Distinguishing Affective Temperament Profiles in Major Depressive Disorder and Bipolar Disorder Through the Short Version of TEMPS-A: Cross-Sectional Study Using Latent Profile Analysis.

OBJECTIVE: This study aimed to elucidate the distinct response patterns exhibited by patients diagnosed with bipolar disorder (BD) and those with major depressive disorder (MDD) through the application of the short version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A-SV). METHODS: A total of 2,458 participants consisting of patients with MDD (n=288), BD (BD I, n=111; BD II, n=427), and control group (n=1,632) completed the TEMPS-A-SV. The response patterns of the participants were classified into distinct profiles using latent profile analysis. The study further examined the impact of covariates such as age, sex, and diagnostic group on derived latent profile memberships. RESULTS: The following three latent profiles were identified: High Affective Temperament Group (17.86%), Low Affective Temperament Group (41.25%), and Middle Affective Temperament Group (40.89%). Compared with the patient group with MDD and BD, the control group was more likely to belong in the Low Affective Temperament Group, which showed a higher score on hyperthymic temperament than the Middle Affective Temperament Group. Furthermore, compared with the patients with BD, the MDD patients were more likely to be in the Low Affective Temperament Group rather than the Middle Affective Temperament Group. CONCLUSION: These results indicate that different affective temperaments exist between patients with MDD and BD. Attempting to classify response patterns using the TEMPS-A-SV can help diagnose MDD and BD correctly.

The Impact of Morningness-Eveningness on Depression through a Serial Mediation Model of Resilience and Anxiety.

OBJECTIVE: Resilience has been recently considered one of the possible mechanisms for the association between morningness-eveningness and depression. Meanwhile, anxiety is closely associated with mood disorder, but its association with morningness-eveningness is unclear. Therefore, this study aimed to explore the mediating effects of resilience and anxiety on morningness-eveningness and depression as the possible mechanisms. METHODS: This study included patient group and nonpatient group. Patient group consists of 743 patients with mood disorders [Major Depressive Disorder (MDD), 233; Bipolar Disorder Ⅰ (BDⅠ), 113; Bipolar Disorder Ⅱ (BDⅡ), 397] whereas nonpatient group consists of 818 individuals without mood disorder. The Composite Scale of Morningness, Connor-Davidson Resilience Scale, Self-Rating Depression Scale, and Beck Anxiety Inventory were used to evaluate morningness-eveningness, resilience, anxiety, and depression, respectively. RESULTS: Our model provided a good fit for the data. The association between morningness-eveningness and depression symptoms was partially serially mediated by resilience and anxiety in both the patient and nonpatient groups. The patient group exhibited significantly stronger morningness-eveningness toward resilience and anxiety than the nonpatient group. In the indirect effect of morningness-eveningness on depression, group differences exist only through each mediation of resilience and anxiety, not through serial mediation. CONCLUSION: Our results expand on the mechanism underlying the association between morningness-eveningness and depression. They highlight the importance of morningness-eveningness modification to increase resilience and the need to consider anxiety jointly in this process.

Development and Validation of the Mental Health Scale for Maltreated Children.

OBJECTIVE: This study aimed to develop and validate a comprehensive self-report questionnaire to assess emotional and behavioral problems and psychological trauma in maltreated children. METHODS: The Mental Health Scale for Maltreated Children (MHS-MC) was constructed to encompass five major symptoms (depression, anxiety, inattention/hyperactivity/impulsivity, aggression/defiance, and psychological trauma) prevalent in maltreated children. Critical items and ego-resilience subscale were also devised to increase clinical utility. After informed consent, 205 children (maltreated children, n=157, 76.6%) were recruited nationwide, and they answered a package of self-report measures, including the MHS-MC. Reliability, construct validity, concurrent validity, and criterion-related validity were examined to explore the psychometric properties. RESULTS: The reliability was good to excellent. Confirmatory factor analysis yielded a five-factorial solution for the symptom subscales supporting construct validity. In logistic regression, the total scores of the MHS-MC predicted membership in the maltreated group. Criterion-related validity was generally satisfactory in that all subscales of the MHS-MC showed significant correlations with relevant measures in the expected direction. CONCLUSION: This is the first attempt to develop a comprehensive psychological scale based on nationwide data collected from maltreated Korean children. We hope that the continued standardization of this scale will contribute to evidence-based clinical and policy decisionmaking for maltreated children.

