A Bayesian model of the jumping-to-conclusions bias and its relationship to psychopathology

The mechanisms by which delusion and anxiety affect the tendency to make hasty decisions (Jumping-to-Conclusions bias) remain unclear. This paper proposes a Bayesian computational model that explores the assignment of evidence weights as a potential explanation of the Jumping-to-Conclusions bias using the Beads Task. We also investigate the Beads Task as a repeated measure by varying the key aspects of the paradigm. The Bayesian model estimations from two online studies showed that higher delusional ideation promoted reduced belief updating but the impact of general and social anxiety on evidence weighting was inconsistent. The altered evidence weighting as a result of a psychopathological trait appeared insufficient in contributing to the Jumping-to-Conclusions bias. Variations in Beads Task aspects significantly affected subjective certainty at the point of decisions but not the number of draws to decisions. Repetitions of the Beads Task are feasible if one assesses the Jumping-to-Conclusions bias using number of draws to decisions.

Internet-delivered transdiagnostic psychological treatments for individuals with depression, anxiety or both: a systematic review with meta-analysis of randomised controlled trials

OBJECTIVE

Depression and anxiety are major public health problems. This study evaluated the effects of internet-delivered transdiagnostic psychological treatments for individuals with depression, anxiety, or both.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Medline (Ovid), Cochrane Library (Wiley), the Web of Science Core Collection (Clarivate), and PsycInfo (EBSCO) were searched on 24 May 2021, with an update on 6 February 2023.

ELIGIBILITY CRITERIA

Randomised controlled trials of internet-delivered transdiagnostic psychological treatments, open to both participants with primary depression and participants with primary anxiety. This review concerned all treatment frameworks, both guided and unguided formats and all age groups.

DATA EXTRACTION AND SYNTHESIS

In random-effects meta-analysis, we estimated pooled effects on depression symptoms and anxiety in terms of Hedges' g with 95% CIs. Absolute and relative heterogeneity was quantified as the τ2 and I 2.

RESULTS

We included 57 trials with 21 795 participants. Nine trials (16%) recruited exclusively from routine care, and three (5%) delivered treatment via video. For adults, large within-group reductions were seen in depression (g=0.90; 95% CI 0.81 to 0.99) and anxiety (g=0.87; 95% CI 0.78 to 0.96). Compared with rudimentary passive controls, the added effects were moderate (depression: g=0.52; 95% CI 0.42 to 0.63; anxiety: g=0.45; 95% CI 0.34 to 0.56) and larger in trials that required all participants to meet full diagnostic criteria for depression or an anxiety disorder. Compared with attention/engagement controls, the added effects were small (depression: g=0.30; 95% CI 0.07 to 0.53; anxiety: g=0.21; 95% CI 0.01 to 0.42). Heterogeneity was substantial, and the certainty of the evidence was very low. Two trials concerned adolescents and reported mixed results. One trial concerned older adults and reported promising results.

CONCLUSION

Internet-delivered transdiagnostic treatments for depression and anxiety show small-to-moderate added effects, varying by control condition. Research is needed regarding routine care, the video format, children and adolescents and older adults.

PROSPERO REGISTRATION NUMBER

CRD42021243172.

Automated procedure for demographic adjustments on cognitive test scores

Performances of normal people on cognitive tests are known to vary by demographic characteristics, such as age, education, and sex. Thus, cognitive test scores should be corrected for demographic influences when they are used to detect below-expected results due to disease or injury involving the central nervous system (CNS). Normative corrections, if estimated from a large, diverse, and well-characterized cohort of controls, help to remove expected differences in cognitive performance associated with normal demographic characteristics and associated socio-economic disadvantages. In this paper, we (1) describe in detail the process of generating regression-based normative standards, and its advantages and limitations, (2) provide recommendations for applying these normative standards to data from individuals and populations at risk for CNS dysfunction, and (3) introduce an R package, test2norm, that contains functions for producing and applying normative formulas to generate demographically corrected scores for measuring deviations from expected, normal cognitive performances.

Parenting Practices May Buffer the Impact of Adversity on Epigenetic Age Acceleration Among Young Children With Developmental Delays

This study examined whether children exposed to adversity would exhibit lower epigenetic age acceleration in the context of improved parenting. Children with developmental delays and externalizing behavior problems (N = 62; Mage = 36.26 months; 70.97% boys, 29.03% girls; 71% Latinx, 22.6% Black) were drawn from a larger randomized controlled trial (RCT), which randomized them to receive Internet-delivered parent-child interaction therapy (iPCIT; n = 30) or community referrals as usual (RAU; n = 32). Epigenetic age acceleration was estimated with the pediatric buccal epigenetic clock, using saliva. Adversity was assessed using parent, family, and neighborhood-level cumulative-risk indicators. Adversity interacted with Time 2 (T2) observations of positive and negative-parenting practices to predict epigenetic age acceleration 1.5 years later, regardless of treatment assignment. Children exposed to more adversity displayed lower epigenetic age acceleration when parents evidenced increased positive (b = -0.15, p = .001) and decreased negative (b = -0.12, p = .01) parenting practices.

Changes in anxiety in the general population over a six-year period

BACKGROUND

Anxiety is a frequent condition in patients and in the general population. The aim of this study was to investigate changes in anxiety over time and to test several psychometric properties of the Generalized Anxiety Disorder Screener (GAD-7) from a longitudinal perspective.

METHODS

The GAD-7 was included in an examination with two waves, six years apart. The study sample (n = 5355) was comprised of representatively selected adults from the general population with a mean age of 57.3 (SD = 12.3) years.

