Psychosocial factors associated with treatment preference in mental health.

BACKGROUND: Studies examining the effects of incorporating patients' preferences into treatment outcomes highlight their impact on crucial aspects such as reduced dropout rates and enhanced effectiveness. Recognizing individuals' rights to participate in decisions about their treatments underscores the importance of studying treatment preferences and the factors influencing these choices. AIM: This study aims to identify treatment preferences (psychological, pharmacological, or combined) among a sample of patients and to discern the psychosocial and clinical factors influencing these preferences. METHODS: A total of 2,133 individuals receiving care at a community mental health unit completed assessments on anxious-depressive symptoms, social and occupational adjustment, and their treatment preference. Data analysis was conducted using SPSS, with descriptive statistics, Chi-square tests, and one-way ANOVA applied. RESULTS: Preferences for treatments were distributed as follows: Combined (49.8%), psychological (33%), and pharmacological (10.6%). Factors such as diagnosis, severity of depressive and anxious symptoms, and functional impact were related to treatment preference with a moderate effect size. Meanwhile, various sociodemographic factors correlated with the selected treatment, though with a weak effect size. CONCLUSIONS: There is a pronounced preference for combined treatments. The significance of psychological treatments is evident, as four out of five participants favored them in their choices. Addressing these preferences calls for an exploration within the broader context of prescription freedom in mental health.

Systemic neurophysiological signals of auditory predictive coding.

Predictive coding framework posits that our brain continuously monitors changes in the environment and updates its predictive models, minimizing prediction errors to efficiently adapt to environmental demands. However, the underlying neurophysiological mechanisms of these predictive phenomena remain unclear. The present study aimed to explore the systemic neurophysiological correlates of predictive coding processes during passive and active auditory processing. Electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and autonomic nervous system (ANS) measures were analyzed using an auditory pattern-based novelty oddball paradigm. A sample of 32 healthy subjects was recruited. The results showed shared slow evoked potentials between passive and active conditions that could be interpreted as automatic predictive processes of anticipation and updating, independent of conscious attentional effort. A dissociated topography of the cortical hemodynamic activity and distinctive evoked potentials upon auditory pattern violation were also found between both conditions, whereas only conscious perception leading to imperative responses was accompanied by phasic ANS responses. These results suggest a systemic-level hierarchical reallocation of predictive coding neural resources as a function of contextual demands in the face of sensory stimulation. Principal component analysis permitted to associate the variability of some of the recorded signals.

Neurovascular coupling during auditory stimulation: event-related potentials and fNIRS hemodynamic.

Intensity-dependent amplitude changes (IDAP) have been extensively studied using event-related potentials (ERPs) and have been linked to several psychiatric disorders. This study aims to explore the application of functional near-infrared spectroscopy (fNIRS) in IDAP paradigms, which related to ERPs could indicate the existence of neurovascular coupling. Thirty-three and thirty-one subjects participated in two experiments, respectively. The first experiment consisted of the presentation of three-tone intensities (77.9 dB, 84.5 dB, and 89.5 dB) lasting 500 ms, each type randomly presented 54 times, while the second experiment consisted of the presentation of five-tone intensities (70.9 dB, 77.9 dB, 84.5 dB, 89.5 dB, and 94.5 dB) in trains of 8 tones lasting 70 ms each tone, the trains were presented 20 times. EEG was used to measure ERP components: N1, P2, and N1-P2 peak-to-peak amplitude. fNIRS allowed the analysis of the hemodynamic activity in the auditory, visual, and prefrontal cortices. The results showed an increase in N1, P2, and N1-P2 peak-to-peak amplitude with auditory intensity. Similarly, oxyhemoglobin and deoxyhemoglobin concentrations showed amplitude increases and decreases, respectively, with auditory intensity in the auditory and prefrontal cortices. Spearman correlation analysis showed a relationship between the left auditory cortex with N1 amplitude, and the right dorsolateral cortex with P2 amplitude, specifically for deoxyhemoglobin concentrations. These findings suggest that there is a brain response to auditory intensity changes that can be obtained by EEG and fNIRS, supporting the neurovascular coupling process. Overall, this study enhances our understanding of fNIRS application in auditory paradigms and highlights its potential as a complementary technique to ERPs.

Head hemodynamics and systemic responses during auditory stimulation.

The present study aims to analyze the systemic response to auditory stimulation by means of hemodynamic (cephalic and peripheral) and autonomic responses in a broad range of auditory intensities (70.9, 77.9, 84.5, 89.5, 94.5 dBA). This approach could help to understand the possible influence of the autonomic nervous system on the cephalic blood flow. Twenty-five subjects were exposed to auditory stimulation while electrodermal activity (EDA), photoplethysmography (PPG), electrocardiogram, and functional near-infrared spectroscopy signals were recorded. Seven trials with 20 individual tones, each for the five intensities, were presented. The results showed a differentiated response to the higher intensity (94.5 dBA) with a decrease in some peripheral signals such as the heart rate (HR), the pulse signal, the pulse transit time (PTT), an increase of the LFnu power in PPG, and at the head level a decrease in oxygenated and total hemoglobin concentration. After the regression of the visual channel activity from the auditory channels, a decrease in deoxyhemoglobin in the auditory cortex was obtained, indicating a likely active response at the highest intensity. Nevertheless, other measures, such as EDA (Phasic and Tonic), and heart rate variability (Frequency and time domain) showed no significant differences between intensities. Altogether, these results suggest a systemic and complex response to high-intensity auditory stimuli. The results obtained in the decrease of the PTT and the increase in LFnu power of PPG suggest a possible vasoconstriction reflex by a sympathetic control of vascular tone, which could be related to the decrease in blood oxygenation at the head level.

Multivariate analysis of the systemic response to auditory stimulation: An integrative approach.

NEW FINDINGS: What is the central question of this study? Auditory stimulation produces a response in different physiological systems: cardiac, peripheral blood flow, electrodermal, cortical and peripheral haemodynamic responses and auditory event-related potentials. Do all these subsystems covary when responding to auditory stimulation, suggesting a unified locus of control, or do they not covary, suggesting independent loci of control for these physiological responses? What is the main finding and its importance? Auditory sensory gating reached a fixed level of neural activity independently of the intensity of auditory stimulation. The use of multivariate techniques revealed the presence of different regulatory mechanisms for the different physiologically recorded signals. ABSTRACT: We studied the effects of an increasing amplitude of auditory stimulation on a variety of autonomic and CNS responses and their possible interdependence. The subjects were stimulated with an increasing amplitude of auditory tones while the auditory event-related potentials (ERPs), the cortical and extracerebral functional near-infrared spectroscopy (fNIRS) signal of standard and short separation channel recordings, the peripheral pulse measured by photoplethysmography, heart rate and electrodermal responses were recorded. Trials with eight tones of equal amplitude were presented. The results showed a parallel increase of activity in ERPs, fNIRS and peripheral responses with the increase in intensity of auditory stimulation. The ERPs, measured as peak-to-peak N1-P2, showed an increase in amplitude with auditory stimulation and a high attenuation from the first presentation with respect to the second to eighth presentations. Peripheral signals and standard and short channel fNIRS responses showed a decrease in amplitude in the high-intensity auditory stimulation conditions. Principal components analysis showed independent sources of variance for the recorded signals, suggesting independent control of the recorded physiological responses. The present results suggest a complex response associated to the increase of auditory stimulation with a fixed amplitude for ERPs, and a decrease in the peripheral and cortical haemodynamic response, possibly mediated by activation of the sympathetic nervous system, constituting a defensive reflex to excessive auditory stimulation.