Emotional Distress, Suicidal Behavior, and Help-Seeking Among Transgender and Gender Diverse People in Israel.

Purpose: The aim of this study was to evaluate emotional distress, suicidality, and help-seeking among Israeli transgender and gender diverse (TGD) persons. Methods: TGD (n=139) and cisgender (n=275) participants reported on suicidal thoughts and behavior (STB), help-seeking behavior, and emotional distress (General Health Questionnaire [GHQ-12]) in an online survey. Results: GHQ-12 and STB were significantly higher among TGD compared with cisgender participants. More TGD participants reported seeking help. Conclusion: TGD persons reported high levels of emotional distress and STB, suggesting that their needs for mental health care are not met by the Israeli health services.

Sex classification from functional brain connectivity: Generalization to multiple datasets.

Machine learning (ML) approaches are increasingly being applied to neuroimaging data. Studies in neuroscience typically have to rely on a limited set of training data which may impair the generalizability of ML models. However, it is still unclear which kind of training sample is best suited to optimize generalization performance. In the present study, we systematically investigated the generalization performance of sex classification models trained on the parcelwise connectivity profile of either single samples or compound samples of two different sizes. Generalization performance was quantified in terms of mean across-sample classification accuracy and spatial consistency of accurately classifying parcels. Our results indicate that the generalization performance of parcelwise classifiers (pwCs) trained on single dataset samples is dependent on the specific test samples. Certain datasets seem to "match" in the sense that classifiers trained on a sample from one dataset achieved a high accuracy when tested on the respected other one and vice versa. The pwCs trained on the compound samples demonstrated overall highest generalization performance for all test samples, including one derived from a dataset not included in building the training samples. Thus, our results indicate that both a large sample size and a heterogeneous data composition of a training sample have a central role in achieving generalizable results.

Julearn: an easy-to-use library for leakage-free evaluation and inspection of ML models.

The fast-paced development of machine learning (ML) and its increasing adoption in research challenge researchers without extensive training in ML. In neuroscience, ML can help understand brain-behavior relationships, diagnose diseases and develop biomarkers using data from sources like magnetic resonance imaging and electroencephalography. Primarily, ML builds models to make accurate predictions on unseen data. Researchers evaluate models' performance and generalizability using techniques such as cross-validation (CV). However, choosing a CV scheme and evaluating an ML pipeline is challenging and, if done improperly, can lead to overestimated results and incorrect interpretations. Here, we created julearn, an open-source Python library allowing researchers to design and evaluate complex ML pipelines without encountering common pitfalls. We present the rationale behind julearn's design, its core features, and showcase three examples of previously-published research projects. Julearn simplifies the access to ML providing an easy-to-use environment. With its design, unique features, simple interface, and practical documentation, it poses as a useful Python-based library for research projects.

Sex classification from functional brain connectivity: Generalization to multiple datasets Generalizability of sex classifiers.

Machine learning (ML) approaches are increasingly being applied to neuroimaging data. Studies in neuroscience typically have to rely on a limited set of training data which may impair the generalizability of ML models. However, it is still unclear which kind of training sample is best suited to optimize generalization performance. In the present study, we systematically investigated the generalization performance of sex classification models trained on the parcelwise connectivity profile of either single samples or a compound sample containing data from four different datasets. Generalization performance was quantified in terms of mean across-sample classification accuracy and spatial consistency of accurately classifying parcels. Our results indicate that generalization performance of pwCs trained on single dataset samples is dependent on the specific test samples. Certain datasets seem to "match" in the sense that classifiers trained on a sample from one dataset achieved a high accuracy when tested on the respected other one and vice versa. The pwC trained on the compound sample demonstrated overall highest generalization performance for all test samples, including one derived from a dataset not included in building the training samples. Thus, our results indicate that a big and heterogenous training sample comprising data of multiple datasets is best suited to achieve generalizable results.

Examining the relationship between non-suicidal self-injury and mental health among female Arab minority students: the role of identity conflict and acculturation stress.

