The Structure of Executive Dysfunction in Depression and Anxiety

Reconceptualizing the relationship between anxiety, mindfulness, and cognitive control

Prior research has provided initial support for the claim that cognitive control mediates the relationship between anxiety and mindfulness; however, findings are often inconsistent. In this review, we argue that the inconsistency may be due to a lack of both conceptual and methodological precision in terms of how anxiety, cognitive control, and mindfulness are operationalized and assessed, and that this imprecision may be a critical source of study confounds and ambiguous outcomes. We unpack this argument by first decomposing anxiety, cognitive control, mindfulness, and relevant experimental paradigms into key dimensions in order to develop a non-unitary, multi-dimensional taxonomy of these constructs. Subsequently, we review and reinterpret the prior experimental literature, focusing on studies that examine the relationship between anxiety and cognitive control, mindfulness and cognitive control, and the three-way relationship between anxiety, mindfulness, and cognitive control. Across the reviewed studies, there was great variation in the dimensions being examined and the behavioral and/or neural measures employed; therefore, results were often mixed. Based on this review of literature, we propose a conceptually and methodologically precise framework from which to study the effects of mindfulness on cognitive control in anxiety. The framework theoretically aligns anxiety dimensions with specific mindfulness states and interventions, further suggesting how these will impact specific cognitive control dimensions (proactive, reactive). These can be assessed with experimental paradigms and associated behavioral and neural metrics to index the relevant dimensions with high precision. Novel experimental studies and tractable research designs are also proposed to rigorously test this theoretical framework.

Improving Cognitive and Psychological Functioning in Older Latinos With HIV: Results From a Pilot Health Promotion Intervention

BACKGROUND/OBJECTIVES

Older Latino persons with HIV (OLPWH) experience early-onset cognitive decline due to specific factors associated with accelerated aging as well as more established risk factors like depression, anxiety, and sedentary behavior. Yet, few behavioral interventions to improve OLPWH's psychological and cognitive health have been assessed. Thus, this pilot study evaluated the feasibility, acceptability, and preliminary intervention effects of the Happy Older Latinos are Active (HOLA) physical activity health promotion intervention on cognition and mental health among this underserved population.

RESEARCH DESIGN/METHODS

Thirty OLPWH (Age: M = 61.7 years, SD = 6.00 years 40% female, 46.7% less than high-school education) enrolled in a pilot single-arm selective prevention intervention trial evaluating changes in psychological and neurocognitive outcomes at two timepoints (baseline and postintervention). Participants were asked at the end of the study to offer qualitative feedback on their acceptance of and interest in the intervention. Results: Within 7-months, enrollment targets were met (<5% of eligible participants refusing participation) and lost-to-follow up was minimal (10%). Participants attended an average of 54% of sessions and reported a high degree of satisfaction with the intervention via the Client-Satisfaction-Questionnaire-8 (M = 30.5, SD = 2.2). Significant improvements in cognitive (delayed recall [aRR = 1.16], working memory [aRR = 0.79], verbal fluency [aRR = 1.09]) and psychological (depression [aRR = 0.63], and anxiety severity [aRR = 0.73]) domains were observed when controlling for age, gender, and education.

DISCUSSION/IMPLICATIONS

Results indicate that HOLA is an innovative and promising health promotion program that is uniquely tailored to address the multiple cognitive and psychological concerns affecting OLPWH in a nonstigmatizing and culturally acceptable manner.

Empirical validation of a developmental model for binge-eating disorder in adolescents: a structural equation modeling approach

Loss of control (LOC) eating is characterized by a reported sense of being unable to control food intake, regardless of the amount of food consumed. It is the hallmark feature of binge-eating episodes, which involve consuming an unusually large amount of food within a discrete time frame, accompanied by a sense of LOC over eating. Some studies investigating the progression of LOC-eating symptoms in children and adolescents suggest that LOC-eating may be a precursor to binge-eating disorder (BED) in adults. To explain the progression from LOC-eating in childhood and adolescence to BED in adulthood, Tanofsky-Kraff and her colleagues developed a theoretical model highlighting three main constructs: negative affectivity, reward sensitivity, and executive functioning. However, a thorough empirical validation of this model has not yet been performed. The current study aims to empirically test Tanofsky-Kraff and her colleagues' model via structural equation modeling (SEM) and explore potential gender and age differences within this framework. We surveyed 969 adolescents aged 12 to 18 years from the Quebec City area who completed self-report questionnaires. Our findings revealed that both negative affectivity and reward sensitivity are significantly associated with binge-eating symptomatology, whereas self-reported executive functioning is not significantly associated with binge-eating symptomatology. These results support several key components of the proposed model and provide insights into the interactions between the variables when tested simultaneously. Additionally, our study underscores the importance of considering individual factors such as age and gender in understanding binge-eating symptomatology.

Structural equation modeling of problematic internet use based on executive function, interpersonal needs, fear of missing out and depression

This study aimed to model PIU (Problematic Internet Use) based on executive functions, interpersonal needs, depression, and fear of missing out in adolescents aged 15 to 19 residing in Tehran. The sample size included 200 girls and boys selected through convenience sampling. Participants completed the computerized Wisconsin Card Sorting Test, Young's Internet Addiction Test (IAT), Beck Depression Inventory (BDI-II), Fear of Missing Out scale (FOMOS), and Interpersonal Needs Questionnaire (INQ). The data were analyzed using structural equation modeling with SPSS 26 and AMOS 24 software. According to the results, executive functions directly and through the mediating effects of depression and the fear of missing out, predicted PIU. Thwarted belongingness through the mediating effect of depression and the fear of missing out had an effect on PIU. Perceived burdensomeness predicted PIU directly and indirectly through the mediating effect of depression. The relationship between perceived burdensomeness and fear of missing out was not significant in this study. Overall, the fit indices indicated that the proposed research model is a good fit, and executive functions, depression, interpersonal needs, and fear of missing out can predict PIU. Moreover, executive functions, thwarted belongingness, and perceived burdensomeness were able to predict depression, and executive functions, along with thwarted belongingness, could predict fear of missing out.

Predicting Post-School Outcomes in Autistic Young Adults One Year after High School Graduation

The aim of the present longitudinal study was to identify malleable factors during the last year of high school that predicted post-school outcomes in autistic youth one year after high school graduation. We then explored whether depressive symptoms in high school mediated the associations between other malleable factors and post-school outcomes. Thirty-two autistic youth and a parent completed surveys during the youth's final year of high school (T1) and one-year post-high school graduation (T2). Malleable factors measured at T1 included social communication skills, executive functions, responsibility for daily tasks, and depressive symptoms. The T2 young adult outcome measure included both objective and subjective indicators of productivity, social well-being, and autonomy in living situation. All malleable factors except social communication skills were significantly correlated with young adult outcomes. T1 executive functions, responsibility for daily tasks, and depressive symptoms jointly predicted 40.2% of the variance in young adult outcomes. Only depressive symptoms explained a significant amount of unique variance in young adult outcomes. In addition, depressive symptoms mediated the predictive association between executive functioning and young adult outcomes. The findings suggest that depressive symptoms may be a key intervention target for autistic high school students. Adapting cognitive behavioral approaches to comprehensively address multiple transdiagnostic factors such as executive functions, responsibility for daily tasks, and mental health may be a promising avenue to promote positive post-school outcomes in this population.

The role of executive functioning in smoking cessation: A scoping review

ISSUES

Creating and implementing a plan to successfully quit smoking likely requires executive function (EF) skills such as inhibition, cognitive flexibility, attention and working memory. This scoping review consolidates the research evidence evaluating the role of EF in smoking cessation.

APPROACH

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), researchers and a medical librarian searched PubMed, EMBASE, ERIC, CINAHL and PSYCINFO in June 2022, hand-search in September 2022 using relevant MeSH terms, and an updated search was completed in August 2024.

