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Recent evidence from event-related potentials (ERPs) has identified N2 posterior contralateral (pc) amplitudes as a neural marker of early attention allocation. The N2pc has been used to evaluate attention biases (ABs) in samples with anxiety-based problems, but its utility has yet to be considered among persons with chronic pain, another group theorized to display ABs that perpetuate their difficulties. To address this gap, we assessed N2pc responses of adults with chronic pain (N = 70) and pain-free controls (N = 70) during a dot-probe task comprising painful-neutral and happy-neutral facial expression image pairs. Analyses indicated that (1) larger N2pc amplitudes were elicited by both painful and happy expressions compared to complementary neutral expressions in each sample, (2) the chronic pain sample displayed larger N2pc amplitudes during exposure to both painful and happy expressions than controls did and (3) no group differences were evident for N2pc latencies. Overall N2pc results reflected general biases in early allocation of attention towards affectively valenced expressions rather than pain-specific ABs among chronic pain cohorts. SIGNIFICANCE: Although numerous researchers have examined pain-related attention biases, these data are based exclusively upon behavioural measures of attention such as reaction times and eye movements. Drawing from relevant event-related potentials research, this study is the first to evaluate and identify differences in orienting of attention between adults with chronic pain and pain-free controls based on N2 posterior contralateral (pc) amplitudes which provide a neural index of early attention allocation.

Although researchers have documented behavioral and brain structure correlates of pain resilience, associated physiological responses have received little consideration. In this study, we assessed psychophysiological differences between high (HPR), moderate (MPR), and low (LPR) pain resilience subgroups during anticipation, experiencing, and recovery from laboratory pain. In an initial pain anticipation task, participants (79 women, 32 man) viewed visual cues to signal possible mild or intense shocks prior to receiving these shocks. Subsequently, in a pain recovery task, participants received uncued mild and intense shocks. Subjective appraisals were assessed during each task in tandem with continuous recording of skin conductance level (SCL), heart rate variability (HRV), and corrugator electromyography (cEMG). On physiological indexes, HPR subgroup members displayed significantly lower SCL than MPR and LPR subgroups did during anticipation and experiencing of pain while no resilience group effects were found for HRV or cEMG. During pain recovery, HPR and LPR subgroups displayed weaker SCL than the MPR subgroup did in the immediate aftermath of shock. However, HPR members continued to display lower SCL than other groups did over an extended recovery period. On self-report measures, the LPR subgroup reported higher levels of anticipatory anxiety and expected pain than HPR and MPR subgroups did during the pain anticipation task. Together, results suggested higher pain resilience is characterized, in part, by comparatively reduced SCL during the course of anticipating, experiencing and recovering from painful shock.

Background Objectively measured differences in physical activity (PA) and sleep have been documented among people with osteoarthritis (OA) and rheumatoid arthritis (RA) compared to non-arthritic controls. However, it is not clear whether OA and RA subgroups also differ on these indexes or the extent to which distinct arthritis subgroups versus controls can be accurately identified on the basis of objective PA and sleep indexes compared to self-report responses on questionnaires. This study addressed these gaps. Methods This case-control study comprised Chinese adults with OA (N = 40) or RA (N = 40) diagnoses based on physician assessments as well as a control group of adults without chronic pain (N = 40). All participants wore a Sensewear Armband (SWA) for consecutive 7 days and completed the International Physical Activity Questionnaire Short Form-Chinese as well as Pittsburgh Sleep Diary to obtain objective and subjective PA and sleep data, respectively. Results There were no differences between the three groups on any self-report indexes of PA or sleep. Conversely, OA and RA subgroups displayed significantly lower PA levels and more sleep problems than controls did on a majority of SWA indexes, though arthritis subgroups were not differentiated from one another on these measures. Logistic regression analyses indicated four non-multicollinear SWA indexes (i.e., steps, active energy expenditure, vigorous activity, time awake after sleep onset) correctly identified the subgroup membership of 75.0–82.5% of participants with RA or OA while classification accuracy results were attenuated for controls. Conclusions Where possible, objective measures should be used to assess PA and sleep of adults with OA and RA while particular self-report PA questionnaires should be used sparingly.

People who are especially afraid of pain may display attention biases that increase their risk for developing chronic pain following an injury. However, specific neurophysiological mechanisms underlying associations between elevated trait fear of pain levels and environmental cues that signal potential pain experiences are not well understood. To address this gap, event-related potentials (ERPs) were recorded among 39 high pain-fearful (H-FOP) and 36 low pain-fearful (L-FOP) adults exposed to potentially painful somatosensory stimulation cued by sensory pain words versus non-painful stimulation cued by neutral words. H-FOP group members displayed slower reaction times in judging somatosensory stimulation and rated stimulation to be more intense than L-FOP group members did. H-FOP group members also exhibited comparatively earlier peak latencies of P2 and N2 components during word cue presentations as well as weaker P3 amplitudes in processing non-painful stimulation cued by sensory pain words. These findings suggested that, among the high trait pain-fearful, exposure to word cues signaling potential pain results in the allocation of fewer cognitive resources toward processing somatosensory stimuli that are not actually painful.

BACKGROUND In this eye tracking study, we evaluated pain-related biases in orienting and maintenance of gaze within impending touch versus impending pain tasks and examined features of pain resilience as individual difference influences on potential biases. METHODS Gaze preferences of healthy adults (25 women and 39 men) were assessed during standardized pain-neutral (P-N) image pair presentations (2,000 ms) of an impending touch task versus an impending pain task whereby image pair offsets were followed by potential non-painful touch and potential pain stimulation, respectively. RESULTS Within each task, participants were significantly more likely to fixate first upon pain images in P-N pairs and maintain gaze on these images for longer overall durations during trials. Between task comparisons indicated pain-related biases in orienting and maintenance were significantly stronger when image pairs signalled potential pain rather than impending touch. Finally, within the impending pain task, higher scores on the behaviour perseverance dimension of pain resilience were related to shorter first fixation durations and overall gaze durations towards pain images. CONCLUSIONS Supporting specific threat interpretation model premises, comparatively more threatening external pain cues for impending pain were characterized by gaze biases reflecting pronounced early attentional capture and subsequent prolonged vigilance. However, elevations in self-reported behavioural perseverance in spite of pain corresponded to an increased capacity to disengage from pain images that signalled potential pain. SIGNIFICANCE Gaze biases were assessed within a comparatively benign "impending touch" paradigm versus a higher threat, impending pain task. Early capture and maintenance of gaze towards pain images were more pronounced on the latter task, although pain resilient participants were able to disengage more easily from pain images signalling possible pain.

