Behavioral Outcomes Research Articles

The researcher's guide to selecting biomarkers in mental health studies.

Clinical mental health researchers may understandably struggle with how to incorporate biological assessments in clinical research. The options are numerous and are described in a vast and complex body of literature. Here we provide guidelines to assist mental health researchers seeking to include biological measures in their studies. Apart from a focus on behavioral outcomes as measured via interviews or questionnaires, we advocate for a focus on biological pathways in clinical trials and epidemiological studies that may help clarify pathophysiology and mechanisms of action, delineate biological subgroups of participants, mediate treatment effects, and inform personalized treatment strategies. With this paper we aim to bridge the gap between clinical and biological mental health research by (1) discussing the clinical relevance, measurement reliability, and feasibility of relevant peripheral biomarkers; (2) addressing five types of biological tissues, namely blood, saliva, urine, stool and hair; and (3) providing information on how to control sources of measurement variability.

A meta-analysis approach to evaluate the effects of early group housing on calf performance, health and behavior during the preweaning period

This study aimed to evaluate the effects of early group housing on the performance, health, and behavior of dairy calves during the pre-weaning period using systematic and meta-analysis approaches. Peer-reviewed articles written in English that compared dairy calves individually and group-housed with performance, health, or behavior outcomes were collected from Web of Science, PubMed and CabDirect databases. The resulting articles (n = 850) underwent a PRISMA 4-step appraisal process, resulting in a final sample of 51 articles containing 85 studies. The weighted or standardized mean differences between individually and group [pair or group (with > 2 calves)] housed calves were analyzed for each variable using the Der-Simonian and Laird methods. Heterogeneity between calf housing systems was evaluated by the chi-squared test and I2 statistics. A meta-regression analysis was conducted to identify categorical covariate effects for variables with high heterogeneity. Most of the studies included in this review evaluated female calves (45.8%) weaned at 8 weeks old (52.6%). Housing systems were mainly paired housing (55.3%), followed by groups of 3 to 6 calves (30.65) and groups of 7 to 15 calves (4.7%). We did not find studies with comparable outcomes for more robust health parameters (as occurrence of diseases), only blood parameters, that were not influenced by the housing system (P > 0.05). But, weight gain and feed intake parameters were higher (P < 0.05) in group-housed calves. Through the meta-regression, we found that average daily gain was positively affected (P < 0.05) by the group housing in studies with calves housed in small pen areas (<1.5 m2 per calf). Group-housed calves presented more active behaviors (feeding and playing) and less stress-related behaviors (self-grooming and interacting with the pen) than individually-housed calves. The behavioral tests most used were novel object, human approach, novel environment, and social tests. Individually-housed calves presented fewer vocalizations on these tests and spent more time interacting with humans during the human approach test than group-housed calves. Our findings provide consistent evidence that group housing improves the welfare of dairy calves; however, the effects on health parameters are still scarce and unclear.

Therapeutic Doll Interventions for People Living with Dementia in Care Homes: A Scoping Review.

Doll therapy is a psychosocial intervention that has been commonly used within dementia care for many decades. The practice of doll therapy involves supporting people with dementia to engage with a therapeutic doll and this has been associated with positive changes in a person's wellbeing and behavior. While there have been several systematic reviews that have focused on behavioral outcomes, limited reviews have explored the broader psychosocial outcomes associated with doll therapy in care home settings. A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Four electronic databases were searched systematically (CINAHL Plus, Medline, PsycINFO, and PubMed). Twelve primary research studies from the past ten years (2013-2023) were included in this review. Primary data were synthesized using a narrative synthesis methodology. The three main themes from this review relate to a reduction in levels of behavioral and psychological symptoms of dementia (BPSD), increased communication skills, and a reduction in caregiver distress. Doll therapy has the potential to be an effective person-centered intervention that can enhance quality of life for people living with dementia in care home settings.

