Corrigendum: Effect of the nature of subsequent environment on oxytocin and cortisol secretion in maltreated children.

[This corrects the article DOI: 10.3389/fpsyt.2015.00173.].

The potentiality of telepsychiatry using a teleoperated robot for a patient with alcohol abuse on an isolated island.

Background: Providing medical care on isolated islands can be challenging in several ways. Telepsychiatry can potentially offer a solution for accessible psychiatric services on isolated islands. When video conferencing is used in telepsychiatry, the psychiatry specialist, who is remotely located, may find it difficult to establish trust. To address this, we developed a teleoperated robot system termed "Sota 100," which is equipped to convey various elements of nonverbal communication, such as eye contact, in remote settings. Case Presentation: In this report, we introduce the case of a patient with alcohol use disorder who lived on an isolated island and received medical care from a primary care physician at the island's medical clinic and from Sota 100 teleoperated by a psychiatry specialist. Using this system, the patient admitted that he had developed a physical illness and had damaged his relationships partly because of alcohol abuse. At the conclusion of the three-way conversation, the patient understood that stopping drinking alcohol was the only way to prevent worsening his physical condition and damaging his relationships further. Concurrently, the primary care physician gained a deeper understanding of the etiology of alcohol use disorder and of how to support patients with alcohol dependency. Conclusion: These case findings suggest that our system is helpful for patients with alcohol use disorder who need to receive telepsychiatry services. Future studies should include single-case experimental designs with regular measurements of key outcome variables and other relevant variables over time.

Language and sensory characteristics are reflected in voice-evoked responses in low birth weight children.

BACKGROUND: Children born with very low birth weight (VLBW) are at higher risk for cognitive impairment, including language deficits and sensorimotor difficulties. Voice-evoked response (P1m), which has been suggested as a language development biomarker in young children, remains unexplored for its efficacy in VLBW children. Furthermore, the relation between P1m and sensory difficulties in VLBW children remains unclear. METHODS: 40 children with VLBW were recruited at 5-to-6 years old (26 male, 14 female, mean age of months ± SD, 80.0 ± 4.9). We measured their voice-evoked brain response using child-customized magnetoencephalography (MEG) and examined the relation between P1m and language conceptual inference ability and sensory characteristics. RESULTS: The final sample comprised 36 children (23 boys, 13 girls; ages 61-86 months; gestational ages 24-36 weeks). As a result of multiple regression analysis, voice-evoked P1m in the left hemisphere was correlated significantly with language ability (ß = 0.414 P = 0.015) and sensory hypersensitivity (ß = 0.471 P = 0.005). CONCLUSION: Our findings indicate that the relation between P1m and language conceptual inference ability observed in term children in earlier studies is replicated in VLBW children, and suggests P1m intensity as a biomarker of sensory sensitivity characteristics. IMPACT: We investigated brain functions related to language development and sensory problems in very low birth-weight children. In very low birth weight children at early school age, brain responses to human voices are associated with language conceptual inference ability and sensory hypersensitivity. These findings promote a physiological understanding of both language development and sensory characteristics in very low birth weight children.

Self-administered questionnaires enhance emotion estimation of individuals with autism spectrum disorders in a robotic interview setting.

Background: Robots offer many unique opportunities for helping individuals with autism spectrum disorders (ASD). Determining the optimal motion of robots when interacting with individuals with ASD is important for achieving more natural human-robot interactions and for exploiting the full potential of robotic interventions. Most prior studies have used supervised machine learning (ML) of user behavioral data to enable robot perception of affective states (i.e., arousal and valence) and engagement. It has previously been suggested that including personal demographic information in the identification of individuals with ASD is important for developing an automated system to perceive individual affective states and engagement. In this study, we hypothesized that assessing self-administered questionnaire data would contribute to the development of an automated estimation of the affective state and engagement when individuals with ASD are interviewed by an Android robot, which will be linked to implementing long-term interventions and maintaining the motivation of participants. Methods: Participants sat across a table from an android robot that played the role of the interviewer. Each participant underwent a mock job interview. Twenty-five participants with ASD (males 22, females 3, average chronological age = 22.8, average IQ = 94.04) completed the experiment. We collected multimodal data (i.e., audio, motion, gaze, and self-administered questionnaire data) to train a model to correctly classify the state of individuals with ASD when interviewed by an android robot. We demonstrated the technical feasibility of using ML to enable robot perception of affect and engagement of individuals with ASD based on multimodal data. Results: For arousal and engagement, the area under the curve (AUC) values of the model estimates and expert coding were relatively high. Overall, the AUC values of arousal, valence, and engagement were improved by including self-administered questionnaire data in the classification. Discussion: These findings support the hypothesis that assessing self-administered questionnaire data contributes to the development of an automated estimation of an individual's affective state and engagement. Given the efficacy of including self-administered questionnaire data, future studies should confirm the effectiveness of such long-term intervention with a robot to maintain participants' motivation based on the proposed method of emotion estimation.

