Overeating and resulting obesity is a public health concern in the United States, and portion size is a factor that contributes to these problems (Zlatevska, Dubelaar, & Holden, 2014). The present research demonstrates that the granularity of labels used to describe portions also influences food consumption, independent of previously documented portion size effects. Across 6 studies and 7 different food items, we find a robust and reliable effect of portion size granularity labels on consumption intentions and food consumption. Having people think about food using fine-grained labels leads them to decrease their consumption intentions (Study 1, n = 80) and ultimately eat less food (Study 2a, n = 79; Study 2b, n = 79). This process operates by shifting people’s perceptions of the size of foods (rather than changing levels of construal) whereby portions described with fine-grained labels (e.g., “15 gummy candies”) are perceived to be bigger than portions described with gross-grained labels (e.g., “one serving;” Study 3, n = 200). In addition, granularity facilitates self-regulation of consumption for individuals with a weight-loss goal both when self-regulation is measured (Study 4, n = 160) and when we manipulate that mediator (Study 5, n = 300). Finally, a high-powered registered report replicated effects of granularity on consumption via shifts in perception and intentions with a diverse community sample (Study 6, n = 323). Implications for theory and practice are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

Background: Alcohol use is prevalent in many societies and has major adverse impacts on health, but the availability of effective interventions limits treatment options for those who want assistance in changing their patterns of alcohol use. Objective: This study evaluated the new Daybreak program, which is accessible via mobile app and desktop and was developed by Hello Sunday Morning to support high-risk drinking individuals looking to change their relationship with alcohol. In particular, we compared the effect of adding online coaching via real-time chat messages (intervention group) to an otherwise self-guided program (control group). Methods: We designed the intervention as a randomized control trial, but as some people (n=48; 11.9%) in the control group were able to use the online coaching, the main analysis comprised all participants. We collected online surveys at one-month and three-months follow-up. The primary outcome was change in alcohol risk (measured with the alcohol use disorders identification test–consumption [AUDIT–C] score), but other outcomes included the number of standard drinks per week, alcohol-related days out of role, psychological distress (Kessler-10), and quality of life (EUROHIS-QOL). Markers of engagement with the program included posts to the site and comments on the posts of others. The primary analysis used Weighted Generalized Estimating Equations. Results: We recruited 398 people to the intervention group (50.2%) and 395 people to the control group (49.8%). Most were female (71%) and the mean age was 40.1 years. Most participants were classified as probably dependent (550, 69%) on the AUDIT–10, with 243 (31%) classified with hazardous or harmful consumption. We followed up with 334 (42.1%) participants at one month and 293 (36.9%) at three months. By three months there were significant improvements in AUDIT–C scores (down from mean 9.1 [SD 1.9] to 5.8 [SD 3.1]), alcohol consumed per week (down from mean 37.1 [SD 28.3] to mean 17.5 [SD 18.9]), days out of role (down from mean 1.6 [SD 3.6] to 0.5 [SD 1.6]), quality of life (up from 3.2 [SD 0.7] to 3.6 [SD 0.7]) and reduced distress (down from 24.8 [SD 7.0] to 19.0 [SD 6.6]). Accessing online coaching was not associated with improved outcomes, but engagement with the program (eg, posts and comments on the posts of others) were significantly associated with improvements (eg, in AUDIT–C, alcohol use and EUROHIS-QOL). Reduced alcohol use was found for both probably dependent (estimated marginal mean of 40.8 to 20.1 drinks) and hazardous or harmful alcohol users (estimated marginal mean of 22.9 to 11.9 drinks). Conclusions: Clinically significant reductions in alcohol use were found, as well as reduced alcohol risk (AUDIT–C) and days out of role. Importantly, improved alcohol-related outcomes were found for both hazardous or harmful and probably dependent drinkers. Since October 2016, Daybreak has reached more than 50,000 participants. Therefore, there is the potential for the program to have an impact on alcohol-related problems at a population health level, importantly including an effect on probably dependent drinkers. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12618000010291; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373110 International Registered Report Identifier (IRRID): RR2-10.2196/9982

