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Find video protocols related to scientific articles indexed in Pubmed.
Cost-utility analysis of a treatment advice to discontinue inappropriate long-term antidepressant use in primary care.
Fam Pract
PUBLISHED: 08-13-2014
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Antidepressant prescriptions have increased exponentially, burdening health care costs.
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Mindfulness-based cognitive therapy (MBCT) for patients with medically unexplained symptoms: process of change.
J Psychosom Res
PUBLISHED: 04-28-2014
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A recent randomized controlled trial provided preliminary evidence for the effectiveness of mindfulness based cognitive therapy (MBCT) for the top 10% frequent attenders in primary care with persistent medically unexplained symptoms (MUS). This qualitative study aims to explore working mechanisms and possible barriers of MBCT in this population.
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Modulation of induced frontocentral theta (Fm-?) event-related (de-)synchronisation dynamics following mindfulness-based cognitive therapy in Major Depressive Disorder.
Cogn Neurodyn
PUBLISHED: 04-20-2014
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Depressive severity has been associated with attenuated neocortical frontal midline theta (Fm-?) power/evoked activity. Mindfulness-Based Cognitive Therapy (MBCT) has shown to be a successful novel intervention for Major Depressive Disorder (MDD), albeit precise working mechanisms remain elusive. We examined the hypothesis that MBCT would have modulating effects upon evoked Fm-? power, in addition to investigating possible mediation of induced event-related de/synchronisation (ERD/ERS) dynamics. Fifty one patients with a primary diagnosis of MDD (26 exposed to MBCT vs. 25 wait-list/WL controls) undertook a Go/NoGo task consisting of positive, negative and neutral words, further stratified into abstract versus trait adjective matrices. Depressive symptom severity and rumination were also examined. A pattern of enhanced induced Fm-? synchronisation during the latter 400-800 ms temporal-window pre-to-post MBCT was observed; the contrary in the WL. Modulated ERD/ERS dynamics correlated to amelioration in depressive and rumination symptoms in the MBCT group. We propose the primary action pathway alluded to a neural disengagement mechanism enacting upon tonic neuronal assemblies implicated in emotional and self-related processing. Due to the complexity and presently undiscovered complete unified scientific understanding of neuro-oscillatory-dynamics, and associated clinical interplays; we hypothesise that the electro-cortical and connected clinical working pathways of MBCT in depression are multi-levelled constituting nonlinear and interdependent mechanisms, represented by mediated EEG synchronisation dynamics.
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The impact of comorbid depression on recovery from personality disorders and improvements in psychosocial functioning: Results from a randomized controlled trial.
Behav Res Ther
PUBLISHED: 04-04-2014
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Depressive disorders often co-occur with personality disorders. The extent to which depressive disorders influence treatment outcome in personality disorders remains unclear. The aim of this study was to determine the impact of co-morbid depression on recovery from personality disorders and improvements in psychosocial functioning. This study drew data from a randomized-controlled trial in which patients (N = 320) with cluster-c (92%), paranoid, histrionic and/or narcissistic personality disorders received schema-therapy, treatment-as-usual, or clarification-oriented psychotherapy. Recovery from personality disorders at three-year follow-up and improvements in psychosocial functioning over a course of three years was predicted by the diagnostic status of depressive disorders at baseline using mixed model regression analyses. Based on the number of axis-I and axis-II disorders, personality disorder severity and global symptomatic distress and functioning a baseline severity index was computed and included in subsequent analyses to test the specificity of baseline depression in predicting outcomes. Patients with co-occurring depression reported higher baseline severity compared to patients without co-occurring depression. Depression at baseline was associated with lower recovery rates at three-year follow-up (p = 0.01) but this effect disappeared after controlling for baseline severity. Patients with depression at baseline reported higher psychosocial impairments throughout treatment (p < 0.001). Depression at baseline did not moderate treatment effects except for one psychosocial outcome measure. In conclusion, depression is associated with lower recovery rates from personality disorders but this effect disappears when general severity is taken into account. Patients with primarily cluster-c personality disorders and co-occurring depression might benefit from additional depression treatment in terms of improved psychosocial functioning.
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Shorter gaze duration for happy faces in current but not remitted depression: evidence from eye movements.
