Unravelling the link between media multitasking and attention across three samples.

A negative link between media multitasking and sustained attention has been proposed; yet, whether such a link exists remains hotly debated as previous studies found mixed effects. The present study seeks to evaluate the size of this effect taking into account possible variations due to how media multitasking is measured, how sustained attention is assessed, and the origin of the samples. Using an established and a novel, shortened measure for media multitasking, 924 participants were recruited through three different platforms (MTurk, Prolific and university students). In addition to questionnaire- and task-based assessments for sustained attention, impulsivity and sensation seeking were also assessed to further qualify behavioral problems associated with media multitasking. The findings establish a negative link between media multitasking and sustained attention of a medium effect size, whether questionnaires (r =.20) or a task-based measure (r =.21) are used. Importantly, the findings support the notion that previous differences across studies can be at least partly attributed to the choice of media multitasking measure as well as differences across samples.

Social Media Use, Social Media Stress, and Sleep: Examining Cross-Sectional and Longitudinal Relationships in Adolescents.

There are concerns that social media (SM) use and SM stress may disrupt sleep. However, evidence on both the cross-sectional and longitudinal relationships is limited. Therefore, the main aim of this study is to address this gap in the literature by examining the cross-sectional and longitudinal relationships between SM use, SM stress, and sleep (i.e., sleep latency and daytime sleepiness) in adolescents. In total, 1,441 adolescents 11-15 years, 51% boys) filled out a survey in at least one of three waves that were three to four months apart (NWave1 = 1,241; NWave2 = 1,216; NWave3 = 1,103). Cross-sectionally, we found that SM use and SM stress were positively related to sleep latency and daytime sleepiness. However, when examined together, SM use was not a significant predictor of sleep latency and daytime sleepiness above the effects of SM stress. The longitudinal findings showed that SM stress was positively related to subsequent sleep latency and daytime sleepiness, but only among girls. Our findings stress that it is important to focus on how adolescents perceive and cope with their SM use, instead of focusing on the mere frequency of SM use.

Norms of online expressions of emotion: Comparing Facebook, Twitter, Instagram, and WhatsApp.

The main aim of this study was to examine the norms of expressing emotions on social media. Specifically, the perceived appropriateness (i.e. injunctive norms) of expressing six discrete emotions (i.e. sadness, anger, disappointment, worry, joy, and pride) was investigated across four different social media platforms. Drawing on data collected in March 2016 among 1201 young Dutch users (15-25 years), we found that positive expressions were generally perceived as more appropriate than negative expressions across all platforms. In line with the objective of the study, some platform differences were found. The expression of negative emotions was rated as most appropriate for WhatsApp, followed by Facebook, Twitter, and Instagram. For positive emotion expression, perceived appropriateness was highest for WhatsApp, followed by Instagram, Facebook, and Twitter. Additionally, some gender differences were found, while age showed little variations. Overall, the results contribute to a more informed understanding of emotion expression online.

A psychometric evaluation of the Dutch Short Health Anxiety Inventory in the general population.

Distress or anxiety about health is known as health anxiety. One of the most widely used scales to measure health anxiety is the Short Health Anxiety Inventory (SHAI; Salkovskis, Rimes, Warwick, & Clark, 2002). The current study contributes to both the applicability and understanding of the SHAI by making 5 interrelated methodological contributions: (a) developing a Dutch translation of the SHAI, (b) validating this translation in the Dutch general population, (c) comprehensively examining its factor structure, (d) examining predictive validity and test-retest reliability of test scores, and (e) testing measurement invariance across subsamples and over time and comparing SHAI scores in subsamples of healthy and ill individuals and males and females. Data were collected from 5,310 respondents in 2 consecutive waves with a 2-month time gap. The results revealed that the SHAI comprises 2 factors: Illness Likelihood (14 Items) and Negative Consequences of Illness (4 Items). Further empirical evidence for the measurement invariance of this factor structure across subsamples and over time was revealed, as well as predictive validity, internal consistency and test-retest reliability of test scores, thereby proving that it is a useful tool for measuring health anxiety in the general Dutch population. On the basis of our results, we recommend that the 14-item SHAI, that is, the Illness Likelihood subscale, be adopted to measure health anxiety in future studies. We suggest slight adaptations to some answer options and argue that the benefit of adding the Negative Consequences of Illness subscale is debatable. (PsycINFO Database Record

The curious case of cyberchondria: A longitudinal study on the reciprocal relationship between health anxiety and online health information seeking.

