Resilience in alcohol use disorder: associations with negative and positive emotionality, quality of life, and disorder severity

In previous work looking at individuals exposed to childhood trauma, we have found that decreased neuroticism, impulsivity, and trait anxiety, and increased conscientiousness are associated with a decreased risk of alcohol use disorder (AUD), suggesting these characteristics contribute to a relative resilience to alcohol misuse. In the current study we confirm and expand on these findings using the Connor-Davidson Resilience Scale (CD-RISC), which assesses resilience based on individual characteristics and coping mechanisms as well as social relationships. We analyzed CD-RISC data from two NIAAA protocols: 1) the Natural History Protocol (NHP) (n = 245;156 with AUD, 89 without AUD);2) the COVID-19 Pandemic Impact on Alcohol Protocol (C19PIA) (n = 280;77 with AUD, 203 without AUD). Participants ranged from non-drinking healthy volunteers to heavy drinkers. In addition to the CD-RISC, assessments included the Structured Clinical Interview for DSM-5 disorders, and questionnaires related to problematic alcohol use, positive and negative affect, personality, perceived stress, and quality of life (i.e., physical health, psychological health, social relationships, and environment). Data analysis was conducted using general linear models, and analyses were run separately for the two independent samples due to differences in data collection methodology. For the C19PIA protocol sample, analyses were conducted on measures collected both pre-pandemic and during the pandemic. In both the NHP and C19PIA samples, CD-RISC score was negatively associated with neuroticism, negative affect, and perceived stress, and positively associated with extraversion, conscientiousness, positive affect, and all four quality of life measures. In the C19PIA sample, these results were consistent for analyses of both pre-pandemic and pandemic-associated measures. CD-RISC score was lower in individuals with AUD compared to those without AUD. In the NHP sample, which was enriched for individuals with AUD, greater resilience was associated with decreased AUD severity, and decreased anxiety and depression symptoms, among those diagnosed with AUD. A similar association between resilience and decreased AUD severity was observed in the C19PIA sample before the pandemic. Resilience was also associated with a reduction in impaired control over drinking in the C19PIA sample, both before and during the pandemic. The current findings highlight resilience as a key construct associated with multiple factors at the individual, social, and environmental levels. Of note, the same resilience-associated factors were observed both before and during the COVID 19 pandemic, with the latter representing a major stressor for many individuals. The finding that greater resilience is associated with decreased disorder severity and reduced depression and anxiety symptoms among those with AUD highlights the potential of resilience-oriented approaches to treatment. These approaches, often promoted for trauma-exposed individuals, could also prove beneficial for alcohol use disorder.Copyright © 2023

Mental health outcomes in patients discharged after COVID-19 hospitalization: the case report of a male nurse in the context of occupational surveillance program of health care workers

This case study draws attention on mental health sequelae that emerged in the context of the COVID-19 outbreak after recovery from hospitalization, even in subjects without personal psychiatric history. The case involves a 65-year-old male shift nurse who took SARS-COV-2 infection through a co-worker and that had been hospitalized for interstitial pneumonia from April 6 to April 17. After recovery, he developed psychiatric symptoms overlapping between different dimensions of psychiatric disorders and started to be followed by the Occupational Health Department of a Major University Hospital in central Italy. He reported a score of 28 at the Peritraumatic Distress Inventory and of 39 at the Self-Rating Anxiety State. He was treated with a combination therapy of SSRI and NaSSA antidepressants with clinical remission. In this case study, authors discuss the possible overlapping role of post-traumatic stress and anxiety symptoms in patients discharged after COVID-19 hospitalization that may deserve appropriate classification, treatment and follow up with the future goal to refine clinical management of post and long COVID syndromes of subjects who present low abnormalities in other specialty investigations.Copyright © 2022 EDIZIONI MINERVA MEDICA.

