Improving Depression Severity Prediction from Passive Sensing: Symptom-Profiling Approach.

Depression is a significant mental health issue that profoundly impacts people's lives. Diagnosing depression often involves interviews with mental health professionals and surveys, which can become cumbersome when administered continuously. Digital phenotyping offers an innovative approach for detecting and monitoring depression without requiring active user involvement. This study contributes to the detection of depression severity and depressive symptoms using mobile devices. Our proposed approach aims to distinguish between different patterns of depression and improve prediction accuracy. We conducted an experiment involving 381 participants over a period of at least three months, during which we collected comprehensive passive sensor data and Patient Health Questionnaire (PHQ-9) self-reports. To enhance the accuracy of predicting depression severity levels (classified as none/mild, moderate, or severe), we introduce a novel approach called symptom profiling. The symptom profile vector represents nine depressive symptoms and indicates both the probability of each symptom being present and its significance for an individual. We evaluated the effectiveness of the symptom-profiling method by comparing the F1 score achieved using sensor data features as inputs to machine learning models with the F1 score obtained using the symptom profile vectors as inputs. Our findings demonstrate that symptom profiling improves the F1 score by up to 0.09, with an average improvement of 0.05, resulting in a depression severity prediction with an F1 score as high as 0.86.

STDD: Short-Term Depression Detection with Passive Sensing.

It has recently been reported that identifying the depression severity of a person requires involvement of mental health professionals who use traditional methods like interviews and self-reports, which results in spending time and money. In this work we made solid contributions on short-term depression detection using every-day mobile devices. To improve the accuracy of depression detection, we extracted five factors influencing depression (symptom clusters) from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), namely, physical activity, mood, social activity, sleep, and food intake and extracted features related to each symptom cluster from mobile devices' sensors. We conducted an experiment, where we recruited 20 participants from four different depression groups based on PHQ-9 (the Patient Health Questionnaire-9, the 9-item depression module from the full PHQ), which are normal, mildly depressed, moderately depressed, and severely depressed and built a machine learning model for automatic classification of depression category in a short period of time. To achieve the aim of short-term depression classification, we developed Short-Term Depression Detector (STDD), a framework that consisted of a smartphone and a wearable device that constantly reported the metrics (sensor data and self-reports) to perform depression group classification. The result of this pilot study revealed high correlations between participants` Ecological Momentary Assessment (EMA) self-reports and passive sensing (sensor data) in physical activity, mood, and sleep levels; STDD demonstrated the feasibility of group classification with an accuracy of 96.00% (standard deviation (SD) = 2.76).

Development and validation of self- and caregiver-report of a distress screening tool for pediatric cancer survivors.

PURPOSE: To develop and validate the Distress Screening Tool (DST) for child and adolescent cancer survivors. METHODS: In part 1, items of the DST were generated through literature search and group interviews. Initially, the DST was tested on pediatric cancer survivors and their caregivers. In part 2, the modified version of the DST was retested with a different set of participants. Lastly, the psychometric properties and cutoff scores of the DST were evaluated on a separate set of survivors and caregivers. RESULTS: In part 1, six items of the DST self- and caregiver-report versions were generated. The initial 6 DST items of both versions showed acceptable internal consistency, but low inter-item correlation. Following the item modification, both versions of the DST showed improved inter-item correlation. In part 2, the modified DST had acceptable internal consistency and convergent validity, with acceptable psychometric properties. Cutoff scores were also generated. CONCLUSIONS: The DST could be a useful tool for pediatric cancer survivors.

A pilot randomized controlled trial of 6-week combined exercise program on fasting insulin and fitness levels in individuals with spinal cord injury.

