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BACKGROUND: To evoke a therapeutically effective seizure, electrical stimulation in electroconvulsive therapy (ECT) has to overcome the combined resistivity of scalp, skull and other tissues. Static impedances are measured prior to stimulation using high-frequency electrical alternating pulses, dynamic impedances during passage of the stimulation current. Static impedance can partially be influenced by skin preparation techniques. Earlier studies showed a correlation between dynamic and static impedance in bitemporal and right unilateral ECT. OBJECTIVE: This study aims at assessing the correlation of dynamic and static impedance with patient characteristics and seizure quality criteria in bifrontal ECT. METHODS: We performed a cross-sectional single-centre retrospective analysis of ECT treatments at the Psychiatric University Hospital Zurich between May 2012 and March 2020 and used linear mixed-effects regression models in 78 patients with a total of 1757 ECT sessions. RESULTS: Dynamic and static impedance were strongly correlated. Dynamic impedance was significantly correlated with age and higher in women. Energy set and factors positively (caffeine) and negatively (propofol) affecting seizure at the neuronal level were not associated with dynamic impedance. For secondary outcomes, dynamic impedance was significantly related to Maximum Sustained Power and Average Seizure Energy Index. Other seizure quality criteria showed no significant correlation with dynamic impedance. CONCLUSION: Aiming for low static impedance might reduce dynamic impedance, which is correlated with positive seizure quality parameters. Therefore, good skin preparation to achieve low static impedance is recommended.
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Terapia Electroconvulsiva , Humanos , Femenino , Terapia Electroconvulsiva/métodos , Estudios Transversales , Impedancia Eléctrica , Estudios Retrospectivos , Convulsiones/terapia , ElectroencefalografíaRESUMEN
Light-induced melatonin suppression data from 29 peer-reviewed publications was analysed by means of a machine-learning approach to establish which light exposure characteristics (ie photopic illuminance, five α-opic equivalent daylight illuminances [EDIs], duration and timing of the light exposure, and the dichotomous variables pharmacological pupil dilation and narrowband light source) are the main determinants of melatonin suppression. Melatonin suppression in the data set was dominated by four light exposure characteristics: (1) melanopic EDI, (2) light exposure duration, (3) pupil dilation and (4) S-cone-opic EDI. A logistic model was used to evaluate the influence of each of these parameters on the melatonin suppression response. The final logistic model was only based on the first three parameters, since melanopic EDI was the best single (photoreceptor) predictor that was only outperformed by S-cone-opic EDI for (photopic) illuminances below 21 lux. This confirms and extends findings on the importance of the metric melanopic EDI for predicting biological effects of light in integrative (human-centric) lighting applications. The model provides initial and general guidance to lighting practitioners on how to combine spectrum, duration and amount of light exposure when controlling non-visual responses to light, especially melatonin suppression. The model is a starting tool for developing hypotheses on photoreceptors' contributions to light's non-visual responses and helps identifying areas where more data are needed, like on the S-cone contribution at low illuminances.
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Melatonina , Ritmo Circadiano/fisiología , Humanos , Células Fotorreceptoras Retinianas ConosRESUMEN
The present study aimed to differentiate pedophilic child sex offenders (CSOs) from nonoffending controls (CTLs), as well as contact from noncontact CSOs. For this purpose, we investigated 21 contact CSOs, 20 noncontact CSOs (child pornography offenders), as well as 21 CTLs on neuropsychological test measures and indirect test measures of sexual interest. Multiple logistic regression models showed that three parameters of indirect tests and two neuropsychological test parameters allowed the differentiation of CSOs from CTLs with a maximum accuracy of 87%. The profile of contact and noncontact CSOs was remarkably similar and the optimal model for this group differentiation had a maximum accuracy of 66%, with slightly increased levels of risk-taking behavior and greater susceptibility for perceptual interference in contact CSOs than in noncontact CSOs. The findings suggest that standardized, objective methods can support the assessment of sexual offenders against children in forensic psychiatry and legal psychology.
