Short-Term Medication Effect on Fall Risk in Multimorbid Inpatients with Dementia

INTRODUCTION

Dementia increases the risk of falls and fall-related injuries, which may be caused by inappropriate medication use. To date, there is little evidence on which medications are more likely to cause falls. We therefore investigated the effects of medication use and medication changes 48 h before falls in hospitalised patients with dementia.

METHODS

This matched case-control study included 74 patients with a mean age of 83 years (38% women) who had been hospitalised for at least 7 days. Information on medications, diagnoses, disease severity, use of walking aids, falls, and demographics was collected from electronic medical records. The effects of the number of medications and psychotropics, equivalent daily doses of antidepressants, antipsychotics and benzodiazepines, anticholinergic burden, medication initiation, dose change, medication discontinuation, as-needed medications, opioid use and the presence of fall-increasing diseases were examined separately for the periods 0 h-24 h and 24 h-48 h before the falls using binomial logistic regression analyses.

RESULTS

Falls increased significantly with higher daily antipsychotic doses 24 h before the fall. In addition, the rate of falls increased with higher anticholinergic burden and prevalence of medication discontinuation 24-48 h before the fall. Notably, the total number of medications and psychotropic medications had no effect on the incidence of falls.

CONCLUSION

With regard to the short-term effects of medication on fall risk, particular attention should be paid to the daily dose of antipsychotics, anticholinergic burden and medication discontinuation. Further studies with larger samples are needed to confirm the results of this study.

Learning to be inventive in the face of statistics: A positive reappraisal intervention for statistics anxiety

BACKGROUND AND OBJECTIVES

The burden of statistics anxiety on students calls for effective interventions. This study investigated whether a cognitive reappraisal training designed to stimulate the generation of positive re-interpretations may yield behavioral changes in anxiety measures and changes in cerebral activation patterns reflecting the activation of approach/avoidance motivational tendencies (frontal EEG alpha asymmetry response).

METHODS

Three groups of female psychology students (n = 45) with statistics anxiety were tested. Two groups received a guided, two-week reappraisal training with either statistics-anxiety or general anxiety situations; the control group received no intervention.

RESULTS

Both training groups significantly increased their amount of positive re-interpretations from pre-to post-test compared to the control group. Increased habitual use of reappraisal in statistics situations and significant EEG changes reflecting more approach-oriented coping with anxiety occurred in the statistics-anxiety training group only. No changes in statistics anxiety and statistics attitudes were observed, suggesting that the training effects, though corroborated through neurophysiological changes, did not sufficiently translate to improving students' deep-rooted anxiety.

LIMITATIONS

Effects, though robust and following the same pattern, were observed in a small sample.

CONCLUSIONS

Our findings delineate a promising expandable approach for helping students' cope with statistics anxiety in a healthier way.

The contribution of difficulty of an irrelevant task to task conflict

In the standard colour-word Stroop task, participants are presented with colour words and required to respond to their colour while ignoring their meaning. Two types of conflict might occur in such experiments: information conflict and task conflict. Information conflict reflects the processing of two contradicting pieces of information and is indicated by shorter reaction times (RTs) in congruent than in incongruent trials. Task conflict reflects the additional effort associated with performing two tasks, as opposed to one, and is indicated by shorter RTs in neutral trials than in congruent trials (termed reverse facilitation). While information conflict is commonly seen in Stroop and Stroop-like tasks, task conflict is rarely observed. In the present study, participants were presented with coloured segments that, by applying Gestalt principles, could be perceived as colour words. We found that incongruent trials were slower than congruent trials, suggesting that participants successfully perceived the colour words, which led to involuntary reading. In addition, reversed facilitation was found so that neutral trials (i.e., trials that only consist of one task) were faster than congruent trials (as well as incongruent trials; both consist of two tasks). The presence of both interference from the incongruent trials and reverse facilitation suggests that involuntary reading could also occur in scenarios requiring cognitive effort.

Simulated Acute Hypobaric Hypoxia Effects on Cognition in Helicopter Emergency Medical Service Personnel - A Randomized, Controlled, Single-Blind, Crossover Trial

OBJECTIVE

To evaluate, under replicable, blinded and standardised conditions, the effect of acute exposure to hypobaric hypoxia (HH) (equivalent to 200 or 3000 or 5000 m above sea level (asl)) on selected cognitive domains and physiological parameters in personnel of helicopter emergency medical service (HEMS).

METHODS

We conducted a randomized clinical trial using a single-blind crossover design in an environmental chamber (terraXcube) to induce HH in 48 HEMS personnel. Participants performed cognitive tests (CT) before the ascent, after 5 min at altitude, and after simulated cardiopulmonary resuscitation (SCR). CT evaluated: sustained attention using the psychomotor vigilance test (PVT) that included measurement of reaction time (RT); risky decision making using the balloon analogue risk task (BART), and attention and speed of processing using the digit symbol substitution test (DSST). CT performance was subjectively rated with a visual analogue scale (VAS). Physiological data were recorded with a physiological monitoring system. Data were analysed using a linear mixed model and correlation analysis.

RESULTS

Mean reaction time was significantly slower (p = 0.002) at HH (5000 m asl), but there were no independent effects of HH on the other parameters of the PVT, BART or DSST. Participants did not detect subjectively the slower RT at altitude since VAS performance results showed a positive correlation with mean RT (p = 0.009). DSST results significantly improved (p = 0.001) after SCR.

CONCLUSION

Acute exposure of HEMS personnel to HH induced a slower RT but no changes in any other investigated measures of cognition. The reduced RT was not detected subjectively by the participants. Trial number 3489044136, ClinicalTrials.gov trial registration.

Insights from Eye Blinks into the Cognitive Processes Involved in Visual Word Recognition

Behavioral differences in speed and accuracy between reading familiar and unfamiliar words are well-established in the empirical literature. However, these standard measures of skill proficiency are limited in their ability to capture the moment-to-moment processing involved in visual word recognition. In the present study, the effect of word familiarity was initially investigated using an eye blink rate among adults and children. The probability of eye blinking was higher for familiar (real) words than for unfamiliar (pseudo)words. This counterintuitive pattern of results suggests that the processing of unfamiliar (pseudo)words is more demanding and perhaps less rewarding than the processing of familiar (real) words, as previously observed in both behavioral and pupillometry data. Our findings suggest that the measurement of eye blinks might shed new light on the cognitive processes involved in visual word recognition and other domains of human cognition.

Impact of repeated morning bright white light exposures on attention in a simulated office environment

Attention is essential to the work. This study investigated the effects of two different light pulses on a simple attention task. In addition, the effects of subsequent exposure to constant but different illuminance levels on the continuation of the simple attention task and a subsequent complex attention task were examined. A total of 56 subjects were assigned in random order to two white light interventions that were repeated five times during the morning. Each light intervention consisted of a brief light pulse followed by constant light exposure and differed in temporal dimming dynamics and corneal illuminance. Subjective and psychometric parameters were recorded several times during light exposure. Heart rate variability (HRV) was derived from continuous electrocardiograms. Subjects showed improved reaction speed in the simple attention task, accompanied by higher HRV under a brighter light pulse without habituation by repetition. This difference in simple attention performance disappeared when light exposure remained the same after the light pulse. In addition, higher reaction speed and HRV were observed in the complex attention task under constant bright light exposure. Intermittent bright light seems promising to acutely improve attentional performance in office workplaces. Future research is needed to investigate daytime light effects on other work-related cognitive functions.

