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While there is evidence that long-chain n-3 PUFA supplementation benefits mood, the extent to which a single high dose of n-3 PUFA can induce acute mood effects has not been examined. The present study investigated whether a single dose of a DHA-rich powder affects self-reported mood in middle-aged males during elevated cognitive demand. In a randomised, double-blind, placebo-controlled trial with a balanced crossover design, twenty-nine healthy males (age M = 52.8 years, sd = 5.3) were administered a powder (in a meal) containing 4·74 g n-3 PUFA (DHA 4020 mg; EPA 720 mg) or placebo in random order on two different testing days separated by a washout period of 7 ± 3 d. Participants completed mood assessments before and after completing two cognitive test batteries at baseline and again 3·5–4·0 h following the consumption of the active treatment or placebo. While completion of the cognitive test batteries increased negative mood, differential effects for alertness (P = 0·008) and stress (P = 0·04) followed consumption of the DHA-rich powder compared with placebo. Although alertness declined when completing the cognitive batteries, it was higher following consumption of the DHA-rich powder compared with placebo (P = 0·006). Conversely, stress was lower following consumption of the DHA-rich powder relative to placebo, though this difference only approached significance (P = 0·05). Overall, results from this pilot study demonstrate that a single high dose of n-3 PUFA may deliver acute mood benefits following elevated cognitive demand in healthy middle-aged males.
Research has demonstrated that positive and negative moods may differently affect semantic processing due to the activation of mood-dependent thinking. Interestingly, recent studies have indicated that the interplay between mood and semantic processing may also be modulated by the language of operation (native [L1] vs. second language [L2]). Still, it remains an open question if and how mood interacts with varying depths of semantic processing, particularly in bilinguals. Here, we show that a negative mood may differently modulate shallow and deep semantic processing in bilinguals at a behavioral level. In two experiments, Polish–English bilinguals, induced into positive and negative moods, performed a lexical decision task (marking shallow semantic processing; Experiment 1) and a semantic decision task (marking deep semantic processing; Experiment 2) with sentences in L1 and L2 of varying semantic complexity: literal, novel metaphoric, and anomalous sentences. While no interactive mood–language effect was observed for shallow semantic processing, we found faster semantic judgments when bilinguals were in a negative relative to positive mood in L2, but not L1, for deep semantic processing. These findings suggest that a negative mood may activate more analytical and effort-maximizing thinking in L2, yet only when the linguistic content requires deeper understanding.
Previous studies show that maternal mind-mindedness positively impacts children’s social development. In the current studies, we examine the relation between mind-mindedness during parent–child interaction, oxytocin (OT), and postnatal depression in a sample of mothers (N = 62, ages 23–44) and their infant (ages 3–9 months). In Study 1, infant salivary OT was positively correlated with mothers’ appropriate mind-related comments, and negatively correlated (at trend level) with maternal depression scores. Mothers experiencing symptoms of depression used fewer appropriate mind-related comments than controls. Study 2 was a double-blind, placebo-controlled, experimental study, in which the same women who participated in Study 1 were administered nasal OT. This did not significantly influence levels of mind-mindedness. Study 2 warrants a larger trial to investigate the effect of OT on mind-mindedness further. Study 1 is the first to demonstrate an association between maternal mind-mindedness and variation in children’s OT levels. Since both OT and mind-mindedness have been repeatedly implicated in processes of maternal–infant attachment, this association highlights the centrality of mothers’ caregiving representations in facilitating the parent–child relationship and children’s early development.
We examined the efficacy of cognitive and behavioral interventions for improving symptoms of depression and anxiety in adults with neurological disorders. A pre-registered systematic search of Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, Embase, and Neurobite was performed from inception to May 2024. Randomized controlled trials (RCTs) which examined the efficacy of cognitive and behavioral interventions in treating depression and/or anxiety among adults with neurological disorders were included. Estimates were pooled using a random-effects meta-analysis. Subgroup analyses and meta-regression were performed on categorical and continuous moderators, respectively. Main outcomes were pre- and post-intervention depression and anxiety symptom scores, as reported using standardized measures. Fifty-four RCTs involving 5372 participants with 11 neurological disorders (including multiple sclerosis, epilepsy, stroke) were included. The overall effect of interventions yielded significant improvements in both depression (57 arms, Hedges' g = 0.45, 95% confidence interval [CI] 0.35–0.54) and anxiety symptoms (29 arms, g = 0.38, 95% CI 0.29–0.48), compared to controls. Efficacy was greater in studies which employed a minimum baseline symptom severity inclusion criterion for both outcomes, and greater in trials using inactive controls for depression only. There was also evidence of differential efficacy of interventions across the neurological disorder types and the outcome measure used. Risk of bias, intervention delivery mode, intervention tailoring for neurological disorders, sample size, and study year did not moderate effects. Cognitive and behavioral interventions yield small-to-moderate improvements in symptoms of both depression and anxiety in adults with a range of neurological disorders.
