Increased food choice-evoked brain activation in adolescents with excess weight: Relationship with subjective craving and behavior.

OBJECTIVE: We used functional magnetic resonance imaging (fMRI) to assess brain regions associated with food choices between appetizing (i.e., high sugar, high fat) and plain food in adolescents with excess weight and those with normal weight. The associations between choice-evoked brain activation and subjective food craving and behavioral food choices were also evaluated. METHODS: Seventy-three adolescents (aged 14-19 years), classified into excess weight (n = 38) or normal weight (n = 39) groups, participated in the study. We used a food-choice fMRI task, between appetizing and plain food, to analyse brain activation differences between groups. Afterwards, participants assessed their "craving" for each food presented in the scanner. RESULTS: Adolescents with excess weight showed higher brain activation in frontal, striatal, insular and mid-temporal regions during choices between appetizing and standard food cues. This pattern of activations correlated with behavioral food choices and subjective measures of craving. CONCLUSIONS: Our findings suggest that adolescents with excess weight have greater food choice-related brain reactivity in reward-related regions involved in motivational and emotional responses to food. Increased activation in these regions is generally associated with craving, and increased dorsolateral prefrontal cortex is specifically associated with appetizing food choices among adolescents with excess weight, which may suggest greater conflict in these decisions. These overweight- and craving-associated patterns of brain activation may be relevant to decision-making about food consumption.

Responses to Slowly Repeated Evoked Pain Stimuli in Fibromyalgia Patients: Evidence of Enhanced Pain Sensitization.

OBJECTIVE: The pathophysiology of fibromyalgia has been related to central pain sensitization. This study tested a laboratory protocol evaluating responses to slowly repeated evoked pain stimuli (SREP) that may index central pain sensitization in fibromyalgia. DESIGN: A between-subjects controlled laboratory study. SUBJECTS: Twenty-four fibromyalgia patients and 24 healthy participants. METHODS: A SREP protocol was administered to all subjects, consisting of a single series of nine low-intensity pressure stimuli of five-second duration and thirty-second interstimulus interval. Subjective evoked pain intensity was assessed with a visual analogical scale. Clinical fibromyalgia pain was assessed with the McGill Pain Questionnaire. RESULTS: Perceived pain intensity increased during the SREP protocol in fibromyalgia patients but not in healthy participants. Neither pain threshold nor pain tolerance was associated with SREP. Degree of SREP sensitization was associated with McGill Pain Questionnaire-Sensory ratings of fibromyalgia pain. The effect size for differences between the fibromyalgia and healthy control groups was greater, and the overlaps of the groups distributions lower, for SREP sensitization than for traditional evoked pain measures of pain threshold and tolerance. SREP demonstrated higher specificity in discriminating fibromyalgia and control groups relative to pain threshold or tolerance. CONCLUSIONS: A protocol employing a single series of nine low-suprathreshold-intensity slowly repeated pain stimuli elicits increased perceived pain in fibromyalgia patients, consistent with central sensitization despite relatively long interstimulus intervals. SREP appears to be more useful than traditional evoked pain threshold tolerance measures in terms of predicting levels of clinical pain and discriminating between fibromyalgia patients and healthy individuals.

Did you get the joke? Physiological, subjective and behavioral responses to mirth.

Mirth is elicited by the perception of humor, which requires the resolution of an incongruity in an unexpected and playful manner. Previous psychophysiological research using affective pictures is scarce, and did not elucidate the cognitive and affective components of the humor process. In this study, the passive viewing paradigm is applied to mirthful, incongruent, neutral and erotic pictures to characterize the emotional response of mirth. Physiological (zygomaticus major [ZM] activity, skin conductance response [SCR] and heart rate [HR]), behavioral (free viewing time) and subjective responses (mirthful ratings) were recorded from 63 participants. The presence of an inflection change in the ZM response and mirthfulness ratings were used as markers of humor comprehension. Participants showed the greatest ZM and HR in response to mirthful compared to incongruent, erotic and neutral pictures, as well as a stronger SCR response to mirthful compared to incongruent and neutral pictures. The overall results shed light on the temporal course of the humor process, suggesting that humor comprehension (cognitive component) occurred around 1000-1500 ms after picture onset, according to the ZM and SCR responses; and the humor appreciation stage (emotional component) occurred at around 3500 ms after stimulus onset, according to the HR and SCR changes. Moreover, marked interindividual variability was observed in the number of smiles, and in the pictures that provoked them. This points to the complexity of the humor process, and suggests the need to develop methods to elicit mirth and elucidate the factors potentially underlying individual differences in humor.

