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Pinto JO, Peixoto B, Dores AR, Barbosa F. A model of sensory, emotional, and cognitive reserve. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-3. [PMID: 38118148 DOI: 10.1080/23279095.2023.2291480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- CESPU, University Institute of Health Sciences, Gandra, Portugal
| | - Bruno Peixoto
- CESPU, University Institute of Health Sciences, Gandra, Portugal
- NeuroGen - Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Smith PJ, Whitson HE, Merwin RM, O’Hayer CV, Strauman TJ. Engineering Virtuous health habits using Emotion and Neurocognition: Flexibility for Lifestyle Optimization and Weight management (EVEN FLOW). Front Aging Neurosci 2023; 15:1256430. [PMID: 38076541 PMCID: PMC10702760 DOI: 10.3389/fnagi.2023.1256430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/20/2023] [Indexed: 02/12/2024] Open
Abstract
Interventions to preserve functional independence in older adults are critically needed to optimize 'successful aging' among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals' ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting self-regulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of self-regulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to 'top-down' training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to 'bottom-up' approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands.
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Affiliation(s)
- Patrick J. Smith
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Heather E. Whitson
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Durham Veterans Affairs Medical Center, Durham, NC, United States
| | - Rhonda M. Merwin
- Department of Psychiatry, Duke University Medical Center, Durham, NC, United States
| | - C. Virginia O’Hayer
- Department of Psychiatry and Human Behavior, Thomas Jefferson University, Philadelphia, PA, United States
| | - Timothy J. Strauman
- Department of Psychiatry, Duke University Medical Center, Durham, NC, United States
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
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Lo Buono V, Corallo F, Bonanno L, Quartarone A, De Cola MC. Body Image and Emotional Status in Patients with Acquired Brain Injury. J Clin Med 2023; 12:4070. [PMID: 37373763 DOI: 10.3390/jcm12124070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Emotional experiences can lead to a real or distorted self-representation. After brain damage, altered self-perception of one's own body image is frequent. This study evaluates the relationship of mood disorders and lesion sites on body image in a cohort of ABI patients. A total of 46 patients (26 men, 20 women) without severe physical impairments were found eligible for this study. Patients underwent Beck's Depression Inventory and the Hamilton Rating Scale for Anxiety to assess mood disorders, whereas the Body Image Scale and Human Figure Drawing were used to evaluate body dissatisfaction and implicit body image. The Montreal Cognitive Assessment was used to assess patients' cognitive condition. We found a moderate correlation between depression and body image (r = 0.48), as well as between anxiety and body image (r = 0.52), and the regression model also reported the right lesion site as a predictive variable for body image score. In addition, the regression model built by Human Figure Drawing scores showed anxiety, cognitive functioning, and a marital status of single to be significant predictors. The study confirmed that participants with acquired brain injury have deficits in body representation associated with mood disorders, regardless of the side of the lesions. A neuropsychological intervention could be useful for these patients to improve their cognitive performance and learn to manage emotional dysfunction in order to increase their self-perception of body image and improve their quality of life.
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Affiliation(s)
| | | | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy
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Sarah A, Ownsworth T, Clough B, Neumann DL. Impairments in Physiological Reactivity to Emotive Stimuli After Traumatic Brain Injury: A Systematic Review of Skin Conductance and Heart Rate Variability Evidence. J Head Trauma Rehabil 2023; 38:214-230. [PMID: 35862893 DOI: 10.1097/htr.0000000000000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine evidence of impairments in physiological reactivity to emotive stimuli following traumatic brain injury (TBI). METHODS A search of PsychINFO, CINAHL (Cumulative Index to Allied Health Literature), Web of Science, EMBASE (Excerpta Medica dataBASE), and Scopus databases was conducted from 1991 to June 24, 2021, for studies comparing changes in skin conductance or heart rate variability to emotive stimuli between adults with TBI and controls. Two reviewers independently assessed eligibility and rated methodological quality. RESULTS Twelve eligible studies examined physiological reactivity to laboratory-based emotive stimuli, which included nonpersonal pictures/videos, posed emotion, stressful events, and personal event recall. Overall, 9 reported evidence that individuals with TBI experience lower physiological reactivity to emotive stimuli compared with healthy controls, although the findings varied according to the type and valence of emotional stimuli and physiological parameter. Most studies using nonpersonal pictures or videos found evidence of lower physiological reactivity in TBI participants compared with controls. CONCLUSIONS Based on laboratory-based studies, individuals with TBI may experience lower physiological reactivity to emotive stimuli. Further research is needed to investigate physiological responses to personally relevant emotional stimuli in real-world settings and to understand the interplay between physiological reactivity, subjective experiences, and behavior.
