Search

Background: An increase in drinking to cope with anxiety provoked by the coronavirus was observed during the first few months of the COVID-19 pandemic. Objective: In the present study, we examined the role of drinking motives in the anxiety–alcohol link one year into the pandemic. Methods: Using a cross-sectional design, we collected data between April and May 2021: 678 participants located in Romania or the Netherlands completed an online survey on alcohol consumption in the past month (assessed using a simple quantity-frequency measure), change in drinking during the past year (assessed using a single item asking whether there had been an increase, decrease or no change), drinking motives (assessed using the Revised Drinking Motives Questionnaire), drinking-related problems (assessed using the Alcohol Use Disorder Identification Test), and COVID-19-related anxiety (assessed using the Coronavirus Anxiety Scale). Results: Compared to before the pandemic, while 42% of participants had decreased their alcohol consumption, 15% reported an increase. Participants with clinically relevant COVID-19-related anxiety (11%) were more likely to drink to cope with negative affect, enhance positive affect, and conform to others. The association between COVID-19-related anxiety and drinking-related problems was specifically moderated by drinking to cope, such that the anxiety–alcohol link was stronger in participants who endorsed this drinking motive more. Conclusion: Drinking is a maladaptive coping strategy for individuals with high levels of COVID-19-related anxiety. These individuals might benefit from interventions involving the learning of healthier skills to deal with the ongoing pandemic.

Background: The introduction of esketamine into the field of psychiatry comes on the heels of excitement from studies on racemic ketamine. While the intranasal route has been the most studied to date, other modes of administration of esketamine may also be of interest in the management of depression. Aims: To systematically review the literature on non-intranasal esketamine for depression in terms of its antidepressant effect and safety. Methods: We searched PubMed, Embase, the Cochrane Library, and Google Scholar from inception up to February 2021. Search terms included a combination of Medical Subject Headings and text words indicative of esketamine and depression. We selected both controlled and uncontrolled studies examining non-intranasal esketamine for the treatment of depression. Results: We identified four randomized controlled trials (RCTs) on intravenous esketamine and 15 open-label studies on intravenous ( n = 80), subcutaneous ( n = 73), and oral ( n = 5) esketamine. We found intravenous, subcutaneous, and possibly oral administration of esketamine to be effective in reducing depressive symptoms in most patients with major depressive disorder, bipolar depression, and (severe) treatment-resistant depression. Clinical response to repeated administration of esketamine persisted over the course of treatment. Esketamine was well tolerated by most patients, but open-label data indicate marked psychotomimetic symptoms in exceptional cases. The overall quality of the controlled studies was considered high, the overall quality of the uncontrolled studies low to moderate. Conclusions: Intravenous, subcutaneous, and possibly oral esketamine may offer an effective and safe addition to the depression treatment armamentarium. However, as most included studies lacked a control group and had small sample sizes, the quality of our results is limited. Different types and formulations of ketamine remain to be compared directly.

OBJECTIVE: Childhood trauma is a key public health risk factor for developing physical illness. This study examined how childhood abuse and neglect predict adult somatic symptoms assessed retrospectively and in real-time.METHODS: Participants in the HowNutsAreTheDutch (HND) project completed the Childhood Trauma Questionnaire Short Form (CTQ-SF) and, to assess somatic symptoms, the cross-sectional Patient Health Questionnaire (PHQ-15; N = 406) or a longitudinal ecological momentary assessment (EMA) protocol which included responding to an item on physical discomfort 3 times/day for 30 days (N = 290).RESULTS: As hypothesized, childhood trauma was positively associated with adult somatic symptoms assessed using the PHQ-15 (d = 0.30) and assessed using the EMA item (d = 0.31), also after adjustment for age, gender, educational level, and relationship status. Longitudinally, we also explored whether interpersonal context moderated abuse outcomes, and observed that social company dampened momentary physical discomfort among people with a history of more physical neglect (d = 0.04).CONCLUSION: Childhood trauma, especially emotional and sexual abuse, predict specific adult somatic symptoms. Future work may examine how symptom expression is influenced by the social lives of traumatized individuals.

Traditionally, symptoms of youth psychopathology are assessed with questionnaires, clinical interviews, or laboratory observations. Ecological Momentary Assessment (EMA) could be a particularly valuable additional methodology, since EMA enables examining the daily lives of youths near real-time, considering fluctuations and specific contexts of symptoms. This systematic review aimed to review the characteristics of current EMA applications and to provide a synthesis of their potential in studying youth psychopathology. Following a systematic search in PsycInfo and Medline, we identified 50 studies in clinical samples. Most studies used EMA to examine fluctuations in symptoms, affect, and behavior, and the relation with contextual factors. EMA was also used to investigate interactions between parents and their children over time, and to monitor and predict treatment response. EMA appeared feasible in youth and could provide valuable insights that contribute to understanding youth psychopathology. Benefits, gaps, and suggestions for future research and clinical practice are discussed.

A significant minority experiences severe, persistent, and disabling grief, termed prolonged grief or complicated grief, after bereavement. Prolonged grief treatments may be enhanced by improving understanding of malleable risk factors in post-loss psychological adaptation. Repetitive negative thought (e.g., rumination, worry) constitutes such a risk factor. Rumination and worry are both theorized to be maladaptive through interrelations with affect, yet this assumption has not been systematically investigated in the bereaved. We aimed to fill this gap in knowledge with a baseline survey and 10-day daily diary investigation among a bereaved sample. Survey between-subject analyses (N = 113) demonstrated that trait rumination and worry, trait negative affect and prolonged grief symptoms are positively related to each other and negatively related with trait positive affect. Within-subject multilevel analyses of diaries (N = 62) demonstrated that trait rumination and trait worry relate positively to daily negative affect and negatively to daily positive affect. Daily rumination and worry showed similar relationships with daily negative and positive affect. A stronger relationship emerged between daily rumination and daily negative affect in people with higher prolonged grief symptom levels. Findings consistently support interrelationships between repetitive negative thought, affect, and prolonged grief symptoms. Rumination appears particularly detrimental in people with severe grief reactions. Results align with research demonstrating the effectiveness of targeting repetitive negative thought in prolonged grief treatments. Additionally, our study demonstrates the potential feasibility and usefulness of using daily diaries to study behaviours of relevance to post-loss adaptation in everyday life.