When conveying a message to an interlocutor, speakers need to code concepts in lexical expressions, a process known as lexical retrieval. There is evidence that speakers can take into account the dialectal background of their interlocutor to tailor their lexical retrieval; for instance, our pilot experiment showed that participants, when asked to guess the defined expression according to a definition, were more likely to produce American English (AE) expressions (e.g., apartment instead of flat) when the definition was spoken by an AE interlocutor than a British English (BE) interlocutor. It is possible that such an interlocutor effect arises from a top-down interlocutor model, from bottom-up accent details, or a combination of both. This registered report aimed to address this issue with two experiments. In Experiment 1, we observed that the interlocutor effect on lexical retrieval did not differ regardless of whether a definition was presented by the interlocutor via speaking (with accent details) or writing (without accent details), suggesting that the effect arises from top-down interlocutor modeling instead of bottom-up accent details. Experiment 2 interleaved two interlocutors with different dialects, one providing a spoken filler definition and the other a written target definition. Participants used more AE expressions for target definitions given by an AE interlocutor than a BE interlocutor, suggesting they maintained concurrent models for interlocutors and used them to retrieve dialect-congruent expressions. These findings highlight top-down influences of the communicative context in language production. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Background: Most survivors of cancer have multiple cardiovascular risk factors, increasing their risk of poor cardiovascular and cancer outcomes. The Automated Heart-Health Assessment (AH-HA) tool is a novel electronic health record clinical decision support tool based on the American Heart Association’s Life’s Simple 7 cardiovascular health metrics to promote cardiovascular health assessment and discussion in outpatient oncology. Before proceeding to future implementation trials, it is critical to establish the acceptability of the tool among providers and survivors. Objective: This study aims to assess provider and survivor acceptability of the AH-HA tool and provider training at practices randomized to the AH-HA tool arm within WF-1804CD. Methods: Providers (physicians, nurse practitioners, and physician assistants) completed a survey to assess the acceptability of the AH-HA training, immediately following training. Providers also completed surveys to assess AH-HA tool acceptability and potential sustainability. Tool acceptability was assessed after 30 patients were enrolled at the practice with both a survey developed for the study as well as with domains from the Unified Theory of Acceptance and Use of Technology survey (performance expectancy, effort expectancy, attitude toward using technology, and facilitating conditions). Semistructured interviews at the end of the study captured additional provider perceptions of the AH-HA tool. Posttreatment survivors (breast, prostate, colorectal, endometrial, and lymphomas) completed a survey to assess the acceptability of the AH-HA tool immediately after the designated study appointment. Results: Providers (n=15) reported high overall acceptability of the AH-HA training (mean 5.8, SD 1.0) and tool (mean 5.5, SD 1.4); provider acceptability was also supported by the Unified Theory of Acceptance and Use of Technology scores (eg, effort expectancy: mean 5.6, SD 1.5). Qualitative data also supported provider acceptability of different aspects of the AH-HA tool (eg, “It helps focus the conversation and give the patient a visual of continuum of progress”). Providers were more favorable about using the AH-HA tool for posttreatment survivorship care. Enrolled survivors (n=245) were an average of 4.4 (SD 3.7) years posttreatment. Most survivors reported that they strongly agreed or agreed that they liked the AH-HA tool (n=231, 94.3%). A larger proportion of survivors with high health literacy strongly agreed or agreed that it was helpful to see their heart health score (n=161, 98.2%) compared to survivors with lower health literacy scores (n=68, 89.5%; P=.005). Conclusions: Quantitative surveys and qualitative interview data both demonstrate high acceptability of the AH-HA tool among both providers and survivors. Although most survivors found it helpful to see their heart health score, there may be room for improving communication with survivors who have lower health literacy. Trial Registration: ClinicalTrials.gov NCT03935282; http://clinicaltrials.gov/ct2/show/NCT03935282

