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Neuroscience and Biobehavioral Reviews Oct 2021Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for... (Review)
Review
Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for anxiety-related disorders. Yet, there is limited basic research on fear conditioning and extinction in obsessive-compulsive disorder (OCD). This is surprising because exposure-based treatments based on associative learning principles are among the most popular and effective treatment options for OCD. Here, we systematically review and critically assess existing aversive conditioning and extinction studies of OCD. Across 12 studies, there was moderate evidence that OCD is associated with abnormal acquisition of conditioned responses that differ from comparison groups. There was relatively stronger evidence of OCD's association with impaired extinction processes. This included multiple studies finding elevated conditioned responses during extinction learning and poorer threat/safety discrimination during recall, although a minority of studies yielded results inconsistent with this conclusion. Overall, the conditioning model holds value for OCD research, but more work is necessary to clarify emerging patterns of results and increase clinical translational utility to the level seen in other anxiety-related disorders. We detail limitations in the literature and suggest next steps, including modeling OCD with more complex conditioning methodology (e.g., semantic/conceptual generalization, avoidance) and improving individual-differences assessment with dimensional techniques.
Topics: Conditioning, Classical; Conditioning, Psychological; Extinction, Psychological; Fear; Humans; Obsessive-Compulsive Disorder
PubMed: 34314751
DOI: 10.1016/j.neubiorev.2021.07.026 -
Social Psychiatry and Psychiatric... Aug 2021Psychiatric hospitals or mental asylums grew across the world in the colonial era. Despite concerns over quality of care and human rights violations, these hospitals... (Review)
Review
PURPOSE
Psychiatric hospitals or mental asylums grew across the world in the colonial era. Despite concerns over quality of care and human rights violations, these hospitals continue to provide the majority of mental health care in most low- and middle-income countries (LMICs). We sought to review the evidence of reform of mental hospitals and associated patient outcomes.
METHODS
We adopted an integrative review methodology by including experimental and non-experimental research. The review protocol was registered on PROSPERO (CRD42019130399). A range of databases and systematic hand searches were conducted by two independent reviewers. Research conducted between 1980 and May 2019, that focused on any aspect of reform in mental hospitals for adults (age 18 and upwards) with severe mental illness and published in English, were considered.
RESULTS
16 studies were included in the review. 12 studies met inclusion criteria, and four additional reports emerged from the hand search. Studies covered-India, China, South Africa, Grenada, Georgia, Sri Lanka, Argentina and Brazil. Key findings emphasise the role of judicial intervention as a critical trigger of reform. Structural reform composed of optimisation of resources and renovations of colonial structures to cater to diverse patient needs. Process reforms include changes in medical management, admission processes and a move from closed to open wards. Staff engagement and capacity building have also been used as a modality of reform in mental hospital settings.
CONCLUSION
There is some documentation of reform in psychiatric hospitals. However, poor methodological quality and variation in approach and outcomes measured, make it challenging to extrapolate specific findings on process or outcomes of reform. Despite being integral service providers, psychiatric hospitals still do not adopt patient centric, recovery-oriented processes. Hence, there is an urgent need to generate robust evidence on psychiatric reform and its effect on patient outcomes.
Topics: Adolescent; Adult; Argentina; Brazil; China; Developing Countries; Hospitals, Psychiatric; Humans; India; South Africa; Sri Lanka
PubMed: 33884439
DOI: 10.1007/s00127-021-02075-z -
Brain and Behavior Oct 2021Autism Spectrum Disorder (ASD) is considered a neurodevelopmental condition that is characterized by alterations in social interaction and communication, as well as... (Review)
Review
BACKGROUND
Autism Spectrum Disorder (ASD) is considered a neurodevelopmental condition that is characterized by alterations in social interaction and communication, as well as patterns of restrictive and repetitive behaviors (RRBs). RRBs are defined as broad behaviors that comprise stereotypies, insistence on sameness, and attachment to objects or routines. RRBs can be divided into lower-level behaviors (motor, sensory, and object-manipulation behaviors) and higher-level behaviors (restrictive interests, insistence on sameness, and repetitive language). According to the DSM-5, the grade of severity in ASD partially depends on the frequency of RRBs and their consequences for disrupting the life of patients, affecting their adaptive skills, and increasing the need for parental support.