PURPOSE: The aim of this randomized controlled trial study was to investigate the effect of combined exercise program on the fasting insulin and fitness levels of people with spinal cord injury (SCI). METHODS: A total of 19 individuals with SCI participated in a combined exercise program consisting of aerobic and resistance exercises for 60 min per day, 3 days per week for 6 weeks. Peak oxygen consumption, body mass index, percent body fat, waist circumference, shoulder abduction and adduction, shoulder flexion and extension, elbow flexion and extension, fasting insulin levels, and homeostasis model assessment of insulin resistance (HOMA-IR) levels were measured at baseline and after the intervention. RESULTS: The 6-week exercise program significantly decreased the average fasting insulin (baseline: 7.5 ± 4.7 µU/ml vs. post-intervention: 4.5 ± 2.2 µU/ml, p < 0.05) and HOMA-IR (baseline: 1.5 ± 1.0 vs. post-intervention: 0.9 ± 0.4, p < 0.05) in the exercise group, whereas there was no change in control group (between group difference, mean fasting insulin: - 3.2 µU/ml, p = 0.003; mean HOMA-IR: - 0.66, p = 0.001). In addition, muscle strength of the shoulder flexors, extensors, abductors, adductors, and elbow flexors was significantly improved in the exercise group compared to the controls. CONCLUSION: A combined exercise program is effective in decreasing fasting insulin and HOMA-IR levels while improving fitness in those with SCI. These slides can be retrieved under Electronic Supplementary Material.

Investigation of gender role behaviors in boys with hypospadias: comparative study with unaffected boys and girls.

The purpose of the study was (1) to investigate gender role behaviors of boys with hypospadias compared with groups of unaffected boys and girls using parental reports and direct observations; and (2) to directly observe effects of socialization (mothers' presence) on children's gender role behaviors. Ages of 19 children with hypospadias ranged from 3 to 7 years, and each of them were matched to controls of unaffected boys and girls by age. All the children participated with their mothers. Children's gender role behaviors and their mothers' behaviors were evaluated using an observation coding system. Mothers also completed questionnaires regarding their children's gender role behaviors. Results indicated no atypical gender role behavior for the boys with hypospadias and no direct effects of socialization on their gender role behaviors. However, differences were found in negative communicative behaviors between boys with hypospadias and unaffected boys, suggesting a possible role of socialization.

Impact of psychological and cancer-related factors on HRQoL for Korean childhood cancer survivors.

PURPOSE: The purposes of this study were (1) to compare health-related quality of life (HRQoL) between Korean childhood cancer survivors and healthy controls and (2) to examine the impact of demographic, diagnosis/treatment, and psychological variables on physical and psychosocial health in survivors. METHODS: The HRQoL (PedsQL), Self-Concept Inventory, and Child Behavior Checklist were administered to childhood cancer survivors, age/gender-matched healthy counterparts, and their parents. Independent-samples t tests and hierarchical multiple regression analyses were conducted. RESULTS: Compared with healthy controls, childhood cancer survivors reported significantly lower scores across physical and psychosocial HRQoL. For survivors, demographic, diagnosis/treatment, current health status, and psychological variables explained more than 50 % of the variance in both subscales of HRQoL. Especially, self-concept, a psychological variable, explained a significant portion of the variance in physical and psychosocial HRQoL after controlling for cancer-related factors. Several cancer-related factors including time since treatment completion, having a history of allogeneic hematopoietic stem cell transplantation, multiple treatment modalities, and suffering from severe late effects also associated with specific dimension of HRQoL. CONCLUSIONS: Childhood cancer survivors do experience lower level of QoL and psychological factors, especially self-concept, should be considered when supporting the well-being of childhood cancer survivors.

Behavioral Interventions for Autism Spectrum Disorder: A Brief Review and Guidelines With a Specific Focus on Applied Behavior Analysis.

We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual's needs and delivered by qualified professionals with expertise in the specific intervention.

Psychosocial predictors of four health-promoting behaviors for cancer prevention using the stage of change of Transtheoretical Model.

