Incidence of hippocampal and perihippocampal brain metastases and impact on hippocampal-avoiding radiotherapy: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: In patients requiring prophylactic cranial irradiation (PCI) or whole-brain radiotherapy (WBRT) for brain metastases (BMs), hippocampal avoidance (HA) has been shown to preserve neurocognitive function and quality of life. Here, we aim to estimate the incidence of hippocampal and perihippocampal BMs and the subsequent risk of local undertreatment in patients undergoing hippocampal sparing radiotherapy. MATERIALS AND METHODS: MEDLINE, Embase, and Scopus were searched with the terms "Hippocampus", "Brain Neoplasms", and related terms. Trials reporting on the incidence of hippocampal and/or perihippocampal BMs or hippocampal failure rate after PCI or WBRT were included. RESULTS: Forty records were included, encompassing a total of 5,374 patients with over 32,570 BMs. Most trials employed a 5 mm margin to define the HA zone. In trials reporting on BM incidence, 4.4 % (range 0 - 27 %) and 9.2 % (3 - 41 %) of patients had hippocampal and perihippocampal BMs, respectively. The most common risk factor for hippocampal BMs was the total number of BMs. The reported failure rate within the HA zone after HA-PCI or HA-WBRT was 4.5 % (0 - 13 %), salvageable with radiosurgery in most cases. SCLC histology was not associated with a higher risk of hippocampal failure (OR = 2.49; p = 0.23). In trials comparing with a conventional (non-HA) PCI or WBRT group, HA did not increase the hippocampal failure rate (OR = 1.90; p = 0.17). CONCLUSION: The overall incidence of hippocampal and perihippocampal BMs is considerably low, with a subsequent low risk of local undertreatment following HA-PCI or HA-WBRT. In patients without involvement, the hippocampus should be spared to preserve neurocognitive function and quality of life.

For better or for worse? Visualizing previous intensity levels improves emotion (dynamic) measurement in experience sampling.

It is a long known reality that humans have difficulty to accurately rate the absolute intensity of internal experiences, yet the predominant way experience sampling (ESM) researchers assess participants' momentary emotion levels is by means of absolute measurement scales. In a daily-life experiment (n = 178), we evaluate the efficacy of two alternative assessment methods that should solicit a simpler, relative emotional evaluation: (a) visualizing a relative anchor point on the absolute rating scale that depicts people's previous emotion rating and (b) phrasing emotion items in a relative way by asking for a comparison with earlier emotion levels, using a relative rating scale. Determining five quality criteria relevant for ESM, we conclude that a visual "Last" anchor significantly improves emotion measurement in daily life: (a) Theoretically, this method has the best perceived user experience, as people, for example, find it the easiest and most accurate way to rate their momentary emotions. Methodologically, this type of measurement generates ESM time series that (b) exhibit less measurement error, produce person-level emotion dynamic measures that are (c) often more stable, and in a few cases show stronger (d) univariate and (e) incremental relations with external criteria like neuroticism and borderline personality (e.g., emotional variability). In sum, we see value in the addition of a relative "Last" anchor to absolute measurement scales of future ESM studies on emotions, as it structures the ambiguous rating space and introduces more standardization within and between individuals. In contrast, using relatively phrased emotion items is not recommended. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

m-Path: an easy-to-use and highly tailorable platform for ecological momentary assessment and intervention in behavioral research and clinical practice.