RATIONALE: Alcohol effects on social cognition have been studied by measuring facial emotion recognition, empathy, Theory of Mind (ToM) and other forms of information processing. OBJECTIVES: Using the PRISMA guidelines, we reviewed experimental studies that examined acute effects of alcohol on social cognition. METHODS: Scopus, PsycInfo, PubMed, and Embase were searched between July 2020 - January 2023. The PICO strategy was used for identifying participants, interventions, comparators, and outcomes. Participants (N = 2330) were adult social alcohol users. Interventions consisted of acute alcohol administration. Comparators included placebo or the lowest alcohol dose. Outcome variables were grouped into three themes: facial processing, empathy and ToM, and perceptions of inappropriate sexual behavior. RESULTS: A total of 32 studies were reviewed. Studies measuring facial processing (67%) often found no effects of alcohol on the recognition of specific emotions, facilitated emotion recognition at lower doses and worsened emotion recognition at higher doses. In studies measuring empathy or ToM (24%), lower doses were more likely to lead to improvements while higher doses were generally impairing. Within the third group of studies (9%), moderate to high alcohol doses made it more difficult to perceive sexual aggression accurately. CONCLUSIONS: Lower alcohol doses might sometimes help facilitate social cognition, but most data were in line with the idea that alcohol tends to worsen social cognition, particularly at higher doses. Future studies might focus on examining other moderators of the effects of alcohol on social cognition, particularly interpersonal characteristics such as trait emotional empathy, and participant and target gender.

BACKGROUND: Cognitive behavioural analysis system of psychotherapy (CBASP) is an effective individual treatment for persistent depressive disorder (PDD), but evidence on group treatment (Group-CBASP) is limited. Our aim was to review the effect of Group-CBASP on self-report depression severity in outpatients with PDD, overall and by age of depression-onset.METHODS: A retrospective chart review study (November 2011-March 2017) in 54 patients with PDD (29 late-onset, 25 early-onset). Patients were previously treated by pharmacotherapy (92.6%), psychotherapy (98.1%) and/or electroconvulsive therapy (11.1%). Group-CBASP involved 24 weekly sessions during 6 months, followed by individual appointments over 6 months. The Inventory of Depressive Symptoms -self rating(IDS-SR) was used at baseline and after 3, 6, 9 and 12 months, computing mean differences and response rates.RESULTS: The mean IDS-SR score decreased significantly from 39.83 at baseline to 33.78 at 6 months: a decrease from severe to moderate depression after 24 weeks of Group-CBASP, with a medium effect size (Cohen's d = .49). At 12 months, the mean IDS-SR score was 32.81, indicating moderate symptom levels remained. At 6 and 12 months, mean IDS-SR scores were similar among late- versus early-onset patients, but at 12 months response rates were higher among late-onset patients.LIMITATIONS: Although results of our study provide valuable input for future prospective studies, limitations were the use of a retrospective design and the small group size.CONCLUSION: Group-CBASP offered to an outpatient population with PDD was associated with clinically relevant decrease in self-reported symptom severity, and with sustained response particularly in patients with late onset of depression.PRACTITIONER POINTS: Group-CBASP seems to be a good alternative for CBASP in individual setting. Patients with late age of depression-onset seem to benefit more from Group-CBASP. This study shows that clinical relevant effects of Group-CBASP, followed by individual contacts, remain at least for 6 months. Research on personalizing treatment strategies is needed to improve patient assignment for Group-CBASP.

Alcoholinname wordt in verband gebracht met interpersoonlijke effecten, waaronder die op empathie. Echter, de effecten op empathische accuratesse (EA) werden niet eerder bestudeerd. EA is het vermogen om iemands emoties nauwkeurig te beoordelen door deze af te leiden uit iemands verbale en non-verbale gedrag. Aan onze gerandomiseerde, dubbelblinde studie namen 54 mannelijke sociale drinkers deel, met uiteenlopende scores op de Alcohol Use Disorders Identification Test (AUDIT). De deelnemers dronken een matige dosis alcohol of een placebo, waarna hun EA werd bepaald door hen 16 video’s te laten zien van personen die over positieve en negatieve autobiografische gebeurtenissen vertelden, en hen tijdens het kijken te laten beoordelen hoe deze personen zich voelden. Allen deelnemers met lagere AUDIT-scores in de alcoholgroep waren minder empathisch accuraat tijdens positieve video’s dan vergelijkbare deelnemers in de placebogroep. Onze resultaten geven aan dat alcoholinname een negatief effect kan hebben op EA voor positieve emoties, namelijk bij mannen die geen riskant alcoholgebruik vertonen en dus weinig risico lopen op een alcoholverslaving. Een door alcohol veroorzaakte verminderde EA voor positieve emoties kan duiden op een positieve vertekening tijdens interpersoonlijke interacties. Deze interpretatie sluit aan bij het beeld van alcohol als ‘sociaal glijmiddel’.

The ratio between the second and fourth digit of the hand (2D:4D ratio) has been used as a marker of prenatal exposure to sex hormones. A previous study found that men with smaller 2D:4D ratios, relative to men with larger ratios, were more agreeable and less quarrelsome with women than with men. We aimed to replicate this study, using a similar procedure for sampling interpersonal behaviors but including participants who were first-year students (n = 81) rather than working adults in a long-term romantic relationship. Event-contingent recording of everyday social interactions yielded data on agreeableness, quarrelsomeness, dominance, and submissiveness in different social contexts (e.g., with male vs. female interaction partners). While we did not replicate the findings previously obtained in men, this might be due to the relatively low number of male participants. Female participants with larger 2D:4D ratios were more agreeable with women than with men; this was not found among women with smaller ratios. Future studies on the link between the 2D:4D ratio and interpersonal behavior should consider with whom interactions take place and examine additional factors such as participants' relationship status and hormonal contraceptive use.

