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Diagnostic and Statistical Manual of Mental Disorders: DSM-V

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... Autism spectrum disorders (ASD) are among the most common neurodevelopmental conditions encountered in medicine [1]. Many types of structural lesions and inherited factors predispose individuals to ASD [2], illustrating that the core clinical features (deficits in language and social function, restricted and rigid interactions and interests, repetitive behaviors, and altered sensory perceptions) [1] are likely a final common pathway of diverse developmental injuries. ...
... Autism spectrum disorders (ASD) are among the most common neurodevelopmental conditions encountered in medicine [1]. Many types of structural lesions and inherited factors predispose individuals to ASD [2], illustrating that the core clinical features (deficits in language and social function, restricted and rigid interactions and interests, repetitive behaviors, and altered sensory perceptions) [1] are likely a final common pathway of diverse developmental injuries. Prior studies in humans with ASD and in animal models of ASD have demonstrated that specific brain abnormalities covary with features of ASD, including structural abnormalities (cortical thickness [3,4] and regional volumetry [4][5][6]) and network abnormalities, such as the power spectrum, global connectivity, and nodal interaction assessments derived from scalp EEG [7,8] or functional MRI [4,9]. ...
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Background Autism spectrum disorder (ASD) is the second-most common neurodevelopmental disorder in childhood. This complex developmental disorder manifests with restricted interests, repetitive behaviors, and difficulties in communication and social awareness. The inherited and acquired causes of ASD impact many and diverse brain regions, challenging efforts to identify a shared neuroanatomical substrate for this range of symptoms. The striatum and its connections are among the most implicated sites of abnormal structure and/or function in ASD. Striatal projection neurons develop in segregated tissue compartments, the matrix and striosome, that are histochemically, pharmacologically, and functionally distinct. Immunohistochemical assessment of ASD and animal models of autism described abnormal matrix:striosome volume ratios, with an possible shift from striosome to matrix volume. Shifting the matrix:striosome ratio could result from expansion in matrix, reduction in striosome, spatial redistribution of the compartments, or a combination of these changes. Each type of ratio-shifting abnormality may predispose to ASD but yield different combinations of ASD features. Methods We developed a cohort of 426 children and adults (213 matched ASD-control pairs) and performed connectivity-based parcellation (diffusion tractography) of the striatum. This identified voxels with matrix-like and striosome-like patterns of structural connectivity. Results Matrix-like volume was increased in ASD, with no evident change in the volume or organization of the striosome-like compartment. The inter-compartment volume difference (matrix minus striosome) within each individual was 31% larger in ASD. Matrix-like volume was increased in both caudate and putamen, and in somatotopic zones throughout the rostral-caudal extent of the striatum. Subjects with moderate elevations in ADOS (Autism Diagnostic Observation Schedule) scores had increased matrix-like volume, but those with highly elevated ADOS scores had 3.7-fold larger increases in matrix-like volume. Conclusions Matrix and striosome are embedded in distinct structural and functional networks, suggesting that compartment-selective injury or maldevelopment may mediate specific and distinct clinical features. Previously, assessing the striatal compartments in humans required post mortem tissue. Striatal parcellation provides a means to assess neuropsychiatric diseases for compartment-specific abnormalities. While this ASD cohort had increased matrix-like volume, other mechanisms that shift the matrix:striosome ratio may also increase the chance of developing the diverse social, sensory, and motor phenotypes of ASD.
... Depression is a heterogeneous construct defined by the presence of self-reported symptoms that may be variously combined to satisfy the criteria for a diagnosis of major depressive disorder. Two individuals with the same diagnosis may share only one symptom [22,23]. Thus, relying on total symptom scores may obscure potential differential effects of single symptoms or symptom clusters [24]. ...
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Aims/hypothesis Insulin resistance and inflammation are components of a biological framework that is hypothesised to be shared by type 2 diabetes and depression. However, depressive symptoms include a large heterogeneity of somatic and cognitive-affective symptoms, and this may obscure the associations within this biological framework. Cross-sectional and longitudinal data were used to disentangle the contributions of insulin resistance and inflammation to somatic and cognitive-affective symptoms of depression. Methods This secondary analysis used data from the Emotional Distress Sub-Study of the GRADE trial. Insulin resistance and inflammation were assessed using the HOMA-IR estimation and high-sensitivity C-reactive protein (hsCRP) levels, respectively, at baseline and at the study visits at year 1 and year 3 (HOMA-IR) and every 6 months (hsCRP) for up to 3 years of follow-up. Depressive symptoms were assessed at baseline using the Patient Health Questionnaire (PHQ-8), and a total score as well as symptom cluster scores for cognitive-affective and somatic symptoms were calculated. For the cross-sectional analyses, linear regression analyses were performed, with inflammation and insulin resistance at baseline as dependent variables. For the longitudinal analyses, linear mixed-effect regression analyses were performed, with inflammation and insulin resistance at the various time points as dependent variables. In all analyses, depressive symptoms (total score and symptom cluster scores) were the independent variables, controlled for important demographic, anthropometric and metabolic confounders. For the analysis of insulin resistance (HOMA-IR), data from 1321 participants were analysed. For the analysis of inflammation (hsCRP), data from 1739 participants were analysed. Results In cross-sectional analysis and after adjustment for potential confounders, a one-unit increase in PHQ-8 total score was significantly associated with a 0.8% increase in HOMA-IR (p=0.007), but not with hsCRP (0.6% increase, p=0.283). The somatic symptom score was associated with a 5.8% increase in HOMA-IR (p=0.004). Single-item analyses of depressive symptoms showed that fatigue (3.6% increase, p=0.002) and increased/decreased appetite (3.5% increase, p=0.009) were significantly associated with HOMA-IR cross-sectionally. The cognitive-affective symptom score was not significantly associated with HOMA-IR at baseline. In longitudinal analyses, a one-unit increase in PHQ-8 total score was significantly associated with a 0.8% increase in hsCRP over time (p=0.014), but not with HOMA-IR over time (0.1% decrease, p=0.564). Again, only the somatic symptom cluster was significantly associated with hsCRP over time (5.2% increase, p=0.017), while the cognitive-affective symptom score was not. Conclusion/interpretation The results highlight the associations of depressive symptoms with markers of inflammation and insulin resistance, both cross-sectionally and longitudinally, in individuals with type 2 diabetes. In particular, somatic symptoms of depression appear to be the driver of these associations, even after controlling for concomitant conditions, with a potential role for fatigue and issues with appetite. Trial registration: ClinicalTrials.gov NCT01794143 Graphical Abstract
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Studies of protective factors regarding the suicidal risk in individuals with depression commonly suggest that social resources are important. However, there are some incoherent results that may be due to the cognitive distortion of depressed people. Therefore, the purpose of this study was to explore the relationship using social network variables, a relatively objective measurement method. The 145 participants were college students who studied in Seoul, South Korea. The Center for Epidemiologic Studies Depression Scale (CES‐D), the Suicide Ideation Scale, and an indicator evaluating the number of social networks were used. In the relationship between depression and suicide attempts, the size of social networks showed a significant moderating effect. In particular, when the size of the social network is fewer than six people, it is found that there is a conditional effect, confirming that the minimum human resources play an important role in identifying the risk of suicide attempts. This study may be meaningful in that it uses social network variables to examine the impact of social resources in more diverse aspects and to present specific goals for suicide crisis intervention.