Background and objective: Research suggests that individuals from minority backgrounds, including immigrants and ethnic minorities, may be at a higher risk for non-suicidal self-injury (NSSI). The aim of the present research is to examine the relationship between non-suicidal self-injury (NSSI) and identity conflict and acculturation stress, depression, and risk behaviors among female Arab minority students. Methods: The sample analyzed consisted of 1,529 female Arab students (85.8% B.A. students, 14% M.A. students) aged 21-54 (M = 23, SD = 4.17). The participants completed self-reported questionnaires assessing NSSI engagement, identity conflict and acculturation stress, depression, and risky substance use behavior. Results: As expected, we found a significant positive association between NSSI and identity crisis. In addition, an identity conflict and acculturation stress impact the effect of depression and risky substance use behaviors in engaging in self-injury. Namely, participants were more likely to engage in NSSI when they also experienced identity conflict and acculturation stress and exhibited depressive symptoms and tended to display risky substance use behavior. Conclusion: These findings provide evidence that the relationship between depression, risky substance use behavior, and NSSI may be stronger among individuals who experience higher levels of identity conflict and acculturation stress. Implications for intervention and future research are briefly presented.

Implicit Identification with Death, Clinician Evaluation and Suicide Ideation among Adolescent Psychiatric Outpatients-The Mediating Role of Depression.

Implicit identification with death (i.e., subconsciously self-associating oneself with death), measured by the Death-Suicide Implicit Association Test (D/S-IAT), is associated with Suicide Ideation (SI). Our understanding of the mechanisms underlying this association is limited. The current study examined (1) the mediating role of depression between D/S-IAT and recent SI and (2) the association between SI, D/S-IAT, and clinician evaluation of SI among a clinical sample of adolescents. 148 adolescents aged 10-18 years (69.4% female) from two outpatient clinics were assessed at intake. Participants completed D/S-IAT and self-report measures for recent SI and depression during intake. Findings indicate that depression is a mediator between D/S-IAT and recent SI, controlling for gender, site differences, and past suicidal thoughts and behaviors. D/S-IAT and clinician evaluation were correlated with recent SI but not beyond depression. Our findings highlight the importance of examining the underlying psychological mechanisms regarding the association between D/S-IAT and suicide.

Accurate sex prediction of cisgender and transgender individuals without brain size bias.

The increasing use of machine learning approaches on neuroimaging data comes with the important concern of confounding variables which might lead to biased predictions and in turn spurious conclusions about the relationship between the features and the target. A prominent example is the brain size difference between women and men. This difference in total intracranial volume (TIV) can cause bias when employing machine learning approaches for the investigation of sex differences in brain morphology. A TIV-biased model will not capture qualitative sex differences in brain organization but rather learn to classify an individual's sex based on brain size differences, thus leading to spurious and misleading conclusions, for example when comparing brain morphology between cisgender- and transgender individuals. In this study, TIV bias in sex classification models applied to cis- and transgender individuals was systematically investigated by controlling for TIV either through featurewise confound removal or by matching the training samples for TIV. Our results provide strong evidence that models not biased by TIV can classify the sex of both cis- and transgender individuals with high accuracy, highlighting the importance of appropriate modeling to avoid bias in automated decision making.

Depression, Complicated Grief, and Suicide Ideation Following Bereavement During the COVID-19 Pandemic.

Many people lost a relative during the COVID-19 pandemic. Such a loss may have deleterious implications due to the circumstances of bereavement during lockdowns and social distancing. This study aimed to explore depressive symptoms, complicated grief, and suicidal ideation in the grieving process among 104 bereaved jewish adults who had lost relatives during the COVID-19 pandemic by completing self-reported questionnaires. The results indicate high suicidal ideation, complicated grief, and depression among them. Bereaved with suicidal ideation have an avoidant attachment and a close relationship with the deceased. These results highlight the adverse implication of COVID-19 on the grief process.

Burnout, depression, and suicidal ideation among physicians before and during COVID-19 and the contribution of perfectionism to physicians' suicidal risk.

