Helen G.M. Vossen

Treatment of post-myocardial infarction depressive disorder: a randomized, placebo-controlled trial with mirtazapine.

Objective: To examine the antidepressant efficacy of a dual-acting antidepressant (mirtazapine) in patients with post-myocardial infarction (MI) depressive disorder. Antidepressants used in post MI trials with a randomized, double-blind, placebo-controlled design have been restricted to selective serotonin reuptake inhibitors (SSRIs). Antidepressant effects have been limited. Methods: In a prospective multicenter study, 2177 patients with MI were evaluated for depressive disorder during the first year post MI. Ninety-one patients who met the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for major or minor depressive disorder were randomized to a 24-week, double-blind, placebo-controlled trial. Antidepressant efficacy was tested using last-observation-carried-forward procedure and repeated measurements analysis using the SPPS mixed models approach, with as primary outcome reduction in depressive symptomatology on the 17-item Hamilton-Depression Rating Scale (Ham-D), and secondary outcomes the Beck Depression Inventory (BDI) and depression subscale of the Symptom Check List 90 items (dSCL-90) as well as the Clinical Global Impression (CGI) scale. Results: Using the “last observation carried forward” (LOCF) method, mirtazapine did not show to be superior to placebo on the Ham-D, but did on the BDI, dSCL-90, and CGI scale over the acute treatment phase of 8 weeks (n = 91). Using mixed models analysis over the entire 24 weeks of treatment (n = 40), we did find a significant difference favoring mirtazapine to placebo on the Ham-D, BDI, and CGI, but on the dSCL-90, this difference was not significant. Conclusions: This trial shows efficacy of mirtazapine on primary and secondary depression measures. Mirtazapine seems to be safe in the treatment of post-MI depression. MI = myocardial infarction; RCT = randomized controlled trial; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders; CAD = coronary artery disease; SSRI = selective serotonin reuptake inhibitors; TCA = tricyclic antidepressant; Ham-D = Hamilton-Depression Rating Scale; BDI = Beck Depression Inventory; CGI = Clinical Global Impression; dSCL-90 = Symptom Check List 90 items, depression subscale; SES = standardized effect size.

Media Violence and Adolescents’ ADHD-Related Behaviors: The Role of Parental Mediation

We examined the role of parental media mediation in the relationship between media violence and adolescents’ ADHD-related behaviors. Survey data from 1,017 adolescents (10–14 years) show that parents can play an important role in this relationship, depending on the media mediation strategies that they use (i.e., restrictive or active mediation) and how they apply these strategies (i.e., in a controlling, inconsistent, or autonomy-supportive way). Our findings support the notion that contextual factors are critical in understanding media effects, and provide directions for how parents can manage their adolescents’ violent media use, and possibly by extension, their ADHD-related behaviors.

Does Habituation Differ in Chronic Low Back Pain Subjects Compared to Pain-Free Controls? A Cross-Sectional Pain Rating ERP Study Reanalyzed with the ERFIA Multilevel Method

AbstractThe objective of the present study was to investigate cortical differences between chronic low back pain (CLBP) subjects and pain-free controls with respect to habituation and processing of stimulus intensity. The use of a novel event-related fixed-interval areas (ERFIA) multilevel technique enables the analysis of event-related electroencephalogram (EEG) of the whole post stimulus range at a single trial level. This technique makes it possible to disentangle the cortical processes of habituation and stimulus intensity.In a cross-sectional study, 78 individuals with CLBP and 85 pain-free controls underwent a rating paradigm of 150 nonpainful and painful somatosensory electrical stimuli. For each trial, the entire epoch was partitioned into 20-ms ERFIAs, which acted as dependent variables in a multilevel analysis. The variability of each consecutive ERFIA period was modeled with a set of predictor variables, including 3 forms of habituation and stimulus intensity.Seventy-six pain-free controls and 65 CLBP subjects were eligible for analysis. CLBP subjects showed a significantly decreased linear habituation at 340 to 460 ms in the midline electrodes and C3 (Ps < .05) and had a significantly more pronounced dishabituation for the regions of 400 to 460 ms and 800 to 820 ms for all electrodes, except for T3 and T4 (Ps < .05). No significant group differences for stimulus intensity processing were observed.In this study, group differences with respect to linear habituation and dishabituation were demonstrated. By means of the ERFIA multilevel technique, habituation effects were found in a broad post stimulus range and were not solely limited to peaks. This study suggests that habituation may be a key mechanism involved in the transition process to chronic pain. Future studies with a longitudinal design are required to solve this issue.