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Affiliation(s)
- Alysha Sarah
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia (Ms Sarah and Drs Ownsworth, Clough, and Neumann); and The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Australia (Ms Sarah and Dr Ownsworth)
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Kulzer J, Beck KB, Trabert C, Meyer EC, Colacci J, Pramuka M, McCue M. A vocational rehabilitation partnership to provide transition services to young adults with neurodevelopmental disabilities: The cognitive skills enhancement program. JOURNAL OF VOCATIONAL REHABILITATION 2023; 58:155-164. [DOI: 10.3233/jvr-230005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND: There is an urgent need for services that support a successful transition to postsecondary education and employment for young adults with neurodevelopmental and cognitive disabilities (e.g. autism spectrum disorder, attention-deficit/hyperactivity disorder, traumatic brain injury). OBJECTIVE: The purpose of this expository article is to describe the Cognitive Skills Enhancement Program (CSEP), a comprehensive clinical program designed for young adults with neurodevelopmental and cognitive disabilities transitioning to postsecondary education. METHODS: CSEP was developed through a community-academic partnership between a university and a state vocational rehabilitation program. Young adult participants complete programming that addresses four primary clinical targets: (1) emotion regulation, (2) social skills, (3) work readiness, and (4) community participation with the overall goal to increase awareness and promote successful employment outcomes while they transition to post-secondary education. RESULTS: To date, CSEP has supported 18 years of sustained programming and clinical services to 621 young adults with neurodevelopmental and cognitive disabilities. CONCLUSION: This partnership model allows for flexible responses to participant needs, implementation barriers, and advances in evidence-based practices. CSEP meets the needs of diverse stakeholders (e.g. state vocational rehabilitation, post-secondary training facilities, participants, universities) while providing high-quality and sustainable programming. Future directions include examining the clinical efficacy of current CSEP programming.
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Affiliation(s)
- Jamie Kulzer
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kelly B. Beck
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Caitlin Trabert
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric C. Meyer
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jenna Colacci
- Monte Nido & Affiliates, The Clementine Program, New York, NY, USA
| | - Michael Pramuka
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael McCue
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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Lin PC, Ko CH, Yen JY. Early and Late Luteal Executive Function, Cognitive and Somatic Symptoms, and Emotional Regulation of Women with Premenstrual Dysphoric Disorder. J Pers Med 2022; 12:jpm12050819. [PMID: 35629240 PMCID: PMC9147888 DOI: 10.3390/jpm12050819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 01/27/2023] Open
Abstract
Objective: Cognitive and somatic symptoms were vital factors in developing personalized treatment of depressive disorder. The study aimed to evaluate the following: (1) the cognitive and somatic symptoms of premenstrual dysphoric disorder (PMDD) in the early luteal (EL) and later luteal (LL) phase; and (2) their association with depression and functional impairment of PMDD. Methods: We prospectively evaluated executive function, emotion regulation, cognitive and somatic symptoms, and depression in the EL and LL phases in women with PMDD. Sixty-three women with PMDD and 53 healthy controls completed Simon’s task and questionnaire to assess emotion regulation, inattention, fatigue, insomnia, and depression. Results: Women with PMDD had a poor performance in Simon’s task during the LL phase. They were less likely to exercise cognitive reappraisal during EL and LL phases. Their cognitive reappraisal positively correlated with executive function and negatively associated with depression. In the LL phase, they also experience higher inattention, insomnia, and fatigue, which correlate with the depression and functional impairment of PMDD. Inattention is the most associated factor of PMDD and functional impairment in controlling depression. Conclusion: Executive function was impaired in women with PMDD during the LL phase. Its performance correlated positively with emotion regulation and negatively with depression. The association between inattention and PMDD functional impairment indicates that evaluation and intervention for cognitive impairment were essential in treating women with PMDD. Further studies were required to elucidate the possible etiology underlying these associations.
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Affiliation(s)
- Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, Faculty of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan
| | - Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, Faculty of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101
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