Studies have documented behavior differences between more versus less resilient adults with chronic pain (CP), but the presence and nature of underlying neurophysiological differences have received scant attention. In this study, we attempted to identify regions of interest (ROIs) in which resting state (Rs) brain activity discriminated more from less resilient CP subgroups based on multiple kernel learning (MKL). More and less resilient community-dwellers with chronic musculoskeletal pain (70 women, 39 men) engaged in structural and functional magnetic resonance imaging (MRI) scans, wherein MKL assessed Rs activity based on amplitude of low frequency fluctuations (ALFF), fractional amplitudes of low frequency fluctuations (fALFF), and regional homogeneity (ReHo) modalities to identify ROIs most salient for discriminating more versus less resilient subgroups. Compared to classification based on single modalities, multi-modal classification based on combined fALFF and ReHo features achieved a substantially higher classification accuracy rate (79%). Brain regions with the best discriminative power included those implicated in pain processing, reward, executive function, goal-directed action, emotion regulation and resilience to mood disorders though variation trends were not consistent between more and less resilient subgroups. Results revealed patterns of Rs activity that serve as possible biomarkers for resilience to chronic musculoskeletal pain.

Background: The prevalence of post-traumatic stress symptoms (PTSS) in COVID-19 survivors is unclear. This study examined the prevalence of PTSS and its association with quality of life (QOL) among COVID-19 survivors during the post-COVID-19 era in China.Methods: This was a comparative, cross-sectional study. PTSS, depressive symptoms, and QOL were assessed with standardized instruments.Results: A total of 134 COVID-19 survivors and 214 non-infected controls (healthy controls hereafter) were recruited. Among COVID-19 survivors, the PTSS prevalence was 18.66% (95%CI: 11.98–25.34%), which was significantly higher than that (5.61%, 95%CI: 2.50–8.71%) of healthy controls (P < 0.001). After controlling for covariates, an analysis of covariance (ANCOVA) showed that COVID-19 survivors had a higher PTSS total score than did healthy controls [F(1,348) = 4.664, P = 0.032]. A separate ANCOVA revealed there were no significant differences in overall QOL between COVID-19 survivors with and without PTSS [F(1,348) = 1.067, P = 0.304]. A multiple logistic regression analysis showed that more severe depressive symptoms were significantly associated with PTSS in COVID-19 survivors (OR = 1.425, P < 0.001).Conclusions: PTSS were more severe in COVID-19 survivors compared to healthy controls in the post-COVID-19 era. Considering their negative impact on daily life and functional outcomes, regular assessment and appropriate treatments of PTSS should be conducted in COVID-19 survivors.

Background Coronavirus disease 2019 (COVID-19) is closely associated with physical and mental health problems; however, little is known about the severity of stigma caused by COVID-19 among its survivors. Thus, the aim of this study was to compare differences in stigma experiences of COVID-19 survivors versus healthy controls after the COVID-19 outbreak peak in China. Methods This cross-sectional study comprised 154 COVID-19 survivors and 194 healthy controls recruited through consecutive and convenience sampling methods, respectively. COVID-19 related stigma was measured by the Social Impact Scale (SIS). Stigma differences between the two groups were compared with analysis of covariance (ANCOVA) and a generalized linear model (GLM) was used to identify independent correlates of COVID-19-related stigma in this study. Results Compared with healthy controls, COVID-19 survivors reported more overall stigma (F(1,347) = 60.82, p F(1,347) = 56.54, p F(1,347) = 19.96, p F(1,347) = 71.40, p F(1,347) = 34.73, p p values Conclusion COVID-19-related stigma is commonly experienced among COVID-19 survivors even though the outbreak has been well-contained in China. Routine assessment of stigma experiences should be conducted on COVID-19 survivors and appropriate psychological assistance, public education, and anti-stigma campaigns and policies should be enforced to reduce stigma within this vulnerable subpopulation.

Purpose: The objective of this study is to quantitatively evaluate terahertz (THz) imaging for differentiating cancerous from non-cancerous tissues in mammary tumors developed in response to injection of N-ethyl-N-nitrosourea (ENU) in Sprague Dawley rats. Approach: While previous studies have investigated the biology of mammary tumors of this model, the current work is the first study to employ an imaging modality to visualize these tumors. A pulsed THz imaging system is utilized to experimentally collect the time-domain reflection signals from each pixel of the rat’s excised tumor. A statistical segmentation algorithm based on the expectation-maximization (EM) classification method is implemented to quantitatively assess the obtained THz images. The model classification of cancer is reported in terms of the receiver operating characteristic (ROC) curves and the areas under the curves. Results: The obtained low-power microscopic images of 17 ENU-rat tumor sections exhibited the presence of healthy connective tissue adjacent to cancerous tissue. The results also demonstrated that high reflection THz signals were received from cancerous compared with non-cancerous tissues. Decent tumor classification was achieved using the EM method with values ranging from 83% to 96% in fresh tissues and 89% to 96% in formalin-fixed paraffin-embedded tissues. Conclusions: The proposed ENU breast tumor model of Sprague Dawley rats showed a potential to obtain cancerous tissues, such as human breast tumors, adjacent to healthy tissues. The implemented EM classification algorithm quantitatively demonstrated the ability of THz imaging in differentiating cancerous from non-cancerous tissues.

Objective: Poor mental health is associated with impaired social functioning, lower quality of life, and increased risk of suicide and mortality. This study examined the prevalence of poor general mental health among older adults (aged 65 years and above) and its sociodemographic correlates in Hebei province, which is a predominantly agricultural area of China.Methods: This epidemiological survey was conducted from April to August 2016. General mental health status was assessed using the 12-item General Health Questionnaire (GHQ-12).Results: A total of 3,911 participants were included. The prevalence of poor mental health (defined as GHQ-12 total score ≥ 4) was 9.31% [95% confidence interval (CI): 8.4–10.2%]. Multivariable logistic regression analyses found that female gender [P < 0.001, odds ratio (OR) = 1.63, 95% CI: 1.29–2.07], lower education level (P = 0.048, OR = 1.33, 95% CI: 1.00–1.75), lower annual household income (P = 0.005, OR = 1.72, 95% CI: 1.17–2.51), presence of major medical conditions (P < 0.001, OR = 2.95, 95% CI: 2.19–3.96) and family history of psychiatric disorders (P < 0.001, OR = 3.53, 95% CI: 2.02–6.17) were significantly associated with poor mental health.Conclusion: The prevalence of poor mental health among older adults in a predominantly agricultural area was lower than findings from many other countries and areas in China. However, continued surveillance of mental health status among older adults in China is still needed.

