Social functioning in major depressive disorder. Neurosci Biobehav Rev. 2016;69:313-332. [PMID: 27395342 DOI: 10.1016/j.neubiorev.2016.07.002]

Functional social isolation mediates the association between depression and executive function in older women: findings from the Canadian Longitudinal Study on Aging Comprehensive cohort

Depression and social isolation increase risk for executive function declines and are among the top five modifiable risk factors for dementia. However, the interrelationships between depression, social isolation and executive function are not well established. Further evidence is needed to inform strategies to promote executive function and independence in older age. We examined whether social isolation mediated the association between depression and executive function in community-dwelling middle-aged and older adults and whether this association was modified by age and sex. Adults aged 45 to 85 years from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort were followed over three years (complete case analysis, n = 14,133). Baseline depressive symptoms, a history of clinical depression, and functional social isolation (perceived lack of social support) were self-reported. Executive function at follow-up was a composite measure of five cognitive tests. Conditional process analysis assessed the mediating effects of functional social isolation across age group and sex, adjusted for sociodemographic and health covariates. Functional social isolation significantly mediated the association of depressive symptoms (proportion mediated [PM] = 8.0%) or clinical depression (PM = 17.5%) with executive function only among women aged 75+ years. Functional social isolation explains a proportion of the total effect of depressive symptoms or clinical depression on executive function in women aged 75 and older. Although reverse causation cannot be ruled out, our findings suggest that interventions that reduce functional social isolation or depression in older women may promote executive function.

A scoping review of functional near-infrared spectroscopy biomarkers in late-life depression: Depressive symptoms, cognitive functioning, and social functioning

Late-life depression is one of the most damaging mental illnesses, disrupting the normal lives of older people by causing chronic illness and cognitive impairment. Patients with late-life depression, accompanied by changes in appetite, insomnia, fatigue and guilt, are more likely to experience irritability, anxiety and somatic symptoms. It increases the risk of suicide and dementia and is a major challenge for the public health systems. The current clinical assessment, identification and effectiveness assessment of late-life depression are primarily based on history taking, mental status examination and scale scoring, which lack subjectivity and precision. Functional near-infrared spectroscopy is a rapidly developing optical imaging technology that objectively reflects the oxygenation of hemoglobin in different cerebral regions during different tasks and assesses the functional status of the cerebral cortex. This article presents a comprehensive review of the assessment of functional near-infrared spectroscopy technology in assessing depressive symptoms, social functioning, and cognitive functioning in patients with late-life depression. The use of functional near-infrared spectroscopy provides greater insight into the neurobiological mechanisms underlying depression and helps to assess these three aspects of functionality in depressed patients. In addition, the study discusses the limitations of previous research and explores potential advances in the field.

Suicide attempts in the absence of depression: Differences between broad cultural groups

Suicide is one of the leading causes of death worldwide (WHO, 2021). Depression is a common precursor to suicide and suicidality; however, individuals' experience of depression and the meaning of suicide differs depending on one's cultural background (Colucci, 2013; Goodmann et al., 2021; Kleinman, 2004). The current study explores the relationship between suicide and depression among six broad cultural groups in a large sample (N = 17,015) of adults representing six broad cultural groups (Latin America, South Asia, former Soviet Bloc, Western English-speakers, Chinese, and Arab World). Participants were recruited to a multilingual depression and suicide screening study via Google Ads (Leykin et al., 2012; Gross et al., 2014). As expected, the presence of depression was associated with suicide attempts. However, cultural group moderated this association, with Chinese participants being most likely to report suicide attempts while screening negative for depression. Although depression remains an important predictor of suicidality, it appears that certain cultural groups may be at higher risk even when depression is not present. Clinicians should consider using culturally adapted assessments for depression and suicidality.

Reduced reward responsiveness and depression vulnerability: Consideration of social contexts and implications for intervention

Depression is a prevalent, heterogeneous, and debilitating disorder that often emerges in adolescence, and there is a need to better understand vulnerability processes to inform more targeted intervention efforts. Psychophysiological methods, like event-related potentials (ERPs), can offer unique insights into the cognitive and emotional processes underlying depression vulnerability. I review my and others' research examining ERP measures of reward responsiveness in youth depression and present a conceptual model of the development of low reward responsiveness, its role in depression vulnerability, and potential windows for targeted intervention. There is evidence that a blunted reward positivity (RewP) is observable in children at risk for depression, appears to be shaped in part by early social experiences, and predicts later depressive symptoms in combination with other risk factors like stress exposure. Further, a component consistent with RewP is reliably elicited in response to social acceptance feedback in computerized peer interaction tasks and demonstrates unique associations with social contextual factors and depressive symptoms, supporting the utility of developing psychophysiological tasks that may better capture youths' real-world experiences and social risk processes. In addition, I address the translational implications of clinical psychophysiological research and describe a series of studies showing that a reduced RewP predicts greater reductions in depressive symptoms with treatment but is not modifiable by current treatments like cognitive behavioral therapy. Finally, I describe our preliminary efforts to develop a positive emotion-focused intervention for the offspring of depressed mothers, informed by the RewP literature, and describe future directions for translating psychophysiological research to intervention and prevention.

A web-based survey on the occurrence of emotional blunting in patients with major depressive disorder in Japan: Patient perceptions and attitudes

AIMS

To determine the prevalence and impact of emotional blunting (EB) in patients with major depressive disorder (MDD) in Japan, and identify treatment needs for EB using patients' perceptions and attitudes.

METHODS

Eligible patients in Japan (aged 18-59 years) who reported a diagnosis of MDD and antidepressant medication use for >3 months were eligible to complete an online survey. The primary outcome was the prevalence of EB, self-reported using a validated screening question. Secondary outcomes included the correlation between EB symptoms (measured by the Oxford Depression Questionnaire [ODQ]) and scores on the Patient Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Work and Social Adjustment Scale (WSAS), and the EuroQol 5-Dimension 5-Levels questionnaire (EQ-5D-5L). Descriptive questions were used to explore patients' perceptions and attitudes toward EB.

RESULTS

In total, 3376 patients were included in the analysis (56% male; 48% aged 50-59 years). Overall, 67.1% of patients self-reported symptoms of EB, with 10% rating these as severe. The mean (SD) ODQ total score was 78.2 (21.5), which increased with worsening EB symptoms. There were correlations between ODQ total scores and the PHQ-9, GAD-7, WSAS, and EQ-5D-5L scores (correlation coefficients: 0.67, 0.55, 0.56, -0.51, respectively; all p < 0.0001). Descriptive analyses showed that one-third of patients reporting EB symptoms did not tell their physician, with two-thirds finding these symptoms distressing and likely to affect recovery.

CONCLUSION

EB is an important clinical issue in Japan that needs to be considered alongside functional recovery when managing treatment of patients with MDD.

Factors affecting major depression in Iran: a mixed-method study

Depression is a major cause of disability and, if left untreated, can increase the risk of suicide. Evidence on the determinants of depression is incomplete, making it challenging to interpret results across studies. This study aims to identify the social, economic, environmental, political, and technological factors influencing the great recession in Iran. The study was conducted in two parts. The first step involved a literature review to identify the factors, using PubMed, Scopus, and Web of Science for the search. The reference lists of all identified articles were reviewed to find relevant studies, and the extracted information was summarized and reported descriptively. The second steps involved compiling and consulting 14 experts from different fields, using a framework analysis method. Twenty-four articles were used as primary sources of information, and a total of 28 factors were found to exist. After removing duplicates and related factors, 19 of these were subsequently declared as factors, resulting in a total of 36 determinants being identified. Most of these factors belong to the social category. The health policies implemented have a significant impact on disease risk factors and ultimately their occurrence. Political decisions and policy-making processes play a crucial role in all areas, particularly in addressing disease risk factors. Severe depression can disrupt all aspects of the healthcare system, underscoring the importance of access to care. Policies concerning physical education, transportation, nutrition, employment, green spaces, recreational facilities, and tobacco are vital in this context. The influence of health policies on disease risk factors and disease occurrence is profound. Severe depression can have far-reaching effects on the healthcare system, emphasizing the critical need for access to care. The formulation of policies to combat depression must be thoroughly evaluated in terms of economic, political, social, technological, and environmental factors. The findings suggest that addressing social inequalities and emphasizing the role of political action, as highlighted by the social determinants of health, should be top priorities in addressing depression. Efforts to prevent depression should incorporate ecological approaches that consider the impact of the socioeconomic environment on depressive symptoms.

Social environment-based opportunity costs dictate when people leave social interactions

There is an ever-increasing understanding of the cognitive mechanisms underlying how we process others' behaviours during social interactions. However, little is known about how people decide when to leave an interaction. Are these decisions shaped by alternatives in the environment - the opportunity-costs of connecting to other people? Here, participants chose when to leave partners who treated them with varying degrees of fairness, and connect to others, in social environments with different opportunity-costs. Across four studies we find people leave partners more quickly when opportunity-costs are high, both the average fairness of people in the environment and the effort required to connect to another partner. People's leaving times were accounted for by a fairness-adapted evidence accumulation model, and modulated by depression and loneliness scores. These findings demonstrate the computational processes underlying decisions to leave, and highlight atypical social time allocations as a marker of poor mental health.

