Search Results (79)

Background: Worry proneness has been proposed to influence uncertainty processing; however, its neural mechanisms during different forms of uncertain decision-making remain poorly understood. This study used functional magnetic resonance imaging (fMRI) to investigate behavioral and neural responses associated with risky and ambiguous decision-making and to examine how individual differences in worry proneness relate to uncertainty-related neural processing. Methods: Participants completed a modified ambiguity–risk decision-making task during fMRI scanning. Whole-brain, region-of-interest (ROI), and continuous PSWQ-based correlation analyses were conducted to characterize neural responses associated with uncertainty type and individual differences in worry proneness. Results: Behavioral analyses revealed no significant effects of worry proneness or uncertainty type on gambling choices or reaction times. Whole-brain analyses showed that risky decisions elicited greater activation than ambiguous decisions in the right insula, right inferior parietal lobule, and left supramarginal gyrus, whereas ambiguous decisions preferentially recruited the right superior temporal gyrus. An exploratory peak-level interaction between worry proneness and uncertainty type was identified in the right middle frontal gyrus (BA6), with higher worry proneness associated with lower BA6 activation during risky decision-making. Continuous analyses further showed that BA6 activation during risky decisions was negatively correlated with PSWQ scores. ROI analyses demonstrated greater activation during risky than ambiguous decisions in the bilateral caudate nucleus, left insula, and right inferior frontal gyrus. Conclusions: These findings demonstrate that risky and ambiguous decision-making are associated with partially dissociable patterns of neural activation. Worry proneness was not associated with widespread alterations in behavioral performance or uncertainty-related neural responses; however, exploratory analyses identified localized associations between worry proneness and prefrontal neural responses during risky decision-making. These findings suggest that individual differences in worry proneness may be related to selective variation in specific neural processes rather than broad alterations in the neural systems supporting uncertainty processing. Full article

Mild traumatic brain injury (mTBI) is a common cause for pediatric emergency department visits and can impose substantial burdens on families, including missed work and childcare needs. Socioeconomic context may influence both healthcare use and these downstream impacts. This study examined the association between Child Opportunity Index (COI), a neighborhood-level measure of socioeconomic status, and healthcare utilization and indirect costs following pediatric concussion. In a secondary analysis of a multisite randomized controlled trial of patients with acute (<72 h) concussion, participants were categorized into high, middle, and low COI groups. Outcomes included follow-up care, caregiver missed workdays, childcare needs, and indirect costs, analyzed using multivariable regression models. Participants from lower COI neighborhoods were more likely to present to the emergency department, with 93.02% compared to 71.43% in higher COI groups (p = 0.005); had higher symptom scores at 14 days, 28.69 versus 16.64 (p = 0.03); and were less likely to be seen by concussion specialists, 6.98% versus 28.57% (p = 0.005). They also had lower odds of attending follow-up within 14 days (OR = 0.36, p = 0.015) and higher caregiver burden, including more missed workdays and childcare needs. Although total indirect costs did not differ significantly for low COI groups after adjustment, middle COI participants had lower costs than high COI ones. Overall, disparities were observed in care patterns and caregiver burden despite similar recovery outcomes. These findings suggest that expanding access to affordable concussion follow-up through school-based programs, telehealth services, transportation assistance, and flexible scheduling may help reduce caregiver burden and improve continuity of care for children from lower COI neighborhoods following pediatric mTBI. Full article

