Inflammatory myofibroblastic tumor of the bladder: dramatic presentation of an unusual tumor

We report a case of an inflammatory myofibroblastic tumor of the bladder (IMT) in an adult male who presented with recurrent hematuria. He required partial cystectomy which revealed perivesical fat infiltration. In spite of this, the tumor was categorized as benign and the patient remained symptom- and tumor-free 18 months post-operatively.Key Words: Myofibroblastic tumor, bladder, IM

Sleep-related attentional and interpretive-bias in insomnia: a systematic review and meta-analysis

Cognitive models of insomnia highlight internal and external cognitive-biases for sleep-related “threat” in maintaining the disorder. This systematic review of the sleep-related attentional and interpretive-bias literature includes meta-analytic calculations of each construct. Searches identified N = 21 attentional-bias and N = 8 interpretive-bias studies meeting the inclusion/exclusion criteria. Seventeen attentional-bias studies compared normal-sleepers and poor-sleepers/insomnia patients. Using a random effects model, meta-analytic data based on standardized mean differences of attentional-bias studies determined the weighted pooled effect size to be moderate at 0.60 (95%CI:0.26–0.93). Likewise, seven of eight interpretive-bias studies involved group comparisons. Meta-analytic data determined the weighted pooled effect size as moderate at .44 (95%CI:0.19–0.69). Considering these outcomes, disorder congruent cognitive-biases appear to be a key feature of insomnia. Despite statistical support, absence of longitudinal data limits causal inference concerning the relative role cognitive-biases in the development and maintenance of insomnia. Methodological factors pertaining to task design, sample and stimuli are discussed in relation to outcome variation. Finally, we discuss the next steps in advancing the understanding of sleep-related biases in insomnia

The therapeutic potential of attentional bias modification training for insomnia: study protocol for a randomised controlled trial.

The efficacy of attentional bias modification (ABM) as a treatment for anxiety and depression has been extensively studied with promising results. Despite some evidence of sleep-related attentional biases in insomnia, only a small number of studies, yielding mixed results, have examined the application of ABM in insomnia. This study specifically aims to determine whether ABM can reduce (i) the presence of an attentional bias for sleep-related threatening words; (ii) insomnia symptom severity; (iii) sleep onset latency; and (iv) pre-sleep cognitive arousal amongst individuals with insomnia compared to a non-treatment control group of individuals with insomnia. We propose a randomised controlled trial of 90 individuals from the general population who meet the criteria for Insomnia Disorder. Following an initial examination for the presence of a sleep-related attentional bias using the dot-probe paradigm, participants will be randomised to an online attentional bias modification training condition, or to a standard attentional bias task (non-treatment) control condition. Both conditions will be delivered online by a web platform. All participants allocated to the non-treatment control group will be offered ABM training once the study is complete. The primary outcome will be the attentional bias indices of vigilance and disengagement and self-reported insomnia symptoms, sleep onset latency and pre-sleep cognitive arousal. Attentional bias and insomnia symptoms will be assessed at baseline (day 1) and post-treatment (2 days after the final training session: day 9). Insomnia symptoms will be again assessed at follow-up (day 16). Secondary outcomes include examining whether sleep associated monitoring and worry are related to a sleep-related attentional bias in insomnia, and whether such reports reduce following ABM. All main analyses will be carried out on completion of follow-up assessments. The trial is supported by the Department of Psychology, Sociology and Politics at Sheffield Hallam University. This study will extend the research base examining the efficacy of attentional bias modification for insomnia. ISRCTN ( ISRCTN11643569 , registered on 5 June 2018)

Investigating the effects of inhibition training on attentional bias change: A simple Bayesian approach

Attention bias modification (ABM), in which participants are trained to direct attention away from negative information, has been shown to reduce anxiety. However, such findings have been inconsistent. Changes in attentional bias are often absent, suggesting need for further investigation of the underlying mechanisms of ABM, as well as better statistical methods to analyze ABM data in order to reduce inferential error. In this study, we (a) compared inhibition control training to standard ABM training conditions, and (b) demonstrated the benefits of using simple Bayesian analyses to analyze ABM data. We recruited 116 participants and assessed their attentional bias prior to and after training, which involved practice avoiding negative stimuli, attending to negative stimuli, or avoiding a non-emotional, exogenous attentional cue (inhibitory control training). Our results suggested no impact of any of the training conditions on attentional bias. We further demonstrate Bayesian analyses may help control for both Type I and Type II error relative to a frequentist approach

Sleep-related attentional bias in insomnia: time to examine moderating factors?

Prominent cognitive models of insomnia have emphasized the notion that the disorder is in part maintained by an attentional bias for sleep related “threat” cues which may be internal (i.e., bodily sensations) or external (i.e., environmental) in nature (Harvey, 2002; Espie et al., 2006). To support this proposition, a growing number of studies have examined the presence of a sleep-related attentional bias for words and images using experimental tasks including the dot-probe, flicker, Posner, emotional Stroop, and eye-tracking paradigms (see Harris et al., 2015 for a review). Many of these studies have provided encouraging evidence for the presence of such a bias in insomnia. However, the evidence base advocating the presence of such a bias remains mixed with a number of studies yielding no statistically significant effects. While a recent review (Harris et al., 2015) cautiously suggests biased attention for sleep-related threat information to be a likely feature of insomnia, the authors highlight the need to understand the specificity of this bias and its relationship with mechanisms believed to underpin the disorder (e.g., sleep preoccupation). Furthermore, whilst it is possible that the mixed evidence may stem from methodological differences relating to the task or population used, the possible moderating influence of these factors on the relationship between attentional bias for sleep-related threat information and insomnia have only recently been examined (e.g., Zheng et al., 2018). With this in mind, we propose candidate factors that may play a crucial role in addressing moderating questions such as “when,” “for whom” and “under which” conditions are sleep-related attentional biases evident in individuals characterized by insomnia