METHODS
We conducted a systematic review to examine the biopsychological correlates of the symptomatic domains of RRBs according to the type of RRBs (lower- or higher-level). We searched for articles from the National Library of Medicine (PubMed) using the terms: autism spectrum disorders, ASD, and autism-related to executive functions, inhibitory control, inflexibility, cognitive flexibility, hyper or hypo connectivity, and behavioral approaches. For describing the pathophysiological mechanism of ASD, we also included animal models and followed PRISMA guidelines.
RESULTS
One hundred and thirty-one articles were analyzed to explain the etiology, continuance, and clinical evolution of these behaviors observed in ASD patients throughout life.
CONCLUSIONS
Biopsychological correlates involved in the origin of RRBs include alterations in a) neurotransmission system, b) brain volume, c) inadequate levels of growth factors, d) hypo- or hyper-neural connectivity, e) impairments in behavioral inhibition, cognitive flexibility, and monitoring and f) non-stimulating environments. Understanding these lower- and higher-level of RRBs can help professionals to improve or design novel therapeutic strategies.
Topics: Autism Spectrum Disorder; Autistic Disorder; Cognition; Executive Function; Humans; Stereotyped Behavior
PubMed: 34472728
DOI: 10.1002/brb3.2341 -
International Journal of Environmental... Jul 2022Body image involves perceptions, attitudes, and beliefs concerning one's body, while body schema involves the sensorimotor capacities to control movement and posture. A... (Review)
Review
Body image involves perceptions, attitudes, and beliefs concerning one's body, while body schema involves the sensorimotor capacities to control movement and posture. A review study is needed to obtain sufficient data to determine the effect of body awareness on the normal development of children. This study is a systematic review of interventions related to body awareness among typically developing children. Studies focusing on interventions related to body awareness from 2010 to 2021 were analyzed and extracted from four major scientific databases, and the three that met the inclusion criteria were analyzed. Methods were analyzed by frequency, and the results were analyzed by calculating effect sizes. Two studies involved a nonrandomized two-group design and a single-case experimental study. Two studies targeted early childhood, and one study focused on middle childhood. This review indicates that determining the effectiveness of interventions related to body awareness is necessary for typically developing children because body awareness is a potential influencing factor in their development. Additional research is needed to determine the effectiveness of body awareness assessment tools and interventions.
Topics: Attitude; Awareness; Child; Child, Preschool; Humans
PubMed: 35897271
DOI: 10.3390/ijerph19158900 -
Neuropsychology Review Mar 2022Hyperbaric oxygen therapy (HBOT) is a modality of treatment in which patients inhale 100% oxygen inside a hyperbaric chamber pressurised to greater than 1 atmosphere.... (Review)
Review
Hyperbaric oxygen therapy (HBOT) is a modality of treatment in which patients inhale 100% oxygen inside a hyperbaric chamber pressurised to greater than 1 atmosphere. The aim of this review is to discuss neuropsychological findings in various neurological disorders treated with HBOT and to open new perspectives for therapeutic improvement. A literature search was conducted in the MEDLINE (via PubMed) database from the inception up 10 May 2020. Eligibility criteria included original articles published in English. Case studies were excluded. Full-text articles were obtained from the selected studies and were reviewed on the following inclusion criteria (1) performed cognitive processes assessment (2) performed HBOT with described protocol. Two neuropsychologists independently reviewed titles, abstracts, full texts and extracted data. The initial search retrieved 1024 articles, and a total of 42 studies were finally included after applying inclusion and exclusion criteria. The search yielded controversial results with regard to the efficiency of HBOT in various neurological conditions with cognitive disturbance outcome. To the best of our knowledge this is the first state-of-the art, systematic review in the field. More objective and precise neuropsychological assessment methods are needed to exact evaluation of the efficacy of HBOT for neuropsychological deficits. Future studies should widen the assessment of HBOT effects on different cognitive domains because most of the existing studies have focussed on a single process. Finally, there is a need for further longitudinal studies.
