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1.
Neuropsychol Rev ; 34(1): 232-249, 2024 Mar.
Article in English | MEDLINE | ID: mdl-36853526

ABSTRACT

In recent years, cognitive control training (CCT) has gained momentum as an intervention to remediate cognitive impairments and decrease depressive symptoms. One promising operationalization to train cognitive control is the adaptive Paced Auditory Serial Addition Task (aPASAT). In this systematic review and meta-analysis of aPASAT training, the efficacy of the intervention and potential moderators were examined. The PsycINFO, MEDLINE, Embase, Web of Science and Cochrane Library electronic databases were searched for studies examining aPASAT training for depressive symptomatology or rumination. Nineteen studies (n = 1255) were included, comprising of depressed patients, remitted depressed patients, at-risk, and healthy participants. We found small significant effects directly after training for both depressive symptomatology and rumination, with similar effect sizes at follow-up. Subgroup analyses suggest a significantly higher mean effect of aPASAT training in non-healthy populations for rumination immediately following training, but not for depressive symptomatology. The amount of training sessions did not moderate effects of CCT. aPASAT has a small but significant effect on depressive symptoms, with direct effects immediately after training, as well as sustained long-term effects. It is currently unclear how many sessions are required for sustained effects due to heterogeneity in training dosage and absence of sufficient trials. Our results suggest that aPASAT training may be most effective for at-risk, remitted- and clinically depressed populations. The effect sizes resulting from this meta-analysis could be used to adequately power future research, which could investigate a dose-response relationship and examine potential treatment gains when combining CCT with other antidepressant interventions.


Subject(s)
Cognitive Dysfunction , Depressive Disorder, Major , Humans , Depression/therapy , Depression/psychology , Antidepressive Agents/therapeutic use , Research Design , Depressive Disorder, Major/psychology
2.
Behav Res Methods ; 54(2): 910-921, 2022 04.
Article in English | MEDLINE | ID: mdl-34357541

ABSTRACT

Recently, the possibilities of detecting psychosocial stress from speech have been discussed. Yet, there are mixed effects and a current lack of clarity in relations and directions for parameters derived from stressed speech. The aim of the current study is - in a controlled psychosocial stress induction experiment - to apply network modeling to (1) look into the unique associations between specific speech parameters, comparing speech networks containing fundamental frequency (F0), jitter, mean voiced segment length, and Harmonics-to-Noise Ratio (HNR) pre- and post-stress induction, and (2) examine how changes pre- versus post-stress induction (i.e., change network) in each of the parameters are related to changes in self-reported negative affect. Results show that the network of speech parameters is similar after versus before the stress induction, with a central role of HNR, which shows that the complex interplay and unique associations between each of the used speech parameters is not impacted by psychosocial stress (aim 1). Moreover, we found a change network (consisting of pre-post stress difference values) with changes in jitter being positively related to changes in self-reported negative affect (aim 2). These findings illustrate - for the first time in a well-controlled but ecologically valid setting - the complex relations between different speech parameters in the context of psychosocial stress. Longitudinal and experimental studies are required to further investigate these relationships and to test whether the identified paths in the networks are indicative of causal relationships.


Subject(s)
Speech Acoustics , Voice , Humans , Speech , Speech Production Measurement , Stress, Psychological
3.
BMC Psychiatry ; 20(1): 453, 2020 09 16.
Article in English | MEDLINE | ID: mdl-32938410

