this study are (1) to establish the effectiveness of the RG method in increasing empowerment in patients with severe mental illnesses (SMI) in the Netherlands; (2) to investigate the cost-effectiveness and cost utility of the RG method; and (3) to qualitatively explore its dynamics and processes.

METHODS/DESIGN

This multisite randomized controlled trial will compare the effects of the RG-method integrated in Flexible Assertive Community Treatment (FACT) (90 patients) with those of standard FACT (90 patients). Baseline assessments and 9-month and 18-month follow-up assessments will be conducted in face-to-face home visits. The primary outcome measure, empowerment, will be assessed using the Netherlands Empowerment List (NEL). The secondary outcomes will be quality of life (MANSA); personal, community and clinical recovery (I.ROC); general, social and community functioning (WHODAS 2.0); general psychopathological signs and symptoms (BSI-18); and societal costs (TiC-P). An economic evaluation of the cost-effectiveness and cost utility of the RG method will also be conducted. A qualitative multiple case-study will be added to collect patients', RG members' and professionals' perspectives by in-depth interviews, observations and focus groups.

DISCUSSION

This trial will be the first to study the effects of the RG method on empowerment in patients with SMI. By combining clinical-effectiveness data with an economic evaluation and in-depth qualitative information from primary stakeholders, it will provide a detailed overview of the RG method as a mean of improving care for patients with SMI.Trial registration The study has been registered in the Dutch Trial Register, identifier: NTR6737, September 2017.

Alcohol consumption behaviours in the immediate aftermath of earthquakes: time series study

OBJECTIVES

Earthquakes are a distressing natural phenomenon that can disrupt normal health-related behaviours. The aim of this study was to investigate changes in alcohol consumption behaviours in the immediate aftermath of mild to moderate earthquakes.

SETTING

This retrospective cohort study was conducted at a large academic hospital in Tokyo, Japan from April 2004 to March 2017.

PARTICIPANTS

We included all adult patients presenting with acute alcohol intoxication in the emergency room.

PRIMARY AND SECONDARY OUTCOME MEASURES

Our outcome was the number of such patients per 24 hours period comparing days with and without earthquake activity. We mainly focused on mild to moderate earthquakes (Shindo scale of less than 3). We conducted a simple generalised autoregressive conditional heteroscedasticity (GARCH) analysis, followed by a multivariate GARCH, including year-fixed effects and secular changes in alcohol taxation. Subanalyses were conducted by gender and age group.

RESULTS

During the study period, 706 earthquakes were observed with a median Shindo scale of 2 (IQR: 1). During this period, 6395 patients were admitted with acute ethanol intoxication; the mean age was 42.6 (SD: 16.9) years and 4592 (71.8%) patients were male. In univariate analyses, the occurrence of daytime earthquakes was marginally inversely related to the number of acutely intoxicated patients (β coefficient: -0.19, 95% CI -0.40 to 0.01). This finding remained similar in multivariate analyses after adjustment for covariates. In analyses stratified by gender, the inverse association between daytime earthquakes and alcohol intoxication was only observed among men (p<0.03 for males and p=0.99 for females). In subanalyses by age, older people were less likely to be admitted to the hospital due to acute alcohol intoxication on days with daytime earthquakes (p=0.11), but this was not the case for younger people (p=0.36).

CONCLUSION

On days when a mild to moderate daytime earthquake occurred, the number of patients with acute alcohol intoxication was lower compared with days without earthquakes. Even milder forms of potentially catastrophic events appear to influence social behaviour; mild to moderate earthquake activity is associated with the avoidance of excessive alcohol consumption.

The temporal relationship of daily life stress, emotions, and bowel symptoms in irritable bowel syndrome-Diarrhea subtype: A smartphone-based experience sampling study

BACKGROUND

The current study aimed to model the moment-to-moment relationship between daily life stress, emotions, and bowel symptoms among patients with irritable bowel syndrome-diarrhea subtype (IBS-D) in the flow of daily life using a smartphone-based experience sampling method (ESM).

METHODS

Patients with IBS-D (N = 27) and healthy controls (HC; N = 30) completed ESM ratings of their real-time daily life stress, which was defined as subjective stress related to daily activities, both positive and negative emotions, as well as bowel symptoms eight times a day for 14 consecutive days, following a baseline interview measuring bowel and mood symptoms. Moment-to-moment association between ESM variables was tested within and between groups using multilevel regression modeling.