Mastery is central: an examination of complex interrelationships between physical health, stress and adaptive cognition, and social connection with depression and anxiety symptoms

Background

Research has established the link between physical health, stress and cognition, and social connection with depression and anxiety. Nevertheless, an understanding of the comorbidity of depression and anxiety symptoms and their complex interrelationships with relevant factors remains still limited. This study investigated the complex pattern of interplay between depression and anxiety symptoms and pertinent physical, cognitive, and social factors and potential gender differences.

Methods

Using a sample of 600 middle-aged men and women, depression and anxiety as well as physical health, perceived stress and mastery, and social connection were assessed. The network structure of depression and anxiety symptoms and risk and resilience factors were characterized by examining interrelationships and the centrality indices of Strength and Bridge Strength. Gender differences were examined using the Network Comparison Test.

Results

Perceived stress and mastery were central bridge factors influencing comorbid depression and anxiety symptoms, and perceived stress, anhedonia, and mastery exhibited strong inter-connections to each other. The connections of physical health-anhedonia and sleep disturbance-irritability were stronger in men than in women, while social connection with family was linked to interpersonal problems only in women.

Conclusions

The results underscore that prevention and interventions targeting reducing perceptions of stress and promoting mastery would prevent onset or recurrence of depression and anxiety symptoms among middle-aged men and women. Engaging in behavioral activities to maintain physical health and ensuring adequate sleep could be particularly beneficial for men in reducing overall symptom severity.

Life stress influences the relationship between sex hormone fluctuation and affective symptoms in peripubertal female adolescents

Female adolescents have a greatly increased risk of depression starting at puberty, which continues throughout the reproductive lifespan. Sex hormone fluctuation has been highlighted as a key proximal precipitating factor in the development of mood disorders tied to reproductive events; however, hormone-induced affective state change is poorly understood in the pubertal transition. The present study investigated the impact of recent stressful life events on the relationship between sex hormone change and affective symptoms in peripubertal female participants. Thirty-five peripubertal participants (ages 11-14, premenarchal, or within 1 year of menarche) completed an assessment of stressful life events, and provided weekly salivary hormone collections [estrone, testosterone, dehydroepiandrosterone (DHEA)] and mood assessments for 8 weeks. Linear mixed models tested whether stressful life events provided a context in which within-person changes in hormones predicted weekly affective symptoms. Results indicated that exposure to stressful life events proximal to the pubertal transition influenced the directional effects of hormone change on affective symptoms. Specifically, greater affective symptoms were associated with increases in hormones in a high stress context and decreases in hormones in a low stress context. These findings provide support for stress-related hormone sensitivity as a diathesis for precipitating affective symptoms in the presence of pronounced peripubertal hormone flux.

Altered asymmetry of functional connectome gradients in major depressive disorder

Introduction

Major depressive disorder (MDD) is a debilitating disease involving sensory and higher-order cognitive dysfunction. Previous work has shown altered asymmetry in MDD, including abnormal lateralized activation and disrupted hemispheric connectivity. However, it remains unclear whether and how MDD affects functional asymmetries in the context of intrinsic hierarchical organization.

Methods

Here, we evaluate intra- and inter-hemispheric asymmetries of the first three functional gradients, characterizing unimodal-transmodal, visual-somatosensory, and somatomotor/default mode-multiple demand hierarchies, to study MDD-related alterations in overarching system-level architecture.

Results

We find that, relative to the healthy controls, MDD patients exhibit alterations in both primary sensory regions (e.g., visual areas) and transmodal association regions (e.g., default mode areas). We further find these abnormalities are woven in heterogeneous alterations along multiple functional gradients, associated with cognitive terms involving mind, memory, and visual processing. Moreover, through an elastic net model, we observe that both intra- and inter-asymmetric features are predictive of depressive traits measured by BDI-II scores.

Discussion

Altogether, these findings highlight a broad and mixed effect of MDD on functional gradient asymmetry, contributing to a richer understanding of the neurobiological underpinnings in MDD.

The influence of acute dopamine transporter inhibition on manic-, depressive-like phenotypes, and brain oxidative status in adult zebrafish

Functional changes in dopamine transporter (DAT) are related to various psychiatric conditions, including bipolar disorder (BD) symptoms. In experimental research, the inhibition of DAT induces behavioral alterations that recapitulate symptoms found in BD patients, including mania and depressive mood. Thus, developing novel animal models that mimic BD-related conditions by pharmacologically modulating the dopaminergic signaling is relevant. The zebrafish (Danio rerio) has been considered a suitable vertebrate system for modeling BD-like responses, due to the well-characterized behavioral responses and evolutionarily conservation of the dopaminergic system of this species. Here, we investigate whether GBR 12909, a selective inhibitor of DAT, causes neurobehavioral alterations in zebrafish similar to those observed in BD patients. Behaviors were recorded after a single intraperitoneal (i.p.) administration of GBR 12909 at different doses (3.75, 7.5, 15 and 30 mg/kg). To observe temporal effects on behavior, swim path parameters were measured immediately after the administration period during 30 min. Locomotion, anxiety-like behavior, social preference, aggression, despair-like behavior, and oxidative stress-related biomarkers in the brain were measured 30 min post administration. GBR 12909 induced prominent effects on locomotor activity and vertical exploration during the 30-min period. Hyperactivity was observed in GBR 30 group after 25 min, while all doses markedly reduced vertical drifts. GBR 12909 elicited hyperlocomotion, anxiety-like behavior, decreased social preference, aggression, and induced depressive-like behavior in a behavioral despair task. Depending on the dose, GBR 12909 also decreased SOD activity and TBARS levels, as well as increased GR activity and NPSH content. Collectively, our novel findings show that a single GBR 12909 administration evokes neurobehavioral changes that recapitulate manic- and depressive-like states observed in rodents, fostering the use of zebrafish models to explore BD-like responses in translational neuroscience research.

Dose‒Response Effects of Patient Engagement on Anxiety and Depression in a Cognitive-Behavioral Intervention: Secondary Analysis of a Pilot Randomized Controlled Trial and a Clinical Controlled Trial

Understanding the dose‒response relationship between patient engagement in cognitive behavioral therapy (CBT) and health outcomes is critical for developing and implementing effective CBT programs. In studies of CBT interventions, patient engagement is measured only at a single time point, and outcomes are typically assessed before and after the intervention. Examination of the dose‒response relationship between patient engagement in CBT and outcomes is limited. It is unclear whether a dose‒response relationship exists between patient engagement in on-site CBT intervention and anxiety and depression in people living with HIV (PLWH). If present, does this dose‒response relationship occur early or later in the intervention? This study aimed to address this gap by examining the dose‒response relationships between patient engagement and anxiety and depression in CBT interventions among PLWH. Utilizing data from a pilot randomized trial (10 participants) and a clinical controlled trial (70 participants), our secondary analysis spans baseline, 3-month, and 6-month assessments. Both trials implemented the nurse-led CBT intervention. Cluster analysis identified two groups based on on-site attendance and WeChat activity. Patients with good adherence (6-10 times) of on-site attendance exhibited significantly lower anxiety and depression scores at 3 months (β = 1.220, P = 0.047; β = 1.270, P = 0.019), with no significant differences observed at 6 months. WeChat activity did not significantly influence anxiety or depression scores. The findings highlight a significant short-term dose‒response relationship, endorsing nurse-led CBT interventions for mental health in PLWH. Organizational strategies should focus on incentivizing and facilitating patient engagement, particularly through enhancing WeChat features.

Factors that contributed to Ontario adults' mental health during the first 16 months of the COVID-19 pandemic: a decision tree analysis

The COVID-19 pandemic has negatively impacted the mental health of individuals globally. However, less is known about the characteristics that contributed to some people having mental health problems during the pandemic, while others did not. Mental health problems can be understood on a continuum, ranging from acute (e.g., depression following a stressful event) to severe (e.g., chronic conditions that disrupt everyday functioning). Therefore, the purpose of this article was to generate profiles of adults who were more or less at risk for the development of mental health problems, in general, during the first 16-months of the COVID-19 pandemic in Ontario, Canada. Data were collected via online surveys at two time points: April-July 2020 and July-August 2021; 2,188 adults (Mage = 43.15 years; SD = 8.82) participated. Surveys included a demographic questionnaire and four previously validated tools to measure participants' mental health, subjective wellbeing, physical activity and sedentary behaviour, and sleep. A decision tree was generated at each time point for those with mental health problems, and those with no mental health problems. Results showed that subjective wellbeing was the biggest contributor to mental health status. Characteristics associated with no mental health problems among adults included having good wellbeing, being a good sleeper (quantity, quality, and patterns of sleep), and being over the age of 42. Characteristics associated with mental health problems included having poor wellbeing and being a poor sleeper. Findings revealed that specific characteristics interacted to contribute to adults' mental health status during the first 16 months of the COVID-19 pandemic. Given that wellbeing was the biggest contributor to mental health, researchers should focus on targeting adults' wellbeing to improve their mental health during future health crises.

