Evaluating the Efficacy of a Digital Therapeutic (CT-152) as an Adjunct to Antidepressant Treatment in Adults With Major Depressive Disorder: Protocol for the MIRAI Remote Study.

BACKGROUND: Major depressive disorder (MDD) is common worldwide and can be highly disabling. People with MDD face many barriers to treatment and may not experience full symptom relief even when treated. Therefore, new treatment modalities are needed for MDD. Digital therapeutics (DTx) may provide people with MDD an additional treatment option. OBJECTIVE: This study aimed to describe a phase 3 remote, multicenter, randomized, masked, sham-controlled trial evaluating the efficacy of a smartphone app-based DTx (CT-152) in adult participants diagnosed with MDD, used as an adjunct to antidepressant therapy (ADT). METHODS: Participants aged 22-64 years with a current primary diagnosis of MDD and an inadequate response to ADT were included. Participants were randomized 1:1 to CT-152 or a sham DTx. CT-152 is a smartphone app-based DTx that delivers a cognitive-emotional and behavioral therapeutic intervention. The core components of CT-152 are the Emotional Faces Memory Task exercises, brief lessons to learn and apply key therapeutic skills, and SMS text messaging to reinforce lessons and encourage engagement with the app. The sham DTx is a digital working memory exercise with emotionally neutral stimuli designed to match CT-152 for time and attention. Participants took part in the trial for up to 13 weeks. The trial included a screening period of up to 3 weeks, a treatment period of 6 weeks, and an extension period of 4 weeks to assess the durability of the effect. Sites and participants had the option of an in-person or remote screening visit; the remaining trial visits were remote. Efficacy was evaluated using the Montgomery-Åsberg Depression Rating Scale, the Generalized Anxiety Disorder-7, Clinical Global Impression-Severity scale, the Patient Health Questionnaire-9, and the World Health Organization Disability Assessment Schedule 2.0. The durability of the effect was evaluated with the Montgomery-Åsberg Depression Rating Scale and Generalized Anxiety Disorder-7 scale. Adverse events were also assessed. Satisfaction, measured by the Participant and Healthcare Professional Satisfaction Scales, and health status, measured by the EQ-5D-5L, were summarized using descriptive statistics. RESULTS: This study was initiated in February 2021 and had a primary completion date in October 2022. CONCLUSIONS: This represents the methodological design for the first evaluation of CT-152 as an adjunct to ADT. This study protocol is methodologically robust and incorporates many aspects of conventional pivotal pharmaceutical phase 3 trial design, such as randomization and safety end points. Novel considerations included the use of a sham comparator, masking considerations for visible app content, and outcome measures relevant to DTx. The rigor of this methodology will provide a more comprehensive understanding of the effectiveness of CT-152. TRIAL REGISTRATION: ClinicalTrials.gov NCT04770285; https://clinicaltrials.gov/study/NCT04770285. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/56960.

Predicting the Arousal and Valence Values of Emotional States Using Learned, Predesigned, and Deep Visual Features.

The cognitive state of a person can be categorized using the circumplex model of emotional states, a continuous model of two dimensions: arousal and valence. The purpose of this research is to select a machine learning model(s) to be integrated into a virtual reality (VR) system that runs cognitive remediation exercises for people with mental health disorders. As such, the prediction of emotional states is essential to customize treatments for those individuals. We exploit the Remote Collaborative and Affective Interactions (RECOLA) database to predict arousal and valence values using machine learning techniques. RECOLA includes audio, video, and physiological recordings of interactions between human participants. To allow learners to focus on the most relevant data, features are extracted from raw data. Such features can be predesigned, learned, or extracted implicitly using deep learners. Our previous work on video recordings focused on predesigned and learned visual features. In this paper, we extend our work onto deep visual features. Our deep visual features are extracted using the MobileNet-v2 convolutional neural network (CNN) that we previously trained on RECOLA's video frames of full/half faces. As the final purpose of our work is to integrate our solution into a practical VR application using head-mounted displays, we experimented with half faces as a proof of concept. The extracted deep features were then used to predict arousal and valence values via optimizable ensemble regression. We also fused the extracted visual features with the predesigned visual features and predicted arousal and valence values using the combined feature set. In an attempt to enhance our prediction performance, we further fused the predictions of the optimizable ensemble model with the predictions of the MobileNet-v2 model. After decision fusion, we achieved a root mean squared error (RMSE) of 0.1140, a Pearson's correlation coefficient (PCC) of 0.8000, and a concordance correlation coefficient (CCC) of 0.7868 on arousal predictions. We achieved an RMSE of 0.0790, a PCC of 0.7904, and a CCC of 0.7645 on valence predictions.

