On the specificity of positive emotional dysfunction in psychopathology: evidence from the mood and anxiety disorders and schizophrenia/schizotypy

Implementation Study of "Building Resilience," Including Positive Psychology Interventions and Positive Emotion Regulation Training in Patients With Severe Mental Illness in an Adult Outpatient Psychiatric Mental Health Setting: An Exploratory Clinical Trial

Deficits in positive emotion regulation skills may be an important factor in the development and maintenance of anxiety and mood disorders. A treatment, which includes strategies to build and strengthen positive emotion regulation skills has been provided to patients primarily diagnosed with an anxiety and or mood disorder in an adult mental health outpatient service setting. To study the effects on positive and negative emotion, emotion regulation skills, emotional disorder symptoms, quality of life, and wellbeing during a new developed treatment. An exploratory clinical trial was used to conduct a preliminary assessment of a novel intervention. The intervention was provided in a group format over a 6-week period and independent practice over an 8-week period. Outcome variables were assessed pre- and post-treatment and at a 2-month follow up. Life quality, subjective wellbeing ratings, depressive and anxiety symptoms improved at follow up. The data suggests that the intervention may have the potential to produce desired change in positive emotion regulation. Preliminary findings suggest the intervention can have beneficial effects. These findings are promising and support the possibility that disturbances in positive emotion regulation may be a generative target for treatment research.

Social Motivation Differentiates Social Anxiety and Depression: A Daily Diary Study

Because social anxiety and depression commonly co-occur, it can be challenging to disentangle the emotional and motivational features of these conditions in everyday life contexts. In this daily diary study, we sought to understand the interplay between daily social anxiety and depression symptoms and emotion and motivation, determining whether daily symptoms are independently linked with positive affect, negative affect, and social motivation (desire to approach or to withdraw from others). Community-dwelling adults (N = 269) with a wide range of social anxiety and depression symptoms completed daily assessments for 14 consecutive days (a total of 2,986 daily surveys). Within-person analyses found that increases in social anxiety and depression symptoms were uniquely associated with elevated negative affect; only increases in depression symptoms were associated with diminished positive affect. Increases in social anxiety symptoms were associated with an elevated desire to approach others but not a desire to withdraw from others. By contrast, increases in depression symptoms were associated with a diminished desire to approach others and an elevated desire to withdraw from others. Desire for social connection may distinguish social anxiety from depression. Examining patterns of daily social motivation may enhance clinicians' ability to differentiate the difficulties that arise from social anxiety from those that arise from depression.

Depressive symptoms and their correlates among predoctoral dental students in the United States

OBJECTIVE

To investigate the prevalence of self-reported depressive symptoms among predoctoral dental students in the United States and examine potential correlates.

METHODS

A survey was emailed to all 66 dental schools in the United States, inviting them to distribute it to their predoctoral students. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Data collection occurred from February to April 2020. Multivariable ordinal logistic regression was used to assess associations between demographic variables and depressive symptom severity category, adjusting for potential confounding.

RESULTS

Of an estimated 25,000 predoctoral dental students at the 66 schools, 631 students from 21 schools completed the survey. A total of 24.1% were categorized as having minimal or no depressive symptoms, 33.6% as having mild depressive symptoms, and 42.3% as having moderate, moderately severe, or severe depressive symptoms. Gender (p = 0.015) and race/ethnicity (p = 0.002) were significant predictors of severity, adjusting for other variables. Students identifying as female had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as male. Students identifying as African American/Black (non-Hispanic) and Asian/Pacific Islander had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as White.

CONCLUSION

There is evidence of a high prevalence of depressive symptoms among predoctoral dental students in the United States. Demographic variables may be risk indicators within this population. Approaches to reduce depressive symptoms among US predoctoral dental students are needed.

An in vivo Dissection, and Analysis of Socio-Affective Symptoms related to Cerebellum-Midbrain Reward Circuitry in Humans

Emerging research in non-human animals implicates cerebellar projections to the ventral tegmental area (VTA) in appetitive behaviors, but these circuits have not been characterized in humans. Here, we mapped cerebello-VTA white-matter connectivity in humans using probabilistic tractography on diffusion imaging data from the Human Connectome Project. We uncovered the topographical organization of these connections by separately tracking from parcels of cerebellar lobule VI, crus I/II, vermis, paravermis, and cerebrocerebellum. Results revealed that connections from the cerebellum to the VTA predominantly originate in the right hemisphere, interposed nucleus, and paravermal cortex, and terminate mostly ipsilaterally. Paravermal crus I sends the most connections to the VTA compared to other lobules. We discovered a medial-to-lateral gradient of connectivity, such that the medial cerebellum has the highest connectivity with the VTA. Individual differences in microstructure were associated with measures of negative affect and social functioning. By splitting the tracts into quarters, we found that the socio-affective effects were driven by the third quarter of the tract, corresponding to the point at which the fibers leave the deep nuclei. Taken together, we produced detailed maps of cerebello-VTA structural connectivity for the first time in humans and established their relevance for trait differences in socio-affective regulation.

Exploring phenotypic overlap across schizotypy and autism spectrum conditions in American and Chinese young adults

Competing theories have been proposed to explain the considerable overlap in social-cognitive features and risk factors across schizotypy and autism spectrum conditions (ASCs). Six previous factor analyses have been reported in the literature, yet all have major limitations; evidence for the clear superiority of any of the competing theories is insufficient and warrants further investigation. The primary aim of the present research was to identify dimensions that cut across schizotypy and ASCs while addressing limitations of past research. Data were collected from three independent samples (n = 1006, 544, and 2469) in the U.S. and China using the Autism-Spectrum Quotient, the Schizotypal Personality Questionnaire, and the Wisconsin Schizotypy Scales. Exploratory factor analyses in Sample 1 identified an interpretable three-factor structure, which was replicated in Samples 2 and 3 using confirmatory factor analyses. We found consistent evidence for three dimensions (Aberrant Salience, Asociality, and Concrete Thinking) underlying schizotypy and ASCs. This three-dimension model is consistent with a common vulnerability model of schizotypy and ASCs. Implications of these findings for the schizotypy and ASCs literature are discussed.

