Examining the relationship between substance use and exploration-exploitation behavior in young adults.

Substance use is characterized by reward processing dysregulation and cognitive control deficits. One area of research that remains relatively unexplored is the relationship between substance use and exploration-exploitation trade-offs, which involve a continuum from switching (exploration) to perseverative (exploitation). In dynamic, volatile environments, exploitation of well-known options can lead to habit-driven perseveration, and exploration of new opportunities can produce new information that may enhance one's future state. The primary aim was to investigate the relationship between regular substance use and spontaneous eyeblink rate (EBR) on exploration-exploitation behavior. Young adults (N = 83) aged 18-23 completed a single laboratory session. A dynamic foraging task was used to characterize exploration/exploitation behavior. Substance use was defined using the Externalizing Spectrum Inventory-Brief Form. Dopamine levels were operationalized using spontaneous EBR. The primary outcome was proportion of switch choices on the foraging task, which reflects a continuum of exploitation (low values) to exploration (high values) behavior. A linear mixed-effects regression was conducted to examine the effect of substance use and EBR on the proportion of switch trials. Results demonstrated a significant negative interaction between substance use and EBR on proportion of switch trials (p < .001). Participants with regular substance use and low EBR showed decreased switch choices, indicative of increased exploitation, compared to those with higher EBR. EBR was positively associated with proportion of switch trials (p = .032) and thus greater exploration. The relationship between substance use and increased exploitation in young adults appears specific to those with low EBR. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis.

BACKGROUND: Previous research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health apps incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce depressive symptoms over and above mental health apps without gamification. OBJECTIVE: The aim of this study was to determine whether mental health apps with gamification elements differ in their effectiveness to reduce depressive symptoms when compared to those that lack these elements. METHODS: A meta-analysis of studies that examined the effect of app-based therapy, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness, on depressive symptoms was performed. A total of 5597 articles were identified via five databases. After screening, 38 studies (n=8110 participants) remained for data extraction. From these studies, 50 total comparisons between postintervention mental health app intervention groups and control groups were included in the meta-analysis. RESULTS: A random effects model was performed to examine the effect of mental health apps on depressive symptoms compared to controls. The number of gamification elements within the apps was included as a moderator. Results indicated a small to moderate effect size across all mental health apps in which the mental health app intervention effectively reduced depressive symptoms compared to controls (Hedges g=-0.27, 95% CI -0.36 to -0.17; P<.001). The gamification moderator was not a significant predictor of depressive symptoms (ß=-0.03, SE=0.03; P=.38), demonstrating no significant difference in effectiveness between mental health apps with and without gamification features. A separate meta-regression also did not show an effect of gamification elements on intervention adherence (ß=-1.93, SE=2.28; P=.40). CONCLUSIONS: The results show that both mental health apps with and without gamification elements were effective in reducing depressive symptoms. There was no significant difference in the effectiveness of mental health apps with gamification elements on depressive symptoms or adherence. This research has important clinical implications for understanding how gamification elements influence the effectiveness of mental health apps on depressive symptoms.

Development and implementation of a remote patient monitoring program for heart failure: a single-centre experience.

AIMS: Remote patient monitoring (RPM) in the management of heart failure (HF), including telemonitoring, thoracic impedance, implantable pulmonary artery pressure (PAP) monitors, and cardiac implantable electronic device (CIED)-based sensors, has had varying outcomes in single platform studies. Uncertainty remains regarding the development of single-centre RPM programs; additionally, no studies examine the effectiveness of dual platform RPM programs for HF. This study describes the implementation and outcomes of a dual platform RPM program for HF at a single centre. METHODS AND RESULTS: An RPM program was developed to include two platforms (e.g. CardioMEMS™ HF System and HeartLogic™ HF Diagnostic). To examine changes within each participant over time, study-related outcomes including total hospitalizations (TH), total length of stay (TLOS), cardiac hospitalizations (CH), cardiac LOS (CLOS), and cardiac-related emergency department (ED) visits were compared in two timeframes: 12 months pre-enrolment and post-enrolment into RPM. For 141 participants enrolled, there was a significant reduction in the likelihood of experiencing a CH by 19% (0.77 vs. 0.61 events/patient-year; HR: 0.81, 95% CI: 0.67-0.97, P = 0.03) and a cardiac-related ED visit by 28% (0.48 vs. 0.34 events/patient-year; HR: 0.72, 95% CI: 0.55-0.93, P = 0.01). There was also a 51% decrease (SE = 1.41, 95% CI: 2.79-8.38 days, P < 0.001) and 62% decrease (SE = 1.24, 95% CI: 3.35-8.22 days, P < 0.001) in TLOS and CLOS, respectively. CONCLUSIONS: A dual platform RPM program for HF using structured education, RPM-capable devices, and alert-specific medication titration reduces the likelihood of experiencing a cardiac hospitalization and cardiac-related ED visit in this single-centre study.

Ostracism Reduces Reliance on Poor Advice from Others during Decision Making.

Decision-making is rarely context-free, and often both social information and non-social information are weighed into one's decisions. Incorporating information into a decision can be influenced by previous experiences. Ostracism has extensive effects, including taxing cognitive resources and increasing social monitoring. In decision-making situations, individuals are often faced with both objective and social information and must choose which information to include or filter out. How will ostracism affect the reliance on objective and social information during decision-making? Participants (N=245) in Experiment 1 were randomly assigned to be included or ostracized in a standardized, group task. They then performed a dynamic decision-making task that involved the presentation of either non-social (i.e. biased reward feedback) or social (i.e., poor advice from a previous participant) misleading information. In Experiment 2, participants (N=105) completed either the ostracism non-social condition or social misleading information condition with explicit instructions stating that the advice given was from an individual who did not partake in the group task. Ostracized individuals relied more on non-social misleading information and performed worse than included individuals. However, ostracized individuals discounted misleading social information and outperformed included individuals. Results of Experiment 2 replicated the findings of Experiment 1. Across two experiments, ostracized individuals were more critical of advice from others, both individuals who may have ostracized them and unrelated individuals. In other words, compared to included individuals, ostracized individuals underweighted advice from another individual, but overweighted non-social information during decision-making. We conclude that when deceptive objective information is present, ostracism results in disadvantageous decision-making.