Meaning-making while staying connected matters in psychological adaptation during pandemic: a longitudinal moderated mediation study.

Adversity may bring about both negative and positive changes in psychological adaptation. Although there is mounting evidence regarding the psychological distress during the pandemic, the other side of posttraumatic change, posttraumatic growth (PTG) and its predictors are relatively underexamined. Moreover, there is a paucity of longitudinal investigations that examined intra- and interpersonal predictors responsible for both sides of psychological adaptation. Therefore, this study comprehensively examined the longitudinal relationship among cognitive processing, social support, and adaptation during the pandemic using a moderated mediation model. Specifically, it was tested whether two types of event-related rumination mediated the link between perceived stress and ambilateral adaptational outcomes, and whether social support moderated the mediating pathways of ruminations on adaptation. After informed consent, a representative sample of adults was followed up for over a year, and answered a package of online questionnaires. The results showed that intrusive rumination prospectively predicted greater psychological distress and less PTG in response to stress, whereas deliberate rumination led to less psychological distress and more PTG over time. As predicted, the indirect protective effect of deliberate rumination was stronger when perceived social support was higher. This longitudinal study highlighted the core factors responsible for continued suffering and personal growth during the pandemic. These results have both practical and clinical implications for mental healthcare in the post-COVID era, when the heterogeneity of psychological adaptation increases and preparation for the next pandemic is warranted.

Interpersonal sensitivity and childhood trauma in patients with major depressive disorder, bipolar I, and II disorder.

Childhood trauma and interpersonal sensitivity impact the development of mood disorders. In this study, we investigate the association between childhood trauma and interpersonal sensitivity in patients with mood disorders. A total 775 patients (major depressive disorder [MDD, n = 241], bipolar I disorder [BD I, n = 119], and bipolar II disorder [BD II, n = 415]) and 734 controls. For evaluation, we used the Childhood Trauma Questionnaire-Short Form (CTQ) and Interpersonal Sensitivity Measure (IPSM). We examined between-group differences for each subscale in the CTQ and IPSM. Patients with BD II had significantly higher IPSM total scores than patients with MDD, BD I, or controls. The CTQ total score was related to the IPSM total score in all participants and subgroups. Among the CTQ subscales, emotional abuse showed the highest correlation with the IPSM total score, while separation anxiety and fragile inner self showed higher positive correlations with CTQ than the other subscales of IPSM in all patient groups and the control group, respectively. The findings reveal that childhood trauma and interpersonal sensitivity are positively correlated among patients with MDD, BD I, and BD II, and that interpersonal sensitivity is higher in patients with BD II than those with BD I or MDD. Childhood trauma is associated with interpersonal sensitivity, and each trauma type has a different impact on mood disorders. We expect that this study will encourage future research on interpersonal sensitivity and childhood trauma in mood disorders to improve treatment approaches.

Network structure of symptomatology of adult attention-deficit hyperactivity disorder in patients with mood disorders.

Patients with mood disorders commonly manifest comorbid psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated ADHD symptoms in this population. The current study aimed to explore the network structure of ADHD symptomology and identify central symptoms in patients with mood disorders. The Korean version of the Adult ADHD Self-Report Scale was used to assess the overall ADHD symptoms in 1,086 individuals diagnosed with mood disorders (major depressive disorder [n = 373], bipolar I disorder [n = 314], and bipolar II disorder [n = 399]). We used exploratory graph analysis to detect the number of communities, and the network structure was analyzed using regularized partial correlation models. We identified the central ADHD symptom using centrality indices. Network comparison tests were conducted with different subgroups of patients with mood disorders, including three mood diagnosis groups, between the patients who met the diagnostic criteria for ADHD [ADHD-suspected, n = 259] in their self-report and the others [ADHD-non-suspected, n = 827], and groups with high [n = 503] versus low [n = 252] levels of depressive state. The network analysis detected four communities: disorganization, agitation/restlessness, hyperactivity/impulsivity, and inattention. The centrality indices indicated that "feeling restless" was the core ADHD symptom. The result was replicated in the subgroup analyses within our clinically diverse population of mood disorders, encompassing three presentations: Patients with suspected ADHD, patients without suspected ADHD, and patients with a high depressive state. Our findings reveal that "feeling restless" is the central ADHD symptom. The treatment intervention for "feeling restless" may thus play a pivotal role in tackling ADHD symptoms in adult patients with mood disorders.

