Search

Open-label placebos (OLPs) are administered without the deception of participants or patients. Placebo recipients are informed that they are receiving a physiologically inert substance or another type of sham treatment. OLPs have been successfully used to reduce stress and negative affective states. There are also preliminary findings that OLPs can improve sleep quality. However, the general evidence on the improvement of sleep quality by OLPs is still very limited, and further research is needed to evaluate whether OLPs are a suitable tool to improve sleep quality or to attenuate sleep disturbance symptoms in clinical psychological practice. The evaluation of possible interventions to improve sleep quality is highly relevant since more than one-third of the population in German-speaking countries suffers from sleep problems. Insufficient sleep duration is increasingly discussed as a risk factor for weight gain and obesity. Observational studies describe higher intakes of fat and carbohydrates in sleep-deprived or sleep-disordered individuals. For example, sleepier participants in one study reported higher cravings for high-fat sweet foods. This craving suggests that fatigue, short sleep duration, and poor sleep quality promote overconsumption of high-calorie foods. In this study, we aim to assess how an OLP (compared to a classic placebo intervention and a control group with no intervention) affects sleep quality and how this change affects reactivity to food stimuli (e.g., specific appetite, visual attention).

Food information has a high reward value for human beings, and may be more so for those who are overweight or obese. Attention bias towards or away from food stimuli appears to be related to clinical symptoms in disordered eating and obesity. A popular task to assess attentional bias is the dot probe task. However, several studies have shown that the dot probe task has low reliability, making it a poor candidate to study individual differences or assess changes. A recent study (van Ens et al., 2019), however, seems to suggest that, by using a long stimulus presentation duration (3 seconds or longer), reaction time index may have acceptable internal and good test-retest reliability; in addition, although eye-tracking based first fixation measure had poor internal and test-retest reliability, the total dwell time measure had excellent internal and acceptable test-retest reliability. But several confounding factors and major limitations in this study may affect the validity and generalizability of the results: 1) it was mentioned that the color and complexity between food and nonfood stimuli were carefully matched, but it was not clear how; moreover, important physical properties such as luminance and contrast were not controlled for. Therefore, it was not clear whether any bias observed between food and nonfood images might be due to potential physical differences in luminance, contrast, etc. 2) Only 20 food stimuli (10 for high caloric density and 10 for low caloric density) were used, each presented for four times in the experiment. The limited number of images raises the question of generalizability across different food images; and repetitive presentations of images raises the possibility that any bias observed might not be due to attention per se but might relate to memory. 3) It was mentioned that appetizing stimuli were used to draw participants’ attention but it was not clear whether and how tastefulness was actually measured, which is important given individual differences in food preference. Moreover, caloric density was used, but it might not be a good index of healthfulness, since healthfulness, too, can be subjective. 4) reliability was measured only by Pearson’s correlation, which is a limited measure of reliability; for example, it does not take into account systematic differences between testing sessions. 5) the food and nonfood images were presented for 3 seconds, which is much longer than typically used in the dot probe task. It is then not clear how presentation duration might affect attentional bias and its reliability. Therefore, we plan to conduct a systematic investigation of the reliability of eye tracking based attention bias to food images in the dot-probe task using both reaction time and eye tracking measures. We plan to do so in two studies. In study 1, we resolve the confounds and limitations identified above with a few key innovations: 1) to control for differences in physical properties between food and nonfood stimuli, we use diffeomorphic transformed images based on the food images to serve as low-level control stimuli; 2) to improve generalizability and avoid the memory confound, we will increase the number of food images from 20 to 288, with each food image presented only once; 3) to control for individual differences in subjective perception, healthfulness and tastiness of the food items are rated by each participant individually, with the ratings then used to divide the food images into four groups (low healthfulness and low tastiness, low healthfulness and high tastiness, high healthfulness and low tastiness, and high healthfulness and high tastiness); 4) to provide a comprehensive evaluation, reliability is assessed by Pearson’s correlation coefficients/intraclass correlation coefficients (ICC), standard errors of measurement, and Cronbach’s alpha. In study 2, we also systematically investigate the role of presentation duration and the role of image repetitions in attention bias, by manipulating stimulus duration (100 ms, 500 ms, 1000 ms, vs. 3000 ms) and repetitions (1 time vs. 4 times).

