Alpha Neurofeedback Training in Elite Soccer Players Trained in Groups.

Neurofeedback training is applied in the world of sports as a means to improve athletes' performance. Training sessions are usually organized on an individual basis, one at a time. Here we investigated if the training could also be organized in groups. Forty-one national-level football (soccer) players (26 females, 15 males) carried out training sessions simultaneously in groups of up to 13, using a wearable device with Bluetooth connection, during their regular training hours at the club. It was possible to obtain good EEG measurements using this setup, albeit with a somewhat higher data loss than usual in standard laboratory sessions. The brain's alpha activity was trained using music-based neurofeedback in a crossover design. A training session consisted of alternating periods of neurofeedback and execution of cognitive tasks. EEG alpha (8-12 Hz) activity was higher in the neurofeedback periods compared to the cognitive task periods, and the reverse was true for beta (13-30 Hz) activity. The training program resulted in an increase of 34% in alpha activity associated with the training, and improved the athletes' performance on task switching and mental rotation tasks. In addition, self-reported sleep duration, as well as scores on the Being in Shape questionnaire (Feeling of Control and Flow) also improved. This study shows that neurofeedback training is feasible in groups of athletes, which can stimulate its application in team sports.

Subjective cognitive concerns not related to objective impairment in patients with somatic symptom and related disorders.

OBJECTIVES: Patients with Somatic Symptom and Related Disorders (SSRD) report subjective cognitive concerns, and research indicates that they show objective cognitive impairment. This study explored the value of subjective concerns flagging objective impairment. Furthermore, we investigated whether coping moderated this relationship, and the role of depressive symptomatology. METHOD: In a cross-sectional design, objective impairment was measured with an extensive neuropsychological assessment; subjective concerns with the Cognitive Failure Questionnaire; coping styles with the Coping Inventory of Stressful Situations; and symptoms of depression with the Patient Health Questionnaire- 9. RESULTS: The results show that subjective concerns are of limited value in signaling objective impairment in patients with SSRD. Regression analyses performed on data from 225 patients showed that symptoms of depression (ß = .32) were the main predictor of subjective concerns, which were unrelated to objective impairment. Coping was not a moderator, but patients with emotion-oriented coping styles had more subjective concerns (ß=.40), and conversely, patients with avoidance- and/or task-oriented coping styles had less (respectively, ß=-.27 and ß=-.24). CONCLUSIONS: These results align with the Somatosensory Amplification Theory; patients with SSRD may amplify benign cognitive failures and experience them as intrusive, noxious, and more intense. In patients with SSRD, subjective cognitive concerns are more related to psychological constructs (symptoms of depression and coping styles) than to objective impairment.

Group Changes in Cortisol and Heart Rate Variability of Children with Down Syndrome and Children with Autism Spectrum Disorder during Dog-Assisted Therapy.

Dog-assisted therapy is hypothesized to lower stress in children with autism spectrum disorder (ASD) and children with Down syndrome (DS), which may be visible on a physiological level. In this study, we measured heart rate variability (HRV) and salivary cortisol of 20 children with DS or ASD at the beginning and end of six weekly sessions of dog-assisted therapy. We found a decrease of cortisol levels during single sessions, but no overall effect after six sessions (six weeks). The effect of dog-assisted therapy on the increase of HRV could not be confirmed. This study is one of the first to use physiological measurements to test the effects of DAT.

Does sports participation affect the mediating role of impulsivity in the association between adverse childhood experiences and aggression?

Introduction: Adverse childhood experiences (ACEs) and self-reported aggression have often been associated, however, the mediating and moderating mechanisms underlying this association are not fully understood. In addition, less is known about potential factors that could serve as protection against the development of aggressive behavior. In this study, we investigated a moderated mediation model of sports participation and five impulsivity traits including positive and negative urgency, sensation seeking, and lack of premeditation and perseverance, in the association between ACEs and two forms of aggression. Methods and results: The sample comprised 651 (68.5% females) individuals from a Dutch community ranging in age from 18 to 82 years (M = 34.08). Contrary to our expectations, sports participation did not affect the associations of ACEs, the five impulsivity traits, and reactive and proactive aggression, except the association between ACEs and lack of premeditation. Specifically, the detrimental effect of ACEs on the propensity to act without thinking, increases among individuals with lower levels of sports participation. In addition, it was also found that sports participation directly contributed to higher levels of sensation seeking. Finally, after controlling for sociodemographic variables, the positive association between ACEs and reactive aggression was significantly mediated by negative urgency, lack of perseverance, and lack of premeditation, while the positive association between ACEs and proactive aggression was significantly mediated by lack of premeditation and positive urgency. Conclusion: The findings of this study add to the body of knowledge about the role of sports participation and impulsivity traits in the development of both forms of aggression, however, replication studies among multiple populations are needed before firm conclusions can be drawn.

