[Why Did the Sports Pharmacists Create the Card Game?]

Anti-doping (AD) education for athletes is mainly one-way and through passively attended lectures. As such, learning about prohibited substances and highly technical doping rules is often difficult for athletes. Therefore, having athletes passively attending lectures is not enough to prevent unintentional doping violations caused by medicines and supplements. Therefore, it is important for athletes to acquire knowledge about individual prohibited substances as well as active learning and practical knowledge about AD measures. "Doping Guardian" is an educational card game that has been developed to help prevent unintentional doping violations. Participants (pharmacists) of this game can learn how to use medicines and supplements from an AD perspective while simulating the life of an athlete. This presentation will provide an overview of this card game and how it has been used to date.

Gossip drives vicarious learning and facilitates social connection.

Complex language and communication is one of the unique hallmarks that distinguishes humans from most other animals. Interestingly, the overwhelming majority of our communication consists of social topics involving self-disclosure and discussions about others, broadly construed as gossip. Yet the precise social function of gossip remains poorly understood as research has been heavily influenced by folk intuitions narrowly casting gossip as baseless trash talk. Using a novel empirical paradigm that involves real interactions between a large sample of participants, we provide evidence that gossip is a rich, multifaceted construct, that plays a critical role in vicarious learning and social bonding. We demonstrate how the visibility or lack thereof of others' behavior shifts conversational content between self-disclosure and discussions about others. Social information acquired through gossip aids in vicarious learning, directly influencing future behavior and impression formation. At the same time, conversation partners come to influence each other, form more similar impressions, and build robust social bonds. Consistent with prior work, gossip also helps promote cooperation in groups without a need for formal sanctioning mechanisms. Altogether these findings demonstrate the rich and diverse social functions and effects of this ubiquitous human behavior and lay the groundwork for future investigations.

Impact of software for mobile devices on the behavior of adolescents in obesity prevention / Impacto de un software para dispositivos móviles en el comportamiento de los adolescentes en la prevención de la obesidad / Impacto de um software para dispositivos móveis no comportamento dos adolescentes na prevenção da obesidade

ABSTRACT Objective: to analyze the impact of educational software on the behavior of adolescents about obesity prevention in two public schools of Divinópolis-MG. Method: uncontrolled clinical trial involving 238 adolescents, in the city of Divinópolis, MG, Brazil. Between June and October 2018, weight and height were measured, 24-hour dietary recall was performed, physical activity level was verified, socioeconomic classification and the stage of readiness for behavioral change was evaluated. The McNemar test was used to compare the qualitative variables. For the effect of the intervention on the quantitative variables, the Generalized Estimating Equations model was used. In the intervention, the educational game Healthy Running was used, developed for this study. Data were collected before and two months after the intervention. Results: among the participants, 62.6% are female, with a median age of 16.7 years, ranging from 15 to 19 years. Regarding the nutritional situation before the intervention, 18.5% had excess weight. As to the level of physical activity is concerned, 50.4% were classified as active. After the intervention, the z-score of body mass index for males showed a significant improvement (p<0.000), as well as the level of physical activity (p<0.001). Conclusion: the use of the educational game was valid and presented relevant results in improving the adolescents' behavior regarding food and physical activity. The use of the educational game can be considered appropriate to support education in the health area.

