Recalling and anticipating positive events to improve the positive affect and mental health of adolescents: A cluster randomized controlled trial in secondary schools.

This cluster randomized controlled trial examined the effectiveness of Positive Events Training (PET), a combined group training aimed at simultaneously improving positive autobiographical memory (AM) and episodic future thinking (EFT) among adolescents (12-16 years). Delivered as a universal school-based program, PET was compared with an active (creative writing) control group (CREAT). Effects on resilience, wellbeing, positive emotions, emotional response styles towards positive emotions (savoring, dampening), anhedonia, depressive symptoms, and multiple AM and EFT indices were examined. Adolescents (NPET = 95, NCREAT = 93) completed self-report scales at baseline, post-training and two-month follow-up. Multilevel models revealed that PET led to significant improvements in certain AM and EFT skills. Moreover, a decrease in anhedonia was observed at post-training. However, this effect did not withstand correction for multiple testing. Absence of changes in the other outcomes should be interpreted within the context of the universal school-based approach and the potential limited scope for detectable changes. Exploratory analyses suggest the importance of further investigating PET's potential in addressing positive affect dysregulations in indicated samples, and exploring perceived likelihood of generated future events and dampening as potential underlying mechanisms. Study limitations and future directions to maximize the demonstrated potential of PET are discussed.

Imagery rescripting and extinction: Effects on US expectancy, US revaluation, and the generalization of fear reduction.

Exposure therapy consists of exposing patients to their fears and thereby diminishing their harm expectancies (i.e., extinction or expectancy learning). Although effective for many anxiety patients, its long-term success depends on the generalization of these harm expectancies to other stimuli. However, research shows that this generalization of extinction is limited. Besides decreasing harm expectancies, fear reduction may also be achieved by changing the meaning of an aversive memory representation (US revaluation). Imagery rescripting (ImRs) may be more successful in generalizing fear reduction because it allegedly works through US revaluation. The current experiment aimed to test working mechanisms for ImRs and extinction (revaluation and expectancy learning, respectively), and to examine generalization of fear reduction. In a fear conditioning paradigm, 113 healthy participants watched an aversive film clip that was used as the US. The manipulation consisted of imagining a script with a positive ending to the film clip (ImRs-only), extinction (extinction-only), or both (ImRs + extinction). Results showed enhanced US revaluation in ImRs + extinction. US expectancy decreased more strongly in the extinction conditions. Generalization of fear reduction was found in all conditions. Our results suggest different working mechanisms for ImRs and exposure. Future research should replicate this in (sub)clinical samples.

Computerized Memory Specificity Training (c-MeST) for major depression: A randomised controlled trial.

Given modest response and high relapse after treatment for Major Depressive Episodes (MDE), the development and refinement of treatments to target cognitive vulnerabilities is indicated. Memory Specificity Training (MeST) remediates deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial aimed to assess the efficacy of an online, computerized version of MeST (c-MeST) for MDE. Adults (N = 245, 88.4% female; M age = 46.4) with a current MDE were randomised to the c-MeST program or wait-list control group. Significantly fewer participants in the c-MeST group, relative to control, met criteria for an MDE at one-month follow-up (35.7% c-MeST vs. 60.6% control), but not at other time-points. The c-MeST group, relative to the control group, scored significantly higher on memory specificity at all time-points following baseline (d = 0.53-0.93), and lower on depressive symptoms at one (d = 0.57) and three-month follow-up (d = 0.67). Changes in memory specificity mediated the effect of c-MeST on depressive symptoms at follow-up. c-MeST can improve memory specificity and depressive symptoms in people with an MDE, and may speed the rate of recovery. Future studies can further examine the mechanisms through which this occurs.

Changing the future: An initial test of Future Specificity Training (FeST).

