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The growing use of digitized mental health applications requires new reliable early screening tools to identify user suicide risk. We used a lexicon-based random forest machine learning algorithm to predict suicide ideation scores from 714 online community text posts from December 2019 to April 2020. We validated predicted scores against expert-rated suicide ideation scores. The algorithm-predicted scores offered high validity and a low error rate and correctly identified 95% of expert-rated high-risk suicide ideation posts. Our findings highlight a potential new method to detect suicidal ideation of digital mental health application users. [ABSTRACT FROM AUTHOR]

Objectives: The Toronto Mindfulness Scale (TMS) and the State Mindfulness Scale (SMS) are two relevant self-report measures of state mindfulness. The purpose of this study was to examine the internal structure and to offer evidence of the reliability and validity of the Spanish versions of the TMS and SMS. Methods: Data from six distinct non-clinical samples in Spain were obtained. They responded to the TMS (n = 119), SMS (n = 223), and measures of trait mindfulness, decentering, non-attachment, depression, anxiety, stress, positive and negative affect, self-criticism, and self-reassurance. The internal structure of the TMS and SMS was analyzed through confirmatory factor analysis. Reliability, construct validity, and sensitivity to change analyses were performed. Results: The correlated two-factor structure (curiosity and decentering) was the best-fitting model for the TMS (CFI = 0.932; TLI = 0.913; RMSEA = 0.100 [0.077– 0.123]; WRMR = 0.908). The bifactor structure (general factor, mindfulness of body, and mindfulness of mind) was the best-fitting model for the SMS (CFI = 0.961; TLI = 0.950; RMSEA = 0.096 [0.086–0.106]; WRMR = 0.993). Adequate reliability was found for both measures. The reliability of the SMS specific factors was very poor when controlling for the general factor. The patterns of correlations were mainly as expected and according to previous literature. The TMS and SMS have been able to detect state mindfulness changes after different meditation practices. Conclusion: Validity evidence is provided to support the use of the TMS and SMS in Spanish populations, though the reliability of the SMS specific factors merit revision. [ABSTRACT FROM AUTHOR]

Background: Longitudinal neuroimaging investigations of antidepressant treatment offer the opportunity to identify potential baseline biomarkers associated with poor outcome. Methods: To explore the neural correlates of nonresponse to cognitive behavioural therapy (CBT) or venlafaxine (VEN), we compared pretreatment (18)F-fluoro-2-deoxy-D-glucose positron emission tomography scans of participants with major depressive disorder responding to either 16 weeks of CBT (n = 7) or VEN treatment (n = 9) with treatment nonresponders (n = 8). Results: Nonresponders to CBT or VEN, in contrast to responders, exhibited pretreatment hypermetabolism at the interface of the pregenual and subgenual cingulate cortices. Limitations: Limitations of our study include the small sample sizes and the absence of both arterial sampling to determine absolute glucose metabolism and high-resolution structural magnetic resonance imaging coregistration for region-of-interest analyses. Conclusion: Our current findings are consistent with those reported in previous studies of relative hyperactivity in the ventral anterior cingulate cortex in treatment-resistant populations. Contexte: Les etudes de neuro-imagerie longitudinales pendant le traitement antidepresseur offrent la possibilite de reperer certains biomarqueurs de base susceptibles d'etre associes a une evolution moins favorable. Methodes: Pour explorer les correlats neuraux propres au phenomene de resistance a la therapie cognitivo-comportementale (TCC) ou au traitement par venlafaxine (VEN), nous avons compare les tomographies par emission de positrons au (18)F-fluoro-2-desoxy-D-glucose pretherapeutiques de participants atteints de troubles depressifs majeurs qui ont repondu soit a 16 semaines de TCC (n = 7), soit a un traitement par VEN (n = 9), a celles de participants n'ayant pas repondu au traitement (n = 8). Resultats: Comparativement aux participants ayant repondu au traitement, ceux qui n'ont repondu ni a la TCC ni a la VEN presentaient en pretraitement un hypermetabolisme au niveau de l'interface du cortex cingulaire ventro-anterieur du genou du corps calleux. Limites: Les limites de notre etude sont notamment la petite taille des echantillons et l'absence a la fois de prelevements arteriels pour determiner le metabolisme absolu du glucose et d'enregistrements simultanes d'imagerie par resonance magnetique structurelle de haute resolution a des fins d'analyse des regions concernees. Conclusion: Nos resultats actuels concordent avec ceux d'etudes anterieures sur l'hyperactivite relative du cortex cingulaire ventro-anterieur dans le traitement des populations refractaires au traitement., Introduction The 2 most established acute treatment modalities for major depressive disorder (MDD) are pharmacotherapy and evidence-based psychotherapy, particularly cognitive behavioural therapy (CBT). Both have roughly comparable outcomes. (1,2) Nevertheless, [...]

