Latent profiles of telehealth care satisfaction during the COVID-19 pandemic among patients with cardiac conditions in an outpatient setting.

Background: During the COVID-19 pandemic, telemedicine was advocated and rapidly scaled up worldwide. However, little is known about for whom this type of care is acceptable. Objective: To examine which patient characteristics (demographic, medical, psychosocial) are associated with telehealth care satisfaction, attitude toward telehealth, and preference regarding telehealth over time in a cardiac patient population. Methods: In total, 317 patients were recruited at the Elisabeth-TweeSteden Hospital in The Netherlands. All patients who had received telehealth care (telephone and video) in the previous 2 months were approached for participation. Baseline, 3-month, and 6-month questionnaires were administered online. A 3-step latent class analysis was conducted to identify trajectories of telehealth use over time and the possible association of the found trajectories with external variables. Results: Five trajectories (classes) were identified for satisfaction with telehealth and 4 for attitude toward telehealth. Patients with higher distress, lower physical and mental health, higher scores on pessimism, and negative affectivity were more likely to be less satisfied. Patients with no partner, more comorbidities, higher distress, lower physical and mental health, and higher scores on pessimism were more likely to hold a negative attitude toward telehealth. For the future application of telehealth, marital status, comorbidities, digital health literacy, and pessimism were significantly related. Conclusion: Results show that patients' profiles should be considered when offering telehealth care and that the "one size fits all" approach does not apply. Results can inform clinical practice on how to better implement remote health care in the future while considering a personalized approach.

Are depressive symptoms linked to a reduced pupillary response to novel positive information?-An eye tracking proof-of-concept study.

Introduction: Depressive symptoms have been linked to difficulties in revising established negative beliefs in response to novel positive information. Recent predictive processing accounts have suggested that this bias in belief updating may be related to a blunted processing of positive prediction errors at the neural level. In this proof-of-concept study, pupil dilation in response to unexpected positive emotional information was examined as a psychophysiological marker of an attenuated processing of positive prediction errors associated with depressive symptoms. Methods: Participants (N = 34) completed a modified version of the emotional Bias Against Disconfirmatory Evidence (BADE) task in which scenarios initially suggest negative interpretations that are later either confirmed or disconfirmed by additional information. Pupil dilation in response to the confirmatory and disconfirmatory information was recorded. Results: Behavioral results showed that depressive symptoms were related to difficulties in revising negative interpretations despite disconfirmatory positive information. The eye tracking results pointed to a reduced pupil response to unexpected positive information among people with elevated depressive symptoms. Discussion: Altogether, the present study demonstrates that the adapted emotional BADE task can be appropriate for examining psychophysiological aspects such as changes in pupil size along with behavioral responses. Furthermore, the results suggest that depression may be characterized by deviations in both behavioral (i.e., reduced updating of negative beliefs) and psychophysiological (i.e., decreased pupil dilation) responses to unexpected positive information. Future work should focus on a larger sample including clinically depressed patients to further explore these findings.

Modeling Effects of Rumination on Free Recall Using ACT-R.

Ruminative thinking, characterized by a recurrent focus on negative and self-related thought, is a key cognitive vulnerability marker of depression and, therefore, a key individual difference variable. This study aimed to develop a computational cognitive model of rumination focusing on the organization and retrieval of information in memory, and how these mechanisms differ in individuals prone to rumination and individuals less prone to rumination. Adaptive Control of Thought-Rational (ACT-R) was used to develop a rumination model by adding memory chunks with negative valence to the declarative memory. In addition, their strength of association was increased to simulate recurrent negative focus, thereby making it harder to disengage from. The ACT-R models were validated by comparing them against two empirical datasets containing data from control and depressed participants. Our general and ruminative models were able to recreate the benchmarks of free recall while matching the behavior exhibited by the control and the depressed participants, respectively. Our study shows that it is possible to build a computational theory of rumination that can accurately simulate the differences in free recall dynamics between control and depressed individuals. Such a model could enable a more fine-tuned investigation of underlying cognitive mechanisms of depression and potentially help to improve interventions by allowing them to more specifically target key mechanisms that instigate and maintain depression.