Evaluating the sensitivity to threat and affiliative reward (STAR) model in relation to the development of conduct problems and callous-unemotional traits across early adolescence

BACKGROUND

The Sensitivity to Threat and Affiliative Reward (STAR) model proposes low threat sensitivity and low affiliation as risk factors for callous-unemotional (CU) traits. Preliminary evidence for the STAR model comes from work in early childhood. However, studies are needed that explore the STAR dimensions in late childhood and adolescence when severe conduct problems (CP) emerge. Moreover, it is unclear how variability across the full spectrum of threat sensitivity and affiliation gives rise to different forms of psychopathology beyond CU traits.

METHODS

The current study addressed these gaps using parent- and child-reported data from three waves and a sub-study of the Adolescent Brain Cognitive Development Study® of 11,878 youth (48% female; ages 9-12).

RESULTS

Consistent with the STAR model, low threat sensitivity and low affiliation were independently related to CU traits across informants and time. Moreover, there was significant interaction between the STAR dimensions, such that children with lower sensitivity to threat and lower affiliation had higher parent-reported CU traits. Unlike CU traits, children with higher threat sensitivity had higher parent-reported CP and anxiety. Finally, children with lower affiliation had higher parent-reported CP, anxiety, and depression. Results largely replicated across informants and time, and sensitivity analysis revealed similar findings in children with and without DSM-5 defined CP.

CONCLUSIONS

Results support the STAR model hypotheses as they pertain to CU traits and delineate threat sensitivity and affiliation as independent transdiagnostic risk factors for different types of psychopathology. Future research is needed to develop fuller and more reliable and valid measures of affiliation and threat sensitivity across multiple assessment modalities.

Depressive symptoms and visual attention to others' eyes in healthy individuals

BACKGROUND

Eye contact is a fundamental part of social interaction. In clinical studies, it has been observed that patients suffering from depression make less eye contact during interviews than healthy individuals, which could be a factor contributing to their social functioning impairments. Similarly, results from mood induction studies with healthy persons indicate that attention to the eyes diminishes as a function of sad mood. The present screen-based eye-tracking study examined whether depressive symptoms in healthy individuals are associated with reduced visual attention to other persons' direct gaze during free viewing.

METHODS

Gaze behavior of 44 individuals with depressive symptoms and 49 individuals with no depressive symptoms was analyzed in a free viewing task. Grouping was based on the Beck Depression Inventory using the cut-off proposed by Hautzinger et al. (2006). Participants saw pairs of faces with direct gaze showing emotional or neutral expressions. One-half of the face pairs was shown without face masks, whereas the other half was presented with face masks. Participants' dwell times and first fixation durations were analyzed.

RESULTS

In case of unmasked facial expressions, participants with depressive symptoms looked shorter at the eyes compared to individuals without symptoms across all expression conditions. No group difference in first fixation duration on the eyes of masked and unmasked faces was observed. Individuals with depressive symptoms dwelled longer on the mouth region of unmasked faces. For masked faces, no significant group differences in dwell time on the eyes were found. Moreover, when specifically examining dwell time on the eyes of faces with an emotional expression there were also no significant differences between groups. Overall, participants gazed significantly longer at the eyes in masked compared to unmasked faces.

CONCLUSIONS

For faces without mask, our results suggest that depressiveness in healthy individuals goes along with less visual attention to other persons' eyes but not with less visual attention to others' faces. When factors come into play that generally amplify the attention directed to the eyes such as face masks or emotions then no relationship between depressiveness and visual attention to the eyes can be established.

MDMA enhances positive affective responses to social feedback

BACKGROUND

The prosocial compound ± 3,4-methylenedioxymethamphetamine (MDMA) is an amphetamine derivative that has shown promise as an adjunct to psychotherapy in the treatment of post-traumatic stress disorder. MDMA increases positive responses to social images, and it has been suggested that the ability of MDMA to positively bias social perception may underlie its therapeutic efficacy as a psychotherapy adjunct. However, the effect of the compound on affective responses to positive or negative social feedback has not been tested.

AIMS

In this study, we aimed to test the effects of MDMA compared to placebo and the prototypical stimulant, methamphetamine (MA), on responses to positive and negative social feedback.

METHODS

This was a double-blind, placebo-controlled, crossover trial (NCT03790618), comparing the effects of two doses of MDMA (0.75 mg/kg, 1.5 mg/kg) to both placebo and MA (20 mg) on responses to a personalized social feedback task, similar to a dating app, in healthy adult volunteers ages 18-40 (N = 36, 18 women, 18 men).

RESULTS/OUTCOMES

The high dose of MDMA increased positive affective responses to social feedback.

CONCLUSIONS/INTERPRETATIONS

These findings suggest one process by which MDMA may facilitate social connection. Further work is needed to understand how MDMA affects responses to more generalized types of social feedback and to understand these effects in clinical populations.

Altered States and Social Bonds: Effects of MDMA and Serotonergic Psychedelics on Social Behavior as a Mechanism Underlying Substance-Assisted Therapy

There has been renewed interest in the use of 3,4-methylenedioxy-methamphetamine (MDMA) and serotonergic psychedelics in the treatment of multiple psychiatric disorders. Many of these compounds are known to produce prosocial effects, but how these effects relate to therapeutic efficacy and the extent to which prosocial effects are unique to a particular drug class is unknown. In this article, we present a narrative overview and compare evidence for the prosocial effects of MDMA and serotonergic psychedelics to elucidate shared mechanisms that may underlie the therapeutic process. We discuss 4 categories of prosocial effects: altered self-image, responses to social reward, responses to negative social input, and social neuroplasticity. While both categories of drugs alter self-perception, MDMA may do so in a way that is less related to the experience of mystical-type states than serotonergic psychedelics. In the case of social reward, evidence supports the ability of MDMA to enhance responses and suggests that serotonergic psychedelics may also do so, but more research is needed in this area. Both drug classes consistently dampen reactivity to negative social stimuli. Finally, preclinical evidence supports the ability of both drug classes to induce social neuroplasticity, promoting adaptive rewiring of neural circuits, which may be helpful in trauma processing. While both MDMA and serotonergic psychedelics produce prosocial effects, they differ in the mechanisms through which they do this. These differences affect the types of psychosocial interventions that may work best with each compound.

Negative feedback-seeking in depression: The moderating roles of rumination and interpersonal life stress

OBJECTIVES

Swann's self-verification theory proposes that negative feedback seeking (NFS)-the solicitation of negative feedback from others that confirms one's self-views-works in a negative cycle to maintain and exacerbate depression in the face of interpersonal stress. We propose a cognitive-interpersonal integration account of NFS such that this maladaptive behavior prospectively predicts depression only among those with a trait tendency to ruminate on the causes and consequences of depressed mood and stress.

METHOD

Participants included 91 young adults who were over-sampled for a lifetime history of a unipolar depressive disorder (age 17-33; 69% women; 67% lifetime depressive disorder). At baseline, participants completed a structured diagnostic interview and self-report measures of NFS, rumination, and depression symptoms. In addition, participants engaged in an interpersonal rejection task (the Yale Interpersonal Stressor) followed by a behavioral measure of NFS. At a 3-month follow-up, depression symptoms were again assessed by self-report and exposure to stressful interpersonal life events in the intervening period were assessed with a rigorous contextual interview and independent rating system.

RESULTS

Controlling for baseline depression severity, greater self-reported, and behaviorally assessed NFS predicted greater follow-up depression severity, but only among those with higher trait tendency to ruminate. For self-reported NFS, this association was further moderated by level of interpersonal, but not noninterpersonal, life events experienced over follow-up.

CONCLUSION

These findings suggest that rumination may represent a modifiable intervention target that could break the vicious interpersonal cycle of depression and, thus, mitigate the depressogenic effects of NFS.

