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BACKGROUND There has been an increased interest in understanding social anxiety (SA) and social anxiety disorder (SAD) antecedents and consequences as they occur in real-time, resulting in a proliferation of studies utilizing ambulatory assessment (AA). Despite the exponential growth of research in this area, these studies have not been synthesized yet. OBJECTIVE To identify and describe the latest advances in the understanding of social anxiety by means of the use of ambulatory assessment METHODS Following PRISMA guidelines a Scopus, Pubmed and Web of Science systematic literature search was conducted. RESULTS 55 articles met the inclusion criteria. The qualitative synthesis of these studies showed that AA permitted the exploration of the emotional, cognitive and behavioral dynamics associated with the experience of SA and SAD. In line with the available models of SA and SAD, emotion regulation, perseverative cognition, cognitive factors, substance use and interactional patterns were the principal topics among the included studies. Besides, the incorporation of AA to study psychological interventions, the multimodal assessment through the use of sensors and biosensors and transcultural differences were some of the identified emerging topics. CONCLUSIONS AA constitutes a very powerful methodology to grasp SA from a complementary perspective to laboratory experiments and usual self-report measures, shedding light upon the cognitive, emotional and behavioral antecedents and consequences of SA and the development and maintenance of the experience of SA as a mental disorder.

Research suggests that optimism is positively related to emotional wellbeing. However, little is known about the emotion regulation mechanisms that potentially explain (i.e., mediate) this relationship. The present study was designed to address this issue. To this end, it examined emotion regulation strategies (i.e., appreciation, rumi nation, problem solving, and avoidance) that are theoretically and/or empirically related to optimism as possible mediators of the optimism-emotional wellbeing relationship. In the first of two phases, we established a baseline measure of dispositional optimism among 218 French adults. In the second phase, an experience sampling method was used to assess emotional wellbeing and emotion regulation strategy use over a 1-month period. A multiple mediation analysis suggested that the optimism-emotional wellbeing relationship is significantly mediated by appreciation and rumination but not by problem solving and avoidance. More specifically, engaging more in appreciation mediated 41 % of this relationship, while engaging less in rumination mediated 20 % of it. The results are discussed in light of the current knowledge on optimism, wellbeing, and emotion regulation.

International audience; The present study aimed at (1) identifying the emotion regulation processes that can explain the trait hedonism positive emotions relationship, and (2) determining whether this relationship varies according to which part of the distribution of positive emotions is considered. To this end, the intensity of the positive emotions felt by 84 adult participants, and the intensity of their engagement in savoring, were assessed twice a day over a month period, using an Experience Sampling Method. Participants’ distributions of these variables were then related to their level of trait hedonism, assessed with a common questionnaire. Results suggested that, as expected, the trait hedonism positive emotions relationship varied according to which part of the distribution of positive emotions was considered. In their worst times (i.e., first centiles of each individual’s distribution), individuals with low versus high trait hedonism differed very little from each other. By contrast, in more favorable times (i.e., following centiles), individuals with high levels of trait hedonism experienced more intense positive emotions than individuals with low levels of trait hedonism. This phenomenon was mediated by individuals’ engagement in savoring. These results are discussed in light of current theories on emotion dynamics.

This dissertation describes a way of organising parsimoniously the ample existing evidence that has been produced along these years in the field of digital mental health. For that purpose the DIU framework is presented. That is, D for dissemination, I for improvement and U for understanding. This framework is applied to the specific field of emotion regulation in emotional disorders. In that sense, it presents a description of the current psychopathological transformation in order to outline the role of emotion regulation (ER) as a transdiagnostic and transtheorical mechanism of change. A review of all the existing developments in each of the categories of the DIU framework are described. Each section presents novel empirical results that show how digital interventions may serve to improve ER in emotional disorders. These empirical contributions used a variety of research designs and statistical solutions depending on the different contexts in which the studies were conducted. Overall, this dissertation boosts the discussion concerning some of the current debates in clinical psychology and suggests theoretical and empirical answers in order to improve the field.

BackgroundFor many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase.MethodsTwo different strings were considered for each of the two objectives of the study: A first group comprising studies patients with major depressive disorder (MDD) and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions.ResultsIn the first group of studies including patients with MDD, the within-group analyses yielded an effect size of Hedges' g = 0.717, while the between-group analysis an effect size of Hedges' g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of randomized controlled trials (RCTs) in comparison to non RCTs, whereas the type of neurofeedback, trial design, year of publication, number of sessions, age, sex and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges' g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables.ConclusionsHeart rate variability (HRV) biofeedback and neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.