Partizipation von Studierenden mit neurokognitiven Beeinträchtigungen am Beispiel von ADHS und spezifischen Lernstörungen

Zusammenfassung: Das Hauptziel des vorliegenden Beitrags ist eine kritische Reflexion der Situation von Studierenden mit neurokognitiven Beeinträchtigungen in Hinblick auf deren Partizipation im universitären Setting. Nach einer kurzen Erläuterung der aktuellen universitätsrechtlichen Rahmenbedingungen in Deutschland, Österreich und der Schweiz werden (i) am Beispiel von Aufmerksamkeitsstörungen und spezifischen Lernstörungen charakteristische Schwierigkeiten von betroffenen Studierenden beim Studium anhand von Fallvignetten dargestellt und (ii) Ziele in Hinblick auf eine gelingende Partizipation und Chancengleichheit für Studierende mit Beeinträchtigungen skizziert. Anhand eines tentativen Rahmenmodells zur Förderung der Partizipation diskutieren wir die Notwendigkeit differenzierter universitätsinterner und -externer struktureller Rahmenbedingungen, die zusätzlich zu den bereits bestehenden – aber nicht ausreichenden – universitätsinternen Maßnahmen wie dem Nachteilsausgleich implementiert werden sollten.

Light Intervention Effects on Circadian Activity Rhythm Parameters and Nighttime Sleep in Dementia Assessed by Wrist Actigraphy: A Systematic Review and Meta-Analysis

BACKGROUND AND OBJECTIVES

Persons with dementia often show circadian rhythm disturbances and sleep problems. Timed light exposure seems to be a promising nonpharmacological treatment option. In this review, meta-analyses were run on light effects on circadian activity rhythm parameters in persons with dementia measured with wrist actimetry. Furthermore, we update a Cochrane review, published in 2014, on actigraphically measured light effects in nighttime sleep parameters in persons with dementia.

RESEARCH DESIGN AND METHODS

Four electronic databases were searched for randomized controlled trials. Effects in meta-analyses were summarized by using mean differences and 95% confidence intervals. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to assess the risk of bias and registered the review protocol (PROSPERO: CRD42020149001).

RESULTS

Thirteen trials met inclusion criteria, and either utilized light therapy devices, ambient room lighting systems, or dawn-dusk interventions. Eleven of these studies were subjected to meta-analyses. They did not reveal significant light effects on circadian activity parameters: amplitude (p = .62; n = 313), acrophase (p = .34; n = 313), intradaily variability (p = .51; n = 354), and interdaily stability (p = .38; n = 354). Furthermore, no light effects were found on sleep parameters: total sleep duration (p = .53; n = 594), sleep efficiency (p = .63; n = 333), wake after sleep onset (p = .95; n = 212), and sleep onset latency (p = .26; n = 156). Subgroup analyses, pooling data from 3 studies including persons with Alzheimer's dementia, also did not show light effects on circadian activity and sleep parameters. The overall risk of bias of included studies was high.

DISCUSSION AND IMPLICATIONS

There is insufficient evidence for actigraphically measured circadian light effects in persons with dementia. More high-quality research is needed to recommend the application of adjunctive light.

Self-efficacy matters: Influence of students' perceived self-efficacy on statistics anxiety

Statistical knowledge is a key competency for psychologists in order to correctly interpret assessment outcomes. Importantly, when learning statistics (and its mathematical foundations), self-efficacy (defined as an individual's belief to successfully accomplish specific performance attainments) is a central predictor of students' motivation to learn, learning engagement, and actual achievement. Therefore, it is crucial to gain a better understanding of students' self-efficacy for statistics and its interrelations with statistics anxiety and students' belief in the relevance of statistics. Here, we present results showing development and validation of a self-assessment questionnaire for examining self-efficacy for statistics in psychology students (Self-Efficacy for Learning Statistics for Psychologists, SES-Psy). Upon using different methodological approaches, we demonstrate that the SES-Psy questionnaire has (1) sound psychometric properties, and within our sample of university students, (2) a robust latent structure disclosing three clearly distinctive profiles that are characterized by a complex and nonlinear interplay between perceived self-efficacy (for basic and advanced statistics), statistics anxiety, and students' belief in the relevance of statistics. Implications for educational settings and future research are discussed.

Disorder-Specific Profiles of Self-Perceived Emotional Abilities in Schizophrenia and Major Depressive Disorder

Deficits in social cognition are a core feature of neuropsychiatric disorders. The purpose of this study was to compare profiles of self-perceived abilities across the core domains of emotional functioning between patients with schizophrenia (n = 22), major depressive disorder (n = 31) and healthy participants (n = 43) with the Self-report Emotional Ability Scale (SEAS). Profile analyses were used to explore group differences in the overall level of self-perceived effectiveness of emotional functioning and in the patterns in which the four functions of emotion perception and regulation in the intra- and inter-personal domains are arranged to each other. Both patient groups showed significantly lower overall levels of self-perceived emotional functioning compared to healthy controls. Most importantly, we found significant differences between patient groups in their profile patterns. Patients with schizophrenia indicated experiencing difficulties in all investigated domains, but the profile pattern largely matched that of healthy individuals. Instead, the profile of patients with depression was much more accentuated, showing lower perceived effectiveness of emotion perception and regulation in the intra-personal domain compared to inter-personal functions. Our results of disorder-specific emotional deficits may have profound implications for early screening and identification of at-risk populations as well as recovery-oriented interventions.

Body Mass Index Predicts Decline in Executive Function in Bipolar Disorder: Preliminary Data of a 12-Month Follow-up Study

INTRODUCTION

Obesity and associated risk factors have been linked to cognitive decline before.

OBJECTIVES

In the present study, we evaluated potential cumulative negative effects of overweight and obesity on cognitive performance in euthymic patients with bipolar disorder (BD) in a longitudinal design.

METHODS

Neurocognitive measures (California Verbal Learning Test, Trail Making Test [TMT] A/B, Digit-Symbol-Test, Digit-Span, d2 Test), anthropometrics (e.g., body mass index [BMI]), and clinical ratings (Hamilton Depression Scale, Young Mania Rating Scale) were collected over a 12-month observation period. Follow-up data of 38 patients with BD (mean age 40 years; 15 males, 23 females) were available.

RESULTS

High baseline BMI predicted a decrease in the patient's performance in the Digit-Span backwards task measuring working memory performance. In contrast, cognitive performance was not predicted by increases in BMI at follow-up. Normal weight bipolar patients (n = 19) improved their performance on the TMT B, measuring cognitive flexibility and executive functioning, within 1 year, while overweight bipolar patients (n = 19) showed no change in this task.

CONCLUSIONS

The results suggest that overweight can predict cognitive performance changes over 12 months.

