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The modeling of abnormal behavior in ‘normal’ subjects (often animals) has a long history in pharmacological research for the screening of novel drug compounds. Systematic criteria have been outlined in that literature to estimate the external validity of a model, that is to estimate how closely the model is linked to the disorder of interest. Experimental psychopathology (EPP) also uses behavioral models to study the psychological processes that underlie abnormal behavior. Although EPP researchers may occasionally feel uneasy about the validity of the model that they use, the issue has not received direct attention in this literature. Here, we review the criteria of validity as set out in pharmacology research (face, predictive and construct validity) and discuss their relevance for EPP research. Furthermore, we propose diagnostic validity as an additional criterion of external validity that is relevant to EPP research. We evaluate two models for the study of anxiety and depression, and show that they have good face, diagnostic and construct validity. However, EPP research generally lacks direct tests of predictive validity. We conclude that combined evaluations of predictive, diagnostic and construct validity provide a sound basis to infer the external validity of behavioral models in EPP research.

BackgroundImproving future thinking, such as characteristics of specificity, detail, and use of mental imagery, may be one means to reduce anhedonia, particularly in a Major Depressive Episode (MDE) in which future thinking is impaired. The current study aimed to test this using a validated program, Future Event Specificity Training (FEST).MethodsParticipants (N = 177; 80.8% women; M age = 43.7, SD = 11.8) with a current depressive episode with anhedonia and high symptom severity were randomized to FEST or no FEST. Future thinking, anhedonia-related variables, and other clinical outcomes were assessed at baseline, one- and three-month follow-up.ResultsRelative to the control group, FEST was associated with significantly improved future thinking characteristics, a reduced likelihood of anhedonia (35.1% vs. 61.1%, p = .015), improvements on other anhedonia-related variables such as anticipatory (d = 0.63, p = .004) and anticipated pleasure for future events (d = 0.77, p < .001), and desirable clinical outcomes such as less people meeting criteria for an MDE (37.8% vs. 64.8%, p = .011), higher behavioural activation (d = 0.71, p = .001) and improved global functioning (d = 0.52, p = .017). Changes in future thinking were found to mediate the effect of FEST on anhedonia.ConclusionThe quality of future thinking can be enhanced in Major Depression, and this leads to a substantially reduced likelihood of anhedonia, other significant clinical effects, and functional gains.

Overgeneral memory (OGM) refers to the failure to recall memories of specific personally experienced events, which occurs in various psychiatric disorders. One pathway through which OGM is theorized to develop is the avoidance of thinking of negative experiences, whereby cumulative avoidance may maladaptively generalize to autobiographical memory (AM) more broadly. We tested this, predicting that negative experiences would interact with avoidance to predict AM specificity. In Study 1 ( N = 281), negative life events (over six months) and daily hassles (over one month) were not related to AM specificity, nor was avoidance, and no interaction was found. In Study 2 ( N = 318), we revised our measurements and used an increased timeframe of 12 months for both negative life events and daily hassles. The results showed no interaction effect for negative life events, but they did show an interaction for daily hassles, whereby increased hassles and higher avoidance of thinking about them were associated with reduced AM specificity, independent of general cognitive avoidance and depressive symptoms. No evidence was found that cognitive avoidance or AM specificity moderated the effect of negative experiences on depressive symptoms. Our findings suggest that life events over 6–12 months are not associated with AM specificity, but chronic daily hassles over 12 months predict reduced AM specificity when individuals avoid thinking about them. The findings provide evidence for the functional-avoidance hypothesis of OGM development and future directions for longitudinal studies.

Background Youth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning. Evidence-based treatments are available, but many young people do not respond or sufficiently recover with first-line options, and a significant proportion experience relapse. Consequently, there is clear scope to enhance intervention in this critical period of early-onset depression. Memory specificity training (MeST) is a low-intensity intervention for depression that targets reduced specificity when recalling memories of the past, a common cognitive vulnerability in depression. This randomised controlled trial will assess the efficacy of adding a computerised version of MeST (c-MeST) to usual care for youth depression. Methods/design Young people aged 15–25 years with a major depressive episode (MDE) will be recruited and randomised to have immediate access to the seven session online c-MeST program in addition to usual care, or to usual care and wait-list for c-MeST. The primary outcomes will be diagnostic status of an MDE and self-reported depressive symptoms assessed at baseline, 1-, 3- and 6-month intervals. Autobiographical memory specificity and other variables thought to contribute to the maintenance of reduced memory specificity and depression will be assessed as mediators of change. Discussion Online provision of c-MeST provides a simple, low-intensity option for targeting a cognitive vulnerability that predicts the persistence of depressive symptoms. If found to be efficacious as an adjunct to usual care for depressed youth, it could be suitable for broader roll-out, as c-MeST is highly accessible and implementation requires only minimal resources due to the online and automated nature of intervention. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000234112p . Registered on the 18 February 2019. All items from the WHO Trial Registration Data Set can be found within the protocol. Protocol version 1.0