In this paper, we present m-Path (www.m-Path.io), an online platform that provides an easy-to-use and highly tailorable framework for implementing smartphone-based ecological momentary assessment (EMA) and intervention (EMI) in both research and clinical practice in the context of blended care. Because real-time monitoring and intervention in people's everyday lives have unparalleled benefits compared to traditional data collection techniques (e.g., retrospective surveys or lab-based experiments), EMA and EMI have become popular in recent years. Although a surge in the use of these methods has led to a myriad of EMA and EMI applications, many existing platforms only focus on a single aspect of daily life data collection (e.g., assessment vs. intervention, active self-report vs. passive mobile sensing, research-dedicated vs. clinically-oriented tools). With m-Path, we aim to integrate all of these facets into a single platform, as it is exactly this all-in-one approach that fosters the clinical utility of accumulated scientific knowledge. To this end, we offer a comprehensive platform to set up complex and highly adjustable EMA and EMI designs with advanced functionalities, using an intuitive point-and click web interface that is accessible for researchers and clinicians with limited programming skills. We discuss the strengths of daily life data collection and intervention in general and m-Path in particular. We describe the regular workflow to set up an EMA or EMI design within the m-Path framework, and summarize both the basic functionalities and more advanced features of our software.

Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials.

PURPOSE: Radiation dermatitis (RD) is the most common side effect of adjuvant whole-breast or chest wall irradiation, majorly impacting quality of life in numerous patients. The use of barrier films (polyurethane dressings such as Hydrofilm® and Mepitel® film remaining on the skin for the duration of the radiation treatment) has been investigated as a prophylactic measure in several prospective trials. Here, we critically appraise the available evidence behind preventive barrier film application in the context of breast cancer treatment. METHODS: International literature was reviewed and high-quality randomised controlled trials (RCTs) were included in this meta-analysis. RESULTS: The results of 5 RCTs (663 patients; >90% Caucasian) were analysed. Overall, barrier films lead to improved clinician- and patient-reported outcomes: fewer grade ≥2 RD (11% vs. 42%; OR = 0.16; p < 0.001) and moist desquamation (2% vs. 16%; OR = 0.12; p = 0.006), as well as less patient-reported pain (standardised mean difference [SMD] -0.51; p < 0.001), itching (SMD -0.52; p = 0.001), burning (SMD -0.41; p = 0.011), and limitations in daily activities (SMD -0.20; p = 0.007). Furthermore, barrier films have a high acceptance rate among patients, as well as a favourable cost-benefit ratio. Possible side effects due to its application are mild and mostly self-limiting. Overall, there was a lack of information on the radiation treatment techniques used. CONCLUSION: The evidence presented in this meta-analysis suggests that barrier films are an excellent tool in the prevention of RD among Caucasian patients receiving whole-breast or chest wall irradiation. Its use should therefore be considered routinely in these patients.

Overnight emotional inertia in relation to depressive symptomatology and subjective sleep quality.

Emotions show a certain degree of continuity during the day, a quality referred to as emotional inertia, and that is typically elevated in depression. Little is known however about the extent to which our emotional experiences may or may not also persist overnight. Do our feelings continue from evening to morning or not? And how is this related to depressive symptoms and sleep quality? In an experience sampling studies in healthy subjects (ns = 123) we investigated (1) to what extent people's mood, in terms of positive and negative affect, in the morning, after a night of sleep, can be predicted from their mood of the evening before, and whether this is moderated by (2) depressive symptom severity or (3) subjective sleep quality. Results showed that morning negative affect could be strongly predicted based on previous evening negative affect, whilst this carry-over effect was not observed for positive affect, indicating that negative affect shows a general tendency to persist overnight, while positive affect did not show such continuity. The overnight prediction of both negative and positive affect was not moderated by level of depressive symptoms, nor by subjective sleep quality.

Practitioner and researcher perspectives on the utility of ecological momentary assessment in mental health care: A survey study.