Why step in? Shifting justifications for bystander behaviors through interventions with youth in the Middle East.

Research shows positive bystander intervention effectively mitigates bullying experiences. Yet, more evidence regarding bystander responses to bias-based social exclusion (BSE) is needed in intergroup contexts, especially in the majority world and in areas of intractable conflict. This study assessed the effectiveness of skills and skills + contact-based interventions for BSE among 148 Palestinian Citizens of Israel (Mage = 10.55) and 154 Jewish-Israeli (Mage = 10.54) early adolescents (Girls = 52.32%) in Tel Aviv-Yafo. Bystander responses were assessed by participants' reactions to hypothetical BSE scenarios over three time points. Repeated measures ANOVAs revealed both interventions significantly increased positive and decreased negative bystander responses, with changes maintained at the follow-up. The opposite result pattern emerged for the control group. Findings suggest that both interventions can effectively encourage youth to publicly challenge BSE, even amidst intractable conflict.

Associations of rumination with suicidal ideation and suicide attempts amongst individuals with major depressive disorder: A 12-month longitudinal study in China.

BACKGROUND: This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD). METHODS: Participants were derived from the Depression Cohort in China study (DCC). Those who completed at least one follow-up visit during the 12 months were included in the analysis. Dimensions of rumination including brooding and reflection were each measured using five items of the Ruminative Responses Scale. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. Suicide attempts were also assessed and all were analyzed with generalized estimating equations. RESULTS: Our final sample included 532 participants aged 18 to 59 years (mean [SD], 26.91 [6.94] years) consisting of 148 (27.8%) males and 384 (72.2%) females. After adjusting for temporal trend and potential confounders, individuals with higher levels of reflection were more likely to report suicidal ideation (AOR =1.11, 95% CI:1.01-1.22). However, no statistically significant association was found between brooding and suicidal ideation (AOR =1.06, 95% CI:0.96-1.17). Conversely, individuals with higher levels of brooding were more likely to report suicide attempts (AOR =1.13, 95% CI:1.02-1.24), while no statistically significant association was observed between reflection and suicide attempts (AOR =0.91, 95% CI:0.82-1.01). CONCLUSION: Rumination reflects a disturbance in cognitive emotional processing and manifests in different dimensions. Our findings suggest that high levels of reflection and brooding may be associated with a higher likelihood of having suicidal ideation and suicide attempts, respectively. However, it should be interpreted with caution, given that effect sizes are small.

Non-adaptive cognitive emotion regulation mediates the relationship between disease uncertainty and acute stress disorder in patients with ischaemic stroke.

Background: During epidemic outbreaks, hospitalized patients, especially those with cerebrovascular disease, were identified as a vulnerable group suffering from acute stress disorder (ASD) and consequent psychological distress. For stroke patients, not only will they suffer from physical illness, but the uncertainty of illness caused by sudden illness may also cause patients to experience different degrees of ASD. Relevant studies have shown that the impact of ASD on individuals may vary according to age, gender, disease characteristics, individual personality, treatment methods, income level, family support, cognitive psychology and other factors. However, non-adaptive cognitive emotion regulation plays a crucial role in influencing individual psychological states. At present, the risk factors of ASD after stroke and the mechanism between illness uncertainty and cognitive emotion regulation are not fully understood. Therefore, we focus on exploring the predictive effects of general demographic and disease-related characteristics, maladaptive cognitive emotion regulation, and illness uncertainty on ASD after stroke, and make hypotheses. When a disease acts on the body, the patient will have the corresponding cognition of the disease, and ASD will appear at the same time. Then the maladaptive cognitive emotion regulation as an important mediating variable can aggravate the level of acute stress disorder and be verified. Methods: We used a cross-sectional design, which can be used to investigate the distribution of a disease or health condition and its related factors in a specific population at a specific time, so as to describe the distribution of the disease or health condition and its relationship with related factors. A total of 256 hospitalized patients with ischemic stroke were enrolled, including 145 males and 111 females, aged from 26 to 90 years, with a mean age of (64.71 ± 12.20) years. All patients completed and returned a self-report questionnaire that included demographic information, illness uncertainty, cognitive emotion regulation, and ASD. We then compared the differences in general demographic data, illness uncertainty, and maladaptive cognitive emotion regulation in acute stress disorders. Results: The majority of hospitalized stroke patients (67.6%) developed ASD due to the COVID-19 pandemic and were therefore at risk for PTSD. More than one third (39.1%) of stroke survivors also suffered from severe psychological distress. More specifically, younger stroke patients are more likely to experience ASD than older patients. Although higher illness uncertainty scores indicate more severe ASD, adaptive cognitive emotion regulation was a protective factor. Conclusion: Given that individuals with ASD are susceptible to PTSD, it is critical to follow up hospitalized patients with ischemic stroke for screening for PTSD and referral to appropriate psychological services. Maladaptive cognitive emotion regulation can increase the impact of uncertainty on the traumatic experience of stroke patients. Therefore, health care institutions should increase their efforts to provide psychosocial support services to hospitalized patients and make continuous efforts to screen for symptoms of trauma and psychological distress in hospitalized stroke patients.