Psychiatry Res
PUBLISHED: 03-28-2014
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Cognitive theories of depression propose that depressed individuals preferentially attend to negative information and that such cognitive biases constitute important vulnerability and maintenance factors for the disorder. Most studies examined this bias by registration of response latencies. The present study employed a direct and continuous measurement of attentional processing for emotional stimuli by recording eye movements. Currently depressed (CD), remitted depressed (RD) and healthy control (HC) participants viewed slides presenting sad, angry, happy and neutral facial expressions. For each expression, four components of visual attention were analyzed: first fixation, maintained fixation, relative fixation frequency and glance duration. Results showed that healthy controls were characterized by longer gaze duration for happy faces compared to currently depressed individuals but not compared to remitted depressed individuals. Both patient groups (CD, RD) demonstrated longer maintained fixation (dwelling time) on all emotional faces compared to healthy controls. The present findings are in line with the presumption that depression is associated with a loss of elaborative processing of positive stimuli that characterizes healthy controls. Importantly, successful remission of depression (RD group) may result in positive attentional processing as no group differences were found between healthy controls and remitted patients on glance duration for happy faces.
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Psychiatric diagnosis by telephone: is it an opportunity?
Soc Psychiatry Psychiatr Epidemiol
PUBLISHED: 02-27-2014
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For reasons of feasibility, diagnostic telephone interviews are frequently used in research of psychiatric morbidity. However, it is unknown whether diagnostic telephone interviews are as valid as diagnostic face-to-face interviews.
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What is the contribution of different cognitive biases and stressful childhood events to the presence and number of previous depressive episodes?
Psychiatry Res
PUBLISHED: 02-20-2014
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Negative cognitive biases as well as stressful childhood events are well-known risk factors for depression. Few studies have compared the association of different types of biases and events with depression. The current study examined whether different cognitive biases and stressful childhood events variables were associated with depression and recurrence. Three types of childhood events were assessed in 83 never-depressed and 337 formerly depressed individuals: trauma within the family, trauma outside the family, and adverse events. Furthermore, after a sad mood induction procedure, participants executed a Dot Probe task (selective attentional bias), an Emotional Stroop task (attentional interference bias) and an incidental learning task (memory bias). The association of these measures with case status and recurrence status (one or multiple past episodes) was examined. Negative memory bias and traumatic childhood events within the family were associated with case status, whereas none of the bias measures or childhood events variables were associated with recurrence status. The results indicate that memory bias as well as the experience of aggression and/or abuse within the family during childhood are independently associated with depression. Biases and stressful childhood events did not offer differentiation between individuals with one or multiple past episodes.
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Study protocol of a randomized controlled trial comparing Mindfulness-Based Stress Reduction with treatment as usual in reducing psychological distress in patients with lung cancer and their partners: the MILON study.
BMC Cancer
PUBLISHED: 01-03-2014
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Lung cancer is the leading cause of cancer death worldwide and characterized by a poor prognosis. It has a major impact on the psychological wellbeing of patients and their partners. Recently, it has been shown that Mindfulness-Based Stress Reduction (MBSR) is effective in reducing anxiety and depressive symptoms in cancer patients. The generalization of these results is limited since most participants were female patients with breast cancer. Moreover, only one study examined the effectiveness of MBSR in partners of cancer patients. Therefore, in the present trial we study the effectiveness of MBSR versus treatment as usual (TAU) in patients with lung cancer and their partners.
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No Evidence for the Association between a Polymorphism in the PCLO Depression Candidate Gene with Memory Bias in Remitted Depressed Patients and Healthy Individuals.
PLoS ONE
PUBLISHED: 01-01-2014
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The PCLO rs2522833 candidate polymorphism for depression has been associated to monoaminergic neurotransmission. In healthy and currently depressed individuals, the polymorphism has been found to affect activation of brain areas during memory processing, but no direct association of PCLO with memory bias was found. We hypothesized that the absence of this association might have been obscured by current depressive symptoms or genetically driven individual differences in reactivity to stressful events. Experiencing stressful childhood events fosters dysfunctional assumptions that are related to cognitive biases, and may modulate the predisposition for depression via epigenetic effects. The association between PCLO and memory bias, as well as interaction between PCLO and childhood events was studied in patients remitted from depression (N?=?299), as well as a sample of healthy individuals (N?=?157). The participants performed an emotional verbal memory task after a sad mood induction. Childhood trauma and adversity were measured with a questionnaire. The Genotype main effect, and Genotype by Childhood Events interaction were analyzed for memory bias in both samples. PCLO risk allele carrying remitted depressed patients did not show more negatively biased memory than non-risk allele carriers, not even patients with stressful childhood events. A similar pattern of results was found in healthy individuals. Memory bias may not be strongly associated with the PCLO rs2522833 polymorphism. We did not find any support for the PCLO-childhood events interaction, but the power of our study was insufficient to exclude this possibility.