KEY RESULTS

Patients with IBS-D reported more severe bowel symptoms and lower positive affect than HCs, but levels of daily life stress and negative affect were comparable between groups. Time-lagged analysis of ESM data revealed that, among patients with IBS-D, daily life stress predicted a decrease in abdominal pain and urgency to defecation at a subsequent time point, whereas severity of bowel symptoms and occurrence of diarrhea predicted a subsequent increase in negative affect and daily life stress. The above associations were not found among HCs.

CONCLUSIONS AND INFERENCES

ESM unveiled the dynamic relationship between bowel symptoms, stress, and emotionality. Patients with IBS-D responded to bowel symptoms with more stress and distress momentarily. Counter-intuitively, daily life activity stress appeared to ameliorate bowel symptoms, although a more rigorous study design is required to testify this claim. Psychological understanding of IBS-D is discussed.

Neural correlates of depression in women across the reproductive lifespan - An fMRI review

INTRODUCTION

Depressive disorders in women emerge largely during transitions in their reproductive aging cycle, which can be attributed to internal endocrine possesses that affect emotion-associated brain circuits. A review was performed to outline the neural basis in depression during female puberty, premenstrual dysphoric disorder (PMDD), postpartum depression disorder (PPD) and perimenopausal depression disorder.

METHODS

For this review, Web of science, Pubmed and PsychInfo databases were searched for functional brain imaging studies addressing reproductive cycle-related mood disorder. The results are summarized and discussed within a broader theoretical framework of major depression disorder (MDD) to determine how reproductive-sensitive phases contribute to affective symptoms and how they relate to the neurobiology of MDD.

RESULTS

Neural activation patterns of all depressive disorders related to female reproductive cycle, except for puberty depression, differ from these observed in MDD. While the PMDD results are widely divergent, the activation patterns in PPD show general hypoactivation in all respects.

LIMITATIONS

Systematic comparisons between the diverse depression disorders are impeded by the heterogeneous experimental protocols used on different samples, reproductive aging stages and depression types.

CONCLUSION

Given that hormonal fluctuations strongly influence the development of a reproductive cycle-related depression, it is possible that the hormonal and neural patterns are indicative of distinct mood disorder with phase specific biotypes, that only show behavioral similarities to MDD. Understanding the similarities and differences in the neural functioning of female cycle-related mood disorders evaluated against MDD might help elucidate the role of neuroendocrine involvement in development of depression in women, and potentially facilitate the search for prevention and treatment approaches for women' reproductive-related depressions.

Public beliefs and attitudes toward schizophrenia and depression in Taiwan: A nationwide survey

Beliefs about and attitudes toward mental illness may be influenced by cultural- or country-specific contexts. Through a national survey, the current study investigated beliefs and attitudes toward people with schizophrenia and depression among the general public in Taiwan. A random-digit-dialing telephone-based cross-sectional survey was administered to Taiwanese adults aged 20-64 years (n = 1600). The data were analyzed through binary logistic regressions to test for differences between these disorders in causal beliefs, stereotypes, emotional reactions, desire for social distance, and help-seeking behavior. The results revealed that respondents were more concerned with biogenetic causal explanations for people with schizophrenia than for those with depression. Significantly more respondents perceived people with schizophrenia as more likely to be unpredictable and violent toward others. A similar trend was observed for the desire for social distance. For both disorders, respondents were significantly more likely to express compassion than to express anger toward the person described in the vignette. Respondents also expressed more desire for social distance from someone like the vignette who have received psychiatric treatment. These findings provide useful directions for the implementation of optimal psychoeducation among such communities. .

An Investigation of the Psychometric Properties of the Chinese Trait Emotional Intelligence Questionnaire Short Form (Chinese TEIQue-SF)

The present study examined the psychometric properties of the Chinese version of the Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF). Analyses were performed using a sample of undergraduates (N = 585) recruited from four universities across China. Confirmatory factor analysis of the Chinese TEIQue-SF supported the one-factor structure of trait emotional intelligence. Measurement invariance analyses were conducted across the Chinese sample and a sample of Canadian undergraduate students (N = 638). Although the two samples demonstrated configural and partial metric invariance, scalar invariance was not found. Cross-cultural implications and explanations of the present findings, as well as suggestions for future research are discussed.

