The impact of preexisting psychiatric disorders and antidepressant use on COVID-19 related outcomes: a multicenter study.

Pre-existing mental disorders are linked to COVID-19-related outcomes. However, the findings are inconsistent and a thorough analysis of a broader spectrum of outcomes such as COVID-19 infection severity, morbidity, and mortality is required. We investigated whether the presence of psychiatric diagnoses and/or the use of antidepressants influenced the severity of the outcome of COVID-19. This retrospective cohort study evaluated electronic health records from the INSIGHT Clinical Research Network in 116,498 individuals who were diagnosed with COVID-19 between March 1, 2020, and February 23, 2021. We examined hospitalization, intubation/mechanical ventilation, acute kidney failure, severe sepsis, and death as COVID-19-related outcomes. After using propensity score matching to control for demographics and medical comorbidities, we used contingency tables to assess whether patients with (1) a history of psychiatric disorders were at higher risk of more severe COVID-19-related outcomes and (2) if use of antidepressants decreased the risk of more severe COVID-19 infection. Pre-existing psychiatric disorders were associated with an increased risk for hospitalization, and subsequent outcomes such as acute kidney failure and severe sepsis, including an increased risk of death in patients with schizophrenia spectrum disorders or bipolar disorders. The use of antidepressants was associated with significantly reduced risk of sepsis (p = 0.033), death (p = 0.026). Psychiatric disorder diagnosis prior to a COVID-19-related healthcare encounter increased the risk of more severe COVID-19-related outcomes as well as subsequent health complications. However, there are indications that the use of antidepressants might decrease this risk. This may have significant implications for the treatment and prognosis of patients with COVID-19.

Electrophysiological correlates of attentional bias towards threat in children with high levels of social anxiety.

Pediatric social anxiety is characterized by attentional biases (AB) towards social threats. This study used a new response-based calculation method to assess AB from response times (RT) in a visual dot-probe task and electroencephalography (EEG) to explore its electrophysiological correlates. Twenty, high socially anxious children (HSA) (mean [M ] = 10.1 years; standard deviation [SD] = 1.01) were compared with 22 healthy control children (HC) (M = 10.20 years; SD = 1.30) matched in age and gender. Participants had to identify targets preceded by disgust-neutral, happy-neutral, or neutral-neutral pairs of faces. RT and electroencephalograms were recorded throughout the task. While no significant group difference was found at the behavioral level, principal component analyses performed on EEG data revealed that event-related potentials for threat-related stimuli were impacted by social anxiety. Analyses indicated a larger N170 amplitude in response to all facial stimuli in HC when compared to the HSA. However, we found increased P2 amplitudes for disgust-neutral pairs compared with happy-neutral pairs in has only. Then, thasHSA group showed increased P2 amplitudes for targets following disgusted faces on the opposite side of the screen compared with targets appearing on the same side of the screen. These results suggest that HSA may display an increased anchorage of attention on threatening stimuli and need more effort to disengage their attentional focus from threats and to perform the task correctly. Taken together, our data confirmed the presence of AB in children with high levels of social anxiety, which are reflected by increased neural processing during the confrontation to faces depicting a potential threatening expression.

Attribution of intentions and context processing in psychometric schizotypy.

INTRODUCTION: Impairment in Theory of mind (TOM) has frequently been associated with schizophrenia and with schizotypy. Studies have found that a tendency to over-attribute intentions and special meaning to events and to people is related to positive psychotic symptoms. Further, it has been suggested that this intentionality bias may be due to a broader deficit in context processing (CP). The aim of the present study was thus to investigate the relationship between positive schizotypy and both over-attribution of intentions and contextual processing. METHODS: One-hundred and nineteen healthy individuals completed the Schizotypal Personality Questionnaire and were assessed with tasks measuring contextual treatment and ToM. RESULTS: Results revealed that positive schizotypy was significantly related to an over-attribution of intentions on the ToM task and with a faster processing of implicit context. Partial correlational analyses indicated that the association between the attribution of intentions and positive schizotypy was not explained by a deficit of CP. In contrast, stepwise multiple regression analyses showed that both an over-attribution of intentions and a faster processing of implicit context significantly predicted positive schizotypy. CONCLUSIONS: These results show that an over-attribution of intention is independent from a broader deficit in context information processing and that they both possibly contribute to the development and maintenance of positive psychotic symptoms.

Stress response and experiential avoidance among firefighters: Preliminary insights from network analyses.

Firefighters are at increased risk of developing posttraumatic stress disorder (PTSD) due to exposure to potentially traumatic events during their careers. However, little is known about the prevalence of PTSD among this population, particularly when taking moderating variables into account. Using Gaussian Graphical Models and Directed Acyclic Graphs, we conducted network analyses to examine the interactions between clusters of PTSD symptoms, perceived stress, hardiness, and experiential avoidance among 187 firefighters. The data and code are published with the paper. Experiential avoidance, as part of psychological inflexibility, was found to be the only variable that interacted with PTSD symptomatology. Strong positive associations were observed between experiential avoidance and the "negative mood and cognitions" subscale of the PTSD Checklist for DSM-5 (PCL-5). Through this association, other PTSD symptoms were activated, particularly avoidance and arousal. Our findings suggest that experiential avoidance and negative mood and cognition symptoms are particularly important in the expression of PTSD symptomatology in firefighters. In addition, experiential avoidance may be used as a coping strategy to reduce perceived stress during potentially traumatic events. Therefore, experiential avoidance may be a prime target for future interventions and training focused on flexible self-regulation strategies in this population.

Cognitive flexibility and attentional patterns among trauma survivors: preliminary evidence from an eye-tracking study.

Background: Executive functioning has been linked to both the development of post-traumatic symptoms and the efficiency of therapy. Specifically, flexibility processes seem to play a major role in the use of efficient coping strategies after a traumatic event. However, only a few studies have focused on the links between flexibility, resilience, and concrete behaviours displayed by individuals. Objective: The aim of this study was to investigate the influence of emotional content on the efficiency of cognitive flexibility among trauma-exposed individuals. Method: Twenty-eight trauma-exposed (TE) and 27 non-trauma-exposed (NTE) individuals performed an overlap task in which neutral, positive, and negative pictures appeared in the centre of the screen. Participants were required to disengage their attentional focus from this picture to identify a peripheral target. Analyses included eye movements during the presentation of the scenes and the response times associated with target localization. Results: TE individuals initially presented a rapid overt disengagement from both neutral and negative emotional information. In other words, TE participants moved their gaze away from the central picture towards the target more rapidly than NTE participants. However, TE participants then displayed longer reaction times to identify the target in comparison with NTE participants. Discussion: This study presents preliminary evidence that cognitive flexibility may be relevant when considering the impact of trauma. The developed task could provide a novel way to assess this flexibility within an emotional context. HIGHLIGHTS: • This study developed an original assessment of cognitive flexibility processes in an emotional context.• Cognitive flexibility was assessed using an overlap task and eye-tracking technology.• Cognitive flexibility may be relevant when considering the impact of a trauma.

Antecedentes: El funcionamiento ejecutivo se ha relacionado tanto con el desarrollo de síntomas postraumáticos como con la eficiencia de la terapia. Específicamente, los procesos de flexibilidad parecen jugar un papel importante en el uso de estrategias de afrontamiento después de un evento traumático. Sin embargo, solo unos pocos estudios se han centrado en los vínculos entre la flexibilidad, la resiliencia y los comportamientos concretos que muestran los individuos.Objetivo: El objetivo de este estudio fue investigar la influencia del contenido emocional en la eficiencia de la flexibilidad cognitiva entre individuos expuestos a traumas.Método: 28 personas expuestas a trauma (ET) y 27 no expuestas a trauma (NET) realizaron una tarea superpuesta en la que aparecían imágenes neutras, positivas y negativas en el centro de la pantalla. Se pidió a los participantes que desvincularan su foco de atención de esta imagen para identificar un objetivo periférico. Los análisis incluyeron movimientos oculares durante la presentación de las escenas y los tiempos de respuesta asociados con la localización del objetivo.Resultados: Los individuos con ET inicialmente presentaron una desconexión abierta y rápida de la información emocional tanto neutral como negativa. En otras palabras, los participantes con ET alejaron su mirada de la imagen central hacia el objetivo más rápido que los participantes NET. Sin embargo, los participantes con ET mostraron tiempos de reacción más largos para identificar el objetivo en comparación con los participantes NET.Discusión: Los individuos con ET inicialmente presentaron una desconexión abierta y rápida de la información emocional tanto neutral como negativa. En otras palabras, los participantes con ET alejaron su mirada de la imagen central hacia el objetivo más rápido que los participantes NET. Sin embargo, los participantes con ET mostraron tiempos de reacción más largos para identificar el objetivo en comparación con los participantes NET.

French Adaptation of the Brief Irritability Test: Factor Structure, Psychometric Properties, and Relationship with Depressive Symptoms.

The Brief Irritability Test (BITe, Holtzman et al., 2014) is a brief, reliable, and valid self-report measure of irritability. Despite the growing interest to understand the underlying causes and consequences of irritability, this questionnaire has not been developed and validated for a French-speaking population yet. In the present study, 413 participants completed our French adaptation of the BITe (i.e., TCI; Test Court d'Irritabilité) and measures of associated constructs (depression, anger, hostility, and aggression) and well-being (life satisfaction and social support). Descriptive, psychometric (i.e., Cronbach alpha and Spearman correlation coefficients), and factor analyses were conducted. An exploratory factor analysis in sample 1 (n = 209), yielded one single factor. The confirmatory factor analysis in sample 2 (n = 204) showed a reasonable fit of this single factor model explaining 55.5% of the variance and presenting a strong internal consistency (α = .80). Compared to the original English questionnaire, the TCI shares similar unidimensional factor organization and correlations with other constructs, although a gender bias was identified, with women scoring higher than men. Irritability was higher among respondents in the age range 17-25, compared to older adults. A hierarchical regression analysis showed that TCI scores significantly predict depressive symptoms when demographics were controlled for. In summary, the TCI presents good psychometric properties and could constitute a valuable tool to evaluate irritability in clinical and research contexts.

Neural responses associated with attentional engagement and disengagement from threat in high socially anxious children: Evidence from temporal-spatial PCA.

BACKGROUND: Cognitive models indicated that social anxiety disorder (SAD) would be caused and maintained by a biased attentional processing of threatening information. This study investigates whether socially anxious children may present impaired attentional engagement and disengagement from negative emotional faces, as well as their underlying event-related potential responses. METHODS AND FINDINGS: Fifteen children with high levels of social anxiety (HSA; 9 boys; mean age = 9.99y; SD = 1.14) and twenty low socially anxious children (LSA; 16 boys; mean age = 10.47y; SD = 1.17) participated in a spatial cueing task in which they had to detect targets following neutral/disgusted faces in a valid or invalid location. No group effect was reported on reaction times [p>.05]. However, electrophysiological data showed lower P3a amplitude in HSA children compared with the LSA group when processing facial stimuli. They also reported larger N2 amplitudes for valid-disgusted targets and a larger P3a amplitude for the invalid-disgusted ones. CONCLUSION: In terms of electrophysiological data, our results validated, the hypothesis of attentional disengagement difficulties in SAD children. We also confirm the idea that high levels of social anxiety are associated with cognitive control impairments and have a greater impact on the processing efficiency than on the performance effectiveness.

Covert Attention to Gestures Is Sufficient for Information Uptake.

Numerous studies have explored the benefit of iconic gestures in speech comprehension. However, only few studies have investigated how visual attention was allocated to these gestures in the context of clear versus degraded speech and the way information is extracted for enhancing comprehension. This study aimed to explore the effect of iconic gestures on comprehension and whether fixating the gesture is required for information extraction. Four types of gestures (i.e., semantically and syntactically incongruent iconic gestures, meaningless configurations, and congruent iconic gestures) were presented in a sentence context in three different listening conditions (i.e., clear, partly degraded or fully degraded speech). Using eye tracking technology, participants' gaze was recorded, while they watched video clips after which they were invited to answer simple comprehension questions. Results first showed that different types of gestures differently attract attention and that the more speech was degraded, the less participants would pay attention to gestures. Furthermore, semantically incongruent gestures appeared to particularly impair comprehension although not being fixated while congruent gestures appeared to improve comprehension despite also not being fixated. These results suggest that covert attention is sufficient to convey information that will be processed by the listener.

Influence of acute stress on attentional bias toward threat: How a previous trauma exposure disrupts threat apprehension.

While previous trauma exposure is known to be a risk factor for the development and maintenance of many psychological disorders, it remains unclear how it increases individual risk for prospective psychopathology in the aftermath of a new trauma exposure. The aim of this study was to investigate how a prior exposure to trauma affects attentional processing of threat before and after an acute stress task. Specifically, we assessed attentional biases to threat before and after a cold pressor task in 17 individuals who have been exposed to trauma (TE) compared to 18 individuals without trauma exposure (NTE). Behavioral results showed difficulties to disengage from threat in TE but not in the control group prior to stress induction, as well as a switch to an attentional bias toward threat after the cold pressor task in the TE group. For the ERPs, we highlighted (1) decreased N1 negativity in response to threatening stimuli after an acute stress in both groups, and (2) a parallel increase in P1 for such stimuli only in the TE group. Those results suggest a vulnerability presented by previously traumatized individuals when dealing with threats as well as an acute responsitity toward stress. Those results are interpreted in regards with the theorical models of stress and anxiety.

The Role of Iconic Gestures in Speech Comprehension: An Overview of Various Methodologies.

Iconic gesture-speech integration is a relatively recent field of investigation with numerous researchers studying its various aspects. The results obtained are just as diverse. The definition of iconic gestures is often overlooked in the interpretations of results. Furthermore, while most behavioral studies have demonstrated an advantage of bimodal presentation, brain activity studies show a diversity of results regarding the brain regions involved in the processing of this integration. Clinical studies also yield mixed results, some suggesting parallel processing channels, others a unique and integrated channel. This review aims to draw attention to the methodological variations in research on iconic gesture-speech integration and how they impact conclusions regarding the underlying phenomena. It will also attempt to draw together the findings from other relevant research and suggest potential areas for further investigation in order to better understand processes at play during speech integration process.

Affective Ratings of Pictures Related to Interpersonal Situations.

Many studies require standardized and replicable protocols composed of emotional stimuli. To this aim, several databases of emotional pictures are available. However, there are only few images directly depicting interpersonal violence, which is a specific emotion evocative stimulus for research on aggressive behavior or post-traumatic stress disorder. The objective of the current study is to provide a new set of standardized stimuli containing images depicting interpersonal situations (both positive and negative). This will allow a sensitive assessment of a wide range of cognitions linked to social interaction (empathy, perspective taking, traumatic experiences, etc.). To this aim, 240 participants rated the valence and arousal of 79 pictures collected from online sources in 2018. Results showed (1) a distinctive pattern of valence and arousal regarding the picture content and (2) specific associations between those two dimensions. Taken together, these results suggest a good reliability of the selected images. In conclusion, our study provides an open access set of recent pictures depicting interpersonal situations along with normative valence and arousal ratings, that are available for download from: https://osf.io/ak4m7/?view_only=None.

Eye-tracking exploration of inhibitory control in post-traumatic stress disorder: an emotional antisaccade paradigm.

