What are the determinants of altruism? While economists assume that altruism is mainly driven by fairness norms, social psychologists consider empathy to be a key motivator for altruistic behavior. ...To unite these two theories, we conducted an experiment in which we compared behavior in a standard economic game that assesses altruism (the so-called Dictator Game) with a Dictator Game in which participants' behavioral choices were preceded either by an empathy induction or by a control condition without empathy induction. The results of this within-subject manipulation show that the empathy induction substantially increased altruistic behavior. Moreover, the increase in experienced empathy predicted over 40% of the increase in sharing behavior. These data extend standard economic theories that altruism is based on fairness considerations, by showing that empathic feelings can be a key motivator for altruistic behavior in economic interactions.
IMPORTANCE: Major depressive disorder (MDD) affects approximately 10% of the population globally. Approximately 20% to 30% of patients with MDD do not sufficiently respond to standard treatment. ...Therefore, there is a need to develop more effective treatment strategies. OBJECTIVE: To investigate whether the efficacy of cognitive behavioral therapy (CBT) for the treatment of MDD can be enhanced by concurrent transcranial direct current stimulation (tDCS). DESIGN, SETTING, AND PARTICIPANTS: The double-blind, placebo-controlled randomized clinical trial PsychotherapyPlus was conducted at 6 university hospitals across Germany. Enrollment took place between June 2, 2016, and March 10, 2020; follow-up was completed August 27, 2020. Adults aged 20 to 65 years with a single or recurrent depressive episode were eligible. They were either not receiving medication or were receiving a stable regimen of antidepressant medication (selective serotonin reuptake inhibitor and/or mirtazapine). A total of 148 women and men underwent randomization: 53 individuals were assigned to CBT alone (group 0), 48 to CBT plus tDCS (group 1), and 47 to CBT plus sham-tDCS (group 2). INTERVENTIONS: Participants attended a 6-week group intervention comprising 12 sessions of CBT. If assigned, tDCS was applied simultaneously. Active tDCS included stimulation with an intensity of 2 mA for 30 minutes (anode over F3, cathode over F4). MAIN OUTCOMES AND MEASURES: The primary outcome was the change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to posttreatment in the intention-to-treat sample. Scores of 0 to 6 indicate no depression; 7 to 19, mild depression; 20 to 34, moderate depression; and 34 and higher, severe depression. RESULTS: A total of 148 patients (89 women, 59 men; mean SD age, 41.1 13.7 years; MADRS score at baseline, 23.0 6.4) were randomized. Of these, 126 patients (mean SD age, 41.5 14.0 years; MADRS score at baseline, 23.0 6.3) completed the study. In each of the intervention groups, intervention was able to reduce MADRS scores by a mean of 6.5 points (95% CI, 3.82-9.14 points). The Cohen d value was –0.90 (95% CI, –1.43 to –0.50), indicating a significant effect over time. However, there was no significant effect of group and no significant interaction of group × time, indicating the estimated additive effects were not statistically significant. There were no severe adverse events throughout the whole trial, and there were no significant differences of self-reported adverse effects during and after stimulation between groups 1 and 2. CONCLUSIONS AND RELEVANCE: Based on MADRS score changes, this trial did not indicate superior efficacy of tDCS-enhanced CBT compared with 2 CBT control conditions. The study confirmed that concurrent group CBT and tDCS is safe and feasible. However, additional research on mechanisms of neuromodulation to complement CBT and other behavioral interventions is needed. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02633449
Ulceration of melanoma is associated with neutrophil infiltrates and lower survival rates opposite to non‐ulcerated melanoma. Neutrophils release neutrophil extracellular traps (NETs) that are ...chromatin structures loaded with antimicrobial proteins. Since NETs have been correlated with tumor progression, we investigated whether NETs appear in melanoma and affect melanoma cells. Indeed, human primary melanoma biopsies revealed neutrophils releasing NETs in all of 27 ulcerated melanomas, whereas NETs were absent in all of 7 non‐ulcerated melanomas. However, the quantity of intratumoral NETs did not correlate with tumor progression of melanoma. Interestingly, in vitro assays showed that melanoma cells attach to NETs via integrin‐mediated adhesion and that NETs inhibit tumor cell migration. Moreover, co‐culturing of NETs and melanoma cells had a cytotoxic effect on melanoma cells resulting in necrosis. Hence, we discovered in vitro an antineoplastic role of NETs in melanoma.
•We assessed multiple levels of empathy in violent offenders and controls.•Empathy induction led to an increase in prosocial behavior in both groups.•Findings suggest a distinct association of ...psychopathic traits and empathy.