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Young people with autism have support needs related to self-determination that are currently not adequately addressed in Spain. This study aimed to assess the effectiveness, implementation, and acceptability of a program to support self-determination for young adults with autism in Spain. A multicenter, mixed methods randomized controlled trial (RCT) study was conducted (2020–2022). Young adults with autism between 17 and 30 years of age were recruited, and 40 were randomly assigned to the intervention or waiting-list group. Quantitative and qualitative data on outcomes relating to self-determination, program implementation and acceptability were collected at baseline, during, and after the intervention using several tools, including the SDI: SR and focus groups. Joint displays were used to integrate the quantitative and qualitative results for a comprehensive evaluation of the program. The quantitative results revealed no significant differences between the intervention and waiting list groups but indicated positive impacts on agentic actions and overall self-determination as reported by participants and caregivers. The qualitative results expanded the quantitative results by identifying personal and contextual barriers and facilitators of self-determination while offering deeper insights into the quantitative outcomes. Implementation fidelity was high, and the qualitative data provided areas for improvement and identified challenges and best practices. Program acceptability was high, and the group format proved useful. Our study provides the first empirical evidence of an intervention designed to promote self-determination in individuals with autism in Spain, but further research is needed. This trial was retrospectively registered at www.clinicaltrial.org (NCT05938751) on January 1st, 2023.
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Challenges with social communication and social interaction are a defining characteristic of autism spectrum disorder (ASD). These challenges frequently interfere with making friendships, securing and maintaining employment, and can lead to co-occurring conditions. While face-to-face clinical interventions with trained professionals can be helpful in improving social conversation, they can be costly and are unavailable to many, particularly given the high prevalence of ASD and lack of professional training. The purpose of this study was to assess whether an AI program using a Large Language Model (LLM) would improve verbal empathetic responses during social conversation. Autistic adolescents and adults, 11–35 years of age, who were able to engage in conversation but demonstrated challenges with empathetic responses participated in this study. A randomized clinical trial design was used to assess the effects of the AI program (Noora) compared to a waitlist control group. Noora asks participants to respond to leading statements and provides feedback on their answers. In this study, participants were asked to respond to 10 statements per day 5 days per week for 4 weeks for an expected total of 200 trials. Pre- and post-intervention conversation samples were collected to assess generalization during natural conversation. Additionally pre- and post-intervention questionnaires regarding each participant’s comfort during social conversation and participants’ satisfaction with the AI program were collected. The results of this study demonstrated that empathetic responses could be greatly improved by using an AI program for a short period of time. Participants in the experimental group showed statistically significant improvements in empathetic responses, which generalized to social conversation, compared to the waitlist control group. Some participants in the experimental group reported improved confidence in targeted areas and most reported high levels of satisfaction with the program. These findings suggest that AI using LLMs can be used to improve empathetic responses, thereby providing a time- and cost-efficient support program for improving social conversation in autistic adolescents and adults.
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Background Anxiety due to a phobia of normal body weight is a core feature and maintenance factor of anorexia nervosa (AN). This is the first study to explore the efficacy and acceptability of using a novel imaginal exposure response prevention group to target fears associated with being a normal body weight to reduce anxiety in adolescents with AN. Methods The lead author adapted an I-ERP manual used to treat AN in adults in 1–1 therapy. Content was adapted for an adolescent population, sessions reduced from 10 to 4 and was delivered in a group format with audio recordings to be more accessible for patients. Nineteen patients with AN completed the group and the group therapist collected outcome measures before and after the intervention. A paired samples t-test was used to assess change in eating disorder psychopathology (EDEQ), anxiety and depression (RCAD) and fear of food (FOFM). Qualitative feedback to assess acceptability was also gathered. Results Statistically significant reduction in anxiety in a variety of situations pertaining to weight and shape was found after completion of the group. There were no significant changes shown in eating disorder psychopathology. Adolescents provided qualitative feedback which suggested the intervention was acceptable for users. Conclusions I-ERP which has been adapted for adolescents with AN in a group format seems to improve eating disorder psychopathology and reduce weight, shape, social and separation anxiety and phobias when used as an adjuvant to inpatient treatment. Further controlled research is advised. Level of evidence Level III.
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Background Factors that cause changes in insulin signaling in the brain are thought to affect the synaptic plasticity and accelerate the process of brain aging and neurodegeneration. Insulin receptor substrate (IRS) molecules are key mediators in insulin signaling. The aim of the current study is to determine whether there is an association between IRS gene polymorphisms, which are critical for insulin signaling, and the late-onset Alzheimer’s disease in Turkish patients. Methods and results Demographic and clinical characteristics of 115 patients with late-onset Alzheimer’s disease (age of onset ≥ 65 years) and 107 age-matched control subjects were obtained. DNAs were isolated from patient and control groups, IRS-1 and IRS-2 gene polymorphisms were investigated and genotyped according to the PCR-RFLP method. No statistically significant difference was observed in the genotypes for IRS-1 Gly972Arg (rs1801278) (p = 0.499) and IRS-2 Gly1057Asp (rs1805097) polymorphism between late-onset Alzheimer’s disease patients and controls (p = 0.658). However, when the compliance of IRS-2 polymorphism with Hardy- Weinberg distribution was tested, in the case-control comparison, G allele frequency of IRS-2 polymorphisms was significantly higher in the patient population than in the control group in the Turkish population of the Thrace region. Conclusions Despite the potential role of insulin resistance and hyperinsulinemia in the development of Alzheimer’s disease, we did not find any association between polymorphism of the IRS-1 and IRS-2 genes and late-onset Alzheimer’s disease. However, compared to the healthy subjects, Gly/Gly genotypes and the G allele in the IRS-2 were significantly more frequent in patients with late-onset Alzheimer’s disease.