Objectives: There is limited data regarding the prevalence of suicidal risk among physicians during COVID-19, and the risk factors relating to it. Dominant risk factors for suicide among physicians are depression and burnout. Maladaptive perfectionism may also serve as a profound risk factor for suicidality among physicians and may aggravate symptoms of distress under the challenges of COVID-19. This study aims to evaluate current suicidal risk, suicidal ideation, depression, and burnout before and during COVID-19 among physicians in Israel, and to identify the best sets of correlates between perfectionism and burnout, depression and suicidal ideation, during these time periods. Methods: A sample of 246 Israeli physicians (160 before COVID-19 and 86 during COVID-19) completed online surveys assessing lifetime suicidal risk, suicidal ideation during the last year and current suicidal ideation, depression, burnout symptoms and maladaptive perfectionism. Results: More than one-fifth of the sample (21.9%) reported high suicidal risk (Lifetime suicidal behaviors). More than one-fourth (27.2%) reported suicidal ideation during the last 12 months; and 13.4% reported suicidal ideation during the last 3 months. In addition, more than one-third (34.6%) exhibited moderate-severe levels of depressive symptoms and more than a half of the sample reported burnout symptoms. Maladaptive perfectionism was positively correlated with current suicidal ideation, burnout, and depression. Moderated serial mediation analysis demonstrated indirect effect of perfectionism on suicidal ideation by its impact on burnout and depression only during COVID-19. Before COVID-19, physicians were more likely to experience depressive symptoms. Conclusion: Physicians in Israel are at increased risk for depression and suicidal ideation, regardless of the COVID-19 pandemic. Maladaptive perfectionism was found to be a risk factor for burnout, depression, and suicidal ideation. During the first waves of the pandemic, physicians were less likely to experience depressive symptoms. However, among physicians who were characterized with high maladaptive perfectionism, depression served as a significant risk factor for suicidal ideation during the pandemic, which places these individuals at increased risk for suicidality. These results highlight the importance of implementing intervention programs among physicians to reduce suicidal risk and to better identify rigid perfectionism and depressive symptoms.

Shame, depression, and complicated grief among suicide loss-survivors: the moderating role of self-disclosure.

Background: Suicide-loss survivors (SLSs) are recognised as an at-risk population for several psychiatric complications, including complicated grief (CG) and depression (SI). However, whereas shame is known as one of the characteristics of this population, knowledge about possible psychological processes which may moderate the contribution of shame levels to CG and depression in the aftermath of suicide loss is sparse. This study examines the role of self-disclosure - the inclination to share personal information with others - as a possible moderator of the associations of shame with CG and shame with depression over time.Method: Participants were 152 suicide-loss survivors, aged 18-70, who completed questionnaires tapping CG and depression at three time points (T1- index measurement, T2-two years after T1. and T3-four years after T1) and questionnaires tapping shame and SD at T3.Results: Hierarchical regression analyses showed that shame significantly and positively contributed to CG at T3 and to depression at T3, beyond the CG/depression trajectories. Notably, two significant interactions were found: Self-disclosure moderated the contribution of shame to CG at T3 and to depression at T3. At lower self-disclosure levels, shame's contribution to CG and depression was higher.Conclusion: The study's findings highlight shame as a significant facilitator of CG and depression in the aftermath of suicide loss. Moreover, the role of interpersonal interaction on SLSs' distress levels and grieving process was underscored, as this interaction may serve as a buffer against the deleterious sequelae of the suicide of a loved one.

Shame significantly and positively contributed to CG and depression at trajectories.Self-disclosure moderated the contribution of shame to CG and depression at T3 beyond their natural trajectories.Interpersonal activities may serve as a buffer against the deleterious effects of suicide in the family.

Attention bias modification add-on to inpatient treatment for young women with anorexia nervosa-A randomized controlled trial.

Patients with anorexia nervosa (AN) display elevated anxiety and attention biases (ABs) in threat processing. Attention bias modification treatment (ABMT) is considered promising for anxiety disorders, but its potential for AN is limited. In this study, 154 young women hospitalised because of AN were assigned to ED-related and anxiety-related threat stimuli, or to a non-ABMT intervention control condition in a randomized control trial. Hundred-and-ten patients completed the study. ABMT was an add-on to the regular inpatient treatment. Research participants completed two pretreatment training sessions and eight biweekly sessions of ABMT. AB, ED-related symptoms, depression, anxiety and stress were assessed before and after ABMT in the research groups, and, similarly, 5 weeks apart, in the controls. We found that despite the different patterns of change in AB between the three groups following ABMT, the reduction in AB, or the between-group differences in AB-reduction, were not significant. While the severity of ED-symptoms, depression, anxiety and stress was reduced following ABMT, or control condition, in all groups, there were no between-group differences in these changes. Changes in AB were not correlated with baseline and pre-post-treatment changes in ED-related and comorbid symptomatology. Methodological and inpatient treatment-related considerations may explain our negative ABMT-related results.

Trends in Newspaper Coverage of Suicide in Israel: An 8-Year Longitudinal Study.