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Effects of mindfulness-based cognitive therapy on neurophysiological correlates of performance monitoring in adult attention-deficit/hyperactivity disorder.
Clin Neurophysiol
PUBLISHED: 11-01-2013
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To examine whether mindfulness-based cognitive therapy (MBCT) would enhance attenuated amplitudes of event-related potentials (ERPs) indexing performance monitoring biomarkers of attention-deficit/hyperactivity disorder (ADHD).
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Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: a randomized controlled trial.
Psychother Psychosom
PUBLISHED: 01-24-2013
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BaCKGROUND: Patients with medically unexplained symptoms make heavy demands on the health care system. An offer for psychological treatment is often declined. There is a need for acceptable and effective treatments. We assessed the acceptability and effectiveness of mindfulness-based cognitive therapy (MBCT) for patients with persistent medically unexplained symptoms.
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Prescribing ANtiDepressants Appropriately (PANDA): a cluster randomized controlled trial in primary care.
BMC Fam Pract
PUBLISHED: 01-08-2013
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Inappropriate use of antidepressants (AD), defined as either continuation in the absence of a proper indication or continuation despite the lack of therapeutic efficacy, applies to approximately half of all long term AD users.
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Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: a cost-effectiveness study.
J Psychosom Res
PUBLISHED: 01-03-2013
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Our aim was to assess cost-effectiveness of mindfulness-based cognitive therapy (MBCT) compared with enhanced usual care (EUC) in treating patients with persistent medically unexplained symptoms(MUS).
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On the Relationship Between the Practice of Mindfulness Meditation and Personality-an Exploratory Analysis of the Mediating Role of Mindfulness Skills.
Mindfulness (N Y)
PUBLISHED: 06-18-2011
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Mindfulness meditation (MM) has often been suggested to induce fundamental changes in the way events in life are experienced and dealt with, presumably leading to alterations in personality. However, the relationship between the practice of MM and personality has not been systematically studied. The aim of this study was to explore this relationship and to investigate the mediating role of mindfulness skills. Thirty-five experienced mindfulness meditators (age range, 31-75 years; meditation experience range, 0.25-35 years; mean, ?13 years) and 35 age-, gender-, and ethnicity-matched controls (age range, 27-63 years) without any meditation experience completed a personality (NEO-FFI) and mindfulness (KIMS) questionnaire. The practice of MM was positively related to openness and extraversion and negatively related to neuroticism and conscientiousness. Thus, the results of the current study associate the practice of MM with higher levels of curiosity and receptivity to new experiences and experience of positive affect and with less proneness toward negative emotions and worrying and a reduced focus on achievements. Furthermore, the mediating role of specific mindfulness skills in the relationship between the practice of MM and personality traits was shown.
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Facilitated attentional disengagement from negative information in relation to self-reported depressive symptoms of Dutch female undergraduate students.
Psychol Rep
PUBLISHED: 04-30-2011
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Prior research has shown that depressive symptoms are associated with an enhanced attention toward negative stimuli and difficulty of disengaging attention from negative stimuli. The current study was an extension of a 2005 study by Koster and colleagues. A different stimulus presentation time and word set were used. The whole range of depressive symptoms was included in this sample instead of creating dichotomized groups. The Exogenous Cueing Task with negative, positive, and neutral cues was administered to 85 female undergraduate university students. Participants completed the Becks Depression Inventory-II-NL questionnaire to measure self-reported depression. Contrary to previous findings, depressive symptoms were related to a facilitated rather than impaired attentional disengagement from negative stimuli. An explanation for the discrepancy with findings from Koster, et al. may be the different stimulus presentation time (1000 msec. instead of 500 or 1500 msec.).
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Prevalence and correlates of lifetime deliberate self-harm and suicidal ideation in naturalistic outpatients: the Leiden Routine Outcome Monitoring study.
J Affect Disord
PUBLISHED: 03-10-2011
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Deliberate self-harm and suicidal ideation (DSHI) are common phenomena in general and mental health populations. Identifying factors associated with DSHI may contribute to the early identification, prevention and treatment of DSHI. Aims of the study are to determine the prevalence and correlates of lifetime DSHI in a naturalistic sample of psychiatric outpatients with mood, anxiety or somatoform (MAS) disorders.
