Efficacy of mindfulness to regulate induced emotions in the laboratory: A systematic review and meta-analysis of self-report and biobehavioral measures.

A substantial part of the research on the efficacy of mindfulness-based interventions on mood regulation is conducted in the laboratory. Nevertheless, a systematic review of the results is lacking. This meta-analysis aimed to investigate the effects of mindfulness as an emotion regulation (ER) strategy when using mood induction procedures. A systematic search of databases was conducted and a total of 43 studies were included in the meta-analysis. We found a small significant overall effect size of mindfulness [g= -0.15 (95% CI [-0.30, -0.01], p = 0.04)], which became non-significant after removing outliers (g=-0.15, p = 0.06). We also found high levels of heterogeneity which was not explained by the moderating variables analyzed. Thus, there is limited meta-analytic evidence of the efficacy of mindfulness strategies in down-regulating or preventing heightened or chronic effects of induced mood states in well-controlled laboratory settings. We propose that this could be partially due to some limitations in laboratory methodologies and suggest some guidelines to overcome them in future primary research.

Echocardiographic Prediction of Successful Weaning From Venoarterial Extracorporeal Membrane Oxygenation.

BACKGROUND: Weaning from venoarterial extracorporeal membrane oxygenation (VA-ECMO) support fails in 30% to 70% of patients. OBJECTIVE: To explore the utility of echocardiographic parameters in predicting successful disconnection from VA-ECMO. METHODS: Patients receiving VA-ECMO in a referral hospital were included. The relationships between echocardiographic parameters during the weaning trial and weaning success (survival > 24 hours after VA-ECMO explant and no death from cardiogenic shock, heart failure, or cardiac arrest during the hospital stay) and survival were evaluated. RESULTS: Of 85 patients included, 61% had successful weaning. Parameters significantly related to weaning success were higher left ventricular ejection fraction (LVEF; 40% in patients with weaning success vs 30% in patients with weaning failure, P = .01), left ventricular outflow tract velocity time integral (15 cm vs 11 cm, P = .01), aortic valve opening in every cycle (98% vs 91% of patients, P = .01), and normal qualitative right ventricular function (60% vs 42% of patients, P = .02). The LVEF remained as an independent predictor of weaning success (hazard ratio, 0.938; 95% CI, 0.888-0.991; P = .02). An LVEF >33.4% was the optimal cutoff value to discriminate patients with successful weaning (area under the curve, 0.808; sensitivity, 93%; specificity, 72%) and was related to higher survival at discharge (60% vs 20%, P < .001). CONCLUSION: Among weaning trial echocardiographic parameters, LVEF was the only independent predictor of successful VA-ECMO weaning. An LVEF >33.4% was the optimal cutoff value to discriminate patients with successful weaning and was related to final survival.

Relations between emotion regulation strategies and affect in daily life: A systematic review and meta-analysis of studies using ecological momentary assessments.

Emotion regulation (ER) is a central target in the study of psychological and neurobiological processes of emotions for numerous psychological disorders. Ecological momentary assessments, overcoming retrospective self-reports, allow a better understanding of the relation between the use of ER strategies and daily life affective experiences. A systematic review and meta-analyses of studies testing these relations through experience sampling methods (ESM) and daily diaries were conducted. ESM studies showed significant large effect sizes in contemporaneous relations between negative affect (NA) and rumination, suppression, and worry, and in both contemporaneous and prospective relations between positive affect (PA) and reappraisal; medium effect sizes in prospective relations between NA and rumination, and PA and distraction; and a small effect size in the prospective relation between NA and suppression. Daily diary studies showed significant large effect sizes in contemporaneous relations between NA and rumination and suppression, and in both contemporaneous and prospective relations between PA and reappraisal; medium effect sizes in contemporaneous relations between PA and acceptance, and problem-solving; and a small effect size in the prospective relation between NA and reappraisal. These findings shed light on the temporal relations between the use of ER strategies and affective experiences and highlight conceptual and methodological limitations in the field.

Short-term mechanical circulatory support in elderly patients.