Validation of the Short Form of the Mood Instability Questionnaire-Trait (MIQ-T-SF) in the Korean General Population.

OBJECTIVE: Mood instability (MI) is a clinically significant trait associated with psychiatric disorders. However, there are no concise measurements to evaluate MI. The initial Mood Instability Questionnaire-Trait (MIQ-T) was developed to fill this gap. The current study aimed to create a short form of MIQ-T (MIQ-T-SF) that measures MI with high validity and reliability in the Korean general population. METHODS: Of the 59 items in the MIQ-T, 17 items were chosen for the MIQ-T-SF following the factor analysis process. In total, 540 participants completed the MIQ-T-SF. Cronbach's alpha and McDonald's omega were used to evaluate reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to determine construct validity. Concurrent validity was confirmed via comparisons with Personality Assessment Inventory-Borderline Features Scale. Measurement invariance across gender and age groups was confirmed before analyzing differences in scores using Kruskal-Wallis test. RESULTS: The MIQ-T-SF displayed expected correlations and high internal consistency (α=0.71-0.90, Ωt=0.72-0.92). Using EFA and CFA, a five-factor structure was confirmed. Measurement invariance was supported, and gender differences were observed. CONCLUSION: The MIQ-T-SF is an accurate and reliable method to detect MI in the Korean general population. The study's results offer new perspectives for future studies on MI.

Genetic network structure of 13 psychiatric disorders in the general population.

Psychiatric disorders frequently co-occur and share common symptoms and genetic backgrounds. Previous research has used genome-wide association studies to identify the interrelationships among psychiatric disorders and identify clusters of disorders; however, these methods have limitations in terms of their ability to examine the relationships among disorders as a network structure and their generalizability to the general population. In this study, we explored the network structure of the polygenic risk score (PRS) for 13 psychiatric disorders in a general population (276,249 participants of European ancestry from the UK Biobank) and identified communities and the centrality of the network. In this network, the nodes represented a PRS for each psychiatric disorder and the edges represented the connections between nodes. The psychiatric disorders comprised four robust communities. The first community included attention-deficit hyperactivity disorder, autism spectrum disorder, major depressive disorder, and anxiety disorder. The second community consisted of bipolar I and II disorders, schizophrenia, and anorexia nervosa. The third group included Tourette's syndrome and obsessive-compulsive disorder. Cannabis use disorder, alcohol use disorder, and post-traumatic stress disorder make up the fourth community. The PRS of schizophrenia had the highest values for the three metrics (strength, betweenness, and closeness) in the network. Our findings provide a comprehensive genetic network of psychiatric disorders and biological evidence for the classification of psychiatric disorders.

A latent profile approach for classifying internet gamers based on motives for online gaming.

Background and aims: Online gaming motives have proven to be useful in differentiating problematic engagement in online gaming. However, the mixture modeling approach for classifying problematic subtypes based on gaming motives remains limited. This study attempted to differentiate heterogeneous online gamers into more homogenous subtypes based on gaming motives using latent profile analysis (LPA). We also compared various psychological and gaming/leisure related variables across the derived profiles. Methods: A total of 674 Korean online game users (mean age = 21.81 years, male = 76%) completed self-report questionnaires, including the Korean version of the Motives for Online Gaming Questionnaire (K-MOGQ). After the LPA, the relationships between latent profile membership and auxiliary variables were explored. Results: Four latent profiles were identified, that were further classified into one problematic (highly motivated-dissatisfied gamer), one highly engaged (highly motivated-satisfied gamer), and two casual (moderately-motivated casual gamer and lowly-motivated casual gamer) gamer profiles. Inter-profile comparisons revealed that highly motivated-dissatisfied gamer had the most pathological profile, characterized by high Internet gaming disorder (IGD) tendency, neuroticism, and impulsivity, but the lowest recreation motive. While highly motivated-satisfied gamer also demonstrated a heightened IGD tendency, they showed positive patterns of psychological and gaming/leisure-related variables, which indicated they could be better considered as high engaged instead of problematic gamers. Discussion and conclusions: These results indicate that the recreation motive, in addition to fantasy or escape motives, is an important factor in differentiating maladaptive online gamers. Classifying online gamers based on gaming motives can contribute to a clearer conceptualization of heterogeneous gamers, paving the way for individualized assessment and treatment planning.