Research on the perception of the terrain image of the tourism destination based on multimodal user-generated content data.

Destination image is a powerful means by which destinations compete in the tourism industry, and the accurate identification of a destination image better serves destination marketing and management. This study uses multimodal data, such as text, images, and videos uploaded by tourists, to construct a comprehensive and systematic destination image process. The "cognitive-emotional-overall image" model, latent Dirichlet allocation (LDA) model, and deep residual neural networks are implemented to build a framework to examine the perception of a destination image, travelogues, and short videos from the sources called Ctrip, Qunar, and TikTok. The results show that tourists' overall perception of Sanya is based mainly on the cognitive image of natural scenery, human resources, and food. In addition, there are differences between textual and visual cognitive images among the perceptual images when multimodal data is under consideration. Furthermore, tourists have an overall positive affective image of Sanya as a destination.

Needs for supporting women undergoing termination of pregnancy for fetal anomaly: A phenomenological study based on the cognitive-emotional-behavioral framework.

OBJECTIVE: To determine and describe the needs of women undergoing termination of pregnancy for fetal anomaly (TOPFA) in China. STUDY DESIGN: Qualitative study with semi-structured interviews. Consolidated Criteria for Reporting Qualitative Studies checklist was used for reporting. SETTING: Three general hospitals and one special hospital in Changsha, Hunan, China. PARTICIPANTS: 12 women who had undergone TOPFA and 12 healthcare providers who had experienced in caring for these women. METHODS: This study was based on the cognitive-emotional-behavioral framework (CEBF) of women who had to undergo TOPFA. Twenty-four participants (12 women and 12 healthcare providers) were recruited from two hospitals in China. Semi-structured face-to-face interviews were conducted based on interview guides. ATLAS.ti software was used to encode and analyze data. Qualitative content analysis was also applied. FINDINGS: Four themes emerged: information, emotional, professional psychological, and social supports. Each theme was subdivided into four phases for a detailed description of the temporal order (denial, confirmation, decision-making, and recovery phases) within the framework. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Our study analyzes the four needs of women who underwent TOPFA and the specifics of each need at different phases based on the CEBF. The importance of offering professional psychological support, detailed information, timely emotional support, and comprehensive social support for these women is illustrated. This study contributes to the understanding of women's needs, hence providing a theoretical basis for the construction of supportive programs.

Cognitive-emotional networks in students with and without a history of non-suicidal self-injury.

BACKGROUND: Contemporary models of non-suicidal self-injury (NSSI) suggest that emotional vulnerabilities, negative self-schemas, and beliefs about NSSI work together to differentiate students who self-injure from those who do not. However, it is unclear how these mechanisms are differentially related among students with and without a history of NSSI. Considering this, we used a network analysis approach to explore how students with and without a history of NSSI vary in processing their emotional experiences in relation to their self-concepts and beliefs about NSSI. METHOD: A sample of 480 university students (Mage = 21.18, SD = 2.43; 73.5 % female) completed self-report measures about their perceived emotional experiences (e.g., emotional reactivity, emotion regulation difficulties), self-concepts (e.g., self-esteem, self-efficacy), and NSSI. RESULTS: A network comparison test revealed that students with a history of NSSI perceived themselves to have difficulties regulating particularly intense, unwanted negative emotions. In light of this, students with a history of NSSI expected some benefits of NSSI (e.g., emotion regulation) regardless of potential barriers (e.g., pain). Conversely, for students without a history of NSSI, expecting NSSI to have aversive outcomes was tied to expecting NSSI to have few benefits. LIMITATIONS: The cross-sectional design limits inferences to be made about the network structures. CONCLUSIONS: Students with and without a history of NSSI appear to differ in their cognitive processing of negative emotions and strategies used to deal with these emotions.