Background People with a psychotic disorder commonly experience problems in social cognition and functioning. Social cognition training (SCT) improves social cognition, but may inadequately simulate real-life social interactions. Virtual reality (VR) provides a realistic, interactive, customizable, and controllable training environment, which could facilitate the application of skills in daily life. Objective We developed a 16-session immersive VR SCT (Dynamic Interactive Social Cognition Training in Virtual Reality [DiSCoVR]) and conducted a single-group feasibility pilot study. Methods A total of 22 people with a psychotic disorder and reported problems in social cognition participated. Feasibility and acceptability were assessed using a survey for participants and therapists, and by examining relevant parameters (eg, dropouts). We analyzed preliminary treatment effects on social cognition, neurocognition, and psychiatric symptoms. Results A total of 17 participants completed the study. Participants enjoyed DiSCoVR (mean 7.25, SD 2.05; range 3-10), thought it was useful for daily social activities (mean 7.00, SD 2.05; range 3-10), and enjoyed the combination of VR and a therapist (mean 7.85, SD 2.11; range 3-10). The most frequently mentioned strength of DiSCoVR was the opportunity to practice with personalized social situations (14/20, 70%). A significant improvement of emotion perception was observed (Ekman 60 Faces; t16=–4.79, P Conclusions DiSCoVR was feasible and acceptable to participants and therapists, and may improve emotion perception.

Objective: This systematic review and meta-analysis aimed to clarify the association between social anxiety and affective (AE) and cognitive empathy (CE). Methods: 1442 studies from PsycINFO, Medline, and EMBASE (inception-January 2020) were systematically reviewed. Included studies (N = 48) either predicted variance in empathy using social anxiety scores or compared empathy scores between socially anxious individuals and a control group. Results: Social anxiety and AE were statistically significantly positively associated, k = 14, r= .103 (95%CI [.003, .203]), z =2.03, p =.043. Sex (QM (2) = 18.79, p< .0001), and type of measures (QM (1 = 7.34, p =.007) moderated the association. Correlations were significant for male samples (rmale= .316, (95%CI [.200, .432])) and studies using self-report measures (rself-report = .162 (95%CI [.070, .254])). Overall, social anxiety and CE were not significantly associated, k=52, r =-.021 (95%CI [-.075, .034]), z= -0.74, p = .459. Sample type moderated the association (QM (1)= 5.03, p

Background: The biopsychosocial model of challenge and threat specifies a challenge-threat continuum where favorable demand-resource evaluations, efficient cardiovascular responses, and superior performance characterize challenge; and maladaptive outcomes like clinical depression characterize threat states. The model also specifies task engagement, operationalized as heart rate and ventricular contractility increases, as a prerequisite for challenge and threat states. The blunted cardiovascular reactivity to stress literature describes reductions of these increases and associates them with problems like clinical depression. Objectives: To determine whether blunted cardiovascular reactivity to stress has implications for challenge and threat theory. Methods: We review and synthesize the literatures on blunted cardiovascular reactivity to stress and the biopsychosocial model. Results: Blunted cardiovascular reactivity appears not to reflect a physiological inability to respond to stress. Rather, it reflects a contextually dependent motivational dysregulation and reduced reactivity to stress consistent with deficient task engagement in the biopsychosocial model. Conclusion: We argue that blunted cardiovascular reactivity represents deficient task engagement, and more generally, motivational disengagement due to threat states. Our biopsychosocial model-based approach conceptualizes this motivational disengagement as a tendency to avoid motivated performance situations. This tendency may represent a defense mechanism against subsequent threat and might explain associations with disorders like clinical depression.

BACKGROUND People with a psychotic disorder commonly experience problems in social cognition and functioning. Social cognition training (SCT) improves social cognition, but may inadequately simulate real-life social interactions. Virtual reality (VR) provides a realistic, interactive, customizable, and controllable training environment, which could facilitate the application of skills in daily life. OBJECTIVE We developed a 16-session immersive VR SCT (Dynamic Interactive Social Cognition Training in Virtual Reality [DiSCoVR]) and conducted a single-group feasibility pilot study. METHODS A total of 22 people with a psychotic disorder and reported problems in social cognition participated. Feasibility and acceptability were assessed using a survey for participants and therapists, and by examining relevant parameters (eg, dropouts). We analyzed preliminary treatment effects on social cognition, neurocognition, and psychiatric symptoms. RESULTS A total of 17 participants completed the study. Participants enjoyed DiSCoVR (mean 7.25, SD 2.05; range 3-10), thought it was useful for daily social activities (mean 7.00, SD 2.05; range 3-10), and enjoyed the combination of VR and a therapist (mean 7.85, SD 2.11; range 3-10). The most frequently mentioned strength of DiSCoVR was the opportunity to practice with personalized social situations (14/20, 70%). A significant improvement of emotion perception was observed (Ekman 60 Faces; t16=–4.79, Pd=–0.67), but no significant change was found in other measures of social cognition, neurocognition, psychiatric symptoms, or self-esteem. CONCLUSIONS DiSCoVR was feasible and acceptable to participants and therapists, and may improve emotion perception.

ACHTERGROND Therapieresistentie komt voor bij ongeveer 30% van de patiënten met een depressie. Er is dan ook grote behoefte aan nieuwe behandelmogelijkheden. Ketamine, oorspronkelijk ontwikkeld als anestheticum, wordt onderzocht en incidenteel reeds toegepast bij patiënten met een therapieresistente depressieve stoornis. DOEL Kritische beschouwing over het huidige gebruik van ketamine als antidepressivum. METHODE Literatuuronderzoek. RESULTATEN Een kortdurend antidepressief effect van ketamine is aangetoond. Veel minder is bekend over het in stand houden van dit effect, de potentiële risico’s van herhaalde toediening, en de effectiefste toedieningsmethoden en behandelschema’s. CONCLUSIE Aanvullend onderzoek naar ketamine als antidepressivum blijft noodzakelijk. Eventuele (offlabel-) behandeling dient in de tussentijd alleen onder voorbehoud van zorgvuldige patiëntselectie en strikte monitoring te worden toegepast. BACKGROUND Treatment-resistance occurs in about 30% of patients with depression. Therefore, there is an urgent need to identify new treatment strategies. Ketamine, originally developed as an anesthetic, is studied and applied as treatment for patients with treatment-resistant depression. AIM A critical review of the current use of ketamine as an antidepressant. METHOD Literature study. RESULTS Ketamine is a proven effective acute antidepressant. However, limited information is available about maintenance of effect of ketamine, potential risks of repeated administration, and different routes of administration and treatment schedules. CONCLUSION Additional research on ketamine as an antidepressant is needed. Meanwhile, (off-label) treatment should only be applied after careful patient selection and under close monitoring.