KEY FINDINGS

Fifteen articles were included. Self-regulation was the most frequently evaluated EF across all studies. Performance on measures of impulsivity was most frequently related to successful smoking cessation. Across studies, performance on measures in areas of attention, working memory, cognitive flexibility and higher-level EF was variable as it relates to smoking cessation success. There was considerable variability in the measures used to evaluate EF and definitions of cessation success. Across studies, very little research evaluates higher-level EF.

IMPLICATIONS AND CONCLUSION

Differences in EF and cessation measures make comparisons across studies difficult. Future work is needed utilising common assessment and outcome measures that will improve our understanding of the complex cognitive skills needed for successful cessation. Particular consideration should be given to higher-level EFs including reasoning, planning, problem-solving and decision-making.

The effects of aerobic exercise on goal-directed attention and inhibitory control in individuals with high trait anxiety: an EEG study

Anxiety is known to significantly impair cognitive function, particularly attentional control. While exercise has been demonstrated to alleviate these cognitive deficits, the precise neural mechanisms underlying these effects remain poorly understood. This study examines the effects of exercise on attentional control in individuals with high trait anxiety, based on attentional control theory, which suggests that such individuals have reduced top-down attention. Thirty-eight participants were randomly assigned to either an exercise group or a reading group. The exercise group engaged in 30 min of moderate-intensity cycling, while the reading group spent 30 min reading quietly. In Experiment 1, goal-directed attention was assessed using a cue-object paradigm, and in Experiment 2, inhibitory control was evaluated through a visual search task. EEG data indicated that the exercise group exhibited significantly larger Pd components in both experiments, suggesting enhanced attentional focus and improved inhibition of distractors. These findings suggest that aerobic exercise enhances top-down attentional processes, particularly goal-directed attention and distractor inhibition, offering potential as an intervention for individuals with high trait anxiety.

The Relationship Between Empirical Avoidance, Anxiety, Difficulty Describing Feelings and Internet Addiction Among College Students: A Moderated Mediation Model

With the increasing detection rate of Internet addiction in college students, the correlation between Internet addiction and emotional problems is further strengthened. Therefore, it is crucial to actively investigate the emotional mechanisms underlying college students' internet addiction to foster their healthy development. This study establishes a moderated mediation model based on the relationships among experiential avoidance, internet addiction, anxiety, and difficulty describing feelings to explore the link between experiential avoidance and internet addiction, the mediating role of anxiety, and the moderating effect of difficulty describing feelings. The study collected data from 1,591 Chinese college students across seven provinces (municipalities), utilizing measures such as the Experiential Avoidance Questionnaire, the Internet Addiction Scale, the Anxiety Subscale, and the Difficulty Describing Feelings Scale. A cross-sectional analysis was conducted to further investigate the potential emotional mechanisms behind college students' internet addiction. The results indicated that experiential avoidance significantly predicts internet addiction among college students, with anxiety mediating the relationship between experiential avoidance and internet addiction. Additionally, difficulty describing feelings moderate the relationship between experiential avoidance and anxiety. These findings further suggest that emotional disorders such as experiential avoidance, anxiety, and difficulty describing feelings are potential risk factors behind college students' internet addiction. The study recommends enhancing psychological counseling and other intervention measures in interventions for college students' internet addiction.

Anxiety symptoms are distinctly related to working memory deficits in adults with ADHD

Working memory (WM), the cognitive system that briefly stores and updates information during complex tasks, is one of the most consistently identified neurocognitive deficits in individuals with ADHD. WM deficits are linked to significant challenges in daily life. Adults with ADHD often experience co-occurring anxiety and mood disorders, which are associated with more severe clinical presentations and greater WM deficits. Disentangling how co-occurring depression and anxiety symptoms uniquely contribute to WM deficits in individuals with ADHD is critical for tailoring effective, evidence-based interventions and treatments. This study used a regression approach to explore the relationships among anxiety, depression symptoms, and WM performance in adults with ADHD (n = 439) referred for neuropsychological evaluation at a Midwestern academic medical center. ADHD diagnostic group (ADHD-I and ADHD-C; Predominately Inattentive presentation, and Combined presentation, respectively), depression symptoms, and anxiety symptoms were modeled as predictors of WM performance, with education as a covariate, as education is linked to better cognitive performance. Anxiety and education significantly predicted WM performance, while depression did not, highlighting distinct effects. Anxiety was associated with poorer WM performance, whereas education was linked to better WM. These results emphasize the need for clinical assessments that account for the impacts of specific symptoms on WM in adults with ADHD.

The relationship between autistic traits and problematic smartphone use in adolescents: The serial mediating role of anxiety and executive dysfunction

BACKGROUND

Based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, this study aimed to explore the relationship between autistic traits and problematic smartphone use (PSU) among Chinese adolescents and to examine the serial mediation effect of anxiety and executive dysfunction in the association between autistic traits and PSU.

METHODS

The Autism-Spectrum Quotient, Smartphone Addiction Scale, the trait version of the State-Trait Anxiety Inventory, and Dysexecutive Questionnaire were administered to a sample comprising 412 senior high school students (average age = 17.05 years, SD = 0.65). Structural equation models were utilized to explore the simple and serial mediating role of anxiety and executive dysfunction played in the association between autistic traits and PSU.

RESULTS

This study found that social rather than non-social autistic traits were positively associated with anxiety, executive dysfunction, and PSU. Furthermore, after controlling for gender, anxiety and executive dysfunction acted as sequential mediators in the connection between social autistic trait and PSU. However, non-social autistic trait did not predict anxiety, executive dysfunction, or PSU.

CONCLUSION

This study supports the I-PACE model and deepens understanding of PSU formation. Furthermore, the findings underscore the importance of addressing social challenges faced by adolescents with high autistic traits, providing a viable potential intervention pathway to promote healthy smartphone use in this population.

Components of hot and cold executive functions and their relations to different forms of stress resilience: A systematic review

Increasing evidence points out that Executive Functions (i.e., EFs) may be core mechanisms for the generation of resilient responses to adversity. A systematic review testing the relations between either affective (hot) and/or non-affective (cold) EFs (i.e., inhibition, flexibility and working memory updating) and resilience was conducted. A total of 449 articles were initially identified. After two steps of title-and-abstract (k = 449), and full-text reading filtering (k = 67), 11 studies were reviewed. Three studies included cold measures of working memory and supported significant positive relations between higher working memory functioning and higher trait resilience levels. One study included cold measures of inhibition and another one both hot and cold measures, with only the first one supporting a positive relation between more efficient inhibition and higher trait resilience levels. Finally, 7 studies measured flexibility in its cold and/or hot dimensions and overall supported significant relations between higher flexibility and higher levels of trait, process and outcome resilience measures. These results support the role of EFs performance to promote different forms of resilience. This review allows to identify different issues that need to be addressed in future research and highlight the need to integrate the analysis of all hot and cold EFs components to understand their role in the generation of resilience.

Subregions of the fusiform gyrus are differentially involved in the attentional mechanism supporting visual mental imagery in depression

BACKGROUND

Impaired visual mental imagery is an important symptom of depression and has gradually become an intervention target for cognitive behavioral therapy.

METHODS

Our study involved a total of 25 healthy controls (HC) and 23 individuals with moderate depressive symptoms (MD). This study explored the attentional mechanism supporting visual mental imagery impairments in depression using the Vividness of Visual Imagery Questionnaire (VVIQ), attentional network test (ANT), and resting-state functional magnetic resonance imaging (rs-fMRI). The intrinsic activity of attention-related regions relative to those supporting visual mental imagery was identified in depression patients. In addition, a meta-analysis was used to describe the cognitive function related to this intrinsic activity.

