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Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI).
Methods
This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period.
Results
A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (−) groups had a higher risk of MACE [95% confidence interval (CI) 1.74–6.07] (95% CI 1.25–2.96) and ISR (95% CI 3.09–8.28) (95% CI 1.85–6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (−) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients.
Conclusions
These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.
Although mental wellbeing has been linked with positive health outcomes, including longevity and improved emotional and cognitive functioning, studies examining the underlying neural mechanisms of both subjective and psychological wellbeing have been sparse. We assessed whether both forms of wellbeing are associated with neural activity engaged during positive and negative emotion processing and the extent to which this association is driven by genetics or environment.
Methods
We assessed mental wellbeing in 230 healthy adult monozygotic and dizygotic twins using a previously validated questionnaire (COMPAS-W) and undertook functional magnetic resonance imaging during a facial emotion viewing task. We used linear mixed models to analyse the association between COMPAS-W scores and emotion-elicited neural activation. Univariate twin modelling was used to evaluate heritability of each brain region. Multivariate twin modelling was used to compare twin pairs to assess the contributions of genetic and environmental factors to this association.
Results
Higher levels of wellbeing were associated with greater neural activity in the dorsolateral prefrontal cortex, localised in the right inferior frontal gyrus (IFG), in response to positive emotional expressions of happiness. Univariate twin modelling showed activity in the IFG to have 20% heritability. Multivariate twin modelling suggested that the association between wellbeing and positive emotion-elicited neural activity was driven by common variance from unique environment (r = 0.208) rather than shared genetics.
Conclusions
Higher mental wellbeing may have a basis in greater engagement of prefrontal neural regions in response to positive emotion, and this association may be modifiable by unique life experiences.
We have developed the bispectral electroencephalography (BSEEG) method for detection of delirium and prediction of poor outcomes.
Aims
To improve the BSEEG method by introducing a new EEG device.
Method
In a prospective cohort study, EEG data were obtained and BSEEG scores were calculated. BSEEG scores were filtered on the basis of standard deviation (s.d.) values to exclude signals with high noise. Both non-filtered and s.d.-filtered BSEEG scores were analysed. BSEEG scores were compared with the results of three delirium screening scales: the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), the Delirium Rating Scale-Revised-98 (DRS) and the Delirium Observation Screening Scale (DOSS). Additionally, the 365-day mortalities and the length of stay (LOS) in the hospital were analysed.
Results
We enrolled 279 elderly participants and obtained 620 BSEEG recordings; 142 participants were categorised as BSEEG-positive, reflecting slower EEG activity. BSEEG scores were higher in the CAM-ICU-positive group than in the CAM-ICU-negative group. There were significant correlations between BSEEG scores and scores on the DRS and the DOSS. The mortality rate of the BSEEG-positive group was significantly higher than that of the BSEEG-negative group. The LOS of the BSEEG-positive group was longer compared with that of the BSEEG-negative group. BSEEG scores after s.d. filtering showed stronger correlations with delirium screening scores and more significant prediction of mortality.
Conclusions
We confirmed the usefulness of the BSEEG method for detection of delirium and of delirium severity, and prediction of patient outcomes with a new EEG device.
Psychosocial difficulties, including changed relationships are among the most pervasive and concerning issues following stroke. This study aimed to collate and thematically analyse qualitative literature describing the experience of close personal relationships from the perspective of stroke survivors.
Method:
Using a scoping review methodology, four databases (CINAHL/EBSCO, MEDLINE/Pubmed, Embase, Psychinfo) were systematically searched, yielding 3100 citations. Following exclusion of duplicates and screening against inclusion criteria at title/abstract and full text levels, 53 articles were included in the review. Data were charted and thematically analysed.
Results:
While research has increased since 2000, longitudinal designs are few. Four overarching themes and 12 subthemes were identified. ‘Social disruption’ described changing social worlds, lost social opportunities and shrinking networks. ‘Changed relationships’ included changed family and spousal relationships and changed parenting relationships. The third theme ‘relationships help’ highlighted positive aspects including belonging, support and a life worth living. The final theme was ‘coping with an altered social world’ and described adjustment and emotional responses.
