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Journal of Medical Internet Research May 2017Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal... (Review)
Review
BACKGROUND
Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors.
OBJECTIVE
We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research.
METHODS
Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study's background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study's aims and outcomes.
RESULTS
This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into clinical effects of ECAs, such as a reduction in symptom severity.
CONCLUSIONS
ECAs for mental disorders are emerging. State-of-the-art techniques, involving, for example, communication through natural language or nonverbal behavior, are increasingly being considered and adopted for psychotherapeutic interventions in ECA research with promising results. However, evidence on their clinical application remains scarce. At present, their value to clinical practice lies mostly in the experimental determination of critical human support factors. In the context of using ECAs as an adjunct to existing interventions with the aim of supporting users, important questions remain with regard to the personalization of ECAs' interaction with users, and the optimal timing and manner of providing support. To increase the evidence base with regard to Internet interventions, we propose an additional focus on low-tech ECA solutions that can be rapidly developed, tested, and applied in routine practice.
Topics: Communication; Humans; Psychology, Clinical; Telemedicine
PubMed: 28487267
DOI: 10.2196/jmir.6553 -
Comprehensive Psychiatry Oct 2023Converging evidence supports that gaming and gambling disorders are associated with executive dysfunction. The involvement of different components of executive functions... (Review)
Review
BACKGROUND
Converging evidence supports that gaming and gambling disorders are associated with executive dysfunction. The involvement of different components of executive functions (EF) in these forms of behavioural addiction is unclear.
AIM
In a systematic review, we aim to uncover the association between working memory (WM), a crucial component of EF, and disordered gaming and gambling. Note that, in the context of this review, gaming has been used synonymously with video gaming.
METHODS
Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we systematically searched for studies published from 2012 onwards.
RESULTS
The search yielded 6081 records after removing duplicates, from which 17 peer-reviewed journal articles were eligible for inclusion. The association between WM and problem or disordered gaming and gambling have been categorized separately to observe possible differences. Essentially, problem gaming or gambling, compared to disorder, presents lesser severity and clinical significance. The results demonstrate reduced auditory-verbal WM in individuals with gambling disorder. Decreased WM capacity was also associated with problem gambling, with a correlation between problem gambling severity and decreased WM capacity. Similarly, gaming disorder was associated with decreased WM. Specifically, gaming disorder patients had lower WM capacity than the healthy controls.
CONCLUSION
Working memory seems to be a significant predictor of gambling and gaming disorders. Therefore, holistic treatment approaches that incorporate cognitive techniques that could enhance working memory may significantly boost gambling and gaming disorders treatment success.
Topics: Humans; Gambling; Memory, Short-Term; Cognition; Disruptive, Impulse Control, and Conduct Disorders; Video Games; Behavior, Addictive
PubMed: 37573802
DOI: 10.1016/j.comppsych.2023.152408 -
PloS One 2016Research investigating cognition and behaviour in Sotos syndrome has been sporadic and to date, there is no published overview of study findings. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Research investigating cognition and behaviour in Sotos syndrome has been sporadic and to date, there is no published overview of study findings.
METHOD
A systematic review of all published literature (1964-2015) presenting empirical data on cognition and behaviour in Sotos syndrome. Thirty four journal articles met inclusion criteria. Within this literature, data relating to cognition and/or behaviour in 247 individuals with a diagnosis of Sotos syndrome were reported. Ten papers reported group data on cognition and/or behaviour. The remaining papers employed a case study design.
RESULTS
Intelligence quotient (IQ) scores were reported in twenty five studies. Intellectual disability (IQ < 70) or borderline intellectual functioning (IQ 70-84) was present in the vast majority of individuals with Sotos syndrome. Seven studies reported performance on subscales of intelligence tests. Data from these studies indicate that verbal IQ scores are consistently higher than performance IQ scores. Fourteen papers provided data on behavioural features of individuals with Sotos syndrome. Key themes that emerged in the behavioural literature were overlap with ASD, ADHD, anxiety and high prevalence of aggression/tantrums.
CONCLUSION
Although a range of studies have provided insight into cognition and behaviour in Sotos syndrome, specific profiles have not yet been fully specified. Recommendations for future research are provided.