Low Treatment Fidelity as an Indication to Switch Interventions: Pivoting From Child-Parent Psychotherapy to Parent-Child Interaction Therapy for Early Childhood Trauma

Young children who experience trauma and adverse experiences are at an increased risk of developing an insecure attachment style as well as negative physical and mental health problems. These can include internalizing and externalizing behavioral problems, developmental delay, emotional dysregulation, and aggression. Several evidence-based interventions exist to treat young children with symptoms related to trauma, each with different foundational theories. This article presents the case of a 4-year-old boy with posttraumatic stress disorder who was in the middle of a legal fight between caregivers and transitioning between caregivers' homes. Initially, therapy began with Child-Parent Psychotherapy to address caregivers' first concerns. Later, the therapeutical approach was switched to Parent-Child Interaction Therapy due to difficulty with treatment fidelity related to caregivers' symptoms and conflict. This case demonstrates great improvement in treatment fidelity and subsequently problem behaviors after switching to an intervention that allowed to address behavior management shortcomings in a family with ongoing conflict.Copyright © The Author(s) 2022.

Environmental context and expectancy of alcohol use on changes in reflection-impulsivity and craving

The present study primarily aimed to (a) determine the effects of environmental context and the expectancy of alcohol consumption on changes in reflection-impulsivity (R-I), a state behavioral aspect of impulsivity and (b) test R-I as a mediator of the association between environment, expectancy of alcohol consumption, and subjective craving for alcohol in a sample of college-aged heavy drinkers. Participants were 81 (76.5% female) college students between the ages of 21 and 29 (M = 21.86, SD = 1.87) who were classified as heavy drinkers. Participants first completed measures of alcohol use, trait impulsivity, behavioral R-I, and subjective craving for alcohol in a neutral location prior to being randomized into one of four conditions: (1) a neutral environment without the expectancy of alcohol consumption, (2) a neutral environment with the expectancy of alcohol consumption, (3) a simulated bar without the expectancy of alcohol consumption, and (4) a simulated bar with the expectancy of alcohol consumption. Participants completed post-condition exposure assessments of R-I and subjective craving. Post hoc analyses determined that statistical tests for both aims were underpowered. As such, significant findings may not have been detected due to a high probability of Type II error and thus, null findings should be considered with caution. Findings revealed that environment nor expectancy of alcohol consumption elicited changes in R-I or subjective craving. There was a significant effect of time on R-I, whereby R-I improved over time. Such improvement may suggest the potential presence of a testing effect. Further, the association between condition and subjective craving for alcohol was not mediated by R-I. Trait impulsivity was found to positively associate with subjective craving at baseline and post-condition exposure. Thus, alcohol-related cues in one's environment and the priming of future alcohol consumption were not found to elicit changes in R-I or subsequent increases in subjective craving for alcohol. Future research may benefit from replication, as the COVID-19 pandemic may impacted the internal and external validity of this study. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Investigating Functioning Profile of Adolescents with Anorexia before and during the COVID-19 Pandemic: A Cross-Sectional Study on Mentalizing, Alexithymia, and Impulsiveness.

Anorexia nervosa (AN) usually emerges in adolescence when important changes occur in cognitive, emotional, and social processes. Mentalizing, alexithymia, and impulsiveness represent key dimensions for the understanding and interpretation of psychological difficulties in AN. The outbreak of the COVID-19 pandemic has impacted adolescents with AN, showing a worsening of the disease. The main aims of the present paper are (1) to compare adolescents with AN before and during the COVID-19 pandemic and (2) to explore the relationship between mentalizing, alexithymia, impulsiveness, and psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. One hundred and ninety-six AN female adolescents (N = 94 before COVID-19; N = 102 during COVID-19) participated in this study. The results show that adolescents with AN during the COVID-19 pandemic had a more impaired functioning profile than the before COVID-19 group. Mentalizing, alexithymia, and impulsiveness had a predictive role on psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. In conclusion, our data reveal that the COVID-19 pandemic has likely represented a stress condition that affects mental health; worsening the severity of adolescents with AN clinical condition. Lastly, predictive patterns suggest the existence of a link between difficulties in the ability to face the problems of the present time using effective strategies and the severity of psychological symptoms.