A systematic review of the role of vitamin D and calcium in premenstrual syndrome

Premenstrual syndrome (PMS) is a common disorder that affects millions of women of reproductive age worldwide. In recent years, there has been a focus on finding accessible, acceptable, and cost-effective therapeutic approaches with minimal side effects to treat the symptoms of PMS. This systematic review aimed to investigate the role of calcium and vitamin D in Premenstrual syndrome. The PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar databases were systematically searched for relevant articles from clinical trial, case-control, and cross-sectional studies. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used to assess the quality of the selected papers. A total of 28 eligible high-quality papers were reviewed. Low serum levels of calcium and vitamin D during the luteal phase of the menstrual cycle were found to cause or exacerbate the symptoms of PMS. Therefore, the administration of calcium and vitamin D supplements or the use of a diet rich in these two substances can restore serum levels and eliminate or reduce the symptoms of PMS. Calcium and vitamin D supplementation are recommended as an inexpensive, low-risk, acceptable, and accessible approach to eliminate or reduce the symptoms of PMS.

The Role of Talker Familiarity in Auditory Distraction

The current research employed a classic irrelevant sound effect paradigm and investigated the talker-specific content of the irrelevant speech. Specifically, we aimed to determine if the participants' familiarity with the irrelevant speech's talker affected the magnitude of the irrelevant sound effect. Experiment 1 was an exploration of talker familiarity established in a natural listening environment (i.e., a university classroom) in which we manipulated the participants' relationships with the talker. In Experiment 2, we manipulated the participants' familiarity with the talker via 4 days of controlled exposure to the target talker's audio recordings. For both Experiments 1 and 2, a robust effect of irrelevant speech was found; however, regardless of the talker manipulation, talker familiarity did not influence the size of the effect. We interpreted the results within the processing view of the auditory distraction effect and highlighted the notion that talker familiarity may be more vulnerable than once thought.

The molecular neurobiology of chronic pain-induced depression

The increasing number of individuals with comorbidities poses an urgent need to improve the management of patients with multiple co-existing diseases. Among these comorbidities, chronic pain and mood disorders, two long-lasting disabling conditions that significantly reduce the quality of life, could be cited first. The recent development of animal models accelerated the studies focusing on the underlying mechanisms of the chronic pain and depression/anxiety comorbidity. This review provides an overview of clinical and pre-clinical studies performed over the past two decades addressing the molecular aspects of the comorbid relationship of chronic pain and depression. We thus focused on the studies that investigated the molecular characteristics of the comorbid relationship between chronic pain and mood disorders, especially major depressive disorders, from the genetic and epigenetic point of view to key neuromodulators which have been shown to play an important role in this comorbidity.

Behavioural and psychiatric phenotypes in female carriers of genetic mutations associated with X-linked ichthyosis

X-linked ichthyosis (XLI) is a rare X-linked dermatological condition arising from deficiency for the enzyme steroid sulfatase (STS). STS is normally expressed in the brain, and males with XLI exhibit personality differences from males in the general population, and are at increased risk of developmental and mood disorders. As the STS gene escapes X-inactivation, female carriers of XLI-associated genetic mutations have reduced STS expression/activity relative to non-carrier females, and could manifest similar behavioural phenotypes to males with XLI. Additionally, as STS activity normally increases in female tissues towards late pregnancy and into the puerperium, carrier females could theoretically present with increased rates of postpartum psychopathology. Using a worldwide online survey comprising custom-designed demographic questionnaires and multiple validated psychological questionnaires, we collected detailed self-reported information on non-postpartum and postpartum behaviour in confirmed adult (>16yrs) female carriers of genetic mutations associated with XLI (n = 94) for statistical comparison to demographically-matched previously-published normative data from female controls (seven independent studies, 98≤n≤2562), adult males with XLI (n = 58), and to newly-obtained online survey data from a general population sample of mothers from the United Kingdom and United States of America (n = 263). The pattern of results in carrier females relative to controls was remarkably similar to that previously observed in males with XLI, with evidence for increased rates of developmental and mood disorders, and elevated levels of inattention, impulsivity, autism-related traits and general psychological distress. Carrier females exhibited a significantly elevated rate of postpartum mental health conditions (notably mild depression) relative to controls which could not be accounted for by social factors. Our data confirm the psychological profile associated with XLI-associated mutations, and suggest that female carriers may be at increased risk of psychopathology, including in the postpartum period. These findings are relevant to families affected by XLI, to clinicians involved in the care of these families, and to genetic counsellors.

