A game for emotional regulation in adolescents: The (body) interface device matters

The aim of this study is to evaluate the role of the type of interface device in the efficacy of a serious game that teaches emotional regulation (ER) strategies in a non-clinical sample of adolescents. We conducted a between-participants experiment in which participants (N = 61) played a frustration induction game, and then an ER game (a breathing strategy game), using one of three types of devices (computer, smartphone, and RGB-D camera). Frustration mood and perceived arousal were the main variables measured. Results revealed a significant interaction between moment (pre-induction phase, post-induction phase, and regulation phase) and the type of interface device used in the frustration mood scores. In participants who used the computer and smartphone, frustration increased after the induction phase and decreased after the regulation phase. However, for participants who used the RGB-D camera, frustration decreased significantly after the induction phase, and this change was maintained after the regulation phase. Changes in arousal were similar with the three devices. This study highlights that the type of interface device (and specifically, the participation of the body) is a crucial variable in the efficacy of serious games affecting users emotional experience.This work was supported by the Ministerio de Educacion y Ciencia (Spain), Project Game Teen (TIN2010-20187), and partially by Ministerio de Economia y Competitividad (Spain) under grants "PROMOSAM" (PSI2014-56303-REDT), "BODYTA" (Plan Nacional I + D + I 2013-2016 PSI2014-51928-R), and CIBEROBN, an initiative of ISCIII (ISC III CB06 03/0052).Vara-Villodre, MD.; Baños Rivera, RM.; Rasal, P.; Rodríguez Ortega, A.; Rey, B.; Wrzesien, M.; Alcañiz Raya, ML. (2016). A game for emotional regulation in adolescents: The (body) interface device matters. Computers in Human Behavior. 57:267-273. https://doi.org/10.1016/j.chb.2015.12.033S2672735

Effect of sleep disturbance symptoms on treatment outcome in blended CBT for depression: A secondary analysis of the E-COMPARED study. (Preprint)

Background: Sleep disturbance symptoms are common in major depressive disorder (MDD) and have been found to hamper the treatment effect of conventional face-to-face psychological treatments such as cognitive behavioral therapy. To increase the dissemination of evidence-based treatment, blended cognitive behavioral therapy (bCBT) consisting of web-based and face-to-face treatment is on the rise for patients with MDD. To date, no study has examined whether sleep disturbance symptoms have an impact on bCBT treatment outcomes and whether it affects bCBT and treatment-as-usual (TAU) equally. Objective: The objectives of this study are to investigate whether baseline sleep disturbance symptoms have an impact on treatment outcomes independent of treatment modality and whether sleep disturbance symptoms impact bCBT and TAU in routine care equally. Methods: The study was based on data from the E-COMPARED (European Comparative Effectiveness Research on Blended Depression Treatment Versus Treatment-as-Usual) study, a 2-arm, multisite, parallel randomized controlled, noninferiority trial. A total of 943 outpatients with MDD were randomized to either bCBT (476/943, 50.5%) or TAU consisting of routine clinical MDD treatment (467/943, 49.5%). The primary outcome of this study was the change in depression symptom severity at the 12-month follow-up. The secondary outcomes were the change in depression symptom severity at the 3- and 6-month follow-up and MDD diagnoses at the 12-month follow-up, assessed using the Patient Health Questionnaire-9 and Mini-International Neuropsychiatric Interview, respectively. Mixed effects models were used to examine the association of sleep disturbance symptoms with treatment outcome and treatment modality over time. Results: Of the 943 patients recruited for the study, 558 (59.2%) completed the 12-month follow-up assessment. In the total sample, baseline sleep disturbance symptoms did not significantly affect change in depressive symptom severity at the 12-month follow-up (β=.16, 95% CI –0.04 to 0.36). However, baseline sleep disturbance symptoms were negatively associated with treatment outcome for bCBT (β=.49, 95% CI 0.22-0.76) but not for TAU (β=–.23, 95% CI −0.50 to 0.05) at the 12-month follow-up, even when adjusting for baseline depression symptom severity. The same result was seen for the effect of sleep disturbance symptoms on the presence of depression measured with Mini-International Neuropsychiatric Interview at the 12-month follow-up. However, for both treatment formats, baseline sleep disturbance symptoms were not associated with depression symptom severity at either the 3- (β=.06, 95% CI −0.11 to 0.23) or 6-month (β=.09, 95% CI −0.10 to 0.28) follow-up. Conclusions: Baseline sleep disturbance symptoms may have a negative impact on long-term treatment outcomes in bCBT for MDD. This effect was not observed for TAU. These findings suggest that special attention to sleep disturbance symptoms might be warranted when MDD is treated with bCBT. Future studies should investigate the effect of implementing modules specifically targeting sleep disturbance symptoms in bCBT for MDD to improve long-term prognosis

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Delaying surgery for patients with a previous SARS-CoV-2 infection

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