The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. In China, all schools were shut down and students were home quarantined to prevent disease spread; these steps could have potential negative effects on mental health of adolescents. This study aimed to examine changes in depression and anxiety among Chinese adolescents during the COVID-19 epidemic, and explore factors associated with depression and anxiety. Two survey administrations were conducted among Chinese adolescents between February 20 and February 27 and between April 11 and April 19, 2020, respectively. The Center for Epidemiological Studies-Depression Scale (CES-D) and the 7-item Generalized Anxiety Disorder (GAD-7) scale were used to assess depressive symptoms and anxiety symptoms, respectively. A total of 9554 and 3886 adolescents participated in the first and second surveys. During the initial survey, the prevalence of depression was 36.6% (95% CI: 35.6–37.6%) while the prevalence of anxiety was 19% (95% CI: 18.2–19.8%). Rates of depression and anxiety increased to 57.0% (95% CI: 55.4–58.6%) and 36.7% (95% CI: 35.2–38.2%), respectively, in the second survey. Multivariable logistic regression analyses revealed that group membership in the second survey, female gender, senior secondary school enrollment, and concerns about entering a higher grade were positively associated with both depression and anxiety. Conversely, a sleep duration of ≥6 h/day, an exercise duration ≥30 min/day, having the same as typical or higher study efficiency during the COVID-19 outbreak, and living in provinces with 1000–9999 confirmed COVID-19 cases were negatively associated with depression and anxiety. In conclusion, compared to figures reported during the COVID-19 outbreak, the prevalence of depression and anxiety in Chinese adolescents significantly increased after the initial outbreak. Regular screening and appropriate interventions are urgently needed to reduce the risk for emotional disturbances among adolescents during and after the initial COVID-19 outbreaks.

Background The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. Results A total of 1063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1–50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P = 0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR = 1.15, P P P Conclusions Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.

Background Painful physical symptoms (PPS) are common in patients with major depressive disorder (MDD), but their prevalence has been mixed. This is a systematic review and meta-analysis of the pooled prevalence of PPS in MDD patients. Methods Systematic literature searches were independently conducted in major databases (PubMed, EMBASE, PsycINFO and Web of Science). Data analyses were conducted using a random-effects model. Results A total of 20 studies with 53,852 patients were included. The overall prevalence of PPS in MDD patients was 55.2% (95%CI: 47.9–62.3%), with a point prevalence of 64.2% (95%CI: 53.2–73.8%) and a 12-month prevalence of 57.0% (95%CI: 23.9–84.8%). No significant publication bias was found in this meta-analysis. Conclusion PPS are common in MDD patients. Considering the negative impact of PPS on daily functioning, effective preventive measures and routine screening should be conducted for MDD patients, and timely treatments should be offered to those in need. Registration number: CRD42020179471.

This study examined the prevalence of burnout and its association with quality of life (QOL) among psychiatric nurses in China.Ten psychiatric hospitals were included. Burnout and QOL were measured using standardized instruments. Altogether, 1449 nurses completed the assessment. The mean scores of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) were 11.87 (SD = 6.72), 6.98 (SD = 5.71) and 22.06 (SD = 8.67), respectively. Of the participants, 59.8% (95% CI: 57-62%) experienced burnout; with 23.3% (95% CI: 21-25%) in EE, 14.6% (95% CI: 13-16%) in DP and 45.1% (95% CI: 43-48%) in PA. Psychiatric nurses who reported burnout had lower QOL in social (F ((1, 1448)) = 86.20, P

Resilience refers to the capacity to function well despite adversity and facilitates adaptation to various stressors, including pain. Previous studies have operationalized resilience via questionnaires or task performance behaviors that do not always correlate with one another and tested extreme (lower vs. higher) resilience subgroup differences that do not permit the assessment of nonlinear associations between resilience and brain matter volume. To address these limitations, we identified high (HPR, N = 21), moderate (MPR, N = 20), and low (LPR, N = 16) pain resilience subgroups from a trait resilience questionnaire as well as behavioral performance on a laboratory pain task. Subsequently, resilience subgroup differences in gray matter volume (GMV) and behavior responses to a novel numerical interference task (NIT) were assessed. Behavioral results indicated the LPR subgroup was slower in responding to NIT trials accompanied by pain compared to MPR, and especially, HPR subgroups. Voxel-based morphology analyses indicated the LPR subgroup had more GMV in the left postcentral gyrus than did MPR and HPR subgroups. LPR and MPR subgroups displayed larger GMV in the right inferior temporal gyrus than did the HPR subgroup. Nonlinear relations reflecting less regional GMV in the right inferior frontal gyrus (IFG)/putamen, orbitofrontal cortex and left IFG/insula were also observed for the MPR subgroup compared to LPR and HPR subgroups. In sum, lower pain resilience is characterized, in part, by comparatively greater GMV in pain processing regions and reduced GMV in "resilience" regions, though regional GMV also has several nonlinear associations with resilience.

The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). in the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (eta(2) = .02-.03). the results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. in addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being. (C) 2020 Elsevier Ltd. All rights reserved., Hungarian Scientific Research Fund (OTKA)Orszagos Tudomanyos Kutatasi Alapprogramok (OTKA) [K125437], Data collection in Hungary was supported by a Hungarian Scientific Research Fund (OTKA) awarded to the sixty-third author (K125437).

Numerous behavior studies have assessed links of pain-related fear with biases in attention towards pain stimuli but considerably less is known about neural processes underlying such biases. To address this gap, event-related potentials (ERPs) were examined as 39 high pain-fearful (Hi-FOP) and 36 low pain-fearful (Lo-FOP) adults (1) viewed non-painful versus painful images and (2) subsequently received non-painful versus possibly painful somatosensory stimulation, respectively. The Hi-FOP group judged both non-painful and painful somatosensory stimulation to be more intense than Lo-FOP group members did. Hi-FOP group members also displayed smaller N1 amplitudes than Lo-FOP group members did during image presentations, regardless of image type. Finally, Lo-FOP group members exhibited larger P3 amplitudes when processing potentially painful somatosensory stimulation compared to non-painful stimulation while no such difference was observed in Hi-FOP group members. Overall results suggested that the pain-fearful tended to exaggerate the subjective intensity of potentially painful somatosensory stimuli but allocated comparatively fewer cognitive resources to processing such stimulation; arguably, this pattern perpetuates high fear of pain levels.

Background Chronic pain post-surgical pain (CPSP) is common and has far-reaching negative consequences for patients, yet relatively few studies have evaluated the impact of both deficit- and resource-based beliefs about pain and surgery on subjective intensities of acute and chronic post-surgical pain. To address this issue a prospective cohort study was performed. Method 259 consecutive surgery patients from general surgery, gynecology, and thoracic departments completed a self-report battery of demographics, pain experiences, and psychological factors 24 h before surgery (T1) and provided follow-up pain intensity ratings 48 h–72 h after surgery (T2), and at a 4-month follow-up (T3). Results In the hierarchical regression model for acute post-operative pain intensity, pre-surgery pain self-efficacy beliefs made a significant unique contribution independent of all other pre-surgery and surgery-related factors (i.e., age, presence of pre-surgical pain, type of anesthesia, surgery duration). In the prediction model for intensity of chronic post-surgical pain, beliefs about long-term effects of surgery had a unique impact after controlling other significant pre-surgery and surgery influences (gender, education, surgery time). Conclusion Results underscored the potential utility of considering specific pre-surgery pain- and surgery-related beliefs as factors that predict patient experiences of acute and chronic post-operative pain.