Aromatic constituents from Ganoderma lucidum and their neuroprotective and anti-inflammatory activities

Five new aromatic compounds, designed as lucidumins A-D (1-4) and lucidimine E (9), along with seven known aromatic compounds (5-8, 10-12) were isolated from Ganoderma lucidum. Their structures were determined by spectroscopic method. Bioactive evaluation showed that compounds 2-4 and 6-10 displayed remarkable neuroprotective activities against corticosterone-induced PC12 cell damage, with the cell viability ranging from 69.99% to 126.00%; and compounds 1-4, 9 and 10 exhibited significant anti-inflammatory activities against LPS-induced nitric oxide (NO) production in RAW264.7 macrophages, with IC₅₀ values ranging from 4.68 to 15.49 μM. In particular, compound 10 showed remarkable neuroprotection with EC₅₀ value of 2.49 ± 0.12 μM, and potent anti-inflammation with IC₅₀ value of 4.68 ± 0.09 μM.

Neuronal underpinnings of cognitive impairment and - improvement in mood disorders

Neuropsychiatric illnesses including mood disorders are accompanied by cognitive impairment, which impairs work capacity and quality of life. However, there is a lack of treatment options that would lead to solid and lasting improvement of cognition. This is partially due to the absence of valid and reliable neurocircuitry-based biomarkers for pro-cognitive effects. This systematic review therefore examined the most consistent neural underpinnings of cognitive impairment and cognitive improvement in unipolar and bipolar disorders. We identified 100 studies of the neuronal underpinnings of working memory and executive skills, learning and memory, attention, and implicit learning and 9 studies of the neuronal basis for cognitive improvements. Impairments across several cognitive domains were consistently accompanied by abnormal activity in dorsal prefrontal (PFC) cognitive control regions-with the direction of this activity depending on patients' performance levels-and failure to suppress default mode network (DMN) activity. Candidate cognition treatments seemed to enhance task-related dorsal PFC and temporo-parietal activity when performance increases were observed, and to reduce their activity when performance levels were unchanged. These treatments also attenuated DMN hyper-activity. In contrast, nonspecific cognitive improvement following symptom reduction was typically accompanied by decreased limbic reactivity and reversal of pre-treatment fronto-parietal hyper-activity. Together, the findings highlight some common neural correlates of cognitive impairments and cognitive improvements. Based on this evidence, studies are warranted to examine the reliability and predictive validity of target engagement in the identified neurocircuitries as a biomarker model of pro-cognitive effects.

Neural bases underlying the association between balanced time perspective and trait anxiety

The aims of present study were to investigate the association between balanced time perspective (BTP) and trait anxiety, and the neural substrates underlying this association using voxel-based morphometry (VBM) and resting-state functional connectivity (RSFC) methods. 140 college students (83 females) ranging in age from 17 to 25 years were assessed on deviation from the balanced time perspective (DBTP) and trait anxiety. Behavioral analyses found BTP could significantly predict trait anxiety after controlling age and gender. Whole-brain VBM analyses found that DBTP was positively correlated with gray matter volume (GMV) in the parahippocampal gyrus (PHG) and precuneus, while trait anxiety positively correlated with GMV in the PHG. Considering the overlapping region in the PHG, we further defined the overlapping region as the seed, and calculated seed-to-voxel-based functional connectivity in resting-state. RSFC results showed that DBTP was positively associated with the RSFC between the PHG and medial prefrontal cortex (mPFC), posterior cingulate cortex (PCC), and precuneus, whereas negatively correlated with the RSFC between the PHG and cuneus. Trait anxiety was also positively correlated with the RSFC between the PHG and PCC while negatively correlated with the RSFC between the PHG and cuneus. Mediation analysis further found GMV in the overlapping PHG and PHG-PCC, PHG-cuneus functional connectivity played significantly mediating roles in the relation between DBTP and trait anxiety. In sum, our research suggests the structural features of the PHG and its connectivity with PCC and cuneus may be the neural bases underlying the association between BTP and trait anxiety.