Background: Ecological momentary assessment (EMA) is a scientific self-monitoring method to capture individuals' daily life experiences. Early on, EMA has been suggested to have the potential to improve mental health care. However, it remains unclear if and how EMA should be implemented. This requires an in-depth investigation of how practitioners and researchers view the implementation of EMA. Objective: Explore the perspectives of mental health practitioners and EMA researchers on the utility of EMA for mental health care. Methods: Practitioners (n = 89; psychiatrists, psychologists, psychiatric nurses) and EMA researchers (n = 62) completed a survey about EMA in clinical practice. This survey addressed EMA goals for practitioner and patient, requirements regarding clinical use of EMA, and (dis)advantages of EMA compared to treatment-as-usual. t-Tests were used to determine agreement with each statement and whether practitioners' and researchers' views differed significantly. Linear regression was used to explore predictors of goals and preferences (e.g., EMA experience). Results: Practitioners and researchers considered EMA to be a useful clinical tool for diverse stages of care. They indicated EMA to be most useful for gaining insight into the context specificity of symptoms (55.0 %), whereas receiving alerts when symptoms increase was rated the least useful (11.3 %, alerts is in 95 % of bootstrap iterations between rank 8 and 10). Compared to treatment-as-usual, EMA was considered easier to use (M = 4.87, t = 5.30, p < .001) and interpret (M = 4.52, t = 3.61, p < .001), but also more burdensome for the patient (M = 4.48, t = 3.17, p < .001). Although participants preferred personalization of the EMA diary, they also suggested that EMA should cost practitioners and patients limited time. The preference for creating personalized EMA was related to the level of experience with EMA. Finally, they highlighted the need for practitioner training and patient full-time access to the EMA feedback. Conclusions: This survey study demonstrated that practitioners and researchers expect EMA to have added value for mental health care. Concrete recommendations for implementation of EMA are formulated. This may inform the development of specific clinical applications and user-friendly EMA software.

Assessing the reliability of single-item momentary affective measurements in experience sampling.

Emotion researchers that use experience sampling methods (ESM) study how emotions fluctuate in everyday life. To reach valid conclusions, confirming the reliability of momentary emotion measurements is essential. However, to minimize participant burden, ESM researchers often use single-item measures, preventing a reliability assessment of people's emotion ratings. Furthermore, because emotions constantly change, checking reliability via conventional test-retest procedures is impractical, for it is impossible to separate measurement error from meaningful emotional variability. Here, drawing from classical test theory (CTT), we propose two time-varying test-retest adaptations to evaluate the reliability of single-item (emotion) measures in ESM. Following Method 1, we randomly repeat one emotion item within the same momentary survey and evaluate the discrepancy between test and retest ratings to determine reliability. Following Method 2, we introduce a subsequent, shortly delayed retest survey and extrapolate the size of test-retest discrepancies to the hypothetical instance where no time between assessments would exist. First, in an analytical study, we establish the mathematical relation between observed test-retest discrepancies and measurement error variance for both methods, based on common assumptions in the CTT literature. Second, in two empirical studies, we apply both methods to real-life emotion time series and find that the size of error in people's emotion ratings corresponds with almost a 10th of the scale, comprising around 27% of the total variability in participants' affective responses. Consequently, disregarding measurement error in ESM is problematic, and we encourage researchers to include a test-retest procedure in their future studies when relying on single-item measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Some Recommendations on the Use of Daily Life Methods in Affective Science.

Real-world emotions are often more vivid, personally meaningful, and consequential than those evoked in the lab. Therefore, studying emotions in daily life is essential to test theories, discover new phenomena, and understand healthy emotional functioning; in short, to move affective science forward. The past decades have seen a surge of research using daily diary, experience sampling, or ecological momentary assessment methods to study emotional phenomena in daily life. In this paper, we will share some of the insights we have gained from our collective experience applying such daily life methods to study everyday affective processes. We highlight what we see as important considerations and caveats involved in using these methods and formulate recommendations to improve their use in future research. These insights focus on the importance of (i) theory and hypothesis-testing; (ii) measurement; (iii) timescale; and (iv) context, when studying emotions in their natural habitat.

Perceiving societal pressure to be happy is linked to poor well-being, especially in happy nations.

Happiness is a valuable experience, and societies want their citizens to be happy. Although this societal commitment seems laudable, overly emphasizing positivity (versus negativity) may create an unattainable emotion norm that ironically compromises individual well-being. In this multi-national study (40 countries; 7443 participants), we investigate how societal pressure to be happy and not sad predicts emotional, cognitive and clinical indicators of well-being around the world, and examine how these relations differ as a function of countries' national happiness levels (collected from the World Happiness Report). Although detrimental well-being associations manifest for an average country, the strength of these relations varies across countries. People's felt societal pressure to be happy and not sad is particularly linked to poor well-being in countries with a higher World Happiness Index. Although the cross-sectional nature of our work prohibits causal conclusions, our findings highlight the correlational link between social emotion valuation and individual well-being, and suggest that high national happiness levels may have downsides for some.