Decision Making under Risk in Patients Suffering from Schizophrenia or Depression

Studies have reported difficulties in decision making for patients with schizophrenia or depression. Here, we investigated whether there are differences between schizophrenia patients, depressed patients, and healthy individuals (HC) when decisions are to be made under risk and cognitive flexibility is required. We were also interested in the relationships between decision making, cognitive functioning, and disease severity. Thirty HC, 28 schizophrenia patients, and 28 depressed patients underwent structured clinical assessments and were assessed by the Positive and Negative Syndrome Scale or Hamilton Rating Scale. They performed the Probability-Associated Gambling (PAG) Task and a neuropsychological test battery. Both patient groups obtained lower scores than HC in memory and executive function measures. In the PAG task, relative to HC, depressed patients made slower decisions but showed a comparable number of advantageous decisions or strategy flexibility. Schizophrenia patients were slower, riskier, and less flexible compared to HC. For them, the decision making behavior correlated with the symptom severity. In both groups, decision making scores correlated with memory and executive function scores. Patients with schizophrenia or depression may have difficulties under risk when quick and flexible decisions are required. These difficulties may be more pronounced in patients who have marked cognitive deficits or severe clinical symptoms.

A Prospective Evaluation of the Acute Effects of High Altitude on Cognitive and Physiological Functions in Lowlanders

Cognitive function impairment due to high altitude exposure has been reported with some contradictory results regarding the possible selective cognitive domain involvement. We prospectively evaluated in 36 lowlanders, exposed for 3 consecutive days to an altitude of 3,269 m, specific cognitive abilities (attention, processing speed, and decision-making) required to safely explore the mountains, as well as to work at altitude. We simultaneously monitored the physiological parameters. Our study provides evidence of a reduced processing speed in lowlanders when exposed to altitude in the first 24 h. There was a fairly quick recovery since this impairment was no more detectable after 36 h of exposure. There were no clinically relevant effects on decision-making, while psychomotor vigilance was unaffected at altitude except for individuals with poor sleep. Significant changes were seen in physiological parameters (increased heart rate and reduced peripheral oxygen saturation). Our results may have practical implications, suggesting that individuals should practice prudence with higher ascent when performing risky activities in the first 24–36 h, even at altitudes below 3,500 m, due to an impairment of the cognitive performance that could worsen and lead to accidents.

Unaffected Memory and Inhibitory Functioning Several Weeks Postpartum in Women with Pregnancy Complicated by Preeclampsia

Several studies reported impaired cognitive functioning after pregnancy complicated by preeclampsia. The present study examined cognitive and executive functioning in women with preeclampsia at a time at which immediate effects of gestation have resolved, brain damage due to other risk factors have not yet manifested, and impairments may thus primarily occur as a result of the huge stress induced by the potentially life threatening condition. Verbal learning/memory (California Verbal Learning Test) and inhibitory functioning (Mittenecker Pointing Test) of 35 women with preeclampsia and 38 women with uncomplicated pregnancy were followed over five measurement time points during the period from 16 to 48 weeks postpartum. A further control group comprised 40 women with no history of recent pregnancy. The groups did not differ in their verbal learning/memory performance. Higher levels of currently experienced everyday-life stress were associated with poorer inhibitory control/greater stereotypy in responding, but this effect was not directly connected with pregnancy complications. Taken together, the findings do not indicate rapid-onset cognitive impairment after preeclampsia, brought about by its extremely stressful nature or other factors that take effect during gestation. Deficits observed in later life may develop on a long-term basis through late-diagnosed hypertension and unfavorable lifestyle factors. The large time window in which exaggerated cognitive decline can be prevented or mitigated should be utilized for the control of risk factors and interventions to improve lifestyle where appropriate.

The Impacts of the Presence of an Unfamiliar Dog on Emerging Adults' Physiological and Behavioral Responses Following Social Exclusion

Research indicates that non-human attachment figures may mitigate the negative consequences of social exclusion. In the current experiment, we examined how the presence of an unfamiliar companion dog in the laboratory effects physiological and behavioral reactions in female emerging adults after social exclusion compared to inclusion. Results revealed the beneficial effects of the dog: Socially excluded participants in the company of a dog showed less aggressive behavior in response to the hot sauce paradigm compared to excluded participants in the control condition. Furthermore, cardiac responses indicated mitigated perception of threat in a subsequent insult episode when a dog was present. The presence of a dog did not impact the most instantaneous, "reflexive" response to the social exclusion as revealed by characteristic cardiac changes. Together, the findings indicate that the presence of a companion dog takes effect in a later, reflective period following a social exclusion experience, which implicates relevant social elaboration and appraisal processes.

More habitual physical activity is linked to the use of specific, more adaptive cognitive reappraisal strategies in dealing with stressful events

Physical activity may improve stress resilience and well-being. However, specific links to individuals' coping abilities with stressful events are sparse. This study tested whether individuals reporting more physical activity in daily life showed a higher capacity for cognitive reappraisal in dealing with potential stressors. Ninety-eight participants reported their regular physical activity in the Freiburger Questionnaire on Physical Activity and completed a maximum performance test of their inventiveness in generating reappraisals for situations depicting real-life stressors. The latter provides scores for overall cognitive reappraisal capacity (quantity of ideas) and preference for specific cognitive reappraisal strategies (quality of ideas; positive reinterpretation; problem-oriented, de-emphasizing reappraisals). Additionally, participants' anxious and depressive dispositions and general creative abilities were assessed. Results showed no association between time spent on physical activities per week and total quantity of generated reappraisal ideas. However, a higher degree of physical activity was specifically linked to a greater relative preference for the reappraisal strategy of positive reinterpretation. Opposite associations emerged for the strategy of de-emphasizing reappraisals. The findings support the notion of more adaptive cognitive reappraisal use in more physically active individuals and may advance research on interrelationships between physical activity and cognitive and affective functions implicated in stress management.

Humor comprehension and creative cognition: Shared and distinct neurocognitive mechanisms as indicated by EEG alpha activity

Humor comprehension is increasingly recognized as showing parallels to more conventional creative cognition; yet our understanding of brain mechanisms underlying creative cognition in a humorous context is still limited. The present study addressed this issue by investigating functional patterns of EEG alpha activity while 93 participants viewed nonverbal humorous cartoons until they indicated having recognized the punch line, and subsequently vocalized their idea as to what constituted it. In a similar fashion, EEG was also assessed during performance of the Alternate Uses Task (AUT), in order to identify similarities and differences in EEG alpha activity implicated in conventional creative cognition vs. humor comprehension. Analyses revealed a pattern of robust task-related alpha power increases in both tasks, which were markedly more right-lateralized at ventral fronto-temporal sites in the humor task as compared to the AUT. Findings are interpreted in line with recent literature on the functional role of alpha activity in the creativity domain. Altogether, this study adds further evidence to the particular role of EEG alpha oscillations in creative cognition and supports the idea that conventional creative ideation and the comprehension of humor share neural mechanisms affiliated to creative cognition.