ABSTRACT

BACKGROUND: Major depressive episode (MDE) is worldwide one of the most prevalent and disabling mental health conditions. In cases of persistent non-response to treatment, electroconvulsive therapy (ECT) is a safe and effective treatment strategy with high response rates. Unfortunately, longitudinal data show low sustained response rates with 6-month relapse rates as high as 50% using existing relapse prevention strategies. Cognitive side effects of ECT, even though transient, might trigger mechanisms that increase relapse in patients who initially responded to ECT. Among these side effects, reduced cognitive control is an important neurobiological driven vulnerability factor for depression. As such, cognitive control training (CCT) holds promise as a non-pharmacological strategy to improve long-term effects of ECT (i.e., increase remission, and reduce depression relapse). METHOD/DESIGN: Eighty-eight patients aged between 18 and 70 years with MDE who start CCT will be included in this randomized controlled trial (RCT). Following (partial) response to ECT treatment (at least a 25% reduction of clinical symptoms), patients will be randomly assigned to a computer based CCT or active placebo control. A first aim of this RCT is to assess the effects of CCT compared to an active placebo condition on depression symptomatology, cognitive complaints, and quality of life. Secondly, we will monitor patients every 2 weeks for a period of 6 months following CCT/active placebo, allowing the detection of potential relapse of depression. Thirdly, we will assess patient evaluation of the addition of cognitive remediation to ECT using qualitative interview methods (satisfaction, acceptability and appropriateness). Finally, in order to further advance our understanding of the mechanisms underlying effects of CCT, exploratory analyses will be conducted using video footage collected during the CCT/active control phase of the study. DISCUSSION: Cognitive remediation will be performed following response to ECT, and an extensive follow-up period will be employed. Positive findings would not only benefit patients by decreasing relapse, but also by increasing acceptability of ECT, reducing the burden of cognitive side-effects. TRIAL REGISTRATION: The study is registered with ClinicalTrials.gov . Study ID: NCT04383509 Trial registration date: 12.05.2020.


Subject(s)
Cognitive Remediation , Depressive Disorder, Major , Depressive Disorder, Treatment-Resistant , Electroconvulsive Therapy , Adolescent , Adult , Aged , Depressive Disorder, Major/therapy , Depressive Disorder, Treatment-Resistant/therapy , Humans , Middle Aged , Secondary Prevention , Treatment Outcome , Young Adult
4.
Clin Psychol Psychother ; 26(3): 388-398, 2019 May.
Article in English | MEDLINE | ID: mdl-30771229

ABSTRACT

Borderline personality disorder (BPD) is a challenging problem. Early maladaptive schemas (EMSs) are considered as important vulnerability factors for the development and maintenance of BPD. Literature suggests a complex relationship between BPD and EMSs. The current study employed network analysis to model the complex associations between central BPD features (i.e., affective instability, identity problems, negative relations, and self-harm) and EMSs in 706 undergraduate students. The severity of BPD symptoms was assessed using the Personality Assessment Inventory-Borderline subscale; the Young Schema Questionnaire-Short Form was used to assess EMSs. Results suggest that specific EMSs show unique associations with different BPD features. Interestingly, affective instability showed no unique associations with EMSs. Identity problems were uniquely associated with abandonment, insufficient self-control, dependence/incompetence, and vulnerability to harm/illness schemas. Negative relations in BPD showed unique connections with mistrust/abuse and abandonment. Finally, BPD self-harm was connected to emotional deprivation and failure. These findings indicate potential pathways between EMSs and specific BPD features that could improve our understanding of BPD theoretically and clinically.


Subject(s)
Borderline Personality Disorder/psychology , Personality Development , Self Concept , Adolescent , Adverse Childhood Experiences , Affective Symptoms/psychology , Female , Humans , Iran , Male , Personality Inventory/statistics & numerical data , Psychometrics , Self-Injurious Behavior/psychology , Young Adult
5.
Psychol Res ; 82(3): 520-534, 2018 May.
Article in English | MEDLINE | ID: mdl-28239771