Informing VAR(1) with qualitative dynamical features improves predictive accuracy.

The AR(1) model has been shown to outperform the general VAR(1) model on typical affective time series. Even in combination with a lasso penalty, the reduced VAR(1) model (VAR-lasso) is generally outperformed. A reason for the AR dominance is that the VAR-lasso selects models that are still too complex-the space of all possible VAR models includes simpler models but these are hard to select with a traditional lasso penalty. In this article, we propose a reparametrization of the VAR model by decomposing its transition matrix into a symmetric and antisymmetric component (denoted as SAD), allowing us to construct a hierarchy of meaningful signposts in the VAR model space ranging from simple to complex. The decomposition enables the lasso procedure to pick up qualitatively distinct dynamical features in a more targeted way (like relaxation, shearing, and oscillations); this procedure is called SAD-lasso. This leads to a more intuitive interpretation of the reduced models. By removing the antisymmetric component altogether, we obtain a subclass of symmetric VAR models that form a natural extension of the AR model with the same simple relaxation dynamics but allowing for interactions between the system components. We apply these reparametrized and constrained VAR models to 1,391 psychological time series of affect, and compare their predictive accuracy. This analysis indicates that the SAD-lasso is a better regularization technique than the VAR-lasso. Additionally, the results of an extensive simulation study suggest the existence of symmetric interactions for almost half of the time series considered in this article. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Short-Term Psychological Impact of the COVID-19 Pandemic in Psychiatric Patients: Evidence for Differential Emotion and Symptom Trajectories in Belgium.

The spread of COVID-19 and the implementation of various containment strategies across the world have seriously disrupted people's everyday life, and it is especially uncertain what the psychological impact of this pandemic will be for vulnerable individuals, such as psychiatric (ex-)patients. Governments fear that this virus outbreak may prelude a major mental health crisis, and psychiatrists launch critical calls to flatten an upcoming mental ill-health surge. Here, we aim to add nuance to the idea that we are heading towards a mental health pandemic and that psychiatric populations will unavoidably (re)develop psychopathology. Despite being subjected to the same challenges posed by COVID-19, we argue that people with a history of psychiatric illness will psychologically deal with this adversity in different ways. To showcase the short-term differential impact of COVID-19 on patients' mental health, we present the day-to-day emotion and symptom trajectories of different psychiatric patients that took part in an experience sampling study before, during, and after the start of the first wave of the COVID-19 pandemic in March 2020 and associated lockdown measures in Belgium. Piecewise regression models show that not all patients' psychological well-being is affected to a similar degree. As such, we argue that emphasizing human resilience, also among the more vulnerable in society, may be opportune in these unsettling times.

Inflexibly sustained negative affect and rumination independently link default mode network efficiency to subclinical depressive symptoms.

Aberrant DMN connectivity and activity have been robustly linked to Major Depressive Disorder (MDD) and risk for depression. This link has mostly been explained in terms of rumination, a form of negative, repetitive cognitive processing. Yet, accumulating findings are indicating altered DMN dynamics during emotional processing in MDD, pointing at a potential emotion-related DMN pathology in depression linked to inflexibly sustained emotional responses. Such a link might be especially important in understanding risk of depression. However, whether inflexible emotional processing (i.e. emotional inertia) is connecting aberrant DMN organization to risk of depression as well as how this might relate to rumination remains unclear. Addressing this gap, 34 participants underwent a resting-state fMRI and a 7-day Experience Sampling phase. Using regression and multiple mediation analysis we investigated the relations between negative emotional inertia, rumination, DMN organization and risk of depression as indicated by high subclinical depressive symptoms. The findings indicated that DMN efficiency at rest was positively associated with depressive symptoms and risk of depression. Both negative emotional inertia in daily life and rumination were independently mediating this relationship. While negative emotional inertia was connected to a broad increase in the coupling of DMN regions, rumination was only related to an increase in node strength of the dorsomedial Prefrontal Cortex. These findings are pointing towards an emotional-related DMN pathology contributing to risk of depression. Furthermore the findings are indicating that this relationship is independent from the rumination-related link between the DMN and depression - representing different aspects of DMN organization.

