Depressive symptoms in outpatients with heart failure: Importance of inflammatory biomarkers,disease severity and personality

Objective: Depressive symptoms are highly prevalent in heart failure (HF) patients, however the underlying etiology of depression in HF patients remains yet unclear. Hence, the goal is to examine the relative importance of inflammation, disease severity and personality as predictors of depression in HF patients. Design: Depressive symptoms (Hospital Anxiety and Depression Scale, depression subscale) were assessed at baseline and one-year follow-up in 268 HF patients (75.6% men; mean age?=?66.7?±?8.7). Markers of inflammation (TNFα, sTNFr1, sTNFr2, IL-6 and IL-10), disease severity (e.g. New York Heart Association (NYHA) classification) and personality (Type D personality, loneliness) were assessed at baseline. Results: At baseline, NYHA class, body mass index, educational level, Type D personality and loneliness were significantly associated with depression. Higher NYHA class (B?=?2.25; SE?=?.83), higher educational level (B?=?1.41; SE?=?.48), Type D personality (B?=?2.56; SE?=?.60) and loneliness (B?=?.19; SE?=?.05) were also independently associated with higher depression levels at one-year follow-up (all p-values?<?.005). Inflammation, brain natriuretic peptide and left ventricular ejection fraction were not related to depression over time. Conclusions: Personality factors, but not inflammation, were independent concomitants of depressive symptoms in patients with HF. Gaining more insight into the etiology of depression in HF patients is important in order to identify potential targets for novel interventions.     

Emotional (Non-)Expression and Health: Data,Questions, and Challenges

The available evidence on the relationship between expression and non-expression of emotions (E/NE) and health is selectively and critically reviewed. It is concluded that research in this field still lacks conceptual lucidity with regard to the many existing E/NE concepts. Despite the fact that few studies adopted appropriate designs for examining causal relationships, some intriguing results have been reported showing promise for the future. These results involve prospective associations between E/NE and chronic disease, such as cardiovascular disease and HIV infection related outcomes. Future studies have to better discriminate between (i) various forms of E/NE, (ii) different (social) contexts of E/NE as well as different cognitive decision processes underlying E/NE, and (iii) individuals for whom different forms of E/NE may be adaptive. We recommend that besides (quasi)experimental studies on the potential mechanisms involved, more prospective studies are conducted in this field in order to allow for causal inferences.     

Cognitive development in absence epilepsy during long-term follow-up

Absence epilepsy (AE) has been associated with lower than average cognitive functioning, which are clinically relevant in some and may predispose to problems later in life. This study aimed to assess cognitive development during long-term follow-up in children with AE. Thirty-one children with AE, who had undergone two neuropsychological assessments between 2010 and 2017 were analyzed retrospectively. Cognitive measurements were 1.7 ± 0.95 years apart. The difference in neurocognitive test scores was assessed on a group level and on an individual level using reliable change methodology. Results show that sustained attention was lower at the first measurement compared to the normative mean. Sustained attention improved during follow-up and 7 out of 14 children showed improvement after correction for practice effects. Receptive vocabulary showed a decline over time, but did not differ from the normative mean. Significant lower mean group scores were present for performance IQ, perceptual organization, processing speed, simple reaction times, and visual motor integration, while being stable over time in the majority of children. Cognitive development was not associated with seizure freedom. Mild-to-severe academic underachievement was present in 65% and comorbidities that might affect learning in 38%. This study in children with AE showed improvement in sustained attention during long-term follow-up while other cognitive weaknesses persisted over time, regardless of seizure freedom.     

Hobbes's Account of Distributive Justice as Equity

This paper examines the rationale for and grounds and implications of Hobbes's redefinition of distributive justice as equity. I argue that this unprecedented reformulation served to ensure the justness of distributive laws. Hobbes acknowledges that the sovereign can distribute rights and goods iniquitously by failing to treat citizens as equals. However, he insists that improper allocations are not unjust, properly speaking – they do not `wrong' citizens. To support this claim, Hobbes puts forth the un-Aristotelian maxim that merit in distributive justice is due by grace alone. You deserve what the sovereign gives you: there is no desert prior to and independent of his allocation of rights. For Hobbes, distributive justice does not track but create merit. It follows that distributive laws cannot fail to give what is due (which would be unjust). This paper proceeds to analyze the nature of the limits equity sets to the apportionment of goods. I argue that these limits are moral and purely procedural: citizens cannot invoke equity to claim a fair share of the goods distributed. Thanks to Hobbes's redefinition of distributive justice, the justness of the sovereign's conduct, and hence his legal immunity, remains intact.     