Effects of an integrated lifestyle intervention for overweight and obese breast cancer survivors: A quasi-experimental study

PurposeThis study aimed to identify the effects of an integrated lifestyle intervention on health-promoting behavior, depression, body composition, and quality of life for overweight and obese breast cancer survivors. MethodsThis study used a quasi-experimental design with a non-equivalent control group pretest-posttest. The participants were 42 overweight and obese breast cancer survivors. An integrated lifestyle intervention was implemented for eight weeks and comprised eight sessions on diet education, physical activity, stress management, and spousal participation. Outcomes for health-promoting behavior, depression, marital intimacy, body composition, natural killer cell activity, and quality of life were measured. ResultsThe experimental group scored significantly higher than the control group for health-promoting behavior (t = 2.912, p = .007), marital intimacy (t = 2.306, p = .021), and quality of life (t = 2.559, p = .014). Moreover, depression was significantly lower in the experimental group than in the control group (t = −2.723, p = .013). ConclusionThis study demonstrated that the integrated lifestyle intervention increased health-promoting behavior, marital intimacy, and quality of life and reduced depression among overweight and obese breast cancer survivors. Integrated lifestyle interventions can have a positive effect in communities and in clinical environment to improve health and quality of life among overweight and obese breast cancer survivors.

The impact of risk factor disclosure on the initial return of IPO companies amidst a pandemic

The capital market has increasingly become a pivotal avenue for enterprises seeking additional capital for expansion or operational enhancements. In raising funds through an Initial Public Offering (IPO), the company must publish its risk disclosure in the prospectus. Therefore, this study aims to investigate the impact of risk disclosure on the initial return of Indonesian companies undergoing IPOs during the pandemic. Using data from 136 out of 164 companies that went public between 2020 and 2022, sourced from the Indonesian Stock Exchange and company websites, the study employs the ordinary least squares method to estimate the impact of risk disclosures on initial returns during the pandemic. The findings reveal that external and overall risk disclosures significantly influence IPO initial returns. Specifically, Indonesian investors were particularly attentive to external and overall risks when evaluating IPOs during the pandemic. This heightened concern suggests that comprehensive risk disclosure can affect investor behavior and financial outcomes for companies going public in uncertain times, highlighting the importance of transparency in risk communication to support investor decision-making and market stability.

A pilot trial of an LGBTQ-affirmative cognitive-behavioral therapy for transgender and gender expansive individuals’ mental, behavioral, and sexual health

Transgender and gender expansive (TGE) individuals face minority stress and associated health risks, especially in high-stigma contexts. LGBTQ-affirmative cognitive-behavioral therapy (CBT) is one of the only evidence-based interventions developed to address minority stress to improve psychosocial health. Yet, trials of this treatment have mostly enrolled cisgender sexual minorities, TGE youth, and those living in North American contexts. This study tested the feasibility, acceptability, and preliminary efficacy of LGBTQ-affirmative CBT for TGE adults living in the high-stigma context of Romania. Twenty-five TGE individuals (Mage=25.16, SDage=6.39; 44% transgender women, 40% transgender men, 16% non-binary) reporting depression and/or anxiety symptoms received 16 virtual sessions of LGBTQ-affirmative CBT from trained psychologists. Assessments of mental (e.g., depression), behavioral (e.g., hazardous drinking), and sexual (e.g., HIV-transmission risk behavior) health outcomes, and minority stress and universal risk mechanisms were administered at baseline and 5-month follow-up. Results showed reductions in depression and anxiety symptoms and certain minority stress (e.g., anticipated stigma, identity concealment) and universal risk (e.g., unassertiveness) mechanisms from baseline to follow-up. The intervention was highly feasible (e.g., timely recruitment, high session attendance), and exit interviews revealed high acceptability in terms of the treatment’s relevance, goals, imparting minority stress knowledge and identity-related hope and acceptance, format, and therapeutic alliance. LGBTQ-affirmative CBT shows feasibility, acceptability, and preliminary efficacy among TGE individuals living in Romania, with promise for other high-stigma contexts. Future randomized controlled trials and reductions in structural determinants remain priorities.

The Influence of Structural Brain Changes on Cognition in the Context of Healthy Aging: Exploring Mediation Effects Through gBAT-The Graphical Brain Association Tool.