BACKGROUND: Age over 70 years seems to confer poor prognosis for patients under mechanical circulatory support (MCS). Advanced age is usually a relative contraindication. Our objective was to assess the impact of age on survival of patients with short-term MCS. METHODS: Retrospective analysis of ≥70-year-old patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP® due to cardiogenic shock and other situations of hemodynamic instability in a referral hospital (elderly group), compared with younger patients (<70 years). We analyze factors associated with survival in elderly group. RESULTS: Out of 164 short-term MCS implants from 2013 to October 2020, 45 (27.4%) correspond to ≥70-year-old patients (73.3% VA-ECMO; 26.7% Impella CP®), 80% as bridge to recovery and 15.6% for high-risk percutaneous coronary intervention (PCI). We found no significant differences in complications developed between both groups. Survivals at discharge (40% vs. 43.7%, p = 0.403) and at follow-up (median 13.6 [30] months) were similar in elderly and young patients (35.6% vs. 37.8%, log-rank p = 0.061). Predictive factors of mortality in elderly patients were peripheral artery disease (p = 0.037), higher lactate (p = 0.003) and creatinine (p = 0.035) at implant, longer cardiac arrest (p = 0.003), and worse post-implantation left ventricular ejection fraction (p = 0.003). Patients with indication of MCS for high-risk PCI had higher survival compared to other indications (p = 0.013). CONCLUSION: Short-term MCS with VA-ECMO or Impella CP® in elderly patients may be a reasonable option in hemodynamic compromise situations as bridge to recovery or elective high-risk PCI, without a significant increase in complications or mortality. Age should not be an absolute contraindication, but careful selection of candidate patients is necessary.

Disentangling the mediating role of modifying interpretation bias on emotional distress using a novel cognitive bias modification program.

BACKGROUND: Negative interpretation bias is a potential risk factor for emotional disorders. In this study, we tested a clinically inspired 4-session online Cognitive Bias Modification-Interpretation (CBM-IClin) program to modify negative interpretation biases. METHODS: We randomized one hundred and twenty-one volunteer young adults (Mean age = 21.6 years, SD = 3.5; 85 % women) with varying levels of emotional distress to either an experimental or waitlist control group. Mediation analyses were used to disentangle the associations between the intervention, changes in interpretation biases (assessed by both a self-report and an experimental task), and changes in measures of cognitive vulnerability and symptoms of depression and anxiety. RESULTS: The results showed that the CBM-IClin could change negative interpretation biases. Also, it had a direct effect on the change in negative memory bias, an indirect effect on the change in depression symptoms via the change in interpretation bias, and both direct and indirect effects on the change in self-reported dysfunctional attitudes. LIMITATIONS: The study included a non-clinical sample of participants and it did not control for some potential confounding factors (e.g., attentional disorders). Furthermore, participants' engagement during the sessions at home was not supervised. CONCLUSIONS: The CBM-IClin is a potential tool to prevent and intervene in emotional disorders in young adults and could complement other traditional CBM procedures or clinical interventions.

'Relearning how to think': A brief online intervention to modify biased interpretations in emotional disorders-study protocol for a randomised controlled trial.

BACKGROUND: Cognitive biases play an important role in the development and maintenance of emotional disorders, such as depression and anxiety. Novel procedures, known as Cognitive Bias Modification (CBM), aim to reduce these dysfunctional information processing modes. This study develops a brief clinically based online intervention programme to modify biased interpretations in depression and anxiety (CBM-IClin), overcoming some methodological issues that have been addressed in previous literature. METHODS: Volunteer participants will be recruited via social media and posters at the university. They will be randomly assigned to an experimental group or a waiting list control group. Both groups will complete two assessment sessions (before and after the intervention) consisting of questionnaires measuring cognitive and emotional variables as well as experimental tasks measuring cognitive biases (i.e. attention, memory, and interpretation). After the first assessment session, only participants in the experimental group will receive a link to follow the four CBM-IClin sessions at home. All participants will receive, via email, follow-up questionnaires 2 weeks and 3 months after the second assessment. DISCUSSION: This study will test the 'Relearning how to think', an online programme potentially beneficial to modify cognitive biases in emotional disorders. Several limitations of previous CBM procedures are addressed, and the impact of the programme both on objective cognitive bias tasks and clinical symptoms will be explored. TRIAL REGISTRATION: ClinicalTrials.gov NCT03987477 . Prospectively registered on June 17, 2019.