Edited by
Allan Young, Institute of Psychiatry, King's College London,Marsal Sanches, Baylor College of Medicine, Texas,Jair C. Soares, McGovern Medical School, The University of Texas,Mario Juruena, King's College London
Bipolar depression is an important and difficult to treat facet of bipolar disorder. However, it poses a number of challenges to the clinician. This chapter offers an overview of the difficulties in diagnosing bipolar depression and the main risks associated with it, whilst emphasising the factors which differentiate it from unipolar depression. Following this, there is an overview of the official guidance and evidence base for treatment options. There is an especial focus on pharmacotherapy, but the chapter also reviews psychotherapy, ECT, as well as emerging treatment options, such as sleep interventions and ketamine.
This chapter provides an overview of the inventory, formation, and use of synthetic and periphrastic tense and mood forms in modern Belarusian, Bosnian/Croatian/Montenegrin/Serbian, Bulgarian, Czech, Macedonian, Polish, Russian, Slovak, Slovene, Lower and Upper Sorbian, and Ukrainian. It addresses both characteristics common to all modern languages and features of individual languages.
Things get to us. We are moved or affected by 'things' in the ordinary sense=the paraphernalia of our daily lives-and also by ourselves, by others, and by ontological phenomena such as being and time. How can such things get to us? How can things matter to me? Heidegger answers this question with his concepts of finding (Befindlichkeit) and attunement (Stimmung). This Element explores how being finding allows things to matter to us in attunements such as fear and hope by allowing those things to show up as benefits or detriments to our pursuits and so to put those pursuits at stake. It also explores how we can be affected ontologically-that is, affected by being-in special attunements such as angst and boredom, as well as how Heidegger's account of being affected has contributed to our understanding of emotions, moods, and affective disorders.
The role of flavonoids on cognitive performance in older adults has been intensively studied, with the subclass of anthocyanins showing promising outcomes(1). However, there is conflicting evidence in the case of individuals at high risk of developing dementia, namely those with mild cognitive impairment (MCI). A recent study has suggested that cognitive scores in people with MCI were higher in those who had higher anthocyanin intake (>10 mg)(2). Baseline data from 65 participants of an ongoing clinical trial that had an MIS (Memory Index Score) score ≤ 13 with self-reported subjective memory complaints, (mean age 69.1y ± 6.2) were used to investigate the relationship between dietary anthocyanin intake and indices of mood and cognitive performance. Repeated 24-hour dietary intake was recorded through Intake24 (a computer-based program) for three days (2Xweekday and 1Xweekend day) and anthocyanin intake was quantified using the PhenolExplorer food composition database. The primary outcome of interest was the Buschke and Grober Free and Cued Selective Reminding Test-Immediate Recall (FCSRT+IR) (assesses auditory anterograde memory functioning), while other cognitive functions assessed included: Spot the Word-2 (assessing premorbid estimate); Oral Symbol Digit Test (speed of processing); List Sorting (working memory); Trail Making Test A & B (speed of processing/executive function); and Verbal Fluency (language/semantic memory). Subjective memory complaints were assessed using the Memory Assessment Clinic-Q (MAC-Q) and mood was assessed using the Geriatric Depression Scale (GDS). Independent t-tests were used to compare differences in cognitive tasks and mood scores between high (>10 mg/d) and low consumers of anthocyanins (<10 mg/d). There was a trend for high anthocyanin consumers (n = 35, median = 44.87 (10.01, 177.83)) to score better on FCSRT-Delayed Free Recall scores (16.57 ± 3.74) compared to lower consumers (n = 30, median = 0.01 (0, 9.51)), (15.97 ± 0.18) with a mean difference (SE) of −1.06 (0.58) (p = 0.06) suggesting recall of 1.06 more words after a 20-30 minute delay. Higher consumers had a lower GDS score (1.77 ± 3.73) compared to lower consumers (3.73 ± 1.77), p = 0.01. Spot the word test scores (assesses premorbid verbal abilities using a robust lexical decision task) were higher for high anthocyanin consumers (53.06 ± 4.38) compared to lower consumers (50.40 ± 4.38), mean difference (SE) = −2.66 (1.10), p = 0.01, meaning participants with higher intake of dietary anthocyanin were able to point at 2.7 more real words than low consumers. Dietary consumption of anthocyanin in older adults with MIS is associated with beneficial effects on depressive scores and the ability to retrieve words. Further research is warranted to identify optimal dosage for recommended intake. This cross-sectional study used baseline data from a randomised controlled trial registered with the Australian New Zealand Clinical Trials Registry (ANZCTR):12622000065796.
