The role of acute stress recovery in emotional resilience.

Background: Resilience refers to the process of demonstrating better outcomes than would be expected based on the adversity one experienced. Resilience is increasingly measured using a residual approach, which typically assesses adversity and mental health outcomes over a longitudinal timeframe. It remains unknown to what extent such a residual-based measurement of resilience is sensitive to variation in acute stress resilience, a candidate resilience factor. Methods: Fifty-seven emerging adults enrolled in tertiary education completed measures of adversity and emotional experiences. To assess stress recovery, participants were exposed to a lab-based adverse event from which a Laboratory Stress Resilience Index was derived. Results: We derived a residual-based measure of emotional resilience from regressing emotional experience scores onto adversity scores. This residual-based measure of emotional resilience predicted variance in the Laboratory Stress Resilience Index over and above that predicted by both a traditional resilience measure and the emotional experiences measure. These findings suggest that acute stress resilience may be a factor underpinning variation in emotional resilience, and that the residual-based approach to measuring resilience is sensitive to such variation in stress resilience.

Navigating the landscape of fear: Fruit flies exhibit distinct antipredator and antiparasite defensive behaviors.

Most organisms are at risk of being consumed by a predator or getting infected by a parasite at some point in their life. Theoretical constructs such as the landscape of fear (perception of risk) and nonconsumptive effects (NCEs, costly responses sans predation or infection) have been proposed to describe and quantify antipredator and antiparasite responses. How prey/host species identify and respond to these risks determines their survival, reproductive success and, ultimately, fitness. Most studies to date have focused on either predator-prey or parasite-host interactions, yet habitats and ecosystems contain both parasitic and/or predatory species that represent a complex and heterogenous mosaic of risk factors. Here, we experimentally investigated the behavioral responses of a cactophilic fruit fly, Drosophila nigrospiracula, exposed to a range of species that include parasites (ectoparasitic mite), predators (jumping spiders), as well as harmless heterospecifics (nonparasitic mites, ants, and weevils). We demonstrate that D. nigrospiracula can differentiate between threat and non-threat species, increase erratic movements and decrease velocity in the presence of parasites, but decrease erratic movements and time spent grooming in the presence of predators. Of particular importance, flies could distinguish between parasitic female mites and nonparasitic male mites of the same species, and respond accordingly. We also show that the direction of these NCEs differs when exposed to parasitic mites (i.e., risk of infection) versus spiders (i.e., risk of predation). Given the opposing effects of predation versus infection risk on fly behavior, we discuss potential trade-offs between parasite and predator avoidance behaviors. Our findings illustrate the complexity of risk assessment in a landscape of fear and the fine-tuned NCEs that arise in response. Moreover, this study is the first to examine these behavioral NCEs in a terrestrial system.

Severe measles with pneumonitis in an immunocompetent adult.

Measles is a highly contagious but vaccine-preventable airborne-transmitted viral infection of which there has been a recent resurgence of cases worldwide over the past year, including in countries such as the UK, which had previously successfully achieved endemic measles elimination through vaccination programmes. Measles is typically a self-limiting illness, but can rarely cause severe, life-threatening disease, particularly when complicated by respiratory or neurological involvement. These severe complications are not typically seen in the absence of immunosuppression. We describe a rare case of severe measles with pneumonitis in an immunocompetent adult necessitating admission to an intensive care unit (ICU).

How varying cue duration influences item-method directed forgetting: A novel selective retrieval interpretation.

A series of four experiments tested the assumptions of the most prominent and longstanding account of item-method directed forgetting: the selective rehearsal account. In the item-method directed forgetting paradigm, each presented item is followed by its own instructional cue during the study phase - either to-be-forgotten (F) or to-be-remembered (R). On a subsequent test, memory is poorer for F items than for R items. To clarify the mechanism underlying memory performance, we manipulated the time available for rehearsal, examining instructional cue durations of 1 s, 5 s, and 10 s. Experiments 1a and 1b, where the order of cue durations was randomized, showed no effect of cue duration on item recognition of unrelated single words, for either R or F items. Experiment 2, using unrelated word pairs, again showed no effect of randomized cue duration, this time on associative recognition. Experiments 3 and 4 blocked cue duration and showed equivalent increases in recognition of both R and F single words and word pairs with increasing cue duration. We suggest that any post-cue rehearsal is carried out only when cue duration is predictable, and that such limited rehearsal is equally likely for F items and R items. The consistently better memory for R items than for F items across cue duration depends on selective retrieval involving (1) a rapid retrieval check engaged for R items only and (2) a rapid removal process implemented for F items only.

