Role of emotions in the clinical decision-making process of the hospital nurse: A multicentre qualitative study

While for a long-time emotional reaction and moral distress, have been primarily investigated for the possible outcomes of the nursing decision-making process rather than in terms of their role as antecedents of the final decision taken. The primary study's aim is to explore how inpatient nurses' decision-making takes place in different care settings, with a special focus on the role played by emotions during decision-making. The secondary aim is to explore the subjective experience of hospital nurses in relation to successful and unsuccessful decision-making situations. Multicentre qualitative study, consisting of three phases with different designs: participatory study, grounded theory study, and phenomenological study. Participants will be nurses and may be doctors with various levels of professional experience working in hospital, outpatient, or ward settings. Participants will be recruited through different sampling (purposive and convenience). Data will be collected through focus groups and in-depth interviews with nurses working in different hospital care settings. The researchers expect to find themes that will contribute to a better understanding of the role of emotions in decision-making. The results of this study have the potential of providing important implications to support nurses in the recognition and management of their emotions during the decision-making process.

Speechlessness: a Conceptual Framework

The phenomenon of speechlessness has hardly been considered in the literature from a psychological point of view. Previous research on speechlessness is limited to the fields of neurology, medicine or psychopathology. The present review aims to consider speechlessness from a psychological perspective distinct from pathology, and to highlight its observability and possible connections to existing research in the context of emotional cognition and processing. Search terms were developed and a comprehensive, systematic literature search was conducted in various databases based on previous scientific work on the understanding of non-speech, silence and speechlessness. Only results that examined the phenomenon of speechlessness from a non-pathological or non-neurological perspective were included. A total of N = 7 publications matching the inclusion criteria were identified. The results were used to develop a procedual model for the phenomenological definition of speechlessness. The developed model differentiates the observable phenomenon of speechlessness into a non-intentional, unconscious form and a intentional, conscious form. The present work suggests that meaningful emotions and their perception and processing is a core element in the emergence of speechlessness and provides a first, psychological, non-pathological explanation of speechlessness.

Dysphoria as trans-diagnostic mood symptom and as lived experience. Lessons from prose, poetry and philosophy

This paper attempts to provide a characterisation of it from a first-person perspective of dysphoria, answering the question 'how it feels like to be dysphoric?'. Starting with a definition of emotions as embodied phenomena that provide the person with a felt motivation to move, a rich characterisation of dysphoria is provided centred on the coenesthetic and kinesthetic feelings inherent to this emotion. To fulfil this task, a selected choice of literary, poetic, theatrical and philosophical texts is used to compensate for the quasi-ineffability of the contrasting feelings inherent to dysphoria. Current definitions of dysphoria only highlight the 'negative' side of dysphoria, including irritability, discontent, surrender and interpersonal resentment. A more accurate characterisation necessitates the recognition of the 'positive' side of dysphoria and the ambiguities and contradictions inherent in this emotion. Dysphoric persons feel burdened by a weight that prevents them from moving and simultaneously incites movement. The inertia that accompanies dysphoria is inextricably tied in with a vital urge, however disordered and purposeless. Dysphoria is experienced both as a deadly stagnation and as a chaotic, wild impulse that brings with it an inane aspiration to explore the darkest parts of one's self in search of a glimmer of meaning and authenticity. This characterisation of dysphoria can help to differentiate it from other emotions such as sadness, anger, anxiety and anguish, and thus to identify it more precisely within the spectrum of mood disorders.

Swedish translation and psychometric testing of the Self-Conscious Emotions in COPD Questionnaire

Assessment of self-conscious emotions is important to develop tailored interventions for people with chronic obstructive pulmonary disease (COPD). Previous instruments have largely been developed for mental health populations. The Self-Conscious Emotions in COPD Questionnaire was the first instrument to assess self-conscious emotions in people with COPD, but it was only available in English. The aim was to translate the Self-Conscious Emotions in COPD Questionnaire into Swedish and to evaluate its psychometric properties and internal structure in a Swedish context. The translation process included forward and backward translation, a multidisciplinary meeting, assessment of content validity, and cognitive interviews. The translated instrument was tested in a sample of 173 people with COPD between September 2021 and September 2022. Parallel analysis (PA), exploratory factor analysis (EFA), and test-retest reliability was performed. The content validity index (CVI) for the instrument was 0.88. Based on the PA, an EFA with a two-factor solution was conducted, with a high Cronbach's alpha (0.786-0.821), and one item about self-blame was excluded. The two factors were labelled: The burden of living with a disability and The desire to hide vulnerability. Test-retest reliability showed no difference between scale scores on factor or item level, except for one item. The Swedish Self-Conscious Emotions in COPD showed good validity and reliability. One item was excluded from the two subscales, indicating that the instrument needs to be further developed to cover the concept of self-blame. The instrument is expected to be a valuable tool for assessing self-conscious emotions in people with COPD.

Impacts of childhood malocclusion on the family

PURPOSE

To analyze the effects of children's malocclusions and associated quality of life on family relationships by evaluating psychometric characteristics of the Family Impact Scale (FIS) in adolescents seeking orthodontic treatment.

MATERIALS AND METHODS

Included were 334 participants (children aged 11-14 years; 53% female and 47% male) and their parents (84% mothers, 16% fathers) who were recruited at two dental clinics in Croatia. The Child Perception Questionnaire, Parental-Caregiver Perception Questionnaire, and FIS were administered. Malocclusion severity was estimated using the Index of Orthodontic Treatment Need Dental Health Component. The presence of caries was also recorded. Factor analysis, t‑test, Pearson correlation, and multiple linear regression analysis were used for statistical analysis.

RESULTS

Unidimensional FIS measuring global family impacts had higher internal consistency (α = 0.73-0.81) compared to the specific dimensions of family impacts (α = 0.60-0.69). Global family impacts were higher in children with more severe malocclusions and existing dental caries, primarily influencing parental activity, and parental emotions dimensions (p < 0.05). In multiple regression, parental perception of child's emotional well-being, oral symptoms, and social well-being (p < 0.001) were significant predictors of global family impacts, whereas child's quality of life perception, malocclusion severity, or child sex were not. Reduction of an increased overjet by orthodontic treatment affected changes in the global family impacts, mainly by reducing the emotional issues of parents (p < 0.05).

CONCLUSIONS

The child's malocclusion influenced the family, primarily parental emotions. Family influences were mostly determined by parental perception of the child's altered psychosocial well-being. The FIS had adequate psychometric properties.

Compensatory prosocial behavior in high-risk adolescents observing social exclusion: The effects of emotion feedback

Although exposure to violence has been consistently associated with deficits in prosocial behavior among adolescents, effective methods of mitigating these deficits have yet to be identified. The current investigation tested whether prosocial behavior could be promoted by providing adolescents with feedback about the emotional states of others and whether the effects of feedback varied between adolescents who had versus had not experienced violence in the home or in the community. Adolescents aged 8 to 17 years with (n = 87) and without (n = 61) histories of violence exposure completed a virtual social exclusion ball-tossing paradigm in which information about an excluded peer's emotions (sad, angry, or neutral) was experimentally manipulated. Among adolescents with histories of violence exposure, those who received feedback that the peer was sad due to being excluded compensated by throwing the ball more often to that peer. In contrast, adolescents without histories of violence exposure did not engage in compensatory prosocial behavior, instead maintaining a relatively even number of tosses to all players. Findings offer new insight into simple potential methods of eliciting prosocial behavior in adolescents for whom such responding may be compromised and may provide a potential starting point for interventions.

Economic valuation of a mesocarnivore's impact management

Red foxes (Vulpes vulpes) have interacted with humans during their common history. We used a contingent valuation method to assess the economic value of the management of this mesocarnivore's negative impacts. We carried out face-to-face interviews with 746 Greek residents, using a multiple-bounded discrete choice approach to estimate willingness to pay (WTP) for red fox management under three impact situations: attack domestic animals, reduce game, carry disease. About 51.9%, 33.0%, and 81.1% of the respondents stated a mean WTP of €34.1, €44.9, and €72.1 for each situation, respectively. The total annual amounts of €18.7 million, €15.7 million, and €61.7 million could be collected from the target population for red fox management when they attack domestic animals, reduce game, and carry disease, respectively. Attitudes and likeability toward foxes were negatively associated while knowledge about foxes and fear of them were positively associated with WTP. The younger, richer, less educated, rural, farmers, hunters, and pet owners were generally more willing to pay for red fox management across situations. Females were more willing to pay for managing predation on domestic animals, while males were more willing to pay for managing predation on game. Our findings showed that the Greek residents highly value the management of red foxes in all impact situations and would be valuable for further advising the management process.