RESULTS

The global correlation (GCOR) of the right anterior fusiform gyrus (FG) was decreased in depression patients. Attention-related areas were concentrated in the right posterior FG; the anterior and posterior functional connectivity (FC) of the FG was decreased in depression patients. Graph theoretic analysis showed that the degree of the right anterior FG was decreased, the degree of the anterior insula was increased, and the negative connection between these two regions was strengthened in depression patients. In addition, the degree of the right anterior FG, the FC between the subregions of the right FG, and the FC between the right anterior FG and insula were correlated with VVIQ scores; however, this correlation was not significant in depression patients. The meta-analysis suggested that the changes in the anterior FG in depressed patients may stem from difficulties of semantic memory retrieval.

CONCLUSION

The changed intrinsic activity of subregions of the FG relative to the semantic memory retrieval may be associated with visual mental imagery impairments in depression.

Comparisons of the amplitude of low-frequency fluctuation and functional connectivity in major depressive disorder and social anxiety disorder: A resting-state fMRI study

BACKGROUND

Studies comparing the brain functions of major depressive disorder (MDD) and social anxiety disorder (SAD) at the regional and network levels remain scarce. This study aimed to elucidate their pathogenesis using neuroimaging techniques and explore biomarkers that can differentiate these disorders.

METHODS

Resting-state fMRI data were collected from 48 patients with MDD, 41 patients with SAD, and 82 healthy controls. Differences in the amplitude of low-frequency fluctuations (ALFF) among the three groups were examined to identify regions showing abnormal regional spontaneous activity. A seed-based functional connectivity (FC) analysis was conducted using ALFF results as seeds and different connections were identified between regions showing abnormal local spontaneous activity and other regions. The correlation between abnormal brain function and clinical symptoms was analyzed.

RESULTS

Patients with MDD and SAD exhibited similar abnormal ALFF and FC in several brain regions; notably, FC between the right superior frontal gyrus (SFG) and the right posterior supramarginal gyrus (pSMG) in patients with SAD was negatively correlated with depressive symptoms. Furthermore, patients with MDD showed higher ALFF in the right SFG than HCs and those with SAD.

LIMITATION

Potential effects of medications, comorbidities, and data type could not be ignored.

CONCLUSION

MDD and SAD showed common and distinct aberrant brain function patterns at the regional and network levels. At the regional level, we found that the ALFF in the right SFG was different between patients with MDD and those with SAD. At the network level, we did not find any differences between these disorders.

Disentangling effects of remote mild traumatic brain injury characteristics and posttraumatic stress on processing speed and executive function in veterans

Mild traumatic brain injury (mTBI) and posttraumatic stress are prevalent in military service members and share objective and subjective cognitive symptoms, complicating recovery. We investigated the effects of remote mTBI characteristics and current posttraumatic stress symptoms on neuropsychological performance in 152 veterans with a history of remote mTBI and current cognitive concerns. Participants completed clinical neuropsychological evaluations within a Veterans Affairs Level-II TBI/Polytrauma outpatient clinic (i.e. tertiary trauma care center for US military veterans outside of a research or teaching hospital setting). Archival data analysis of mTBI injury characteristics, clinical diagnoses, scores on the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and performance on tests of processing speed, attention and executive function was conducted. Hierarchical linear regression demonstrated that elevated PCL-M scores were associated with slower performance on trail making test (TMT) Parts A and B (p < .016). PCL-M symptoms moderated the effect of alteration of consciousness (AOC) on TMT performance, with endorsement of AOC associated with better performance, but only when PCL-M scores were high (p < .005). Follow-up mediation analyses demonstrated that PCL-M score fully mediated the relationship between AOC and TMT-A performance and partially mediated the relationship between AOC and TMT-B performance. Post-hoc analyses meant to separate the impact of processing speed on TMT-B were all non-significant. Remote mTBI characteristics, specifically AOC, were not associated with decrements in cognitive performance. Posttraumatic symptoms were associated with worse processing speed, suggesting that psychological distress and psychopathology are contributing factors in understanding and treating persistent cognitive distress following remote mTBI.

Higher substance use is associated with low executive control neural activity and higher inflammation

Individuals with substance use problems show lower executive control and alterations in prefrontal brain systems supporting emotion regulation and impulse control. A separate literature suggests that heightened inflammation also increases risk for substance use, in part, through targeting brain systems involved in executive control. Research on neural and inflammatory signaling in substance use, however, has occurred in parallel. Drawing on recent neuroimmune network models, we used fMRI to examine the relationships between executive control-related brain activity (as elicited by an n-back working memory task), peripheral inflammation, as quantified by inflammatory cytokines and C-reactive protein (CRP), and substance use for the past month in 93 participants [mean age = 24.4 (SD = 0.6)]. We operationalized low executive control as a neural inefficiency during the n-back task to achieve normative performance, as reflected in higher working memory-related brain activity and lower activity in the default mode network (DMN). Consistent with prediction, individuals with low executive control and high inflammation reported more substance use over the past month, controlling for behavioral performance on the n-back, sex, time between assessments, body-mass-index (BMI), and personal socioeconomic status (SES) (interaction between inflammation and working memory-related brain activity, b = 0.210, p = 0.005; interaction between inflammation and DMN, b = -0.219, p < 0.001). Findings suggest that low executive control and high inflammation may be associated with higher substance use. This has implications for understanding psychological, neural, and immunological risk for substance use problems and the development of interventions to target each of these components.

Cognitive Dysfunction in Unipolar Depression

Background

Cognitive dysfunctions play a critical role in the psychopathology of depression. They regulate various psychosocial and functional outcomes and affect workplace functionality, productivity, and relapses. An objective evaluation of affected cognitive domains is germane in understanding the relapses and functional recovery in depression. Thus, to know cognitive dysfunctions beyond affective biases, this study was conducted to compare the cognitive functions of drug-naïve patients with unipolar depression with healthy matched controls.

Methods

Fifty patients diagnosed with unipolar depression as per the International Classification of Diseases, tenth revision: Diagnostic Criteria for Research (Depressive Episode and Recurrent Depressive Disorder) and 50 healthy controls were enrolled on an outpatient basis from January 2022 to June 2023. Cases were regrouped as mild, moderate, and severe based on Beck's Depression Inventory (BDI-II). A battery of tests assessed the cognitive functions: Wisconsin Card Sorting Test, Trail Making Test, Visual Retention subtests of PGI Battery of Brain Dysfunction, Digit Span, and Verbal Memory. The Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire was used for a subjective assessment of cognitive functioning.

Results

The sociodemographic characteristics of cases and controls did not differ significantly. However, within-group and between-group analyses revealed significantly lower performance of cases compared to controls. Cognitive impairment was positively correlated with BDI-II scores.

Conclusion

Depression is associated with dysfunction in the domains of planning, attention, sustained attention, and visual and verbal memory. This dysfunction is independent of cognitive and affective bias and may exist even after clinical remission.

The Impact of Executive Dysfunction on Anxiety in Hearing-Impaired College Students: Smartphone Addiction as a Mediator and Academic Procrastination as a Moderator

Purpose

Hearing-impaired college students often rely on smartphones for information exchange and social interaction due to their hearing limitations, which may increase their risk of smartphone addiction. This study aims to explore the impact of executive dysfunction on anxiety levels in hearing-impaired college students, investigating smartphone addiction as a mediator and academic procrastination as a moderator.

Methods

We conducted a questionnaire survey using the Executive Function Scale, the Anxiety Scale, the Smartphone Addiction Scale, and the Academic Procrastination Scale. The survey included 609 hearing-impaired college students from three universities in Jiangsu, Hunan, and Heilongjiang Provinces, China.

Results

After controlling for age, executive dysfunction was found to significantly predict higher anxiety levels in hearing-impaired college students. Additionally, smartphone addiction partially mediated the relationship between executive dysfunction and anxiety. Academic procrastination further moderated the relationship between smartphone addiction and anxiety.

Conclusion

This study enhances the understanding of the complex interactions between executive dysfunction, smartphone addiction, and academic procrastination in contributing to anxiety among hearing-impaired college students. The findings offer valuable insights for developing strategies to promote the mental health of this population.