Topics: Cognition; Humans; Hyperbaric Oxygenation
PubMed: 33847854
DOI: 10.1007/s11065-021-09500-9 -
Pain Nov 2023Observing someone experience pain relief or exacerbation after an intervention may induce placebo hypoalgesia or nocebo hyperalgesia. Understanding the factors that... (Meta-Analysis)
Meta-Analysis
Observing someone experience pain relief or exacerbation after an intervention may induce placebo hypoalgesia or nocebo hyperalgesia. Understanding the factors that contribute to these effects could help in the development of strategies for optimizing treatment of chronic pain conditions. We systematically reviewed and meta-analyzed the literature on placebo hypoalgesia and nocebo hyperalgesia induced by observational learning (OL). A systematic literature search was conducted in the databases PubMed, PsycINFO, Web of Science, ScienceDirect, PsycARTICLES, Scopus, and Academic Search Ultimate. Twenty-one studies were included in the systematic review, 17 of which were suitable for meta-analysis (18 experiments; n = 764 healthy individuals). The primary end point was the standardized mean difference (SMD) for pain following placebo cues associated during OL with low vs high pain. Observational learning had a small-to-medium effect on pain ratings (SMD 0.44; 95% confidence interval [CI] 0.21-0.68; P < 0.01) and a large effect on pain expectancy (SMD 1.11; 95% CI 0.49-2.04; P < 0.01). The type of observation (in-person vs videotaped) modulated the magnitude of placebo hypoalgesia/nocebo hyperalgesia ( P < 0.01), whereas placebo type did not ( P = 0.23). Finally, OL was more effective when observers' empathic concern (but no other empathy-related factors) was higher ( r = 0.14; 95% CI 0.01-0.27; P = 0.03). Overall, the meta-analysis demonstrates that OL can shape placebo hypoalgesia and nocebo hyperalgesia. More research is needed to identify predictors of these effects and to study them in clinical populations. In the future, OL could be an important tool to help maximize placebo hypoalgesia in clinical settings.
Topics: Humans; Hyperalgesia; Nocebo Effect; Pain; Learning; Pain Perception; Placebo Effect
PubMed: 37326688
DOI: 10.1097/j.pain.0000000000002943 -
Neurological Sciences : Official... Feb 2022Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to... (Meta-Analysis)
Meta-Analysis Review
Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to analyze and synthesize the evidence on the efficacy of cognitive TR interventions in patients with neurological diseases, compared with conventional face-to-face rehabilitation. From a total of 4485 records, 9 studies met the inclusion criteria for qualitative analysis. At the end of the process, 7 studies remained for quantitative analysis. By comparing TR with face-to-face treatments for cognitive impairments, we assessed improvements in global cognitive domain (Mini Mental State Exam) (MD = -0.86; 95% CI -2.43, 0.72, I = 0%), in learning and memory domains (SMD = 0.26, 95% CI -0.22, 0.74, I = 24%), in verbal fluency (SMD = 0.08, 95% CI -0.47, 0.62, I = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I = 0%). In all the included studies, improvement in the performance of the TR groups was comparable to that achieved through face-to-face intervention. Significant differences between those two modalities of providing treatments were observed for working memory and total executive function comparison, in favor of TR. The results of this study can sustain the efficacy of TR and its application for the treatment of neurological patients, especially when treated for executive function impairments.
Topics: Cognition; Cognitive Dysfunction; Executive Function; Humans; Telerehabilitation
PubMed: 34822030
DOI: 10.1007/s10072-021-05770-6 -
Journal of Medical Internet Research Aug 2022Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context, being present, values, and committed action.
OBJECTIVE
This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to examine the effects of internet-based ACT (iACT) on process measures.