RESULTS

During the 6-year time interval, anxiety increased significantly from 3.28 ± 3.16 (t1) to 3.66 ± 3.46 (t2). Confirmatory factor analyses proved the longitudinal measurement invariance of the GAD-7. Reliability of the GAD-7 was established both for the cross-sectional and the longitudinal perspective. The test-retest correlation was r = 0.53, and there were no substantial sex or age differences in these coefficients of temporal stability. The mean changes in anxiety were similar for males and females, and there was no linear age trend in the changes measured by the GAD-7. Changes in anxiety over the 6-year period were correlated with changes in satisfaction with life (r = -0.30), bodily complaints (r = 0.31), and the mental component of quality of life (r = -0.48).

CONCLUSION

The GAD-7 is a suitable instrument for measuring changes in anxiety. Age and gender have only minor significance when interpreting change scores.

Bifactor analysis of the Hospital Anxiety and Depression Scale (HADS) in individuals with traumatic brain injury

Anxiety and depression symptoms are commonly experienced after traumatic brain injury (TBI). However, studies validating measures of anxiety and depression for this population are scarce. Using novel indices derived from symmetrical bifactor modeling, we evaluated whether the Hospital Anxiety and Depression Scale (HADS) reliably differentiated anxiety and depression in 874 adults with moderate-severe TBI. The results showed that there was a dominant general distress factor accounting for 84% of the systematic variance in HADS total scores. The specific anxiety and depression factors accounted for little residual variance in the respective subscale scores (12% and 20%, respectively), and overall, minimal bias was found in using the HADS as a unidimensional measure. Further, in a subsample of 184 participants, the HADS subscales did not clearly discriminate between formal anxiety and depressive disorders diagnosed via clinical interview. Results were consistent when accounting for degree of disability, non-English speaking background, and time post-injury. In conclusion, variance in HADS scores after TBI predominately reflects a single underlying latent variable. Clinicians and researchers should exercise caution in interpreting the individual HADS subscales and instead consider using the total score as a more valid, transdiagnostic measure of general distress in individuals with TBI.

Worsening general health and psychosocial wellbeing of Australian hospital allied health practitioners during the COVID-19 pandemic

Objective To describe self-reported general and psychological health for allied health practitioners at an Australian acute public health service over three time points within the coronavirus disease 2019 (COVID-19) pandemic. Methods This study collected data from cross-sectional online surveys at three time points: May-June 2020 (T 1 ), October-November 2020 (T 2 ) and November-December 2021 (T 3 ). The self-report questionnaire consisted of demographic questions, a general health question and the 21-item version of the Depression Anxiety Stress Scales (DASS-21). Results A total of 308 responses were received (T 1 n  = 135, T 2 n  = 78, T 3 n  = 95) from representatives of eight allied health professions. The proportion of allied health practitioners reporting poor general health significantly increased over time, as did mean scores on all DASS-21 sub-scales. General health status was also significantly associated with DASS-21 subscale scores. Anxiety scores increased significantly between T 1 and T 2 , while depression scores increased significantly between T 2 and T 3 . Significant increases in stress scores were recorded across all time intervals. Between T 1 and T 3 , the proportion of allied health practitioners reporting moderate, severe, or extremely severe symptoms increased for depression (10.3-30.9%), anxiety (5.2-18.2%) and stress (13.3-36.3%). Conclusion The general and psychological health of allied health practitioners appears to be worsening as the COVID-19 pandemic continues. Organisational strategies to support the health of the allied health workforce in acute care settings must address the cumulative effects of prolonged pressure on their general and psychosocial health. Support strategies need to be responsive to changes in psychological wellbeing at different phases of the pandemic.

Psychological well-being and exercise addiction: The treatment effects of an REBT intervention for females

Whilst there is growing research on the benefits of Rational Emotive Behaviour Therapy (REBT) for athletic performance and wellbeing, there has been little attention on the effectiveness of REBT for the exercising population. Recent evidence suggests that REBT may be helpful for males who show signs of exercise addiction, but the effects for females are currently unknown. The current study aims to build on the extant research by adopting a single-case research design to examine the effects of REBT on irrational beliefs, exercise addiction symptomology, psychological distress, and unconditional self-acceptance (USA) of three female exercisers. Self-report data were collected at pre-, during, and post-REBT timepoints. Visual analyses revealed reductions in irrational beliefs and psychological distress, and increases in USA, maintained two-weeks post-REBT. Exercise addiction symptomology also reduced during the intervention, and this was maintained for two out of the three exercisers post-REBT. Social validation data supported these findings. The study adds weight to the efficacy of REBT in improving exercise addiction and its comorbidities.

Depression, anxiety and stress in women with breech pregnancy compared to women with cephalic presentation-a cross-sectional study

PURPOSE

This study aims to evaluate the level of psychological distress for women with breech compared to cephalic presentation. We hypothesized, that women with breech presentation have higher levels of depression, stress and anxiety. Secondary objectives were to analyze potential demographic risk factors and comorbidity of psychological distress in breech pregnancy.

METHODS

The breech study group was formed by 379 women with breech presentation. A sample of 128 women with cephalic presentation was recruited during routine clinical care. Depression, anxiety and stress symptoms were ascertained by means of the Depression-Anxiety-Stress-Score (DASS)-21 questionnaire. Categorial data was analyzed with Chi-square or exact test, continuous data with unpaired t test or Mann-Whitney U test. Demographic risk factors were identified using a binary logistic regression model.

RESULTS

Prevalence of psychological distress among women with breech was not higher compared to those of other pregnant women. Symptomatic depression, anxiety and stress affected 5.8%, 14.5% and 11.9% of women with breech, respectively. Decreasing age was identified as a risk factor for anxiety (p = 0.006). Multiparity increased risk for depression (p = 0.001), for anxiety (p = 0.026) and for perinatal stress (p = 0.010). More than 80% of women with depressive symptoms had comorbidities of psychological distress.

