Mental Health & Psychology

Sleep is a fundamental biological process with broad implications for physical and mental health, yet its complex relationship with disease remains poorly understood. Polysomnography (PSG)—the gold standard for sleep analysis—captures rich physiological signals but is underutilized due to challenges in standardization, generalizability and multimodal integration. To address these challenges, we developed SleepFM, a multimodal sleep foundation model trained with a new contrastive learning approach that accommodates multiple PSG configurations. Trained on a curated dataset of over 585,000 hours of PSG recordings from approximately 65,000 participants across several cohorts, SleepFM produces latent sleep representations that capture the physiological and temporal structure of sleep and enable accurate prediction of future disease risk. From one night of sleep, SleepFM accurately predicts 130 conditions with a C-Index of at least 0.75 (Bonferroni-corrected P < 0.01), including all-cause mortality (C-Index, 0.84), dementia (0.85), myocardial infarction (0.81), heart failure (0.80), chronic kidney disease (0.79), stroke (0.78) and atrial fibrillation (0.78). Moreover, the model demonstrates strong transfer learning performance on a dataset from the Sleep Heart Health Study—a dataset that was excluded from pretraining—and performs competitively with specialized sleep-staging models such as U-Sleep and YASA on common sleep analysis tasks, achieving mean F1 scores of 0.70–0.78 for sleep staging and accuracies of 0.69 and 0.87 for classifying sleep apnea severity and presence. This work shows that foundation models can learn the language of sleep from multimodal sleep recordings, enabling scalable, label-efficient analysis and disease prediction.

EEG microstates represent functional brain networks observable in resting EEG recordings that remain stable for 40–120ms before rapidly switching into another network. It is assumed that microstate characteristics (i.e., durations, occurrences, percentage coverage, and transitions) may serve as neural markers of mental and neurological disorders and psychosocial traits. However, robust data on their retest-reliability are needed to provide the basis for this assumption. Furthermore, researchers currently use different methodological approaches that need to be compared regarding their consistency and suitability to produce reliable results. Based on an extensive dataset largely representative of western societies (2 days with two resting EEG measures each; day one: n = 583; day two: n = 542) we found good to excellent short-term retest-reliability of microstate durations, occurrences, and coverages (average ICCs = 0.874-0.920). There was good overall long-term retest-reliability of these microstate characteristics (average ICCs = 0.671-0.852), even when the interval between measures was longer than half a year, supporting the longstanding notion that microstate durations, occurrences, and coverages represent stable neural traits. Findings were robust across different EEG systems (64 vs. 30 electrodes), recording lengths (3 vs. 2 min), and cognitive states (before vs. after experiment). However, we found poor retest-reliability of transitions. There was good to excellent consistency of microstate characteristics across clustering procedures (except for transitions), and both procedures produced reliable results. Grand-mean fitting yielded more reliable results compared to individual fitting. Overall, these findings provide robust evidence for the reliability of the microstate approach.

Light modulates mood through various retina-brain pathways. We showed that mice treated with short-term acute bright light exposure displayed anxiety-related phenotypes in a prolonged manner even after the termination of the exposure. Such a postexposure anxiogenic effect depended upon melanopsin-based intrinsically photosensitive retinal ganglion cell (ipRGC) activities rather than rod/cone photoreceptor inputs. Chemogenetic manipulation of specific central nuclei demonstrated that the ipRGC–central amygdala (CeA) visual circuit played a key role in this effect. The corticosterone system was likely to be involved in this effect, as evidenced by enhanced expression of the glucocorticoid receptor (GR) protein in the CeA and the bed nucleus of the stria terminalis and by the absence of this effect in animals treated with the GR antagonist. Together, our findings reveal a non-image forming visual circuit specifically designed for “the delayed” extinction of anxiety against potential threats, thus conferring a survival advantage.