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How mood challenges emotional memory formation: an fMRI investigation.
Neuroimage
PUBLISHED: 02-17-2011
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Experimental mood manipulations and functional magnetic resonance imaging (fMRI) provide a unique opportunity for examining the neural correlates of mood-congruent memory formation. While prior studies in mood-disorder patients point to the medial temporal lobe in the genesis of mood-congruent memory (MCM) bias, the interaction between mood and emotional memory formation has not been investigated in healthy participants. In particular it remains unclear how regulatory structures in the pre-frontal cortex may be involved in mediating this phenomenon. In this study, event-related fMRI was performed on 20 healthy participants using a full-factorial, within-subjects repeated-measures design to examine how happy and sad moods impact memory for valenced stimuli (positive, negative and neutral words). Main effects of mood, stimulus valence and memory were examined as was activity related to successful memory formation during congruent and in-congruent moods. Behavioral results confirm an MCM bias while imaging results show amygdala and hippocampal engagement in a global mood and successful recall, respectively. MCM formation was characterized by increased activity during mood-congruent encoding of negative words in the orbito-frontal cortex (OFC) and for mood-incongruent processing of negative words in medial- and inferior-frontal gyri (MFG/IFG). These findings indicate that different pre-frontal regions facilitate mood-congruent and incongruent encoding of successfully recalled negative words at the time of learning, with OFC enhancing congruency and the left IFG and MFG helping overcome semantic incongruities between mood and stimulus valence.
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The reassuring value of diagnostic tests: a systematic review.
Patient Educ Couns
PUBLISHED: 02-02-2011
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This review is a narrative synthesis of the RCTs which studied the efficacy of using diagnostic tests to reassure patients.
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Rose or black-coloured glasses? Altered neural processing of positive events during memory formation is a trait marker of depression.
J Affect Disord
PUBLISHED: 01-21-2011
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Valence-specific memory enhancement is one of the core cognitive functions that causes and maintains Major Depressive Disorder (MDD). While previous neuroimaging studies have elucidated the neural underpinnings of this emotional enhancement effect in depressed patients, this study aimed at detecting processing biases that are maintained throughout remission while patients were euthymic.
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The influence of mood on the processing of syntactic anomalies: evidence from P600.
Neuropsychologia
PUBLISHED: 07-30-2010
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In several domains of psychology it has been shown that mood influences the way in which we process information. So far, little is known about the relation between mood and processes of language comprehension. In the present study we explore, whether, and if so how, mood affects the processing of syntactic anomalies in real time by recording event-related potentials (ERPs). To this aim we compared the P600 effect to subject-verb agreement errors relative to correct sentences while ERPs were recorded and mood was manipulated by presenting happy or sad film clips. The prediction was that if emotional state affects processes of language comprehension this should be reflected by an interaction between mood and P600. The results were as follows: first, the mood induction procedure was effective: participants were happier after watching happy film clips and sadder after watching sad film clips compared to baseline. Second, for P600 a mood by syntactic correctness interaction was obtained for the midline and lateral electrodes. The interaction reflected a broadly distributed P600 effect for the happy mood condition and a strong reduction in P600 effect for the sad mood condition. Correlation analyses confirmed that the observed changes in P600 effect were accompanied by reliable changes in emotional state. The present ERP findings demonstrate that mood interacts with processes of language comprehension. Three possible explanations for the mood by syntactic correctness interaction are discussed; one in terms of syntactic processing, one in terms of heuristic processing, and one in terms of more general factors like attention and/or motivation.
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Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials.
Br J Psychiatry
PUBLISHED: 07-02-2010
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Meta-analyses on psychological treatment for depression in individuals with a somatic disease are limited to specific underlying somatic diseases, thereby neglecting the generalisability of the interventions.
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Greater efficiency in attentional processing related to mindfulness meditation.