Deficiencies in empathic functioning are considered a core characteristic of violent behavior. Enhancing empathy in aggressive populations may thus represent a promising intervention target. Hence, the aims of the present work were two-fold: First, we wanted to thoroughly assess empathic competencies and second, we aimed to investigate effects of an empathy induction on experienced empathy levels and prosocial behavior in a sample of violent offenders relative to matched controls. Empathy was assessed using both self-report as well as objective measures. For the empathy induction, participants were presented with empathy inducing and control videos. To assess the effects of the empathy induction on behavior, participants played a dictator game indicative of prosocial behavior after every video. Violent offenders showed no systematic impairment in empathy measures. Despite lower shares in the dictator game across conditions, the empathy induction led to a substantial increase in prosocial behavior in both groups. Importantly, high psychopathy scores were distinctively associated with lower self-reported empathy levels, an attenuated affective responsiveness to the empathy induction, and less altruistic behavior. Treatment programs aiming to improve empathy should take individual characteristics into account and may be applied to distinctive subgroups rather than to violent offenders per se.
The prevalence and impact of trauma exposure among young people in the child welfare system in Canada warrants holistic intervention as a means of trauma recovery for this vulnerable population. A ...trauma-informed approach to practice is outlined through consideration of traditional trauma treatments and mind-body interventions that serve as complementary methods of therapy. Despite limited research on the effectiveness of mind-body interventions with children and adolescents in out-of-home care in Canada, a review of available literature on mindfulness, arts-based methods, and yoga suggests these therapeutic interventions promote resilience and positive development. Additional research is needed to support the use of mind-body interventions with young people in out-of-home care. Practice implications and recommendations for future research within Canada are included to increase awareness and support a working understanding of the pervasiveness of trauma exposure among this population and the value of trauma-informed, holistic intervention.
Based on the approach‐withdrawal model of hemispheric asymmetry, anger and aggression have been linked to an approach‐related pattern, characterized by stronger relative left‐hemispheric anterior ...cortical activity. Recent work suggests that also in individuals with extremely violent tendencies, such as imprisoned offenders, approach‐related asymmetry may be associated with self‐reported trait anger and aggression. A putative association between alpha asymmetry and further characteristics relevant for aggression, such as callous‐unemotional (CU) traits, remains to be explored. CU traits may increase the probability of aggressive behavior; nevertheless, they may also enable individuals to inhibit and postpone the overt display of aggression until circumstances grant its strongest impact. In the current exploratory study, we measured trait aggression, CU traits, and resting‐state EEG asymmetry in the alpha band (8–13 Hz) in imprisoned violent offenders in a German high security prison. Results revealed that particularly trait callousness was associated with stronger relative right‐hemispheric anterior cortical activity (i.e., a withdrawal‐related pattern). An association between alpha asymmetry and aggression was not replicated. These preliminary findings suggest that, due to the involved emotional and interpersonal detachment, callousness might be withdrawal related, despite its potential to bring about aggressive behavior. They also imply that the identification of putative clinical subtypes in prisoners is required, as varying psychopathology might undermine an association between alpha asymmetry and aggression.
Abstract
Background
Technology can support healthy aging and empower older adults to live independently. However, technology adoption by older adults, particularly assistive technology (AT), is ...limited and little is known about the types of AT used among older adults. This study explored the use of key information and communication technologies (ICT) and AT among community-dwelling adults aged ≥ 65.
Methods
A cross-sectional study was conducted among community-dwelling adults aged ≥ 65 in southern Germany using a paper-based questionnaire. The questionnaire included questions on the three domains sociodemographic aspects, health status, and technology use. Technology use was considered separately for key ICT (smartphone, computer/laptop, and tablet) and a range of 31 different AT. Data were analyzed using descriptive statistics, univariate analyses, and Bernoulli Naïve Bayes modelling.
Results
The questionnaire was answered by 616 participants (response rate: 24.64%). ICT were used by 497 (80.68%) participants and were associated with lower age, higher level of education, living together with someone, availability of internet connection, higher interest in technology, and better health status (
p
< .05). No association was found with sex and size of the hometown. The most frequently owned AT were a landline phone, a body scale, and a blood pressure monitor. Several AT related to functionality, (instrumental) activities of daily living- (IADL), and morbidity were used more frequently among non-ICT users compared to ICT-users: senior mobile phone (19.33% vs. 3.22%), in-house emergency call (13.45% vs. 1.01%), hearing aid (26.89% vs. 16.7%), personal lift (7.56% vs. 1.61%), electronic stand-up aid (4.2% vs. 0%). Those with higher interest in technology reported higher levels of benefit from technology use.