Anticipation is central to perceptual–cognitive expertise in badminton, but the decision mechanisms through which experts use visual and auditory cues remain unclear. This study examined expert–novice differences in unimodal anticipation and latent decision processes estimated by a hierarchical drift diffusion model (HDDM). Sixty-six participants (33 experts and 33 novices) completed a landing-region anticipation task under visual-only and auditory-only conditions. Behavioral performance was analyzed using mixed analyses of variance (ANOVAs), and accuracy and reaction time were jointly modeled with HDDM parameters: boundary separation (a), drift rate (v), non-decision time (t), and starting-point bias (z). Experts showed higher overall accuracy than novices, F(1, 64) = 56.46, p < 0.001, ηp² = 0.469, whereas reaction time did not differ significantly by group. The auditory-only condition produced higher accuracy, F(1, 64) = 12.69, p = 0.001, ηp² = 0.165, but longer reaction times, F(1, 64) = 150.32, p < 0.001, ηp² = 0.701. HDDM results showed higher drift rates in experts under both visual-only (BF10 = 1992.845) and auditory-only (BF10 = 24.354) conditions; auditory-only anticipation also involved higher boundary separation (BF10 = 53.095). These findings suggest that badminton expertise is associated with higher anticipatory accuracy and more efficient evidence accumulation under unimodal cue conditions, while auditory-only anticipation may also involve a more cautious decision threshold. Full article

This qualitative study incorporates caregiver perspectives to identify their (1) experiences with medical and educational supports for their children with chronic TBI following inpatient rehabilitation and across the recovery trajectory and (2) recommendations to improve service provision for young people with TBI. Nineteen caregivers of children with complicated-mild-to-severe TBI participated in semi-structured virtual interviews. Participants were from a large Midwestern U.S. city. Researchers used reflexive thematic analysis, incorporating an experiential orientation and a deductive approach. Standards for Reporting Qualitative Research guided this process. Children were an average of 5.2 years post-injury, and age at injury ranged from 2.6 to 18.0 years, providing depth of caregiver experiences discussed in interviews. Four primary themes were identified: (1) TBI leads to lasting changes in the child, (2) the healthcare environment is overwhelming, (3) TBI forces a shift in caregiver responsibilities, and (4) school challenges persist over time. Caregivers generated concrete, experience-based recommendations, highlighting the need for increased support, resources, and education in specific areas following pediatric TBI. By centering caregiver voices across recovery, this study underscores their unique expertise in identifying system-level gaps and informing the development of interventions, services, and policies that better support children with TBI and their families over time. Full article

Caregivers of children with traumatic brain injury (TBI) often report unmet healthcare needs following their child’s injury. The objective of this study was to survey medical and educational professionals in focus groups to respond to caregiver perceived gaps in care and service provision for children with TBI identified in a prior qualitative study. Subjects included 29 medical and educational providers. Reflexive thematic analysis of responses included inductive and deductive analysis and iterative consensus among the authors. Themes identified included (1) improving education and care in the hospital, (2) preparing families to go home, (3) improving behavioral health care, (4) navigating schools, (5) empowering caregivers with resources and (6) medical and system barriers. These solutions require implementation at the individual, hospital, and broader systemic levels. Overall, provider solutions illuminate a greater need to improve care coordination to navigate a child’s long-term medical needs and transition back to school, as well as the need to train more pediatric brain-injury-aware providers and improve policy and support systems. Full article

Culturally responsive frameworks are essential for delivering equitable rehabilitation services to diverse communities. Culturally informed practices that use evidence-based strategies facilitate holistic, family-centered interventions. This scoping review explores the literature published over the last 5 years on barriers and facilitators to the use of culturally responsive interventions for children and families receiving pediatric rehabilitation services. Databases searched included PubMed, CINAHL Complete, Medline, Cochrane Library, and OTseeker. Search terms included cultural competence, culturally informed, culturally grounded, pediatrics, rehabilitation, physical therapy, occupational therapy, barriers, facilitators, and a combination of these terms. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Published intervention studies that identified the barriers and facilitators of culturally responsive care were included in this review. Data from presentations, non-peer-reviewed literature, published abstracts, and dissertations were excluded. Ten studies were included, two Level III, three Level IV, and five Level V, according to the commonly accepted research Levels of Evidence. The outcomes of these studies suggest that rehabilitation providers should consider how to implement tailored, culturally informed interventions to improve holistic, accessible care for all communities. Full article

