[Trends in the lifetime risk to be diagnosed with cancer in the Netherlands]. / Ontwikkeling van de kans op kanker in 1990-2019.

OBJECTIVE: To describe for the Dutch population the lifetime risk to be diagnosed with or to die from cancer. DESIGN: The cancer incidence and death rates of 1990-2019 were analyzed by 5-year periods. METHOD: For the calculations cancer incidence rates were used from the Netherlands Cancer Registry. Population and mortality data were obtained from Statistics Netherlands. All rates were stratified according to gender and age groups. Using these rates, the lifetime risk of cancer or of dying from cancer were calculated using the software program DevCan. RESULTS: Compared to 1990, probabilities of being diagnosed with cancer increased by over ten percent points, to 54% for men and 47% for women. In the most recent period, the highest probabilities were for prostate cancer in men (13%), and breast cancer in women (14%). The lifetime risk of dying from cancer was comparably stable for all age groups combined, but decreased under 75 years (males) and 65 years (females), while it increased in the elderly. CONCLUSION: During their lifetime, roughly half of all Dutch residents are diagnosed with cancer. The sharp increase in lifetime risk of diagnosis with cancer shows the need for additional efforts to aim at prevention of cancer.

Seeking neutral: A VR-based person-identity-matching task for attentional bias modification - A randomised controlled experiment.

BACKGROUND: Attentional bias modification (ABM) aims to reduce anxiety by attenuating bias towards threatening information. The current study incorporated virtual reality (VR) technology and 3-dimensional stimuli with a person-identity-matching (PIM) task to evaluate the effects of a VR-based ABM training on attentional bias and anxiety symptoms. METHODS: One hundred participants with elevated social anxiety were randomised to four training groups. Attentional bias was assessed at pre- and post-training, and anxiety symptoms were assessed at pre-training, post-training, 1-week follow-up, and 3-month follow-up. RESULTS: Change in anxiety did not correlate with change in bias (r = -0.08). A repeated-measures ANOVA showed no significant difference in bias from pre- to post-ABM, or between groups. For anxiety symptoms, a linear mixed-effects model analysis revealed a significant effect of time. Participants showed reduction in anxiety score at each successive assessment (p < .001, Nagelkerke's pseudo r 2 = 0.65). However, no other significant main effect or interactions were found. A clinically significant change analysis revealed that 4% of participants were classified as 'recovered' at 3-month follow-up. CONCLUSIONS: A single session of VR-based PIM task did not change attentional bias. The significant reduction in anxiety was not specific to active training, and the majority of participants remained clinically unchanged.

Attentional Bias Modification in Virtual Reality - A VR-Based Dot-Probe Task With 2D and 3D Stimuli.

BACKGROUND: Attentional bias modification (ABM) aims to reduce anxiety by attenuating bias toward threatening information. The current study incorporated virtual reality (VR) technology and three-dimensional stimuli with a dot-probe task to evaluate the effects of a VR-based ABM training on attentional bias and anxiety symptoms. METHODS: A total of 100 participants were randomized to four training groups. Attentional bias was assessed at pre- and post-training, and anxiety symptoms were assessed at pre-training, post-training, 1-week follow-up, and 3-months follow-up. RESULTS: Change in anxiety did not correlate with change in bias (p = 0.24). A repeated-measures ANOVA showed no significant difference in bias from pre- to post-ABM (p = 0.144), or between groups (p = 0.976). For anxiety symptoms, a linear mixed-effects model analysis revealed a significant effect of time. Participants showed reduction in anxiety score at each successive assessment (p < 0.001). However, no other significant main effect or interactions were found. A clinically significant change analysis revealed that 9% of participants were classified as 'recovered' at 3-months follow-up. CONCLUSION: A single session of VR-based ABM did not change attentional bias. The significant reduction in anxiety was not specific to active training, and the majority of participants remained clinically unchanged.

A meta-analysis of bias at baseline in RCTs of attention bias modification: No evidence for dot-probe bias towards threat in clinical anxiety and PTSD.

Considerable effort and funding have been spent on developing Attention Bias Modification (ABM) as a treatment for anxiety disorders, theorized to exert therapeutic effects through reduction of a tendency to orient attention toward threat. However, meta-analytical evidence that clinical anxiety is characterized by threat-related attention bias is thin. The largest meta-analysis to date included dot-probe data for n = 337 clinically anxious individuals. Baseline measures of biased attention obtained in ABM RCTs form an additional body of data that has not previously been meta-analyzed. This article presents a meta-analysis of threat-related dot-probe bias measured at baseline for 1,005 clinically anxious individuals enrolled in 13 ABM RCTs. Random-effects meta-analysis indicated no evidence that the mean bias index (BI) differed from zero (k = 13, n = 1005, mean BI = 1.8 ms, SE = 1.26 ms, p = .144, 95% confidence interval [-0.6, 4.3]. Additional Bayes factor analyses also supported the point-zero hypothesis (BF10 = .23), whereas interval-based analysis indicated that mean bias in clinical anxiety is unlikely to extend beyond the 0 to 5 ms interval. Findings are discussed with respect to strengths (relatively large samples, possible bypassing of publication bias), limitations (lack of control comparison, repurposing data, specificity to dot-probe data), and theoretical and practical context. We suggest that it should no longer be assumed that clinically anxious individuals are characterized by selective attention toward threat. Clinically anxious individuals enrolled in RCTs for Attention Bias Modification are not characterized by threat-related attention bias at baseline. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Capturing Dynamics of Biased Attention: Are New Attention Variability Measures the Way Forward?