ABSTRACT

Recently, there is increasing interest in the causal relationship between attentional breadth and emotion regulation. To test this causal relationship, attentional breadth needs to be manipulated stringently. The aim of the current research was to establish whether visual attentional breadth could be manipulated through experimental training procedures. We conducted two single-session training experiments and one multiple-session training experiment, all of which contained pre- and post-training assessments to test the direct transfer effects of training on attentional breadth construed in different measures. For the first single-session training (Experiment 1), no training effects were found to transfer to the subsequent attentional breadth measures in terms of global-local processing preference. For the second single-session training (Experiment 2) and the 5-day training (Experiment 3) which combined both trainings from Experiment 1 and 2, there were some indications that attentional breadth can be decreased, but there was no evidence that it could be increased neither in terms of global-local processing preference nor in terms of scope of visual perception. Bayesian analysis confirmed the null hypothesis of no increase in attentional breadth through delivery of these training procedures. Therefore, our findings do not support the hypothesis that training variants of the Global-Local attentional breadth task or of the visuospatial attentional breadth task can stably alter attentional breadth in healthy students. Possible explanations and implications are discussed.


Subject(s)
Attention/physiology , Practice, Psychological , Space Perception/physiology , Transfer, Psychology/physiology , Visual Perception/physiology , Adult , Bayes Theorem , Female , Humans , Male , Young Adult
6.
BMC Psychiatry ; 15: 125, 2015 Jun 09.
Article in English | MEDLINE | ID: mdl-26055122

ABSTRACT

BACKGROUND: Preventing recurrence of depression forms an important challenge for current treatments. Cognitive control impairments often remain present during remission of depression, putting remitted depressed patients at heightened risk for new depressive episodes by disrupting emotion regulation processes. Importantly, research indicates that cognitive control training targeting working memory functioning shows potential in reducing maladaptive emotion regulation and depressive symptomatology in clinically depressed patients and at-risk student samples. The current study aims to test the effectiveness of cognitive control training as a preventive intervention in a remitted depressed sample, exploring effects of cognitive control training on rumination and depressive symptomatology, along with indicators of adaptive emotion regulation and functioning. METHODS/DESIGN: We present a double blind randomized controlled design. Remitted depressed adults will complete 10 online sessions of a cognitive control training targeting working memory functioning or a low cognitive load training (active control condition) over a period of 14 days. Effects of training on primary outcome measures of rumination and depressive symptomatology will be assessed pre-post training and at three months follow-up, along with secondary outcome measure adaptive emotion regulation. Long-term effects of cognitive control training on broader indicators of functioning will be assessed at three months follow-up (secondary outcome measures). DISCUSSION: This study will provide information about the effectiveness of cognitive control training for remitted depressed adults in reducing vulnerability for depression. Furthermore, this study will address key questions concerning the mechanisms underlying the effects of cognitive control training, will take into account the subjective experience of the patients (including a self-report measure for cognitive functioning), and explore whether these effects extend to broad measures of functioning such as Quality of Life and disability. TRIAL REGISTRATION: This study is registered with ClinicalTrials.Gov, number NCT02407652 .


Subject(s)
Clinical Protocols , Cognitive Behavioral Therapy/methods , Depression/prevention & control , Internet , Therapy, Computer-Assisted , Adult , Aged , Cognition Disorders/complications , Cognition Disorders/prevention & control , Cognition Disorders/therapy , Depression/complications , Double-Blind Method , Humans , Male , Middle Aged , Quality of Life , Treatment Outcome , Young Adult
7.
Sci Rep ; 14(1): 10874, 2024 05 13.
Article in English | MEDLINE | ID: mdl-38740852