METHODS
A comprehensive search was conducted using 4 databases. The quality of the included RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. A random-effects or fixed-effects model was used. Subgroup analyses for each outcome were conducted according to the type of control group, use of therapist guidance, delivery modes, and use of targeted participants, when applicable.
RESULTS
A total of 34 RCTs met the inclusion criteria. This meta-analysis found that iACT had a medium effect on psychological flexibility and small effects on mindfulness, valued living, and cognitive defusion at the immediate posttest. In addition, iACT had a small effect on psychological flexibility at follow-up. The overall risk of bias across studies was unclear.
CONCLUSIONS
Relatively few studies have compared the effects of iACT with active control groups and measured the effects on mindfulness, valued living, and cognitive defusion. These findings support the processes of change in iACT, which mental health practitioners can use to support the use of iACT.
Topics: Acceptance and Commitment Therapy; Humans; Internet; Mental Health; Mindfulness; Models, Psychological
PubMed: 36040783
DOI: 10.2196/39182 -
Frontiers in Public Health 2024Gambling disorder (GD) is a pressing public health concern with significant societal costs. The recently developed nudge theory, which is rooted in behavioral economics,... (Review)
Review
BACKGROUND
Gambling disorder (GD) is a pressing public health concern with significant societal costs. The recently developed nudge theory, which is rooted in behavioral economics, aims to influence the decision-making behaviors of individuals by implementing changes in the environment.
AIM
This scoping review aims to synthesize the literature on nudge theory as it relates to gambling.
METHODS
This scoping review accords with the Arksey and O'Malley framework, as refined by Levac et al. It includes only articles from peer-reviewed journals that focus, as main themes, on both nudge theory and gambling. The final study selection includes six articles.
RESULTS
The scoping review process led to studies explaining how (1) nudges aim to prod people toward healthier gambling choices, fostering the adoption of more responsible gambling practices, and (2) some gambling features, called dark nudges (or sludges), exploit and harm the decision-making processes of people who gamble.
CONCLUSION
This scoping review highlights the fact that many stakeholders are involved in the field of gambling, and that better cooperation between them would promote safer and more responsible gambling practices. Future research is also needed to empirically test nudges to develop a better understanding of their impact on those who gamble.
Topics: Gambling; Humans; Decision Making; Psychological Theory; Choice Behavior; Behavior, Addictive; Economics, Behavioral
PubMed: 38915754
DOI: 10.3389/fpubh.2024.1377183 -
International Journal of Environmental... Dec 2022Environmental noise affects our daily functioning in many ways, and the cognitive, motivational, and emotional effects of noise are intertwined. Our task performance... (Review)
Review
Environmental noise affects our daily functioning in many ways, and the cognitive, motivational, and emotional effects of noise are intertwined. Our task performance under noisy conditions depends on our ability to cope with the noise and our cognitive resources. The process of (failed) coping may wear us out cognitively, lead to learned helplessness, and, consequently, alter the motivation to persist in a task. The direct effect of irrelevant sounds on cognitive functioning in children is relatively well-established, however, the research on the framework of learned helplessness is limited when it comes to children. Learned helplessness can give more insight into effects of environmental noise on learning and child development and how the effects of short-term and long-term exposure interact. A systematic literature review is performed to assess to what extent the current evidence addresses the (interaction) effects of the sound environment on cognition and learned helplessness as measured by motivation in children and young adults up to the age of 21. The search resulted in 8 included papers that addressed both cognition and learned helplessness in their research. The included papers study children between 8-13 years old and show evidence for a relation between environmental noise, cognition, and helplessness individually, but none study a possible interaction. Based on the individual study designs, it could be hypothesized that cognitive fatigue may play a role in the interaction. Studies that conducted motivation tasks after cognitive tasks found stronger effects than those that conducted tasks in a random order. More research is needed using the same methods in different age groups to further assess the interaction between cognition and learned helplessness in relation to the sound environment.
Topics: Child; Young Adult; Humans; Adolescent; Cognition; Motivation; Emotions; Helplessness, Learned; Learning
PubMed: 36612610
DOI: 10.3390/ijerph20010288