The current study is the first to longitudinally investigate the reciprocal relationship between online health information seeking and health anxiety, i.e., cyberchondria. Expectations were that health anxious individuals who go online to find health information, experience an increase in health anxiety, which in turn will reinforce online seeking. A 4-wave longitudinal survey study among 5322 respondents aged 16-93 was conducted. Our results showed that individuals who are more health anxious than others, search online for health information more. Moreover, the results provided initial evidence for the expected reciprocal relationship between health anxiety and online health information seeking in respondents with non-clinical levels of health anxiety at the start of the study. However, this reciprocal relationship could not be found in a subsample of clinically health anxious individuals. Although for these individuals online health information seeking did not seem to exacerbate health anxiety levels, it might still serve as a maintaining factor of clinical health anxiety.

Therapeutic Alliance in Patients With Schizophrenia: Introduction of a New Rating Instrument.

OBJECTIVE: The quality of the patient-psychiatrist relationship can be seen as a cornerstone of adherence to medications in patients with chronic psychiatric disorders. Although therapeutic alliance in psychotherapy has been investigated broadly, it has received little attention in the context of medication adherence. The goal of this study was to develop and validate a user-friendly questionnaire for the assessment of therapeutic alliance in clinically stable outpatients with schizophrenia. METHODS: The "Brief Questionnaire on Therapeutic Alliance" (BQTA) addresses both the physician and the patient, each of whom responds to 5 items that focus on important domains of the therapeutic alliance. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) and patients' attitudes toward the illness and medication were assessed using the Drug Attitude Inventory (DAI). RESULTS: A total of 61 patients who met ICD-10 criteria for schizophrenia spectrum disorders and their treating psychiatrists were included in the study. Overall, patients and psychiatrists gave high (ie, favorable) ratings on all BQTA items. The 5 patient-related items showed high internal consistency (Cronbach α=0.77), whereas physician-related items showed slightly less internal consistency (Cronbach α=0.68). The concordance between patient and physician ratings was fair, although statistically significant (κ=0.33, P=0.007). Physicians' total score on the BQTA was moderately correlated with patients' PANSS total score and with the DAI total score and its compliance subscale, whereas patients' total score on the BQTA did not correlate with DAI or PANSS scores. CONCLUSION: The BQTA was found to cover crucial aspects of the doctor-patient relationship in chronically ill individuals with schizophrenia. Further validation will shed more light on the usefulness of this questionnaire.

Bilirubin concentration correlates with positive symptoms in patients with schizophrenia.

OBJECTIVE: Besides its toxic effects, bilirubin has been demonstrated to have antioxidant properties to counteract oxidative stress, which has been suggested to play a role in the pathophysiology of schizophrenia. METHODS: This study investigated the potential association between changes in psychopathology measured by the Lindenmayer model of the Positive and Negative Syndrome Scale (PANSS) and changes in total plasma bilirubin concentrations. Data of patients with schizophrenia (ICD-10) starting monotherapy with a new-generation antipsychotic were analyzed at baseline (N = 52) and 2 (n = 40), 4 (n = 46), and 12 weeks (n = 30) after the initiation of treatment. Data were collected between December 1997 and October 2007 and analyzed retrospectively. RESULTS: The PANSS total score decreased significantly from baseline to weeks 2, 4, and 12 of treatment (all P values ≤ .001). Total plasma bilirubin concentration also dropped significantly from baseline to week 2 (P = .015) and decreased further until week 4 (P = .013); no significant decrease was observed between baseline and week 12. Spearman rank correlation revealed a significant association of bilirubin concentration with the PANSS positive (r = 0.371, P = .007) and excitement (r = 0.322, P = .020) components at baseline. No further correlations were found. From baseline to weeks 2, 4, and 12, changes in the PANSS positive component correlated significantly with changes in plasma bilirubin concentration (all P values < .05), whereas correlations between changes in the remaining PANSS components and bilirubin were less consistent. CONCLUSIONS: Assuming that positive symptoms are associated with the subjective experience of psychological distress, our findings indirectly expand the evidence on potential antioxidant properties of bilirubin in patients with schizophrenia.