Therapeutic potential of robots for people who stutter: a preliminary study.

Introduction: Growing anecdotal evidence suggests the feasibility of robotic intervention for people who suffer from disorders related to state anxiety. Few studies have been conducted on utilizing robots for persons who stutter (PWS). The present study examines the feasibility of using a robot for speech therapy for PWS. Methods: We prepared four settings (i.e., interviews with unfamiliar persons, interviews with unfamiliar communication robots, reading sentences aloud with a tandem robot that can utter the same words as a user by repeating the user's voice after a short delay, and reading sentences aloud while being alone). We assessed the potential of the robots as both interlocutors and practice partners in training with delayed auditory feedback (DAF) for PWS. Moreover, we assessed the relationship between the trait of stuttering and the participants' affinity to the robots. Results: Eleven PWS participated in the study. Eight (72.7%) participants had fewer stuttering-related psychological symptoms when they communicated with robots than when they communicated with humans. Spearman's rank correlation analysis revealed that there was a significant negative correlation between the Modified Erickson Communication Attitude scale (S-24) and the difference between the scores for stuttering-related psychological symptoms pertaining to the communication robot and humans (p < 0.01). Six participants (54.5%) had fewer stuttering-related psychological symptoms when they read aloud with the tandem robot than when they read aloud alone. There were significant positive correlations between S-24 and the differences between the scores for stuttering-related psychological symptoms when reading aloud with the tandem robot and those when reading aloud alone (p < 0.01). Discussion: The communication robot and tandem utterance robot can sometimes be burdensome, although both robots were always easier to talk to for PWS in this preliminary study. The participants with positive speech-related attitudes were more inclined to decrease stuttering-related psychological symptoms when communicating with CommU than when communicating with humans. The participants whose speech-related attitudes were negative were more inclined to show a decrease in stuttering-related psychological symptoms when reading aloud with the tandem robot. Further studies are needed to provide more detailed information.

Development of depression assessment tools using humanoid robots -Can tele-operated robots talk with depressive persons like humans?

BACKGROUND: Depression is a common mental disorder and causes significant social loss. Early intervention for depression is important. Nonetheless, depressed patients tend to conceal their symptoms from others based on shame and stigma, thus hesitate to visit psychiatrists especially during early phase. We hypothesize that application of humanoid robots would be a novel solution. Depressed patients may feel more comfortable talking with such robots than humans. METHODS: We recruited 13 patients with major depressive disorder (MDD) and 27 healthy volunteers as controls. Participants took both tele-operated humanoid robot and human interviews to evaluate severity of depression using the Hamilton Depression Rating Scale (HDRS). In addition, participants completed a self-administered questionnaire asking about their impressions of the robot interview. RESULTS: Confidence interval and t-test analysis have revealed that the HDRS scores are equally reliable between robot and human interviews. No significant differences were observed between the two interviews regarding "nervousness about the interview" and "hesitancy to talk about depressed moods and suicidal ideation." Compared to human interviews, robot interviews yielded significantly lower scores on shame-related factors especially among patients with MDD. LIMITATION: Small sample size, and the evaluator is male only. CONCLUSIONS: This is the first report to show the reliability of tele-operated humanoid robot interviews for assessment of depression. Robot interviews are potentially equally reliable as human interviews. Robot interviews are suggested to be more appropriate in assessing shame-related suppressed emotions and hidden thoughts of depressed patients in clinical practice, which may reduce the stigma associated with depression.