Korean Validation of the Short Version of the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire) in Patients with Mood Disorders.

BACKGROUND AND OBJECTIVES: The Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) is designed to assess affective temperaments. The short version of the TEMPS-A (TEMPS-A-SV) has been translated into various languages for use in research and clinical settings. However, no research has been conducted to validate the Korean version of the TEMPS-A-SV in patients with mood disorders. The goal of this study is to evaluate the reliability and validity of the TEMPS-A-SV in Korean mood disorder patients. MATERIALS AND METHODS: In this cross-sectional retrospective study, a total of 715 patients (267 patients with major depressive disorder, 94 patients with bipolar disorder I, and 354 patients with bipolar disorder II) completed the Korean TEMPS-A-SV. Cronbach's alpha and McDonald's omega were used to assess the reliability. Exploratory factor analysis (EFA) was also performed. Spearman's correlation coefficient was used to examine associations between the five temperaments. The difference in five temperament scores between the gender or diagnosis groups was analyzed, and the correlation between five temperament scores and age was tested. RESULTS: The Korean TEMPS-A-SV displayed good internal consistency (α = 0.65-0.88, ω = 0.66-0.9) and significant correlations between the subscales except one (the correlation between hyperthymic and anxious). Using EFA, a two-factor structure was produced: Factor I (cyclothymic, depressive, irritable, and anxious) and Factor II (hyperthymic). The cyclothymic temperament score differed by gender and the anxious temperament score was significantly correlated with age. All the temperaments, except for irritable temperament, showed significant differences between diagnosis groups. CONCLUSIONS: Overall, the results show that the TEMPS-A-SV is a reliable and valid measurement that can be used for estimating Koreans' affective temperaments. However, more research is required on affective temperaments and associated characteristics in people with mood disorders.

Relationship between childhood trauma and resilience in patients with mood disorders.

BACKGROUND: Childhood trauma has lasting negative impacts on individuals' psychological functioning. However, there is limited empirical evidence on the association between childhood trauma and resilience and none examining such relationship among diverse clinical populations. This study aimed to investigate the relationship in patients with major depressive disorder, bipolar I disorder, bipolar II disorder, and a comparison group. METHODS: In total, 787 psychiatric patients and 734 people from the general population participated in the study. The Childhood Trauma Questionnaire-Short Form and Connor-Davidson Resilience Scale were used to assess childhood trauma and resilience, respectively. RESULTS: Individuals with childhood trauma showed lower levels of resilience in all subjects; among them, those who experienced emotional abuse and emotional neglect exhibited even stronger associations than other types of childhood trauma. There was a significant difference in the negative relationship between childhood trauma and resilience by group, where the association was more prominent in the comparison group than in MDD and BD II patient groups. LIMITATIONS: The generalizability of our results may be limited due to unproportionate patient sample size. Also, we could not examine the causal relationship between childhood trauma and resilience. CONCLUSION: Childhood trauma and resilience had a significantly negative association. Our results suggest that people who have experienced emotional abuse and emotional neglect should be closely assisted to develop resilience. Interventions that promote resilience should be provided to individuals predisposed to psychological risks as a result of childhood trauma.

Understanding of Depressive Symptomatology across Major Depressive Disorder and Bipolar Disorder: A Network Analysis.

Background and Objectives: Depressive symptoms are prominent in both major depressive disorder (MDD) and bipolar disorder (BD). However, comparative research on the network structure of depressive symptoms in these two diagnostic groups has been limited. This study aims to compare the network structure of depressive symptoms in MDD and BD, providing a deeper understanding of the depressive symptomatology of each disorder. Materials and Methods: The Zung Self-Rating Depressive Scale, a 20-item questionnaire, was administered to assess the depressive symptoms in individuals with MDD (n = 322) and BD (n = 516). A network analysis was conducted using exploratory graph analysis (EGA), and the network structure was analyzed using regularized partial correlation models. To validate the dimensionality of the Zung SDS, principal component analysis (PCA) was adopted. Centrality measures of the depressive symptoms within each group were assessed, followed by a network comparison test between the two groups. Results: In both diagnostic groups, the network analysis revealed four distinct categories, aligning closely with the PCA results. "Depressed affect" emerged as the most central symptom in both MDD and BD. Furthermore, non-core symptoms, "Personal devaluation" in MDD and "Confusion" in BD, displayed strong centrality. The network comparison test did not reveal significant differences in the network structure between MDD and BD. Conclusions: The absence of significant differences in the network structures between MDD and BD suggests that the underlying mechanisms of depressive symptoms may be similar across these disorders. The identified central symptoms, including "Depressed affect", in both disorders and the distinct non-core symptoms in each highlight the complexity of the depressive symptomatology. Future research should focus on validating these symptoms as therapeutic targets and incorporate various methodologies, including non-metric dimension reduction techniques or canonical analysis.