CONCLUSIONS

Breech presentation compared to cephalic presentation was not associated with higher levels of psychological distress. However, breech pregnancies are affected by symptoms of potential mental disorder. Multiparous women and younger women may need additional support and would benefit from a standardized screening tool for the assessment of perinatal psychological distress.

CLINICAL TRIAL REGISTRATION

Ethical approval (EA2/241/18) was granted by the Ethics Commission of the Charité University Hospital on the 23.01.2019 (ClinicalTrials.gov Identifier: NCT03827226).

Examining associations between suicidal desire, implicit fearlessness about death, and lifetime frequency of suicide attempts

INTRODUCTION

Suicide models propose that the capability for suicide, such as fearlessness about death (FAD), is necessary for the transition from suicidal desire to a suicide attempt. Most studies have relied on self-report methods to assess FAD. However, this research has produced equivocal results. As individuals may have limited awareness of learned or pre-existing associations between fearlessness and death, implicit measures of FAD hold promise. This study used a novel implicit association test (IAT), the IAT-FAD, to examine associations between suicidal desire, implicit FAD, and lifetime suicide attempt frequency.

METHODS

Patients in residential substance use treatment (N = 75), a population with increased suicide risk and exposure to painful and provocative events, completed the IAT-FAD and assessments of suicidal desire and past suicide attempts.

RESULTS

Implicit FAD moderated the association between suicidal desire and lifetime frequency of suicide attempts associated with an intent to die and requiring medical attention (although not ambivalent suicide attempts). Suicidal desire related to medically attended suicide attempts only at high implicit FAD levels, and to suicide attempts with a clear intent to die only at high or mean implicit FAD levels.

CONCLUSION

Results provide initial support for the relevance of implicit measures of FAD for understanding suicide risk.

Translation and Initial Validation of the Depression Anxiety and Stress Scale (DASS-21) in Ilokano

The Depression Anxiety and Stress Scale (DASS-21) is a self-report screening tool of psychological symptoms used in many countries and translated in different languages. The DASS-21 was translated into Ilokano, one of the major languages in the Philippines spoken by over 9 million people all over the world. The translation process involved independent translations by multilingual clinical psychologists, reviews by two multilingual mental health professionals, and pilot testing. The translation was then validated in a study with 668 Ilokano speakers mainly from three regions of the Philippines where Ilokano was a native language or a lingua franca. A confirmatory factor analysis indicated a good fit of the three-factor model compared to a one-factor model. The three subscales showed good internal consistency were also positively correlated with other measures of depression, anxiety, and negative affect, and negatively correlated with measures of positive affect and flourishing. Using a stringent test of criterion validity, the results also show that DASS-Depression was more strongly correlated with a criterion measure of depression, compared to with measures of anxiety and negative affect, and that DASS-Anxiety was more strongly correlated with a criterion measure of anxiety compare to a measure of negative affect. The results provide good initial evidence for the validity and viability of the DASS-21 in Ilokano, which should be a useful tool in mental health programs in parts of the Philippine community, particularly in identifying individuals who may need attention of mental health professionals.

Digital Interventions for Psychological Well-being in University Students: Systematic Review and Meta-analysis

BACKGROUND

Life at university provides important opportunities for personal growth; however, this developmental phase also coincides with the peak period of risk for the onset of mental health disorders. In addition, specific university lifestyle factors, including impaired sleep and academic and financial stress, are known to exacerbate psychological distress in students. As a result, university students have been identified as a vulnerable population who often experience significant barriers to accessing psychological treatment. Digital psychological interventions are emerging as a promising solution for this population, but their effectiveness remains unclear.

OBJECTIVE

This systematic review and meta-analysis aimed to assess digital interventions targeting psychological well-being among university students.

METHODS

Database searches were conducted on December 2, 2021, via Embase, MEDLINE, PsycINFO, and Web of Science.

RESULTS

A total of 13 eligible studies were identified, 10 (77%) of which were included in the meta-analysis. Mean pre-post effect sizes indicated that such interventions led to small and significant improvement in psychological well-being (Hedges g=0.32, 95% CI 0.23-0.4; P<.001). These effects remained, albeit smaller, when studies that included a wait-list control group were excluded (Hedges g=0.22, 95% CI 0.08-0.35; P=.002). An analysis of acceptance and commitment therapy approaches revealed small and significant effects (k=6; Hedges g=0.35, 95% CI 0.25-0.45; P<.001).

CONCLUSIONS

Digital psychological interventions hold considerable promise for university students, although features that optimize service delivery and outcomes require further assessment.

TRIAL REGISTRATION

PROSPERO CRD42020196654; https:/www.crd.york.ac.uk/prospero/display_record.php?RecordID=196654.

Common measures or common metrics? A plea to harmonize measurement results

OBJECTIVE

There is a great variety of measurement instruments to assess similar constructs in clinical research and practice. This complicates the interpretation of test results and hampers the implementation of measurement-based care.

METHOD

For reporting and discussing test results with patients, we suggest converting test results into universally applicable common metrics. Two well-established metrics are reviewed: T scores and percentile ranks. Their calculation is explained, their merits and drawbacks are discussed, and recommendations for the most convenient reference group are provided.

RESULTS

We propose to express test results as T scores with the general population as reference group. To elucidate test results to patients, T scores may be supplemented with percentile ranks, based on data from a clinical sample. The practical benefits are demonstrated using the published data of four frequently used instruments for measuring depression: the CES-D, PHQ-9, BDI-II and the PROMIS depression measure.

DISCUSSION

Recent initiatives have proposed to mandate a limited set of outcome measures to harmonize clinical measurement. However, the selected instruments are not without flaws and, potentially, this directive may hamper future instrument development. We recommend using common metrics as an alternative approach to harmonize test results in clinical practice, as this will facilitate the integration of measures in day-to-day practice.