Identifying tripartite relationship among cortical thickness, neuroticism, and mood and anxiety disorders

The number of young adults seeking help for emotional distress, subsyndromal-syndromal mood/anxiety symptoms, including those associated with neuroticism, is rising and can be an early manifestation of mood/anxiety disorders. Identification of gray matter (GM) thickness alterations and their relationship with neuroticism and mood/anxiety symptoms can aid in earlier diagnosis and prevention of risk for future mood and anxiety disorders. In a transdiagnostic sample of young adults (n = 252;177 females; age 21.7 ± 2), Hypothesis (H) 1:regularized regression followed by multiple regression examined relationships among GM cortical thickness and clinician-rated depression, anxiety, and mania/hypomania; H2:the neuroticism factor and its subfactors as measured by NEO Personality Inventory (NEO-PI-R) were tested as mediators. Analyses revealed positive relationships between left parsopercularis thickness and depression (B = 4.87, p = 0.002), anxiety (B = 4.68, p = 0.002), mania/hypomania (B = 6.08, p ≤ 0.001); negative relationships between left inferior temporal gyrus (ITG) thickness and depression (B = - 5.64, p ≤ 0.001), anxiety (B = - 6.77, p ≤ 0.001), mania/hypomania (B = - 6.47, p ≤ 0.001); and positive relationships between left isthmus cingulate thickness (B = 2.84, p = 0.011), and anxiety. NEO anger/hostility mediated the relationship between left ITG thickness and mania/hypomania; NEO vulnerability mediated the relationship between left ITG thickness and depression. Examining the interrelationships among cortical thickness, neuroticism and mood and anxiety symptoms enriches the potential for identifying markers conferring risk for mood and anxiety disorders and can provide targets for personalized intervention strategies for these disorders.

Transitioning young adults with spina bifida: Challenges and paths to success

INTRODUCTION AND BACKGROUND

Recent medical advances, including closure of myelomeningocele defects, shunting of hydrocephalus, and focusing on renal preservation have led to many individuals with spina bifida (SB) living into adulthood. This has led to more individuals with SB transitioning their care from pediatric-based to adult-based care models.

OBJECTIVE

We seek to explore the process of transition, with a focus on difficulties in transitioning individuals with SB. Additionally, we explore new problems that arise during the period of transition related to sexual function and dysfunction. We also discuss some of the difficulties managing neurogenic bladder and the sequalae of their prior urologic surgeries.

STUDY DESIGN

Each of the authors was asked to provide a summary, based on current literature, to highlight the challenges faced in their area of expertise.

CONCLUSIONS

Transitioning care for individuals with SB is especially challenging due to associated neurocognitive deficits and neuropsychological functioning issues. Sexual function is an important component of transition that must be addressed in young adults with SB. Management of neurogenic bladder in adults with SB can be challenging due to the heterogeneity of the population and the sequelae of their prior urologic surgeries. The aim is to ensure that all individuals with SB receive appropriate, evidence-based care throughout their lifetime.

Introducing a Neuroscience-Based Assessment Instrument: Development and Psychometric Study of the Neural Networks Symptomatology Inventory

Background: Neuroscience research methods contribute to the understanding of the underlying neural impairments associated with psychopathology. Previous research suggested that impairments in Default Mode Network, Fronto-Parietal Executive Network, Amygdaloid-Hippocampal Memory Network, and Attentional Salience Network are present in different psychopathological symptoms. However, a self-report measure based on this evidence is lacking. Aims: Therefore, the present study describes the development and preliminary psychometric study of the Neural Network Symptomatology Inventory (NNSI). Method: Two different samples were recruited (sample 1: N = 214, Mage = 21.0, SD = 7.10; sample 2: N = 194, Mage = 21.5, SD = 8.41) and responded to self-report instruments in a cross-sectional design. Standard methodologies to scale development and psychometric study were applied: Item development, Exploratory (EFA), Confirmatory Factor Analysis (CFA), and Pearson correlations. Results: EFA and CFA suggested a 4-factor model with adequate goodness-of-fit indices (χ2(449) = 808,9841, TLI = .89, CFI = .92, RMSEA = .048 (.042-.053). All NNSI subscales correlated positively with psychopathological domains and correlated negatively with psychological well-being. Conclusions: This preliminary study suggests that NNSI may be a valid instrument to assess symptomatology associated with complex neural network impairments. Nevertheless, further research is required to deepen and improve NNSI psychometric characteristics.

Effectiveness of single-session therapy for adult common mental disorders: a systematic review

BACKGROUND

Common mental disorders (CMDs) impose significant socioeconomic impacts on the global community. Nevertheless, over 50% of individuals with CMDs do not receive proper treatment, indicating that the current treatment modalities do not adequately tackle this issue. Since single-session therapy (SST) is a potential method for reducing the treatment gap, it is crucial to evaluate its effectiveness. Therefore, this systematic review aimed to evaluate the effectiveness of SST on CMD symptoms in adults.

METHODS

This systematic review included randomised and non-randomised studies assessing the clinical effectiveness of SST on CMD symptoms in adults. English-written, peer-reviewed studies or dissertations were included, while grey literature was excluded. MEDLINE, Embase, PsycINFO, and Cochrane's CENTRAL were searched on December 13, 2022, from their inception dates. The risk of bias in the included studies was evaluated using RoB 2 and ROBINS-I. A narrative synthesis was performed. This systematic review was registered in the PROSPERO database on July 6, 2022 (CRD42022343925).

RESULTS

Six randomised and three non-randomised studies were included after screening 2,130 records. Three non-randomised studies with a "critical" or "serious" risk of bias were excluded from the synthesis. Therefore, six randomised trials involving 298 participants were included in the synthesis. Four out of six studies had a "high" risk of bias. The participants had non-severe symptoms at baseline, and three intervention types (behavioural activation, DBT, and solution-focused psychotherapy) were evaluated. Five of six studies showed positive results for depression, with only one reporting a positive result for anxiety.

CONCLUSIONS

SST may be effective in improving CMD symptoms in adults, particularly depression. However, there is a limit to deriving definite conclusions due to a high risk of bias in included studies, insufficient sample size and research volume. Further research exploring the characteristics of clients who can benefit from SST is required to facilitate its widespread use.

Psychological intervention for gambling disorder: A systematic review and meta-analysis

Background and aims

Increasingly, gambling features migrate into non-gambling platforms (e.g., online gaming) making gambling exposure and problems more likely. Therefore, exploring how to best treat gambling disorder (GD) remains important. Our aim was to review systematically and quantitatively synthesize the available evidence on psychological intervention for GD.

Methods

Records were identified through searches for randomized controlled trials (RCTs) evaluating psychological intervention for GD via six academic databases without date restrictions until February 3, 2023. Study quality was assessed with the revised Cochrane risk-of-bias tool for randomized trials (RoB2). Primary outcomes were GD symptom severity and remission of GD, summarized as Hedges' g and odds ratios, respectively. The study was preregistered in PROSPERO (#CRD42021284550).

Results

Of 5,541 records, 29 RCTs (3,083 participants analyzed) were included for meta-analysis of the primary outcomes. The efficacy of psychological intervention across modality, format and mode of delivery corresponded to a medium effect on gambling severity (g = -0.71) and a small effect on remission (OR = 0.47). Generally, risk of bias was high, particularly amongst early face-to-face interventions studies.

Discussion and conclusions

The results indicate that psychological intervention is efficacious in treating GD, with face-to-face delivered intervention producing the largest effects and with strongest evidence for cognitive behavioral therapy. Much remains to be known about the long-term effects, and investigating a broader range of treatment modalities and digital interventions is a priority if we are to improve clinical practice for this heterogeneous patient group.