Is combined antidepressant medication (ADM) and psychotherapy better than either monotherapy at preventing suicide attempts and other psychiatric serious adverse events for depressed patients? A rare events meta-analysis

Antidepressant medication (ADM)-only, psychotherapy-only, and their combination are the first-line treatment options for major depressive disorder (MDD). Previous meta-analyses of randomized controlled trials (RCTs) established that psychotherapy and combined treatment were superior to ADM-only for MDD treatment remission or response. The current meta-analysis extended previous ones by determining the comparative efficacy of ADM-only, psychotherapy-only, and combined treatment on suicide attempts and other serious psychiatric adverse events (i.e. psychiatric emergency department [ED] visit, psychiatric hospitalization, and/or suicide death; SAEs). Peto odds ratios (ORs) and their 95% confidence intervals were computed from the present random-effects meta-analysis. Thirty-four relevant RCTs were included. Psychotherapy-only was stronger than combined treatment (1.9% v. 3.7%; OR 1.96 [1.20-3.20], p = 0.012) and ADM-only (3.0% v. 5.6%; OR 0.45 [0.30-0.67], p = 0.001) in decreasing the likelihood of SAEs in the primary and trim-and-fill sensitivity analyses. Combined treatment was better than ADM-only in reducing the probability of SAEs (6.0% v. 8.7%; OR 0.74 [0.56-0.96], p = 0.029), but this comparative efficacy finding was non-significant in the sensitivity analyses. Subgroup analyses revealed the advantage of psychotherapy-only over combined treatment and ADM-only for reducing SAE risk among children and adolescents and the benefit of combined treatment over ADM-only among adults. Overall, psychotherapy and combined treatment outperformed ADM-only in reducing the likelihood of SAEs, perhaps by conferring strategies to enhance reasons for living. Plausibly, psychotherapy should be prioritized for high-risk youths and combined treatment for high-risk adults with MDD.

Volatile organic compounds exposure associated with depression among U.S. adults: Results from NHANES 2011-2020

Volatile organic compounds (VOCs) are important contributors to air pollution. VOCs exposure was associated with various human diseases. Depression is one of the most prevalent mental disorders and poses a serious mental health burden. Although VOCs are neurotoxic and can damage the central nervous system, the association between VOCs exposure and depression remains obscure. Based on data from the National Health and Nutrition Examination Survey, we included 5676 adult individuals and 15 major components of urinary volatile organic compound metabolites (mVOCs). We comprehensively evaluated the potential association between each single urinary mVOC exposure and depressive symptoms using binary logistic and restricted cubic spline regression, whereas the weighted quantile sum regression and least absolute shrinkage and selection operator regression model were used to explore the mixture co-exposure association. The results indicated significantly higher mean concentrations of the 11 urinary mVOC components in the depression group than that in the non-depression group. And 12 mVOC components had a significantly positive association with depression. The overall effect of all 15 mVOCs components was also significantly positive. The corresponding odds ratio was 1.56 (95%CI: 1.2-2.03) in the categorical variable model and the regression coefficient was 0.36 (95%CI: 0.12-0.6) in the numerical variable model. Five urinary mVOCs (URXCYM, URXPHG, URX34 M, URXMB3, and URXAMC) were identified as the most relevant components associated with depression, with 89.06% total weights in the categorical variable model and 89.39% in the numerical variable model. The mVOCs were the biomarkers of VOCs, their concentrations in urine could specifically represent the contents of their metabolic parents in the human body. Considering that the metabolic parents of the above five mVOCs were predominantly acrylonitrile, toluene, styrene, acrylamide, 1,3-Butadiene, and xylenes, our results further indicated that exposure to these VOCs was closely related to depression, and more attention should be paid to the mental health risks of VOCs exposure.

Personal and perceived stigma in relation to diverse domains of quality of life among patients with major depressive disorder having residual symptoms: a hospital-based cross-sectional study in Thailand

PURPOSE

Depression is a debilitating disease with residual symptoms that negatively impact patients' quality of life (QoL). Stigma is associated with poor QoL; however, knowledge regarding stigma subtypes and each QoL domain concerning residual depression is limited. We aimed to investigate the association of residual depression symptoms with QoL and stigma among patients with major depressive disorder (MDD).

METHODS

This cross-sectional study was conducted at an outpatient clinic among patients with MDD (March-July 2022). We administered the Thai version of the Patient Health Questionnaire-9, World Health Organization Quality of Life Brief, and Mental Health Consumers' Experience of Stigma to assess patients' levels of depression, QoL, and personal and perceived stigma, respectively. We performed correlational and logistic regression analyses to evaluate the association of demographics, QoL, stigma, and stress with residual depression.

RESULTS

Of 384 patients with MDD (median age = 39.5, females = 73.2%), 54.4% had residual depression. Among those with residual depression, depression was negatively correlated with QoL (ρ = - 0.58, p < 0.001) and positively correlated with stigma (ρ = 0.24, p < 0.001). The risk of residual depression decreased as the QoL score increased (adjusted OR per 1-point increase 0.93 [0.91, 0.96], p < 0.001); residual depression was significantly associated with personal stigma.

CONCLUSION

Stigma and QoL exhibit an inverse relationship. Physical-, psychological-, and environmental-health domains of QoL and personal stigma are key contributing factors to residual MDD symptoms. Improvement of QoL and stigma requires further theoretical research and should be of concern in clinical practice. Longitudinal studies on relatively diverse populations and subsyndromal symptoms are needed.

Cross-cultural adaptation and clinical application of the Perth Empathy Scale

OBJECTIVE

Alterations of empathy have been observed in patients with various mental disorders. The Perth Empathy Scale (PES) was recently developed to measure a multidimensional construct of empathy across positive and negative emotions. However, its psychometric properties and clinical applications have not been examined in the Chinese context.

METHODS

The Chinese version of the PES was developed and administered to a large Chinese sample (n = 1090). Factor structure, internal consistency, test-retest reliability, and convergent, discriminant, as well as concurrent validity were examined. Moreover, 50 patients with major depressive disorder (MDD) and 50 healthy controls were recruited to explore the clinical utility of the PES.

RESULTS

Confirmatory factor analyses supported a theoretically congruent three-factor structure of empathy, namely Cognitive Empathy, Negative Affective Empathy and Positive Affective Empathy. The PES showed good to excellent internal consistency reliability, good convergent and discriminant validity, acceptable concurrent validity, and moderate to high test-retest reliability. Patients with MDD had significantly lower PES scores compared to healthy controls. Linear discriminant function comprised of the three factors correctly differentiated 71% of participants, which further verified the clinical utility of the PES.

CONCLUSIONS

Our findings indicated that the Chinese version of the PES is a reliable and valid instrument to measure cognitive and affective empathy across negative and positive emotions, and could therefore be used in both research and clinical practice.

Normalized affective responsiveness following deep brain stimulation of the medial forebrain bundle in depression

Deep brain stimulation (DBS) of the supero-lateral medial forebrain bundle (slMFB) is associated with rapid and sustained antidepressant effects in treatment-resistant depression (TRD). Beyond that, improvements in social functioning have been reported. However, it is unclear whether social skills, the basis of successful social functioning, are systematically altered following slMFB DBS. Therefore, the current study investigated specific social skills (affective empathy, compassion, and theory of mind) in patients with TRD undergoing slMFB DBS in comparison to healthy subjects. 12 patients with TRD and 12 age- and gender-matched healthy subjects (5 females) performed the EmpaToM, a video-based naturalistic paradigm differentiating between affective empathy, compassion, and theory of mind. Patients were assessed before and three months after DBS onset and compared to an age- and gender-matched sample of healthy controls. All data were analyzed using non-parametric Mann-Whitney U tests. DBS treatment significantly affected patients' affective responsiveness towards emotional versus neutral situations (i.e. affective empathy): While their affective responsiveness was reduced compared to healthy subjects at baseline, they showed normalized affective responsiveness three months after slMFB DBS onset. No effects occurred in other domains with persisting deficits in compassion and intact socio-cognitive skills. Active slMFB DBS resulted in a normalized affective responsiveness in patients with TRD. This specific effect might represent one factor supporting the resumption of social activities after recovery from chronic depression. Considering the small size of this unique sample as well as the explorative nature of this study, future studies are needed to investigate the robustness of these effects.

Differential temporal utility of passively sensed smartphone features for depression and anxiety symptom prediction: a longitudinal cohort study

While studies show links between smartphone data and affective symptoms, we lack clarity on the temporal scale, specificity (e.g., to depression vs. anxiety), and person-specific (vs. group-level) nature of these associations. We conducted a large-scale (n = 1013) smartphone-based passive sensing study to identify within- and between-person digital markers of depression and anxiety symptoms over time. Participants (74.6% female; M age = 40.9) downloaded the LifeSense app, which facilitated continuous passive data collection (e.g., GPS, app and device use, communication) across 16 weeks. Hierarchical linear regression models tested the within- and between-person associations of 2-week windows of passively sensed data with depression (PHQ-8) or generalized anxiety (GAD-7). We used a shifting window to understand the time scale at which sensed features relate to mental health symptoms, predicting symptoms 2 weeks in the future (distal prediction), 1 week in the future (medial prediction), and 0 weeks in the future (proximal prediction). Spending more time at home relative to one's average was an early signal of PHQ-8 severity (distal β = 0.219, p = 0.012) and continued to relate to PHQ-8 at medial (β = 0.198, p = 0.022) and proximal (β = 0.183, p = 0.045) windows. In contrast, circadian movement was proximally related to (β = -0.131, p = 0.035) but did not predict (distal β = 0.034, p = 0.577; medial β = -0.089, p = 0.138) PHQ-8. Distinct communication features (i.e., call/text or app-based messaging) related to PHQ-8 and GAD-7. Findings have implications for identifying novel treatment targets, personalizing digital mental health interventions, and enhancing traditional patient-provider interactions. Certain features (e.g., circadian movement) may represent correlates but not true prospective indicators of affective symptoms. Conversely, other features like home duration may be such early signals of intra-individual symptom change, indicating the potential utility of prophylactic intervention (e.g., behavioral activation) in response to person-specific increases in these signals.