Conclusions:
Relationships are an important aspect of life post stroke but are subject to changes and challenges. This article brings together a breadth of qualitative data to describe lived experiences. Further research, in particular, longitudinal research is required.
The COVID-19 pandemic may pose a specific threat for Holocaust survivors, as such threats may be linked with increased psychological distress. Moreover, research has demonstrated that engaging in planful problem-solving activities is associated with reduced distress. Accordingly, we aimed to examine the link between engaging in activities during COVID-19 and psychological distress among Holocaust survivors with varying levels of post-traumatic symptoms (PTS) and comparisons (not directly exposed to the Holocaust).
Design:
A cross-sectional design composed of Holocaust survivors and a comparison group.
Setting:
Participants were interviewed face-to-face, over the telephone, or filled the scales online at their leisure.
Participants:
Data were collected from 131 older Jewish Israelis (age range 76–94, M = 82.73, SD = 4.09), who were divided into three groups (comparisons; low-PTS survivors; high-PTS survivors).
Measurements:
Participants completed scales assessing PTS, activity engagement, and psychological distress and provided additional sociodemographic, medical, and COVID-19-related information.
Results:
When activity engagement was low, high-PTS survivors reported extremely high levels of psychological distress relative to low-PTS survivors and comparisons. However, when activity engagement was high, these group differences were considerably reduced, as the psychological distress of high-PTS survivors was significantly lower.
Conclusions:
The study highlights the importance of daily planning and activity engagement for Holocaust survivors with high PTS levels in reducing psychological distress. Clinicians are urged to take this factor into account when dealing with the psychological effects of COVID-19 on survivors and on traumatized older adults in general.
Experimental studies applying cognitive bias modification of attention (CBM-A) and interpretation (CBM-I) to reduce aggression have examined the effect of modifying each cognitive bias in isolation. In order to maximise the potential impact on both biases and symptom reduction, we examined whether a combined bias training procedure targeting both attention and interpretation biases (CBM-AI) in combination would be more effective than targeting interpretation bias (CBM-I) alone. University students (17–35 years) were randomly assigned to either a single session of CBM-AI training (n = 40), CBM-I training (n = 40), or a control condition (n = 40). Contrary to our expectations, participants showed an increase in adaptive attention and pro-social interpretation bias in all training conditions. Additionally, in none of the conditions, we found a significant change on self-reported or behavioural aggression. These findings suggest: (1) that the combined training did not have added effect over single interpretation bias training, (2) that training interpretation bias may lead to changes in attention bias, (3) that elements of the control condition unexpectedly, but interestingly, also affected attention and interpretation biases, and (4) single-session CBM procedures do not produce robust effects on self-report or behavioural measures of aggression in unselected samples.
Attention and memory deficits are common following paediatric acquired brain injury (ABI). However, there are few evidence-based interventions to improve these domains and benefit the everyday life of children post-injury. The Amsterdam Memory and Attention Training for children (Amat-c) has been translated from Dutch to English and shown to improve attention and memory skills in children following ABI. This protocol describes a study to expand accessibility of the program by using online, clinician-supported delivery with children post-ABI.
Method/design:
The study is a randomized controlled trial. Participants will be 40 children aged 8–16 a minimum of one-year post-ABI. Participants in the treatment group will complete 18 weekly sessions of the Amat-c program with weekly online clinician support. Participants in the active-control group will be administered ABI psychoeducation via a booklet for parents, with weekly online clinician contact. Attention and memory will be assessed at three time points up to six months post-intervention.
Results:
Analysis will be repeated measures multivariate planned comparisons; using the Statistical Package for the Social Sciences (IBM SPSS Statistics) General Linear Model procedure will compare pre- and post-intervention and six-month follow-up outcomes.
Discussion:
If shown efficacious in improving attention and memory, our team will then take a key role in implementing Amat-c into clinical care.