BACKGROUND: New indices, calculated on data from the widely used Dot Probe Task, were recently proposed to capture variability in biased attention allocation. We observed that it remains unclear which data pattern is meant to be indicative of dynamic bias and thus to be captured by these indices. Moreover, we hypothesized that the new indices are sensitive to SD differences at the response time (RT) level in the absence of bias. METHOD: Randomly generated datasets were analyzed to assess properties of the Attention Bias Variability (ABV) and Trial Level Bias Score (TL-BS) indices. Sensitivity to creating differences in 1) RT standard deviation, 2) mean RT, and 3) bias magnitude were assessed. In addition, two possible definitions of dynamic attention bias were explored by creating differences in 4) frequency of bias switching, and 5) bias magnitude in the presence of constant switching. RESULTS: ABV and TL-BS indices were found highly sensitive to increasing SD at the response time level, insensitive to increasing bias, linearly sensitive to increasing bias magnitude in the presence of bias switches, and non-linearly sensitive to increasing the frequency of bias switches. The ABV index was also found responsive to increasing mean response times in the absence of bias. CONCLUSION: Recently proposed DPT derived variability indices cannot uncouple measurement error from bias variability. Significant group differences may be observed even if there is no bias present in any individual dataset. This renders the new indices in their current form unfit for empirical purposes. Our discussion focuses on fostering debate and ideas for new research to validate the potentially very important notion of biased attention being dynamic.

The 5-HTTLPR polymorphism, early and recent life stress, and cognitive endophenotypes of depression.

Studies associating interactions of 5-HTTLPR and life adversities with depression have yielded equivocal results. Studying endophenotypes may constitute a more powerful approach. In the current study, it was assessed whether interactions of 5-HTTLPR with childhood emotional abuse (CEA) and recent negative life events (RNLE) affect possible cognitive endophenotypes of depression, namely, attention-allocation bias and the ability to recognise others' mind states in 215 young adults of North-West European descent. The ability to classify others' negative mind states was found to be increased with increasing RNLE in carriers of low-expressing Serotonin Transporter Linked Polymorphic Region (5-HTTLPR) alleles. Carriers of two low-expressing alleles also preferentially oriented attention towards negative information. Gene-environment interactions were not observed for attention allocation bias. No effects involving CEA were observed. These results suggest that low-expressing 5-HTTLPR alleles may confer increased risk for depression through enhanced recognition of negative facial expressions following RNLE.

The influence of worry and avoidance on the Iowa Gambling Task.

BACKGROUND: It has been proposed that worry in individuals with Generalized Anxiety Disorder may be reinforced by a positive effect of worry on decision making, as reflected by a steeper learning curve on the Iowa Gambling Task (IGT). We hypothesized that this apparent positive effect of worry is dependent on the IGT parameters, in particular the absence of an opportunity to avoid decisions. OBJECTIVE: (1) To replicate previous findings on the effect of worry on IGT performance. (2) To examine the influence of avoidance opportunity on IGT performance. We hypothesized that the positive effect of worry on learning would be abolished or reversed by the opportunity to avoid. METHOD: A standard IGT and a new IGT version that includes a pass (avoidance) option were completed by 78 and 79 participants, respectively. RESULTS: A beneficial effect of worry on learning in the standard version of the IGT was not observed. In the pass version of the IGT, worry status and avoidance were negatively associated with performance. Worry was not related, however, to pass usage. The hypothesized mediating effect of avoidance was non-significant. LIMITATIONS: It is unclear to what extent these findings generalize to real-life decision making and how clinical status affects results. CONCLUSION: The possibility to avoid a decision results in poorer IGT performance in high relative to low trait worriers. Possible explanations for these findings are discussed.

Cognitive reactivity, implicit associations, and the incidence of depression: a two-year prospective study.

BACKGROUND: Cognitive reactivity to sad mood is a vulnerability marker of depression. Implicit self-depressed associations are related to depression status and reduced remission probability. It is unknown whether these cognitive vulnerabilities precede the first onset of depression. AIM: To test the predictive value of cognitive reactivity and implicit self-depressed associations for the incidence of depressive disorders. METHODS: Prospective cohort study of 834 never-depressed individuals, followed over a two-year period. The predictive value of cognitive reactivity and implicit self-depressed associations for the onset of depressive disorders was assessed using binomial logistic regression. The multivariate model corrected for baseline levels of subclinical depressive symptoms, neuroticism, for the presence of a history of anxiety disorders, for family history of depressive or anxiety disorders, and for the incidence of negative life events. RESULTS: As single predictors, both cognitive reactivity and implicit self-depressed associations were significantly associated with depression incidence. In the multivariate model, cognitive reactivity was significantly associated with depression incidence, together with baseline depressive symptoms and the number of negative life events, whereas implicit self-depressed associations were not. CONCLUSION: Cognitive reactivity to sad mood is associated with the incidence of depressive disorders, also when various other depression-related variables are controlled for. Implicit self-depressed associations predicted depression incidence in a bivariate test, but not when controlling for other predictors.