A range of psychiatric disorders are characterised by impairments in episodic future thinking (EFT), and particularly simulating specific, spatiotemporally-located future events. No study has examined whether training can lead to sustained improvement in specific EFT. In this study, participants (N = 60; M age = 31, SD = 13.2) were randomized to a two-session, group-based future thinking program (Future Specificity Training; FeST) or wait-list. At follow-up the training group, relative to wait-list, showed large, statistically-significant improvements in the ability to mentally simulate specific EFT (d = .82), increases in detail (d = 1.32), use of mental imagery (d = 1.32), anticipated (d = 1.78) and anticipatory pleasure (d = 1.07), perceived control (d = 1.20), and likelihood of occurrence (d = 1.09). Some effects were also observed on positive, generalised future self-states. In the context of inherent limitations of subjective reporting in trials, this study provides evidence that EFT specificity can be enhanced, and the effects of FeST indicate a possible avenue to disrupt psychopathological processes.

A study protocol for a randomised trial of adjunct computerised memory specificity training (c-MeST) for major depression in youth: targeting cognitive mechanisms to enhance usual care outcomes in mental health settings.

BACKGROUND: Youth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning. Evidence-based treatments are available, but many young people do not respond or sufficiently recover with first-line options, and a significant proportion experience relapse. Consequently, there is clear scope to enhance intervention in this critical period of early-onset depression. Memory specificity training (MeST) is a low-intensity intervention for depression that targets reduced specificity when recalling memories of the past, a common cognitive vulnerability in depression. This randomised controlled trial will assess the efficacy of adding a computerised version of MeST (c-MeST) to usual care for youth depression. METHODS/DESIGN: Young people aged 15-25 years with a major depressive episode (MDE) will be recruited and randomised to have immediate access to the seven session online c-MeST program in addition to usual care, or to usual care and wait-list for c-MeST. The primary outcomes will be diagnostic status of an MDE and self-reported depressive symptoms assessed at baseline, 1-, 3- and 6-month intervals. Autobiographical memory specificity and other variables thought to contribute to the maintenance of reduced memory specificity and depression will be assessed as mediators of change. DISCUSSION: Online provision of c-MeST provides a simple, low-intensity option for targeting a cognitive vulnerability that predicts the persistence of depressive symptoms. If found to be efficacious as an adjunct to usual care for depressed youth, it could be suitable for broader roll-out, as c-MeST is highly accessible and implementation requires only minimal resources due to the online and automated nature of intervention. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12619000234112p. Registered on the 18 February 2019. All items from the WHO Trial Registration Data Set can be found within the protocol. PROTOCOL VERSION: 1.0.

Impairments in episodic future thinking for positive events and anticipatory pleasure in major depression.

BACKGROUND: Characteristic of the cardinal symptom of anhedonia, people with clinical depression report lower levels of anticipatory pleasure. However, the psychological mechanisms underlying these deficits are poorly understood. This is the first study to assess whether, and to what extent, phenomenological characteristics of episodic future thinking for positive future events are associated with anticipatory pleasure among depressed individuals. METHODS: Individuals with a Major Depressive Episode (MDE; N = 117) and without (N = 47) completed ratings scales for depressive symptoms and trait anticipatory and consummatory pleasure. They then provided descriptions of personally-relevant positive future events and rated them for phenomenological characteristics and state anticipatory pleasure. RESULTS: Between-groups analysis showed that those with MDE reported lower trait anticipatory and consummatory pleasure. They also simulated future events with less specificity, less detail/vividness, less use of mental imagery, less use of first-person perspective, less plausibility/perceived likelihood of occurring, and reported less associated state anticipatory pleasure. In regression analyses in the depressed group, lower scores for detail/vividness, mental imagery, and personal significance all uniquely predicted lower state anticipatory pleasure. LIMITATIONS: Cognitive functioning was not assessed, which may help clarify deficits that underpin these findings. History of previous depressive episodes in the comparison group were not assessed, which may mean the observed between-group effects are underestimated. CONCLUSIONS: This study provides further evidence of deficits in episodic future thinking and anticipatory pleasure in depressed individuals. It also establishes links between particular characteristics of episodic future thinking and state anticipatory pleasure, and indicates cognitive targets that may be amenable to intervention in order to reduce anhedonia.