When facing a negative event, people implement different strategies to regulate ongoing emotions. Although the previous literature has suggested that the emotional intensity of a negative episode is associated with the characteristics of the subsequent autobiographical memory, it is still unknown whether emotion regulation (ER) moderates this relationship. In the present study, we provided undergraduate students with a smartphone-based diary to report a negative episode immediately after its occurrence and rate the momentary use of two ER strategies: cognitive reappraisal and rumination. To explore autobiographical memory, two “surprise” recall tasks were performed one week and one month after the event. According to the results, cognitive reappraisal was linked with better memory performances, and a tendency to retrospectively underestimate the negativity of highly intense events was observed only in participants adopting high rates of this strategy. Conversely, intense rumination was found to be associated with less detailed memories of emotionally intense events, as well as with higher emotional involvement with negative episodes over time, regardless of their intensity. Together, our results support the maladaptive role of rumination and the adaptive influence of cognitive reappraisal on autobiographical memory.

International audience; A growing body of research has investigated the regulation of negative emotions in ecological settings, but little is known about the mechanisms underlying positive emotion regulation in everyday life. Although some evidence suggests that adopting positive strategies is beneficial for emotional well-being, the literature is inconsistent about the effects of positive emotions on subsequent regulatory processes. In the present study, we adopted a two-week ecological momentary assessment to explore the association between positive emotions and positive emotion regulation in daily life. According to our results, the less individuals felt positive emotions at one point, the more they tended to enhance their use of positive strategies from this time to the next, which in turn resulted in subsequent higher levels of positive emotions. This prototype of positive regulation can be seen as a highly adaptive mechanism that makes it possible to compensate for a lack of positive emotions by enhancing the deployment of positive strategies. The theoretical and clinical implications of these findings are discussed.

In recent decades, a growing body of literature has focused on emotion regulation (ER), which refers to the ability to implement strategies in order to modulate emotional responses and reach desirable goals. To date, impaired ER (i.e., emotion dysregulation) has been identified as a transdiagnostic factor across a wide range of psychopathological conditions, which shows the importance of improving patients' ability to regulate negative and positive emotions in clinical practice. In addition to the increasing evidence showing its efficacy in the treatment of several clinical conditions, virtual reality (VR) has recently emerged as a potentially powerful tool for enhancing ER, thus breaking new ground in the development of cutting-edge transdiagnostic interventions. In the present narrative review, we will provide an overview of the existing evidence about VR-based interventions in the field of ER, emphasizing the promising findings and the barriers that still have to be addressed. To this aim, the available VR-based literature will be analysed in relation to four categories of ER strategies: situational strategies, attentional strategies, cognitive strategies, and response modulation strategies. Furthermore, new emerging fields of research targeting innovative aspects of ER will be highlighted, including the use of VR to promote positive emotions and interpersonal ER skills. Besides, its cost-effectiveness will be discussed, taking into account the costs for both developers (e.g., clinicians and researchers) and end-users. Finally, future directions in this promising field of research will be outlined.

So far, several aspects of autobiographical memory (AM) have been found to be impaired in depression. Among others, depressed patients show the tendency to recall more negative than positive events (i.e., negative bias) and usually retrieve memories that lack of specificity and details (i.e., overgeneral memories). Based on this, we designed an AM task enhanced by the use of virtual reality (VR) to specifically train the recall of positive memories. Using a single-case, multiple baseline experimental design, we explored the effects of a brief intervention consisting of two sessions of this training in a sample of 18 individuals with moderate-to-moderately severe depressive symptoms. According to the results, changes occurred at the short term only. In particular, almost all participants reported a significant improvement in at least one outcome measure 0–3 days after the intervention. However, these clinical gains were not maintained in the mid-term (from day 4 to 10). The present findings do not support the efficacy of our VR-based AM recall treatment as a standalone intervention. Nevertheless, it might represent a suitable procedure to obtain immediate and/or short-term improvements. It might also serve as a valid component to be integrated in broader protocols for patients with moderate-to-moderately severe depressive symptoms., Highlights • There is increasing evidence supporting the association between depression and autobiographical memory impairments. • Addressing memory impairments represents a useful therapeutic tool for the treatment of depression. • Virtual reality could enhance the retrieve of positive events, thus making it a good candidate in memory interventions. • After the training, all participants reported a significant improvement in at least one outcome measure. • This training may be a suitable procedure to obtain immediate and/or brief-term improvements.

