Randomized single-blind multicenter trial comparing the effects of standard and augmented acupuncture protocols on sleep quality and depressive symptoms in patients with depression

The study was aimed to compare the effects of standard and augmented acupuncture on depressive symptoms and sleep disturbances in patients with depression. This is a randomized, single-blind, multicenter trial. 140 subjects with clinical insomnia (score of ≥ 7 on the Pittsburgh Sleep Quality Index (PSQI)) were randomized to the standard (LI4, LIV3, EX-HN3, and GV20) or augmented (LI4, LIV3, EX-HN3, GV20, LU7, and KID6, including intradermal needles for sustained treatment) acupuncture groups. Participants received two sessions weekly for six weeks. In trial, The primary outcomes were improvements in PSQI and the Hamilton Rating Scale (HAMD). Secondary outcomes were treatment credibility and adverse events. Outcomes were assessed at baseline, week 3, end of treatment, and 4-week follow-up. From the 105 randomized patients, 89 completed the trial and were included in the final analyses. Better efficacy was observed in the augmented group compared with the standard acupuncture to improve the PSQI and HAMD at week 3, end of treatment, and 4-week follow-up (all p < .05). The HAMD scores improved with time, except between end of treatment and 4-week follow-up, while in the standard group, HAMD scored improved from baseline to week 3, and stopped improving thereafter. The PSQI scores improved with time in the two groups, except between end of treatment and 4-week follow-up. Compared with the standard protocol, the augmented acupuncture protocol had a better efficacy to treat depression and to improve sleep quality of patients with depression.     

Effect sizes and cut-off points: a meta-analytical review of burnout in latin American countries

Burnout is a highly prevalent globalized health issue that causes significant physical and psychological health problems. In Latin America research on this topic has increased in recent years, however there are no studies comparing results across countries, nor normative reference cut-offs. The present meta-analysis examines the intensity of burnout (emotional exhaustion, cynicism and personal accomplishment) in 58 adult nonclinical samples from 8 countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru and Venezuela). We found low intensity of burnout but there are significant differences between countries in emotional exhaustion explained by occupation and language. Social and human service professionals (police officers, social workers, public administration staff) are more exhausted than health professionals (physicians, nurses) or teachers. The samples with Portuguese language score higher in emotional exhaustion than Spanish, supporting the theory of cultural relativism. Demographics (sex, age) and study variables (sample size, instrument), were not found significant to predict burnout. The effect size and confidence intervals found are proposed as a useful baseline for research and medical diagnosis of burnout in Latin American countries.     

The Loss of Loss Aversion: Paying Attention to Reference Points

We agree with Gal and Rucker ( 2018 , in press) that loss aversion is not as firmly established as typically assumed. We affirm, however, the more general principle put forward within Prospect Theory (D. Kahneman & A. Tversky, 1979), which is that reference points increase people's sensitivity to objective changes in value. We show how the literatures on counterfactual thought, social comparison, and goal pursuit are consistent with the notion that reference points increase sensitivity to change in value, while not being consistent with loss aversion. We then examine, within the framework of Regulatory Focus theory (E. T. Higgins, 1997, 1998), how different reference points combine with characteristics of the actor and the situation to give rise to loss aversion (more sensitivity to negative outcomes than to positive outcomes) as well as to the reverse pattern (more sensitivity to positive outcomes than to negative outcomes). Our review suggests that the status quo, even when used as a reference point, is not necessarily neutral. It also suggests that anchor points other than the status quo may serve as reference points and that people may use more than one reference point simultaneously. More generally, we call for a critical examination of the “bad is stronger than good” principle.     

Keeping the end in mind: Preliminary brain and behavioral evidence for broad attention to endpoints in pre-linguistic infants

Infants must learn to carve events at their joints to best understand who is doing what to whom or whether an object or agent has reached its intended goal. Recent behavioral research demonstrates that infants do not see the world as a movie devoid of meaning, but rather as a series of sub-events that include agents moving in different manners along paths from sources to goals. This research uses behavioral and electrophysiological methods to investigate infants’ (10–14 months) attention to disruptions within relatively unfamiliar human action that does not rely on goal-objects to signal attainment (i.e., Olympic figure skating). Infants’ visual (Study 1, N = 48) and neurophysiological (Study 2, N = 21) responses to pauses at starting points, endpoints, and within-action locations were recorded. Both measures revealed differential responses to pauses at endpoints relative to pauses elsewhere in the action (i.e., starting point; within-action). Eye-tracking data indicated that infants’ visual attention was greater for events containing pauses at endpoints relative to events with pauses at starting points or within-actions. ERP activity reflecting perceptual processes in early-latency windows (<200 ms) and memory updating processes in long-latency windows (700−1000 ms) showed differential activation to disruptions at the end of a figure-skating action compared to other locations. Mid-latency windows (250−750 ms), in contrast, showed enhanced activation at frontal regions across conditions, suggesting electrophysiological resources may have been recruited to encode disruptions within unfamiliar dynamic human action. Combined, results hint at broad sensitivity to endpoints as a mechanism that supports infants’ proclivity for carving continuous and complex event streams into meaningful units. Findings have potential implications for language development as these units are mapped onto budding linguistic representations. We discuss empirical and methodological contributions for action perception and address potential merits and pitfalls of applying behavioral techniques in conjunction with brain-based measures to study infant development.     

The discovery and comparison of symbolic magnitudes

Humans and other primates are able to make relative magnitude comparisons, both with perceptual stimuli and with symbolic inputs that convey magnitude information. Although numerous models of magnitude comparison have been proposed, the basic question of how symbolic magnitudes (e.g., size or intelligence of animals) are derived and represented in memory has received little attention. We argue that symbolic magnitudes often will not correspond directly to elementary features of individual concepts. Rather, magnitudes may be formed in working memory based on computations over more basic features stored in long-term memory. We present a model of how magnitudes can be acquired and compared based on BARTlet, a representationally simpler version of Bayesian Analogy with Relational Transformations (BART; Lu, Chen, & Holyoak, 2012). BARTlet operates on distributions of magnitude variables created by applying dimension-specific weights (learned with the aid of empirical priors derived from pre-categorical comparisons) to more primitive features of objects. The resulting magnitude distributions, formed and maintained in working memory, are sensitive to contextual influences such as the range of stimuli and polarity of the question. By incorporating psychological reference points that control the precision of magnitudes in working memory and applying the tools of signal detection theory, BARTlet is able to account for a wide range of empirical phenomena involving magnitude comparisons, including the symbolic distance effect and the semantic congruity effect. We discuss the role of reference points in cognitive and social decision-making, and implications for the evolution of relational representations.     

Mental health – a normal state?

ABSTRACT

How can we conceptualize mental health; what is the relation between mental health and normality; and what has psychoanalysis to say about these questions? After a short resume of the views concerning normality and melancholia in the last centuries, the author turns to Freud and Bion. For Freud, mental health at best seems to be a relatively mild neurotic state, and perfect mental health is an unattainable ideal. Bion underlines the dynamic nature of the concept; mental health comprehended as a process. Problems connected to the individual’s subjective view of his or her mental health are considered, and some consequences that the questions under discussion have for psychoanalytic treatment are discussed. The author concludes with a reflection on the complex relation between mental health and normality.