Post-traumatic stress disorder symptoms after veno-arterial extracorporeal membrane oxygenator support.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a common long-term outcome after intensive care of critical illness. OBJECTIVES: Assess the prevalence and factors associated to PTSD after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. METHODS: Retrospective analysis of admission data and cross-sectional assessment of PTSD symptoms in adult survivors from admission requiring VA-ECMO support in a referral hospital. People were screened through abbreviated Impact of Event Scale-6 (IES-6). RESULTS: Out of 135 VA-ECMO implants performed from 2013 to 2020, 48 (35.6%) patients survived the admission. After a median follow-up of 31.4 [36] months, 34 survivors responded the questionnaire. All patients required sedation and invasive mechanical ventilation. Up to 29.4% of patients had PTSD symptoms. Patients with altered IES-6 items had passed a longer time since admission in ICCU (44±15 vs 30±20 months, p = 0.034). No baseline characteristic or admission-related variables were correlated with IES-6 except the lower time under mechanical ventilation (6.5 [8.5] vs. 8.5 [21] days, p = 0.044). CONCLUSIONS: Survivors from admission requiring VA-ECMO support show high prevalence of PTSD symptoms, appearing more frequently when more time has elapsed since admission. Special attention should be paid to psychological symptoms after VA-ECMO support.

Emotional SNARC: emotional faces affect the impact of number magnitude on gaze patterns.

The Spatial-Numerical Association of Response Codes (SNARC) effect is characterised by a spatial cognitive representation of low numbers to the left side of space and high numbers to the right side of space. This effect has been found using a diversity of stimuli and experimental paradigms. However, the influence of emotional stimuli on this effect remains unclear. In this study, the SNARC effect is analysed in relation to pairs of emotional facial stimuli (happy-neutral, sad-neutral and happy-sad pairs). Gaze patterns of 151 participants were analysed when exposed to a free-viewing eye-tracking paradigm consisting of pairs of emotional faces preceded by small and large numbers. Replicating previous results, a standard SNARC effect was found independently of the emotional expressions of the faces (i.e., there was a significant linear trend of number magnitude in the frequency of first fixations of the gaze to the left side space). However, specific slope analyses revealed that the SNARC effect was influenced by the spatial position of each emotion presented in the emotional pairs. Specifically, the effect disappeared in happy-neutral trials, when the happy faces were allocated in the right position and also in happy-sad trials when two emotional stimuli were simultaneously displayed. The study revealed that the SNARC effect is sensitive to the spatial position of emotional stimuli which further adds to other known limits of the phenomenon. The limitations of the study and its implications in the area of cognition and emotion are also discussed.

Levosimendan in veno-arterial extracorporeal membrane oxygenator supported patients: Impact on the success of weaning and survival.

Weaning failure and mortality rates in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) supported patients are significant. Small studies suggest the possible usefulness of levosimendan in this environment, especially in postcardiotomy shock. We performed a retrospective analysis of VA-ECMO implants in a referral hospital comparing weaning failure and survival of patients treated with levosimendan with a control group. From 2013 to May 2020, 123 VA-ECMO for several indications were implanted. Levosimendan was administered in 23 patients (18.7%) with good tolerance. Levosimendan was used more frequently in cardiogenic shock due to acute coronary syndrome indication, and in patients with lower left ventricular ejection fraction (LVEF) at the implant. No significant differences were found in success of ECMO weaning (60.9% levosimendan group vs. 44% non-levosimendan group, P = .169) despite worse LVEF in levosimendan group. Survival at follow-up (20.6 [58] months) was higher in the group that received levosimendan, although without finding statistically significant differences (47.8% vs. 32.0%, log rank P = .124). Levosimendan can be safely administered during VA-ECMO support. Patients receiving levosimendan were weaned similarly from circulatory support despite worse LVEF. Its use did not influence in short- and medium-term survival. Randomized studies are needed to evaluate the levosimendan impact in this indication.