Capturing the emotional and social experiences of COVID-19 through journal entries: A qualitative study of COVID-19 experiences over six weeks following infection

COVID-19's wide-ranging effects on patients' physical health are well-documented, but comparatively less research has explored the impact on patients' emotional and social experiences. We examined how patients across a multi-state health system experience the emotional and social aspects of COVID-19 during the first six weeks of recovery from infection. We leveraged the larger My COVID Diary project to capture open-ended journal data from an app-based platform available to patients who test positive for COVID-19 within the health system. Our sample was limited to participants with multiple journal entries during the first six weeks after infection, with one entry in the top 5% of all participants for word count to ensure sufficient journal content was available for analysis. We randomly selected 100 eligible participants and coded and analyzed all of their journal entries in weeks 1-6 after infection, utilizing a thematic analysis approach. Despite journal entry prompts' orientation towards physical symptoms, the majority of participants discussed emotional experiences (such as anxiety, depression, and gratitude) and social factors (such as work and family) when describing their COVID-19-related experiences. Physical, emotional, and social experiences related to COVID-19 infection and recovery were often interconnected and overlapping. These findings demonstrate that a holistic understanding of the patient experience that extends beyond physical symptoms is necessary to fully support patient care and recovery.

Why consciousness?

Conscious emotions drive all we do, except for automatic tasks like breathing. Specifically, they enable the operation of incentives-like hunger for eating-that motivate us to perform tasks that are vital to our lives. Indeed, we act because we want to act, and desire is an emotion. Next, we want to act because we expect the action to lead to some positive emotion such as pleasure, enjoyment, satisfaction, comfort, fulfillment, …. Finally, to feel this emotion, we must perceive-consciously experience-the outer world. Conscious emotions also operate indirectly, as when driving an automobile: Though most driving is nonconscious, each particular journey is consciously undertaken for some specific reason; also, emotions operated consciously during the period in which driving was being learned, and for some time afterwards. In short, we suggest that the adaptive function of consciousness is to enable conscious emotions to operate.

Brief Report: Quantifying Speech Production Coordination from Non- and Minimally-Speaking Individuals

PURPOSE

Non-verbal utterances are an important tool of communication for individuals who are non- or minimally-speaking. While these utterances are typically understood by caregivers, they can be challenging to interpret by their larger community. To date, there has been little work done to detect and characterize the vocalizations produced by non- or minimally-speaking individuals. This paper aims to characterize five categories of utterances across a set of 7 non- or minimally-speaking individuals.

METHODS

The characterization is accomplished using a correlation structure methodology, acting as a proxy measurement for motor coordination, to localize similarities and differences to specific speech production systems.

RESULTS

We specifically find that frustrated and dysregulated utterances show similar correlation structure outputs, especially when compared to self-talk, request, and delighted utterances. We additionally witness higher complexity of coordination between articulatory and respiratory subsystems and lower complexity of coordination between laryngeal and respiratory subsystems in frustration and dysregulation as compared to self-talk, request, and delight. Finally, we observe lower complexity of coordination across all three speech subsystems in the request utterances as compared to self-talk and delight.

CONCLUSION

The insights from this work aid in understanding of the modifications made by non- or minimally-speaking individuals to accomplish specific goals in non-verbal communication.

'It's like being in a tunnel': Understanding the patient journey from tooth loss to life with removable dentures

INTRODUCTION

The aim of this study was to conceptualise the key stages of the patient journey in the provision of a new denture and examine the factors leading to successful patient-related outcomes.

METHODS

Two partially dentate patient samples were included: (i) Denture wearers - patients who had a denture fitted within the previous five years and (ii) New dentures - patients receiving treatment for a new or replacement denture. The methods involved direct targeted participant observations of the denture fitting process, debriefing interviews and a follow-up focus group exploring the patient journey. Data were analysed through the use of phenomenology and grounded theory.

RESULTS

Interviews were completed with twenty participants of the denture-wearing sample (11 males and nine females, age range 22 to 86 years). Thirteen participants were included in the treatment journey sample in two primary care settings (six males and seven females, age range 55 to 101 years). Tooth loss and recovery was described as being in an 'emotional tunnel' resulting from 'bodyphonic processes' associated with tooth loss. 'Bodyphonia' subsequently became the context for 'taking control' and 'managing disclosure' when living with a removable denture. Different courses through this process can be readily observed, moderated by different variables (i.e., previous experience, working knowledge, a good fit, the treatment alliance, negotiated compromises and bounded responsibility).

CONCLUSIONS

An'integrating framework' that seeks to describe the patient journey from the experience of tooth loss to recovery with a denture is proposed. This framework could be used to aid development of a clinical pathway to guide treatment options.

CLINICAL SIGNIFICANCE

This paper conceptualises the patient journey. It stresses the importance of understanding the stages patients go through and highlights that for the dental team, the try-in stage is perhaps the best stage to give information about the denture and plans for continued care.

Intergenerational concern relates to constructive coping and emotional reactions to climate change via increased legacy concerns and environmental cognitive alternatives

As the threat of climate change looms large, and we experience first-hand the impacts of rapid global warming, researchers and clinicians emphasize the need to better understand the impact of these changes on our mental health. Existing research suggests that coping with and emotional reactions to climate change can promote action to adapt to and mitigate the impacts of climate change and reduce its negative impacts to one's mental health. In this pre-registered study (N = 771) we examined whether people who display extreme intergenerational concern would also constructively cope with climate change. Empirically-identified individuals showing high intergenerational concern reported more problem-focused and meaning-based coping, and less avoidant coping strategies with climate change. Further, even though they felt guilty, angry, sorrowful and isolated, these individuals also felt hopeful about the future. These effects were explained by increased concerns about one's legacy and higher access to environmental cognitive alternatives. By instilling values that highlight intergenerational concern as a key priority, we could thus not only increase pro-climate action, but also help individuals actively and constructively cope with changes produced by climate change.

Social Listening in Gout: Impact of Proactive vs. Reactive Management on Self-Reported Emotional States

INTRODUCTION

This study aimed to characterize patient-reported outcomes from social media conversations in the gout community. The impact of management strategy differences on the community's emotional states was explored.

METHODS

We analyzed two social media sources using a variety of natural language processing techniques. We isolated conversations with a high probability of discussing disease management (score > 0.99). These conversations were stratified by management type: proactive or reactive. The polarity (positivity/negativity) of language and emotions conveyed in statements shared by community members was assessed by management type.

RESULTS

Among the statements related to management, reactive management (e.g., urgent care) was mentioned in 0.5% of statements, and proactive management (e.g., primary care) was mentioned in 0.6% of statements. Reactive management statements had a significantly larger proportion of negative words (59%) than did proactive management statements (44%); "fear" occurred more frequently with reactive statements, whereas "trust" predominated in proactive statements. Allopurinol was the most common medication in proactive management statements, whereas reactive management had significantly higher counts of prednisone/steroid mentions.

CONCLUSIONS

A unique aspect of examining gout-related social media conversations is the ability to better understand the intersection of clinical management and emotional impacts in the gout community. The effect of social media statements was significantly stratified by management type for gout community members, where proactive management statements were characterized by more positive language than reactive management statements. These results suggest that proactive disease management may result in more positive mental and emotional experiences in patients with gout.

Characterization of sleep efficiency transitions in family caregivers

Family caregivers are at high risk of psychological distress and low sleep efficiency resulting from their caregiving responsibilities. Although psychological symptoms are associated with sleep efficiency, there is limited knowledge about the association of psychological distress with variations in sleep efficiency. We aimed to characterize the short- and long-term patterns of caregivers' sleep efficiency using Markov chain models and compare these patterns between groups with high and low psychological symptoms (i.e., depression, anxiety, and caregiving stress). Based on 7-day actigraphy data from 33 caregivers, we categorized sleep efficiency into three states, < 75% (S1), 75-84% (S2), and ≥ 85% (S3), and developed Markov chain models. Caregivers were likely to maintain a consistent sleep efficiency state from one night to the next without returning efficiently to a normal state. On average, it took 3.6-5.1 days to return to a night of normal sleep efficiency (S3) from lower states, and the long-term probability of achieving normal sleep was 42%. We observed lower probabilities of transitioning to or remaining in a normal sleep efficiency state (S3) in the high depression and anxiety groups compared to the low symptom groups. The differences in the time required to return to a normal state were inconsistent by symptom levels. The long-term probability of achieving normal sleep efficiency was significantly lower for caregivers with high depression and anxiety compared to the low symptom groups. Caregivers' sleep efficiency appears to remain relatively consistent over time and does not show rapid recovery. Caregivers with higher levels of depression and anxiety may be more vulnerable to sustained suboptimal sleep efficiency.