Differential roles of reflection and brooding on the relationship between perceived stress and life satisfaction during the COVID-19 pandemic: A serial mediation study.

Perceived stress is associated with low life satisfaction; however, the underlying mechanism is relatively underexplored. This study investigated whether rumination might mediate this link during the highly stressful COVID-19 pandemic. Building on the distinction between the subtypes of rumination, we predicted that reflection and brooding would sequentially mediate this relationship and that maladaptive brooding would negatively influence life satisfaction. A representative sample of 316 adults was recruited from the greater Daegu area, where the first massive outbreak occurred in South Korea. After informed consent was obtained, they completed a package of questionnaires that included demographics, COVID-19-related experiences, perceived stress, life satisfaction, and rumination. A serial mediation analysis showed that reflection and brooding sequentially mediated the relationship between perceived stress and life satisfaction. As predicted, only brooding was negatively related to life satisfaction. In contrast, reflection per se was positively related to life satisfaction, and it negatively affected life satisfaction only through brooding. Our results extended the negative effect of brooding, as compared to reflection, in the pandemic. Given that reflection may easily turn into brooding under stress, it will be necessary to develop ways to guide people to counteract brooding while maintaining a reflective self-focus to preserve their well-being.

Borderline Personality Pathology in Major Depressive Disorder, Bipolar I and II Disorder, and Its Relationship With Childhood Trauma.

OBJECTIVE: Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls. METHODS: A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory-Borderline Features Scale. RESULTS: BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients. CONCLUSION: The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.

Korean Validation of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire.

OBJECTIVE: The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) has been validated in more than 30 languages and is noted for its broad application in research and clinical settings. This study presents the first attempt to examine the reliability and validity of the TEMPS-A in Korea. METHODS: A total of 540 non-clinical participants completed the Korean TEMPS-A, which was adapted from the original English version via a comprehensive translation procedure. Reliability was assessed using Cronbach's α, and associations between temperaments were examined using Spearman's correlation coefficient. Exploratory factor analysis (EFA) was performed, and differences in TEMPS-A scores between the gender- and age-based groups were examined using Kruskal-Wallis analysis. RESULTS: The Korean TEMPS-A exhibited excellent internal consistency (0.70-0.91) and significant correlations between subscales. EFA resulted in a two-factor structure: Factor I (depressive, cyclothymic, irritable, and anxious) and Factor II (hyperthymic). Gender and age group differences were observed. CONCLUSION: Overall, our results suggest that TEMPS-A is a reliable and valid measure of affective temperaments for the Korean population. This study opens new possibilities for further research on affective temperaments and their related traits.

Korean validation of the Motives for Online Gaming Questionnaire: Focusing on its factor structure and incremental validity.

BACKGROUND AND AIMS: Research has suggested that considering gaming motives can be useful in differentiating between heterogenous online game users. This study validated the Korean version of the Motives for Online Gaming Questionnaire (K-MOGQ) and attempted to reconcile the mixed findings on its factor structure. We also examined the incremental validity of the K-MOGQ beyond the personality variables implicated in Internet gaming disorder (IGD). METHODS: After informed consent, six hundred and forty-one Korean online game users (mean age = 21.49 years) completed a survey package including the K-MOGQ. After exploratory factor analysis (EFA) was conducted, all existing models were compared using confirmatory factor analysis (CFA). A hierarchical regression analysis was conducted to demonstrate the incremental variance explained by gaming motives. RESULTS: The K-MOGQ demonstrated a satisfactory reliability. The EFA and CFA revealed a six-factor (fantasy, escape, skill development, competition, recreation, and social motives) solution in which the coping factor disappeared from the original seven-factor structure. In addition, the escape and fantasy motives significantly predicted increased IGD symptoms even when introversion, neuroticism, and impulsivity were controlled for. DISCUSSION AND CONCLUSIONS: Our results indicate that the K-MOGQ possesses good psychometric properties for measuring the motivational basis of online gaming in Korean-speaking populations. Furthermore, escape and fantasy factors emerged as the most salient motives for IGD symptoms. More research is required to clarify whether a Western-Eastern distinction applies to the factor structure of the MOGQ.