Factors that contributed to Ontario adults' mental health during the first 16 months of the COVID-19 pandemic: a decision tree analysis

The COVID-19 pandemic has negatively impacted the mental health of individuals globally. However, less is known about the characteristics that contributed to some people having mental health problems during the pandemic, while others did not. Mental health problems can be understood on a continuum, ranging from acute (e.g., depression following a stressful event) to severe (e.g., chronic conditions that disrupt everyday functioning). Therefore, the purpose of this article was to generate profiles of adults who were more or less at risk for the development of mental health problems, in general, during the first 16-months of the COVID-19 pandemic in Ontario, Canada. Data were collected via online surveys at two time points: April-July 2020 and July-August 2021; 2,188 adults (Mage = 43.15 years; SD = 8.82) participated. Surveys included a demographic questionnaire and four previously validated tools to measure participants' mental health, subjective wellbeing, physical activity and sedentary behaviour, and sleep. A decision tree was generated at each time point for those with mental health problems, and those with no mental health problems. Results showed that subjective wellbeing was the biggest contributor to mental health status. Characteristics associated with no mental health problems among adults included having good wellbeing, being a good sleeper (quantity, quality, and patterns of sleep), and being over the age of 42. Characteristics associated with mental health problems included having poor wellbeing and being a poor sleeper. Findings revealed that specific characteristics interacted to contribute to adults' mental health status during the first 16 months of the COVID-19 pandemic. Given that wellbeing was the biggest contributor to mental health, researchers should focus on targeting adults' wellbeing to improve their mental health during future health crises.

Positive and negative affect change following psychotherapeutic treatment for anxiety-related disorders: A systematic review and meta-analysis

BACKGROUND

Anxiety-related disorders feature elevated negative affect (NA), and in some cases, diminished positive affect (PA). It remains unclear how well extant psychotherapies for anxiety-related disorders improve PA versus NA.

METHODS

We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, PsychInfo, and Web of Science databases. Records included studies involving (1) patients with a principal or co-principal diagnosis of at least one anxiety-related disorder (i.e., generalized anxiety, social anxiety, panic, agoraphobia, health anxiety, specific phobia, obsessive-compulsive disorder, or posttraumatic stress disorder), and (2) pre- and post-treatment PA and NA scores or a change index between pre- and post-treatment PA and NA scores. Effect sizes were calculated for meta-analyses.

RESULTS

Fourteen studies with 1001 adults with an anxiety-related disorder were included. Psychotherapeutic interventions included cognitive behavioral, present-centered, and imagery-based approaches. Treatments reduced NA (g = -0.90; 95%CI [-1.19, -0.61]) to a greater extent than they improved PA (g = 0.27; 95%CI [0.05, 0.59]), Z = -5.26, p < .001. The limited number of studies available precluded analyses of the relationship between changes in affect and symptoms.

LIMITATIONS

Results should be considered with caution given the small number and heterogeneity of included studies.

CONCLUSIONS

Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels.

If it Ain't Broke, Don't Fix it: Positive Versus Negative Emotion Regulation in Daily Life and Depressive Symptoms

BACKGROUND

Despite the importance of positive emotions for affective psychopathology, prior research primarily focused on negative emotion regulation. To address this gap, this ecological momentary assessment study compared a broad set of emotion regulation strategies in the context of positive versus negative emotions regarding their effectiveness and associations with depressive symptoms.

METHODS

We analyzed data from 1066 participants who were notified five times daily for seven consecutive days to complete a smartphone survey assessing their predominant emotions, strategies to regulate them, and subsequent emotional outcomes.

RESULTS

Findings show that the effectiveness of most regulation strategies depended on whether the emotional context was positive or negative. While acceptance and savoring predicted improved emotional outcomes across emotional contexts, reappraisal and problem-solving were associated with deteriorated emotional outcomes and increased depressive symptoms when regulating positive but not negative emotions.

LIMITATIONS

Future studies should replicate our findings in demographically and culturally diverse clinical samples to improve generalizability.

CONCLUSION

These results emphasize that strategies effective for regulating negative emotions may be less helpful in the context of positive emotions. Thus, context-specific interventions may be a promising approach to improve the treatment of affective disorders.

Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review

The purposes of this brief integrative review are to identify and critically evaluate recent work in the area of Dialectical Behavior Therapy-Skills Group (DBT-SG) for Social Anxiety Disorder (SAD) with suicidal ideation (SI) and to suggest further how DBT-based skills may be applied to cognitive maintenance factors of SAD. Accordingly, we first evaluate the relevance of DBT in treating SI in other disorders. Second, we evaluate the relationship between SI and SAD, providing considerations for the complexity of comorbid disorders and presentations. Finally, we extend this knowledge to discuss considerations for the use of DBT-SG skills to target specific etiological and maintenance elements of SAD, with a focus on four themes (interpersonal effectiveness, mindfulness, emotion regulation, and distress tolerance). Overall, we conclude that DBT-SG may prove beneficial in reducing SI and symptoms in SAD that impact social and emotional functioning.

The dimensional structure of internalizing psychopathology: Relation to diagnostic categories

Recent approaches aim to represent the dimensional structure of psychopathology, but relatively little research has rigorously tested sub-dimensions within internalizing psychopathology. This study tests pre-registered models of the dimensional structure of internalizing psychopathology, and their relations with current and lifetime depressive and anxiety disorders diagnostic data, in adult samples harmonized across three sites (n=427). Across S-1 bifactor and hierarchical models, we found converging evidence for both general and specific internalizing dimensions. Depression, generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic attacks were all associated with a general internalizing factor that we posit primarily represents motivational anhedonia. GAD was also associated with a specific anxious apprehension factor, and SAD with specific anxious apprehension and low positive affect factors. We suggest that dimensional approaches capturing shared and specific internalizing symptom facets more accurately describe the structure of internalizing psychopathology and provide useful alternatives to categorical diagnoses to advance clinical science.

Event-related potentials during the ultimatum game in people with symptoms of depression and/or social anxiety

Depression and social anxiety are common disorders that have a profound impact on social functioning. The need for studying the neural substrates of social interactions in mental disorders using interactive tasks has been emphasized. The field of neuroeconomics, which combines neuroscience techniques and behavioral economics multiplayer tasks such as the Ultimatum Game (UG), can contribute in this direction. We assessed emotions, behavior, and Event-Related Potentials in participants with depression and/or social anxiety symptoms (MD/SA, n = 63, 57 females) and healthy controls (n = 72, 67 females), while they played the UG. In this task, participants received fair, mid-value, and unfair offers from other players. Mixed linear models were implemented to assess trial level changes in neural activity. The MD/SA group reported higher levels of sadness in response to mid-value and unfair offers compared to controls. In controls, the Medial Frontal Negativity associated with fair offers increased over time, while this dynamic was not observed in the MD/SA group. The MD/SA group showed a decreased P3/LPP in all offers, compared to controls. These results indicate an enhanced negative emotional response to unfairness in the MD/SA group. Neural results reveal a blunted response over time to positive social stimuli in the MD/SA group. Moreover, between-group differences in P3/LPP may relate to a reduced saliency of offers and/or to a reduced availability of resources for processing incoming stimuli in the MD/SA group. Findings may shed light into the neural substrates of social difficulties in these disorders.