The contribution of age-related structural brain changes to the well-established link between aging and cognitive decline is not fully defined. While both age-related regional brain atrophy and cognitive decline have been extensively studied, the specific mediating role of age-related regional brain atrophy on cognitive functions is unclear. This study introduces an open-source software tool with a graphical user interface that streamlines advanced whole-brain mediation analyses, enabling researchers to systematically explore how the brain acts as a mediator in relationships between various behavioral and health outcomes. The tool is showcased by investigating regional brain volume as a mediator to determine the contribution of age-related brain volume loss toward cognition in healthy aging. We analyzed regional brain volumes and cognitive testing data (Montreal Cognitive Assessment [MoCA]) from a cohort of 131 neurologically healthy adult participants (mean age 50 ± 20.8 years, range 20-79, 73% females) drawn from the Aging Brain Cohort Study at the University of South Carolina. Using our open-source tool developed for evaluating brain-behavior associations across the brain and optimized for exploring mediation effects, we conducted a series of mediation analyses using participant age as the predictor variable, total MoCA and MoCA subtest scores as the outcome variables, and regional brain volume as potential mediators. Age-related atrophy within specific anatomical networks was found to mediate the relationship between age and cognition across multiple cognitive domains. Specifically, atrophy in bilateral frontal, parietal, and occipital areas, along with widespread subcortical regions mediated the effect of age on total MoCA scores. Various MoCA subscores were influenced by age through atrophy in distinct brain regions. These involved prefrontal regions, sensorimotor cortex, and parieto-occipital areas for executive function subscores, prefrontal and temporo-occipital regions, along with the caudate nucleus for attention and concentration subscores, frontal and parieto-occipital areas, alongside connecting subcortical areas such as the optic tract for visuospatial subscores and frontoparietal areas for language subscores. Brain-based mediation analysis offers a causal framework for evaluating the mediating role of brain structure on the relationship between age and cognition and provides a more nuanced understanding of cognitive aging than previously possible. By validating the applicability and effectiveness of this approach and making it openly available to the scientific community, we facilitate the exploration of causal mechanisms between variables mediated by the brain.

A Scoping Review of Multimodal, Dyadic Early Relational Health Interventions in NICUs in the United States.

Early relational health (ERH) interventions can buffer toxic stress and improve the developmental trajectories of neonatal intensive care unit (NICU) infants. The purpose was to examine the current state of the science related to multimodal, dyadic ERH interventions implemented in the NICU setting in the United States and identify gaps in the current literature. PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo were searched in November 2022 and November 2023 for original studies and conference proceedings from 1970 to present in the English language. Gray literature searches were performed in February 2023 and December 2023. English language, original research, with a focus on multimodal, dyadic ERH interventions that took place primarily in a NICU in the United States were included. Outcome measures could be related to implementation, relational health, or physical and/or mental health outcomes of parent and/or infant. Eighteen of 2021 reviewed articles met the inclusion criteria. Data were extracted for author, year, intervention, purpose, methods, sample, paternal inclusion, dyadic components, non-dyadic components, and major outcomes/results and distilled for study characteristics, multimodal, dyadic intervention characteristics, and outcome measures. Several multimodal dyadic interventions exist to aid ERH in the NICU, providing evidence of improved outcomes for infants and families. More research is required using higher sample sizes and replication studies. ERH interventions show promise in improving neurodevelopmental, behavioral, and maternal mental health outcomes and should be considered for implementation into NICU services.

Network-level enrichment provides a framework for biological interpretation of machine learning results.

Machine learning algorithms are increasingly being utilized to identify brain connectivity biomarkers linked to behavioral and clinical outcomes. However, research often prioritizes prediction accuracy at the expense of biological interpretability, and inconsistent implementation of ML methods may hinder model accuracy. To address this, our paper introduces a network-level enrichment approach, which integrates brain system organization in the context of connectome-wide statistical analysis to reveal network-level links between brain connectivity and behavior. To demonstrate the efficacy of this approach, we used linear support vector regression (LSVR) models to examine the relationship between resting-state functional connectivity networks and chronological age. We compared network-level associations based on raw LSVR weights to those produced from the forward and inverse models. Results indicated that not accounting for shared family variance inflated prediction performance, the k-best feature selection via Pearson correlation reduced accuracy and reliability, and raw LSVR model weights produced network-level associations that deviated from the significant brain systems identified by forward and inverse models. Our findings offer crucial insights for applying machine learning to neuroimaging data, emphasizing the value of network enrichment for biological interpretation.