Changes in psychopathology in schizophrenia patients starting treatment with new-generation antipsychotics: therapeutic drug monitoring in a naturalistic treatment setting.

Previous studies on the relationship between plasma levels of new-generation antipsychotics (NGAs) and clinical response did not account for inter- and intra-individual variability in drug levels. Therefore, the present study calculated the ratio of observed versus expected NGA plasma levels and investigated its relationship with changes in the Positive and Negative Syndrome Scale (PANSS). Data of patients starting monotherapy with a NGA were collected 2, 4, 8, and 12 weeks after initiation of treatment. Next to the assessment of changes in psychopathology (PANSS) the ratio of observed versus expected plasma level was calculated. A total number of 221 ratios were eligible for analysis. About half of them ranged from 0.5-2 and were considered "normal", whereas the others were considered either "too low" or "too high". Psychopathological symptoms improved over the course of treatment, but changes in PANSS from baseline did not correlate significantly with the ratios of observed versus expected plasma levels at any assessment. The lack of linear correlation can be explained by the fact that 92% of the observed NGA plasma levels were at ≥ 50% of the lower limit of the therapeutic reference range, i.e., within the asymptote of the logistic plasma level-effect relationship. Accordingly, our findings indicate that the great majority of patients were treated with NGA doses that led to optimal plasma levels, based on the clinical impression of the treating psychiatrist only. Thus, calculating the ratio of observed versus expected plasma level may not be necessary in a routine clinical setting.

Prosodic and semantic affect perception in remitted patients with bipolar I disorder.

OBJECTIVE: Bipolar disorder is associated with impairments in emotion processing that are present during both mood episodes and periods of remission. In this context, most previous studies have investigated facial emotion recognition abilities. In contrast, the current study focused on the perception of prosodic and semantic affect. METHOD: The present study directly contrasted the perception of prosodic and semantic affect in 58 remitted patients meeting DSM-IV criteria for bipolar I disorder and 45 healthy volunteers by using 2 subtests of the Comprehensive Affective Testing System (CATS) and investigated the relationship of prosodic and semantic affect perception with patients' outcomes. Participants were investigated from June 2011 until May 2013. RESULTS: Patients and controls did not differ regarding the recognition of the vocal emotion while ignoring the affective meaning of test trials (CATS 1), but patients significantly more often misinterpreted sad as happy prosody (P = .039). In addition, patients were impaired in recognizing the affective meaning of test trials while ignoring the vocal emotion (CATS 2; P = .052). Again, they significantly more often misinterpreted a sad affective meaning as a happy one (P = .025). However, the findings on misinterpretations did not withstand Bonferroni correction for multiple testing. CATS 1 test performance was negatively correlated with depression scores, whereas a positive association was found between performance on both tests and patients' functioning. Patients indicated a significantly lower quality of life (P < .001); however, multiple mediation analysis revealed that this finding was not mediated by differences in prosodic and/or semantic affect perception between the 2 groups. CONCLUSIONS: Even during periods of remission, patients with bipolar disorder may be impaired in semantic but not prosodic affect perception. Notably, they may frequently misinterpret sadly expressed emotions as happy ones. Our findings underscore the relevance of these deficits in the psychosocial context.