Positive affect improves a transdiagnostic model of perinatal depression symptoms

INTRODUCTION

Accurate measurement of perinatal depression is vital. We aimed to 1) test whether a factor that measured positive affect (PA) bettered a transdiagnostic model of depression symptoms and 2) replicate the model in a second sample.

METHODS

We conducted secondary analyses from two samples (n's = 657 and 142) of women in treatment at perinatal psychiatric clinics. Data were derived from items from seven commonly used measures. We compared fit indices from our original factor model-one general and six specific factors derived from the Research Domain Criteria (Loss, Potential Threat, Frustrative Nonreward, and Sleep-Wakefulness) and depression literatures (Somatic and Coping)-to our novel factor model with a PA factor. The PA factor was created by recategorizing items that measured affective states with a positive valence into a new factor. Sample 1 data were split into six perinatal periods.

RESULTS

In both samples, the addition of a PA factor improved model fit. At least partial metric invariance was found between perinatal periods, with the exception of trimester 3 - postpartum period 1.

LIMITATIONS

Our measures did not operationalize PA in the same way as in the positive valence system in RDoC and we were unable to perform longitudinal analyses on our cross-validation sample.

CONCLUSIONS

Clinicians and researchers are encouraged to consider these findings as a template for understanding symptoms of depression in perinatal patients, which can be used to guide treatment planning and the development of more effective screening, prevention, and intervention tools to prevent deleterious outcomes.

The mediating role of negative symptoms in "secondary factors" determining social functioning in chronic schizophrenia

Background

Chronic schizophrenia is significantly influenced by negative symptoms, with several known contributors to secondary negative symptoms. However, the impact of these factors and negative symptoms on social functioning warrants further exploration.

Methods

We assessed the clinical symptoms, antipsychotic adverse reactions, and social functioning of 283 hospitalized patients with chronic schizophrenia using various standardized interviews and scales. We conducted multiple regression and mediation analyses to elucidate the impact of secondary factors on negative symptoms, and the relationship among these "secondary factors," negative symptoms, and social functioning.

Results

Our findings identified depressive symptoms, extrapyramidal symptoms, and positive symptoms as significant contributors to secondary negative symptoms. We found that negative symptoms play a notable mediating role in the effect of depressive and positive symptoms on social functioning. However, the relationship between positive symptoms, negative symptoms, and social functioning proved to be intricate.

Conclusion

Our findings propose that negative symptoms act as pivotal mediators in the correlation between "secondary factors" (including the depressive symptoms and positive symptoms) and social functioning. The treatment of chronic schizophrenia necessitates focusing on key factors such as depressive and positive symptoms, which might significantly contribute to the development of secondary negative symptoms. Further research is essential to clarify the complex relationship among positive symptoms, negative symptoms, and social functioning in schizophrenia.

Anhedonia as a transdiagnostic symptom across psychological disorders: a network approach

BACKGROUND

Anhedonia is apparent in different mental disorders and is suggested to be related to dysfunctions in the reward system and/or affect regulation. It may hence be a common underlying feature associated with symptom severity of mental disorders.

METHODS

We constructed a cross-sectional graphical Least Absolute Shrinkage and Selection Operator (LASSO) network and a relative importance network to estimate the relationships between anhedonia severity and the severity of symptom clusters of major depressive disorder (MDD), anxiety sensitivity (AS), attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) in a sample of Dutch adult psychiatric patients (N = 557).

RESULTS

Both these networks revealed anhedonia severity and depression symptom severity as central to the network. Results suggest that anhedonia severity may be predictive of the severity of symptom clusters of MDD, AS, ADHD, and ASD. MDD symptom severity may be predictive of AS and ADHD symptom severity.

CONCLUSIONS

The results suggest that anhedonia may serve as a common underlying transdiagnostic psychopathology feature, predictive of the severity of symptom clusters of depression, AS, ADHD, and ASD. Thus, anhedonia may be associated with the high comorbidity between these symptom clusters and disorders. If our results will be replicated in future studies, it is recommended for clinicians to be more vigilant about screening for anhedonia and/or depression severity in individuals diagnosed with an anxiety disorder, ADHD and/or ASD.

The Role of Shame in Schizophrenia Delusion: The Interplay Between Cognitive-Perceptual and Emotional Traits

ABSTRACT

Through a strictly dimensional approach, the present study aimed at evaluating the interplay between cognitive-perceptual disturbances and emotional dispositions, particularly shame proneness, in schizophrenia delusion. One hundred one outpatients with schizophrenia were administered the Peters et al. Delusions Inventory, the Referential Thinking Scale (REF), the Magical Ideation Scale (MIS), the Perceptual Aberration Scale (PAS), the Positive and Negative Affect Schedule and the Experiences of Shame Scale (ESS). The severity of delusional ideation was positively related to all the cognitive-perceptual scales (REF, MIS, and PAS) and to shame proneness (ESS). Referential thinking (REF) emerged as the strongest predictor of delusion severity. The experience of shame played a mediation role in the relationship between cognitive-perceptual traits and delusional severity. These data suggest that severity delusion in schizophrenia depends, at least in part, on a complex interplay between cognitive-perceptual disturbances and experiences of shame.

Temporal dynamics of interoceptive attention and positive and negative affect in adults engaging in disordered eating and nonsuicidal self-injury

OBJECTIVE

Interoception (the sense of the body's state) is associated with eating disorders and nonsuicidal self-injury, potentially through relationships with affect. We examined the relationship between interoceptive attention and both positive and negative affect.

METHODS

Participants (N = 128) who reported recent self-harm (i.e., disordered eating and/or non-suicidal self-injury) completed ecological momentary assessment for 16 days. Participants completed multiple daily assessments of affect and interoceptive attention. We then tested the temporal dynamic relationship between interoceptive attention and affect.

RESULTS

There was a relationship between positive affect and interoceptive attention such that people with higher average positive affect, and times when people were above their typical positive affect, were associated with higher interoceptive attention. There was a negative relationship between negative affect and interoceptive attention, such that people with higher average negative affect, and times when people were above their own typical negative affect, were associated with lower interoceptive attention.

CONCLUSIONS

Better mood may associate with greater willingness to attend to body sensations. Our findings support active inference models of interoception and highlight the importance of refining our understanding of the dynamic nature of interoception and its relationship with affect.

"Don't [ruminate], be happy": A cognitive perspective linking depression and anhedonia

Anhedonia, a lack of pleasure in things an individual once enjoyed, and rumination, the process of perseverative and repetitive attention to specific thoughts, are hallmark features of depression. Though these both contribute to the same debilitating disorder, they have often been studied independently and through different theoretical lenses (e.g., biological vs. cognitive). Cognitive theories and research on rumination have largely focused on understanding negative affect in depression with much less focus on the etiology and maintenance of anhedonia. In this paper, we argue that by examining the relation between cognitive constructs and deficits in positive affect, we may better understand anhedonia in depression thereby improving prevention and intervention efforts. We review the extant literature on cognitive deficits in depression and discuss how these dysfunctions may not only lead to sustained negative affect but, importantly, interfere with an ability to attend to social and environmental cues that could restore positive affect. Specifically, we discuss how rumination is associated to deficits in working memory and propose that these deficits in working memory may contribute to anhedonia in depression. We further argue that analytical approaches such as computational modeling are needed to study these questions and, finally, discuss implications for treatment.