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Criminales , Pedofilia , Delitos Sexuales , Niño , Literatura Erótica , Humanos , Conducta SexualRESUMEN
While much is known about immediate brain activity changes induced by the confrontation with emotional stimuli, the subsequent temporal unfolding of emotions has yet to be explored. To investigate whether exposure to emotionally aversive pictures affects subsequent resting-state networks differently from exposure to neutral pictures, a resting-state fMRI study implementing a two-group repeated-measures design in healthy young adults (N = 34) was conducted. We focused on investigating (i) patterns of amygdala whole-brain and hippocampus connectivity in both a seed-to-voxel and seed-to-seed approach, (ii) whole-brain resting-state networks with an independent component analysis coupled with dual regression, and (iii) the amygdala's fractional amplitude of low frequency fluctuations, all while EEG recording potential fluctuations in vigilance. In spite of the successful emotion induction, as demonstrated by stimuli rating and a memory-facilitating effect of negative emotionality, none of the resting-state measures was differentially affected by picture valence. In conclusion, resting-state networks connectivity as well as the amygdala's low frequency oscillations appear to be unaffected by preceding exposure to widely used emotionally aversive visual stimuli in healthy young adults.
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Amígdala del Cerebelo/fisiología , Nivel de Alerta/fisiología , Conectoma/métodos , Electroencefalografía/métodos , Emociones/fisiología , Red Nerviosa/fisiología , Reconocimiento Visual de Modelos/fisiología , Adolescente , Adulto , Amígdala del Cerebelo/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Red Nerviosa/diagnóstico por imagen , Adulto JovenRESUMEN
Introduction: Psychotic disorders have been associated with dysregulated stress reactions and adaptation. Little is known about the neuroendocrine responses to psychosocial stress in justice-involved individuals with schizophrenia. Methods: Using an experimental research design, the present study aims to examine differences in the subjective and neuroendocrine responses to psychosocial stress and its impact on facial emotion recognition (FER) and performance on an arithmetic task in chronically ill justice-involved individuals with schizophrenia (PAT) and a healthy control group. PAT undergoing treatment in forensic psychiatric inpatient wards (n = 17) and a healthy control group (n = 17) were assessed regarding sociodemographic and clinical characteristics. Additionally, salivary cortisol levels, measured before and after performing a psychosocial stress task [Montreal Imaging Stress Task (MIST)], and performance on an arithmetic problem-solving task and two FER tasks were recorded. Two participants dropped out, one from each group. Therefore, the final sample consisted of 32 individuals. Results: Significant group differences in FER were recorded. There was a significant rise in subjective perception of momentary strain relating to the induction of psychosocial stress in both groups. Notably, the pre-stress level of subjective strain was higher in the PAT group than controls. Acute psychosocial stress induced an increase in FER performance in a sub-task related to naming emotions in individuals with schizophrenia spectrum disorder. Discussion: The results underline the importance of psychosocial and therapeutic interventions aimed at strengthening stress resilience in individuals with schizophrenia spectrum disorders.
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Exposure to natural daylight benefits human well-being, alertness, circadian rhythms and sleep. Many workplaces have limited or no access to daylight. Thus, we implemented a light-panel ("Virtual Sky"), which reproduced nature-adapted light scenarios. In a laboratory office environment, three lighting scenarios were presented during the day: two lighting conditions with nature-adapted spectral light distributions, one with static and one with dynamic clouds, and a standard office lighting condition. We compared the impact of the three lighting scenarios on subjective and objective measures of alertness, cognitive performance, wellbeing, visual comfort, contrast sensitivity, and cortisol levels in 18 healthy young male volunteers in a within-participant cross-over study design. We found no evidence that an 8-h lighting scenario with static or dynamic clouds during the waking day (9am-5pm) was associated with any significant effect on objective and/or subjective alertness, cognitive performance and morning cortisol concentrations compared to standard workplace lighting. However, the dynamic light scenario was accompanied with lower levels of perceived tensionafter completing cognitive tasks and less effort to concentrate compared to the static lighting scenarios. Our findings suggest that apart from smaller effects on tension and concentration effort, nature-adapted lighting conditions did not improve daytime alertness and cognitive performance in healthy well-rested young participants, as compared to standard office lighting.