Polygenic risk for neuroticism is associated with less efficient control in more difficult situations

Neuroticism is a heritable trait and a risk factor for mental health due to its relevance to poor control of negative events. To examine the relationship between genetic propensity for neuroticism and control processing, we used the polygenic risk score (PRS) approach and a stop signal task during fMRI. We hypothesized that genetic propensity for neuroticism may moderate control processing as a function of control difficulty. PRSs for neuroticism were computed from a transdiagnostic group of individuals (n=406) who completed the stop signal task. The level of control difficulty was a function of the stop signal asynchrony: shorter asynchrony allows easier stopping whereas longer asynchrony makes stopping difficult. The relationship between PRS for neuroticism and neural activity for controlling responses was examined by the stop signal asynchrony. Although PRS for neuroticism did not relate to the overall inhibitory control, individuals with high PRS for neuroticism showed greater activity in left dorsal prefrontal cortex, middle temporal gyrus, and dorsal posterior cingulate cortex for difficult control. Thus, the genetic propensity for neuroticism affects neural processing in a difficult control context, which may help to explain why individuals with high levels of neuroticism exert poor control of negative events in difficult situations.

Effectiveness of executive functioning training among heterogeneous adolescent samples: A systematic review

The aim of the present systematic review was to discuss the reported efficacy of executive functioning training techniques among adolescents. A systematic review of the literature was conducted to retrieve and consolidate findings from articles evaluating executive functioning training techniques among adolescents. A total of 26 articles were located that examined the role of executive functioning training techniques among adolescents (age 10-19 years). Articles retrieved enabled comparison across psychiatric and medical diagnoses including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), as well as adolescents with physical health concerns. Results revealed that among typically developing adolescents, executive functioning training was non-significant or yielded small effect size improvements in executive functioning as measured by behavioral and neuroimaging tasks among 62.5% of studies reviewed. In contrast, in those with medical conditions, ASD, ADHD, and conduct disorder, all but two studies reviewed yielded a medium to large effect size, supporting the effectiveness of EF training. Future research is needed to identify the long-term efficacy of these treatments, as well as their generalizability to real-world conditions.

How Self-Regulation and Executive Functions Deficits Affect Quality of Life of Children/Adolescents with Emotional Regulation Disorders

BACKGROUND

Deficits in self-regulation and executive functions (EFs) frequently characterize children/adolescents with emotional regulation disorders and restrict their daily function and quality of life (QOL). These deficits are mainly manifested by neuropsychological measures in laboratory settings. This study aimed to compare self-regulation and EFs by ecological measures to reflect the implications in daily life between children with emotional regulation disorders and healthy controls and examine the relations between self-regulation, EFs and QOL in the study group.

METHODS

the participants were 49 children aged 8-18: 25 children/adolescents with emotional regulation disorders and 24 healthy children. The parents completed a socio-demographic questionnaire, the Child Behavior Checklist (CBCL), the Behavior Rating Inventory of Executive Functions (BRIEF) and the Pediatric Quality of Life Inventory (Peds-QL).

RESULTS

The study group had greater self-regulation difficulties (internalization and externalization problems), executive dysfunctions (EFdys) (including metacognition difficulties) and a lower QOL. Their internalization and externalization problems correlated with reduced EFs and QOL. Internalization predicted the physical and emotional QOLs, while metacognition predicted social and school-related QOLs.

CONCLUSIONS

Deficits in self-regulation and EFs are prevalent in children/adolescents with emotional disorders and restrict their daily function and QOL. Therefore, they should be routinely evaluated by ecological instruments to reflect daily restrictions.

Effects of Exercise Training on Executive Functioning in Adults with Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Exercise is a promising nonpharmacological intervention to improve executive function (EF). However, results from randomized trials and meta-analyses examining the effects of exercise on working memory in adults with depression are mixed, and the influence of exercise on EF, as well as the key moderators of the relationship, remain inconclusive.

OBJECTIVE

The present systematic review with meta-analysis examined the influence of exercise interventions on EF in adults with depression, and the influence of key moderating variables.

METHODS

Electronic searches were conducted using Embase, Cochrane Central, Scopus, Ovid MEDLINE, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Weipu Database up to 25 June 2022, and updated on 16 January 2023. Randomized controlled trials (RCTs) examining the effects of exercise training on EF in adults with depression were included. A three-level meta-analysis based on a random-effects model was applied in R. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

A total of 14 RCTs that evaluated 1201 adults with depression were included. The results indicated that exercise significantly improved global EF [g = 0.180; 95% confidence intervals (CI) = 0.038, 0.323], and the subdomains of working memory (g = 0.182; 95% CI = 0.015, 0.350), cognitive flexibility (g = 0.222; 95% CI = 0.048, 0.395), and reasoning/planning (g = 0.889; 95% CI = 0.571, 1.206). In subgroup analyses, significant improvements in EF were only observed for aerobic exercise (g = 0.203; 95% CI = 0.023, 0.382), moderate-to-vigorous intensity exercise (g = 0.200; 95% CI = 0.022, 0.379), exercise performed three or more times per week (g = 0.207; 95% CI = 0.026, 0.388), in sessions ≤ 60 min (g = 0.173; 95% CI = 0.003, 0.343), and in program durations lasting at least 13 weeks (g = 0. 248; 95% CI = 0.034, 0.462).

CONCLUSIONS

This meta-analysis demonstrates the benefits of exercise training for improving EF and the subdomains of working memory, cognitive flexibility, and reasoning/planning in adults with depression. Future randomized clinical trials are warranted to determine the therapeutic effects of exercise training on EF and cognitive symptoms in depressed patients.

The Influence of Emotional Regulation and Cognitive Flexibility on Sleep Habits in Spanish Children and Adolescents through the Lens of Parents

BACKGROUND

Previous research studies have suggested the importance of studying the relationship between emotional regulation and sleep habits. Some investigations have especially focused on how emotional regulation could impact sleep habits in children and adolescents. Therefore, these researchers have stated there exists a two-way direction in this relationship.

OBJECTIVE

This study aimed to analyze the influence of emotional regulation on sleep habits in Spanish children and adolescents and the mediating role of anxiety in this relationship.

METHOD

Participants were 953 Spanish parents who completed the assessment protocol according to their children and adolescents' information.

RESULTS

The results revealed moderate-strong correlations between emotional regulation problems and sleep habit disturbances (r = 0.375, p < 0.001), trait (r = 0.488, p < 0.001) anxiety, and state (r = 0.589, p < 0.001) anxiety. Additionally, emotional regulation showed a direct impact on sleep habits (β = 0.011, p = 0.005). Trait and state anxiety demonstrated a significant mediating role in the relationship between emotional regulation and sleep habits.

CONCLUSIONS

Emotional regulation may have an impact on sleep habits during childhood and adolescence, suggesting the importance of early intervention focused on the emotions management and the prevention of sleep habit disturbances.

Psilocybin's effects on cognition and creativity: A scoping review

BACKGROUND

Research on psilocybin has become increasingly popular during the current psychedelic renaissance, which began in the early 1990s. Psilocybin's effects on mental health are promising and there are ongoing efforts to investigate its clinical implementation and its effects on cognition.

AIMS

The purpose of this study is to report trends in publications, methods, and findings from research examining the effects of psilocybin on cognition and creativity in adults.

METHODS

We conducted an Open Science Framework preregistered scoping review, guided by the JBI Manual for Evidence Synthesis, on literature pertaining to psilocybin's effects on cognition and creativity.

RESULTS/OUTCOMES

In the 42 included studies, psilocybin was primarily administered orally (83%) in a bodyweight-adjusted manner (74%) to healthy participants (90%). Of the few studies that explicitly reported safety outcomes (26%), only one reported serious adverse reactions. During the acute phase post-intake (i.e., minutes to hours), macrodoses tended to impair cognitive performance and creativity, whereas microdoses tended toward creative enhancement. The few macrodosing studies that included post-acute measures (i.e., 1-85 days) reported primarily null but some positive effects.

CONCLUSIONS/INTERPRETATION

This scoping review identified a time-based variation of psilocybin macrodosing effects on cognition and creativity, in which impairment may be observed early post-intake but withdraw over time, and some positive effects may emerge afterward. These findings are limited by methodological concerns and inadequate assessment of long-term effects. We therefore recommend that future psilocybin research be conducted according to existing guidelines and include well-validated measures of cognition and creativity at multiple timepoints.