Gender-related stress factors and emotional perception in migraine: a structured online questionnaire in migraine patients and controls

BACKGROUND

While migraine is markedly prevalent in women, gender-related phenotype differences were rarely assessed. For this reason, we investigated, through a multicenter observational cross-sectional study, based on an online questionnaire, gender-related differences in stress factors, emotions, and pain perception in migraine patients and controls and their impact on migraine severity.

METHODS

The study was designed as an online questionnaire. The link was emailed to healthy subjects (C) and migraine patients (MIG) (age 18-75, education ≥ 13 years) recruited during the first visit in 8 Italian Headache Centers adhering to Italian Society for Headache Study (SISC). The questionnaire included personal/social/work information, the Perceived Stress Scale, the Romance Quality Scale, the Emotion Regulation Questionnaire, the Beck Anxiety Inventory, the Body Perception Questionnaire, the pain perception, and a self-assessment of migraine severity in the last 3 months.

RESULTS

202 MIG and 202 C completed the survey. Independently from gender, migraine was characterized by higher pain sensitivity and more severe partner relationships. The female gender, in MIG, exhibited higher anxiety scores, body awareness, and reduced emotional suppression. Body awareness and emotional suppression were discriminating factors between genders in control and migraine groups without relevant influence on disease features. Perceived perception of migraine severity was similar between genders.

CONCLUSION

Gender-related emotional and stress factors did not contribute to delineate a distinct phenotype in migraine men and women. The possible impact of emotional and stress factors characterizing genders could be considered for a single case-tailored therapeutic approach.

Clinical heterogeneity of sleep quality, emotional and behavioral characteristics, and eating habits in adolescents with obesity: A cluster analysis

This study aims to examine the role of sleep quality, emotional and behavioral characteristics, and eating behavior in adolescents with obesity by means of cluster analysis. One hundred ninety-four adolescents (78 girls, 116 boys) aged 12-17 (mean 14.3 ± 2.7) with obesity (ICD-10 code E 66.0) entered the study. The Adolescent Sleep Wake Scale was used to evaluate sleep quality. The Achenbach Youth Self-Report for Ages 11-18 questionnaire was used to evaluate emotional and behavioral disturbances. The Dutch Eating Behavior Questionnaire was used to assess maladaptive eating. k-Means cluster analysis was used to clarify heterogeneity. Four clusters were identified: the first included anxious, depressed, socially withdrawn adolescents with thought problems and somatic complaints, non-aggressive, obedient, and having mean values on the sleep quality scale, inclined to restrict their food consumption. The second consisted of rule-breaking youngsters with poor sleep quality, reluctant to restrict their food consumption. The third comprised subjects with the highest values on the sleep quality and lowest values on emotional and behavioral problems, aimed at restricting food consumption. The fourth comprised adolescents with obvious signs of emotional disorders, poorest sleep quality, disinhibited behavior, and emotional and external eating. No statistically significant difference was found between the clusters in sex distribution. Patient allocation to the second or fourth cluster was associated with significantly higher body mass index values, as opposed to the reference third cluster.    Conclusion: There is significant variation in teenagers with obesity who have divergent psychological profiles, which should be taken into account. What is Known: • Patients with obesity present with different clinical characteristics. What is New: • Adolescents with obesity may be partitioned into clusters described in terms of emotional, behavioral patterns, including sleep characteristics, and maladaptive eating habits.

Current understanding of nociplastic pain

Nociplastic pain by the "International Association for the Study of Pain" is defined as pain that arises from altered nociception despite no clear evidence of nociceptive or neuropathic pain. Augmented central nervous system pain and sensory processing with altered pain modulation are suggested to be the mechanism of nociplastic pain. Clinical criteria for possible nociplastic pain affecting somatic structures include chronic regional pain and evoked pain hypersensitivity including allodynia with after-sensation. In addition to possible nociplastic pain, clinical criteria for probable nociplastic pain are pain hypersensitivity in the region of pain to non-noxious stimuli and presence of comorbidity such as generalized symptoms with sleep disturbance, fatigue, or cognitive problems with hypersensitivity of special senses. Criteria for definitive nociplastic pain is not determined yet. Eight specific disorders related to central sensitization are suggested to be restless leg syndrome, chronic fatigue syndrome, fibromyalgia, temporomandibular disorder, migraine or tension headache, irritable bowel syndrome, multiple chemical sensitivities, and whiplash injury; non-specific emotional disorders related to central sensitization include anxiety or panic attack and depression. These central sensitization pain syndromes are overlapped to previous functional pain syndromes which are unlike organic pain syndromes and have emotional components. Therefore, nociplastic pain can be understood as chronic altered nociception related to central sensitization including both sensory components with nociceptive and/or neuropathic pain and emotional components. Nociplastic pain may be developed to explain unexplained chronic pain beyond tissue damage or pathology regardless of its origin from nociceptive, neuropathic, emotional, or mixed pain components.

Claiming ecological grief: Why are we not mourning (more and more publicly) for ecological destruction?

Eco-anxiety, grief and despair are increasing, yet these emotions tend to remain private, rarely expressed in public. Why is it important and necessary to grieve for ecological loss? Why are we not-as individuals and societies-coming together to express and share our grief for ecological destruction? I address these questions from three angles. Firstly, I draw on recent literature on ecological grief and prior work on grief for human lives, to argue for the importance and urgency of grieving publicly for ecological loss. Building on this, I identify perceptual, cognitive, affective, ritual and political obstacles to ecological mourning; these obstacles point at critical intersections between emotions, practices, disciplines, public and private realms, which can turn into fruitful venues for further research, debate and action on ecological grief (and its absence). In closing, I propose a set of 'ecological skills' that might help us overcome these obstacles, and lead us to embrace ecological grief and mourning as acts of ethical responsibility and care for the planet.

How emotions impact sleep: A quantitative review of experiments

Although sleep and emotional processes are recognized as mutually dependent, the causal impact of emotions on sleep has been comparatively neglected. To appraise evidence for the causal influence of emotions on sleep, a meta-analysis of the existing experimental literature evaluated the strength, form, and context of experimental effects of emotion inductions on sleep parameters (k = 31). Quality of experiments was evaluated, and theoretically-relevant features were extracted and examined as moderating factors of observed effects (i.e., sleep parameter, design, sleep context, types of emotion inductions and emotions). Random-effect models were used to aggregate effects for each sleep parameter, while-mixed effect models examined moderators. There was a significant impact of emotion inductions on delayed sleep onset latency (D = 3.36 min, 95%CI [1.78, 4.94], g = 0.53), but not other parameters. There was little evidence of publication bias regarding sleep-onset latency effect, the studies overall were heterogeneous, sometimes of limited methodological quality, and could only detect moderate-to-large impacts. The findings supported the hypothesis that negative emotions delayed sleep onset, but evidence regarding other sleep parameters was inconclusive. The results call for more targeted investigation to disambiguate distinct features of emotions and their import for sleep.

Effects of perioperative intravenous lidocaine and esketamine on the quality of recovery and emotional state of patients after thyroidectomy: A randomised, double-blind, controlled trial

Background and Aims

Perioperative intravenous (IV) infusions of lidocaine and esketamine reduce postoperative pain, but there are few studies on the quality of recovery and patients' emotional states postoperatively. We aimed to explore the effects of perioperative IV lidocaine and esketamine on the quality of recovery and emotional state after thyroidectomy.

Methods

In this randomised trial, 137 patients undergoing thyroidectomy were randomly assigned to three groups: a lidocaine group (Group L), an esketamine group (Group E) and a normal saline placebo group (Group C). The primary outcome was the Quality of Recovery 40 (QoR-40) on postoperative days (PODs) 1 and 2. The secondary outcomes included Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores on days 1 and 2 after surgery, pain scores, opioid consumption and incidence of postoperative nausea and vomiting (PONV). Statistical analysis was performed using the one-way analysis of variance (ANOVA), the Kruskal-Wallis and Chi-square tests.

Results

The global QoR-40 scores in groups L and E on POD 1 and POD 2 were significantly higher than in group C (P < 0.001). The SAS and SDS scores on POD 1 and POD 2 in groups L and E were significantly lower than in group C (P < 0.05). There were statistically significant differences in Numerical Rating Scale (NRS) scores among the three groups at 1 h, 2 h, 6 h and 12 h (P < 0.05).