OBJECTIVES: The present study aimed to examine whether demographic as well as psychosocial variables related to the five stages of change of the Transtheoretical Model can predict non-clinical adults' cancer preventive and health-promoting behaviors. This study specifically focused on cancer, one of the major chronic diseases, which is a serious threat of national health. METHODS: A total of 1530 adults participated in the study and completed questionnaires. Collected data were analyzed by using multinominal logistic regression. RESULTS: The significant predictors of later stages varied among the types of health-promoting behaviors. Certain cancer preventive health-promoting behaviors such as well-balanced diet and exercise were significantly associated with psychosocial variables including cancer prevention-related self-efficacy, personality traits, psychosocial stress, and social support. On the other hand, smoking cessation and moderate or abstinence from drinking were more likely to be predicted by demographic variables including sex and age. CONCLUSIONS: The present study found that in addition to self-efficacy-a relatively well-studied psychological variable-other personality traits and psychological factors including introversion, neuroticism, psychosocial stress, and social support also significantly predicted later stages of change with respect to cancer preventive health-promoting behaviors. The implications of this study are also discussed.

Parenting stress and child behavior problems among clinic-referred youth: cross-cultural differences across the US and Korea.

Due to increased multiculturalism in the US and abroad, there is a need for increased understanding of the different ways in which parenting stress is related to child problems across cultures. In the present study, we investigated (a) differences in reported parenting stress and childhood problem behaviors across a Korean (n = 71) and US (n = 71) sample, as well as (b) differences in the ways in which parenting stress and childhood problems were related across Korean and US children based on mothers' reports. Results revealed that Korean mothers reported significantly higher parenting stress yet significantly lower childhood problem behaviors compared to US mothers. In addition, mother-based reports of child problems were significantly associated with parenting stress in the US sample, but not in the Korean sample. Clinical implications and culturally-relevant issues relevant to these findings are addressed, including a potential under-reporting bias of child problems among Asian parents.

Effectiveness of three contingency-nonspecific stimuli on bathroom graffiti prevention in a college setting.

An A-B-A design was adopted to test the effectiveness of different types of contingency-nonspecific stimuli in the prevention of bathroom graffiti in a college setting. The three stimuli examined in this study have been frequently used to prevent bathroom graffiti in South Korea and they were: (a) "Please do not write, draw, or mark on these walls;" (b) a mirror; and (c) "Courteous people keep public places clean." No graffiti was observed when the first and second stimuli were presented. In contrast, a notable increase in bathroom graffiti was observed when the third sign was presented. The results suggest that a contingency non-specific stimuli posting intervention can be effective in the prevention of bathroom graffiti only when appropriate stimuli are used. The practical implications, including cost-effectiveness, are discussed.

Pilot Randomized Control Trial of an App-Based CBT Program for Reducing Anxiety in Individuals with ASD without Intellectual Disability.

This study developed and tested the effectiveness of an app-based cognitive behavioral therapy (CBT) program in alleviating anxiety among adolescents and adults with autism without co-occurring intellectual disability. Thirty participants from 15 to 35 years old were randomly assigned to either the intervention or waitlist control group, and self- and caregiver proxy report questionnaires were administered, accompanied by direct behavior observation before and after the intervention period. There was a significant decrease in anxiety level, an increase in positive affect, and a decline in stereotypic behaviors, hyperactivity, noncompliance, and inappropriate speech in proxy reports for the intervention group, compared to the control group. A significant rise in passive response in the direct observation was also seen in the intervention group.

Impact of college-level courses on self-control: Comparison between a self-management course and a physical exercise course.

We examined the relative effectiveness of a college-level self-management (SM) course and a physical exercise (PE) course on improving self-control. In Study 1, Barratt Impulsiveness Scale (BIS-11) and general regulatory behavior questionnaire were administered before and after the courses to students from an SM course (experimental group 1; n = 87), a PE course (experimental group 2; n = 22), and a liberal arts course (control group; n = 28). There was a significant decrease in impulsivity and improvement in daily self-control behaviors in the SM group only. In Study 2, the same tests were administered before, after, and 3 months after the courses to the SM (n = 47) and PE groups (n = 20). Impulsivity and daily self-control behaviors were improved only in the SM group and maintained after 3 months. Thus, self-control can be improved and stabilized by teaching and directing self-control behaviors among college students.