What’s in a smile? A review of the benefits of the clinician’s smile

For millennia, the smile has been recognised as a powerful communication device, offering benefits to both giver and receiver with few drawbacks. A sign of compassion, empathy and friendliness, smiling can benefit healthcare professionals and their patients, helping to build a relationship of trust. But beware the false smile, which is all too easily identified and may do more harm than good. In this review, we explore the literature surrounding smiling in healthcare and beyond, discussing the many reasons to be cheerful, from good health to a happy marriage, among aviators, table waiters, doctors, dentists and even dogs.

Adults' facial reaction to affective facial expressions of children and adults

Facial mimicry, the unconscious imitation of others' affective facial expressions, serves as an important basis for interpersonal communication. Although there are many studies dealing with this phenomenon regarding the interaction between adults, only few experiments have explored facial mimicry in response to affective facial expressions of children. In the following study affect-prototypical video clips of children's and adults' faces were presented to 44 adults while the activity of corrugator supercilii and zygomaticus muscles was electromyographically measured. A discrete mimic reaction was detected in response to each basic affect (fear, disgust, happiness, sadness, surprise and anger). The activity of corrugator supercilii muscle was significantly lower when affective facial expressions of children were presented in contrast to those of adults. In addition, negative correlations between alexithymia and the averaged facial EMG activity were detected.

Returning to the present moment: Thinking about one's childhood increases focus on the hedonistic present

Children seem to live more in the present moment than adults. But is it possible to make the present time perspective more available among adults? Four experiments demonstrated that activating childhood selves can lead adults to be more embedded in the hedonistic present. Studies 1 and 2 showed that recalling memories from childhood, either in an open-ended or a structured form, increased participants' focus on the hedonistic present. Study 3 showed that this effect also occurred after an implicit childhood manipulation. Study 4 revealed that taking the perspective of a child significantly increased orientation to the hedonistic present, compared to taking the perspective of an adult. The effects of activation of childhood selves were not mediated by mood, nostalgia, impatience, concentration, difficulty of the task, enjoyment connected with the task, or involvement in the task. Evaluation of one's childhood and tendency to relive childhood memories did not affect the results.

Understanding the public's profile of mental health literacy in China: a nationwide study

BACKGROUND

In the wake of China's massive economic development, attention has only recently turned to the enormous treatment gap that exists for mental health problems. Our study is the first comprehensive, national examination of the levels and correlates of the public's ability to recognize mental illness in the community and suggest sources of help, setting a baseline to assess contemporary Chinese efforts.

METHODS

Data were collected in China as part of the Stigma in Global Context - Mental Health Study (SGC-MHS) through face-to-face interviews using vignettes meeting clinical criteria for schizophrenia and major depression. Our analysis targets the Han Chinese participants (n = 1812). Differences in the recognition of mental health problems were assessed using a chi-square test and further stratified by vignette illness type and urban vs. rural residence. Adjusted regression models estimated the effects of each predictor towards the endorsement three types of help-seeking: medical doctor, psychiatrist, and mental health professional.

RESULTS

As expected, recognition of mental health problems is low; it is better for depression and most accurate in urban areas. Perceived severity increases endorsement of the need for care and for treatment by all provider types. Recognition of a mental health problem specifically decreases endorsement of medical doctors while increasing recommendations for psychiatrists and mental health professionals. Neurobiological attributions decrease recommendations for mental health professionals as opposed to general or specialty physicians.

CONCLUSIONS

Continued efforts are needed in China to promote mental illness recognition within rural areas, and of schizophrenia specifically. Promoting recognition of mental illness, while balancing the special challenges among individuals who understand the neurobiological roots of mental illness, may constitute a key strategy to reduce the sizeable mental health treatment gap in China.

Cultural adaptations of CBT for the British Jewish Orthodox community

There is a national drive to increase access to psychological therapies across England, with a specific focus on under-represented groups such as Black, Asian Minority and Ethnic (BAME) groups. Although prevalence rates for common mental health conditions such as depression and anxiety in Orthodox British Jews are less than those of the generic population in the United Kingdom, accessing services to help treat these conditions within this group are considerably less than other groups. This paper seeks to consider reasons for this, as well as what adaptations, both from a therapist and service perspective, can be made to increase access within the Orthodox Jewish community with lessons to be made to other BAME groups.

Positive Affect and Health: What Do We Know and Where Next Should We Go?