Violent Recidivism and Adverse Childhood Experiences in Forensic Psychiatric Patients With Impaired Intellectual Functioning.

Accurate risk assessment and insight into which factors are associated with recidivism are essential for forensic correctional practice. Therefore, we investigated whether the Historical, Clinical, and Future-Revised (HKT-R [Historisch Klinisch Toekomst-Revised]) risk assessment instrument could predict violent recidivism over a 2-year follow-up period in forensic psychiatric patients with intelligence quotient (IQ) < 80. We refer to these patients as intellectually disabled (ID) and patients with IQ ≥ 80 as non-ID. Additionally, the associations of the 14 clinical HKT-R factors with ID versus non-ID group membership were investigated, as well as a possible moderating role of adverse childhood experiences (ACE) in these associations. The final sample encompassed 748 forensic psychiatric patients (15.9% were patients with ID) who were unconditionally released from highly secured Dutch forensic psychiatric institutions between 2004 and 2014. The results showed that the HKT-R total score (AUC = 0.705, 95% confidence interval [CI] [0.527, 0.882]) and the clinical domain (AUC = 0.733, 95% CI [0.579, 0.886]) had a large effect size for predictive validity for 2-year violent recidivism, while the future domain (AUC = 0.653, 95% CI [0.524, 0.781]) and the historical domain (AUC = 0.585, 95% CI [0.397, 0.772]) had a medium effect size for predictive validity for 2-year violent recidivism in ID patients. It was also found that lower levels of self-reliance and social skills were associated with ID, indicating that treatment should prioritize these skills. However, ACE was not associated with ID, nor did it moderate the associations of the clinical HKT-R factors with ID. This study contributes to the understanding of both risk assessment and treatment of forensic psychiatric patients with ID.

EEG study on implicit beliefs regarding sexuality: Psychophysiological measures in relation to self-report measures.

In this exploratory, correlational study, several psychophysiological measures were assessed and the relation between these measures and an experimental self-report questionnaire to measure the seven implicit beliefs of sexual offenders (the Questionnaire for Implicit Theories of Sexual Offenders (QITSO)) was established in a sample of Dutch participants recruited from the healthy population (N = 28) using correlational analyses. After analyzing task performance, electroencephalogram (EEG) data and electrocardiogram (ECG) data, the psychophysiological variables were correlated with the experimental QITSO subscales. The subscale "children as sexual beings" correlated positively with the P300 amplitude at electrode Pz. The subscale "women are unknowable" correlated positively with resting-state beta activity during eyes closed and eyes open, and with alpha activity during eyes open. Additionally, the subscale "entitlement' correlated positively with low frequency heart rate variability power during eyes closed and eyes open, and with high frequency power during eyes closed. This study is a first exploratory step towards establishing a psychophysiological profile underlying the self-report questionnaire QITSO.

The Long-Term Changes in Dynamic Risk and Protective Factors Over Time in a Nationwide Sample of Dutch Forensic Psychiatric Patients.

The long-term changes of dynamic risk and protective factors have rarely been studied in forensic psychiatric patients. We utilized a latent growth curve analysis to investigate trajectories of risk and protective factors over time in all 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from any of 12 Dutch forensic psychiatric centers (FPCs). The study covered the period from juridical observation until unconditional release. Moreover, we investigated whether these trajectories differ between patients depending on their psychiatric diagnosis namely substance use disorders (SUD), psychotic disorders, and cluster B personality disorders (PDs). In addition, we also investigated whether SUD may influence changes in risk and protective factors in a group of psychotic and cluster B PDs patients, respectively. Overall, findings suggest that all changes in dynamic risk and protective factors could be depicted by two phases of patients' stay in the FPCs. Specifically, most changes on dynamic risk and protective factors occurred at the beginning of treatment, that is, from the time of juridical assessment up to the time of unguided leave. Moreover, the moment of unguided leave could be considered the 'turning point' in the treatment of offenders. We also found that SUD and psychotic patients changed the most in the first phase of their stay, while cluster B PDs patients changed the most in the second phase. However, SUD did not modify changes in risk and protective factors in psychotic and cluster B PDs patients. These findings may help improve offender treatment and crime prevention strategies.