Self-reported symptoms of developmental dyslexia predict impairments in everyday cognition in adults

BACKGROUND

Research into the impact of dyslexia on everyday cognition in adults with dyslexia is relatively limited and has tended to focus on university students.

AIMS AND METHODS

The present online study aimed to add to this small corpus by investigating the everyday effects of dyslexia on memory and attention in a larger community-based sample. One hundred and seventy-two adult volunteers completed five well-established self-report questionnaires, assessing dyslexia and Attention Deficit Hyperactivity Disorder symptomatology and everyday experiences with memory, attention, and mind-wandering.

RESULTS

After controlling for ADHD symptomatology, hierarchical regression analyses revealed that higher levels of dyslexia-related symptomatology were associated with greater, more frequent everyday memory and attentional problems, but not with a greater propensity to mind-wandering. Increased levels of dyslexia symptomatology were positively associated with the frequency of both everyday attentional lapses (at least when performing a pair of tasks or easy tasks while inhibiting intervening stimuli) and everyday memory failures. No significant associations were found between dyslexia symptomatology and attentional lapses when performing difficult tasks in the presence of concurrent stimuli or between dyslexia symptomatology and the propensity to mind-wandering.

CONCLUSIONS AND IMPLICATIONS

Dyslexia symptomatology was perceived as being associated with more everyday memory and attention problems in adulthood. Adjustments to educational and workplace settings and interventions to compensate for these difficulties are proposed.

Screening of Depressive Symptoms in a Russian General Population Sample: A Web-based Cross-sectional Study

Background and Objective:

Web-based screening of depressive symptoms in general non-clinical population can provide better insights into actual prevalence of depressive symptoms and associated risk factors. To study the current prevalence of depressive symptoms in Russian non-clinical population we conducted screening using an online survey based on Depression subscale of Hospital Anxiety and Depression Scale (HADS-D).

Methods:

The online survey covered 2610 Russian-speaking respondents and included HADS-D, questions about sex, age and presence of cardiovascular diseases (CVD) diagnoses or symptoms in respondents.

Results:

The proportion of respondents with depressive symptoms, estimated by online HADS-D, was 14.4% (11.5% - at subclinical level, 2.9% - at clinical level). The overall HADS-D score was higher in women (p=0.003), in young individuals under 30 y.o vs. participants over 42 y.o. (p=0.004) and in individuals with self-reported CVD symptoms (p=0.00002). Linear regression analysis showed that self-reported CVD symptoms increase HADS-D score (p<0.001), but male sex (p=0.002) and older age (p<0.001) decrease it. Logistic regression showed that CVD symptoms increase the risk of depressive symptoms by HADS-D (p=0.033, OR=1.29), but older age (p=0.015, OR=0.87) and male sex (as a trend, p=0.052, OR=0.80) decrease this risk.

Conclusion:

Online survey based on HADS-D showed new patterns of depressive symptoms prevalence in Russian non-clinical population. Depressive symptoms prevalence did not differ between men and women and was higher among young people. The reported association between depressive symptoms and CVD was confirmed.

Reorganization of the Social Brain in Individuals with Only One Intact Cerebral Hemisphere

Social cognition and emotion are ubiquitous human processes that recruit a reliable set of brain networks in healthy individuals. These brain networks typically comprise midline (e.g., medial prefrontal cortex) as well as lateral regions of the brain including homotopic regions in both hemispheres (e.g., left and right temporo-parietal junction). Yet the necessary roles of these networks, and the broader roles of the left and right cerebral hemispheres in socioemotional functioning, remains debated. Here, we investigated these questions in four rare adults whose right (three cases) or left (one case) cerebral hemisphere had been surgically removed (to a large extent) to treat epilepsy. We studied four closely matched healthy comparison participants, and also compared the patient findings to data from a previously published larger healthy comparison sample (n = 33). Participants completed standardized socioemotional and cognitive assessments to investigate social cognition. Functional magnetic resonance imaging (fMRI) data were obtained during passive viewing of a short, animated movie that distinctively recruits two social brain networks: one engaged when thinking about other agents’ internal mental states (e.g., beliefs, desires, emotions; so-called Theory of Mind or ToM network), and the second engaged when thinking about bodily states (e.g., pain, hunger; so-called PAIN network). Behavioral assessments demonstrated remarkably intact general cognitive functioning in all individuals with hemispherectomy. Social-emotional functioning was somewhat variable in the hemispherectomy participants, but strikingly, none of these individuals had consistently impaired social-emotional processing and none of the assessment scores were consistent with a psychiatric disorder. Using inter-region correlation analyses, we also found surprisingly typical ToM and PAIN networks, as well as typical differentiation of the two networks (in the intact hemisphere of patients with either right or left hemispherectomy), based on idiosyncratic reorganization of cortical activation. The findings argue that compensatory brain networks can process social and emotional information following hemispherectomy across different age levels (from 3 months to 20 years old), and suggest that social brain networks typically distributed across midline and lateral brain regions in this domain can be reorganized, to a substantial degree.

Seasonality of mood and affect in a large general population sample

Mood and behaviour are thought to be under considerable influence of the seasons, but evidence is not unequivocal. The purpose of this study was to investigate whether mood and affect are related to the seasons, and what is the role of neuroticism in this association. In a national internet-based crowdsourcing project in the Dutch general population, individuals were invited to assess themselves on several domains of mental health. ANCOVA was used to test for differences between the seasons in mean scores on the Positive and Negative Affect Schedule (PANAS) and Quick Inventory of Depressive Symptomatology (QIDS). Within-subject seasonal differences were tested as well, in a subgroup that completed the PANAS twice. The role of neuroticism as a potential moderator of seasonality was examined. Participants (n = 5,282) scored significantly higher on positive affect (PANAS) and lower on depressive symptoms (QIDS) in spring compared to summer, autumn and winter. They also scored significantly lower on negative affect in spring compared to autumn. Effect sizes were small or very small. Neuroticism moderated the effect of the seasons, with only participants higher on neuroticism showing seasonality. There was no within-subject seasonal effect for participants who completed the questionnaires twice (n = 503), nor was neuroticism a significant moderator of this within-subjects effect. The findings of this study in a general population sample participating in an online crowdsourcing study do not support the widespread belief that seasons influence mood to a great extent. For, as far as the seasons did influence mood, this only applied to highly neurotic participants and not to low-neurotic participants. The underlying mechanism of cognitive attribution may explain the perceived relation between seasonality and neuroticism.