Clinical, neuroimaging, and behavioural risk factors for neurocognitive impairment in Chinese patients with haemophilia: A multicentre study

BACKGROUND

Few studies have evaluated the impact of subclinical microstructural changes and psychosocial factors on cognitive function in patients with haemophilia.

OBJECTIVES

To determine the prevalence and characteristics of cognitive impairment in patients with haemophilia, and identify associated risk factors.

METHODS

We recruited haemophilia A or B patients who were aged ≥10 years old from three public hospitals in Hong Kong. A neurocognitive battery was administered to evaluate their attention, memory, processing speed and cognitive flexibility performances. They also underwent magnetic resonance imaging to identify cerebral microbleeds. Validated self-reported questionnaires were administered to assess their mental health status and adherence to prophylactic treatment. General linear modelling was used to investigate the association of neurocognitive outcomes with risks factors, adjusting for age and education attainment.

RESULTS

Forty-two patients were recruited (median age 32.0 years; 78.6% haemophilia A; 80.9% moderate-to-severe disease). Six patients (14.3%) had developed cerebral microbleeds. A subgroup of patients demonstrated impairments in cognitive flexibility (30.9%) and motor processing speed (26.2%). Hemarthrosis in the previous year was associated with worse attention (Estimate = 7.62, 95% CI: 1.92-15.33; p = .049) and cognitive flexibility (Estimate = 8.64, 95% CI: 2.52-13.29; p = .043). Depressive (Estimate = 0.22, 95% CI: 0.10-0.55; p = .023) and anxiety (Estimate = 0.26, 95% CI: 0.19-0.41; p = .0069) symptoms were associated with inattentiveness. Among patients receiving prophylactic treatment (71.4%), medication adherence was positively correlated with cognitive flexibility (p = .037).

CONCLUSION

A substantial proportion of patients with haemophilia demonstrated cognitive impairment, particularly higher-order thinking skills. Screening for cognitive deficits should be incorporated into routine care. Future studies should evaluate the association of neurocognitive outcomes with occupational/vocational outcomes.

Individual-Level Risk and Resilience Factors Associated with Mental Health in Siblings of Individuals with Neurodevelopmental Conditions: A Network Analysis

Siblings of individuals with neurodevelopmental conditions (NDCs) are exposed to unique family environments and experience a range of psychosocial risk and resilience factors. Networks of self-reported risk, resilience, and neuropsychiatric variables were estimated for siblings of individuals with (n = 235) and without (n = 480) NDCs (N = 715, mean age 22.40 years, 76% female, 74% White Caucasian). The NDC group reported more depressive (g = 0.39) and anxious (g = 0.43) symptoms than controls, and 71.5% of the NDC group reported at least one neuropsychiatric diagnosis compared to 36.9% of controls. Self-reported sleep and post-traumatic stress disorders were high amongst NDC siblings. Everyday executive functioning difficulties (cognitive inflexibility, hyperactivity/impulsivity) and emotion dysregulation were the most influential transdiagnostic risk factors for poorer functioning within the NDC group network.

Anxiety predicts internet addiction, which predicts depression among male college students: A cross-lagged comparison by sex

Objectives

Internet addiction has become an increasingly serious public health issue, putting young people at particular risk of psychological harm. This study aimed to analyze the interactions between college students' depression, anxiety, and Internet addiction and explore how these interactions differ between men and women.

Methods

A 6-month follow-up study was conducted on 234 college students using the Self-Rating Depression Scale, Self-rating Anxiety Scale, and Revised Chen Internet Addiction Scale.

Results

Depression, anxiety, and Internet addiction were positively correlated (p < 0.01). Anxiety can predict Internet addiction and that Internet addiction can predict depression. Moreover, anxiety had a significant predictive effect on Internet addiction among men.

Conclusion

Anxiety predicts Internet addiction, and Internet addiction predicts depression among male college students. These findings may better inform future Internet addiction intervention strategies. Particularly, interventions may better address Internet addiction by focusing on the role of anxiety, especially among men.

The Role of Emotion Regulation and Executive Functioning in the Intervention Outcome of Children with Emotional and Behavioural Problems

Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem scores post-intervention, and further explore the extent to which emotion regulation mediates these outcomes. Participants were 41 primary school children who exhibited emotional and/or behavioural problems, aged 8 to 11 years. All the children completed measures of emotional and behavioural problems, cognitive emotion regulation, anxiety symptoms, and performed two experimental tasks to measure working memory and response inhibition before and after participating in a transdiagnostic Cognitive Behaviour Therapy-based programme, "Super Skills for Life" (SSL), and at 3-months follow-up. Results revealed significant reduction in the use of maladaptive emotion regulation strategy catastrophising and other blame following the intervention. Additionally, EF and emotion regulation was associated with outcomes for emotional problems and conduct problems. More specifically maladaptive emotion regulation strategy such as catastrophising and other blame was closely related with self-reports of emotional problems, likewise other blame, was also linked with scores of conduct problems. This study provides preliminary empirical support for EF and emotion regulation in predicting outcomes of emotional and behavioural problems in children following intervention.

The effect of high-intensity interval training on cognitive function in patients with substance use disorder: Study protocol for a two-armed randomized controlled trial

Introduction

Substance use disorder (SUD) is characterized by cognitive impairment, especially executive dysfunction. Executive function is recognized as an important determinant of treatment outcome as it is associated with dropout rate, attendance to therapy and potential relapse after treatment termination. Physical activity can have beneficial effects on cognitive function, but there is still a lack of knowledge regarding potential benefits of aerobic exercise for executive function in SUD treatment. The aim of this study is to examine the effect of aerobic high-intensity interval training (HIIT) on cognitive function and the subsequent effect on treatment outcome in patients with SUD.

Methods and analysis

This study is a randomized controlled trial, including men and women ≥18 years with diagnosed SUD by ICD-10. The patients will be recruited from the department for inpatient treatment at Blue Cross - Lade Addiction Treatment Center, Trondheim, Norway. Participants will be randomized 1:1 into either HIIT (3x/week) + treatment as usual (TAU), or TAU alone. Study outcomes will be assessed at baseline, after eight weeks of intervention, and at 3- and 12-months follow-up. The primary outcome is to compare the change in executive function (via altered BRIEF-A score, Behavior Rating Inventory of Executive Function-Adult) measured between the two study groups after eight weeks. Secondary outcomes include mapping of cognitive function in different subgroups (e.g. type of substance, age, fitness level), collecting self-reported information about quality of life, craving, sleep quality, etc., as well as assessing compliance to TAU and long-term treatment outcome.

Ethics and dissemination

The project was approved by the Regional Ethical Committee and will be performed in accordance with this protocol and the Declaration of Helsinki. Written informed consent will be obtained from all participants prior to inclusion. This project will explore a novel approach to how exercise can be applied in SUD treatment, beyond the well-known effects on physical health. We expect to achieve new knowledge in regard to what extent HIIT can improve cognitive abilities and subsequent treatment outcome in SUD.

Trial registration number

https://www.clinicaltrials.gov/NCT05324085.

Multiscale neural signatures of major depressive, anxiety, and stress-related disorders

The extent of shared and distinct neural mechanisms underlying major depressive disorder (MDD), anxiety, and stress-related disorders is still unclear. We compared the neural signatures of these disorders in 5,405 UK Biobank patients and 21,727 healthy controls. We found the greatest case–control differences in resting-state functional connectivity and cortical thickness in MDD, followed by anxiety and stress-related disorders. Neural signatures for MDD and anxiety disorders were highly concordant, whereas stress-related disorders showed a distinct pattern. Controlling for cross-disorder genetic risk somewhat decreased the similarity between functional neural signatures of stress-related disorders and both MDD and anxiety disorders. Among cases and healthy controls, reduced within-network and increased between-network frontoparietal and default mode connectivity were associated with poorer cognitive performance (processing speed, attention, associative learning, and fluid intelligence). These results provide evidence for distinct neural circuit function impairments in MDD and anxiety disorders compared to stress disorders, yet cognitive impairment appears unrelated to diagnosis and varies with circuit function.

