An affective neuroscience model of boosting resilience in adults

Resilience phenotypes derived from an active inference account of allostasis

Within a theoretical framework of enactive allostasis, we explore active inference strategies for minimizing surprise to achieve resilience in dynamic environments. While individual differences and extrinsic protective factors traditionally account for variability in resilience trajectories following stressor exposure, the enactive model emphasizes the importance of the physical and social environment, specifically the "enactive niche," which is both shaped by and impacts organisms living in it, accounting for variable success in allostatic prediction and accommodation. Enactive allostasis infers or predicts states of the world to minimize surprise and maintain regulation after surprise, i.e., resilience. Action policies are selected in accordance with the inferred state of a dynamic environment; those actions concurrently shape one's environment, buffering against current and potential stressors. Through such inferential construction, multiple potential solutions exist for achieving stability within one's enactive niche. Spanning a range of adaptive resilience strategies, we propose four phenotypes-fragile, durable, resilient, and pro-entropic (PE)-each characterized by a constellation of genetic, epigenetic, developmental, experiential, and environmental factors. Biological regulatory outcomes range from allostatic (over)load in the fragile and durable phenotypes, to allostatic recovery in resilience, and theoretically to increasing allostatic accommodation or "growth" in the proposed PE phenotype. Awareness distinguishes phenotypes by minimizing allostatically demanding surprise and engenders the cognitive and behavioral flexibility empirically associated with resilience. We further propose a role for awareness in proactively shaping one's enactive niche to further minimize surprise. We conclude by exploring the mechanisms of phenotypic plasticity which may bolster individual resilience.

Cross-Species Framework for Emotional Well-Being and Brain Aging: Lessons From Behavioral Neuroscience

Importance

Emotional well-being (EWB) is an emerging therapeutic target for managing and preventing symptoms associated with Alzheimer disease and related dementias (ADRD). However, more research is needed to establish causal inferences between brain changes, EWB, and behavioral changes observed in typical aging and ADRD.

Observations

This article presents a framework for using a cross-species behavioral neuroscience approach to study EWB and brain aging, adopting a well-established biobehavioral model that highlights the reciprocal roles of brain changes, EWB, and ADRD symptoms. First, the challenges and opportunities in this field are reviewed. Then, a practical solution to improve comparability between animal and human studies is proposed.

Conclusions and Relevance

The goal is to draw comprehensive parallels and distinctions that could enhance the understanding of the mechanisms linking brain aging, EWB, and ADRD symptomatic disturbances across different species.

Improvement in coping skills from culturally-adapted digital CBT for Spanish-speaking Hispanics with substance use disorder: Secondary analysis of a randomized clinical trial

INTRODUCTION

Developing adaptive coping skills for avoiding substance use is a proposed treatment mechanism of cognitive behavioral therapy (CBT) for substance use disorder (SUD). However, the generalizability of research on treatment mechanisms of CBT for SUD is limited by the underrepresentation of racial/ethnic minorities in clinical trials. In a secondary analysis of clinical trial data, we tested whether a culturally-adapted digital CBT program for Hispanics ("Spanish CBT4CBT") improved the quality of coping skills for avoiding substance use. We also tested whether coping skills' quality was associated with reductions in primary substance use.

METHODS

Participants were Spanish-speaking Hispanic adults seeking outpatient treatment for SUD (n = 85; 68 % male; primary substance type: 36 % cannabis, 33 % alcohol, 26 % cocaine, 5 % other). They were randomized to 8 weeks of outpatient treatment as usual (TAU) or TAU + Spanish CBT4CBT and assessed for 6 months after treatment. The study conducted separate analyses for the full sample (n = 85) and for those who engaged in at least 5 treatment sessions ("treatment exposed"; n = 64). Daily substance use and coping skills' quality were assessed repeatedly during the treatment and follow-up periods. Bayesian mixed models for repeated measures tested hypotheses.

RESULTS

Among treatment-exposed participants, those receiving TAU + Spanish CBT4CBT improved the quality of coping skills more than TAU alone during the treatment period (b = 0.77; 95 % CI[0.08, 1.47]), but this difference was not detected during the follow-up period. In the full sample and treatment exposed subsample, participants with higher quality coping skills during the study reported less primary substance use (b = -0.67; 95 % CI[-1.08, -0.26]). Among treatment-exposed participants only, within-person increases in the quality of coping skills were associated with reductions in future primary substance use (b = -0.18; 95 % CI[-0.36, -0.01]).

CONCLUSIONS

Spanish-speaking Hispanics with SUD may improve the quality of their coping skills more when they are sufficiently exposed to a culturally-adapted digital CBT program during outpatient treatment. Coping skills' quality may be a mechanism of CBT for SUD among Hispanic populations. Spanish-speaking Hispanics' access to treatments that target mechanisms of behavior change may be expanded by digital therapeutics.

Effects of Savoring Meditation on Positive Emotions and Pain-Related Brain Function: A Mechanistic Randomized Controlled Trial in People With Rheumatoid Arthritis

Positive emotions are a promising target for intervention in chronic pain, but mixed findings across trials to date suggest that existing interventions may not be optimized to efficiently engage the target. The aim of the current pilot mechanistic randomized controlled trial was to test the effects of a positive emotion-enhancing intervention called Savoring Meditation on pain-related neural and behavioral targets in patients with rheumatoid arthritis. Participants included 44 patients with a physician-confirmed diagnosis of rheumatoid arthritis (n = 29 included in functional magnetic resonance imaging (fMRI) analyses), who were randomized to either Savoring Meditation or a Slow Breathing control. Both meditation interventions were brief (four 20-minute sessions). Self-report measures were collected pre-and post-intervention. An fMRI task was conducted at post-intervention, during which participants practiced the meditation technique on which they had been trained while exposed to non-painful and painful thermal stimuli. Savoring significantly reduced experimental pain intensity ratings relative to rest (P < .001). Savoring also increased cerebral blood flow in the ventromedial prefrontal cortex and increased connectivity between the ventromedial prefrontal cortex and caudate during noxious thermal stimulation relative to Slow Breathing (z = 2.3 voxelwise, false discovery rate cluster corrected P = .05). Participants in the Savoring condition also reported significantly increased positive emotions (ps < .05) and reduced anhedonic symptoms (P < .01) from pre- to post-intervention. These findings suggest that Savoring recruits reward-enhancing corticostriatal circuits in the face of pain, and future work should extend these findings to evaluate if these mechanisms of Savoring are associated with improved clinical pain outcomes in diverse patient populations. PERSPECTIVE: Savoring Meditation is a novel positive emotion-enhancing intervention designed for patients with chronic pain. The present findings provide preliminary evidence that Savoring Meditation is acutely analgesic, and engages neural and subjective emotional targets that are relevant to pain self-management. Future work should evaluate the clinical translation of these findings.