This paper tackles a power minimization problem of interleave-division multiple-access (IDMA) systems over a fading multiple-access channel. The problem is minimizing the total power received by the receiver while keeping the bit error rates (BERs) of all users below a predefined value. The original formulation of the problem has highly nonlinear and implicitly defined functions, which render most existing optimization methods incapable. A new formulation is proposed in this paper, whose solution can effectively be obtained by a branch-and-bound (B&B) technique. An algorithm is devised based on B&B, and its effectiveness is also demonstrated by numerical experiments of systems with a moderate numbers of users. Index Terms--Branch-and-bound (B&B), code-division multiple access (CDMA), interleave-division multiple access (IDMA), iterative multiuser detection (MUD), optimization, power allocation.

In this study, the authors both developed and validated a self-report mindfulness measure, the Toronto Mindfulness Scale (TMS). In Study 1, participants were individuals with and without meditation experience. Results showed good internal consistency and two factors, Curiosity and Decentering. Most of the expected relationships with other constructs were as expected. The TMS scores increased with increasing mindfulness meditation experience. In Study 2. criterion and incremental validity of the TMS were investigated on a group of individuals participating in 8-week mindfulness-based stress reduction programs. Results showed that TMS scores increased following treatment, and Decentering scores predicted improvements in clinical outcome. Thus, the TMS is a promising measure of the mindfulness state with good psychometric properties and predictive of treatment outcome. Keywords: Toronto Mindfulness Scale; self-report assessment: mindfulness; meditation; psychometric characteristics

Teasdale's differential activation hypothesis (DAH) has been proposed as one account of cognitive vulnerability to depression. This view holds that important factors determining whether one's initial depression becomes more severe or persistent are the degree of activation, and content, of negative thinking patterns that become accessible in the depressed state. This phenomenon has been referred to as cognitive reactivity. Empirical support for the predictions of this model derives from a combination of cross-sectional and prospective studies. In this article, we evaluate this evidence with the goal of determining whether mood-induced cognitive reactivity can be considered a risk factor for depressive relapse/recurrence. Our review demonstrates sufficient evidence to consider cognitive reactivity as a potential causal risk factor for depressive relapse/recurrence. Furthermore, we extend the application of this model to the problem of suicidal relapse/recurrence including a review of preliminary support for this approach. Keywords: Major depression; Relapse/recurrence; Differential activation hypothesis; Cognitive reactivity; Risk factor; Suicide

Objective: "Decentering" is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind (Safran & Segal, 1990), and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The present study sought to examine the role of decentering, and other related variables, in the efficacy of Mindfulness-based cognitive therapy (MBCT) as compared to two active comparison conditions. Method: Formerly depressed individuals (N = 227), randomly assigned to MBCT (n = 74), relaxation group therapy (RGT; n = 77) or Treatment as usual (TAU; n = 76), completed self-report measures of decentering and symptoms of depression at pre-, mid-, and posttreatment, and relapse was assessed at 3, 6, 9, and 12 months, posttreatment. Results: With regard to the acute treatment phase, results indicated that, whereas levels of depression increased in both RGT and TAU, MBCT patients remained free from symptom gains. Moreover, gains in decentering from mid- to posttreatment predicted reductions in depression from pre- to posttreatment for MBCT and TAU, but not for RGT. Participants who experienced increases in decentering, measured from mid- to posttreatment, generally evidenced the lowest levels of relapse/recurrence (during the four follow-up assessments), largely irrespective of treatment group. However, results related to change in decentering should be considered exploratory due to small cell sizes among participants who did not experience gains in decentering. Conclusions: Taken together, these results suggest that decentering is a potent mechanism for reduction of relapse in major depression, albeit one that is nonspecific to MBCT. What is the public health significance of this article?: Gains in decentering, regardless of treatment modality, are associated with reductions in relapse/recurrence in depression. [ABSTRACT FROM AUTHOR]

Neuropsychological tests enable an analysis of the correlations between extensive intoxication due to alcohol, aggressive behavior, provocation and frontal-lobe function. The response of subjects with low cognitive functioning to provocation was more aggressive than that of the others. These individuals, upon alcohol intoxication, exhibit an enhanced intensity of shock. These studies imply the increase in aggression due to provocation, coupled with alcohol intoxication.