This paper examined the relationship between working memory (WM) and L2 linguistic knowledge as well as L2 listening comprehension with 150 Japanese EFL learners. The study also investigated the extent to which these relationships vary across L2 proficiency levels. The results in the study were as follows: (a) WM capacity was more strongly associated with L2 listening comprehension, L2 perceptual processing, and L2 syntactic parsing processing in the lower-proficiency group than in the higher-proficiency group; (b) L1 WM capacity still accounted for the unique variance in L2 listening comprehension after adjusting for the L2 language-related variables in the lower-proficiency group. The results suggest that the relationship between WM capacity and L2 listening comprehension may be mediated by L2 proficiency and depend on the domain-general processing efficiency reflecting central executive attention when the listening comprehension task requires conscious attention for less proficient listeners. The findings provide suggestive evidence for variation in the role of WM in L2 listening comprehension across proficiency levels and the significant role of L1 WM capacity in L2 listening comprehension as the general cognitive factor independent of L2 linguistic knowledge for L2 learners with limited linguistic knowledge.
There are concerns that eating disorders have become commoner during the coronavirus disease 2019 (COVID-19) pandemic. Using the electronic health records of 5.2 million people aged under 30, mostly in the USA, we show that the diagnostic incidence was 15.3% higher in 2020 overall compared with previous years (relative risk 1.15, 95% CI 1.12−1.19). The relative risk increased steadily from March 2020 onwards, exceeding 1.5 by the end of the year. The increase occurred solely in females, and primarily related to teenagers and anorexia nervosa. A higher proportion of patients with eating disorders in 2020 had suicidal ideation (hazard ratio HR = 1.30, 1.16−1.47) or attempted suicide (HR = 1.69, 1.21−2.35).
Older age is often identified as a risk factor for poor outcome from traumatic brain injury (TBI). However, this relates predominantly to mortality following moderate–severe TBI. It remains unclear whether increasing age exerts risk on the expected recovery from mild TBI (mTBI). In this systematic review of mTBI in older age (60+ years), a focus was to identify outcome through several domains – cognition, psychological health, and life participation.
Methods:
Fourteen studies were identified for review, using PRISMA guidelines. Narrative synthesis is provided for all outcomes, from acute to long-term time points, and a meta-analysis was conducted for data investigating life participation.
Results:
By 3-month follow-up, preliminary findings indicate that older adults continue to experience selective cognitive difficulties, but given the data it is possible these difficulties are due to generalised trauma or preexisting cognitive impairment. In contrast, there is stronger evidence across time points that older adults do not experience elevated levels of psychological distress following injury and endorse fewer psychological symptoms than younger adults. Meta-analysis, based on the Glasgow Outcome Scale at 6 months+ post-injury, indicates that a large proportion (67%; 95% CI 0.569, 0.761) of older adults can achieve good functional recovery, similar to younger adults. Nevertheless, individual studies using alternative life participation measures suggest more mixed rates of recovery.
Conclusions:
Although our initial review suggests some optimism in recovery from mTBI in older age, there is an urgent need for more investigations in this under-researched but growing demographic. This is critical for ensuring adequate health service provision, if needed.
Obsessive–compulsive disorder (OCD) is a severe psychiatric disorder characterized by its heterogeneous nature and by different dimensions of obsessive–compulsive (OC) symptoms. Serotonin reuptake inhibitors (SRIs) are used to treat OCD, but up to 40% to 60% of patients do not show a significant improvement with these medications. In this study, we aimed to test the impact of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism on the efficacy of antidepressants in OCD overall, and in relation to the different OC dimensions.
Methods
In a 6-month prospective treatment study, 69 Caucasian OCD patients were treated with escitalopram for 24 weeks or with escitalopram for 12 weeks followed by paroxetine for an additional 12-week period. Patients were genotyped and assessed for treatment response. The main clinical outcomes were improvement of the Yale-Brown Obsessive–Compulsive Scale score and in different OC symptom dimension scores.
Results
The Val/Val group comprised 43 (62%) patients, the Val/Met and Met/Met group comprised 26 (38%) patients. Forty-two patients were classified as responders at 12 weeks and 38 at 24 weeks; no significant association was found between BDNF Val66Met and SRIs response at 12 and 24 weeks. In analyses of the different OC symptom dimensions, the Met allele was associated with a slightly reduced score in the aggressive/checking dimension at 6 months (P = .048).