The Complex Associations Between Early Childhood Adversity, Heart Rate Variability, Cluster B Personality Disorders, and Aggression.

Early childhood adversity can cause an imbalance in the autonomic function, which may in turn lead to the development of trauma-spectrum disorders and aggressive behavior later in life. In the present study, we investigated the complex associations between early adversity, heart rate variability (HRV), cluster B personality disorders, and self-reported aggressive behavior in a group of 50 male forensic inpatients (M age = 41.16; SD = 10.72). Structural Equation Modeling analysis revealed that patients with cluster B personality disorders were more likely to have adverse early childhood experiences and reduced sympathetic dominance in response to a threat than patients without cluster B personality disorders. In addition, HRV and cluster B personality disorders did not significantly mediate the association between early childhood adversity and self-reported aggressive behavior. These findings are important for clinical practice to facilitate specific treatment programs for those affected.

Behavioral effects of neurofeedback in adolescents with ADHD: a randomized controlled trial.

Neurofeedback has been proposed as a potentially effective intervention for reducing Attention Deficit Hyperactivity Disorder (ADHD) symptoms. However, it remains unclear whether neurofeedback is of additional value to treatment as usual (TAU) for adolescents with clinical ADHD symptoms. Using a multicenter parallel-randomized controlled trial design, adolescents with ADHD symptoms were randomized to receive either a combination of TAU and neurofeedback (NFB + TAU, n = 45) or TAU-only (n = 26). Randomization was computer generated and stratified for age group (ages 12 through 16, 16 through 20, 20 through 24). Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex (Cz). Primary behavioral outcome measures included the ADHD-rating scale, Youth Self Report, and Child Behavior Checklist all assessed pre- and post-intervention. Behavioral problems decreased equally for both groups with medium to large effect sizes, range of partial η2 = 0.08-0.31, p < 0.05. Hence, the combination of NFB + TAU was not more effective than TAU-only on the behavioral outcome measures. In addition, reported adverse effects were similar for both groups. On behavioral outcome measures, the combination of neurofeedback and TAU was as effective as TAU-only for adolescents with ADHD symptoms. Considering the absence of additional behavioral effects in the current study, in combination with the limited knowledge of specific treatment effects, it is questionable whether theta/SMR neurofeedback for adolescents with ADHD and comorbid disorders in clinical practice should be used. Further research is warranted to investigate possible working mechanisms and (long-term) specific treatment effects of neurofeedback.

The Body Action Coding System II: muscle activations during the perception and expression of emotion.

Research into the expression and perception of emotions has mostly focused on facial expressions. Recently, body postures have become increasingly important in research, but knowledge on muscle activity during the perception or expression of emotion is lacking. The current study continues the development of a Body Action Coding System (BACS), which was initiated in a previous study, and described the involvement of muscles in the neck, shoulders and arms during expression of fear and anger. The current study expands the BACS by assessing the activity patterns of three additional muscles. Surface electromyography of muscles in the neck (upper trapezius descendens), forearms (extensor carpi ulnaris), lower back (erector spinae longissimus) and calves (peroneus longus) were measured during active expression and passive viewing of fearful and angry body expressions. The muscles in the forearm were strongly active for anger expression and to a lesser extent for fear expression. In contrast, muscles in the calves were recruited slightly more for fearful expressions. It was also found that muscles automatically responded to the perception of emotion, without any overt movement. The observer's forearms responded to the perception of fear, while the muscles used for leaning backwards were activated when faced with an angry adversary. Lastly, the calf responded immediately when a fearful person was seen, but responded slower to anger. There is increasing interest in developing systems that are able to create or recognize emotional body language for the development of avatars, robots, and online environments. To that end, multiple coding systems have been developed that can either interpret or create bodily expressions based on static postures, motion capture data or videos. However, the BACS is the first coding system based on muscle activity.

Development of response activation and inhibition in a selective stop-signal task.

