The influence of maternal psychological distress on the mode of birth and duration of labor: findings from the FinnBrain Birth Cohort Study.

Antepartum depression, general anxiety symptoms, and pregnancy-related anxiety have been recognized to affect pregnancy outcomes. Systematic reviews on these associations lack consistent findings, which is why further research is required. We examined the associations between psychological distress, mode of birth, epidural analgesia, and duration of labor. Data from 3619 women with singleton pregnancies, from the population-based FinnBrain Birth Cohort Study were analyzed. Maternal psychological distress was measured during pregnancy at 24 and 34 weeks, using the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) and its subscale "Fear of Giving Birth" (FOC), the anxiety subscale of the Symptom Checklist-90 (SCL-90) and the Edinburgh Postnatal Depression Scale (EPDS). Mode of birth, epidural analgesia, and labor duration were obtained from the Finnish Medical Birth Register. Maternal psychological distress, when captured with PRAQ-R2, FOC, and SCL-90, increased the likelihood of women having an elective cesarean section (OR: 1.04, 95% CI 1.01-1.06, p = .003; OR: 1.13, 95% CI 1.07-1.20, p < .001; OR: 1.06, 95% CI 1.03-1.10, p = .001), but no association was detected for instrumental delivery or emergency cesarean section. A rise in both the PRAQ-R2, and FOC measurements increased the likelihood of an epidural analgesia (OR: 1.02, 95% CI 1.01-1.03, p = .003; OR: 1.09, 95% CI 1.05-1.12, p < .001) and predicted longer second stage of labor (OR: 1.01, 95% CI 1.00-1.01, p = .023; OR: 1.03, 95% CI 1.02-1.05, p < .001). EPDS did not predict any of the analyzed outcomes. The results indicate that maternal anxiety symptoms (measured using PRAQ-R2, FOC, and SCL-90) are associated with elective cesarean section. Psychological distress increases the use of epidural analgesia, but is not associated with complicated vaginal birth.

An fMRI intervention study of creative mathematical reasoning: behavioral and brain effects across different levels of cognitive ability.

BACKGROUND: Many learning methods of mathematical reasoning encourage imitative procedures (algorithmic reasoning, AR) instead of more constructive reasoning processes (creative mathematical reasoning, CMR). Recent research suggest that learning with CMR compared to AR leads to better performance and differential brain activity during a subsequent test. Here, we considered the role of individual differences in cognitive ability in relation to effects of CMR. METHODS: We employed a within-subject intervention (N=72, MAge=18.0) followed by a brain-imaging session (fMRI) one week later. A battery of cognitive tests preceded the intervention. Participants were divided into three cognitive ability groups based on their cognitive score (low, intermediate and high). RESULTS: On mathematical tasks previously practiced with CMR compared to AR we observed better performance, and higher brain activity in key regions for mathematical cognition such as left angular gyrus and left inferior/middle frontal gyrus. The CMR-effects did not interact with cognitive ability, albeit the effects on performance were driven by the intermediate and high cognitive ability groups. CONCLUSIONS: Encouraging pupils to engage in constructive processes when learning mathematical reasoning confers lasting learning effects on brain activation, independent of cognitive ability. However, the lack of a CMR-effect on performance for the low cognitive ability group suggest future studies should focus on individualized learning interventions, allowing more opportunities for effortful struggle with CMR.

Neurocognitive processes underlying heuristic and normative probability judgments.

Judging two events in combination (A&B) as more probable than one of the events (A) is known as a conjunction fallacy. According to dual-process explanations of human judgment and decision making, the fallacy is due to the application of a heuristic, associative cognitive process. Avoiding the fallacy has been suggested to require the recruitment of a separate process that can apply normative rules. We investigated these assumptions using functional magnetic resonance imaging (fMRI) during conjunction tasks. Judgments, whether correct or not, engaged a network of brain regions identical to that engaged during similarity judgments. Avoidance of the conjunction fallacy additionally, and uniquely, involved a fronto-parietal network previously linked to supervisory, analytic control processes. The results lend credibility to the idea that incorrect probability judgments are the result of a representativeness heuristic that requires additional neurocognitive resources to avoid.

Building Memory Representations for Exemplar-Based Judgment: A Role for Ventral Precuneus.

The brain networks underlying human multiple-cue judgment, the judgment of a continuous criterion based on multiple cues, have been examined in a few recent studies, and the ventral precuneus has been found to be a key region. Specifically, activation differences in ventral precuneus (as measured with functional magnetic resonance imaging, fMRI) has been linked to an exemplar-based judgment process, where judgments are based on memory for previous similar cases. Ventral precuneus is implicated in various episodic memory processes, notably such that increased activity during learning in this region as well as in the ventromedial prefrontal cortex (vmPFC) and the medial temporal lobes (MTL) have been linked to retrieval success. The present study used fMRI during a multiple-cue judgment task to gain novel neurocognitive evidence informative for the link between learning-related activity changes in ventral precuneus and exemplar-based judgment. Participants (N = 27) spontaneously learned to make judgments during fMRI, in a multiple-cue judgment task specifically designed to induce exemplar-based processing. Contrasting brain activity during late learning to early learning revealed higher activity in ventral precuneus, the bilateral MTL, and the vmPFC. Activity in the ventral precuneus and the vmPFC was found to parametrically increase between each judgment event, and activity levels in the ventral precuneus predicted performance after learning. These results are interpreted such that the ventral precuneus supports the aspects of exemplar-based processes that are related to episodic memory, tentatively by building, storing, and being implicated in retrieving memory representations for judgment.

Correction to: Sex differences in drugs: the development of a comprehensive knowledge base to improve gender awareness prescribing.

CORRECTION: Unfortunately, after publication of this article [1], two errors were noticed. The names of Linnéa Karlsson Lind and Karin Schenck-Gustafsson were formatted incorrectly, attributing incorrect elements to the Given and Family names. Further to this, a reference in Fig. 1 was missing. The line reading, "Fig. 1 shows the working process and each step is explained in more detail below" should instead read, "Fig. 1, modified from Nörby et al. [2], shows the working process and each step is explained in more detail below".

A Similarity-Based Process for Human Judgment in the Parietal Cortex.

One important distinction in psychology is between inferences based on associative memory and inferences based on analysis and rules. Much previous empirical work conceive of associative and analytical processes as two exclusive ways of addressing a judgment task, where only one process is selected and engaged at a time, in an either-or fashion. However, related work indicate that the processes are better understood as being in interplay and simultaneously engaged. Based on computational modeling and brain imaging of spontaneously adopted judgment strategies together with analyses of brain activity elicited in tasks where participants were explicitly instructed to perform similarity-based associative judgments or rule-based judgments (n = 74), we identified brain regions related to the two types of processes. We observed considerable overlap in activity patterns. The precuneus was activated for both types of judgments, and its activity predicted how well a similarity-based model fit the judgments. Activity in the superior frontal gyrus predicted the fit of a rule-based judgment model. The results suggest the precuneus as a key node for similarity-based judgments, engaged both when overt responses are guided by similarity-based and rule-based processes. These results are interpreted such that similarity-based processes are engaged in parallel to rule-based-processes, a finding with direct implications for cognitive theories of judgment.