Background: The usual diagnosis of sarcopenia requires a dual-energy x-ray absorptiometry (DXA) exam, which has low accessibility in primary care for Latin American countries. Objective: The aim of this study is to design and validate software for mobile devices (Android, IOS) and computers, based on an adapted version of the diagnostic algorithm of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). Methods: Follow-up exams were conducted on 430 community-dwelling Chileans 60 years and older (mean 68.2 years, SD 4.9) participating in the IsaMayor and Alexandros cohorts designed to study sarcopenia and disability associated with obesity, respectively. All the participants from the cohorts were randomly selected from the registries of primary health care centers and, for this study, must have a DXA scan at baseline. The software (HTSMayor) was designed according to an adapted version of the algorithm proposed by the EWGSOP and was divided into four phases: longitudinal validation of diagnostic algorithm of sarcopenia, alpha version, beta version, and release version. The software estimates appendicular skeletal muscle mass (ASM) using an anthropometric equation or DXA measurements with Chilean cut-off points. The predictive validation of the algorithm was estimated, comparing functional limitations (at least one activity of daily living, two instrumental activities of daily living, or three mobility limitations), falls, and osteoporosis at follow-ups in patients with and without sarcopenia at baseline, using adjusted logistic models. Results: After a median follow-up of 4.8 years (2078.4 person-years), 37 (9.9%) new cases of sarcopenia, out of the 374 patients without sarcopenia at baseline, were identified (incidence density rate=1.78 per 100 person-years). ASM estimated with the anthropometric equation showed both a high sensitivity and specificity as compared with those estimated by DXA measurements, yielding a concordance of 0.96. The diagnostic algorithm of sarcopenia considered in the software with the equation showed both a high sensitivity (82.1%) and specificity (94.9%) when compared with DXA (reference standard). Adults without sarcopenia (at baseline) showed better physical performance (after approximately 5 years) than adults with sarcopenia. Loss of functionality was greater in adults with sarcopenia (OR 5.0, 95% CI 2.2-11.4) than in adults without sarcopenia. In addition, the risks of falls (OR 2.2, 95% CI 1.1-4.3) and osteoporosis (OR 2.8, 95% CI 1.2-6.6) were higher in older persons with sarcopenia than those without sarcopenia. The measurements and results were completed for the beta and release tests with a mean time of 10 minutes and 11 minutes, respectively. Conclusions: We developed and validated a software for the diagnosis of sarcopenia in older Chilean adults that can be used on a mobile device or a computer with good sensitivity and specificity, thus allowing for the development of programs for the prevention, delay, or reversal of this disease. To our knowledge, HTSMayor is the first software to diagnose sarcopenia.

Background: Smartphone apps promoting physical activity (PA) are abundant, but few produce substantial and sustained behavior change. Although many PA apps purport to induce users to compare themselves with others (by invoking social comparison processes), improvements in PA and other health behaviors are inconsistent. Existing literature suggests that social comparison may motivate PA for some people under some circumstances. However, 2 aspects of work that apply social comparison theory to PA apps remain unclear: (1) how comparison processes have been operationalized or harnessed in existing PA apps and (2) whether incorporating sources of variability in response to comparison have been used to tailor comparison features of apps, which could improve their effectiveness for promoting PA. Objective: The aim of this meta-review was to summarize existing systematic, quantitative, and narrative reviews of behavior change techniques in PA apps, with an emphasis on social comparison features, to examine how social comparison is operationalized and implemented. Methods: We searched PubMed, Web of Science, and PsycINFO for reviews of PA smartphone apps. Of the 3743 initial articles returned, 26 reviews met the inclusion criteria. Two independent raters extracted the data from these reviews, including the definition of social comparison used to categorize app features, the percentage of apps categorized as inducing comparison, specific features intended to induce comparison, and any mention of tailoring comparison features. For reference, these data were also extracted for related processes (such as behavioral modeling, norm referencing, and social networking). Results: Of the included review articles, 31% (8/26) categorized app features as prompting social comparison. The majority of these employed Abraham and Michie’s earliest definition of comparison, which differs from versions in later iterations of the same taxonomy. Very few reviews specified what dimension users were expected to compare (eg, steps, physical fitness) or which features of the apps were used to induce comparison (eg, leaderboards, message boards). No review referenced tailoring of comparison features. In contrast, 54% (14/26) reviews categorized features for prompting behavioral modeling and 31% (8/26) referenced tailoring app features for users’ personal goals or preferences. Conclusions: The heterogeneity across reviews of PA apps and the absence of relevant information (eg, about dimensions or features relevant for comparison) create confusion about how to best harness social comparison to increase PA and its effectiveness in future research. No evidence was found that important findings from the broader social comparison literature (eg, that people have differing preferences for and responses to social comparison information) have been incorporated in the design of existing PA apps. Greater integration of the mobile health (mHealth) and social comparison literatures may improve the effectiveness of PA apps, thereby increasing the public health impact of these mHealth tools.