Conclusion

Perioperative IV lidocaine and esketamine improve the quality of postoperative recovery and the emotional state of patients undergoing thyroidectomy.

Art therapy masks reflect emotional changes in military personnel with PTSS

Among disabling post-traumatic stress symptoms (PTSS) are irritability, aggressive behavior, distressing memories and general impaired cognition and negative mood. Art therapy interventions, including mask-making, can potentially alleviate these symptoms. We tested the hypothesis that art conveys emotions and predicted that blinded viewers would be able to perceive changes in theoretically derived emotional profiles expressed in art made by military personnel with PTSS from the onset to the end of therapy. Five service members and veterans exhibiting PTSS were enrolled in an 8-session art therapy protocol, during which they artistically transformed papier-mâché masks at the beginning and end of the protocol. We found that blinded viewers without knowledge of the masks' creation stage (onset or end of therapy) read initial masks as conveying more negative emotions (e.g., angry, upset, and challenged) and later masks as conveying more positive emotions (calm and pleasure). Based on the assessments from the blinded evaluators, we infer the emotional transition experienced by the participants was expressed in the masks. In an exploratory arm of the study, we also found that viewers were better able to empathize with the negative emotions experienced by participants with PTSS when asked to explicitly take their perspective.

Associations between continuous glucose monitoring (CGM) metrics and psycholinguistic measures: a correlational study

AIM

Recently, the relationship between diabetes and mental health has been widely studied. With the advent of continuous glucose monitoring (CGM), some researchers have been interested in exploring the association between glucose-related metrics and psychological aspects. These studies have primarily relied on self-report questionnaires which present some limitations. Therefore, the present multicenter study aims at testing potential associations between CGM metrics and affective processes derived from narratives about using a CGM sensor.

METHODS

An exploratory correlational design was used. Fifty-eight adults with type 1 diabetes using CGM were enrolled and invited to complete an online survey, where they replied to an open-ended question regarding their personal experience with the CGM sensor. Texts derived from the answers were analyzed through Linguistic Inquiry and Word Count, a widely used text analysis tool that can automatically identify and quantify linguistic patterns related to various psychological dimensions. Psycholinguistic measures were correlated with CGM metrics.

RESULTS

Higher levels of sadness/depression correlated with lower %TIR (r = - 339; p < .01) and higher %TAR (r = .342; p < .01).

CONCLUSIONS

The study highlights the relationship between CGM metrics and psychological variables derived from patients' narratives. In particular, it is possible to hypothesize a positive role of %TIR in reducing depressive feelings in individuals with diabetes, as well as a negative role of depressive feelings in achieving desirable CGM outcomes. Additionally, there is a potential role of glycemic variability, particularly hyperglycemia, in the expression of depressive and sad feelings, which has been less studied compared to the effects of hypoglycemia.

Learning to teach with patients and caregivers: a focused ethnography

BACKGROUND

Little is known about what happens when patients and caregivers are involved in an academic setting as co-teachers and how healthcare professionals approach a new model of partnership-based teaching. This study aimed to explore the learning and behavioural patterns of a group of healthcare professionals who were learning to teach with patients and caregivers as co-teachers in a post-graduate course.

METHODS

A focused ethnographic study involving 11 health professionals was conducted. Data were collected through participatory observation during the course, individual semi-structured interviews, and a follow-up focus group. Taxonomic analysis was performed.

RESULTS

Three categories were identified: 'group', 'role of narration' and 'applying co-teaching with patients and caregivers '. Specifically, heterogeneity, absence of hierarchies, and balanced relationships characterised the group dynamic and promoted partnership. Narration played a key role both in learning and in healthcare professionals' relationship with patients and caregivers and promoted emotional skills and self-awareness. Project planning and lessons simulations were essential aspects of the implementation process.

CONCLUSIONS

This focused ethnography helped further understanding of the context of a specific project involving patients and caregivers as co-teachers in healthcare professional education. The development of emotional skills and self-awareness are the main learning patterns of co-teaching, and interprofessionalism and balanced relationships are the basis of the behavioural patterns. These patterns facilitated the involvement of patients and caregivers in health education.

Activity increases in empathy-related brain regions when children contribute to peers' sadness and happiness

Responding empathically when causing peers' emotions is critical to children's interpersonal functioning, yet there are surprising gaps in the literature. Previous research has focused on empathy when witnessing others' emotions instead of causing others' emotions, on negative emotions instead of positive emotions, and on behavioral correlates instead of neural correlates. In this study, children (N = 38; Mage = 9.28 years; 50% female) completed a functional magnetic resonance imaging block design task in which they played a rigged game where they won and lost coins for themselves or peers and viewed their peers' happiness and sadness. We used a region of interest approach to test whether activity in brain regions associated with positive and negative empathy in adults showed significantly greater activity in each condition (i.e., when children won and lost tokens for themselves and peers) compared with a fixation baseline. We predicted that experiencing self-conscious emotions, such as pride and guilt, would heighten the experience of empathy. Activity in the amygdala, which is associated with visceral arousal, and in the anterior insula and dorsal anterior cingulate cortex, which are associated with integrated arousal, increased significantly when winning and losing for oneself and peers and observing their resulting happy and sad facial expressions. Activity did not differ when playing for oneself versus peers, indicating that self-conscious emotions do not heighten empathy and instead support similar neural processes underlying firsthand and secondhand (empathic) emotions. These findings support that empathy during middle childhood involves the same brain regions as empathy during adulthood and that children experience firsthand and secondhand positive and negative emotions in similar ways.

Age differences in emotional reactions to ageist memes and changes in age of one's Best Self

Memes on social media can carry ageist messages and can elicit reactions that are both emotional and self-evaluative. The present study investigates age-related differences in nine discrete emotions and in the evaluation of when individuals have been or will be their best selves. Participants (n = 360) representing young (m = 26 years), middle-aged (m = 39 years) and older adults (m = 63 years) were randomly assigned to view either non-ageist (animals) or ageist (e.g., incompetent older people) memes. After viewing memes, we assessed nine emotional reactions (i.e., fear, anger, sadness, happiness, anxiety, discomfort, disgust, surprise, enjoyment) and Best Self evaluations. Younger and middle-aged people reported more intense emotional reactions to memes than older people, with the exception that older people reported more discomfort and disgust in response to ageist versus non-ageist memes. Younger adults were less surprised by ageist memes (vs. non-ageist) and for all age groups ageist memes (vs. non-ageist) elicited less happiness and enjoyment and were less likely to be shared. With respect to evaluations of one's Best Self, older individuals were more likely to report being their best selves in the past, while after viewing ageist memes, younger individuals were more likely to report being their best selves in the future. Emotions of disgust and discomfort were related to identifying one's Best Self as further in the past. The current study adds to the literature on the impact of ageism by examining age-related differences in the emotions and self-evaluations experienced when confronted with memes on social media.

Inducing Novel Sound-Taste Correspondences via an Associative Learning Task

The interest in crossmodal correspondences, including those involving sounds and involving tastes, has experienced rapid growth in recent years. However, the mechanisms underlying these correspondences are not well understood. In the present study (N = 302), we used an associative learning paradigm, based on previous literature using simple sounds with no consensual taste associations (i.e., square and triangle wave sounds at 200 Hz) and taste words (i.e., sweet and bitter), to test the influence of two potential mechanisms in establishing sound-taste correspondences and investigate whether either learning mechanism could give rise to new and long-lasting associations. Specifically, we examined an emotional mediation account (i.e., using sad and happy emoji facial expressions) and a transitive path (i.e., sound-taste correspondence being mediated by color, using red and black colored squares). The results revealed that the associative learning paradigm mapping the triangle wave tone with a happy emoji facial expression induced a novel crossmodal correspondence between this sound and the word sweet. Importantly, we found that this novel association was still present two months after the experimental learning paradigm. None of the other mappings, emotional or transitive, gave rise to any significant associations between sound and taste. These findings provide evidence that new crossmodal correspondences between sounds and tastes can be created by leveraging the affective connection between both dimensions, helping elucidate the mechanisms underlying these associations. Moreover, these findings reveal that these associations can last for several weeks after the experimental session through which they were induced.