Changes in anxiety and depression levels and meat intake following recognition of low genetic risk for high body mass index, triglycerides, and lipoproteins: A randomized controlled trial.

BACKGROUND: Psychological status affects dietary intake, and recognizing genetic information can lead to behavior changes by influencing psychological factors such as anxiety or depression. OBJECTIVES: In this study, we examined the effects of disclosing genetic information on anxiety or depression levels and the association between these psychological factors and dietary intake. METHODS: A total of 100 healthy adults were randomly assigned to an intervention group (n = 65) informed about their genetic test results regarding body mass index and lipid profiles (triglyceride and cholesterol concentrations) and a not-informed control group (CON, n = 35). Based on polygenic risk scores, participants in the intervention group were subclassified into an intervention-low risk (ILR, n = 32) and an intervention-high risk (IHR, n = 33) group. Nutrient and food intakes were assessed via a 3-day dietary record at baseline and at 3 and 6 months. Depression and anxiety levels were measured using PHQ-9 and GAD-7 questionnaires, and the relative levels of blood metabolites were measure using GC-MS/MS analysis. RESULTS: Noticeable changes in dietary intake as well as psychological factors were observed in male subjects, with those perceiving their genetic risks as low (ILR) showing a significant increase in protein intake at 3 months compared to baseline (ILR: 3.9 ± 1.4, p<0.05). Meat intake also increased significantly in males in the ILR group at 3 months, but not in the IHR and CON groups (ILR: 49.4 ± 30.8, IHR: -52.2 ± 25.4, CON: -5.3 ± 30.3 g/d). ILR group showed a significant decrease in anxiety levels at 3 months, and their anxiety scores showed a negative association with meat intake (standardized ß = -0.321, p<0.05). The meat intake at 3 months was associated with the relative levels of arginine and ornithine (standardized ß = 0.452, p<0.05 and standardized ß = 0.474, p<0.05, respectively). CONCLUSIONS: Taken together, anxiety levels were decreased in male subjects who perceived their genetic risk to be low, and the decrease in anxiety levels was associated with an increase in meat intake. This suggests that recognizing genetic information may affect psychological factors and dietary intake.

High intake of sweet foods and low life satisfaction can act as risk factors for acute coronary syndrome through synergistic interaction.

Purpose: Dietary and psychological status contributes to the development of coronary artery disease. However, these lifestyle factors may vary depending on ethnic and environmental background, and secondary prevention programs dealing with these factors in a specific population are not well-established. We aimed to assess dietary and psychological characteristics in Korean patients with acute coronary syndrome (ACS) and analyze their interactions as independent risk factors for ACS. Methods: Ninety-two patients with ACS (29 acute myocardial infarction and 63 unstable angina) and 69 controls were subjected to dietary and psychological analyses. Dietary intake was assessed by a food frequency questionnaire. Psychological depression and perceived stress were assessed using the Patient Health Questionnaire-9 and the Perceived Stress Scale, respectively. Eight domains of life satisfaction (marital/love relationship, leisure, standard of living, job, health, family life, sex life, and self) were assessed using the Domain Satisfaction Questionnaire (DSQ). Results: The ACS group had a higher consumption of sweets and fish/seafood, as well as higher levels of depressive symptoms. Additionally, they had lower DSQ scores in total, and all eight individual domains compared with the control group. In multivariate logistic regression analysis, sweet intake (OR 4.57, 95% CI: 1.94-11.40) and total DSQ scores (OR 0.34, 95% CI: 0.14-0.81) were identified as independent risk factors for ACS. Furthermore, these factors, which displayed a significant inverse correlation (ρ = -0.23, p = 0.01), were determined as having a synergistic contribution to the development of ACS. Conclusion: High sweet food intake and low life satisfaction can act as risk factors for ACS through a synergistic interaction, which emphasizes a demand for a more comprehensive approach to secondary prevention of ACS. In addition, these data highlight the role of positive psychological wellbeing factors in cardiovascular health.

