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Background: In the absence of disease-modifying treatments, identifying potential psychosocial risk factors for dementia is paramount. Depression and anxiety have been identified as potential risk factors. Studies however have yielded mixed findings, lending possibility to the fact that potential constellations of co-occurring depression and anxiety symptoms may better explain the link between affective symptoms and cognitive decline.Methods: Data from participants (aged 50 and above) of the PROTECT study was used. Latent Class Analysis (LCA) was conducted on 21,684 participants with baseline anxiety and depression measures. Multiple linear regressions models, using a subset of these participants (N = 6136) who had complete cognition data at baseline and at 2-year follow-up, were conducted to assess for associations between class membership and longitudinal changes in cognition.Results: The LCA identified a 5-class solution: "No Symptoms", "Sleep", "Sleep and Worry", "Sleep and Anhedonia", and "Co-morbid Depression and Anxiety". Class membership was significantly associated with longitudinal change in cognition. Furthermore, this association differed across different cognitive measures.Limitations: Limitations included significant attrition and a generally healthy sample which may impact generalisability.Conclusions: Substantial heterogeneity in affective symptoms could explain previous inconsistent findings concerning the association between affective symptoms and cognition. Clinicians should not focus solely on total symptom scores on a single affective domain, but instead on the presence and patterns of symptoms (even if sub-clinical) on measures across multiple affective domains. Identifying particular subgroups that are at greater risk of poor cognitive outcomes may support targeted prevention work. [ABSTRACT FROM AUTHOR]

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited. Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery. Study Design: Cohort study; Level of evidence, 3. Methods: Using SRC data from the Ivy League–Big Ten Epidemiology of Concussion Study among varsity athletes through February 2020, we identified the 4 affective symptoms from the Sport Concussion Assessment Tool symptom inventory. We modeled the relationship between a 4-category affective symptom variable and time to symptom resolution, RTP, and RTP progression, adjusting for nonaffective symptom prevalence and concussion history. Cox regressions were used to estimate hazard ratios for time to event outcomes, and linear regressions were used to evaluate mean differences for continuous outcomes. Results: Among 2077 student-athletes (men, 63.5%) with SRC symptoms, affective symptom prevalence was 47.6% and 44.3% in women and men, respectively, and nervous-anxious prevalence was 24.2% and 22.5%, respectively. When comparing women with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with affective symptoms, and women with nervous-anxious symptoms spent significantly longer in RTP progression. When comparing men with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with co-occurring affective symptoms, and affective symptoms were not associated with time in RTP progression. Conclusion: Student-athletes with affective symptoms and nervous-anxious symptoms exhibited delayed clinical recovery and RTP timelines, particularly for time in RTP. Symptom prevalence and concussion history contributed to this; however, unmeasured confounding remains, as indicated by the poor model fit. This study motivates future work to explore affective symptoms and RTP timelines, considering anxiety and risk/protective factors over time. [ABSTRACT FROM AUTHOR]

Background : Stressful situations and psychopathology symptoms (e.g., depression and anxiety) shape how individuals regulate and respond to others' emotions. However, how emotional expressions influence mental health and impact intrapersonal and interpersonal experiences is still unclear. Objective : Here, we used the Flexible Regulation of Emotional Expression (FREE) scale to explore the relationship between emotional expression abilities with affective symptoms and mental health markers. Methods : From a sample of 351 participants, we firstly validate a German version of the FREE scale on a final sample of 222 participants located in Germany, recruited through an online platform. Following this, we performed confirmatory factor analyses to assess the model structure of the FREE-scale. We then utilize a LASSO regression to determine which indicators of psychopathology symptoms and mental health are related to emotional expressive regulation and determine their particular interactions through the general linear model. Results : We replicated the FREE scale's four latent factors (i.e., ability to enhance and suppress positive as well as negative emotional expressions). After the selection of relevant instruments through LASSO regression, the suppress ability showed specific negative associations with depression (r = 0.2) and stress symptoms (r = 0.16) and positive associations with readiness to confront distressing situations (r = 0.25), self-support (r = 0.2), and tolerance of emotions (r = 0.2). Both, emotional expressions enhance and suppress abilities positively associated with coping markers (resilience) and emotion regulation skills. Finally, the interaction effects between emotional flexibility abilities and stress, depression, and anxiety symptoms evidenced that consistent with the flexibility theory, enhancing and suppressing abilities may predict psychopathological symptoms. Conclusions : These findings emphasize the importance of considering the flexibility to express emotions as a relevant factor for preserved mental health or the development of psychopathological symptoms and indicate that online surveys may serve as a reliable indicator of mental health. [ABSTRACT FROM AUTHOR]

Background: Screening glioma patients regularly for possible mood disorders may facilitate early identification and referral of patients at risk. This study evaluated if the EORTC QLQ‐C30 Emotional Functioning (EF) scale could be used as an initial screening measure to identify patients possibly having a mood disorder. Methods: EORTC QLQ‐C30 EF and Hospital Anxiety and Depression Scale (HADS) scores were collected as part of a study assessing the impact of timing of patient‐reported outcome assessments on actual health‐related quality of life outcomes (N = 99). Spearman correlations and Mann‐Whitney U tests were used to determine the association between the EF and HADS (sub)scales. Receiver Operating Characteristic analyses were performed to determine optimal cut‐off EF scores to identify patients possibly having a mood disorder (i.e. HADS subscale score ≥8 points). Results: EF and HADS (sub)scales correlated moderately (HADS‐A: r = −0.65; HADS‐D: r = −0.52). Significant EF score differences were found between patients with HADS ≥8 versus <8 points (HADS‐A: mean difference (MD) = 32 and HADS‐D: MD = 23). The EF scale had excellent (HADS‐A; AUC = 0.88) and borderline excellent (HADS‐D; AUC = 0.78) distinguishing capabilities. A statistically optimal (EF score <80) and a most inclusive (sensitivity of 100%, corresponding to an EF score <97) EF cut‐off score correctly identified 88.0% and 96.0% of patients with a possible mood disorder, respectively. Conclusion: EORTC QLQ‐C30 EF scale seems to be an appropriate screening measure to identify glioma patients possibly having a mood disorder in need of further assessment. [ABSTRACT FROM AUTHOR]

Objectives: To compare the prevalence of select cardiovascular risk factors (CVRFs) in patients with mild cognitive impairment (MCI) versus lifetime history of major depression disorder (MDD) and a normal comparison group using baseline data from the Prevention of Alzheimer's Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study. Design: Baseline data from a multi-centered intervention study of older adults with MCI, history of MDD, or combined MCI and history of MDD (PACt-MD) were analyzed. Setting: Community-based multi-centered study based in Toronto across 5 academic sites. Participants: Older adults with MCI, history of MDD, or combined MCI and history of MDD and healthy controls. Measurements: We examined the baseline distribution of smoking, hypertension and diabetes in three groups of participants aged 60+ years in the PACt-MD cohort study: MCI (n = 278), MDD (n = 95), and healthy older controls (n = 81). Generalized linear models were fitted to study the effect of CVRFs on MCI and MDD as well as neuropsychological composite scores. Results: A higher odds of hypertension among the MCI cohort compared to healthy controls (p <.05) was noted in unadjusted analysis. Statistical significance level was lost on adjusting for age, sex and education (p >.05). A history of hypertension was associated with lower performance in composite executive function (p <.05) and overall composite neuropsychological test score (p <.05) among a pooled cohort with MCI or MDD. Conclusions: This study reinforces the importance of treating modifiable CVRFs, specifically hypertension, as a means of mitigating cognitive decline in patients with at-risk cognitive conditions. [ABSTRACT FROM AUTHOR]