Affective prosody perception in symptomatically remitted patients with schizophrenia and bipolar disorder.

Affect perception has frequently been shown to be impaired in patients suffering from schizophrenia or bipolar disorder (BD), but it remains unclear whether these impairments exist during symptomatic remission and whether the two disorders differ from each other in this regard. Most previous studies have investigated facial affect recognition, but not the ability to decode mental states from emotional tone of voice, i.e. affective prosody perception (APP). Accordingly, the present study directly compared APP in symptomatically remitted patients with schizophrenia or BD and healthy control subjects and investigated its relationship with residual symptomatology in patients. Patients with schizophrenia and BD showed comparable APP impairments despite being symptomatically remitted. In comparison to healthy control subjects, overall APP deficits were found in BD but not in schizophrenia patients. Both patient groups were particularly impaired in the identification of anger and confounded it with neutral prosody. In addition, schizophrenia patients frequently confused sadness with happiness, anger, or fright. There was an inverse association between the degree of residual positive symptoms and the ability to correctly recognize happiness in schizophrenia patients. Overall, these data indicate that impairments in APP represent an enduring deficit and a trait marker of both schizophrenia and BD and that the level of impairment is comparable between disorders.

Facial affect recognition in symptomatically remitted patients with schizophrenia and bipolar disorder.

Both schizophrenia and bipolar disorder (BD) have consistently been associated with deficits in facial affect recognition (FAR). These impairments have been related to various aspects of social competence and functioning and are relatively stable over time. However, individuals in remission may outperform patients experiencing an acute phase of the disorders. The present study directly contrasted FAR in symptomatically remitted patients with schizophrenia or BD and healthy volunteers and investigated its relationship with patients' outcomes. Compared to healthy control subjects, schizophrenia patients were impaired in the recognition of angry, disgusted, sad and happy facial expressions, while BD patients showed deficits only in the recognition of disgusted and happy facial expressions. When directly comparing the two patient groups individuals suffering from BD outperformed those with schizophrenia in the recognition of expressions depicting anger. There was no significant association between affect recognition abilities and symptomatic or psychosocial outcomes in schizophrenia patients. Among BD patients, relatively higher depression scores were associated with impairments in both the identification of happy faces and psychosocial functioning. Overall, our findings indicate that during periods of symptomatic remission the recognition of facial affect may be less impaired in patients with BD than in those suffering from schizophrenia. However, in the psychosocial context BD patients seem to be more sensitive to residual symptomatology.

Identifying teens at risk: developmental pathways of online and offline sexual risk behavior.

OBJECTIVES: The aims of this study were (1) to investigate the prevalence and development of both online (OnSRB) and offline sexual risk behavior (OffSRB) in adolescence, (2) to establish whether OnSRBs and OffSRBs are related, and (3) to identify risk factors that determine problematic pathways of OnSRB and OffSRB. METHODS: A 4-wave longitudinal study with 1762 Dutch adolescents aged 12 to 18 was conducted (mean age, T1 = 14.52, 49% girls). By using group-based modeling, developmental pathways for OnSRB and OffSRB were identified and the relationship between both behaviors over time was examined. RESULTS: Substantial intraindividual differences in the development of OnSRB and OffSRB were found. The analysis revealed 3 developmental pathways of OnSRB: no risk (70.2%), moderate risk (23.7%), and high risk (6.1%). For OffSRB, we identified a no risk (90.6%) and an increasing pathway (9.4%). OnSRBs and OffSRBs were related and had common predictors (ie, sensation seeking, low educational level, gender). CONCLUSIONS: Only a minority of adolescents shows sustained high OnSRB. This group is likely to consist of low-educated, high-sensation-seeking adolescents who spend more time communicating on the Internet and come from less cohesive families. These same adolescents are also more likely to engage in OffSRB. Preventions should focus on these adolescents.