Background Acute gastroenteritis (AGE) and acute respiratory infections (ARIs) cause significant pediatric morbidity and mortality. Developing childhood vaccines against major enteric and respiratory pathogens should be guided by the natural history of infection and acquired immunity. The United States currently lacks contemporary birth cohort data to guide vaccine development. Objective The PREVAIL (Pediatric Respiratory and Enteric Virus Acquisition and Immunogenesis Longitudinal) Cohort study was undertaken to define the natural history of infection and immune response to major pathogens causing AGE and ARI in US children. Methods Mothers in Cincinnati, Ohio, were enrolled in their third trimester of pregnancy, with intensive child follow-up to 2 years. Blood samples were obtained from children at birth (cord), 6 weeks, and 6, 12, 18, and 24 months. Whole stool specimens and midturbinate nasal swabs were collected weekly and tested by multipathogen molecular assays. Saliva, meconium, maternal blood, and milk samples were also collected. AGE (≥3 loose or watery stools or ≥1 vomiting episode within 24 hours) and ARI (cough or fever) cases were documented by weekly cell phone surveys to mothers via automated SMS text messaging and review of medical records. Immunization records were obtained from registries and providers. follow-up ended in October 2020. Pathogen-specific infections are defined by a PCR-positive sample or rise in serum antibody. Results Of the 245 enrolled mother–child pairs, 51.8% (n=127) were White, 43.3% (n=106) Black, 55.9% (n=137) publicly insured, and 86.5% (n=212) initiated breastfeeding. Blood collection was 100.0% for mothers (n=245) and 85.7% for umbilical cord (n=210). A total of 194/245 (79.2%) mother–child pairs were compliant based on participation in at least 70% (≥71/102 study weeks) of child-weeks and providing 70% or more of weekly samples during that time, or blood samples at 18 or 24 months. Compliant participants (n=194) had 71.0% median nasal swab collection (IQR 30.0%-90.5%), with 98.5% (191/194) providing either an 18- or 24-month blood sample; median response to weekly SMS text message surveys was 95.1% (IQR 76.5%-100%). Compliant mothers reported 2.0 AGE and 4.5 ARI cases per child-year, of which 25.5% (160/627) and 38.06% (486/1277) of cases, respectively, were medically attended; 0.5% of AGE (3/627) and 0.55% of ARI (7/1277) cases were hospitalized. Conclusions The PREVAIL Cohort demonstrates intensive follow-up to document the natural history of enteric and respiratory infections and immunity in children 0-2 years of age in the United States and will contribute unique data to guide vaccine recommendations. Testing for pathogens and antibodies is ongoing. International Registered Report Identifier (IRRID) RR1-10.2196/22222

Background: Recent evidence suggests the effectiveness of stepwise, targeted approaches for the prevention of lifestyle-related diseases with combinations of web-based and face-to-face interventions showing promising results. Objective: This paper reports on 1-year changes in health-risk behaviors, BMI, self-rated health, mental well-being, and risk of disease at 1-year follow-up after participation in a stepwise intervention that targeted persons at high risk of disease and persons with health-risk behavior. To this end, we distinguish between participants who took up the full intervention (web-based plus face-to-face) and those who received only the web-based intervention. Methods: The Early Detection and Prevention (Danish acronym: TOF) pilot study was conducted as a nonrandomized, 1-year follow-up intervention study in two municipalities in the Region of Southern Denmark. A total of 9400 citizens born between 1957 and 1986 (aged 29 to 60 years) were randomly sampled from participating general practitioner (GP) patient-list systems and were invited to take part in the study. Participants were subsequently stratified into risk groups based on their responses to a questionnaire on health-risk behavior and data from their GP’s electronic patient record (EPR) system. All participants received a digital personal health profile with individualized information on current health-risk behavior and targeted advice on relevant health-risk behavior changes. In addition, patients at high risk of disease, as indicated by their digital health profile, were offered a targeted intervention at their GP. Patients who were not deemed at high risk of disease but who exhibited health-risk behaviors were offered a targeted intervention at their municipal health center (MHC). At 1-year follow-up, health-risk behaviors, self-rated health, BMI, and mental well-being were reassessed by questionnaire, and current information on diagnoses and medical treatment was retrieved from the EPRs. Results: Of 598 patients at high risk of disease or with health-risk behavior, 135 took up the targeted intervention at their GP or MHC and 463 received the personal health profile only. From baseline to 1-year follow-up, the number of patients with unhealthy eating habits decreased, mean mental well-being increased, and smoking prevalence decreased in patients who had received the digital personal health profile alone. Among patients who took up the targeted intervention, unhealthy eating habits and sedentary lifestyles decreased and significant reductions in mean BMI were observed. At 1-year follow up, no health-risk behaviors were detected among 17.4% of patients who at baseline had exhibited health-risk behaviors or high risk of disease. Conclusions: A stepwise targeted preventive approach using web-based and face-to-face elements may lead to favorable lifestyle changes. Specifically, a web-based approach may improve smoking and eating habits and mental well-being, whereas supplementary face-to-face interventions may be necessary to improve exercise habits and BMI. Trial Registration: ClinicalTrials.gov NCT02797392; https://clinicaltrials.gov/ct2/show/NCT02797392