Social network addiction symptoms and body dissatisfaction in young women: exploring the mediating role of awareness of appearance pressure and internalization of the thin ideal.

BACKGROUND: Previous studies testing for a direct relationship between social networking sites (SNS) addiction and body dissatisfaction (BD) have yielded inconsistent results. Here, we aimed to identify underlying processes that could mediate this relationship. Specifically, we studied the relationship between SNS addiction symptoms and BD through the awareness of appearance pressures and the internalization of beauty ideals, both individually and serially: SNS addiction → Awareness → BD; SNS addiction → Internalization → BD; SNS addiction → Awareness → Internalization → BD. METHOD: A total of 368 female undergraduates with SNS accounts completed scales to assess SNS addiction symptoms (Social Network Addiction Questionnaire), BD (Body Shape Questionnaire), awareness, and internalization (Sociocultural Attitudes Towards Appearance Questionnaire-4; awareness and internalization scales). A theoretical serial mediation model was constructed to examine the proposed relationships. Body mass index was included as a covariate to control the influence of this important variable. RESULTS: The results indicated that both awareness and internalization independently mediated the relationship between SNS addiction symptoms and BD. Also, there was a significant serial mediation effect; women with more SNS addiction symptoms tended to be more aware of appearance pressure, which was associated with the internalization of beauty ideals. In turn, this internalization was positively related to BD symptoms. CONCLUSIONS: These findings shed light on the indirect relationship between SNS addiction and BD, demonstrating independent and accumulative mediating effects of awareness and internalization.

Narcissistic Personality and Its Relationship with Post-Traumatic Symptoms and Emotional Factors: Results of a Mediational Analysis Aimed at Personalizing Mental Health Treatment.

BACKGROUND: Narcissism is characterized by entitlement, grandiose fantasies and the need for admiration. This personality trait has been associated with both traumatic experiences and emotional problems. Most studies have only focused on narcissism in the context of childhood trauma and negative emotional factors. However, dimensions of grandiose narcissism such as authority have been linked to adaptive outcomes. Furthermore, narcissism might not be linked only to negative childhood experiences; it may also be associated with the presence of post-traumatic symptoms. Therefore, the present study aimed to assess the associations between narcissism and the frequency and severity of post-traumatic symptoms and emotional factors (resilience capacity, emotional regulation, positive and negative affect, intolerance of uncertainty and perceived stress), as well as the possible mediational role of the latter in the relationship between narcissism and post-traumatic symptoms. METHOD: A total of 115 healthy young psychology undergraduates and their relatives, aged from 18 to 40 years, were asked to complete a set of questionnaires to evaluate the aforementioned variables. RESULTS: The results showed that most of the grandiose narcissism dimensions were positively related to emotional adaptive outcomes, except exploitativeness and entitlement. The negative associations observed between the frequency and severity of post-traumatic symptoms and narcissism (self-sufficiency) were mediated by affect and resilience, which were in turn positively associated with the majority of the narcissism dimensions. Both positive affect and resilience were important factors mediating the association between grandiose narcissism and post-traumatic symptoms. CONCLUSIONS: Our findings reaffirm the need to assess not only desirable personality traits, but also ones that are not initially desirable, before pathologizing them. This consideration may be essential to achieve a personalized approach to the prevention of mental health problems, and promotion of positive emotions, in the general population.

Blood Pressure Prediction Using Ensemble Rules during Isometric Sustained Weight Test.

BACKGROUND: Predicting beat-to-beat blood pressure has several clinical applications. While most machine learning models focus on accuracy, it is necessary to build models that explain the relationships of hemodynamical parameters with blood pressure without sacrificing accuracy, especially during exercise. OBJECTIVE: The aim of this study is to use the RuleFit model to measure the importance, interactions, and relationships among several parameters extracted from photoplethysmography (PPG) and electrocardiography (ECG) signals during a dynamic weight-bearing test (WBT) and to assess the accuracy and interpretability of the model results. METHODS: RuleFit was applied to hemodynamical ECG and PPG parameters during rest and WBT in six healthy young subjects. The WBT involves holding a 500 g weight in the left hand for 2 min. Blood pressure is taken in the opposite arm before and during exercise thereof. RESULTS: The root mean square error of the model residuals was 4.72 and 2.68 mmHg for systolic blood pressure and diastolic blood pressure, respectively, during rest and 4.59 and 4.01 mmHg, respectively, during the WBT. Furthermore, the blood pressure measurements appeared to be nonlinear, and interaction effects were observed. Moreover, blood pressure predictions based on PPG parameters showed a strong correlation with individual characteristics and responses to exercise. CONCLUSION: The RuleFit model is an excellent tool to study interactions among variables for predicting blood pressure. Compared to other models, the RuleFit model showed superior performance. RuleFit can be used for predicting and interpreting relationships among predictors extracted from PPG and ECG signals.