Preferential processing of visual trauma-film reminders predicts subsequent intrusive memories

This study used an analogue design to test the hypothesis that preferential processing of visual trauma reminders in the aftermath of a stressful or traumatic event gives rise to subsequent intrusive memories. Shortly after the presentation of a stressful film fragment, participants (n=36) were asked to detect neutral targets (rotated buildings or nature scenes) in a single target rapid serial visual presentation (RSVP) paradigm. During half of the streams, the target was preceded by a distracter. The distracters consisted of visual images extracted from an earlier presented stressful film (e.g., persons and objects that figured in the film). The degree of interference by these film reminders predicted subsequent intrusions recorded in a one-week diary. The results provide evidence that a deficient ability to obtain attentional control over perceptual “trauma” reminders during goal-directed behaviour may set people at risk for persistent intrusive memories. Implications for research investigating attentional bias and intrusive memories in context of posttraumatic stress disorder (PTSD) are discussed.     

Why is working memory related to intelligence? Different contributions from storage and processing

Domain-specific contributions of working memory (WM), short-term memory (STM), and executive functioning (EF) to individual differences in intelligence were analysed using a latent variable approach. A sample of 345 participants completed a battery of 24 tests tapping the constructs of interests as comprehensively as possible. Visuospatial and verbal STM and WM tasks were administered along with three subcomponents of EF, namely inhibition, planning, and shifting. Intelligence was assessed by non-verbal/abstract/fluid intelligence (Gf) and verbal/crystallised intelligence (Gc) standardised tests. Structural equation modelling results show that EF is the main predictor of Gf, whereas verbal STM is the main predictor of Gc. Storage and processing providing different contributions to the prediction of Gf and Gc supports the view that both short-term storage and executive functioning account for the relationship between WM and intelligence. This main conclusion stresses the importance of acknowledging core cognitive constructs as being hierarchical systems with general and domain-specific mechanisms.     

Professional values and their development among trainees in psychoanalytic psychotherapy1

Forty-six psychotherapy students in three groups at one training institute for psychoanalytic psychotherapy in Sweden were asked to fill out a questionnaire about important influences on their professional development during their three-year training and afterwards. The questionnaire was distributed on three occasions during the training program and on one later occasion. Twenty-one students responded to the questionnaire on all four occasions. Working with patients in therapy, getting supervision, and participating in personal psychotherapy were viewed as the three most important influences on the students. The importance attributed to specialist literature and technical skills seemed to increase over time during the training, while the influences of experiences in personal life and personal qualities decreased. These changes in reported views were reversed in the initial years after graduation. Concerning assets, the students valued the ability to be containing and emphatic as the most important, but in their first years as licensed psychotherapists assigned more importance to the ability to create contact. The training program led to a change over time in a higher rating for the importance of technical and methodological attributes and less emphasis on personal characteristics and experiences. Most of the changes reported during training tended to be reversed afterwards.     

Type D Personality as a Prognostic Factor in Heart Disease: Assessment and Mediating Mechanisms

Type D personality, a synergy between negative affectivity and social inhibition, has established itself as a serious risk factor for morbidity and mortality in patients suffering from cardiovascular disease. In this review, we summarize studies on the validity of the assessment methods of Type D, emphasizing its role as an independent vulnerability factor in the progression of cardiovascular disease. We further present evidence on the physiological characteristics that accompany the 2 psychological traits negative affectivity and social inhibition and may mediate the relation between personality and prognosis in heart disease. Further research needs to determine the mechanisms by which Type D affects the course and outcome of cardiovascular disease as well as how Type D patients may benefit from psychosocial intervention.     

Early Childhood Assessments of Community Pediatric Professionals Predict Autism Spectrum and Attention Deficit Hyperactivity Problems

For clinically referred children with Autism Spectrum Disorder (ASD) or Attention Deficit/Hyperactivity Disorder (ADHD) several early indicators have been described. However, knowledge is lacking on early markers of less severe variants of ASD and ADHD from the general population. The aim of the present study is to identify early indicators of high risk groups for ASD and ADHD problems based on routine data from community pediatric services between infancy and age four. Data are from 1,816 participants who take part in Tracking Adolescents’ Individual Lives Survey (TRAILS), a longitudinal study. Information on early developmental factors was extracted from charts of routine Preventive Child Healthcare (PCH) visits. To assess ASD and ADHD problems, respectively, we used the Children’s Social Behavior Questionnaire (CSBQ) and the Child Behavior Checklist (CBCL), filled out by parents three times between the ages of 11 and 17. Note that these are parent ratings and not diagnostic instruments performed by trained clinicians. Male gender, low birth weight, low level of education of the mother, social, behavioral, language, psychomotor and eating problems significantly predicted ASD problems (odds ratios (OR) between 1.34 and 2.41). ADHD problems were also predicted by male gender and low level of education of the mother and by maternal smoking during pregnancy, good gross motor skills in first year, early attention and hyperactivity problems, and absence of parent-reported positive behavior (ORs between 1.36 and 1.74). Routine data on early childhood from PCH services are predictive for ASD and ADHD problems in adolescents in the general population. The PCH services are a useful setting to identify high risk groups, and to monitor them subsequently.