"No man is an island": How Chinese netizens use deliberate metaphors to provide "depression sufferers" with social support

Objective

Online social support provides a way to positively influence depression sufferers. In the present study, we aim to analyze how social support in Chinese online depression communities is communicated through the lens of deliberate metaphor theory (DMT) to deepen the understanding of the under-researched complicated, emotionally laden, and culture-related concepts of this experience.

Methods

We collected data (n = 3546 comments) from the Warm Supporting section of the Depression Super Topic, a major Chinese online depression community on Weibo. The data were analyzed using a metaphorical analysis with the Metaphor Identification Procedure Vrije Universiteit and a thematic analysis.

Results

Our findings identify two themes: deliberate metaphors (DMs) of depression and DMs of social environment for depression sufferers. The former conceptualizes future expectations without depression (as rosy images; victorious battles; the beaten black dog); disorder (as subtle objects; subjective initiative events); depression sufferers (as valuable objects; important roles); and present life with depression (as optional events; spiritual practices; fragile objects). The latter conceptualizes social connection (as solid objects; nonessentials); individuals in the social environment (as energetic objects; vicious roles); and prejudice (as colored objects).

Conclusions

The findings suggest that DMs as important online social support resources, helping to express empathy and normalize depression with more common-sense, and non-judgmental concepts. Additionally, in DMs, Chinese netizens navigate the intricate intersection of medical and moral perspectives on depression and its recovery, leveraging both aspects to offer comprehensive social support. "Confucian-based" elements are embedded in culture-related social support expressions in DMs. In practice, our findings contribute to tailored and appropriate health interventions for depression.

Altered reward network responses to social touch in major depression

BACKGROUND

Social touch is an integral part of social relationships and has been associated with reward. Major depressive disorder (MDD) is characterized by severe impairments in reward processing, but the neural effects of social touch in MDD are still elusive. In this study, we aimed to determine whether the neural processing of social touch is altered in MDD and to assess the impact of antidepressant therapy.

METHODS

Before and after antidepressant treatment, 53 MDD patients and 41 healthy controls underwent functional magnetic resonance imaging (fMRI) while receiving social touch. We compared neural responses to social touch in the reward network, behavioral ratings of touch comfort and general aversion to interpersonal touch in patients to controls. Additionally, we examined the effect of treatment response on those measures.

RESULTS

Clinical symptoms decreased after treatment and 43.4% of patients were classified as responders. Patients reported higher aversion to interpersonal touch and lower comfort ratings during the fMRI paradigm than controls. Patients showed reduced responses to social touch in the nucleus accumbens, caudate nucleus and putamen than controls, both before and after treatment. Contrary to our hypotheses, these effects were independent of touch velocity. Non-responders exhibited blunted response in the caudate nucleus and the insula compared to responders, again irrespective of time.

CONCLUSIONS

These findings suggest altered striatal processing of social touch in MDD. Persistent dysfunctional processing of social touch despite clinical improvements may constitute a latent risk factor for social withdrawal and isolation.

Thermosensation and emotion: Thermosensory accuracy in a dynamic thermal matching task is linked to depression and anxiety symptomatology

Interoception is related to the generation of bodily feelings and the awareness of ourselves as 'sentient beings', informing the organism about its bodily needs to guarantee survival. Previous studies have reported links among interoception, emotion processing, and mental health. For example, the alignment of interoceptive dimensions (i.e., accuracy, sensibility, awareness) can predict emotional symptoms, such as anxiety. Here, we aimed to investigate the relationship between the perception of a certain type of skin-mediated interoceptive signal, i.e., thermosensation, and self-reported depression, anxiety, and stress. One hundred seventy participants completed the Depression Anxiety Stress Scale (DASS-21) and a dynamic thermal matching task, a static temperature detection task, and a heartbeat counting task. Our results revealed that self-reported anxiety and depression were related to the perception of temperature on hairy and non-hairy skin, respectively: higher anxiety was related to better performance on the thermal matching task on the forearm, while higher depression was related to poorer performance on dynamic and static temperature tasks on the palm. Discrepancies between thermosensory accuracy and sensibility measures ('trait prediction error') were related to heightened anxiety, in line with previous studies. No significant correlations were found between DASS-21 scores and heartbeat counting accuracy. In conclusion, this study suggests that individual differences in thermosensory perception in different areas of the body are associated with self-reported anxiety and depression.

Associations of adolescent substance use and depressive symptoms with adult major depressive disorder in the United States: NSDUH 2016-2019

BACKGROUND

Few studies have focused on the associations of adolescent substance use and depressive symptoms with adult major depressive disorder (MDD).

METHODS

Data from 168,859 adults, among which, 15,959 had experienced MDD in the past year, as indicated by a major depressive episode (MDE) marked by MDD symptoms, were from the 2016-2019 National Surveys on Drug Use and Health. Weighted multivariable logistic regression (MLR) analyses were used to determine the associations.

RESULTS

The overall MDD prevalence was 7.2 %, whereas the prevalence for adults without early onset depressive symptoms prior to age 18 was 4.6 %. Variable cluster analysis revealed that adolescent use of alcohol, cigarettes, marijuana, cocaine, hallucinogen use, and inhalants prior to age 18 were in one cluster. MLR analyses showed that the presence of depressive symptoms prior to age 18 was the major risk factor for MDD, while adolescent use of alcohol, marijuana, and inhalants prior to age 18 were associated with increased odds of MDD (p < 0.05) both in the whole data and the subset of adults without depressive symptoms prior to age 18. Adolescent use of cocaine prior to age 18 were associated with MDD only in the whole data, whereas adolescent smokeless tobacco use was associated with MDD only in those without depressive symptoms prior to age 18.

CONCLUSIONS

These findings highlight the comorbid early substance use and depressive symptoms during adolescence with adult MDD. Intervention strategies should simultaneously address early-onset substance use and depressive symptoms prior to age 18.

The effects of treatment via telemedicine interventions for patients with depression on depressive symptoms and quality of life: a systematic review and meta-ranalysis

Aim: The aim of this systematic review and meta-analysis was to identify, evaluate, and synthesize the evidence from studies that have investigated the treatment effect via telemedicine interventions on depressive symptoms, quality of life, and work and social functioning in patients with depression.Methods: Six electronic databases (MEDLINE [1916-2021], PubMED [1950-2021], PsycINFO [1971-2021], Scopus [2004-2021], Embase [1972-2021], and CINAHL [1937-2021]) were systematically searched in March 2021. Reference lists of identified articles were hand searched. Randomized controlled trials were included if they investigated the treatment effects via telemedicine interventions in patients who had a depression diagnosis. Quality assessment was evaluated using the critical appraisal checklists developed by the Joanna Briggs Institute.Results: Seventeen (17) trials (n = 2,394) met eligibility criteria and were included in the analysis. Eleven (11) randomized controlled trials shared common outcome measures, allowing meta-analysis. The results provided evidence that treatment via telemedicine interventions were beneficial for depressive symptoms (standardized mean difference= -0.44; 95% CI= -0.64 to -0.25; p < .001) and quality of life (standardized mean difference= 0.25, 95% CI -0.01 to 0.49, p = .04) in patients of depression. There were insufficient data for meta-analysis of work and social functioning.Conclusion: This study showed the positive effects of treatment via telemedicine interventions on depressive symptoms and quality of life in patients with depression and supported the idea for clinical practice to establish a well-organized telepsychiatry system.KEY MESSAGESTelemedicine is effective at reducing symptoms of depression.Telemedicine can improve quality of life in persons with depression.

Prolonged ketamine therapy differentially rescues psychobehavioural deficits via modulation of nitro-oxidative stress and oxytocin receptors in the gut-brain-axis of chronically-stressed mice

Ketamine is an anaesthetic known to have short but rapid-acting anti-depressant effects; however, the neurobehavioural effects of its prolonged use and its role on the oxytocin system in the gut-brain axis are largely undetermined. Female BALB/c mice were either exposed to the chronic unpredictable mild stress (CUMS) paradigm for 21 days and then treated with ketamine in four doses for 14 days or exposed to CUMS and treated simultaneously in four doses of ketamine during the last two weeks of CUMS exposure. After each dose, the forced swim test was conducted to assess depressive-like behaviour. Before sacrifice, all the mice were subjected to behavioural tests to assess anxiety, memory, and social interaction. Prolonged treatment of depression with ketamine did not rescue depressive-like behaviour. It did, however, improve depression-associated anxiety-like behaviours, short-term memory and social interaction deficits when compared to the stressed untreated mice. Furthermore, ketamine treatment enhanced plasma oxytocin levels, expression of oxytocin receptors; as well as abrogated nitro-oxidative stress biomarkers in the intestinal and hippocampal tissues. Taken together, our findings indicate that while short-term use of ketamine has anti-depressant benefits, its prolonged therapeutic use does not seem to adequately resolve depressive-like behaviour in mice.