Towards implementation of cognitive bias modification in mental health care: State of the science, best practices, and ways forward.

Cognitive bias modification (CBM) has evolved from an experimental method testing cognitive mechanisms of psychopathology to a promising tool for accessible digital mental health care. While we are still discovering the conditions under which clinically relevant effects occur, the dire need for accessible, effective, and low-cost mental health tools underscores the need for implementation where such tools are available. Providing our expert opinion as Association for Cognitive Bias Modification members, we first discuss the readiness of different CBM approaches for clinical implementation, then discuss key considerations with regard to implementation. Evidence is robust for approach bias modification as an adjunctive intervention for alcohol use disorders and interpretation bias modification as a stand-alone intervention for anxiety disorders. Theoretical predictions regarding the mechanisms by which bias and symptom change occur await further testing. We propose that CBM interventions with demonstrated efficacy should be provided to the targeted populations. To facilitate this, we set a research agenda based on implementation frameworks, which includes feasibility and acceptability testing, co-creation with end-users, and collaboration with industry partners.

The role of expectancies and selective interrogation of information in trait anxiety-linked affect when approaching potentially stressful future events.

The present study examined cognitive mechanisms underpinning the increased tendency of individuals with high trait anxiety to experience inflation of negative affect when approaching potential stressors. Specifically, the roles of (1) disproportionately negative relative to positive expectancies (i.e., negative expectancy bias) and (2) disproportionately interrogating negative relative to positive information (i.e., negative interrogation bias), each concerning the potential stressor, were examined. High and low trait anxiety participants (N = 286) completed the experimental session, in which they were informed they may view a potentially stressful film. As participants approached the putative film viewing, participants' negative and positive affect, as well as their negative and positive expectancies were assessed. Additionally, negative interrogation bias was assessed by providing participants the opportunity to selectively interrogate information from a larger pool of negative and positive information concerning the putative film viewing. Our findings provide evidence indirect associations between trait anxiety and inflation of negative affect is serially mediated via negative interrogation bias and, in turn, negative expectancy bias. Findings are discussed with regards to limitations and potential implications for public health campaigns, and cognitive interventions for anxiety, highlighting the utility of further examining negative interrogation bias as an avenue for improving the efficacy of each.

Perceptions around medications for opioid use disorder among a diverse sample of U.S. adults.