The Role of Event-Related Rumination and Perceived Social Support on Psychological Distress during the COVID-19 Pandemic: Results from Greater Daegu Region in South Korea.

OBJECTIVE: Research on psychological distress from the coronavirus disease 2019 (COVID-19) crisis has increased significantly, but the factors that can exacerbate or mitigate such distress have remained underexplored. To address the research gap, this study examined whether two types of rumination and perceived social support predict psychological distress during the pandemic. METHODS: Participants were recruited from communities of the greater Daegu area (n=316) where the first massive outbreak in South Korea occurred and most residents underwent substantial disruption of daily life. They completed self-report questionnaires that included measures of psychological distress, event-related rumination, and social support. RESULTS: The hierarchical regression analysis showed that maladaptive intrusive rumination and perceived social support predicted increases and decreases in psychological distress, respectively, even when subjective severity of COVID-19-related experiences was controlled. Putatively adaptive type of rumination (i.e., deliberate rumination) was not a significant predictor concurrently. CONCLUSION: This is among the early endeavors to comprehensively understand risk and protective factors associated with an effective coping strategy against the COVID-19 crisis. Our results indicate that intrusive rumination aggravates but social support mitigates psychological distress during the pandemic, indicating that we can better adapt by differently attending to recent experiences and maintaining perceived social support.

Age-related Differences and Individual Differences of the Positivity Effect in Korean Older Adults: Focused on Attentional Process for Emotional Faces.

OBJECTIVES: Most prior studies on the positivity effect have been conducted in Western cultures, and research in East Asian cultures has been limited, with inconsistent findings. Herein we investigate whether the positivity effect is present in Korean older adults. Moreover, we examined individual indifferences alongside age differences in the positivity effect because not all older adults display the positivity effect. METHOD: Forty older adults and 40 undergraduate students completed a series of self-report questionnaires and a dot probe task for 500 ms and 1000 ms. Next, we divided the subjects into groups who showed and did not show the positivity effect. RESULTS: In the dot probe task, older adults were more positive at the presentation duration of 500 ms and less negative at presentation times of 1000 ms, suggesting that the positivity effect is present in the attentional process. On the other hand, older adults who do show the positivity effect exhibit less negative affect, are less anxious, have fewer difficulties in emotion regulation, and achieve higher scores in a digit span task. DISCUSSION: These results suggest that the positivity effect emerges during more controlled stages of informational processing, and it is important to consider individual differences when investigating age-related differences in the positivity effect.

Extrapyramidal Signs and Risk of Progression from Mild Cognitive Impairment to Dementia: A Clinical Research Center for Dementia of South Korea Study.

OBJECTIVE: Extrapyramidal signs (EPS) are common in patients with mild cognitive impairment (MCI). However, few studies have assessed the effect of EPS on the clinical course of MCI. We aimed to evaluate whether patients with EPS show more frequent progression from MCI to Alzheimer's disease (AD) and to other types of dementia. METHODS: Participants (n=882) with MCI were recruited, and were followed for up to 5 years. The EPS positive group was defined by the presence of at least one EPS based on a focused neurologic examination at baseline. RESULTS: A total of 234 converted to dementia during the follow-up period. The risk of progression to AD was lower in the patients with EPS after adjusting for potential confounders [hazard ratio (HR)=0.70, 95% confidence interval (CI)=0.53-0.93, p=0.01]. In contrast, the patients with EPS had a six-fold elevated risk of progression to dementia other than AD (HR=6.33, 95%CI=2.30-17.39, p<0.001). CONCLUSION: EPS in patients with MCI is a strong risk factor for progression of MCI to non-Alzheimer dementia. The careful neurologic examination for EPS in patients with MCI can yield important clinical information for prognosis.