Q J Exp Psychol (Hove)
PUBLISHED: 05-29-2010
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In this study, attentional processing in relation to mindfulness meditation was investigated. Since recent studies have suggested that mindfulness meditation may induce improvements in attentional processing, we have tested 20 expert mindfulness meditators in the attention network test. Their performance was compared to that of 20 age- and gender-matched controls. In addition to attentional network analyses, overall attentional processing was analysed by means of efficiency scores (i.e., accuracy controlled for reaction time). Better orienting and executive attention (reflected by smaller differences in either reaction time or error score, respectively) were observed in the mindfulness meditation group. Furthermore, extensive mindfulness meditation appeared to be related to a reduction of the fraction of errors for responses with the same reaction time. These results provide new insights into differences in attentional processing related to mindfulness meditation and suggest the possibility of increasing the efficiency in attentional processing by extensive mental training.
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Medically unexplained physical symptoms in elderly people: a pilot study of psychiatric geriatric characteristics.
Am J Geriatr Psychiatry
PUBLISHED: 09-29-2009
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To examine the somatic complaints, functional impairment, and psychiatric comorbidity in elderly patients with medically unexplained symptoms (MUSs).
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Predictors of suicidality in depressive spectrum disorders in the general population: results of the Netherlands Mental Health Survey and Incidence Study.
Soc Psychiatry Psychiatr Epidemiol
PUBLISHED: 07-02-2009
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The aim was to assess determinants of suicidality (suicidal ideation and suicide attempts) in a general population cohort with depressive spectrum disorders, and to compare determinants for suicidal ideation and determinants for suicide attempts in this cohort.
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The Maudsley Obsessive-Compulsive Stimuli Set: validation of a standardized paradigm for symptom-specific provocation in obsessive-compulsive disorder.
Psychiatry Res
PUBLISHED: 06-09-2009
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This article describes and further validates a standardized symptom-provocation procedure that combines symptom-specific audio instructions and pictures to reliably provoke different kinds of symptom-specific anxiety in obsessive-compulsive disorder, corresponding to its four major symptom dimensions: contamination/washing, obsessions/checking, hoarding and symmetry/order. The Maudsley Obsessive-Compulsive Stimuli Set has excellent convergent and discriminant validity, and it will be a useful resource for OCD researchers.
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Detecting somatoform disorders in primary care with the PHQ-15.
Ann Fam Med
PUBLISHED: 05-13-2009
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Because recognition and management of patients with somatoform disorders are difficult, we wanted to determine the specificity, sensitivity, and the test-retest reliability of the 15-symptom Patient Health Questionnaire (PHQ-15) for detection of somatoform disorders in a high-risk primary care population.
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Medically unexplained symptoms, somatisation disorder and hypochondriasis: course and prognosis. A systematic review.
J Psychosom Res
PUBLISHED: 04-22-2009
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To study the course of medically unexplained symptoms (MUS), somatisation disorder, and hypochondriasis, and related prognostic factors. Knowledge of prognostic factors in patients presenting persistent MUS might improve our understanding of the naturalistic course and the identification of patients with a high risk of a chronic course.
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Approach and Avoidance of Emotional Faces in Happy and Sad Mood.
Cognit Ther Res
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Since the introduction of the associative network theory, mood-congruent biases in emotional information processing have been established in individuals in a sad and happy mood. Research has concentrated on memory and attentional biases. According to the network theory, mood-congruent behavioral tendencies would also be predicted. Alternatively, a general avoidance pattern would also be in line with the theory. Since cognitive biases have been assumed to operate strongly in case of social stimuli, mood-induced biases in approach and avoidance behavior towards emotional facial expressions were studied. 306 females were subjected to a highly emotional fragment of a sad or a happy movie, to induce either a sad mood or a happy mood. An Approach-Avoidance Task was implemented, in which single pictures of faces (with angry, sad, happy, or neutral expression) and non-social control pictures were presented. In contrast to our expectations, mood states did not produce differential behavioral biases. Mood-congruent and mood-incongruent behavioral tendencies were, however, present in a subgroup of participants with highest depressive symptomatology scores. This suggests that behavioral approach-avoidance biases are not sensitive to mood state, but more related to depressive characteristics.
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Fronto-limbic microstructure and structural connectivity in remission from major depression.
Psychiatry Res
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Previous research has suggested that abnormalities within the amygdala and prefrontal cortex (PFC) may underlie major depressive disorder (MDD). The contribution of microstructural alterations within these regions in adult MDD is still equivocal. Therefore, seventeen middle-aged medication-free remitted MDD patients and 21 matched never-depressed control subjects underwent structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Despite comparable amygdala volumes, remitted MDD patients revealed decreased mean diffusivity (MD) and increased fractional anisotropy (FA) within the left amygdala, which may be interpreted as greater cell density and increased number of fibers, respectively. This last notion was supported by probabilistic tractography results, which revealed increased connectivity from the left amygdala to the hippocampus, the cerebellum and the brain stem. Further, altered microstructure as indicated by increased MD possibly reflecting decreased cell density within the medial PFC (mPFC) was found. Taken together, the current DTI study shows that abnormal microstructure and connectivity of the amygdala and mPFC might be key factors in the pathophysiology of MDD that may account for functional changes.