Gold kiwifruit consumption and increased vitamin C intake have been associated with improved mood, vitality, and wellbeing in healthy individuals(1,2). However, to date, no studies have focussed exclusively on the efficacy of gold kiwifruit for improving such outcomes in participants with disturbed mood. A randomised crossover trial was undertaken to examine the efficacy of ZespriTM SunGoldTM kiwifruit for improving psychological wellbeing and vitamin C concentrations in adults with sub-clinical levels of mood disturbance. In a two-period, non-blinded crossover trial, N = 26 adults aged 21 to 60 years (M = 36.1, SD = 11.0) with mild to moderate mood disturbance were randomised to a counter-balanced sequence. Participants consumed 2x SunGold kiwifruit daily or their typical diet for four weeks, with a two-week washout between periods. The primary outcome was change in mood disturbance, with secondary outcomes including plasma vitamin C, wellbeing, vitality and gut health. Results indicated a significant time x treatment interaction effect for mood disturbance (F(2,107.3) = 6.19, p = ,003) with significant improvements in mood disturbance scores between baseline and post-intervention during the SunGold kiwifruit period. A significant time x treatment interaction effect for blood plasma vitamin C (F(2,98.5) = 3.65, p = ,029) also demonstrated increased vitamin C concentrations during the SunGold kiwifruit period. A significant time x treatment interaction effect for wellbeing (F(2,104.7) = 4.5, p = ,013) was evident with wellbeing significantly improved between baseline and post-intervention during the SunGold kiwifruit period. The time x treatment interaction for vitality approached significance (F(2,104.7) = 2.89, p = ,06) with increases in vitality following SunGold kiwifruit consumption. These results provide preliminary evidence that SunGold kiwifruit consumption improves psychological wellbeing in mood-disturbed adults, which corresponds to increased plasma vitamin C concentrations. Future research is required to replicate this effect and to further demonstrate the potential benefit of whole-food interventions for treating mood-disturbance.
This essay examines the link between eros and metaphysics in “The Seducer’s Diary.” It argues that Johannes approaches seduction as a performative rather than strategic medium, in which the goal is not conquest but a way of playing with reality. The diary, on this reading, allows us to explore the erotic structure of our most fundamental experiences of mediation and serves as a key to understanding the spiritual dimensions of aesthetic existence.
Kierkegaard’s aesthete, named only as A, continually laments the lack of meaning in his life. He suffers through passions that flare up and quickly die away, leaving him in a melancholic state. His mode of being is on display in the Diapsalmata, the fragmentary writings at the start of Either/Or. In this chapter, we examine why he avoids becoming consistently engaged in the world and remains trapped within his alienated melancholia. We offer a general account of melancholy, arguing that melancholia is an existential condition that must be understood in terms of the metaphysics of possibility. We also provide a sympathetic interpretation of A’s melancholy, rather than placing blame upon him, because melancholia attunes us to certain aspects of the world and of human existence. The aesthetic life has epistemic, moral, and aesthetic worth on its own terms, so a person may legitimately decide to remain melancholic. This avoids compromising our possibilities, makes us receptive to the suffering of others, and may inspire creative activity such as writing poetical fragments.
Neuropsychiatric symptoms (NPSs) after moderate-to-severe traumatic brain injury (TBI) have been well documented in WEIRD (Western, educated, industrialized, rich, and democratic) populations. In non-WEIRD populations, such as Vietnam, however, patients with TBI clinically remain uninvestigated with potential neuropsychiatric disorders, limiting on-time critical interventions. This study aims to (1) adapt the Vietnamese Neuropsychiatric Inventory (V-NPI), (2) examine NPSs after moderate-to-severe TBI and (3) evaluate their impact on caregiver burden and well-being in Vietnam.