A test of the functional avoidance hypothesis in the development of overgeneral autobiographical memory.

Overgeneral memory (OGM) refers to the failure to recall memories of specific personally experienced events, which occurs in various psychiatric disorders. One pathway through which OGM is theorized to develop is the avoidance of thinking of negative experiences, whereby cumulative avoidance may maladaptively generalize to autobiographical memory (AM) more broadly. We tested this, predicting that negative experiences would interact with avoidance to predict AM specificity. In Study 1 (N = 281), negative life events (over six months) and daily hassles (over one month) were not related to AM specificity, nor was avoidance, and no interaction was found. In Study 2 (N = 318), we revised our measurements and used an increased timeframe of 12 months for both negative life events and daily hassles. The results showed no interaction effect for negative life events, but they did show an interaction for daily hassles, whereby increased hassles and higher avoidance of thinking about them were associated with reduced AM specificity, independent of general cognitive avoidance and depressive symptoms. No evidence was found that cognitive avoidance or AM specificity moderated the effect of negative experiences on depressive symptoms. Our findings suggest that life events over 6-12 months are not associated with AM specificity, but chronic daily hassles over 12 months predict reduced AM specificity when individuals avoid thinking about them. The findings provide evidence for the functional-avoidance hypothesis of OGM development and future directions for longitudinal studies.

Psychopathology and episodic future thinking: A systematic review and meta-analysis of specificity and episodic detail.

Episodic future thinking (EFT) refers to the mental simulation of future events that might be personally-experienced; a crucial mental process in adaptation. Psychiatric disorders are associated with deficits in recalling episodic memory, however, no study has reviewed the empirical literature to assess for similar deficits in EFT. A systematic review comparing psychiatric groups with control groups on the specificity and episodic detail of EFT returned 19 eligible studies. An overall effect of g = -0.84 (95%CI = -1.06, - 0.62, p < .001) indicated individuals with a psychiatric diagnosis have significantly less specific and detailed EFT. Publication bias was not detected, but heterogeneity was. No methodological characteristics were significant moderators. Subgroup analyses showed significant effects for depression (g = -0.79, p < .001, k = 7), bipolar disorder (g = -1.00, p < .001, k = 2), and schizophrenia (g = -1.06, p < .001, k = 6), but not posttraumatic stress disorder (g = -1.04, p = .260, k = 2) or complicated grief (g = -0.41, p = .08, k = 2). Deficits in EFT are apparent in some psychiatric disorders. However, many clinical groups are understudied, and the causal mechanisms and remediation of these deficits require further research attention.

Criteria of validity in experimental psychopathology: application to models of anxiety and depression.

The modeling of abnormal behavior in 'normal' subjects (often animals) has a long history in pharmacological research for the screening of novel drug compounds. Systematic criteria have been outlined in that literature to estimate the external validity of a model, that is to estimate how closely the model is linked to the disorder of interest. Experimental psychopathology (EPP) also uses behavioral models to study the psychological processes that underlie abnormal behavior. Although EPP researchers may occasionally feel uneasy about the validity of the model that they use, the issue has not received direct attention in this literature. Here, we review the criteria of validity as set out in pharmacology research (face, predictive and construct validity) and discuss their relevance for EPP research. Furthermore, we propose diagnostic validity as an additional criterion of external validity that is relevant to EPP research. We evaluate two models for the study of anxiety and depression, and show that they have good face, diagnostic and construct validity. However, EPP research generally lacks direct tests of predictive validity. We conclude that combined evaluations of predictive, diagnostic and construct validity provide a sound basis to infer the external validity of behavioral models in EPP research.

[Gerotranscendence in the second half of life: first empirical investigation in Flanders]. / Gerotranscendentie in de tweede levenshelft: een eerste empirische benadering in Vlaanderen.