Between loss and restoration: The role of liminality in advancing theories of grief and bereavement

A recent national survey of bereaved partners found high levels of complicated grief and psychological distress, with evidence that loneliness and isolation may contribute to these outcomes. However, the mechanisms of action for this have not been explored. To advance grief theory this paper reports analysis of the survey free-text data to examine the relationship between social support and emotional responses to bereavement. Individuals bereaved of a civil partner or spouse 6-10 months previously were identified through death registration data. 569/1945 (29 %) completed surveys were received. Of those, 311 participants (55 %) provided responses to two free-text questions which asked about their 'feelings since the death of their partner or spouse', and 'about the support around' them. Data were analysed using corpus-assisted discourse analysis and the discourse dynamics approach for figurative language. Participants described diverse emotional responses to the bereavement (e.g. sadness, anger, denial, acceptance), and the value of formal and informal bereavement support. Although many of the experiences described are accounted for in existing grief theory, some participants described a liminal experience not recognised within these theories. They felt trapped, unable to engage with loss or restoration, and unable to move forward as their planned future no longer existed. They sought out 'communitas' (solidarity in experiences), but often found support from their social networks had diminished. Metaphors were used to describe this liminality, with partner grief expressed as a dark agentic force, a monster, an abyss, and as water. The findings of this study offer original insights into experiences and trajectories of bereavement, and our understandings of prolonged or complicated grief. A novel model 'Between Loss and Restoration' is presented to include these experiences. Recognition of the place for liminality within the spectrum of grief experiences could enhance grief literacy and improve formal and informal bereavement support provision.

The role of the peripheral and central adrenergic system in the construction of the subjective emotional experience of panic

RATIONALE

Although the study of emotions can look back to over 100 years of research, it is unclear which information the brain uses to construct the subjective experience of an emotion.

OBJECTIVE

In the current study, we assess the role of the peripheral and central adrenergic system in this respect.

METHODS

Healthy volunteers underwent a double inhalation of 35% CO2, which is a well-validated procedure to induce an intense emotion, namely panic. In a randomized, cross-over design, 34 participants received either a β1-blocker acting selectively in the peripheral nervous system (atenolol), a β1-blocker acting in the peripheral and central nervous system (metoprolol), or a placebo before the CO2 inhalation.

RESULTS

Heart rate and systolic blood pressure were reduced in both β-blocker conditions compared to placebo, showing effective inhibition of the adrenergic tone. Nevertheless, the subjective experience of the induced panic was the same in all conditions, as measured by self-reported fear, discomfort, and panic symptom ratings.

CONCLUSIONS

These results indicate that information from the peripheral and central adrenergic system does not play a major role in the construction of the subjective emotion.

Emotions and music through an innovative project during compulsory secondary education

This article presents the results and main conclusions of a quasi-experimental study after the implementation of an innovative project extended as a multi-year programme, called 'MusMotion', applied in compulsory secondary education, which is based on the relationship between music and emotions, as well as its effects on the academic performance of adolescents. The research analysed and tested an educational innovation project that improves students' academic performance, as well as the classroom climate between teachers and students (N = 444). A key strand of this research concerns the use of music to support students' emotional development and awareness. As we will explain, the results of this research have shown positive outcomes that have direct implications for pedagogy and classroom practice. The results confirm that there is a relationship between emotions and students' academic performance, and the innovative educational programme MusMotion can help to improve students' academic performance and the classroom climate by improving their state of mind. Educational systems, through the management of emotions via music, could help many children who today may have difficulty with their emotions.

Exploring nurses' emotional reactions to and reporting of patient-on-nurse workplace violence: A mixed-methods study

BACKGROUND

Workplace violence, including violent, intimidating, and disruptive acts, commonly occurs in healthcare settings. Type 2 workplace violence in nursing refers to patient/visitor behaviors directed toward clinicians, contributing to physical and psychological harm. Nurse victims often do not report these events to employers or law enforcement, making it challenging to address workplace violence.

OBJECTIVES

Our research examined nurse reactions to Type 2 workplace violence by identifying what behaviors they perceived as aggressive and reportable. Specific aims included: 1) developing and testing video vignettes to portray realistic patient aggression scenarios; 2) identifying nurse understandings of aggressive events that prompt affective reactions, and; 3) examining clinical characteristics related to the nurse victim's likelihood to report.

DESIGN

Through a sequential mixed-methods design, we qualitatively developed novel video vignettes portraying Type 2 workplace violence to experimentally examine how nurses interpreted them within a quantitative repeated measures survey.

METHODS

Two expert nurse research panels (n = 10) created five vignettes, from which nurses (n = 282) completed a survey with 1382 unique responses. Analyses included descriptive statistics and repeated measures ANOVA/regression models.

RESULTS

Video vignettes realistically portrayed workplace violence events, eliciting negative emotional responses among nurses that increased in magnitude with statistical significance as the level of displayed aggression escalated. Statistically significant factors influencing nurse reporting of workplace violence included; 1) the level of aggression displayed by the patient; 2) the level of harm received by the nurse; 3) whether the nurse felt the patient's actions were intentional, and; 4) the nurse's perceived frequency of exposure to workplace violence.

CONCLUSIONS

Results suggested that nurse victims of Type 2 workplace violence experience depression, anger, fear, and anxiety, which may contribute to long-term mental health consequences. Findings also identified factors related to nurse reporting behaviors, which may help mitigate workplace violence in healthcare settings by informing research and promoting workplace practices that encourage reporting and safety.

REGISTRATION

Not registered.

TWEETABLE ABSTRACT

Nurse reactions to workplace violence: Video vignettes reveal escalating aggression's impact on reporting. #EndNurseAbuse #WorkplaceViolence.

Family's preferences for and experiences of writing practices in adult intensive care and its use in early bereavement: A descriptive qualitative study

BACKGROUND

Family partaking in writing practices, such as writing intensive care unit (ICU) patient diaries, personal diaries/journaling, social media, or instant messaging services, during ICU admission may allow the family to unintentionally participate in a form of expressive writing. These writing practices could provide structure for the family authors to explore emotions and manage significant life events, including death of a loved one. Limited studies have explored the family's postmortem experiences and perceived value of writing practices maintained during an ICU admission.

OBJECTIVES

The objective of this study was to explore the family member's preferences for and experiences of writing practices in the adult ICU and its use in early bereavement.

METHODS

descriptive qualitative design using inductive reflexive thematic analysis from a purposeful, convenience sample of 16 bereaved participants from a tertiary referral, adult ICU in Australia who discussed their experiences of and preferences in writing practices. Reporting adheres to the consolidated criteria for reporting qualitative research checklist.

FINDINGS

Six participants maintained writing practices during the ICU admission and 10 did not. Three themes were generated from the data: the decision to maintain writing practices was shaped by past behaviours and perceived utility; moments captured were influenced by the loved ones' clinical status and their ability to access the writing medium; and writing practices have limited utility as a memory making object in early bereavement.

CONCLUSIONS

Based on the generated findings, participants who did not maintain writing practices did not later regret this decision during early bereavement. Participants who did maintain writing practices predominately used a personal diary/journal that they carried with them. As the loved one approached death, the written entries became shorter, then ceased. Most of the written entries were not read during early bereavement, suggesting the writing practices' psychological value might have been predominately gained at the time of writing, rather than during early bereavement.

Neurobiological sensitivity to popular peers moderates daily links between social media use and affect

Social media behaviors increase during adolescence, and quantifiable feedback metrics (e.g., likes, followers) may amplify the value of social status for teens. Social media's impact on adolescents' daily affect may be exacerbated given the neurodevelopmental changes that increase youths' sensitivity to socio-emotional information. This study examines whether neurobiological sensitivity to popularity moderates daily links between social media use and affect. Adolescents (N = 91, Mage=13.6 years, SDage=0.6 years) completed an fMRI task in which they viewed faces of their high (>1 SD above the mean) and low (<1 SD below the mean) popular peers based on peer-nominated sociometric ratings from their school social networks. Two years later, adolescents reported their time spent on social media and affect daily for two weeks. Neural tracking of popularity in the ventromedial and dorsomedial prefrontal cortex moderated the association between time on social media and affect. Specifically, adolescents who tracked high popular peers in the vmPFC reported more positive affect on days when they used social media more. Adolescents who tracked low popular peers in the vmPFC and dmPFC reported more negative affect on days when they used social media more. Results suggest that links between social media and affect depend on individual differences in neural sensitivity to popularity.

Gender difference in emotional distress among nursing and health science college students: An online survey

This cross-sectional study investigates the self-reported emotional distress of medical, nursing, dental, pharmacy, and public health students and identifies gender-related differences through an online survey. The data of 364 students were analyzed using Pearson correlation coefficients and multiple logistic regression. Emotional distress was more prevalent among female respondents (11.7 %) than male (3.8 %) respondents. The stigma, isolation, and depression experienced by female respondents influenced their emotional distress, whereas only the depression of male respondents influenced their emotional distress. Our findings suggest that mental health professionals should consider gender-specific factors when developing interventions for the study population to minimize emotional distress.