Acute Effects of a Short Bout of Physical Activity on Cognitive Function in Sport Students

Physical activity is a promising intervention to restore cognitive function after prolonged sedentary periods. However, little is known about the effect of short physical activity bouts on cognition especially among individuals that are used to physical activity. Therefore, the goal of the present study was to assess the impact of a single ten-minute physical activity bout on the cognitive domain of visual attention compared to sedentary behavior in a population of physically active sport students. Using a randomized controlled design, 51 healthy and physically active sport students [mean age: 22.3 (SD: 2.0) years, 33.3% female] were allocated to one of the following interventions in the break of a two-hour study course: physical activity group (running for ten minutes) and sedentary control group. Visual attention was measured post-intervention using a modified trail making test. Pre-, post-, and 30 min after intervention, perceived attention, and affective states were measured. Between-group comparisons were used to analyze whether visual attention and/or changes in perceived attention or affective states differed between groups. The physical activity group showed significantly higher visual attention post-intervention compared with the sedentary control group, p = 0.003, d = 0.89. Perceived attention, p = 0.006, d = 0.87, and arousal, p < 0.001, d = 1.68, showed a significantly larger pre- and post-intervention increase in the physical activity group compared with the sedentary control group, which was not evident 30 min after intervention. A single ten-minute running intervention in study breaks might help to restore the basal visual attentional domain of cognition after prolonged sedentary periods more effectively compared with common sedentary behavior in breaks between study lessons.

Gender differences in facial emotion recognition in persons with chronic schizophrenia

Background

The aim of the present study was to investigate possible sex differences in the recognition of facial expressions of emotion and to investigate the pattern of classification errors in schizophrenic males and females. Such an approach provides an opportunity to inspect the degree to which males and females differ in perceiving and interpreting the different emotions displayed to them and to analyze which emotions are most susceptible to recognition errors.

Methods

Fifty six chronically hospitalized schizophrenic patients (38 men and 18 women) completed the Penn Emotion Recognition Test (ER40), a computerized emotion discrimination test presenting 40 color photographs of evoked happy, sad, anger, fear expressions and neutral expressions balanced for poser gender and ethnicity.

Results

We found a significant sex difference in the patterns of error rates in the Penn Emotion Recognition Test. Neutral faces were more commonly mistaken as angry in schizophrenic men, whereas schizophrenic women misinterpreted neutral faces more frequently as sad. Moreover, female faces were better recognized overall, but fear was better recognized in same gender photographs, whereas anger was better recognized in different gender photographs.

Conclusions

The findings of the present study lend support to the notion that sex differences in aggressive behavior could be related to a cognitive style characterized by hostile attributions to neutral faces in schizophrenic men.

Actigraphy for Assessing Light Effects on Sleep and Circadian Activity Rhythm in Alzheimer's Dementia: A Narrative Review

Background:

Alzheimer's Disease (AD) is often accompanied by severe sleep problems and circadian rhythm disturbances which may to some extent be attributed to a dysfunction in the biological clock. The 24-h light/dark cycle is the strongest Zeitgeber for the biological clock. People with AD, however, often live in environments with inappropriate photic Zeitgebers. Timed bright light exposure may help to consolidate sleep- and circadian rest/activity rhythm problems in AD, and may be a low-risk alternative to pharmacological treatment.

Objective & Method:

In the present review, experts from several research disciplines summarized the results of twenty-seven light intervention studies which used wrist actigraphy to measure sleep and circadian activity in AD patients.

Results:

Taken together, the findings remain inconclusive with regard to beneficial light effects. However, the considered studies varied substantially with respect to the utilized light intervention, study design, and usage of actigraphy. The paper provides a comprehensive critical discussion of these issues.

Conclusion:

Fusing knowledge across complementary research disciplines has the potential to critically advance our understanding of the biological input of light on health and may contribute to architectural lighting designs in hospitals, as well as our homes and work environments.

Functional coupling of brain networks during creative idea generation and elaboration in the figural domain

The neuroscientific investigation of creative cognition has advanced by considering the functional connectivity between brain regions and its dynamic changes over time, which are consistent with stages in the ideation process. Surprisingly, although the communication between neuronal networks takes place in a time-scale of milliseconds, EEG studies investigating a time-course in cortico-cortical communication during creative ideation are rare and findings are typically restricted to the verbal domain. Therefore, this study examined functional coupling using EEG (task-related phase-locking in the upper-alpha range) during creative thinking in the figural domain. Using an innovative computerized experimental paradigm, we specifically investigated the stage of idea generation and the stage of idea elaboration in an adapted picture completion task. The findings confirmed a hypothesized increase of functional coupling from idea generation to elaboration, which was most pronounced in frontal-central as well as frontal-temporal networks. The connectivity in the frontal-parietal/occipital network already increased during idea generation and remained constant during elaboration. Importantly, more original participants generally showed higher functional connectivity in all brain networks. This elevated functional coupling with frontal brain regions might reflect increased executive processes related to internal attention, motor planning, and semantic selection processes supporting highly original thought in the figural domain.

Assessment of Fractal Characteristics of Locomotor Activity of Geriatric In-Patients With Alzheimer's Dementia

INTRODUCTION

Many physiological signals yield fractal characteristics, i.e., finer details at higher magnifications resemble details of the whole. Evidence has been accumulating that such fractal scaling is basically a consequence of interaction-dominant feedback mechanisms that cooperatively generate those signals. Neurodegenerative diseases provide a natural framework to evaluate this paradigm when this cooperative function declines. However, methodological issues need to be cautiously taken into account in order to be able to provide reliable as well as valid interpretations of such signal analyses.

METHODS

Two conceptually different fractal analyses, i.e., detrended fluctuation analysis (DFA) and analysis of cumulative distributions of durations (CDDs), are applied to actigraphy data of 36 geriatric in-patients diagnosed with dementia. The impact of the used time resolution for data acquisition on the assessed fractal outcome parameters is particularly investigated. Moreover, associations between these parameters and scores from the Mini-Mental-State-Examination and circadian activity parameters are explored.

RESULTS

Both analyses yield significant deviations from (mono-)fractal scaling over the entire considered time range. DFA provides robust measures for the observed break-down of fractal scaling. In contrast, analysis of CDDs results in measures which highly fluctuate with respect to the time resolution of the assessed data which affects also further derived quantities such as scaling exponents or associations with other (clinically relevant) assessed parameters.

DISCUSSION

To scrutinize actigraphic signal characteristics and especially their (deviations from) fractal scaling may be a useful tool for aiding diagnosis, characterization, and monitoring of dementia. However, results may, besides contextual aspects, also substantially depend on specific methodological choices. In order to arrive at both reliable and valid interpretations, these complications need to be carefully elaborated in future research.

Creative challenge: Regular exercising moderates the association between task-related heart rate variability changes and individual differences in originality

Coping with mental challenges is vital to everyday functioning. In accordance with prominent theories, the adaptive and flexible adjustment of the organism to daily demands is well expressed in task-related changes of cardiac vagal control. While many mental challenges are associated with increased effort and associated decreased task-related heart rate variability (HRV), some cognitive challenges go along with HRV increases. Especially creativity represents a cognitive process, which not only results from mental effort but also from spontaneous modes of thinking. Critically, creativity and HRV are associated with regular exercising and fitness. Furthermore, the cross-stressor adaptation theory suggests that changes in cardiac reactions to physical challenges may generalize to mental challenges. In line with this idea the amount of regular exercising was hypothesized to moderate the association between HRV changes and creativity. A sample of 97 participants was investigated. They reported the amount of regular exercise and their ECG was measured at baseline and during a creativity task. An association between task-related HRV changes and originality as a function of participants' amount of regular exercise was found. Participants reporting more regular exercising produced more original ideas when they had higher HRV increases during the task, while more sedentary participants showed the opposite association. Results suggest that individuals with a higher amount of regular exercise achieve higher originality probably via the engagement in more spontaneous modes of thinking, while more sedentary people may primarily benefit from increased mental effort. This supports the conclusion that higher creativity can be achieved by different strategies.