Media and child development

Decades of research have shown that the relationship between media and childhood is not unidirectional but reciprocal. In this article, both directions of the media-child development relationship are presented. We discuss how child development predisposes childrens media use and preferences by reviewing key developmental characteristics of four periods across childhood, the typical media use during each period, and then hypothesizing how these characteristics influence media use and preferences. Next, we present an overview on the negative and positive influences of media that are most prominent in the public debate. We conclude by identifying directions for future research.

The Longitudinal Relationship Between Media Violence and Empathy: Was It Sympathy All Along?

Previous research with adolescents has reported a negative relationship between media violence and empathy. There are, however, two important conceptual issues in this earlier literature that deserve further research attention. First, studies often treat empathy as a one-dimensional construct while it consists of both an affective and cognitive component. Second, while aiming to measure empathy, several studies have measured sympathy instead. Driven by these concerns, this study was designed to investigate the longitudinal relationship between media violence, affective empathy, cognitive empathy, and sympathy. Using data from a two-wave panel study with 943 adolescents (10–14 years old), a cross-lagged model tested whether media violence exposure negatively influences empathy and sympathy (desensitization) or whether empathy and sympathy negatively influence media violence exposure (selection). Results were in line with desensitization. However, rather than showing that media violence leads to a decrease in empathy (which previous studies have shown), results indicate a decrease in sympathy instead. These findings provide clarification to existing work as well as offer methodological and practical implications.

Introducing the event related fixed interval area (ERFIA) multilevel technique: a method to analyze the complete epoch of event-related potentials at single trial level

In analyzing time-locked event-related potentials (ERPs), many studies have focused on specific peaks and their differences between experimental conditions. In theory, each latency point after a stimulus contains potentially meaningful information, regardless of whether it is peak-related. Based on this assumption, we introduce a new concept which allows for flexible investigation of the whole epoch and does not primarily focus on peaks and their corresponding latencies. For each trial, the entire epoch is partitioned into event-related fixed-interval areas under the curve (ERFIAs). These ERFIAs, obtained at single trial level, act as dependent variables in a multilevel random regression analysis. The ERFIA multilevel method was tested in an existing ERP dataset of 85 healthy subjects, who underwent a rating paradigm of 150 painful and non-painful somatosensory electrical stimuli. We modeled the variability of each consecutive ERFIA with a set of predictor variables among which were stimulus intensity and stimulus number. Furthermore, we corrected for latency variations of the P2 (260 ms). With respect to known relationships between stimulus intensity, habituation, and pain-related somatosensory ERP, the ERFIA method generated highly comparable results to those of commonly used methods. Notably, effects on stimulus intensity and habituation were also observed in non-peak-related latency ranges. Further, cortical processing of actual stimulus intensity depended on the intensity of the previous stimulus, which may reflect pain-memory processing. In conclusion, the ERFIA multilevel method is a promising tool that can be used to study event-related cortical processing.