A multiple case series analysis of six variants of attentional bias modification for depression.

Background. Attention bias modification (ABM) is a new treatment for affective disorders. A meta-analysis of ABM for anxiety disorders showed that the effect size may be large but the number of studies is low. The working mechanism is still unclear, and little is known about the optimal treatment parameters. ABM for depression is much less studied. A few studies claimed positive effects but the sample sizes are low. Furthermore, the treatment parameters varied widely and differed from the anxiety literature. Aim. To select the most promising version of ABM for depression for further evaluation in clinical trials. Methods. Multiple case series design. We tested six versions of ABM that varied on stimulus duration and training direction. Thirty students with mild to moderate symptoms of depression underwent four sessions of ABM. Change of attentional bias was measured during each session. Generalization of treatment effects and the role of awareness of receiving training were also investigated. Results. None of the investigated versions of ABM had a consistent effect on attentional bias. Changes of attentional bias in individual participants the effects did not generalize to untrained stimuli. Conclusion. It is unlikely that any of these ABM versions will have a specific effect on symptoms in controlled studies.

The effects of a visual search attentional bias modification paradigm on attentional bias in dysphoric individuals.

BACKGROUND AND OBJECTIVES: Attentional Bias Modification (ABM) may constitute a new type of treatment for affective disorders. ABM refers to computerized training programs that have been developed based on laboratory findings in experimental psychology. Meta-analyses have reported moderate effect sizes in anxiety disorders. Two small studies have also claimed an effect in dysphoria. Furthermore, a series of studies in individuals with low self-esteem has shown that they benefit from a single session of an ABM variant based on a visual search task. The current study tested the working mechanism of visual search ABM in dysphoria. METHODS: Forty dysphoric individuals engaged in a single session of ABM training or control training. Attentional bias for positive and negative facial expressions was assessed pre- and post training. Positive and negative mood states were assessed throughout the procedure. RESULTS: Attentional training had no effect on attentional bias. Positive and negative mood states were not differentially affected by training condition. LIMITATIONS: Small treatment effects may have gone undetected and there are some methodological differences with prior research. CONCLUSION: We found no evidence that engaging in a single session of a visual search ABM modifies attentional biases for happy, sad or disgusted facial expressions.

The effects of MAOA genotype, childhood trauma, and sex on trait and state-dependent aggression.

Monoamine oxidase A (MAOA) genotypic variation has been associated with variation in aggression, especially in interaction with childhood trauma or other early adverse events. Male carriers of the low-expressing variant (MAOA-L) with childhood trauma or other early adverse events seem to be more aggressive, whereas female carriers with the high-expressing variant (MAOA-H) with childhood trauma or other early adverse events may be more aggressive. We further investigated the effects of MAOA genotype and its interaction with sex and childhood trauma or other early adverse events on aggression in a young adult sample. We hypothesized that the association between genotype, childhood trauma, and aggression would be different for men and women. We also explored whether this association is different for dispositional (trait) aggression versus aggression in the context of dysphoric mood. In all, 432 Western European students (332 women, 100 men; mean age 20.2) were genotyped for the MAOA gene. They completed measures of childhood trauma, state and trait measures of aggression-related behaviors (STAXI), and cognitive reactivity to sad mood (LEIDS-R), including aggression reactivity. Women with the MAOA-H had higher aggression reactivity scores than women with the MAOA-L. This effect was not observed in men, although the nonsignificant findings in men may be a result of low power. Effects on the STAXI were not observed, nor were there gene by environment interactions on any of the aggression measures. A protective effect of the low-expression variant in women on aggression reactivity is consistent with previous observations in adolescent girls. In females, the MAOA-H may predispose to aggression-related problems during sad mood.

Testosterone administration impairs cognitive empathy in women depending on second-to-fourth digit ratio.

During social interactions we automatically infer motives, intentions, and feelings from bodily cues of others, especially from the eye region of their faces. This cognitive empathic ability is one of the most important components of social intelligence, and is essential for effective social interaction. Females on average outperform males in this cognitive empathy, and the male sex hormone testosterone is thought to be involved. Testosterone may not only down-regulate social intelligence organizationally, by affecting fetal brain development, but also activationally, by its current effects on the brain. Here, we show that administration of testosterone in 16 young women led to a significant impairment in their cognitive empathy, and that this effect is powerfully predicted by a proxy of fetal testosterone: the right-hand second digit-to-fourth digit ratio. Our data thus not only demonstrate down-regulatory effects of current testosterone on cognitive empathy, but also suggest these are preprogrammed by the very same hormone prenatally. These findings have importance for our understanding of the psychobiology of human social intelligence.