Tornstam regards gerotranscendence as the final stage in a natural process towards maturity and wisdom, that can be described as a shift in meta-perspective which accompanies the process of aging: from a materialistic and rational perspective to a more cosmic and transcendent one. The present study contributes to the development of a by Tornstam used gerotranscendence scale, and looks for theoretically expected relations between gerotranscendence and psychosocial variables such as life satisfaction, death attitude, and recently experienced life crises. The relation between gerotranscendence and dimensions of religion and faith will also be examined. Participants were 120 older adults, 58 men and 62 women, aged 45-92 years. The scores on the gerotranscendence scale were not congruent, neither with the hypothetical threefold apriori scales, nor with the factor structure Tornstam had found in his research. An exploratory factor analysis yielded three factors which were to a certain extent reconcilable with the gerotranscendence theory. The subscales are Transcendent connection, Active involvement and coherence, and Attachment to life and material goods. Older respondents and respondents who experienced one or more life crises, have higher scores on Transcendent connection. The experience of connection seems to be related to dimensions of religion and faith. The results warrant further research into a measurement of gerotranscendence and the relation with dimensions of religion and faith.

A multidisciplinary treatment approach to a complicated maxillary dental trauma: a case report.

This case report describes the treatment of an 18-year-old male who lost two central maxillary incisors due to dental trauma. Because of a deep overbite and serious occlusal instability, the lost teeth 11 and 21 could not be replaced by a conventional fixed prosthesis. The vertical dimension of occlusion was increased using a Hawley-type appliance over a period of 1 year. When sufficient intermaxillary space was gained the alveolar ridge was augmented with a mandibular symphysis graft. Nine months later two one-stage non-submerged implants (ITI, Straumann, Waldenburg, Switzerland) were inserted. After further soft tissue adaptation to two temporary acrylic crowns, porcelain veneers were placed on the two implants and the lateral incisors.

Necrosis of the gingiva caused by calcium hydroxide: a case report.

CASE REPORT: The present case demonstrates the possible detrimental effect of an overextension of a calcium hydroxide intracanal dressing into the periradicular and soft tissue after iatrogenic buccal root perforation of a maxillary central incisor. At first this perforation was not recognized by the dentist, which resulted in the introduction of a large amount of non-setting calcium hydroxide paste under the gingival tissues through a dehiscence on the buccal side of the root. This report describes the consequences and management of the necrosis of the buccal gingiva and mucosa, and the subsequent treatment and follow-up of the root perforation.

[Retention of adhesive bridges]. / Retentie van adhesiefbruggen.

Since the development of adhesive bridges in the early seventies, the retention and therefore the durability of these bridges has been tremendously improved. Conditioning of the non-precious metal by silanisation, careful acid etching of the enamel and the use of the appropriate composite resin are of prime importance. Furthermore, the meticulous preparation with enough interproximal embrace, occlusal rests, interocclusal clearance and cingulum stops is equally important. Including more teeth in the design does not necessarily lead to an improved retention. Besides the material and technical aspects, the whole clinical procedure needs much attention. The retention does not depend on one single factor, but on the precision of all the necessary clinical steps and on a well-defined selection of the material. In this way a five-year survival rate of close to 80% can be obtained.

Multi-fractal nature of radioactivity deposition on soil after the Chernobyl accident.

Fractal analysis is introduced in the field of environmental health physics. In particular, it is applied to the complex and inhomogeneous deposition pattern of radioactivity after the Chernobyl accident. The patchiness of 137Cs hot spots is quantified by a fractal dimension as low as 1. The problem of finding hot spots that might be of health concern is discussed.

A simple and fractal analysis of the European on-line network for airborne radioactivity monitoring.