Technology-Based Interventions to Promote Diabetes Self-Management Behaviors for Persons Newly Diagnosed with Type 2 Diabetes: A Scoping Review.

Type 2 diabetes (T2D) management is complex and requires daily personal involvement and self-management skills to maintain optimal glycemic levels and improve health outcomes. Engagement in self-management behaviors in the early years of diagnosis can be challenging due to prevailing psychosocial factors present during this critical transition period, coupled with a lack of information, support, and skills. Technology-based diabetes self-management interventions can improve access to needed education and support, and their effectiveness in the general T2D population is well documented. This scoping review synthesized evidence on the use of technology for promoting diabetes self-management behaviors and related outcomes among individuals newly diagnosed with T2D (within the first 12months since diagnosis). Twenty-five studies were included. Technology-based diabetes self-management interventions tailored to those newly diagnosed with T2D have grown exponentially in the past five years. Existing evidence, though limited, showed that technologies such as websites, mobile apps, and continuous glucose monitoring combinedwith other communication features, can facilitate patient education, patient-provider communication, and health data monitoring. However, these technologies less commonly involved social support functions. These technologies have the potential to improve diabetes knowledge and positively impactclinical, behavioral, and psychological outcomes. However, small sample sizes, use of non-experimental designs, and the absence of formative research and theoretical foundations limit the strength ofexisting studies. Technology-based self-management interventions for those newly diagnosed with T2D show promise in improving T2D-related outcomes. Future studies should include larger sample sizes, adopt rigorous study designs, and integrate formative work to enhance relevance, adoption, and impact.

Improving working memory by electrical stimulation and cross-frequency coupling

Working memory (WM) is essential for the temporary storage and processing of information required for complex cognitive tasks and relies on neuronal theta and gamma oscillations. Given the limited capacity of WM, researchers have investigated various methods to improve it, including transcranial alternating current stimulation (tACS), which modulates brain activity at specific frequencies. One particularly promising approach is theta-gamma peak-coupled-tACS (TGCp-tACS), which simulates the natural interaction between theta and gamma oscillations that occurs during cognitive control in the brain. The aim of this study was to improve WM in healthy young adults with TGCp-tACS, focusing on both behavioral and neurophysiological outcomes. Thirty-one participants completed five WM tasks under both sham and verum stimulation conditions. Electroencephalography (EEG) recordings before and after stimulation showed that TGCp-tACS increased power spectral density (PSD) in the high-gamma region at the stimulation site, while PSD decreased in the theta and delta regions throughout the cortex. From a behavioral perspective, although no significant changes were observed in most tasks, there was a significant improvement in accuracy in the 14-item Sternberg task, indicating an improvement in phonological WM. In conclusion, TGCp-tACS has the potential to promote and improve the phonological component of WM. To fully realize the cognitive benefits, further research is needed to refine the stimulation parameters and account for individual differences, such as baseline cognitive status and hormonal factors.

Microdosing of a kappa opioid receptor agonist within proximal nucleus accumbens shell microstructures revealing opposing behavioral outcomes

Targeted intracranial delivery of molecularly-specific therapies within intricate brain structures poses a formidable challenge due to the heterogeneity of neuronal phenotypes and functions. Here we report the use of an implantable, miniaturized neural drug delivery system permitting dynamic adjustment of pharmacotherapies. Specifically, we exploit the spatial accuracy afforded by this method for targeting modulation of neuronal microstructures. Kappa opioid receptors (KOR) within the dorsal medial nucleus accumbens shell (NASh) are selectively activated through micro infusions of the KOR agonist, U-50488. Remarkably, we demonstrate that micro infusions of U-50488 into the dorsal NASh induces reward-like conditioned place preferences, whereas a mere 1 mm shift ventrally results in conditioned place aversions. The striking precision afforded by this method may prove useful in other neurotherapeutic interventions.

A full-factorial test of motivational and volitional intervention strategies for promoting exercise habit formation and exercise maintenance among new users of an online exercise class platform.