Conclusions
Despite the benefits older adults can gain from technology, its use remains low, especially among those with multimorbidity. Particularly newer, more innovative and (I)ADL-related AT appear underutilized. Considering the potential challenges in providing adequate care in the future, it may be crucial to support the use of these specific AT among older and frailer populations. To focus scientific and societal work, AT with a high impact on autonomy ((I)ADL/disease-related) should be distinguished from devices with a low impact on autonomy (household-/ comfort-related).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Major Depressive Disorder (MDD) is one of the most prevalent psychiatric disorders worldwide. About 20–30% of patients do not respond to the standard psychopharmacological and/or psychotherapeutic ...interventions. Mounting evidence from neuroimaging studies in MDD patients reveal altered activation patterns in lateral prefrontal brain areas. Successful cognitive behavioral therapy (CBT) is associated with a recovery of these neural alterations. Moreover, it has been demonstrated that transcranial direct current stimulation (tDCS) is capable of influencing prefrontal cortex activity and cognitive functions such as working memory and emotion regulation. Thus, a clinical trial investigating the effects of an antidepressant intervention combining CBT with tDCS seems promising. The present study investigates the antidepressant efficacy of a combined CBT–tDCS intervention as compared to CBT with sham-tDCS or CBT alone. A total of 192 patients (age range 20–65 years) with MDD (Hamilton Depression Rating Scale Score ≥ 15, 21-item version) will be recruited at four study sites across Germany (Berlin, Munich, Tuebingen, and Freiburg) and randomly assigned to one of the following three treatment arms: (1) CBT + active tDCS; (2) CBT + sham-tDCS; and (3) CBT alone. All participants will attend a 6-week psychotherapeutic intervention comprising 12 sessions of CBT each lasting 100 min in a closed group setting. tDCS will be applied simultaneously with CBT. Active tDCS includes stimulation with an intensity of 2 mA for 30 min with the anode placed over F3 and the cathode over F4 according to the EEG 10–20 system, if assigned. The primary outcome measure is the change in Montgomery–Åsberg Depression Rating Scale scores from baseline to 6, 18, and 30 weeks after the first session. Participants also undergo pre- and post-treatment neuropsychological testing and functional magnetic resonance imaging (fMRI) to assess changes in prefrontal functioning and connectivity. The study investigates whether CBT can be augmented by non-invasive brain stimulation techniques such as tDCS in the treatment of MDD. It is designed as a proof-of-principle trial for the combined tDCS–CBT treatment, but also allows the investigation of the neurobiological underpinnings of the interaction between both interventions in MDD.
Trial registration
ClinicalTrials.gov Identifier NCT02633449.
While disparities in consent rates for research have been reported in multiple adult and pediatric settings, limited data informing enrollment in pediatric intensive care unit (PICU) research are ...available. Acute care settings such as the PICU present unique challenges for study enrollment, given the highly stressful and emotional environment for caregivers and the time-sensitive nature of the studies.
To determine whether race and ethnicity, language, religion, and Social Deprivation Index (SDI) were associated with disparate approach and consent rates in PICU research.
This retrospective cohort study was performed at the Children's Hospital of Philadelphia PICU between July 1, 2011, and December 31, 2021. Participants included patients eligible for studies requiring prospective consent. Data were analyzed from February 2 to July 26, 2022.
Exposures included race and ethnicity (Black, Hispanic, White, and other), language (Arabic, English, Spanish, and other), religion (Christian, Jewish, Muslim, none, and other), and SDI (composite of multiple socioeconomic indicators).
Multivariable regressions separately tested associations between the 4 exposures (race and ethnicity, language, religion, and SDI) and 3 outcomes (rates of approach among eligible patients, consent among eligible patients, and consent among those approached). The degree to which reduced rates of approach mediated the association between lower consent in Black children was also assessed.
Of 3154 children included in the study (median age, 6 IQR, 1.9-12.5 years; 1691 53.6% male), rates of approach and consent were lower for Black and Hispanic families and those of other races, speakers of Arabic and other languages, Muslim families, and those with worse SDI. Among children approached for research, lower consent odds persisted for those of Black race (unadjusted odds ratio OR, 0.73 95% CI, 0.55-0.97; adjusted OR, 0.68 95% CI, 0.49-0.93) relative to White race. Mediation analysis revealed that 51.0% (95% CI, 11.8%-90.2%) of the reduced odds of consent for Black individuals was mediated by lower probability of approach.
In this cohort study of consent rates for PICU research, multiple sociodemographic factors were associated with lower rates of consent, partly attributable to disparate rates of approach. These findings suggest opportunities for reducing disparities in PICU research participation.
Children with sickle cell disease (SCD) are at risk for neurologic and cognitive complications beginning in early childhood. Current treatment for SCD focuses on primary prevention of complications, ...such as hydroxyurea for prevention of pain and acute chest syndrome, and chronic transfusion therapy for children who are at high risk for strokes. In this article, the prevalence, pathophysiology, and available interventions to prevent and treat neurologic and cognitive complications of SCD will be reviewed.
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