Cognitive reappraisal capacity mediates the relationship between prefrontal recruitment during reappraisal of anger-eliciting events and paranoia-proneness

Difficulties in emotion regulation, particularly in using adaptive regulation strategies such as cognitive reappraisal, are a commonly observed correlate of paranoia. While it has been suggested that poor implementation of cognitive reappraisal in dealing with aversive events precedes the onset of subclinical paranoid thinking, there is little empirical research on neural activation patterns during cognitive reappraisal efforts that might indicate vulnerability towards paranoid thinking. Prefrontal EEG alpha asymmetry changes were recorded while n = 57 participants were generating alternative appraisals of anger-eliciting events, and were linked to a behavioral measure of basic cognitive reappraisal capacity and self-reported paranoia proneness (assessed by personality facets of hostility and suspiciousness; Personality Inventory for DSM-5). Mediation analysis revealed that less left-lateralized activation at ventrolateral prefrontal sites during reappraisal efforts predicted a higher degree of paranoia proneness. This relationship was mediated through poorer cognitive reappraisal capacity. Matching previous evidence, findings suggest that inappropriate brain activation during reappraisal efforts impairs individuals' capacity to come up with effective alternative interpretations for anger-evoking situations, which may accentuate personality features related to increased paranoid thinking. The findings add to our understanding of neurally underpinned impairments in the capacity to generate cognitive reappraisals and their link to maladaptive personality and behavior.

Poor control of interference from negative content hampers the effectiveness of humour as a source of positive emotional experiences

The brain-based ability to direct attention away from interfering negative information may co-determine to which degree one may benefit from humour as a source of positive emotional experiences. This should be particularly relevant when it comes to humour that implicates a target the joke makes fun of, which inherently entails rivalry between positive and negative emotional representations. One hundred healthy individuals completed a pictorial negative affective priming task and a nonverbal humour processing task. In line with the notion that during the elaborative processing of malicious jokes, interference from negative emotional representations hampers the experience of amusement, participants took more time to judge their amusement evoked by malicious compared to benign jokes. Lesser ability to distract attention from interfering negative emotional representations was associated with slower judgements of amusement following the processing of malicious jokes, as well as with lower amusement ratings. The time it took participants to comprehend the punch-lines was not affected, neither was the immediate, short-lived pleasure after having comprehended the humour, measured by characteristic transient cardiac activation. The findings suggest that the effective use of humour as a source of positive emotional experiences requires the ability to overcome the dark side of typical humour.

Humor creation during efforts to find humorous cognitive reappraisals of threatening situations

This interdisciplinary study examined the structure of humor creation in the specific context of efforts to positively reappraise stressful situations for effective coping. In a sample of n = 101 participants, a performance test was used to assess the quantity (fluency, number of generated ideas that qualified as humor) and quality (rated funniness) of humor creation in cognitive reappraisal. Linguistic mechanisms were identified and quantified using cognitive-linguistic methods of corpus analysis, and their employment was correlated with humor production performance on the level of the individual. Almost all individuals were able to come up with reappraisal ideas that qualified as humorous. Depressive symptoms, a negative mood state, and high perceptions of threat did not compromise the participants' capability to create humor. Individuals who were more serious-minded as a trait produced ideas that were rated as less funny, but their basic ability to create humor was unaffected. Metonymy (a contiguity-based principle of meaning extension) emerged as by far the most prominent semantic mechanism in the creation of humorous re-interpretations. Furthermore, its use was related to good humor creation performance in terms of quantity and quality, which is in line with its assumed importance in the extension of meaning in general and the creation of humor in particular. Further effective linguistic mechanisms and conceptual phenomena were identified. The empirical data may be valuable for the development of interventions involving the creation of humorous ideas for cognitive reappraisal.

Gender Differences in Generating Cognitive Reappraisals for Threatening Situations: Reappraisal Capacity Shields Against Depressive Symptoms in Men, but Not Women

Despite major research interest regarding gender differences in emotion regulation, it is still not clear whether men and women differ in their basic capacity to implement specific emotion regulation strategies, as opposed to indications of the habitual use of these strategies in self-reports. Similarly, little is known on how such basic capacities relate to indices of well-being in both sexes. This study took a novel approach by investigating gender differences in the capacity for generating cognitive reappraisals in adverse situations in a sample of 67 female and 59 male students, using a maximum performance test of the inventiveness in generating reappraisals. Participants' self-perceived efficacy in emotion regulation was additionally assessed. Analyses showed that men and women did not differ in their basic capacity to generate alternative appraisals for anxiety-eliciting scenarios, suggesting similar functional cognitive mechanisms in the implementation of this strategy. Yet, higher cognitive reappraisal capacity predicted fewer depressive daily-life experiences in men only. These findings suggest that in the case of cognitive reappraisal, benefits for well-being in women might depend on a more complex combination of basic ability, habits, and efficacy-beliefs, along with the use of other emotion regulation strategies. The results of this study may have useful implications for psychotherapy research and practice.

Learning Unicycling Evokes Manifold Changes in Gray and White Matter Networks Related to Motor and Cognitive Functions

A three-week unicycling training was associated with (1) reductions of gray matter volume in regions closely linked to visuospatial processes such as spatial awareness, (2) increases in fractional anisotropy primarily in the right corticospinal tract and in the right forceps major of the corpus callosum, and (3) a slowly evolving increase in cortical thickness in the left motor cortex. Intriguingly, five weeks later, during which participants were no longer regularly engaged in unicycling, a re-increase in gray matter was found in the very same region of the rSTG. These changes in gray and white matter morphology were paralleled by increases in unicycling performance, and by improvements in postural control, which diminished until the follow-up assessments. Learning to ride a unicycle results in reorganization of different types of brain tissue facilitating more automated postural control, clearly demonstrating that learning a complex balance task modulates brain structure in manifold and highly dynamic ways.

The relationship between "Eyes Reading" ability and verbal memory in bipolar disorder

In psychiatric disorders, neurocognitive impairments are prevalent and have been associated with poor outcome. Deficits in Theory of Mind (ToM, "mentalising") have also been observed in bipolar disorder (BD); however, the literature shows inconsistent data. The aim of this study was to explore ToM performance in a well-characterized sample of euthymic individuals with BD and its relationship with neurocognitive function. One hundred sixteen euthymic patients with BD between 18 and 74 years (mean age = 42.4, SD = 13.8) and 79 healthy controls (mean age = 39.8, SD = 16.5) were investigated with an extensive neurocognitive test battery (Trail Making Test A/B, d2 Test of Attention, Stroop Color-Word Test, California Verbal Learning Test, Multiple Choice Vocabulary Test). Additionally, all participants were given the Reading the Mind in the Eyes Test (RMET) to measure affective ToM, the ability to make assumptions about other people´s feelings. Overall, "Eyes Reading" performance was not impaired in individuals with BD compared with controls. However, a significant relationship between RMET and verbal memory in BD was shown, particularly in males. Data showed worse RMET performance in patients with memory deficits compared to patients without memory deficits and controls. Due to cross-sectional data, no conclusions can be made with respect to cause and effect.