Social skills training using multiple humanoid robots for individuals with autism spectrum conditions.

Introduction: Social skills training (SST) is used to help individuals with autism spectrum conditions (ASC) better understand the perspectives of others and social interactions, develop empathy skills, and learn how to engage with others socially. However, many individuals with ASC cannot easily sustain high motivation and concentration during such an intervention when it is administered by humans. We developed a social skills training program using multiple humanoid robots (STUH), including an android robot, that aimed to enable individuals with ASC to become familiar with the perspectives of others and improve their sociability and empathy skills. The objective of the present study was to investigate the effectiveness of STUH for these individuals. Methods: In STUH, we prepared 50 social exercises that consisted of conversations and behavioral interactions between an android robot and a simple humanoid robot. We prepared another humanoid robot that featured a cartoon-like and mechanical design, which played the role of host. In the first half-session of STUH, participants worked on the exercise from the perspective of an outsider. In the second half-session of STUH, they simulated experience by using robots as their avatars. The intervention associated with STUH was conducted for five days in total. We conducted an analysis of variance (ANOVA) featuring the intervention time point as the independent variable to examine changes in each score on the sociability index items. Results: In total, 14 individuals with ASC participated in the study. The results of multiple comparison tests using the Bonferroni method indicated that all sociability index items improved between preintervention and follow-up. Our program enabled the participants to become familiar with the perspectives of others and improve their sociability. Discussion: Given the promising results of this study, future studies featuring long-term follow-up should be conducted to draw definitive conclusions about the efficacy of our training system.

A new group-based online job interview training program using computer graphics robots for individuals with autism spectrum disorders.

Introduction: Job interviews are a major barrier to employment for individuals with autism spectrum disorders (ASD). During the coronavirus pandemic, establishing online job interview training at home was indispensable. However, many hurdles prevent individuals with ASD from concentrating on online job interview training. To facilitate the acquisition of interview skills from home for individuals with ASD, we developed a group interview training program with a virtual conferencing system (GIT-VICS Program) that uses computer graphics (CG) robots. Methods: This study investigated the feasibility of the GIT-VICS Program in facilitating skill acquisition for face-to-face job interviews in pre-post measures. In the GIT-VICS Program, five participants were grouped and played the roles of interviewees (1), interviewers (2), and human resources (2). They alternately practiced each role in GIT-VICS Program sessions conducted over 8 or 9 days over three consecutive weeks. Before and after the GIT-VICS Program, the participants underwent a mock face-to-face job interview with two experienced human interviewers (MFH) to evaluate its effect. Results: Fourteen participants completed the trial procedures without experiencing any technological challenges or distress that would have led to the termination of the session. The GIT-VICS Program improved their job interview skills (verbal competence, nonverbal competence, and interview performance). Discussion: Given the promising results of this study and to draw clear conclusions about the efficacy of CG robots for mock online job interview training, future studies adding appropriate guidance for manner of job interview by experts are needed.

Reduced gamma oscillation during visual processing of the mother's face in children with autism spectrum disorder: A pilot study.

Aim: This study aimed to investigate gamma oscillations related to face processing of children with autism spectrum disorders and typically developed children using magnetoencephalography. Methods: We developed stimuli that included naturalistic real-time eye-gaze situations between participants and their mothers. Eighteen young children with autism spectrum disorders (62-97 months) and 24 typically developed children (61-79 months) were included. The magnetoencephalography data were analyzed in the bilateral banks of the superior temporal sulcus, fusiform gyrus, and pericalcarine cortex for frequency ranges 30-59 and 61-90 Hz. The gamma oscillation normalized values were calculated to compare the face condition (children gazing at mother's face) and control measurements (baseline) using the following formula: (face - control)/(face + control). Results: The results revealed significant differences in gamma oscillation normalized values in the low gamma band (30-59 Hz) in the right banks of the superior temporal sulcus, right fusiform gyrus, and right pericalcarine cortex between children with autism spectrum disorders and typically developed children. Furthermore, there were significant differences in gamma oscillation normalized values in the high gamma band (61-90 Hz) in the right banks of the superior temporal sulcus, bilateral fusiform gyrus, and bilateral pericalcarine cortex between the groups. Conclusion: This report is the first magnetoencephalography study revealing atypical face processing in young children with autism spectrum disorders using relevant stimuli between participants and their mothers. Our naturalistic paradigm provides a useful assessment of social communication traits and a valuable insight into the underlying neural mechanisms in children with autism spectrum disorders.