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Iluminación , Melatonina , Humanos , Masculino , Hidrocortisona , Somnolencia , Estudios Cruzados , Sueño , Ritmo Circadiano , Lugar de Trabajo , Cognición , LuzRESUMEN
PURPOSE: Insurers often commission psychiatric experts to evaluate the eligibility of workers with mental disorders for disability benefits, by estimating their residual work capacity (RWC). We investigated the validity of a standardized, computer-based battery of established diagnostic instruments, for evaluating the personality, cognition, performance, symptom burden, and symptom validity of claimants. METHODS: One hundred and fifty-three claimants for benefits were assessed by the assembled test battery, which was applied in addition to a conventional clinical work disability evaluation. RESULTS: A principal component analysis of the test and questionnaire battery data revealed six factors (Negative Affectivity, Self-Perceived Work Ability, Behavioral Dysfunction, Working Memory, Cognitive Processing Speed, and Excessive Work Commitment). Claimants with low, medium, and high RWC exclusively varied in the factor Negative Affectivity. Importantly, this factor also showed a strong association to psychiatric ratings of capacity limitations in psychosocial functioning. CONCLUSIONS: The findings demonstrate that the used test battery allows a substantiation of RWC estimates and of psychiatric ratings by objective and standardized data. If routinely incorporated in work disability evaluations, the test battery could increase their transparency for all stakeholders (insurers, claimants, medical experts, expert case-coordinators, and legal practitioners) and would open new avenues for research in the field of insurance medicine.Implications for rehabilitationThe residual work capacity (RWC) estimation by medical experts is internationally good practice, but plagued by a relatively low interrater agreement.The current study shows that psychiatric RWC estimates and capacity limitation ratings can be substantiated by data from objective, standardized psychometric instruments.Systematically using such instruments might help to improve the poor interrater agreement for RWC estimates in work disability evaluations.Such data could also be used for adopting vocational trainings and return-to-work programs to the individual needs of workers with mental health problems.
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Personas con Discapacidad , Seguro por Discapacidad , Medicina , Humanos , Psicometría , Evaluación de Capacidad de Trabajo , Evaluación de la Discapacidad , Personas con Discapacidad/psicologíaRESUMEN
Adolescents often suffer from short and mistimed sleep. To counteract the resulting daytime sleepiness they frequently consume caffeine. However, caffeine intake may exaggerate sleep problems by disturbing sleep and circadian timing. In a 28-hour double-blind randomized crossover study, we investigated to what extent caffeine disturbs slow-wave sleep (SWS) and delays circadian timing in teenagers. Following a 6-day ambulatory phase of caffeine abstinence and fixed sleep-wake cycles, 18 male teenagers (14-17 years old) ingested 80 mg caffeine vs. placebo in the laboratory four hours prior to an electro-encephalographically (EEG) recorded nighttime sleep episode. Data were analyzed using both frequentist and Bayesian statistics. The analyses suggest that subjective sleepiness is reduced after caffeine compared to placebo. However, we did not observe a strong caffeine-induced reduction in subjective sleep quality or SWS, but rather a high inter-individual variability in caffeine-induced SWS changes. Exploratory analyses suggest that particularly those individuals with a higher level of SWS during placebo reduced SWS in response to caffeine. Regarding salivary melatonin onsets, caffeine-induced delays were not evident at group level, and only observed in participants exposed to a higher caffeine dose relative to individual bodyweight (i.e., a dose > 1.3 mg/kg). Together, the results suggest that 80 mg caffeine are sufficient to induce alertness at a subjective level. However, particularly teenagers with a strong need for deep sleep might pay for these subjective benefits by a loss of SWS during the night. Thus, caffeine-induced sleep-disruptions might change along with the maturation of sleep need.