A Pilot Study for Testing the Effectiveness and Cost-Efficiency of Lottery Incentive in mHealth App that Promotes Walking.

This is a pilot study that investigated differences in effectiveness, maintenance of effectiveness, cost-efficiency, satisfaction, and usability of a lottery incentive via mobile devices to promote walking, depending on the chance of winning the lottery, the amount of the prize, and gender. Sixty-six college students (male = 26) were randomly assigned to 3 groups: 10% chance of a big prize (10% + B), 50% chance of a medium prize (50% + M), and 100% chance of a small prize (100% + S). Step counts were collected through mobile devices before and after the intervention, as well as at the 2-month follow-up. The results showed significant increases in the step counts among males after the intervention in the 10% + B and the 50% + M groups, and females in the 100% + S group. Only males in the 50% + M group exhibited maintenance in effectiveness during follow-up. With regard to cost-efficiency, the 10% + B and the 50% + M male groups, which showed significant differences in effectiveness, were compared, and no significant difference was found. With regard to intervention satisfaction, satisfaction of the 10% + B group was lower than that of the 100% + S group. There were no significant interactions or main effects regarding the usability of the intervention. The results suggest that a lottery incentive is effective only for men to promote walking when a medium size prize is given with a 50% of chance of winning the lottery.

A Pilot Study Testing the Efficacy of dCBT in Patients With Cancer Experiencing Sleep Problems.

Objective: This pilot study aimed to evaluate the efficacy of a digital cognitive behavioral therapy (dCBT) in patients with cancer experiencing sleep problems. Methods: A total of 57 participants aged 25-65 years (6M/51F with a mean of 42.80 years and a standard deviation of 14.15 years) were randomly assigned to three groups-21 participants to a dCBT program (HARUToday Sleep), 20 participants to an app-based attentional control program (HARUCard Sleep), and 16 participants to a waitlist control group-and evaluated offline before and after the program completion. Of the 57 participants, there were a total of 45 study completers, 15 participants in each group. The dependent variables were sleep quality scores, measured by the Pittsburgh Sleep Quality Index (PSQI) and health-related quality of life scores, measured using the Short-Form 36 (SF-36), and attentional bias scores from a dot-probe computer task. Results: For both the intention-to-treat (N = 57) and study-completers analyses (N = 45, 15 for each group), a significant increase supported by a large effect size was found in the quality of sleep score of the HARUToday Sleep group compared to both the app-based attentional control and the waitlist control group. However, no significant changes were found in the quality of life and attentional bias scores. Conclusion: Our results suggest that the HARUToday Sleep app has the potential to serve as an intervention module to enhance the sleep quality of patients with cancer experiencing sleep problems.

The Effect of Alcohol Drinking on Metabolic Syndrome and Obesity in Koreans: Big Data Analysis.

The purpose of this study was to assess the effect of alcohol consumption on metabolic syndrome (MetS) and obesity in Koreans by analysis of big data from the National Health Insurance Service health checkup database. A total of 26,991,429 subjects aged 20 years or older were included. Alcohol consumption was divided into five groups: nondrinkers, ≤7.0 g/d, 7.1-14.0 g/d, 14.1-28.0 g/d, ≥28.1 g/d. Logistic regression analyses were performed after adjusting for age, exercise, smoking, and income. The odds ratios (ORs) of MetS and obesity in men and women were lowest at ≤7.0 g/d, similar to that of the nondrinkers at 7.1-14.0 g/d, and increased with the alcohol consumption. At 7.1-14.0 g/d in older men, the ORs of metabolic syndrome and obesity were similar to those in the nondrinkers, but the OR of obesity was slightly increased in older women. This study suggests that the risk of MetS and obesity may be higher in Korean men, women, and the elderly who drink more than 14 g/d than the nondrinkers. In people with obesity or abdominal obesity, or those who need to manage their blood pressure, glucose, or triglyceride, drinking more than 7 g/d may increase the risk of MetS.