INTRODUCTION: Medications for opioid use disorder (MOUD) including methadone (MMT), buprenorphine (BUP), and naltrexone (NTX) are safe and effective. However, there are significant negative perceptions surrounding MOUD, creating barriers to uptake. While research on MOUD stigma has largely focused on provider and patient experiences, fewer studies have explored MOUD perceptions among the general public. Given that MOUD stigma expressed by social ties surrounding individuals with OUD can influence treatment choices, we assessed MOUD perceptions among U.S. adults to determine how beliefs impacted treatment preference. We further explored how MOUD perceptions may be amplified among racialized groups with histories of experiencing drug-related discrimination. METHODS: The study collected survey data from a diverse sample of U.S. adults (n = 1508) between October 2020 and January 2021. The survey measured knowledge of MOUD and non-medication treatments, relative agreement with common MOUD perceptions, and treatment preferences. Multinomial logistic regression analysis tested associations with treatment preference, stratified by race/ethnicity. RESULTS: Descriptive results indicated that across groups, many respondents (66.8 %) had knowledge of MOUD, but believed MOUD was a "substitute" for opioids and had some degree of concern about misuse. Multivariable results showed knowledge of non-medication treatments was positively associated with MOUD preference among White (MMT OR = 3.16, 95 % CI = 1.35-7.39; BUP OR = 2.69, CI = 1.11-6.47), Black (MMT OR = 3.91, CI = 1.58-9.69), and Latino/a (MMT OR = 5.12, CI = 1.99-13.2; BUP OR = 3.85, CI = 1.5-9.87; NTX OR = 4.51, CI = 1.44-14.06) respondents. Among White respondents, we identified positive associations between MOUD experience and buprenorphine preference (OR = 4.33, CI = 1.17-16.06); non-medication treatment experience and preference for buprenorphine (OR = 2.86, CI = 1.03-7.94) and naltrexone (OR = 3.17, CI = 1.08-9.28). Concerns around misuse of methadone were negatively associated with methadone preference among White (OR = 0.65, CI = 0.43-0.98) and Latino/a (OR = 0.49, CI = 0.34-0.7), and concerns around misuse of buprenorphine was negatively associated with preference for MOUD among White (MMT OR = 0.62, CI = 0.39-0.99; BUP OR = 0.48, CI = 0.3-0.77; NTX OR = 0.6, CI = 0.36-0.99) and Latino/a (BUP OR = 0.59, CI = 0.39-0.89) respondents. CONCLUSIONS: This analysis offers critical insights into treatment perceptions beyond the patient population, finding that negative beliefs around MOUD are common and negatively associated with preferences for medication-based treatment. These findings highlight implications for public support of evidence-based treatment and lay the groundwork for future interventions addressing public stigma toward MOUD.

The effect of a pilot brief educational intervention on preferences regarding treatments for opioid use disorder.

Purpose: Negative perceptions around medications for opioid use disorder (MOUD) amongst the public could deter patients with opioid use disorder (OUD) from engaging with MOUD. Thus, we evaluated whether a brief intervention could improve preferences for MOUD in people who may or may not use opioids. Methods: We employed a pre-post design to assess the effect of a brief educational intervention on preferences for methadone, buprenorphine, naltrexone, and non-medication treatment in an online sample of US adults stratified by race, who may or may not use opioids. Respondents ranked their preferences in OUD treatment before and after watching four one-minute educational videos about treatment options. Changes in treatment preferences were analyzed using Bhapkar's test and post hoc McNemar's tests. A binary logistic generalized estimating equation (GEE) assessed factors associated with preference between treatments. Results: The sample had 530 responses. 194 identified as White, 173 Black, 163 Latinx. Treatment preferences changed significantly towards MOUD (p<.001). This effect was driven by changes toward buprenorphine (OR=2.38; p<.001) and away from non-medication treatment (OR=0.20; p<.001). There was no significant difference in effect by race/ethnicity. People with lower opioid familiarity were significantly more likely to change their preferences towards MOUD following the intervention. Conclusion: Respondent preferences for MOUD increased following the intervention suggesting that brief educational interventions can change treatment preferences towards MOUD. These findings offer insights into perceptions of OUD treatment in a racially stratified sample and serve as a foundation for future educational materials that target MOUD preferences in the general public.

Less bang for my buck: Diminished anticipated enjoyment contributes to dysphoria-linked deficit in activity behavioural engagement choice.

This study experimentally investigated the role of anticipated enjoyment and effort in mediating dysphoria-related deficit in activity engagement behavioural choice. Using a novel activity information processing task (about a fictional "new" Nintendo Wii sports game called "Tornado Ball"), N = 249 participants (n = 95 High Dysphoria; n = 154 Low Dysphoria) were presented information about the benefits (enjoyable features) and costs (mental and physical effort barriers) as product reviews from another player. The order of cost vs. benefit information was manipulated such that participants either heard cost information before benefit information, or vice versa. They then rated what their anticipated enjoyment and effort will be if they were to play Tornado Ball, before being given the opportunity to choose to try it themselves or not. The High Dysphoria group reported lower anticipated enjoyment (but not higher effort) relative to the Low Dysphoria group, but only when cost information was presented first. Importantly, a moderated mediation showed that the High Dysphoria group reported lower tendency to choose activity engagement (game play) as a function of having lower anticipated enjoyment, but only when cost information was presented first. The present finding indicate that reduced anticipated enjoyment may causally contribute to dysphoria-linked deficits in activity engagement behavioural choice.