Topics: Adult; Aggression; Anxiety; Attention Deficit Disorder with Hyperactivity; Behavior; Child; Cognition; Humans; Intelligence Tests; Language; Longitudinal Studies; Sotos Syndrome
PubMed: 26872390
DOI: 10.1371/journal.pone.0149189 -
BMJ Open Mar 2020Verbal face-to-face feedback on clinical task performance is a fundamental component of health professions education. Experts argue that feedback is critical for... (Comparative Study)
Comparative Study Meta-Analysis
Effect of face-to-face verbal feedback compared with no or alternative feedback on the objective workplace task performance of health professionals: a systematic review and meta-analysis.
OBJECTIVE
Verbal face-to-face feedback on clinical task performance is a fundamental component of health professions education. Experts argue that feedback is critical for performance improvement, but the evidence is limited. The aim of this systematic review was to investigate the effect of face-to-face verbal feedback from a health professional, compared with alternative or no feedback, on the objective workplace task performance of another health professional.
DESIGN
Systematic review and meta-analysis.
METHODS
We searched the full holdings of Ovid MEDLINE, CENTRAL, Embase, CINAHL and PsycINFO up to 1 February 2019 and searched references of included studies. Two authors independently undertook study selection, data extraction and quality appraisal. Studies were included if they were randomised controlled trials investigating the effect of feedback, in which health professionals were randomised to individual verbal face-to-face feedback compared with no feedback or alternative feedback and available as full-text publications in English. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach. For feedback compared with no feedback, outcome data from included studies were pooled using a random effects model.
RESULTS
In total, 26 trials met the inclusion criteria, involving 2307 participants. For the effect of verbal face-to-face feedback on performance compared with no feedback, when studies at high risk of bias were excluded, eight studies involving 392 health professionals were included in a meta-analysis: the standardised mean difference (SMD) was 0.7 (95% CI 0.37 to 1.03; p<0.001) in favour of feedback. The calculated SMD prediction interval was -0.06 to 1.46. For feedback compared with alternative feedback, studies could not be pooled due to substantial design and intervention heterogeneity. All included studies were summarised, and key factors likely to influence performance were identified including components within feedback interventions, instruction and practice opportunities.
CONCLUSIONS
Verbal face-to-face feedback in the health professions may result in a moderate to large improvement in workplace task performance, compared with no feedback. However, the quality of evidence was low, primarily due to risk of bias and publication bias. Further research is needed. In particular, we found a lack of high-quality trials that clearly reported key components likely to influence performance.
TRIAL REGISTRATION NUMBER
CRD42017081796.
Topics: Clinical Competence; Formative Feedback; Health Personnel; Humans; Task Performance and Analysis; Verbal Behavior; Work Performance
PubMed: 32213515
DOI: 10.1136/bmjopen-2019-030672 -
Child: Care, Health and Development May 2016Children born before full term (39-41 weeks' gestation) are at increased risk of adverse cognitive outcomes. Risk quantification is important as late-preterm (LPT;... (Review)
Review
BACKGROUND
Children born before full term (39-41 weeks' gestation) are at increased risk of adverse cognitive outcomes. Risk quantification is important as late-preterm (LPT; 34-36 weeks) and early-term (ET; 37-38 weeks) births are common.
METHOD
This review analyses the effect of LPT and ET births on long-term cognitive and educational outcomes. The primary outcome was general cognitive ability. Secondary outcomes included verbal/non-verbal intelligence quotient, subject-specific school performance and special educational needs. The search strategy included Medline and Embase from January 1975 to June 2013. Eligible studies investigated specified outcomes and included suitable gestational age participants assessed at 2 years and older. Outcome measures and socio-demographic descriptors were extracted, and data meta-analysed where possible.
RESULTS
Eight studies compared ET birth with full-term birth. Fourteen studies compared LPT birth with either term birth (>37 weeks, n = 12 studies) or full-term birth (39-41 weeks, n = 2 studies). Substantial between-study heterogeneity existed. LPT and ET children underperformed in most outcomes compared with their term/full-term counterparts, respectively. For example, LPT children had an increased risk of lower general cognitive ability (adjusted risk ratio 1.38 [95% confidence interval 1.06-1.79]), and full-term children performed 5% of a standard deviation higher (z-score 0.05 [0.02, 0.08]) than ET children. Poorer outcomes persist into adulthood; term cohorts performed 5% of a standard deviation higher than LPT cohorts (z-score 0.05 [0.04, 0.07]), and full-term cohorts performed 3% of a standard deviation higher than ET cohorts (z-score 0.03 [0.02, 0.04]).