Background: Immigrant populations are often disproportionally affected by chronic diseases, such as type 2 diabetes mellitus (T2DM). Use of information and communication technology (ICT) is one promising approach for better self-care of T2DM to mitigate the social health inequalities, if designed for a wider population. However, knowledge is scarce about immigrant populations’ diverse electronic health (eHealth) activities for self-care, especially in European countries. Objective: With a target group of first-generation immigrants from Pakistan in the Oslo area, Norway, we aimed to understand their diverse eHealth activities for T2DM self-care in relation to immigration-related user factors specific to this target group: proficiency in relevant languages (Urdu, Norwegian, English), length of residence in Norway, and diagnosis of T2DM compared with general user factors (age, gender, education and digital skills, and self-rated health status). Methods: Data were from a survey among the target population (N=176) conducted in 2015-2016. Using logistic regression, we analyzed associations between user factors and experiences of each of the following eHealth activities for T2DM self-care in the last 12 months: first, information seeking by (1) search engines and (2) Web portals or email subscriptions; second, communication and consultation (1) by closed conversation with a few acquaintances using ICT and (2) on social network services; and third, active decision making by using apps for (1) tracking health information and (2) self-assessment of health status. Using Poisson regression, we also assessed the relationship between user factors and variety of eHealth activities experienced. The Bonferroni correction was used to address the multiple testing problem. Results: Regression analyses yielded the following significantly positive associations: between Urdu literacy and (1) information seeking by Web portals or email subscriptions (odds ratio [OR] 2.155, 95% CI 1.388-3.344), (2) communication and consultation on social network services (OR 5.697, 95% CI 2.487-13.053), and (3) variety (estimate=0.350, 95% CI 0.148-0.552); between length of residence in Norway and (1) communication and consultation by closed conversation with a few acquaintances using ICT (OR 1.728, 95% CI 1.193-2.503), (2) communication and consultation on social network services (OR 2.098, 95% CI 1.265-3.480), and (3) variety (estimate=0.270, 95% CI 0.117-0.424); between Norwegian language proficiency and active decision making by using apps for self-assessment of health status (OR 2.285, 95% CI 1.294-4.036); between education and digital skills and active decision making by using apps for tracking health information (OR 3.930, 95% CI 1.627-9.492); and between being a female and communication and consultation by closed conversation with a few acquaintances using ICT (OR 2.883, 95% CI 1.335-6.227). Conclusions: This study implies immigration-related factors may confound associations between general user factors and eHealth activities. Further studies are needed to explore the influence of immigration-related user factors for eHealth activities in other immigrant groups and countries. International Registered Report: RR2-DOI 10.2196/resprot.5468