Alterations in the function of the medial prefrontal cortex (mPFC) and its major thalamic source of innervation, the mediodorsal (MD) thalamus, have been hypothesized to contribute to the symptoms of schizophrenia. The NMDAR antagonist ketamine, used to model schizophrenia, elicits a brain state resembling early stage schizophrenia characterized by cognitive deficits and increases in cortical low gamma (40–70 Hz) power. Here we sought to determine how ketamine differentially affects spiking and gamma local field potential (LFP) activity in the rat mPFC and MD thalamus. Additionally, we investigated the ability of drugs targeting the dopamine D4 receptor (D4R) to modify the effects of ketamine on gamma activity as a measure of potential cognitive therapeutic efficacy. Rats were trained to walk on a treadmill to reduce confounds related to hyperactivity after ketamine administration (10 mg/kg s.c.) while recordings were obtained from electrodes chronically implanted in the mPFC and MD thalamus. Ketamine increased gamma LFP power in mPFC and MD thalamus in a similar frequency range, yet did not increase thalamocortical synchronization. Ketamine also increased firing rates and spike synchronization to gamma oscillations in the mPFC but decreased both measures in MD thalamus. Conversely, walking alone increased both firing rates and spike-gamma LFP correlations in both mPFC and MD thalamus. The D4R antagonist alone (L-745,870) had no effect on gamma LFP power during treadmill walking, although it reversed increases induced by the D4R agonist (A-412997) in both mPFC and MD thalamus. Neither drug altered ketamine-induced changes in gamma power or firing rates in the mPFC. However, in MD thalamus, the D4R agonist increased ketamine-induced gamma power and prevented ketamine’s inhibitory effect on firing rates. Results provide new evidence that ketamine differentially modulates spiking and gamma power in MD thalamus and mPFC, supporting a potential role for both areas in contributing to ketamine-induced schizophrenia-like symptoms.

Objectives: To distinguish between ethnic differences among segregated schoolgirls and restrictive anorexia nervosa using a simple culture-fair test of body image (BI) figure drawings. Methods: Several responses to BI figure drawings by 178 adolescent schoolgirls from three ethnically distinct and segregated schools and communities in Israel, Jewish secular (JS), Jewish Haredi (H), and Christian Arab (C), and a group of 14 severely restricting anorexic girls (AN). BI evaluations were analyzed by MANCOVA, followed by paired or Student‑t tests for comparisons between responses and groups respectively. Pearson r served for correlations and the Fisher Z for differences between slopes. Results: Despite the total ethnic segregation among the schoolgirls, there are commonalities; all prefer a thinner ideal BI, and are similarly dissatisfied with their BI. However, ethnic differences also emerge: C underestimate their BI and how others view them, and H true and Ideal BI evaluations correlate, unlike the other groups. Despite this variability, and in stark contrast, the anorexic girls show a gross misperception of their BI, even in comparison to girls equated for BMI. Discussion: The findings show that figure drawings evaluation of BI is a simple and robust instrument dissociating clinical and ethnic responses. Clinicians may consider body figure drawings as a simple, supportive, diagnostic for first‑line recognition for risk of AN in adolescent girls.

Background: An emerging approach for investigating patient perspectives of their illness is the use of drawings. Objective: This scoping review consolidates findings from current literature regarding the use of drawings to explore patients’ perceptions and experiences of their illness and treatment. Methods: Electronic databases (Medline, PubMed, Embase, PsychINFO, Cinahl, Art Index and Scopus) and reference lists were searched to identify published English language studies using participant-generated drawings to explore adults’ perceptions and experiences of their illness and treatment. Using the scoping methodological framework, data were analyzed with respect to each study’s design, key findings and implications. Results: Thirty-two studies were identified and these reflected diversities in both health conditions and methods of data collection and analysis. Participants’ drawings revealed new, insightful knowledge about patients’ perceptions, beliefs and experiences of their condition and were associated with clinical and psychological markers of health. Drawing was a powerful adjunct to traditional data collection approaches, and demonstrated potential benefits for participants. This review provides detailed insights and guidance on the use of drawings in research and clinical practice. Conclusion: Drawing is a novel and potentially valuable technique for exploring patients’ perceptions and experiences about their illness and treatment. Advancing the methodology and applicability of drawings in this area will assist in the future development of this technique, with benefits for the patient, researcher and health care professional alike.

Experts from a range of disciplines assess the foundations and implications of a novel action-oriented view of cognition. Cognitive science is experiencing a pragmatic turn away from the traditional representation-centered framework toward a view that focuses on understanding cognition as “enactive.” This enactive view holds that cognition does not produce models of the world but rather subserves action as it is grounded in sensorimotor skills. In this volume, experts from cognitive science, neuroscience, psychology, robotics, and philosophy of mind assess the foundations and implications of a novel action-oriented view of cognition. Their contributions and supporting experimental evidence show that an enactive approach to cognitive science enables strong conceptual advances, and the chapters explore key concepts for this new model of cognition. The contributors discuss the implications of an enactive approach for cognitive development; action-oriented models of cognitive processing; action-oriented understandings of consciousness and experience; and the accompanying paradigm shifts in the fields of philosophy, brain science, robotics, and psychology.