QEEG Individualized Protocols for the Treatment of Alcohol Use Disorder

Throughout United States history, alcohol use disorder (AUD) continues to be a national health concern. Within the last few years, pandemic stressors may also increase the potential for relapse in individuals struggling with AUD (Da et al., 2020). Medical professionals are imploring helping professionals to stay aware of this rising concern and to enhance AUD treatment options. Whereas treatments such as psychotherapy and pharmacology can be efficacious for AUD, there are also limitations to these types of interventions. AUD affects brain wave activity;while the prior mentioned treatments do not directly target brain activity, one treatment that does is neuron feed back. Neurofeed back is well documented for helping individuals with AUD, and other addiction concerns, to reach an enhanced state of regulation (Sokhadze et al., 2008). After IRB approval and participant recruitment, my supervisor and I created qEEG individualized protocols while also considering Peniston and Kulkosky's (1989, 1990) seminal neuron feed back studies that recommend certain brain wave parameters for AUD protocols. In addition, we also referred to the Scott-Kaiser modification (Scott & Kaiser, 1998) of the Peniston Protocol. The Peniston Protocol uses alpha/theta training and seeks to reduce states of stress and anxiety, while the Scott-Kaiser modification (e.g., SMR-beta modulation) aims to reduce impulsivity tendencies by remedying cognitive issues (Dousset et al., 2020). Participants were asked to complete pre and post qEEG and heart rate variability (HRV) measures along with self-report assessments of pre, post, and follow-up measures of the Alcohol Use Disorders Identification Test (AUDIT;Saunders et al., 1993), and repeated measures of a craving desire assessment after every neuron feed back session. Also, participants were asked to attend twice-weekly neuron feedback sessions for 6 weeks or at least twelve 10- to 25-minute sessions. University student clinicians and neuron feedback clinicians administered the neuron feedback sessions. Due to the pandemic and subsequent limiting factors (i.e., COVID concerns or lack of money for transportation), participants were allowed remote neuron feedback. Only one participant asked to utilize remote services. The primary purpose of this study was to determine if qEEG individualized neuron feedback protocols helped participants regulate their brain activity and reduce AUD cravings. Secondary purposes included comparing physiological data to self-report data and exploring neuron feedback session-to-session changes with a single-subject approach. This poster presentation will include pre and post qEEG z-score comparisons from NeuroGuide and pre and post HRV comparisons from BioTrace. Further, I will explore individual changes over time according to participants' neuron feedback protocols using single-case research design methods and participants' individual craving desire changes. The presentation will also entail implications for future research..

Covid-19 and impulsivity: an evaluation of self-harm admissions in emergency care

Introduction: Several studies highlighted how COVID-19-related isolation and quarantine deeply weighed on the mental health of both the general and psychiatric population. There has been limited investigation about self-harm and impulsivity during the COVID-19 pandemic. Objective(s): The aim of this study is to evaluate how COVID-19- related lockdown affected self-harm rates in an Italian hospital. Method(s): Data on 59 patients were retrospectively collected from the Emercency deparment of the Policlinico Tor Vergata, Rome, from March 11 to May 4, 2020 (Italian mass quarantine) and the same periods of 2019 and 2021. Demographics, psychiatric history, substance use/abuse, types of self-harm and admission in psychiatric acute unit (PAU) rates were recorded. Result(s): No statistical difference was reported in self-harm rates [9.8%(26/266) in 2019 vs 13.2%(10/76) in 2020 vs 10.7%(23/215) in 2021;p>0.05]. In 2020 subjects were younger (31.9+/-12.1 vs 39.2+/-14.4,p=0.22;vs 38.1+/-14.4;p=0.15) and had higher incidence of psychiatric history [90%(9/10) vs 73.1%(19/26), p= 0.42;vs 65.2% (15/23),p=0.29],than 2019 and 2021 respectively. Substance use/abuse rates were significantly lower in 2020 compared to 2019 and 2021 [10%(1/10) vs 53.8%(14/26),p= 0.04;vs 60.9% (14/23), p=0.02]. In 2020, subjects committing self-harms were more frequently admitted to PAU compared to 2019 and 2021 [60%(6/10)vs19.2%(5/26),p=0.04;vs 17.4% (4/23), p=0.04). Conclusion(s): Consistent with the literature, lockdown-related measures negatively impacted on younger people, with higher rates of self-harm between March and May 2020. This, together with a higher rate of admissions to PAU, should warn the mental health system to target with specific programs to support adolescents and youngers.