Background: There is a clear need for enhanced mental health assessment, depressive symptom (DS) evaluation being no exception. A promising approach to this aim is using virtual reality (VR), which entails the potential of adding a wider set of assessment domains with enhanced ecological validity. However, whilst several studies have used VR for both diagnostic and treatment purposes, its acceptance, in particular how exposure to virtual environments affects populations with psychiatric conditions remains unknown. Objective: This study aims to report on the acceptability, usability, and cybersickness levels of a pilot VR environment designed for the purpose of differentiating between individuals with DSs. Methods: The exploratory study, conducted in Italy, included 50 healthy controls and 50 young adults with mild-to-moderate DSs (without the need for a formal diagnosis). The study used an observational design with approximately 30 minutes of VR exposure followed by a self-report questionnaire battery. The battery included a questionnaire based on the Theoretical Framework of Acceptability, the System Usability Scale as well as the Simulator Sickness Questionnaire. Results: Results indicate that the majority found VR acceptable for the purposes of mental health screening and treatment. However, for diagnostics, there was a clear preference for VR to be used by mental health professionals as a supplementary tool, as opposed to a stand-alone solution. In practice, following exposure to the pilot VR environment, generally, good levels of acceptability and usability were reported, but areas in need of improvement were identified (such as self-efficacy). Self-reported cybersickness levels were comparable to literature averages but were considerably higher among those with DSs. Conclusions: These findings raise questions about the potential interplay between underlying somatic symptoms of depression and VR-induced cybersickness and call for more attention from the scientific community both in terms of methodology as well as potential clinical and theoretical implications. Conclusively, user support indicates a potential for VR to aid mental health assessment, but further research is needed to understand how exposure to virtual environments might affect populations with varying severity and other forms of psychiatric symptoms.

Psychopathic personality disorder (PPD) is a widely recognized disorder that has been associated with high levels of dysfunction across clinical, forensic, occupational, and social settings. The psychopathy construct displays robust connections to social and interpersonal dysfunction; however, research investigating these associations thus far largely relies on total or domain-level scores. This study aimed to employ a higher degree of abstraction to examine associations between psychopathy symptoms and various interpersonal outcomes at different levels of the psychopathy trait hierarchy. The Comprehensive Assessment of Psychopathic Personality (Cooke et al., 2012) was used, allowing for the highest level of nuance, with 33 individual symptom scales. A variety of different interpersonal outcome variables were collected using multiple methods. A university sample ( N = 669) was used and informant reports ( N = 337) were collected. Consistent with our hypotheses, correlation analyses indicated that there were distinct, and at times unique, associations between symptoms and interpersonal outcomes. Furthermore, regression models and dominance analyses showed taking a symptom-level approach can add incremental information over factor scores, particularly for self-reported outcomes. Future research should seek to replicate these findings across populations to elucidate any consistent patterns that could aid in the assessment and treatment of PPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)

In an era where digital imagery has become ubiquitous, the ease of creating fake or AI-generated images poses a critical challenge to credibility assessment. Repetition increases the credibility of written and verbal information. Does this credibility gain also apply to pictures? Participants were exposed to both genuine and AI-generated images, followed by a credibility assessment phase including repeated and new images. We found that participants judged repeated images as more credible than new images, regardless of whether those images were genuine or AI-generated. This repetition effect remained consistent across diverse image categories with low between-image variability. These findings highlight a potent mechanism for the spread of visual misinformation: Images repeatedly shared across social media platforms may gain unwarranted credibility through mere exposure, regardless of their authenticity. However, the precise cognitive mechanisms underlying the repetition effect for pictures—and whether they differ from those established for verbal information—remain important questions for future research. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Background: Generalized anxiety disorder (GAD) is common among university students due to academic pressure and financial uncertainty, among other challenges. Despite the need, the receipt of available psychological services is often low. Objective: This study investigates the feasibility of a digital unguided cognitive behavioral therapy (CBT)–based mobile app, Cerina, and examines the likely effects of this intervention in reducing GAD symptoms compared to the waitlist control group. Methods: Eligible students (n=158) with mild to moderate GAD symptoms were self-assessed through web-based questionnaires and were randomly allocated to the intervention group (n=79) or to the waitlist control group (n=79) following their informed consent. The intervention group had direct access to Cerina and followed CBT-based interactive sessions for 6 weeks. The waitlist control group participants had access to optional on-campus well-being services, and they were given access to Cerina 6 weeks after their randomization. Participants completed assessments on anxiety, depression, worry, and usability at three time points. Additionally, upon completing the intervention, they were invited to a web-based interview to understand the implementation of the intervention in more depth. Results: On average, 13% (10/79) intervention group participants dropped out, 61% (36/69) completed the core clinical content (2 sessions), and 12% (7/69) completed the desired number of sessions (6 or 7 sessions). Analyses of the completers (2 or more sessions) revealed significant group differences in GAD (mean 8.4, SD 3.7; t42=–2.25; P=.03; d=–0.7) and worry symptoms (mean 42.3, SD 10.8; t42=–2.50; P=.02; d=–0.8), as well as functional impairment (mean 16.7, SD 2.44; t42=–2.12; P=.04; d=–0.6) in favor of the intervention group at posttest with medium to large effect sizes. The intention-to-treat analyses confirmed significant group differences in GAD (mean 8.47, SD 2.7; t156=–2.23; P=.03; d=–0.4), and there were marginally nonsignificant group differences in worry symptoms (mean 41.5, SD 8.40; t156=–1.94; P=.05; d=–0.3) in favor of the intervention group at posttest with medium effect sizes. These results suggest that the intervention had a meaningful impact on reducing GAD symptoms and a modest impact on reducing worry symptoms among participants. Conclusions: The Cerina app showed promising results in reducing GAD symptoms among students. This result supports findings from other randomized controlled trials showing that digital CBT-based interventions are effective and feasible for a wide range of age groups and populations experiencing GAD symptoms. The low number of participants completing the recommended number of sessions suggests a usability issue. To address this, the intervention could be refined through an iterative design process informed by user feedback, and the long-term impact of specific engagement features in improving usability and retention could be assessed through extended evaluations. Trial Registration: ClinicalTrials.gov NCT06146530; https://clinicaltrials.gov/study/NCT06146530