Abstract Background Severity of symptoms in patients with schizophrenia is a determinant of patient’s well-being, but evidence in low- and middle-income countries is limited. We aimed to measure the symptom severity using objective measurements, the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity scale (CGI-S), and their associations with well-being in patients with schizophrenia. Methods Patients with schizophrenia aged ≥18 years, without active psychosis including no history of hospitalization within the last 6 months, were included. Symptom severity was measured by the clinicians using BPRS and CGI-S. The patients’ well-being was assessed by self-report using the Subjective Well-being under Neuroleptic treatment scale (SWN) as continuous and binary outcomes (categorized into adequate or poor well-being). Correlations between symptom severity (BPRS and CGI-S scores) and well-being (SWN score) were analyzed using Pearson’s correlation. Association between well-being status and BPRS was analyzed using multivariate logistic regression. Results Of 150 patients, BPRS and CGI-S were inversely correlated with SWN score (r = − 0.47; p

Abstract Background The majority of people with dementia have behavioral and psychological symptoms of dementia (BPSD), including depression, anxiety and agitation. These may be elicited or aggravated by disrupted circadian rhythms. Bright light treatment (BLT) is a promising non-pharmacological approach to the management of BPSD, but previous research has yielded mixed results. Methods Eight nursing home dementia units (1 unit = 1 cluster) with 78 patients were invited to participate in a cluster randomized controlled trial from September 2017 to April 2018 investigating the effects of BLT on sleep and circadian rhythms (primary outcome) and BPSD (secondary outcome). Ceiling mounted LED-panels were installed in the intervention group (four units), providing light at 1000 lx and 6000 K (vertically at 1.2 m) between 10 a.m. and 3 p.m., with lower values in the mornings and evenings. Standard indoor light was used in the control group (four units). BPSD were assessed with The Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory Nursing Home Version (NPI-NH). Data collection took place at baseline and after 8, 16 and 24 weeks. Multilevel regression models with and without false discovery rate correction were used for the analysis, with baseline values and dementia stage entered as covariates. Results Sixty-nine patients were included in the study at baseline. Compared to the control group, the intervention group had a larger reduction on the composite scores of both the CSDD (95% CI = − 6.0 – − 0.3) and the NPI-NH (95% CI = − 2.2 – − 0.1), as well as on the NPI-NH Affect sub-syndrome, and the CSDD Mood related signs sub-scale at follow-up after 16 weeks. With FDR correction, the group difference was significant on the CSDD Mood related signs sub-scale (95% CI = − 2.7 – − 0.8) and the NPI-NH Affect sub-syndrome (95% CI = − 1.6 – − 0.2). No differences were found between conditions at weeks 8 or 24. Conclusion Compared to the control condition, affective symptoms were reduced after 16 weeks in the group receiving BLT, suggesting BLT may be beneficial for nursing home patients with dementia. Trial registration ClinicalTrials.gov Identifier: NCT03357328 . Retrospectively registered on November 29, 2017.

Clozapine has shown signs of effectiveness in treating symptoms of schizoaffective disorder, although little research has been carried out to specifically assess this question. The objective of this current work was to analyse the mood-stabilising effectiveness and tolerability of clozapine in patients with schizoaffective disorder. This was a prospective, longitudinal, and quasi-experimental trial with three months of follow-up in patients with refractory schizoaffective disorder (PANSS score exceeding 80). Clinical response was evaluated through monthly visits using the YMRS, MADRS, CDSS, CGI-S and UKU. Twenty-seven participants (63% men, 37% women) with a mean age of 32.56 years were included. Clozapine significantly reduced the symptoms of mania, as measured by the YMRS (pre-treatment: 16.19, post-treatment: 0.67; p < 0.01) as well as the symptoms of depression, quantified with the CDSS (pre-treatment: 6.11, post-treatment: 0.67; p < 0.01), MADRS (pre-treatment: 9.56, post-treatment: 1.07; p < 0.01), and CGI-S (pre-treatment: 4.74, post-treatment: 1.15; p < 0.01). The prescription of clozapine significantly reduced the average daily dose of neuroleptics, measured in mg of chlorpromazine (pre-treatment: 1253.55, post-treatment: 742.59; p < 0.01) and hypnosedatives, measured in mg of diazepam (pre-treatment: 33.88, post-treatment: 5.74; p < 0.05) required in these patients. Patient-perceived tolerability, measured with the UKU, also improved during follow-up (pre-treatment: 12.89, post-treatment: 8.14; p < 0.01). The efficacy of clozapine was significant for the affective symptoms of schizoaffective disorder, thereby improving patient tolerability and permitting reductions in the other medications the patients used. • Clozapine may act as a mood stabiliser in schizoaffective disorder. • Clozapine reduces affective symptoms in the first weeks, maintaining an in-time effect. • Clozapine allows to reduce the dose of psychopharmaceuticals, improving tolerability. • Clozapine significantly improves dual diagnosis by reducing substance use. • Its possible stabiliser effect reinforces clozapine utility beyond resistant psychosis. [ABSTRACT FROM AUTHOR]

Maladaptive emotional traits (anxiety sensitivity [AS], fear of anxiety-related sensations and consequences) and symptoms (major depressive disorder [MDD] and generalized anxiety disorder [GAD] symptoms) could play a role in altering sensitivity to the subjective effects of drugs of abuse in adolescents. Data were drawn from a longitudinal study of high school students in Los Angeles, CA, USA who completed surveys and reported past six-month use of alcohol (n=1054), cigarettes (n=297), or cannabis (n=706). At each of the four semi-annual waves during mid-adolescence (14-16years old), students reported positive and negative subjective drug effects experienced in the prior six-months. Controlling for covariates and the simultaneous covariance across the three domains of emotional dysfunction, AS was associated with more positive and negative cannabis effects (βs=0.09-0.16, ps

Individuals with social anxiety disorder (SAD) have difficulty forming social relationships. The prevailing clinical perspective is that negative emotions such as anxiety inhibit one's capacity to develop satisfying social connections. However, empirical findings from social psychology and affective neuroscience suggest that positive emotional experiences are fundamental to establishing new social bonds. To reconcile these perspectives, we collected repeated measurements of anxiety, positive emotions (pleasantness), and connectedness over the course of a controlled relationship formation encounter in 56 participants diagnosed with SAD (64% female; Mage=23.3, SD=4.7). Participants experienced both increases in positive emotions and decreases in anxiety throughout the interaction. Change in positive emotions was the most robust predictor of subsequent increases in connectedness, as well as a greater desire to engage one's partner in future social activities, above and beyond reductions in anxiety (medium to large sized effects). Those findings suggest that anxiety-based models alone may not fully explain difficulties in relationship formation in SAD, and underscore the potential value of considering positive emotional experiences in conceptual and treatment models of SAD.