BACKGROUND: The nature of newspaper coverage of suicide events can impact suicide risk. Thus, the World Health Organization published recommendations for reporting suicide in the media. To date, Israel has no data regarding adherence to these media guidelines and no indication of the influence of the Israeli National Suicide Prevention Program (NSPP) on adherence. Aiming to fill these gaps, the current study examined (1) Israeli newspapers' adherence to the guidelines for suicide coverage and (2) the impact of the NSPP on the adherence level of media reporting. METHOD: Adherence to newspapers coverage guidelines was examined in two leading Israeli newspapers at three time points: T1 (2012, two years before the NSPP's establishment), T2 (2016-2017, 2-3 years after its establishment), and T3 (2018-2019, 4-5 years after NSPP's establishment). All articles reporting on suicide or suicidal behavior were analyzed at each time point regarding their adherence to the media guidelines. RESULTS: Two hundred articles were assessed and analyzed. The adherence level was 49.35% across all time points. We found improved adherence at T2 (after the initiation of the NSPP) in most of the guidelines but a slight decline at T3. Adherence to guidelines regarding prevention (Do guidelines) showed no significant improvement over time. CONCLUSIONS: General adherence to guidelines was relatively low. However, steps can be taken to improve media coverage of suicide stories. The NSPP should make greater efforts to promote changes in media coverage of suicide events in Israel, such as providing information about risk factors, prevention, and intervention. HIGHLIGHTSA longitudinal study examined Israeli newspapers over three time points in the last decade.General adherence level to the suicide coverage guidelines was 49.35% across all time points.The National Suicide Prevention Program was linked to improvement in adherence to most guidelines.

The relationship between non-suicidal self-injury, identity conflict, and risky behavior among Druze adolescents.

Objectives: This study aimed to explore the prevalence of non-suicidal self-injury (NSSI) among Druze adolescents in Israel, an ethnic minority, and examine the influence of identity conflict, depression, and performance of risky behaviors on such adolescents' engagement in NSSI. This investigation is important because little is known about NSSI among adolescents from ethnic minorities. Methods: Overall, 290 Druze adolescents aged 16-18 (mean = 16.26, standard deviation = 0.9) years (63.9% female) participated in this study. They were recruited through snowball sampling from three Druze schools that agreed to participate in the study. All participants completed self-report measures for NSSI, depression, anxiety, engagement in risky behaviors, emotion regulation, sleep problems, and identity integration. Results: Almost 20% of the total sample engaged in NSSI. Those who engaged in NSSI reported more significant depression, anxiety, sleep problems, and engagement in risky behaviors when compared with those who did not engage in NSSI. Moreover, those who engaged in NSSI reported experiencing a higher level of identity conflict. Further analysis revealed an indirect effect of identity conflict on NSSI through engagement in risky behaviors. Conclusions: This study's findings clarify the prevalence of NSSI among Druze adolescents, as well as contributing factors, and also highlights the importance of developing interventions that specifically target this unique ethnic group.

Racial and Ethnic Disparities in HIV Testing in People Who Use Drugs Admitted to a Tertiary Care Hospital.

Ending the HIV epidemic requires increased testing, diagnosis, and linkage to care. In the past 10 years, rates of HIV have increased among people with substance use disorder (SUD). HIV testing is recommended during hospitalization. Despite rising rates of infections and recommendations, HIV testing remains suboptimal. This study sought to detect differences in HIV testing by race and ethnicity in people who use drugs (PWUD) admitted to Tufts Medical Center (TuftsMC). This study is a retrospective review of hospitalized PWUD admitted from January 1, 2017 to December 31, 2020. PWUD were identified through toxicology results, medication prescribed for SUD, and nursing intake questions. The primary outcome of interest was whether an HIV test was ordered during hospitalization. The indicator of interest was race and ethnicity. Of 13,486 PWUD admitted to TuftsMC, only 10% had an HIV test ordered. Compared with White patients, Black patients [adjusted odds ratio (AOR): 0.69, 95% confidence interval (CI) (0.59-0.83)] and Hispanic patients [AOR: 0.68, 95% CI (0.55-0.84)] had decreased odds of receiving an HIV test. Our report is the first to show racial and ethnic differences in HIV testing ordering for hospitalized PWUD. Without access to harm reduction tools and expanded systems-based testing strategies, the HIV epidemic will continue and disproportionately impact minoritized communities.

Non-suicidal Self-Injury Among Adolescents From Diverse Ethnocultural Groups in Israel: The Association With Sleep Problems and Internet Addiction.