Connected minds in disconnected bodies: Exploring the role of interoceptive sensibility and alexithymia in problematic use of the internet

INTRODUCTION

The ever-increasing prominence of the internet and digital technology in our society requires a deeper examination of how these developments alter perception of our bodies and emotions. One such consequence is the emergence of Problematic Use of the Internet (PUI) - an array of compulsive or addictive behaviors mediated by the web that detrimentally affect an individual's functioning. This suggests that some people may be shifting their consciousness from the physical realm to the digital world. The objective of this study was to investigate how shortcomings in interoception (the sensibility to bodily signals) and alexithymia (an inability to identify and express emotions) might contribute to PUI.

METHODS

The Internet Addiction Test (IAT), the Toronto Alexithymia Scale (TAS-20), and the Multidimensional Assessment of Interoceptive Awareness (MAIA) were used to assess a sample of 1076 adolescents and young adults aged between 16 and 26 years via an online survey. Data analysis was based on t-test, correlations and multivariate regression.

RESULTS

26.8% (n = 288) of participants met the criteria for moderate PUI. Individuals with PUI displayed higher levels of alexithymia (p < 0.001) and diminished abilities in certain aspects of interoceptive sensibility, including placing trust in their own bodily signals (p = 0.006), not responding excessively to uncomfortable sensations with worry (p < 0.001), and not denying them (p = 0.006). Multivariate modelling revealed associations between PUI and the following factors: having a boyfriend/girlfriend (aOR = 5.70), substance use (aOR = 1.78), difficulty in identifying feelings (aOR = 1.09), externally oriented thinking (aOR = 1.05), low disposition in perceiving body sensations (aOR = 0.25), tendency to become distracted (aOR = 0.82) or excessively worried (aOR = 0.11) in the face of pain. Furthermore, the analysis indicated how these aspects of body perception may be interrelated, either enhancing or reducing the risk of PUI when examined individually, collectively, or in combination.

CONCLUSIONS

This study underlines the potential connection between difficulties in the mind-body interaction and the development of PUI. It suggests a bidirectional relationship between excessive digital device use and distorted bodily interoceptive processes in PUI, reinforcing the notion that individuals struggling with emotion identification and expression may be more prone to excessive internet usage. To further comprehend the relevance of these constructs in PUI, it is necessary to conduct more targeted investigations and longitudinal studies.

Adaptive and maladaptive emotion regulation skills are associated with food intake following a hunger-induced increase in negative emotions

Many individuals would like to lose weight and often attempt to do so by dieting. However, dieting attempts often backfire and contribute to the risk of weight gain and obesity. Food restriction inevitably leads to hunger and hunger, in turn, induces negative emotions. The inability to regulate such a hunger-induced increase in negative emotions in an adaptive way may be responsible for overeating. The current study aimed to gain a better understanding of this potential psychological mechanism underlying failed dieting attempts. Adaptive and maladaptive emotion regulation (ER) were assessed with an online questionnaire in women with a healthy weight. Subsequently, participants were assigned to the fasted condition (fasting for 14h, n = 49) or the satiated condition (eating between 2 h and 30 min before the lab session, n = 59) and attended a lab session in which they completed tasks while given the opportunity to eat chips and M&M's. We did not find an association between any ER variable and the likelihood to begin eating. Among those who began eating, higher scores on adaptive cognitive ER and on maladaptive behavioral ER were associated with lower caloric intake in fasted individuals. Higher scores on adaptive behavioral ER were associated with higher caloric intake in fasted individuals. Utilizing adaptive cognitive ER when experiencing a hunger-induced increase in negative emotions may help individuals manage their food intake and maintain a healthy weight.

Emotional culture and humor in organizations: A social-functional approach

Adopting a social-functionalist theoretical lens, this review examines emotional culture and its relation to discrete emotions such as joviality and humor-supportive or "joking" organizational cultures. We propose four primary pathways through which humor influences emotional culture in organizations and social units: (1) creating and defining emotional culture through "bottom-up" affective mechanisms, (2) a "top-down" normative function that promotes or inhibits humor through cultural values, norms, and traditions of organizational life, (3) a maintenance function, whereby humor corrects emotional culture norm violations, and (4) a link to positive work outcomes via a reciprocal feedback loop. We also describe negative consequences of humor for emotional culture, highlight unanswered questions in the literature, and suggest future research opportunities, including a comprehensive new framework.

Effectiveness of Group Emotional Schema Therapy on Psychological Distress, Severity and Frequency of Symptoms in Women with Irritable Bowel Syndrome

Background

This study aimed to evaluate the effectiveness of emotional schema therapy on psychological distress, severity and frequency of symptoms in women with irritable bowel syndrome (IBS).

Materials and Methods

This semi-experimental two-group three-stage (pre and post-test and two-month follow-up) study was done on 30 women of 18-50 years old with IBS. They were randomly assigned to two groups (experimental and control). Psychological distress and Bowel symptoms severity and frequency in the three stages were measured. The emotional schema therapy group was treated for 8 sessions and the control group remained on the waiting list.

Results

The mean score of pre-test, post-test and follow-up of emotional therapy schema group in psychological distress were 21.23 ± 8.18, 16.08 ± 6.05 and 14.69 ± 4.05; in symptom intensity 7.46 ± 1.98, 5.23 ± 1.30 and 6.46 ± 1.33 and in symptom frequency 7.46 ± 1.98, 6.08 ± 1.66 and 7.54 ± 2.18 respectively. In the control group, there was no difference between the scores of different tests; in the pre-test, post-test and follow-up, the scores of psychological distress were 20.23 ± 5.39, 20.08 ± 5.59, and 20.38 ± 4.75, in the symptoms severity 7.69 ± 1.49, 7.62 ± 1.33, and 7.69 ± 1.80, and in the symptoms frequency 6.92 ± 2.75, 6.54 ± 2.40 and 6.62 ± 2.63 respectively. In the control group, there was no difference between the scores in different tests. In the pre-test, post-test and follow-up, in psychological distress, the scores were 20.23 ± 5.39, 20.08 ± 5.59, and 20.38 ± 4.75 in the symptom severity 7.69 ± 1.49, 7.62 ± 1.33, and 7.69. ±1.80 and in the symptoms frequency 6.92 ± 2.75, 6.54 ± 2.40 and 6.92 ± 2.75 respectively (P < 0.05).

Conclusion

Emotional schema therapy can be used as a complementary psychological treatment to reduce psychological distress and severity and frequency of symptoms in women with IBS.

Advances in functional MRI research in bipolar disorder: from the perspective of mood states

Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression. Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disorder. However, the pathophysiology underlying mood instability, mood switching and the development of extreme mood states is less well understood. This review presents a comprehensive overview of current evidence from functional MRI studies from the perspective of mood states. We first summarise the disrupted brain activation patterns and functional connectivity that have been reported in bipolar disorder, irrespective of the mood state. We next focus on research that solely included patients in a single mood state for a better understanding of the pathophysiology of bipolar disorder and research comparing patients with different mood states to dissect mood state-related effects. Finally, we briefly summarise current theoretical models and conclude this review by proposing potential avenues for future research. A comprehensive understanding of the pathophysiology with consideration of mood states could not only deepen our understanding of how acute mood episodes develop at a neurophysiological level but could also facilitate the identification of biological targets for personalised treatment and the development of new interventions for bipolar disorder.

The influence of screen time on behaviour and emotional problems among adolescents: A comparison study of the pre-, peak, and post-peak periods of COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has brought drastic changes globally in the past three years, one of which is an increase in the use of digital media or electronic devices. Previous studies have shown that long screen time may stimulate the neurobiological system, resulting in various behavioural and emotional problems; however, there is insufficient population-based evidence. This study aimed to investigate the influence of screen time on behavioural and emotional problems in Indonesian adolescents at three time points: the pre-, peak, and post-peak periods of COVID-19. Data were collected using an online community mental health survey. This survey incorporated the Youth Screen Time Survey to gauge screen time and the adolescent version of the Strengths and Difficulties Questionnaire to assess emotional, conduct, and prosocial behaviour problems. The participants were adolescents in secondary and senior high schools, with 337, 423, and 1,096 participants from the pre-, peak-, and post-pandemic periods, respectively, included in the analysis. Daily average screen time was compared, followed by the calculation of odds ratios for screen time and mental health problems during the different periods. The results demonstrated significant differences in adolescents' total daily average screen time between the different pandemic periods. Decreased screen time was associated with reduced emotional, conduct, and prosocial behaviour problems, especially during the peak period. Thus, psychoeducation on screen time in adolescents should be considered as a point of interest for mental well-being interventions.