Positive affect (PA) is associated with better health across a wide range of physical health outcomes. This review reflects on why the study of PA is an essential component of our understanding of physical health and expands on pathways that connect these two variables. To encourage forward movement in this burgeoning research area, measurement and design issues in the study of PA and health are discussed, as are the connections between PA and a range of different health outcomes. Plausible biological, social, and behavioral pathways that allow for positive feelings to get under the skin and influence physical wellness are detailed and framed in the context of several theoretical models. Finally, new directions for the field and important methodological and interpretative considerations that are essential to moving this important research area forward are explored.

Multilevel Interactions of Stress and Circadian System: Implications for Traumatic Stress

The dramatic fluctuations in energy demands by the rhythmic succession of night and day on our planet has prompted a geophysical evolutionary need for biological temporal organization across phylogeny. The intrinsic circadian timing system (CS) represents a highly conserved and sophisticated internal "clock," adjusted to the 24-h rotation period of the earth, enabling a nyctohemeral coordination of numerous physiologic processes, from gene expression to behavior. The human CS is tightly and bidirectionally interconnected to the stress system (SS). Both systems are fundamental for survival and regulate each other's activity in order to prepare the organism for the anticipated cyclic challenges. Thereby, the understanding of the temporal relationship between stressors and stress responses is critical for the comprehension of the molecular basis of physiology and pathogenesis of disease. A critical loss of the harmonious timed order at different organizational levels may affect the fundamental properties of neuroendocrine, immune, and autonomic systems, leading to a breakdown of biobehavioral adaptative mechanisms with increased stress sensitivity and vulnerability. In this review, following an overview of the functional components of the SS and CS, we present their multilevel interactions and discuss how traumatic stress can alter the interplay between the two systems. Circadian dysregulation after traumatic stress exposure may represent a core feature of trauma-related disorders mediating enduring neurobiological correlates of trauma through maladaptive stress regulation. Understanding the mechanisms susceptible to circadian dysregulation and their role in stress-related disorders could provide new insights into disease mechanisms, advancing psychochronobiological treatment possibilities and preventive strategies in stress-exposed populations.

Psychosocial factors mediating the relationship between childhood emotional trauma and internet gaming disorder: a pilot study

Internet gaming disorder (IGD) has been related to a wide range of detrimental psychological and health consequences. The purpose of the present pilot study was to test the direct and indirect relationships between IGD and emotional trauma, body image dissatisfaction, social anxiety, loneliness, depression, and self-esteem. A total of 242 online gamers completed a survey comprising a comprehensive battery of psychometric self-report scales concerning aforementioned variables. Results indicated that IGD was significantly correlated with all the variables except for body image dissatisfaction. Path analysis indicated an indirect relationship between childhood emotional trauma and IGD through depressive symptoms, while adjusting for gender, age, and number of hours gaming. The findings of the present study indicate that online gamers with a history of emotional abuse and/or neglect have higher levels of depressive symptoms, and that depressive symptoms are important risk factors of IGD.

Category-bounded emotional enhancement: spillover effects in the valuation of public goods

We examined whether enhancing (vs. not enhancing) the emotionality of a referent public good influences the subsequent valuation of a target public good. We predicted that it would and that the directionality of its impact would depend on a fundamental cognitive process - categorisation. If the target and referent goods belong to the same domain, we expected that the effect on the target would be in the same direction as the emotional enhancement of the referent (assimilation effect). However, if the target and referent goods belong to different domains, we expected that the effect on the target would be either negligible or in the opposite direction to that of the emotional enhancement of the referent (null or contrast effect). In Experiment 1 we examined the impact of emotionally enhancing a referent public good on feelings towards a target public good, whereas in Experiment 2 on the willingness to contribute towards a target public good. The results support the predicted interaction, which was driven by an assimilation effect for same-domain goods and a null effect for different-domain goods. In doing so, the present findings highlight the interplay between cognition and emotion in the valuation of public goods. We discuss theoretical and practical implications.

Implementing Measurement-Based Care in Behavioral Health: A Review

IMPORTANCE

Measurement-based care (MBC) is the systematic evaluation of patient symptoms before or during an encounter to inform behavioral health treatment. Despite MBC's demonstrated ability to enhance usual care by expediting improvements and rapidly detecting patients whose health would otherwise deteriorate, it is underused, with typically less than 20% of behavioral health practitioners integrating it into their practice. This narrative review addresses definitional issues, offers a concrete and evaluable operationalization of MBC fidelity, and summarizes the evidence base and utility of MBC. It also synthesizes the extant literature's characterization of barriers to and strategies for supporting MBC implementation, sustainment, and scale-up.

