Fear of cancer recurrence and mental health: A comprehensive meta-analysis.

OBJECTIVE: This study aimed to examine the relationship between fear of cancer recurrence (FCR) and symptoms of anxiety, depression, and emotional distress in cancer survivors. Additionally, potential effect modifiers of this link were investigated. METHODS: A systematic search was conducted in PsychInfo, PubMed/Medline, Web of Science, and the Cochrane Central Register of Controlled Trials until June 2022. Studies reporting the association between FCR and mental health indices in adolescent and young adult survivors (15-39 years) and adult survivors (>18 years) were included. Study quality was assessed using the Joanna Briggs Institute checklist for cross-sectional studies. RESULTS: A total of 72 primary studies with 31,740 participants were identified, with the majority having a low risk of bias. The results revealed a significant association between FCR and depression, anxiety, and emotional distress. This association was observed whether FCR was examined in relation to each factor individually or collectively. The effect sizes fell within the medium range. Notably, the relationship between FCR and mental health strengthened over the years of publication. Additionally, lengthier FCR assessment instruments yielded larger effect sizes compared to shorter and single-item instruments, underscoring the significance of instrument selection. CONCLUSIONS: This meta-analysis provides further evidence that FCR is linked to a range of common mental health problems. The medium effect sizes observed indicate the need to consider FCR when evaluating the mental health of cancer survivors, and vice versa. Further research is required to elucidate the underlying mechanisms of the FCR-mental health link.

Mental health at different stages of cancer survival: a natural language processing study of Reddit posts.

Introduction: The purpose of this study was to use text-based social media content analysis from cancer-specific subreddits to evaluate depression and anxiety-loaded content. Natural language processing, automatic, and lexicon-based methods were employed to perform sentiment analysis and identify depression and anxiety-loaded content. Methods: Data was collected from 187 Reddit users who had received a cancer diagnosis, were currently undergoing treatment, or had completed treatment. Participants were split according to survivorship status into short-term, transition, and long-term cancer survivors. A total of 72524 posts were analyzed across the three cancer survivor groups. Results: The results showed that short-term cancer survivors had significantly more depression-loaded posts and more anxiety-loaded words than long-term survivors, with no significant differences relative to the transition period. The topic analysis showed that long-term survivors, more than other stages of survivorship, have resources to share their experiences with suicidal ideation and mental health issues while providing support to their survivor community. Discussion: The results indicate that Reddit texts seem to be an indicator of when the stressor is active and mental health issues are triggered. This sets the stage for Reddit to become a platform for screening and first-hand intervention delivery. Special attention should be dedicated to short-term survivors.

Cumulative Risk Exposure and Social Isolation as Correlates of Carer and Child Mental Health During the COVID-19 Pandemic: An Online Study with Families from Various Europeans Countries.

This study adopted a cumulative risk approach to examine the relations between various domains of risk factors (i.e., social isolation and home confinement, other pandemic-related risk factors, and pre-existing psychosocial risk factors) and carers' and children's mental health during the first wave of the COVID-19 pandemic in Europe. The sample consisted of 1475 carers of 6- to 16-year-old children and adolescents residing in five European countries (Portugal, United Kingdom, Romania, Spain, and The Netherlands) who completed an online survey. The results showed that each of the three domains of adversity accounted for unique variation in carers' and children's mental health outcomes. Also, the results indicated that pre-existing psychosocial risk factors moderated the relationship between pandemic-related risk factors and children and carers' anxiety and between social isolation and confinement and carers' well-being. Simple slopes analysis suggested a stronger relationship between these domains of adversities and mental health outcomes in already more vulnerable families. It is important to consider the implications of social isolation measures and confinement for families' mental health, paying special attention to families with pre-existing psychosocial vulnerabilities.

Neural Networks Implicated in Autobiographical Memory Training.