CONCLUSION
This review critically examines the knowledge around long-term cognitive outcomes of LPT and ET births, demonstrating multiple, small, adverse differences between LPT/ET and term/full-term births.
Topics: Child Behavior Disorders; Child, Preschool; Cognition Disorders; Early Intervention, Educational; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Odds Ratio
PubMed: 26860873
DOI: 10.1111/cch.12320 -
Neuroscience and Biobehavioral Reviews Feb 2017There is not a consensus as to whether neuropsychological profiling can distinguish depressive subtypes. We aimed to systematically review and critically analyse the... (Review)
Review
There is not a consensus as to whether neuropsychological profiling can distinguish depressive subtypes. We aimed to systematically review and critically analyse the literature on cognitive function in patients with melancholic and atypical depression. We searched in databases PubMed, SCOPUS, Web of Knowledge and PsycInfo for papers comparing the neuropsychological performance of melancholic patients (MEL) to non-melancholic depressive patients (NMEL), including atypical depressives, and healthy controls (HC). All studies were scrutinised to determine the main methodological characteristics and particularly possible sources of bias influencing the results reported, using the STROBE statement checklist. We also provide effect size of the results reported for contrasts between MEL; patients and NMEL patients. Seventeen studies were included; most of them demonstrated higher neuropsychological impairments of MEL patients compared to both NMEL patients and HC on tasks requiring memory, executive function, attention and reaction time. Detailed analysis of the methodologies used in the studies revealed significant variability especially regarding the participants' sociodemographic characteristics, clinical characteristics of patients and differences in neuropsychological assessment. These findings suggest that MEL may have a distinct and impaired cognitive performance compared to NMEL depressive patients on tasks involving verbal and visual memory, executive function, sustained attention and span, as well as psychomotor speed, this last especially when cognitive load is increased. Additional studies with adequate control of potentially confounding variables will help to clarify further differences in the neuropsychological functioning of depressive subtypes.
Topics: Cognition Disorders; Depression; Depressive Disorder, Major; Executive Function; Humans; Neuropsychological Tests; Reaction Time
PubMed: 28027956
DOI: 10.1016/j.neubiorev.2016.12.014 -
Journal of Anxiety Disorders Mar 2015Inconsistent results in neuropsychological research of obsessive-compulsive disorder (OCD) may be the result of the heterogeneous nature of OCD symptoms. The most... (Comparative Study)
Comparative Study Meta-Analysis Review
Inconsistent results in neuropsychological research of obsessive-compulsive disorder (OCD) may be the result of the heterogeneous nature of OCD symptoms. The most frequently investigated symptoms are contamination/cleaning and doubt/checking. The aim of this review was to determine whether OCD washers and checkers differ in their neuropsychological performance. We conducted a meta-analysis of 13 studies (including 535 patients) comprising tests in 10 different neuropsychological domains. Washers showed significant better task performance than checkers in 8 of 10 cognitive domains. Large effect sizes were found in planning/problem solving and response inhibition. Effect size in set shifting was medium, whereas effect sizes in attention, processing speed, encoding, verbal memory and nonverbal memory were small. Limitations consisted in a relatively small number of primary studies. In line with current neurobiological findings, the results provide further evidence for the validity of different symptom dimensions in OCD. Clinical and theoretical implications are discussed.
Topics: Attention; Compulsive Behavior; Emotions; Female; Humans; Hygiene; Male; Memory; Middle Aged; Neuropsychological Tests; Obsessive-Compulsive Disorder; Psychomotor Performance
PubMed: 25601381
DOI: 10.1016/j.janxdis.2014.12.016 -
Journal of Affective Disorders Aug 2023Although insulin resistance (IR) and cardiometabolic syndrome are prevalent in patients with bipolar disorder (BD), only a few studies have attempted to precisely assess... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although insulin resistance (IR) and cardiometabolic syndrome are prevalent in patients with bipolar disorder (BD), only a few studies have attempted to precisely assess the degree and clinical impact of IR in BD.
METHODS
A comprehensive search was conducted from multiple research databases through May 2022, following a pre-defined protocol (PROSPERO: CRD42022359259). We extracted neuroimaging, cognition, illness course, and treatment response findings from individuals with BD with evidence of IR compared with euglycemic BD individuals.