Background Threat is hypothesized to affect the degree to which pain captures attention but little is known about its impact on dynamic courses of attention towards pain. In this eye-tracking study, we evaluated pain-related visual attention biases during image pair presentations in comparatively lower versus higher threat conditions. Methods Gaze biases of healthy adults (47 women, 35 men) were assessed during image presentation phases standardized across (1) a modified visual dot-probe task featuring painful-neutral (pain) and neutral-neutral contrast (neutral) image pair blocks (lower threat context); and (2) an impending pain task wherein the same image pair blocks, respectively, cued potentially painful postoffset somatosensory stimuli (higher threat context) and its absence. Results Across tasks, participants were more often oriented towards, gazed longer at, and fixated more times on pain images in pain block trials, although trait fear of pain was not related to any gaze biases. Critically, however, participants reported more state fear and displayed significantly fewer initial fixations, longer first and overall gaze durations, and more unique fixations on pain images when image pairs signalled possible postoffset pain stimulation. Conclusions Results underscored stronger overall attention maintenance on visual pain cues in a higher threat (impending pain) context. Significance Through considering gaze parameters during image presentation phases of dot-probe and impending pain tasks, possible effects of lower versus higher threat contexts on attention biases were elucidated. Participants reported more fear and gazed longer at painful than neutral images in the higher threat context whereby image pairs cued possible pain.

Background Clinical depression (including major depression, dysthymia, and unspecified depression) is common in children and adolescents with obesity and overweight. The objective of this systematic review and meta-analysis was to examine prevalence of clinical depression among overweight and obese children. Methods PubMed, EMBASE, Web of Science, Medline, Cochrane library, and PsycINFO databases were systematically and independently searched by three researchers from the inception dates to April 01, 2019. The fixed-effects model was used to perform meta-analysis. Data analyses were performed with STATA Version 12.0. Results Eleven studies with 69,893 subjects were included; 5 studies examined major depressive disorder (MDD), while the remaining 6 studies examined other types of clinical depression. In the overweight and obese group, the prevalence of clinical depression ranged from 1.7% to 26.7% in obese subjects and from 4.0% to 16.9% in overweight subjects. In studies on MDD, prevalence ranged from 10.1% to 26.7% in obese subjects and from 9.0% to 16.9% in overweight subjects. The odd ratios (ORs) of clinical depression ranged from 0.92 to 4.39 between obese subjects and healthy controls (i.e., normal-weight controls), and ranged from 0.96 to 1.67 between overweight subjects and controls. Compared to healthy controls, obese (OR = 1.851, 95% CI: 1.410–2.429) but not overweight (OR = 1.068, 95% CI: 0.889–1.283) children and adolescents were more likely to have MDD. Conclusion Obese children and adolescents had a significantly higher risk for MDD compared with healthy controls. Considering the negative health outcomes of depression, regular screening and effective treatments should be implemented for obese children and adolescents.

Introduction Comorbid depressive symptoms (depression thereafter) often occur in schizophrenia and are associated with negative outcomes. This meta-analysis estimated the prevalence of comorbid depression and its associated factors in schizophrenia. Methods Both international (PubMed, EMBASE, PsycINFO, and Web of Science) and Chinese (WANFANG and CNKI) databases were systematically searched. Studies with data on the prevalence of comorbid depression in schizophrenia measured with the Calgary Depression Scale for Schizophrenia (CDSS) were included. Random-effects models were used in all analyses. Results Fifty-three studies covering 9,879 patients were included. The pooled prevalence of comorbid depression was 28.6% (95%CI: 25.3%-32.2%). Subgroup analyses revealed that studies examining inpatients, being published in Chinese language, or those with lower CDSS cut-od values reported higher depression rates. Meta-regression analyses indicated that the rate of depression was positively associated with publication year, proportion of males, mean age, and severity of psychotic symptoms, and negatively associated with illness duration and study quality. Conclusion Comorbid depression is common in schizophrenia. Due to its negative impact on patients’ quality of life and prognosis, regular screening and effective treatment for comorbid depression should be implemented in patients with schizophrenia.

Biases in the way that people direct their attention towards or away from pain-related information are hypothesised to contribute to the onset and severity of pain-related disorders. This systematic review summarised 24 eye-tracking studies (N = 1424) examining effects of chronic pain, stimulus valence, individual differences in pain-related constructs such as fear of pain and pain catastrophising, and experimentally-induced pain or pain-related threat on attentional processing of visual stimuli. The majority of studies suggest that people with and without chronic pain do not differ in their eye movements on pain-related stimuli, although there is preliminary evidence that gaze biases vary across subtypes of chronic pain and may be evident only for certain stimuli. In contrast, participants with and without chronic pain exhibit a general tendency to allocate more first fixations and total fixations upon pain-related compared to neutral stimuli. Fear of pain was found to have limited effects on eye movements, whereas the tendency to catastrophise about pain, the anticipation of pain, and actual experimental pain stimulation have had stronger associations with eye movements, although results have been mixed. Methodological limitations and future research directions are discussed. ispartof: Clinical Psychology Review vol:80 pages:1-20 ispartof: location:United States status: published

In previous studies that examined the impact of attention biases (ABs) on later pain outcomes, reaction times (RTs) in response to brief stimulus presentations had been used as measures of attention. Consequently, little is known about effects of ABs assessed during presentations of cues or biases in prolonged attention towards pain stimuli as influences on subsequent functioning. To address these gaps, 89 adults with chronic pain (68 women, 21 men) engaged in a baseline dot-probe task in which visual attention was tracked during injury-neutral (I-N) image pair presentations as well as a 6-month follow-up reassessing pain intensity and interference from pain. Neither RTs to probes after image pair offsets nor biases in initial orienting of gaze towards injury images predicted follow-up outcomes. However, participants who gazed at injury images for longer durations during I-N trials reported significantly more pain and interference at follow-up than did peers who gazed at injury images for less time, even after the impact of other significant baseline predictors had been controlled. In sum, results provided initial evidence for gaze biases reflecting prolonged vigilance towards pain-related information as a potential risk factor for relative elevations in pain and interference from chronic pain.

According to the hedonic-inhibitory model, overeating occurs when active inhibitory capacities mediated by the prefrontal areas are overridden by hedonic-eating motivation mediated by the mesolimbic reward system. The inferior frontal gyrus (IFG) has a crucial role in inhibiting hedonic-cues response yet transcranial direct current stimulation (tDCS) studies have emphasized the dorsolateral prefrontal cortex (DLPFC), to the neglect of other executive network regions including the IFG. Therefore, we investigated modulating effects of single session tDCS over the right IFG on behavior response inhibition to external food cues and subjective food cravings among highly disinhibited restrained eaters (REs), a group susceptible to overeating and overweight. Within a randomized blinded between-groups design; participants (N = 57) received a single session of real or sham tDCS over the right IFG. Compared to peers in the sham condition, those who received tDCS stimulation showed higher levels of response inhibition toward external food cues on a post-intervention stop-signal task. Conversely, stimulation had no effects on subjective food cravings. Overall, results suggested tDCS targeting the right IFG has potential utility in treating disinhibited REs. However, because effects were isolated to increasing response inhibition to external food cues, follow-ups are needed to evaluate whether multi-session tDCS targeting this area has effects that extend to subjective food cravings.