OBSERVATIONS

Barriers to implementing MBC occur at multiple levels: patient (eg, concerns about confidentiality breach), practitioner (eg, beliefs that measures are no better than clinical judgment), organization (eg, no resources for training), and system (eg, competing requirements). Implementation science-the study of methods to integrate evidence-based practices such as MBC into routine care-offers strategies to address barriers. These strategies include using measurement feedback systems, leveraging local champions, forming learning collaboratives, training leadership, improving expert consultation with clinical staff, and generating incentives.

CONCLUSIONS AND RELEVANCE

This narrative review, informed by implementation science, offers a 10-point research agenda to improve the integration of MBC into clinical practice: (1) harmonize terminology and specify MBC's core components; (2) develop criterion standard methods for monitoring fidelity and reporting quality of implementation; (3) develop algorithms for MBC to guide psychotherapy; (4) test putative mechanisms of change, particularly for psychotherapy; (5) develop brief and psychometrically strong measures for use in combination; (6) assess the critical timing of administration needed to optimize patient outcomes; (7) streamline measurement feedback systems to include only key ingredients and enhance electronic health record interoperability; (8) identify discrete strategies to support implementation; (9) make evidence-based policy decisions; and (10) align reimbursement structures.

Temporal and spectral profiles of conflict processing among multiple frames of reference

Individuals rely on various frames of reference (FORs), such as an egocentric FOR (EFOR) and intrinsic FOR (IFOR), to represent spatial information. Previous behavioral studies have shown different IFOR-IFOR (II) and EFOR-IFOR (EI) conflict effects and an effect of their interaction. However, the neural mechanism of conflict processing between two FOR-based conflicts is unclear. In the current ERP study, two FOR-based conflicts were manipulated using a two-cannon task to elucidate common and distinct brain mechanisms that underlie FOR-based conflict processing. The behavioral results showed that both conflicts exhibited longer reaction times and larger error rates in the II (180° cannon angle) and EI (target cannon pointed down) incongruent conditions than in the II (0° cannon angle) and EI (target cannon pointed up) congruent conditions and that an interaction existed between the two conflicts. The ERP results indicated that, for both conflicts, more negative N2 amplitudes and less positive P3 amplitudes occurred in the incongruent conditions than in the congruent conditions, and the interactions between the two conflicts during later P3 amplitudes were significant. Time-frequency analysis further indicated that, in the early time window, the II conflict and the EI conflict specifically modulated power in the theta bands and beta bands, respectively. In contrast, in the later time window, both conflicts modulated power in the alpha and beta bands. In summary, our findings provide insights into the potential existence of two specific early conflict monitoring systems and a general late executive control system for FOR-based conflicts.

Numerical Processing Impairment in 22q11.2 (LCR22-4 to LCR22-5) Microdeletion: A Cognitive-Neuropsychological Case Study

Although progress has been made, the cognitive, biological and, particularly, the genetic underpinnings of math learning difficulties (MD) remain largely unknown. This difficulty stems from the heterogeneity of MD and from the large contribution of environmental factors to its etiology. Understanding endophenotypes, e.g., the role of the Approximate Number System (ANS), may help understanding the nature of MD. MD associated with ANS impairments has been described in some genetic conditions, e.g., 22q11.2 deletion syndrome (22q11.2DS or Velocardiofacial syndrome, VCFS). Recently, a girl with MD was identified in a school population screening. She has a new syndrome resulting from a microdeletion in 22q11.2 (LCR22-4 to LCR22-5), a region adjacent to but not overlapping with region 22q11.2 (LCR22-2 to LCR22-4), typically deleted in VCFS. Here, we describe her cognitive-neuropsychological and numerical-cognitive profiles. The girl was assessed twice, at 8 and 11 years. Her numerical-cognitive performance at both times was compared to demographically similar girls with normal intelligence in a single-case, quasi-experimental study. Neuropsychological assessment was normal, except for relatively minor impairments in executive functions. She presented severe and persistent difficulties in the simplest single-digit calculations. Difficulties in commutative operations improved from the first to the second assessment. Difficulties in subtraction persisted and were severe. No difficulties were observed in Arabic number writing. Difficulties in single-digit calculation co-occurred with basic numerical processing impairments in symbolic and non-symbolic (single-digit comparison, dot sets size comparison and estimation) tasks. Her difficulties suggest ANS impairment. No difficulties were detected in visuospatial/visuoconstructional and in phonological processing tasks. The main contributions of the present study are: (a) this is the first characterization of the neuropsychological phenotype in 22q11.2DS (LCR22-4 to LCR22.5) with normal intelligence; (b) mild forms of specific genetic conditions contribute to persistent MD in otherwise typical persons; (c) heterogeneity of neurogenetic underpinnings of MD is suggested by poor performance in non-symbolic numerical processing, dissociated from visuospatial/visuoconstructional and phonological impairments; (d) similar to what happens in 22q11.2DS (LCR22-2 to LCR22-4), ANS impairments may also characterize 22q11.2DS (LCR22-4 to LCR22-5).