RESULTS
Of 1436 identified articles, 10 reports fulfilling inclusion criteria were included (n = 1183). BD patients with IR displayed worse composite verbal memory scores and worse executive function and exhibited smaller hippocampal volumes along with prefrontal neurochemical alterations compared to euglycemic BD patients. Fixed-effect meta-analysis revealed that BD patients with impaired glucose metabolism (IGM) were more likely to develop a chronic and rapid cycling course when compared with euglycemic BD patients (k = 2, OR = 2.96, 95 % CI 1.69-5.17, OR = 2.88, 95 % CI 1.59-5.21, p < 0.001, respectively), with a trend for significantly lower Global Assessment of Functioning scores (k = 5, MD = -4, 95 % CI -8.23-0.23, p = 0.06). BD patients with IGM displayed a higher rate of poor response to mood stabilizers when compared with euglycemic BD patients (k = 2, OR = 6.74, 95 % CI 1.04-43.54, p = 0.04).
LIMITATIONS
Cross-sectional design and small sample sizes of studies included limit the generalizability of results.
CONCLUSION
IR is associated with worse clinical outcomes of BD and inadequate treatment response. Implementing strategies to prevent and treat IR in BD is crucial to improve the prognosis of such a difficult-to-treat population.
Topics: Humans; Bipolar Disorder; Cross-Sectional Studies; Executive Function; Immunoglobulin M; Insulin Resistance; Insulin
PubMed: 37086806
DOI: 10.1016/j.jad.2023.04.068 -
Schizophrenia Research Mar 2017Patients with schizophrenia display abnormalities in pitch discrimination of non-verbal tones as revealed by the Tone-Matching Task (TMT). It may lead to deficits in... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Patients with schizophrenia display abnormalities in pitch discrimination of non-verbal tones as revealed by the Tone-Matching Task (TMT). It may lead to deficits in higher-order cognitive functions and clinical symptoms.
OBJECTIVES
We conducted a systematic review and meta-analysis pooling data about TMT score differences between patients with schizophrenia and healthy controls, to evaluate the deficit's effect size, and to develop reliable knowledge about pitch processing impairment and its pejorative impact.
METHOD
Relevant publications were identified by a systematic search of PubMed and EMBASE databases. Then, we excluded non-relevant studies for the meta-analysis. Effect size for percent of correct responses to the TMT was expressed as standardized mean difference (SMD).
RESULTS
Eighteen of 167 identified studies met eligibility criteria for review, of which 10 were included in the meta-analysis. Our meta-analysis showed that the effect size for the percent of correct response to the TMT between patients (N=371) and controls (N=342) was large: SMD=1.17 [95% CI: 0.926-1.418] (z-value=9.338 and p-value<0.001). Meta-analysis showed moderate heterogeneity between studies (Q(9)=17.22, p=0.04, I=47.74%). The relationship between tone-matching impairment and clinical symptoms of schizophrenia remains heterogeneous across studies. Some authors observed significant correlations between tone-matching performance and a number of higher-order cognitive abilities.
CONCLUSION
This review and meta-analysis highlights a large significant disturbance in tone-matching ability in patients as compared with controls. The study of basic auditory processing opens promising perspectives for pathophysiological modelling of the disorder and therapeutic issues.
Topics: Auditory Perceptual Disorders; Humans; Pitch Discrimination; Schizophrenia
PubMed: 27742161
DOI: 10.1016/j.schres.2016.10.009 -
Current Aging Science 2020Verbal Fluency (VF) tasks are known as multimodal measures clinically useful for monitoring cognitive decline during the aging process. Considering that the executive...
BACKGROUND
Verbal Fluency (VF) tasks are known as multimodal measures clinically useful for monitoring cognitive decline during the aging process. Considering that the executive control observed along VF tasks calls for a set of functions directing the behavior toward a general goal, it may be assumed that there is a correspondence between VF ability and Functional Capacity (FC).
METHODS
With this assumption in mind, the author aimed at performing a literature research on VF ability and FC within aging.
RESULTS
Only four studies whose title/abstract presented the target key-terms, partially fulfilled the adopted criteria and were selected for discussion. Taken together, these articles attempted to correlate cognitive material to aspects of functionality, one of which not doing so directly with the elderly and another with no specific association with VF abilities.
CONCLUSION
Theories suggest that VF might be associated with complex executive mechanisms. Still, a theoretical scheme and controlled researches possibly able to shed light on the underlying balance among the VF abilities and functionality within aging are as yet, unknown.
Topics: Aged; Aging; Cognitive Dysfunction; Executive Function; Humans; Neuropsychological Tests
PubMed: 31530271
DOI: 10.2174/1874609812666190917151043