ABSTRACT

Theories of rumination have proposed different psychological factors to place one at risk for repetitive negative thinking. A comprehensive empirical test that captures the most relevant contributors to rumination is lacking. Building on influential self-regulatory and metacognitive frameworks, we modeled how key constructs in this context relate to ruminative thinking. 498 participants completed online questionnaires including indicators of rumination, metacognition, promotion goal orientation, effortful control, and depression. We estimated regularized partial correlation networks to investigate unique associations between the different constructs and followed these analyses up with directed acyclic graphs to identify potential pathways towards rumination. Results demonstrated that: (1) both self-regulatory and metacognitive factors were directly linked to rumination, amongst these were (2) positive beliefs, negative beliefs about uncontrollability and harm, cognitive self-consciousness, depression, effortful control, perfectionism, and (lack of) cognitive confidence, and (3) we identified multiple directed pathways, suggesting three direct contributors to rumination while controlling for the influence of all other variables: diminished effortful control, positive beliefs, and cognitive self-consciousness. This study is the first to comprehensively assess metacognitive and self-regulatory frameworks of rumination in a data-driven manner. Our findings suggest that there are multiple pathways towards rumination, which should be incorporated in clinical case conceptualization of rumination and related disorders.


Subject(s)
Metacognition , Rumination, Cognitive , Humans , Female , Male , Rumination, Cognitive/physiology , Adult , Young Adult , Surveys and Questionnaires , Metacognition/physiology , Depression/psychology , Middle Aged , Adolescent , Thinking/physiology
8.
J Affect Disord ; 351: 372-380, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38302063

ABSTRACT

BACKGROUND: The COVID-19 pandemic brought along many known risk factors for suicide. It is important to map out contributing and protective factors for suicide risk and examine possible changes in these associations during pandemics such as COVID-19. The current study aimed to examine how information on risk and protective factors obtained through a suicide prevention helpline is linked to the assessed suicide risk and the possible impact of the COVID-19 pandemic. METHODS: Data on 9474 calls registered by operators of the suicide prevention helpline of Flanders (i.e., part of Belgium) were analysed using network analysis. Using network analyses allowed for a data-driven examination of direct and indirect pathways through which risk and protective factors are associated to perceived suicide risk. The network before and during COVID-19 were compared to examine the possible impact of the pandemic. RESULTS: Our findings suggest that different vulnerability and protective factors contribute to perceived suicide risk. Experiencing a break-up, abuse, previous attempt(s), experienced difficulties with the healthcare system and availability of resources were directly and uniquely associated with perceived suicide risk before and during COVID-19. LIMITATIONS: Main limitations of this study are the possible bias of operator assessment accuracy, absence of several important psychological risk factors and the use of cross-sectional data. CONCLUSIONS: The current study provides insight in the effect of COVID-19 on suicidality and its risk and protective factors amongst suicide prevention helpline users, a population with high risk of suicide. Implications for suicide prevention helplines are discussed.


Subject(s)
COVID-19 , Suicide , Humans , Suicide Prevention , Hotlines , Cross-Sectional Studies , Pandemics , COVID-19/prevention & control , Suicide/psychology
9.
Behav Res Ther ; 177: 104521, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38615373

ABSTRACT

OBJECTIVE: Rumination is a major risk factor for the onset and recurrence of depressive episodes and has been associated with deficits in updating working memory content. This randomized controlled trial examines whether training updating-specific cognitive control processes reduces daily ruminative thoughts in clinically depressed individuals. METHODS: Sixty-five individuals with a current major depressive episode were randomized to 10 sessions of either cognitive control training (N = 31) or placebo training (N = 34). The frequency and negativity of individuals' daily ruminative thoughts were assessed for seven days before training, after training, and at a 3-month follow-up using experience sampling methodology. Secondary outcomes were depressive symptoms, depressed mood, and level of disability. RESULTS: Cognitive control training led to stronger improvements in the trained task than placebo training. However, cognitive control training did not lead to greater reductions in the frequency or negativity of daily ruminative thoughts than placebo training. There were no training-specific effects on participants' depressive symptoms or level of disability. CONCLUSIONS: The robustness of the present null-findings, combined with the methodological strengths of the study, suggest that training currently depressed individuals to update emotional content in working memory does not affect the frequency or negativity of their daily ruminative thoughts.