People performing actions together have a natural tendency to synchronize their behavior. Consistently, people doing a task together build internal representations not only of their actions and goals, but also of the other people performing the task. However, little is known about which are the behavioral mechanisms and the psychological factors affecting the subjective sensation of synchrony, or “connecting” with someone else. In this work, we sought to find which factors induce the subjective sensation of synchrony, combining motion capture data and psychological measures. Our results show that the subjective sensation of synchrony is affected by performance quality together with task category, and time. Psychological factors such as empathy and negative subjective affects also correlate with the subjective sensation of synchrony. However, when people estimate synchrony as seen from a third person perspective, their psychological factors do not affect the accuracy of the estimation. We suggest that to feel this sensation it is necessary to, first, have a good joint performance and, second, to assume the existence of an attention monitoring mechanism that reports that the attention of both participants (self and other) is focused on the task.

We have recently demonstrated that motor execution, observation, and imagery of movements expressing certain emotions can enhance corresponding affective states and therefore could be used for emotion regulation. But which specific movement(s) should one use in order to enhance each emotion? This study aimed to identify, using Laban Movement Analysis (LMA), the Laban motor elements (motor characteristics) that characterize movements whose execution enhances each of the basic emotions: anger, fear, happiness, and sadness. LMA provides a system of symbols describing its motor elements, which gives a written instruction (motif) for the execution of a movement or movement-sequence over time. Six senior LMA experts analyzed a validated set of video clips showing whole body dynamic expressions of anger, fear, happiness and sadness, and identified the motor elements that were common to (appeared in) all clips expressing the same emotion. For each emotion, we created motifs of different combinations of the motor elements common to all clips of the same emotion. Eighty subjects from around the world read and moved those motifs, to identify the emotion evoked when moving each motif and to rate the intensity of the evoked emotion. All subjects together moved and rated 1241 motifs, which were produced from 29 different motor elements. Using logistic regression, we found a set of motor elements associated with each emotion which, when moved, predicted the feeling of that emotion. Each emotion was predicted by a unique set of motor elements and each motor element predicted only one emotion. Knowledge of which specific motor elements enhance specific emotions can enable emotional self-regulation through adding some desired motor qualities to one’s personal everyday movements (rather than mimicking others’ specific movements) and through decreasing motor behaviors which include elements that enhance negative emotions.

This report reviews thirteen integrative mind‑body techniques—breath exercises, body‑tension modulation, and mindfulness/meditation practices—for regulating the autonomic nervous system to reduce stress, anxiety, and PTSD symptoms in military personnel. It presents evidence levels, training requirements, and potential implementation pathways.

The aim of this study was to clarify which cognitive mechanisms underlie Trail Making Test (TMT) direct and derived scores. A comprehensive review of the literature on the topic was carried out to clarify which cognitive factors had been related to TMT performance. Following the review, we explored the relative contribution from working memory, inhibition/interference control, task-switching ability, and visuomotor speed to TMT performance. Forty-one healthy old subjects participated in the study and performed a battery of neuropsychological tests including the TMT, the Digit Symbol subtest [Wechsler Adult Intelligence Scale (Third Version) (WAIS-III)], a Finger Tapping Test, the Digits Forward and Backward subtests (WAIS-III), Stroop Test, and a task-switching paradigm inspired in the Wisconsin Card Sorting Test. Correlation and regression analyses were used in order to clarify the joint and unique contributions from different cognitive factors to the prediction of TMT scores. The results suggest that TMT-A requires mainly visuoperceptual abilities, TMT-B reflects primarily working memory and secondarily task-switching ability, while B-A minimizes visuoperceptual and working memory demands, providing a relatively pure indicator of executive control abilities.

We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke, but little is known about the effects of an enriched sound environment on recovery from neural damage in humans. In humans, music listening activates a wide-spread bilateral network of brain regions related to attention, semantic processing, memory, motor functions, and emotional processing. Music exposure also enhances emotional and cognitive functioning in healthy subjects and in various clinical patient groups. The potential role of music in neurological rehabilitation, however, has not been systematically investigated. This single-blind, randomized, and controlled trial was designed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke. In the acute recovery phase, 60 patients with a left or right hemisphere middle cerebral artery (MCA) stroke were randomly assigned to a music group, a language group, or a control group. During the following two months, the music and language groups listened daily to self-selected music or audio books, respectively, while the control group received no listening material. In addition, all patients received standard medical care and rehabilitation. All patients underwent an extensive neuropsychological assessment, which included a wide range of cognitive tests as well as mood and quality of life questionnaires, one week (baseline), 3 months, and 6 months after the stroke. Fifty-four patients completed the study. Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups. The music group also experienced less depressed and confused mood than the control group. These findings demonstrate for the first time that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood. The neural mechanisms potentially underlying these effects are discussed.