Mapping the mental space of emotional concepts through kinematic measures of decision uncertainty

Emotional concepts and their mental representations have been extensively studied. Yet, some ecologically relevant aspects, such as how they are processed in ambiguous contexts (e.g., in relation to other emotional stimuli that share similar characteristics), are incompletely known. We employed a similarity judgement of emotional concepts and manipulated the contextual congruency of the responses along the two main affective dimensions of hedonic valence and physiological activation, respectively. Behavioural and kinematics (mouse-tracking) measures were combined to gather a novel 'similarity index' between emotional concepts, to derive topographical maps of their mental representations. Self-report (interoceptive sensibility, positive-negative affectivity, depression) and physiological measures (heart rate variability, HRV) have been collected to explore their possible association with emotional conceptual representation. Results indicate that emotional concepts typically associated with low arousal profit by contextual congruency, with faster responses and reduced uncertainty when contextual ambiguity decreases. The emotional maps recreate two almost orthogonal axes of valence and arousal, and the similarity measure captures the smooth boundaries between emotions. The emotional map of a subgroup of individuals with low positive affectivity reveals a narrower conceptual distribution, with variations in positive emotions and in individuals with reduced arousal (such as those with reduced HRV). Our work introduces a novel methodology to study emotional conceptual representations, bringing the behavioural dynamics of decision-making processes and choice uncertainty into the affective domain. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.

Solitude and affect during emerging adulthood: When, and for whom, spending time alone is related to positive and negative affect during social interactions

The present study examines within- and between-person associations between emerging adults’ daily time spent alone and their positive/negative affect during social interactions. We also consider whether motivations for seeking solitude (shyness, unsociability, avoidance) moderate these associations. Participants were 411 emerging adults (ages 18–26 years; 51% female; 52% ethnic minority) who reported on their motivations for solitude and completed daily reports of their time spent alone and positive/negative affect experienced during social interactions for 7 consecutive days. Among the results, multi-level modeling indicated that on days when emerging adults spent more time alone than usual, they experienced increased levels of high and low arousal positive affect when they interacted with others. Interactions between shy and avoidant motivations and change in time spent alone also emerged, with follow-up analyses indicating that for highly and moderately shy and avoidant emerging adults, days with more time spent alone than usual were associated with greater reports of anxious affect during social interactions. Findings suggest that although many emerging adults may find social interactions more enjoyable on days with increased time alone, those who actively seek solitude as an escape from perceived stressful or unpleasant social circumstances may not.

A Comprehensive Review on the Effects of Humor in Patients With Depression

Depression is a leading cause of disability worldwide and a major contributor to the overall global burden of disease. Although there are known, effective treatments for depression, people in low- and middle-income areas experience multiple barriers which limit their ability to receive adequate treatment. Some known barriers to effective care include a lack of resources, lack of trained healthcare providers, and social stigma associated with mental disorders and this creates gaps in mental health care and the need for more treatment modalities and adjuvant therapies to address these gaps. This review article was conducted using the scale for the assessment of non-systematic review articles (SANRA). We searched three databases; EMBASE, PubMed (MEDLINE), and Google Scholar using specified search terms. We had a total of nine articles with sample sizes ranging from 37 to 1551, and the age of participants ranged from 23 to 93 years. Articles were diverse in race and geographical locations. The articles were derived from cross-sectional studies, randomized studies, and experimental studies, and they focused on the relationship between humor and depression, and the reduced risk of depression in the study population. The articles identified different aspects of the relationship between humor and depression. The willingness of patients with depression to recognize or participate in humor could be defective resulting in abnormal social interactions such as withdrawal. However, there was some significant influence of humor or its styles on patients with depression either mitigating depressive symptoms or having no impact at all.

Differentiating the abnormalities of social and monetary reward processing associated with depressive symptoms

BACKGROUND

Reward dysfunction is a major dimension of depressive symptomatology, but it remains obscure if that dysfunction varies across different reward types. In this study, we focus on the abnormalities in anticipatory/consummatory processing of monetary and social reward associated with depressive symptoms.

METHODS

Forty participants with depressive symptoms and forty normal controls completed the monetary incentive delay (MID) and social incentive delay (SID) tasks with event-related potential (ERP) recording.

RESULTS

In the SID but not the MID task, both the behavioral hit rate and the ERP component contingent negative variation (CNV; indicating reward anticipation) were sensitive to the interaction between the grouping factor and reward magnitude; that is, the depressive group showed a lower hit rate and a smaller CNV to large-magnitude (but not small-magnitude) social reward cues compared to the control group. Further, these two indexes were correlated with each other. Meanwhile, the ERP components feedback-related negativity and P3 (indicating reward consumption) were sensitive to the main effect of depression across the MID and SID tasks, though this effect was more prominent in the SID task.

CONCLUSIONS

Overall, we suggest that depressive symptoms are associated with deficits in both the reward anticipation and reward consumption stages, particularly for social rewards. These findings have a potential to characterize the profile of functional impairment that comprises and maintains depression.

Taking a One-Week Break from Social Media Improves Well-Being, Depression, and Anxiety: A Randomized Controlled Trial

The present study aimed to understand the effects of a 1-week break from social media (SM) (Facebook, Instagram, Twitter, and TikTok) on well-being, depression, and anxiety compared with using SM as usual. We also aimed to understand whether time spent on different SM platforms mediates the relationship between SM cessation and well-being, depression, and anxiety. We randomly allocated 154 participants (mean age of 29.6 years) to either stop using SM (Facebook, Twitter, Instagram, and TikTok) for 1 week or continue to use SM as usual. At a 1-week follow-up, significant between-group differences in well-being (mean difference [MD] 4.9, 95% confidence interval [CI] 3.0-6.8), depression (MD -2.2, 95% CI -3.3 to -1.1), and anxiety (MD -1.7, 95% CI -2.8 to -0.6) in favor of the intervention group were observed, after controlling for baseline scores, age, and gender. The intervention effect on well-being was partially mediated by a reduction in total weekly self-reported minutes on SM. The intervention effect on depression and anxiety was partially mediated by a reduction in total weekly self-reported minutes on Twitter and TikTok, and TikTok alone, respectively. The present study shows that asking people to stop using SM for 1 week leads to significant improvements in well-being, depression, and anxiety. Future research should extend this to clinical populations and examine effects over the longer term.