There is an urgent need to develop additional treatment strategies for patients with treatment-resistant depression (TRD). The rapid but short-lived antidepressant effects of intravenous (IV) ketamine as a racemic mixture have been shown repeatedly in this population, but there is still a paucity of data on the efficacy and safety of (a) different routes of administration, and (b) ketamine's enantiomers esketamine and arketamine. Given practical advantages of oral over IV administration and pharmacodynamic arguments for better antidepressant efficacy of esketamine over arketamine, we designed a study to investigate repeated administration of oral esketamine in patients with TRD.This study features a triple-blind randomized placebo-controlled trial (RCT) comparing daily oral esketamine versus placebo as add-on to regular antidepressant medications for a period of 6 weeks, succeeded by a follow-up of 4 weeks. The methods support examination of the efficacy, safety, tolerability, mechanisms of action, and economic impact of oral esketamine in patients with TRD.This is the first RCT investigating repeated oral esketamine administration in patients with TRD. If shown to be effective and tolerated, oral esketamine administration poses important advantages over IV administration.Dutch Trial Register, NTR6161. Registered 21 October 2016.

Ambulatory assessment (AA) is a research method that aims to collect longitudinal biopsychosocial data in groups of individuals. AA studies are commonly conducted via mobile devices such as smartphones. Researchers tend to communicate their AA protocols to the community in natural language by describing step-by-step procedures operating on a set of materials. However, natural language requires effort to transcribe onto and from the software systems used for data collection, and may be ambiguous, thereby making it harder to reproduce a study. Though AA protocols may also be written as code in a programming language, most programming languages are not easily read by most researchers. Thus, the quality of scientific discourse on AA stands to gain from protocol descriptions that are easy to read, yet remain formal and readily executable by computers. This paper makes the case for using the HyperText Markup Language (HTML) to achieve this. While HTML can suitably describe AA materials, it cannot describe AA procedures. To resolve this, and taking away lessons from previous efforts with protocol implementations in a system called TEMPEST, we offer a set of custom HTML5 elements that help treat HTML documents as executable programs that can both render AA materials, and effect AA procedures on computational platforms.

Rationale Drinking alcohol is associated with various interpersonal effects, including effects on cognitive empathy. Empathic accuracy (EA) is a form of cognitive empathy concerned with perceivers’ accuracy in inferring a target’s thoughts and feelings. The effects of alcohol on EA have not previously been studied. Objectives We examined the effect of a moderate alcohol dose on EA in social drinkers. Methods Fifty-four men with varying levels of hazardous drinking according to the Alcohol Use Disorders Identification Test (AUDIT) participated in a randomized, double-blind, between-group study. The alcohol group received 0.56 g/kg alcohol in a vodka and tonic-mixed drink. The placebo group received tonic, with 4 ml of vodka sprayed on top. All participants performed an EA task that involved watching 16 videos of people narrating positive and negative emotional autobiographical events and continuously rating how targets felt while narrating. Results There were no significant main effects of beverage condition on the EA task. There was an effect of the condition by AUDIT interaction for EA on the positive videos. Post-hoc simple contrasts revealed that in participants with lower AUDIT scores, the alcohol condition had lower EA for positive videos than the placebo condition. No significant main effect for condition occurred in the participants with higher AUDIT scores. Conclusions The effect of condition in participants with lower AUDIT scores indicates alcohol selectively reduced EA in individuals low on hazardous drinking. This suggests either alcohol-induced impairments of EA for positive events or a positivity bias in men at low risk for alcohol dependency. Electronic supplementary material The online version of this article (10.1007/s00213-018-4859-y) contains supplementary material, which is available to authorized users.

OBJECTIVE: To examine whether prosocial behaviors help sustain a positive mood, we tested the dynamic reciprocal associations between prosocial behavior and positive affect (PA) in daily life. A second aim was to examine whether the personality traits neuroticism and extraversion moderate these associations.METHODS: The study included a community sample (N = 553). Participants completed an electronic diary assessing prosocial behavior and PA three times a day over 30 days. A subsample of 322 participants filled out the NEO-Five-Factor Inventory to assess neuroticism and extraversion. Multilevel autoregressive models were performed to examine the within-person bidirectional associations between prosocial behavior and PA and possible moderation by neuroticism and extraversion.RESULTS: Within individuals, more PA was followed by more prosocial behavior at the next assessment and more prosocial behavior was followed by more PA. The effect of prosocial behavior on PA was stronger for individuals high on neuroticism. Extraversion did not moderate the associations under study.CONCLUSION: The findings indicate that prosocial behavior and PA reinforce each other in daily life. Prosocial behavior seems most beneficial for individuals high on neuroticism. This article is protected by copyright. All rights reserved.

Contains fulltext : 156142.pdf (Publisher’s version ) (Closed access) Major depressive disorder (MDD) has been associated with abnormalities in speech and behavioural mimicry. These abnormalities may contribute to the impairments in interpersonal functioning that are often seen in MDD patients. MDD has also been associated with disturbances in the brain serotonin system, but the extent to which serotonin regulates speech and behavioural mimicry remains unclear. In a randomized, double-blind, crossover study, we induced acute tryptophan depletion (ATD) in individuals with or without a family history of MDD. Five hours afterwards, participants engaged in two behavioural-mimicry experiments in which speech and behaviour were recorded. ATD reduced the time participants waited before speaking, which might indicate increased impulsivity. However, ATD did not significantly alter speech otherwise, nor did it affect mimicry. This suggests that a brief lowering of brain serotonin has limited effects on verbal and non-verbal social behaviour. The null findings may be due to low test sensitivity, but they otherwise suggest that low serotonin has little effect on social interaction quality in never-depressed individuals. It remains possible that recovered MDD patients are more strongly affected. 9 p.

