Issues and opportunities of digital phenotyping: ecological momentary assessment and behavioral sensing in protecting the young from suicide

Digital phenotyping refers to the collection of real-time biometric and personal data on digital tools, mainly smartphones, and wearables, to measure behaviors and variables that can be used as a proxy for complex psychophysiological conditions. Digital phenotyping might be used for diagnosis, clinical assessment, predicting changes and trajectories in psychological clinical conditions, and delivering tailored interventions according to individual real-time data. Recent works pointed out the possibility of using such an approach in the field of suicide risk in high-suicide-risk patients. Among the possible targets of such interventions, adolescence might be a population of interest, since they display higher odds of committing suicide and impulsive behaviors. The present work systematizes the available evidence of the data that might be used for digital phenotyping in the field of adolescent suicide and provides insight into possible personalized approaches for monitoring and treating suicidal risk or predicting risk trajectories. Specifically, the authors first define the field of digital phenotyping and its features, secondly, they organize the available literature to gather all the digital indexes (active and passive data) that can provide reliable information on the increase in the suicidal odds, lastly, they discuss the challenges and future directions of such an approach, together with its ethical implications

Il perito e lo straniero

Il contributo ha lo scopo di analizzare i problemi e le prassi dell’accertamento dell’imputabilità su soggetti stranieri.Non solo gli “strumenti” di cui si avvale l’accertamento in ambito psicopatologico-forense (colloquio e test) dipendono dal linguaggio e dalla cultura, ma il concetto stesso di capacità di intendere e di volere è in gran parte culturalmente connotato e lo è persino la psicopatologia, tanto che il DSM 5 riserva una parte specifica all’inquadramento culturale nella diagnosi.All’interno di un campione di 51 perizie sull’imputabilità effettuate su stranieri tra il 1975 ed il 2015, gli autori valutano se e in che misura i professionisti si siano preoccupati di tenere conto del fattore culturale nella valutazione peritale, anche per quanto concerne l’utilizzo di tecniche psicodiagnostiche.Dall’analisi effettuata, emergono alcune difficoltà e talora una sostanziale carenza di attenzione per la cultura di appartenenza del periziando, solo raramente valutata e soppesata

Patients' health locus of control and preferences about the role that they want to play in the medical decision-making process

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The personalization of naturalistic virtual reality scenarios to improve relaxation and manage anxiety: a scoping review

This document represents the pre-registration of the scoping review protocol for the study 'The personalization of naturalistic virtual reality scenarios to improve relaxation and manage anxiety : a scoping review". Brief Background: Virtual reality (VR) is widely used to treat various mental diseases and helps facilitate multisensory stimulation, sense of presence, and achievement of relaxation (Riva, 2020; Pizzoli et al., 2019). Data suggest that VR can facilitate learning relaxation techniques through exposure to scenarios in which natural environments commonly considered relaxing are shown (Beverly et al., 2020). The personalization of the scenarios presented together with VR could be an element that further facilitates relaxation. This latter type of user-centered approach (Pizzoli et al., 2019) allows the participants to experience more realistic emotional conditions like those experienced in everyday life, increasing relaxation, sense of presence, and perception of security in the virtual context (e.g., Holland et al., 2010). The study of the user experience related to the role of personalized VR scenarios has attracted interest in the scientific community

Heart Rate Variability Biofeedback in Cancer Patients: A Scoping Review

Heart Rate Variability (HRV) Biofeedback (BFB) has been shown to improve autonomic balance and wellbeing in chronic diseases. As cardiac variability represents an index of cognitive and emotional regulation, HRV-BFB has been shown to lead to improvements in physiological and psychological adaptability and quality of life. However, knowledge of HRV-BFB in cancer patients is lacking, and available results are diversified according to methods and outcomes. The present paper undertakes a scoping review, exploring the use of HRV-BFB to modulate autonomic balance, cancer symptom management, and quality of life in cancer. This scoping review analyzes empirical evidence considering study designs, BFB methods, and psychophysiological outcomes. Research that focused on HRV-BFB effects in cancer patients was selected (79%). In addition, a systematic review and meta-analysis (31%) focusing on HRV, or BFB in chronic conditions, including cancer, were considered. The studies examined BFB treatment for thyroid, lung, brain or colon cancer, hematologic cancer, and survivors or terminal cancer patients. Retrieved studies reported physiological and psychological indices as primary outcomes: they included HRV values, sleep, pain, fatigue, depression, anxiety, and quality of life. Although the heterogeneity of publications makes it difficult to generalize the effectiveness of HRV-BFB, the training has been proven to improve cancer symptoms and well-being