Background: Family physicians have an important role to play in accessing and coordinating community mental health services and supports for patients affected by mood disorders such as depression and anxiety. Bounce Back is a program introduced in British Columbia in 2008 to help physicians meet the mental health needs of their patients while lessening the demand on the health care system. The program offers cognitive behavior therapy to patients with mild to moderate depression with or without anxiety who might benefit from a low-intensity intervention. Clinical measures such as the Patient Health Questionnaire are used to determine patient eligibility and for ongoing assessment of mental health status. Patients are ineligible if they require more intensive mental health services (e.g., they have bipolar disorder or cognitive impairment) and may become ineligible while in the program if their clinical presentation changes. Workbooks for the program include carefully sequenced questions designed to bring about change in how participants think and in what they do to improve how they feel. Coaches trained by registered psychologists provide motivational support by telephone and communicate with the referring health professional to provide updates on the status of the patient. In 2017 a study was undertaken to evaluate the clinical effectiveness of this program using data from the first 6 years of operation. Methods: Data were collected for 25 338 patients with closed cases who were referred to Bounce Back from 1 July 2008 to 31 March 2014. Clinical outcomes were explored in terms of improvement, remission, and recovery from depression and anxiety over time. Recovery was defined using criteria from the UK National Health Services program, Improving Access to Psychological Therapies, and presented as a percentage of patients who had scored in the subclinical range at completion after scoring in the clinical range at assessment. Means and standard deviations were calculated for patient age and clinical measure scores. Results: More women than men were referred to Bounce Back (74% vs 26%) and the mean age at referral was 44.5 years. Four groups of patients were identified: declined (patients who did not receive further assessment or coaching), inappropriate (patients deemed ineligible for the program), incomplete (patients who received some service but did not complete the program), and completed (patients with preintervention and postintervention scores for all clinical measures). When preintervention and postintervention scores were compared, patients were found to have significant reductions in symptoms of depression and anxiety. A recovery rate of 68.5% was calculated, based on 5537 participants who initially had symptoms of depression, anxiety, or both, and 3794 participants who no longer had clinical symptoms after completing the program. Conclusions: Study findings show Bounce Back is associated with positive outcomes for patients with mild to moderate depression with or without anxiety and that the program's clinical effectiveness is in line with initiatives assessed by other studies. While the study had some limitations regarding the grouping of patients, only patients completing the program had both preintervention and postintervention data, and the results would therefore not be affected by other possible grouping methods, suggesting the outcomes for the completed group would remain unchanged. Like other large-scale initiatives being implemented to provide low-intensity mental health treatments, Bounce Back allows for earlier and easier access to services and better matching of service intensity to need. [ABSTRACT FROM AUTHOR]

This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients (n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.

Input shaping has been shown to yield good performance in the control of flexible structures while being insensitive to modeling errors. However, previous studies do not take into account the distributions of the parameter variations. We develop a new input shaping method that allows the ranges of system parameter values to be weighted according to the expected modeling errors. Comparisons with previously proposed input shaper designs are presented to illustrate the qualities of the new input shaper design method. These new shapers will be shown to have better robustness under uncertainty in structural parameters and shorter shaper lengths for lightly damped systems. [S0022-0434(00)02201-2]

This study examined the clinical applicability of the Group Therapy Questionnaire (GTQ) for identifying individuals at risk of poor attendance in cognitive-behavioral therapy (CBT) groups for depression, anxiety, and obsessive-compulsive disorder (OCD). Participants (n = 80) completed the GTQ prior to their involvement in one of five types of CBT groups. Participants’ attendance was recorded by the group therapists. Findings revealed that patients’ expectations of group were associated with attendance. Level of interpersonal difficulty, health issues, and drug and alcohol use—as assessed by the GTQ—were not associated with attendance. A shorter version of the GTQ with questions tapping expectations of group participation would provide a valuable screening tool to aid clinicians in identifying clients at risk for low attendance. [ABSTRACT FROM AUTHOR]