Method:
Caregivers of seventy-five patients with TBI completed the V-NPI, and other behavior, mood, and caregiver burden scales.
Results:
Our findings demonstrated good internal consistency, convergent validity, and structural validity of the V-NPI. Caregivers reported that 78.7% of patients with TBI had at least three symptoms and 16.0% had more than seven. Behavioral and mood symptoms were more prevalent (ranging from 44.00% to 82.67% and from 46.67% to 66.67%, respectively) and severe in the TBI group. Importantly, NPSs in patients with TBI uniquely predicted 55.95% and 33.98% of caregiver burden and psychological well-being, respectively.
Conclusion:
This study reveals the first evidence for the presence and severity of NPSs after TBI in Vietnam, highlighting an urgent need for greater awareness and clinical assessment of these symptoms in clinical practice. The adapted V-NPI can serve as a useful tool to facilitate such assessments and interventions. In addition, given the significant impact of NPS on caregiver burden and well-being, psychosocial support for caregivers should be established.
Seizure freedom without deficits is the primary goal for epilepsy surgery. However, patients with medically refractory epilepsy commonly suffer from many co-morbidities related to mood, cognition, and sleep as well as social problems and resultant stigma. While epilepsy surgery literature does describe quality of life (QOL) and neuropsychological outcomes, there is a paucity of information on various common non-seizure outcomes, especially pertaining to mood, sleep, cognition, and social aspects. The objective of this study was to evaluate the role of various non-seizure parameters on post-epilepsy surgery QOL.
Methods:
Consecutive adult patients operated for refractory epilepsy at least 1 year prior to initiation of this study were included and classified as seizure-free (group 1) or non-seizure-free (group 2). QOL was assessed using the QOLIE-31 instrument; patients with a T score less than 40 were categorized as “poor QOL.” Non-seizure parameters assessed were cognition, mood disturbances, social improvement, social stigma, and sleep disturbances. Categorization into “good” and “poor” outcome subgroups on each item was carried out by dichotomization of scores.
Results:
Thirty-seven patients (16 F) [mean age 23.5 ± 5.6 years] were evaluated; 26 were seizure-free (group 1). In this group, impaired memory, lower language scores, depression, not having been employed, not receiving education prior to surgery, and experiencing social stigma were factors significantly associated with poor QOL. In group 2, all patients had poor QOL scores.
Conclusion:
Non-seizure factors related to common epilepsy co-morbidities and social issues are highly prevalent among seizure-free patients reporting poor QOL after epilepsy surgery.
Childhood trauma (CT) may increase vulnerability to psychopathology through affective dysregulation (greater variability, autocorrelation, and instability of emotional symptoms). However, CT associations with dynamic affect fluctuations while considering differences in mean affect levels across CT status have been understudied.
Methods
346 adults (age = 49.25 ± 12.55, 67.0% female) from the Netherlands Study of Depression and Anxiety participated in ecological momentary assessment. Positive and negative affect (PA, NA) were measured five times per day for two weeks by electronic diaries. Retrospectively-reported CT included emotional neglect and emotional/physical/sexual abuse. Linear regressions determined associations between CT and affect fluctuations, controlling for age, sex, education, and mean affect levels.
Results
Compared to those without CT, individuals with CT reported significantly lower mean PA levels (Cohen's d = −0.620) and higher mean NA levels (d = 0.556) throughout the two weeks. CT was linked to significantly greater PA variability (d = 0.336), NA variability (d = 0.353), and NA autocorrelation (d = 0.308), with strongest effects for individuals reporting higher CT scores. However, these effects were entirely explained by differences in mean affect levels between the CT groups. Findings suggested consistency of results in adults with and without lifetime depressive/anxiety disorders and across CT types, with sexual abuse showing the smallest effects.
Conclusions
Individuals with CT show greater affective dysregulation during the two-week monitoring of emotional symptoms, likely due to their consistently lower PA and higher NA levels. It is essential to consider mean affect level when interpreting the impact of CT on affect dynamics.
Willis J. Edmondson,Juliane House, Universität Hamburg and the Hungarian Research Centre for Linguistics,Daniel Z. Kadar, Dalian University of Foreign Languages, China and Hungarian Research Centre for Linguistics
Chapter 9 illustrates how conventional grammatic categories such as a specific tense or auxiliary verb may be linked with interactional behaviour as it is described in this grammar. The chapter shows how formal grammatical items may be practised in interactional sequences in the classroom.