Ozone, along with other air pollutants, has been measured for two years from a monitoring station placed on a cruise ship that follows a regular track in the Western Mediterranean between April and October. Conditions favouring high ozone levels have been studied by analysis of weather maps and back trajectories. This analysis was focused on a transect over the open sea in the South Western Mediterranean between Tunis and Palma de Mallorca. High ozone levels were found in situations with an anticyclonic circulation over the Western Mediterranean when subsidence brings air masses down from altitudes between 1000 and 3500 m a.s.l. Analysis of composite meteorological maps suggests a relevant contribution of breeze circulation to subsidence during events with high surface ozone concentrations; this points to an important contribution from local ozone formation. A detailed back trajectory analysis of the origin of air masses with high ozone concentrations was carried out for two \"hot spots\" for ozone pollution, in the Gulf of Genoa and between Naples and Palermo, respectively. The main cause of high ozone levels in the Gulf of Genoa was found to be outflow from the Po Valley and the Genoa area while such episodes along the Naples-Palermo transect were most often associated with trajectories from the Rome or Naples areas. Analysis of the relationship between measured concentrations of Black Carbon and ozone allowed to evaluate the degree of photochemical \"ageing\" of the air masses encountered along the route of the cruise ship.

We examined the concurrent and prospective relations between response styles to positive affect and depression in a community sample. Participants ( n  = 345) completed self-report measures of current and past depressive episodes, depressive symptoms, anhedonia, and responses to positive affect (including dampening and positive rumination) at two time points, with a 5-month interval. Higher levels of dampening responses to positive affect were related to higher concurrent levels of depressive symptoms. The tendency to positively ruminate on positive affect was negatively related to concurrent anhedonic symptoms. When controlling for current depressive symptomatology, formerly depressed individuals had a higher tendency to dampen positive affect than never-depressed controls, and did not differ from a currently depressed group. Dampening responses did not predict depressive symptoms prospectively, but lower levels of (self-focused) positive rumination did predict higher levels of future anhedonic symptoms. Results indicate that not only currently but also formerly depressed individuals engage in dysfunctional (dampening) strategies in response to positive affect. It is possible that currently as well as formerly depressed individuals might benefit from interventions that are directed at the remediation of disturbed regulation of positive affect. However, our prospective results make clear that more research is needed to examine the precise conditions under which dampening would be a detrimental (and positive rumination a beneficial) response style in the course of depression.

Depression rates are rising globally, with traditional treatments often failing to address cognitive overgeneralization - a distortion that perpetuates negative thinking and depressive symptoms. This study aimed to evaluate the efficacy of Cognitive Specificity Enhancement Training (CoST) in reducing rumination, cognitive avoidance, and depressive symptoms, particularly in patients with childhood maltreatment. Using a quasi-experimental design, 40 depressed patients (Mage = 33.02 ± 10.69) with a history of childhood maltreatment were purposively sampled and randomly assigned to experimental (  = 20) or control (  = 20) groups. The experimental group underwent four CoST sessions, while the control group received no intervention. After dropouts, 35 participants (18 experimental, 17 control) completed the study. Beck Depression Inventory-II (BDI-II), Ruminative Response Scale (RRS-10), and Cognitive Avoidance Questionnaire (CAQ) were administered pre-intervention, post-intervention, and at a one-month follow-up. Repeated measures ANOVA revealed significant reductions in BDI-II and RRS-10 scores in the experimental group (  < .05), maintained at follow-up. No significant changes were observed for cognitive avoidance in either group. These findings highlight that the short-term intervention CoST may be effective in improving rumination and depression symptoms amongst depressed patients with history of childhood maltreatment as a vulnerable social group.