The cognitive model of depression specifies the role of schema-driven negative processing biases in the onset and maintenance of depression. Research has shown that cognitive reactivity, or the ease with which negative thinking patterns are activated by mild changes in negative mood, is related to relapse and recurrence. The goal of this study was to examine cognitive reactivity following a mood prime in individuals vulnerable to depression. Formerly (n = 28) and never (n = 36) depressed individuals were assessed on two measures of negative cognition, the Automatic Thoughts Questionnaire (ATQ) and Dysfunctional Attitudes Scale (DAS), before and after participating in a sad or neutral mood induction procedure (MIP). The negative mood induction resulted in increased belief in negative automatic thoughts across groups; however, only the formerly depressed participants assigned to this condition demonstrated increased DAS scores. Importantly, individuals who completed the neutral mood induction did not exhibit increases in negative cognition, providing evidence against the possibility that the MIP itself may lead to increases in negative cognition. These findings are discussed in relation to understanding the role of negative cognition and vulnerability to depression. [ABSTRACT FROM AUTHOR]

This study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non-directed attention. Healthy adults were tested before and after random assignment to an 8-week Mindfulness-Based Stress Reduction (MBSR) course (n = 39) or a wait-list control (n = 33). Testing included measures of sustained attention, attention switching, Stroop interference (as a measure of inhibition of elaborative processing), detection of objects in consistent or inconsistent scenes (as a measure of non-directed attention), as well as self-report measures of emotional well-being and mindfulness. Participation in the MBSR course was associated with significantly greater improvements in emotional well-being and mindfulness, but no improvements in attentional control relative to the control group. However, improvements in mindfulness after MBSR were correlated with improvements in object detection. We discuss the implications of these results as they relate to the role of attention in mindfulness. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Recent innovations in psychological treatments have integrated mindfulness meditation techniques with traditional cognitive and behavioural therapies, challenging traditional cognitive and behavioural therapists to integrate acceptance- and change-based strategies. This article details how 2 treatments, mindfulness-based cognitive therapy and dialectical behaviour therapy, have met this challenge. We review the integration rationale underlying the 2 treatments, how the treatments combine strategies from each modality to accomplish treatment goals, implications for therapist training, and treatment effectiveness. In addition, we discuss the challenges of assessing the benefits of incorporating acceptance-based strategies. Both therapies have integrated acceptance-based mindfulness approaches with change-based cognitive and behavioural therapies to create efficacious treatments. [ABSTRACT FROM AUTHOR]

Objective: This report describes the design and feasibility of conducting a unique longitudinal supervision course incorporating both therapist and patient evaluation measures in teaching cognitive-behavioural therapy (CBT) to a group of mental health practitioners.Method: We designed a 10-session longitudinal supervision course to teach CBT by applying key continuing medical education (CME) principles. Each session consisted of 30 minutes of didactics and demonstrations followed by 90 minutes of group case supervision. Course participants were mental health practitioners who treated patients from their own practice; most of the patients suffered from a depressive and (or) anxiety disorder. We assessed therapists for CBT skill acquisition at the beginning and at the end of the course, using the Cognitive Therapy Scale (CTS). We assessed patients' symptoms weekly, using the Beck Depression Inventory, the Beck Anxiety Inventory, and the Clinical Global Impression scale.Results: A total of 34 participants enrolled in three 10-session courses. Most participants submitted audiotapes for rating at the beginning and end of the course, and most submitted patient symptom information.Conclusions: This course shows promise as an effective way to teach complex skills in CBT to mental health providers. In limited samples, the course showed clear improvement in therapist adherence to CBT and in patients' clinical outcomes. Future research is required to validate the potential benefit of this CME intervention for mental health practitioners treating patients with mood and anxiety disorders. [ABSTRACT FROM AUTHOR]

We consider the problem of minimum time input shaping and its relation to the classical time-optimal control problem. We demonstrate that some typical minimum time input shapers are equivalent to the time-optimal control of different, although related, systems. The analytical proofs are based on the optimality criteria stipulated by the Karush-Kuhn-Tucker conditions. [Copyright &y& Elsevier]

Presents the case study of an old woman who was admitted for new onset diabetes with diabetic ketoacidosis and urinary tract infection. Results of medical examination; Factors involved in the pathogenesis of emphysematous pyelonephritis; Causes of gas within the urinary tract.