Insula-cortico-subcortical networks predict interoceptive awareness and stress resilience

BACKGROUND

Interoception, the neural sensing of visceral signals, and interoceptive awareness (IA), the conscious perception of interoception, are crucial for life survival functions and mental health. Resilience, the capacity to overcome adversity, has been associated with reduced interoceptive disturbances. Here, we sought evidence for our Insula Modular Active Control (IMAC) model that suggest that the insula, a brain region specialized in the processing of interoceptive information, realizes IA and contributes to resilience and mental health via cortico-subcortical connections.

METHODS

64 healthy participants (32 females; ages 18-34 years) answered questionnaires that assess IA and resilience. Mental health was evaluated with the Beck Depression Inventory II that assesses depressive mood. Participants also underwent a 15 minute resting-state functional resonance imaging session. Pearson correlations and mediation analyses were used to investigate the relationship between IA and resilience and their contributions to depressive mood. We then performed insula seed-based functional connectivity analyzes to identify insula networks involved in IA, resilience and depressive mood.

RESULTS

We first demonstrated that resilience mediates the relationship between IA and depressive mood. Second, shared and distinct intra-insula, insula-cortical and insula-subcortical networks were associated with IA, resilience and also predicted the degree of experienced depressive mood. Third, while resilience was associated with stronger insula-precuneus, insula-cerebellum and insula-prefrontal networks, IA was linked with stronger intra-insula, insula-striatum and insula-motor networks.

CONCLUSIONS

Our findings help understand the roles of insula-cortico-subcortical networks in IA and resilience. These results also highlight the potential use of insula networks as biomarkers for depression prediction.

Sleep Quality and Suicidal Ideation in Adolescent Depression: A Chain Mediation Effect of Perceived Social Support and Resilience

BACKGROUND

The prevalence of suicide is high among major depressive adolescents. Poor sleep quality has been documented as a significant risk factor for suicide, influencing perceived social support. Enhanced social support acts as a buffer against suicidal ideation and positively impacts resilience, reducing the prevalence of suicidal ideation. This reciprocal relationship between sleep quality, social support and resilience forms the basis for understanding the mechanisms contributing to suicidal ideation in major depressive adolescents.

METHODS

A total of 585 major depressive adolescents aged 11 to 24 years was conducted to explore these associations. Assessments included the Pittsburgh Sleep Quality Index, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and Beck Scale for Suicide Ideation. Pearson correlation and Model 6 in the SPSS program were employed for chain mediating tests.

RESULTS

Better sleep quality positively predicted decreased suicide ideation (β = 0.207, p < 0.01) and predicted lower perceived social support (β = -0.226, p < 0.01) and resilience (β = -0.355, p < 0.01). Perceived social support positively predicted increased resilience (β = 0.422, p < 0.01) and negatively predicted suicide ideation (β = -0.288, p < 0.01). Resilience negatively predicted suicide ideation (β = -0.187, p < 0.01). Sleep quality indirectly predicted suicide ideation through perceived social support and resilience, with a mediation value of 0.0678 (95% CI [0.0359, 0.1060]), constituting 10.65% of the total effect.

CONCLUSIONS

This study establishes that sleep quality indirectly predicts suicide ideation in major depressive adolescents, mediated independently by perceived social support and resilience.

A feasibility study of goal-directed network-based real-time fMRI neurofeedback for anhedonic depression

Anhedonia is a hallmark symptom of depression that often lacks adequate interventions. The translational gap remains in clinical treatments based on neural substrates of anhedonia. Our pilot study found that depressed individuals depended less on goal-directed (GD) reward learning (RL), with reduced reward prediction error (RPE) BOLD signal. Previous studies have found that anhedonia is related to abnormal activities and/or functional connectivities of the central executive network (CEN) and salience network (SN), both of which belong to the goal-directed system. In addition, it was found that real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) could improve the balance between CEN and SN in healthy individuals. Therefore, we speculate that rt-fMRI NF of the CEN and SN associated with the GD system may improve depressive and/or anhedonic symptoms. Therefore, this study (1) will examine individuals with anhedonic depression using GD-RL behavioral task, combined with functional magnetic resonance imaging and computational modeling to explore the role of CEN/SN deficits in anhedonic depression; and (2) will utilize network-based rt-fMRI NF to investigate whether it is feasible to regulate the differential signals of brain CEN/SN of GD system through rt-fMRI NF to alleviate depressive and/or anhedonic symptoms. This study highlights the need to elucidate the intervention effects of rt-fMRI NF and the underlying computational network neural mechanisms.

Engineering Virtuous health habits using Emotion and Neurocognition: Flexibility for Lifestyle Optimization and Weight management (EVEN FLOW)

Interventions to preserve functional independence in older adults are critically needed to optimize 'successful aging' among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals' ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting self-regulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of self-regulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to 'top-down' training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to 'bottom-up' approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands.

Female youth and mental health service providers' perspectives on the JoyPop™ app: a qualitative study

Introduction

Mobile health (mHealth) apps are a promising adjunct to traditional mental health services, especially in underserviced areas. Developed to foster resilience in youth, the JoyPop™ app has a growing evidence base showing improvement in emotion regulation and mental health symptoms among youth. However, whether this novel technology will be accepted among those using or providing mental health services remains unknown. This study aimed to evaluate the JoyPop™ app's acceptance among (a) a clinical sample of youth and (b) mental health service providers.

Method

A qualitative descriptive approach involving one-on-one semi-structured interviews was conducted. Interviews were guided by the Technology Acceptance Model and were analyzed using a deductive-inductive content analysis approach.

Results

All youth (n = 6 females; Mage = 14.60, range 12-17) found the app easy to learn and use and expressed positive feelings towards using the app. Youth found the app useful because it facilitated accessibility to helpful coping skills (e.g., journaling to express their emotions; breathing exercises to increase calmness) and positive mental health outcomes (e.g., increased relaxation and reduced stress). All service providers (n = 7 females; Mage = 43.75, range 32-60) perceived the app to be useful and easy to use by youth within their services and expressed positive feelings about integrating the app into usual care. Service providers also highlighted various organizational factors affecting the app's acceptance. Youth and service providers raised some concerns about apps in general and provided recommendations to improve the JoyPop™ app.

Discussion

Results support youth and service providers' acceptance of the JoyPop™ app and lend support for it as an adjunctive resource to traditional mental health services for youth with emotion regulation difficulties.