Academic stress and adaptation to university life: mediation of cognitive-emotionalregulationand social suppor / Estrés académico y adaptación a la vida universitaria: mediación de la regulación cognitivo-emocional y el apoyo social

La vida universitaria implica retos personales, sociales, académicos e institucionales a los que los estudiantes deben adaptarse no sólo para lograr el éxito académico sino también para garantizar una buena salud física y mental durante la carrera. Este periodo puede estar influenciado por situaciones estresantes que pueden afectar a nivel personal y académico. El objetivo del presente estudio fue determinar, mediante un análisis con ecuaciones estructurales, si diversas estrategias de regulación cognitivo-emocional y el apoyo social percibido, actúan como mediadores del efecto del estrés sobre la adaptación a la vida universitaria en 555 estudiantes universitarios colombianos (437 mujeres, 78,7%) con edades comprendidas entre los 16 y los 49 años (M= 22,83; DT = 4,774). Los resultados muestran que las estrategias de regulación cognitivo-emocional positiva (Focus y Reappraisal), negativa (Rumiación, Autoculpabilización y Culpar a otros) y el apoyo social son mediadores del efecto del estrés sobre la adaptación a la vida universitaria.(AU)

University life involve personal, social, academic, and institu-tionalchallenges to which the students must adapt not only to achieve aca-demic successbut also to guarantee a good physical and mental health dur-ing the career. Thisperiod can be influenced by stressful situations that can affect at personal andacademic level. The objective of the present study was to determine, through ananalysis with structural equations, whether various cognitive-emotional regulationstrategies and perceived social sup-port, act as mediators of the effect of stress onadaptation to university life in 555 Colombian university students (437 women,78.7%) with ages from 16 to 49 years (M = 22.83; SD = 4.774). The results showthat the cogni-tive-emotional regulation strategies positive (Focus andReappraisal), nega-tive (Rumination, Self-blame and Blaming others) and socialsupportaremediators oftheeffect ofstresson adaptationto universitylife.(AU)

Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial.

OBJECTIVES: To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology. METHODS: Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index). RESULTS: The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed. CONCLUSIONS: Results provide evidence of the HEPPI's feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. CLINICAL IMPLICATIONS: Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.

Mental Healthcare through Cognitive Emotional Regulation Strategies among Prisoners.

Prisoners are exposed to a deprived environment, which triggers mental illness and psychological problems. Abundant research has reported that mental illness problems, suicide, aggression, and violent behaviors occur in incarcerated people. Although the mental healthcare system for incarcerated people is emphasized, little research has been conducted due to their limited environment. In particular, the regulation of negative emotion is significantly associated with mental illness and anti-social and violent behaviors. However, mental healthcare through cognitive emotional regulation based on cognitive behavioral therapy has not been fully investigated. This study identified four different patterns in cognitive strategies for regulating negative emotions. Cognitive emotional regulation strategies (i.e., self-blame, other-blame, rumination, catastrophizing, putting into perspective, positive refocusing, positive reappraisal, acceptance, and refocus on planning) were examined and addressed their vulnerable psychological factors. We analyzed a total of 500 prisoners' responses to the cognitive emotional regulation questionnaire (CERQ) by latent class profiling analysis. A four-class model was identified based on the responses of CERQ. In addition, the significant effect of depression on classifying the four classes was found. Furthermore, differences in the average number of incarcerations were also shown across four classes. In conclusion, Class 2 (Negative Self-Blamer) uses dysfunctional/negative strategies that may place the group at a high risk of psychological disorder symptoms, including depression and post-traumatic stress. Class 3 (Distorted Positivity) uses positive/functional strategies but seems to utilize the positive strategies in distorted manners to rationalize their convictions. Class 1 (Strong Blamer) and Class 4 (Moderator Blamer) showed similar patterns focused on the "other-blame" strategy for regulating negative emotion, but they are at different levels, indicating that they attribute incarceration to external factors. These findings provide useful information for designing mental healthcare interventions for incarcerated people and psychological therapy programs for clinical and correctional psychologists in forensic settings.