To gain more insight into the development of action control, the current brain potential study examined response selection, activation, and selective inhibition during choice- and stop-signal processing in three age groups (8-, 12-, and 21-year-olds). Results revealed that age groups differed in the implementation of proactive control; children slowed their go response and showed reduced cortical motor output compared to adults. On failed inhibition trials, children were less able than adults to suppress muscle output resulting in increased partial-inhibition rates. On invalid stop trials, all age groups initially activated, subsequently inhibited, and then reactivated the go response. Yet, children were less efficient in implementing this strategy. Then, older children recruit motor responses to a greater extent than younger children and adults, which reduced the efficiency of implementing response inhibition and proactive control. The results are discussed in relation to current notions of developmental change in proactive and reactive action control.

Neurocognitive effects of neurofeedback in adolescents with ADHD: a randomized controlled trial.

OBJECTIVE: Neurofeedback aims to reduce symptoms of attention-deficit/hyperactivity disorder (ADHD), mainly attention problems. However, the additional influence of neurofeedback over treatment as usual (TAU) on neurocognitive functioning for adolescents with ADHD remains unclear. METHOD: By using a multicenter parallel randomized controlled trial (RCT) design, male adolescents with a DSM-IV-TR diagnosis of ADHD (mean age = 16.1 years; range, 12-24) were randomized to receive either a combination of TAU and neurofeedback (n = 45) or TAU (n = 26). Randomization was computer generated and stratified by age group (ages 12 through 15, 16 through 20, and 21 through 24 years). The neurofeedback intervention consisted of approximately 37 sessions over a period of 25 weeks of theta/sensorimotor rhythm training on the vertex (Cz). Primary neurocognitive outcomes included performance parameters derived from the D2 Test of Attention, the Digit Span backward, the Stroop Color-Word Test and the Tower of London, all assessed preintervention and postintervention. Data were collected between December 2009 and July 2012. RESULTS: At postintervention, outcomes of attention and/or motor speed were improved, with faster processing times for both intervention conditions and with medium to large effect sizes (range, ηp2 = .08-.54; P values < .023). In both groups, no improvements for higher executive functions were observed. Results might partly resemble practice effects. CONCLUSIONS: Although neurocognitive outcomes improved in all adolescents receiving treatment for ADHD, no additional value for neurofeedback over TAU was observed. Hence, this study does not provide evidence for using theta/sensorimotor rhythm neurofeedback to enhance neurocognitive performance as additional intervention to TAU for adolescents with ADHD symptoms. TRIAL REGISTRATION: Trialregister.nl identifier: 1759.

Feasibility of eyes open alpha power training for mental enhancement in elite gymnasts.

This study focuses on a novel, easy to use and instruction-less method for mental training in athletes. Previous findings suggest that particular mental capacities are needed for achieving peak performance; including attentional control, focus, relaxation and positive affect. Electroencephalography (EEG) alpha brain activity has been associated with neural inhibition during processes of selective attention, for improving efficiency in information processing. Here we hypothesised that eyes open alpha power training by music teaches athletes to (1) learn to self-regulate their brain activity, and (2) learn to increase their baseline alpha power, herewith improving mental capacities such as focusing the allocation of attention. The study was double-blind and placebo-controlled. Twelve elite gymnasts were either given eyes open alpha power training or random beta power training (controls). Results indicate small improvements in sleep quality, mental and physical shape. In our first attempt at getting a grip on mental capacities in athletes, we think this novel training method can be promising. Because gymnastics is one of the most mentally demanding sports, we value even small benefits for the athlete and consider them indicative for future research.

Repeated measurements of the auditory oddball paradigm is related to recovery from the vegetative state.

The auditory oddball response has been found to be of predictive value for neurologic outcome at the early stages of coma. In the present study, the auditory oddball response was examined longitudinally during the recovery from the vegetative state to consciousness. This response was repeatedly examined every 2 weeks for an average period of 3.5 months in severely brain-injured patients. Results showed that amplitude of the auditory oddball response was unrelated to the behavioral changes during the patients' recovery from the vegetative state to consciousness. However, the presence and size of a negative potential at about 350 milliseconds predicted behavioral outcome, both for the short and long term (2 to 3 years after injury). Practical and theoretical implications of these findings are discussed.

The Body Action Coding System I: muscle activations during the perception and expression of emotion.