Despite dramatic increases in cosmetic surgery in China during the past two decades, little is known about factors that predict individual differences in willingness to consider cosmetic surgery among young Chinese women and men. To address this issue, 379 undergraduate women and 204 undergraduate men from Chongqing, Southwest China completed a self-report battery assessing demographics, facets of objectified body consciousness (body surveillance, body shame), tripartite influence model features (i.e., appearance pressure from mass media and close interpersonal networks, appearance social comparisons, body dissatisfaction), specific culturally-salient sources of appearance dissatisfaction (facial appearance, fatness, stature) and cosmetic surgery consideration. In line with previous research, correlation analyses indicated cosmetic surgery consideration among women, and especially, among men, was related to body surveillance, body shame, most tripartite influence model features, and concerns with facial appearance. In final multiple regression models for each gender, body surveillance and facial appearance concerns emerged as the strongest unique predictors of cosmetic surgery consideration. Findings highlighted how features of objectified body consciousness and tripartite influence model as well as specific culturally-salient appearance concerns, rather than general body dissatisfaction, may help to account for variability in willingness to consider cosmetic surgery within samples of young Chinese women and men.

Theory and prospective studies have linked restrained eating (RE) to risk for future weight gain and the onset of obesity, but little is known about resting state neural activity that may underlie this association. To address this gap, resting fMRI was used to test the extent to which spontaneous neural activity in regions associated with inhibitory control and food reward account for potential relations between baseline RE levels and changes in body weight among dieters over a one-year interval. Spontaneous regional activity patterns corresponding to RE were assessed among 50 young women using regional homogeneity (ReHo) analysis, which measured temporal synchronization of spontaneous fluctuations within a food deprivation condition. Analyses indicated higher baseline RE scores predicted more weight gain at a one-year follow-up. Furthermore, food-deprived dieting women with high dietary restraint scores exhibited more spontaneous local activity in brain regions associated with the expectation and valuation for food reward [i.e., orbitofrontal cortex (OFC)/ventromedial prefrontal cortex (VMPFC)] and reduced spontaneous local activity in inhibitory control regions [i.e., bilateral dorsal-lateral prefrontal cortex (DLPFC)] at baseline. Notably, the association between baseline RE and follow-up weight gain was mediated by decreased local synchronization of the right DLPFC in particular and, to a lesser degree, increased local synchronization of the right VMPFC. In conjunction with previous research, these findings highlight possible neural mechanisms underlying the relation between RE and risk for weight gain.

Objective Acute postsurgical pain is common and has potentially negative long-term consequences for patients. In this study, we evaluated effects of presurgery sociodemographics, pain experiences, psychological influences, and surgery-related variables on acute postsurgical pain using logistic regression vs classification tree analysis (CTA). Design The study design was prospective. Setting This study was carried out at Chongqing No. 9 hospital, Chongqing, China. Subjects Patients (175 women, 84 men) completed a self-report battery 24 hours before surgery (T1) and pain intensity ratings 48-72 hours after surgery (T2). Results An initial logistic regression analysis identified pain self-efficacy as the only presurgery predictor of postoperative pain intensity. Subsequently, a classification tree analysis (CTA) indicated that lower vs higher acute postoperative pain intensity levels were predicted not only by pain self-efficacy but also by its interaction with disease onset, pain catastrophizing, and body mass index. CTA results were replicated within a revised logistic regression model. Conclusions Together, these findings underscored the potential utility of CTA as a means of identifying patient subgroups with higher and lower risk for severe acute postoperative pain based on interacting characteristics.

Objective and Methods: To investigate the neural correlates of earthquake-related stimuli among earthquake-exposed survivors, 13 earthquake-exposed undergraduates without posttraumatic stress disorder (PTSD) and 13 matched controls completed a study-test task during which event-related potentials were recorded synchronously. Results: The earthquake-exposed group exhibited stronger P2, P300 and late positive component amplitudes to earthquake-related stimuli compared with the control group on the anterior scalp during recognition memory processing. In addition, earthquake-related stimuli elicited enhanced positivity compared with neutral stimuli in the earthquake-exposed group. Conclusion: The results indicate that earthquake-exposed subjects demonstrate recognition memory bias toward threatening stimuli. Even though both groups showed no PTSD symptoms, potential threat cues or stimuli associated with a traumatic event may trigger traumatic memories in this group.

In this research, we examined effects of higher versus lower threat contexts on attention biases in more and less pain-fearful chronic pain subgroups via eye-tracking methodology. Within a mixed chronic pain sample (69 women, 29 men), biases in orienting and maintenance of visual attention were assessed during the standardized image pair presentation phase (2,000 ms) of a modified visual dot probe task featuring painful-neutral (P-N) image pairs (lower threat context) and a parallel task in which these P-N pairs cued potential pain (higher threat context). Across both tasks, participants more often oriented toward, gazed longer at, and made more unique fixations upon pain images during P-N pair presentations. Although trait-based fear of pain was not related to any gaze bias index in either task, between task analyses indicated the sample reported more state fear, directed their initial gaze less often, and displayed longer overall gaze durations toward pain images in the higher threat context in which P-N trials signaled potential pain. Results supported the threat interpretation model premise that persons with chronic pain have difficulty disengaging from moderately threatening visual painful cues. Perspective Through integrating dot-probe and impending pain task paradigms, we assessed effects of lower versus higher threat contexts on visual attention biases of persons with chronic pain via eye tracking. Under higher threat conditions featuring possible pain, state fear levels were elevated and maintenance of attention on painful depictions was more prolonged.

INTRODUCTION Assisting polypharmacy patients with complex health regimens is a part of health provider responsibilities. The concepts of adherence and concordance contrast the traditional emphasis on patient compliance. However, health provider students may not be able to empathize with polypharmacy patients. The purpose of this study was to measure the effect of a medication simulation on medical, nursing, and pharmacy students' beliefs about adherence and concordance. METHODS A prospective, quasi-experimental, pretest, and posttest design was used with institutional review board approval. The participants (N = 62) took four simulated medications (varied dosing schedules) for 1 week. Attitudes toward adherence and concordance were assessed before and after the intervention. RESULTS Subjects averaged 24.6 years (SD = 4.32), 72.6% female, and 79% white. Most were medical students (n = 33, 53%), followed by nursing (n = 21, 34%) and pharmacy students (n = 8, 13%). There were significant changes [t(61) = 3.92, P < 0.001] in beliefs about adherence from time 1 (mean = 25.13, SD = 5.77) to time 2 (mean = 22.05, SD = 6.06), and about concordance (mean = 41.85, SD = 5.58 time 1) to (mean = 44.29, SD = 6.32 time 2) [t(61) = 3.31, P < 0.05], for the entire group. Most students (84%) predicted that they would be able to take four medications correctly for 1 week. Fifty-eight students (94%) found that adherence was 'much harder' or 'a little harder' than anticipated. Most (89%) felt that the simulation will impact their patient care. CONCLUSIONS Participation in a medication simulation exercise affected health provider students' attitudes toward adherence and concordant behaviors. These experiences may influence future patient interactions.