Role of hippocampus and orbitofrontal cortex in the association of interdependent self-construal with an acute stress response

Empirical evidence indicates that high interdependent self-construal (InterSC) is correlated with exaggerated acute stress responses; however, the underlying neural correlates remain unclear. Considering the regulatory effect of the prefrontal cortex and limbic system on the acute stress response, the primary aim of this study was to investigate the role of the orbitofrontal cortex (OFC) and hippocampus (HIP) in the relationship between InterSC and acute stress responses. Forty-eight healthy college students underwent a modified version of the Montreal imaging stress task (MIST), while brain activity was recorded using functional magnetic resonance imaging (fMRI). Participants' saliva samples and subjective stress feelings were collected before, during, and after the MIST. Additionally, participants' self-construal was measured using questionnaires. Results revealed that InterSC was positively correlated with the activation of OFC, which, in turn, was associated with higher subjective stress feelings. A higher InterSC was also significantly associated with an enhanced salivary cortisol response in those with lower HIP activity. Furthermore, the HIP moderated the indirect effect of InterSC on subjective stress feelings by moderating the effect of InterSC on neural activity in the OFC. This indicated the mediation of the OFC was stronger in those with higher neural activity in the HIP than in those with lower activity in the HIP. In summary, the current study proposed an important role of the OFC-HIP regions in the relationship between InterSC and acute stress responses, making contribution to broadening the field of personality and stress and deepening our understanding of individual differences in acute stress responses.

Effects of Savoring Meditation on Positive Emotions and Pain-Related Brain Function: A Mechanistic Randomized Controlled Trial in People With Rheumatoid Arthritis

Positive emotions are a promising target for intervention in chronic pain, but mixed findings across trials to date suggest that existing interventions may not be optimized to efficiently engage the target. The aim of the current mechanistic randomized controlled trial was to test the effects of a single skill positive emotion-enhancing intervention called Savoring Meditation on pain-related neural and behavioral targets in patients with rheumatoid arthritis (RA). Participants included 44 patients with a physician-confirmed diagnosis of RA (n=29 included in fMRI analyses), who were randomized to either Savoring Meditation or a Slow Breathing control. Both meditation interventions were brief (four 20-minute sessions). Self-report measures were collected pre- and post-intervention. An fMRI task was conducted at post-intervention, during which participants practiced the meditation technique on which they had been trained while exposed to non-painful and painful thermal stimuli. Relative to Slow Breathing, Savoring significantly reduced experimental pain intensity ratings relative to rest (p<.001), increased cerebral blood flow in the ventromedial prefrontal cortex (vmPFC) and increased connectivity between the vmPFC and caudate during noxious thermal stimulation (z=2.3 voxelwise, FDR cluster corrected p=0.05). Participants in the Savoring condition also reported significantly increased positive emotions (ps<.05) and reduced anhedonic symptoms (p<.01) from pre- to post-intervention. These findings suggest that that Savoring recruits reward-enhancing corticostriatal circuits in the face of pain, and future work should extend these findings to evaluate if these mechanisms of Savoring are associated with improved clinical pain outcomes in diverse patient populations.

Negative affect and craving during abstinence from smoking are both linked to default mode network connectivity

BACKGROUND

Negative affect and craving during abstinence from cigarettes predict resumption of smoking. Therefore, understanding their neural substrates may guide development of new interventions. Negative affect and craving have traditionally been linked to functions of the brain's threat and reward networks, respectively. However, given the role of default mode network (DMN), particularly the posterior cingulate cortex (PCC), in self-related thought, we examined whether DMN activity underlies both craving and negative affective states in adults who smoke.

METHODS

46 adults who smoke abstained from smoking overnight and underwent resting-state fMRI, after self-reporting their psychological symptoms (negative affect) and craving on the Shiffman-Jarvik Withdrawal Scale and state anxiety (negative affect) on the Spielberger State-Trait Anxiety Inventory. Within-DMN functional connectivity using 3 different anterior PCC seeds was tested for correlations with self-report measures. Additionally, independent component analysis with dual regression was performed to measure associations of self-report with whole-brain connectivity of the DMN component.

RESULTS

Craving correlated positively with connectivity of all three anterior PCC seeds with posterior PCC clusters (pcorr<0.04). The measures of negative affective states correlated positively with connectivity of the DMN component to various brain regions, including posterior PCC (pcorr=0.02) and striatum (pcorr<0.008). Craving and state anxiety were correlated with connectivity of an overlapping region of PCC (pcorr=0.003). Unlike the state measures, nicotine dependence and trait anxiety were not associated with PCC connectivity within DMN.

CONCLUSIONS

Although negative affect and craving are distinct subjective states, they appear to share a common neural pathway within the DMN, particularly involving the PCC.

The mediating role of default mode network during meaning-making aroused by mental simulation between stressful events and stress-related growth: a task fMRI study

BACKGROUND

Stressful events and meaning-making toward them play an important role in adolescents' life and growth. However, ignoring positive stressful events leads to negativity bias; further, the neural mechanisms of meaning-making are unclear. We aimed to verify the mediating role of meaning-making in stressful events and stress-related growth and the function of the default mode network (DMN) during meaning-making in this functional magnetic resonance imaging (fMRI) study.

METHODS

Participants comprised 59 university students. Stressful life events, meaning-making, and stress-related growth were assessed at baseline, followed by fMRI scanning during a meaning-making task aroused by mental simulation. General linear modeling and psychophysiological interaction (PPI) analyses were used to explore the activation and functional connectivity of DMN during meaning-making.

RESULTS

Mental simulation triggered meaning-making, and DMN activity decreased during meaning-making. Activation of the DMN was negatively correlated with coping flexibility, an indicator of stress-related growth. PPI analysis showed that meaning-making was accompanied by diminished connectivity in the DMN. DMN activation during meaning-making can mediate the relationship between positive stressful events and coping flexibility.

CONCLUSIONS

Decreased DMN activity and diminished functional connectivity in the DMN occurred during meaning-making. Activation of the DMN during meaning-making could mediate the relationship between positive stressful events and stress-related growth, which provides a cognitive neural basis for the mediating role of meaning-making in the relationship between stressful events and indicators of stress-related growth.

IMPLICATIONS

This study supports the idea that prosperity makes heroes, expands the meaning-making model, and suggests the inclusion of enhancing personal resources and meaning-making in education. This study was the first to validate the activation pattern and functional connectivity of the DMN during meaning-making aroused by mental simulation using an fMRI task-state examination, which can enhance our sense of meaning and provide knowledge that can be used in clinical psychology interventions.

TRIAL REGISTRATION

The study protocol was pre-registered in Open Science Framework (see osf.io/ahm6e for details).

The role of the prefrontal cortex in social interactions of animal models and the implications for autism spectrum disorder

Social interaction is a complex behavior which requires the individual to integrate various internal processes, such as social motivation, social recognition, salience, reward, and emotional state, as well as external cues informing the individual of others' behavior, emotional state and social rank. This complex phenotype is susceptible to disruption in humans affected by neurodevelopmental and psychiatric disorders, including autism spectrum disorder (ASD). Multiple pieces of convergent evidence collected from studies of humans and rodents suggest that the prefrontal cortex (PFC) plays a pivotal role in social interactions, serving as a hub for motivation, affiliation, empathy, and social hierarchy. Indeed, disruption of the PFC circuitry results in social behavior deficits symptomatic of ASD. Here, we review this evidence and describe various ethologically relevant social behavior tasks which could be employed with rodent models to study the role of the PFC in social interactions. We also discuss the evidence linking the PFC to pathologies associated with ASD. Finally, we address specific questions regarding mechanisms employed by the PFC circuitry that may result in atypical social interactions in rodent models, which future studies should address.