Humorous cognitive reappraisal: More benign humour and less "dark" humour is affiliated with more adaptive cognitive reappraisal strategies

The capacity to find humorous perspectives in aversive situations may outline a helpful strategy in the context of cognitive reappraisal. Yet, research suggested that some people produce more adaptive humour than others. At the same time, not all forms of cognitive reinterpretation seem to be unequivocally beneficial. The present study aimed to investigate specific cognitive reappraisal strategies that individuals employ in humorous reappraisal of adverse events. In a sample of 95 participants, the use of cognitive reappraisal sub-strategies was assessed in a behavioural test in which participants were required to generate a series of humorous reappraisals of self-relevant, threatening events. These reappraisal sub-strategies (three positive reinterpretation strategies, three de-emphasising strategies) were then related to the habitual use of different kinds of humour as well as the broader DSM-5 personality trait domains and well-being in terms of depressive experiences, assessed by self-report questionnaires. While no robust relationships were found for reappraisal strategies based on de-emphasising, sub-strategies within the positive reinterpretation category showed specific and contrasting associations with the examined traits. Findings indicated that the ability to produce humour is only linked to a favourable pattern of reappraisal strategies when manifested in benign forms of humour. Specific relations also emerged for the broader personality traits. The study suggests that some characteristics that advance the use of benign humour also benefit adaptive emotion regulation. The opposite seems to be true for malicious, or "dark" humour. The introduced behavioural approach to the analysis of humorous cognitive reappraisal may prove useful also in future related research.

Brain Structure Alterations in Poly-Drug Use: Reduced Cortical Thickness and White Matter Impairments in Regions Associated With Affective, Cognitive, and Motor Functions

Substance use disorders (SUDs) are defined by obsessive and uncontrolled consumption, which is related to neurobiological changes. Based on previous work, this study investigated potential alterations in brain structure in poly-drug use disordered (PUD) patients in comparison to controls from the normal population. This study involved a sample of 153 right-handed men aged between 18 and 41 years, comprising a clinical group of 78 PUD and a group of 75 healthy controls. Group differences in gray matter (GM) and white matter (WM), as well as cortical thickness (CT), were investigated by means of diffusion tensor imaging using automated fiber quantification (AFQ) and voxel-based morphometry. We observed significant WM impairments in PUD, especially in the bilateral corticospinal tracts and the inferior longitudinal fasciculi. Furthermore, we found reduced CT in the PUD group especially in the left insular and left lateral orbitofrontal cortex. There were no group differences in GM. In addition, PUD exhibited a higher amount of psychiatric symptoms (Brief Symptom Inventory) and impairments in cognitive functions (Wonderlic Personnel Test). In line with previous research, this study revealed substantial impairments in brain structure in the PUD group in areas linked with affective, cognitive, and motor functions. We therefore hypothesize a neurologically informed treatment approach for SUD. Future studies should consequently explore a potential positive neuroplasticity in relation to a better therapeutic outcome.

Brain and soccer: Functional patterns of brain activity during the generation of creative moves in real soccer decision-making situations

This fMRI study investigated brain activity while soccer players were imagining creative moves in real soccer decision-making situations. After presenting brief video clips of a soccer scene, participants had to imagine themselves as the acting player and think either of a creative or obvious move that might lead to a goal. Findings revealed stronger activation during trials in which the generation of obvious moves was required, relative to trials requiring creative moves. The reversed contrast (creative > obvious) showed no significant effects. Activations were mainly left-lateralized, primarily involving the cuneus, middle temporal gyrus, and the rolandic operculum, which are known to support the processing of multimodal input from different sensory, motor and perceptual sources. Interestingly, more creative solutions in the soccer task were associated with smaller contrast values for the activation difference between obvious and creative trials, or even with more activation in the latter. Furthermore, higher trait creative potential (as assessed by a figural creativity test) was associated with stronger activation differences between both conditions. These findings suggest that with increasing soccer-specific creative task performance, the processing of the manifold information provided by the soccer scenario becomes increasingly important, while in individuals with higher trait creative potential these processes were recruited to a minor degree. This study showed that soccer-specific creativity tasks modulate activation levels in a network of regions supporting various cognitive functions such as semantic information processing, visual and motor imagery, and the processing and integration of sensorimotor and somatosensory information.

History of Preeclampsia Adds to the Deleterious Effect of Chronic Stress on the Cardiac Ability to Flexibly Adapt to Challenge

Preeclampsia, a pregnancy-specific disorder, presents a major health problem during gestation, but is also associated with increased risk for cardiovascular complications in later life. We aimed to investigate whether chronic stress experience and preeclampsia may have additive adverse effects on the cardiac ability to flexibly adapt to challenge, that is, to mount an appropriately vigorous heart rate response to an acute psychological challenge, or whether they may perhaps have synergistic effects (e.g., mutual augmentation of effects). Blunted cardiac responding to challenge has been linked to poor health outcomes in the longer term. Women previously affected by preeclampsia and women after uncomplicated pregnancies were tested 15-17 weeks post-partum in a standardized stress-reactivity protocol, while cardiovascular variables were simultaneously recorded. Changes in heart rate and blood pressure in response to the stressor were analyzed with regard to the effects of history of preeclampsia and chronic stress experience. Findings indicated blunted cardiac responses in women with higher chronic stress experience (p = 0.020) and, independently from that, in women with a history of preeclampsia (p = 0.018), pointing to an additive nature of the effects of preeclampsia and chronic stress on impaired cardiovascular functioning. Consequently, if both are present, a history of preeclampsia may add to the already deleterious effects of the experience of chronic stress. The additive nature of the effects suggests that stress-reducing interventions, albeit they will not eliminate the heightened cardiovascular risk in patients with a history of preeclampsia, may improve their overall prognosis by avoiding further accumulation of risk.

[Genetics of Posttraumatic Stress Disorder (PTSD)]

Post-traumatic stress disorder (PTSD) is a mental disorder following a severe traumatic experience and is characterized by high rates of comorbidity with related psychiatric disorders. However, even for individuals experiencing the same trauma, there is considerable inter-individual variability in the risk of PTSD, and this is largely thought to be determined by biological processes, such as genetic predisposition and epigenetic mechanism. In this review we will summarize recent research on genetics of PTSD, primarily focusing on candidate gene-association studies, targeting on functional genetic variants in the monoaminergic system and the hypothalamic-pituitary-adrenal (HPA) axis. In addition, results from recent genome-wide association studies (GWAS) will be reported and we will highlight the interplay of genetic factors with environmental factors, based on evidence from gene-environment interaction analysis and studies on the epigenetic regulation of PTSD. Finally, we will provide a brief outlook towards the potential and perspectives of pharmaco-genetic studies.