Behavioral activation (BA) is a structured psychotherapeutic approach for the treatment of major depressive disorder (MDD), which aims at increasing the engagement in activities that might bring enjoyment and meaning to patients’ lives. Although a growing body of evidence supports the effectiveness of BA, enhancing the motivation and activity level of depressed patients is often challenging. In the present study, we explored the effectiveness of a brief BA treatment supported by virtual reality (VR) to facilitate the visualization and anticipation of four pleasurable activities that we tried to re-introduce in the patients’ daily routine. To do so, we conducted a single-case experimental design with multiple baselines in a sample of patients with moderate to severe depressive symptoms. Three overlap analyses across participants and across behaviors were conducted to calculate the rate of improvement of each patient after the delivery of the intervention. Across the three overlap indices, the participants generally showed moderate-to-large improvements in the level of daily activity, as well as in the time spent planning and/or engaging in one or more activities scheduled during the intervention. Furthermore, most patients also reported a moderate-to-large reduction in daily depressive symptoms and improved mood. Overall, the promising results of the present study suggest that the proposed VR-based BA intervention might represent a valid approach to behaviorally activate depressed patients. The barriers and future lines of research of this innovative field are discussed.

For many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase.Two different strings were considered for each of the two objectives of the study: A first group comprising studies with Major Depressive Disorder (MDD) patients and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions.In the first group of studies including MDD patients, the within-group analyses yielded an effect size of Hedges’ g = 0.717, while the between-group analysis an effect size of Hedges’ g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of RCTs in comparison to non RCTs, whereas type of neurofeedback, trial design, year of publication, number of sessions, age, gender and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges’ g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables.HRV Biofeedback and Neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.

Background According to a growing body of literature, people are quite inaccurate in recalling past affective experiences. Nevertheless, the mechanism underlying this recall bias (i.e., the tendency to overestimate and/or underestimate positive or negative past emotional experiences) remains unclear, and its association with mental health has not been studied yet. Methods We adopted a smartphone-based Ecological Momentary Assessment to monitor daily affect (n = 92) and investigate the association between affect recall bias, mental health and resilience. Results While the tendency to overestimate negative affective experiences was observed in participants reporting mild depressive symptoms, positive affect (PA) overestimation as compared to PA underestimation was associated with better mental health (i.e. higher psychological well-being and lower depressive and anxiety symptoms) through the enhancement of resilience. Furthermore, positively biased participants (i.e. PA over estimators) benefited from greater well-being, even when compared to accurate individuals. Conclusions While people appear to use retrospective PA overestimation as a strategy to enhance well-being and resilience, they are not likely to underestimate past negative experiences to feel better. Accordingly, owning an optimistic vision of the past may represent an adaptive “distortion” of reality that fosters people’s mental health. The clinical implications of cultivating PA and learning strategies to regulate both negative and positive emotions are discussed.

In recent years, there has been an increase in the attention to positive emotions and, more specifically, to the mechanisms underlying the regulation of positive experiences. So far, there is strong evidence suggesting the importance of cultivating positive emotions in relation to well-being and mental health. Importantly, positive emotion regulation does not only entail the deployment of regulatory mechanisms during the experience of a positive emotional state. Rather, positive emotions may be regulated also before and after the generation of a positive state. Though, despite the increasing body of studies exploring the mechanisms underlying positive emotions, several questions remain unanswered. The general aim of the present thesis is to expand our knowledge about the regulation of positive emotions in daily life, taking into account the gaps existing in the previous literature and considering the different time frames in which emotion regulation may occur: 1. Anticipation of positive emotional states: Does affective forecasting play a role for well-being? Does one’s future-oriented disposition influence resilience, thus enhancing and/or decreasing one’s resources to deal with stressors? 2. Savoring of positive emotional states: Which is the association between positive emotions and subsequent positive emotion regulation in daily life? Is positive emotion regulation fostered by the experience of high levels of positive emotions (i.e., consistent with the Broaden and Build theory) or by the presence of low levels of positive emotions (i.e., consistent with the hedonic flexibility principle)? 3. Recall of positive emotional states: Which are the mechanisms underlying the bias in recalling past positive experiences? Does holding a biased, yet optimistic, past-oriented disposition boost well-being and resilience? This doctoral dissertation consists of six publications which aim at solving the aforementioned research questions. First, three theoretical chapters are presented, which support the use of the EMA approach to the study of daily emotional dynamics. Subsequently, three experimental studies are provided, which aim at exploring how people anticipate, savor and recall positive emotional experiences, as well as the association between these processes and mental health.

In the last decades, Emotion Regulation (ER) represented one of the most studied constructs within the psychological field. Most research, however, has been conducted in laboratory settings; consequently, there are still questions that need to be addressed concerning the deployment and consequences of ER in everyday life. Beyond traditional methods, ecological momentary assessment (EMA) via mobile devices (e.g. smartphones) has the potential to capture ER dynamics during the flow of daily experiences and in real-life settings. Compared to retrospective surveys and laboratory experiments, this approach allows to ecologically and repeatedly investigate the deployment of ER, as well as understand the direct consequences of this process on different aspects of daily life, including behaviors and affect. We will discuss what we currently know about the deployment and consequences of ER in real-life settings focusing on studies that investigated this process by means of EMA. In doing so, we will point out the potentialities of this approach both from a theoretical and clinical point of view.

The emerging fields of predictive and precision medicine are changing the traditional medical approach to disease and patient. Current discoveries in medicine enable to deepen the comprehension of diseases, whereas the adoption of high-quality methods such as novel imaging techniques (e.g. MRI, PET) and computational approaches (i.e. machine learning) to analyse data allows researchers to have meaningful clinical and statistical information. Indeed, applications of radiology techniques and machine learning algorithms rose in the last years to study neurology, cardiology and oncology conditions. In this chapter, we will provide an overview on predictive precision medicine that uses artificial intelligence to analyse medical images to enhance diagnosis, prognosis and treatment of diseases. In particular, the chapter will focus on neurodegenerative disorders that are one of the main fields of application. Despite some critical issues of this new approach, adopting a patient-centred approach could bring remarkable improvement on individual, social and business level.

La regulación emocional se ha convertido a lo largo de las últimas dos décadas en uno de los constructos más estudiados en el campo de la psicología clínica. En el presente artículo se exponen en una primera sección los conceptos primordiales en torno a los hallazgos psicopatológicos que dan cuenta del papel primordial de la regulación emocional como factor transdiagnóstico. Posteriormente, se describen las nociones centrales que deben ser consideradas para llevar a cabo una mejor articulación entre investigación y práctica clínica. Por último, se presentan algunos de los principales tratamientos existentes que abordan la regulación emocional como eje central, para plantear en último lugar los caminos por los que el campo de la regulación emocional debería transitar como campo específico de estudio en el contexto del desarrollo de la psicoterapia en general.

Well-designed clinical trials are the gold standard for evidence-based research and for the assessment of the effectiveness of a clinical intervention. Methodological guidelines are available from various sources, such as textbook, funding applications and institutional guidelines. Nevertheless, a high number of published trials still lack methodological rigor, decreasing their utility, quality and scientific validity. In this article, we aim at providing some methodological recommendations for the development and report of a clinical trial, including the definition and recruitment of the sample, the basic study designs, randomization, blindness, data analysis and data report. Finally, we will discuss some of the most important ethical issues. Los ensayos clínicos bien diseñados son el estándar por excelencia para la investigación basada en la evidencia y para la evaluación de la eficacia de una intervención clínica. Las directrices metodológicas se encuentran disponibles en varias fuentes, tales como libros de texto, solicitudes de financiamiento y directrices institucionales. Sin embargo, un gran número de ensayos publicados todavía carecen de rigor metodológico, disminuyendo su utilidad, calidad y validez científica. En este artículo, nuestro objetivo es proporcionar algunas recomendaciones metodológicas para el desarrollo e informe de un ensayo clínico, incluyendo la definición y selección de la muestra, los diseños básicos de estudio, la aleatorización, el cegamiento, el análisis y el reporte de datos. Finalmente, discutiremos algunas de las consideraciones éticas más importantes.

VirtualReality(VR) Therapy has emerged in the 90s as an appealing way of delivering exposure treatment. Throughout these years, ample evidence has been published. Although there is an agreed consensus regarding its efficacy, currentlyaquick shift in the field is being experienced, especially due to the advent of off-the-shelf technology that is greatly facilitating its dissemination. In this context, theoretical discussions of the field appear as an important action in order to take stock of the mounting evidence that has been produced and the main challenges for the coming future. To stimulate the discussion inaburgeoning field,aSWOTanalysisis proposed, which may help to map the field of VR therapy foranxietyand stress-relateddisorders. Overall, it is undoubted that VR appears asawell-established technology for the treatment of ASRD and the main challenges are in line with the possibility of hurdling the same obstacles that the whole field of clinical psychology and psychotherapy has to deal with: How to bridge the gap between research and clinical practice. © 2019, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.

Ecological momentary assessment (EMA) and ecological momentary intervention (EMI) are alternative approaches to retrospective self-reports and face-to-face treatments, and they make it possible to repeatedly assess patients in naturalistic settings and extend psychological support into real life. The increase in smartphone applications and the availability of low-cost wearable biosensors have further improved the potential of EMA and EMI, which, however, have not yet been applied in clinical practice. Here, we conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to explore the state of the art of technology-based EMA and EMI for major depressive disorder (MDD). A total of 33 articles were included (EMA = 26; EMI = 7). First, we provide a detailed analysis of the included studies from technical (sampling methods, duration, prompts), clinical (fields of application, adherence rates, dropouts, intervention effectiveness), and technological (adopted devices) perspectives. Then, we identify the advantages of using information and communications technologies (ICTs) to extend the potential of these approaches to the understanding, assessment, and intervention in depression. Furthermore, we point out the relevant issues that still need to be addressed within this field, and we discuss how EMA and EMI could benefit from the use of sensors and biosensors, along with recent advances in machine learning for affective modelling.

Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31–1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.

7th International Conference on Pervasive Computing Paradigms for Mental Health (MindCare 2018) Emotion regulation (ER) is defined as the processes deployed by an individual or group of individuals to explicitly or implicitly influence the experienced emotions in order achieve desirable states or goals. The available literature within this domain has grown exponentially in the last years. Nevertheless, to the best of our knowledge no scientometric analysis has been carried out yet. This kind of analysis allows to grasp how the scientific production within this field is configured, by establishing patterns and connections between the main authorities of the community. In the current analysis, descriptive data of the citation counts of main authors, institutions, journals, categories and countries are presented. Overall, the description shows the prominent role some authors as the principal authorities within the field, the predominance of United States in the citation counts as well as the high-impact journals in which the articles of this discipline are published. The most relevant implications of the findings are discussed in terms of future lines regarding the field of emotion regulation.

BACKGROUND Given the rise of internet-based treatments as an effective therapeutic tool for psychological disorders, it is necessary to carry out research that examines clients’ experiences with this type of intervention. The qualitative methodology has been found to be useful for analyzing clients’ perceptions in terms of facilitators and barriers, acceptability, and negative effects of internet-based treatments. However, a lack of integration of these primary studies has prevented their findings from being applied to new research and in clinical practice. OBJECTIVE The objective of this paper is to describe the protocol for a metasynthesis of qualitative studies exploring the experiences of clients who underwent an internet-based treatment. METHODS Elliot and Timulak’s metasynthesis approach will be used to review and synthesize qualitative studies related to client experiences in terms of the barriers and facilitators they perceived when undergoing internet-based treatment. For each search string, the features in the Sample, Phenomenon of Interest, Design, Evaluation, Research type (SPIDER) tool will be considered. Electronic databases (PubMed, PsycINFO, and Web of Science) will be searched. Two independent reviewers will analyze the material in order to determine whether the eligibility criteria are fulfilled. Findings will make it possible to create a hierarchy of domains in terms of their relevance across all the primary studies. The data obtained from primary studies will be cross-analyzed using descriptive and interpretative procedures. RESULTS The search strategy is currently being conducted. First results are expected to be submitted for publication in 2019. CONCLUSIONS We will develop conceptual framework of the barriers and facilitators perceived by clients and propose their implications and recommendations for clinical practice, research, and training. CLINICALTRIAL PROSPERO CRD42018079894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=79894 (Archived by WebCite at http://www.webcitation.org/73C6OtlS7). INTERNATIONAL REGISTERED REPOR PRR1-10.2196/9722