General and Specific Dimensions of Mood Symptoms Are Associated With Impairments in Common Executive Function in Adolescence and Young Adulthood

Both unipolar and bipolar depression have been linked with impairments in executive functioning (EF). In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions (anhedonia, physiological arousal, and mania) using structural equation modeling in adolescents and young adults with varying severity of mood symptoms (n = 495, ages = 13-25 years, 68.69% female). A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal.

Parent Emotion Socialization and Positive Emotions in Child and Adolescent Clinical Samples: A Systematic Review and Call to Action

The majority of the emotion socialization behaviors (ESB) literature has focused on community samples and socialization of negative emotions. However, it is becoming increasingly apparent that ESB are also critical in setting the foundations for the healthy development of positive emotions, with implications for developmental psychopathology. We conducted a systematic review of research examining parent ESB and youth positive emotions in clinical child and adolescent samples. A literature search was conducted in March 2021, resulting in 563 abstracts being reviewed. Two reviewers independently screened the titles and abstracts to identify relevant papers, with 53 articles being reviewed in full. Seven articles (four cross-sectional and correlational, three intervention) were included in the current review, of which one was with an internalizing sample, three were with an externalizing sample, and three were with a neurodevelopmental disorder sample. Results varied regarding the role of parent ESB in youth positive emotions across clinical populations. In correlational studies, minimal evidence was found for the association between parent ESB and youth positive emotions, but across the three intervention studies, there was evidence that both parent ESB and children's positive emotions can be improved through intervention. We present a preliminary model of relations between youth psychopathology, parent ESB, and child positive emotions, with consideration of potential moderators of links between ESB and positive emotions. Finally, we discuss limitations of the existing body of research, and offer specific recommendations for future research directions.

Pleasure, Reward Value, Prediction Error and Anhedonia

In order to develop effective treatments for anhedonia we need to understand its underlying neurobiological mechanisms. Anhedonia is conceptually strongly linked to reward processing, which involves a variety of cognitive and neural operations. This chapter reviews the evidence for impairments in experiencing hedonic response (pleasure), reward valuation and reward learning based on outcomes (commonly conceptualised in terms of "reward prediction error"). Synthesising behavioural and neuroimaging findings, we examine case-control studies of patients with depression and schizophrenia, including those focusing specifically on anhedonia. Overall, there is reliable evidence that depression and schizophrenia are associated with disrupted reward processing. In contrast to the historical definition of anhedonia, there is surprisingly limited evidence for impairment in the ability to experience pleasure in depression and schizophrenia. There is some evidence that learning about reward and reward prediction error signals are impaired in depression and schizophrenia, but the literature is inconsistent. The strongest evidence is for impairments in the representation of reward value and how this is used to guide action. Future studies would benefit from focusing on impairments in reward processing specifically in anhedonic samples, including transdiagnostically, and from using designs separating different components of reward processing, formulating them in computational terms, and moving beyond cross-sectional designs to provide an assessment of causality.

Psychological Treatments for Anhedonia

Anhedonia, a loss of interest or pleasure in activities, is a transdiagnostic symptom that characterizes many individuals suffering from depression and anxiety. Most psychological interventions are designed to decrease negative affect rather than increase positive affect, and are largely ineffective for reducing anhedonia. More recently, affective neuroscience has been leveraged to inform treatments for anhedonia by targeting aspects of the Positive Valence Systems, including impairments in reward anticipation, reward responsiveness, and reward learning. In this chapter, we review the efficacy of treatments and, when possible, highlight links to reward constructs. Augmented behavioral approaches and targeted cognitive interventions designed to target reward anticipation, responsiveness, and learning show preliminary efficacy in reducing anhedonia, while there is a relative lack of treatments that target positive emotion regulation and reward devaluation. In addition to developing treatments that address these targets, the field will benefit from establishing standardized measurement of anhedonia across units of analysis, mapping mechanisms of change onto aspects of reward processing, and examining anhedonia outcomes in the long-term.

Motivation to Improve Mental Wellbeing via Community Physical Activity Initiatives and the Associated Impacts-A Cross-Sectional Survey of UK parkrun Participants

Participation in regular physical activity is a well-established strategy to support good mental wellbeing in adults with, and without, mental health conditions. The physical activity initiative parkrun is a free, weekly, timed, running and walking event which is attended by people from the local community of all abilities. The purpose of this study was to investigate the mental wellbeing of UK parkrun participants along with their motives for taking part and the impact of participation. Mental health conditions were self-reported in 2.5% of 60,000 respondents to an online survey of parkrunners, with the most prevalent being depression and anxiety. Those with mental health conditions were more motivated than those without to first participate in parkrun to manage their health conditions and improve their mental health. Those with mental health conditions were equally motivated to improve their physical health when compared to those without, and reported similar levels of improvement. Mental wellbeing scores for those with mental health conditions were close to the normal range, suggesting that engagement in parkrun may have had a role in limiting the effect of their illness. Community initiatives could replicate parkrun's model, and use the potential for both mental and physical health improvement, as well as health condition management, as a motivation for participation.

The Model for Sustainable Mental Health: Future Directions for Integrating Positive Psychology Into Mental Health Care

This position paper proposes a model for systematic integration of positive psychology interventions (PPIs) in mental healthcare. On the one hand, PPIs can contribute to the decrease of dysfunctional processes underlying mental illness. This evidence is at the core of the new domains of positive clinical psychology and positive psychiatry. On the other hand, a growing number of studies demonstrate that mental health is not merely the absence of mental illness. Mental wellbeing represents a related but separate dimension of mental health. Mental wellbeing reduces the risk of future incidence of mental illness and is highly valued by people receiving psychological treatment as an important aspect of personal and complete recovery and personal growth. This makes mental wellbeing a vital outcome of mental healthcare. PPIs can directly increase mental wellbeing. The model of sustainable mental health is presented integrating the science of positive psychology and mental wellbeing into mental healthcare. This heuristic model can guide both practitioners and researchers in developing, implementing, and evaluating a more balanced, both complaint- and strength-oriented, treatment approach. The role of gratitude interventions is discussed as an example of applying the model. Also, three potential modalities for implementing PPIs as positive psychotherapy in treatment are as: positive psychotherapy as primary treatment, as combinatorial treatment, and as intervention for personal recovery of people with severe or persistent mental disorder. Finally, we argue that longitudinal studies are needed to substantiate the model and the processes involved.