Meaning in meaninglessness: The propensity to perceive meaningful patterns in coincident events and randomly arranged stimuli is linked to enhanced attention in early sensory processing

Perception of objectively independent events or stimuli as being significantly connected and the associated proneness to perceive meaningful patterns constitute part of the positive symptoms of schizophrenia, which are associated with altered attentional processes in lateralized speech perception. Since perceiving meaningful patterns is to some extent already prevalent in the general population, the aim of the study was to investigate whether the propensity to experience meaningful patterns in co-occurring events and random stimuli may be associated with similar altered attentional processes in lateralized speech perception. Self-reported and behavioral indicators of the perception of meaningful patterns were assessed in non-clinical individuals, along with EEG auditory evoked potentials during the performance of an attention related lateralized speech perception task (Dichotic Listening Test). A greater propensity to perceive meaningful patterns was associated with higher N1 amplitudes of the evoked potentials to the onset of the dichotically presented consonant-vowel syllables, indicating enhanced automatic attention in early sensory processing. The study suggests that more basic mechanisms in how people associate events may play a greater role in the cognitive biases that are manifest in personality expressions such as positive schizotypy, rather than that positive schizotypy moderates these cognitive biases directly.

EEG alpha activity during imagining creative moves in soccer decision-making situations

This study investigated task-related changes of EEG alpha power while participants were imagining creative moves in soccer decision-making situations. After presenting brief video clips of a soccer scene, participants had to imagine themselves as the acting player and to think either of a creative/original or an obvious/conventional move (control condition) that might lead to a goal. Performance of the soccer task generally elicited comparatively strong alpha power decreases at parietal and occipital sites, indicating high visuospatial processing demands. This power decrease was less pronounced in the creative vs. control condition, reflecting a more internally oriented state of information processing characterized by more imaginative mental simulation rather than stimulus-driven bottom-up processing. In addition, more creative task performance in the soccer task was associated with stronger alpha desynchronization at left cortical sites, most prominently over motor related areas. This finding suggests that individuals who generated more creative moves were more intensively engaged in processes related to movement imagery. Unlike the domain-specific creativity measure, individual's trait creative potential, as assessed by a psychometric creativity test, was globally positively associated with alpha power at all cortical sites. In investigating creative processes implicated in complex creative behavior involving more ecologically valid demands, this study showed that thinking creatively in soccer decision-making situations recruits specific brain networks supporting processes related to visuospatial attention and movement imagery, while the relative increase in alpha power in more creative conditions and in individuals with higher creative potential might reflect a pattern relevant across different creativity domains.

Laughter as a social rejection cue: Influence of prior explicit experience of social rejection on cardiac signs of "freezing"

The study aimed at investigating the immediate cardiac effect of the sudden perception of other people's laughter after experimentally manipulating healthy participants' proneness to experience laughter as a cue of social threat. We expected that participants would show cardiac signs of freezing (i.e., sustained heart rate deceleration immediately after perception of the laughter) after prior social rejection but not or less so after prior acceptance, due to an increased bias to perceive the ambiguous social signal as a cue of social threat and rejection after rejection had been primed. Contrary to expectations, the perception of other people's laughter elicited a decelerative (freezing) response regardless of whether it was preceded by the experience of social rejection or acceptance. The response was prolonged in participants who had been accepted beforehand compared to those who had been rejected. The findings indicate that, given a relevant social context, other people's laughter can be a powerful cue of social threat and rejection also in healthy individuals. Prolonged heart rate deceleration after an ambiguous social signal may facilitate the processing of significant social information in the socially threatening situation. The study adds to the literature rendering the course of the immediate transient heart rate response a useful tool in social rejection research. Additionally, the findings suggested that in some cases the further progress of transient heart rate changes in more extended time-windows (about 30 s) may provide additional relevant information about the processing of social cues.

Reappraisal inventiveness: impact of appropriate brain activation during efforts to generate alternative appraisals on the perception of chronic stress in women

BACKGROUND AND OBJECTIVES

Previous research indicated that more left-lateralized prefrontal activation during cognitive reappraisal efforts was linked to a greater capacity for generating reappraisals, which is a prerequisite for the effective implementation of cognitive reappraisal in everyday life. The present study examined whether the supposedly appropriate brain activation is relevant in terms of more distal outcomes, i.e., chronic stress perception.

DESIGN AND METHODS

Prefrontal EEG alpha asymmetry was recorded while female participants were generating reappraisals for stressful events and was correlated with their self-reported chronic stress levels in everyday life (n = 80).

RESULTS

Women showing less left-lateralized brain activity in the ventrolateral prefrontal cortex during cognitive reappraisal efforts reported experiencing more stress in their daily lives. This effect was independent of self-efficacy beliefs in managing negative emotions.

CONCLUSION

These findings underline the practical relevance of individual differences in appropriate brain activation during emotion regulation efforts and the assumedly related basic capacity for the generation of cognitive reappraisals to the feeling of being stressed. Implications include the selection of interventions for the improvement of coping with stress in women in whom the capability for appropriate brain activation during reappraisal efforts may be impaired, e.g., due to depression or old age.

The capacity for generating cognitive reappraisals is reflected in asymmetric activation of frontal brain regions

Encouraging patients to use cognitive reappraisal constitutes the core of modern psychotherapeutic approaches. However, evidence for specific neural correlates of the capacity for cognitive reappraisal, which is a necessary prerequisite for the effective implementation of cognitive reappraisal in everyday life, has been sparse to date. In the present study, the capacity for cognitive reappraisal was studied in terms of the participants’ inventiveness in generating alternative appraisals of anger-evoking events, and was correlated with frontal EEG alpha asymmetry recorded while the participants were generating reappraisals as well as during a common creative idea generation task. During cognitive reappraisal efforts, individuals higher on the capacity for generating cognitive reappraisals showed more left-lateralized activity in lateral prefrontal cortex, specifically in ventrolateral prefrontal cortex extending toward the frontal pole. This effect was observed independently from the activation during novel idea generation without emotional component, indicating that specific demands are implicated in the generation of reappraisals of emotional events. Taken together, the results indicate that individuals higher on the capacity for cognitive reappraisal are more capable or more prone to recruit appropriate brain regions when the situation demands coming up with alternative appraisals of stressful events. The findings may stimulate the development of more individually targeted interventions.

Subtypes in clinical burnout patients enrolled in an employee rehabilitation program: differences in burnout profiles, depression, and recovery/resources-stress balance

BACKGROUND

Burnout is generally perceived a unified disorder with homogeneous symptomatology across people (exhaustion, cynicism, and reduced professional efficacy). However, increasing evidence points to intra-individual patterns of burnout symptoms in non-clinical samples such as students, athletes, healthy, and burned-out employees. Different burnout subtypes might therefore exist. Yet, burnout subtypes based on burnout profiles have hardly been explored in clinical patients, and the samples investigated in previous studies were rather heterogeneous including patients with various physical, psychological, and social limitations, symptoms, and disabilities. Therefore, the aim of this study is to explore burnout subtypes based on burnout profiles in clinically diagnosed burnout patients enrolled in an employee rehabilitation program, and to investigate whether the subtypes differ in depression, recovery/resources-stress balance, and sociodemographic characteristics.