Food information has a high reward value for human beings, and may be more so for those who are overweight or obese. Stimuli with high reward value may be particularly conspicuous, demanding our attention even when we are attending to something else. Yet, the nature and neural signals of potential biased processing of food information remains unclear. Moreover, despite decades of research, a reliable measure of food information processing remains elusive, making it a methodological bottleneck in obesity and disordered eating research. To address the nature of biased attention processing, we ask 1) how attention is biased toward two cardinal properties of food information, namely, healthfulness and tastiness, even though the food information is irrelevant to the task at hand; and 2) whether and how such processing might be dependent on the demandingness of the central task (i.e., perceptual load). In our previous study which has been preregistered, we recruited 32 participants and measured their responses to infrequent visual food information embedded in streams of other visual objects in EEG, specifically, by using a variant of steady-state visual evoked potential (SSVEP), oddball fast periodic visual stimulation (FPVS). The infrequent food objects (i.e., oddballs) are one of four different combinations in different trials based on healthfulness and tastiness: 1) high healthfulness and high tastiness; 1) high healthfulness and low tastiness; 3) low healthfulness and high tastiness; and 4) low healthfulness and low tastiness. The perceptual load of the central task is either low (detection of a certain color of letters) or high (detection of certain combinations of color and identity of letters). In this study, the results demonstrated robust and reliable implicit categorization of food information at the individual level for all 32 participants, with the effect not modulated by perceptual load or tastiness (but might be by healthfulness). Since oddball FPVS is a novel paradigm applied to studying food information processing, it would be critical to replicate the findings in order to develop FPVS as a reliable measure of food information processing as well as apply this tool to obesity or other clinical sample with eating disorders. In particular, the modulating effect of healthfulness observed was not salient and requires further evidence. Furthermore, the lack of modulation by tastiness and perceptual load also warrants replication. Therefore, we plan to conduct a replication study with the same paradigm and sample size to validate our previous findings.

People with Autism Spectrum Disorder (ASD) are often judged as less engaging, less likeable, and more awkward based on nonverbal behavior alone (Grossman, 2015; Marchena & Eigsti, 2010). Such first impressions can have a significant negative impact on social development and functional outcome for individuals with ASD. Recent studies have also found that individuals with ASD do not achieve the same level of nonverbal coordination in their interactions as typically-developed (TD) individuals (Georgescu et al., 2020; Wadge et al., 2019). This study investigates whether impression formation by TD participants differs between ASD and TD individuals and is influenced by non-verbal interpersonal synchrony.

The study is an initial investigation of the feasibility of applying Bayesian sequential analyses to individual participant single-case data for rapid detection of whether or not the individual is benefitting from a low-intensity computerized cognitive training intervention for depression. Patients waiting for, or in follow-up from, outpatient psychological therapy will complete first a two-week period of daily symptom monitoring, followed by two different two-week cognitive training interventions. Data collected will be used to assess feasibility of a future formal case series using Bayesian sequential analyses to determine switching of interventions, and inform the analysis parameters for such a future study.

Depression and related mood disorders constitute an enormous burden on health, quality of life, and the global economy, and women have roughly twice the lifetime risk of men for experiencing depression. Here, we review sex differences in human brain physiology that may be connected to the increased susceptibility of women to major depressive disorder (MDD). Moreover, we summarize decades of preclinical research using animal models for the study of mood dysfunction that uncover some of the potential molecular, cellular, and circuit-level mechanisms that may underlie sex differences and disease etiology. We place particular emphasis on a series of recent studies demonstrating the central contribution of the circuit projecting from ventral hippocampus to nucleus accumbens and how inherent sex differences in the excitability of this circuit may predict and drive depression-related behaviors. The findings covered in this review underscore the continued need for studies using preclinical models and circuit-specific strategies for uncovering molecular and physiological mechanisms that could lead to potential sex-specific diagnosis, prognosis, prevention, and/or treatments for MDD and other mood disorders.

BackgroundMaternal depression and anxiety may increase the risk of offspring incontinence; however, current evidence is unable to draw causal inferences. This study aimed to examine prospective associations between maternal psychopathology and offspring incontinence/constipation and examine evidence for causal intra-uterine effects.MethodsThe study used data from 6,489 children from the Avon Longitudinal Study of Parents and Children. Mothers provided data on depression and anxiety (antenatal and postnatal) and their child’s incontinence (daytime wetting, bedwetting, soiling) and constipation at age 7. We used multivariable logistic regression to examine evidence for independent effects of maternal depression/anxiety on offspring incontinence/constipation and explore a critical/sensitive period of exposure. A negative control design was utilised to examine evidence causal intra-uterine effects.ResultsPostnatal maternal psychopathology was associated with an increased risk of offspring incontinence and constipation (e.g. postnatal anxiety and daytime wetting OR: 1.53; 95% CI: 1.21-1.94), and data were consistent with a critical period model. There was evidence for an independent effect of maternal anxiety. Antenatal maternal psychopathology was associated with constipation (e.g. antenatal anxiety OR: 1.57; 95% CI: 1.25-1.98), but there was no evidence for a causal intra-uterine effect.LimitationsAttrition and maternal reports without use of established diagnostic criteria for incontinence/constipation are potential limitations.ConclusionsChildren exposed to maternal postnatal psychopathology had a greater risk of incontinence/constipation, and maternal anxiety had stronger associations than depression.