Training of autobiographical memory has been proposed as an intervention to improve cognitive function. The neural substrates for such improvements are poorly understood. Several brain areas have been previously linked to autobiographical recollection, including structures in the default mode network (DMN) and the sensorimotor network. Here, we tested the hypothesis that changes in connectivity within different neural networks support distinct aspects of memory improvement in response to training on a group of 59 human subjects. We found that memory training using olfactory cues increases resting-state intranetwork DMN connectivity, and this associates with improved recollection of cue-specific memories. On the contrary, training decreased resting-state connectivity within the sensorimotor network, a decrease that correlated with improved ability for voluntary recall. Moreover, preliminary data indicate that only the decrease in sensorimotor connectivity associated with the training-induced decrease in the tumor necrosis factor α (TNFα) factor, an immune modulation previously linked to improved cognitive performance. We identified functional and biochemical factors that associate with distinct memory processes improved by autobiographical training. Pathways which connect autobiographical memory with both high-level cognition and somatic physiology are discussed.

Subjective well-being among psychotherapists during the coronavirus disease pandemic: A cross-cultural survey from 12 european countries.

OBJECTIVE: The aim of this study is to examine the amount of the total variance of the subjective well-being (SWB) of psychotherapists from 12 European countries explained by between-country vs. between-person differences regarding its cognitive (life satisfaction) and affective components (positive affect [PA] and negative affect [NA]). Second, we explored a link between the SWB and their personal (self-efficacy) and social resources (social support) after controlling for sociodemographics, work characteristics, and COVID-19-related distress. METHODS: In total, 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Satisfaction with Life Scale (SWLS), the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF), the General Self-Efficacy Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS: Cognitive well-being (CWB; satisfaction with life) was a more country-dependent component of SWB than affective well-being (AWB). Consequently, at the individual level, significant correlates were found only for AWB but not for CWB. Higher AWB was linked to being female, older age, higher weekly workload, and lower COVID-19-related distress. Self-efficacy and social support explained AWB only, including their main effects and the moderating effect of self-efficacy. CONCLUSIONS: The results highlight more individual characteristics of AWB compared to CWB, with a more critical role of low self-efficacy for the link between social support and PA rather than NA. This finding suggests the need for greater self-care among psychotherapists regarding their AWB and the more complex conditions underlying their CWB.

Burnout among psychotherapists: a cross-cultural value survey among 12 European countries during the coronavirus disease pandemic.

The aim of this study was to examine cross-cultural differences, as operationalized by Schwartz's refined theory of basic values, in burnout levels among psychotherapists from 12 European countries during the coronavirus disease (COVID-19) pandemic. We focused on the multilevel approach to investigate if individual- and country-aggregated level values could explain differences in burnout intensity after controlling for sociodemographic, work-related characteristics and COVID-19-related distress among participants. 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Maslach Burnout Inventory-Human Service Survey, the revised version of the Portrait Values Questionnaire, and a survey questionnaire on sociodemographic, work-related factors and the COVID-19 related distress. In general, the lowest mean level of burnout was noted for Romania, whereas the highest mean burnout intensity was reported for Cyprus. Multilevel analysis revealed that burnout at the individual level was negatively related to self-transcendence and openness-to-change but positively related to self-enhancement and conservation values. However, no significant effects on any values were observed at the country level. Male sex, younger age, being single, and reporting higher COVID-19-related distress were significant burnout correlates. Burnout among psychotherapists may be a transcultural phenomenon, where individual differences among psychotherapists are likely to be more important than differences between the countries of their practice. This finding enriches the discussion on training in psychotherapy in an international context and draws attention to the neglected issue of mental health among psychotherapists in the context of their professional functioning.

Spontaneous thought and microstate activity modulation by social imitation.