Objective: This study aims to evaluate the feasibility, acceptability, appropriateness, and preliminary impact of the eHub digital platform for caregivers of children aged 0-12 years, particularly those experiencing adversity. The evaluation will assess implementation outcomes, caregiver and child mental health outcomes, and help-seeking behaviors over a 6-month period. Methods: A prospective cohort of 270 caregivers of children aged 0-12 years will be recruited from 3 socioeconomically diverse Australian sites (Wyndham Vale in Victoria and Marrickville and Fairfield in New South Wales). Participants will be recruited through local community hubs, health and social service providers, and social media, and will enroll via the REDCap (Research Electronic Data Capture; Vanderbilt University) survey platform. A mixed methods type 3 implementation impact evaluation will be undertaken, which tests an implementation strategy while observing and gathering information on the intervention’s impact on relevant outcomes. In this protocol, implementation will be assessed as a primary outcome using Proctor’s outcomes for the implementation framework, and secondary outcomes will include caregiver access and use of the eHub and associated child and parent mental health outcomes. Data will be collected at baseline and 6 months. Quantitative data will be analyzed using descriptive statistics and regression models; repeated measures will be analyzed using generalized estimating equations. Qualitative data will be analyzed using framework analysis. Results: The study was funded in December 2021. Participant enrollment for the study began in February 2024, with participants involved in the eHub evaluation for 6 months. Conclusions: The results of this study will be instrumental in refining the intervention for future scaling to other Australian sites. This study has the potential to offer an accessible, cost-effective, and scalable digital solution to improve service navigation and mental health outcomes for children and families experiencing adversity.

Hosted on the Open Science Framework

Abstract. As an entertainment technology, video games are a popular social activity that can allow for multiple players to cooperatively engage on-screen challenges. Emerging research has found tha...

A recent series of experiments suggests that fostering superstitions can substantially improve performance on a variety of motor and cognitive tasks (Damisch, Stoberock, & Mussweiler, 2010). We con...

Abstract. The self-sufficiency hypothesis suggests that priming individuals with money makes them focus more strongly on themselves than on others. However, recently, research supporting this claim...

According to social cognition textbooks, stereotypes are activated automatically if appropriate categorical cues are processed. Although many studies have tested effects of activated stereotypes on...

The present work includes three attempts to replicate the moral licensing effect by Sachdeva, Iliev, and Medin (2009). The original authors found that writing about positive traits led to lower don...

Hosted on the Open Science Framework

Our appraisals and beliefs about our memory functioning shape how we reconstruct and report specific memory episodes. Research has shown that people differ in the extent to which they are skeptical about their memories, which is termed as memory distrust. In general, memory distrust has two aspects: distrust over forgetting (i.e., making omission errors) and distrust over falsely recollecting events that did not happen (i.e., making commission errors). Although these two aspects of memory distrust have been studied, how they are associated with memory validation (e.g., the formation of autobiographical belief) and reporting remains unclear. In the present study, we plan to examine the effect of metacognitive appraisals on the memory validation process as well as the commission and omission errors in memory reporting. Hosted on the Open Science Framework

Abstract. How do people judge the veracity of a message? The negativity bias in judgments of truth describes the phenomenon that the same message is more likely judged as true when framed negativel...