Borderline personality disorder features are associated with inflexible social interpretations.

BACKGROUND: Borderline personality disorder (BPD) is thought to involve aberrant social learning, including impaired revision of social interpretations with new evidence (social interpretation inflexibility). However, this topic has received little empirical attention outside of specific literatures, such as moral inference or behavioral economics. Further, the contribution of comorbid depression to BPD-related interpretation inflexibility has not yet been assessed. METHODS: In two independent samples (Study 1: N = 213; Study 2: N = 210, oversampled for BPD features), we assessed the associations between BPD symptoms, depressive symptoms, and task-based measures of social interpretation flexibility. RESULTS: We found that BPD symptoms, particularly volatility of identity and relationships, were associated with less revision of social interpretations with both positive and negative evidence. Meanwhile, depressive symptoms were associated with a pattern of less revision of social interpretations with positive versus negative information. LIMITATIONS: The use of cross-sectional, crowdsourced samples limits causal interpretations. Translation to clinical populations should be assessed in future studies. CONCLUSIONS: Results suggest that inflexible social interpretations across valences may be a feature of BPD-related pathology, and could be connected to symptoms involving volatility in social contexts. Future studies should investigate whether treatments geared toward increasing the flexibility of social interpretations are effective in treating BPD symptoms, especially those involving interpersonal difficulties.

Engineering of Phenylpyridine- and Bipyridine-Based Covalent Organic Frameworks for Photocatalytic Tandem Aerobic Oxidation/Povarov Cyclization.

Covalent organic frameworks (COFs) are emerging as a new class of photoactive organic semiconductors, which possess crystalline ordered structures and high surface areas. COFs can be tailor-made toward specific (photocatalytic) applications, and the size and position of their band gaps can be tuned by the choice of building blocks and linkages. However, many types of building blocks are still unexplored as photocatalytic moieties and the scope of reactions photocatalyzed by COFs remains quite limited. In this work, we report the synthesis and application of two bipyridine- or phenylpyridine-based COFs: TpBpyCOF and TpPpyCOF. Due to their good photocatalytic properties, both materials were applied as metal-free photocatalysts for the tandem aerobic oxidation/Povarov cyclization and α-oxidation of N-aryl glycine derivatives, with the bipyridine-based TpBpyCOF exhibiting the highest activity. By expanding the range of reactions that can be photocatalyzed by COFs, this work paves the way toward the more widespread application of COFs as metal-free heterogeneous photocatalysts as a convenient alternative for commonly used homogeneous (metal-based) photocatalysts.

Social interpretation inflexibility moderates emotional reactions to social situations in children and adolescents.

Interpretation biases and inflexibility (i.e., difficulties revising interpretations) have been linked to increased internalizing symptoms. Although adolescence is a developmental period characterized by novel social situations and increased vulnerability to internalizing disorders, no studies have examined interpretation inflexibility in adolescents. Additionally, no studies (on adolescents or adults) have examined interpretation flexibility as a protective factor against adverse outcomes of interpersonal events. Using a novel task and a 28-day diary we examined relations among interpretation bias and inflexibility, internalizing symptoms, and negative interpersonal events in a sample of children and adolescents (N = 159, ages 9-18). At baseline, negative interpretation bias was positively correlated with social anxiety symptoms, and positive interpretation bias negatively correlated with social anxiety and depressive symptoms. Inflexible positive interpretations were correlated with higher social anxiety and depressive symptoms, while inflexible negative interpretations were correlated with higher social anxiety. Finally, interpretation inflexibility moderated daily associations between negative interpersonal events and depressive symptoms in daily life, such that higher inflexibility was associated with stronger associations between interpersonal events and subsequent depressive symptoms, potentially increasing depressive symptom instability. These results suggest that interpretation biases and inflexibility may act as both risk and protective factors for adolescent anxiety and depression.

Interplay between uncertainty intolerance, emotion regulation, cognitive flexibility, and psychopathology during the COVID-19 pandemic: a multi-wave study.

The COVID-19 pandemic has created a significant mental health burden on the global population. Studies during the pandemic have shown that risk factors such as intolerance of uncertainty and maladaptive emotion regulation are associated with increased psychopathology. Meanwhile, protective factors such as cognitive control and cognitive flexibility have been shown to protect mental health during the pandemic. However, the potential pathways through which these risk and protective factors function to impact mental health during the pandemic remain unclear. In the present multi-wave study, 304 individuals (18 years or older, 191 Males), residing in the USA during data collection, completed weekly online assessments of validated questionnaires across a period of five weeks (27th March 2020-1st May 2020). Mediation analyses revealed that longitudinal changes in emotion regulation difficulties mediated the effect of increases in intolerance of uncertainty on increases in stress, depression, and anxiety during the COVID-19 pandemic. Further, individual differences in cognitive control and flexibility moderated the relationship between intolerance of uncertainty and emotion regulation difficulties. While intolerance of uncertainty and emotion regulation difficulties emerged as risk factors for mental health, cognitive control and flexibility seems to protect against the negative effects of the pandemic and promote stress resilience. Interventions aimed at enhancing cognitive control and flexibility might promote the protection of mental health in similar global crises in the future.

Positive Interpretation Bias Predicts Longitudinal Decreases in Social Anxiety.

Theoretical models of social anxiety suggest that distorted interpretation processes contribute to its development and maintenance, although the pathways through which this occurs are not well understood. Therefore, the present longitudinal study sought to determine whether negative interpretation bias, positive interpretation bias, and interpretation inflexibility (the degree to which participants correctly revise initial interpretations) predict changes in social anxiety over time. In an important advance over prior studies, individual differences in working memory capacity (WMC) were accounted for, as WMC is thought to play a crucial role in the generation and maintenance of interpretation biases. Following a baseline assessment of social anxiety, interpretation biases, and WMC, participants completed follow-up assessments of social anxiety both 2 weeks (n = 106) and 4 weeks (n = 96) later. After controlling for baseline social anxiety and WMC, greater positive interpretation bias was found to predict lower social anxiety at both follow-ups. Neither negative interpretation bias nor interpretation inflexibility was significantly associated with follow-up social anxiety. These results provide support for greater positive interpretation bias as a facilitator of decreases in social anxiety and a potential target for clinical intervention.

Emotion Regulation in the Classroom: A Network Approach to Model Relations among Emotion Regulation Difficulties, Engagement to Learn, and Relationships with Peers and Teachers.

Emotion regulation is theorized to shape students' engagement in learning activities, but the specific pathways via which this occurs remain unclear. This study examined how emotion regulation mechanisms are related to behavioral and emotional engagement as well as relations with peers and teachers. The sample included 136 secondary school students (59,7% girls; Mage = 14.93, SDage = 1.02, range: 13-18 years). Psychometric network models revealed that difficulties in emotional awareness, emotional clarity, and access to emotion regulation strategies were differentially related to behavioral and emotional engagement, establishing an indirect link with teacher and/or peer relations. Nonacceptance of emotional responses, emotional awareness, and impulse control difficulties were uniquely related to teacher and/or peer relations, establishing an indirect link with student engagement. Causal discovery analysis suggested that student emotional engagement is an empirically-plausible direct cause of increased access to emotion regulation strategies. These findings uncover potential pathways through which emotion regulation hampers or facilitates learning at school, providing information useful for the design of school curricula and teacher training programs.

Moment-to-Moment Interplay Among Stress Appraisals and Emotion Regulation Flexibility in Daily Life.

Flexible use of emotion regulation (ER) strategies in daily life is theorized to depend on appraisals of occurring stressful events. Yet, to date, little is known about (a) how appraisals of the current situation modulate the use of ER strategies in daily life and (b) how individual differences in affective symptoms impact these relations among appraisals and ER strategy use. This study attempted to address these two limitations using a 5-day experience sampling protocol, with three surveys administered per day in a sample of 97 participants. Each survey measured momentary appraisals of stress intensity and controllability as well as ER strategy use (i.e., rumination, reappraisal, avoidance, and active coping). Results showed that, in situations of low-stress intensity, higher stress controllability was related to greater use of reappraisal and rumination. In situations of high-stress intensity, higher controllability was related to reduced use of rumination. This pattern of flexible use of ER strategies depending on momentary stress appraisals was found for both rumination and avoidance and occurred specifically in individuals reporting lower levels of depression and/or anxiety levels. These findings provide new insight into how flexible use of ER strategies in daily life is modulated by interactions between stress intensity and controllability appraisals at varying levels of affective symptoms. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-022-00122-9.

Which features of repetitive negative thinking and positive reappraisal predict depression? An in-depth investigation using artificial neural networks with feature selection.

Emotion regulation habits have long been implicated in risk for depression. However, research in this area traditionally adopts an approach that ignores the multifaceted nature of emotion regulation strategies, the clinical heterogeneity of depression, and potential differential relations between emotion regulation features and individual symptoms. To address limitations associated with the dominant aggregate-level approach, this study aimed to identify which features of key emotion regulation strategies are most predictive and when those features are most predictive of individual symptoms of depression across different time lags. Leveraging novel developments in the field of machine learning, artificial neural network models with feature selection were estimated using data from 460 participants who participated in a 20-wave longitudinal study with weekly assessments. At each wave, participants completed measures of repetitive negative thinking, positive reappraisal, perceived stress, and depression symptoms. Results revealed that specific features of repetitive negative thinking (wondering "why cannot I get going?" and having thoughts or images about feelings of loneliness) and positive reappraisal (looking for positive sides) were important indicators for detecting various depressive symptoms, above and beyond perceived stress. These features had overlapping and unique predictive relations with individual cognitive, affective, and somatic symptoms. Examining temporal fluctuations in the predictive utility, results showed that the utility of these emotion regulation features was stable over time. These findings illuminate potential pathways through which emotion regulation features may confer risk for depression and help to identify actionable targets for its prevention and treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Biased and inflexible interpretations of ambiguous social situations: Associations with eating disorder symptoms and socioemotional functioning.

BACKGROUND: Research indicates that difficulties across multiple socioemotional functioning domains (e.g., social emotion expression/regulation, response to social elicitors of emotion) and negatively biased interpretations of ambiguous social situations may affect eating disorder symptoms. The impact of inflexible interpretations of social situations on eating disorder symptoms is less clear. The present study therefore examined relations between inflexible and biased social interpretations, socioemotional functioning, and eating disorder symptoms. METHOD: A total of 310 participants from the general population, recruited from an online crowdsourcing platform, completed measures of socioemotional functioning (e.g., rejection sensitivity, negative social exchange), eating disorder symptoms, and positive and negative interpretation bias and inflexibility on a single measurement occasion. RESULTS: Socioemotional functioning impairments (Pillai's trace = 0.11, p < .001), but not negative (ß = .07, p = .162) or positive (ß = -.01, p = .804) interpretation bias or inflexible interpretations (ß = .04, p = .446), were associated with eating disorder symptoms in multiple regression models. In network analyses controlling statistically for multiple markers of socioemotional functioning, eating disorder symptoms were directly associated with negative (but not positive) interpretation bias. Inflexible interpretations were indirectly linked to symptoms via co-dampening of positive emotions. Exploratory causal discovery analyses suggested that several socioemotional functioning variables (social anxiety, depression, negative social exchange) may cause eating disorder symptoms. CONCLUSIONS: Consistent with cognitive-interpersonal models of disordered eating, our results suggest that less accurate (biased, inflexible) interpretations of social information contribute to patterns of cognition (anxious anticipation of rejection) and emotion regulation (down-regulation of positive social emotion) thought to encourage disordered eating. PUBLIC SIGNIFICANCE: This study suggests that less accurate interpretations of ambiguous social information encourage anxious anticipation of rejection and downregulation of positive social emotions, both of which are thought to promote eating disorder symptoms. Knowledge provided by this study about the likely relations between interpretive processes, social/emotional functioning, and eating disorder symptoms may help inform treatments for eating disorders, particularly those that attempt to modify patterns of interpretation.

Positive emotion in daily life: Emotion regulation and depression.

Depression is associated with the infrequent use of emotion regulation strategies that increase positive emotion and the frequent use of strategies that decrease positive emotion. However, prior research mostly relies on global, retrospective assessments that fail to capture dynamic relations between positive emotion and emotion regulation in ecologically valid settings. This study used an ecological momentary assessment (EMA) design to test whether depression is related to positive emotion regulation in daily life. We recruited 108 individuals to complete a 14-day EMA study, tracking strategy use and positive emotion over time. Higher momentary positive emotion was associated with greater subsequent use of positive rumination and less use of dampening. Elevated depressive symptoms, however, were associated with lower average use of positive rumination and higher average use of dampening. Depressive symptom levels did not modulate relations between positive emotion and emotion regulation strategy use. Less use of positive rumination and more use of dampening were related to lower levels of momentary positive emotion. Taken together, depression was associated with a pattern of strategy use that is associated with low positive emotion. Emotion regulation may help to explain positive emotion deficits in depression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Emotion regulation and self-criticism in children and adolescence: Longitudinal networks of transdiagnostic risk factors.

Adolescence is a time of heightened risk for the development of psychopathology. Difficulties in emotion regulation and heightened levels of self-criticism are two processes that have been proposed as critical risk factors. Considering the accumulating evidence that risk factors rarely work in isolation, there is a pressing need to examine how self-criticism and emotion regulations strategies interact. The present study utilizes a network analysis approach to address this goal. One-hundred thirty-five children and adolescents (ages 8-15) completed daily-diaries every evening for 21 days (total N of assessments = 2,564), reporting self-criticism and use of emotion regulation strategies focused on negative and positive emotions. Network analysis was applied to estimate contemporaneous, temporal, and between-person networks. Results show that emotion regulation strategies are generally positively associated with each other at the within and between individual levels. As predicted, self-criticism was positively associated with rumination and dampening at the between and within-person networks; unexpectedly, problem-solving also clustered with them in the contemporaneous network. Moreover, problem-solving led to next-day increases in rumination and dampening, whereas self-criticism led to next-day increases in rumination but decreases in dampening. Finally, distraction in response to negative affect was closely tied with strategies that up-regulate positive affect. Collectively, these results shed light on the complex pathways through which self-criticism and emotion regulation interact over time. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Interpreting ambiguous emotional information: Convergence among interpretation bias measures and unique relations with depression severity.

This study aimed to examine the convergence among interpretation bias measures and their associations with depressive symptom severity. Research into interpretation biases employs measures of interpretation bias interchangeably, however, little is known about the relationship between these measures. Participants (N = 82 unselected undergraduate students; 59 female) completed four computer-based interpretation bias tasks in a cross-sectional design study. Indirect measures, based on participants' reaction times, were not correlated with each other and had poor split-half reliability. Direct measures were more strongly correlated with depressive symptoms than indirect measures, but only the Scrambled Sentences Task explained a reliable unique portion of the variance in depressive symptoms. Interpretation bias tasks may not measure the same cognitive process and may differ in the extent to which they are a cognitive marker of depression-linked interpretation bias. These findings help to improve the measurement of and theory underlying interpretation bias and depressive symptoms.

Interpretation of ambiguity in depression.

Distorted interpretations of ambiguous information have been theorized to confer risk to experiencing depression. This article discusses recent research characterizing biased and inflexible interpretation processes to resolve ambiguous situations in depression, its underlying cognitive mechanisms, and potential pathways to depression. Future research directions are outlined to consolidate the understanding of the nature, causes, and effects of interpretation processes in depression to advance psychological treatments for this burdensome mental health condition.

Emotional working memory updating in individuals with borderline personality features.

BACKGROUND AND OBJECTIVES: Individuals with features of borderline personality disorder (BPD) are highly sensitive to social rejection. Working memory (WM) may play a critical role in processing emotional interpersonal information in BPD. Yet, little is known about how emotional WM operations are related to sensitivity to rejection cues and BPD features. Therefore, this study examined relationships among emotional WM operations, rejection sensitivity, and BPD features. METHODS: Participants with BPD features (n = 39 with non-suicidal self-injury history; n = 47 without non-suicidal self-injury history) and healthy participants (n = 46) completed an emotional two-back task before and after a social exclusion induction (the Cyberball game). RESULTS: Results showed that participants with BPD features were slower at discarding faces expressing anger and pain from WM compared to healthy individuals before the social exclusion induction. Participants with BPD features and a history of self-injury were also slower at entering happy faces into WM compared to the other participants. Moreover, across participants, slower WM discarding of angry and pain faces was associated with higher levels of rejection sensitivity. Finally, no group differences emerged with respect to WM entering and discarding operations for emotional faces in response to social exclusion. LIMITATIONS: This study was conducted in a sample of undergraduate students and did not consider comorbidity with other forms of psychopathology. CONCLUSIONS: These findings cast light on how emotional WM difficulties may be involved in how individuals with BPD process emotional interpersonal information.

Emotion and Emotion Preferences in Daily Life: The Role of Anxiety.

People vary in their emotion preferences (i.e., desired emotional states). No study, however, has examined the nature of emotion preferences in anxiety. The current study utilized a 14-day ecological momentary assessment (EMA) paradigm to investigate the daily dynamics of emotion preferences and state emotion as they relate to individual differences in trait anxiety and anxiety symptom severity. Individuals with higher levels of trait anxiety and with more severe anxiety symptoms report greater preferences for state anxiety compared to their low anxiety counterparts. Relations between anxiety preferences and subsequent anxiety vary as a function of trait anxiety and symptom severity, and different associations are observed between the two measures of anxiety. The current findings suggest that aberrant emotion preferences may contribute to emotion dysfunction in anxiety, and highlight emotion preferences as a novel treatment target for interventions that aim to improve emotion functioning among people with elevated levels of anxiety.

Measuring Depression in Autistic Adults: Psychometric Validation of the Beck Depression Inventory-II.

Depressive disorders are common in autistic adults, but few studies have examined the extent to which common depression questionnaires are psychometrically appropriate for use in this population. Using item response theory, this study examined the psychometric properties of the Beck Depression Inventory-II (BDI-II) in a sample of 947 autistic adults. BDI-II latent trait scores exhibited strong reliability, construct validity, and moderate ability to discriminate between depressed and nondepressed adults on the autism spectrum (area under the receiver operating characteristic curve = 0.796 [0.763, 0.826], sensitivity = 0.820 [0.785, 0.852], specificity = 0.653 [0.601, 0.699]). These results collectively indicate that the BDI-II is a valid measure of depressive symptoms in autistic adults, appropriate for quantifying depression severity in research studies or screening for depressive disorders in clinical settings. A free online score calculator has been created to facilitate the use of BDI-II latent trait scores for clinical and research applications (available at https://asdmeasures.shinyapps.io/bdi_score/).

Structural and Photophysical Properties of Various Polypyridyl Ligands: A Combined Experimental and Computational Study.

Covalent triazine frameworks (CTFs) with polypyridyl ligands are very promising supports to anchor photocatalytic complexes. Herein, we investigate the photophysical properties of a series of ligands which vary by the extent of the aromatic system, the nitrogen content and their topologies to aid in selecting interesting building blocks for CTFs. Interestingly, some linkers have a rotational degree of freedom, allowing both a trans and cis structure, where only the latter allows anchoring. Therefore, the influence of the dihedral angle on the UV-Vis spectrum is studied. The photophysical properties are investigated by a combined computational and experimental study. Theoretically, both static and molecular dynamics simulations are performed to deduce ground- and excited state properties based on density functional theory (DFT) and time-dependent DFT. The position of the main absorption peak shifts towards higher wavelengths for an increased size of the π-system and a higher π-electron deficiency. We found that the position of the main absorption peak among the different ligands studied in this work can amount to 271 nm; which has a significant impact on the photophysical properties of the ligands. This broad range of shifts allows modulation of the electronic structure by varying the ligands and may help in a rational design of efficient photocatalysts.