The human mind wanders spontaneously and frequently, revisiting the past and imagining the future of self and of others. External and internal factors can influence wandering spontaneous thoughts, whose content predicts subsequent emotional states. We propose that social imitation, an action that increases well-being and closeness by poorly understood mechanisms, impacts behavioural states in part by modulating post-imitation mind-wandering. In 43 young subjects, we find that imitating the arm movements of an actor alters the dynamics and the content of subsequent resting-state spontaneous thoughts. Imitation-sensitive features of spontaneous thoughts correlate with behavioural states and personality traits. EEG microstate analysis reveals that global patterns of correlated neuronal activity predict imitation-induced changes in spontaneous thoughts. Exploratory analyses indicate a possible modulatory effect of social imitation via the endogenous release of oxytocin. Thus, social imitation can induce selective modulations of ongoing activity in specific neural networks to change spontaneous thought patterns as a function of personality traits, and to ultimately orchestrate behavioural states.

Contamination fear in the time of the COVID-19 pandemic: A moderated mediation quasi-experimental model of the effect of disgust on outgroup bias towards diaspora.

Disgust sensitivity plays a key role in generating and maintaining outgroup biases. To test our hypotheses, we used a quasi-experimental between-subjects design, in which participants were randomly assigned to a disgust induction condition (N = 102) or a non-induction neutral group (N = 92). The induction scenario featured the return of the diaspora to their home country due to COVID-19 concerns. In one scenario, the diaspora lied about the country they arrived from, and in the other, there was no moral transgression. We hypothesized that the effect of disgust sensitivity on dehumanization and aggressive tendencies passed through contamination fear and the moderated mediation model indicated that this indirect effect was stronger for participants in the disgust-induction than in the non-induction group. This effect was found for biological dehumanization and passive aggression outcomes, both related to outgroup bias. Consistent with the role of disgust as a disease-avoidance mechanism, our results suggest that disgust could facilitate stronger outgroup bias in the context of a high health threat, such as the COVID-19 pandemic.

Resting state predicts neural activity during reward-guided decision making: An fMRI study on Balloon Analogue Risk Task.

In our previous work [8], we have shown that resting state (RS) functional connectivity metrics are significantly related with behavioural performance at Balloon Analogue Risk Task (BART). In the present study we investigated the hypothesis of an association between RS metrics and neural activity evoked by BART execution. A group-level whole-brain regression was run to assess whether RS metrics predict brain activation during the BART, in a sample of 35 young healthy adults (mean age 23 ± 2 years, 25 F). Results complete the previous findings showing that RS is also significantly associated with the neural activity during BART execution. Specifically, ALFF is positively associated with the activity of both the right inferior parietal lobule and the left caudate. These new results are coherent with previous evidence indicating RS abnormalities in clinical conditions characterised by symptoms of impulse control disorders, and further suggest that RS might be a stable predictor of both behavioural indices and neural correlates of impulsivity and of reward-guided decision-making.

Predictors and moderators of outcome of psychotherapeutic interventions for mental disorders in adolescents and young adults: protocol for systematic reviews.

BACKGROUND: Adolescence and young adulthood is a risk period for the emergence of mental disorders. There is strong evidence that psychotherapeutic interventions are effective for most mental disorders. However, very little is known about which of the different psychotherapeutic treatment modalities are effective for whom. This large systematic review aims to address this critical gap within the literature on non-specific predictors and moderators of the outcomes of psychotherapeutic interventions among adolescents and young adults with mental disorders. METHODS: The protocol is being reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) Statement. PubMed and PsycINFO databases will be searched for randomized controlled and quasi-experimental/naturalistic clinical trials. Risk of bias of all included studies will be assessed by the Mixed Methods Appraisal Tool. The quality of predictor and moderator variables will be also assessed. A narrative synthesis will be conducted for all included studies. DISCUSSION: This systematic review will strengthen the evidence base on effective mental health interventions for young people, being the first to explore predictors and moderators of outcome of psychotherapeutic interventions for a wide range of mental disorders in young people. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020166756 .

Social Feedback During Sensorimotor Synchronization Changes Salivary Oxytocin and Behavioral States.