Objectives: Although Non-suicidal Self-Injury (NSSI) has received more attention in recent years, most of these studies focused on samples from North American and European countries; consequently, little is known about its patterns and frequency in other cultures as well as its relation to sleep problems and internet addiction. As one of the few studies that aim to fill this gap, the current study examined the prevalence, characteristics, and types of NSSI behaviors among adolescents from diverse ethnocultural groups. Methods: A sample of 642 adolescents, aged 12-18 years, were randomly recruited from different middle and high schools in Israel, employing a snowball sampling technique. The sample included the following: 50% Jews and 34.7% Muslims born in Israel, 9.7% immigrants from the former Soviet Union (FSU), and 4.4% immigrants from Ethiopia. The participants completed self-report questionnaires that assessed their NSSI, sleep problems, internet addictions, and depressive symptoms. Results: Almost one-third of the sample had engaged in NSSI, while 6% frequently injured themselves. More than half of the FSU immigrants and one-third of the Muslim participants indicated that they engaged in NSSI. These two population groups also exhibited severe depressive symptoms, sleep problems, and internet addictions. The most parsimonious correlations with NSSI included being male, an immigrant/Muslim minority who exhibited severe depressive symptoms and internet addictions. Conclusions: These results emphasize the need for routine NSSI assessments to prevent long-term sequelae, including any forms of suicidal thoughts and behaviors and adult borderline personality disorder (BPD). Primary preventive programs that include adaptive coping skills may eliminate the social contagion effect of NSSI.

Suicidal ideation and behavior among perinatal women and their association with sleep disturbances, medical conditions, and known risk factors.

Objective: Suicide is considered one of the leading causes of maternal mortality, especially among women with postpartum depression. In the current systematic review, we conducted a qualitative data synthesis of recent studies exploring novel risk factors including sleep disturbances and medical conditions, alongside known and significant risk factors for perinatal suicidality. Evidence acquisition: We conducted a systematic search of the literature according to PRISMA guidelines on PubMed, PsycNET, and Scopus databases. Search terms were "pregnancy" "OR" "postpartum" "OR" "peripartum" "OR" "perinatal" "OR" "postnatal" combined with the Boolean "AND" operator with "suicide" "OR" "suicidality" "OR" "suicidal ideation" "OR" "suicidal behavior." Evidence synthesis: The initial search yielded 1,458 records, of which 51 research reports that met inclusion criteria were analyzed. These 51 studies sampled a total of 45,942 participants. Clinically, sleep disturbance, psychopathology, and social support have been identified as dominant risk factors for suicidal behavior among pregnant and postpartum women, as well as medical conditions and aversive life events. Conclusion: Monitoring sleep disturbance, depression, and perceived social support is critical given that they are significant risk factors for suicide among perinatal women. Early identification of perinatal women who may be at risk of suicide, although not depressed, is crucial. Limitations: The use of tools designed to identify depression to identify suicidal risk, fail to identify women who are at risk but who do not suffer from depression. Other methodological limitations are the lack of longitudinal studies and the complexity of examining suicidal behavior in sample studies.

Confound-leakage: confound removal in machine learning leads to leakage.

BACKGROUND: Machine learning (ML) approaches are a crucial component of modern data analysis in many fields, including epidemiology and medicine. Nonlinear ML methods often achieve accurate predictions, for instance, in personalized medicine, as they are capable of modeling complex relationships between features and the target. Problematically, ML models and their predictions can be biased by confounding information present in the features. To remove this spurious signal, researchers often employ featurewise linear confound regression (CR). While this is considered a standard approach for dealing with confounding, possible pitfalls of using CR in ML pipelines are not fully understood. RESULTS: We provide new evidence that, contrary to general expectations, linear confound regression can increase the risk of confounding when combined with nonlinear ML approaches. Using a simple framework that uses the target as a confound, we show that information leaked via CR can increase null or moderate effects to near-perfect prediction. By shuffling the features, we provide evidence that this increase is indeed due to confound-leakage and not due to revealing of information. We then demonstrate the danger of confound-leakage in a real-world clinical application where the accuracy of predicting attention-deficit/hyperactivity disorder is overestimated using speech-derived features when using depression as a confound. CONCLUSIONS: Mishandling or even amplifying confounding effects when building ML models due to confound-leakage, as shown, can lead to untrustworthy, biased, and unfair predictions. Our expose of the confound-leakage pitfall and provided guidelines for dealing with it can help create more robust and trustworthy ML models.