Rationale Major depressive disorder (MDD) has been associated with disturbances in social functioning and in the brain serotonin system. Reduced levels of serotonin may negatively influence social functioning, for example by impairing the recognition of facial emotion expressions. Objectives The present study investigated the effect of acute tryptophan depletion (ATD), which reduces brain serotonin, on a related component of social functioning, empathic accuracy (EA), and oxytocin levels. Methods Individuals with (FH+) and without (FH−) a family history of MDD participated in a randomized, double-blind, crossover study. On two separate test days, participants ingested tryptophan-deficient and nutritionally balanced amino acid mixtures. Six hours later, they performed an EA task, which involved watching videos of people recounting autobiographical emotional events. While watching, participants continuously rated how these people felt during the recounting. Mood state was repeatedly assessed using the Positive Affect and Negative Affect Schedule and a series of visual analogue scales. Blood samples obtained at baseline and 5 h after mixture ingestion were assessed for tryptophan and oxytocin levels. Results ATD decreased circulating levels of tryptophan and oxytocin. Nevertheless, there were no significant effects of ATD on EA or mood in either FH group. Conclusions While previous studies have shown that acute reductions in brain serotonin alter the recognition of facial emotion expressions in never-depressed individuals, the present study suggests that empathic abilities may remain unaffected. Electronic supplementary material The online version of this article (doi:10.1007/s00213-015-4093-9) contains supplementary material, which is available to authorized users.

Background: To review how daily symptom ratings have been used in research into premenstrual dysphoric disorder (PMDD), and to discuss opportunities for the future. Methods: PsycINFO and Medline were systematically searched, resulting in the inclusion of 75 studies in which (1) participants met the diagnostic criteria for late luteal phase dysphoric disorder (LLPDD) or PMDD and (2) diaries were used to study LLPDD/PMDD. Results: To date, diaries have been used to gain insight into the aetiology and phenomenology of PMDD, to examine associated biological factors, and to assess treatment efficacy. We found low consistency among the diaries used, and often only part of the menstrual cycle was analysed instead of the whole menstrual cycle. We also observed that there was substantial variability in diagnostic procedures and criteria. Limitations: This review excluded diary studies conducted in women with premenstrual syndrome, women seeking help for premenstrual complaints without a clear diagnosis, and women without premenstrual complaints. Conclusions: Prospective daily ratings of symptoms and related variables provide a valuable and important tool in the study of PMDD. This paper addresses some options for improving the use of diaries and proposes the use of experience sampling and ecological momentary assessment to investigate within-person variability in symptoms in more detail. (C) 2015 Elsevier B.V. All rights reserved.

Experience sampling methods (ESM) and ecological momentary assessment (EMA) offer insight into daily life experiences, including symptoms of mental disorders. The application of ESM/EMA in psychopharmacology can be a valuable addition to more traditional measures such as retrospective self-report questionnaires because they may help reveal the impact of psychotropic medication on patients' actual experiences. In this paper we systematically review the existing literature on the use of ESM/EMA in psychopharmacology research. To this end, we searched the PsycInfo and Medline databases for all available ESM/EMA studies on the use of psychotropic medication in patients with DSM-III-R and DSM-IV disorders. Dissertations were excluded. We included 18 studies that applied ESM/EMA to study the effects of medication on patients with major depressive disorder, substance use disorder, attention-deficit hyperactivity disorder, psychotic disorder, and anxiety disorder. We found that ESM/EMA may allow researchers and clinicians to track patients during different phases of treatment: before treatment to predict outcome, during treatment to examine the effects of treatment on symptoms and different aspects of daily life experience, and after treatment to detect vulnerability for relapse. Moreover, ESM/EMA can potentially help determine how long and in what contexts medications are effective. Thus, ESM/EMA may benefit both researchers and clinicians and might prove to be an effective tool for improving the treatment of psychiatric patients. (C) 2015 Elsevier B.V. and ECNP. All rights reserved.

Researchers who perform Ecological Momentary Assessment (EMA) studies tend to rely on informatics experts to set up and administer their data collection protocols with digital media. Contrary to standard surveys and questionnaires that are supported by widely available tools, setting up an EMA protocol is a substantial programming task. Apart from constructing the survey items themselves, researchers also need to design, implement, and test the timing and the contingencies by which these items are presented to respondents. Furthermore, given the wide availability of smartphones, it is becoming increasingly important to execute EMA studies on user-owned devices, which presents a number of software engineering challenges pertaining to connectivity, platform independence, persistent storage, and back-end control. We discuss TEMPEST, a web-based platform that is designed to support non-programmers in specifying and executing EMA studies. We discuss the conceptual model it presents to end-users, through an example of use, and its evaluation by 18 researchers who have put it to real-life use in 13 distinct research studies.

BACKGROUND: We examined the influence of interindividual differences in alcohol use on the intraindividual associations of drinking occurrence with interpersonal behaviors, affect, and perceptions of others during naturally occurring social interactions.METHODS: For 14 consecutive days, 219 psychology freshmen (55% female; Mage = 20.7 years, SD = 2.18) recorded their behaviors, affect, and perceptions in social interactions soon after an interpersonal event occurred. Interpersonal behaviors and perceptions were assessed in terms of dominance-submissiveness and agreeableness-quarrelsomeness. Participants also reported the number of alcoholic drinks consumed within 3 hours of each interaction. We considered the intraindividual associations of (i) having a drinking episode and (ii) the number of drinks during an episode with behaviors, affect, and perceptions and examined interindividual differences in drinking frequency and intensity during social interactions as potential moderators of these associations.RESULTS: Social drinking frequency and intensity moderated the associations between drinking episode and behaviors, affect, and perceptions in social interactions. During a drinking episode, more frequent social drinkers perceived others as more dominant than less frequent social drinkers. During a drinking episode in which more alcohol was consumed than usual, more frequent social drinkers also reported behaving more dominantly and experiencing less pleasant affect.CONCLUSIONS: As more frequent social drinkers had different interpersonal responses to drinking than less frequent social drinkers, including when they had consumed larger amounts of alcohol than usual, our results suggest a differential susceptibility to the effects of alcohol during naturally occurring social interactions among drinkers with varying drinking frequency.