Background: Cognitive-behavioural studies among individuals suffering from post-traumatic stress disorder (PTSD) have highlighted attentional biases towards threats as a key factor in the maintenance of the disorder. Anxiety-related studies have hypothesized that attentional biases were due to attentional control difficulties in inhibition and flexibility of threatening information. Objective: Because it remains unclear how this theory could be applied to PTSD, this study aims to evaluate the inhibitory control and flexibility abilities of negative and threatening information in this population, using eye-tracking technology. Method: Fifteen adults with a history of physical assault and a current diagnosis of PTSD, and 15 healthy control participants, completed an original mixed antisaccade task. Results: We found enhanced overt attentional allocation towards every item of emotional information among PTSD participants, such as indexed by the latencies of the first saccade in prosaccade trials, followed by disengagement difficulties, such as indexed by increased reaction time to identify the target. Conclusion: Our results could represent empirical evidence of the general enhancement of attentional vigilance in people with PTSD in comparison with healthy controls, as well as specific inhibitory deficits. The results are interpreted through a fear-generalization hypothesis.

Antecedentes: Los estudios cognitivo-conductuales entre personas que padecen Trastorno de Estrés Postraumático (TEPT) han destacado los sesgos atencionales (AB, por su sigla en inglés) por amenaza como factor clave para el mantenimiento del trastorno. La literatura relacionada con ansiedad ha planteado la hipótesis de que los AB se debían a la dificultad del control atencional en la inhibición y flexibilidad de la información amenazante (Eysenck, 2008).Objetivo: Debido a que no está claro cómo se podría aplicar esta teoría al TEPT, este estudio tiene como objetivo evaluar el control inhibitorio y las capacidades de flexibilidad de la información negativa y amenazante en esta población, utilizando tecnología de seguimiento-ocular.Método: 15 adultos agredidos físicamente con un diagnóstico actual de TEPT y 15 participantes de Controles Sanos (CS) completaron una tarea original de antisacada mixta.Resultados: Encontramos una asignación atencional directa-abierta aumentada hacia información emocional entre los participantes con TEPT, tales como las latencias indexadas de la primera sacada en los ensayos de prosacada, seguida por las dificultades de desenganche, indexada por un tiempo de reacción mayor para identificar el objetivo diana.Conclusión: Nuestros resultados podrían representar una evidencia empírica de un aumento general de la vigilancia atencional en el TEPT en comparación con los CS, así como de déficits inhibitorios específicos. Los resultados se interpretan a través de una hipótesis de generalización del miedo.

Examining the Hierarchical Influences of the Big-Five Dimensions and Anxiety Sensitivity on Anxiety Symptoms in Children.

Anxiety sensitivity (AS), namely the fear of anxiety symptoms, has been described as a precursor of sub-threshold anxiety levels. Sexton et al. (2003) posited that increased AS would arise from an elevated neuroticism and that both would act as vulnerability factors for panic disorder (PD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) symptoms. Accordingly, this study aimed to (1) evaluate the applicability of this model to a pediatric population and (2) examine the influences of the other Big-Five personality dimensions on the four lower-order dimensions of AS (cognitive, physical, control, and physical) and on social phobia (SP), separation anxiety disorder (SAD) and depression symptoms. 200 children (104 girls) aged between 8 and 12 years old (mean age = 132.52 months, SD = 14.5) completed the Childhood Anxiety Sensitivity Index (Silverman et al., 1991), the Big Five Questionnaire for Children (Barbaranelli et al., 2003), and the Revised's Children Anxiety and Depression Scale (Chorpita et al., 2000). Regression analyses confirmed that AS and neuroticism together significantly predicted the presence of PD, OCD, and GAD symptoms but also SP, SAD, and depression symptoms. Moreover, neuroticism interacted with extraversion, conscientiousness and agreeableness to significantly predict SP, GAD, and depression. Surprisingly, the global AS score was only predicted by agreeableness, while AS dimensions also specifically related to openness. Finally, AS dimensions did not predict the presence of specific anxiety symptoms. To conclude, the predicting model of anxiety symptoms in children sets neuroticism and AS on the same level, with an unexpected influence of agreeableness on AS, raising the importance of other trait-like factors in the definition of such models. Moreover, AS should be considered as a unitary construct when predicting the presence of anxiety symptoms in children. Future interventions must consider these associations to help children detect and recognize the symptoms of their anxiety and help them to interpret them correctly.