A meta-analysis on heart rate variability biofeedback and depressive symptoms

Heart rate variability biofeedback (HRVB) has been used for a number of years to treat depressive symptoms, a common mental health issue, which is often comorbid with other psychopathological and medical conditions. The aim of the present meta-analysis is to test whether and to what extent HRVB is effective in reducing depressive symptoms in adult patients. We conducted a literature search on Pubmed, ProQuest, Ovid PsycInfo, and Embase up to October 2020, and identified 721 studies. Fourteen studies were included in the meta-analysis. Three meta-regressions were also performed to further test whether publication year, the questionnaire used to assess depressive symptoms, or the interval of time between T0 and T1 moderated the effect of HRVB. Overall, we analysed 14 RCTs with a total of 794 participants. The random effect analysis yielded a medium mean effect size g=0.38 [95% CI=0.16, 0.60; 95% PI=-0.19, 0.96], z=3.44, p=0.0006. The total heterogeneity was significant, Q(T)=23.49, p=0.03, I-2=45%, which suggested a moderate variance among the included studies. The year of publication (chi (2)(1)=4.08, p=0.04) and the questionnaire used to assess symptoms (chi (2)(4)=12.65, p=0.01) significantly moderated the effect of the interventions and reduced heterogeneity. Overall, results showed that HRVB improves depressive symptoms in several psychophysiological conditions in adult samples and should be considered as a valid technique to increase psychological well-being

Emotional Tone, Analytical Thinking, and Somatosensory Processes of a Sample of Italian Tweets During the First Phases of the COVID-19 Pandemic: Observational Study

BackgroundThe COVID-19 pandemic is a traumatic individual and collective chronic experience, with tremendous consequences on mental and psychological health that can also be reflected in people’s use of words. Psycholinguistic analysis of tweets from Twitter allows obtaining information about people’s emotional expression, analytical thinking, and somatosensory processes, which are particularly important in traumatic events contexts. ObjectiveWe aimed to analyze the influence of official Italian COVID-19 daily data (new cases, deaths, and hospital discharges) and the phase of managing the pandemic on how people expressed emotions and their analytical thinking and somatosensory processes in Italian tweets written during the first phases of the COVID-19 pandemic in Italy. MethodsWe retrieved 1,697,490 Italian COVID-19–related tweets written from February 24, 2020 to June 14, 2020 and analyzed them using LIWC2015 to calculate 3 summary psycholinguistic variables: emotional tone, analytical thinking, and somatosensory processes. Official daily data about new COVID-19 cases, deaths, and hospital discharges were retrieved from the Italian Prime Minister's Office and Civil Protection Department GitHub page. We considered 3 phases of managing the COVID-19 pandemic in Italy. We performed 3 general models, 1 for each summary variable as the dependent variable and with daily data and phase of managing the pandemic as independent variables. ResultsGeneral linear models to assess differences in daily scores of emotional tone, analytical thinking, and somatosensory processes were significant (F6,104=21.53, P<.001, R2= .55; F5,105=9.20, P<.001, R2= .30; F6,104=6.15, P<.001, R2=.26, respectively). ConclusionsThe COVID-19 pandemic affects how people express emotions, analytical thinking, and somatosensory processes in tweets. Our study contributes to the investigation of pandemic psychological consequences through psycholinguistic analysis of social media textual data

Training Cognitive Functions Using Mobile Apps in Breast Cancer Patients: Systematic Review