To examine whether acute changes in cognitive empathy might mediate the impact of light therapy on mood, we assessed the effects of a single light-therapy session on mood and cognitive empathy in 48 premenstrual women, including 17 who met Premenstrual Symptoms Screening Tool criteria for moderate-to-severe premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD). Using a participant-blind between-groups design, 23 women underwent 30 min of morning light therapy (5,000 lx; blue-enriched polychromatic light, 17,000 K) while 25 women had a sham session (200 lx, polychromatic light, 5,000 K). We administered the Positive Affect and Negative Affect Schedule and the Affect Grid right before and after the intervention, and 60 min later upon completion of a computerized empathic accuracy task. There were no significant effects of light condition on cognitive empathy as assessed using the computer task. Nonetheless, bright light reduced negative affect, specifically in women not using hormonal contraceptives. No effects of bright light on mood were observed in women who were using contraceptives. If a single light-therapy session does not alter cognitive empathy, then cognitive empathy may not mediate the impact of light therapy on mood in premenstrual women.

The amino acid tyrosine is the precursor to the catecholamine neurotransmitters dopamine and norepinephrine. Increasing tyrosine uptake may positively influence catecholamine-related psychological functioning. We conducted a systematic review to examine the effects of tyrosine on behavior and cognition. Fifteen studies were reviewed. All studies except one involved tyrosine loading during a single test session. In most behavioral studies, there were no significant effects of tyrosine on exercise performance. In contrast, cognitive studies employing neuropsychological measures found that tyrosine loading acutely counteracts decrements in working memory and information processing that are induced by demanding situational conditions such as extreme weather or cognitive load. The buffering effects of tyrosine on cognition may be explained by tyrosine's ability to neutralize depleted brain catecholamine levels. There is evidence that tyrosine may benefit healthy individuals exposed to demanding situational conditions. For future research we recommend moving from studying the acute effects of a single tyrosine load in small samples to studying the behavioral and cognitive effects of tyrosine in larger groups over multiple weeks.

Many studies have shown that having a meal together with others increases food intake. In contrast, the effects of having a meal on interactions with others have rarely been examined. More specifically, it is unknown if having a social interaction during a meal alters how people feel, behave, and perceive others. In the present study, 98 working individuals provided information on their everyday social interactions over a three-week period by filling in a form soon after each interaction. Record forms included items representing mood state, interpersonal behaviors, and perceptions of interaction partners. Participants also indicated whether interactions took place during a meal. Engaging in an interaction that involved eating a meal was associated with decreased alertness and, particularly in women, with increased pleasant affect, compared to interactions that did not involve eating a meal. Independently of this, during a meal participants reported fewer dominant and submissive behaviors and more agreeable behaviors, and also perceived interaction partners as more agreeable. These results were largely independent of contextual factors such as the gender and role of the primary social interaction partner, the presence of multiple partners, and the location of the interaction. Overall, social interactions during a meal were more positive in terms of how people felt, behaved, and perceived others. At the same time, agentic behaviors were reduced. These results suggest that shared meals are events in which affiliative bonds are strengthened in the context of weakened displays of hierarchy.

Associations between impulsivity and interpersonal behaviours have rarely been examined, even though impulsivity may disrupt the flow of social interactions. For example, it is unknown to what extent the commonly used Barratt Impulsiveness Scale (BIS-11) predicts impulsive behaviour in social situations, and how behaving impulsively during interpersonal encounters might influence levels of quarrelsomeness and agreeableness. In this study, 48 healthy working individuals completed the BIS-11 and recorded their behaviour in social situations using event-contingent recording. Record forms included items representing quarrelsome, agreeable, and impulsive behaviours. BIS-11 motor impulsiveness scores predicted impulsive behaviour in social situations. Impulsive behaviour was associated, in different interactions, with both agreeableness and quarrelsomeness. Behaving impulsively in specific interactions was negatively associated with agreeableness in participants with higher BIS-11 motor impulsiveness and positively associated with agreeableness in participants with lower BIS-11 motor impulsiveness. Impulsive quarrelsome behaviour may cause interpersonal problems. Impulsive agreeable behaviour may have positive effects in individuals with low trait impulsivity. The idea that there are between-person differences in the effects of state impulsivity on the flow of social interaction deserves further study.

Bright light can affect mood states and social behaviours. Here, we tested potential interacting effects of light and dopamine on facial emotion recognition. Participants were 32 women with subsyndromal seasonal affective disorder tested in either a bright (3000 lux) or dim light (10 lux) environment. Each participant completed two test days, one following the ingestion of a phenylalanine/tyrosine-deficient mixture and one with a nutritionally balanced control mixture, both administered double blind in a randomised order. Approximately four hours post-ingestion participants completed a self-report measure of mood followed by a facial emotion recognition task. All testing took place between November and March when seasonal symptoms would be present. Following acute phenylalanine/tyrosine depletion (APTD), compared to the nutritionally balanced control mixture, participants in the dim light condition were more accurate at recognising sad faces, less likely to misclassify them, and faster at responding to them, effects that were independent of changes in mood. Effects of APTD on responses to sad faces in the bright light group were less consistent. There were no APTD effects on responses to other emotions, with one exception: a significant light × mixture interaction was seen for the reaction time to fear, but the pattern of effect was not predicted a priori or seen on other measures. Together, the results suggest that the processing of sad emotional stimuli might be greater when dopamine transmission is low. Bright light exposure, used for the treatment of both seasonal and non-seasonal mood disorders, might produce some of its benefits by preventing this effect.

Background/Aims: Before diagnosing premenstrual dysphoric disorder (PMDD), 2 months of prospective assessment are required to confirm menstrual cyclicity in symptoms. For a diagnosis of premenstrual syndrome (PMS), this is not required. Women with PMDD and PMS often report that their symptoms interfere with mood and social functioning, and are said to show cyclical changes in interpersonal behaviour, but this has not been examined using a prospective approach. We sampled cyclicity in mood and interpersonal behaviour for 2 months in women with self- reported PMS. Methods: Participants met the criteria for PMS on the Premenstrual Symptoms Screening Tool (PSST), a retrospective questionnaire. For 2 menstrual cycles, after each social interaction, they used the online software TEMPEST to record on their smartphones how they felt and behaved. We examined within-person variability in negative affect, positive affect, quarrelsomeness, and agreeableness. Results: Participants evaluated TEMPEST as positive. However, we found no evidence for menstrual cyclicity in mood and interpersonal behaviour in any of the individual women (n = 9). Conclusion: Retrospective questionnaires such as the PSST may lead to oversampling of PMS. The diagnosis of PMS, like that of PMDD, might require 2 months of prospective assessment.