Alarm or emotion? intranasal oxytocin helps determine information conveyed by dog barks for adult male human listeners

BACKGROUND

Barks play an important role in interspecific communication between dogs and humans, by allowing a reliable perception of the inner state of dogs for human listeners. However, there is growing concern in society regarding the nuisance that barking dogs cause to the surrounding inhabitants. We assumed that at least in part, this nuisance effect can be explained by particular communicative functions of dog barks. In this study we experimentally tested two separate hypotheses concerning how the content of dog barks could affect human listeners. According to the first hypothesis, barks that convey negative inner states, would especially cause stress in human listeners due to the process called interspecific empathy. Based on the second hypothesis, alarm-type dog barks cause particularly strong stress in the listener, by capitalizing on their specific acoustic makeup (high pitch, low tonality) that resembles to the parameters of a baby's cry. We tested 40 healthy, young adult males in a double-blind placebo controlled experiment, where participants received either intranasal oxytocin or placebo treatment. After an incubation period, they had to evaluate the (1) perceived emotions (happiness, fear and aggression), that specifically created dog bark sequences conveyed to them; and (2) score the annoyance level these dog barks elicited in them.

RESULTS

We found that oxytocin treatment had a sensitizing effect on the participants' reactions to negative valence emotions conveyed by dog barks, as they evaluated low fundamental frequency barks with higher aggression scores than the placebo-treated participants did. On the other hand, oxytocin treatment attenuated the annoyance that noisy (atonal) barks elicited from the participants.

CONCLUSIONS

Based on these results, we provide first-hand evidence that dog barks provide information to humans (which may also cause stress) in a dual way: through specific attention-grabbing functions and through emotional understanding.

Validation and Cultural Adaptation of the Problem Areas in Diabetes-5 (PAID-5) Scale to European Portuguese

INTRODUCTION

Diabetes distress syndrome (DDS) can lead to poor outcomes and should be assessed with adapted and validated tools. One of these tools is the Problem Areas in Diabetes (PAID) scale, which assesses diabetes distress in people suffering from diabetes (PsD). A short five-item form, PAID-5, is an easier and quicker alternative to be used in clinical and research practices, than the previous one with 20-items and has been validated by the original authors. This study intended to perform the cultural adaptation and validation of the PAID-5 scale in European Portuguese.

METHODS

To create the Portuguese version of PAID-5, translation-back translation, a clinical review, and a cognitive debriefing panel were performed. A convenience sample of 90 PsD was studied in three primary healthcare units for reliability and validity tests. Reliability was studied by the internal consistency (Cronbach's alpha) and the interval coefficient correlation (ICC) under a test-retest design. Structural validity was studied by principal component analysis. The construct validity was tested by the sensitivity of the PAID-5 total score with age, most recent HbA1c test, and socioeconomic class by the Socio-Economic Deprivation Index (SEDI). Criterion validity was tested by correlating the PAID-5 total score with the psychological distress questions of the Diabetes Health Profile 18 Questions (DHP-PDQ).

RESULTS

A Cronbach's alpha coefficient value of 0.905 and an ICC of 0.905 were computed. In a sample of n = 90 PsD, 55.6% were males, 63.3% aged 65 years or more, SEDI was 5.2 ± 0.8 [3 to 6], 44.4% studied for less than 4 years, and 18.9% were living alone. The Spearman correlation between PAID-5 and DHP-PDQ total scores was ρ = 0.382, p < 0.001, between PAID-5 total score and age was ρ = -0.207, p = 0.050 and between PAID-5 total score and most recent HbA1c knowledge was ρ = 0.275, p = 0.040. There was no significant relationship between PAID-5 total score and SEDI ρ = 0.080, p = 0.452.

CONCLUSION

DDS can now be assessed in the Portuguese context, accounting for better intervention by primary care teams. PAID-5 has good psychometric properties and is a reliable scale to identify diabetes-specific distress in the Portuguese diabetic population.

Virtual vs. real: exploring perceptual, cognitive and affective dimensions in design product experiences

BACKGROUND

Virtual Reality (VR) has already emerged as an effective instrument for simulating realistic interactions, across various domains. In the field of User Experience (UX), VR has been used to create prototypes of real-world products. Here, the question is to what extent the users' experience of a virtual prototype can be equivalent to that of its real counterpart (the real product). This issue particularly concerns the perceptual, cognitive and affective dimensions of users' experiences.

METHODS

This exploratory study aims to address this issue by comparing the users' experience of a well-known product, i.e., the Graziella bicycle, presented either in Sumerian or Sansar VR platform, or in a physical setting. Participants' Emotional Engagement, Sense of Presence, Immersion, and Perceived Product Quality were evaluated after being exposed to the product in all conditions (i.e., Sumerian, Sansar and Physical).

RESULTS

The findings indicated significantly higher levels of Engagement and Positive Affect in the virtual experiences when compared to their real-world counterparts. Additionally, the sole notable distinction among the VR platforms was observed in terms of Realism.

CONCLUSIONS

This study suggests the feasibility and potential of immersive VR environments as UX evaluation tools and underscores their effectiveness in replicating genuine real-world experiences.

Psychometric Evaluation of a Persian Version of Beliefs about Emotions Scale in Community and Clinical Samples

Objective: This research is primarily conducted to determine the psychometric properties of the Beliefs about Emotions Scale (BES) in community and clinical samples. The BES is a scale measure used for evaluating individuals' beliefs in terms of how acceptable it is for them to experience and express their emotions. Method : This study was conducted on two separate samples. In the first part, 300 individuals were selected from a general sample in Tehran using the quota sampling method. For the second part of the study, we used purposive sampling to gather data from 119 patients suffering from Major Depressive Disorder (MDD) and 121 patients from Somatic Symptoms Disorder (SSD), whose disorders were diagnosed based on the DSM-5 diagnostic criteria. The BES structural validity was examined through Confirmatory Factor Analysis (CFA). Additionally, test-retest composite and internal consistency indices were explored to investigate the reliability of the BES score. Finally, the associations of the BES score with the Hospital Anxiety and Depression Scale (HADS), Young Schema Questionnaire (YSQ), Multidimensional Perfectionism Scale (MPS), Difficulties in Emotion Regulation Scale (DERS), and Emotion Regulation Questionnaire (ERQ) scores were highlighted to investigate the discriminant and convergent validity of the BES score. Results: According to CFAs, the one-factor model for the BES demonstrated a good fit with the data collected from both the clinical and community samples. The internal consistency (Cronbach's alpha) was satisfactory in the community sample (α = 0.84) and the clinical samples of SSD (α = 0.86) and MDD (α = 0.83). The community sample demonstrated high overall test-retest reliability (ICC = 0.93, P < 0.001; 95% CI: 0.89 - 0.95). In terms of convergent validity, the findings confirmed that in the MMD sample, there was a significant relationship between the BES and almost all measures (including Depression (r = 0.39, P < 0.01), Anxiety (r = 0.21, P < 0.05), Self-Sacrifice (r = 0.27, P < 0.01), MPS-total score (r = 0.22, P < 0.05), DERS total score (r = 0.50, P < 0.01), and Suppression (r = 0.38, P < 0.01). However, in the SSD group, this finding was not found. Conclusion: The results demonstrated that the Persian BES is a reliable and valid scale of maladaptive beliefs about emotions which could be implemented for both clinical and research aims.

Differences in the Social Motivations and Emotions of Humans and Other Great Apes

Humans share with other mammals and primates many social motivations and emotions, but they are also much more cooperative than even their closest primate relatives. Here I review recent comparative experiments and analyses that illustrate humans' species-typical social motivations and emotions for cooperation in comparison with those of other great apes. These may be classified most generally as (i) 'you > me' (e.g., prosocial sympathy, informative and pedagogical motives in communication); (ii) 'you = me' (e.g., feelings of mutual respect, fairness, resentment); (iii) 'we > me' (e.g., feelings of obligation and guilt); and (iv) 'WE (in the group) > me' (e.g., in-group loyalty and conformity to norms, shame, and many in-group biases). The existence of these species-typical and species-universal motivations and emotions provides compelling evidence for the importance of cooperative activities in the human species.