On the association between intention and visual word identification.

One of the most fundamental distinctions in cognitive psychology is between processing that is "controlled" and processing that is "automatic." The widely held automatic processing account of visual word identification asserts that, among other characteristics, the presentation of a well-formed letter string triggers sublexical, lexical, and semantic activation in the absence of any intention to do so. Instead, the role of intention is seen as independent of stimulus identification and as restricted to selection for action using the products of identification (e.g., braking in response to a sign saying "BRIDGE OUT"). We consider four paradigms with respect to the role of an intention-defined here as a "task set" indicating how to perform in the current situation-when identifying single well-formed letter strings. Contrary to the received automaticity view, the literature regarding each of these paradigms demonstrates that the relation between an intention and stimulus identification is constrained in multiple ways, many of which are not well understood at present. One thing is clear: There is no simple relation between an intention, in the form of a task set, and stimulus identification. Automatic processing of words, if this indeed ever occurs, certainly is not a system default. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

IMproving psYchosocial adjustment to Traumatic Brain Injury from acute to chronic injury through development and evaluation of the myTBI online psychoeducation platform: protocol for a mixed-methods study.

INTRODUCTION: This protocol describes the myTBI study which aims to: (1) develop an online psychoeducation platform for people with traumatic brain injury (TBI), their family members/caregivers, and healthcare staff to improve psychosocial adjustment to TBI across different phases of injury (acute, postacute, and chronic), and (2) undertake an evaluation of efficacy, acceptability, and feasibility. METHODS AND ANALYSIS: A three-stage mixed-methods research design will be used. The study will be undertaken across four postacute community-based neurorehabilitation and disability support services in Western Australia. Stage 1 (interviews and surveys) will use consumer-driven qualitative methodology to: (1) understand the recovery experiences and psychosocial challenges of people with TBI over key stages (acute, postacute, and chronic), and (2) identify required areas of psychosocial support to inform the psychoeducation platform development. Stage 2 (development) will use a Delphi expert consensus method to: (1) determine the final psychoeducation modules, and (2) perform acceptance testing of the myTBI platform. Finally, stage 3 (evaluation) will be a randomised stepped-wedge trial to evaluate efficacy, acceptability, and feasibility. Outcomes will be measured at baseline, postintervention, follow-up, and at final discharge from services. Change in outcomes will be analysed using multilevel mixed-effects modelling. Follow-up surveys will be conducted to evaluate acceptability and feasibility. ETHICS AND DISSEMINATION: Ethics approval was granted by North Metropolitan Health Service Mental Health Research Ethics and Governance Office (RGS0000005877). Study findings will be relevant to clinicians, researchers, and organisations who are seeking a cost-effective solution to deliver ongoing psychoeducation and support to individuals with TBI across the recovery journey. TRIAL REGISTRATION NUMBER: ACTRN12623000990628.

Productions Need Not Match Study Items to Confer a Production Advantage, But It Helps.

The production effect is the finding that, relative to silent reading, producing information at study (e.g., reading aloud) leads to a benefit in memory. In most studies of this effect, individuals are presented with a set of unique items, and they produce a subset of these items (e.g., they are presented with the to-be-remembered target item TABLE and produce table) such that the production is both unique and representative of the target. Across two preregistered experiments, we examined the influence of a production that is unique but that does not match the target (e.g., producing fence to the target TABLE, producing car to the target TREE, and so on). This kind of production also yielded a significant effect-the mismatching production effect-although it was smaller than the standard production effect (i.e., when productions are both unique and representative of their targets) and was detectable only when targets with standard productions were included in the same study phase (i.e., when the type of production was manipulated within participant). We suggest that target-production matching is an important precursor to the production effect and that the kind of production that brings about a benefit depends on the other productions that are present.

Improving Medical Student Knowledge and Reducing Stigmatizing Attitudes Toward Treating Patients With Opioid Use Disorder.