Non-suicidal self-injury and bulimia: the role of emotion dysregulation and body dissatisfaction

PURPOSE

Risk factors of negative affect, body dissatisfaction, distress tolerance, and negative urgency are independently associated with bulimia symptoms and non-suicidal self-injury (NSSI). However, relationships of these risk factors within comorbid presentations are not fully understood. The current study examined specific roles of these risk factors within this relationship.

METHODS

An at-risk community sample of young adults (N = 429) completed an online survey of negative affect, body dissatisfaction, distress tolerance, negative urgency, bulimia symptoms, and NSSI.

RESULTS

A hypothesized path model was a good fit to the data. Results indicated direct paths from body dissatisfaction, negative urgency, and distress tolerance to bulimia symptoms. Negative urgency, distress tolerance, and bulimia symptoms were directly associated with NSSI. Consistent with hypotheses, distress tolerance and negative urgency acted as vulnerability factors, increasing the strength of associations between bulimia symptoms and NSSI. Distress tolerance also strengthened associations between negative urgency and NSSI. In addition to the direct effect, negative urgency was indirectly associated with NSSI via body dissatisfaction bulimia. Hypothesized indirect effects through distress tolerance were not supported.

CONCLUSIONS

Results support etiological models of bulimia and NSSI, and suggest deficits in emotion regulation strengthen risk of comorbid presentations. Furthermore, individuals with greater impulsivity and difficulty tolerating distress are at increased risk of engaging in both bulimia behaviors and NSSI, providing targets for clinical intervention.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Physical activity in periods of social distancing due to COVID-19: a cross-sectional survey

Physical inactivity and sedentary behavior are associated with poor physical and mental health. The article aims to assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020. The secondary objective was to describe their levels of anxiety and depression. The questionnaire used in this online survey included demographic information, questions about self-perceptions of the impact of the COVID-19 in the life routines and the 14-item Hospital Anxiety Depression Scale. A total of 1,613 adults completed the questionnaire between May 11 and 15, 2020. Of those, 79.4% reported that the measures to contain the epidemic had any impact on their physical activities, and many had to interrupt or decrease the frequency of their practices. Participants who felt a higher impact of quarantine on their physical activities tend to have higher prevalence of anxiety and depression symptoms. Individuals who practiced physical activities reported that social distance had a high influence on their practices. Furthermore, changes in these habits are associated with high levels of poor mental health.

Impact of childhood maltreatment on obsessive-compulsive disorder symptom severity and treatment outcome

Background: Preliminary evidence suggests childhood maltreatment to play a causal role in the development and maintenance of obsessive-compulsive disorder (OCD). However, both the effect of childhood maltreatment on the course of OCD treatment and the role of specific subtypes of maltreatment remain largely unknown. Objective: This study aimed to investigate the relationship between childhood maltreatment and the severity and time course of OCD symptoms within a clinical sample of OCD patients (N = 68). We hypothesized that higher levels of childhood maltreatment in OCD patients would be associated with higher symptom severity and worse treatment outcomes. Method: Assessments of childhood maltreatment, OCD symptomatology, and related variables were completed in a sample of OCD patients before and after inpatient treatment as well as at 6 month follow-up. Results: Emotional abuse, sexual abuse and neglect were highly prevalent in our sample. Additionally, the severity of experienced childhood maltreatment was associated with higher OCD symptom severity, with the strongest association found for emotional abuse. Hierarchical linear models indicated that patients with childhood maltreatment showed higher OCD symptom severity at pre-treatment, post-treatment, and follow-up compared to patients without these experiences. However, childhood maltreatment did not moderate symptom improvement during treatment. Conclusion: Thus, although childhood maltreatment is not related to treatment outcome, it is highly prevalent among OCD patients and childhood trauma survivors still show higher OCD symptom severity after treatment. Therefore, childhood maltreatment should be considered in psychological interventions in individuals with OCD.

Bringing light into darkness: A multiple baseline mixed methods case series evaluation of Augmented Depression Therapy (ADepT)

Two core features of depression are elevations in negative valence system (NVS) functioning and reductions in positive valence system (PVS) functioning. Existing psychological treatments have focused on the NVS and neglected the PVS, which may contribute to sub-optimal outcomes. The present mixed methods multiple randomised baseline case series preliminarily evaluates Augmented Depression Therapy (ADepT), a novel depression treatment targeting PVS and NVS disturbance, that aims both to reduce depression and enhance wellbeing. Eleven clinically depressed participants were recruited. Intensive time series analyses showed that 7/11 participants improved on both wellbeing and depression. Reliable and clinically significant improvement was observed for 9/11 participants on at least one of these outcomes (and also across a range of other PVS and NVS outcomes). Group level analyses showed significant pre to post change on all outcomes. Benchmarking analyses indicated these effect sizes were at least comparable (and for some PVS outcomes superior) to existing treatments. Gains were largely sustained over one-year follow-up. Qualitative interviews indicated ADepT was feasible and acceptable. These findings provide preliminary support for ADepT as a novel depression treatment. Further evaluation, directly comparing ADepT to existing treatments using randomised controlled trial designs, is now required.