Perceived stress and symptoms of post-traumatic stress disorder in nurses: A moderated mediation model of maladaptive cognitive emotional regulation and psychological capital.

Nurses often face a variety of work-related and life-related stresses that make them more prone to symptoms of post-traumatic stress disorder (PTSD), yet the underlying mechanism of this association is poorly understood. To address this research gap, we investigated the mediating role of maladaptive cognitive emotion regulation strategies in the relationship between perceived stress and PTSD symptoms, and explored whether psychological capital could moderate the direct or indirect effects between perceived stress and PTSD symptoms. Nurses (N = 723) completed a questionnaire about perceived stress, PTSD symptoms, maladaptive cognitive emotion regulation strategies and psychological capital. After controlling for gender, age and work department, perceived stress was positively correlated with PTSD symptoms. Maladaptive cognitive emotion regulation strategies partially mediated this relationship. Psychological capital moderates the effects of perceived stress and maladaptive cognitive emotion regulation strategies on PTSD symptoms. Specifically, the positive correlation between perceived stress and PTSD symptoms was stronger among nurses with low levels of psychological capital than among nurses with high levels of psychological capital. At the same time, the positive correlation between maladaptive cognitive emotion regulation strategies and PTSD symptoms was stronger in nurses with a low level of psychological capital. Therefore, cognitive strategies and interventions oriented toward psychological capital may alleviate the PTSD symptoms of nurses in stressful situations.

Differences in psychological distress, resilience and cognitive emotional regulation strategies in adults during the Coronavirus pandemic: A cross-cultural study of Poland and Spain

El objetivo de este estudio transcultural fue analizar las diferencias en resiliencia, estrategias de regulación cognitiva de las emociones (CERS) y distress psicológico durante la pandemia del COVID-19 en Polonia y España. Método. Se realizó una encuesta online en una muestra de 1,182 adultos. Se llevó a cabo un análisis MANOVA para examinar las diferencias en las variables estudiadas entre estos países. Esto fue seguido de un análisis MANCOVA controlando el sexo y la edad. Se realizaron análisis de regresión lineal segmentados por país con el fin de identificar modelos predictivos de distrés psicológico. Resultados. La población polaca se caracterizó por niveles más altos de ansiedad, menos resiliencia y más uso de CERS desadaptativas durante el confinamiento. La población española sufrió más estrés pero utilizó CERS adaptativas y fue más resiliente. La edad y el sexo femenino aparecieron como factores de riesgo de malestar psicológico en España. Se encontró que los modelos de predicción de distrés psicológico fueron diferentes en ambos países: las CERS adaptativas fueron predictivas en España y la resiliencia fue predictiva en Polonia. Conclusiones. Este estudio podría guiar en iniciativas para la promoción del bienestar psicológico como vía para prevenir trastornos psicopatológicos durante la pandemia.(AU)

Background.The objective of this cross-cultural study was to ana-lyze the differences in resilience, cognitive emotion regulation strategies (CERS), as well as psychological distress during the COVID-19 pandemic between Poland and Spain. Method.An online survey was conducted on a sample of 1,182 adults. A MANOVA analysis was carried out to examine the differences in the studied variables between these countries. This was followed by MANCOVA analysis to control for gender and age. Linear re-gression analyses segmented by country were conducted in order to identi-fy psychological distress prediction models. Results.Polish population was characterized by higher levels of anxiety, less resilience and more maladap-tive CERS during the lockdown. Spanish population was more affected by stress but used more adaptable CERS and was more resilient. Age and fe-male gender appeared as risk factors of psychological distress in Spain. The psychological distress prediction models were found to be different be-tween both countries: adaptive CERS was predictive only in Spain, and re-silience was predictive only in Poland. Conclusions.This study could guide in initiatives for the promotion of psychological well-being as a way to pre-vent psychopathological disorders during the pandemic.(AU)

Smart Device-Driven Corticolimbic Plasticity in Cognitive-Emotional Restructuring of Space-Related Neuropsychiatric Disease and Injury.