Associations between COVID-19 pandemic impact, dimensions of behavior and eating disorders: a longitudinal UK-based study

Introduction: There is growing concern about how people with eating disorders are impacted by the widespread societal restructuring during the COVID-19 crisis. Objective(s): We aimed to examine how factors relating to the impact of the pandemic associate with eating disorders and quantify this relationship while adjusting for concurrent and longitudinal parameters of risk. Method(s): We gathered demographic, behavioral and clinical data pre- and mid-pandemic as well as childhood trauma history from a longitudinal online survey of 489 adults (mean age 23.4 years) recruited from the Neuroscience in Psychiatry Network (NSPN). Using pre-pandemic (T1) and concurrent (T2) data we aimed to predict eating disorders at mid-pandemic (T2). We deployed hierarchical generalized logistic regression to ascertain the strength of longitudinal and concurrent associations. Result(s): Pre-pandemic eating disorder scores strongly associated with concurrent eating disorder (z=5.93). More conflict at home mid-pandemic (z=2.03), pre- (lower sensation seeking z=-2.58) and mid-pandemic (higher lack of perseverance z=2.33) impulsivity traits also associated with mid-pandemic eating disorder. Significant correlations between pandemic-related disrupted lifestyle and eating disorder psychopathology both pre- and mid-pandemic were observed. Conclusion(s): Conflict at home mid-pandemic and specific aspects of impulsiveness significantly associated with concurrent eating disorder when adjusted for pre-pandemic eating disorder symptoms, baseline demographics, behavioral traits, history of traumatic experiences and concurrent psychopathology. These results provide insight into the struggles of those suffering with eating disorders during the COVID-19 pandemic and highlight the importance of impulsiveness traits and the immediate family environment in their experience of illness during the pandemic.

Use of social network as a coping strategy for depression among young people during the COVID-19 lockdown: findings from the COMET collaborative study.

BACKGROUND: Use of social media (SM) has exponentially grown particularly among youths in the past two years, due to COVID-19-related changing lifestyles. Based on the Italian COvid Mental hEalth Trial (COMET), we investigated the association between SM use and depressive symptoms among Italian young adults (aged 18-24). METHODS: The COMET is a nationwide multi-center cross-sectional study that investigated socio-demographic data, social networking addiction (BSNAS), depression, anxiety, and stress (DASS-21), as well as impulsiveness (BIS-15) and aggressiveness (AQ) in a large sample of youngsters, in order to assess the association between BSNAS and DASS-21 indices. Mediation analyses were performed to evaluate the role of impulsiveness and aggressive personality traits in the association between SM use (SMU) and depression. RESULTS: 75.8% of the sample (n = 491) had a problematic SMU. SMU was reduced by high AQ and high DASS-21 scores (F = 42.338, p < 0.001, R2 = 0.207). Mediation analyses showed that SMU negatively predicted depressive symptomatology with the interaction mediated by AQ total (ß = - 0.1075), physical (ß = - 0.207) and anger (ß = - 0.0582), BIS-15 total (ß = - 0.0272) and attentional (ß = - 0.0302). High depressive levels were predicted by high AQ scores, low SMU levels, low verbal and physical AQ, and low attentional BIS-15 (F = 30.322, p < 0.001, R2 = 0.273). Depressive symptomatology negatively predicted SMU with their interaction mediated by AQ total (ß = - 0.1640), verbal (ß = 0.0436) and anger (ß = - 0.0807), BIS-15 total (ß = - 0.0448) and attentional (ß = - 0.0409). CONCLUSIONS: SMU during the early phases of the COVID-19 pandemic could have a beneficial role in buffering negative consequences linked to social isolation due to quarantine measures, despite this association being mediated by specific personality traits.