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Play is a central feature of childhood and a fundamental right of all children. Currently, our understanding of autistic play is based on a deficit perspective, most often framed in comparison to neurotypical ‘norms’ and assumptions where the views of the players themselves have been overlooked. In moving towards a strengths-based neuroaffirmative understanding of autistic play, this study consulted with 19 autistic children (aged 5 to 13 years) using a series of semi-structured interviews and a range of creative and participatory methods. Reflexive thematic analysis generated three themes where children conceptualised: (1) enjoyment and pleasure as central to the definition of play, (2) social connections as fundamental to play and (3) play as engagement with meaningful materials and activities. Children’s autonomy and agency in play was important to all themes. These findings challenge long-standing deficit-oriented assumptions that have persisted throughout the literature for decades and have implications for future programmes of research, theory and practice, in particular on the importance of providing and facilitating authentic play experiences for autistic children in education and care contexts. Lay abstract Autistic play is generally described from a deficit perspective where the players themselves have been overlooked. It is important to consult with autistic children themselves about their understanding of play. We asked autistic children about their views on play using many different creative ways that were chosen by the children themselves. We analysed findings using reflexive thematic analysis. Autistic children in this research described play as involving feelings and emotions of pleasure and joy, autonomy and agency, playing by themselves and with others and engagement with materials and activities as meaningful. It is very important that we ask the players themselves what they think about play rather than relying on deficit framed, non-autistic definitions of autistic play. In this article, we will discuss how these findings will help develop future research, theory and practice in respecting children’s right to authentic play experiences.
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Our exchange of information through health technologies helps to increase access to care, analyze information, and disseminate practices. Clinical informatics is a rapidly expanding area and can facilitate patient-centered care as defined by quality, affordable, and timely health care. This chapter covers developments in information systems and electronic health records for communications with patients and staff (e.g., alerts, texts), setting behavioral health indicators and developing digital advances to improve practice and research. Patient-centered care with technology facilitates quality outcomes and efficiency via sound system processes. By learning how systems are designed and tailored to collect data, clinicians can use technology to inform decisions and facilitate outcomes. Setting priorities involves input from all care participants, as well as technological competencies for the clinician and institution. Cultural safety and humility focuses on patients’ experiences and values. This empowers patients’ roles in clinical care and helps to avoid inadvertent perpetuation or repetition of traumatic or stigmatizing experiences. Patient, clinician, and institutional attitudes and skills in technology, equity, and diversity can align clinical care, training, and research missions and stimulate process improvement.
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Internet-delivered psychodynamic treatments (IPDT) have a shorter history and smaller research base than those based on CBT, but the number of studies is rapidly growing. This chapter introduces the theoretical background and main principles of those IPDT treatments researched as of yet. Furthermore, it presents an overview of the research base for IPDT for different psychiatric disorders, where IPDT shows promising results for adult depression, adolescent depression, and several anxiety disorders in adulthood, as well as an adjunct treatment for inpatients with mixed disorders. Lastly, the chapter provides an illustrative case example of a treatment process in IPDT for adolescent depression.
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Mental disorders including neurodevelopmental difficulties are frequent, creating a substantial disparity between the demand for mental health care and the available resources. The potential of therapeutic technologies to address this treatment gap is immense, offering scalable solutions to enhance access. Yet, the intricate nature of mental disorders, woven with diverse risk factors, poses challenges to a comprehensive understanding of their mechanisms and assessment of this potential. Current assessments of mental disorders heavily rely on the expertise of trained clinicians, making it imperative to explore innovative avenues such as “digital phenotyping” to capture nuanced behaviors. However, integrating technology into healthcare encounters obstacles exacerbated by the divergent cultures of medical professionals and engineers. While technical feasibility is a priority for engineers, it often needs to match the acceptability standards set by healthcare professionals. Navigating the complexity of the healthcare ecosystem compounds the challenge of identifying precise needs. Furthermore, the time-intensive nature of clinical research methods hinders the swift evaluation of efficacy. To surmount these hurdles, we advocate for the incorporation of user-centered design methodologies and participatory research in the development of therapeutic technologies. This chapter delves into the multifaceted challenges of designing technologies, such as robots, for therapeutic programs focused on individuals with neurodevelopmental disorders. By proposing solutions that prioritize participatory co-design environments, we aim to empower individuals from diverse backgrounds to collaboratively support those undergoing therapy with technology, ensuring its efficacy and benefits.
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Zusammenfassung Die Befundlage zum Zusammenhang von traumatischen Erfahrungen über die Lebensspanne (TEL) und dem Auftreten von kognitiven Veränderungen und Demenzen ist heterogen und beruht häufig auf Untersuchungen in Risikogruppen. Die vorliegende Arbeit prüft in einer deutschen bevölkerungsbasierten Studie, ob es einen Zusammenhang zwischen TEL und Missbrauchs- (MB) und Vernachlässigungserfahrungen (VN) in der Kindheit mit leichter Neurokognitiven Störung im Alter (miNCD) gibt. 889 Teilnehmer:innen wurden in die Analyse eingeschlossen. Zur Erfassung von TEL wurde die Traumaliste des PTBS-Moduls des Strukturierten Klinischen Interviews für DSM-IV (SKID-I) und der Childhood Trauma Screener (CTS) genutzt. Die Diagnose von miNCD erfolgte mit einer neurokognitiven Testbatterie gemäß DSM-5-Kriterien. In binär logistischen Regressionsanalysen wurde geprüft, ob das Vorliegen von TEL mit dem Vorliegen einer miNCD zusammenhängt. In der Stichprobe berichteten 31,0% mindestens ein TEL, 30,3% berichteten VN und 13,2% MB. 19,1% erfüllten die Kriterien einer miNCD. Es wurden vier Modelle getestet, die Alter, Geschlecht und Bildungsstand als mögliche konfundierende Variablen berücksichtigen. In Modell 1 wurde untersucht, ob TEL (ja/nein) mit miNCD im Alter zusammenhängt. In Modell 2 wurde geprüft, ob die Anzahl der TEL mit miNCD zusammenhängt. In Modell 3 wurde getestet, ob VN mit miNCD zusammenhängen und in Modell 4 wurde getestet, ob MB und miNCD zusammenhängen. In keinem der Modelle wurde ein signifikanter Effekt der untersuchten Variablen auf das Auftreten von miNCD gefunden. Internationale Studien zeigen Hinweise auf einen Zusammenhang zwischen TEL, VN, MB und miNCD, jedoch fehlen entsprechende Studien in Deutschland. Unsere Analyse fand trotz methodischer Stärken (standardisierte Erfassung aller Variablen, bevölkerungsbasierte Studie) keine Zusammenhänge. Möglicherweise führten die Studienanforderungen zu einer positiven Selektion gesunder Älterer. Trotzdem waren TEL, MB, und VN nicht unterrepräsentiert. Die Ergebnisse widersprechen denen an Hochrisikopopulationen, passen aber zu neueren bevölkerungsbasierten Studien, die keine Zusammenhänge finden. Auf Bevölkerungsebene scheint der gesuchte Zusammenhang nicht eindeutig nachweisbar zu sein, im Gegensatz zu Populationen mit hoher traumatischer Last, wie z. B. Veteranen, was angesichts der Tatsache, dass TEL Risikofaktoren für zahlreiche Komorbiditäten darstellen, die dann eine Rolle bei der Entwicklung der kognitiven Veränderungen spielen könnten, eine beruhigende Nachricht zu sein scheint.