BACKGROUND: The choice of antidepressants for initial pharmacological treatment of depression in older adults and associated patients' characteristics are understudied. We aimed to describe the first selected antidepressant (first-choice) for depression in older adults (≥65 years) and whether patients' sociodemographic and clinical characteristics influence selecting an alternative first-choice (any other antidepressant than the nationally recommended first-choice sertraline) in Denmark.METHODS: Register-based cross-sectional study including all older adults who redeemed their first antidepressant prescription for depression at community pharmacies in Denmark in 2015-2019. We analyzed the effect of patients' characteristics on the first-choice antidepressant selection using multinomial logistic regression.RESULTS: Among 34,337 older adults with a first antidepressant-prescription, over two-thirds filled alternative first-choice antidepressants than sertraline (28.9 %): escitalopram or citalopram (30.3 %) or mirtazapine (34.4 %). Socially disadvantaged older adults (e.g., with short educational attainment, being single, or of non-western ethnicity) and clinically vulnerable older adults (e.g., having somatic diagnoses and hospital contacts) were more likely to use alternative first-choice antidepressants.LIMITATIONS: Information on prescribers and in-hospital medications was not included in this study.CONCLUSIONS: Further investigation of the first antidepressant selection and its impact on depression treatment outcomes in older adults is necessary. Moreover, for older patients, national guidelines on depression treatment should be more specific.ARTICLE SUMMARY: Antidepressant selection for initial pharmacological treatment of depression in older adults can be difficult due to comorbidity, polypharmacy, and age-related changes in pharmacokinetics and pharmacodynamics. Real-world evidence/knowledge on first-choice antidepressant selection and associated user characteristics are rare. This Danish register-based cross-sectional study found over two-thirds of older adults filled alternative antidepressants (primarily escitalopram/citalopram or mirtazapine) than nationally recommended first-choice sertraline for depression treatment and identified wide-ranging sociodemographic and clinical factors influencing the first antidepressant selection.

Experience sampling studies into daily-life affective reactivity indicate that depressed individuals react more strongly to both positive and negative stimuli than non-depressed individuals, particularly on negative affect (NA). Given the different mean levels of both positive affect (PA) and NA between patients and controls, such findings may be influenced by floor/ceiling effects, leading to violations of the normality and homoscedasticity assumptions underlying the used statistical models. Affect distributions in prior studies suggest that this may have particularly influenced NA-reactivity findings. Here, we investigated the influence of floor/ceiling effects on the observed PA- and NA-reactivity to both positive and negative events. Data came from 346 depressed, non-depressed, and remitted participants from the Netherlands Study of Depression and Anxiety (NESDA). In PA-reactivity analyses, no floor/ceiling effects and assumption violations were observed, and PA-reactivity to positive events, but not negative events, was significantly increased in the depressed and remitted groups versus the non-depressed group. However, NA-scores exhibited a floor effect in the non-depressed group and naively estimated models violated model assumptions. When these violations were accounted for in subsequent analyses, group differences in NA-reactivity that had been present in the naive models were no longer observed. In conclusion, we found increased PA-reactivity to positive events but no evidence of increased NA-reactivity in depressed individuals when accounting for violations of assumptions. The results indicate that affective-reactivity results are very sensitive to modeling choices and that previously observed increased NA-reactivity in depressed individuals may (partially) reflect unaddressed assumption violations resulting from floor effects in NA.

BACKGROUND: Depression is a heterogeneous disease. Identification of latent depression subgroups and differential associations across these putative groups and sociodemographic and health-related factors might pave the way toward targeted treatment of individuals.METHODS: We used model-based clustering to identify relevant subgroups of 2900 individuals with moderate to severe depression (defined as scores ≥10 on the PHQ-9 instrument) from the NHANES cross-sectional survey. We used ANOVA and chi-squared tests to assess associations between cluster membership and sociodemographics, health-related variables, and prescription medication use.RESULTS: We identified six latent clusters of individuals, three based on depression severity and three differentially loaded by somatic and mental components of the PHQ-9. The Severe mental depression cluster had the most individuals with low education and income (P LIMITATIONS: Due to the cross-sectional design we cannot make conclusions about causal relationships. We used self-reported data. We did not have access to a replication cohort.CONCLUSIONS: We show that socioeconomic factors, somatic diseases, and prescription medication use are differentially associated with distinct and clinically relevant clusters of individuals with moderate to severe depression.