Network analysis of depressive and anxiety symptoms in older Chinese adults with diabetes mellitus.

Background: The move away from investigating mental disorders as whole using sum scores to the analysis of symptom-level interactions using network analysis has provided new insights into comorbidities. The current study explored the dynamic interactions between depressive and anxiety symptoms in older Chinese adults with diabetes mellitus (DM) and identified central and bridge symptoms in the depression-anxiety network to provide potential targets for prevention and intervention for depression and anxiety. Methods: This study used a cross-sectional design with data from the 2017-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A regularized partial correlation network for depressive and anxiety symptoms was estimated based on self-reported scales completed by 1685 older adults with DM aged 65 years or older. Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the Seven-Item Generalized Anxiety Disorder Scale (GAD-7), respectively. Expected influence (EI) and bridge expected influence (BEI) indices were calculated for each symptom. Results: According to cutoff scores indicating the presence of depression and anxiety, the prevalences of depression and anxiety in our sample were 52.9% and 12.8%, respectively. The comorbidity rate of depression and anxiety was 11.5%. The six edges with the strongest regularized partial correlations were between symptoms from the same disorder. "Feeling blue/depressed", "Nervousness or anxiety", "Uncontrollable worry", "Trouble relaxing", and "Worry too much" had the highest EI values. "Nervousness or anxiety" and "Everything was an effort" exhibited the highest BEI values. Conclusion: Central and bridge symptoms were highlighted in this study. Targeting these symptoms may be effective in preventing the comorbidity of depressive and anxiety symptoms and facilitate interventions in older Chinese adults with DM who are at risk for or currently have depressive and anxiety symptoms.

A new perspective for evaluating the efficacy of tACS and tDCS in improving executive functions: A combined tES and fNIRS study.

BACKGROUND: Executive function enhancement is considered necessary for improving the quality of life of patients with neurological or psychiatric disorders, such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder and Alzheimer's disease. Transcranial electrical stimulation (tES) has been shown to have some beneficial effects on executive functioning, but the quantification of these improvements remains controversial. We aimed to explore the potential beneficial effects on executive functioning induced by the use of transcranial alternating current stimulation (tACS)/transcranial direct current stimulation (tDCS) on the right inferior frontal gyrus (IFG) and the accompanying brain function variations in the resting state. METHODS: We recruited 229 healthy adults to participate in Experiments 1 (105 participants) and 2 (124 participants). The participants in each experiment were randomly divided into tACS, tDCS, and sham groups. The participants completed cognitive tasks to assess behavior related to three core components of executive functions. Functional near-infrared spectroscopy (fNIRS) was used to monitor the hemodynamic changes in crucial cortical regions in the resting state. RESULTS: Inhibition and cognitive flexibility (excluding working memory) were significantly increased after tACS/tDCS, but there were no significant behavioral differences between the tACS and tDCS groups. fNIRS revealed that tDCS induced decreases in the functional connectivity (increased neural efficiency) of the relevant cortices. CONCLUSIONS: Enhancement of executive function was observed after tES, and the beneficial effects of tACS/tDCS may need to be precisely evaluated via brain imaging indicators at rest. tDCS revealed better neural benefits than tACS during the stimulation phase. These findings might provide new insights for selecting intervention methods in future studies and for evaluating the clinical efficacy of tES.

Questionnaires based on natural language processing elicit immersive ruminative thinking in ruminators: Evidence from behavioral responses and EEG data.

Rumination is closely related to mental disorders and can thus be used as a marker of their presence or a predictor of their development. The presence of masking and fabrication in psychological selection can lead to inaccurate detection of psychological disorders. Human language is considered crucial in eliciting specific conscious activities, and the use of natural language processing (NLP) in the development of questionnaires for psychological tests has the potential to elicit immersive ruminative thinking, leading to changes in neural activity. Electroencephalography (EEG) is commonly used to detect and record neural activity in the human brain and is sensitive to changes in brain activity. In this study, we used NLP to develop a questionnaire to induce ruminative thinking and then recorded the EEG signals in response to the questionnaire. The behavioral results revealed that ruminators exhibited higher arousal rates and longer reaction times, specifically in response to the ruminative items of the questionnaire. The EEG results showed no significant difference between the ruminators and the control group during the resting state; however, a significant alteration in the coherence of the entire brain of the ruminators existed while they were answering the ruminative items. No differences were found in the control participants while answering the two items. These behavioral and EEG results indicate that the questionnaire elicited immersive ruminative thinking, specifically in the ruminators. Therefore, the questionnaire designed using NLP is capable of eliciting ruminative thinking in ruminators, offering a promising approach for the early detection of mental disorders in psychological selection.

Trait anxiety affects attentional bias to emotional stimuli across time: A growth curve analysis.

Many studies have illustrated the close relationship between anxiety disorders and attentional functioning, but the relationship between trait anxiety and attentional bias remains controversial. This study examines the effect of trait anxiety on the time course of attention to emotional stimuli using materials from the International Affective Picture System. Participants with high vs. low trait anxiety (HTA vs. LTA) viewed four categories of pictures simultaneously: dysphoric, threatening, positive, and neutral. Their eye-movements for each emotional stimulus were recorded for static and dynamic analysis. Data were analyzed using a mixed linear model and growth curve analysis. Specifically, the HTA group showed a greater tendency to avoid threatening stimuli and more pupil diameter variation in the early period of stimulus presentation (0-7.9 s). The HTA group also showed a stronger attentional bias toward positive and dysphoric stimuli in the middle and late period of stimulus presentation (7.9-30 s). These results suggest that trait anxiety has a significant temporal effect on attention to emotional stimuli, and that this effect mainly manifests after 7 s. In finding stronger attentional avoidance of threatening stimuli and more changes in neural activity, as well as a stronger attentional bias toward positive stimuli, this study provides novel insights on the relationship between trait anxiety and selective attention.

Current study on the influence of psychological factors on returning to sports after ACLR.

It is considered that psychological factors are important in determining exercise regression outcomes of patients with anterior cruciate ligament reconstruction (ACLR). This review summarizes the definition and research progress of current undefined psychological factors related to returning to sports (RTS) after ACLR, as well as the application of corresponding measuring scales, and common psychological interventions in the field. The aim is to understand and clarify the impact of psychological factors in the ACL injury and rehabilitation, and to provide a theoretical basis for the application of psychological evaluation and intervention in the later stage. It is believed that there are still many prospects for the research in this field.

The role of ventral tegmental area orexinergic afferents in depressive-like behavior in a chronic unpredictable mild stress (CUMS) mouse model.

Orexin has been implicated in comorbid diseases of depression, making it a promising target for anti-depression treatment. Although orexin neurons exhibit abnormal activity in depression, the neurocircuit mechanism of orexin remains unclear. As one of the important downstream factors of orexin neurons, the ventral tegmental area (VTA) is considered crucial to the mechanism of depression. However, the role of VTA orexinergic afferents in depression remains unclear. In this study, we applied a combination of opto/chemogenetic and neuropharmacology methods to investigate whether the VTA orexinergic afferents participate in the pathogenesis of depression in a chronic unpredictable mild stress (CUMS) mouse model. We found that c-Fos expression in these VTA-projecting orexin neurons specifically decreased in CUMS-treated mice. Optogenetic and chemogenetic activation of orexin terminals in the VTA significantly reversed depressive behavior. Microinjection of orexin-A, but not orexin-B, into the VTA significantly improved depressive-like behavior. Our study provided direct evidence that the VTA orexinergic afferents participate in the mechanism of depression, and the orexin-1 receptor plays a major role.

Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study.

OBJECTIVE: This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. METHODS: The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. RESULTS: The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. CONCLUSION: The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

Operational method of reliability and content-validity analysis: Taking "trait-symptoms" screening of individuals at high-risk for OCD as an example.

A well-designed self-reported scale is highly applicable to current clinical and research practices. However, the problems with the scale method, such as quantitative analysis of content validity and test-retest reliability analysis of state-like variables are yet to be resolved. The main purpose of this paper is to propose an operational method for solving these problems. Additionally, it aims to enhance understanding of the research paradigm for the scale method (excluding criterion-related validity). This paper used a study that involved screening of high-risk groups for OCD (Obsessive-Compulsive Disorder), conducted 5 rounds of tests, and developed scales, reliability, and validity analysis (using sample sizes of 496, 610, 600, 600 and 990). The operational method we propose is practical, feasible, and can be used to develop and validate a scale.

Career Calling and Job Satisfaction in Army Officers: A Multiple Mediating Model Analysis.

This study focuses on the relationships of career calling to job satisfaction in army officers. The direct and indirect (via meaning in life and meaning in work) effects of career calling on job satisfaction were investigated in 355 male army officers in China. For this purpose, structural equation modeling and bootstrap method were used. Results of confirmatory factor analysis verified the latent structures of meaning in work and job satisfaction. Structural equation modeling and χ2 test indicated meaning in work and presence meaning in life partially mediated the association between career calling and job satisfaction. The bootstrap method also revealed a significant indirect path from career calling to job satisfaction through them. These findings extend previous studies and shed light on promoting job satisfaction from a positive and meaningful perspective through the effect of adaptive career calling.

Relationship between meaning in life and death anxiety in the elderly: self-esteem as a mediator.

BACKGROUND: Death anxiety is a common phenomenon in all societies. Older adults may be more prone to death anxiety than their younger counterparts; however, death anxiety among older adults is not well understood. This study explores the relationship between meaning in life, self-esteem, and death anxiety in senior citizens in China. METHODS: A total of 283 older adults participated in this study; data were collected via the Meaning in Life Questionnaire, the Rosenberg Self-Esteem Scale, and the Death Anxiety Scale. RESULTS: Results show that the dimensions of meaning in life, presence of meaning (r = - 0.43, p < 0.01), search for meaning (r = - 0.31, p < 0.01), and self-esteem (r = - 0.54, p < 0.01) were each negatively correlated with death anxiety. Regression analysis reveals that meaning in life significantly predicted self-esteem and death anxiety (F = 45.70, p < 0.01; R2 = 0.33). Path analysis indicated that self-esteem either completely or partially mediated the effects of meaning in life on death anxiety in older adults. CONCLUSIONS: Overall, meaning in life appears to be significantly correlated with death anxiety in older adults, and self-esteem can mediate this effect.

Categorization of emotional faces in schizophrenia patients: An ERP study.

Schizophrenia patients often show deficits in facial emotion recognition, which contributes to their poor social functioning. The present study investigated the time course of categorization of emotional faces in schizophrenia patients by recording and analyzing ERPs elicited by emotional faces. Behavioral data show that in comparison with controls, schizophrenia patients categorized emotional faces more slowly with decreased accuracy and did not show evident positive classification advantage. The ERP data showed that the N170 decreased in schizophrenia patients although it was not modulated by facial emotions. In comparison with controls, schizophrenia patients exhibited the lack of frontal and posterior N2 components and decreased P3 component, without P3 modulation of emotional faces. These data provide new evidence for the dysfunction of processing emotional faces in schizophrenia patients.

Information processing under high and low distractions using eye tracking.

The previous studies found the differences of eye movements between systematic and heuristic processing were inconsistent. To bridge this gap, we manipulated both systematic and heuristic processings (using high vs. low distractions) and argument quality (using strong vs. weak), and measured both eye movements and self-reported attitude. The results suggested that low distraction induced larger differentiation of post-message attitude between strong and weak arguments compared to high distraction, indicating the successful operation of both processings. More importantly, low distraction enabled more fixations and shorter saccade lengths independent of argument quality. However, no differentiations were found involving fixation duration, regressions, and reading speed. In addition, argument quality influenced eye movements, i.e., less fixation and faster reading speed were found in strong arguments. Our results explain why distractions reduce the efficiency of information processing from an eye tracking perspective and why fixation duration results were inconsistent in the previous studies.

Identifying first-episode drug naïve patients with schizophrenia with or without auditory verbal hallucinations using whole-brain functional connectivity: A pattern analysis study.

Many studies have focused on patients with schizophrenia with or without auditory verbal hallucinations (AVHs), but due to the complexity of schizophrenia, biologically based diagnosis of patients with schizophrenia remains unsolved. The objectives of this study are to classify between first-episode drug-naïve patients with schizophrenia and healthy controls, and to classify between patients with and without AVHs. Resting state fMRI data from 41 patients with schizophrenia (22 with and 19 without AVHs) and 23 normal controls (NC) were included to compute functional connectivity between brain regions. Classifiers based on support vector machine (SVM) were developed to classify patients with schizophrenia from NC, as well as between the two subgroups of patients. The classification accuracy was evaluated with a leave-one-out cross-validation (LOOCV) strategy. The accuracy in discriminating both subgroups of patients from NC was 81.3%, with 92.0% (sensitivity) and 65.2% (specificity) for the patients and NC, respectively. The classification accuracy in discriminating patients with and without AVHs was 75.6%, with 77.3% (sensitivity) and 73.9% (specificity) for patients with and without AVHs, respectively. The results suggest that functional connectivity provided good discriminative power not only for identifying patients with schizophrenia among NC, but also in discriminating patients with schizophrenia with and without AVHs.

Perceptual expertise impacts preattentive processing of visual simple feature: a visual mismatch negativity study.

Perceptual expertise can be defined as enhanced abilities of discriminating, learning, and recognizing object of special categories. It is unclear whether the perceptual expertise effects occur at the preattentive stage. In the present study, visual mismatch negativity (vMMN) elicited by deviant orientation (90°/270° vs. 0°) for faces, houses, and arrows, respectively, was investigated. Compared with standard stimuli (0° orientation), the orientation changes elicited posterior vMMNs for all deviant stimuli. vMMN amplitudes were similar between houses and arrows, except the significant delayed peak latency for houses. Importantly, compared with houses and arrows, vMMN elicited by the orientation change of faces was significantly decreased and delayed. These data indicated that the perceptual expertise for faces relevant to high-level configural processing impaired the change detection of low-level visual features at the preattentive stage of information processing.

Sample size determination for mediation analysis of longitudinal data.

BACKGROUND: Sample size planning for longitudinal data is crucial when designing mediation studies because sufficient statistical power is not only required in grant applications and peer-reviewed publications, but is essential to reliable research results. However, sample size determination is not straightforward for mediation analysis of longitudinal design. METHODS: To facilitate planning the sample size for longitudinal mediation studies with a multilevel mediation model, this article provides the sample size required to achieve 80% power by simulations under various sizes of the mediation effect, within-subject correlations and numbers of repeated measures. The sample size calculation is based on three commonly used mediation tests: Sobel's method, distribution of product method and the bootstrap method. RESULTS: Among the three methods of testing the mediation effects, Sobel's method required the largest sample size to achieve 80% power. Bootstrapping and the distribution of the product method performed similarly and were more powerful than Sobel's method, as reflected by the relatively smaller sample sizes. For all three methods, the sample size required to achieve 80% power depended on the value of the ICC (i.e., within-subject correlation). A larger value of ICC typically required a larger sample size to achieve 80% power. Simulation results also illustrated the advantage of the longitudinal study design. The sample size tables for most encountered scenarios in practice have also been published for convenient use. CONCLUSIONS: Extensive simulations study showed that the distribution of the product method and bootstrapping method have superior performance to the Sobel's method, but the product method was recommended to use in practice in terms of less computation time load compared to the bootstrapping method. A R package has been developed for the product method of sample size determination in mediation longitudinal study design.

A New Look at the Impact of Maximizing on Unhappiness: Two Competing Mediating Effects.

The current study aims to explore how the decision-making style of maximizing affects subjective well-being (SWB), which mainly focuses on the confirmation of the mediator role of regret and suppressing role of achievement motivation. A total of 402 Chinese undergraduate students participated in this study, in which they responded to the maximization, regret, and achievement motivation scales and SWB measures. Results suggested that maximizing significantly predicted SWB. Moreover, regret and achievement motivation (hope for success dimension) could completely mediate and suppress this effect. That is, two competing indirect pathways exist between maximizing and SWB. One pathway is through regret. Maximizing typically leads one to regret, which could negatively predict SWB. Alternatively, maximizing could lead to high levels of hope for success, which were positively correlated with SWB. Findings offered a complex method of thinking about the relationship between maximizing and SWB.

Mixed Frames and Risky Decision-Making.

By applying unitive vocabulary, "die" or "save," to respective frames of the Asian disease problem, Tversky and Kahneman were able to define framing effect. In this study, we preliminarily explored the effect of mixed frames, which are characterized by the use of different vocabulary in one frame. In study 1, we found that only the sure option description had significant effect on decision-making, while the effects of risky option descriptions were not significant, nor were interactions between descriptions. In study 2, the results suggested that after controlling the effects of the hedonic tone of the sure options, risky option description did not significantly predict decision-making. In study 3, we found that neither the sure-to-risky option presentation order nor presentation order within risky options had significant effect on decision-making. We thus concluded that sure option description can serve as the decision-making foundation (reference point) for decision-makers in mixed frames.

Framing Effect in the Trolley Problem and Footbridge Dilemma.

The present study investigated the effect of dilemma type, framing, and number of saved lives on moral decision making. A total of 591 undergraduates, with a mean age of 20.56 (SD = 1.37) were randomly assigned to 12 groups on the basis of a grid of two dilemma types (the trolley problem or the footbridge dilemma) by three frames (positive, neutral, or negative frame) by two different numbers of workers (5 or 15 people). The main effects of dilemma type, frame, and number of saved workers were all significant. The interaction of dilemma type and number of saved workers and the interaction of the three independent factors were significant. Results indicated that moral judgment is affected by framing. Specifically, people were more inclined to utilitarianism in the positive or neutral frame and more inclined to intuitionism in the negative frame. Furthermore, this effect can be moderated by dilemma type and number of saved lives. Implications of our results are discussed.

Categorization and Prediction of Crimes of Passion Based on Attitudes Toward Violence.

The present study explored implicit and explicit attitudes toward violence in crimes of passion. Criminals ( n = 96) who had perpetrated crimes of passion and students ( n = 100) participated in this study. Explicit attitudes toward violence were evaluated using the Abnormal Personality Risk Inventory (APRI), and implicit attitude toward violence was evaluated using the Implicit Association Test (IAT). Results indicated that APRI scores of the perpetrators were significantly higher than that of the control group ( p < .05), suggesting that explicit attitudes toward violence could discriminate between the criminals and the control group. There was a significant IAT effect demonstrating a negative implicit attitude toward violence in both the control group and in the criminals ( n = 68); whereas there was a significant IAT effect manifesting a positive implicit attitude toward violence in the criminals ( n = 16) only. These results suggest that combining explicit and implicit attitudes could provide an empirical classification of crimes of passion.

Effect of mental fatigue on nonattention: a visual mismatch negativity study.

Individuals experience mental fatigue during or after prolonged periods of cognitive activity. The aim of the present study was to investigate the effect of mental fatigue on detection of changes at the preattentive stage in the visual system by recording visual mismatch negativity of event-related potential components. Twenty-four students who volunteered for the study were divided randomly into either a mental fatigue group or a control group. Participants in the mental fatigue group were asked to perform an AX continued practice test for 2.5 h while the control group rested in the lab for 2.5 h. Then, subjective fatigue and mood state were measured by the Subjective Fatigue Symptom Questionnaire and the Profile of Mood States, respectively. Preattentive processing was evaluated as well by assessing the duration of the passive oddball task both before and after manipulation. In participants who performed the AX continued practice test, we observed a significant increase in feelings of fatigue and tiredness, and negative emotion. In these same participants, we observed a significant decrease in attention and positive emotion. This indicates that continuous cognitive operation induces mental fatigue. In addition, we found that the visual mismatch negativity amplitude was significantly reduced in participants with mental fatigue, implying that visual deviant/change detection is affected by mental fatigue. These results suggest that preattentive change detection and automatic processing decline as a result of mental fatigue.