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Individuals living with mental illness can experience dire oral health and face numerous barriers to oral health care. While mental health providers are important in oral health promotion, there is a major gap in knowledge on their oral health knowledge, attitudes and practices and guidelines/recommendations for best practice. This integrative review addresses this gap by synthesising evidence on mental health providers oral health knowledge, attitudes and practices and available clinical guidelines/recommendations. Searches were undertaken across six databases, supplemented with grey literature searches. The inclusion criteria were mental health providers, including nurses, doctors and allied health providers. Articles or guidelines/recommendations were excluded if they primarily related to drug and alcohol or substance use and eating disorders. A total of 16 studies and five guidelines/recommendations were included (20 were of high‐moderate quality). Mental health providers were receptive to playing a role in oral health promotion and screening and this was supported by guidelines/recommendations. However, current practices of mental health providers in promoting oral health are fragmented and inconsistent due to various barriers: limited knowledge, education, and training, lack of collaboration with dental services, heavy workloads, time constraints and challenging client behaviours. This review highlights an urgent need to strengthen supports for mental health providers to promote oral health with professional development in oral health, more detailed clinical practice guidelines, brief and user‐friendly oral health screening tools and streamlined dental referral pathways.
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Background Behavioral and Psychological Symptoms of Dementia (BPSD) are core and highly detrimental symptoms of dementia. Previous research has suggested a potential association between pain and BPSD, but pieces of evidence are lacking. Objective This study aimed to investigate the association between pain and BPSD in patients with dementia. Methods Seven databases were searched from inception to February 2024, including PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang Data. Cross-sectional and longitudinal studies were included. We included studies that involved older adults with dementia and assessed the pain and BPSD by using validated tools. The quality of cohort studies was assessed using the Newcastle–Ottawa Scale, and the quality of cross-sectional studies was evaluated using AHRQ criteria. Two researchers independently screened the articles, extracted the data, and assessed the quality of the studies. A meta-analysis was conducted using Stata 15.0. Data not suitable for meta-analysis was analyzed through a qualitative synthesis to provide a comprehensive overview of the findings. Results A total of 12 studies were included, comprising nine cross-sectional studies and three longitudinal studies. All studies were of medium to high quality. Studies reported that pain was associated with 13 different types of BPSD, including agitation, aggression, abnormal thought process, anxiety, care refusal, delirium, depression, delusions, hallucinations, sexual disinhibition, sleep disturbances, socially inappropriate behavior, and wandering. A pooled odds ratio (OR) of 1.25 (95%CI [1.17,1.33], p < 0.001) indicated a significant positive association between pain and BPSD. Specifically, pain was positively associated with aggression (OR = 1.07, 95%CI [1.00,1.13], p = 0.035), agitation (OR = 1.17, 95%CI [1.14, 1.21], p < 0.001), and depression (OR = 2.11, 95%CI [1.76,2.52], p < 0.001). However, pain was significantly negatively associated with wandering (OR = 0.77, 95%CI [0.73, 0.81], p < 0.001). Conclusions Pain was significantly positively associated with BPSD in patients with dementia, specifically with aggression, depression, and agitation. However, pain was negatively associated with wandering. This emphasizes the importance of further research in this area and improved interventions for pain and BPSD management. Trial registration www.crd.york.ac.uk CRD42023432320, registered 08/08/2024.
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This study explores the effectiveness of a comprehensive intervention program for improving writing skills in Spanish. Participants were 167 Spanish children (3rd to 6th Grades) with reading and writing difficulties and typical development. Children exhibited problems in writing, reading, and related skills, like phonological and prosodic skills. The intervention targeted the reinforcement of orthographic patterns, decoding activities based on meta-analytical strategies; meta-phonological, morphological, and prosodic activities; visual vocabulary; sentence building, and reading, considering the reciprocity between both skills in literacy development. It was a paper-and-pencil program, considering the main approaches of writing intervention (cognitive and multisensorial), the relevance of frequent and direct feedback, the use of explicit instructions, the recommended levels of intervention (sub-lexical, lexical, and sentence levels), and the use of motivating activities through a game-based design. Sixteen individualized sessions of direct, systematic, and explicit training were conducted with the support of a trainer who provided immediate and continuous feedback. A quasi-experimental non-equivalent waiting control group pre-post intervention design, with three groups (intervention group; waiting-control group; and typical development group), was applied. Results showed that the intervention had a positive impact on writing-related skills. Specifically, children who received the intervention performed close to peers without difficulties in several tasks after the intervention program, especially those involving phonological and prosodic processing. These findings support that phonological and prosodic training is related to writing performance and its development. Furthermore, this study presents psychoeducational implications because it supports that explicit and supplemental meta-phonological strategies could play an important role in teaching writing to children with reading and writing difficulties.
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Objective. The aim of this paper is to review the literature to identify the factors that influence the formation of medical and nursing students' attitudes towards individuals with ID. Methods. Data from the literature were collected using PubMed, KoBSON, and Google Scholar databases. The access was provided to free full texts in both English and Serbian. Results. Based on the review of research results, it is possible to identify a range of different factors that have both positive and negative influences on the formation of medical and nursing students' attitudes towards individuals with ID. Some of these factors include: gender, year of study, previous experience with individuals with ID, and prior knowledge about this population. Conclusion. Considering the attitudes of medical and nursing students towards individuals with ID is significant, as their attitudes will greatly shape the approach to healthcare for this population. Furthermore, the attitudes of future healthcare professionals can be a key factor in creating or mitigating inequalities in the healthcare system for individuals with ID.