Escalating government and commercial efforts to plan and deploy viable manned near-to-deep solar system exploration and habitation over the coming decades now drives next-generation space medicine innovations. The application of cutting-edge precision medicine, such as brain stimulation techniques, provides powerful clinical and field/flight situation methods to selectively control vagal tone and neuroendocrine-modulated corticolimbic plasticity, which is affected by prolonged cosmic radiation exposure, social isolation or crowding, and weightlessness in constricted operational non-terran locales. Earth-based clinical research demonstrates that brain stimulation approaches may be combined with novel psychotherapeutic integrated memory structure rationales for the corrective reconsolidation of arousing or emotional experiences, autobiographical memories, semantic schema, and other cognitive structures to enhance neuropsychiatric patient outcomes. Such smart cotherapies or countermeasures, which exploit natural, pharmaceutical, and minimally invasive neuroprosthesis-driven nervous system activity, may optimize the cognitive-emotional restructuring of astronauts suffering from space-related neuropsychiatric disease and injury, including mood, affect, and anxiety symptoms of any potential severity and pathophysiology. An appreciation of improved neuropsychiatric healthcare through the merging of new or rediscovered smart theragnostic medical technologies, capable of rendering personalized neuroplasticity training and managed psychotherapeutic treatment protocols, will reveal deeper insights into the illness states experienced by astronauts. Future work in this area should emphasize the ethical role of telemedicine and/or digital clinicians to advance the (semi)autonomous, technology-assisted medical prophylaxis, diagnosis, treatment, monitoring, and compliance of astronauts for elevated health, safety, and performance in remote extreme space and extraterrestrial environments.

The influence of peripheral emotions on inhibitory control among children.

In this study, we investigated the cognitive-emotional interplay by measuring the effects of executive competition (Pessoa, 2013), i.e., how inhibitory control is influenced when emotional information is encountered. Sixty-three children (8 to 9 years of age) participated in an inhibition task (central task) accompanied by happy, sad, or neutral emoticons (displayed in the periphery). Typical interference effects were found in the main task for speed and accuracy, but in general, these effects were not additionally modulated by the peripheral emoticons indicating that processing of the main task exhausted the limited capacity such that interference from the task-irrelevant, peripheral information did not show (Pessoa, 2013). Further analyses revealed that the magnitude of interference effects depended on the order of congruency conditions: when incongruent conditions preceded congruent ones, there was greater interference. This effect was smaller in sad conditions, and particularly so at the beginning of the experiment. These findings suggest that the bottom-up perception of task-irrelevant emotional information influenced the top-down process of inhibitory control among children in the sad condition when processing demands were particularly high. We discuss if the salience and valence of the emotional stimuli as well as task demands are the decisive characteristics that modulate the strength of this relation.

The impact of disease severity on the psychological well-being of youth affected by an inborn error of metabolism and their families: A one-year longitudinal study.

BACKGROUND: Inborn errors of metabolism (IEMs) refer to rare heterogeneous genetic disorders with various clinical manifestations that can cause serious physical and psychological sequelae. Results of previous studies on the impact of an IEM on health-related quality of life (HR-QoL) were incongruent and only few studies considered more broadly the psychological well-being of children with IEM and their families. Our objectives were to examine: (1) the impact of the IEM severity on the HR-QoL and psychological functioning of patients and their parents at baseline; and (2) its evolution over time; and (3) the correlation between parental and children's perspectives. Methods: The sample included 69 pediatric patients (mean age = 7.55 y, SD = 4.59) with evaluations at baseline and after one year. We collected data on HR-QoL, child mental health and emotional regulation as well as on parental mood and stress using different validated questionnaires. IEM severity was rated by a clinician through the biological subdomain of the pediatric INTERMED instrument. Results: Two groups of patients based on IEM severity scores were created (n = 31 with low and n = 38 with moderate/high IEM severity). The two groups differed with respect to age, diet and supplement intake. IEM severity had an impact on HR-QoL and behavioral symptoms in children, as well as on HR-QoL and stress in parents. For patients with moderate/high IEM severity, child and parental HR-QoL improved after 1-year of follow-up. We did not observe any significant difference between evaluations by patients versus parents. Conclusions: Our findings demonstrate that moderate/high IEM severity altered child and parental psychological well-being, but also revealed a significant improvement after one-year follow-up. This observation suggests that patients with a moderate/high IEM severity and their families benefit from the care of an interdisciplinary team including a child psychologist specialized in IEMs. Moreover, in patients with higher IEM severity there may also be more room for improvement compared to patients with low IEM severity. Future studies should focus on observations over a larger time span, particularly during adolescence, and should include objective measurements.