The Statistical Specificity of Emotion Dynamics in Borderline Personality Disorder.

Persons with borderline personality disorder (BPD) experience heightened emotional instability. Different components underlie instability, and the relation between instability and well-being could be confounded by average emotionality and within-person standard deviation across emotional states, reflecting variability. Therefore, the goal was to examine which pattern of emotion dynamics parsimoniously captures the emotional trajectories of persons with BPD. Forty persons with BPD, 38 clinical controls in a major depressive episode, and 40 healthy controls rated the intensity of their emotions 10 times a day for 1 week. After correction for differences in average emotionality, persons with BPD showed heightened emotional instability compared to both control groups. When additionally correcting for emotional variability, the authors found that instability indices did not differ between groups anymore. This shows that persons with BPD differ from control groups in the magnitude of emotional deviations from the emotional baseline, and not necessarily in the degree of abruptness of these deviations.

Ambulatory assessment in psychopathology research: Current achievements and future ambitions.

Ambulatory assessment (AA) - a collection of methods that aim to track individuals in the realm of everyday life via repeated self-reports or passive mobile sensing - is well established in contemporary psychopathology research. Unravelling the dynamic signature of patients' symptoms and emotions over time and in their own personal ecology, AA methodology has improved our understanding of the real-time pathogenic processes that underlie mental ill-being. In this article, we evaluate the current strengths and shortcomings of AA in psychopathology research and spell out important ambitions for next-generation AA studies to consider. Regarding AA's current achievements, a selective review of recent AA studies underscores the ecological qualities of this method, its ability to bypass retrospective biases in self-report and the introduction of a within-person perspective. Regarding AA's future ambitions, we advocate for a stronger idiosyncratic focus, the incorporation of contextual information and more psychometric scrutiny.

The relation between positive and negative affect becomes more negative in response to personally relevant events.

Can we experience positive (PA) and negative affect (NA) separately (i.e., affective independence), or do these emotional states represent the mutually exclusive ends of a single bipolar continuum (i.e., affective bipolarity)? Building on previous emotion theories, we propose that the relation between PA and NA is not invariable, but rather fluctuates in response to changing situational demands. Specifically, we argue that our affective system shifts from relative independence to stronger bipolarity when we encounter events or situations that activate personally relevant concerns. We test this idea in an experience sampling study, in which we tracked the positive and negative emotional trajectories of 101 first-year university students who received their exam results, an event that potentially triggers a personally significant concern. Using multilevel piecewise regression, we show that running PA-NA correlations become increasingly more negative in the anticipation of results release, indicating stronger affective bipolarity, and ease back toward greater independence as time after this event passes. Furthermore, we show that this dynamic trajectory is particularly apparent for event-related PA and NA, and not affect in general, and that such shifts are partly a function of the importance people attribute to that event. We suggest that such flexible changes in the affect relation may function as an emotional compass by signaling personally relevant information, and create a motivational push to respond to these meaningful events in an appropriate manner. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Affective Ising Model: A computational account of human affect dynamics.