Children with developmental disabilities are less physically active and at increased risk for chronic conditions that physical activity might ameliorate. This study examined the relationships between the impact of physical activity (e.g., muscles burning, body tiredness), physical activity time and fatigue in children with Cerebral Palsy (CP) and Down Syndrome (DS) in comparison to typically developing (TD) children. A convenience sample of children and parents was enrolled. All children were between 4 and 10 years, ambulatory, medically stable, not taking sleep-aid medications and were either TD (n = 20) or diagnosed with CP (n = 14) or DS (n = 5). Children and parents separately answered questionnaires about participation in physical activity and fatigue during the past week, yielding retrospective data. Additionally, they completed prospective questionnaires for 3 consecutive days. Repeated measures multivariate and univariate analyses (post hoc) of variance, along with correlations between variables were completed. Analyses of retrospective data yielded no specific findings. Prospectively, all groups of parents reported that as the impact of physical activity increased, perceptions of fatigue decreased (r = −0.349; p < 0.001). Parents of children with Cerebral Palsy noted a negative relationship between the time spent doing physical activity and perceptions of fatigue (r = −0.553; p < 0.001). Between-group differences in perceptions of fatigue occurred for children with CP compared to TD (F = 8.248; p < 0.001). Parent-reported findings suggest potential associations between physical activity participation and perceptions of fatigue across diagnostic groups. Full article

Suicidal mental imagery are self-generated images of injury and death experienced across a range of mental health conditions, but also experienced in people who have no diagnosable mental health condition. For some, these images can be quite distressing and unwanted, but for others, these mental pictures serve to bring comfort and problem-solving capabilities. From a clinical and research perspective, they are not fully understood and are underexplored. Suicidal mental imagery is a known risk factor for attempted suicide due to imagery’s amplification and habituation effects, potentially moving a person from imagining suicide to acting on it. This paper presents a taxonomy of the different types of suicidal mental imagery from first-hand accounts extracted from phase one of a two-phase qualitative study called the suicidal mental imagery (SUMI) study. This taxonomy of imagery types is drawn from fifteen semi-structured interviews exploring imagery experiences in adults from Ireland. The characteristics of these images were analysed qualitatively using an Interpretive Description approach, with the resulting taxonomy developed through additional analytic processes informed by cognitive behavioural therapy (CBT) principles and a priori coding. The taxonomy, therefore, illustrates experiences from a rich dataset under distinct categories to improve our understanding of the key mechanisms underpinning suicidal mental imagery for practice, helping to assist open dialogue in imagery assessment to better inform suicide prevention interventions. Full article

This study investigated the psychological, temperamental, and experiential factors associated with background music use among Chinese adults and examined predictive models incorporating psychological variables, demographic characteristics, and music-related experiences. In total, 332 Chinese adults aged 18–65 years (M = 35.89, SD = 13.34) participated in the study. Background music use was analyzed using correlational analyses, stepwise regression, and decision tree modeling. Results indicated that extraversion, neuroticism, and self-efficacy were significantly associated with background music use. Among temperamental traits, fun seeking showed a small but significant negative relationship. Stepwise regression analysis revealed that extraversion accounted for the largest proportion of variance, followed by neuroticism and self-efficacy, with the overall model explaining a significant portion of the variance in background music use. The decision tree model further identified experiential and contextual variables, including formal music education, enjoyment of music classes in childhood, living arrangements, and music-related family experiences, as important factors differentiating usage patterns. These findings suggest that background music use among Chinese adults is shaped by arousal-related personality traits, self-regulatory resources, and early musical experience. The results provide useful implications for further research and offer foundational knowledge for understanding background music use in everyday contexts. Full article