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Estudos científicos sobre a fisiopatologia da depressão têm destacado a relevância da transmissão glutamatérgica e alterações histopatológicas associadas em circuitos neurais responsáveis pela modulação do comportamento emocional. Nesse contexto, agentes glutamatérgicos, como a cetamina e a escetamina, surgem como potenciais opções terapêuticas para a depressão resistente ao tratamento (DRT). Este trabalho revisou a literatura científica recente sobre a eficácia terapêutica e a segurança clínica do uso de cetamina e escetamina no manejo da DRT. Foram consultadas as bases de dados PubMed®, Elsevier Science® e Literatura Científica e Técnica da América Latina e Caribe (LILACS) para artigos publicados entre 2014 e 2024, utilizando os seguintes descritores: “Treatment-resistant depression,” “Ketamine OR Esketamine,” e “Efficacy AND Safety.” Após triagem inicial, 50 estudos foram selecionados para leitura integral, resultando na inclusão de 12 artigos nesta revisão. Os resultados indicam um crescente interesse científico no uso de cetamina intravenosa (IV) e escetamina intranasal (IN) como estratégias para potencializar a resposta terapêutica em pacientes com DRT refratários ao tratamento com antidepressivos orais. Os ensaios clínicos randomizados e controlados (ECRs) revisados apresentam resultados controversos acerca da eficácia superior dessas intervenções em comparação ao placebo. Os efeitos observados são atribuídos ao bloqueio dos receptores NMDA, o que proporcionaria alívio rápido dos sintomas depressivos, com boa segurança e tolerabilidade, além de efeitos colaterais geralmente leves e transitórios. No entanto, permanecem lacunas relacionadas à segurança em longo prazo e à duração dos efeitos terapêuticos. Essas questões demandam novos ECRs, que investiguem diferentes esquemas de dosagem, frequência e protocolos terapêuticos.
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The classification of emotional distress has significant diagnostic and treatment implications in psychological therapy. Traditionally models of distress have favoured a unitary model of emotions where an emotional reaction is dysfunctional according to the severity of its experience. An alternative to this is the binary model of emotional distress, which deems an emotion dysfunctional on the basis of the quality of the emotion itself. This is determined by rational or irrational beliefs and behavioural drives associated with the emotion. Some research has sought to investigate the binary model. However, attempts to find support for its theoretical assumptions have been challenging, specifically including a lack of psychometrically sound measures relevant to its investigation. Accordingly, this paper aimed to address this issue by creating a new measurement scale (the Negative Emotions Scale ) to provide preliminary validation of the binary model. A pilot study sample of adults ( N = 108, M age = 39, Males = 26.9%, Females = 72.2%) completed the Depression, Anxiety and Stress Scale (DASS-21), the Attitudes and Beliefs Scale II (ABS-II), the Automatic Thoughts Questionnaire (ATQ), and the Negative Emotions Scale (NES). Exploratory factor analyses indicated adequate loading of NES items to distinguish between functional and dysfunctional emotional pairings for depression/sadness, anxiety/concern, and anger/annoyance. Differences in association between rational and irrational beliefs were not found for anger-annoyance and shame-guilt constructs. However, depression-sadness showed difference according to rationality, and concern-anxiety to irrationality. These findings indicate initial support for the binary model of distress in this pilot study. This suggests future research with more robust analysis (such as CFA) and a larger sample may enhance these findings and provide practical utility for the clinical assessment of emotional distress.
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Objective Previous research has indicated that patients with Anorexia Nervosa (AN) exhibit specific eye movement changes, identified through eye tracking sensor technology. These changes have been proposed as potential digital biomarkers and endophenotypes for early diagnosis and preventive clinical interventions. This study aims to explore whether these eye movement changes are also present in individuals with subclinical eating disorder (ED) symptomatology compared to control participants. Method The study recruited participants using convenience sampling and employed the Eating Disorder Examination Questionnaire for initial screening. The sample was subsequently divided into two groups: individuals exhibiting subclinical ED symptomatology and control participants. Both groups performed various tasks, including a fixation task, prosaccade/antisaccade task, and memory-guided task. Alongside these tasks, anxiety and premorbid intelligence were measured as potential confounding variables. The data were analyzed through means comparison and exploratory Pearson’s correlations. Results No significant differences were found between the two groups in the three eye tracking tasks. Discussion The findings suggest that the observed changes in previous research might be more related to the clinical state of the illness rather than a putative trait. Implications for the applicability of eye movement changes as early biomarkers and endophenotypes for EDs in subclinical populations are discussed. Further research is needed to validate these findings and understand their implications for preventive diagnostics. Registration https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00573-2
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Autism has been associated with differences in functional brain network organization. However, the exact nature of these differences across development compared to non-autistic individuals and their relationship to autism-related social cognition, remains unclear. This study first aimed to identify EEG resting-state network characteristics in autistic versus non-autistic children, adolescents, and adults. Second, we investigated associations with social cognition measures. Analyzing resting-state EEG data from the EU-AIMS Longitudinal European Autism Project, we compared network metrics (global efficiency, clustering coefficient, and small-worldness) between 344 autistic and non-autistic individuals within and across age groups in four frequency bands (delta, theta, alpha, and beta). If significant, we explored their relationships to measures of empathy (empathy quotient), complex emotion recognition [reading the mind in the eyes task (RMET)], and theory of mind (animated shapes task). Compared to their non-autistic peers, autistic adolescents showed lower alpha global efficiency, while autistic adults showed lower alpha clustering and small-worldness. No network differences were observed among children. In adolescents, higher long-range integration was tentatively associated with higher RMET scores; in those with high autistic traits, higher long-range integration related to fewer parent-reported empathic behaviors. No brain-behavior relationships were observed in adults. Our findings suggest subtle differences in network topology between autistic and non-autistic individuals, with less efficient long-range efficiency during adolescence, and less local and overall network efficiency in adulthood. Furthermore, long-range integration may play a role in complex emotion recognition and empathy difficulties associated with autism in adolescence.