Cumulative risk research has increased understanding of how multiple risk factors impact various socioemotional and interpersonal outcomes across the life span. However, little is known about risk factors for parent-child conflict early in development, where identifying predictors of change could be highly salient for intervention. Given their established association with parent-child conflict, child developmental delay (DD) and emotion dysregulation were examined as predictors of change in conflict across early to middle childhood (ages 3 to 7 years). Participants (n = 211) were part of a longitudinal study examining the development of psychopathology in children with or without DD. Level of parent-child conflict was derived from naturalistic home observations, whereas child dysregulation was measured using an adapted CBCL-Emotion Dysregulation Index. PROCESS was used to examine the conditional interactive effects of delay status (typically developing, DD) and dysregulation on change in conflict from child ages 3 to 5 and 5 to 7 years. Across both of these timeframes, parent-child conflict increased only for families of children with both DD and high dysregulation, providing support for an interactive risk model of parent-child conflict. Findings are considered in the context of developmental transitions, and implications for intervention are discussed. (PsycINFO Database Record

ObjectivePeople at ultra-high risk (UHR) for psychosis have a high prevalence of tobacco smoking, and rates are even higher among the subgroup that later develop a psychotic disorder. However, the longitudinal relationship between the course of tobacco smoking and clinical outcomes in UHR subjects is unknown.MethodsWe investigated associations between tobacco smoking and clinical outcomes in a prospective study of UHR individuals (n = 324). Latent class mixed model analyses were used to identify trajectories of smoking severity. Mixed effects models were applied to investigate associations between smoking trajectory class and the course of attenuated psychotic symptoms (APS) and affective symptoms, as assessed using the CAARMS.ResultsWe identified four different classes of smoking trajectory: (i) Persistently High (n = 110), (ii) Decreasing (n = 29), (iii) Persistently Low (n = 165) and (iv) Increasing (n = 20). At two-year follow-up, there had been a greater increase in APS in the Persistently High class than for both the Persistently Low (ES = 9.77, SE = 4.87, p = 0.046) and Decreasing (ES = 18.18, SE = 7.61, p = 0.018) classes. There were no differences between smoking classes in the incidence of psychosis. There was a greater reduction in the severity of emotional disturbance and general symptoms in the Decreasing class than in the High (ES = −10.40, SE = 3.41, p = 0.003; ES = −22.36, SE = 10.07, p = 0.027), Increasing (ES = −11.35, SE = 4.55, p = 0.014; ES = −25.58, SE = 13.17, p = 0.050) and Low (ES = −11.38, SE = 3.29, p = 0.001; ES = −27.55, SE = 9.78, p = 0.005) classes, respectively.ConclusionsThese findings suggests that in UHR subjects persistent tobacco smoking is associated with an unfavorable course of psychotic symptoms, whereas decrease in the number of cigarettes smoked is associated with improvement in affective symptoms. Future research into smoking cessation interventions in the early stages of psychoses is required to shine light on the potential of modifying smoking behavior and its relation to clinical outcomes.

Introduction The highly infectious novel coronavirus disease (COVID-19) emerged in Wuhan, China in late 2019 and soon became a global pandemic. COVID-19 is escalating medical staff psychological stress and creating an increasingly heavy professional burden. Fear of transmitting the virus to family, community perception of frontline workers as potential disease carriers, extreme workloads and moral dilemmas add additional stressors. In Novi Sad Clinical Centre of Vojvodina (CCV) for the past 2 years there has been a continuous struggle against the COVID-19 crisis. Both senior specialist doctors and newly hired young doctors, some without work experience, were hired immediately after completing their studies. Objectives To investigate the mental health of clinical first-line medical staff in COVID-19 pandemic. Methods This is a cross-sectional study involving CCV staff who worked in the first line of patient treatment during the COVID-19 pandemic. They were given a self-administered questionnaire which included information on demographic and socio-economic characteristics and the validated Depression, Anxiety, and Stress Scales (DASS-21) and the Impact of Events Scale–Revised (IES-R) instrument. A total of 190 medical workers were involved. Results Sixty-two (32,6%) participants screened positive for anxiety, 38 (20%) for depression, 68 (35,8%) for stress, and 22 (11,5%) for clinical concern of PTSD. The most endangered are young nurses and doctors with less than 6 months of previous work experience. Conclusions In conclusion, our results suggest frontline medical staff involved in treatment of COVID-19 patients should be closely monitored as a high-risk group for depression and anxiety, and given proper training before deployment. Disclosure No significant relationships.

Background: Stressful situations and psychopathology symptoms (e.g., depression and anxiety) shape how individuals regulate and respond to others’ emotions. However, how emotional expressions influence mental health and impact intrapersonal and interpersonal experiences is still unclear.Objective: Here, we used the Flexible Regulation of Emotional Expression (FREE) scale to explore the relationship between emotional expression abilities with affective symptoms and mental health markers.Methods: From a sample of 351 participants, we firstly validate a German version of the FREE scale on a final sample of 222 participants located in Germany, recruited through an online platform. Following this, we performed confirmatory factor analyses to assess the model structure of the FREE-scale. We then utilize a LASSO regression to determine which indicators of psychopathology symptoms and mental health are related to emotional expressive regulation and determine their particular interactions through the general linear model.Results: We replicated the FREE scale’s four latent factors (i.e., ability to enhance and suppress positive as well as negative emotional expressions). After the selection of relevant instruments through LASSO regression, the suppress ability showed specific negative associations with depression (r = 0.2) and stress symptoms (r = 0.16) and positive associations with readiness to confront distressing situations (r = 0.25), self-support (r = 0.2), and tolerance of emotions (r = 0.2). Both, emotional expressions enhance and suppress abilities positively associated with coping markers (resilience) and emotion regulation skills. Finally, the interaction effects between emotional flexibility abilities and stress, depression, and anxiety symptoms evidenced that consistent with the flexibility theory, enhancing and suppressing abilities may predict psychopathological symptoms.Conclusions: These findings emphasize the importance of considering the flexibility to express emotions as a relevant factor for preserved mental health or the development of psychopathological symptoms and indicate that online surveys may serve as a reliable indicator of mental health.

Background: Mental disorders can cause many problems in students' academic performance and also severely affect their cognitive, emotional, moral and social development. The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy (ACT) on emotional stability and alexithymia in female second-grade high school students. Methods: The present study was a quasi-experimental with a pretest-posttest design. The statistical population included all girls’ second grade students of the second secondary school in District 8 of Tehran. The sample size consisted of 118 students who were selected by stratified random sampling and assigned to two groups of 59 people as experimental and control groups). Data collection tools were emotional adjustment measure (EAM), Toronto alexithymia scale (TAS-20), and the ACT protocol. Data analysis was done using SPSS V.21 and multivariate analysis of covariance, and significance level was considered ≤ 0.05. Results: The findings showed that after adjusting the pre-test scores, ACT in the post-test has a significant effect on the Lack of regulation of emotional and physiological arousals, and despair and wishful thinking with values (F=90.143, F=178.324 respectively, P

Affective symptoms (e.g., depression, anxiety, shame) are a potent risk factor for binge eating. However, less is known on the role of loneliness as a moderator of affective symptoms and binge eating. This objective of the current study was to investigate main effects and interactions of affective symptoms and loneliness in relation to binge eating in college women. A sample of 556 undergraduate women completed self-report questionnaires of affective symptoms, loneliness, and binge eating. Results revealed significant interactions between each affective symptom variable and loneliness in relation to binge eating, such that loneliness strengthened the positive association of affective symptoms and greater binge eating. The findings of this study demonstrate an important role of loneliness to binge eating among college women, especially those with underlying affective vulnerabilities. More theoretical and treatment-oriented work on the role of loneliness in binge eating is needed to understand mechanisms and interventions/preventions. • Binge eating is a significant problem among college women. • Affective symptoms and loneliness were examined in relation to binge eating. • Loneliness strengthened the positive association of affective symptoms and greater binge eating. [ABSTRACT FROM AUTHOR]

(1) Background: The pandemic context has limited the social and family contacts of institutionalized older adults, and intervention is urgently needed. The aim of this study is to assess the impact of the implementation of a “Geriatric Proximity” intervention on the functioning, satisfaction with social support, affective experience, and feelings of loneliness of institutionalized older adults in the times of the pandemic. (2) Methods: This is a pilot study. An experimental group (subject to the “Geriatric Proximity” intervention) and a control group were constituted. Four assessment instruments were applied to both groups: the satisfaction with social support scale; the elderly nursing core set; the positive and negative affect schedule; and the UCLA loneliness scale. (3) Results: The control group shows no differences between the three measurement instants, while the experimental group shows between first and third measurements (all p < 0.05). We observed a reduction in the scores of loneliness scale, negative affect, and cognition functioning and an increase in satisfaction with social support and positive affect. (4) Conclusions: The intervention “Geriatric Proximity” showed a positive contribution by decreasing loneliness and increasing affectivity, satisfaction with social support, and cognitive function during the pandemic period.

Background: Social factors such as perceived social support and a sense of belonging may be protective against stress-related outcomes. It is unclear how these constructs may interact with cognitive vulnerabilities for mental health. The current study examined whether belonging and perceived social support buffered the effect of two cognitive vulnerabilities, perseverative thinking and distress intolerance, on affective symptoms. Methods: Participants (N = 1269) were Florida residents aged 18–79 years (M = 35.13, SD = 11.66) who experienced Hurricane Irma. All participants completed an online survey approximately 4–8 months post-Irma, assessing perseverative thinking, distress intolerance, and current symptoms of depression and anxiety. Participants also completed two measures of social support: belonging and perceived social support during the hurricane. Results: Belonging significantly moderated the effect of both perseverative thinking and distress intolerance on anxiety and depression, such that the relationship was weaker in those with high levels of belonging. Perceived social support did not exhibit the same moderating role for either anxiety or depression. Discussion: The results of this study suggest that belonging buffers the relationship between perseverative thinking, distress intolerance, and affective symptoms post-hurricane. Interestingly, perceived social support did not display the same buffering role. This study highlights the important role of social factors, particularly belonging, in protecting against affective symptoms following a stressor. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: After a stroke, several aspects of health and function may influence how individuals perceive their own health. However, self-rated health (SRH), as well as its relationship with functioning, has been little explored in individuals with stroke. The aims of this study were to determine how individuals with chronic post-stroke disabilities evaluate their health, considering general, time- and age-comparative SRH questions and to investigate whether SRH measures would be influenced by the following health and functioning domains: mental/physical functions and personal factors.Methods: Sixty-nine individuals with chronic post-stroke disabilities answered the three types of SRH questions and were assessed regarding depressive symptoms (emotional function domain), physical activity levels (physical function domain), and engagement in physical activity practice (personal factor domain). Subjects were divided into the following groups: good/poor for the general SRH question; better, similar, and "worse" for both time- and age-comparative questions. Between-group differences in the three domains for each SRH question were investigated (α = 5%).Results: General SRH was rated as good by 73% of the participants. Time- and age-comparative SRH was rated as better by 36% and 47% and as similar by 31% and 28% of the subjects, respectively. Significant between-group differences in emotional function were found for both the general and age-comparative questions. For the time-comparative question, significant differences were only observed for physical function.Conclusion: SRH evaluation differed in individuals with chronic post-stroke disabilities according to the types of questions and health/functioning domains. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psychotherapeut is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Schizophrenia is a chronic disorder with positive and negative symptoms, and insight is involved in its prognosis. Illness management is considered a skill and strategy for patients with some mental disorders. Objectives: We aimed to investigate the illness management effectiveness on the positive and negative symptoms and insight in schizophrenic patients. Materials & Methods: This study was a quasi-experimental, controlled study with a pre-test-posttest design. The study population included all schizophrenic patients admitted to the Shafa Hospital, Guilan Province in the North of Iran, from March 2019 to April 2020. The sample included 30 schizophrenic patients selected using the convenience sampling method and was divided into 2 groups (experimental and control groups), with 15 patients in each group. For data collection, the scale for the assessment of negative symptoms, the scale for the assessment of positive symptoms, and the scale to assess unawareness of mental disorders were used before and after the intervention. Illness management was performed on the experimental group as group therapy. The control group did not undergo any concomitant intervention. Data analysis was performed in SPSS software version 24 using the univariate analysis of variance in normal distribution and the non-parametric Kruskal-Wallis test for the variable which didn't follow the normal distribution.. Results: Results indicated that illness management could effectively alleviate the positive and negative symptoms and improve the insight in schizophrenic patients (P

Background: Although high-risk behaviors lead to adverse physical, psychological, and sociological consequences, less attention has been paid to identifying their related factors. The aim of this study was to investigate the mediating role of alexithymia in the relationship between defense mechanisms and high-risk behaviors among adolescents in Zahedan. Methods: In this descriptive-correlative study, junior and senior high school students of Zahedan, Iran were studied in the academic year 2015-2016. A sample of 250 (125 males and 125 females) students were chosen by multi-stage cluster sampling and asked to complete the Defense Style Questionnaire (DSQ), Toronto Alexithymia Scale (TAS), and the Risk-Taking Scale (IARS) for Iranian Adolescents. Data analysis was conducted by measuring coefficients of correlation and performing a path analysis. Results: Path analysis showed a significant correlation between defense mechanisms and alexithymia (P

Background/Aim. Children with attention-deficit hyperactivity disorder (ADHD) show lower degree of recognition of their own emotions and greater behavioral difficulties than children who do not have this disorder. This also affects the recognition of other people's emotions that are expressed not only by their language content, but also by their facial expression and the way they express the emotional message through speech. Most research in this area focuses on recognizing emotions based on facial expressions rather than on emotions in speech. The aim of this study was to examine how children with ADHD recognize emotions in speech (joy, anger, fear, sadness) and affective attitudes (threat and commandment) in relation to children of typical development. Methods. The study included 31 children with ADHD and 29 typical developmental children aged 6 to 13. To assess the ability to recognize emotions and affective attitudes, a corpus of Speech Emotional Expression and Attitudes (Govorna emocionalna ekspresija i stavovi – GEES, in Serbian) was used. This corpus included sentences that expressed emotions of anger, joy, fear, and sadness, and of affective attitudes, threat and command. Results. The results obtained showed that children with ADHD had worse recognition of emotions and affective attitudes in speech than children of typical development (t = 8.81; p = 0.000). Joy was the only emotion where no statistically significant difference was found. In all other emotions and affective attitudes, statistically significant differences were found (p < 0.01). Also, the results showed that there was a statistically significant association between age and recognition of emotion and affective attitudes in both groups, but this association was more pronounced in children of typical development. Conclusion. The results of this study provided important clues about the perception of emotions and affective attitudes in speech in children with ADHD. These results are very important for the conception of therapeutic procedures, especially in the development of strategies for modeling the behavior of children with ADHD.