Background/Objectives: The multifaceted concept of body image (BI) refers to an individual’s attitudes and impressions of their body. Negative BI is associated with a number of harmful health consequences, including obesity, eating disorders, and symptoms of sadness. The contemporary digital era, marked by the dominance of platforms, has brought about a considerable transformation in the landscape of BI issues. This study’s goal is to compile and assess the connections between social media (SM) use, body weight, and BI in adult populations. Methods: This is a narrative review that comprehensively searches across multiple academic databases, such as PubMed, Medline, Scopus, Web of Science, and Google Scholar. Studies that used SM (online blogs, microblogs, content communities, or social networking sites) for engagement (e.g., sharing, commenting, liking) or image-related activities (e.g., viewing, posting, or engaging with images) with healthy adults (aged 18–70 years) of any body mass index (BMI kg/m²) met the inclusion criteria. Included were observational and experimental studies that examined habitual SM use. Only peer-reviewed works published in English between 2015 and 2025 met the search criteria. Results: The currently available findings suggest that obese people are more dissatisfied with their bodies than people of normal weight, and obese women are more dissatisfied with their bodies than their peers of normal weight. Furthermore, experimental studies have demonstrated that immediate BI is adversely affected by acute exposure to idealized social media photographs. Conclusions: Policies should support specialized training that emphasizes a holistic approach to health and puts functionality and health above attractiveness. This training is crucial for dispelling weight-related stigmas and enabling healthcare providers to offer compassionate treatment that supports mental and physical health. Future research must concentrate on internalization and social pressure or reinforcement because these subjects have not gotten as much emphasis in prior studies. Such mechanism research could help better contextualize the role of recently introduced SM items. Full article

Exercise dependence is a maladaptive pattern of excessive exercise characterized by psychological and cognitive symptoms. The existence and nature of attentional bias in individuals with exercise dependence remain unclear. This study combined behavioral measures and event-related potentials (ERPs) to examine the processing of exercise-related cues in this population. The experiment compared exercise-dependent individuals (n = 21) and matched controls (n = 21) using a dot-probe task. Results demonstrated that the exercise dependence group exhibited significantly faster response times in congruent conditions and higher attentional bias scores compared to controls. ERPs data revealed enhanced N1 amplitudes in the exercise dependence group, while no significant group differences were observed in P2 amplitudes. These findings indicate that exercise-related cues automatically capture cognitive resources during the initial stages of attentional processing in dependent individuals. The study provides neurophysiological evidence that may advance the understanding of neurocognitive mechanisms underlying exercise dependence. Full article

Recovery from aphasia is a complex process involving restoring language ability to a level comparable to an individual’s pre-aphasia state. This recovery extends beyond linguistic functions such as improved quality of life and functional communication. Understanding language recovery in PWAs is a key area in aphasia research. Thus, the current study aimed to understand the pattern of language recovery in the acute and sub-acute stages of persons with aphasia (PWAs). A total of 11 PWAs aged between 40 and 80 were recruited. The study was conducted in two phases. In the acute stage (within one week post-stroke), participants were assessed using the Western Aphasia Battery-Kannada (WAB-K). In the sub-acute stage (between seven and fifteen days post-stroke), a similar test battery was repeated. The findings of the study showed auditory verbal comprehension scores were pronounced in the acute and sub-acute stages of recovery. Further, language quotient (LQ) scores were higher in the sub-acute stage compared to the acute stage, though these differences failed to evince statistical differences. Correlation analysis revealed strong positive correlations between LQ and spontaneous speech, repetition, and naming, with moderate correlations for auditory verbal comprehension. The study’s findings highlight the importance of targeted therapeutic interventions for PWAs, emphasizing an early focus on auditory verbal comprehension to enhance overall language recovery. Full article