Predictive utility of symptom measures in classifying anxiety and depression: A machine-learning approach

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent, co-occurring disorders with significant symptom overlap, posing challenges in accurately distinguishing and diagnosing these disorders. The tripartite model proposes that anxious arousal is specific to anxiety and anhedonia is specific to depression, though anxious apprehension may play a greater role in GAD than anxious arousal. The present study tested the efficacy of the Mood and Anxiety Symptom Questionnaire anhedonic depression (MASQ-AD) and anxious arousal (MASQ-AA) scales and the Penn State Worry Questionnaire (PSWQ) in identifying lifetime or current MDD, current major depressive episode (MDE), and GAD using binary support vector machine learning algorithms in an adult sample (n = 150). The PSWQ and MASQ-AD demonstrated predictive utility in screening for and identification of GAD and current MDE respectively, with the MASQ-AD eight-item subscale outperforming the MASQ-AD 14-item subscale. The MASQ-AA did not predict MDD, current MDE, or GAD, and the MASQ-AD did not predict current or lifetime MDD. The PSWQ and MASQ-AD are efficient and accurate screening tools for GAD and current MDE. Results support the tripartite model in that anhedonia is unique to depression, but inclusion of anxious apprehension as a separate dimension of anxiety is warranted.

Neuroplasticity, the Prefrontal Cortex, and Psychopathology-Related Deviations in Cognitive Control

A basic survival need is the ability to respond to, and persevere in the midst of, experiential challenges. Mechanisms of neuroplasticity permit this responsivity via functional adaptations (flexibility), as well as more substantial structural modifications following chronic stress or injury. This review focuses on prefrontally based flexibility, expressed throughout large-scale neuronal networks through the actions of excitatory and inhibitory neurotransmitters and neuromodulators. With substance use disorders and stress-related internalizing disorders as exemplars, we review human behavioral and neuroimaging data, considering whether executive control, particularly cognitive flexibility, is impaired premorbidly, enduringly compromised with illness progression, or both. We conclude that deviations in control processes are consistently expressed in the context of active illness but operate through different mechanisms and with distinct longitudinal patterns in externalizing versus internalizing conditions.

Depression and loneliness may predict work inefficiency among professionally active adults

Purpose

Both depression and loneliness have been recognized as major public health issues, yet investigation into their role among young and middle-aged, professionally active persons is still required. The aim of the present study was to evaluate whether depression and loneliness may independently predict inefficiency at work among professionally active adults.

Methods

This is a cross-sectional study on a representative, nationwide sample. 1795 questionnaires were gathered from among professionally active adults from Poland from 1 to 31 July 2018 with a direct pen-and-paper interview. The sample was chosen by means of the stratified random method. The survey included a Patient Health Questionnaire (PHQ-9) to measure depression and questions, devised by the authors, relating to loneliness and inefficiency at work. Regression models were constructed with depression and loneliness as predictors of inefficiency at work, unadjusted and adjusted for selected sociodemographic, health- and work-related factors.

Results

In the unadjusted models, both depression and loneliness were independently associated with an increase of work inefficiency and absence from work, with effect sizes being higher for loneliness than for depression. After accounting for the control variables (i.e., sociodemographic, work- and health-related factors), the PHQ-9 score, but not the loneliness score, was associated with an increased probability of frequent thoughts about changing or leaving a job.

Conclusion

Depression and loneliness independently predicted occupational functioning and differentially affect its various aspects. Counteracting depression and loneliness among employees should be regarded as a public health priority.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-022-01869-1.

A Comparison Study of Impulsiveness, Cognitive Function, and P300 Components Between Gamma-Hydroxybutyrate and Heroin-Addicted Patients: Preliminary Findings

Purpose

The aim of this study was to investigate and compare impulsiveness, negative emotion, cognitive function, and P300 components among gamma-hydroxybutyrate (GHB)-addicted patients, heroin-dependent patients, and methadone maintenance treatment (MMT) subjects.

Methods

A total of 48 men including 17 GHB addicts, 16 heroin addicts, 15 MMT subjects, and 15 male mentally healthy controls (HC) were recruited. All subjects were evaluated for symptoms of depression, anxiety, impulsiveness, and cognitive function through the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item (GAD-7), the Barratt Impulsiveness Scale version II (BIS-II), the Beijing version of the Montreal Cognitive Assessment (BJ-MoCA), the behavioral test (response time), and event-related potential P300 detection.

Results

(1) The mean scores of BIS-II in the GHB addiction group, heroin dependence group, and MMT group were significantly higher than those of the HC group (F = 30.339, P = 0.000). (2) The total scores of BJ-MOCA in GHB addiction group was the worst among the four groups, followed by heroin addiction, MMT group and HC group (F = 27.880, P = 0.000). (3) The response time in the GHB addiction group was the longest among the four groups, followed by the heroin addiction, MMT, and HC groups (F = 150.499, P = 0.000). (4) The amplitude and latency of P300 in GHB addiction subjects were significantly lower and longer than those of the MMT group and the HC group. (5) For the three types of addiction, the P300 amplitudes at Fz, Cz, Pz, T5, and T6 were negatively correlated with the scores of GAD-7, PHQ-9, and BIS-II; the P300 latencies were positively correlated with the response time and negatively correlated with the scores of the BJ-MoCA.

Conclusion

People with an addiction were likely to have increased impulsiveness. The cognitive function of the GHB and heroin-addicted subjects, including the heroin detoxification and the MMT groups, was severely impaired, especially for the GHB-addicted patients. The impairment manifested as abnormalities of BJ-MoCA, response time, and P300 components.

General and Specific Dimensions of Mood Symptoms Are Associated With Impairments in Common Executive Function in Adolescence and Young Adulthood

Both unipolar and bipolar depression have been linked with impairments in executive functioning (EF). In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions (anhedonia, physiological arousal, and mania) using structural equation modeling in adolescents and young adults with varying severity of mood symptoms (n = 495, ages = 13-25 years, 68.69% female). A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal.

Common Predictive Factors of Social Media Addiction and Eating Disorder Symptoms in Female College Students: State Anxiety and the Mediating Role of Cognitive Flexibility/Sustained Attention

This study aimed to investigate the common predictive factors between social media addiction (SMA) and eating disorder symptoms (EDS), in a group of Chinese female college students. A total of 216 students completed the behavioral assessments of cognitive flexibility and sustained attention, as well as the questionnaires on anxiety, social media dependence, and eating disorders. The results indicate that SMA is significantly correlated with EDS. Structural equation modeling was used to test the model in which state anxiety, cognitive flexibility, and sustained attention predicted social gain and EDS. Additionally, the results confirmed the mediating role of cognitive flexibility and sustained attention between state anxiety and SMA/EDS in the participants. The findings revealed that in the sample group, state anxiety was related to SMA and EDS through cognitive flexibility and sustained attention. These proposals reflect the significance of improving cognitive flexibility/sustained attention and reducing state anxiety to prevent EDS and SMA in female college students.