A compassion-based treatment for couples with the female partner suffering from current depressive disorder: A randomized-controlled trial

BACKGROUND

Studies have shown that depression and interpersonal relationships are interdependently connected and that including the intimate partner in treatment for depression has beneficial effects. Given evidence that compassion is both an interpersonal quality and a promising treatment target, the goal of this study was to examine the effects of a compassion-based, contemplative treatment for couples employing a multi-method approach for evaluation.

METHODS

In a pre-post-follow-up design, n = 53 different-sex couples including women with current depression were randomly assigned to a 10-week-long CBCT®-fC (Cognitively-Based Compassion Training/intervention for couples) or treatment-as-usual (TAU) condition. Multi-level linear regression models and post-hoc contrasts were calculated to determine changes in depressive symptoms, mindfulness and self-compassion, interpersonal functioning and neuroendocrine markers collected during a partnership appreciation task (PAT) in the laboratory before and after CBCT-fC treatment.

RESULTS

While CBCT-fC led to a comparable decrease of depressive symptoms as TAU, the training specifically increased self-compassion and mindfulness versus TAU. Interestingly, interpersonal functioning did not improve, which was also reflected in participants' preferred self-focus in-between-session practices, instead of practices with interpersonal focus. There were no group-specific changes in psychobiological stress-marker reactivity.

CONCLUSIONS

CBCT-fC was effective in decreasing current depressive symptomatology and increasing mindfulness, and self-compassion. Especially the motivation to participate, such as improving interpersonal functioning, should be addressed and intrinsic motives of the partners to be involved. In highly burdened individuals, self-regulation may need to be improved before co-regulation can be addressed, which would requiring longer treatments. Facilitating factors for engaging in the practice between-sessions seem meaningful.

Major Depression and the Perception of Affective Instrumental and Expressive Gestures: An fMRI Investigation

Major depressive disorder (MDD) is associated with biased perception of human movement. Gesture is important for communication and in this study we investigated neural correlates of gesture perception in MDD. We hypothesised different neural activity between individuals with MDD and typical individuals when viewing instrumental and expressive gestures that were negatively or positively valenced. Differences were expected in brain areas associated with gesture perception, including superior temporal, frontal, and emotion processing regions. We recruited 12 individuals with MDD and 12 typical controls matched on age, gender, and handedness. They viewed gestures displayed by stick figures while functional magnetic resonance imaging (fMRI) was performed. Results of a random effects three-way mixed ANOVA indicated that individuals with MDD had greater activity in the right claustrum compared to controls, regardless of gesture type or valence. Additionally, we observed main effects of gesture type and valence, regardless of group. Perceiving instrumental compared to expressive gestures was associated with greater activity in the left cuneus and left superior temporal gyrus, while perceiving negative compared to positive gestures was associated with greater activity in the right precuneus and right lingual gyrus. We also observed a two-way interaction between gesture type and valence in various brain regions.

Association between screen time and depressive symptoms in a sample of Chinese medical students: Mediator role of empathy

Medical students are at high risk of psychological subhealth under heavy stress with increasing screen time. This study aimed to explore the association between screen time and depressive symptoms and determine empathy as a mediating factor. In this cross-sectional study, a total of 945 medical students were surveyed, and 924 medical students were ultimately included after standard exclusion criteria. They reported their daily screen time and completed the Chinese version of the Jefferson Scale of Empathy-Student Version (JSE-S) and the Self-Rating Depression Scale (SDS). t tests and analysis of variance showed a significant difference in empathy and depressive symptoms by sex, stage, and screen time. The correlation analysis revealed that both affective and cognitive empathy have inverse associations with depressive symptoms. The mediation model confirmed that cognitive empathy played a positive mediating role between screen time and depressive symptoms, reducing the impact of screen time on depressive symptoms. Our study may add empirical evidence to prevent and intervene in depressive symptoms. These findings call for considering controlling screen time and enhancing cognitive empathy as interventions for medical students' depressive symptoms.

The sex differences in anhedonia in major depressive disorder: A resting-state fMRI study

OBJECTIVE

The external behavioural manifestations and internal neural mechanisms of anhedonia are sexually dimorphic. This study aimed to explore the sex differences in the regional brain neuroimaging features of anhedonia in the context of major depressive disorder (MDD).

METHOD

The resting-fMRI by applying amplitude of low-frequency fluctuation (ALFF) method was estimated in 414 patients with MDD (281 high anhedonia [HA], 133 low anhedonia [LA]) and 213 healthy controls (HC). The effects of two factors in patients with MDD were analysed using a 2 (sex: male, female) × 2 (group: HA, LA) ANOVA concerning the brain regions in which statistical differences were identified between patients with MDD and HC. We followed up with patients with HA at baseline, and 43 patients completed a second fMRI scan in remission. Paired t-test was performed to compare the ALFF values of anhedonia-related brain regions between the baseline and remission periods.

RESULTS

For the sex-by-group interaction, the bilateral insula, right hippocampus, right post cingulum cortex, and left putamen showed significant differences. Furthermore, the abnormally elevated ALFF values in anhedonia-related brain regions at baseline decreased in remission.

CONCLUSION

Our findings point to the fact that the females showed unique patterns of anhedonia-related brain activity compared to males, which may have clinical implications for interfering with the anhedonia symptoms in MDD. Using task fMRI, we can further examine the distinct characteristics between consumption anhedonia and anticipation anhedonia in MDD.

The role of sociability in social instability stress: Behavioral, neuroendocrine and monoaminergic effects

Extensive literature has reported a link between social stress and mental health. In this complex relationship, individual strategies for coping with social stress are thought to have a possible modulating effect, with sociability being a key factor. Despite the higher incidence of affective disorders in females and sex-related neurochemical differences, female populations have been understudied. The aim of the present study was, therefore, to analyze the behavioral, neuroendocrine, and neurochemical effects of stress in female OF1 mice, paying special attention to social connectedness (female mice with high vs low sociability). To this end, subjects were exposed to the Chronic Social Instability Stress (CSIS) model for four weeks. Although female mice exposed to CSIS had increased arousal, there was no evidence of depressive-like behavior. Neither did exposure to CSIS affect corticosterone levels, although it did increase the MR/GR ratio by decreasing GR expression. Female mice exposed to CSIS had higher noradrenaline and dopamine levels in the hippocampus and striatum respectively, with a lower monoaminergic turnover, resulting in an increased arousal. CSIS increased serotonin levels in both the hippocampus and striatum. Similarly, CSIS was found to reduce kynurenic acid, 3-HK, and IDO and iNOS enzyme levels in the hippocampus. Interestingly, the observed decrease in IDO synthesis and the increased serotonin and dopamine levels in the striatum were only found in subjects with high sociability. These highly sociable female mice also had significantly lower levels of noradrenaline in the striatum after CSIS application. Overall, our model has produced neuroendocrine and neurochemical but not behavioral changes, so it has not allowed us to study sociability in depth. Therefore, a model that induces both molecular and behavioral phenotypes should be applied to determine the role of sociability.

A re-introduction of the psychodynamic approach to the standard clinical psychology curriculum

OBJECTIVE

There is a strong evidence-base for a psychodynamic approach, supporting primary theoretical tenets as well as the treatment effectiveness. Additionally, there are increasing calls from the field for more individualized treatment for clients, and the lack of training in multiple orientations limits the ability of students in clinical psychology Ph.D. programs in the United States to personalize their treatments. The accumulated evidence-base for contemporary relational psychodynamic theory and therapy places it in good standing to return to the standard clinical psychology curriculum, along with other evidence-based approaches.

METHODS

We use data from the Insider's Guide (which describes clinical Ph.D. programs in the United States) from three time points over 20 years to document the waning psychodynamic approach in clinical psychology programs. We review the scientific evidence for four primary tenets of a contemporary psychodynamic approach: three related to development-from healthy to psychopathological: (1) unconscious processes; (2) internal representations of self and other; (3) dimensional model of psychopathology, and a fourth tenet that builds on these three and is the foundation for a contemporary psychodynamic approach to psychotherapy: (4) therapeutic relationship as a primary mechanism of change.

RESULTS/CONCLUSIONS

Based on the review of the evidence, we make specific recommendations for clinical psychology training programs about how to include a psychodynamic approach in the curriculum.