NASA resilience and leadership: examining the phenomenon of awe

This study examines how a phenomenon, awe, along with related resilience practices, is perceived by a NASA medical and mental health professional, who also serves in a leadership role, and how awe has impacted their work and personal life. Considering both their leadership role and how their work involves supporting the wellbeing of astronauts pre-mission, during missions, and post-mission, the potential impact of awe on the NASA expert has individual implications along with many others, especially in stressful environments. The results indicate that reflecting on awe experiences can support a person finding meaning and purpose in their life, evoke gratitude, increase social connectedness, promote optimism and other resilience skills in the moment, and generally have a sustainable positive effect.

Parenting Styles and Psychological Resilience: The Mediating Role of Error Monitoring

Parenting styles are associated with children's psychological resilience. However, the underlying mechanisms of this have not been investigated. Parenting styles influence how individuals respond to self-inflicted errors, and error monitoring is related to psychological resilience. Therefore, this study proposed that error monitoring might be a bridging factor between parenting styles and psychological resilience. Seventy-two young healthy adults were recruited for this study. Parenting styles were assessed using the Parental Bonding Instrument, and psychological resilience was measured using the Connor-Davidson Resilience Scale. Error monitoring was investigated in the Flanker task using event-related potentials (ERPs), and two error-related components of ERPs were measured: error-related negativity (ERN) and error positivity. Mediation analyses showed that the ERN partially mediated the relationship between parenting styles and psychological resilience. Specifically, a higher level of self-reported parental overprotection was related to larger ERN amplitude, which in turn was associated with lower psychological resilience. Additionally, a higher level of self-reported parental allowance of autonomy was related to lower ERN amplitude, which in turn was linked to higher psychological resilience. These results suggest that shaping children's sensitivity in early automatic error detection is one possible mechanism through which parental styles influence their psychological resilience.

Hostage negotiator resilience: A phenomenological study of awe

Law enforcement crisis and hostage negotiators (CHNs) are tasked with resolving incidents that are stressful, unpredictable, and often dangerous. These negotiators must work as a team and be able to successfully utilize a variety of skills in order to gain the subject's voluntary compliance and peaceful surrender. It is necessary for negotiators to continually practice these skills while also, and importantly, care for their own wellbeing. This study examines how a phenomenon, awe, when viewed as a resilience practice, can support law enforcement crisis hostage negotiators with their crisis work and personal wellness. Utilizing phenomenological methodologies, the findings demonstrate that reflecting on awe experiences had an overall positive impact on the negotiators in both their professional and personal lives. Based on the results, it is suggested that awe practices could be incorporated into future negotiator trainings in order to increase resilience and assist negotiators personally and professionally.

Network analysis of affect, emotion regulation, psychological capital, and resilience among Chinese males during the late stage of the COVID-19 pandemic

Background

Previous studies have confirmed that both affect and emotion regulation strategies are closely associated with psychological capital (PsyCap) and resilience. These factors are assumed to buffer the effect of the COVID-19 pandemic on mental health, especially among males. However, these interactions have not been closely examined to date. To fill this gap, this paper explores the dimension-level relationships of these psychological constructs among Chinese males during the late stage of the COVID-19 pandemic and identified critical bridge dimensions using network analysis.

Methods

A total of 1,490 Chinese males aged 21-51 years completed self-report scales assessing emotion regulation strategies, affect, PsyCap, and psychological resilience. Two regularized partial correlation networks, namely the affect and emotion regulation-PsyCap network and the affect and emotion regulation-psychological resilience network, were then constructed to examine links between the dimensions of these constructs. The bridge expected influence (BEI) index was also calculated for each node to identify important bridge nodes.

Results

Positive affect, negative affect, cognitive reappraisal, and expressive suppression showed distinct and complex links to various dimensions of PsyCap or psychological resilience. In both networks, positive affect, cognitive reappraisal, and negative affect were identified as critical bridge nodes, with the first two having positive BEI values and the third having a negative value.

Conclusion

The findings elucidate the specific role of the dimensions of emotion regulation or affect in relation to PsyCap and psychological resilience, which facilitates further understanding of the mechanisms underlying these interrelationships. These findings also provide implications for developing effective intervention strategies to increase PsyCap and psychological resilience.

Social support enhances the mediating effect of psychological resilience on the relationship between life satisfaction and depressive symptom severity

Psychosocial factors, including life satisfaction, resilience, and social support, have been proposed to influence depressive symptom severity in adults because the age of onset of depressive disorders, i.e. adolescence to early adulthood, is associated with various impairments in psychosocial functioning. In this study, a psychosocial model was constructed to verify these relationships to prevent depression. For this study, 370 participants were recruited from the community via poster or online advertisements. They completed several questionnaires to assess depressive symptom severity: the Connor-Davidson Resilience Scale (CD-RISC), Satisfaction with Life Scale (SwLS), Peace of Mind (PoM) scale, Social Support Questionnaire (SSQ), and Beck Depression Inventory (BDI-II). A negative association was found between depressive symptom severity and all other variables, including PoM and CD-RISC scores, life satisfaction, and social support. Such factors can be considered protective against increased depressive symptom severity. In addition, indirect effects of PoM and resilience on the negative association between SwLS scores and depressive symptom severity were observed. Moreover, social support was found to mediate the correlation between PoM and resilience, implying that social support mediates the relationship between state of mind and resilience. The psychosocial model suggested that depressive symptom severity is influenced by internal factors (an individual's state of mind, subjective view of events and their life) and external factors (including social support).

Blunted reward responsiveness prospectively predicts emotional distress when exposed to a naturalistic stressor

Both stress and blunted reward responsiveness have been identified as core risk factors of depression. Whether blunted reward responsiveness increases psychological vulnerability to real-life stress from a dynamic perspective (from stress reactivity to recovery) has not been investigated. By utilizing a real-world stressful event (i.e. the final examination), this study aimed to explore the role of reward responsiveness in the stress-emotional distress relationship during stress reactivity and recovery phases. We followed 57 undergraduates with three assessments, from six weeks before examination weeks (T1, baseline), one day before the examinations (T2) to two weeks after the examinations (T3), therefore, covering stress reactivity (T1 to T2) and recovery (T2 to T3) phases. At baseline, reward responsiveness was measured as the Reward Positivity (RewP) in the doors task. Stress and emotional distress (anxiety and depression) were reported at T1, T2 and T3 to capture their dynamic changes. Results showed that self-report stress levels significantly increased from T1 to T2 (stress reactivity phase) and decreased from T2 to T3 (stress recovery phase). Furthermore, blunted reward responsiveness at baseline prospectively predicted emotional distress during the stress reactivity phase but not the recovery phase. Specifically, during the stress reactivity phase, higher perceived stress was associated with greater anxiety and depression only in participants with relatively smaller residual RewP amplitudes but not in participants with relatively larger residual RewP amplitudes. Our study demonstrated that a blunted reward responsiveness is a vulnerable factor of depression, especially when exposed to stress. Our findings provide insights into prevention and intervention for stress-related disturbance.

