Search

Depression is highly comorbid among individuals with Parkinson's Disease (PD), who often experience unique challenges to accessing and benefitting from empirically supported interventions like Cognitive Behavioral Therapy (CBT). Given the role of reward processing in both depression and PD, this study analyzed a subset (N = 25) of participants who participated in a pilot telemedicine intervention of PD-informed CBT, and also completed a Reward- and Punishment-Learning Task (RPLT) at baseline. At the conclusion of CBT, participants were categorized into treatment responders (n = 14) and non-responders (n = 11). Responders learned more optimally from negative rather than positive feedback on the RPLT, while this pattern was reversed in non-responders. Computational modeling suggested group differences in learning rate to negative feedback may drive the observed differences. Overall, the results suggest that a within-subject bias for punishment-based learning might help to predict response to CBT intervention for depression in those with PD. Plain Language Summary Performance on a Computerized Task may predict which Parkinson's Disease Patients benefit from Cognitive Behavioral Treatment of Clinical Depression Why was the study done? Clinical depression regularly arises in individuals with Parkinson's Disease (PD) due to the neurobiological changes with the onset and progression of the disease as well as the unique psychosocial difficulties associated with living with a chronic condition. Nonetheless, psychiatric disorders among individuals with PD are often underdiagnosed and likewise undertreated for a variety of reasons. The results of our study have implications about how to improve the accuracy and specificity of mental health treatment recommendations in the future to maximize benefits for individuals with PD, who often face additional barriers to accessing quality mental health treatment. What did the researchers do? We explored whether performance on a computerized task called the Reward- and Punishment-Learning Task (RPLT) helped to predict response to Cognitive Behavioral Therapy (CBT) for depression better than other predictors identified in previous studies. Twenty-five individuals with PD and clinical depression that completed a 10-week telehealth CBT program were assessed for: Demographics (Age, gender, etc.); Clinical information (PD duration, mental health diagnoses, levels of anxiety/depression, etc.); Neurocognitive performance (Memory, processing speed, impulse control, etc.); and RPLT performance. What did the researchers find? A total of 14 participants significantly benefitted from CBT treatment while 11 did not significantly benefit from treatment. There were no differences before treatment in the demographics, clinical information, and neurocognitive performance of those participants who ended up benefitting from the treatment versus those who did not. There were, however, differences before treatment in RPLT performance so that those individuals that benefitted from CBT seemed to learn better from negative feedback. What do the findings mean? Our results suggest that the CBT program benefitted those PD patients with clinical depression that seemed to overall learn best from avoiding punishment rather than obtaining reward which was targeted in CBT by focusing on increasing engagement in rewarding activities. The Reward- and Punishment-Learning Task hence may be a useful tool to help predict treatment response and provide more individualized recommendations on how to best maximize the benefits of psychotherapy for individuals with PD that may struggle to connect to mental health care. Caution is recommended about interpretating these results beyond this study as the overall number of participants was small and the data for this study were collected as part of a previous study so there was no opportunity to include additional measurements of interest. [ABSTRACT FROM AUTHOR]

College is a stressful time for many students, including student-athletes, who may benefit from mindfulness interventions focusing on present-moment awareness and nonjudgmental acceptance. Mindful sport performance enhancement (MSPE) has shown promise in previous open trials for promoting both athlete well-being and psychological factors related to sport performance, and this first randomized controlled trial of MSPE was conducted with mixed-sport groups of 52 NCAA Division III student-athletes. Each of the six sessions included educational, discussion-based, experiential, and home practice components, with meditation exercises progressing from sedentary mindfulness to mindfulness in motion. Whereas wait-list controls showed significant increases in depressive symptoms, those who received MSPE evidenced non-significant reductions in depressive symptoms over the course of treatment. Furthermore, once controls had also received MSPE, treatment completers (the 41% who attended at least five of six MSPE sessions) demonstrated significant increases in flow, trait mindfulness, satisfaction with life, and self-rated sport performance, along with reductions in worry, with medium to large effect sizes. There were no significant changes for treatment completers from post-treatment to 6-month follow-up, suggesting that improvements were maintained over time. [ABSTRACT FROM AUTHOR]

Although mindfulness training for athletes is an area of increasing interest, few studies have focused on the qualitative experiences of athletes in such programs. Before beginning six sessions of mindful sport performance enhancement (MSPE) training, 45 mixed-sport collegiate athletes reported what they hoped and expected to get from the training, and responded afterward to open-ended questions about their experiences. Participants' responses were coded for themes, with high interrater reliability. Athletes initially hoped to gain psychological benefits in both sport and everyday life, such as relaxation and less stress or anxiety, better emotion regulation, mental toughness, and self-awareness, as well as sport performance improvement. Overall, they found MSPE to be a positive experience and reported many of the same benefits that they expected. Participants also provided constructive feedback and recommendations for future MSPE training. Finally, there was evidence to suggest that athletes' expectations predicted similar improvements in outcome measures. [ABSTRACT FROM AUTHOR]

Prior work has implicated several neurocognitive domains, including memory, in patients with a history of prior suicide attempt. The current study evaluated whether a delayed recognition test could enhance prospective prediction of near-term suicide outcomes in a sample of patients at high-risk for suicide. 132 Veterans at high-risk for suicide completed a computer-based recognition memory test including semantically-related and -unrelated words. Outcomes were coded as actual suicide attempt (ASA), other suicide-related event (OtherSE) such as aborted/interrupted attempt or preparatory behavior, or neither (noSE), within 90 days after testing. Reduced performance was a significant predictor of upcoming ASA, but not OtherSE, after controlling for standard clinical variables such as current suicidal ideation and history of prior suicide attempt. However, compared to the noSE reference group, the OtherSE group showed a reduction in the expected benefit of semantic relatedness in recognizing familiar words. A computational model, the drift diffusion model (DDM), to explore latent cognitive processes, revealed the OtherSE group had decreased decisional efficiency for semantically-related compared to semantically-unrelated familiar words. This study was a secondary analysis of an existing dataset, involving participants in a treatment trial, and requires replication; ~10 % of the sample was excluded from analysis due to failure to master the practice tasks and/or apparent noncompliance. Impairments in recognition memory may be associated with near-term risk for suicide attempt, and may provide a tool to improve prediction of when at-risk individuals may be transitioning into a period of heightened risk for suicide attempt. • Memory deficits form part of the clinical profile of suicidality. • Cognitive changes may prospectively predict suicide attempt in at-risk individuals. • Poor recognition memory predicted suicide attempt (SA) within next 90 days. • The prediction remained significant after controlling for other clinical variables. • Computational model suggested latent cognitive processes in those with upcoming SA. [ABSTRACT FROM AUTHOR]