Attention or Distraction? The Impact of Mobile Phone on Users' Psychological Well-Being.

Cumulative evidence has demonstrated that mobile phone distraction, in particular among emerging adults, is a growing problem. Considerable efforts have been made to contribute to the literature by proposing cognitive emotion pre-occupation which acts as an underlying mechanism through which mobile phone distraction results in a reduction in psychological well-being. The proposed model is supported by distraction-conflict theory which reveals that users, with high attention control, are better at coping with the negative consequences of mobile phone distraction. The data, consisting of 914 University students in China, was analyzed using statistical tools. The results support that mobile phone distraction has a significant positive relationship with cognitive emotional pre-occupation which negatively affects users' psychological well-being. Our findings also reveal that attention control moderated the mediation effect of cognitive emotional pre-occupation in association with mobile phone distraction and psychological well-being. The theoretical and practical implications are also discussed along with limitations and future research.

Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update.

Fibromyalgia is a syndrome characterized by chronic and widespread musculoskeletal pain, often accompanied by other symptoms, such as fatigue, intestinal disorders and alterations in sleep and mood. It is estimated that two to eight percent of the world population is affected by fibromyalgia. From a medical point of view, this pathology still presents inexplicable aspects. It is known that fibromyalgia is caused by a central sensitization phenomenon characterized by the dysfunction of neuro-circuits, which involves the perception, transmission and processing of afferent nociceptive stimuli, with the prevalent manifestation of pain at the level of the locomotor system. In recent years, the pathogenesis of fibromyalgia has also been linked to other factors, such as inflammatory, immune, endocrine, genetic and psychosocial factors. A rheumatologist typically makes a diagnosis of fibromyalgia when the patient describes a history of pain spreading in all quadrants of the body for at least three months and when pain is caused by digital pressure in at least 11 out of 18 allogenic points, called tender points. Fibromyalgia does not involve organic damage, and several diagnostic approaches have been developed in recent years, including the analysis of genetic, epigenetic and serological biomarkers. Symptoms often begin after physical or emotional trauma, but in many cases, there appears to be no obvious trigger. Women are more prone to developing the disease than men. Unfortunately, the conventional medical therapies that target this pathology produce limited benefits. They remain largely pharmacological in nature and tend to treat the symptomatic aspects of various disorders reported by the patient. The statistics, however, highlight the fact that 90% of people with fibromyalgia also turn to complementary medicine to manage their symptoms.

Nocturnal cognitive hyperarousal, perinatal-focused rumination, and insomnia are associated with suicidal ideation in perinatal women with mild to moderate depression.

OBJECTIVES: This prospective study explored associations among insomnia, nocturnal cognitive hyperarousal, and nocturnal perinatal-focused rumination with suicidal ideation (SI) in perinatal women with depression. METHODS: From late pregnancy through early postpartum, 39 depressed women completed 17 weekly surveys assessing SI, insomnia, depression, stress, and cognitive arousal. RESULTS: Women with nocturnal cognitive hyperarousal at baseline, relative to those with low cognitive arousal, were at greater risk for new onset SI (33% vs 1%). Moreover, nocturnal perinatal-focused rumination was independently associated with SI. SI-risk was highest when women reported clinical insomnia combined with nocturnal cognitive hyperarousal (OR = 5.66, p = 0.037) or perinatal-focused rumination (OR = 11.63, p = 0.018). Daytime perseverative thinking was not uniquely associated with SI. CONCLUSIONS: Nocturnal cognitive arousal predicts the development of new onset SI, and perinatal-focused rumination is also uniquely associated with SI-risk in late pregnancy and early parenting. Critically, SI-risk is highest when perinatal women endorsed insomnia and high cognitive arousal at the same time. Future research should determine whether alleviating nocturnal cognitive arousal, pregnancy- and fetal/infant-related concerns, and insomnia with psychotherapy reduces SI for women with perinatal depression.