Intervention with a humanoid robot avatar for individuals with social anxiety disorders comorbid with autism spectrum disorders.

For some individuals with social anxiety disorders (SAD) comorbid with autism spectrum disorders (ASD), it is difficult to speak in front of others. Herein, we report the case of a patient with SAD comorbid with ASD who could not speak in front of others until she used a humanoid robot as her avatar. During the intervention, her personality changed from shy to outgoing, which is explained by the Proteus effect. These case findings suggest that interventions with a robot avatar might improve the motivation for individuals with SAD comorbid with ASD who cannot speak in front of others to communicate.

Subjective achievement from psychiatry rotation in the Japanese postgraduate residency system: a longitudinal questionnaire study.

BACKGROUND: Psychiatry rotation has been mandatory in the Japanese postgraduate residency system since 2020. Some psychiatry-related competency items are stipulated as mandatory for residents. The current study aimed to clarify whether psychiatry rotation affected residents' subjective achievement of these competency items. METHODS: This longitudinal study was conducted among postgraduate residents who completed a rotation in the psychiatry department at Nagasaki University Hospital across two academic years (2020-2021). The survey was administered at the start and at the end of the psychiatry rotation. Residents evaluated their subjective understanding and confidence regarding initiating treatment for these competency items using a six-point Likert scale. The average scores for each item were compared between pre-rotation and post-rotation. RESULTS: In total, 99 residents (91.7%) responded to this survey. Residents had significantly higher scores at post-rotation compared with pre-rotation in all psychiatry-related competency items in both subjective understanding and confidence in initiating treatment. Additionally, strong effect sizes were found for many items. CONCLUSION: Residents improved learning about psychiatry-related competency items through psychiatry rotation. This finding suggests that it is reasonable for psychiatry rotation to be mandatory in the current Japanese postgraduate residency system. The importance of psychiatry is likely to increase in both undergraduate and postgraduate medical education in the future. It is necessary to continuously update educational strategies to meet changing social needs over time. As this study was conducted at a single institution, a multi-center study is needed to expand the current findings.

Android Robot Promotes Disclosure of Negative Narratives by Individuals With Autism Spectrum Disorders.

Many individuals with autism spectrum disorders (ASD) demonstrate some challenges with personal narrative writing. Sentence completion tests (SCT) is a class of semi-structured projective techniques and encourage respondents to disclose their private narratives. Even in SCT, only providing beginning of sentences is inadequate to compensate atypicalities in their creativity and imagination, and self-disclosure is difficult for many individuals with ASD. It is reported that many individuals with ASD often achieve a higher degree of task engagement through interactions with robots and that robotic systems may be useful in eliciting and promoting social communication such as self-disclosure for some individuals with ASD. There is a possibility that exemplification by android robots in place of human interviewers can result in a higher degree of task engagement for individuals with ASD. The objective of this study was to investigate whether additional exemplifications by android robots in the SCT can prompt self-disclosure for individuals with ASD. We compared the difference in disclosure statements and subjective emotion in the testing paper of the SCT in additional exemplification by an android robot and a human interviewer. In addition, we assessed the disclosure statements and subjective emotions in the SCT, for which exemplifications were written on testing paper to make the comparison. Our quantitative data suggested that exemplification by android robot promoted more self-disclosure, especially about the negative topic compared to exemplification by a human interviewer and that written on test paper. In addition, the level of participant embarrassment in response to exemplification by the android robot seemed to be lower compared to that in the human interviewer condition. In the assessment and support for individuals with ASD, eliciting self-disclosure is a pressing issue. It is hoped that the appropriate use of robots will lead to a better understanding and support for their application.

Differences in the Optimal Motion of Android Robots for the Ease of Communications Among Individuals With Autism Spectrum Disorders.