Unprofessional or Admirable? Determinants of Purchasing Behavior in Government Officials' Livestreamed Shopping.

As a new form of poverty governance, government officials' livestreaming e-commerce of agricultural and sideline products has been booming since the outbreak of the coronavirus disease (COVID-19) in 2019. However, exploring the determinants of consumer purchase intentions in the context of government officials' livestreaming is still limited. Drawing on the stimulus-organism-response (S-O-R) framework, this study develops a research model to examine the effect of platform factor (information quality), user factor (bullet screen mutuality), and streamer factors (streamer trustworthiness, streamer expertise, and streamer responsiveness) on perceived information usefulness and arousal, which in turn affect purchase intention. This study also integrates impulsiveness as a moderator. We use structural equation modeling to analyze 430 samples. Our results show that perceived information usefulness and arousal have a significant positive influence on purchase intention. Moreover, impulsiveness moderates the relationship between perceived information usefulness and purchase intention and between arousal and purchase intention. Livestreaming features and streamer characteristics can activate these two mechanisms. This study provides theoretical contributions to livestreaming and the S-O-R literature, as well as practical insights into livestreaming government officials.

Panic buying: Perspectives and prevention

This brief provides a thorough overview of the history and underlying motivations for consumer panic buying, evaluating psychological perspectives on this behavior on both an individual and societal level. The first volume of its kind to focus specifically on the topic of panic buying, the book situates its analysis within the context of the modern COVID-19 pandemic as well as in a broader psychology context. Chapters encompass a variety of interdisciplinary perspectives, incorporating insights from consumer psychology, marketing, sociology, and public health. Finally, contributors discuss the long-term implications of panic buying and potential prevention strategies. Panic Buying: Perspectives and Prevention will be a useful reference for researchers and students in consumer psychology, as well as those interested emergency preparedness, and supply chain management. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Environmental context and expectancy of alcohol use on changes in reflection-impulsivity and craving

The present study primarily aimed to (a) determine the effects of environmental context and the expectancy of alcohol consumption on changes in reflection-impulsivity (R-I), a state behavioral aspect of impulsivity and (b) test R-I as a mediator of the association between environment, expectancy of alcohol consumption, and subjective craving for alcohol in a sample of college-aged heavy drinkers. Participants were 81 (76.5% female) college students between the ages of 21 and 29 (M = 21.86, SD = 1.87) who were classified as heavy drinkers. Participants first completed measures of alcohol use, trait impulsivity, behavioral R-I, and subjective craving for alcohol in a neutral location prior to being randomized into one of four conditions: (1) a neutral environment without the expectancy of alcohol consumption, (2) a neutral environment with the expectancy of alcohol consumption, (3) a simulated bar without the expectancy of alcohol consumption, and (4) a simulated bar with the expectancy of alcohol consumption. Participants completed post-condition exposure assessments of R-I and subjective craving. Post hoc analyses determined that statistical tests for both aims were underpowered. As such, significant findings may not have been detected due to a high probability of Type II error and thus, null findings should be considered with caution. Findings revealed that environment nor expectancy of alcohol consumption elicited changes in R-I or subjective craving. There was a significant effect of time on R-I, whereby R-I improved over time. Such improvement may suggest the potential presence of a testing effect. Further, the association between condition and subjective craving for alcohol was not mediated by R-I. Trait impulsivity was found to positively associate with subjective craving at baseline and post-condition exposure. Thus, alcohol-related cues in one's environment and the priming of future alcohol consumption were not found to elicit changes in R-I or subsequent increases in subjective craving for alcohol. Future research may benefit from replication, as the COVID-19 pandemic may impacted the internal and external validity of this study. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Determinants and consequences of obesity – contribution of the French NutriNet-Santé cohort