METHODS

One hundred three patients (66 women, 37 men) with a clinical burnout diagnosis, who were enrolled in a 5 week employee rehabilitation program in two specialized psychosomatic clinics in Austria, completed a series of questionnaires including the Maslach Burnout Inventory - General Survey (MBI-GS), the Beck Depression Inventory, and the Recovery-Stress-Questionnaire for Work. Cluster analyses with the three MBI-GS subscales as clustering variables were used to identify the burnout subtypes. Subsequent multivariate/univariate analysis of variance and Pearson chi-square tests were performed to investigate differences in depression, recovery/resources-stress balance, and sociodemographic characteristics.

RESULTS

Three different burnout subtypes were discovered: the exhausted subtype, the exhausted/cynical subtype, and the burned-out subtype. The burned-out subtype and the exhausted/cynical subtype showed both more severe depression symptoms and a worse recovery/resources-stress balance than the exhausted subtype. Furthermore, the burned-out subtype was more depressed than the exhausted/cynical subtype, but no difference was observed between these two subtypes with regard to perceived stress, recovery, and resources. Sociodemographic characteristics were not associated with the subtypes.

CONCLUSIONS

The present study indicates that there are different subtypes in clinical burnout patients (exhausted, exhausted/cynical, and burned-out), which might represent patients at different developmental stages in the burnout cycle. Future studies need to replicate the current findings, investigate the stability of the symptom patterns, and examine the efficacy of rehabilitation interventions in different subtypes.

Affective creativity meets classic creativity in the scanner

The investigation of neurocognitive processes underlying more real-life creative behavior is among the greatest challenges in creativity research. In this fMRI study, we addressed this issue by investigating functional patterns of brain activity while participants were required to be creative in an affective context. Affective creativity was assessed in terms of individual's inventiveness in generating alternative appraisals for anger-evoking events, which has recently emerged as a new ability concept in cognitive reappraisal research. In addition, a classic divergent thinking task was administered. Both creativity tasks yielded strong activation in left prefrontal regions, indicating their shared cognitive processing demands like the inhibition of prepotent responses, shifting between different perspectives and controlled memory retrieval. Regarding task-specific differences, classic creative ideation activated a characteristic divergent thinking network comprising the left supramarginal, inferior temporal, and inferior frontal gyri. Affective creativity on the other hand specifically recruited the right superior frontal gyrus, presumably involved in the postretrieval monitoring of reappraisal success, and core hubs of the default-mode network, which are also implicated in social cognition. As a whole, by taking creativity research to the realm of emotion, this study advances our understanding of how more real-life creativity is rooted in the brain. Hum Brain Mapp 39:393-406, 2018. © 2017 Wiley Periodicals, Inc.

White matter integrity in polydrug users in relation to attachment and personality: a controlled diffusion tensor imaging study

The relationship between substance use disorders (SUD) and brain deficits has been studied extensively. However, there is still a lack of research focusing on the structural neural connectivity in long-term polydrug use disorder (PUD). Since a deficiency in white matter integrity has been reported as being related to various parameters of increased psychopathology, it might be considered an aggravating factor in the treatment of SUD. In this study we compared two groups of PUD inpatients (abstinent: n = 18, in maintenance treatment: n = 15) to healthy controls (n = 16) with respect to neural connectivity in white matter, and their relation to behavioral parameters of personality factors/organization and attachment styles. Diffusion Tensor Imaging was used to investigate white matter structure. Compared with healthy controls, the PUD patients showed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) mainly in the superior fasciculus longitudinalis and the superior corona radiata. These findings suggest diminished neural connectivity as a result of myelin pathology in PUD patients. In line with our assumptions, we observed FA in the biggest cluster as negatively correlated with anxious attachment (r = 0.36, p < 0.05), personality dysfunctioning (r = -0.41; p < 0.01) as well positively correlated with personality factors Openness (r = 0.34; p < 0.05) and Agreeableness (r = 0.28; p < 0.05). Correspondingly these findings were inversely mirrored by RD. Further research employing enhanced samples and addressing longitudinally neuronal plastic effects of SUD treatment in relation to changes in personality and attachment is recommended.

Age-related differences in inhibitory control and memory updating in boys with Asperger syndrome

Deficits in specific executive domains are highly prevalent in autism spectrum disorder; however, age-related improvements in executive functions (reflecting prefrontal maturational changes) have been reported even in individuals diagnosed with autism. The current study examined two components of cognitive flexibility (inhibition of prepotent responses and memory monitoring/updating) by using a random-motor-generation task (MPT) in a group of 23 boys with Asperger syndrome (AS) and 23 matched healthy controls. We found poorer inhibition and more repetitive responses in younger AS children solely, but comparable memory monitoring/updating skills across groups. Overall, our findings correspond well with previous studies and reveal that even in AS specific EFs may improve with age and, thus, call for a more differentiated view of executive (dys) function profiles in children diagnosed with AS. Tests such as the random-motor-generation task may help to disentangle more specific processes of executive deficits in autism spectrum disorder as compared to the more classical tests.

Addiction as an Attachment Disorder: White Matter Impairment Is Linked to Increased Negative Affective States in Poly-Drug Use

Substance use disorders (SUD) have been shown to be linked to various neuronal and behavioral impairments. In this study, we investigate whether there is a connection between the integrity of white matter (WM) and attachment styles as well as different affective states including spirituality in a group of patients diagnosed for poly-drug use disorder (PUD) in comparison to non-clinical controls. A total sample of 59 right-handed men, comprising the groups of patients with PUD (n = 19), recreational drug-using individuals (RUC; n = 20) as well as non-drug using controls were recruited (NUC; n = 20). For the behavioral assessment, we applied the Adult Attachment-Scale, the Affective Neuroscience Personality-Scale (short version) and the Multidimensional Inventory for Religious/Spiritual Well-Being. Diffusion Tensor Imaging was used to investigate differences in WM neural connectivity. Analyses revealed decreased Fractional Anisotropy and decreased Mean Diffusivity in PUD patients as compared to RUC and NUC. No differences were found between RUC and NUC. Additional ROI analyses suggested that WM impairment in the superior longitudinal fasciculus (SLF) and the superior corona radiata (SCR) was linked to more insecure attachment as well as to more negative affectivity. No substantial correlation was observed with spirituality. These findings are mainly limited by the cross-sectional design of the study. However, our preliminary results support the idea of addiction as an attachment disorder, both at neuronal and behavioral levels. Further research might be focused on the changes of insecure attachment patterns in SUD treatment and their correlation with changes in the brain.

[Cognitive impairments accompanying the burnout syndrome - a review]

BACKGROUND

The rising prevalence of the burnout syndrome has increasingly moved it into the focus of scientific interest. In addition to emotional exhaustion and depersonalization, particularly reduced personal accomplishment has strong societal and economic effects. In recent years reduced personal accomplishment has increasingly been linked to cognitive impairment. However, up to now only a few studies have objectively assessed cognitive deficits in burnout patients. This article gives an overview of 16 studies which examined cognitive abilities in burnout patients. The findings are partly contradictory, probably due to methodical differences. Consensus has emerged concerning impairments of executive functions, i.a. vigilance, and memory updating and monitoring. Multifactorial causation may underlie the cognitive impairments.

OUTLOOK

Targeted longitudinal studies are necessary in order to identify the affected cognitive functions and be able to make causal inferences on links between the burnout syndrome and specific cognitive impairments.