Increased chronic stress predicts greater emotional negativity bias and poorer social skills but not cognitive functioning in healthy adults

Background and Objectives: Chronically stressed individuals report deficits spanning cognitive and emotional functioning. However, limitations to clinical populations and measures of stress have impeded the generalisability and scope of results. This study investigated whether chronic stress predicted cognitive and emotional functioning, and whether these relationships differed between males and females, in a large representative sample of healthy participants. Design: Cross-sectional study. Method: 1883 healthy adults sampled from the Brain Resource International Database reported stress using the 21-item Depression Anxiety Stress Scales. Participants then completed a cognitive and emotional assessment battery (IntegNeuro), as well as questionnaires related to sleep, emotional functioning, and self-regulation. Results: In contrast to previously reported results, chronic stress did not predict cognitive functioning. However, higher stress predicted a greater negativity bias and poorer social skills, confirming previous research identifying these links. Conclusions: Cognitive deficits related to stress are absent in healthy participants when stress is measured using the 21-items Depression Anxiety Stress Scales. Identifying how chronic stress is associated with aspects of emotional functioning can lead to personalized interventions for individuals to better manage the negative outcomes resulting from stress.

Positive cognitive behavior therapy in the treatment of depression: A randomized order within-subject comparison with traditional cognitive behavior therapy

Previous research suggests that a stronger focus on positive emotions and positive mental health may improve efficacy of Cognitive Behavior Therapy (CBT). Objectives were to compare differential improvement of depressive symptoms (primary outcome), positive affect, and positive mental health indices during positive CBT (P-CBT; CBT in a solution-focused framework, amplified with optional positive psychology exercises) versus traditional, problem-focused CBT (T-CBT). Forty-nine patients with major depressive disorder (recruited in an outpatient mental health care facility specialized in mood disorders) received two treatment blocks of eight sessions each (cross-over design, order randomized). Intention-To-Treat mixed regression modelling indicated that depressive symptoms improved similarly during the first, but significantly more in P-CBT compared to T-CBT during the second treatment block. Rate of improvement on the less-frequently measured secondary outcomes was not significantly different. However, P-CBT was associated with significantly higher rates of clinically significant or reliable change for depression, negative affect, and happiness. Effect sizes for the combined treatment were large (pre-post Cohen's d = 2.71 for participants ending with P-CBT, and 1.85 for participants ending with T-CBT). Positive affect, optimism, subjective happiness and mental health reached normative population averages after treatment. Overall, findings suggest that explicitly focusing on positive emotions efficiently counters depressive symptoms.

An Uncontrolled Open Trial of a Brief Behavioural Activation Treatment for Depression in Patients with Chronic Spontaneous Urticaria

Chronic spontaneous urticaria (CSU) has been associated with depression and can have an impact on quality of life. Therefore, researchers have suggested the potential utility of psychological interventions for targeting depression among CSU patients. Psychological interventions that may hold the most promise are those that are brief and easily transportable, such as brief behavioural activation treatment for depression. We report results of a preliminary investigation of an uncontrolled open trial of a one-session behavioural activation treatment for depression designed for patients with CSU (BATD-CSU) at a university-based allergy and immunology clinic. Participants were 11 females with chronic, poorly controlled urticaria and symptoms of depression. Following the completion of pretreatment questionnaires, participants were administered BATD-CSU primarily by non-mental health professionals trained and supervised in its delivery. One month post-BATD-CSU, participants completed follow-up questionnaires. Participants exhibited significant reductions in depression severity, avoidance/rumination, and work/school impairment. BATD-CSU was also associated with improvements in urticaria control one month post-treatment. Moreover, five of nine patients reported reliable and clinically significant improvement on at least one outcome. Results demonstrate that BATD-CSU may have benefits for CSU patients even when consisting of one session and delivered by professionals with limited background in psychological interventions, thus speaking to its feasibility and transportability.

Patient-reported Outcomes and Quality of Life After Treatment of Choroidal Melanoma: A Comparison of Enucleation Versus Radiotherapy in 1596 Patients

PURPOSE

To test the hypothesis that patients treated with radiotherapy for choroidal melanoma enjoy better quality of life (QoL) than patients who have undergone enucleation.

METHODS

In this nonrandomized study, patients with choroidal melanoma treated at the Royal Liverpool University Hospital, Liverpool, UK, were invited to complete QoL questionnaires approximately 6 months postoperatively and then on each anniversary of their primary treatment. These instruments consisted of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-OPT30 questionnaire, Hospital Anxiety & Depression Scale, and the Functional Assessment of Cancer Treatment questionnaire. Patient-reported outcomes were correlated with demographics, ocular treatment, social factors, presenting tumor and ocular status, self-reported general health, marital status, and employment status.

RESULTS

The 1596 patients were treated with radiotherapy (72.3%) or enucleation (27.7%). Enucleation was associated with male sex (χ², P = .004), older age (t test, P < .001), larger tumor diameter (t test, P < .001), monosomy 3 (χ², P < .001), depression (linear regression, 95% confidence interval [CI], .17 to 1.01), and reduced physical and functional well-being (linear regression, 95% CI, -1.14 to -0.12 and -1.96 to -0.47), respectively. Poor QoL was attributed to the ocular disease by 21% and 20% of enucleated and irradiated patients, respectively (χ², P = .938).

