Exploratory Clinical Trial of a Depression Diagnostic Software That Integrates Stress Biomarkers and Composite Psychometrics

Objective@#This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity. @*Methods@#Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic–pituitary–adrenal (HPA) axis. @*Results@#Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with “adrenal exhaustion stage” was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034). @*Conclusion@#This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.

Development and Validation of a Virtual Reality-Based Training Program for Promoting Subjective Well-Being

Objective@#Enhancing subjective well-being is an effective way to improve mental health. This study aimed to validate a virtual reality-based interactive feedback program as an intervention tool for promoting subjective well-being. @*Methods@#Thirty-six males participated in this program, consisting of three tasks constructed based on the theories of positive psychology: ‘Experience-based problem recognition task’, ‘Future self-based success story expression task’, and ‘Strength expression task’. Participants rated visual analog scores associated with each of the tasks’ contents. The concurrent validity of task scores was evaluated by correlations with the psychological scale scores. @*Results@#The total task score was positively correlated with scores of Mental Health Continuum-Short Form (MHC-SF) emotional well-being and psychological well-being, Rosenberg’s Self-Esteem Scale, Dispositional Hope Scale agency dimension and pathways dimension, and Life Orientation Test Revised, but not with MHC-SF social well-being scores. After controlling for the effects of the other task scores, the task scores had linear relationships with certain psychological assessments. @*Conclusion@#Since the task scores are closely related to indicators of well-being, self-esteem, hope, and optimism, the program contents are well associated with certain aspects of subjective well-being and thus may be available for training that improves subjective well-being through interactive feedback.

Development and Validation of a Virtual Reality-Based Training Program for Promoting Subjective Well-Being

Objective@#Enhancing subjective well-being is an effective way to improve mental health. This study aimed to validate a virtual reality-based interactive feedback program as an intervention tool for promoting subjective well-being. @*Methods@#Thirty-six males participated in this program, consisting of three tasks constructed based on the theories of positive psychology: ‘Experience-based problem recognition task’, ‘Future self-based success story expression task’, and ‘Strength expression task’. Participants rated visual analog scores associated with each of the tasks’ contents. The concurrent validity of task scores was evaluated by correlations with the psychological scale scores. @*Results@#The total task score was positively correlated with scores of Mental Health Continuum-Short Form (MHC-SF) emotional well-being and psychological well-being, Rosenberg’s Self-Esteem Scale, Dispositional Hope Scale agency dimension and pathways dimension, and Life Orientation Test Revised, but not with MHC-SF social well-being scores. After controlling for the effects of the other task scores, the task scores had linear relationships with certain psychological assessments. @*Conclusion@#Since the task scores are closely related to indicators of well-being, self-esteem, hope, and optimism, the program contents are well associated with certain aspects of subjective well-being and thus may be available for training that improves subjective well-being through interactive feedback.

Relationship Between Self-Referential Processing and Intrinsic Motivation in Patients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The close relationship between impaired self-referential processing and intrinsic motivation in schizophrenia has been suggested, but is not investigated yet. The purpose of this study was to explore the characteristics of self-referential processing and its relationship with intrinsic motivation in patients with schizophrenia. METHODS: Nineteen patients with schizophrenia and 24 healthy controls performed a self-referential processing task, in which a face (self, familiar other, or unfamiliar other) and three words (positive, neutral, and negative nouns) were presented. Participants were asked to indicate which word is relevant to the face. Intrinsic motivation and basic psychological needs affecting intrinsic motivation were assessed using self-reports. RESULTS: Compared to healthy controls, the relevance rating between self-face and neutral word was significantly lower in patients with schizophrenia (p=0.02). In patients with schizophrenia, it was negatively correlated with intrinsic motivation (r=-0.47, p=0.04) and competence (r=-0.47, p=0.05) which is known to influence intrinsic motivation. CONCLUSION: These results suggest that there is an impairment in self-referential processing in schizophrenia and it is associated with an impairment in intrinsic motivation. In particular, amotivation in patients with schizophrenia may represent a facet of selfdisorder.

A Study on the Neurobiological Basis of Communicative Intelligence Using Voxel-Based Morphometry / 대한정신분열병학회지

OBJECTIVES: To develop reliable tools for measuring communication skills in schizophrenia, the present study proposed the concept of communication intelligence, consisting of conversational competence, emotional competence, and empathic competence, and explored its neurobiological underpinnings using regional gray matter volume with healthy people. METHODS: Communicative intelligence scores were obtained from 126 healthy young participants. Correlation analyses between regional volume distributions and communication intelligence subcomponents were conducted using voxel-based morphometry of structural MRI. RESULTS: The significant positive correlations between the regional gray matter volumes with conversational competence were found mainly at the ventromedial frontal gyrus while the negative correlations between the bilateral middle frontal gyrus. With emotional competence, the volume of right superior temporal gyrus was positively and that of bilateral insula was negatively correlated. With empathic competence, the volume of the left middle frontal gyrus was positively and that of the insula was negatively correlated. CONCLUSION: Each of the subcomponents of communicative intelligence scores showed distinctive neurobiological underpinnings. The regions for the subcomponents, which constitute a common network for social cognition and emotion, are highly associated with the regions of the schizophrenia pathology. In conclusion, communicative intelligence scales have neurobiological basis to evaluate social skills of patients with schizophrenia.

The Protective Role of Resilience in Attenuating Emotional Distress and Aggression Associated with Early-life Stress in Young Enlisted Military Service Candidates

Early life stress (ELS) may induce long-lasting psychological complications in adulthood. The protective role of resilience against the development of psychopathology is also important. The purpose of this study was to investigate the relationships among ELS, resilience, depression, anxiety, and aggression in young adults. Four hundred sixty-one army inductees gave written informed consent and participated in this study. We assessed psychopathology using the Korea Military Personality Test, ELS using the Childhood Abuse Experience Scale, and resilience with the resilience scale. Analyses of variance, correlation analyses, and hierarchical multiple linear regression analyses were conducted for statistical analyses. The regression model explained 35.8%, 41.0%, and 23.3% of the total variance in the depression, anxiety, and aggression indices, respectively. We can find that even though ELS experience is positively associated with depression, anxiety, and aggression, resilience may have significant attenuating effect against the ELS effect on severity of these psychopathologies. Emotion regulation showed the most beneficial effect among resilience factors on reducing severity of psychopathologies. To improve mental health for young adults, ELS assessment and resilience enhancement program should be considered.

Relationship between Evaluation for the Self and others and Anhedonia in Patients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The dysfunctional neural networks underlying self-evaluation in schizophrenia are overlapped with the neural structures involved in emotion regulation. The purpose of this study was to investigate the influence of anhedonia on the self-evaluation attitude of patients with schizophrenia. METHODS: Twenty healthy controls and twenty patients with schizophrenia performed a self-evaluation task, presenting a pair of the face (self, familiar other, and unfamiliar other) and word (negative, neutral, and positive noun) at the same time. Participants were asked to evaluate relevance between the pairs by pressing a corresponding button. Relevance rating scores were compared between the groups and were correlated with the severity of physical and social anhedonia. RESULTS: Patients evaluated the condition of a self face with a negative word and a familiar face with a negative word to be more relevant than healthy controls. In the patient group, the scores of relevance rating in the condition of an unfamiliar other face with a negative word were positively correlated with the anhedonia scale scores (physical : r=0.486, p=0.030 ; social : r=0.499, p=0.025). There was no correlation between the self-evaluation attitude and the severity of anhedonia. CONCLUSION: Patients with schizophrenia evaluate themselves badly in only negative circumstances, and anhedonia is not related to self-evaluation, but rather other-evaluation.