Dynamic Modulation of Mouse Locus Coeruleus Neurons by Vasopressin 1a and 1b Receptors

The locus coeruleus (LC) is a brainstem nucleus distinguished by its supply of noradrenaline throughout the central nervous system. Apart from modulating a range of brain functions, such as arousal, cognition and the stress response, LC neuronal excitability also corresponds to the activity of various peripheral systems, such as pelvic viscera and the cardiovascular system. Neurochemically diverse inputs set the tone for LC neuronal activity, which in turn modulates these adaptive physiological and behavioral responses essential for survival. One such LC afferent system which is poorly understood contains the neurohormone arginine-vasopressin (AVP). Here we provide the first demonstration of the molecular and functional characteristics of the LC-AVP system, by characterizing its receptor-specific modulation of identified LC neurons and plasticity in response to stress. High resolution confocal microscopy revealed that immunoreactivity for the AVP receptor 1b (V1b) was located on plasma membranes of noradrenergic and non-noradrenergic LC neurons. In contrast, immunoreactivity for the V1a receptor was exclusively located on LC noradrenergic neurons. No specific signal, either at the mRNA or protein level, was detected for the V2 receptor in the LC. Clusters immunoreactive for V1a-b were located in proximity to profiles immunoreactive for GABAergic and glutamatergic synaptic marker proteins. AVP immunopositive varicosities were also located adjacent to labeling for such synaptic markers. Whole-cell patch clamp electrophysiology revealed that the pharmacological activation of V1b receptors significantly increased the spontaneous activity of 45% (9/20) of recorded noradrenergic neurons, with the remaining 55% (11/20) of cells exhibiting a significant decrease in their basal firing patterns. Blockade of V1a and V1b receptors on their own significantly altered LC neuronal excitability in a similar heterogeneous manner, demonstrating that endogenous AVP sets the basal LC neuronal firing rates. Finally, exposing animals to acute stress increased V1b, but not V1a receptor expression, whilst decreasing AVP immunoreactivity. This study reveals the AVP-V1a-b system as a considerable component of the LC molecular architecture and regulator of LC activity. Since AVP primarily functions as a regulator of homeostasis, the data suggest a novel pathway by modulating the functioning of a brain region that is integral to mediating adaptive responses.

Masked ambiguity - Emotion identification in schizophrenia and major depressive disorder

Both patients with schizophrenia and with a major depressive disorder (MDD) display deficits in identifying facial expressions of emotion during acute phases of their illness. However, specific deficit patterns have not yet been reliably demonstrated. Tasks that employ emotionally ambiguous stimuli have recently shown distinct deficit patterns in patients with schizophrenia compared to other mental disorders as well as healthy controls. We here investigate whether a task which uses an ambiguous Japanese (Noh) mask and a corresponding human stimulus generates distinctive emotion attribution patterns in thirty-two Caucasian patients with schizophrenia, matched MDD patients and healthy controls. Results show that patients with schizophrenia displayed reaction time disadvantages compared to healthy controls while identifying sadness and anger. MDD patients were more likely to label stimuli with basic compared to subtle emotional expressions. Moreover, they showed more difficulties assigning emotions to the human stimulus than to the Noh mask. IQ, age and cognitive functioning did not modulate these results. Because overall group differences were not observed, this task is not suitable for diagnosing patients. However, the subtle differences that did emerge might give therapists handles that can be used in therapy.