Interventions often fail to achieve long-term behavioral maintenance. Utilizing motivational and volitional strategies to promote behavioral maintenance factors may improve this. Using a full-factorial experiment, we tested the effects of three intervention components (focused on intrinsic motivation and identity, exercise preparation habit, and exercise instigation habit) on exercise participation over a year, among new users (N = 751; 91% identifying as female, 54% identifying as White race) of a global, online exercise class platform, run by Les Mills International Ltd, called LM+. We also tested the intervention components' theoretical mechanisms of action-habit formation, intrinsic motivation, identity, and self-efficacy. Multi-level models found some support for a main effect of the exercise preparation habit intervention component in promoting self-reported and objective exercise participation (behavioral outcomes measured via monthly surveys and the LM+ platform; mechanisms measured via monthly surveys)-in particular online exercise class frequency (fixed effect estimate = 0.84, p < 0.05, and = 0.12, p < 0.05, respectively). The preparation habit component also significantly increased preparation habit strength (0.30, p < 0.05) and instigation habit strength (0.33, p < 0.05). Other expected effects were nonsignificant. Helping individuals form an exercise preparation habit may facilitate initiating and maintaining exercise over time, in particular for attending online exercise classes, potentially through promoting greater preparation and exercise instigation habit strength.

Long-term tracking of social structure in groups of rats

Rodents serve as an important model for examining both individual and collective behavior. Dominance within rodent social structures can determine access to critical resources, such as food and mating opportunities. Yet, many aspects of the intricate interplay between individual behaviors and the resulting group social hierarchy, especially its evolution over time, remain unexplored. In this study, we utilized an automated tracking system that continuously monitored groups of male rats for over 250 days to enable an in-depth analysis of individual behavior and the overarching group dynamic. We describe the evolution of social structures within a group and additionally investigate how past behaviors influence the emergence of new social hierarchies when group composition and experimental area changes. Notably, we find that conventional individual and pairwise tests exhibit a weak correlation with group behavior, highlighting their limited accuracy in predicting behavioral outcomes in a collective context. These results emphasize the context-dependence of social behavior as an emergent property of interactions within a group and highlight the need to measure and quantify social behavior in more naturalistic environments.

Chronic unpredictable stress during adolescence exerts sex-specific effects on depressive-like behavior and neural activation triggered by tail suspension test

During adolescence, acute stress can modify neuronal excitability in various brain regions, leading to negative behavioral outcomes. However, the impact of chronic stress during adolescence on neuronal responses to acute stimuli remains unclear. To address this, we subjected adolescent mice to 12 days of chronic unpredictable stress (CUS). Anxiety and depressive behaviors were evaluated, along with changes in c-Fos expression, which is one of the most widely used markers of neuronal activation. By comparing c-Fos immunoreactivity between the CUS and control groups both before and after the tail suspension test (TST), we found that adolescent CUS induced depressive behaviors in male mice, but not in female mice. Adolescent CUS primarily affected the excitability of neurons in the infralimbic cortex (IL), the dorsomedial and dorsolateral area of the bed nucleus of the stria terminalis (BNST), and the ventral hippocampus CA3. TST exerted a significant main effect on the density of c-Fos+ neurons in the prelimbic cortex (PL), infralimbic cortex (IL), cingulate areas 1 and 2 (Cg1, Cg2), the lateral septum (LS), Bed nucleus terminalis (BNST), and lateral habenular (LHb). Furthermore, the excitability of neurons in the paraventricular thalamic nucleus (PVT) was impacted by sex. These data suggest that adolescent CUS elicits region- and sex-specific modifications in TST-induced c-Fos expression, establishing a theoretical basis for understanding the pathophysiological alterations in mood disorders following adolescent stress.

미국 초⋅중등 통합운영학교의 특성 분석

Objectives Declining school-age population has led to the rise of combined schools. It is time to spread combined schools in Korea. Therefore, we analyzed the case of the United States, where combined schools are popularized, to draw implications. Methods Academic articles, school websites, and statistics related to combined schools in the United States were referenced. Results K-8 schools in the U.S. are replacing middle schools due to their educational effectiveness. In addition, the autonomy of the state and schools in curriculum, teacher qualifications, and school management is guaranteed, so combined schools are operating smoothly. While K-8 schools in the U.S. have been shown to have a positive impact on academic achievement, emotional and behavioral outcomes, they have also been criticized for faculty conflicts and financial burdens. Conclusions In order to successfully scale up, the emphasis should be on both economic efficiency and educational effectiveness. In addition, efforts at the school, district, national, and global levels are needed to ensure the smooth operation of combined schools.