Normative development of the Child Behavior Checklist – Dysregulation Profile from early childhood to adolescence : Associations with personality pathology

The Dysregulation Profile (DP) is a broad indicator of concurrent affective, behavioral, and cognitive dysregulation, often measured with the anxious/depressed, aggressive behavior, and attention problems syndrome scales of the Child Behavior Checklist. Despite an expanding body of research on the DP, knowledge of the normative developmental course of the DP from early childhood to adolescence is lacking. Furthermore, although we know that the DP longitudinally predicts personality pathology, no research yet has examined whether next to the DP in early childhood, the rate of change of the DP across development predicts personality pathology. Therefore, using cohort-sequential latent growth modeling in a population-based sample (N = 668), we examined the normative developmental course of mother-reported DP from ages 4 to 17 years and its associations with a wide range of adolescent-reported personality pathology dimensions 3 years later. The results showed that the DP follows a nonlinear developmental course with a peak in early adolescence. The initial level of the DP at age 4 and, to a lesser extent, the rate of change in the DP predicted a range of personality pathology dimensions in late adolescence. The findings suggest that the DP is a broad developmental precursor of personality pathology in late adolescence.

Children’s Television Viewing and ADHD-related Behaviors: Evidence from the Netherlands

This study examined how ADHD-related behaviors are associated with children’s overall amount of television viewing, specific content viewing (i.e. violent/scary and educational), and attention and arousal responses when viewing television. Additionally, it explored the moderating role of children’s sex in these relationships. To address these aims, parents of 865 Dutch children (3–7 years) completed a survey measuring ADHD-related behaviors and kept four-day television diaries. We found that ADHD-related behaviors were not associated with overall viewing nor with violent/scary content viewing. These relationships, however, were moderated by sex. Further analyses of these moderations revealed a positive trend between ADHD-related behaviors and overall and violent/scary content viewing for boys only. ADHD-related behaviors were not related to educational content viewing. Furthermore, ADHD-related behaviors were related to more arousal when viewing television, regardless of content, and less attention to overall and educational television. We did not find sex differences in arousal and attention responses.

Evaluation of the Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP).

The Dysregulation Profile (DP) has emerged as a measure of concurrent affective, behavioral and cognitive dysregulation, associated with severe psychopathology, and poor adjustment. While originally developed with the Child Behavior Checklist, more recently the DP has also been defined on the Strengths and Difficulties Questionnaire (SDQ), mostly with a 5-item, but also a 15-item, SDQ-DP measure. This study evaluated the SDQ-DP by examining its factor structure, measurement invariance, and construct validity. Different SDQ-DP operationalizations were compared. In a United States longitudinal community sample (N = 768), a bifactor model consisting of a general Dysregulation factor and three specific factors of Emotional Symptoms, Conduct Problems, and Hyperactivity-Inattention fitted best, across three different developmental periods (early childhood, middle childhood, and adolescence) and across three different reporters (parents, teachers, and youth). Measurement invariance across reporter, gender, and developmental period was demonstrated. These findings indicate that the SDQ-DP, like the CBCL-DP, reflects a broad syndrome of dysregulation that exists in addition to specific syndromes of emotional symptoms, conduct problems, and hyperactivity-inattention. SDQ-DP bifactor scores were strongly related with scores on the 5- and 15-item SDQ-DP measures and similarly concurrently associated with two markers of self-regulation, ego-resiliency and effortful control, and longitudinally with antisocial behavior and disciplinary measures. As reliability, validity, and stability was weaker for the SDQ-DP 5-item measure, use of all 15 items is recommended. Advantages of using a bifactor approach are discussed as well as the potential of the SDQ-DP as an easy screening measure of children at risk for developing serious psychopathology.

An experimental test of the effects of online and face-to-face feedback on self-esteem

This study investigated the effect of receiving confirming vs. disconfirming feedback to individuals’ self-disclosure on their self-esteem, the role of giving reciprocal feedback in this relationship, and how these effects differ between online and face-to-face communication. Using a two (communication mode: online vs. face-to-face) by two (feedback valence: confirming vs. disconfirming) between-subjects experiment, we found that feedback had a significant indirect effect on self-esteem, through the receiver’s reciprocal feedback. This indirect effect of feedback differed in online communication from offline: In online communication, participants reciprocated negative feedback when they received it, more than in face-to-face communication. The reciprocal feedback enhanced their self-esteem in online communication, but not in face-to-face communication. Although people tend to respond more negatively to negative comments in online conversations, the process, overall, boosts rather than hinders their self-esteem.