Android robots are employed in various fields. Many individuals with autism spectrum disorders (ASD) have the motivation and aptitude for using such robots. Interactions with these robots are structured to resemble social situations in which certain social behaviors can occur and to simulate daily life. Considering that individuals with ASD have strong likes and dislikes, ensuring not only the optimal appearance but also the optimal motion of robots is important to achieve smooth interaction and to draw out the potential of robotic interventions. We investigated whether individuals with ASD found it easier to talk to an android robot with little motion (i.e., only opening and closing its mouth during speech) or an android robot with much motion (i.e., in addition to opening and closing its mouth during speech, moving its eyes from side to side and up and down, blinking, deeply breathing, and turning or moving its head or body at random). This was a crossover study in which a total of 25 participants with ASD experienced mock interviews conducted by an android robot with much spontaneous facial and bodily motion and an android robot with little motion. We compared demographic data between participants who answered that the android robot with much motion was easier to talk to than android robot with little motion and those who answered the opposite. In addition, we investigated how each type of demographic data was related to participants' feeling of comfort in an interview setting with an android robot. Fourteen participants indicated that the android robot with little motion was easier to talk to than the robot with much motion, whereas 11 participants answered the opposite. There were significant differences between these two groups in the sensory sensitivity score, which reflects the tendency to show a low neurological threshold. In addition, we found correlations between the sensation seeking score, which reflects the tendency to show a high neurological threshold, and self-report ratings of comfort in each condition. These results provide preliminary support for the importance of setting the motion of an android robot considering the sensory traits of ASD.

Emotional and behavioral problems in Japanese preschool children with motor coordination difficulties: the role of autistic traits.

There has been little research on whether younger children with developmental coordination disorder (DCD) symptoms have an increased risk for emotional and behavioral problems. This study examined whether coordination difficulties are associated with emotional and behavioral problems (emotional symptoms, conduct problems, hyperactivity/inattention, peer problems, reduced prosocial behavior) in preschool children and the role of autistic traits in this association. Data (N = 1042, age 58-71 months) were analyzed from the Tama Children's Survey (TCS). The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was used to measure coordination difficulty symptoms. Information was obtained on emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) and on autistic traits with the Social Responsiveness Scale (SRS). Higher autistic traits were based on SRS cutoff scores (53.5 for boys and 52.5 for girls). Logistic regression analysis was used to assess associations between the variables. In adjusted models, children with probable DCD (pDCD) were significantly more likely to score above the clinical thresholds on all SDQ emotional/behavioral domains. However, nearly all of these associations became nonsignificant after including autistic traits in the analysis. Additional analyses showed that children with pDCD with higher autistic traits had significantly increased odds for emotional problems (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.52-13.19), hyperactivity/inattention (OR: 3.74, 95% CI: 1.45-9.64), peer problems (OR: 15.81, 95% CI: 5.96-41.99), and total difficulties (OR: 28.78, 95% CI: 7.23-114.57), compared to children with pDCD alone. These results indicate that the increased risk of emotional/behavioral difficulties in preschool children with pDCD might be mediated by autistic traits.

Brief Report: The Effectiveness of Hugging a Huggable Device Before Having a Conversation with an Unfamiliar Person for Autism Spectrum Disorders.

Sensory overresponsivity (SOR) emerges before anxiety and positively predicts subsequent increasing levels of anxiety in individuals with autism spectrum disorder (ASD). Sensory seeking behavior occurs as compensation for SOR, and individuals may seek sensory input in one sensory domain to compensate for SOR. Tactile seeking behavior is sufficient to decrease social anxiety in communicating with unfamiliar people. We assessed the effectiveness of hugging a huggable device before a conversation for reducing the psychological stress associated with speaking to an unfamiliar person or robot. Our analysis showed a significant effect, with Hugvie contributing to decreased stress for both interlocutors. Thus, this study demonstrated the efficacy of hugging it before conversation, which emphasizes the importance of tactile seeking for individuals with ASD.

Game-related behaviors among children and adolescents after school closure during the COVID-19 pandemic: A cross-sectional study.