Cyber-dating abuse in young adult couples: Relations with sexist attitudes and violence justification, smartphone usage and impulsivity.

Technologies have become important for interaction in couples. However, in some cases, controlling and aggressive behaviors can occur in the context of virtual interactions in couples; this is known as cyber-dating abuse (CDA). Identifying factors linked to CDA, as perpetrator and victim, are relevant for its prevention; therefore, more research is needed in this novel field of study. To contribute to the literature, our first goal was to analyze the associations among certain risk factors for CDA perpetration and victimization of, i.e., sexist attitudes and violence justification, problematic smartphone usage and impulsivity; sex and age were also considered. The second goal was to study whether there were differences in direct aggression and control, from the perpetrator and victim perspectives, with consideration of the above-mentioned risk factors. Third, differences in the diverse range of control behaviors and direct aggression between women and men were explored. To this end, 697 young adults (aged between 18 and 35 years; 548 women) completed self-report questionnaires that allowed assessment of the above-mentioned variables. The results showed that, among the wide range of CDA behaviors, indirect ones such as control behaviors were the most common. The highest level of control was strongly associated with the inability to manage behaviors under certain emotional states, especially negative ones, along with problematic smartphone usage. Sex differences were also observed: men displayed more sexist attitudes and violence justification, and perceived that they were more controlled by their partners. Regarding CDA behaviors, men and women showed differences in control (e.g. men considered themselves to be more controlled in terms of location and status updates), and direct aggression (e.g. men used more insults and humiliations than women). The results were discussed in terms of the importance of better understanding these risk factors to attenuate the increasing prevalence of CDA in relationships.

Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review.

OBJECTIVES: Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). METHODS: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. RESULTS: The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., "waiting list") conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. CONCLUSIONS: There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.

Sociocultural Attitudes Towards Appearance Questionnaire-4: Psychometric properties among a French clinical eating disorder sample and normative comparisons.

Although the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) has been shown to be a reliable and valid tool for assessing appearance pressures and appearance ideal internalization among French college students, to date its psychometric properties among French clinical populations have not been examined. The aim of this study was to evaluate the factor structure, reliability, and validity of the SATAQ-4 among a French female clinical eating disorder sample, and to compare the mean SATAQ-4 scores from this clinical sample to previously published means observed among French female college women. The current sample included 192 French women consecutively recruited from an outpatient eating disorders unit in France. Participants completed the SATAQ-4, as well as validated measures of body image and eating pathology. Confirmatory factor analysis revealed that the original 22-item five-factor solution provided less than adequate fit to the data. In contrast, the reduced 20-item five-factor solution identified among French college students provided a good fit to the data. The SATAQ-4 subscales generally exhibited moderate positive associations with convergent measures of body image and eating disturbance, consistent with expectations. Differences in SATAQ-4 subscale means across diagnostic groups were observed. In addition, the clinical group reported higher scores on the Internalization: Thin/Low Body Fat and Internalization: Muscular/Athletic subscales compared to a non-clinical French sample. Findings support the SATAQ-4 as a valuable tool for assessing sociocultural influences on body image and eating concerns among French women with eating disorders.

Salivary Alpha-Amylase Mediates the Increase in Hunger Levels in Adolescents with Excess Weight after Viewing Food Images.

Background: Salivary alpha-amylase (sAA) initiates the digestion process in the mouth and its levels might influence feelings of hunger and the propensity toward obesity. This study aims to evaluate basal differences in sAA between adolescents with excess weight (EW) and normal weight (NW), and the associations between sAA levels and feelings of hunger after viewing food images. Methods: Adolescents (13-18 years old) classified as EW (n = 30) or NW (n = 30) participated in the study. Saliva samples were collected before the administration of a food-choice task. Hunger was evaluated before and after the food-choice task. Results: EW adolescents showed lower basal sAA levels than NW adolescents and a greater increase in hunger levels after viewing food images. In addition, sAA levels had a significant inverse relationship with the increase in hunger in EW adolescents, but not in NW adolescents. Finally, significant inverse associations between sAA, BMI, and body fat percentage were found. Conclusions: Levels of hunger and changes therein, after viewing food are dependent on sAA levels in EW adolescents. This finding indicates that sAA levels may be a mediator of feelings of hunger in individuals with overweight in the context of viewing food cues, suggesting the utility of the sAA enzyme as a marker of hunger and propensity toward obesity.