CONCLUSIONS

Patient-reported outcomes and QoL were worse in patients who had undergone primary enucleation for choroidal melanoma. These outcomes may partly have been caused by factors predisposing to enucleation rather than enucleation itself, because enucleated patients tended to be older, with more advanced disease at presentation, and a worse prognosis for survival. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Effect of vitamin D supplementation on depressive symptoms and psychological wellbeing in healthy adult women: a double-blind randomised controlled clinical trial

Epidemiological evidence has linked low vitamin D status to a range of mood disorders. However, studies examining whether vitamin D supplementation can improve mood-related outcomes in healthy populations are limited. We investigated whether vitamin D supplementation over winter is beneficial for improving mood-related outcomes in healthy women. A total of 152 healthy women (18–40 years) in Dunedin, New Zealand were randomly assigned to receive 50 000 IU (1·25 mg) of oral vitamin D₃ or placebo once per month for 6 months. They completed the Center for Epidemiologic Studies Depression Scale, the anxiety subscale of the Hospital Anxiety and Depression Scale and the Flourishing Scale every month. Additionally, they reported their positive and negative mood each day for three consecutive days every 2 months. Participants provided a blood sample at the beginning and at the end of the study for 25-hydroxyvitamin D₃ analysis. ANCOVA was used to compare the outcome measures between the groups, controlling for baseline. We found no evidence of lower depression (P = 0·339), lower anxiety (P = 0·862), higher flourishing (P = 0·453), higher positive moods (P = 0·518) or lower negative moods (P = 0·538) in the treatment group compared with the control group at follow-up. Mood outcomes over the study period were similar for the two groups. We found no evidence of any beneficial effect of monthly vitamin D₃ supplementation on mood-related outcomes in healthy premenopausal women over the winter period, so recommendations for supplementations are not warranted in this population for mood-related outcomes.

Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services

BACKGROUND

Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not.

METHODS

Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression.

RESULTS

Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression.

LIMITATIONS

Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression.

CONCLUSION

This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition.

Resilient coping in the general population: standardization of the brief resilient coping scale (BRCS)

Background

There has been a marked tendency for researchers, clinicians, and policy makers to shift their focus from risk to resilience. This should be assessed by comparing the outcome to a context specific reference group.

The objectives of the study were to generate normative data for the BRCS for different age groups for men and women and to further investigate the construct validity and factor structure in a general population.

Methods

Nationally representative face-to face household surveys were conducted in Germany in 2013 (n = 2508).

Results

Normative data for the BRCS were generated for men and women (53.2% female) and different age levels (mean age (SD) of 49.7 (18.0) years). Men had significantly higher mean scores compared with women (14.9 [SD = 3.2] vs. 14.6 [SD = 3.1]). The results of the EFA and CFA clearly indicate a unidimensional solution with one factor. Furthermore, the invariance of the one-factor model was tested for the whole sample across gender and six age groups.

Conclusions

The normative data provide a framework for the interpretation and comparisons of resilience with other populations.

Electronic supplementary material

The online version of this article (10.1186/s12955-017-0822-6) contains supplementary material, which is available to authorized users.

Measuring Emotional Intelligence Enhances the Psychological Evaluation of Chronic Pain

The assessment of emotional factors, in addition to other psychosocial factors, has been recommended as a means of identifying individuals with chronic pain who may not respond to certain pain treatments. Systematic reviews of the evidence regarding the prediction of responsiveness to a treatment called the spinal cord stimulator (SCS) have yielded inconclusive results. Emotional intelligence is a term which refers to the ability to identify and manage emotions in oneself and others and has been shown to be inversely associated with emotional distress and acute pain. This study aims to investigate the relationship between emotional intelligence, chronic pain, and the more established psychosocial factors usually used for SCS evaluations by clinical psychologists in medical settings. A sample of 112 patients with chronic pain on an acute hospital waiting list for SCS procedures in a pain medicine service were recruited. Psychological measures were completed including: a novel measure of emotional intelligence; usual measures of emotional distress and catastrophizing; and a numerical rating scale designed to assess pain intensity, pain-related distress, and interference. As predicted, findings revealed significant associations between most of the measures analyzed and current pain intensity. When entered into a simultaneous regression analysis, emotional intelligence scores remained the only significant predictor of current pain intensity. There are potential clinical, ethical, and organizational implications of emotional intelligence processes partially predicting pain in patients on a waiting list for a medical procedure. These results may offer new insight, understanding, and evaluation targets for clinical psychologists in the field of pain management.

An Initial Open Trial of a Brief Behavioral Activation Treatment for Depression and Medication Adherence in HIV-Infected Patients

Advances in HIV treatment through highly active antiretroviral therapy (HAART) have led to a steady decline in HIV-related mortality rates. However, HAART requires adherence to strict and often complicated medication regimens, and nonadherence to HAART can significantly decrease its effectiveness. Depression has consistently shown a robust association with medication nonadherence; consequently, numerous psychological interventions have been developed to target depression and increase medication adherence among HIV-infected individuals. The length of these interventions, however, may be prohibitive for certain HIV-infected populations, such as patients in rural areas. Therefore, this study provides an initial investigation of a one-session behavioral activation treatment for depression designed specifically for HIV-infected patients (BATD-HIV) at a community infectious disease clinic serving a largely rural population. In this initial uncontrolled open trial, BATD-HIV was administered to 10 HIV-infected patients with elevated symptoms of depression following their clinic appointment. Depression, anxiety, and stress symptom severity; behavioral activation processes; medication adherence; and CD4 T-cell count were assessed pre- and 1 month postintervention. Participants exhibited significant reductions in anxiety symptom severity and avoidance of negative aversive states and rumination from pre- to 1 month posttreatment. Although nonsignificant, participants also showed medium effect size reductions in depression and stress symptoms and work/school and social impairment, and medium effect size improvements in medication adherence and CD4 T-cell counts. Despite the preliminary nature of this study, results suggest that BATD-HIV may have utility as a brief treatment for HIV-infected patients with depression and warrants further investigation in larger scale randomized controlled trials.

Frequency of somatic symptoms in the general population: Normative values for the Patient Health Questionnaire-15 (PHQ-15)

BACKGROUND

The PHQ-15 is widely used as an open access screening instrument for somatic symptoms in different health care settings. The objectives of the study were to contribute to the construct validity and to generate normative data for the PHQ-15.