Interventions for deficits in recognition of emotions in facial expressions in major depressive disorder: An updated systematic review of clinical trials

The recognition of emotions in facial expressions (REFE) is a core construct of social cognition. In the last decades, studies have showed that REFE is altered in major depressive disorder (MDD), but the evidence is conflicting. Thus, we conducted a systematic review of clinical trials involving therapeutic interventions in MDD and any evaluation of REFE to update (2018-2023) and systematically evaluate the evidence derived from controlled clinical trials on the effects of therapeutic strategies to MDD on the REFE. Eleven studies were included in the final review. Some interventions, including drugs (ketamine, bupropion, psylocibin) and non-pharmacological strategies (psychotherapy) seem to be able to reduce pre-existing REFE biases in MDD patients. However, there was a high heterogeneity in the evaluated studies, in terms of sample, interventions, tasks and results. Further studies and more consistent evaluation tools are highly needed to better understand nuanced deficits and specific actions of different treatment options.

Hikikomori: A perspective from bibliometric analysis

AIMS

Hikikomori is a common phenomenon reported in Japan and many other countries. However, the broad trends of the research publications on hikikomori are unclear. Therefore, this study examined the patterns of research on hikikomori using bibliometric analysis.

METHODS

Relevant publications were searched in Web of Science. Bibliometric analyses were performed with CiteSpace, R and VOSviewer.

RESULTS

In total, 297 publications on hikikomori met the eligibility criteria. The International Journal of Social Psychiatry (IF = 10.461) published the most papers (K = 17, or 5.7%) on hikikomori. Takahiro A. Kato from Kyushu University (41; 13.8%; H-index = 18) was the most influential author, while Takahiro A. Kato (total link strength [TLS]: 235), Alan R. Teo (TLS: 157), and Masaru Tateno (TLS: 153) separately had the strongest research collaboration with other researchers. Of all countries that published on hikikomori, Japan had the highest number of publications (K = 91). The keywords "United States" and "psychiatric diagnosis" received the most attention between 2013 and 2015, whereas "health" and "autism spectrum disorder" received the most attention in 2021 and 2022.

CONCLUSIONS

Peer-reviewed research publications on hikikomori are growing rapidly and the research trends in this field are also changing.

Characterizing positive and negative valence systems function in adolescent depression: An RDoC-informed approach integrating multiple neural measures

Depression is a prevalent, debilitating, and costly disorder that often manifests in adolescence. There is an urgent need to understand core pathophysiological processes for depression to inform more targeted intervention efforts. The Research Domain Criteria (RDoC) Positive Valence Systems (PVS) and Negative Valence Systems (NVS) have both been implicated in depression symptomatology and vulnerability; however, the nature of NVS alterations is unclear across studies, and associations between single neural measures and symptoms are often small in magnitude and inconsistent. The present study advances characterization of depression in adolescence via an innovative data-driven approach to identifying subgroups of PVS and NVS function by integrating multiple neural measures (assessed by electroencephalogram [EEG]) relevant to depression in adolescents oversampled for clinical depression and depression risk based on maternal history (N = 129; 14-17 years old). Results of the k-means cluster analysis supported a two-cluster solution wherein one cluster was characterized by relatively attenuated reward and emotion responsiveness across valences and the other by relatively intact responsiveness. Youth in the attenuated responsiveness cluster reported significantly greater depressive symptoms and were more likely to have major depressive disorder diagnoses than youth in the intact responsiveness cluster. In contrast, associations of individual neural measures with depressive symptoms were non-significant. The present study highlights the importance of innovative neuroscience approaches to characterize emotional processing in depression across domains, which is imperative to advancing the clinical utility of RDoC-informed research.

Impaired social learning in patients with major depressive disorder revealed by a reinforcement learning model

Background/objective

Patients with major depressive disorder (MDD) have altered learning rates for rewards and losses in non-social learning paradigms. However, it is not well understood whether the ability to learn from social interactions is altered in MDD patients. Using reinforcement learning during the repeated Trust Game (rTG), we investigated how MDD patients learn to trust newly-met partners in MDD patients.

Method

Sixty-eight MDD patients and fifty-four controls each played as 'investor' and interacted with ten different partners. We manipulated both the level of trustworthiness by varying the chance of reciprocity (10, 30, 50, 70 and 90%) and reputation disclosure, where partners' reputation was either pre-disclosed or hidden.

Results

Our reinforcement learning model revealed that MDD patients had significantly higher learning rates for losses than the controls in both the reputation disclosure and non-disclosure condition. The difference was larger when reputation was not disclosed than disclosed. We observed no difference in learning rates for gains in either condition.

Conclusions

Our findings highlight that abnormal learning for losses underlies the social learning process in MDD patients. This abnormality is higher when situational unpredictability is high versus low. Our findings provide novel insights into social rehabilitation of MDD.

Which is More Important, Proposer Identity or Allocation Motive? Event-Related Potential in Economic Decision-Making

Purpose

Most studies have supported the view that individuals prefer to reward the in-group and discriminate against the out-group in response to unfair offers in the Ultimatum Game. However, the current study advanced a different view, that is, the "black sheep effect", in which in-group members were punished more severely compared with out-group members. This study aimed to incorporate proposer identity and allocation motive as possible explanations for offer rejection.

Methods

In the current study, the in-group and out-group identities were distinguished by their health condition, and the allocation motive was defined according to its benefit maximization. With a total of 89 healthy college student participants, a mixed design of 2 (proposer identity: out-group vs in-group) × 2 (allocation motive: selfish vs random) × 2 (offer type: unfair vs fair) was used in the Ultimatum Game. Event-related potential (ERP) technology was used, and ERPs were recorded while participants processed the task.

Results

The behavioral result showed that the "black sheep effect" was found on the fair offer when a random allocation motive was used. Our ERP result suggested that feedback-related negativity (FRN) and P300 were modulated by proposer identity but not by allocation motive. However, the allocation motive interacted with proposer identity affecting FRN and P300 when the fair offer was proposed.

Conclusion

These findings demonstrated that the "black sheep effect" was related to the experience of the out-group member, such as disadvantage or distress, but it was also modulated by allocation motive. Meanwhile, the out-group (depressed college students) captured more attention because they violated individual expectations, according to the P300. This finding plays an integral role in understanding the mechanism of response to the "black sheep effect".

Early Maladaptive Schemas and Schema Modes in clinical disorders: A systematic review

PURPOSE

Although schema therapy has been predominantly applied to treat personality disorders, interest into its application in other clinical disorders is growing. Central to schema therapy are Early Maladaptive Schemas (EMS) and Schema Modes. Since existing EMS and Schema Modes were primarily developed in the context of personality disorders, their relevance for clinical disorders is unclear.

METHODS

We conducted a systematic review of the presence of EMS and Schema Modes in clinical disorders according to DSM criteria. Per disorder, we evaluated which EMS and Schema Modes were more pronounced in comparison with clinical as well as non-clinical control groups and which EMS and Schema Modes were most highly endorsed within the disorder.

RESULTS

Although evidence concerning EMS was scarce for several disorders, and only few studies on Schema Modes survived inclusion criteria, we identified meaningful relationships and patterns for EMS and Schema Modes in various clinical disorders.

CONCLUSIONS

The present review highlights the relevance of EMS and Schema Modes for clinical disorders beyond personality disorders. Depending on the theme of the representation, EMS act as vulnerabilities both across diagnoses and for specific disorders. Thus, EMS and resulting Schema Modes are potential, valuable targets for the prevention and treatment of clinical disorders.

Event-related potentials during the ultimatum game in people with symptoms of depression and/or social anxiety

Depression and social anxiety are common disorders that have a profound impact on social functioning. The need for studying the neural substrates of social interactions in mental disorders using interactive tasks has been emphasized. The field of neuroeconomics, which combines neuroscience techniques and behavioral economics multiplayer tasks such as the Ultimatum Game (UG), can contribute in this direction. We assessed emotions, behavior, and Event-Related Potentials in participants with depression and/or social anxiety symptoms (MD/SA, n = 63, 57 females) and healthy controls (n = 72, 67 females), while they played the UG. In this task, participants received fair, mid-value, and unfair offers from other players. Mixed linear models were implemented to assess trial level changes in neural activity. The MD/SA group reported higher levels of sadness in response to mid-value and unfair offers compared to controls. In controls, the Medial Frontal Negativity associated with fair offers increased over time, while this dynamic was not observed in the MD/SA group. The MD/SA group showed a decreased P3/LPP in all offers, compared to controls. These results indicate an enhanced negative emotional response to unfairness in the MD/SA group. Neural results reveal a blunted response over time to positive social stimuli in the MD/SA group. Moreover, between-group differences in P3/LPP may relate to a reduced saliency of offers and/or to a reduced availability of resources for processing incoming stimuli in the MD/SA group. Findings may shed light into the neural substrates of social difficulties in these disorders.