Large-scale observational epidemiological studies provide essential information for the development of prevention policies for chronic diseases such as obesity. Since 2009, the French NutriNet-Santé cohort has been used as the basis for 29 empirical studies on obesity. The aim of this review is to present a summary of the findings of those studies and to deduce the contribution of NutriNet-Santé to the understanding of obesity. Among the 29 studies, 5 analyzed obesity as an exposure variable, 23 – as an outcome, and 1 – as a moderator. When modelled as a determinant (or exposure), obesity was cross-sectionally and positively associated with migraine and functional dyspepsia, respectively. In turn, when modelled as a consequence (or outcome), obesity was positively associated with different dietary factors, such as the proportion of ultra-processed foods in the diet and preference for fatty food. Other factors were inversely associated with obesity, such as following an organic diet. Some psychological factors were positively (e.g. impulsivity) or inversely associated (e.g. optimism) with obesity risk. In NutriNet-Santé, further studies on obesity are underway, dealing with its association with COVID-19 and mental disorders.

A Case of Autosarcophagy in a Pediatric Patient With Depression

BACKGROUND: Self-mutilating behavior in the pediatric population is associated with psychiatric and psychosocial factors. Autosarcophagy, or self-cannibalism, is an extremely rare form of self-mutilation and is predominantly seen with psychosis or substance use.1 We report a case of oral autosarcophagy in a pediatric patient in the absence of substance use or psychosis. OBJECTIVE: To learn about autosarcophagy and its treatment in the pediatric population and to explore other neuropsychiatric disorders in which it is a predominant manifestation. METHODS: Review of a case using electronic medical records and relevant literature. Key terms: 'autosarcophagy,' 'body focused repetitive behavior,' 'oral self injury,' 'pediatric self-mutilation' using Medscape and Google Scholar. RESULTS: We present a 14-year-old female with history of seizure disorder in full remission, depression, self-cutting behavior, and suicidal ideation with 2 psychiatric hospitalizations, who presented to the pediatric emergency department with oral bleeding after eating one-third of her tongue over the course of a month. Evaluation was notable for poverty of speech and constricted affect. Patient stated she was 'trying to remove an infection' and alleviate discomfort. She denied that this behavior was an attempt to end her life but endorsed past suicidal ideations and cutting behavior. History revealed emergency room evaluation for aggressive behavior and episodes of volitional enuresis. We diagnosed major depressive disorder, recurrent episode in remission without psychosis. Drug screen, complete blood count, complete metabolic panel, COVID-19, urinalysis, thyroid-stimulating hormone, head computed tomography, and beta-human chorionic gonadotropin were negative. Patient continued home oral medications aripiprazole 10 mg daily, fluoxetine 30 mg daily, and levetiracetam 500 mg twice daily and was discharged the next day. CONCLUSIONS: Self-harm is observed in 17.2% of adolescents, 13.4% of young adults, and 5.5% of older adults.2 Cases of self-mutilation in pediatric patients typically present as cutting, burning, or head banging.3 Our differential diagnoses include borderline personality disorder due to repeated impulsivity and self-harm, and body focused repetitive behavior disorder (obsessive-compulsive disorder-related disorder), which presents with repetitive strain injuries and dental malocclusions. Treatment of self-mutilation involves treating the underlying psychiatric condition with psychotropic medications.4,5 In pediatric patients, dialectical behavioral therapy has been shown to reduce parasuicidal behaviors after 1 year of therapy.6 Our patient, under constant 24-hour observation, was cleared by medical, psychiatric, and dental teams. The patient followed up with outpatient psychotherapy and psychiatry. We are presenting this rare case for clinicians to identify and manage pediatric patients presenting with unique forms of self-harm tendencies.

Predictors of cyberchondria during the COVID-19 pandemic: A supervised machine learning approach

Background and aims: Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. This behaviour has been considered an emerging public health issue, which may have been exacerbated by the COVID-19 pandemic. The present study aimed to investigate changes in the severity of cyberchondria during the pandemic and identify predictors of cyberchondria at this time. Method: Self-reported data on cyberchondria severity (before and during the pandemic), attachment style, impulsivity traits, somatic symptoms, COVID-19 related fears, health anxiety, and intolerance of uncertainty were collected from 725 participants using an online survey distributed in French-speaking European countries during the first wave of the COVID-19 pandemic. Results: COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and interference with functioning increased, whereas the reassurance facet of cyberchondria decreased. Using supervised machine learning regression analyses, the specific COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic. Conclusions: These findings provide evidence about the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. In addition, the findings have implications for the conceptualization and future assessment of cyberchondria.