Objective: Numerous studies have documented rates of chronicpain in developed western nations; however, little is known about itsprevalence or correlates in rapidly developing countries, where muchof the world’s population lives. This study was designed to assess theprevalence of chronic pain among adults in Chongqing, China andthe correlates of chronicity among respondents with pain and degreeof impairment within the subgroup reporting chronic pain.Design: A structured telephone interview was used within a cross-sectional design. Chronic pain was defined as the pain that hadpersisted for Z3 months.Participants: Adults from a random sample of 1003 Chongqinghouseholds completed a structured telephone interview on pain expe-riences of themselves and other family members over the past 6 months.Results: Overall, 42.2% of interviewees reported pain for at least 1day during the past 6 months and 25.8% experienced pain lasting forat least 3 months. The most common complaints were back pain(17.6%), headache (14.2%), joint pain, (10.5%), and abdominal pain(10.4%). Among those who reported pain, correlates of a chronicduration included older age, presence of back pain, heightenedimpairment, use of Chinese medicine, and greater numer of inter-ventions usedfor pain management. For interviewees whose pain waschronic, increased functional impairment was related to older age,presence of pain every day, and increased likelihood of consultingphysicians and using Chinese medicine to manage pain.Conclusions: Rates of chronic pain in Chongqing appear toapproximate to those reported in western countries. A significantminority of those affected report substantial or severe impairmentand are more likely than less impaired cohorts to have soughtmedical interventions to manage pain.Key Words: chronic pain, prevalence, China, random populationstudy, telephone survey

Neuroimaging studies have documented differences in neural responses to food cues in obese versus lean samples but little is known about weight status differences in responsiveness to other key features of obesogenic environments, particularly cues reflecting physical activity. To address this gap, patterns of activation related to visual depictions of sedentary activities and vigorous physical exercise were assessed in overweight (O-W) and average weight (A-W) samples via functional magnetic resonance imaging (fMRI). Thirteen O-W and 13 A-W Chinese women were instructed to imagine engaging in 90 physical exercise activities and 90 sedentary activities and to watch 90 landscape images presented during three runs of an fMRI scan within a cross-sectional design. Behavioral results indicated O-W women endorsed more negative attitudes toward physical activity than A-W did. Imaging analyses indicated that body mass index had a significant negative association with activation of the right putamen and a positive correlation with activation in the right medial frontal gyrus, specifically Brodmann Area 10 in the exercise–sedentary image contrast condition. For the sedentary–control contrast, significantly less activation in an insula area related to negative affect was observed for the O-W group. Finally, for the exercise–control contrast, O-W women also displayed comparatively weaker activation in a cingulate gyrus area implicated in kinesthetic memory of body movements and the re-experiencing real events. Together, results supported contentions that exposure to depictions of physical exercise corresponds to reduced activation of reward centers and heightened activation in regions associated with negative affect regulation among O-W women compared with leaner peers.

Even though reliable eating disorder risk factors have been identified among adolescent girls, little is known about predictors of increased vulnerability within specific phases of adolescence or among adolescent boys, particularly in highly populated non-Western contexts. In this study, early and middle adolescent boys (n = 1,271) and girls (n = 1,415) from Chongqing, China completed validated measures of eating disorder pathology and putative risk factors at baseline and 2 years follow-up. Multivariate models for boys of each age group indicated increases in disordered eating at follow-up were predicted by higher initial body mass index, negative affect and body dissatisfaction levels as well as attendant increases in perceived appearance pressure from mass media, body dissatisfaction, negative affect between assessments. High baseline levels of reported appearance pressure from parents and dating partners contributed, respectively, to prediction models of younger and older boys. More distinct constellations of significant predictors emerged in multivariate models of early versus middle adolescent girls. Together, findings indicated body dissatisfaction and negative affect were fairly robust risk factors for exacerbations in disturbances across samples while risk factors such as perceived pressure from desired/prospective dating partners were salient only during particular phases of adolescence.

In this study, effects of chronic pain and pain-related fear on orienting and maintenance of attention toward pain stimuli were evaluated by tracking eye movements within a dot-probe paradigm. The sample comprised matched chronic pain (n = 24) and pain-free (n = 24) groups, each of which included lower and higher fear of pain subgroups. Participants completed a dot-probe task wherein eye movements were assessed during the presentation of sensory pain-neutral, health catastrophe-neutral, and neutral-neutral word pairs. Higher fear of pain levels were associated with biases in 1) directing initial gaze toward health catastrophe words and, among participants with chronic pain, 2) subsequent avoidance of threat as reflected by shorter first fixation durations on health catastrophe words compared to pain-free cohorts. As stimulus word pairs persisted for 2,000 ms, no group differences were observed for overall gaze durations or reaction times to probes that followed. In sum, this research identified specific biases in visual attention related to fear of pain and chronic pain during early stages of information processing that were not evident on the basis of later behavior responses to probes. Perspective: Effects of chronic pain and fear of pain on attention were examined by tracking eye movements within a dot-probe paradigm. Heightened fear of pain corresponded to biases in initial gaze toward health catastrophe words and, among participants with chronic pain, subsequent gaze shifts away from these words. No reaction time differences emerged.

Stressors can trigger binge-eating but researchers have yet to consider their effects on both neural responses to food cues and food consumption among those at risk. In this experiment, we examined the impact of acute stressors on neural activation to food images and subsequent food consumption within binge-eating disorder (BED) and non-eating disordered control groups. Eighteen women meeting DSM-IV BED criteria and 26 women serving as non-eating disordered controls were randomly assigned to unpleasant stressor (painful cold pressor test (CPT) followed by negative performance feedback) or less unpleasant stressor (non-painful sensory discrimination task followed by positive performance feedback) conditions. Subsequently, they were scanned with functional magnetic resonance imaging (fMRI) while viewing food and neutral images. After the scans, participants completed a self-report battery in an environment conducive to snacking. During exposure to food images, BED-symptomatic women in the unpleasant stressor condition reported more liking of high calorie food images and showed less activation in one inhibitory area, the hippocampus, compared to controls in this condition. BED-symptomatic women exposed to unpleasant stressors also consumed more chocolate than any other group during the post-scan questionnaire completion. Crucially, reduced hippocampal activation to high calorie food images predicted more chocolate consumption following fMRI scans within the entire sample. This experiment provides initial evidence suggesting unpleasant acute stressors contribute to reduced inhibitory region responsiveness in relation to external food cues and later food consumption among BED-symptomatic women.