Body postures provide clear signals about emotional expressions, but so far it is not clear what muscle patterns are associated with specific emotions. This study lays the groundwork for a Body Action Coding System by investigating what combinations of muscles are used for emotional bodily expressions and assessing whether these muscles also automatically respond to the perception of emotional behavior. Surface electromyography of muscles in the arms (biceps and triceps) and shoulders (upper trapezius and deltoids) were measured during both active expression and passive viewing of fearful and angry bodily expressions. The biceps, deltoids, and triceps are recruited strongly for the expression of anger and fear expression predominantly depends on the biceps and the deltoids. During passive viewing, all muscles automatically activate during the passive viewing of anger. During fear perception, a clear activation can be seen in the trapezius, deltoid, and triceps muscles, whereas the biceps shows inhibition. In conclusion, this study provides more insight into the perception and expression of emotions in the body.

The time-course of alpha neurofeedback training effects in healthy participants.

The time-course of alpha neurofeedback training (NFT) was investigated in 18 healthy participants who received 15 sessions of training (eyes open), each consisting of three training periods (data are from Van Boxtel et al., 2012). Here we report on the within- and between-session training effects using multilevel analyses. Over sessions, total alpha power (8-12 Hz) increased up to the tenth session, after which low alpha power (8-10 Hz) remained at the same level, while high alpha power (10-12 Hz) decreased. Within each training session, total alpha power increased from the first to the second period, and then decreased again. This decrease, however, was caused by a decrease in high alpha power only; low alpha power remained up to the end of training. These effects are discussed in terms of attention and motivation, and suggest different trainability for low and high alpha power.

Temporal dynamics of interference in Simon and Eriksen tasks considered within the context of a dual-process model.

Behavioral and brain potential measures were employed to compare interference in Eriksen and Simon tasks. Assuming a dual-process model of interference elicited in speeded response tasks, we hypothesized that only lateralized stimuli in the Simon task induce fast S-R priming via direct unconditional processes, while Eriksen interference effects are induced later via indirect conditional processes. Delays to responses for incongruent trials were indeed larger in the Eriksen than in the Simon task. Only lateralized stimuli in the Simon task elicited early S-R priming, maximal at parietal areas. Incongruent flankers in the Eriksen task elicited interference later, visible as a lateralized N2. Eriksen interference also elicited an additional component (N350), which accounted for the larger behavioral interference effects in the Eriksen task. The findings suggest that interference and its resolution involve different processes for Simon and Eriksen tasks.

Mindfulness-based stress reduction and physiological activity during acute stress: a randomized controlled trial.

OBJECTIVE: The aim was to examine the effects of a Mindfulness-Based Stress Reduction (MBSR) intervention on cardiovascular and cortisol activity during acute stress. METHOD: Eighty-eight healthy community-dwelling individuals reporting elevated stress levels were randomly assigned to the MBSR protocol or a waitlist control group. Before and after the intervention period they participated in a laboratory stress protocol consisting of mental arithmetic and speech tasks. Laboratory measurements included continuous cardiovascular parameters (heart period, heart rate variability, and systolic and diastolic blood pressure [SBP and DBP]), and salivary cortisol. RESULTS: Compared to the control group and controlling for age, sex, body mass index, and beta-blockers, the MBSR group showed larger pre- to postintervention decreases in overall SBP (F(1, 58) = 4.99, p = .029, partial η² = .08) and DBP (F(1, 58) = 11.09, p = .002, partial η² = .16). In addition, the MBSR group exhibited smaller SBP and DBP stress-related changes from pre- to postintervention (F(2, 116) = 4.89, p = .012, partial η² = .08; F(2, 116) = 6.07, p = .007, partial η² = .10, respectively). No effects were obtained on other physiological measures. CONCLUSION: MBSR may help reducing blood pressure levels and blood pressure reactivity to stress.

Proactive and reactive control in S-R compatibility: a brain potential analysis.

We investigated how proactive and reactive control facilitates performance in mixed stimulus-response compatibility (SRC) tasks. SRC effects were eliminated in mixed tasks and reversed following incompatible trials. In mixed tasks, early preferential response activation was present in stimulus-locked lateralized readiness potentials (LRPs) but reduced following incompatible trials. In event-related potentials (ERPs), stimulus-locked N2 was enhanced in all mixed trials but was not significantly influenced by the preceding trial. A response-locked fronto-central negative component (N-120), peaking just before the response, was largest for mixed compatible trials preceded by incompatible trials. This N-120 was paired with an enhancement to the peak of the response-locked LRP. Proactive control is involved in selection of an S-R mapping via the indirect route of a dual-route model. Reactive control corrects the S-R mapping, particularly when alternating between S-R mappings.