COVID-19 Related Hashimoto ' s and VGKC Encephalitis

Objective: We aim to discuss a case of COVID-19-related Hashimoto's and VGKC Encephalitis Background: COVID-19 has been associated with many common neurological sequalae. However, autoimmune encephalitis has been reported only 6 times in the literature. Design/Methods: Retrospective Case Review Results: A 67-year-old male presented to the ED for dyspnea, tested positive for COVID-19, and was treated accordingly. He began to have frequent anger outbreaks and disorientation. His neurological examination was unremarkable. EEG, MRI brain and CSF studies did not reveal abnormalities. While CSF autoimmune panels were pending (which eventually returned negative), he was administered IVIG and improved somewhat. He was readmitted to the hospital for worsening of his neuropsychiatric condition in 1 month. He was verbally abusive, engaged in impulsive behaviors such as purchasing farm animals and riding motorcycles naked. An MRI brain did not reveal any acute changes. He was started on a course of IVIG. He was advised further workup, but he left against medical advice. He was then admitted again for mania. Serum workup revealed elevated anti-thyroid peroxidase antibodies (71 IU/mL). He was therefore considered as a Hashimoto's Encephalitis and was given pulse steroids. He had remarkable improvement in both his neuropsychiatric symptoms, with anti-TPO normalization. He then presented to the ED with dyspnea 8 months later and diagnosed again with COVID-19. Subsequently he had increased disorientation and mania. Repeat anti-TPO antibodies were negative. CSF Autoimmune encephalitis panel revealed VGCC N-type antibody (62), AChR Gangionic antibody (112) and VGKC antibody (85). Therefore, this admission he was considered as a COVID-19-related VGKC encephalitis and given pulse steroids with significant improvement. He was discharged home in good condition and was tapered off steroids in the outpatient setting Conclusions: Per our literature search, this is the only case of both Hashimoto's and VGKC related encephalitis found in a single patient post-COVID-19.

Psychometric Properties of the Turkish Version of the Barratt Impulsiveness Scale-Brief in Adolescents.

Introduction: Barratt Impulsiveness Scale-Brief (BIS-Brief) is a self-report scale that can be used to measure impulsivity in adolescents. In this study, it was aimed to determine the psychometric properties of the Turkish version of the BIS-Brief in clinical and non-clinical adolescent samples. Methods: The study included two groups of 116 psychiatric outpatients and 175 middle and high school students. For the re-test study, a small subgroup of the patient group (n=21) was re-applied BIS-Brief three weeks later. Socio-demographic data of the participants were collected. Aggression subscale of Childhood Behavior Checklist (CBCL), hyperactivity/impulsivity and anger control problems subscales of Conners-Wells' Adolescents Self-Report Scale-Long (CASS-L), and hyperactivity subscale of Conner's Parent Rating Scale-Short Form (CPRS-S) were administered. Results: The mean ages of the patient and control groups were 15.22±1.58 years and 15.16±1.86 years, respectively. There were 77 (66.4%) males in the patient group and 107 (61.1%) males in the control group. Cronbach's alphas for internal consistency were 0.78 (patient group) and 0.70 (control group). Three weeks test-retest reliability was 0.64 (patient group). We found a two-dimensional structure for the Turkish BIS-Brief. The BIS-Brief scores had a significant correlation with the scores of CBCL's aggression subscale (r=0.48; p<0.01), CASS-L's hyperactivity/impulsivity (r=0.45; p<0.01) and anger control problems subscales (r=0.45; p<0.01) and CPRS-S' hyperactivity subscale (r=0.21; p<0.01). Conclusion: Our findings suggest that the Turkish version of the BIS-Brief is a reliable and valid measure for clinical and non-clinical adolescent samples. In addition, the results show that the BIS-Brief has a two-dimensional model in contrast to the unidimensional structure of the original scale.