Background Ecological momentary assessments (EMAs) and ecological momentary interventions (EMIs) represent a novel approach for the assessment and delivery of psychological support to depressed patients in daily life. Beyond the classical paper-and-pencil daily diaries, the more recent progresses in Information and Communication Technologies (ICT) enabled researchers to bring all the needed processes together in only one device, i.e., response signaling, repeated symptom collection, information storage, secure data transfer, and psychological support delivery. Despite evidence showing the feasibility and acceptability of these techniques, EMAs are only beginning to be applied in real clinical practice, whether the development of EMIs for clinically depressed patients is still very limited. The objective of this systematic review is to provide the state of the art of technology-based EMAs and EMIs for major depressive disorder (MDD), with the aim of leading the way to possible future directions for the clinical practice. Methods We will conduct a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Data sources will include two bibliographic databases, PubMed and Web of Science (Web of Knowledge), supplemented by searches for unpublished or ongoing studies. Eligible studies will report data for adult (≥ 18 years old) with a primary (both current and past) diagnosis of MDD, defined by a valid criterion standard. We will consider studies adopting technology-based EMAs and EMIs for the investigation and/or assessment of depression and for the delivery of a psychological intervention. We will exclude studies adopting paper-and-pencil tools. Discussion The proposed systematic review will provide new insights on the advantages and benefits of adopting technology-based EMAs and EMIs for MDD in the traditional clinical practice, taking into consideration both clinical and technological issues. The potential of using sensors and biosensors along with machine learning for affective modeling will also be discussed. Electronic supplementary material The online version of this article (10.1186/s13643-018-0899-y) contains supplementary material, which is available to authorized users.

A growing body of evidence pointed out that a decline in effectively using spatial reference frames for categorizing information occurs both in normal and pathological aging. Moreover, it is also known that executive deficits primarily characterize the cognitive profile of older individuals. Acknowledging this literature, the current study was aimed to specifically disentangle the contribution of the cognitive abilities related to the use of spatial reference frames to executive functioning in both healthy and pathological aging. 48 healthy elderly individuals and 52 elderly suffering from probable Alzheimer&rsquo, s Disease (AD) took part in the study. We exploited the potentiality of Virtual Reality to specifically measure the abilities in retrieving and syncing between different spatial reference frames, and then we administrated different neuropsychological tests for evaluating executive functions. Our results indicated that allocentric functions contributed significantly to the planning abilities, while syncing abilities influenced the attentional ones. The findings were discussed in terms of previous literature exploring relationships between cognitive deficits in the first phase of AD.

Aging affects many aspects of everyday living, such as autonomy, security and quality of life. Among all, spatial memory and spatial navigation show a gradual but noticeable decline, as a result of both neurobiological changes and the general slowing down of cognitive functioning. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify studies that specifically investigated the role of allocentric and egocentric frames in healthy aging. Concerning spatial navigation, our results showed a preservation of egocentric strategies, along with specific impairments in the use of allocentric and switching abilities. Regarding spatial memory, instead, outcomes were more divergent and not frame-specific. With this perspective, spatial impairments were discussed considering the cognitive profile of mild cognitive impairment (MCI) and Alzheimer's Disease (AD).

We present the architecture and usability evaluation of virtual reality system&mdash, &ldquo, Positive Bike&rdquo, &mdash, designed for improving cognitive and motor conditions in frail elderly patients. The system consists of a cycle-ergometer integrated in an immersive virtual reality system (CAVE) which allows combining motor and cognitive exercises according to a &ldquo, dual-task&rdquo, paradigm. We tested the usability and user&rsquo, s experience of the prototype in a pilot evaluation study that involved five elderly patients. The prototype was tested in one-session training to understand the limitations and areas for improvement of our system. The evaluation consisted in (i) usability assessment using the system usability scale, (ii) evaluation of user&rsquo, s engagement using the flow state scale, and (iii) expert evaluation involving interviews with domain experts. Results showed a good usability, both for system usability scale and the semi-structured interview. The level of flow (i.e., enjoyment with the task at hand) measured using the short flow state scale, was also high. Analysis of semi-structured interview carried out with domain experts provided further indications to improve the system. Overall, these findings show that, despite some limitations, the system is usable and provides an enjoyable user&rsquo, s experience.

Ecological momentary assessment (EMA) and ecological momentary intervention (EMI) are alternative approaches to retrospective self-reports and face-to-face treatments, and they make it possible to repeatedly assess patients in naturalistic settings and extend psychological support into real life. The increase in smartphone applications and the availability of low-cost wearable biosensors have further improved the potential of EMA and EMI, which, however, have not yet been applied in clinical practice. Here, we conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to explore the state of the art of technology-based EMA and EMI for major depressive disorder (MDD). A total of 33 articles were included (EMA = 26; EMI = 7). First, we provide a detailed analysis of the included studies from technical (sampling methods, duration, prompts), clinical (fields of application, adherence rates, dropouts, intervention effectiveness), and technological (adopted devices) perspectives. Then, we identify the advantages of using information and communications technologies (ICTs) to extend the potential of these approaches to the understanding, assessment, and intervention in depression. Furthermore, we point out the relevant issues that still need to be addressed within this field, and we discuss how EMA and EMI could benefit from the use of sensors and biosensors, along with recent advances in machine learning for affective modelling.