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Background and purpose Emotional and behavioural problems (EBPs) are the two main forms of mental health problems that hinder the social interactions, learning and daily living of children and adolescents with intellectual disabilities (ID). Studies have shown that sufficient moderate-to-vigorous physical activity (MVPA) is associated with mental health outcomes among children and adolescents with typically developing (TD). However, these associations have not been fully studied in children and adolescent with ID, especially in samples from China. Therefore, this study aimed to examine the associations between MVPA and EBPs in Chinese children and adolescents with ID. Methods A cross-sectional survey was conducted with 116 students with ID (35.34% girls) aged 6–18 years. The wGT3-BT accelerometer was used to measure physical activity (PA), and the Chinese version of the parent-rated Strengths and Difficulties Questionnaire (SDQ) was used to assess the participants’ EBPs. A series of binary logical regression analyses was conducted to examine the ability of the MVPA guideline attainment in predicting EBPs in the total sample. Results The descriptive results showed that 43.97% of children and adolescents with ID present with EBPs. After controlling for age, sex, ID severity and weight status, logistic regression analysis indicated that the participants who meet the MVPA guideline exhibited significantly lower odds ratio for emotional symptoms (OR = 0.334, 95% CI [0.114–0.975], p = 0.045), peer problems (OR = 0.071, 95% CI [0.015–0.328], p < 0.001) and total difficulties (OR = 0.192, 95% CI [0.069–0.535], p = 0.002) compared with those who did not meet the guidelines. Conclusion The prevalence of EBPs in Chinese children and adolescents with ID remains high. Children and adolescents with ID meeting the MVPA guideline were more likely to have lower risks for emotional symptoms, peer problems and total difficulties than those who did not meet the guidelines. Future research adopting longitudinal or interventional designs to determine the relationships between PA and EBPs in this population are expected.
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Background Postoperative delirium is a frequent complication with negative consequences for neurosurgical patients. Recorded music has been shown to reduce the incidence of delirium, however its economic benefit remains unclear. This study aimed to investigate the cost-effectiveness of perioperative music in preventing postoperative delirium. Methods This study used data from a randomized controlled trial (Clinical Trials.gov; NCT04649450) that compared the effect of perioperative music with standard of clinical care on the occurrence of postoperative delirium in patients undergoing craniotomy at the Erasmus Medical Centre. The primary outcome of this study is the cost-effectiveness of the music intervention. A trial-based cost-effectiveness analysis (CEA) was conducted from a societal perspective. Mean costs were calculated using bootstrapping with 95% confidence intervals. Secondary outcomes included postoperative complications, mortality, cognitive functioning, and quality of life. Costs and patient outcomes were assessed separately for the initial hospital admission and long-term follow-up until 6 months after discharge. Results This study included 91 patients in the intervention group and 93 in the control group. On average, medical costs during initial admission were lower, albeit not statistically significant, in the music group compared to the control group (€ 11,819 vs. € 13,106), mostly due to a shorter length of stay. Total costs over the 6-month period were nearly identical between the groups, at € 18,587 and € 18,571 in the music and control group, respectively. Conclusions Pre-recorded perioperative music may be a cost-effective intervention for reducing postoperative delirium in neurosurgical patients, possibly by decreasing healthcare utilization and costs during primary admission. Further studies are needed to confirm its potential as a cost-effective intervention.
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Objectives We analyzed the genotypic and phenotypic features of patients with psychosis of epilepsy (POE). Methods Patients with POE recruited to an epilepsy genetics research program underwent phenotyping and genetic analysis. The latter included screening for rare pathogenic variants in epilepsy genes, and polygenic risk score (PRS) calculation for common risk variants associated with schizophrenia. Results One hundred twenty‐two individuals with POE were identified. Eighty‐six of 122 of the individuals (70%) had interictal psychosis, with schizophrenia the most common interictal phenotype (36/86, 42%). Twenty‐eight of 122 of the individuals (23%) had postictal psychosis (PIP), 2 of 122 of the individuals (2%) had antiseizure medication‐induced psychosis, and 6 of 122 of the individuals (5%) had substance‐induced psychosis. Focal epilepsies were more frequently associated with PIP (24/28, 86%) compared to interictal psychosis (39/86, 45%; p < 0.05). Twenty‐nine percent of the patients with POE with genetic data had a rare pathogenic variant: 19 in an epilepsy gene ( PCDH19 , SCN1A , DEPDC5 , KCNT1 , CHD2 , SLC2A1 , NPRL3 , CLN3 , NPRL3 , ATP1A3 , and CACNA1A ) and 4 had a chromosomal anomaly. Fifty‐seven percent of the patients with a rare pathogenic variant had interictal schizophrenia/schizophreniform disorder rather than PIP (9%; p < 0.05). PRSs showed that schizophrenia‐related common risk variants were enriched in patients with POE compared to population controls ( p = 0.0007), however, among the POE phenotypes, a raised PRS was only observed in interictal schizophrenia ( p = 0.015) and not in those with PIP or other interictal POEs. Interpretation Interictal POE is threefold more common than PIP, and more likely to be associated with both rare pathogenic variants for epilepsy and common risk variants for schizophrenia. Distinguishing between different POE phenotypes enhances clinical practice and our understanding of etiology, paving the way for precision medicine. ANN NEUROL 2025
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Objectives Hearing loss is a prevalent factor contributing to reduced quality of life and has been linked to various comorbidities, with potential significant implications for psychosocial and cognitive health. The aim of this study was to give current information about the prevalence of hearing loss, loneliness and depression, and to examine the association between these. Study Design Cohort study. Methods The Gutenberg Health Study, a large representative cohort study for the general population, was initiated in 2007 at the University Medical Center Mainz, Germany. Hearing loss was assessed using pure‐tone audiometry, with severity graduated in percentages according to the World Health Organization (WHO). Loneliness and depressive symptoms were assessed using self‐report measures: Loneliness Scale (≥2) for loneliness and the PHQ‐9 (≥10) for depressive symptoms. Results Among 5,948 participants (25–86 years), the prevalence of hearing loss was 38.7%. Loneliness was reported by 9.5% of the participants and the prevalence of significant symptoms of depression was 9.9%. The risk of loneliness was found to be significantly higher in participants with severe to complete hearing loss (OR = 3.92, p = 0.011). In addition, the odds ratio (OR) for depressive symptoms was significantly higher in those with a mild to severe hearing loss compared to those with normal hearing (OR = 1.3; p = 0.025). There was no association with hearing aid use. Conclusion Hearing loss is associated with both loneliness and depressive symptoms. Longitudinal studies are required to clarify the causal relationships and to further investigate the direct impact of early hearing aid fitting on the progression of loneliness and depression. Level of Evidence 2 Laryngoscope , 2025
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This study evaluates whether the association between neighborhood cohesion and frequency of anxiety symptoms varies by racial/ethnic group in the United States (US). Our study includes 89,617 respondents ages 18 and older from the National Health Interview Survey (2013–2018). We fit multivariate generalized linear regression models with interactions between neighborhood cohesion and race/ethnicity to test our hypotheses. We find that greater neighborhood social cohesion is associated with a lower frequency of anxiety symptoms for all racial/ethnic groups. However, this relationship was strongest for NL-Whites and Asians compared to NL-Black and Latine adults. No significant differences in this relationship were found between NL-Black, Latine, and Asian adults. Our study suggests that examining markers of mental health, such as anxiety symptoms, among the US population should consider variations in associations by race/ethnicity to expand our understanding of contextual factors that are associated with these outcomes. Population-based assessments of mental health markers should consider how sociocultural mechanisms operate differently by race/ethnicity.