COVID-19-Related Social Isolation Predispose to Problematic Internet and Online Video Gaming Use in Italy.

COVID-19 pandemic and its related containment measures have been associated with increased levels of stress, anxiety and depression in the general population. While the use of digital media has been greatly promoted by national governments and international authorities to maintain social contacts and healthy lifestyle behaviors, its increased access may also bear the risk of inappropriate or excessive use of internet-related resources. The present study, part of the COVID Mental hEalth Trial (COMET) study, aims at investigating the possible relationship between social isolation, the use of digital resources and the development of their problematic use. A cross sectional survey was carried out to explore the prevalence of internet addiction, excessive use of social media, problematic video gaming and binge watching, during Italian phase II (May-June 2020) and III (June-September 2020) of the pandemic in 1385 individuals (62.5% female, mean age 32.5 ± 12.9) mainly living in Central Italy (52.4%). Data were stratified according to phase II/III and three groups of Italian regions (northern, central and southern). Compared to the larger COMET study, most participants exhibited significant higher levels of severe-to-extremely-severe depressive symptoms (46.3% vs. 12.4%; p < 0.01) and extremely severe anxiety symptoms (77.8% vs. 7.5%; p < 0.01). We also observed a rise in problematic internet use and excessive gaming over time. Mediation analyses revealed that COVID-19-related general psychopathology, stress, anxiety, depression and social isolation play a significant role in the emergence of problematic internet use, social media addiction and problematic video gaming. Professional gamers and younger subjects emerged as sub-populations particularly at risk of developing digital addictions. If confirmed in larger and more homogenous samples, our findings may help in shedding light on possible preventive and treatment strategies for digital addictions.

Characteristics of sustained attention in continuous performance task (CPT) and its variants

Many activities require us to sustain attention over time. Yet laboratory tasks using the continuous performance task (CPT) show that people are unable to sustain attention over a long time. What mechanisms underlie sustained attention and what factors account for the vigilance decline? Two theories provide different perspectives on these questions. One class, termed "underload" theories, postulates that the simplicity and tedium of continuous performance tasks drive people to withdraw attentional resources from the ongoing task, redirecting resources to task-unrelated thoughts. In contrast, "overload" theories propose that the need to maintain constant focus on a task drains attentional resources. As resources are depleted over time, fewer are available for completing a task, such as maintaining control over motor impulsivity. Bearing in mind these different theoretical perspectives, this dissertation investigates the underlying mechanisms of errors in a novel gradual-onset continuous performance task (gradCPT). Study 1 provided an independent replication of rapid vigilance decline in the gradCPT within three 8-min blocks. This study found that the rapid performance decrement was modulated by high task-required response rate, but not by the repetitive nature of the task stimuli or the low target prevalence. Using a within-subject design, Study 2 confirmed the deleterious effects of high task-required response rate on gradCPT performance. This study showed that, compared with abrupt onset, the gradual onset of images enhanced CPT performance, suggesting that the gradual transition of images attenuated motor impulsivity. Individual differences in the gradCPT correlated with performance on a stop-signal task, suggesting that response inhibition in the gradCPT reflects executive control. Study 3 tested the relationship between CPT performance and health and financial concerns about COVID-19 in the middle of the pandemic. This study showed that the severity of COVID-related concerns did not correlate with CPT performance. However, CPT performance was worse for participants who reported to engage in mind wandering more frequently during the CPT. Taken together, this dissertation provides converging evidence that response inhibition is a significant component of the gradCPT. These findings are consistent with overload theories, which posit that the CPT is attentionally demanding and the demand to control repetitive motor responses drains attentional resources. Some of the findings also provide partial support for the underload theories, which posit that errors in the CPT reflect the allocation of attentional resources towards task-unrelated thoughts. These findings are consistent with the resource control theory, which postulates that executive control is required to suppress task irrelevant thoughts and to control motor impulsivity in the CPT. More empirical evidence is needed to characterize the relationship between executive control and vigilance performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved)