Review of strategies to investigate low sample return rates in remote tobacco trials: A call to action for more user-centered design research.

Remote collection of biomarkers of tobacco use in clinical trials poses significant challenges. A recent meta-analysis and scoping review of the smoking cessation literature indicated that sample return rates are low and that new methods are needed to investigate the underlying causes of these low rates. In this paper we conducted a narrative review and heuristic analysis of the different human factors approaches reported to evaluate and/or improve sample return rates among 31 smoking cessation studies recently identified in the literature. We created a heuristic metric (with scores from 0 to 4) to evaluate the level of elaboration or complexity of the user-centered design strategy reported by researchers. Our review of the literature identified five types of challenges typically encountered by researchers (in that order): usability and procedural, technical (device related), sample contamination (e.g., polytobacco), psychosocial factors (e.g., digital divide), and motivational factors. Our review of strategies indicated that 35% of the studies employed user-centered design methods with the remaining studies relying on informal methods. Among the studies that employed user-centered design methods, only 6% reached a level of 3 in our user-centered design heuristic metric. None of the studies reached the highest level of complexity (i.e., 4). This review examined these findings in the context of the larger literature, discussed the need to address the role of health equity factors more directly, and concluded with a call to action to increase the application and reporting of user-centered design strategies in biomarkers research.

Self-regulation in youth with bipolar disorder

Objectives: To examine the composition of self-regulation in pediatric bipolar disorder (PBD) through the relationship between executive functions, emotion processing, and family environmental factors. Methods: 58 participants (36 with PBD and 22 controls), ages 12-17, were assessed using the Barratt Impulsiveness Scale (BIS), Conners' Continuous Performance Test (CPT-II), Wisconsin Cards Sorting Test (WCST), Computerized Neurocognitive Battery Emotion Recognition Test-Facial Emotion Recognition Test (PENNCNB ER-40), and Expressed Emotion Adjective Checklist Questionnaire (EEAC). Results: Adolescents with PBD displayed significant deficits in all three spheres when compared to the control group. Emotion processing correlated negatively with inhibition and attention, and correlated positively with mental flexibility/working memory. Family environmental factors correlated negatively with mental flexibility/working memory and emotion processing, and positively with attention and inhibition. These correlations indicate that better inhibitory control, attention, and mental flexibility/working memory are associated with greater emotion processing and a fitter family environment. Conclusion: This study is the first to investigate all of the components of self-regulation deficits simultaneously in patients with PBD. Results suggest that self-regulation is essential for a comprehensive perspective of PBD and should be assessed in an integrative and multifaceted way. Understanding that self-regulation is impacted by the abovementioned factors should influence treatment and improve the functional impairments of daily life observed in this population.

Self-regulation in youth with bipolar disorder.

OBJECTIVES: To examine the composition of self-regulation in pediatric bipolar disorder (PBD) through the relationship between executive functions, emotion processing, and family environmental factors. METHODS: 58 participants (36 with PBD and 22 controls), ages 12-17, were assessed using the Barratt Impulsiveness Scale (BIS), Conners' Continuous Performance Test (CPT-II), Wisconsin Cards Sorting Test (WCST), Computerized Neurocognitive Battery Emotion Recognition Test-Facial Emotion Recognition Test (PENNCNB ER-40), and Expressed Emotion Adjective Checklist Questionnaire (EEAC). RESULTS: Adolescents with PBD displayed significant deficits in all three spheres when compared to the control group. Emotion processing correlated negatively with inhibition and attention, and correlated positively with mental flexibility/working memory. Family environmental factors correlated negatively with mental flexibility/working memory and emotion processing, and positively with attention and inhibition. These correlations indicate that better inhibitory control, attention, and mental flexibility/working memory are associated with greater emotion processing and a fitter family environment. CONCLUSION: This study is the first to investigate all of the components of self-regulation deficits simultaneously in patients with PBD. Results suggest that self-regulation is essential for a comprehensive perspective of PBD and should be assessed in an integrative and multifaceted way. Understanding that self-regulation is impacted by the abovementioned factors should influence treatment and improve the functional impairments of daily life observed in this population.

Social cognition and bipolar disorder: pending questions and unexplored topics

Social cognition has gained prominence in psychiatric research, beginning with schizophrenia and more recently in bipolar disorder. Considering the relevance of this domain to interpersonal relationships and functionality, we aimed to explore the fundamental research and clinical issues regarding social cognition and discuss future directions and challenges in the field of bipolar disorder.

Social cognition and bipolar disorder: pending questions and unexplored topics.

Social cognition has gained prominence in psychiatric research, beginning with schizophrenia and more recently in bipolar disorder. Considering the relevance of this domain to interpersonal relationships and functionality, we aimed to explore the fundamental research and clinical issues regarding social cognition and discuss future directions and challenges in the field of bipolar disorder.

Personality traits and parenting styles in boys victims of sexual abuse: a pilot study

ABSTRACT Objective: We examined the association between personality traits and parenting styles in boys victims of sexual abuse (SA). Methods: Sixty-two (62) boys were divided into two groups: 32 (Victims of SA group, age 11.7±1.28) and 30 non-victims of SA (Comparison group, age 11.6±1.22). All participants completed the Eysenck Personality Questionnaire (EPQ-J) and the Parenting Styles Inventory (PSI). The intelligence quotient (IQ) was also assessed. Results: Both groups did not differ in terms of IQ. In the SA group, men (97%) were the biggest abusers, 85% of the parents were divorced and the father was the biggest aggressor (44%). The SA victims had higher neuroticism (p <0.001) and identified riskier parental practices, while the comparison group reported good parental practices (p<0.05). The results of the logistic regression analysis showed that higher negative paternal parental style scores increase the chance of belonging to the victims group. Discussion: Victims of SA present a higher risk of neuroticism and perception of dysfunctional family dynamics, with seriously reversed social roles. Further studies are needed to investigate the behavioral, cognitive, emotional, personality and parental styles, and the development of psychological intervention programs and other professional practices for victims of SA and their families in various contexts of violence.

Emotion regulation in pediatric bipolar disorder: A meta-analysis of published studies.

BACKGROUND: Emotion regulation is a relatively recent topic in psychiatry, and has only recently begun to be tested across Pediatric Bipolar Disorder (PBD). To date, no meta-analysis has investigated the presence of emotion regulation deficits in PBD patients. OBJECTIVES: The aim of this study is to understand where the literature stands on this topic, as well as how different researchers are measuring and grasping the concept of emotion regulation in pediatric bipolar disorders. METHODS: A systematic search of trials using the terms ("Pediatric Bipolar Disorder") AND ("Emotion Regulation" OR "Affect Regulation" OR "Mood Lability" OR "Mood Instability" OR "Irritability") was conducted using PubMed, Google Scholar, ResearchGate, Web of Science and Psych Info databases. Of the initial 366 articles identified, 8 met eligibility criteria for the meta-analysis and were included in this study. RESULTS: There is a statistically significant difference in Accuracy in Emotion Regulation tasks, with a tendency for lower accuracy in PBD patients; however, both groups did not differ statistically regarding Response Time. CONCLUSION: Our data suggests that PBD patients do present emotion regulation deficits, particularly regarding facial emotion recognition and affective language interference tasks mediated by cognitive assignments. These results have important implications in developing novel psychotherapeutic interventions for this population.

Quality of life and clinical outcomes in bipolar disorder: An 8-year longitudinal study.

OBJECTIVES: This longitudinal study examined the relationship of Quality of Life (QOL) throughout an 8-year follow-up period with baseline and longitudinal clinical variables indicative of outcome in patients with Bipolar Disorder (BD). METHODS: 36 participants, ages 18-70, were recruited from the Bipolar Disorder Research Program (PROMAN) outpatient clinic. Participants completed the WHOQOL-BREF questionnaire in 2009 (baseline), 2015 (6-years) and 2017 (8-years), with high scores being associated with better quality of life. Baseline clinical variables were collected through the Structured Clinical Interview for DSM-IV (SCID-IV) and a structured baseline interview for demographic and clinical assessment. Longitudinal clinical variables were collected through medical records, including mood charts and mood symptoms scales. RESULTS: The results suggest that the QoL, as measured by the WHOQOL-BREF scale, is negatively affected by depressive episodes and is rather stable throughout the course of patients diagnosed with BD. In our study, all three scores were negatively correlated to depressive episodes, and one WHOQOL-BREF score was positively correlated to manic episodes, suggesting that higher scores, both at baseline and throughout the course of the disorder, may be associated to a higher occurrence of manic episodes, while lower QoL scores may be predictive of a higher occurrence of depressive episodes. Also, all three scores revealed significant positive correlations between themselves, suggesting QoL, as measured by the WHOQOL-BREF, remained constant throughout the 8-year observed period. Finally, patients presenting Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and substance abuse comorbidities revealed consistent lower WHOQOL-BREF scores, suggesting that these comorbidities may be an important predictor of QoL in BD patients.

Pragmatic Language and Schizophrenia: Interpretation of Metaphors

ABSTRACT Background: Schizophrenia is a severe and chronic psychiatric disorder with significant cognitive deficits, which are considered structural markers for the disease. Language disturbances have an important role in patients' social functioning and interpersonal relationships. Objectives: Evaluate the capacity to understand pragmatic language in schizophrenic patients, through the comprehension of non-literal meaning in metaphors and the ability to use contextual clues to better understand their meanings. Methods: Thirty patients were evaluated using Abbreviated Intelligence Scale (WASI), Interpretation of Metaphors subtest of the Montreal Communication Evaluation Battery (MAC). Results: The linear regression model showed that schizophrenic patients presented below average performance in the interpretation of metaphors task, with tendency to concrete interpretations. Variables such as IQ, WASI Vocabulary subtest and years since onset influenced the patients' pragmatic language skills. This relation was not found for family history. Existence of the metaphor in native colloquial language (Portuguese) and being given alternatives to choose from, enhanced patients' performance. Discussion: Results corroborate findings regarding this population's difficulties in the language cognitive domain. Development of interventions aiming comprehension of pragmatic language could help ease patients' social difficulties, especially if started early at onset. Also, better understanding of this deficit can help create rehabilitation strategies.

Memory training combined with 3D visuospatial stimulus improves cognitive performance in the elderly: pilot study.

Studies suggest that the engagement of aged participants in cognitive stimulation programs can reduce expected cognitive decline associated with age. OBJECTIVE: To evaluate the effects of memory training (MT) associated with three-dimensional multiple object tracking (3D-MOT) NeuroTracker (NT) in the elderly. METHODS: Forty-four participants (>60 years of age) were recruited and randomly distributed into two groups: experimental (EG; n=22) and comparative (CG; n=22). Both groups performed 12 one-hour MT sessions, twice a week, consisting of specific computerized stimuli associated with teaching of mnemonic strategies; 10 minutes of NT was part only of the EG's sessions. In pre- and post-training periods, both groups were evaluated using a sociodemographic questionnaire, neuropsychological assessment, as well as a specific measure offered by NT. RESULTS: Both groups benefited from the MT and reported more positive feelings regarding their memory and quality of life. However, the EG obtained better results in tests consistent with the strategies trained and which involved attentional resources, reaction time, visual processing speed, episodic, semantic, subjective and working memory as well as aspects of social cognition. CONCLUSIONS: This study showed that the combination of MT and 3D-MOT contributed for a better cognitive performance in the EG. Thus, the results of the present study encourage further research and the development of combined cognitive interventions for the elderly population with and without cognitive deficits.

Estudos sugerem que o envolvimento de idosos em programas de estimulação cognitiva pode reduzir o declínio cognitivo esperado associado à idade. OBJETIVO: Avaliar os efeitos de um treinamento de memória (TM) associado a um estímulo visuoespacial tridimensional (3D-MOT) NeuroTracker (NT) em idosos. MÉTODO: Quarenta e quatro participantes (>60 anos) foram recrutados e distribuídos aleatoriamente em dois grupos: experimental (GE; n=22) e comparativo (GC; n=22). Ambos os grupos realizaram 12 sessões do TM de uma hora, duas vezes por semana, consistindo em estímulos computadorizados específicos associados ao ensino de estratégias mnemônicas; apenas nas sessões do GE foram utilizados 10 minutos com o NT. Nos períodos pré- e pós-treinamento, ambos os grupos foram avaliados por meio de questionário sociodemográfico, avaliação neuropsicológica e medidas cognitivas específicas do NT. RESULTADOS: Ambos os grupos se beneficiaram do TM e relataram sentimentos mais positivos em relação à memória e à qualidade de vida. No entanto, o GE obteve melhores resultados em testes consistentes com as estratégias treinadas e que envolviam recursos atencionais, tempo de reação, velocidade de processamento visual, memória episódica, semântica, subjetiva e de trabalho, além de aspectos da cognição social. CONCLUSÕES: Este estudo mostrou que a combinação do TM e 3D-MOT contribuiu para um melhor desempenho cognitivo no GE. Dessa forma, os resultados do presente estudo incentivam novas pesquisas e o desenvolvimento de intervenções cognitivas combinadas para a população idosa com e sem déficits cognitivos.

Memory training combined with 3D visuospatial stimulus improves cognitive performance in the elderly: pilot study / Treinamento de memória combinado com estímulo visuoespacial em 3D melhora o desempenho cognitivo em idosos: estudo piloto

ABSTRACT. Studies suggest that the engagement of aged participants in cognitive stimulation programs can reduce expected cognitive decline associated with age. Objective: To evaluate the effects of memory training (MT) associated with three-dimensional multiple object tracking (3D-MOT) NeuroTracker (NT) in the elderly. Methods: Forty-four participants (>60 years of age) were recruited and randomly distributed into two groups: experimental (EG; n=22) and comparative (CG; n=22). Both groups performed 12 one-hour MT sessions, twice a week, consisting of specific computerized stimuli associated with teaching of mnemonic strategies; 10 minutes of NT was part only of the EG's sessions. In pre- and post-training periods, both groups were evaluated using a sociodemographic questionnaire, neuropsychological assessment, as well as a specific measure offered by NT. Results: Both groups benefited from the MT and reported more positive feelings regarding their memory and quality of life. However, the EG obtained better results in tests consistent with the strategies trained and which involved attentional resources, reaction time, visual processing speed, episodic, semantic, subjective and working memory as well as aspects of social cognition. Conclusions: This study showed that the combination of MT and 3D-MOT contributed for a better cognitive performance in the EG. Thus, the results of the present study encourage further research and the development of combined cognitive interventions for the elderly population with and without cognitive deficits.

RESUMO. Estudos sugerem que o envolvimento de idosos em programas de estimulação cognitiva pode reduzir o declínio cognitivo esperado associado à idade. Objetivo: Avaliar os efeitos de um treinamento de memória (TM) associado a um estímulo visuoespacial tridimensional (3D-MOT) NeuroTracker (NT) em idosos. Método: Quarenta e quatro participantes (>60 anos) foram recrutados e distribuídos aleatoriamente em dois grupos: experimental (GE; n=22) e comparativo (GC; n=22). Ambos os grupos realizaram 12 sessões do TM de uma hora, duas vezes por semana, consistindo em estímulos computadorizados específicos associados ao ensino de estratégias mnemônicas; apenas nas sessões do GE foram utilizados 10 minutos com o NT. Nos períodos pré- e pós-treinamento, ambos os grupos foram avaliados por meio de questionário sociodemográfico, avaliação neuropsicológica e medidas cognitivas específicas do NT. Resultados: Ambos os grupos se beneficiaram do TM e relataram sentimentos mais positivos em relação à memória e à qualidade de vida. No entanto, o GE obteve melhores resultados em testes consistentes com as estratégias treinadas e que envolviam recursos atencionais, tempo de reação, velocidade de processamento visual, memória episódica, semântica, subjetiva e de trabalho, além de aspectos da cognição social. Conclusões: Este estudo mostrou que a combinação do TM e 3D-MOT contribuiu para um melhor desempenho cognitivo no GE. Dessa forma, os resultados do presente estudo incentivam novas pesquisas e o desenvolvimento de intervenções cognitivas combinadas para a população idosa com e sem déficits cognitivos.

Seizure control and anxiety: Which factor plays a major role in social adjustment in patients with Juvenile Myoclonic Epilepsy?

PURPOSE: This study aimed to determine the presence of anxiety disorder and severity of anxiety symptoms in an extensive series of consecutive patients with JME and its association with epilepsy-related factors. In addition, we evaluated the impact of anxiety and clinical variables on social adjustment. METHODS: We prospectively evaluated 112 (56.2 % females, mean age 27.2 years) patients with an electroclinical diagnosis of JME and 61 (52.4 % females, mean age 29.3 years) healthy controls. Anxiety symptoms were assessed by the State and Trait Anxiety Inventory (STAI). Social functioning was addressed with Self-Report Social Adjustment Scale (SAS). The patient group was also evaluated with a psychiatric interview. RESULTS: Patients with JME presented more severe anxiety symptoms and worse social adjustment compared with controls. The presence of anxiety disorder and the severity of anxiety symptoms was associated with frequent seizures - generalized tonic-clonic seizures (p = 0.008) and drug-resistant epilepsy (p = 0.021). Regarding social adjustment, the severity of anxiety symptoms was associated with lower economic adjustment (p = 0.039), while the presence of anxiety disorder impacted family relationships (p 0.025). The presence of hard-to-control myoclonic seizure was associated with lower scores on work (p = 0.019), leisure activities (p = 0.008), family relationship (p = 0.022) and overall social adjustment (p = 0.038). CONCLUSION: Patients with JME have severe anxiety symptoms and worse social adjustment. Anxiety disorder and symptoms were associated with frequent seizures and drug-resistant epilepsy. Epilepsy-related factors and anxiety impaired distinct aspects of social functioning.