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Verbal and facial-emotional Stroop tasks reveal specific attentional interferences in sad mood.
Brain Behav
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Mood congruence refers to the tendency of individuals to attend to information more readily when it has the same emotional content as their current mood state. The aim of the present study was to ascertain whether attentional interference occurred for participants in sad mood states for emotionally relevant stimuli (mood-congruence), and to determine whether this interference occurred for both valenced words and valenced faces. A mood induction procedure was administered to 116 undergraduate females divided into two equal groups for the sad and happy mood condition. This study employed three versions of the Stroop task: color, verbal-emotional, and a facial-emotional Stroop. The two mood groups did not differ on the color Stroop. Significant group differences were found on the verbal-emotional Stroop for sad words with longer latencies for sad-induced participants. Main findings for the facial-emotional Stroop were that sad mood is associated with attentional interference for angry-threatening faces as well as longer latencies for neutral faces. Group differences were not found for positive stimuli. These findings confirm that sad mood is associated with attentional interference for mood-congruent stimuli in the verbal domain (sad words), but this mood-congruent effect does not necessarily apply to the visual domain (sad faces). Attentional interference for neutral faces suggests sad mood participants did not necessarily see valence-free faces. Attentional interference for threatening stimuli is often associated with anxiety; however, the current results show that threat is not an attentional interference observed exclusively in states of anxiety but also in sad mood.
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Response time variability and response inhibition predict affective problems in adolescent girls, not in boys: the TRAILS study.
Eur Child Adolesc Psychiatry
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The present study examines the relationship between neurocognitive functioning and affective problems through adolescence, in a cross-sectional and longitudinal perspective. Baseline response speed, response speed variability, response inhibition, attentional flexibility and working memory were assessed in a cohort of 2,179 adolescents (age 10-12 years) from the TRacking Adolescents Individual Lives Survey (TRAILS). Affective problems were measured with the DSM-oriented Affective Problems scale of the Youth Self Report at wave 1 (baseline assessment), wave 2 (after 2.5 years) and wave 3 (after 5 years). Cross-sectionally, baseline response speed, response time variability, response inhibition and working memory were associated with baseline affective problems in girls, but not in boys. Longitudinally, enhanced response time variability predicted affective problems after 2.5 and 5 years in girls, but not in boys. Decreased response inhibition predicted affective problems after 5 years follow-up in girls, and again not in boys. The results are discussed in light of recent insights in gender differences in adolescence and state-trait issues in depression.
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Inverse Correlation Between Cardiac Injury and Cardiac Anxiety: A Potential Role for Communication.
J Cardiovasc Nurs
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OBJECTIVE:: General anxiety in cardiac patients is associated with worsened cardiac course. An acute coronary syndrome (ACS) might evoke specific cardiac anxiety. We explored the characteristics associated with cardiac anxiety in ACS patients. METHODS:: We assessed cardiac anxiety in 237 patients admitted with ACS using the Cardiac Anxiety Questionnaire and gathered information on sociodemographic, psychological, and cardiac disease characteristics. Univariate, multivariate logistic, and linear regression analyses were used to determine which characteristics were associated with cardiac anxiety. RESULTS:: Cardiac anxiety was not associated with sociodemographic variables. More severe cardiac injury, as indicated by ST-elevated myocardial infarction and troponin level, was associated with less cardiac anxiety. Psychological variables (depressive symptoms, agoraphobic cognitions, avoidance behavior) were associated with more cardiac anxiety. DISCUSSION:: Cardiac anxiety in ACS patients is associated with more psychological distress but lower severity of cardiac injury as indicated by ST-elevated myocardial infarction and troponin level. Two explanations seem likely for this latter finding. First, anxious persons might seek help earlier, thus being diagnosed more often with minor cardiac pathology. Second, cardiac anxiety might partly be caused by diagnostic uncertainty. Future research should focus on communication strategies to reassure patients more efficiently.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.