Cardiac vagal imbalance to the isometric sustained weight test in adolescents with emotional eating behavior.

PURPOSE: To assess the relationship between emotional eating behavior and heart rate variability in Spanish adolescents during an isometric exercise test. METHODS: Participants included 52 adolescents aged between 13 and 18 years old. Heart rate was continuously recorded at rest (2 minutes) and during the sustained weight test (2 minutes). Linear and nonlinear methods of heart rate variability were assessed and related to the emotional eating behavior divided in two clusters. RESULTS: Statistically significant differences were observed in linear and non-linear parameters of heart rate variability comparing rest and sustained weight test. An increase in the value of emotional eating in overweight adolescents was founded. During the sustained weight test, there were differences between the two emotional eating clusters regarding the variables peak high frequency power, normalized low frequency power, normalized high frequency power, low frequency/high frequency ratio, and sample entropy. A positive correlation between the emotional eating behavior and the peak high frequency power was observed, though the prediction capacity of the high frequency waves is low it is observed that there is a good fit to the regression line. CONCLUSION: Results of this study shows that there was a relationship between vagal tone and emotional eating behavior in adolescents during an isometric exercise, with excessive parasympathetic predominance and sympathetic withdrawal during a physical effort.

Risky decision-making after exposure to a food-choice task in excess weight adolescents: Relationships with reward-related impulsivity and hunger.

OBJECTIVE: To assess the effects of exposure to a food-choice task (appetizing versus healthy food) on risky decision-making by excess versus normal weight adolescents. We also analyzed the influence of food visualization on hunger levels, as well as group differences in food choices and impulsivity. METHODS: Fifty-six adolescents (aged 13-18 years) classified as excess (n = 27) or normal (n = 29) weight participated in the study. Risky-decision-making was assessed through the Balloon Analogue Risk Task, which was administered before and after a food-choice task. We also evaluated impulsivity traits through the UPPS-P Scale, and subjective hunger levels with a visual analogue scale. RESULTS: Adolescents with excess weight showed enhanced risky decision-making after the food-choice task compared to normal weight adolescents, as well as increased hunger levels. Furthermore, excess weight adolescents made more appetizing choices, and showed greater scores for Positive Urgency and Sensation Seeking. Reward-related impulsivity measures were positively associated with the number of appetizing choices in the food-choice task. Several associations were found between impulsivity measures, hunger levels and risk-taking variables. CONCLUSIONS: Excess weight adolescents increased their risky-decision-making after food exposure and this augmentation was associated with the increase in hunger levels. Increased hunger levels and risk-taking after food exposure could lead to overeating. Alterations in decision-making caused by food signals may be a long-term risk factor for the development of obesity in adulthood. In modern societies, with the high availability and continuous exposure to food cues, decision-making may be a crucial factor in maintain healthy eating habits in adolescents.

Social stress increases cortisol and hampers attention in adolescents with excess weight.

OBJECTIVE: To experimentally examine if adolescents with excess weight are more sensitive to social stress and hence more sensitive to harmful effects of stress in cognition. DESIGN AND METHODS: We conducted an experimental study in 84 adolescents aged 12 to 18 years old classified in two groups based on age adjusted Body Mass Index percentile: Normal weight (n=42) and Excess weight (n=42). Both groups were exposed to social stress as induced by the virtual reality version of the Trier Social Stress Task--participants were requested to give a public speech about positive and negative aspects of their personalities in front of a virtual audience. The outcome measures were salivary cortisol levels and performance in cognitive tests before and after the social stressor. Cognitive tests included the CANTAB Rapid Visual Processing Test (measuring attention response latency and discriminability) and the Iowa Gambling Task (measuring decision-making). RESULTS: Adolescents with excess weight compared to healthy weight controls displayed increased cortisol response and less improvement of attentional performance after the social stressor. Decision-making performance decreased after the social stressor in both groups. CONCLUSION: Adolescents who are overweight or obese have increased sensitivity to social stress, which detrimentally impacts attentional skills.