Prolonged exposure to violence: Psychiatric symptoms and suicide risk among college students in the Palestinian territory.

Objective: Little is known about the risk for suicide in those exposed to prolonged political and domestic violence. Thus, this study aims to explore suicidal ideation and attempts in a community sample of Palestinian students and identify the extent to which clinical variables are associated with suicidal ideation. Method: A cross-sectional design was utilized in this study, and 303 college and university students aged 18 to 23 from seven campuses in the Palestinian territory voluntarily and anonymously completed self-report questionnaires that assessed 12 months of suicidal ideation and attempts, posttraumatic stress symptoms (PTSS), depression, anxiety, and sleep problems. Results: The results showed high rates of suicidal ideation and attempts within the last 12 months. Severe symptoms of PTSS, depression, and sleep problems were reported compared with other college samples. An exploratory path analysis showed that PTSS is directly associated with suicidal ideation and indirectly by its association with sleep problems and depressive symptoms. Conclusion: The results highlight the elevated mental health difficulties of students living under prolonged exposure to violence and could be helpful to policy and decision-makers in health care and academic institutions in implementing and design interventions aim to reduce depression and PTSS. Screening for PTSS and depression is a vital first step in suicide prevention efforts in college students exposed to trauma. Future studies should assess the types of traumatic stress exposure and health risk behaviors to offer a more in-depth view. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Pain Catastrophizing Mediates the Association Between Mindfulness and Psychological Distress in Chronic Pain Syndrome.

AIM: Trait mindfulness has been found to be inversely associated with emotional distress such as depression and anxiety among patients suffering from pain. The current study investigated the putative mechanisms underlying these associations by examining whether pain catastrophizing mediates the association between mindfulness and psychological distress and whether this model differs in patients suffering from chronic pain compared to patients experiencing nonchronic pain in a medical rehabilitation setting. METHODS: Forty-eight patients in their subacute stage of recovery participated in the study. Seventeen participants had a diagnosis of chronic pain. Trait mindfulness was assessed using the Mindful Attention Awareness Scale, pain catastrophizing was assessed using the Pain Catastrophizing Scale, depression symptoms were assessed using the Patient Health Questionnaire, and anxiety was assessed using the Generalized Anxiety Disorder scale. Two mediation models were used, with pain catastrophizing mediating the association between mindfulness and depression and anxiety. RESULTS: Catastrophizing significantly mediated the association between trait mindfulness and depression (P < 0.05, confidence interval [CI] = -0.35, -0.05). Catastrophizing also mediated the relationship between trait mindfulness and anxiety (P < 0.05, CI = -0.34, -0.04). Two moderated mediation models were tested, in which pain catastrophizing fully mediated the relationship between trait mindfulness and depression and anxiety, but only in patients with chronic pain. CONCLUSIONS: The negative association between trait mindfulness and psychological distress may thus be partly attributed to pain catastrophizing: individuals high in trait mindfulness engage in less catastrophic thinking and therefore experience less distress. Importantly, this was only observed in the patients with chronic pain. These results further underscore the need to cope with pain catastrophizing and encourage mindfulness among patients with chronic pain.

The associations between executive functions and different aspects of perceived pain, beyond the influence of depression, in rehabilitation setting.

We investigated the relations between several aspects of Perceived Pain (PP) and different measurements of Executive Functions (EFs), above the influence of depression, in the context of medical rehabilitation. Eighty-one neurologically intact patients participated in this study in their sub-acute stage of recovery. Different aspects of EFs were assessed using the Wisconsin Card Sorting Test (WCST), the Stop-Signal Test (SST) and the Digit Span Backward subtest of the WAIS-III (Span-B). Different aspects of PP were measured: Pain Disability Index (PDI), The Short-Form McGill Questionnaire (SF-MPQ) and the Pain Catastrophizing Scale (PCS). Depression symptoms were assessed using the Patient Health Questionnaire. The results indicate that irrespective of the presence of depression, mental flexibility is correlated with pain disability and pain severity (WSCT - PDI partial correlation: r = -.23; p=.047, WSCT - SF-MPQ partial correlation: r = -.31; p = .006). Response inhibition is correlated with pain disability (SST - PDI partial correlation: r = .37; p = .001). Updating was not correlated with any of the PP aspects. These results remain much the same after removing the chronic pain patients from the analyses. The present study emphasizes the multidimensional nature of the term "perceived pain", as well as the term "executive functions", and the relations between them.