Assessing Resources in a Population of Hemodialysis Patients: A New Approach to Improve Quality of Care

Hemodialysis patients constitute a vulnerable population. Their health needs are considerable and they often present psychological symptoms such as depression and anxiety. Empirical studies have demonstrated the efficacy of positive psychology interventions to enhance the well-being of patients and alleviate their depressive symptoms. One such intervention consists in identifying and mobilizing patient resources to activate their recovery. An intervention of the sort was implemented in Switzerland with hemodialysis nurses using AERES, a novel self-assessment instrument. AERES covers 31 domains under three dimensions: personal characteristics/qualities, hobbies/passions, and social/environmental resources. The aim of this qualitative study was to explore hemodialysis nurse perceptions of the use of this instrument. Sixteen hemodialysis nurses were recruited in six hospitals in French-speaking Switzerland and interviewed after delivering the intervention. A consensual qualitative research method was used to analyze the data. Results showed that the resources instrument was easy to administer and beneficial to patients and health professionals. Patient wellbeing became the top priority for the nurses and new interventions centered on patient resources were undertaken. Quality of patient care was improved. Nurses perceived this positive psychology instrument as a means of creating a positive relationship with patients and supporting them emotionally. Assessing the resources of this vulnerable population can provide health professionals with a powerful tool to understand patient intact resources, which can be used to alleviate symptoms and foster wellbeing.

Addressing anhedonia to increase depression treatment engagement

Anhedonia, or reward system dysfunction, is associated with poorer treatment outcomes among depressed individuals. The role of anhedonia in treatment engagement, however, has not yet been explored. We review research on components of reward functioning impaired in depression, including effort valuation, reward anticipation, initial responsiveness, reward learning, reward probability, and reward delay, highlighting potential barriers to treatment engagement associated with these components. We then propose interventions to improve treatment initiation and continuation by addressing deficits in each component of reward functioning, focusing on modifications of existing evidence-based interventions to meet the needs of individuals with heightened anhedonia. We describe potential settings for these interventions and times at which they can be delivered during the process of referring individuals to mental health treatment, conducting intakes or assessments, and providing treatment. Additionally, we note the advantages of using screening processes already in place in primary care, workplace, school, and online settings to identify individuals with heightened anhedonia who may benefit from these interventions. We conclude with suggestions for future research on the impact of anhedonia on treatment engagement and the efficacy of interventions to address it. PRACTITIONER POINTS: Many depressed individuals who might benefit from treatment do not initiate it or discontinue early. One barrier to treatment engagement may be anhedonia, a core symptom of depression characterized by loss of interest or pleasure in usual activities. We describe brief interventions to improve treatment engagement in individuals with anhedonia that can be implemented during the referral process or early in treatment. We argue that interventions aiming to improve treatment engagement in depressed individuals that target anhedonia may be particularly effective.

An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107™): A randomised, double-blind, placebo-controlled study

BACKGROUND

The acute anxiolytic effects of the echinacea angustifolia extract (EP107^TM) have been demonstrated in two previous human trials. The goals of this study were to examine the anxiolytic and mood-enhancing effects of echinacea angustifolia over a longer duration with a larger sample size.

METHODS

In this 6-week, 3-arm, parallel-group, double-blind, randomised controlled trial, 108 adults with mild-to-moderately severe anxiety were recruited and randomised to receive either a placebo, 20 mg, or 40 mg of echinacea angustifolia, twice daily. Outcome measures included the Clinically Useful Anxiety Outcome Scale (CUXOS), Positive and Negative Affect Scale (PANAS), Short Form-36 (SF-36), and Bergen Insomnia Scale (BIS).

RESULTS

Based on data collected from 104 participants, both doses of echinacea were associated with overall reductions in anxiety, although improvements were not different from the placebo. However, both doses of echinacea were associated with greater improvements in the PANAS positive and negative affect scores, and SF-36 emotional wellbeing score compared to the placebo.

LIMITATIONS

The positive improvements associated with echinacea were only identified via the secondary outcome measures and, therefore, require validation in future trials.

CONCLUSIONS

The echinacea angustifolia extract (EP107^TM) administered for 6 weeks at a dose of 40 and 80 mg daily was not associated with greater improvements in anxiety in adults with mild-to-moderately severe anxiety compared to the placebo. However, there were greater improvements in positive and negative affect, and emotional wellbeing, suggesting antidepressant effects. Further studies using clearly-defined populations and validated outcome measures will be useful in future trials.

Exploring the Relation between Emotional Intelligence, Subjective Wellness, and Psychological Distress: A Case Study of University Students in Taiwan

Given the importance of emotions in human life and the necessity of managing one's emotions, this research project conducted an 18 week course on emotional management for a group of undergraduate students, investigated the differences in emotional intelligence (EI) levels before and after the course, and assessed EI's effect on selected subjective wellness and psychological distress variables. The study indicated many significant results. Most importantly, the comparison of the pre-course and post-course EI scores indicated that the EI skills and competencies could be learned and enhanced through formal education. Additionally, there were also significant regression coefficients of pre-course and post-course EI scores on both subjective wellness and psychological distress variables. The significant results endorse that EI knowledge, skills, and competencies could indeed be enhanced through formal education. In particular, the understanding of EI could help the educationists and helping professionals in assessing people's level of EI, designing relevant courses, and raising the impact of EI on both overall wellness and psychological distress.

How did Tunisian university students cope with fear of COVID-19? A comparison across schizotypy features

BACKGROUND

Little consideration has been given to the impact of COVID-19 on people at risk of psychosis despite their particular preexisting vulnerability. We aimed to examine the role of coping strategies in determining the levels of fear in nonclinical students with high levels of self-reported schizotypal personality traits as compared to low-schizotypy controls.

METHOD

This was a cross-sectional survey. The Schizotypal Personality Questionnaire, the Fear of COVID-19 Scale and The Brief-Coping Orientation to Problems Experienced were used.

RESULTS

High-schizotypy students had significantly higher maladaptive strategies scores and higher levels of fear of COVID-19 as compared to low-schizotypy students. Multivariate analyses have shown that high-schizotypy individuals were likely to rely on coping responses that are maladaptive (venting) and have potential exacerbating effects on fear of COVID-19, whereas low-schizotypy individuals were likely to use adaptive responses (acceptance) that seemed to be effective in reducing fear of COVID-19.

CONCLUSION

This study provided preliminary cross-sectional evidence for a differential impact of COVID-19 on individuals according to their schizotypy features. However, larger longitudinal population-based studies are necessary to confirm our findings.

The role of affect in chronic pain: A systematic review of within-person symptom dynamics

OBJECTIVE

Chronic pain is conceptualized as a biopsychosocial phenomenon that involves both physical and emotional processes. The vast majority of research regarding these facets of chronic pain characterizes differences between individuals. In this review, we describe problems with assuming that differences between persons accurately characterize within-person processes. We also provide a systematic review of studies that have examined within-person relationships between pain and affect among individuals with chronic pain.