The human affect system is responsible for producing the positive and negative feelings that color and guide our lives. At the same time, when disrupted, its workings lie at the basis of the occurrence of mood disorder. Understanding the functioning and dynamics of the affect system is therefore crucial to understand the feelings that people experience on a daily basis, their dynamics across time, and how they can become dysregulated in mood disorder. In this paper, a nonlinear stochastic model for the dynamics of positive and negative affect is proposed called the Affective Ising Model (AIM). It incorporates principles of statistical mechanics, is inspired by neurophysiological and behavioral evidence about auto-excitation and mutual inhibition of the positive and negative affect dimensions, and is intended to better explain empirical phenomena such as skewness, multimodality, and non-linear relations of positive and negative affect. The AIM is applied to two large experience sampling studies on the occurrence of positive and negative affect in daily life in both normality and mood disorder. It is examined to what extent the model is able to reproduce the aforementioned non-Gaussian features observed in the data, using two sightly different continuous-time vector autoregressive (VAR) models as benchmarks. The predictive performance of the models is also compared by means of leave-one-out cross-validation. The results indicate that the AIM is better at reproducing non-Gaussian features while their performance is comparable for strictly Gaussian features. The predictive performance of the AIM is also shown to be better for the majority of the affect time series. The potential and limitations of the AIM as a computational model approximating the workings of the human affect system are discussed.

mobileQ: A free user-friendly application for collecting experience sampling data.

In this article we introduce mobileQ, which is a free, open-source platform that our lab has developed to use in experience sampling studies. Experience sampling has several strengths and is becoming more widely conducted, but there are few free software options. To address this gap, mobileQ has freely available servers, a web interface, and an Android app. To reduce the barrier to entry, it requires no high-level programming and uses an easy, point-and-click interface. It is designed to be used on dedicated research phones, allowing for experimenter control and eliminating selection bias. In this article, we introduce setting up a study in mobileQ, outline the set of help resources available for new users, and highlight the success with which mobileQ has been used in our lab.

Confused or curious? Openness/intellect predicts more positive interest-confusion relations.

Open people show greater interest in situations that are complex, novel, and difficult to understand-situations that may also be experienced as confusing. Here we investigate the possibility that openness/intellect is centrally characterized by more positive relations between interest and confusion. Interest and confusion are key states experienced during engagement with information and learning. However, little is known about the within-person relation between them, let alone individual differences in this relation. We tested our hypotheses by making use of different paradigms, stimuli, and participants. Across five studies (N = 640) we tested the relation between openness/intellect and within-person interest-confusion relations in response to art (Study 1); science, philosophy, and art (Study 2); psychology lectures (Study 3); a poem (Study 4); and a complex problem solving task (Study 5). Average interest-confusion relations varied between different studies, but for all studies the distributions of the relations went from highly negative to highly positive-individual differences in direction rather than just degree. In all but 1 study we found consistent support for our hypotheses-openness/intellect is associated with more positive relations between interest and confusion. No other personality domain or intelligence was consistently related to interest-confusion relations. Together, these findings suggest a new phenomenological aspect of being open-curiosity toward confusing situations. Our findings support the link between openness/intellect and sensitivity to the value of complex information, and are discussed with regards to their relevance for engagement with information and learning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Does repeatedly reporting positive or negative emotions in daily life have an impact on the level of emotional experiences and depressive symptoms over time?

The extent to which people are aware of their emotional experiences, label them and communicate them to the outside world are considered to impact emotional experience itself and potentially people's depressive symptom levels. All of these aspects are important elements of one of the most common methods to study and measure emotions in the context of daily life, the so-called experience sampling method (ESM). A straightforward question that arises when using this method is whether participating in ESM may bring about changes in the momentary emotional self-reports of the people engaging in it, thereby effectively influencing that what it intends to measure; emotional experience over time, and whether this would relate to average levels of depressive symptoms. To examine these questions, we conducted a 7-day ESM study in which 90 participants were randomly assigned to repeatedly report either positive emotions only, negative emotions only or non-emotional internal states only, course using smartphones. Participants also completed pre-, post- and follow-up measurements of levels of depressive symptoms. Results showed no significant impact on self-reported momentary emotions, respective to their condition, over time nor on average levels of depressive symptoms across groups. These findings suggest that the repeated assessment of emotions in daily life, over the course of seven days, does not impact their emotional experience over time nor levels of depressive symptoms.