Development and validation of the Yonsei-Cambridge Mindreading Face Battery for assessing complex emotion recognition.

As an essential component of social cognition, emotion recognition is closely related to psychosocial adjustment. Particularly, the usefulness of the assessment of complex emotion recognition has been emphasized in that complex rather than basic emotions reflect the complicated and wide-ranging social cognition of individuals. In this study, the Yonsei-Cambridge Mindreading Face Battery (Y-CAM) was developed based on the Cambridge Mindreading Face Battery to assess complex emotion recognition among Korean adults (age range = 20-27 years). For this, 18 complex emotions from the original tool were selected, and 113 initial items were developed by generating video stimuli. Then, item difficulty and discrimination, internal consistency, test-retest reliability, and convergent validity of the developed items were tested by administering the items to 342 participants. The results yielded 16 complex emotions with 3 items having the highest fit for each emotion; consequently, there were 48 final items. The internal consistency and test-retest reliability of the final version were acceptable. The Y-CAM total scores were significantly negatively correlated with symptoms of autism, state anxiety, and experience of being bullied, thus establishing the convergent validity of the instrument. Based on the findings, the academic and clinical implications and limitations of the current work were discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Effect of Group Contingency Type on Walking: Comparisons of Effectiveness and Cost Efficiency.

Group contingency (GC) is an effective and cost-efficient strategy that can be successfully applied to technology-based interventions. This study examined the relative effectiveness and cost efficiency of three types of technology-based group contingencies on walking among adults. Seventy two students were divided into teams of three. Each team was randomly assigned to one of three GC conditions (independent, interdependent, or dependent) and underwent 66 days of technology-based group contingency intervention. Sixty five participants completed the intervention and 61 completed the follow-up assessment 2 months later. Step counts and self-reported walking activity increased after the intervention under all three conditions. The proportion of participants that met the target step counts was significantly higher under the dependent group contingency condition. However, 2 months later, intervention effects were not maintained under any condition. For cost efficiency, the increase in step count per point was significantly higher under the interdependent group contingency condition. Group cohesion and social validity (point satisfaction and point utility) were significantly higher under the dependent group contingency condition. Finally, the clinical implications and limitations of this study are discussed.

The Role of Racial and Developmental Experience on Emotional Adaptive Coding in Autism Spectrum Disorder.

Sensitivity to emotional face aids in rapid detection and evaluation of others, such that by school-age, children and youth exhibit adult-like patterns when the prolonged viewing of an emotional face distorts the perception of a subsequent face. However, the developmental considerations of this phenomenon (known as emotional adaptive coding) are unclear given ongoing maturational and experiential changes, including the influence of own-race experiences or the lack of face expertise, as is evident in autism spectrum disorder (ASD). This study addressed whether emotional adaptive coding is sensitive to factors of face perception expertise, specifically self-race and developmental experience, in adults (age 19-28 years) and youth (age 10-16 years). Emotional adaptive coding was not influenced by race expertise (i.e., other versus same race identity) in White and Asian adults. Emotional adaptation coding during childhood and adolescence is consistent with adults, though youth with ASD exhibited stronger adaptor after-effects in response to other-race faces, relative to TD youth and adults. By extending prior work to examine the integration of race and emotional adaptive coding in ASD, we discovered that the strength of response in ASD is atypical when viewing other-race faces, which clarifies the role of racial and facial experience on emotional face adaption.