Humans perseverate on punishment avoidance goals in multigoal reinforcement learning

Managing multiple goals is essential to adaptation, yet we are only beginning to understand computations by which we navigate the resource demands entailed in so doing. Here, we sought to elucidate how humans balance reward seeking and punishment avoidance goals, and relate this to variation in its expression within anxious individuals. To do so, we developed a novel multigoal pursuit task that includes trial-specific instructed goals to either pursue reward (without risk of punishment) or avoid punishment (without the opportunity for reward). We constructed a computational model of multigoal pursuit to quantify the degree to which participants could disengage from the pursuit goals when instructed to, as well as devote less model-based resources toward goals that were less abundant. In general, participants (n = 192) were less flexible in avoiding punishment than in pursuing reward. Thus, when instructed to pursue reward, participants often persisted in avoiding features that had previously been associated with punishment, even though at decision time these features were unambiguously benign. In a similar vein, participants showed no significant downregulation of avoidance when punishment avoidance goals were less abundant in the task. Importantly, we show preliminary evidence that individuals with chronic worry may have difficulty disengaging from punishment avoidance when instructed to seek reward. Taken together, the findings demonstrate that people avoid punishment less flexibly than they pursue reward. Future studies should test in larger samples whether a difficulty to disengage from punishment avoidance contributes to chronic worry.

Minding my brain: Fourteen neuroscience-based principles to enhance psychotherapy responsiveness

Intersections between psychotherapy and neurosciences are at its dawn. The quest to understand the neural underpinnings of psychological processes has led several generations of scientists to explore neural correlates between mind, brain, and behavior. Neuroscience methods and research has given psychology new perspectives and insights about the structure and function of complex neural pathways, that underly human functioning (cognition, emotion, motivation, and interpersonal behavior). By translating neuroscientific findings into psychotherapeutic principles of change, it is possible to promote responsiveness towards brain dysfunction that underlies patients' psychological malfunctioning. In psychotherapy, responsiveness is a core aspect of the therapeutic change process, especially to adapt psychological interventions to patients' motivational stages and preferences, coping styles, neurobehavioral modes, and emotional needs. Within a transtheoretical and translational approach, contemporary neuroscientific findings are revised, discussed, and used to attempt to build-on fourteen theoretical brain-based principles that may be applied to psychotherapy. Translating these empirical findings into practical principles, clinical strategies and tasks is expected to enhance psychotherapy responsiveness grounded on a science-based knowledge of brain functioning.

Theory of mind in dysphoric and non--dysphoric adults: An ERP study of true-- and false--belief reasoning

Theory of mind (ToM) - the understanding that others' behaviors are connected with internal mental states - is an important part of everyday social cognition. There is increasing behavioral evidence that ToM reasoning can be affected by mood. To gain insight into the ways sad mood may affect the underlying mechanisms of ToM reasoning, we recorded event-related brain potentials (ERPs) as dysphoric (N = 16) and non-dysphoric (N = 24) participants reasoned about a protagonist's true or false beliefs about an object's location. Results showed significant group effects on early components of the ERP - individuals in the dysphoric group showed greater amplitudes for the anterior N1 and N2/P2 components relative to those in the non-dysphoric group. Later in the ERP, non-dysphoric individuals showed evidence of neurocognitive dissociations between true and false belief. Dysphoric individuals, however, did not show evidence for these later dissociations. This evidence suggests that dysphoria may be associated with effortful reasoning about other's mental states, even when that effort is not necessary (i.e., when reasoning about true beliefs). We discuss the implications of these findings for understanding how mood affects ToM reasoning and for how especially deliberative ToM processing in dysphoria may lead to social difficulties.

Specificity of anhedonic alterations in resting-state network connectivity and structure: A transdiagnostic approach

Anhedonia is a prominent characteristic of depression and related pathology that is associated with a prolonged course of mood disturbance and treatment resistance. However, the neurobiological mechanisms of anhedonia are poorly understood as few studies have disentangled the specific effects of anhedonia from other co-occurring symptoms. Here, we take a transdiagnostic, dimensional approach to distinguish anhedonia alterations from other internalizing symptoms on intrinsic functional brain circuits. 53 adults with varying degrees of anxiety and/or depression completed resting-state fMRI. Neural networks were identified through independent components analysis. Dual regression was used to characterize within-network functional connectivity alterations associated with individual differences in anhedonia. Modulation of between-network functional connectivity by anhedonia was tested using region-of-interest to region-of-interest correlational analyses. Anhedonia was associated with visual network hyperconnectivity and expansion of the visual, dorsal attention, and default networks. Additionally, anhedonia was associated with decreased between-network connectivity among default, salience, dorsal attention, somatomotor, and visual networks. Findings suggest that anhedonia is associated with aberrant connectivity and structural alterations in resting-state networks that contribute to impairments in reward learning, low motivation, and negativity bias characteristic of depression. Results reveal dissociable effects of anhedonia on resting-state network dynamics, characterizing possible neurocircuit mechanisms for intervention.

Neurocognition applied to psychotherapy: A brief theoretical proposal based on the complex neural network perspective

Impairments on executive functions, attention, memory, and self-perception had been systematically associated and document across several psychological disorders. Individuals with anxiety, depression, and schizophrenia spectrum disorders tend to manifest difficulties in response modulation/inhibition, cognitive flexibility, selective attention, updating autobiographical memory patterns, and maintenance in the sense of self and boundaries of others. Difficulties in cognitive, emotional, behavioral, and interpersonal functions in intrapsychic and interpsychic mental domains may be theoretically related to the maladaptive functioning of several neural networks. Frontal-Parietal Executive Network (FPEN), Salience Network (SN), Amygdaloid-Hippocampal Memory Network (AHMN), and Default Mode-Network (DMN) are four major complex neural pathways associated with these neurocognitive processes, sharing some neuroanatomical elements. These shared elements may support a latent factor that accounts for the common neurocognitive symptomatology across several psychopathological conditions. Based on these preliminary observations a new theoretical neurocognitive syndrome is hypothesized, potentially a productive target for clinical case conceptualization. Several articulations bettween neurocognition and psychotherapy are discussed and a new assessment measure is proposed.

Factor Structure, Measurement Invariance, and Concurrent Validity of the Penn State Worry Questionnaire Across Development, Psychopathology, and Culture

The Penn State Worry Questionnaire (PSWQ) is a widely used assessment of excessive worry. American undergraduate samples have predominately been used to evaluate its factor structure, which may not generalize to other developmental, cultural, and psychopathology populations. The present study tested the PSWQ's factor structure across three diverse samples: American undergraduate students (n = 3,243), Dutch high school students (n = 3,906), and American adults with psychopathology (n = 384). Exploratory, confirmatory, and multigroup confirmatory factor analyses were conducted. Measurement invariance and concurrent validity were also tested. Method-factor and two-factor models were largely equivalent and superior to a one-factor model. Invariance tests supported configural and metric invariance but only partial scalar invariance. Positively worded items but not negatively worded items demonstrated concurrent validity with anxiety and depression symptom measures and diagnoses. Overall, the PSWQ appears to measure a unitary construct. Present results warrant further testing of the PSWQ across diverse samples.

The Mediated Moderation Model of Depressive Symptoms, Alcohol Use, and Consequences: The Protective Role of Executive Function

Heavy episodic drinking (HED) and negative drinking consequences represent prevalent and serious health concerns for college students. Depressive symptoms may elevate students' risk for engaging in HED and experiencing negative consequences, but levels of risk may vary by executive function (EF) capabilities. Growing evidence suggests that EF deficits are associated with comorbid depressive symptoms and alcohol misuse. Nevertheless, little is known about unique and shared risks that depressive symptoms and EF may interactively pose for HED and negative drinking consequences. Methods: To address these gaps, the study assessed depressive symptoms, multiple domains of EF via multimethod approach, HED, and negative drinking consequences in a sample of 446 undergraduate students. Mediated moderation models were conducted to examine associations between depressive symptoms and alcohol use behaviors and modulating roles of EF. Results: Depressive symptoms, poor planning, and self-reported executive dysfunction were significantly associated with HED and negative drinking consequences. HED mediated the effect of depressive symptoms and executive dysfunction on negative consequences. A significant interaction indicated that better EF (i.e. low or average self-reported executive dysfunction) may buffer the risk depressive symptoms present for negative drinking consequences. Conclusions: The current findings suggest that among college students, risk and resilience factors for HED and negative drinking consequences may vary. Effective EF capabilities may be especially helpful for reducing students' risk for more serious drinking consequences.