IntroductionInfertility and its treatment bring a considerable emotional burden. Increasing evidence demonstrates the effectiveness of smartphone-delivered mindfulness apps for reducing symptoms of emotional distress in both clinical and non-clinical populations. Evidence on this topic in women, men and couples experiencing infertility is currently under-represented. The aim of the MoMiFer study is, therefore, to investigate the efficacy of a stand-alone mobile mindfulness app on symptoms of emotional distress and fertility-related quality of life in people experiencing infertility.Methods and analysisThis study is an exploratory randomised controlled trial (RCT) with open enrollment. The primary outcomes are symptoms of emotional distress and fertility-related quality of life. Secondary outcomes are mindfulness skills, repetitive negative thinking, self-compassion, user-rated quality of the stand-alone mobile mindfulness app and use of the app. Experience sampling method and standardised self-report questionnaires are combined within a repeated measures design to measure the effects of the stand-alone mobile mindfulness app on the primary and secondary outcomes, apart from the use of the app. The latter will be evaluated through app tracking. People, including women, men and couples, experiencing infertility (n=60) will be randomised to an intervention group receiving the stand-alone mobile mindfulness app for 3 months or a wait-list control group. The app follows the format and content of Mindfulness-Based Stress Reduction. Data will be collected at baseline, at 1.5 months and 3 months after randomisation. Analysis will be according to intention to treat and based on general linear modelling and multilevel mixed-effects modelling.Ethics and disseminationThis study received approval from the Medical Ethical Committee of the Leuven University Hospital (Belgium). The findings of this exploratory RCT will be disseminated through presentations at public lectures, scientific institutions and meetings, and through peer-reviewed scientific articles.Trial registration numberNCT04143828.

IntroductionAdolescents with chronic conditions often experience high levels of stress, anxiety and depression, and reduced quality of life. Mindfulness-based interventions (MBIs) have been found to improve emotional distress in clinical and non-clinical populations and are a promising technique to support adolescents with chronic conditions in managing their symptoms and ultimately enhance their quality of life.Methods and analysisTo test the effects of an MBI on emotional distress and quality of life and delineate the underlying mechanisms, the You.Mind! study uses a randomised staggered within-subjects design. Thirty adolescents with a chronic condition will be randomised to a baseline phase of 14–28 days followed by an MBI, consisting of four online group sessions and online support spread over 8 weeks. Outcomes will be assessed by short, repeated measurements throughout the baseline, intervention and follow-up phases and by standardised questionnaires and experience sampling measures before randomisation, at postintervention and at 3-months follow-up. Analysis will be based on general linear modelling and multilevel mixed-effects modelling.Ethics and disseminationEthical approval was obtained from the Ethics Committee Research UZ/KU Leuven and the Ethics Committee of Ghent University Hospital and Ghent University (S63485). Results will be disseminated through presentations at public lectures, scientific institutions and meetings, and through publication in peer-reviewed journals.Trial registration numberNCT04359563.

Background Mindfulness has been applied to improve cancer care by enhancing psychological well-being. However, little is known about its impact on cognitive impairment experienced by cancer patients after chemotherapy. Mindfulness may be relevant in tackling cognitive impairment by decreasing emotional distress and fatigue, by decreasing inflammation, and by strengthening functional brain connectivity. The aim of the present study protocol is to evaluate the efficacy and mechanisms of a mindfulness-based intervention to reduce cognitive impairment in breast cancer patients after chemotherapy. Methods/design The present study is a three-arm, parallel-group, randomized controlled trial with assessments at baseline, 1 to 3 weeks after the intervention and at 3 months’ follow-up. One hundred and twenty breast cancer patients who ended treatment a minimum of 6 months and a maximum of 5 years before, and who have cognitive complaints, will be enrolled. They will be randomized into one of the following three study arms: (1) a mindfulness-based intervention group ( n  = 40), (2) an active control condition based on physical training ( n  = 40), or (3) a treatment as usual (TAU) control group ( n  = 40). Both the mindfulness-based intervention and the active control condition consist of four group sessions (3 h for the mindfulness condition and 2 h for the physical training) spread over 8 weeks. The primary outcomes will be cognitive symptoms as measured by the Cognitive Failure Questionnaire and changes in functional brain connectivity in the attention network. Secondary outcomes will be (1) levels of emotional distress, fatigue, mindfulness, quality of life; (2) neurocognitive tests; (3) structural and functional brain changes using MR imaging and (4) measures of inflammation. Discussion The study will examine the impact of a mindfulness-based intervention on cognitive impairment in breast cancer patients. If the findings of this study confirm the effectiveness of a mindfulness-based program to reduce cognitive impairment, it will be possible to improve quality of life for ex-cancer patients. We will inform health care providers about the potential use of a mindfulness-based intervention as a non-pharmaceutical, low-threshold mental health intervention to improve cognitive impairment after cancer. Trial registration ClinicalTrials.gov, ID: NCT03736460 . Retrospectively registered on 8 November 2018.