Network modeling of major depressive disorder symptoms in adult women

BACKGROUND

Major depressive disorder (MDD) is one of the growing human mental health challenges facing the global health care system. In this study, the structural connectivity between symptoms of MDD is explored using two different network modeling approaches.

METHODS

Data are from 'the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD)'. A cohort of N = 2163 American Caucasian female-female twins was assessed as part of the VATSPSUD study. MDD symptoms were assessed using personal structured clinical interviews. Two network analyses were conducted. First, an undirected network model was estimated to explore the connectivity between the MDD symptoms. Then, using a Bayesian network, we computed a directed acyclic graph (DAG) to investigate possible directional relationships between symptoms.

RESULTS

Based on the results of the undirected network, the depressed mood symptom had the highest centrality value, indicating its importance in the overall network of MDD symptoms. Bayesian network analysis indicated that depressed mood emerged as a plausible driving symptom for activating other symptoms. These results are consistent with DSM-5 guidelines for MDD. Also, somatic weight and appetite symptoms appeared as the strongest connections in both networks.

CONCLUSIONS

We discuss how the findings of our study might help future research to detect clinically relevant symptoms and possible directional relationships between MDD symptoms defining major depression episodes, which would help identify potential tailored interventions. This is the first study to investigate the network structure of VATSPSUD data using both undirected and directed network models.

Unconscious and conscious acceptance downregulate aggressive behavior: Mediating role of anger regulation

Social exclusion can induce negative emotions and aggression. While previous studies have investigated the effect of trait acceptance on emotional experience and aggression during social exclusion, it is still unclear how different forms of acceptance strategy can downregulate negative emotions and whether this potential reduction of negative emotions should mediate the effect of acceptance on aggression. To address these questions, 100 participants were recruited and randomly divided into three groups: control group (CG, N = 33), conscious acceptance group (CAG, N = 33) and unconscious acceptance group (UAG, N = 34). Negative emotions were induced by the cyberball game and measured by the modified PANAS. Aggressive behavior was assessed by the hot sauce allocation task. Results showed that anger, rather than other negative emotions, mediated the effect of acceptance on aggressive behavior. Conscious and unconscious acceptance both effectively regulated anger, hurt feelings and aggressive behavior during social exclusion. Compared to conscious acceptance, unconscious acceptance was associated with less reduction of positive emotion and had a better effect on reducing sadness. These findings highlight the advantage of applying unconscious acceptance strategy to regulating social exclusion-induced emotions for the purpose of reducing aggressive behavior.

Distinct patterns of gene expression in the medial preoptic area are related to gregarious singing behavior in European starlings (Sturnus vulgaris)

BACKGROUND

Song performed in flocks by European starlings (Sturnus vulgaris), referred to here as gregarious song, is a non-sexual, social behavior performed by adult birds. Gregarious song is thought to be an intrinsically reinforced behavior facilitated by a low-stress, positive affective state that increases social cohesion within a flock. The medial preoptic area (mPOA) is a region known to have a role in the production of gregarious song. However, the neurochemical systems that potentially act within this region to regulate song remain largely unexplored. In this study, we used RNA sequencing to characterize patterns of gene expression in the mPOA of male and female starlings singing gregarious song to identify possibly novel neurotransmitter, neuromodulator, and hormonal pathways that may be involved in the production of gregarious song.

RESULTS

Differential gene expression analysis and rank rank hypergeometric analysis indicated that dopaminergic, cholinergic, and GABAergic systems were associated with the production of gregarious song, with multiple receptor genes (e.g., DRD2, DRD5, CHRM4, GABRD) upregulated in the mPOA of starlings who sang at high rates. Additionally, co-expression network analyses identified co-expressing gene clusters of glutamate signaling-related genes associated with song. One of these clusters contained five glutamate receptor genes and two glutamate scaffolding genes and was significantly enriched for genetic pathways involved in neurodevelopmental disorders associated with social deficits in humans. Two of these genes, GRIN1 and SHANK2, were positively correlated with performance of gregarious song.

CONCLUSIONS

This work provides new insights into the role of the mPOA in non-sexual, gregarious song in starlings and highlights candidate genes that may play a role in gregarious social interactions across vertebrates. The provided data will also allow other researchers to compare across species to identify conserved systems that regulate social behavior.

Depression severity is associated with reduced pleasantness of observed social touch and fewer current intimate touch experiences

Depression is associated with loss of pleasure in previously enjoyed activities and withdrawal from social interactions. Depression alters the perception of social cues, but it is currently unclear whether this extends to social touch. In the current cross-sectional study, we explored the association between depression severity, perceived pleasantness of observed social touch, and general longing for touch. For observed touch, we contrasted videos of slow touch (1-10cm/s), which optimally activates C tactile afferent nerve fibres and generally feels pleasant, with 'non-CT-optimal' touch (i.e., outside the 1-10cm/s range, commonly rated more neutral). We predicted that greater depression severity would be related to lower pleasantness ratings specifically for CT-optimal touch, and less longing for touch. N = 226 adults completed self-report measures of depression severity and longing for touch, and rated touch pleasantness for six videos depicting social touch at three velocities (3cm/s in the CT-optimal range, 0.5 and 30cm/s outside this range) and at two locations varying in CT innervation (palm vs. arm). We controlled for general anhedonia and individual differences in touch experiences and attitudes. Across touch locations, greater depression severity was associated with lower perceived pleasantness of touch, especially for the fastest non-CT-optimal (rather than the CT-optimal) velocity, contrary to our prediction. However, when grouping participants into probable vs. no/minimal depression, the probable depression group rated both the fastest non-CT-optimal and the CT-optimal velocity as less pleasant than did the no/minimal depression group. Overall, while depression was associated with perceived pleasantness of observed touch, this was not specific to CT-optimal touch. Furthermore, touch longing was not associated with depression severity. Instead, variance in depression symptoms was better explained by reduced levels of current intimate touch. Though the direction of causality is unclear, greater depression severity is related to lower pleasantness of observed social touch, and lower levels of current intimate touch.

Biobehavioral mechanisms underlying testosterone and mood relationships in peripubertal female adolescents

The pubertal transition is characterized by pronounced sex hormone fluctuation, refinement of affective neural circuitry, and an increased risk of depression in female adolescents. Sex hormones, including testosterone, exert modulatory effects on frontal-limbic brain networks and are associated with emotion dysregulation and depressive symptoms. Weekly changes in hormones predict affective symptoms in peripubertal female adolescents, particularly in the context of stress; however, the biobehavioral mechanisms underlying hormone change and mood relationships during the pubertal transition have yet to be determined and was the objective of the present study. Forty-three peripubertal female adolescents (ages 11-14) collected 8-weekly salivary hormone (estrone, testosterone) samples and mood assessments to evaluate hormone-mood relationships, followed by a biobehavioral testing session with psychosocial stress and EEG. Within-person correlations between weekly hormone changes and corresponding mood were performed to determine individual differences in mood sensitivity to weekly hormone change. Increased frontal theta activity indexing emotion reactivity, reduced cortisol reactivity, and reduced vagal efficiency predicted the strength of the relationship between testosterone and mood. Further, testosterone-sensitivity strength was associated with the enhancement of negative affect following stress testing. Results identify divergent frontal theta and stress responses as potential biobehavioral mechanisms underlying mood sensitivity to peripubertal testosterone fluctuation.

Resilience and self-compassion among persons with depressive disorders: Prerequisite for a positive mental health approach

Background

Treatment gap for common mental health problems, especially of the depressive disorders is consequential in developing countries like India. Positive mental health domains like resilience and self-compassion have been long hailed as protective factors against depression and viable for use in therapeutic aspects. The objectives were to find an association between resilience, self-compassion, and depression.

Methods

The study was conducted using a cross-sectional design among 75 respondents who were seeking treatment for major depressive disorders from a tertiary care center during the second wave of COVID-19. Three scales were administered online, namely Beck's Depression Inventory-II (BDI-II), Connor Davidson Resilience Scale (CD RISC-25), and Self-Compassion Scale-Short Form (SCS-SF). Spearman's rank correlation test, Chi-square with Fisher's exact test, and Kruskal Wallis H test were used to study the relationships and differences in average scores with respect to the severity of depression.

Results

Most of the respondents had moderate depressive features along with moderately high levels of resilience (CD RISC 25) and self-compassion (SCS-SF) scores. Resilience and self-compassion were found to have no significant relationship with respect to the severity of depression. There was a weakly positive correlation between resilience and self-compassion among those with moderate and severe depression.

Conclusion

Since the individuals with depression had higher scores on resilience and self-compassion, the levels of depression remained at moderate levels of severity despite the devastating impact of the second wave of COVID-19 in the Indian sub-continent. Results are to be interpreted with respect to psychosocial contexts arising during the COVID-19 pandemic. Mental health programs can incorporate the variables of resilience and self-compassion in intervention among individuals with depression which have likely been beneficial in their process of recovery.