Fear of pain (FOP) can increase risk for chronic pain and disability but little is known about corresponding neural responses in anticipation of potential pain. In this study, more (10 women, 6 men) and less (7 women, 6 men) pain-fearful groups underwent whole-brain functional magnetic resonance imaging (fMRI) during anticipation of near pain-threshold stimulation. Groups did not differ in the proportion of stimuli judged to be painful but pain-fearful participants reported significantly more state fear prior to stimulus exposure. Within the entire sample, stronger activation was found in several pain perception regions (e.g., bilateral insula, midcingulate cortex (MCC), thalamus, superior frontal gyrus) and visual areas linked to decoding stimulus valences (inferior orbital cortex) during anticipation of "painful" stimuli. Between groups and correlation analyses indicated pain-fearful participants experienced comparatively more activity in regions implicated in evaluating potential threats and processing negative emotions during anticipation (i.e., MCC, mid occipital cortex, superior temporal pole), though group differences were not apparent in most so-called "pain matrix" regions. In sum, trait- and task-based FOP is associated with enhanced responsiveness in regions involved in threat processing and negative affect during anticipation of potentially painful stimulation.

In this meta-analysis, we evaluated overall strengths of relation between beliefs about pain, health, or illness and problems in functioning (i.e., functional impairment, affective distress, pain severity) in osteoarthritis and rheumatoid arthritis samples as well as moderators of these associations. In sum, 111 samples (N = 17,365 patients) met inclusion criteria. On average, highly significant, medium effect sizes were observed for associations between beliefs and problems in functioning but heterogeneity was also inflated. Effect sizes were not affected by arthritis subtype, gender, or age. However, pain belief content emerged as a significant moderator, with larger effect sizes for studies in which personal incapacity or ineffectiveness in controlling pain was a content theme of belief indices (i.e., pain catastrophizing, helplessness, self-efficacy) compared to those examining locus of control and fear/threat/harm beliefs. Furthermore, analyses of longitudinal study subsets supported the status of pain beliefs risk factors for later problems in functioning in these groups.

This research examined selective biases in visual attention related to fear of pain by tracking eye movements (EM) toward pain-related stimuli among the pain-fearful. EM of 21 young adults scoring high on a fear of pain measure (H-FOP) and 20 lower-scoring (L-FOP) control participants were measured during a dot-probe task that featured sensory pain-neutral, health catastrophe-neutral and neutral-neutral word pairs. Analyses indicated that the H-FOP group was more likely to direct immediate visual attention toward sensory pain and health catastrophe words than was the L-FOP group. The H-FOP group also had comparatively shorter first fixation latencies toward sensory pain and health catastrophe words. Conversely, groups did not differ on EM indices of attentional maintenance (i.e., first fixation duration, gaze duration, and average fixation duration) or reaction times to dot probes. Finally, both groups showed a cycle of disengagement followed by re-engagement toward sensory pain words relative to other word types. In sum, this research is the first to reveal biases toward pain stimuli during very early stages of visual information processing among the highly pain-fearful and highlights the utility of EM tracking as a means to evaluate visual attention as a dynamic process in the context of FOP.

This study was designed to identify predictors of lower versus higher willingness to use pre-exposure prophylaxis (PrEP) to reduce HIV among men who have sex with men (MSM) in China. Participants were 570 MSM who completed self-report measures of willingness to use HIV PrEP, beliefs about HIV, psychosocial factors, sexual experiences and sociodemographic characteristics. Results of a hierarchical binary logistic regression analysis indicated that membership in a higher willingness group was predicted by previous consultation about HIV, more reported barriers to using condoms, and elevations in depressive symptoms. Independent of these factors, higher willingness to use HIV PrEP was predicted by beliefs that the intervention was low in stigma and high in potential benefits. In sum, the study highlighted the utility of broad-based assessment of demographic, behavioral, personality, and cognitive factors in identifying Chinese MSM who express willingness to use a promising biologically-based intervention to lower HIV risk.

This experiment investigated the impact of brief training in acceptance versus distraction-based pain management on experimental pain tolerance in conditions of lower and higher potential threats. One hundred fifty-one pain-free Chinese adults (93 women, 58 men) randomly assigned to acceptance, distraction or pain education control conditions engaged in a cold pressor test (CPT) after reading validated orienting information designed to prime either the safety of the CPT (lower threat) or symptoms and damaging effects of exposure to extreme cold (higher threat). A 2 (threat level) × 3 (training strategy) analysis of covariance, controlling for pre-intervention pain tolerance and education, indicated the acceptance group was more pain tolerant than other training groups. This main effect was qualified by an interaction with threat level: in the lower threat condition, acceptance group participants were more pain tolerant than peers in the distraction or pain education groups while no training group differences were found in the higher threat condition. Supplementary analyses identified catastrophizing as a partial mediator of training group differences in pain tolerance. In summary, findings suggested acceptance-based coping is superior to distraction as a means of managing experimental pain, particularly when pain sensations are viewed as comparatively low in potential threat.

β‐Blockers are first‐line therapy for treatment of heart failure, and for prevention of decline in LV systolic function in post-MI patients. Considerable variability exists in efficacy & tolerability of β‐blockers in HF patients, which may be associated with the genotype of drug-metabolizing enzymes and/or drug targets. Cytochrome P450 2D6 (CYP2D6) is a member of the CYP450 mixed-function oxidase system, which constitutes many important phase I drug metabolizing enzymes and contributes to the metabolism of up to 25% of clinically used drugs. Most genetic polymorphisms to the CYP2D6 gene result in either absent or decreased function of the enzyme activity. Four metabolizer phenotypes are typically used to characterize drug metabolism via CYP2D6: ultra-rapid metabolizer (UM); extensive metabolizer (EM); intermediate metabolizer (IM); and poor metabolizer (PM) phenotypes. Of the 3 β-blockers used for LV systolic dysfunction, CYP2D6 is the predominant metabolizing enzyme of both carvedilol and metoprolol; In contrast, Bisoprolol has a relatively constant β-adrenergic inhibition independent of CYP2D6 genotype. Aims Determine the prevalence of specific genetic CYP2D6 polymorphisms in patients admitted for Acute Coronary Syndromes with systolic dysfunction, and correlate with dose/tolerability or uptitration of metoprolol or carvedilol (BB) treatment. Methods Patients admitted with NSTEMI, ACS or ADHF, with elevated biomarkers had LVEF assessed during index admission. From 10/16/2013 to 07/17/2017, we followed 304 patients admitted for ACS with LVSD in a dedicated ‘post-MI Clinic’ having demonstrated echocardiographic evidence of reduced LVEF ( Results Beta blocker dosage was divided into high (CTD, >150mg daily Metoprolol; >50mg daily Carvedilol; >5mg daily Bisoprolol) or low dose. Within the ultra-rapid / extensive metabolizer (UM/EM) group, 78 patients (41%) were taking high dose BB at 1st visit (35), or successfully uptitrated (43) to high dose in clinic, compared to 9.5% of the (115) patients expressing intermediate metabolizer and poor metabolizer (IM/PM) phenotypes. Within the UM/EM group 36 patients (19%) presented to initial visit on CTD Bisoprolol, with a further 44 (23%) successfully transitioned from low dose BB to CTD Bisoprolol (compared to 12%, and 43%, respectively within the IM/PM group). Conclusion CYP2D6 polymorphisms in patients admitted with ACS and LV systolic dysfunction correlated with tolerability / uptitration of metoprolol and carvedilol, and may be of clinical use in prospectively determining β‐Blocker choice.

