Contextual and historical factors for increased levels of anxiety and depression in patients with head and neck cancer: A prospective longitudinal study.

BACKGROUND: This study aimed at examining predictors of clinical anxiety and depressive symptoms in patients with head and neck cancer (HNC) at 3, 6, and 12 months post-diagnosis, with a particular interest in contextual and historical factors. METHODS: Prospective longitudinal study of 219 consecutive patients newly diagnosed with a first occurrence of primary HNC, including psychometric measures, Structured Clinical Interview for DSM-IV Diagnoses (SCID), and medical chart reviews. RESULTS: Point prevalence of clinical anxiety symptoms (Hospital Anxiety and Depression Scale-Anxiety subscale) was 32.0%, 21.9%, 12.1%, and 12.6% at baseline, 3, 6, and 12 months; and clinical depressive symptoms on the Depression Subscale was 19.4%, 21.9%, 13.5%, and 9.2%, respectively. Predictors of anxiety and depressive symptoms included upon diagnosis SCID major depressive or anxiety disorder, stressful life events in previous year, neuroticism, and levels of anxiety and depressive symptoms upon cancer diagnosis. CONCLUSIONS: This study emphasizes the predictive contribution of broader personal contextual and historical factors that increase psychological vulnerability in HNC and merit consideration.

Phasic and sustained interactions of multisensory interplay and temporal expectation.

Every moment organisms are confronted with complex streams of information which they use to generate a reliable mental model of the world. There is converging evidence for several optimization mechanisms instrumental in integrating (or segregating) incoming information; among them are multisensory interplay (MSI) and temporal expectation (TE). Both mechanisms can account for enhanced perceptual sensitivity and are well studied in isolation; how these two mechanisms interact is currently less well-known. Here, we tested in a series of four psychophysical experiments for TE effects in uni- and multisensory contexts with different levels of modality-related and spatial uncertainty. We found that TE enhanced perceptual sensitivity for the multisensory relative to the best unisensory condition (i.e. multisensory facilitation according to the max-criterion). In the latter TE effects even vanished if stimulus-related spatial uncertainty was increased. Accordingly, computational modelling indicated that TE, modality-related and spatial uncertainty predict multisensory facilitation. Finally, the analysis of stimulus history revealed that matching expectation at trial n-1 selectively improves multisensory performance irrespective of stimulus-related uncertainty. Together, our results indicate that benefits of multisensory stimulation are enhanced by TE especially in noisy environments, which allows for more robust information extraction to boost performance on both short and sustained time ranges.