Conclusions
Our findings do not support the usefulness of BDNF Val66Met genotyping to predict overall response to treatment with SRIs in OCD; they did however suggest a better outcome at 6 months for the aggressive/checking symptom dimension for patients carrying the Met allele.
Given the aging population of people with HIV (PWH), along with increasing rates of binge drinking among both PWH and the general older adult population, this study examined the independent and interactive effects of HIV, binge drinking, and age on neurocognition.
Method:
Participants were 146 drinkers stratified by HIV and binge drinking status (i.e., ≥4 drinks for women and ≥5 drinks for men within approximately 2 h): HIV+/Binge+ (n = 30), HIV−/Binge+ (n = 23), HIV+/Binge− (n = 55), HIV−/Binge− (n = 38). All participants completed a comprehensive neuropsychological battery measuring demographically-corrected global and domain-specific neurocognitive T scores. ANCOVA models examined independent and interactive effects of HIV and binge drinking on neurocognitive outcomes, adjusting for overall alcohol consumption, lifetime substance use, sex, and age. Subsequent multiple linear regressions examined whether HIV/Binge group moderated the relationship between age and neurocognition.
Results:
HIV+/Binge+ participants had worse global neurocognition, processing speed, delayed recall, and working memory than HIV−/Binge− participants (p’s < .05). While there were significant main effects of HIV and binge drinking, their interaction did not predict any of those neurocognitive outcomes (p’s > .05). Significant interactions between age and HIV/Binge group showed that HIV+/Binge+ participants demonstrated steeper negative relationships between age and neurocognitive outcomes of learning, delayed recall, and motor skills compared to HIV−/Binge− participants (p’s < .05).
Conclusions:
Results showed adverse additive effects of HIV and binge drinking on neurocognitive functioning, with older adults demonstrating the most vulnerability to these effects. Findings support the need for interventions to reduce binge drinking, especially among older PWH.
The COVID-19 pandemic has deepened the effects of socioeconomic status (SES) and wellbeing (WB) on students’ academic achievement, particularly in developing countries; thus, it becomes necessary to understand the nature of these concurrent relationships. This study aimed to explore the relationships between SES, WB and academic achievement, based on the data from the Programme for International Student Assessment (PISA) in 2018 within the Turkish context. In this cross-sectional study, we used hierarchical multiple linear regression analysis to explore how the independent variables predicted academic achievement in blocks based on data from 6890 students attending 186 schools. The study revealed that the model, including the independent variables, predicted students’ achievement in reading, mathematics and science; however, the prediction level of demographic factors and domains of WB were very low, while SES had the highest prediction level. The results offer insights into the predictors of academic achievement and educational inequalities in the context of a developing country.
The current study investigates Spanish children's variation between the standard and non-standard forms for second person singular preterit –s (caiste ~ caístes). All second person singular preterit forms were extracted from the spontaneous speech of 78 children in Spain and analyzed for the effects of age, language contact setting, and lexical frequency. Results show that children in contact with Galician and Catalan produce more non-standard than children in non-contact areas like Madrid. Meanwhile, low-frequency verbs (e.g., pillaste) are more likely to occur with the non-standard –s than high-frequency verbs (e.g., fuiste). However, age is not a significant predictor of children's 2sg preterit production. These preliminary findings demonstrate that Spanish children do have the non-standard -s in their speech, and that their 2sg preterit forms are significantly conditioned by language contact and lexical frequency.
Post-traumatic stress disorder (PTSD) is commonly experienced by asylum seekers and refugees (ASR). Evidence supports the use of cognitive behavioural therapy-based treatments, but not in group format for this population. However, group-based treatments are frequently used as a first-line intervention in the UK.
Aims:
This study investigated the feasibility of delivering a group-based, manualised stabilisation course specifically developed for ASR. The second aim was to evaluate the use of routine outcome measures (ROMs) to capture psychological change in this population.