In humans and animal models, oxytocin increases social closeness, attachment and prosocial behaviors, while decreasing anxiety and stress levels. Efficiently triggering the release of endogenous oxytocin could serve as a powerful therapeutic intervention for disorders of social behavior and for anxiety. We designed a new version of a social sensorimotor synchronization task to investigate the role of social approval in inducing biochemical and psychological changes following behavioral synchrony in a sample of 80 college students. Social approval in the form of real time positive feedback increased well-being only in women, while increasing social closeness in both genders. Social disapproval in the form of real time negative feedback prevented a decrease in stress levels that otherwise women reported following engagement in either social or non-social synchronization. Surprisingly, for certain personality traits, negative social feedback during sensorimotor synchronization was psychologically beneficial irrespective of gender. Salivary oxytocin levels increased only in women after the social but not the non-social synchronization tasks. Oxytocin dynamics were independent of the type of real time feedback that subjects received, indicating the existence of distinct mechanisms for hormonal versus behavioral changes following synchronization. Nevertheless, changes in salivary oxytocin after positive social feedback correlated with changes in well-being and predicted changes in prosocial attitudes. Our findings show evidence of distinct mechanisms for behavioral versus hormonal changes following social sensorimotor synchronization, and indicate that gender and personality traits should be carefully considered when designing behavioral therapies for improving social attitudes and for stress management.

Concluding commentary: Treating perfectionism transdiagnostically with an eye on the future.

The current piece of work is a commentary section for the special issue regarding the treatment of perfectionism. It discusses analytically the similarities and the differences between the six clinical case formulations included in the special issue to emphasize that there are different routes to beneficial outcomes. All the psychotherapeutic approaches included here are either transdiagnostic or have transdiagnostic applications. As such, the second part of the commentary focuses on the transdiagnostic future of the treatment of perfectionism. Concluding remarks evidence a collection of clinical case studies covering multiple forms of psychotherapy and an integrating overview of the literature from which practitioners can extract best practices examples. Though there is still a lot to be done with and for interventions on perfectionism, the current collection of case studies is a good starting point.

Resilience in Familial Caregivers of Children with Developmental Disabilities: A Meta-analysis.

The aim of this meta-analysis was to investigate factors associated with resilience in familial caregivers of children with developmental disabilities. The protocol was registered in the PROSPERO database, with the registration number CRD42018105180. Several electronic databases were searched for studies. A random-effects meta-analysis was performed on 26 selected studies that associated resilience to an array of other variables (i.e., psychological distress, social support, coping, perceived health, life satisfaction). Overall, the significant pooled effect sizes were small to medium, ranging from r = 0.291 for coping to r = 0.442 for social support. Although the literature on the topic has improved, there is a lot of study heterogeneity and the need for focusing on male caregivers becomes evident.

You do not have to act to be impulsive: Brain resting-state activity predicts performance and impulsivity on the Balloon Analogue Risk Task.

OBJECTIVE: Impulsivity is a key, trait-like feature of the decision-making process. As personality traits are stable over time, we hypothesized that resting-state (RS) neural activity would predict individual impulsivity. METHODS: Thirty-five healthy individuals underwent fMRI scan during RS and subsequently performed the Balloon Analogue Risk Task (BART). In BART, impulsivity was inversely correlated to monetary earnings. A group-level whole-brain regression assessed the relationship between earnings at BART and RS evaluated by the Hurst Exponent, regional homogeneity; low frequency oscillation (LFO), (including the Amplitude of Low Frequency Fluctuations - ALFF- and the fractional Amplitude of Low Frequency Fluctuations -fALFF) and the Default Mode Network (DMN) functional connectivity. RESULTS: ALFF significantly correlates with total earnings in the ventral part of the ACC/MPFC (FWE corrected p < 0.05 (uncorrected p value <0.0005; cluster size: ≥10 voxels), while H significantly correlates with total earnings in the anterior insula and the part opercularis of the inferior frontal gyrus. CONCLUSIONS: These results suggest that impulsivity and ability to change strategies according to external cues are trait characteristics shaped in the RS's functional architecture that can be detected also when individuals are not engaged in decision-making tasks.

Is there a sleeper effect of exposure-based vs. cognitive-only intervention for anxiety disorders? A longitudinal multilevel meta-analysis.

There is a longstanding debate in the cognitive behavioral literature whether exposure-based methods produce more sustainable outcomes relative to cognitive methods or vice versa. This debate concerns particularly the time after treatment termination (at follow-up assessments), also referred to as the sleeper effect. Therefore, the aim of the current meta-analysis was to examine the enduring efficacy of Exposure Therapy (ET) in comparison to Cognitive Therapy (CT) from treatment termination to follow-up in anxiety disorders. Available literature also allowed for the assessment of their long-term additive benefits relative to ET only. Traditional random effects analyses with restricted maximum likelihood estimators and multilevel longitudinal analyses were conducted on 39 randomized controlled trials (N = 1878). Traditional analyses revealed no differential efficacy at post-treatment or follow-up. Similarly, the multilevel longitudinal analyses identified no differential growth in efficacy from treatment termination to follow-up. The majority of the variables investigated did not moderate the results. However, there was evidence suggesting that CT was superior to ET when treatment was delivered individually, while ET was superior to CT when delivered as group therapy. Overall, the findings did not validate a number of assumptions, such as the existence of a sleeper effect. Several strengths and limitations are further discussed in the paper.

Critical review and meta-analysis of multicomponent behavioral e-health interventions for weight loss.

OBJECTIVES: Multicomponent behavioral e-health interventions are seen as an alternative to in-person treatment for weight loss. However, these estimates may be optimistic at best. This is the first meta-analysis to investigate the relative efficacy of multicomponent behavioral e-health interventions for weight loss against separate groups of active in-person treatment and passive controls (e.g., waitlist, no care, usual care, or placebo group). METHOD: Forty-seven randomized controlled trials on multicomponent e-health interventions for weight loss in overweight and/or obese adults were included. A random-effects model was used for pooling the effect sizes, which were calculated for weight and behavioral outcomes at posttreatment and follow-up. RESULTS: Standard active treatment was more effective than e-health interventions with respect to weight (g = -0.31, 95% CI [-0.43 to -0.20]). There was a statistically significant, albeit small effect size favoring e-health interventions relative to passive control groups for weight (g = 0.34, 95% CI [0.24 to 0.44]) and behavioral outcomes (g = 0.17, 95% CI [0.07 to 0.27]). Several potential moderator variables were examined and discussed. CONCLUSIONS: Overall, the findings raise concerns regarding the current potential of multicomponent behavioral e-health interventions as first-line treatment for weight-loss. Other limitations and possible implications are discussed. (PsycINFO Database Record

An evidence-based gamified mHealth intervention for overweight young adults with maladaptive eating habits: study protocol for a randomized controlled trial.

BACKGROUND: Cognitive behavior therapy (CBT) is the first-line of treatment for overweight and obesity patients whose problems originate in maladaptive eating habits (e.g., emotional eating). However, in-person CBT is currently difficult to access by large segments of the population. The proposed SIGMA intervention (i.e., the Self-help, Integrated, and Gamified Mobile-phone Application) is a mHealth intervention based on CBT principles. It specifically targets overweight young adults with underlying maladaptive behaviors and cognitions regarding food. The SIGMA app was designed as a serious game and intended to work as a standalone app for weight maintenance or alongside a calorie-restrictive diet for weight loss. It uses a complex and novel scoring system that allows points earned within the game to be supplemented by points earned during outdoor activities with the help of an embedded pedometer. METHODS/DESIGN: The efficacy of the SIGMA mHealth intervention will be investigated within a randomized, placebo-controlled trial. The intervention will be set to last 2 months with a 3-month follow-up. Selected participants will be young overweight adults with non-clinical maladaptive eating habits embodied by food cravings, binge eating, and emotional eating. The primary outcomes will be represented by changes in (1) self-reported maladaptive thoughts related to eating and body weight, (2) self-reported maladaptive eating behaviors in the range of urgent food cravings, emotional eating or binge eating, (3) as well as biased attentional processing of food items as indexed by reaction times. Secondary outcomes will be represented by changes in weight, Body Mass Index, general mood, and physical activity as indexed by the number of steps per day. DISCUSSION: Through an evidence-based cognitive behavioral approach and a user-friendly game interface, the SIGMA intervention offers a significant contribution to the development of a cost-effective and preventive self-help tool for young overweight adults with maladaptive eating habits. TRIAL REGISTRATION: ISRCTN, ID: 70907354 . Registered on 6 February 2017. The ISRCTN registration is in line with the World Health Organization Trial Registration Data Set. The present paper represents the original version of the protocol. Any changes to the protocol will be communicated to ISRCTN.