This study aims to analyze the relationship between social isolation and loneliness with smoking in older adults. This is a cross-sectional, population-based study performed with 986 individuals aged 60 years or older. Data were collected from the Health Survey of the Municipality of Campinas (ISACamp 2014/2015), state of São Paulo, Brazil. We estimated the prevalence of smoking and smoking cessation according to independent variables and tested the associations using the chi-square test, considering a 5% significance level. Adjusted prevalence ratios were calculated using simple and multiple Poisson regression. Smoking and smoking cessation were not associated with most variables that indicate objective social isolation. “Often or always” loneliness was related to a higher prevalence of smoking (PR = 2.25; 95%CI: 1.38-3.66) whereas loneliness accompanied of self-reported emotional problems or common mental disorders was strongly associated with smoking and with lower smoking cessation (PR = 6.24; 95%CI: 1.37-28.47 and PR = 0.46; 95%CI: 0.28-0.77, respectively). These findings indicate that loneliness is a psychosocial aspect related to tobacco use which hinders smoking cessation in older adults, emphasizing the importance of emotional problems in this association.

The ability to inhibit unwanted responses is critical for effective control of behavior, and inhibition failures can have disastrous consequences in real-world situations. Here, we examined how prior exposure to negative emotional stimuli affects the response-stopping network. Participants performed the stop-signal task, which relies on inhibitory control processes, after they viewed blocks of either negatively emotional or neutral images. In Experiment 1, we found that neural activity was reduced following negative image viewing. When participants were required to inhibit responding after neutral image viewing, we observed activation consistent with previous studies using the stop-signal task. However, when participants were required to inhibit responding after negative image viewing, we observed reductions in the activation of ventrolateral prefrontal cortex, dorsolateral prefrontal cortex, medial frontal cortex, and parietal cortex. Furthermore, analysis of neural connectivity during stop-signal task blocks indicated that across participants, emotion-induced changes in behavioral performance were associated with changes in functional connectivity, such that greater behavioral impairment after negative image viewing was associated with greater weakening of connectivity. In Experiment 2, we collected behavioral data from a larger sample of participants and found that stopping performance was impaired after negative image viewing, as seen in longer stop-signal reaction times. The present results demonstrate that negative emotional events can prospectively disrupt the neural network supporting response inhibition.

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway blockage, with continued diaphragmatic efforts to breathe during sleep. Brain structural changes in OSA appear in various regions, including white matter sites that mediate autonomic, mood, cognitive, and respiratory control. However, the relationships between brain white matter changes and disease severity in OSA are unclear. This study examines associations between an index of tissue integrity, magnetization transfer (MT) ratio values (which show MT between free and proton pools associated with tissue membranes and macromolecules), and disease severity (apnea-hypopnea index [AHI]) in OSA subjects. We collected whole-brain MT imaging data from 19 newly diagnosed, treatment-naïve OSA subjects (50.4 ± 8.6 years of age, 13 males, AHI 39.7 ± 24.3 events/hr], using a 3.0-Tesla MRI scanner. With these data, whole-brain MT ratio maps were calculated, normalized to common space, smoothed, and correlated with AHI scores by using partial correlation analyses (covariates, age and gender; P < 0.005). Multiple brain sites in OSA subjects, including superior and inferior frontal regions, ventral medial prefrontal cortex and nearby white matter, midfrontal white matter, insula, cingulate and cingulum bundle, internal and external capsules, caudate nuclei and putamen, basal forebrain, hypothalamus, corpus callosum, and temporal regions, showed principally lateralized negative correlations (P < 0.005). These regions showed significant correlations even with correction for multiple comparisons (cluster-level, family-wise error, P < 0.05), except for a few superior frontal areas. Predominantly negative correlations emerged between local MT values and OSA disease severity, indicating potential usefulness of MT imaging for examining the OSA condition. These findings indicate that OSA severity plays a significant role in white matter injury. © 2016 Wiley Periodicals, Inc.

BackgroundIndividuals with substance-use disorders exhibit emotional problems, including deficits in emotion recognition and processing, and this class of disorders also has been linked to deficits in dopaminergic markers in the brain. Because associations between these phenomena have not been explored, we compared a group of recently abstinent methamphetamine-dependent individuals (n=23) with a healthy-control group (n=17) on dopamine D2-type receptor availability, measured using positron emission tomography with [(18)F]fallypride.MethodsThe anterior cingulate and anterior insular cortices were selected as the brain regions of interest, because they receive dopaminergic innervation and are thought to be involved in emotion awareness and processing. The Toronto Alexithymia Scale, which includes items that assess difficulty in identifying and describing feelings as well as externally oriented thinking, was administered, and the scores were tested for association with D2-type receptor availability.ResultsRelative to controls, methamphetamine-dependent individuals showed higher alexithymia scores, reporting difficulty in identifying feelings. The groups did not differ in D2-type receptor availability in the anterior cingulate or anterior insular cortices, but a significant interaction between group and D2-type receptor availability in both regions, on self-report score, reflected significant positive correlations in the control group (higher receptor availability linked to higher alexithymia) but nonsignificant, negative correlations (lower receptor availability linked to higher alexithymia) in methamphetamine-dependent subjects.ConclusionsThe results suggest that neurotransmission through D2-type receptors in the anterior cingulate and anterior insular cortices influences capacity of emotion processing in healthy people but that this association is absent in individuals with methamphetamine dependence.

Alexithymia and alcohol outcome expectancies were investigated in 355 alcohol-dependent treatment seekers. Patients with alexithymia gave stronger self-report ratings of expectancies of affective change related to beliefs that alcohol leads to negative mood states and assertion, that alcohol enhances social skills, compared to those without alexithymia. The findings suggest that alcohol-dependent outpatients with alexithymia may drink to experience intensified negative emotions and improved social functioning.