Method:
Eighty-two participants from 22 countries attended the 8-session Moving On After Trauma (MOAT) group-based stabilisation treatment. PHQ-9, GAD-7, IES-R and idiosyncratic outcomes were administered pre- and post-intervention.
Results:
Seventy-one per cent of participants (n = 58) attended five or more of the treatment sessions. While completion rates of the ROMs were poor – measures were completed at pre- and post-intervention for 46% participants (n = 38) – a repeated-measures MANOVA indicated significant improvements in depression (p = .001, ηp2 = .262), anxiety (p = .000, ηp2 = .390), PTSD (p = .001, ηp2 = .393) and idiosyncratic measures (p = .000, ηp2 = .593) following the intervention.
Conclusions:
Preliminary evidence indicates that ASR who attended a low-intensity, group-based stabilisation group for PTSD experienced lower mental health scores post-group, although the lack of a comparison group means these results should be interpreted with caution. There are significant challenges in administering ROMs to individuals who speak many different languages, in a group setting. Nonetheless, groups have benefits including efficiency of treatment delivery which should also be considered.
To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status.
Design:
An incident cohort study design.
Setting:
Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan.
Participants:
A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years.
Measurements:
Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms.
Results:
One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status.
Conclusions:
Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.
A surprising comprehension-production asymmetry in subject-verb (SV) agreement acquisition has been suggested in the literature, and recent research indicates that task-specific as well as language-specific features may contribute to this apparent asymmetry across languages. The present study investigates when during development children acquiring Mexican Spanish gain competence with 3rd-person SV agreement, testing production as well as comprehension in the same children aged between 3;6 and 5;7 years, and whether comprehension of SV agreement is modulated by the sentential position of the verb (i.e., medial vs. final position). Accuracy and sensitivity analyses show that comprehension performance correlates with SV agreement production abilities, and that comprehension of singular and plural third-person forms is not influenced by the sentential position of the agreement morpheme. Issues of the appropriate outcome measure and the role of structural familiarity in the development of abstract representations are discussed.
We examined the growth trajectories of reading in a consistent orthography (Greek) in two developmental periods (from Grade 1 to Grade 4 and from Grade 4 to Grade 10) and what cognitive skills predict the growth patterns. Seventy-five Greek-speaking children were assessed in Grades 1, 2, 4, 6, and 10 on word-, nonword-, and text-reading fluency. In Grades 1 and 4, they were also assessed on phonological awareness, rapid naming, phonological memory, orthographic knowledge, and articulation rate. Results of growth curve modeling showed that during the first developmental period, there was a rapid initial growth from Grade 1 to Grade 2 followed by a less rapid growth from Grade 2 to Grade 4. In the second developmental period, the slow growth continued. In both developmental periods, rapid naming and orthographic knowledge predicted the initial status of all reading outcomes and phonological memory predicted the initial status of nonword-reading fluency. Phonological awareness predicted the initial status of nonword-reading fluency in the first developmental period and the initial status of word- and text-reading fluency in the second developmental period. None of the cognitive skills predicted the growth rate in reading skills. Theoretical and practical implications of these findings are discussed.
School counsellors implement preventative programs to build student resilience and coping skills to counteract the rising mental health needs of children in Australia. School-based meditation programs are effective for individuals and groups, with documented benefits. Most literature examines mindfulness meditation, and the current, exploratory study aimed to add to the research breadth by considering stillness meditation. The stillness program ‘Let’s be Still’ is a 10-week, class-based program that was conducted between 2015–2020 by the school psychologist in a regional, independent New South Wales school. Data were collected from questionnaire responses of 169 Year 2 (7–9 years) and five teachers to document what the children had learnt and how it helped them. Thematic analysis of the responses revealed an emphasis on stillness promoting positive emotions and behaviours. Both students and teachers articulated that learning and practising stillness provided the students with tools to be calm, relaxed and settled, to deal with conflict and to have a break from the busyness of the school day. While the study design does not allow generalisability of the program’s effectiveness, this study may offer input for school counsellors considering the implementation of a school-based meditation program.