A comprehensive meta-analysis of interpretation biases in depression.

Interpretation biases have long been theorized to play a central role in depression. Yet, the strength of the empirical evidence for this bias remains a topic of debate. This meta-analysis aimed to estimate the overall effect size and to identify moderators relevant to theory and methodology. PsycINFO, Embase, Web of Science, Scopus, PubMed, and dissertation databases were searched. A random-effects meta-analysis was performed on 87 studies (N=9443). Results revealed a medium overall effect size (g=0.72, 95%-CI:[0.62;0.82]). Equivalent effect sizes were observed for patients diagnosed with clinical depression (g=0.60, 95%-CI:[0.37;0.75]), patients remitted from depression (g=0.59, 95%-CI:[0.33;0.86]), and undiagnosed individuals reporting elevated depressive symptoms (g=0.66, 95%-CI:[0.47;0.84]). The effect size was larger for self-referential stimuli (g=0.90, 95%-CI[0.78;1.01]), but was not modified by the presence (g=0.74, 95%-CI[0.59;0.90]) or absence (g=0.72, 95%-CI[0.58;0.85]) of mental imagery instructions. Similar effect sizes were observed for a negative interpretation bias (g=0.58, 95%-CI:[0.40;0.75]) and lack of a positive interpretation bias (g=0.60, 95%-CI:[0.36;0.85]). The effect size was only significant when interpretation bias was measured directly (g=0.88, 95%-CI[0.77;0.99]), but not when measured indirectly (g=0.04, 95%-CI[-0.14;0.22]). It is concluded that depression is associated with interpretation biases, but caution is necessary because methodological factors shape conclusions. Implications and recommendations for future research are outlined.

Genetic Correlates of Maladaptive Beliefs: COMT VAL(158)MET and Irrational Cognitions Linked Depending on Distress.

Maladaptive/irrational beliefs are significant cognitive vulnerability mechanisms in psychopathology. They are more likely to be associated with a genetic vulnerability marker under conditions of emotional distress when irrational beliefs are more salient. Therefore, in the current study we investigated the COMT Val(158)Met gene variation in relation to irrational beliefs, assuming this relationship depended on the level of emotional distress. Two hundred and sixty-seven genotyped volunteers were assessed for core/general maladaptive beliefs, as well as trait emotional distress. We focused on context-independent measures of irrational beliefs and emotional distress in the absence of a stressor. As expected, the relationship between COMT Val(158)Met and irrational beliefs depended on the level of emotional distress (f(2)=.314). The COMT Val(158)Met-irrationality association was significant only when individuals fell in the average to above average range of emotional distress. Furthermore, within this range the Met allele seemed to relate to higher irrational beliefs. These results were significant for overall irrational beliefs and its subtypes, but not for rational beliefs, the functional counterpart of irrationality. In light of the study's limitations, the results should be considered as preliminary. If replicable, these findings have potential implications for therapygenetics, changing the view that COMT Val(158)Met might be of greater relevance when treatment modality does not rely on cognitive variables.