METHOD

Articles published by December 2020 that pertained to within-person assessment of pain and emotion, affect, or mood were identified. Data regarding study design, adherence, and concurrent and prospective relationships among pain and affect variables were extracted and summarized.

RESULTS

Of 611 abstracts, 55 studies met inclusion criteria. Results suggest that individuals with chronic pain tend to experience increased negative affect and decreased positive affect when experiencing more severe pain (r_pooled = .18 and - .19, respectively). However, the size of these effects appeared smaller than between-person associations, and there was evidence of significant variability between individuals. Examination of predictive relationships between pain and affect largely suggested the tendency of symptoms to predict themselves, rather than pain predicting affect or vice versa.

CONCLUSIONS

Consistent with group-level relationships, experiencing more severe pain relative to an individual's average seems to be associated with more negative affect and less positive affect. However, individuals vary in the size and even direction of these effects. More research is necessary to understand the implications of such variability for the assessment and treatment of chronic pain.

The Effects of Anhedonia in Social Context

Purpose of Review

Anhedonia is a transdiagnostic symptom comprising reduced subjective reward or pleasure. Anhedonia influences subjective anticipation and in-the-moment experiences. This review draws together affective learning and engagement evidence for anhedonia affecting subjective experiences of social environments.

Recent Findings

While social engagement is diminished consistently, subjective appraisals of social contexts vary across different mental health disorders. Low positive affect during social experiences or stimuli is reported in PTSD, mood, schizophrenia, and anxiety disorders. Diminished neural reward networks underpin the anticipation of social experiences in ADHD, schizophrenia spectrum, and autistic spectrum disorders. Multiple theories exist to explain how anhedonia might interfere with social environments.

Summary

Anhedonia is a barrier to engagement, motivation, and enjoyment of social contexts. While many studies characterize experiences during social contexts, learning theories provide the most promise for developing targeted interventions.

Latent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome

Posttraumatic stress disorder (PTSD) frequently co-occurs with major depressive disorder, and empirically supported PTSD treatments consistently improve depression. However, both diagnoses are heterogeneous and specific patterns of symptom overlap may be related to worse treatment outcome. Two hundred individuals with chronic PTSD participated in a doubly randomized preference trial comparing prolonged exposure and sertraline. Latent Profile Analysis was used to identify classes based on PTSD and depression symptoms prior to starting treatment. A three-class model best fit the data, with a high depression and PTSD severity class (distressed), a moderate depression and low PTSD avoidance class (depressive), and a low depression and high PTSD avoidance class (avoidant). The avoidant class showed the lowest rates of major depressive disorder diagnosis and transdiagnostic vulnerabilities to depression. Patients in the distressed class experienced more robust PTSD treatment response, with no differences between prolonged exposure and sertraline. These findings highlight the role of avoidance in nondepressed PTSD presentations while also demonstrating that co-occurring depression is not contraindicated in evidence-based PTSD treatment.

Savouring as an Intervention to Decrease Negative Affect in Anxious Mothers of Children with Autism and Neurotypical Children

Savouring is an emotion regulation strategy and intervention that focuses on the process of attending, intensifying and prolonging positive experiences and positive affect associated with these memories. Personal savouring involves a reflection on positive memories that are specific to the individual and do not involve others. In contrast, relational savouring entails reflecting on instances when people were responsive to the needs of their significant others. Such interventions hold potential benefits in enhancing positive affect (PA) and reducing negative affect (NA) for both parents of children with autism spectrum disorder (ASD) and parents of neurotypical children. Adults with greater symptoms of generalised anxiety have been found to have less PA and more NA. However, no study has investigated the effects of a mother’s anxiety symptoms on the efficacy of savouring in enhancing PA and reducing NA. Thus, this paper combined personal and relational savouring to investigate whether savouring may enhance PA and reduce NA of a pooled sample of mothers of neurotypical children and mothers of children with ASD. 52 mothers of neurotypical children and 26 mothers of children with ASD aged 3–7 years old were given a series of questionnaires and randomly assigned to either relational savouring or personal savouring conditions. In relational savouring, mothers were asked to reflect upon a shared positive experience with their child while in the personal savouring condition, a personal positive experience was recalled. Across mothers of children with ASD and neurotypical children, findings suggest that savouring leads to a decrease in NA (p < 0.01) but not increases in PA. Similarly, mothers with higher levels of anxiety experience a greater decrease in NA (p < 0.001) compared to mothers with lower levels of anxiety post-savouring. This study proposes that a brief savouring intervention may be effective among mothers of preschoolers. As lower levels of negative affect is linked to healthier psychological well-being, mothers might be able to engage in more effective and warm parenting after savouring exercises, which would cultivate positive mother-child relationships that benefit their children in the long-term.

Changes in neural reward processing following Amplification of Positivity treatment for depression and anxiety: Preliminary findings from a randomized waitlist controlled trial

Positive valence system (PVS) deficits are increasingly recognized as important treatment targets for depression and anxiety. Emerging behavioral treatments designed to upregulate the PVS show initial promise; however, neural mechanisms underlying these approaches remain unknown. This study investigated neural reward-processing-related changes following Amplification of Positivity (AMP)-a treatment designed to enhance positive thinking, emotions and behaviors through positive activity interventions (Clinicaltrials.gov: NCT02330627). Individuals with depression and/or anxiety (N = 29) were randomized to 10 sessions of AMP (n = 16) or waitlist (WL; n = 13). Participants completed a monetary incentive delay task during fMRI at baseline and post-assessment. Hypothesis-driven region of interest (ventral striatum, insula, anterior cingulate) and exploratory whole-brain activation and connectivity analyses evaluated pre-to-post changes for AMP vs. WL when anticipating potential monetary gain or loss. No between-group brain activation changes emerged in regions of interest or whole-brain analyses. Increased neural connectivity from pre-to-post-treatment was observed in AMP vs. WL, including ventral striatum, anterior insula, and anterior cingulate connectivity with prefrontal, limbic, occipital and parietal regions-predominantly during loss anticipation. This preliminary study is the first to examine neural mechanisms of positive activity interventions in depression and anxiety and suggests that AMP may strengthen brain connectivity in reward processing, attention, and emotion regulation networks.