RESUMEN Objetivo: analizar el impacto de un software educativo en el comportamiento de los adolescentes acerca de la prevención de la obesidad en dos escuelas públicas de Divinópolis-MG. Método: ensayo clínico no controlado con 238 adolescentes, en el municipio de Divinópolis, MG, Brasil. Entre los meses de junio y octubre de 2018, se evaluaron peso y altura, se realizó recordatorio alimentario 24 horas, se verificaron nivel de actividad física, clasificación socioeconómica y se evaluó la etapa de preparación para cambio de comportamiento. Para comparación de las variables cualitativas, se utilizó la prueba de McNemar. Para el efecto de la intervención sobre las variables cuantitativas se utilizó el modelo de Ecuaciones de Estimativas Generalizadas. En la intervención, se utilizó el juego educativo Healthy Running, desarrollado para este estudio. Los datos fueron recolectados antes de la intervención y dos meses después. Resultados: entre los participantes, 62,6% es del sexo femenino, con una mediana de 16,7 años de edad, que varió de 15 a 19 años. Sobre la situación nutricional antes de la intervención, 18,5% presentó exceso de peso. Respecto al nivel de actividad física, 50,4% fue clasificado como activo. Después de la intervención, el score-z de Índice de Masa Corporal para el sexo masculino presentó una mejora significativa (p<0,000), así como el nivel de actividad física (p<0,001). Conclusión: el uso del juego educacional fue válido y presentó resultados relevantes en la mejora del comportamiento de los adolescentes respecto a la alimentación y actividad física. El uso del juego educativo puede considerarse adecuado para apoyar la educación en el área de la salud.

RESUMO Objetivo: analisar o impacto de um software educativo no comportamento dos adolescentes acerca da prevenção da obesidade em duas escolas públicas de Divinópolis-MG. Método: ensaio clínico não controlado com 238 adolescentes, no Município de Divinópolis, MG, Brasil. Entre os meses de junho e outubro de 2018, foram aferidos peso e altura, realizado recordatório alimentar 24 horas, verificados nível de atividade física, classificação socioeconômica e avaliado o estágio de prontidão para mudança de comportamento. Para comparação das variáveis qualitativas, utilizou-se o teste de McNemar. Para o efeito da intervenção sobre as variáveis quantitativas utilizou-se o modelo de Equações de Estimativas Generalizadas. Na intervenção, foi utilizado o jogo educacional Healthy Running, desenvolvido para este estudo. Os dados foram coletados antes da intervenção e dois meses após. Resultados: entre os participantes, 62,6% são do sexo feminino, com uma mediana de 16,7 anos de idade que variou de 15 a 19 anos. Sobre a situação nutricional antes da intervenção, 18,5% apresentou excesso de peso. Quanto ao nível de atividade física, 50,4% foram classificados como ativos. Após a intervenção o escore-z de Índice de Massa Corporal para o sexo masculino apresentou uma melhora significativa (p<0,000), assim como o nível de atividade física (p<0,001). Conclusão: o uso do jogo educacional foi válido e apresentou resultados relevantes na melhora do comportamento dos adolescentes a respeito da alimentação e atividade física. O uso do jogo educacional pode ser considerado adequado no apoio à educação na área da saúde.

Selective suppression of rapid eye movement sleep increases next-day negative affect and amygdala responses to social exclusion.

Healthy sleep, positive general affect, and the ability to regulate emotional experiences are fundamental for well-being. In contrast, various mental disorders are associated with altered rapid eye movement (REM) sleep, negative affect, and diminished emotion regulation abilities. However, the neural processes mediating the relationship between these different phenomena are still not fully understood. In the present study of 42 healthy volunteers, we investigated the effects of selective REM sleep suppression (REMS) on general affect, as well as on feelings of social exclusion, cognitive reappraisal (CRA) of emotions, and their neural underpinnings. Using functional magnetic resonance imaging we show that, on the morning following sleep suppression, REMS increases general negative affect, enhances amygdala responses and alters its functional connectivity with anterior cingulate cortex during passively experienced experimental social exclusion. However, we did not find effects of REMS on subjective emotional ratings in response to social exclusion, their regulation using CRA, nor on functional amygdala connectivity while participants employed CRA. Our study supports the notion that REM sleep is important for affective processes, but emphasizes the need for future research to systematically investigate how REMS impacts different domains of affective experience and their neural correlates, in both healthy and (sub-)clinical populations.

Serious Games as Potential Therapies: A Validation Study of a Neurofeedback Game.

Serious (biofeedback) games offer promising ways to supplement or replace more expensive face-to-face interventions in health care. However, studies on the validity and effectiveness of EEG-based serious games remain scarce. In the current study, we investigated whether the conditions of the neurofeedback game "Daydream" indeed trained the brain activity as mentioned in the game manual. EEG activity was assessed in 14 healthy male volunteers while playing the 2 conditions of the game. The participants completed a training of 5 sessions. EEG frequency analyses were performed to verify the claims of the manual. We found significant differences in α- to ß-ratio between the 2 conditions although only in the amplitude data, not in the power data. Within the conditions, mean α-amplitude only differed significantly from the ß-amplitude in the concentration condition. Our analyses showed that neither α nor ß brain activity differed significantly between game levels (higher level requiring increased brain activity) in either of the two conditions. In conclusion, we found only marginal evidence for the proposed claims stated in the manual of the game. Our research emphasizes that it is crucial to validate the claims that serious games make, especially before implementing them in the clinic or as therapeutic devices.

[Substantiation of a procedure for correction of the properties of human motor abilities via biofeedback for support reaction]. / Obosnovanie metodiki korrektsii svoistv dvigatel'nykh sposobnostei cheloveka s ispol'zovaniem biologicheskoi obratnoi sviazi po opornoi reaktsii.

BACKGROUND: Stability training, including rehabilitation, using the principle of biofeedback for support reaction on the stabilometric platform, is used to restore the functions of maintaining balance in medicine and to increase vertical stability in athletes, etc. in sports. AIM: To substantiate a procedure to correct the properties of human motor abilities during stability training, which are based on the consideration of the consistently involved levels of the nervous system in the construction of movements during games using biofeedback for support reaction. MATERIAL AND METHODS: The multilevel motion construction concept proposed by N.A. Bernstein (1947) was analyzed. Computer-assisted stabilometry, including Romberg's test with the eyes open and closed in the European standing (for 51 sec), was used for objective instrumental assessment of postural function. The study included 7 university students who belonged to a special medical group for their health status. The training was stopped when the student felt worse, tired, and unwilling to continue the game. The training duration was 12 to 22 minutes. To obtain reliable results, all stabilometric examinations were made from 8 to 9 o'clock in the morning. The study results were statistically analyzed using the goodness-of-fit test: Z-test (equality of the observed frequencies of two events), Wilcoxon signed rank test (when comparing dependent samples). RESULTS: The paper describes a relationship between the provisions of the multilevel motion construction concept proposed by N.A. Bernstein and the information about the levelled organization of movements during games via biofeedback for support reaction; guidelines for their use and experimental confirmation for the higher function of motor abilities: muscle synergy and kinesthetic sensitivity. CONCLUSION: There is evidence for the positive training effect on the function of motor ability properties of the pallidothalamic level of the nervous system during games via biological feedback for support reaction, their informative value compared with other stabilometric indicators.

The co-design, implementation and evaluation of a serious board game 'PlayDecide patient safety' to educate junior doctors about patient safety and the importance of reporting safety concerns.

BACKGROUND: We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also 'fresh eyes' on the system providing valuable insights into what they perceive as safe and unsafe behaviour. The aim of this study was to co-design and implement an embedded learning intervention - a serious board game - to educate junior doctors about patient safety and the importance of reporting safety concerns, while at the same time shaping a culture of responsiveness from senior medical staff. METHODS: A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan's Critical Incident Technique. A paper-based questionnaire on 'Safety Concerns' was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians. RESULTS: The game proved to be a valuable patient safety educational tool and proved effective in encouraging deep discussion on patient safety. There was a significant change in the reporting behaviour of junior doctors in one of the hospitals following the intervention. CONCLUSION: In healthcare, limited exposure to patient safety training and narrow understanding of safety compromise patients lives. The existing healthcare system needs to value the role that junior doctors and others could play in shaping a positive safety culture where reporting of all safety concerns is encouraged. Greater efforts need to be made at hospital level to develop a more pro-active safe and just culture that supports and encourages junior doctors and ultimately all doctors to understand and speak up about safety concerns.

The neural signatures of egocentric bias in normative decision-making.

Bargaining parties often disagree on what fair is, due to the reason that people are prone to believe that what favors oneself is fair, i.e., an egocentric bias. In this study, we investigated the neural signatures underlying egocentric bias in fairness decision-making, conjoining an adapted ultimatum game (UG) with event-related fMRI and functional connectivity. Participants earned monetary rewards with a partner in a production stage, wherein their contributions to the earnings were manipulated. Afterwards, the joint earnings were randomly divided, and the distribution was presented simultaneously with contribution information to participants, who accepted/rejected distributions of earnings as the same manner in standard UG. We identified an egocentric bias in fairness decisions, such that participants frequently rejected self-contributed disadvantageous outcomes, but much less so in response to other-contributed advantageous outcomes, although both involved mismatch between contribution and payoff. This bias was underpinned by regions involved in representing fairness norms, including the anterior insula and dorsal anterior cingulate cortex (dACC). Furthermore, the thalamus activity was predictive of the bias, such that the level of egocentric bias decreased as a function of the activation level of the thalamus. Finally, our functional-connectivity findings indicated that the thalamus worked together with insula and dACC to modulate behavioral egocentric bias in fairness-related decisions. Our findings uncover the neural basis underlying the modulation of egocentric bias in normative decision-making, and highlight the role of neural circuits associated with norm enforcement in this phenomenon.

From random to regular: neural constraints on the emergence of isochronous rhythm during cultural transmission.

A core design feature of human communication systems and expressive behaviours is their temporal organization. The cultural evolutionary origins of this feature remain unclear. Here, we test the hypothesis that regularities in the temporal organization of signalling sequences arise in the course of cultural transmission as adaptations to aspects of cortical function. We conducted two experiments on the transmission of rhythms associated with affective meanings, focusing on one of the most widespread forms of regularity in language and music: isochronicity. In the first experiment, we investigated how isochronous rhythmic regularities emerge and change in multigenerational signalling games, where the receiver (learner) in a game becomes the sender (transmitter) in the next game. We show that signalling sequences tend to become rhythmically more isochronous as they are transmitted across generations. In the second experiment, we combined electroencephalography (EEG) and two-player signalling games over 2 successive days. We show that rhythmic regularization of sequences can be predicted based on the latencies of the mismatch negativity response in a temporal oddball paradigm. These results suggest that forms of isochronicity in communication systems originate in neural constraints on information processing, which may be expressed and amplified in the course of cultural transmission.

Proposal of an Extended Taxonomy of Serious Games for Health Rehabilitation.

OBJECTIVE: Serious Games is a field of research that has evolved substantially with valuable contributions to many application domains and areas. Patients often consider traditional rehabilitation approaches to be repetitive and boring, making it difficult for them to maintain their ongoing interest and assure the completion of the treatment program. Since the publication of our first taxonomy of Serious Games for Health Rehabilitation (SGHR), many studies have been published with game prototypes in this area. Based on literature review, our goal is to propose an updated taxonomy taking into account the works, updates, and innovations in game criteria that have been researched since our first publication in 2010. In addition, we aim to present the validation mechanism used for the proposed extended taxonomy. MATERIALS AND METHODS: Based on a literature review in the area and on the analysis of the contributions made by other researchers, we propose an extended taxonomy for SGHR. For validating the taxonomy proposal, a questionnaire was designed to use on a survey among experts in the area. RESULTS: An extended taxonomy for SGHR was proposed. As we have identified that, in general, and besides the mechanisms associated with the adoption of a given taxonomy, there were no reported validation mechanisms for the proposals, we designed a mechanism to validate our proposal. The mechanism uses a questionnaire addressed to a sample of researchers and professionals with experience and expertise in domains of knowledge interrelated with SGHR, such as Computer Graphics, Game Design, Interaction Design, Computer Programming, and Health Rehabilitation. CONCLUSION: The extended taxonomy proposal for health rehabilitation serious games provides the research community with a tool to fully characterize serious games. The mechanism designed for validating the taxonomy proposal is another contribution of this work.

Games as Tools to Address Conservation Conflicts.

Conservation conflicts represent complex multilayered problems that are challenging to study. We explore the utility of theoretical, experimental, and constructivist approaches to games to help to understand and manage these challenges. We show how these approaches can help to develop theory, understand patterns in conflict, and highlight potentially effective management solutions. The choice of approach should be guided by the research question and by whether the focus is on testing hypotheses, predicting behaviour, or engaging stakeholders. Games provide an exciting opportunity to help to unravel the complexity in conflicts, while researchers need an awareness of the limitations and ethical constraints involved. Given the opportunities, this field will benefit from greater investment and development.

Biofeedback vs. game scores for reducing trunk compensation after stroke: a randomized crossover trial.

Background Compensatory movements are commonly employed by stroke survivors, and their use can have negative effects on motor recovery. Current practices to reduce them rely on strapping a person to a chair. The use of technology to substitute or supplement this methodology has not being thoroughly investigated. Objective To compare the use of Scores + Visual + Force and Visual + Force feedback for reducing trunk compensation. Methods Fourteen hemiparetic stroke survivors performed bimanual reaching movements while receiving feedback on trunk compensation. Participants held onto two robotic arms and performed movements in the anterior/posterior direction toward a target displayed on a monitor. A motion-tracking camera tracked trunk compensation; the robots provided force feedback; the monitor displayed the visual feedback and scores. Kinematic variables, a post-test questionnaire, and system usability were analyzed. Results Both conditions reduced trunk compensation from baseline: Scores + Visual + Force: 51.7% (40.8), p = 0.000; Visual + Force: 55.2% (40.9), p = 0.000. No statistically significant difference was found between modalities. Secondary outcome measures were not improved. Most participants would like to receive game scores to reduce trunk compensation, and the usability of the system was rated "Good." Conclusions Multimodal feedback about stroke survivors' trunk compensation levels resulted in reduced trunk displacement. No difference between feedback modalities was obtained. The positive effects of including game scores might not have been observed in a short-term intervention. Longer studies should investigate if the use of game scores could result in trunk compensation improvements when compared to trunk restraint strategies. Clinical Trial Registration Clinicaltrials.gov, NCT02912923, https://clinicaltrials.gov/ct2/show/NCT02912923?term=reaching+in+stroke&rank=2 .

Intergroup Contact and Outgroup Humanization: Is the Causal Relationship Uni- or Bidirectional?

The attribution of uniquely human characteristics to the outgroup may favor the search for contact with outgroup members and, vice versa, contact experiences may improve humanity attributions to the outgroup. To explore this bidirectional relationship, two studies were performed. In Study 1, humanity perceptions were manipulated using subliminal conditioning. Two experimental conditions were created. In the humanization condition, the unconditioned stimuli (US) were uniquely human words; in the dehumanization condition, the US were non-uniquely human and animal words. In both conditions, conditioned stimuli were typical outgroup faces. An approach/avoidance technique (the manikin task) was used to measure the willingness to have contact with outgroup members. Findings showed that in the humanization condition participants were faster in approaching than in avoiding outgroup members: closeness to the outgroup was preferred to distance. Latencies of approach and avoidance movements were not different in the dehumanization condition. In Study 2, contact was manipulated using the manikin task. One approach (contact) condition and two control conditions were created. The attribution of uniquely human traits to the outgroup was stronger in the contact than in the no-contact conditions. Furthermore, the effect of contact on humanity attributions was mediated by increased trust toward the outgroup. Thus, findings demonstrate the bidirectionality of the relationship between contact and humanity attributions. Practical implications of findings are discussed.

Neurofeedback Control in Parkinsonian Patients Using Electrocorticography Signals Accessed Wirelessly With a Chronic, Fully Implanted Device.

Parkinson's disease (PD) is characterized by motor symptoms such as rigidity and bradykinesia that prevent normal movement. Beta band oscillations (13-30 Hz) in neural local field potentials (LFPs) have been associated with these motor symptoms. Here, three PD patients implanted with a therapeutic deep brain neural stimulator that can also record and wirelessly stream neural data played a neurofeedback game where they modulated their beta band power from sensorimotor cortical areas. Patients' beta band power was streamed in real-time to update the position of a cursor that they tried to drive into a cued target. After playing the game for 1-2 hours each, all three patients exhibited above chance-level performance regardless of subcortical stimulation levels. This study, for the first time, demonstrates using an invasive neural recording system for at-home neurofeedback training. Future work will investigate chronic neurofeedback training as a potentially therapeutic tool for patients with neurological disorders.

Genetic influences on functional connectivity associated with feedback processing and prediction error: Phase coupling of theta-band oscillations in twins.

Detection and evaluation of the mismatch between the intended and actually obtained result of an action (reward prediction error) is an integral component of adaptive self-regulation of behavior. Extensive human and animal research has shown that evaluation of action outcome is supported by a distributed network of brain regions in which the anterior cingulate cortex (ACC) plays a central role, and the integration of distant brain regions into a unified feedback-processing network is enabled by long-range phase synchronization of cortical oscillations in the theta band. Neural correlates of feedback processing are associated with individual differences in normal and abnormal behavior, however, little is known about the role of genetic factors in the cerebral mechanisms of feedback processing. Here we examined genetic influences on functional cortical connectivity related to prediction error in young adult twins (age 18, n=399) using event-related EEG phase coherence analysis in a monetary gambling task. To identify prediction error-specific connectivity pattern, we compared responses to loss and gain feedback. Monetary loss produced a significant increase of theta-band synchronization between the frontal midline region and widespread areas of the scalp, particularly parietal areas, whereas gain resulted in increased synchrony primarily within the posterior regions. Genetic analyses showed significant heritability of frontoparietal theta phase synchronization (24 to 46%), suggesting that individual differences in large-scale network dynamics are under substantial genetic control. We conclude that theta-band synchronization of brain oscillations related to negative feedback reflects genetically transmitted differences in the neural mechanisms of feedback processing. To our knowledge, this is the first evidence for genetic influences on task-related functional brain connectivity assessed using direct real-time measures of neuronal synchronization.

Gamificación para la promoción de la salud en Obstetricia / Gamification for health promotion in Obstetrics

OBJETIVO: conocer y analizar la evidencia en relación a la influencia de la gamificación en la mejora del aprendizaje y los conocimientos globales que la mujer gestante adquiere en los programas de promoción de la salud. MÉTODO: se ha realizado una revisión narrativa de los artículos publicados entre enero de 2005 y diciembre de 2015 en las siguientes bases de datos bibliográficas secundarias (en inglés y español): PubMed, Cochrane, JMIR, PLOS y CUIDEN y que versen sobre la utilización de los juegos en promoción de la salud en mujeres gestantes. RESULTADOS: se han considerado de interés 28 referencias bibliográficas, pero solo 17 de ellas cumplen los tres criterios. La gamificación forma parte ya de los procesos de recuperación y rehabilitación siendo accesibles en cualquier lugar a través de dispositivos móviles. Los juegos de salud y la gamificación sanitaria pueden contribuir a mejorar aptitudes y habilidades de los profesionales sanitarios formándolos con pacientes virtuales, lo que posteriormente lleva a una atención de calidad en casos reales. CONCLUSIONES: no se puede asegurar que la gamificación sea efectiva en programas de promoción de la salud en mujeres gestantes en función al insuficiente número de estudios existentes. No hay suficiente evidencia como para contar con la gamificación como herramienta efectiva más allá de su uso como refuerzo en promoción de la salud/conductas saludables

OBJECTIVE: to find and analyze the evidence about the influence of gamification on the improvement in learning and the overall knowledge that pregnant women acquire during health promotion programs. METHOD: a narrative review conducted on the articles published between January, 2005 and December, 2015 in the following secondary bibliographic databases (in English and Spanish): PubMed, Cochrane, JMIR, PLOS and CUIDEN, dealing with the use of games for health promotion among pregnant women. RESULTS: twenty-eight (28) bibliographic references were considered of interest, but only 17 of these met all three criteria. Gamification is already part of the recovery and rehabilitation processes, and can be accessed anywhere through mobile devices. Health games and healthcare gamification can contribute to improve the abilities and skills of healthcare professionals, by training them with virtual patients, which will subsequently lead to a high-quality patient care in real cases. CONCLUSIONS: it cannot be claimed that gamification is effective in health promotion programs for pregnant women, due to the insufficient number of existing studies. There is not enough evidence for considering gamification as an effective tool, beyond its use as reinforcement in the promotion of health / healthy behaviours

Impulsivity is associated with blood pressure and waist circumference among adolescents with bipolar disorder.

OBJECTIVE: Cardiovascular risk factors (CVRFs) and impulsivity are common in bipolar disorder (BD), and CVRFs are also linked with impulsivity through a number of mechanisms, both behavioral and biological. This study examines the association between CVRFs and impulsivity in adolescents with BD. METHODS: Subjects were 34 adolescents with BD and 35 healthy control (HC) adolescents. CVRFs were based on International Diabetes Federation metabolic syndrome criteria (triglycerides, high-density lipoprotein cholesterol, waist circumference, blood pressure (BP) and glucose). Impulsivity was measured using the computerized Cambridge Gambling Task (CGT). Analyses controlled for age, IQ, lifetime attention deficit hyperactivity disorder, and current antipsychotic use. RESULTS: Adolescents with BD had higher diastolic BP (73.36 ± 9.57 mmHg vs. 67.91 ± 8.74 mmHg, U = 401.0, p = 0.03), higher triglycerides (1.13 ± 0.60 mmol/L vs. 0.78 ± 0.38 mmol/L, U = 373.5, p = 0.008), and were more likely to meet high-risk criteria for waist circumference (17.6% vs. 2.9%, p = 0.04) vs. HC. Within the BD group, CGT sub-scores were correlated with CVRFs. For example, overall proportion bet was positively correlated with systolic (r = 0.387, p = 0.026) and diastolic (ρ = 0.404, p = 0.020) BP. Quality of decision-making was negatively correlated with systolic BP (ρ = -0.401, p = 0.021) and waist circumference (ρ = -0.534, p = 0.003). Significant interactions were observed, such that BD diagnosis moderates the relationship between both waist circumference and BP with CGT sub-scores. CONCLUSION: BP and waist circumference are associated with impulsivity in BD adolescents, but not in HC adolescents. Future studies are warranted to determine temporality and to evaluate whether optimizing CVRFs improves impulsivity among BD adolescents.

Mindfulness training increases cooperative decision making in economic exchanges: Evidence from fMRI.

Emotions have been shown to exert influences on decision making during economic exchanges. Here we investigate the underlying neural mechanisms of a training regimen which is hypothesized to promote emotional awareness, specifically mindfulness training (MT). We test the hypothesis that MT increases cooperative economic decision making using fMRI in a randomized longitudinal design involving 8weeks of either MT or active control training (CT). We find that MT results in an increased willingness to cooperate indexed by higher acceptance rates to unfair monetary offers in the Ultimatum Game. While controlling for acceptance rates of monetary offers between intervention groups, subjects in the MT and CT groups show differential brain activation patterns. Specifically, a subset of more cooperative MT subjects displays increased activation in the septal region, an area linked to social attachment, which may drive the increased willingness to express cooperative behavior in the MT cohort. Furthermore, MT resulted in attenuated activity in anterior insula compared with the CT group in response to unfair monetary offers post-training, which may suggest that MT enables greater ability to effectively regulate the anterior insula and thereby promotes social cooperation. Finally, functional connectivity analyses show a coupling between the septal region and posterior insula in the MT group, suggesting an integration of interoceptive inputs. Together, these results highlight that MT may be employed in contexts where emotional regulation is required to promote social cooperation.

Pain Processing after Social Exclusion and Its Relation to Rejection Sensitivity in Borderline Personality Disorder.

OBJECTIVE: There is a general agreement that physical pain serves as an alarm signal for the prevention of and reaction to physical harm. It has recently been hypothesized that "social pain," as induced by social rejection or abandonment, may rely on comparable, phylogenetically old brain structures. As plausible as this theory may sound, scientific evidence for this idea is sparse. This study therefore attempts to link both types of pain directly. We studied patients with borderline personality disorder (BPD) because BPD is characterized by opposing alterations in physical and social pain; hyposensitivity to physical pain is associated with hypersensitivity to social pain, as indicated by an enhanced rejection sensitivity. METHOD: Twenty unmedicated female BPD patients and 20 healthy participants (HC, matched for age and education) played a virtual ball-tossing game (cyberball), with the conditions for exclusion, inclusion, and a control condition with predefined game rules. Each cyberball block was followed by a temperature stimulus (with a subjective pain intensity of 60% in half the cases). The cerebral responses were measured by functional magnetic resonance imaging. The Adult Rejection Sensitivity Questionnaire was used to assess rejection sensitivity. RESULTS: Higher temperature heat stimuli had to be applied to BPD patients relative to HCs to reach a comparable subjective experience of painfulness in both groups, which suggested a general hyposensitivity to pain in BPD patients. Social exclusion led to a subjectively reported hypersensitivity to physical pain in both groups that was accompanied by an enhanced activation in the anterior insula and the thalamus. In BPD, physical pain processing after exclusion was additionally linked to enhanced posterior insula activation. After inclusion, BPD patients showed reduced amygdala activation during pain in comparison with HC. In BPD patients, higher rejection sensitivity was associated with lower activation differences during pain processing following social exclusion and inclusion in the insula and in the amygdala. DISCUSSION: Despite the similar behavioral effects in both groups, BPD patients differed from HC in their neural processing of physical pain depending on the preceding social situation. Rejection sensitivity further modulated the impact of social exclusion on neural pain processing in BPD, but not in healthy controls.

Whether or not to eat: A controlled laboratory study of discriminative cueing effects on food intake in humans.

There is a wealth of data showing a large impact of food cues on human ingestion, yet most studies use pictures of food where the precise nature of the associations between the cue and food is unclear. To test whether novel cues which were associated with the opportunity of winning access to food images could also impact ingestion, 63 participants participated in a game in which novel visual cues signalled whether responding on a keyboard would win (a picture of) chocolate, crisps, or nothing. Thirty minutes later, participants were given an ad libitum snack-intake test during which the chocolate-paired cue, the crisp-paired cue, the non-winning cue and no cue were presented as labels on the food containers. The presence of these cues significantly altered overall intake of the snack foods; participants presented with food labelled with the cue that had been associated with winning chocolate ate significantly more than participants who had been given the same products labelled with the cue associated with winning nothing, and in the presence of the cue signalling the absence of food reward participants tended to eat less than all other conditions. Surprisingly, cue-dependent changes in food consumption were unaffected by participants' level of contingency awareness. These results suggest that visual cues that have been pre-associated with winning, but not consuming, a liked food reward modify food intake consistent with current ideas that the abundance of food associated cues may be one factor underlying the 'obesogenic environment'.