Subject(s)
Cognitive Behavioral Therapy , Depressive Disorder, Major , Memory, Short-Term , Rumination, Cognitive , Humans , Female , Male , Depressive Disorder, Major/psychology , Depressive Disorder, Major/therapy , Adult , Rumination, Cognitive/physiology , Cognitive Behavioral Therapy/methods , Middle Aged , Therapy, Computer-Assisted/methods , Young Adult , Treatment Outcome
10.
Appl Neuropsychol Adult ; 30(5): 567-576, 2023.
Article in English | MEDLINE | ID: mdl-34523373

ABSTRACT

Major depressive disorder (MDD) is associated with both self-reported (subjective) cognitive complaints and deficits in neurocognitive (objective) measures, but the correspondence between subjective and objective measures of cognition is low. This cross-sectional study aimed to (1) assess the association between subjective and objective measures of executive functions (EFs), and (2) explore factors associated with the discrepancy between subjective and objective EFs in MDD. Sixty-two participants with current or previous mild to moderate MDD and subjective EF complaints completed a clinical trial baseline assessment. An objective EF composite score was drawn from six neurocognitive measures, while the Behavior Rating Inventory of Executive Function-Adult version was applied as a measure of subjective EF. The association between the subjective and objective composites was evaluated using Spearman's rank order correlation. A discrepancy score was calculated to quantify the difference between subjective and objective EF. Factors associated with the discrepancy score were analyzed using regression analysis (p < .05). Participants reported extensive EF difficulties, but most performed in the normal range on objective EF measures. A weak correlation was detected between the subjective and objective measures (rs = .015). More rumination (ß = -.364) and higher IQ (ß = -.420) were associated with reporting more subjective complaints than was evident from objective measures of EF (i.e., underestimation). Subjective and objective EF measures are weakly overlapping in MDD. Findings underscore recommendations to include both subjective and objective measures when assessing EFs in depression. In addition, findings suggest that targeting ruminative processes could help correct underestimation.


Subject(s)
Depressive Disorder, Major , Executive Function , Adult , Humans , Depressive Disorder, Major/psychology , Cross-Sectional Studies , Depression/diagnosis , Neuropsychological Tests , Cognition
11.
Emotion ; 23(1): 194-213, 2023 Feb.
Article in English | MEDLINE | ID: mdl-35175068

ABSTRACT

Studies suggest that cognitive control training shows potential as a preventive intervention for depression. At the same time, little is known regarding the mechanisms underlying effects of cognitive control training. Informed by theoretical frameworks of cognitive risk for recurrent depression (De Raedt & Koster, 2010; Siegle et al., 2007), the current study sought to model direct effects of cognitive control training on the complex interplay between affect, emotion regulation, residual symptomatology, and resilience in a sample of remitted depressed patients (n = 92). Combining a 4-week experience sampling procedure with an experimental manipulation of cognitive control, we observed beneficial effects of cognitive control training on deployment of rumination. In addition, we obtained evidence for the causal involvement of cognitive control in efficacy of emotion regulation. In contrast to our expectations, cognitive control training did not exert immediate effects on residual symptomatology or resilience when compared with an active control condition, nor did cognitive control training impact the complex interplay between these variables. Overall, immediate effects of cognitive control training on functioning in daily life were limited. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Emotional Regulation , Emotions , Humans , Emotions/physiology , Cognition/physiology
12.
JMIR Ment Health ; 10: e44679, 2023 Aug 18.
Article in English | MEDLINE | ID: mdl-37594847

ABSTRACT

Depression is a serious and burdensome psychiatric illness that contributes heavily to health expenditures. These costs are partly related to the observation that depression is often not limited to a single episode but can recur or follow a chronic pathway. In terms of risk factors, it is acknowledged that cognitive impairments play a crucial role in vulnerability to depression. Within this context, cognitive control training (CCT) has shown its effectiveness in reducing the risk for recurrence of depression. CCT is low cost intensive and can be provided as a web-based intervention, which makes it easy to disseminate. Despite increasing interest in the field, studies examining the cost-effectiveness of CCT in the context of depression are largely missing. Health economic evaluation (HEE) allows to inform decision makers with evidence-based insights about how to spend limited available (financial) resources in the most efficient way. HEE studies constitute a crucial step in the implementation of a new intervention in clinical practice. Approaching preventive measures for depression such as CCT from an HEE perspective is informative to health policy, fostering optimal use of health expenditures. The aim of this paper was to inform and guide researchers during the phase of designing HEE studies in the context of CCT for depression. A clear view of CCT's cost-effectiveness is paramount for its clinical implementation.