METHODS

The survey was conducted in the general population in Germany from August 2011 to November 2014 (n=9250). All participants underwent an extensive core assessment including a set of questionnaires.

RESULTS

Men reported significantly less (p<0.001) physical symptoms than women (4.6 [SD=3.6] vs. 6.3 [SD=4.1]). The PHQ-15 total score was strongly correlated with the physical component of quality of life (r=-0.58), fatigue (r=0.56), anxiety (r=0.54) and sleep problems (r=0.54). While high socioeconomic status was associated with low prevalences of all complaints, obesity was associated with some of the complaints, especially shortness of breath and pain in arms, legs, and joints. Normative data for the PHQ-15 were generated for men and women.

CONCLUSIONS

This investigation confirms the burden caused by somatic symptoms in terms of impaired physical quality of life. In association with psychosocial consequences such as anxiety as well as sleep problems, future studies should also focus on the disease burden of somatic symptoms. In addition, the normative data provide a framework for the interpretation and comparison with other populations.

Do maternal perceptions of child eating and feeding help to explain the disconnect between reported and observed feeding practices?: A follow-up study

Research demonstrates a mismatch between reported and observed maternal feeding practices. This mismatch may be explained by maternal cognitions, attitudes, and motivations relating to dyadic parent-child feeding interactions. These complex constructs may not be apparent during observations nor evidenced in self-report questionnaire. Therefore, the aim of this study was to use a qualitative approach to gain a more nuanced and contextualized understanding of (a) maternal perceptions of children's food intake control; (b) how parent-child mealtime interactions influence maternal feeding practices; and (c) ways in which mothers may promote healthy child eating and weight outcomes. Semistructured telephone interviews were conducted with 23 mothers (M = 38.4 ± 3.7 years of age) of preschool-aged children (M = 3.8 ± 0.6 years of age, 19 were normal weight, 14 were girls), who had previously completed child feeding questionnaire and participated in two home-based mealtime observations, 12 months apart. Interviews were recorded, transcribed, and themes extracted to create the database. Four major themes emerged: (a) Maternal confidence in children's ability to regulate food intake is variable; (b) Implementing strategies for nurturing healthy relationships with food beyond the dining table; (c) Fostering positive mealtime interactions is valued above the content of what children eat; and (d) Situation-specific practices and inconsistencies. Findings indicate that maternal feeding practices are shaped by both parent and child influences, and child feeding is mostly guided by controlling the family food environment, rather than by directly pressuring or restricting their child's eating. Results also highlighted the need for research to consider both parent and child influences on child feeding.

Caring for the Caregivers: Results of an Extended, Five-component Stress-reduction Intervention for Hospital Staff

The health-related consequences of stress in hospital workers and associated costs of absenteeism and high turnover have increased the need for programs targeting stress in this population. "Caring for the Caregivers," a multimodal approach to stress-reduction designed to address the multidimensional nature of stress in hospital staff, integrates five components: cognitive, somatic, dynamic, emotive and hands-on, in a flexible eight-month format. Significant improvements were demonstrated for 97 participants compared to 67 controls in pre-post scores for the Maslach Burnout Inventory, Job-Related Tension Index, Perceived Stress Scale, Productivity Scale, General Health Questionnaire, Positive and Negative Affect Schedule, and Visual Analogue Scales of 12 stress-associated symptoms. Together with significant reduction in upper respiratory infections and family doctor visits, these results suggest that providing hospital staff with multiple techniques addressing commonly encountered work stressors impacts positively on health and well-being and significantly reduces stress and burnout in this population.

Stressful life transitions and wellbeing: A comparison of the stress buffering hypothesis and the social identity model of identity change

The relationship between stressful life transitions and wellbeing is well established, however, the protective role of social connectedness has received mixed support. We test two theoretical models, the Stress Buffering Hypothesis and the Social Identity Model of Identity Change, to determine which best explains the relationship between social connectedness, stress, and wellbeing. Study 1 (N=165) was an experiment in which participants considered the impact of moving cities versus receiving a serious health diagnosis. Study 2 (N=79) was a longitudinal study that examined the adjustment of international students to university over the course of their first semester. Both studies found limited evidence for the buffering role of social support as predicted by the Stress Buffering Hypothesis; instead people who experienced a loss of social identities as a result of a stressor had a subsequent decline in wellbeing, consistent with the Social Identity Model of Identity Change. We conclude that stressful life events are best conceptualised as identity transitions. Such events are more likely to be perceived as stressful and compromise wellbeing when they entail identity loss.

Anxiety in Multiple Sclerosis: psychometric properties of the State-Trait Anxiety Inventory

OBJECTIVE

The aims of the present study were to examine psychometric properties of the Spielberger State-Trait Anxiety Inventory (STAI-Y-1 and STAI-Y-2, respectively) in a Multiple Sclerosis (MS) population and to identify a cut-off score to detect those MS patients with high level of state and/or trait anxiety who could be more vulnerable to development of depression and/or cognitive defects.

MATERIAL AND METHODS

The STAI-Y-1 and STAI-Y-2 was completed by a group of patients (n = 175) affected by MS and a group of healthy subjects (n = 150) matched for age, educational level, and gender. In MS patients internal consistency, divergent and discriminant validities were evaluated. Construct validity was examined by exploratory factor analysis for each scale.

RESULTS

There was no missing data, no floor or ceiling effects for both scales. The two scales showed high internal consistency, good divergent, and Known-groups validities. To identify high levels of state and trait anxiety in a patient with MS, we proposed three gender specific screening cut-off values (1, 1.5, 2 SD) for the STAI-Y-1 and the STAI-Y-2.

CONCLUSIONS

The findings showed that the STAI-Y-1 and the STAI-Y-2 are a valid tool for clinical use in MS patients and can be useful to measure the severity of anxiety and to identify those patients with high anxiety to introduce them in specific non-pharmacological intervention.