Systemic Functional Linguistics (SFL) is a usage-based theory of language, founded on the assumption that language is shaped entirely by its various functions in the contexts in which it used. The first of its kind, this book advances SFL by applying it comparatively to English, Spanish and Chinese. By analysing English alongside two other, typologically very different major world languages, it shows how SFL can effectively address two central issues in linguistics – namely typology and universals. It concentrates in particular on argumentation, carefully explaining how descriptions of nominal group, verbal group and clause systems and structures are motivated, and draws on examples from key texts which display a full range of ideational, interpersonal and textual grammar resources. By working across three world languages from a text-based perspective, and demonstrating how grammar descriptions can be developed and improved, the book establishes the foundations for a groundbreaking functional approach to language typology.
Chapter 4 explores mood systems and structures. It concentrates on paradigmatic relations – and the ways in which these can be motivated in the grammars of English, Spanish and Chinese. This chapter foregrounds questions about the nature of functional language typology, when confronted with the diverse structural realisations of mood in three different languages. It highlights the need to focus on system rather than structure, on higher ranks rather than lower ones and ultimately on discourse semantics rather than grammar by way of establishing comparable ground whenever languages are being contrasted and compared.
From a mentalizing perspective, symptoms of depression arise from reactions to threats to attachment relationships—and thus threats to the self—and associated impairments in mentalizing problems. Mentalization-based treatment (MBT) for depression targets mentalizing impairments, dominant attachment styles, and problems with epistemic trust. Depression is not a homogeneous disorder, and mentalizing problems vary depending on whether the depressed mood is mild, moderate, or severe. Mentalizing interventions for the different severities of depression are summarized. A specific adaptation of MBT, namely dynamic interpersonal therapy (DIT), is also discussed.
Edited by
Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine,David Castle, University of Tasmania, Australia,Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
Abrupt cessation of chronic and frequent cannabis use is associated with cannabis withdrawal. Cannabis withdrawal syndrome is a clinically significant diagnosis and a criterion of cannabis use disorder (CUD) marked by mood and sleep disturbance symptoms, appetite and/or weight loss and restlessness, and physical symptoms such as abdominal pain, shakiness/tremors, sweating, fever, chills and headaches. The goal of this chapter is to fully characterize the clinical significance, time course, neurological mechanisms and treatment of cannabis withdrawal. The chapter synthesizes studies examining individual difference factors (demographics, cannabis use patterns, genetics and heritability and psychiatric comorbidity) that place some people at disproportionally higher risk for cannabis withdrawal or greater severity of symptoms. The cyclical nature of resuming use due to the inability to cope with the distress of cannabis withdrawal is negatively reinforcing and presents major challenges to individuals trying to abstain from problematic cannabis use. Implications for evidence-based strategies that can help mitigate the psychological and physiological symptoms of cannabis withdrawal are discussed.
Frequently associated with early psychosis, depressive and manic dimensions may play an important role in its course and outcome. While manic and depressive symptoms can alternate and co-occur, most of the studies in early intervention investigated these symptoms independently. The aim of this study was therefore to explore the co-occurrence of manic and depressive dimensions, their evolution and impact on outcomes.
Methods
We prospectively studied first-episode psychosis patients (N = 313) within an early intervention program over 3 years. Based on latent transition analysis, we identified sub-groups of patients with different mood profiles considering both manic and depressive dimensions, and studied their outcomes.
Results
Our results revealed six different mood profiles at program entry and after 1.5 years follow-up (absence of mood disturbance, co-occurrence, mild depressive, severe depressive, manic and hypomanic), and four after 3 years (absence of mood disturbance, co-occurrence, mild depressive and hypomanic). Patients with absence of mood disturbance at discharge had better outcomes. All patients with co-occurring symptoms at program entry remained symptomatic at discharge. Patients with mild depressive symptoms were less likely to return to premorbid functional level at discharge than the other subgroups. Patients displaying a depressive component had poorer quality of physical and psychological health at discharge.
Conclusions
Our results confirm the major role played by mood dimensions in early psychosis, and show that profiles with co-occurring manic and depressive dimensions are at risk of poorer outcome. An accurate assessment and treatment of these dimensions in people with early psychosis is crucial.