Adaption and validation of the Perceived Control of Internal States Scale (PCOISS) in Chinese adults: a cross-sectional study

BACKGROUND

Perceived control of internal states is important for disease prevention, stress buffering and life adaptability. However, there is no psychometric scale to measure control beliefs over internal states in China. This study aimed to adapt and validate the Perceived Control of Internal States Scale (PCOISS) in a large sample of Chinese adults.

METHODS

Data was collected through a big project, in which a cross-sectional online survey was conducted nationwide in China using a powerful Chinese online survey platform named WenJuanXing ( https://www.wjx.cn/ ). We translated the PCOISS into Chinese (C-PCOISS) with the forward-backward translation procedure. For the first time of the survey, a sample of 2709 participants (Sample 1) was valid for final analysis. Sample 1 was split into two datasets for principal component analysis (PCA) (n_A = 1355) and confirmatory factor analyses (CFA) (n_B = 1354) to determine potential factor structure. The scale's validity (i.e., discriminant validity, convergent validity, criterion validity) and internal consistency reliability were evaluated. Among the 1354 respondents (n_B), 761 (n_C = 761) participated in the follow-up second wave of the survey to assess a cross-sectional test-retest reliability.

RESULTS

The C-PCOISS retained 14 items. PCA yielded a three-factor model which was supported with the best fit indices in CFA. The C-PCOISS had satisfactory internal consistency with Cronbach's alpha coefficients of 0.86, 0.78 and 0.72 for three subscales, respectively. The scale also showed adequate test-retest reliability (Pearson correlations coefficient of 0.64, 0.62 and 0.54 with p < 0.001 for three subscales, respectively). Three factors of the C-PCOISS were positively associated with positive affect, and negatively associated with negative affect, depression, compulsion-anxiety and perceived stress.

CONCLUSIONS

The C-PCOISS is reliable and valid for measuring control beliefs over internal states in Chinese adults.

First few seconds for flow: A comprehensive proposal of the neurobiology and neurodynamics of state onset

Flow is a cognitive state that manifests when there is complete attentional absorption while performing a task. Flow occurs when certain internal as well as external conditions are present, including intense concentration, a sense of control, feedback, and a balance between the challenge of the task and the relevant skillset. Phenomenologically, flow is accompanied by a loss of self-consciousness, seamless integration of action and awareness, and acute changes in time perception. Research has begun to uncover some of the neurophysiological correlates of flow, as well as some of the state's neuromodulatory processes. We comprehensively review this work and consider the neurodynamics of the onset of the state, considering large-scale brain networks, as well as dopaminergic, noradrenergic, and endocannabinoid systems. To accomplish this, we outline an evidence-based hypothetical situation, and consider the flow state in a broader context including other profound alterations in consciousness, such as the psychedelic state and the state of traumatic stress that can induce PTSD. We present a broad theoretical framework which may motivate future testable hypotheses.

Affective Attitudes in the Face of the COVID-19 Pandemic: The Dynamics of Negative Emotions and a Sense of Threat in Poles in the First Wave of the Pandemic

For millions of people, the COVID-19 pandemic situation and its accompanying restrictions have been a source of threat and confrontation with negative emotions. The pandemic's universal and long-term character, as well as the ensuing drastic limitation of control over one's life, have made it necessary to work out adaptive strategies that would reduce negative experiences and eventually lead to the restoration of well-being. The aim of this research was to identify strategies that people use in response to a long-term threat that restore affective balance and a subjective sense of security. We registered selected manifestations of affective reactions to the pandemic situation. The researchers focused on the dynamics of changes in the areas of (1) experienced negative emotions (asked in an indirect way) and (2) a subjective feeling of threat regarding the pandemic (in three different contexts: Poland, Europe, and worldwide) during the first phase of the pandemic in Poland. It was expected that both the negative emotions and the sense of threat would decrease with time. In addition, it was anticipated that the physical distance would modify the assessment of the situation as threatening depending on the geographical proximity: in Poland, Europe, and worldwide. We used the mixed quasi-experimental design in the series of four studies conducted by Internet in March, May, June, and July 2020. The intensity of negative emotions and the sense of threat caused by the pandemic situation in Poland, Europe, and worldwide were measured. Despite the objective number of confirmed COVID-19 cases during each of the stages of the study, both the intensity of emotions attributed by participants as well as the feeling of threat were found to have decreased. In addition, surprisingly, a reversed effect of the distance was revealed: namely, a sense of threat experienced towards distant locations (Europe and the world) was found to be more acute when compared with the threat experienced in Poland. The obtained results are interpreted as a manifestation of adaptive perception of the threat that lies beyond one's control, which takes the form of unconscious, biased distortions: unrealistic optimism. The decrease in the intensity of negative emotions explains unrealistic absolute optimism, while the perception of the situation in Poland as less threatening than in Europe and around the world is predicted by unrealistic comparative optimism.

Neurocognitive correlates of psychological resilience: Event-related potential studies

BACKGROUND

There is a growing interest in exploring the neurocognitive mechanisms that may underlie psychological resilience. However, how the bottom-up automatic information processing relates to trait resilience has received less attention. We aimed to explore the relationship between trait resilience and trait-like automatic information processing in healthy adults.

METHODS

Eighty-four healthy adults were recruited to explore whether and how resilience was related to sensory sensitivity by event-related potentials (ERPs). Resilience was measured by Connor-Davidson Resilience Scale (CD-RISC). Sensory sensitivity, more specifically, sensitivity of automatic mismatch detection was measured by two ERPs components, i.e., the mismatch negativity (MMN) with a passive auditory oddball paradigm and the error-related negativity (ERN) with an auditory Go/NoGo task. Using the multiple linear regression analyses, the relationship between self-reported resilience and the sensitivity of automatic mismatch detection (MMN/ERN amplitude/latency) was explored.

RESULTS

The results showed that psychological resilience was positively correlated with both MMN and ERN latencies, i.e., higher resilience scores were associated with delayed MMN and ERN latencies. However, resilience was not significantly correlated with MMN and ERN amplitudes.

CONCLUSIONS

Our results suggested that relatively higher resilience might link with less sensory sensitivity as reflected by slower automatic detection to mismatch information in the environment.