This 18-month prospective study investigated factors that contributed to changes in eating disorder symptoms among adolescents living in the People's Republic of China. Five hundred forty-one Chinese middle school and high school students (182 boys, 359 girls) completed measures of eating disorder symptoms; body dissatisfaction; appearance ideal endorsements; negative affect; and appearance-based social pressure, teasing, and comparison. For girls, baseline levels of negative affect, preference for a thin appearance ideal, and fatness concern made unique contributions to reported eating disturbances at the 18-month follow-up. For boys, baseline body mass index and fatness concerns were the only significant univariate predictors of changes in eating pathology.

Background Numerous studies have found appraisals of pain as a source of potential threat or tissue damage influence pain perception and coping. Conversely, causal effects of challenge appraisals reflecting potential future benefits of bearing pain have received little attention. This experiment was designed to elucidate effects of appraising laboratory pain as a source of potential threat and challenge on pain perception and coping. Methods Before engaging in a cold pressor test (CPT), young adult women (N = 112) and men (N = 49) were randomly assigned to one of three conditions: a higher threat group in which participants read an orienting passage describing symptoms and consequences of frostbite (pain as a signal for nociception), a lower threat group in which participants read about CPT safety (pain independent of nociception) or a challenge appraisal group in which participants read a passage describing how persistence in the face of discomfort predicts future life success and satisfaction. Results The higher threat group had lower pain tolerance and catastrophized more during the task than lower threat and challenge appraisal groups. Conversely, the challenge appraisal group reported using more cognitive strategies (ignoring, diverting attention, coping self-statements) in managing pain than either threat group. Structural equation modelling indicated paths of subjective threat and challenge appraisals with pain tolerance were fully mediated by individual differences in reported cognitive coping and/or pain catastrophizing. Conclusions Findings underscore causal effects of pain appraisals on coping responses and pain perception. What does this study add? Effects of challenge appraisals of pain as a source of potential future growth or development have not been considered in experimental pain research. Causal effects of primary appraisals of laboratory pain as a source of potential threat and challenge were elucidated in relation to pain perception and coping.

This study assessed the extent to which the mere presence of over-the-counter analgesics affected the perception of experimentally-induced pain in healthy adult samples. In Study 1, 68 college undergraduates participating in a cold pressor test (CPT) were randomly assigned to stimulus displays featuring either pain medication cues (i.e. bottles of aspirin and Tylenol) or cues with no obvious relation to pain (i.e. small elephant statue, soda can) and provided ratings of pain severity every 30 seconds for up to four minutes. Contrary to expectations, participants exposed to pain medication cues reported a significantly lower average rating of pain intensity after 30 seconds of exposure to ice water compared to those exposed to pain-irrelevant cues. This effect was relatively short term, as there were no differences between the two conditions on subsequent ratings of pain intensity or overall pain tolerance. These findings were replicated in a second sample ( n = 48) with slightly altered stimulus displays....

This research assessed event-related potentials (ERPs) elicited during the processing of different kinds of visual stimuli among children with Autism Spectrum Disorder (ASD) (n = 15) and typically developing (TD) children (n = 19). Within a simple visual oddball paradigm, participating children passively viewed fruit and vegetable images that were used as standard stimuli in addition to images of these foods with their usual colors modified to create novel stimuli and cartoon depictions of these images (i.e., “deviant” stimuli). Analyses revealed significant main effect differences between the groups for P100, N100 and P300 components; ASD group children showing longer P100 latencies, weaker N100 amplitudes and larger P300 amplitudes than did the TD group. A Group x Hemisphere interaction also emerged for N400 amplitudes but differences were not significant in simple-effects analyses. Together these results suggested children with ASD may be characterized by lower attention resource allocation and engagement during early stages of processing visual stimuli. However, ERPs in later processing stages suggested children with ASD and TD children have similar neural responses in attending to visual images as stimulus presentations continue.

Help seeking (HS) is a core coping strategy that is directed towards obtaining support, advice, or assistance as means of managing stress. Women have been found to use more HS than men. Neural correlates of sex differences have also been reported in prefrontal-limbic system (PLS) regions that are linked to stress and coping, yet structural differences between men and women relating to HS in the PLS are still unknown. Thus, the association between gray matter volume (GMV) and HS was investigated using voxel-based morphometry (VBM) in a large healthy sample (126 men and 156 women). Results indicated women reported more HS than men did. VBM results showed that the relation between HS scores and GMV differed between men and women in regions of the bilateral orbitofrontal cortex extending to the subgenual anterior cingulate cortex(OFC/sgACC). Among women, higher HS scores were associated with smaller GMV in these areas while a positive correlation between GMV and HS scores was observed among men. These results remained significant after controlling for general intelligence, stress, anxiety and depression. Thus, this study suggested that structural differences between men and women are correlated to characteristic brain regions known to be involved in the PLS which is considered critical in stress regulation.

The present study evaluated the extent to which eating-disordered and nonclinical comparison samples could be differentiated on self-reported personality measures of autonomy and sociotropy and a projective measure of dependency. Sixty-two women meeting diagnostic criteria for eating disorder and a nonpsychiatric comparison group of 62 women completed the autonomy and sociotropy subscales of the Personal Style Inventory—II and the Rorschach Oral Dependency Scale (ROD). A discriminant classification analysis indicated 85.5% of eating-disordered subjects and 88.7% of control subjects were identified accurately from their scores on autonomy, sociotropy, and ROD. Results suggest that the experience of eating disorders is associated with a mixed clinical presentation characterized by issues related to sociotropy–dependency, and especially, achievement-related vulnerabilities. Potentially fruitful areas for future study include assessing the utility of autonomy and sociotropy as predictors of eating disturbances in prospective research and evaluating their utility in predicting treatment prognosis among patients with eating disorders. © 2000 John Wiley & Sons, Inc. J Clin Psychol 56: 699–710, 2000.

This study examined how illness schemata—ways people organize information about illness—change over the course of cognitive-behavioral treatment of chronic headache and the extent to which such changes predict reduction of headache. 73 subjects with chronic migraine, mixed migraine and tension, or tension headache were classified on the basis of outcome from imagery-based treatment as Treatment-responders ( n = 24), Treatment-nonresponders ( n = 27), and Monitoring Controls ( n = 22). Self-reported illness schemata related to the seriousness and changeability of headache were assessed at pretreatment and 8-wk. follow-up. While groups did not differ on pretreatment measures of illness schemata, at follow-up the Treatment-responder group reported higher Changeability scores than Treatment-nonresponders and Control subjects and lower Seriousness scores than Control subjects. Headache reduction at follow-up was related to follow-up Changeability scores, in-session changes in systolic blood pressure and reported posttreatment expectations of headache activity, but not pretreatment measures of illness schemata. Findings indicate that improvements in headache activity are not influenced by the severity of headaches and may change prior to cognitive-behavioral treatment. Rather, among individuals who show decreases in headache activity, changes in beliefs about illness and headache reduction may have reciprocal relations both of which result from cognitive-behavioral treatment.