Objectives: Stigma and lack of knowledge are barriers to clinicians when caring for individuals with opioid use disorder (OUD). In 2018, only about 15 out of 180 American medical schools had comprehensive addiction programs. The AAMC reports that institutions are increasingly incorporating competencies to address the OUD and opioid epidemic. There have been few evaluated curriculums focused on reducing stigmatizing attitudes. This study evaluated whether a 4-hour case-based curriculum focused on improving stigmatizing attitudes toward patients with OUD could reduce medical student perceptions around viewing addiction as a punitive condition and other substitution-based misconceptions around opioid agonist-based medication. Methods: Medical students completed a 4-hour curricular workshop which included learning objectives focusing on barriers to healthcare/stigmatizing attitudes, effective behavioral therapy options, and appropriate use of opioid medications. We measured changes in knowledge and attitudes using validated scales on stigma. Non-parametric repeated measure tests determined statistically significant differences between pre and post assessments between OUD related perceptions and a control condition (diabetes). Results: Of 135 eligible participants, 99 (76%) students completed both pre- and post-surveys. Mean scores across knowledge questions improved (60%-81%, P < .001) and stigmatizing attitudes regarding perceived violence of people with OUD decreased (2.04-1.82, P = .016). There was significant improvement in mean scores for OUD-related opinions including desire to work with and effectively treat patients with OUD (3.58-3.88, P < .001) while no significant concurrent change was observed in mean opinion scores of a non-OUD comparator, diabetes (3.88-3.97, P = .201). Conclusions: Results indicate that the workshop was associated with measurable changes in knowledge and attitudinal forms of OUD stigma. With recent policy changes eliminating the X-waiver, healthcare institutions are eager to design curriculum around OUD management and treatment. This study provides a blueprint for an effective curriculum that improves clinician knowledge and reduces stigmatizing attitudes.

Release from response interference in color-word contingency learning.

In identifying the print colors of words when some combinations of color and word occur more frequently than others, people quickly show evidence of learning these associations. This contingency learning effect is evident in faster and more accurate responses to high-contingency combinations than to low-contingency combinations. Across four experiments, we systematically varied the number of response-irrelevant word stimuli connected to response-relevant colors. In each experiment, one group experienced the typical contingency learning paradigm with three colors linked to three words; other groups saw more words (six or twelve) linked to the same three colors. All four experiments disconfirmed a central prediction derived from the Parallel Episodic Processing (PEP 2.0) model (Schmidt et al., 2016)-that the magnitude of the contingency learning effect should remain stable as more words are added to the response-irrelevant dimension, as long as the color-word contingency ratios are maintained. Responses to high-contingency items did slow down numerically as the number of words increased between groups, consistent with the prediction from PEP 2.0, but these changes were unreliable. Inconsistent with PEP 2.0, however, overall response time did not slow down and responses to low-contingency items actually sped up as the number of words increased across groups. These findings suggest that the PEP 2.0 model should be modified to incorporate response interference caused by high-probability associations when responding to low-probability combinations.

Attentional engagement with and disengagement from appearance ideals: Differential associations with body dissatisfaction frequency and duration?

Recent work has served to dissociate two dimensions of trait body dissatisfaction: body dissatisfaction frequency and body dissatisfaction duration. The present study sought to evaluate whether body dissatisfaction frequency and body dissatisfaction duration are each associated with distinct patterns of appearance-related cognitive processing. It was hypothesized that speeded attentional engagement with idealized bodies is associated with higher frequency of body dissatisfaction episodes, while slowed attentional disengagement from such information may instead be associated with higher duration of body dissatisfaction episodes. Participants (238 women, 149 men) completed an attentional task capable of independently assessing attentional engagement with, and attentional disengagement from, idealized bodies. Participants also completed both trait and in vivo (i.e., ecological momentary assessment) measures of body dissatisfaction frequency and duration. Results showed that neither engagement nor disengagement bias index scores predicted variance in either body dissatisfaction frequency measures or body dissatisfaction duration measures. Findings suggest that either biased attentional engagement with, and disengagement from, idealized bodies do not associate with the frequency and duration of body dissatisfaction episodes, or there are other key moderating factors involved in the expression of body dissatisfaction-linked attentional bias.

The prod eff: Partially producing items moderates the production effect.