We introduce two simple descriptors and use the fractal dimension to characterize the capability of a monitoring network to either 'spot', 'delineate' or 'track' a pollution cloud moving across a territory. The descriptors are applied to the 'European' monitoring network for radioactive aerosol (i.e. the sum of the national networks). Simple analysis shows that on average the time and space resolution of the network are well balanced for tracking the movement of a radioactive cloud. Such tracking, however, can only be started one or two days after the release. The geographical inhomogeneity of the network is quantified by a fractal dimension of 1.6, implying that radioactive clouds with a dimension less than 0.4 might not be detected by the network.

Kinetics of Pseudomonas aeruginosa adhesion to 304 and 316-L stainless steel: role of cell surface hydrophobicity.

Fifteen different isolates of Pseudomonas aeruginosa were used to study the kinetics of adhesion to 304 and 316-L stainless steel. Stainless steel plates were incubated with approximately 1.5 X 10(7) CFU/ml in 0.01 M phosphate-buffered saline (pH 7.4). After the plates were rinsed with the buffer, the number of adhering bacteria was determined by a bioluminescence assay. Measurable adhesion, even to the electropolished surfaces, occurred within 30 s. Bacterial cell surface hydrophobicity, as determined by the bacterial adherence to hydrocarbons test and the contact angle measurement test, was the major parameter influencing the adhesion rate constant for the first 30 min of adhesion. A parabolic relationship between the CAM values and the logarithm of the adhesion rate constants (In k) was established. No correlation between either the salt aggregation or the improved salt aggregation values and the bacterial adhesion rate constants could be found. Since there was no significant correlation between the bacterial electrophoretic mobilities and the In k values, the bacterial cell surface charge seemed of minor importance in the process of adhesion of P. aeruginosa to 304 and 316-L stainless steel.

[Retention of adhesive bridges]. / La rétention des bridges collés.

Since the development of adhesive bridges in the early seventies, the retention and therefore the durability of these bridges has been tremendously improved. To ensure an adequate retention over a number of years different factors have to be considered. Conditioning of the non-precious metal by silanisation, careful acid etching of the enamel and the use of the appropriate composite resin (Panavia Ex) are of prime importance. Furthermore, the meticulous preparation with enough interproximal embrace, occlusal rets, interocclusal clearance of 0.4 mm and cingulum stops is equally important. Care should be taken not to remove all the enamel in the cervical region in preparing a mini chamfer. Including more teeth in the design does not necessarily lead to an improved retention. Teeth with a different mobility should not be included in the same bridge. Besides the material and technical aspects, the whole clinical procedure needs much attention. Only an exact impression, a precise model and a reliable casting technique will provide a metal frame with an optimal marginal adaptation and a close fit. The retention does not depend on one single factor but on the precision of all the necessary clinical steps and on a well-defined selection of the material. In this way a five-year survival rate of close to 90% can be obtained.

Description of the properties of unattached 218Po and 212Pb particles by means of the classical theory of cluster formation.

A review is given of the classical theory of cluster formation to see whether it is a useful description of the behaviour of unattached radioactive particles. Special attention is given to the predictions concerning the size of the clusters, their growth, and their dependency on humidity and other trace gases. The theory is compared with the experimental observations of the last two decades. It is found that the theory predicts most of the properties of 218Po and 212Pb particles. It cannot explain the conflicting results regarding the humidity dependency of the unattached particle size. An important prediction of the theory is the failure of the unattached particle concept in some environmental conditions.

A closer look at the behaviour of radioactive decay products in air.

Apart from the "classical" processes like deposition, attachment and ventilation, we have also incorporated the clustering of condensable products around ions and the neutralisation of ions into the description of the behaviour of radioactive decay products in air. The interplay between these various processes and their effect on the active size distribution is studied by numerical model calculations.

The equilibrium of attached and unattached radon daughters in the domestic environment.

The Jacobi Room Model is applied to fit radon daughter concentrations measured in a room. The aerosol size distribution and ventilation rate are measured simultaneously. The mean deposition rate fitted to these experiments is 16 h-1. Once all parameters are fixed, the unattached fraction and the effective dose equivalent are calculated, and are put in perspective to the Working Level concept.