Insights into interoceptive and emotional processing: Lessons from studies on insular HD-tDCS.

Interoception, the processing of internal bodily signals, is proposed as the fundamental mechanism underlying emotional experiences. Interoceptive and emotional processing appear distorted in psychiatric disorders. However, our understanding of the neural structures involved in both processes remains limited. To explore the feasibility of enhancing interoception and emotion, we conducted two studies using high-definition transcranial direct current stimulation (HD-tDCS) applied to the right anterior insula. In study one, we compared the effects of anodal HD-tDCS and sham tDCS on interoceptive abilities (sensibility, confidence, accuracy, emotional evaluation) in 52 healthy subjects. Study two additionally included physical activation through ergometer cycling at the beginning of HD-tDCS and examined changes in interoceptive and emotional processing in 39 healthy adults. In both studies, HD-tDCS was applied in a single-blind cross-over online design with two separate sessions. Study one yielded no significant effects of HD-tDCS on interoceptive dimensions. In study two, significant improvements in interoceptive sensibility and confidence were observed over time with physical preactivation, while no differential effects were found between sham and insula stimulation. The expected enhancement of interoceptive and emotional processing following insula stimulation was not observed. We conclude that HD-tDCS targeting the insula does not consistently increase interoceptive or emotional variables. The observed increase in interoceptive sensibility may be attributed to the activation of the interoceptive network through physical activity or training effects. Future research on HD-tDCS involving interoceptive network structures could benefit from protocols targeting larger regions within the network, rather than focusing solely on insula stimulation.

How the COVID-19 Pandemic and its Consequences Affect the Presence of and Search for Meaning of Life: A Longitudinal Study.

The presence of meaning in life (PML) and the search for meaning in life (SML) are crucial when facing difficult times. Although several theoretical frameworks have tried to explain the dynamics of meaning in life during adversity, empirical evidence about interactions among both constructs using longitudinal designs is scarce. This study examined the trajectories of both PML and SML during the COVID-19 lockdown period in Spain. In total, 220 adults fulfilled an online survey during two periods: a strict and a relaxed lockdown period. Latent growth models showed that both PML and SML declined slightly during the strict lockdown, but they reached a plateau during the relaxed lockdown. Results also showed that age and having a partner predicted higher PML and lower SML at baseline, whereas being male predicted higher scores on PML. PML and SML were negatively associated at baseline, higher SML at baseline was related to a steeper decreasing PML slope during the strict lockdown, and the PML and SML slopes in the relaxed lockdown period were negatively related. This study contributes to better understanding longitudinal fluctuations of meaning in life in situations of adversity.

Too many lemons to make lemonade? Disentangling mental health during the third wave of COVID-19 infections in Spain.

The study aimed to analyze the longitudinal change in mental health during the third wave of COVID-19 infections in Spain. Negative (e.g., emotional distress) and positive (e.g., positive functioning variables) outcomes were analyzed. Protective factors (e.g., resilience) as predictors of psychological adjustment (i.e., positive mental health, openness to the future, and low burden due to COVID-19) after ten months of the pandemic were also examined. The sample consisted of 164 participants, and self-reported questionnaires were administered at the beginning of the lockdown (March 2020), at the end of the lockdown (June 2020), and during the third wave (January 2021). Linear mixed models showed that individuals' emotional distress increased, and positive functioning variables (i.e., meaning in life, gratitude, resilience, and life satisfaction) decreased over time, but an increase was observed in some dimensions of posttraumatic growth. Regression analyses showed that resilience scores at all three data collection time points were significant predictors of positive mental health, openness to the future, and burden during the third wave. Mediation analyses showed that positive mental health and openness to the future were mediators of the effect of resilience on burden. The prolonged situation of the COVID-19 crisis had an important impact on positive and negative mental health. However, resilience may help to build up resources that can act as a buffer against adverse psychological effects.

Psychometric properties of the Spanish version of the functionality appreciation scale.

BACKGROUND: The Functionality Appreciation Scale is a 7-item measure of an individual's appreciation of his or her body for what it can do and is capable of doing. While this instrument has been increasingly used in intervention-based research, its psychometric properties have not been extensively studied in non-English-speaking populations. The psychometric properties of a novel Spanish translation of the FAS were examined. METHODS: An online sample of 838 Spanish adults (mean age = 31.79 ± 11.95 years, 50.48% men) completed the Spanish FAS and validated measures of body appreciation, eating disorder symptomatology, intuitive eating, and life satisfaction. RESULTS: Exploratory factor analysis supported a 1-dimensional factor structure of the FAS, which was further supported by confirmatory factor analysis (SBχ²(14) = 83.82, SBχ²normed = 1.48, robust RMSEA = 0.094 (90% CI = 0.074, 0.115), SRMR = 0.040, robust CFI = 0.946, robust TLI = 0.924). Invariance across genders was shown, and there were no significant differences according to gender (t(417) = 0.77, p =.444, d = 0.07). Construct validity was also supported through significant associations with the other measures of the study. Incremental validity was established in women. Thus, appreciation of functionality predicted life satisfaction over and above the variance accounted for by other body image and eating disorder-related measures (F(4, 399) = 18.86, p <.001, ΔR2 = 0.03). CONCLUSIONS: These results support the psychometric properties of the Spanish FAS and demonstrate the importance of the appreciation of functionality in relation to a healthier body image and psychological wellbeing.

Measurement invariance and differential item functioning of the functionality appreciation scale (FAS) in Colombia and Spain.

The Functionality Appreciation Scale (FAS) is increasingly used in diverse national and linguistic contexts. However, limited work has assessed the extent to which the instrument demonstrates measurement invariance and differential item functioning (DIF) across nations and respondent characteristics. Here, we examined measurement invariance and DIF of the FAS using archival data from adults in Colombia (Mebarak et al., 2023) and Spain (Zamora et al., 2024). Participants included 1420 (women n = 804, men n = 616) respondents from Colombia and 838 (women n = 415, men n = 423) respondents from Spain who completed translations of the FAS. Confirmatory factor analysis supported a unidimensional structure of the FAS in both national groups. Additionally, the FAS achieved full measurement invariance (up to latent mean invariance) across both groups. We also found that the FAS lacked DIF as a function of age, body mass index (BMI), and gender identity across both national groups. Older participants (relative to younger participants), men (relative to women), and participants with lower BMIs (relative to those with higher BMIs) had higher FAS scores. These results support the notion that the FAS is measuring a common underlying construct across these national groups and respondent characteristics.

Levels and Predictors of Suicide Literacy and Suicide Stigma in Spanish-Speaking Individuals.

BACKGROUND: One of the obstacles to seeking help for suicide is its social stigma. The literature suggests that suicide knowledge could impact this stigma. The present study aims to examine levels and predictors of suicide stigma and suicide literacy among Spanish-speaking individuals from Spain and Latin America. METHOD: A total of 678 adults completed an online survey conducted from December 2021 to May 2022. The survey assessed sociodemographic and clinical variables, including the Literacy of Suicide Scale (LOSS-SF) and Stigma of Suicide Scale (SOSS-SF). RESULTS: Results showed the presence of stigmatization and a moderate level of suicide literacy. Latin Americans presented significantly more stigmatizing attitudes and lower levels of suicide literacy than Spaniards. Older age and stronger religious/spiritual beliefs were correlated with lower suicide literacy. Suicide stigma was regressed on lower suicide literacy, gender (men), stronger religious/spiritual beliefs, and lacking knowledge about how to find help. Furthermore, the region was significantly associated with the suicide glorification subscale, reporting Latin Americans' greater glorification. CONCLUSIONS: By examining these factors, we aim to foster a deeper understanding of the attitudes and beliefs toward suicide. This understanding is crucial, as it may inform the development of effective interventions and prevention strategies that are culturally sensitive and tailored to diverse populations.

Daily stress encounters: Positive emotion upregulation and depressive symptoms.

When it comes to coping with stress, positive emotion upregulation is of utmost importance. Positive emotions have been suggested to be an important resource during stressful times since people try to create and upregulate pleasant emotional states when feeling stressed. Accordingly, individual differences in the ability to generate and savor positive emotional states could also affect one's skills in dealing with stress. In this regard, an important factor might be depression, which is associated with impaired positive emotion regulation. To disentangle the reciprocal influence between perceived stress and positive emotion upregulation, we conducted an Ecological Momentary Assessment study (n = 92) in which we assessed participants' stress levels and use of positive upregulating strategies (attentional deployment, cognitive change, and response modulation) three times a day over 2 weeks. Results from linear mixed-effects models showed that higher levels of perceived stress at one point predicted increased use of positive upregulating strategies from this point to the next which, in turn, resulted in subsequent diminished stress levels. Interaction analyses indicated that participants with higher depressive symptoms implemented upregulating strategies to a lower extent when experiencing intense stress. Furthermore, attentional deployment was less effective in decreasing stress in individuals higher in depression, whereas the other strategies showed comparable or even higher efficacy. Overall, positive emotion upregulation might be regarded as an adaptive tool that helps cope with stress. This mechanism might be altered in people higher in depression, who specifically struggle to implement positive upregulating strategies during times of stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Identifying and regulating emotions after acquired brain injury: the role of interoceptive sensibility.

Introduction: Interoceptive deficits are associated with difficulties in identifying and regulating emotions. However, research on interoception after acquired brain injury (ABI) is scarce, and its relationship with emotional difficulties in this population is unknown. This study aimed to (1) examine differences in self-reported alexithymia, performance-based emotional awareness, emotion regulation, depression, and interoceptive sensibility between ABI and control individuals; and (2) analyze the role of adaptive interoceptive dimensions in these emotional processes after ABI. Methods: Forty-three individuals with ABI and 42 matched control individuals completed the Multidimensional Assessment of Interoceptive Awareness-2, the Toronto Alexithymia Scale, the Levels of Emotional Awareness Scale, the Difficulties in Emotion Regulation Scale, and the Hospital Anxiety and Depression Scale. Results: Compared to the control group, individuals with ABI showed reduced tendency to ignore unpleasant sensations increased severity of depressive symptoms, as well as tendencies to have greater difficulties in emotion regulation and lower emotional awareness. Additionally, interoceptive dimensions such as trusting, as well as not-distracting from and not-worrying about bodily sensations, played a relevant role in explaining lower alexithymia and difficulties in emotion regulation. Moreover, lower alexithymia and emotion dysregulation were related to less depressive symptoms. These relationships were invariant across ABI and control individuals. Discussion: Although individuals with ABI may have different levels of emotional abilities compared to non-ABI individuals, the relationship patterns between interoceptive and emotional processes appear to be similar between the two groups. This study suggests the potential benefit of addressing both interoceptive and emotional difficulties in treatments targeting such prevalent sequelae of ABI as depressive symptoms.

Are Peripheral Biomarkers Determinants of Eating Styles in Childhood and Adolescence Obesity? A Cross-Sectional Study.

Disturbances in eating behaviors have been widely related to obesity. However, little is known about the role of obesity-related biomarkers in shaping habitual patterns of eating behaviors (i.e., eating styles) in childhood. The objective of the present study was to explore the relationships between several biomarkers crucially involved in obesity (ghrelin, insulin resistance, and leptin/adiponectin ratio) and eating styles in children and adolescents with obesity. Seventy participants aged between 8 and 16 (56.2% men) fulfilled the Spanish version of the Dutch Eating Behavior Questionnaire for Children to measure external, emotional, and restrained eating styles. In addition, concentrations of ghrelin, leptin, adiponectin, insulin, and glucose were obtained through a blood test. Hierarchical multiple regression analyses controlling for age and sex were computed for each eating style. Results indicated that individuals with higher ghrelin concentration levels showed lower scores in restrained eating (ß = -0.61, p < 0.001). The total model explained 32% of the variance of the restrained pattern. No other relationships between obesity-related biomarkers and eating behaviors were found. This study highlights that one of the obesity-risk factors, namely lower plasma ghrelin levels, is substantially involved in a well-known maladaptive eating style, restraint eating, in childhood obesity.

Enfermedad de Lafora: revisión de la bibliografía / Lafora disease: a review of the literature

Introducción. La enfermedad de Lafora es una forma de epilepsia mioclónica progresiva de herencia autosómica recesiva, de inicio en la infancia tardía o en la adolescencia, y producida por mutaciones de pérdida de función en los genes EPM2A o EPM2B, los cuales codifican para las proteínas laforina y malina, respectivamente. Desarrollo. Los principales síntomas de la enfermedad, que empeoran progresivamente, son mioclonías, crisis occipitales, crisis tonicoclónicas generalizadas, deterioro cognitivo, síntomas neuropsiquiátricos y ataxia. El curso es progresivo y fatal. Patológicamente, se caracteriza por la presencia de depósitos de poliglucosanos (denominados cuerpos de Lafora) en el cerebro, el hígado, el músculo y las glándulas sudoríparas. El diagnóstico de enfermedad de Lafora se realiza mediante hallazgos clínicos, electrofisiológicos, histológicos y genéticos. En la actualidad no existe un tratamiento que erradique o prevenga su desarrollo. Tradicionalmente, se utilizan fármacos antiepilépticos para el tratamiento de las mioclonías y las convulsiones, aunque aparecen resistencias a éstas. Conclusiones. La enfermedad de Lafora es una patología rara que, pese a su baja prevalencia, supone graves consecuencias para los pacientes y sus cuidadores. Así pues, resulta necesario continuar la investigación para clarificar los mecanismos subyacentes y desarrollar nuevos tratamientos paliativos y curativos de la enfermedad

Introduction. Lafora disease is autosomal recessive progressive myoclonus epilepsy with late childhood-to teenage-onset caused by loss-of-function mutations in either EPM2A or EPM2B genes encoding laforin or malin, respectively. Development. The main symptoms of Lafora disease, which worsen progressively, are: myoclonus, occipital seizures, generalized tonic-clonic seizures, cognitive decline, neuropsychiatric syptoms and ataxia with a fatal outcome. Pathologically, Lafora disease is characterized by the presence of polyglucosans deposits (named Lafora bodies), in the brain, liver, muscle and sweat glands. Diagnosis of Lafora disease is made through clinical, electrophysiological, histological and genetic findings. Currently, there is no treatment to cure or prevent the development of the disease. Traditionally, antiepileptic drugs are used for the management of myoclonus and seizures. However, patients become drug-resistant after the initial stage. Conclusions. Lafora disease is a rare pathology that has serious consequences for patients and their caregivers despite its low prevalence. Therefore, continuing research in order to clarify the underlying mechanisms and hopefully developing new palliative and curative treatments for the disease is necessary