Current accounts of the production effect suggest that production leads to the encoding of additional production-associated features and/or better feature encoding. Thus, if it is the act of production that leads to the storage and/or enhanced encoding of these features, then less of this act should reduce the resulting production effect. In two experiments, we provide a direct test of this idea by manipulating how much of a given item is produced within a single mode of production (typing). Results demonstrate that such partial production can yield a significant production effect that is smaller than the effect that emerges from producing the entire item. These results suggest that how much of an item is produced can moderate the size of the production effect and are considered in the context of recent modelling efforts.

Reading text aloud benefits memory but not comprehension.

The production effect-that reading aloud leads to better memory than does reading silently-has been defined narrowly with reference to memory; it has been explored largely using word lists as the material to be read and remembered. But might the benefit of production extend beyond memory and beyond individual words? In a series of four experiments, passages from reading comprehension tests served as the study material. Participants read some passages aloud and others silently. After each passage, they completed multiple-choice questions about that passage. Separating the multiple-choice questions into memory-focused versus comprehension-focused questions, we observed a consistent production benefit only for the memory-focused questions. Production clearly improves memory for text, not just for individual words, and also extends to multiple-choice testing. The overall pattern of findings fits with the distinctiveness account of production-that information read aloud stands out at study and at test from information read silently. Only when the tested information is a very close match to the studied information, as is the case for memory questions but not for comprehension questions, does production improve accuracy.

Accuracy, acceptability and feasibility of photography for use in trachoma surveys: a mixed methods study in Tanzania.

BACKGROUND: Photography could be used to train individuals to diagnose trachomatous inflammation-follicular (TF) as trachoma prevalence decreases and to ensure accurate field TF grading in trachoma prevalence surveys. We compared photograph and field TF grading and determined the acceptability and feasibility of eyelid photography to community members and trachoma survey trainers. METHODS: A total of 100 children ages 1-9 y were examined for TF in two Maasai villages in Tanzania. Two images of the right everted superior tarsal conjunctiva of each child were taken with a smartphone and a digital single-lens reflex (DSLR) camera. Two graders independently graded all photos. Focus group discussions (FGDs) were conducted with community members and Tropical Data trainers. RESULTS: Of 391 photos, one-fifth were discarded as ungradable. Compared with field grading, photo grading consistently underdiagnosed TF. Compared with field grading, DSLR photo grading resulted in a higher prevalence and sensitivity than smartphone photo grading. FGDs indicated that communities and trainers found photography acceptable and preferred smartphones to DSLR in terms of practicalities, but image quality was of paramount importance for trainers. CONCLUSIONS: Photography is acceptable and feasible, but further work is needed to ensure high-quality images that enable accurate and consistent grading before being routinely implemented in trachoma surveys.

The impact of self-referential processing on depression-linked negative interpretive bias.

BACKGROUND AND OBJECTIVES: Cognitive theories propose that individuals with heightened depression are characterized by biases in memory and interpretation, favoring the processing of negative information. Individuals with heightened depression exhibit a negative memory bias, and this bias is disproportionately evident when emotional information is processed in a self-referential manner. In studies investigating whether individuals with heightened depression exhibit a negative interpretative bias, the measures employed have often been compromised by serious methodological limitations. When interpretation has been measured using an eye-blink modulation approach, which overcomes these limitations, evidence of depression-linked negative interpretive bias has emerged. However, the important issue of whether this bias depends upon self-referential processing has gone unresolved. METHOD: In the present study, we assessed interpretation using the eye blink modulation approach, in participants scoring high or low on the Beck Depression Inventory-II. A simple manipulation ensured that ambiguous information either was, or was not, processed in a self-referential manner. RESULTS: The results showed that, when ambiguous information was processed in a self-referential manner, participants scoring high on the BDI-II displayed blink magnitudes indicating greater negative interpretative bias compared to participants scoring low on the BDI-II. This was not the case when ambiguous information was processed in an other-referential manner. LIMITATIONS: The present findings do not permit the inference that this negative interpretive bias causally contributes to depressive symptomatology. CONCLUSIONS: The results support the hypothesis that people with high levels of depression display greater negative interpretive bias than people with low levels of depression, but only when ambiguous information is processed in a self-referential manner.