Background: Self-report physical activity (PA) scales, accelerometry, and heart rate (HR) monitoring are reliable tools for PA measurement for children with cerebral palsy (CP); however, there are limitations for those who are primary wheelchair users. The purpose of our study was to evaluate face and construct validity of the PROMIS^® Pediatric PA parent proxy short form 8a in measuring PA amount and intensity in children with CP who are non-ambulatory. Methods: Face validity: Semi-structured interviews with parents and pediatric physical therapists (PTs) were conducted about the appropriateness of each item on the PROMIS^® Pediatric PA short form. Construct validity: Children with CP who were non-ambulatory participated in a one-week observational study. PA amount and intensity were examined using PA monitors (Actigraph GT9X) and HR monitors (Fitbit Charge 4). Activity counts and time in sedentary and non-sedentary intensity zones were derived and compared to the PROMIS^® T-scaled score. Results: Twenty-two physical therapists (PTs) and fifteen parents participated in the interviews, and ten children completed 1-week PA observation. Eight and seven participants completed sufficient time of uninterrupted PA and HR monitor wear, respectively. Parents and PTs agreed that several questions were not appropriate for children with CP who were non-ambulatory. PA intensity via activity counts derived from wrist worn monitors showed a strong positive correlation with the PROMIS^® PA measure. Conclusions: Construct validity in our small sample was established between PROMIS^® scores and accelerometry activity counts when documenting PA amount and intensity; however, there were some differences on PROMIS^® face validity per parent and PT respondents. Despite some concerns regarding face validity, the PROMIS^® Pediatric PA parent proxy short form 8a shows promise as a valid measure of physical activity amount and intensity in non-ambulatory children with CP, warranting further investigation and refinement. Full article

Reward processing is a vital function for health and survival and is impaired in various psychiatric and neurological disorders. Using a monetary gambling task, the current study aims to elucidate neural substrates in the reward network underlying the evaluation of win versus loss outcomes and their association with behavioral characteristics, such as impulsivity and task performance, and neuropsychological functioning. Functional MRI was recorded in thirty healthy, male community volunteers (mean age = 27.4 years) while they performed a monetary gambling task in which they bet with either 10 or 50 tokens and received feedback on whether they won or lost the bet amount. Results showed that a set of key brain structures in the reward network, including the putamen, caudate nucleus, superior and inferior parietal lobule, angular gyrus, and Rolandic operculum, had greater blood oxygenation level-dependent (BOLD) signals during win relative to loss trials, and the BOLD signals in most of these regions were highly correlated with one another. Furthermore, exploratory bivariate analyses between these reward-related regions and behavioral and neuropsychological domains showed significant correlations with moderate effect sizes, including (i) negative correlations between non-planning impulsivity and activations in the putamen and caudate regions, (ii) positive correlations between risky bets and right putamen activation, (iii) negative correlations between safer bets and right putamen activation, (iv) a negative correlation between short-term memory capacity and right putamen activity, and (v) a negative correlation between poor planning skills and left inferior occipital cortex activation. These findings contribute to our understanding of the neural underpinnings of monetary reward processing and their relationships to aspects of behavior and cognitive function. Future studies may confirm these findings with larger samples of healthy controls and extend these findings by investigating various clinical groups with impaired reward processing. Full article

This study examined the effect of executive function training targeting both updating and inhibition in children. The training included both single training (i.e., number 2-back training) and combined training (i.e., number 2-back and fish flanker training). Event-related potentials were also recorded. In Experiment 1, we employed both single-training and combined-training groups, which were contrasted with each other and with an active control group. In Experiment 2, the control group and the combined-training group were recruited to perform training tasks identical to those used in Experiment 1, and their EEG data were collected during the pretest and posttest stage. Experiment 1 found that the single group showed clear evidence for transfer to letter 2-back task compared with the active control group. The combined group showed significant transfer to the letter 2-back and arrow flanker task. Both groups found no transfer to fluid intelligence or shifting. Experiment 2 revealed that the participants who received updating and inhibition training showed a significant reduction in N2 amplitude and a significant increase in P300 amplitude after training in comparison to the active control group. Importantly, there was a significant positive correlation between reduced N2 amplitude and decreased response time in conflict effects. Additionally, there was a strong positive trend toward a relationship between behavioral performance improvement and an increase in P300 amplitude. From the perspective of the near-transfer effect, combined training is more effective than single training. Our results showed that the extent of transfer depends on the cognitive component overlap between the training and transfer tasks. Full article