Self-reported cognitive biases in depression: A meta-analysis.

Despite the influence of Beck's cognitive models of depression, the presence and magnitude of the specific proposed cognitive biases have not been systematically investigated. After a systematic search in PsycInfo and PubMED, studies reporting self-reported outcomes on cognitive biases and depressive symptoms in depressed and/or healthy groups were included. From a total of 4840 records, two different meta-analyses were conducted. 23 studies on 4865 participants provided data about catastrophising and depression (g = 0.95, 95% CI [0.64; 1.26]) and 40 studies on 4678 participants provided data about interpretation bias in depression (g = 0.78, 95% CI [0.43; 1.13]). Moderation analyses showed that the relationship between catastrophising and depression was higher in studies with more women, when the corresponding author was from a Western country, and when the instrument to measure depression was the DSM criteria, the SCL-90, the BDI, or the DASS. The relationship between interpretation bias and depressive symptoms was significant only in studies comparing depressed and healthy groups, and when using specific instruments to measure symptoms (DSM/RDC criteria plus a scale cut-off score) and cognitive bias (CDQ/CBQ, SCT, AST-D, other). Some limitations are acknowledged, but risk of publication bias was found to be low, and these results support the utility of some self-reported measures of cognitive biases in depression.

The quality of research on mental health related to the COVID-19 pandemic: A note of caution after a systematic review.

BACKGROUND AND AIMS: SARS-CoV-2 pandemic has spurred scientific production in diverse fields of knowledge, including mental health. Yet, the quality of current research may be challenged by the urgent need to provide immediate results to understand and alleviate the consequences of the pandemic. This study aims to examine compliance with basic methodological quality criteria and open scientific research practices on the mental health effects of the COVID-19 pandemic. METHOD AND RESULTS: Twenty-eight studies were identified through a systematic search. Most of them met the requirements related to reporting key methodological and statistical information. However, the widespread use of convenience samples and the lack of a priori power analysis, coupled with low compliance with open science recommendations, such as pre-registration of studies and availability of databases, raise concerns about the validity, generalisability, and reproducibility of the findings. CONCLUSIONS: While the importance of offering rapid evidence-based responses to mitigate mental health problems stemming from the COVID-19 pandemic is undeniable, it should not be done at the expense of sacrificing scientific rigor. The results of this study may stimulate researchers and funding agencies to try to orchestrate efforts and resources and follow standard codes of good scientific practice.

Attentional biases in dysphoria when happy and sad faces are simultaneously presented.

BACKGROUND AND OBJECTIVE: Difficulties to engage attention to positive stimuli and to disengage attention from negative stimuli are typically found in depression. Yet, most of the evidence supporting these attentional biases comes from experimental paradigms in which emotional information (e.g., happy or sad faces) is simultaneously presented with neutral information. Few studies have explored attentional biases when emotional stimuli of different valence are presented simultaneously. The aim of the present study was to assess visual scan patterns of non-dysphoric and dysphoric participants when emotional information is presented simultaneously. METHOD: Using an eye-tracker methodology, the gradient relation between attentional biases and depression scores as well as differences between groups in their attentional performance were assessed in non-dysphoric participants (N = 84) and dysphoric participants (N = 58). Three different pairs of faces were used: happy-neutral, neutral-sad, and happy-sad. RESULTS: First, we found that simultaneous presentation of emotional information (i.e., happy vs. negative faces) reduces the magnitude of attentional biases towards positive information. Second, we also found a significant negative relation between attentional biases towards positive information and depression scores. Finally, compared to non-dysphoric participants, dysphoric individuals marginally spent less time attending positive information in both happy-neutral and happy-sad trials. LIMITATIONS: The cross-sectional nature of our study does not allow us to make inferences about causality. Further, only one type of simultaneous emotional faces presentation (i.e., happy-sad) was used. CONCLUSIONS: These results support the need for further research on the processing of competing emotional stimuli in depression.

