Behavioral activation (BA) is a well-established method of evidence-based treatment for depression. There are clear links between the neural mechanisms underlying reward processing and BA treatment for depressive symptoms, including anhedonia; however, integrated interpretations of these two domains are lacking. Here we examine brain imaging studies involving BA treatments to investigate how changes in brain networks, including the reward networks, mediate the therapeutic effects of BA, and whether brain circuits are predictors of BA treatment responses. Increased activation of the prefrontal and subcortical regions associated with reward processing has been reported after BA treatment. Activation of these regions improves anhedonia. Conversely, some studies have found decreased activation of prefrontal regions after BA treatment in response to cognitive control stimuli in sad contexts, which indicates that the therapeutic mechanism of BA may involve disengagement from negative or sad contexts. Furthermore, the decrease in resting-state functional connectivity of the default-mode network after BA treatment appears to facilitate the ability to counteract depressive rumination, thereby promoting enjoyable and valuable activities. Conflicting results suggest that an intact neural response to rewards or defective reward functioning is predictive of the efficacy of BA treatments. Increasing the benefits of BA treatments requires identification of the unique individual characteristics determining which of these conflicting findings are relevant for the personalized treatment of each individual with depression.

Objective: There is limited data on the outcomes of cardiac arrest occurring in emergency departments (ED). The objective of this study was to identify the factors associated with these outcomes, primarily the survival to hospital discharge and the neurological status at discharge in emergency department cardiac arrest (EDCA) patients. Methods: A retrospective study was conducted in a tertiary hospital. Adult patients aged over 18 years who had suffered an in-hospital cardiac arrest in the ED between July 2018 to June 2021 were included. The primary outcome was the survival to hospital discharge. Descriptive statistics and logistic regression analyses were performed. Results: We identified 157 ED arrests. Among these, 57.9% of the patients died in the emergency room. A total of 24.1% obtained survival discharge. The combined existing illnesses, such as renal insufficiency or malignancy were directly related to the survival of the patients. A cardiac and respiratory cause of arrest increased the probability of survival (P<0.001). The shorter the time spent on cardiopulmonary resuscitation (CPR), the higher the chances of survival (odds ratio of 0.84). The subjects in both the survivor and deceased groups were classified as Korean Triage and Acuity Scale 2 (KTAS 2: emergency) or higher (P=0.719). There was no difference in the ED occupancy, which is an emergency room overcrowding indicator. Conclusion EDCA patients are already in a clinically deteriorated condition. The underlying clinical conditions, the cause of cardiac arrest, the initial rhythm, and the CPR duration time are directly related to the patient’s chances of survival and prognoses. Therefore, it is possible to identify these factors at an early stage and take the appropriate management measures.

PURPOSE: This study was conducted to investigate the effect that detection of chronic disease via health screening programs has on health behaviors, particularly smoking. MATERIALS AND METHODS: We analyzed national health insurance data from 2007 and 2009. Subjects who were 40 years of age in 2007 and eligible for the life cycle-based national health screening program were included. The total study population comprised 153518 individuals who participated in the screening program in 2007 and follow-up screening in 2009. Multiple logistic regression analyses were conducted by sex, with adjustment for health insurance type, socioeconomic status, body mass index, diabetes, hypertension, hyperlipidemia, and family history of cardiovascular and/or neurovascular disease. RESULTS: Among men with smoking behavior changes, those newly diagnosed with hyperlipidemia were more likely to show a positive health behavior change, such as smoking cessation, and were less likely to have a negative behavior change (e.g., smoking initiation). Additionally, men newly diagnosed with diabetes showed lower rates of negative health behavior changes compared to those without disease. Body mass index (BMI)> or =25, compared to BMI<23, showed higher rates of positive health behavior changes and lower rates of negative health behavior changes. Newly diagnosed chronic disease did not influence smoking behavior in women. CONCLUSION: Smoking behavior changes were only detected in men who participated in health screening programs. In particular, those newly diagnosed with hyperlipidemia were more likely to stop smoking and less likely to start smoking.
Adult ; Body Mass Index ; Female ; *Health Behavior ; Health Surveys ; Humans ; Hyperlipidemias/diagnosis ; Hypertension ; Male ; Mass Screening/*methods ; Middle Aged ; *Motivation ; Regression Analysis ; Smoking/epidemiology/*psychology ; Smoking Cessation/*psychology/statistics & numerical data ; Social Class

OBJECTIVE: Not all depressive individuals are suicidal. An increasing body of studies has examined forgiveness, especially self-forgiveness, as a protective factor of suicide based on that suicide is often accompanied by negative self-perceptions. However, less has been studied on how different subtypes of forgiveness (i.e., forgiveness-of-self, forgiveness-of-others and forgiveness-of-situations) could alleviate the effects of depression on suicide. Hence, this study examined forgiveness as a moderator of depression and suicidality. METHODS: 305 participants, consisted of 87 males and 218 females, were included in the study. The mean age was 41.05 (SD: 14.48; range: 19–80). Depression, anxiety, and forgiveness were measured through self-report questionnaires, and suicidal risk was measured through a structuralized interview. Moderations were examined through hierarchical regression analyses. RESULTS: Depression positively correlated with suicidality. Results of the hierarchical regression analysis indicated forgiveness as a moderator of depression on suicidality. Further analysis indicated only forgiveness-of-self as a significant moderator; the effects of forgiveness-of-others and forgiveness-of-situation were not significant. CONCLUSION These findings suggest that forgiveness-of-self is essential in reducing of the effects of depression on suicidality. It is suggested that self-acceptance and the promotion of self-forgiveness should be considered as an important factor when developing suicide prevention strategies.

Objective: While impaired facial expression recognition has been closely associated with reduced temporal lobe volume in patients with schizophrenia, this study aimed at examining whether empathy and social attribution affect such a relationship. Methods: A total of 43 patients with schizophrenia and 43 healthy controls underwent a facial expression recognition task (FERT) and magnetic resonance imaging. Basic empathy scale and the social attribution task-multiple choice were used to measure empathy and social attribution. Results: Patients with schizophrenia showed significant positive correlations between the total temporal lobe volume and the FERT-accuracy (FERT-ACC). Diminished temporal lobe volume predicted the impaired facial emotion recognition ability. Both empathy and social attribution played roles as moderators of the path from the left amygdala volume, left fusiform gyrus volume, both sides of the superior temporal gyrus volume, and left middle temporal gyrus volume to the FERT-ACC. In contrast, empathy alone functioned as a moderator between the right fusiform gyrus volume, right middle temporal gyrus volume, and FERT-ACC. No significant interaction was found for healthy controls. Conclusion Our results suggest that social cognition remediation training on empathy and social attribution, could buffer the negative effects of small temporal lobe volume on interpersonal emotional communication in patients with schizophrenia