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Teachers working with autistic children are at a great risk of stress and burnout, particularly in mainstream classrooms. To identify the general relationship between including a child with a mental disability and teachers' burnout and stress, as well as to discern any autism spectrum disorder (ASD)‐specific associations, this study compared teachers' experiences with children with ASD, attention‐deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) and typical children (control group). Two comparisons with a total sample of 907 teachers were conducted: one involving mainstream teachers (three groups: ASD, ADHD, and control) and one with specialized teachers (two groups: ASD and CD). Participants completed scales measuring perceived stress, self‐efficacy, perceived social support, coping, and burnout. The hypothesis that autism is specifically associated with teachers' burnout was chiefly rejected based on the results; instead, the intensity of behavioral problems appeared to be central. Clinical implications and research perspectives are discussed, particularly regarding the importance of training teachers in children's specific needs and inclusive pedagogy.
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Problematic media use (PMU) among young children is associated with negative psychophysical outcomes, necessitating reliable assessment tools. This study validates the Problematic Media Use Measure (PMUM) long and short forms for Italian parents of children aged between 1 and 14 years. Parents were recruited using a snowball sampling method through various social media platforms. A total of 403 parents (86.7% females) completed an online survey comprising the PMUM and the Child–Parent Relationship Scale – Short Form, which included the conflict and closeness subscales. Results from the Confirmatory Factor Analysis of the Italian version of the PMUM supported the unidimensional structure of the original measure, reporting a high internal consistency in both forms. Significant correlations emerged between PMU, parent–child conflict, and closeness, thereby demonstrating a good concurrent validity of the instrument. Moreover, the Kruskal–Wallis sum rank test revealed that parental perceptions of PMU significantly differed according to the child’s age, with parents of older children reporting higher levels of PMU. These results underscore a negative association between the quality of the parent–child relationship and the cooccurrence of PMU during childhood, further confirming the validity and reliability of the PMUM for assessing parental perception of PMU in the Italian context.
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Given the requirement for split-second decision making in unpredictable and morally ambiguous situations while in the line of duty, there is growing recognition that police officers are uniquely at risk for experiencing moral injury (MI). There is a need for valid and reliable assessment tools of MI within police populations to extend research initially conducted in or within the military context. The Moral Injury Assessment for Public Safety Personnel (MIA-PSP) is a population-specific measure developed to assess MI across police officers, firefighters, paramedics, correctional officers, and 911 dispatchers. Initial exploratory validation work by Roth et al. (2023) identified a three-factor structure capturing Emotional Sequelae, Perpetrations, and Betrayals. The structure of the MIA-PSP has yet to be validated using confirmatory modeling. The present study sought to investigate the psychometric properties of the MIA-PSP in a sample of police officers (N = 367, Mdn = 20 years of service, 72.5% men). We examined measurement invariance across gender and years of service, as well as the concurrent validity of the proposed factors with measures of traumatic stress, trauma-related outcomes, and well-being. Confirmatory factor analysis modeling supported a correlated three-factor structure that was invariant across gender and years of service. Controlling for shared variance among the subscales, the Emotional Sequelae and Betrayals subscales demonstrated unique predictive power with measures of trauma, trauma-related outcomes, and well-being. Findings suggest the MIA-PSP is a promising scale to assess MI within police populations.
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O presente trabalho tem como objetivo examinar as bases teóricas que sustentam a aplicação da psicolinguística em contextos clínicos, com um foco especial nas teorias gerativistas de linguagem e mente e suas implicações para o entendimento da linguagem em populações com desafios específicos de aprendizagem e comunicação. Nesse sentido, o trabalho justifica-se devido a necessidade de entender elementos da linguagem no processo de aprendizagem desses indivíduos. Além disso, como os processos linguísticos auxiliam na compreensão da linguagem, destacando a importância de abordagens personalizadas e inclusivas no diagnóstico e na intervenção nesses casos clínicos (TDAH, DISLEXIA E TEA). Dessa forma, a psicolinguística com sua interface com a psicologia e a linguística têm contribuído de forma assídua e promissora nesses grupos clínicos atípicos, dando subsídio e elementos para a compreensão da linguagem como um fenômeno complexo e multifacetado. Portanto, este artigo reforça a importância de continuar a explorar a fronteira entre a linguística, a psicologia e a neurociência, promovendo uma abordagem interdisciplinar que valoriza tanto a diversidade quanto a universalidade da experiência linguística humana.
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LAY SUMMARY Many studies investigate the various health conditions that impact Veteran populations and describe patterns of diagnosed mental health conditions such as posttraumatic stress disorder, anxiety, and depression. These high rates of mental health diagnoses may be connected to traumatic experiences, military culture, and other challenges when facing reintegration into civilian life. Even though these mental health diagnoses are known to exist among Veteran communities, not very much is known about how Veterans see their health. Do Veterans view their mental distress as being poor? If so, do they report more days of poor mental health than non-Veterans? In this study, the authors found that Veterans perceive their mental health as poor and are more likely to report a greater number of poor mental health days than non-Veterans. Knowledge of a Veteran’s perceived mental health provides insight into population-level mental distress among Veterans rather than solely diagnosed mental health conditions. Veteran populations will remain, and researchers must continue to improve the understanding of the complexities surrounding health to expand Veteran-centred care.
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Research on the dimensional approach to personality disorders in relation to psychosocial functioning is limited, particularly among adolescents. Since adolescence is a critical developmental period from the emergence of personality disorders, it is crucial to understand how both Criterion A (the level of personality functioning) and Criterion B (maladaptive personality traits) contribute to various domains of psychosocial functioning in this age group. To address this research gap, the current study evaluated the extent to which Criterion A and Criterion B of the alternative model for personality disorders predict psychosocial functioning in community-based sample adolescents over a 1-year period, beyond the overall psychopathology and baseline levels of psychosocial functioning. The study involved 855 adolescents aged 11–18 (M = 14.44, SD = 1.60; 62.5% female) at baseline and followed up 1 year later, achieving a 94% retention rate. Measurements included the assessments of the level of personality functioning, maladaptive personality traits, overall psychopathology, academic functioning, social functioning, and well-being. The findings indicated that while both Criterion A and Criterion B are associated with lower levels of psychosocial functioning 1 year later, their contributions varied across domains. Criterion A significantly predicted functioning in social and well-being domains, while Criterion B predicted social difficulties only. Neither Criterion A nor Criterion B was significant in predicting academic functioning. Psychoticism contributed to the experience of social rebuff, while detachment was uniquely linked to a lower quality of life. The results contribute to the understanding of how dimensionally defined personality pathology affects psychosocial functioning, adding a prospective perspective during adolescence.