Paternal coping and psychopathology during the perinatal period: A mixed studies systematic review and meta-analysis

How fathers cope with stress may be critical to their mental health during the perinatal period. Using a sequential explanatory design for systematic review and meta-analysis, we aimed to identify associations and causal relations between higher- and lower-order avoidant and approach coping strategies and paternal psychopathology. We searched five electronic databases and grey literature, and used random-effects models to calculate pooled effects from 11 quantitative studies. Meta-analytic results were integrated with findings from 18 qualitative studies. Fathers' avoidant coping was positively associated with global psychopathology and depression. Approach-oriented coping, particularly problem-solving, was associated with positive affect but not psychopathology. Qualitative findings indicate distressed fathers employ avoidant coping strategies such as suppression, distraction, and social withdrawal. Approach-oriented coping strategies such as problem-solving and cognitive reappraisals appeared to be constructive components of men's coping repertoires supporting adaptation to fatherhood. Different coping strategies and approaches may reflect enactment of constrictive, moderate, or reinterpreted masculine norms. Study designs did not allow conclusions about causal relations between coping and psychopathology. Screening for, and targeting of, high avoidant coping among expectant and new fathers may help detect men at risk of or experiencing mental health difficulties and inform clinical response to psychopathology. Research examining whether different patterns of avoidant and approach coping are associated with psychopathology over time could inform interventions to support men's mental health and adaptation to fatherhood.

Ego-resiliency in borderline personality disorder and the mediating role of positive and negative affect on its associations with symptom severity and quality of life in daily life

Borderline personality disorder (BPD) is a serious mental health condition associated with severe symptoms of distress and poor quality of life (QoL). Research outside the field of BPD suggests that ego-resiliency is negatively associated with psychopathology and positively associated with a range of positive life outcomes. Thus, ego-resiliency may be a valuable construct for furthering our understanding and treatment of BPD. However, the mechanisms linking ego-resiliency to psychopathology and QoL in relation to BPD have not been examined and explored by research. This study has addressed this gap in the collective knowledge by evaluating whether within-person associations between daily reports of positive affect (PA) and negative affect (NA) mediated the relationship between ego-resiliency, BPD symptom severity, and QoL. For 21 consecutive days, 72 women diagnosed with BPD completed end-of-day electronic assessments regarding ego-resiliency, PA and NA, symptom severity, and QoL. Multilevel structural equation modelling established that PA and NA were parallel mediators linking ego-resiliency with BPD symptom severity and QoL. As hypothesized, the path to QoL was stronger through PA than through NA. The mediation paths through NA and PA to BPD symptom severity were both significant, but their strength did not differ. Our findings align with the assertions of theories on emotion, thus suggesting a two-factor approach to PA and NA. Future research can build on these findings by developing psychotherapeutic interventions designed not only to reduce symptom severity but also to enhance PA in individuals with BPD and determine whether an increase in PA is associated with improved QoL.

Virtual Reality Reward Training for Anhedonia: A Pilot Study

Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect (e.g., negative inferential style) instead of deficits in positive affect (e.g., attenuated reward response) and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality (VR) has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled VR environment. Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8-13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals.

Association between negative symptom domains and happiness in schizophrenia

OBJECTIVE

The study aimed to examine the association between levels of self-reported happiness and different domains and subdomains of negative symptoms (NS), as well as symptomatic remission in schizophrenia.

METHODS

274 individuals with schizophrenia were assessed on the Subjective Happiness Scale (SHS), Positive and Negative Syndrome Scale and Clinical Assessment Interview for Negative Symptoms (CAINS). Multiple linear regressions were used to examine the association between levels of happiness and increasingly specific CAINS NS domains and subdomains, as well as symptomatic remission.

RESULTS

177 (64.6%) participants rated themselves as happy. NS, specifically motivation and pleasure related to social activities (MAP Social) (B=-0.402, t=-4.805, p<0.001), and depressive symptoms (B=-0.760, t=-7.102, p<0.001) were significantly associated with levels of happiness. Individuals in symptomatic remission rated themselves happier than those who were not in remission (mean composite SHS: 5.10 [SD=1.18] versus 4.61 [SD=1.16], p=0.002).

CONCLUSIONS

In this largest study on happiness in schizophrenia, we found that the MAP domain of NS, MAP social subdomain and depressive symptoms were significantly associated with levels of happiness. Additionally, individuals in symptomatic remission rated themselves happier than those who were not in remission. Symptom management remains important in the holistic care plan for individuals with schizophrenia.

Humor in Psychiatry: Lessons From Neuroscience, Psychopathology, and Treatment Research

Humor is a ubiquitous human characteristic that is socially motivated at its core and has a broad range of significant positive effects on emotional well-being and interpersonal relationships. Simultaneously, however, impairments in humor abilities have often been described in close association with the occurrence and course of neuropsychiatric disorders, such as schizophrenia, social anxiety, or depression. In the past decade, research in the neuroimaging and psychiatric domain has substantially progressed to (i) characterize impaired humor as an element of psychopathology, and (ii) shed light on the neurobiological mechanisms underlying the role of humor in neuropsychiatric diseases. However, (iii) targeted interventions using concepts of positive psychology have revealed first evidence that a systematic training and/or a potential reactivation of humor-related skills can improve rehabilitative outcome in neuropsychiatric patient groups. Here, we sought to integrate evidence from neuroscience, as well as from psychopathology and treatment research to shed more light on the role of humor in psychiatry. Based on these considerations, we provide directions for future research and application in mental health services, focusing on the question of how our scientific understanding of humor can provide the basis for psychological interventions that foster positive attitudes and well-being.

The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health

Therapeutic psychedelic administration and contact with nature have been associated with the same psychological mechanisms: decreased rumination and negative affect, enhanced psychological connectedness and mindfulness-related capacities, and heightened states of awe and transcendent experiences, all processes linked to improvements in mental health amongst clinical and healthy populations. Nature-based settings can have inherently psychologically soothing properties which may complement all stages of psychedelic therapy (mainly preparation and integration) whilst potentiating increases in nature relatedness, with associated psychological benefits. Maximising enhancement of nature relatedness through therapeutic psychedelic administration may constitute an independent and complementary pathway towards improvements in mental health that can be elicited by psychedelics.

A Low-Intensity Internet-Based Intervention Focused on the Promotion of Positive Affect for the Treatment of Depression in Spanish Primary Care: Secondary Analysis of a Randomized Controlled Trial

Background: A large number of low-intensity Internet-based interventions (IBIs) for the treatment of depression have emerged in Primary Care; most of them focused on decreasing negative emotions. However, recent studies have highlighted the importance of addressing positive affect (PA) as well. This study is a secondary analysis of a randomized control trial. We examine the role of an IBI focused on promoting PA in patients with depression in Primary Care (PC). The specific objectives were to explore the profile of the patients who benefit the most and to analyze the change mechanisms that predict a significantly greater improvement in positive functioning measures. Methods: 56 patients were included. Measures of depression, affect, well-being, health-related quality of life, and health status were administered. Results: Participants who benefited the most were those who had lower incomes and education levels and worse mental health scores and well-being at baseline (7.9%-39.5% of explained variance). Improvements in depression severity and PA were significant predictors of long-term change in well-being, F (3,55) = 17.78, p < 0.001, R2 = 47.8%. Conclusions: This study highlights the importance of implementing IBIs in PC and the relevance of PA as a key target in Major Depressive Disorder treatment.