Importance Few pharmacotherapies have demonstrated sufficient efficacy in the treatment of posttraumatic stress disorder (PTSD), a chronic and disabling condition. Objective To test the efficacy and safety of a single intravenous subanesthetic dose of ketamine for the treatment of PTSD and associated depressive symptoms in patients with chronic PTSD. Design, Setting, and Participants Proof-of-concept, randomized, double-blind, crossover trial comparing ketamine with an active placebo control, midazolam, conducted at a single site (Icahn School of Medicine at Mount Sinai, New York, New York). Forty-one patients with chronic PTSD related to a range of trauma exposures were recruited via advertisements. Interventions Intravenous infusion of ketamine hydrochloride (0.5 mg/kg) and midazolam (0.045 mg/kg). Main Outcomes and Measures The primary outcome measure was change in PTSD symptom severity, measured using the Impact of Event Scale–Revised. Secondary outcome measures included the Montgomery-Asberg Depression Rating Scale, the Clinical Global Impression–Severity and –Improvement scales, and adverse effect measures, including the Clinician-Administered Dissociative States Scale, the Brief Psychiatric Rating Scale, and the Young Mania Rating Scale. Results Ketamine infusion was associated with significant and rapid reduction in PTSD symptom severity, compared with midazolam, when assessed 24 hours after infusion (mean difference in Impact of Event Scale–Revised score, 12.7 [95% CI, 2.5-22.8]; P = .02). Greater reduction of PTSD symptoms following treatment with ketamine was evident in both crossover and first-period analyses, and remained significant after adjusting for baseline and 24-hour depressive symptom severity. Ketamine was also associated with reduction in comorbid depressive symptoms and with improvement in overall clinical presentation. Ketamine was generally well tolerated without clinically significant persistent dissociative symptoms. Conclusions and Relevance This study provides the first evidence for rapid reduction in symptom severity following ketamine infusion in patients with chronic PTSD. If replicated, these findings may lead to novel approaches to the pharmacologic treatment of patients with this disabling condition. Trial Registration clinicaltrials.gov Identifier:NCT00749203

Facial emotions are important for human communication. Unfortunately, traditional facial emotion recognition tasks do not inform about how respondents might behave towards others expressing certain emotions. Approach-avoidance tasks do measure behaviour, but only on one dimension. In this study 81 participants completed a novel Facial Emotion Response Task. Images displaying individuals with emotional expressions were presented in random order. Participants simultaneously indicated how communal (quarrelsome vs. agreeable) and how agentic (dominant vs. submissive) they would be in response to each expression. We found that participants responded differently to happy, angry, fearful, and sad expressions in terms of both dimensions of behaviour. Higher levels of negative affect were associated with less agreeable responses specifically towards happy and sad expressions. The Facial Emotion Response Task might complement existing facial emotion recognition and approach-avoidance tasks.

Increasing serotonin decreases quarrelsome behaviours and enhances agreeable behaviours in humans. Antidepressants, even those whose primary action is not on serotonin, seem to increase serotonin function. We suggest that antidepressants act in part by effects on social behaviour, which leads to a gradual improvement in mood. We review the evidence supporting the idea that anti depressants may be moving behaviour from quarrelsome to agreeable. The more positive social responses of interaction partners would initiate a cycle of more positive social behaviour, and this iterative process would result in a clinically significant improvement in mood.

Background Difficulties in metacognition, or the ability to think about thinking and feeling, form an impediment to daily life functioning for persons with a psychotic disorder. In the past years, our research team has undertaken a multicenter, randomized controlled trial to investigate the efficacy of a new intervention designed to assist persons with a psychotic disorder to improve their metacognitive functioning (Metacognitive Reflection and Insight Therapy; MERIT). Methods After training thirteen therapists from seven mental healthcare institutes in the Netherlands, participants (n=70) with a DSM-IV-TR diagnosis of schizophrenia or schizoaffective disorder were included and randomized into either the MERIT condition or a treatment-as-usual condition. Persons randomized into the MERIT condition received 40 sessions of metacognitive psychotherapy, while persons in the control condition received care as usual. Measures of primary outcome (metacognition), secondary outcomes (empathy, depression, insight, stigma, social functioning, symptoms and quality of life) and control variables (neurocognition, premorbid IQ) were collected at baseline (pre), directly after therapy end (post) and at 6-month follow-up. After the follow-up measurement, research assistants were unblinded in order to conduct an interview with the participants regarding their experience of the therapy. Results Multilevel intention-to-treat and sensitivity analyses demonstrated that in both groups metacognition had improved, with no significant differences between the groups (χ2 (1)=0.435, p=.51). At 6-month follow-up, however, participants in the MERIT condition demonstrated they had continued to improve on metacognition, while scores from the control condition dipped back down (χ2 (1)=3.763, p=.05). Gains mainly seemed to be on metacognitive Self-Reflectivity (χ2 (1)=10.295, p=.001). No effects were found on secondary measures in either condition. Discussion During this presentation, we will discuss our findings and the therapy protocol, including a discussion of the clinical relevance of the current intervention, analysis of post-therapy interviews surrounding the participant’s experiences of the therapy, as well as practical limitations that were encountered during this five-year trial. Note S. de Jong (speaker) and R.J.M van Donkersgoed are early career scientists, expected to defend their dissertations in 2018.

Background Empathy is a complex interpersonal process thought to be impaired in individuals with schizophrenia spectrum disorders. Past studies have mainly used questionnaires or performance-based tasks with static cues to measure cognitive and affective empathy. In contrast, we used an Empathic Accuracy Task (EAT) designed to capture the more dynamic aspects of empathy by using video clips in which perceivers continuously judge emotionally charged stories of various targets. We compared individuals with schizophrenia to healthy controls on the EAT and assessed correlations among the EAT and three other commonly used empathy tasks. Methods Patients (n=92) and healthy controls (n=42) matched for age and education, completed the EAT, the Interpersonal Reactivity Index, the Questionnaire of Cognitive and Affective Empathy and the Faux Pas task. Differences between groups were analyzed and correlations were calculated between empathy measurement instruments. Results The groups differed in EAT performance, with controls outperforming patients. A moderating effect was found for the emotional expressivity of the target: while both patients and controls scored low when judging targets with low expressivity, controls performed better than patients with more expressive targets. Though there were also group differences on the cognitive and affective empathy questionnaires (with lower scores for patients in comparison to controls), EAT performance did not correlate with questionnaire scores. Reduced empathy performance did not seem to be part of a generalized cognitive deficit, as differences between patients and controls on general cognition was not significant. Discussion Individuals with schizophrenia benefit less from the emotional expressivity of other people than controls, which contributes to their impaired empathic accuracy. The lack of correlation between the EAT and the questionnaires suggests a distinction between self-report empathy and actual empathy performance. To explore empathic difficulties in real life, it is important to use instruments that take the interpersonal perspective into account.