Fine wine recognition and appreciation: It is time to change the paradigm of wine tasting

Wine quality maybe understood under two perspectives: (a) commercial quality, intended to satisfy overall consumers, and (b) fine wine quality, aimed at achieving a product with aesthetic value. The current food sensory techniques (e.g. Descriptive Analysis) have been successfully applied to develop wines accepted worldwide and characterized by pleasant sweetish flavours and smooth mouthfeel. On the contrary, these techniques are not suited to characterize fine wines given their dependence on sensory properties with aesthetic value. The conventional tasting approaches follow the sequence of vision, smell (orthonasal), taste and mouthfeel, ending by an overall evaluation. The sensory descriptors tend to be analytic (e.g. different aromas and tastes) or synthetic (e.g. body, structure) and the quality judgement is left for the final step. Some synthetic attributes may have an aesthetic significance (e.g. complexity, harmony, depth) and are more valued when the analytic or synthetic descriptors are highly praised (e.g. oakiness, silkiness, body, minerality). Consequently, these highly praised attributes are regarded as surrogates of fine wine quality. However, commercial wines are frequently judged of higher quality than fine wines irrespective of the taster expertise. We argue that the conventional sensory analysis sequence makes the overall evaluation secondary in relation to the previous analytical steps blurring the assessment of wine's aesthetic properties. Probably due to top-down processing, the initial evaluation of colour or flavours governs the final overall quality evaluation that may be inconsistently rated. Then, to promote the recognition of fine wines, tasting should begin by first acknowledging the aesthetic properties and only proceed to the analytical steps if necessary. A tasting method is proposed to consumer educational programs where emotional responses are used to explain the differences between commercial and fine wine styles. Furthermore, cultural aspects should be included to appreciate the wholeness of wine. Hopefully, this holistic perspective would turn wine appreciation more approachable and facilitate the recognition of fine wines among consumers, increasing their appreciation and enjoyment.

Temporal associations between salivary cortisol and emotions in clinically depressed individuals and matched controls: A dynamic time warp analysis

Depression can be understood as a complex dynamic system where depressive symptoms interact with one another. Cortisol is suggested to play a major role in the pathophysiology of depression, but knowledge on the temporal interplay between cortisol and depressive symptoms is scarce. We aimed to analyze the temporal connectivity between salivary cortisol and momentary affective states in depressed individuals and controls. Thirty pair-matched depressed and non-depressed participants completed questionnaires on momentary positive (PA) and negative (NA) affect and collected saliva three times a day for 30 days. The association between cortisol and affect was analyzed by dynamic time warp (DTW) analyses. These analyses involved lag-1 backward to lag-1 forward undirected analyses and lag-0 and lag-1 forward directed analyses. Large inter- and intra-individual variability in the networks were found. At the group level, with undirected analysis PA and NA were connected in the networks in depressed individuals and in controls. Directed analyses indicated that increases in cortisol preceded specific NA items in controls, but tended to follow upon specific affect items increase in depressed individuals. To conclude, at group level, changes in cortisol levels in individuals diagnosed with a depression may be a result of changes in affect, rather than a cause.

Recalibrating the Scales: Enhancing Ethnographic Uses of Standardized Mental Health Instruments

This article reflects on the narrative data that can emerge through the use of standardized mental health scales, drawing from two studies related to emotional distress among immigrant populations in Texas. In both studies, standardized scales complemented in-depth interviews. The initial goal in using scales was to collect quantifiable data, yet through the research process, the scales also served to elicit complementary narratives that enhanced interview data, forcing the researchers to reconsider the potential uses of scales. In thinking about the ethnographic potential of standardized scales, the goal of this article is twofold. First, based on our findings, it presents methodological considerations for how to use scales in a way that can facilitate the emergence of in-depth responses that complement other ethnographic methods. Second, although the scope of data collected and analyzed utilizing scales is most often limited to quantitative data, this research demonstrates a need to more fully consider other forms of data that may emerge from using scales. Thus, this article reflects on three inter-related areas where scales provided ethnographic data, using examples from two studies. Overall, this research shows that scales have more ethnographic potential than what has typically been recognized.

The relationship between alexithymia, emotion regulation, and sleep problems in school-aged children: A multicentric study

OBJECTIVES

Alexithymia, mood dysregulation, and sleep quality have complicated effects on children's development. The current study aimed to investigate the relationship between alexithymia, emotion regulation, psychiatric problems, and sleep problems among Egyptian school-aged children.

METHODS

A total of 564 Egyptian children, aged 6 to 14, were divided into two groups based on their total Children's Sleep Habits Questionnaire abbreviated score: group 1 (N = 300) with sleep problems and group 2 (N = 264) with non-sleep problems. Their parents completed the Strengths and Difficulties Questionnaire (SDQ) and subjectively assessed the children's emotions using the Children's Alexithymia Measure (CAM) and the Clinical Evaluation of Emotional Regulation-9 (CEER-9).

RESULTS

Males were more proportional in the sleep problems group than others. The sleep problem group was significantly younger and had a longer daily sleep duration than the non-sleep problem group. Alexithymia and emotion dysregulation had the highest mean in the sleep problem group. Furthermore, alexithymia, emotion dysregulation, emotion difficulty, conduct, and prosocial problems were the most significant contributing factors and risk factors for sleep problems in children.

CONCLUSION

Sleep problems in children were associated with younger male children with lengthy daily sleep duration and emotional, behavioural, and prosocial difficulties. Furthermore, alexithymia and emotion dysregulation are significant contributors and risk factors for sleep problems in school-aged children.

Effects of participant-selected versus researcher-selected music on stress and mood - The role of gender

OBJECTIVE

Previous research suggests differential effects of participant-selected (PS) vs. researcher-selected (RS) music on emotional responses to music listening. This study investigates whether such selection strategies, as well as gender, influence (1) stress and (2) mood responses. Additionally, we examine the role of (3) stimulus-induced emotions and (4) emotion regulation strategies.

METHODS

Participants (N = 61) listened to auditory stimuli (PS music, RS music, sound of lapping water (LW); randomized) on three days and underwent a cold pressor test (CPT) while listening. Stress parameters (subjective acute stress, heart rate, parameter RMSSD, salivary alpha-amylase, salivary cortisol), mood dimensions (calmness, valence, energetic arousal), emotions, and emotion regulation strategies were measured. Multilevel and mediation analyses were conducted.

RESULTS

(1) There were no direct effects of selection strategy or gender on stress responses, but interaction effects indicated that women showed the strongest subjective stress response and the longest HR recovery with PS music, while men showed the lowest HR response to the CPT with PS music. (2) No mood differences emerged between PS and RS music overall. Women showed stronger variability in calmness overall as well as perceived higher arousal when listening to PS music compared to men. (3) Higher stimulus-induced anger in men compared to women and with LW compared to PS was associated with lower calmness and valence, while no consistent pattern emerged for the stress responses. (4) Women scored higher on reappraisal, associated with a decrease in parasympathetic activity, whereas men scored higher on suppression, associated with an increase in endocrine activity.

CONCLUSIONS

Music selection and gender appear to have no direct impact on stress and mood responses overall, although men tend to benefit more from self-selected music than women. Our findings provide first indications that avoiding music stimuli that induce anger may facilitate mood management via music. Furthermore, finding alternative emotion regulation strategies to the strategy of suppression may be a helpful approach to improve music-based stress management.

Psychosocial Predictors of Colorectal Cancer Screening Intention: An Experiment on the Invitation Letter

BACKGROUND

In Italy, attendance rates for colorectal cancer (CRC) screening are suboptimal. The present work analysed cognitive and emotional predictors of CRC screening intention and tested an intervention on a real invitation letter to improve CRC screening intention, both directly and in interaction with the predictors of our model.

METHODS

Our model included variables from the theory of planned behaviour and the emotional barriers to bowel screening scale. We applied six changes to an invitation letter used in Italy to avoid the repetition of words like 'faeces', 'blood', or 'occult' and reduce the prompting of disgust. The 228 participants were randomly assigned to a between-participants design (original letter vs. manipulated letter).

RESULTS

Disgust hindered CRC screening intention, while embarrassment, fear, and subjective norms (i.e., perception of the social pressures to attend CRC screening) were not associated with intention to screen. More positive attitudes towards CRC screening were associated with a higher intention to screen. The positive association between perceived behavioural control and CRC screening intention was stronger for participants who read the letter with fewer (vs. more) references to bodily waste. Letter manipulation did not affect intention to screen.

CONCLUSIONS

The disgust associated with faecal matter is a critical factor in determining CRC screening attendance, and it should be acknowledged as such in public policies. Until new screening tests avoiding the activation of this emotional reaction are concretely available, public campaigns should improve CRC screening participation by boosting both positive attitudes towards screening and patients' perceived behavioural control.