El análisis de redes en psicopatología: conceptos y metodología / Network analysis and psychopathology: Concepts and methodology

En las últimas décadas, la validez de los sistemas diagnósticos categoriales, como el DSM o la CIE, ha sido puesta en duda. Una alternativa conceptual es el análisis de redes (AR), que concibe los problemas psicológicos simplemente como cadenas de síntomas causalmente relacionados y no como elementos emergentes de un trastorno o una enfermedad latente. El AR utiliza herramientas estadísticas para analizar los patrones de síntomas y sus dinámicas lo que permite identificar los síntomas centrales y periféricos dentro de una red sintomática y el potencial papel causal de cada síntoma dentro de la red. El AR abre nuevas vías para abordar problemas clásicos de los sistemas categoriales tales como la comorbilidad, los factores de vulnerabilidad y el análisis de las variables diferentes a los síntomas (p. ej., eventos estresantes). En definitiva, el AR en psicopatología se presenta como una alternativa prometedora a las concepciones vigentes de la psicopatología aunque aún ha de demostrar que es una herramienta útil para la clínica y la investigación

In recent decades, the validity of categorical diagnostic systems, like the DSM or the ICD, has been seriously questioned. Network analysis (NA), which conceives of psychological problems simply as chains of causally related symptoms and not as emerging elements of a latent disorder or illness, has been proposed as a conceptual alternative to those traditional systems. NA uses statistical tools to analyze symptom patterns and their dynamics. These analytical tools allow to identify central and peripheral symptoms within a symptom network as well as the potential causal role of each symptom within the network. The network perspective opens new avenues to address classic challenges of categorical systems such as the definition of comorbidity and vulnerability factors. NA also allows to incorporate non-symptom factors (e.g., stressful life events) within the network of psychopathological elements. In short, NA can be considered as a promising alternative to current conceptualizations of psychopathology although it still has to demonstrate its utility for both research and clinical applications

The Study of Psychopathology from the Network Analysis Perspective: A Systematic Review.

BACKGROUND: Network analysis (NA) is an analytical tool that allows one to explore the map of connections and eventual dynamic influences among symptoms and other elements of mental disorders. In recent years, the use of NA in psychopathology has rapidly grown, which calls for a systematic and critical analysis of its clinical utility. METHODS: Following PRISMA guidelines, a systematic review of published empirical studies applying NA in psychopathology, between 2010 and 2017, was conducted. We included the literature published in PubMed and PsycINFO using as keywords any combination of "network analysis" with the terms "anxiety," "affective disorders," "depression," "schizophrenia," "psychosis," "personality disorders," "substance abuse" and "psychopathology." RESULTS: The review showed that NA has been applied in a plethora of mental disorders in adults (i.e., 13 studies on anxiety disorders; 19 on mood disorders; 7 on psychosis; 1 on substance abuse; 1 on borderline personality disorder; 18 on the association of symptoms between disorders), and 6 on childhood and adolescence. CONCLUSIONS: A critical examination of the results of each study suggests that NA helps to identify, in an innovative way, important aspects of psychopathology like the centrality of the symptoms in a given disorder as well as the mutual dynamics among symptoms. Yet, despite these promising results, the clinical utility of NA is still uncertain as there are important limitations on the analytic procedures (e.g., reliability of indices), the type of data included (e.g., typically restricted to secondary analysis of already published data), and ultimately, the psychometric and clinical validity of the results.

Allele frequencies distributions for 13 autosomal STR loci in 3 Black Carib (Garifuna) populations of the Honduran Caribbean coasts.

Allele and genotype frequencies for 13 autosomal STR loci included in the Promega Powerplex 16 kit were assessed in 174 individuals from three Garifuna communities of the Caribbean coasts of Honduras (Central America). For the 13 loci the observed heterozygocity frequencies ranged from 0.571 for the D5S818 locus to 0.939 for the D18S51 locus, both in the Corozal population. Deviations from Hardy-Weinberg equilibrium, as well as pairs of loci in linkage disequilibrium (even after Bonferroni corrections of the level of statistical significance) and high F(is) values were observed. These "spurious" results are probably caused by population substructure (Wahlund effect within communities) and high endogamy.