13.
Internet Interv ; 27: 100507, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35242588

ABSTRACT

Recent research suggests beneficial effects of cognitive control training (CCT) on repetitive negative thinking (RNT), a key risk factor for internalizing symptomatology. However, relatively little is known regarding predictors of adherence to internet-delivered CCT as well as moderators of treatment effects for this intervention. Answering these questions could improve efficiency of clinical implementation of CCT as an eHealth intervention. The current pre-registered single-arm trial set-out to address these questions using a web-based gamified CCT procedure based on the adaptive Paced Auditory Serial Addition Task. Participants (N = 382) entered the internet-based study, where we observed considerable drop-out during the assessment phase and the first training sessions. Emotional stability and resilience emerged as predictors for deciding not to commence the intervention. Drop-out throughout the course of CCT was explained by age, emotion regulation-, and personality factors. We used latent profile analysis, a probabilistic modeling approach, to identify clusters of participants (User Profiles) based on indicators of baseline cognitive- and emotional functioning, training progress, and user experience. We obtained three User Profiles, reflecting low-, moderate-, and high-risk status. Effortful control, emotion regulation, internalizing symptomatology, resilience, and emotional stability played a central role in these User Profiles. Interestingly, User Profile predicted training related cognitive gains, as well as effects of CCT on anxiety- and stress symptoms, and reappraisal. Our findings suggest that CCT is most effective for the moderate- and high-risk groups. In addition, the high-risk group would likely benefit from a more intensive training procedure or repeated administration of the training procedure over time to foster long-term retention of training related gains.

14.
Front Psychol ; 13: 903446, 2022.
Article in English | MEDLINE | ID: mdl-35936259

ABSTRACT

It is increasingly acknowledged that cognitive impairment can play an important role in depression vulnerability. Therefore, cognitive remediation strategies, and cognitive control training (CCT) procedures have gained attention in recent years as possible interventions for depression. Recent studies suggest a small to medium effect on indicators of depression vulnerability. Despite initial evidence for the efficacy and effectiveness of CCT, several central questions remain. In this paper we consider the key challenges for the clinical implementation of CCT, including exploration of (1) potential working mechanisms and related to this, moderators of training effects, (2) necessary conditions under which CCT could be optimally administered, such as dose requirements and training schedules, and (3) how CCT could interact with or augment existing treatments of depression. Revisiting the CCT literature, we also reflect upon the possibilities to evolve toward a stratified medicine approach, in which individual differences could be taken into account and used to optimize prevention of depression.