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Autistic youth are at significant risk of experiencing a mental health crisis. Unfortunately, most clinical approaches to crisis management, such as referral to the emergency department, can be traumatic. At present, no crisis prevention programs have been developed for or rigorously tested among autistic youth. The goals of this study were to develop a parent-mediated mental health crisis prevention program, delivered virtually by a licensed clinician over three 1-h sessions, and test its efficacy via a randomized controlled trial. The trial included 49 autistic youth, ages 3 to 12 years, and their parents, who were recruited from an outpatient autism center. All children had behavioral concerns but were not at acute risk of crisis. Parents in the crisis prevention program (n = 25) reported that the strategies were safe and feasible; they were also very satisfied with the program. Compared to active controls (n = 24), who received the Autism Speaks Challenging Behavior Toolkit, the crisis prevention program was found to have greater improvements in caregiver-reported knowledge, confidence, and preparedness regarding management of crisis behaviors (p < .05). However, effects on caregiver-reported child irritability and behavioral acuity did not differ (p > .05). The brief crisis prevention program is safe, feasible, and acceptable to parents. While it improves mental health crisis preparedness, further research on its efficacy in reducing crisis risk is needed.
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To examine the impact of music as a cross-modal prime on facial emotion recognition ability in autistic children, this study compares the priming effect of music with that of faces as an intramodal prime and nonverbal sounds as the same cross-modal prime. The response time and accuracy of facial emotion recognition (happy and sad) were compared among 21 neurotypical children and 17 autistic children under various priming stimuli. A data analysis revealed that autistic children exhibited worse recognition of facial emotional expressions and demonstrated longer reaction time than neurotypical children. Unlike the other two stimuli (facial expressions and nonverbal sounds), music as a cross-modal prime resulted in slightly higher response accuracy for emotionally congruent conditions compared with emotionally incongruent conditions among autistic children. Furthermore, reaction time was significantly prolonged under emotionally congruent conditions than under emotionally incongruent conditions. This suggests that autistic children demonstrate a greater propensity to allocate additional time to improve the accuracy of their judgments under congruent conditions compared with incongruent conditions. Therefore, music intervention has significant potential for supporting autistic children to empathize with faces by playing emotionally congruent music and improving their facial emotion recognition abilities.
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Learning allows humans and other animals to make predictions about the environment that facilitate adaptive behavior. Casting learning as predictive inference can shed light on normative cognitive mechanisms that improve predictions under uncertainty. Drawing on normative learning models, we illustrate how learning should be adjusted to different sources of uncertainty, including perceptual uncertainty, risk, and uncertainty due to environmental changes. Such models explain many hallmarks of human learning in terms of specific statistical considerations that come into play when updating predictions under uncertainty. However, humans also display systematic learning biases that deviate from normative models, as studied in computational psychiatry. Some biases can be explained as normative inference conditioned on inaccurate prior assumptions about the environment, while others reflect approximations to Bayesian inference aimed at reducing cognitive demands. These biases offer insights into cognitive mechanisms underlying learning and how they might go awry in psychiatric illness.
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In recent years, smart devices have proven their effectiveness in monitoring mental health issues and have played a crucial role in providing therapy. The ability to embed sensors in fabrics opens new horizons for mental healthcare, addressing the growing demand for innovative solutions in monitoring and therapy. The objective of this review is to understand mental health, its impact on the human body, and the latest advancements in the field of smart textiles (sensors, electrodes, and smart garments) for monitoring physiological signals such as respiration rate (RR), electroencephalogram (EEG), electrodermal activity (EDA), electrocardiogram (ECG), and cortisol, all of which are associated with mental health disorders. Databases such as Web of Science (WoS) and Scopus were used to identify studies that utilized smart textiles to monitor specific physiological parameters. Research indicates that smart textiles provide promising results compared to traditional methods, offering enhanced comfort for long-term monitoring.
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Background: Co-occurring conditions and psychiatric comorbidities are more frequently observed in autistic individuals than in typically developing populations. Objective: The present study aimed to investigate the agreement of parent-and self-reported psychopathological assessment using the Child Behavior Checklist (CBCL/6-18) and the Youth Self Report (YSR/11-18), respectively, in autistic adolescents without intellectual impairment. Methods: 54 autistic adolescents without intellectual impairment (11-18 years; M = 14.73; SD = 2.28) were assessed with a psychiatric and psychological evaluation conducted by expert clinicians also using self-and parent-reported scales and semi-structured interviews (K-SADS PL, CDI, MASC) including CBCL/6-18 and YSR/11-18. Results: According to clinical judgment, over 90% of participants had at least a comorbidity: anxiety (68.5%) and mood disorder (57.4%) were the most frequent. The results indicate significant discrepancies between parent-and self-reports across the three summary scales, which assess emotional and behavioral problems, as well as their combined presentation, often observed in youth with ASD. Specifically, differences were found in Internalizing (p < 0.001), Externalizing (p = 0.013), and Total Problems (p < 0.001) scales. Conclusions: The findings show the lack of agreement in parent-and self-reported scales in our sample. These results suggest the need for a cross-and multi-informant approach to support clinical judgment and understand psychopathological comorbidities of autistic adolescents without intellectual impairment.
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The World Health Organization’s decision to include addictive game use (“gaming disorder”) in the International Classification of Diseases was the subject of controversial scientific debates (e.g., Aarseth et al., 2017; Rumpf et al., 2018; for an overview, see Reer & Quandt, 2021). However, knowledge is scarce on how addictive game use is perceived outside of academic circles (Schatto-Eckrodt et al., 2020). The current study aimed to fill this research gap by interviewing a stratified German sample (𝑁 = 1,075) on their attitudes toward the topic. We found that critical views about games and their addiction potential are rather common among the German general population. Further, we found evidence that many participants overestimated the number of players affected by gaming disorder. Regression analyses showed that age, gender, and gaming experience play a role in how individuals think about risks associated with game use. Interestingly, having heard about the topic in the media was associated with more critical attitudes and higher presumed prevalence rates. More exchange between scholars and the wider public is needed to increase knowledge on the topic. Further, media reports on gaming disorder should cover the latest research findings and the opposing views of scientists.
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