Alexithymia is characterized by difficulty identifying feelings, difficulty describing feelings, and an externally oriented thinking style. Alexithymia has been described as a trait-like risk factor for the development of alcohol use disorders. Few studies have investigated the absolute (whether mean scores change over time) and relative (extent to which relative differences among individuals remain the same over time) stability of alexithymia among men and women with alcohol dependence, or have considered potential underlying mechanisms. Social learning processes contribute to and maintain alcohol problems. The reinforcement of alcohol expectancies is one plausible mechanism that links the difficulties in emotional processing associated with alexithymia and alcohol use. The present study investigated the stability of alexithymia as well as alcohol expectancy as a mediator of alexithymia. Three hundred fifty-five alcohol-dependent patients were enrolled in a cognitive behavioral treatment program. Ninety-two alcohol-dependent patients completed assessments at baseline and at 3-month follow-up. Results indicated that total Toronto Alexithymia Scale (TAS-20; Bagby, Parker, & Taylor, 1994) mean score, difficulty identifying feelings, and difficulty describing feelings decreased significantly over time with a larger decrease in alexithymia mean scores for females. Externally oriented thinking mean scores did not change. The TAS-20 and its subfactors demonstrated significant correlations, from baseline to follow-up, which were stronger for males than for females. Regression analyses showed that the total TAS-20 mean scores, difficulty identifying feelings, and difficulty describing feelings were partially mediated through assertion alcohol expectancies. In conclusion, this suggests that alexithymia has relative stability and is a trait-like factor among alcohol-dependent treatment seekers.

• This research examined the associations between sexual objectification, perceived stress, insomnia, and affective symptoms. • We observed positive associations between sexual objectification, perceived stress, insomnia, and affective symptoms. • Perceived stress and insomnia serially mediated the association between sexual objectification and affective symptoms. • Sex-is-power beliefs moderated the serial mediation effect, such that the effect was only observed among participants with weak sex-is-power beliefs. Sexual objectification is a form of interpersonal maltreatment that women may experience in daily life. Research has focused on testing how it leads to various psychological distresses. However, little research has examined its influences on women's sleep quality, the underlying psychological mechanisms, and the potential implications for affective symptoms. We addressed this research gap by testing whether sexual objectification predicted perceived stress and insomnia, thereby predicting affective symptoms (i.e., depression and anxiety). We further examined whether sex-is-power beliefs moderated these associations. Participants completed validated measures of sex-is-power beliefs, sexual objectification, perceived stress, insomnia, depression, and anxiety. We conducted regression analyses, structural equation modeling, and bootstrapping analyses to test the associations between these psychological constructs. As predicted, the results showed that sexual objectification was positively associated with perceived stress, insomnia, and affective symptoms. Moreover, perceived stress and insomnia serially mediated the association between sexual objectification and affective symptoms. Furthermore, sex-is-power beliefs moderated the serial mediation effect, such that the effect was only observed among participants with weak sex-is-power beliefs. These findings advanced current theories and knowledge of sexual objectification by demonstrating that sexual objectification is associated with perceived stress and insomnia, thereby predicting affective symptoms. The findings also highlighted the role of beliefs in weakening the negative consequences of sexual objectification. [ABSTRACT FROM AUTHOR]

Background: Substantial variance exists in outcomes after mild traumatic brain injury (MTBI), and these differences are not fully explained by injury characteristics or severity. Genetic factors are likely to play a role in this variance. Objectives: The aim of this study was to examine associations between the apolipoprotein (APOE)-ε4 allele and memory measures at two months post-MTBI and to evaluate whether subjective cognitive and affective symptoms were associated with APOE-ε4 status. Based on previous research, it was hypothesized that APOE-ε4 carriers would show poorer verbal memory performance compared to APOE-ε4 non-carriers. Methods: Neuropsychological data at two months post-injury and blood samples that could be used to assess APOE genotype were available for 134 patients with MTBI (mean age 39.2 years, 62% males, 37% APOE-ε4 carriers). All patients underwent computed tomography at hospital admission and magnetic resonance imaging four weeks post-injury. Results: The APOE-ε4 + status was associated with decreased immediate memory recall (p = 0.036; β = −0.10, 95% CI [−0.19, −0.01]). Emotional, cognitive, and everyday executive function symptoms at two months post-injury were significantly higher in APOE-ε4 carriers compared to non-carriers. Conclusion: The APOE-ε4+ allele has a negative effect on verbal memory and symptom burden two months after MTBI. [ABSTRACT FROM AUTHOR]

We evaluated gender‐specific associations of two dimensions of dental anxiety (anticipatory and treatment‐related dental anxiety) with three dimensions of alexithymia: difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. The sample comprised 2558 parents from the general population participating in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale and alexithymia with the 20‐item Toronto Alexithymia Scale. Associations between dental anxiety and alexithymia dimensions were modelled using linear regression analysis adjusting for general anxiety and depressive symptoms, age, and education. Structural equation modeling assessed their interrelationships. In women, anticipatory dental anxiety was associated only with difficulty in identifying feelings, but treatment‐related dental anxiety was associated with difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. In men, anticipatory dental anxiety was associated with only externally oriented thinking, whereas treatment‐related dental anxiety was associated with difficulty in describing feelings, and with externally oriented thinking. Structural equation modelling showed that difficulty in identifying feelings was associated with anticipatory and treatment‐related dental anxiety in women, whereas in men, only difficulty in describing feelings was associated with both types of dental anxiety. Anticipatory and treatment‐related dental anxiety have different associations with alexithymia dimensions. [ABSTRACT FROM AUTHOR]

Background: Data on the psychological consequences of social isolation imposed by the global public health threat of the COVID-19 pandemic are limited. Mentally healthy people and psychiatric patients react to stress in different ways. Goal: To examine the impact of the COVID-19 pandemic on the mental health of the general population and the population of psychiatric patients in Vojvodina. Material and Methods: The study is designed as a cross-sectional study. It was conducted during April, May and June 2020 at the end and immediately after the first wave of the COVID-19 epidemic in Serbia on the territory of Novi Sad. Participants were divided into two groups - a clinical group of patients with mental disorders and a control group composed of the healthy volunteers. A self-assessment questionnaire was used to collect data on the presence of anxiety and symptoms of depression and behavioral disorders that indicate increased levels of stress - such as insomnia, sedative abuse. Results: Anxiety, fear, panic attacks (50%), depressive symptoms (42%), sleep problems (30%) and sedative abuse (25%) were the most commonly reported psychiatric symptoms. Healthy subjects did not show a statistically significant presence of any symptoms and signs associated with mental problems. Conclusion: The results support the negative impact of the COVID-19 pandemic on the mental health of psychiatric patients. It can be expected that the most pronounced effects of the pandemic on mental health in the general population will be visible in the future. [ABSTRACT FROM AUTHOR]

Comorbidity of substance use with affective symptoms and suicidality has been well documented in the general population. However, population-based migrant studies about this association are scarce. We examined the association of affective symptoms and suicidal ideation with binge drinking, daily smoking, and lifetime cannabis use among Russian, Somali, and Kurdish migrants in comparison with the Finnish general population. Cross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu, n = 1307) and comparison group data of the general Finnish population (n = 860) from the Health 2011 Survey were used. Substance use included self-reported current binge drinking, daily smoking, and lifetime cannabis use. Affective symptoms and suicidal ideation were measured using the Hopkins Symptom Checklist-25 (HSCL-25). We performed multivariate logistic regression analyses, including age, gender, and additional socio-demographic and migration-related factors. Suicidal ideation (OR 2.4 95% CI 1.3–4.3) was associated with binge drinking among Kurds and lifetime cannabis use among Russians (OR 5.6, 95% CI 1.9–17.0) and Kurds (OR 5.5, 95% CI 1.9–15.6). Affective symptoms were associated with daily smoking (OR 1.6, 95% CI 1.02–2.6) and lifetime cannabis use (OR 6.1, 95% CI 2.6–14.5) among Kurdish migrants. Our results draw attention to the co-occurrence of suicidal ideation, affective symptoms, and substance use, especially among Kurdish migrants. These results highlight the variation of comorbidity of substance use and affective symptoms between the different populations. This implies that screening for substance use in mental healthcare cannot be neglected based on presumed habits of substance use. [ABSTRACT FROM AUTHOR]