Background: Breast cancer is an invalidating disease and its treatment can bring serious side effects that have a physical and psychological impact. Specifically, cancer treatment generally has a strong impact on cognitive function. In recent years, new technologies and eHealth have had a growing influence on health care and innovative mobile apps can be useful tools to deliver cognitive exercise in the patient's home. Objective: This systematic review gives an overview of the state-of-the-art mobile apps aimed at training cognitive functions to better understand whether these apps could be useful tools to counteract cognitive impairment in breast cancer patients. Methods: We searched in a systematic way all the full-text articles from the PubMed and Embase databases. Results: We found eleven studies using mobile apps to deliver cognitive training. They included a total of 819 participants. App and study characteristics are presented and discussed, including cognitive domains trained (attention, problem solving, memory, cognitive control, executive function, visuospatial function, and language). None of the apps were specifically developed for breast cancer patients. They were generally developed for a specific clinical population. Only 2 apps deal with more than 1 cognitive domain, and only 3 studies focus on the efficacy of the app training intervention. Conclusions: These results highlight the lack of empirical evidence on the efficacy of currently available apps to train cognitive function. Cognitive domains are not well defined across studies. It is noteworthy that no apps are specifically developed for cancer patients, and their applicability to breast cancer should not be taken for granted. Future studies should test the feasibility, usability, and effectiveness of available cognitive training apps in women with breast cancer. Due to the complexity and multidimensionality of cognitive difficulties in this cancer population, it may be useful to design, develop, and implement an ad hoc app targeting cognitive impairment in breast cancer patients

Caregiving and Shared Decision Making in Breast and Prostate Cancer Patients: A Systematic Review

Background: A cancer diagnosis can impact patients’ and caregivers’ lives, posing different challenging situations. In particular, breast cancer and prostate cancer are two types of cancer involving families and especially spouses in challenges linked with the diagnosis and treatment process. Caregivers are usually involved in the treatment decision-making (TDM) process concerning patients’ clinical pathway, cancer treatment, and ongoing therapies. To date, no contributions provide an exhaustive overview of the role of caregivers in cancer care and their involvement in the TDM process related to the therapies. Methods: We performed a systematic review of caregiver and patients experiences and perceptions of caregiver involvement in cancer TDM. Articles were searched on Public/Publisher MEDLINE (PubMed), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System Online (Medline), and American Psychological Association APA PsycINFO. Results: 17 studies were included, 10 on prostate cancer and 7 on breast cancer. According to the reviewed studies, patients and caregivers experienced the cancer diagnosis with a sense of unity. Most patients preferred to have an active or collaborative role with caregivers in TDM, feeling it was important to consult or share the decision made with their caregivers. Caregivers preferred to collaborate with patients or let patients decide by themselves after considering their opinions. Caregiver involvement could have a positive influence on the patient’s medical decisions, even if cancer diagnosis and treatments overwhelmed patients and caregivers. Conclusions: These findings highlight the importance of using a perspective that focuses on the relationship between a patient and caregivers when they receive a cancer diagnosis and have to make a treatment decision. Targeting caregiver–patient dyads, rather than individuals, is important since a supported relationship could have a protective effect on psychological distress, quality of life (QOL), and relationship satisfaction. Moreover, dyads may benefit from interventions that focus on the needs of both the patient and caregiver

From life-threatening to chronic disease: Is this the case of cancers? A systematic review

Problem identification Given the importance of a common scientific background on what clinicians mean by the term chronic cancer (CC), the present review examines whether and to what extent a shared definition of CC exists in the literature. Literature Search A systematic search of the existing literature dealing with the definition of CC was performed. Synthesis Considering a statement of the American Cancer Society on CC, a list of attributes for a cancer to be considered chronic was drawn up and used as a common schema to evaluate and organize a description of CC provided by relevant articles. Conclusions Overall, most of the relevant articles recognized a time criterion as a peculiar attribute of a CC, however, there is only a limited degree of overlap within the literature definitions of CC. Implication for Practice It may be useful to talk about a chronic phase within a broader cancer disease continuum