Reward sensitivity modulates the brain reward pathway in stress resilience via the inherent neuroendocrine system

In the previous 10 years, researchers have suggested a critical role for the brain reward system in stress resilience. However, no study has provided an empirical link between activity in the mesostriatal reward regions during stress and the recovery of cortisol stress response. Moreover, although reward sensitivity as a trait has been demonstrated to promote stress resilience, it remains unclear whether it modulates the brain reward system in stress resilience and how this effect is achieved by the inherent neuroendocrine system. To investigate these uncertainties, 70 young adults were recruited to participate in a ScanSTRESS task, and their brain imaging data and saliva samples (for cortisol assay) were collected during the task. In addition, we assessed reward sensitivity, cortisol awakening response, and intrinsic functional connectivity of the brain in all the participants. We found that left putamen activation during stress exposure positively predicted cortisol recovery. In addition, reward sensitivity was positively linked with activation of the left putamen, and this relationship was serially mediated by the cortisol awakening response and right hippocampus-left inferior frontal gyrus intrinsic connectivity. These findings suggest that reward sensitivity modulates reward pathways in stress resilience through the interplay of the diurnal stress response system and network of the hippocampus-prefrontal circuitry. Summarily, the current study built a model to highlight the dynamic and multifaceted interaction between pertinent allostatic factors in the reward-resilience pathway and uncovered new insight into the resilience function of the mesostriatal reward system during stress.

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Cortisol recovery can be predicted by activation of the left putamen in stress.

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Activation of the left putamen was positively linked with reward sensitivity.

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This relationship was serially mediated by the cortisol awakening response and right hippocampus-left inferior frontal gyrus intrinsic coupling.

Trait coping styles and the maternal neural and behavioral sensitivity to an infant

During the postpartum period, new mothers experience drastic changes in their body, brain, and life circumstances. Stress from the emotional and physical demands of caring for an infant is associated with negative mood and parenting outcomes. The use of active coping strategies can increase mothers’ resilience during the postpartum period. However, little is known about the association between coping styles and maternal brain responses to infant cues. In the current study, we examined the associations among trait coping style, maternal brain responses, and behavioral sensitivity in a socioeconomically diverse sample of first-time mothers (N = 59). The use of more active trait coping strategies compared to passive coping strategies was associated with increased brain responses to infant cry sounds in brain regions that are critically involved in motivation and emotion regulation—substantia nigra, anterior cingulate gyrus, and inferior frontal gyrus. Increased brain activations in the midbrain and anterior cingulate gyrus were further associated with higher levels of maternal sensitivity observed during interactions with the infant. Thus, the findings provide support for mothers’ use of more active coping styles to promote neural and behavioral resilience for a positive transition to parenthood.

The Relationship between Self-Concept and Negative Emotion: A Moderated Mediation Model

Background: Emotional problems such as depression and anxiety are very serious among college students, especially during the COVID-2019 pandemic. The present study aimed to explore the mediating role of resilience in the relationship between self-concept and negative emotion, and the moderating role of exercise intensity in the direct and indirect effect of self-concept on negative emotion among college students. Methods: A total of 739 Chinese college students aged between 18 and 25 years (M = 20.13; SD = 1.67) were selected to complete the Tennessee Self-Concept Scale (TSCS), the Depression Anxiety Stress Self Rating Scale, the Adolescent Psychological Resilience Scale, and the Physical Exercise Scale (PARS-3) to assess self-concept, negative emotions, psychological resilience, and exercise intensity, respectively. Hayes' PROCESS macro for SPSS was used to test the relationships among these variables. Results: Self-concept was negatively correlated with negative emotions; psychological resilience partially mediated the association between self-concept and negative emotions; exercise intensity moderated the effect of self-concept on negative emotions, and college students with low intensity physical activity would strengthening the association between self-concept and psychological resilience, psychological resilience, and negative emotions. Conclusions: Psychological resilience is a critical mediating mechanism through which self-concept is associated with negative emotions among college students, and exercise intensity plays a role as a moderating variable in the direct and indirect influence of self-concept on negative emotions. Implications for preventing or reducing negative emotions are discussed.

A corticostriatal pathway mediating self-efficacy enhancement

Forming positive beliefs about one's ability to perform challenging tasks, often termed self-efficacy, is fundamental to motivation and emotional well-being. Self-efficacy crucially depends on positive social feedback, yet people differ in the degree to which they integrate such feedback into self-beliefs (i.e., positive bias). While diminished positive bias of this sort is linked to mood and anxiety, the neural processes by which positive feedback on public performance enhances self-efficacy remain unclear. To address this, we conducted a behavioral and fMRI study wherein participants delivered a public speech and received fictitious positive and neutral feedback on their performance in the MRI scanner. Before and after receiving feedback, participants evaluated their actual and expected performance. We found that reduced positive bias in updating self-efficacy based on positive social feedback associated with a psychopathological dimension reflecting symptoms of anxiety, depression, and low self-esteem. Analysis of brain encoding of social feedback showed that a positive self-efficacy update bias associated with a stronger reward-related response in the ventral striatum (VS) and stronger coupling of the VS with a temporoparietal region involved in self-processing. Together, our findings demarcate a corticostriatal circuit that promotes positive bias in self-efficacy updating based on social feedback, and highlight the centrality of such bias to emotional well-being.

Emerging ecophenotype: reward anticipation is linked to high-risk behaviours after sexual abuse

Adolescents frequently engage in high-risk behaviours (HRB) following childhood sexual abuse (CSA). Aberrant reward processes are implicated in HRB, and their underlying fronto-striatal networks are vulnerable to neurodevelopmental changes during adversity representing a promising candidate for understanding links between CSA and HRB. We examined whether fronto-striatal responses during reward anticipation and feedback (i) are altered in depressed adolescents with CSA compared to depressed, non-abused peers and (ii) moderate the relationship between CSA and HRB irrespective of depression. Forty-eight female adolescents {14 with CSA and depression [CSA +  major depressive disorder (MDD)]; 17 with MDD but no CSA (MDD); 17 healthy, non-abused controls} completed a monetary reward task during functional magnetic resonance imaging. No differences in fronto-striatal response to reward emerged between CSA + MDD and MDD. Critically, high left nucleus accumbens activation during reward anticipation was associated with greater HRB in CSA + MDD compared to MDD and controls. Low left putamen activation during reward feedback was associated with the absence of HRB in CSA + MDD compared to MDD. Striatal reward responses appear to play a key role in HRB for adolescents with CSA irrespective of depression, providing initial support for a CSA ecophenotype. Such information is pivotal to identify at-risk youth and prevent HRB in adolescents after CSA.

Awe Narratives: A Mindfulness Practice to Enhance Resilience and Wellbeing

It is necessary to have available a variety of evidence-based resilience practices as we experience life’s stressors including the ongoing COVID-19 pandemic. Evoking, experiencing, and reflecting on awe moments by developing and sharing an “awe narrative” are a type of mindfulness technique that can have the potential to help someone flourish, enhance their resilience, and have a positive impact on their overall wellbeing. This paper explores how constructing an awe narrative can assist the individual while also possibly having a positive impact on others.