15.
J Psychiatr Res ; 155: 75-84, 2022 11.
Article in English | MEDLINE | ID: mdl-35995017

ABSTRACT

Persisting executive functioning (EF) impairments following remission from depression form an important source of disability in daily life. However, little is known regarding how specific aspects of EF relate to residual depressive symptomatology. Using network analysis, the current study investigates unique associations between cognitive-, affective-, and somatic depressive symptoms (Beck Depression Inventory 2nd edition, BDI-II) and self-reported EF (Behavior Rating Inventory of Executive Function - Adult version, BRIEF-A) in a sample of 161 remitted depressed individuals. We identified three clusters of closely connected nodes, corresponding with the Metacognition- and Behavioral Regulation Index of the BRIEF-A, and one cluster consisting of cognitive, affective-, and somatic depressive symptomatology. Among the clusters consisting of EF domains, working memory and shifting difficulties emerged as bridging nodes. Depressive cognition most strongly connected the cluster of depressive symptoms with the EF clusters. Depressive symptom dimensions demonstrated both shared and unique associations with EF domains. Each depressive symptom dimension was directly related to emotional control impairments. In addition, multiple associations were observed between depressive symptomatology and complaints at the level of working memory, shifting, and planning/organizing. Depressive affect was uniquely related to difficulties initiating activity. The current findings provide insights into the relationship between perceived difficulties in EF and residual depressive symptomatology. EF domains were differentially related to depressive symptom dimensions, suggesting the need for further research into the role of EF following remission from depression.


Subject(s)
Depression , Executive Function , Adult , Cognition , Depression/psychology , Humans , Memory, Short-Term , Self Report
16.
J Affect Disord ; 300: 158-171, 2022 03 01.
Article in English | MEDLINE | ID: mdl-34983006

ABSTRACT

Cognitive control training has gained traction as an intervention for reducing anxiety and depression vulnerability in adults. There are, however, a limited number of studies investigating such training interventions for reducing symptomology of anxiety and depression in children and adolescents. Thus, we aimed to provide a robust review and qualitative synthesis of the available research in young people. Twelve articles met the inclusion criteria, and all were randomised control trials. Evidence of the efficacy of cognitive control training for relief of symptoms are reported separately for anxiety, depression, and other related psychological factors, and on the basis of type of cognitive control training paradigm. A lack of standardisation in relation to type of intervention, duration and context, outcome measures and population was observed. Results are discussed in terms of these variations and recommendations for future research are provided.


Subject(s)
Anxiety Disorders , Depression , Adolescent , Adult , Anxiety/therapy , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Child , Cognition , Depression/therapy , Humans
17.
Stress Health ; 37(4): 692-705, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33434296

ABSTRACT

Healthcare workers are at elevated risk to develop symptoms of post-traumatic stress disorder (PTSD) in response to an outbreak of a highly infectious disease. The current study set-out to model the complex interrelations between PTSD symptoms during the peak of the Coronavirus Disease 2019 outbreak in 291 Chinese healthcare workers and 291 matched control cases that were selected from the general population. For this purpose, we estimated regularized partial correlation networks. Within the network of healthcare workers, we observed a central role for avoidance of reminders of the traumatic event, physiological cue reactivity, anger/irritability, re-experiencing, and startle. We identified three clusters of closely interconnected PTSD symptoms in healthcare workers, consisting of (a) symptoms of re-experiencing and anxious arousal, (b) symptoms of avoidance and amnesia and (c) symptoms of emotional numbing and dysphoric arousal. Respectively, startle, avoidance of reminders and feeling detached emerged as bridging nodes in these communities. Although yielding highly similar network models, the PTSD symptom structure of healthcare workers showed several unique features compared to the matched control sample. This is informative for interventions aimed at targeting PTSD symptoms in healthcare workers in the context of a public health emergency.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , China/epidemiology , Disease Outbreaks , Health Personnel , Humans , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
18.
Neuropsychology ; 35(6): 609-621, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34197132