Methamphetamine-induced impairment of memory and fleeting neuroinflammation: Profiling mRNA changes in mouse hippocampus following short-term and long-term exposure

Methamphetamine (METH) has been implicated in inducing memory impairment, but the precise mechanisms underlying this effect remain unclear. Current research often limits itself to singular models or focuses on individual gene or protein functions, which hampers a comprehensive understanding of the underlying mechanisms. In this study, we established three METH mouse exposure models, extracted hippocampal nuclei, and utilized RNA sequencing to analyze changes in mRNA expression profiles. Our results indicate that METH significantly impairs the learning and memory capabilities of mice. Additionally, we observed that METH-induced inflammatory responses occur in the early phase and do not further exacerbate with repeated injections. However, RNA sequencing revealed the persistent enrichment of inflammatory pathway molecules, which correlated with worsened behaviors. This suggests that although METH-induced neuroinflammation plays a critical role in learning and memory impairment, the continued enrichment of inflammatory pathway molecules is associated with behavioral outcomes. These findings provide crucial evidence for the potential application of immune intervention in METH-related disorders.

Beyond Empathy: Analyzing Compassion Fatigue Among Counselor

Compassion fatigue is an emotional response characterized by a diminished capacity or interest in empathizing with others. This phenomenon often results from continuous exposure to traumatic narratives recounted by clients, leading to negative behavioral and emotional outcomes in counselors. Compassion fatigue can impair the ability to support others and hinder overall productivity. Counselors are particularly vulnerable to experiencing compassion fatigue. Given the increasing number of counselors, it is imperative to investigate the prevalence and characteristics of compassion fatigue. This study aims to delineate the features of compassion fatigue among 45 counselors at East &amp; Central Java. The research employs a quantitative descriptive methodology. The Professional Quality of Life Scale (ProQOL) was adapted for this study, encompassing three subscales that assess compassion fatigue, compassion satisfaction, and burnout. This instrument represents an advanced iteration of the original compassion fatigue scale.

Behavioral development in the Shadow of child Neglect: The roles of resilience and peer rejection

Child neglect, a pervasive issue impacting numerous children globally, directly correlates with poorer behavioral outcomes. Drawing on data from 1043 middle and high school students in Jiangsu Province, this study investigates the impact of child neglect on the behavioral development of children in rural China. The stress process model was employed to examine the mediating roles of resilience and peer rejection, with gender as a moderator. Findings reveal that child neglect directly correlates with poorer behavioral development, with resilience and peer rejection serving as significant mediators in this relationship. The analysis further reveals that the effect of resilience on behavioral development is moderated by gender, being more pronounced in boys. By integrating the stress process model, this study enriches the theoretical discourse on child neglect and provides empirical evidence from a neglected demographic, emphasizing the need for nuanced, gender-specific policy and practice interventions. These insights underscore the necessity for targeted interventions that consider the unique challenges posed by child neglect, advocating for strategies that enhance resilience and effectively manage peer relationships.

Refugee Crisis, News Crisis: The Framing of Episodic and Thematic Articles

A main tenet of 21st Century journalism is to engage the public with highly informative and affective content. Through sociological journalistic processes of creating news content, however, audiences may lose the ability to completely conceptualize the level of human suffering observed in the coverage of refugee crises. This experimental survey tested the use of episodic and thematic frames in formatting American news articles about the Syrian refugee crisis of migrants landing on Grecian shores. It found that episodically framed articles increased moral understanding among Americans, as well as overall engagement in the crisis event. Respondents, however, were not more likely to participate in civic engagement about the refugee crisis with others. The results suggest that the use of episodic frames in the construction of refugee news articles may engage audiences more in the issue, however, alone are not enough to affect behavioral outcomes such as discussion. Further research should investigate the implications of framing choices made in the presentation of news stories about important issues such as mass human migrations. Keywords: framing, news, refugee, diaspora