Emotion Regulation as a Pathway Connecting Early Life Adversity and Inflammation in Adulthood: a Conceptual Framework

Chronic inflammation is implicated in a variety of diseases (e.g., cardiovascular disease and cancer). Much evidence suggests that early life adversity (ELA), such as maltreatment or neglect, can increase risk for inflammation in adulthood. ELA may program proinflammatory activity via its effects on brain areas involved in emotion regulation. Of multiple emotion regulation strategies, some are considered maladaptive (e.g., expressive suppression), while others are generally adaptive (e.g., cognitive reappraisal). We propose a conceptual framework for how emotion regulation tendencies may affect vulnerability or resilience to inflammation in adults who experienced adversity in childhood and/or adolescence. In support of this framework, we summarize evidence for the relationships between emotion dysregulation and higher inflammation (i.e., vulnerability), as well as between cognitive reappraisal and lower inflammation (i.e., resilience), in healthy adults with a history of ELA. Plausible neurobiological, physiological, psychosocial, and ELA-specific factors, as well as interventions, contributing to these associations are discussed. Strengths and limitations of the extant research, in addition to ideas for future directions, are presented.

Mindfulness-Based Interventions and Body Awareness

Body awareness (BA) has long been proposed as a working mechanism of mindfulness-based interventions (MBIs), yet research on the mediating role of BA is scarce. Hence, the present study assesses the impact of an 8-week MBI on self-reported and indirect measures of BA, investigates the potential mediating role of BA in the relationship between an MBI and symptomatology, evaluates the impact of an MBI on important psychological processes (i.e., experiential avoidance, rumination, self-efficacy, and self-discrepancy), and explores whether these variables act alongside BA in mediating the relationship between an MBI and symptomatology. A non-randomized controlled trial was conducted with 148 participants (n = 89 in the MBI group; n = 59 in the control group) who completed questionnaires assessing BA and the above-mentioned psychological processes before and after an MBI. A sub-sample of participants (n = 86) completed a task that evaluates BA indirectly. Results showed a significant effect of MBI on the self-reported BA but not on the indirect measure of BA. The MBI significantly reduced symptomatology, and this effect was mediated by regulatory and belief-related dimensions of BA. Multiple mediator models showed a significant mediation via various pathways involving improved BA and various transdiagnostic psychological processes.

Resilience: a mediator of the negative effects of pandemic-related stress on women's mental health in the USA

The role of resilience in mediating the negative effects of the COVID-19 pandemic on the mental health of US women is poorly understood. We examined socioeconomic factors associated with low resilience in women, the relationship of low resilience with psychiatric morbidity, and the mediating role of resilience in the relationship between pandemic-related stress and other coincident psychiatric morbidities. Using a quota-based sample from a national panel, we conducted a web-based survey of 3200 US women in April 2020. Weighted, multivariate logistic regression was used to model the odds of pandemic-related stress, and coincident depression and anxiety symptoms among those with and without low resilience. Structural equation modeling was used to evaluate resilience as a mediator of the relationship between pandemic-related stress and other coincident psychiatric morbidities. Risk factors for low resilience included younger age, lower household income, lower education, unemployment, East/Southeast Asian race, unmarried/unpartnered status, and higher number of medical comorbidities. Low resilience was significantly associated with greater odds of depression symptoms (OR = 3.78, 95% CI [3.10-4.60]), anxiety symptoms (OR = 4.17, 95% CI [3.40-5.11]), and pandemic-related stress (OR = 2.86, 95% CI [2.26-3.26]). Resilience acted as a partial mediator in the association between pandemic-related stress and anxiety symptoms (proportion mediated = 0.23) and depression symptoms (proportion mediated = 0.28). In the early days of the COVID-19 pandemic, low resilience mediated the association between pandemic-related stress and psychiatric morbidity. Strategies proven to enhance resilience, such as cognitive behavioral therapy, mindfulness-based stress reduction, and addressing socioeconomic factors, may help mitigate mental health outcomes.

The impact of emotion regulation and mental health difficulties on health behaviours during COVID19

The COVID-19 outbreak is having a profound impact on individuals' psychological and physical wellbeing. The aim of this study was to assess the extent of this impact and its mechanisms on a sample of adults living in Italy during the first lockdown (April-May 2020). Two hundred ninety-two individuals (67.1% females) were recruited from the community through social media. They completed baseline online questionnaires to collect demographic information, data on past and present general health and health behaviours, and to assess emotion regulation strategies. Participants completed a brief survey to assess mood and health behaviours three times a week, for three weeks. Individuals with lifetime psychiatric disorders (about 50%) reported greater negative mood and use of unhealthy behaviours over time, compared to those with no psychiatric vulnerability. The use of cognitive reappraisal to regulate emotions was associated with greater resilience (i.e., feelings of hope and resourcefulness, and ability to seek social support and enjoyable activities). Cognitive reappraisal is a skill that can be trained and could be utilised to buffer the effect of general stress (i.e. stress caused by the pandemic) on individuals' wellbeing.

To prevent being stressed-out: Allostatic overload and resilience of general practitioners in the era of COVID-19. A cross-sectional observational study

Background

Responsibility of general practitioners (GPs) in delivering safe and effective care is always high but during the COVID-19 pandemic they face even growing pressure that might result in unbearable stress load (allostatic overload, AO) leading to disease.

Objectives

We aimed to measure AO of Hungarian GPs during the COVID-19 pandemic and explore their recreational resources to identify potential protective factors against stress load.

Methods

In a mixed-method design, Fava’s clinimetric approach to AO was applied alongside the Psychosocial Index (PSI); Kellner’s symptom questionnaire (SQ) to measure depression, anxiety, hostility and somatisation and the Public Health Surveillance Well-being Scale (PHS-WB) to determine mental, social, and physical well-being. Recreational resources were mapped. Besides Chi-square and Kruskal-Wallis tests, regression analysis was applied to identify explanatory variables of AO.

Results

Data of 228 GPs (68% females) were analysed. Work-related changes caused the biggest challenges leading to AO in 60% of the sample. While female sex (OR: 1.99; CI: 1.06; 3.74, p = 0.032) and other life stresses (OR: 1.4; CI: 1.2; 1.6, p < 0.001) associated with increased odds of AO, each additional day with 30 min for recreation purposes associated with 20% decreased odds (OR: 0.838; CI: 0.72; 0.97, p = 0.020). 3–4 days a week when time was ensured for recreation associated with elevated mental and physical well-being, while 5–7 days associated with lower depressive and anxiety symptoms, somatisation, and hostility.

Conclusion

Under changing circumstances, resilience improvement through increasing time spent on recreation should be emphasised to prevent GPs from the adverse health consequences of stress load.

Olfactory Virtual Reality: A New Frontier in the Treatment and Prevention of Posttraumatic Stress Disorder

This perspective piece reviews the clinical condition of posttraumatic stress disorder (PTSD), which is currently increasing due to the COVID-19 pandemic, and recent research illustrating how olfaction is being incorporated into virtual reality (VR) platforms. I then discuss the latest work examining the potential of olfactory virtual reality (OVR) for the treatment of PTSD. From this foundation I suggest novel ways in which OVR may be implemented in PTSD therapy and harnessed for preventing the development of PTSD. Perceptual and chemical features of olfaction that should be considered in OVR applications are also discussed.