Developmental trajectories of peer victimization: off-line and online experiences during adolescence.

PURPOSE: This study investigated the development and consequences of off-line and online victimization during adolescence. We examined the number and shapes of off-line and online victimization trajectories, the relationship between trajectories of off-line and online victimization, and their effect on life satisfaction. METHODS: A four-wave panel study with 6-month time intervals was conducted among a representative sample of Dutch adolescents aged 12-17 years (N = 1,762). We used group-based modeling to investigate the victimization trajectories. RESULTS: Three off-line victimization trajectories could be distinguished. One group followed a trajectory of low to no victimization experiences across adolescence. A second group followed a pathway of moderate and decreasing victimization. A third group followed a pathway of high and decreasing victimization. Two groups in online victimization could be distinguished. One group followed a trajectory of low to no victimization experiences. A second group followed a pathway of moderate victimization that peaked at age 14. Dual-trajectory analyses revealed a substantial overlap between off-line and online victimization trajectories. Finally, victimization and life satisfaction were longitudinally related; moderate and high victimization trajectories resulted in lower levels of life satisfaction during wave 4. CONCLUSIONS: The overlap between the off-line and online victimization trajectories and their negative consequences on life satisfaction suggests that prevention of victimization should focus on both types of victimization. The results suggest that peer victimization should not be studied without considering adolescent peer relationships on the Internet.

Combined clozapine and electroconvulsive therapy in clozapine-resistant schizophrenia: clinical and cognitive outcomes.

For treatment-refractory schizophrenia, electroconvulsive therapy (ECT) remains controversial because of its cognitive adverse effects. We report here on clinical and cognitive outcomes of a treatment-resistant schizophrenia patient treated with clozapine and right unilateral ECT.The patient was administered 300 mg of clozapine and 12 right unilateral ECT sessions. Psychopathology was rated by means of the Positive and Negative Syndrome Scale. The neurocognitive test battery included the Wisconsin Card Sorting Test, the Münchner Gedächtnis Test, an attentional performance test, the Trail Making Test, and the Hamburger-Wechsler Intelligence Test.The Positive and Negative Syndrome Scale total score decreased, and all cognitive measures improved.Electroconvulsive therapy would seem to be a safe treatment option for treatment-refractory schizophrenia patients.

Facial emotion recognition and its relationship to subjective and functional outcomes in remitted patients with bipolar I disorder.

OBJECTIVES: Outcome in bipolar disorder (BD) is multidimensional and consists of clinical and psychosocial domains. Difficulties in affect recognition and in emotional experience are a hallmark of BD, but there is little research investigating the consequences of this deficit on the psychosocial status of patients who are in remission. METHODS: This cross-sectional study examined the relationship of facial affect recognition and treatment outcomes in terms of psychopathology, quality of life, and psychosocial functioning in remitted BD patients compared to healthy volunteers. RESULTS: Altogether, 47 outpatients meeting diagnostic criteria for bipolar I disorder according to DSM-IV and 45 healthy control subjects were included in the study. Patients were particularly impaired in the recognition of facial expressions depicting disgust and happiness. For patients, the most frequently observed misidentifications included disgusted faces misrecognized as angry expressions, fearful faces misrecognized as disgusted or surprised expressions, surprised faces misrecognized as fearful expressions, and sad faces misrecognized as fearful or angry expressions. Regarding emotional experience, shame, guilt, sadness, fear, lifelessness, loneliness, and existential fear were experienced more intensely by patients. CONCLUSIONS: These findings demonstrate deficits in experiencing and recognizing emotions in BD patients who are in remission and underscore the relevance of these deficits in the psychosocial context.

The influence of descriptive and injunctive peer norms on adolescents' risky sexual online behavior.