Aim: Increased exposure to digital gaming content among youth in recent years has raised serious health concerns. Social restrictions such as school closures, imposed worldwide because of the ongoing COVID-19 pandemic, may increase exposure to gaming and lead to addictive gaming behavior in young people. In this study, we investigated gaming behaviors among Japanese students during COVID-19 school closures. Methods: Students completed questionnaires regarding their living conditions, game-related behaviors, diagnosis of Internet addiction, psychological difficulties, and the impact of the COVID-19 pandemic. We compared differences between the responses of potentially at risk for gaming disorder (potentially at risk for gaming disorder; defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder [PGD]) students who met the criteria for a diagnosis of gaming disorder in ICD-11 MMS and those of control students. Logistic regression analysis was performed to predict the extent of factors contributing to potential gaming disorder. Results: Four thousand and forty-eight participants completed the survey. Compared with control students (93%), potentially at risk for gaming disorder (defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder, PGD) students (7%) reported playing games for longer times, spending more money on in-game purchases, were of younger age at the start of game playing, showed a tendency toward Internet dependence, practised school avoidance or absenteeism, and demonstrated the need for psychological support. Moreover, participants in the PGD group reported more anxiety about COVID-19 than control participants, as well as an increase in game-playing time and amount of money spent on games during the COVID-19 pandemic. Conclusion: These results indicate that young people classified as having a gaming disorder not only exhibit characteristic game-related behaviors but may be psychologically and socially vulnerable and need special support, especially during the ongoing COVID-19 pandemic.

Effects of familiarity on child brain networks when listening to a storybook reading: A magneto-encephalographic study.

Parent-child book reading is important for fostering the development of various lifelong cognitive and social abilities in young children. Despite numerous reports describing the effects of familiarity on shared reading for children, the exact neural basis of the functional network architecture remains unclear. We conducted Magnet-Encephalographic (MEG) experiments using graph theory to elucidate the role of familiarity in shared reading in a child's brain network and to measure the connectivity dynamics of a child while Listening to Storybook Reading (LSBR), which represents the daily activity of shared book reading between the child and caregiver. The LSBR task was performed with normally developing preschool- and school-age children (N = 15) under two conditions: reading by their own mother (familiar condition) vs. an experimenter (unfamiliar condition). We used the phase lag index (PLI), which captures synchronization of MEG signals, to estimate functional connectivity. For the whole brain network topology, an undirected weighted graph was produced using 68 brain regions as nodes and interregional PLI values as edges for five frequency bands. Behavioral data (i.e., the degree of attention and facial expressions) were evaluated from video images of the child's face during the two conditions. Our results showed enhanced widespread functional connectivity in the alpha band during the mother condition. In the mother condition, the whole brain network in the alpha band exhibited topographically high local segregation with high global integration, indicating an increased small-world property. Results of the behavioral analysis revealed that children were more attentive and showed more positive facial expressions in the mother condition than in the experimenter condition. Behavioral data were significantly correlated with graph metrics in the mother condition but not in the experimenter condition. In this study, we identified the neural correlates of a familiarity effect in children's brain connectivity dynamics during LSBR. Furthermore, these familiarity-related brain dynamics were closely linked to the child's behavior. Graph theory applied to MEG data may provide useful insight into the familiarity-related child brain response in a naturalistic setting and its relevance to child attitudes.

A huggable device can reduce the stress of calling an unfamiliar person on the phone for individuals with ASD.

Individuals with autism spectrum disorders (ASD) are often not comfortable during mobile-phone conversations with unfamiliar people. "Hugvie" is a pillow with a human-like shape that has been designed to provide users with the tactile sensation of hugging another person during phone conversations to promote feelings of comfort and trust in the speaker toward their conversation partners. Our primary aim was to examine whether physical contact by hugging a Hugvie could reduce the stress of speaking with an unfamiliar person on the phone in individuals with ASD. We enrolled 24 individuals and requested them to carry out phone conversations either using only a mobile phone or using a mobile phone along with the Hugvie. All participants in both groups completed questionnaires designed to evaluate their self-confidence while talking on the phone, and also provided salivary cortisol samples four times each day. Our analysis revealed that the medium of communication was a significant factor, indicating that individuals with ASD who spoke with an unfamiliar person on the phone while hugging a Hugvie had stronger self-confidence and lower stress levels than those who did not use Hugvie. Hence, we recommend that huggable devices be used as adjunctive tools to support individuals with ASD during telephonic conversations with unfamiliar people.