This paper is concerned with the problem of self-identification in the domain of action. We claim that this problem can arise not just for the self as object, but also for the self as subject in the ascription of agency. We discuss and evaluate some proposals concerning the mechanisms involved in self-identification and in agency-ascription, and their possible impairments in pathological cases. We argue in favor of a simulation hypothesis that claims that actions, whether overt or covert, are centrally simulated by the neural network, and that this simulation provides the basis for action recognition and attribution.

How do I know that I am the person who is moving? According to Wittgenstein (1958), the sense of agency involves a primitive notion of the self used as subject, which does not rely on any prior perceptual identification and which is immune to error through misidentification. However, the neuroscience of action and the neuropsychology of schizophrenia show the existence of specific cognitive processes underlying the sense of agency–the “Who” system–which is disrupted in delusions of control. Yet, we have to be careful in the interpretation of such clinical symptoms, which cannot be so easily reduced to deficit of action monitoring or to lack of action awareness. Moreover, we should refine the definition of the sense of agency by distinguishing the sense of initiation and the sense of one’s own movements. A conceptual analysis of the empirical data will lead us to establish the taxonomy of the different levels of action representations.

The current study used qualitative methodology to investigate the body image concerns of people with physical disabilities. Three males and four females aged between 22 and 50 years, in Melbourne, Australia, participated in the study. Three participants were heterosexual, two were homosexual and two described their sexual identity as predominantly heterosexual but ‘bicurious’. The data were gathered through individual interviews of approximately 2 h duration, where participants responded to a set of predetermined open-ended questions. The study found that bodily impairment had a negative influence on the participants’ psychological experiences, feelings and attitudes toward their own bodies. The impact of feedback from the social environment was highlighted, and there was evidence suggesting that individuals gradually adjust to their different bodies and increasingly accept their disabilities over time.

South Africa is perceived as a country with many economic and social problems. These are stressors that put individuals at risk of developing emotional disturbance. Children, as the most vulnerable sector of society, have the least access to resources such as psychological intervention. A measurement instrument that can identify emotional disturbance within this high-risk group; that minimises the effects of formal learning, cultural and language barriers; and utilises the minimum of resources is needed. The Draw A Person: Screening Procedure for Emotional Disturbance (DAP: SPED) (Naglieri, McNeish & Bardos, 1991) is a screening test for emotional disturbance that seems to fulfil these criteria. The present study aimed to explore how useful the DAP: SPED is to identify children with emotional disturbance in South Africa. This involved comparing the scores of the DAP: SPED with those of an independent measure for emotional disturbance, the Beck Youth Inventory (BYI-II). To further explore the usefulness of the DAP: SPED, internal reliability and inter-rater reliability were examined. The DAP: SPED and the BYI-II were administered to a group of English-literate Grade 4 learners from two mainstream schools. The emotional status of the children was unknown, and scores from the BYI-II were used to provide this information. As the BYI-II was used as a control measure, the internal reliability coefficients of its subscales were investigated within the context of the present research. Internal reliability coefficients were good (r=.823 to r=.929, p<.01). A third measure, the Qualitative Questionnaire for Observed Behaviour in the Classroom (QQOBC) was completed by the teachers of participating learners. This measure was used to provide depth to the results as well as independently rate the children’s behaviour. Results showed that the DAP: SPED achieved low correlations with the BYI-II (rho=.024 to rho=.76, p<.01), thereby supporting the null hypothesis. The DAP: SPED was also unable to distinguish between emotional disturbance Present and Absent groups, created post facto according to scores on the BYI-II. A statistical analysis of the internal reliability showed that the DAP: SPED had low internal reliability (α=.448), and that the omission of the measurement items increased the internal reliability (α=.525). Inter-rater reliability was significantly high (rho=.687 to rho=. 816, p<.01), thereby rejecting the null hypothesis. Despite the good inter-rater reliability, certain scoring problems were encountered that showed that a margin for scoring bias could influence the usefulness of the measure.