The aim of this study was to investigate the influence of descriptive and injunctive peer norms on the engagement in risky sexual online behavior. A four-wave longitudinal study among a representative sample of 1,016 Dutch adolescents (12-17 years old) was conducted. Two autoregressive cross-lagged structural equation models were analyzed to investigate the relationship between perceptions of peer norms and risky sexual online behavior. The findings of this study indicate that both, descriptive and injunctive peer norms, predicted adolescents' engagement in risky sexual online behavior. The effect of descriptive peer norms was stronger and more consistent over the four waves. As expected, perceptions of peer norms were predictors, but not consequences, of risky sexual online behavior. The findings suggest that problematic behaviors on the Internet are influenced by perceptions of what peers do, or approve of, in ways similar to offline risk behaviors.

The role of health anxiety in online health information search.

This article is one of the first to empirically explore the relationship between health anxiety and online health information search. Two studies investigate how health anxiety influences the use of the Internet for health information and how health anxious individuals respond to online health information. An exploratory survey study with 104 Dutch participants indicates that health anxiety is related to an increase in online health information search. Moreover, results suggest that health anxious individuals experience more negative consequences from online health information search. Findings from an experimental study (n=120) indicate that online health information results in greater worries among health anxious individuals compared to nonhealth anxious individuals only if the information stems from a trustworthy governmental Web site. Information from a less trustworthy online forum does not lead to greater worries among health anxious individuals. In sum, the Internet appears to play a pivotal role in the lives of health anxious individuals.

Prolactin levels and sexual adverse effects in patients with schizophrenia during antipsychotic treatment.

OBJECTIVE: Patients with schizophrenia often experience sexual dysfunction (SD), to which disorder-related factors like negative symptoms and nondisorder-related factors can theoretically contribute. Thus, we investigated the correlation of SD and serum prolactin level in patients with schizophrenia during antipsychotic treatment. METHODS: We included 39 patients with schizophrenia with a mean age of 34.6 years who were switched to second-generation antipsychotics into the study. Sexual adverse effects (via a specific scale) and serum prolactin levels were measured at baseline and week 4. RESULTS: In males, mean prolactin levels increased over 4 weeks at a trend level of significance. Although a high incidence of SD was reported at baseline, there were no statistically significant changes over the course of 4 weeks. At baseline, a positive correlation between diminished sexual desire and prolactin levels could be found in men, which was not found in women; at week 4, both male and female patients demonstrated a positive correlation between orgastic dysfunction and prolactin levels. We found significant positive correlations between changes in prolactin levels over 4 weeks and changes in orgastic dysfunction for both sexes. Regression analyses showed prolactin levels at baseline to be a predictor of diminished sexual desire in men. Change in prolactin level was found to be a predictor of change for diminished sexual desire in women and for orgastic dysfunction in both sexes. CONCLUSION: We conclude that the potential of antipsychotics to increase serum prolactin levels imposes a certain risk that patients will experience SD of varying severity.

Assessing causality in the relationship between adolescents' risky sexual online behavior and their perceptions of this behavior.

The main aim of this study was to investigate the causal nature of the relationship between adolescents' risky sexual behavior on the internet and their perceptions of this behavior. Engagement in the following online behaviors was assessed: searching online for someone to talk about sex, searching online for someone to have sex, sending intimate photos or videos to someone online, and sending one's telephone number and address to someone exclusively known online. The relationship between these behaviors and adolescents' perceptions of peer involvement, personal invulnerability, and risks and benefits was investigated. A two-wave longitudinal study among a representative sample of 1,445 Dutch adolescents aged 12-17 was conducted (49% females). Autoregressive cross-lagged structural equation models revealed that perceived peer involvement, perceived vulnerability, and perceived risks were all significant predictors of risky sexual online behavior 6 months later. No reverse causal paths were found. When the relationships between perceptions and risky sexual online behavior were modeled simultaneously, only perceived peer involvement was a determinant of risky sexual online behavior. Findings highlight the importance of addressing peer involvement in future interventions to reduce adolescents' risky sexual online behavior.