Objectives: Individuals with bipolar disorder are prone to risk‐taking behavior that is subsequently regretted. Here, we investigated whether this also occurs in relation to the use of social media and online dating. Methods: A questionnaire‐based survey focusing on the use of social media and online dating was conducted among individuals attending an outpatient clinic for bipolar disorder, and among individuals attending two general practices in the same region (controls). The association between bipolar disorder and self‐reported regretted behavior on social media/online dating sites was investigated using logistic regression with adjustment for age and sex. Results: A total of 124 individuals with bipolar disorder and 196 individuals without affective disorder from the general practices (controls) formed the study sample. Among the individuals with bipolar disorder who used social media, 66% reported regretted behavior as a consequence of this use, whereas only 31% of the controls reported such behavior. The corresponding numbers for individuals who used online dating were 65% for those with bipolar disorder and 31% for the controls. Following adjustment for age and sex, bipolar disorder was associated with elevated risk of regretted behavior in relation to the use of both social media (adjusted odds ratio: 3.6, 95% CI: 2.2, 5.9) and online dating (adjusted odds ratio: 4.1, 95% CI: 2.1, 8.0). Conclusions: These findings suggest that risk‐taking behavior and subsequent regret among individuals with bipolar disorder extend to social media and online dating. Cautious use of these platforms may be particularly relevant for individuals with bipolar disorder. [ABSTRACT FROM AUTHOR]

Evidence suggests dysregulation of the salience network in individuals with psychosis, but few studies have examined the intersection of stress exposure and affective distress with prediction error (PE) signals among youth at clinical high-risk (CHR). Here, 26 individuals at CHR and 19 healthy volunteers (HVs) completed a monetary incentive delay task in conjunction with fMRI. We compared these groups on the amplitudes of neural responses to surprising outcomes—PEs without respect to their valence—across the whole brain and in two regions of interest, the anterior insula and amygdala. We then examined relations of these signals to the severity of depression, anxiety, and trauma histories in the CHR group. Relative to HV, youth at CHR presented with aberrant PE-evoked activation of the temporoparietal junction and weaker deactivation of the precentral gyrus, posterior insula, and associative striatum. No between-group differences were observed in the amygdala or anterior insula. Among youth at CHR, greater trauma histories were correlated with stronger PE-evoked amygdala activation. No associations were found between affective symptoms and the neural responses to PE. Our results suggest that unvalenced PE signals may provide unique information about the neurobiology of CHR syndromes and that early adversity exposure may contribute to neurobiological heterogeneity in this group. Longitudinal studies of young people with a range of risk syndromes are needed to further disentangle the contributions of distinct aspects of salience signaling to the development of psychopathology. [ABSTRACT FROM AUTHOR]

Both clinical depression and subthreshold depressive symptoms have been associated with alterations in cortical thickness. Studies have yielded conflicting results regarding whether cortical thinning or cortical thickening best characterize the depressive state. Also unclear is whether cortical thickness differences are lateralized. This study examined the relationship between depressive symptom dimensions and cortical thickness asymmetry in cingulate and orbitofrontal regions. Fifty-four community-dwelling adults between the ages of 18 and 81 years received a 3-Tesla magnetic resonance imaging scan and completed the Center for Epidemiologic Studies Depression Scale (CES-D). Cortical thickness values were extracted for the rostral anterior cingulate, caudal anterior cingulate, posterior cingulate, isthmus cingulate, and orbitofrontal cortex. An asymmetry index was calculated for each region. Data were analyzed using separate general linear models for each region, in which the CES-D somatic symptoms, negative affect, and anhedonia subscale scores predicted the asymmetry indices, controlling for age and sex. Higher scores on the anhedonia subscale were associated with right-sided asymmetry in orbitofrontal thickness, whereas higher somatic symptom subscale scores predicted greater left-sided asymmetry in posterior cingulate thickness. Follow-up analyses showed the orbitofrontal effect was specific to the medial, not the lateral, orbitofrontal cortex. These results suggest asymmetries in cortical thickness are apparent at even subthreshold levels of depressive symptoms, as all but five participants were below the CES-D cutoff for clinical depression, and that the relationship varies for different symptom dimensions of depression. Understanding brain asymmetries across the range of depressive symptom severity is important for informing targeted depression treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Loneliness has not until recently been a prominent focus in research on outcomes of mental illness. The aim of this study was to determine whether loneliness at baseline predicts poor outcomes at 4-month follow-up for individuals who have experienced mental health crises. The outcomes in this study included overall symptom severity, affective symptoms, self-rated recovery and health-related quality of life. Methods Our study reports a secondary analysis of data from a randomised controlled trial. The sample (n = 399) was taken from patients who received treatment from community crisis services. Respondents (n = 310) completed the follow-up measurement 4 months after baseline. Loneliness at baseline was assessed using an eight-item UCLA Loneliness Scale. The four mental health outcomes were measured at both baseline and follow-up. Two scales (or part thereof) assessed objective social isolation and neighbourhood social capital at baseline. Regression analyses were conducted to investigate longitudinal associations between loneliness at baseline and mental health outcomes at follow-up. Results Loneliness at baseline was associated with all four mental health outcomes at 4-month follow-up, adjusting for psychosocial, socio-demographic and clinical characteristics. A one-point higher loneliness score was associated with 0.74-point (95% CI 0.45, 1.02) and 0.34-point (95% CI 0.21, 0.47) increase in overall symptom severity score and affective symptoms score respectively, and with 1.08-point (95% CI -1.45, − 0.71) and 1.27-point (95% CI -1.79, − 0.75) decrease in self-rated recovery score and health-related quality of life score respectively. Loneliness was a better predictor of clinical outcomes than objective social isolation and social capital, even though the associations with clinical outcomes were reduced and no longer statistically significant following adjustment for their baseline values. A significant association with quality of life persisted after adjustment for its baseline score. Conclusions Greater loneliness at baseline predicted poorer health-related quality of life at follow-up. There were cross-sectional associations between loneliness and clinical outcomes, but their longitudinal relationship cannot be confirmed. Further research is needed to clearly establish their underpinning pathways. Reducing loneliness may be a promising target to improve recovery for mental health community crisis service users.