The immediate effect of a single session of pain neuroscience education on pain and the autonomic nervous system in subjects with persistent pain, a pilot study

BACKGROUND

The autonomic nervous system is a system that operates at the subconscious level and has been associated with neurobehavioral aspects of pain. Overall, persistent pain has a stimulating effect on the sympathetic nervous system. A promising emerging nonpharmacological treatment to manage persistent pain is neuroscience-based pain education. The overarching goal of neuroscience-based pain education is to change cognitions about pain and the pain experience through education. The aim was to determine the immediate and short-term impact of a neuroscience-based pain education video on the autonomic nervous system and pain in a subgroup of individuals with persistent pain.

METHODS

A convenience sample of 26 subjects were recruited for this study. Each subject indicated their pain level at the time of testing using a Visual Analogue Scale. Automated pupillometry was utilized to measure pupil diameter. After two minutes of accommodation to the goggles, the pupil was measured continuously for 60 s. Following this a 5-minute video presentation "Understanding Pain" was watched, followed by a continuous pupil measurement for 60 s. Three minutes after this measure, the final pupil diameter measurement was taken for 60 s. After completing the final pupil measure, the subject was asked to fill out a second Visual Analogue Scale and a Global Rate of Change.

OUTCOMES

Each subject completed a Global Rating of Change Scale and the mean score was 1.14 (SD = 1.61 and a SEM = 0.), supporting the hypothesis of an overall self-perceived benefit from the intervention. There was a statistically significant difference in pain following the video, P < 0.01. A significant correlation was observed between the self-perceived decrease in pain level and the Global Rating of Change score, p = 0.02. There was no statistically significant difference in the mean pupil diameter following the video with p = 0.76 for the right eye and p = 0.250 for the left eye.

DISCUSSION

This pilot study demonstrated that a 5-minute neuroscience-based pain education video reduced perceived pain in a small sample of subjects with persistent pain. Watching the neuroscience-based pain education video did not seem to result in an immediate generalized autonomic nervous system response. However, it resulted in a different reaction on each eye. This unequal response might be the result of the hemispheric lateralization of the ANS. This study supports the fact that the pain experience is determined by the balance between conscious cognitive processes and subconscious processes based on previous psychological experiences.

Physical Exercise as a Resilience Factor to Mitigate COVID-Related Allostatic Overload

INTRODUCTION

The long-lasting threat of COVID-19 makes it necessary to explore strategies to improve coping skills which enable us to master a balanced life in the face of adversity.

OBJECTIVE

To unravel the most challenging aspects of COVID-19 in a nonclinical adult population and identify predictors of lost balance and consequent allostatic overload (AO). We examined the role of regular, moderate-intensity formula aerobic exercise (312 meridian exercise) in preventing allostatic overload through increasing well-being.

METHODS

An online survey was conducted to measure CO-VID-related allostatic overload according to clinimetric criteria. The Psychosocial Index (PSI), Kellner's Symptom Questionnaire (KSQ), short Depression Anxiety Stress Scales (DASS-21), Public Health Surveillance Well-Being Scale -(PHS-WB), and Whiteley-7 were used to explore mental health characteristics. Univariate statistics logistic regression analysis and a general linear model were used.

RESULTS

According to 442 valid answers, 217 adults practiced physical exercise (PE) frequently (fPE, 3-5 times/every day) while 120 did it less regularly (1-2 times/week), and 105 did not exercise/practiced irregularly (controls). Restriction-related stressors were most challenging, resulting in AO in 29% (n = 128) of the sample. The main predictors were additional stressors (p = 0.005) and anxiety symptoms (p < 0.001). The prevalence of AO was lower (p = 0.018) in the fPE group when compared to controls. KSQ distress symptoms were also lower in fPE (p < 0.0001), while total well-being was increased (p < 0.001) after adjusting for sex, age, and number of chronic diseases. According to the PHS-WB, both physical and mental well-being were higher (p = 0.003 and p = 0.004, respectively) in fPE.

CONCLUSIONS

Frequent moderate exercise is associated with better mental and physical well-being and a lower prevalence of AO.

Gray Matter Volume Differences Between More Versus Less Resilient Adults with Chronic Musculoskeletal Pain: A Voxel-based Morphology Study

Resilience, a personality construct that reflects capacities to persevere, maintain a positive outlook and/or thrive despite ongoing stressors, has emerged as an important focus of research on chronic pain (CP). Although behavior studies have found more resilient persons with CP experience less pain-related dysfunction than less resilient cohorts do, the presence and nature of associated brain structure differences has received scant attention. To address this gap, we examined gray matter volume (GMV) differences between more versus less resilient adults with chronic musculoskeletal pain. Participants (75 women, 43 men) were community-dwellers who reported ongoing musculoskeletal pain for at least three months. More (n = 57) and less (n = 61) resilient subgroups, respectively, were identified on the basis of scoring above and below median scores on two validated resilience questionnaires. Voxel-based morphology (VBM) undertaken to examine resilience subgroup differences in GMV indicated more resilient participants displayed significantly larger GMV in the (1) bilateral precuneus, (2) left superior and inferior parietal lobules, (3) orbital right middle frontal gyrus and medial right superior frontal gyrus, and (4) bilateral median cingulate and paracingulate gyri, even after controlling for subgroup differences on demographics and measures of pain-related distress. Together, results underscored the presence and nature of specific GMV differences underlying subjective reports of more versus less resilient responses to ongoing musculoskeletal pain.

The 4Ds of Dealing With Distress - Distract, Dilute, Develop, and Discover: An Ultra-Brief Intervention for Occupational and Academic Stress

The Covid-19 crisis has clarified the demand for an ultra-brief single-session, online, theory-led, empirically supported, psychological intervention for managing stress and improving well-being, especially for people within organizational settings. We designed and delivered "4Ds for Dealing with Distress" during the crisis to address this need. 4Ds unifies a spectrum of familiar emotion regulation strategies, resilience exercises, and problem-solving approaches using perceptual control theory and distils them into a simple four-component rubric (Distract-Dilute-Develop-Discover). In essence, the aim is to reduce distress and restore wellbeing, both in the present moment through current actions (distract or dilute), and through expressing longer-term goal conflicts (e.g., through talking, writing, and drawing) to discover new perspectives that arise spontaneously after sufficient time and consideration. The intervention is user-led in that it draws on users' own idiosyncratic and pre-existing experiences, knowledge, skills and resources to help them apply an approach, or combination of approaches, that are proportionate and timed to the nature and context of the stress they are experiencing. In this article we review the empirical basis of the approach within experimental, social, biological and clinical psychology, illustrate the novel and time-efficient delivery format, describe its relevance to sports and exercise, summarise feedback from the recipients of the intervention to date, and describe the directions for future evaluation.