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Encéfalo/efectos de los fármacos , Cafeína/administración & dosificación , Estimulantes del Sistema Nervioso Central/administración & dosificación , Ritmo Circadiano/efectos de los fármacos , Sueño/efectos de los fármacos , Vigilia/efectos de los fármacos , Adolescente , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Cafeína/efectos adversos , Cafeína/metabolismo , Estimulantes del Sistema Nervioso Central/efectos adversos , Estimulantes del Sistema Nervioso Central/metabolismo , Ritmo Circadiano/fisiología , Estudios Cruzados , Método Doble Ciego , Humanos , Masculino , Melatonina/metabolismo , Saliva/metabolismo , Sueño/fisiología , Vigilia/fisiologíaRESUMEN
It is as yet unresolved to what extent the pre-attentive detection of auditory deviance is modulated by emotion. The current event-related potential study was designed to investigate simultaneously the auditory and the visual mismatch negativity (MMN), as well as the impact of emotion on the auditory MMN. Thirty healthy participants saw sequences of neutral and fearful face stimuli and were instructed to identify easily detectable target faces by button press, whereas simultaneously presented auditory stimuli did not require any behavioral response. Increased N170 and N250 amplitudes to fearful faces indicated a differential processing of the fearful and neutral faces as standards. A visual MMN was clearly elicited by fearful face deviants, but hardly by neutral face deviants. Neither the auditory MMN nor the processing of visual targets was modulated by the facial emotion. However, the N250 modulation by emotion was surprisingly larger in target than in non-target trials. Findings suggest that the pre-attentive detection of auditory deviance as reflected in the auditory MMN is not substantially modulated by emotion induced by visual stimulation. The wide lack of a significant visual MMN to neutral deviants indicates that this deviance detection is not driven by physical stimulus properties (because otherwise the visual MMN to fearful and neutral deviants should have the same magnitude) but strongly by the emotional significance. The behavioral significance of targets apparently led to an enhanced processing of emotional features even though these features were irrelevant for target detection task.
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Percepción Auditiva/fisiología , Corteza Cerebral/fisiología , Emociones/fisiología , Potenciales Evocados/fisiología , Expresión Facial , Reconocimiento Facial/fisiología , Adulto , Potenciales Relacionados con Evento P300/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJECTIVE: To monitor objective physiological and self-report measures among apparently disease-free breast cancer patients (n = 33) in the first 2 years of posttreatment recovery, using a cross-sectional design, and compare findings with women without histories of cancer or other serious disorders (n =33). Time-since-treatment also served as an independent variable. Few studies have examined adjustment of breast cancer patients after primary treatment or objectively characterized posttreatment, everyday patterns of functioning. METHODS: A 24-hour ambulatory minute-by-minute cardiorespiratory functioning and accelerometry activity were measured during one day, together with multiple repeated assessments of mood and fatigue. Traditional retrospective measures of well-being were also evaluated. Our ambulatory methodology permitted estimation of physiological rhythms of cardiorespiratory and accelerometry activity. RESULTS: Patients reported lower ambulatory levels of energy and poorer mood during the daytime than controls. Time-since-treatment was related directly to both momentary mood and energy as well as to objective measures of activity and respiratory parameters. Retrospective self-reports of impaired mood and symptoms persisted in patients, independently of time-since-treatment and of ambulatory physical or physiological activity. Ambulatory self-report data were associated with concurrent respiratory measures. Chemotherapy-related elevation of heart rate was found but was unrelated to self-report measures. CONCLUSIONS: Impaired sense of well being based on retrospective measures is not associated with pattern of physical or physiological functioning after treatment for breast cancer. However, ambulatory, momentary levels of mood and fatigue seem to be related to concurrent ventilatory activity and time-since-treatment. This is the first investigation that relates ambulatory and retrospective measures of affect and fatigue to concurrent, real-life physical functioning.
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Afecto/fisiología , Neoplasias de la Mama/psicología , Ejercicio Físico/fisiología , Fatiga/psicología , Monitoreo Ambulatorio/métodos , Percepción/fisiología , Actividades Cotidianas/psicología , Neoplasias de la Mama/rehabilitación , Neoplasias de la Mama/terapia , Estudios Transversales , Electrocardiografía/estadística & datos numéricos , Ejercicio Físico/psicología , Fatiga/etiología , Femenino , Humanos , Cinetocardiografía/métodos , Cinetocardiografía/estadística & datos numéricos , Persona de Mediana Edad , Actividad Motora/fisiología , Calidad de Vida/psicología , Pruebas de Función Respiratoria/métodos , Pruebas de Función Respiratoria/estadística & datos numéricos , Autorrevelación , Sobrevivientes/psicología , Sobrevivientes/estadística & datos numéricos , Factores de TiempoRESUMEN
OBJECTIVE: Impaired response inhibition might play a role in child sexual offences. Recording of event-related potentials (ERPs) can help to clarify whether child sexual offenders (CSOs) show an altered processing of stop signals and commission errors. METHODS: In the current ERP study, we investigated these processes in a Go/Nogo task on two groups of CSOs, pedophilic contact CSOs and non-contact CSOs (child pornography offenders), as well as on non-offenders as controls. RESULTS: Behaviorally, CSOs showed a slight, but non-significant increase of the false alarm rate to Nogo cues, as compared to controls. The amplitudes of the ERP components N2 and P3 to Nogo cues followed by correctly withhold responses did not vary between CSOs and controls. The analysis of the ERPs to committed errors showed that the Ne amplitudes (reflecting error detection) did not differ between the groups either, whereas the Pe amplitudes (reflecting error evaluation and error awareness) were strongly diminished in CSOs. This diminishment was primarily found in contact CSOs. CONCLUSIONS: The findings suggest that response inhibition, processing of stop signals, and error detection are not necessarily impaired in CSOs. However, CSOs appear to dedicate less cognitive resources to the evaluation of committed errors. SIGNIFICANCE: This selective alteration could reflect a reduced sense of responsibility for misconduct in this offender group, which might contribute to their delinquent behavior.
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Atención/fisiología , Encéfalo/fisiopatología , Potenciales Evocados/fisiología , Inhibición Psicológica , Pedofilia/fisiopatología , Adolescente , Adulto , Criminales , Electroencefalografía , Humanos , Masculino , Persona de Mediana Edad , Tiempo de Reacción/fisiología , Adulto JovenRESUMEN
OBJECTIVES: Fibromyalgia (FM) is a syndrome characterized by severe pain, fatigue and sleep disturbance. There is evidence of central hyper-responsiveness to sensory stimulation and impaired cardiovascular autonomic control. Laboratory investigations suggest that mindfulness-based stress reduction (MBSR) may improve autonomic functioning in FM. However, these findings may not reflect what occurs during naturalistic conditions, and MBSR studies during real-life functioning are lacking. We conducted a randomized controlled, 3-armed study with 168 female FM patients. This report describes cardiac, respiratory, and physical activity findings. METHODS: Eight-week MBSR was compared with wait-list and active control intervention. Ambulatory accelerometry and cardiorespiratory function were monitored over 24-h periods at 3 time points: preintervention, postintervention, and at the 8-week follow-up. Also, baseline levels were compared with an age-matched group of 33 healthy women. FINDINGS: Activity heart rate, respiratory sinus arrhythmia, and ventilation were measured. Comparison with controls confirmed differences in cardiac autonomic tone and activity pattern among patients. Most measures also showed effects of time of day and point of measurement. Regarding the intervention study, there were no effects of treatment. In addition, there were no relations between patient-reported clinical improvement and objective physiological or accelerometry parameters. Intervention-related benefits in wellbeing were not associated with changes in daytime cardiorespiratory measures or pattern of physical activity. CONCLUSIONS: MBSR did not produce cardiac autonomic benefits or changes in daily activity in FM. Furthermore, the lack of an association between patient-experienced clinical improvement and objective physiological measures suggests that subjective changes in the wellbeing of FM patients over time are not related to alterations in the cardiorespiratory autonomic function or activity levels.
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Sistema Nervioso Autónomo/fisiopatología , Fibromialgia/fisiopatología , Fibromialgia/terapia , Corazón/fisiopatología , Atención Plena , Actividad Motora , Acelerometría , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Frecuencia Cardíaca , Humanos , Persona de Mediana Edad , Ventilación Pulmonar , Arritmia Sinusal Respiratoria , Autoinforme , Resultado del Tratamiento , Adulto JovenRESUMEN
Studies in child sex offenders (CSO) often report deviant personality characteristics. In our study, we investigated neuroticism in CSO and tested the hypothesis that CSO with high neuroticism show more serious abuse behavior and are more likely to exhibit sexual dysfunction and cognitive distortions, as compared to CSO with low neuroticism. A sample of 40 CSO (both child sexual abusers and child sexual material users) was split into two subsamples based on their neuroticism scores, obtained by the NEO-Personality Inventory-Revised (NEO-PI-R) questionnaire. Subsequently, we compared their scores in the Multiphasic Sex Inventory (MSI) questionnaire and Symptom Checklist-90-Revised (SCL-90-R). Our results show that CSO exhibited higher levels of neuroticism than controls, but were still in the normal range. In CSO, neuroticism was associated with sexual dysfunction and cognitive distortions, rather than with more severe abuse behavior. Moreover, neuroticism in this group was linked to a broad range of psychological problems and psychopathological symptoms, such as somatization or anxiety. Our findings suggest that neuroticism even below the level of personality disorder is associated with a broader range of psychological problems in CSO, which should be addressed in therapy.
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Abuso Sexual Infantil/psicología , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/psicología , Neuroticismo , Disfunciones Sexuales Fisiológicas/psicología , Disfunciones Sexuales Psicológicas/complicaciones , Adolescente , Adulto , Estudios de Casos y Controles , Comorbilidad , Psiquiatría Forense , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Personalidad/complicaciones , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Inventario de Personalidad , Disfunciones Sexuales Fisiológicas/complicaciones , Suiza , Adulto JovenRESUMEN
BACKGROUND: Under stressful conditions such as in an emergency situation, efficient information processing is essential for reasonable responses. PURPOSE OF THE STUDY: Virtual Reality (VR) technology is used to induce stress and to test three main cognitive functions for decision making in stressful situations. METHODS: A VR task was developed to induce stress following the Trier Social Stress Test (TSST) protocol and two VR cognitive performance tests to measure learning aptitude, spatial orientation and cognitive flexibility. Participants (N = 31) gave a public speech in front of a virtual audience (TSST) and later had to find their way out of different VR labyrinths. The first exercise tested spatial orientation and learning aptitude where participants had to learn aspects of the ground layout and geometric icons had to be identified as correct in order to be able to exit. The second labyrinth tested cognitive flexibility on the background of the Wisconsin Card Sorting Test. STATISTICAL TESTS: Correlations were analyzed using Kendall Tau Correlation (One-tailed tests with p set to 0.05 for all analyses). Heart rate (HR) was calculated from the RR time values and averaged across the TSST- speech and the post-stress period. Autonomic nervous system reactivity was defined as the deviation of HR during TSST- speech condition from post-stress baseline measurement. A repeated-measures t-test was used to analyze differences. RESULTS: The newly developed virtual stress test was successfully adapted from the original TSST. Participants perceived the task as stressful and scored an average of 5.7 points on a 1-8 Likert Scale. As a physiological stress parameter, increased heart rates of the participants showed that they were more stressed during the TSST procedure compared to the post-stress period. Also, the subjective stress perception, has a strong correlation with the results of the cognitive tasks performed after the stress induction. CONCLUSIONS: The more a participant experienced the TSST as stressful, the lower their learning aptitude and spatial orientation were found to be at the end of the study. On the other hand, if someone perceived the virtual TSST as "unexpected", as an indicator for a mild stress response, their cognitive flexibility was improved. Potential Implications: The findings indicate that both, the VR stress induction scenario using TSST, as well as the VR cognitive tests, are a first successful step towards a better ecological validity in neuropsychological testing.