Background & aim: Lack of objective expression of emotions leads to the experience of unpleasant thoughts and evocations, followed by the non-recognition of one’s emotions and feelings. This is identified as one of the most important factors accounting for marital conflicts. The purpose of this study was to predict marital burnout based on negative automatic thoughts and alexithymia among couples in Shiraz, Iran. Methods: This correlational study was conducted on 150 couples referring to four counseling centers located in districts 1 and 2 of Shiraz in 2018-2019. The study population was selected using a multistage cluster sampling method. The data were collected using the burnout measure developed by Pines, automatic negative thoughts questionnaire, and twenty-item Toronto alexithymia scale on a self-report basis. Data analysis was performed in SPSS software (version 21) using regression analysis and Pearson correlation coefficient at a significance level of ≤ 0.05. Results: The results showed that the dimensions of an automatic negative thoughts could predict marital burnout positively and significantly (P≤0.05). The coefficient was obtained as 0.27, meaning that automatic negative thoughts, alexithymia, age, and education could predict marital burnout at 27%. Conclusion: Alexithymia and automatic negative thoughts could eventually lead to the elevation of dissatisfaction with marriage due to exerting a negative effect on maintaining a strong emotional relationship between partners.

Introduction. In addition to cognitive deficit, the presence of a dementing process of vascular origin leads to changes in the patient’s personality, as well as in his character. Persons with vascular dementia always have non-cognitive disease manifestations of non-psychotic level. Non-psychotic psychopathological symptoms can lead to a significant deterioration of the well-being and quality of life of patients with vascular dementia, and therefore should be taken into account when drawing up a plan for treatment and rehabilitation of such patients. Psychotherapy interventions play the most important role in management of patients with vascular dementia. The aim of the study: to develop a targeted model of psychotherapeutic support based on the selective correction of non-cognitive psychopathological symptoms of non-psychotic level in patients with vascular dementia. Materials and methods: The study was carried out on 80 patients with vascular dementia with different localization of the lesion. The average age of the patients was 68.6 years. All persons included in the contingent of the study demonstrated non-cognitive psychopathological symptoms of non-psychotic level. Results. Recommendations for psychocorrection of maladaptive non-cognitive pathopsychological symptomatology of non-psychotic level in persons with vascular dementia have been developed. For each of these symptoms, congruent vectors, mechanisms, and methods of psychotherapeutic correction were identified and described. The basic vector for minimizing and eliminating depression in patients with vascular dementia aimed at shifting the mode of emotional experiences from the negative spectrum to the positive or at least neutral. The basic vector for minimizing and eliminating anxiety in patients with vascular dementia aimed at shifting attention from stressful factors to sanogenic, emotionally neutral stimuli. The basic vector for minimizing and eliminating apathy in patients with vascular dementia aimed at activation of mental processes and restoration of a minimum acceptable level of emotional response. The basic vector for minimizing and eliminating irritability in patients with vascular dementia aimed at increasing the threshold of negative emotional response to environmental stimuli. The basic vector for minimizing and eliminating emotion incontinence in patients with vascular dementia aimed at restoring the ability to control external manifestations of internal feelings.

Abstract Background Neuropsychiatric symptoms (NPS) have been reported to be useful in predicting incident dementia among cognitively normal older persons. However, the literature has not been conclusive on the differential utilities of the various NPS in predicting the subtypes of dementia. This study compared the risks of Alzheimer’s and non-Alzheimer’s dementia associated with the various NPS, among cognitively normal older persons. Methods This cohort study included 12,452 participants from the Alzheimer’s Disease Centers across USA, who were ≥ 60 years and had normal cognition at baseline. Participants completed the Neuropsychiatric Inventory-Questionnaire at baseline and were followed up almost annually for incident dementia (median follow-up = 4.7 years). Symptom clusters of NPS—as identified from exploratory and confirmatory factor-analyses—were included in the Cox regression to investigate their associations with incident dementia. Results The various NPS showed independent yet differential associations with incident dementia. Although psychotic symptoms were rarely endorsed by the participants, they predicted much higher risk of dementia (HR 3.6, 95% CI 2.0–6.4) than affective symptoms (HR 1.5, 95% CI 1.2–1.8) or agitation symptoms (HR 1.6, 95% CI 1.3–2.1). Psychotic symptoms predicted all dementia subtypes, while affective and agitation symptoms differentially predicted some subtypes. Across dementia subtypes, psychotic symptoms had relatively higher risk estimates than affective or agitation symptoms, with the risk estimates being particularly high in non-Alzheimer’s dementia. Conclusions Among cognitively normal individuals, the presence of NPS may warrant greater clinical vigilance as precursors to dementia and its subtypes. The findings highlight the need for further research to enrich our understanding on the neurobiological links between various NPS and dementia subtypes. They may also change the clinical approach in managing late-life psychotic symptoms, requiring a greater emphasis on dementia surveillance in the diagnostic criteria of late-life psychotic disorders.

Introduction: Suicide can be defined as a conscious act of self-harm that leads to death. Aim: The aim of this study was to comparison attachment styles and alexithymia in suicidal attempts and control group. Method: In this casual comparative study, 100 individuals (50 suicide attempts and 50 normal individuals) were selected by convenience sampling. All participant completed the attachment styles questionnaire and Toronto emotional alexithymia scale. Data were analyzed using MANOVA by SPSS-21. Results: The results showed that the difference between two groups was significant in difficulty in regulating emotions. Also, the difference between the two groups in avoidant and secure attachment style is significant (p

BackgroundSubstantial variance exists in outcomes after mild traumatic brain injury (MTBI), and these differences are not fully explained by injury characteristics or severity. Genetic factors are likely to play a role in this variance.ObjectivesThe aim of this study was to examine associations between the apolipoprotein (APOE)-ε4 allele and memory measures at two months post-MTBI and to evaluate whether subjective cognitive and affective symptoms were associated with APOE-ε4 status. Based on previous research, it was hypothesized that APOE-ε4 carriers would show poorer verbal memory performance compared to APOE-ε4 non-carriers.MethodsNeuropsychological data at two months post-injury and blood samples that could be used to assess APOE genotype were available for 134 patients with MTBI (mean age 39.2 years, 62% males, 37% APOE-ε4 carriers). All patients underwent computed tomography at hospital admission and magnetic resonance imaging four weeks post-injury.ResultsThe APOE-ε4 + status was associated with decreased immediate memory recall (p = 0.036; β = −0.10, 95% CI [−0.19, −0.01]). Emotional, cognitive, and everyday executive function symptoms at two months post-injury were significantly higher in APOE-ε4 carriers compared to non-carriers.ConclusionThe APOE-ε4+ allele has a negative effect on verbal memory and symptom burden two months after MTBI.

Gut microbiota regulates neurotransmission, neurogenesis, neuroinflammation, and neuroendocrine signaling. The aim of the present review is to analyze the literature concerning gut microbiota dysregulation and mood symptoms, with the specific hypothesis that such alterations play a role in the onset of mood disorders. Here, in fact, we review recent research focusing on how gut microbiota dysregulation influences the onset of mood disorders and on possible pathophysiological mechanisms involved in this interaction. We pay specific attention to the relationship between gut microbiota dysregulation and inflammatory state, Th17 differentiation, neuroactive factors, and TRP metabolism. The association between gut microbiota dysregulation and mood disorders is critically analyzed under a clinical point of view, also focusing on the emergence of mood symptoms in the context of medical conditions.These latter correlations may enable an interdisciplinary perspective in the clinical approach to such symptoms, as well as new treatment strategies, such as nutritional interventions, psychobiotics, antibiotics, as well as fecal microbiota transplantation.