Background: Ketamine is reported to have rapid antidepressant effects; however, there is limited understanding of the time-course of ketamine effects beyond a single infusion. A previous report including 10 participants with treatment-resistant major depression (TRD) found that six ketamine infusions resulted in a sustained antidepressant effect. In the current report, we examined the pattern and durability of antidepressant effects of repeated ketamine infusions in a larger sample, inclusive of the original.Methods: Participants with TRD (n = 24) underwent a washout of antidepressant medication followed by a series of up to six IV infusions of ketamine (.5 mg/kg) administered open-label three times weekly over a 12-day period. Participants meeting response criteria were monitored for relapse for up to 83 days from the last infusion.Results: The overall response rate at study end was 70.8%. There was a large mean decrease in Montgomery-Asberg Depression Rating Scale score at 2 hours after the first ketamine infusion (18.9 +/- 6.6, p Conclusions: Ketamine was associated with a rapid antidepressant effect in TRD that was predictive of a sustained effect. Future controlled studies will be required to identify strategies to maintain an antidepressant response among patients who benefit from a course of ketamine.

Despite a large body of research in non-human primates, the relationship between naturalistic patterns of social behaviour and basal cortisol levels has been understudied in humans. The present study examined the relationship between patterns of interpersonal functioning and cortisol levels in 23 offspring of parents with bipolar disorder (BD), at high risk for the development of an affective disorder, and 22 offspring of parents with no affective disorder (controls) in late adolescence and young adulthood. Using event-contingent recording, participants rated their dominance, submissiveness, quarrelsomeness, and agreeableness in naturally occurring social interactions over 14 consecutive days and provided salivary cortisol twice daily in the afternoon over the same period. In the full sample, multilevel modelling analyses revealed that dominance was a significant positive predictor of afternoon basal cortisol levels, t((35)) = 2.58, p

The Social Behavior Inventory (SBI) assesses social behaviors along the 2 orthogonal axes defining the interpersonal circumplex; that is, in terms of quarrelsomeness-agreeableness and dominance-submissiveness. To contribute to evidence evaluating the cross-cultural construct validity of the SBI, we investigated whether there are differences in how English-speaking students living in Canada and Dutch-speaking students living in The Netherlands view the SBI items. Results suggested there is similarity in the meaning of the items in the 2 cultures. The location of the original English SBI items on the 2 axes of the interpersonal circumplex was generally as expected. Similar results were found for a Dutch translation of the SBI. Differences occurred primarily along the dominance-submissiveness axis and could be explained by cultural differences in men's focus on power.

Since publication of the first randomized controlled trial describing rapid antidepressant effects of ketamine, several reports have confirmed the potential utility of this dissociative anesthetic medication for treatment of major depressive episodes, including those associated with bipolar disorder and resistant to other medications and electroconvulsive therapy. These reports have generated several questions with respect to who might respond to ketamine, how, and for how long. To start answering these questions. We used PubMed.gov and ClinicalTrials.gov to perform a systematic review of all available published data on the antidepressant effects of ketamine and of all recently completed, ongoing, and planned studies. To date, 163 patients, primarily with treatment-resistant depression, have participated in case studies, open-label investigations, or controlled trials. All controlled trials have used a within-subject, crossover design with an inactive placebo as the control. Ketamine administration has usually involved an anaesthesiologist infusing a single, subanesthetic, intravenous dose, and required hospitalization for at least 24 hours postinfusion. Response rates in the open-label investigations and controlled trials have ranged from 25% to 85% at 24 hours postinfusion and from 14% to 70% at 72 hours postinfusion. Although adverse effects have generally been mild, some patients have experienced brief changes in blood pressure, heart rate, or respiratory rate. Risk-benefit analyses support further research of ketamine for individuals with severe mood disorders. However, given the paucity of randomized controlled trials, lack of an active placebo, limited data on long-term outcomes, and potential risks, ketamine administration is not recommended outside of the hospital setting.

Increased serotonergic activity is often described as increasing the inhibition of behaviors. This study examined the more general hypothesis that increased serotonergic activity produces greater control over social behavior. Participants were drawn from two samples, individuals elevated on irritability and individuals unselected on personality characteristics. Individuals participated in a double blind cross-over design, providing event contingent records about their behavior during two 9-day periods which involved taking tryptophan or placebo. When taking tryptophan (which increases serotonergic activity), within-person variability among social behaviors across events (i.e., interpersonal spin) was reduced for irritable individuals, particularly those low on trait Agreeableness. These results suggest that higher levels of serotonergic activity enhance greater control and consistency in social behavior among irritable-disagreeable individuals. (C) 2011 Elsevier Inc. All rights reserved.

In healthy never-depressed individuals, acute tryptophan depletion (ATD) may selectively decrease the accurate recognition of fearful facial expressions. Here we investigated the perception of facial emotions after ATD in more detail. We also investigated whether bright light, which can reverse ATD’s mood-lowering effect, can also reverse its effect on the perception of facial emotions. On two separate test days, spent in a room that was either bright (n = 14) or dim (n = 16), healthy never-depressed women completed a facial emotion perception task six hours after ingesting tryptophan-deficient and balanced amino acid mixtures. Treatments were administered double blind and in randomized order using a crossover design. In dim light ATD decreased recognition accuracy of anger, disgust, and surprise. The labeling of fear and sadness was not affected. In bright light no effects of ATD were seen. Bright light was identified as a potential confounding factor in task performance. The effects of ATD on facial emotion perception may be less emotion-specific than thought previously, and occurred in a direction opposite to what might be expected based on theories of mood-congruent bias.