ABSTRACT

OBJECTIVE: The aims of the present study were to compare fatigue levels in children with pediatric acquired brain injury (pABI) with healthy controls (HCs), and examine the interplay of fatigue with associated factors. METHOD: We used baseline data from a preregistered randomized controlled trial. Seventy-six children aged 10-17 (median 13 years) with pABI in the chronic phase (88% with confirmatory cerebral imaging findings) and executive function (EF) complaints were included, most with moderate disability according to The Glasgow Outcome Scale Extended (GOSE-E) categorization. HCs consisted of 60 children aged 10-17 (median 13 years). All 127 participants completed measures of fatigue and intelligence. pABI participants were also assessed for behavioral problems, health-related quality of life (HRQoL), and EF. Nonparametric statistics were employed, in addition to a network analysis to model the unique associations between parent-reported fatigue and related factors. RESULTS: Parents reported significantly more fatigue in the pABI-group (75% of scores in clinical range; < 70) compared to HCs (11.7% of scores in clinical range). No strong associations were found between fatigue and injury characteristics, but findings indicated more fatigue in the older than younger age-group for pABI participants. Network modeling revealed a central role for HRQoL, behavioral, and EF symptoms in relation to fatigue. CONCLUSIONS: Fatigue is reported to be highly prevalent in the chronic phase of pABI. When addressing fatigue, our findings demonstrate the advantage of including multidimensional measures of fatigue and examining associated psychological and cognitive constructs, such as HRQoL, behavioral problems, and EF. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Brain Injuries , Quality of Life , Child , Executive Function , Fatigue/etiology , Humans , Parents
19.
J Behav Ther Exp Psychiatry ; 63: 66-72, 2019 06.
Article in English | MEDLINE | ID: mdl-30471919

ABSTRACT

BACKGROUND AND OBJECTIVES: Rumination has been shown to prospectively predict the onset of depression. However, it is unclear how rumination and affect in daily life influence the development of depressive symptoms. The present study examined whether the structure of dynamics in rumination and affect could prospectively predict depressive symptoms and trait rumination in an undergraduate sample (n = 63). METHODS: The main index used was entropy, which reflects the instability of a system's structure. Momentary rumination and affect were assessed eight times per day for a period of seven days. Additionally, depressive symptoms and trait rumination were measured at the beginning of the experiment and at six weeks follow-up. RESULTS: The results showed that entropy significantly predicted trait rumination at follow-up (and depressive symptoms at trend level) while taking into account baseline depressive symptoms and trait rumination. LIMITATIONS: The follow-up measurements conducted six weeks after the baseline were relatively short. Further research may test the predictive effect of the structure over a longer period and confirm its effect by using different indices that describe the structure. CONCLUSIONS: These findings indicate that examining the structure of the dynamics in momentary rumination and affect holds promise for understanding the risk for depression.


Subject(s)
Affect , Depression/psychology , Nonlinear Dynamics , Rumination, Cognitive , Adolescent , Depression/diagnosis , Ecological Momentary Assessment , Entropy , Female , Humans , Male , Risk Factors , Young Adult
20.
Behav Res Ther ; 116: 1-9, 2019 05.
Article in English | MEDLINE | ID: mdl-30710666

ABSTRACT

Research exploring how cognitive risk- and protective factors relate following remission from internalizing disorders suggests a central role for resilience. However, it remains unclear what constitutes resilience in this context. Furthermore, previous studies have typically relied on cross-sectional data which do not allow to map the temporal dynamics of such relations. Using a seven-day experience sampling period in 85 remitted depressed patients, we examined the interplay between five transdiagnostic vulnerability- and protective factors in daily life. We present a temporal, contemporaneous, and a between-subjects network, providing an in-depth analysis of how these factors relate to daily life fluctuations in residual symptomatology. Furthermore, we test the role of positive affect as a main resilience factor. Resilience uniquely predicted all other factors over time (temporal network). Higher levels of resilience were related to less momentary use of rumination, more deployment of positive appraisal, and lower occurrence of residual symptoms (contemporaneous network). Participants scoring high on resilience mostly engaged in positive appraisal (between-subjects network). Similar structures were obtained when substituting self-reported resilience by positive affect. This highlights the importance of resilience, and in particular, positive affectivity, to cope with stressors following remission. This may be fostered by facilitating the use of positive appraisal.


Subject(s)
Cognition , Depression/psychology , Resilience, Psychological , Adaptation, Psychological , Adult , Affect , Aged , Female , Humans , Male , Middle Aged , Models, Psychological , Protective Factors , Remission Induction , Risk Factors , Young Adult
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