This Stage 1 Registered Report proposes a preregistered replication and extension of prior exploratory work comparing an Intuition Market (IM) with a traditional Prediction Market (PM) in forecasting binary financial outcomes.

Repetition increases the perceived truth of information. This illusory truth effect is a welldocumented and robust phenomenon. Although research has primarily focused on trivia statements, the effects of repetition on belief have also been identified for consequential statements such as fake news headlines. Moreover, research reveals repetition increases accuracy ratings for conspiracy statements. However, in past work, the illusory truth effect was smaller for conspiracy statements than trivia statements. This result raises the intriguing possibility that there is something unique about conspiracy statements relative to trivia statements that makes them more resistant to the effects of repetition. However, this difference in the illusory truth effect between conspiracy and trivia statements may be due to differences in baseline plausibility rather than anything specific about conspiracy statements. Overall, the conspiracy statements were seen as less plausible than the trivia statements (both true and false trivia statements) in the prior experiment. In this registered report, we examined the illusory truth effect for conspiracy and trivia statements using the same procedure as in previous research, but we matched the statements on baseline plausibility. In line with our hypothesis, the effect of repetition on perceived truth was similar for conspiracy and trivia statements when they were equally implausible (or plausible). Results from this study replicate the generality of the illusory truth effect to statements that can cause harm and suggest that the psychological effect of repetition on truth ratings is equivalent for equally implausible (or plausible) conspiracy and trivia statements.

Emotional episodes involve partially coordinated changes in experience and autonomic activity, and subjective–physiological coherence appears to vary with aging and physiological stress. Physiological accounts of emotional aging propose that age-relat

Background and Aim: In healthy aging, there is a decline of cognitive functions such as episodic memory, i.e., long-term memories of events in one’s life. This process is exacerbated in neurodegenerative diseases such as Alzheimer’s disease. Therefore, developing interventions to maintain memory functions in old age is essential, but requires the identification of the underlying neuronal processes of this decline. However, the neuronal processes underlying age-related memory decline have been inconclusively investigated, particularly regarding the temporal dynamics of memory content integration within brain networks. Here, electroencephalography (EEG) and transcranial alternating current stimulation (tACS) provide methods for investigating and modulating brain oscillations and their association with memory. However, methodological advancements are still required for more practicable and better-tolerated assessments of the neuronal mechanisms of memory impairments and their effective neuromodulation, e.g., in clinical populations. Therefore, this dissertation aims to provide a comprehensive picture of oscillatory processes during memory performance, their age-related changes, and new methods for investigation and potential intervention in healthy older adults and patients. Methods: To this end, I investigated and compared the neuronal correlates of episodic memory in young and older adults using EEG in paper 1. Paper 2 is a Stage 1 Registered Report aiming to investigate the effect of tACS on memory performance and oscillatory activity in healthy older adults. Here, I used EEG, functional magnetic resonance imaging (fMRI) and computational modeling of electric fields of older adults to determine the appropriate stimulation frequency, the exact stimulation sites, and the appropriate electrode set-up to target the identified regions. Paper 2 also includes a pilot study with young adults to ensure the feasibility of the stimulation protocol and involvement of subcortical activity in stimulation effects. In paper 3, I compared memory-relevant measures between conventional and newer dry electrodes (dry EEG) to test whether dry EEG provides a reliable method for investigations in groups or environments where conventional EEG would not be possible, e.g., patient populations in their home. Results: Analyses showed disturbed oscillatory processes in healthy older adults, compared to younger adults, related to age-related memory impairments (paper 1). To target the disturbed memory network in older adults, I developed a multimodal, data-driven approach analyzing EEG, fMRI and electric field modeling pilot data of healthy older adults to identify suitable tACS parameters for modulation of memory and network functioning. An additional pilot study showed the feasibility of the protocol. It also showed that despite the lack of effect on memory performance in a small, high-performing sample of young adults, the stimulation changed this group’s oscillatory processes in cortical and subcortical regions of the memory network (paper 2). The memory-relevant processes investigated in papers 1 and 2 could also be detected with dry EEG, especially using global network measures (paper 3). Conclusion: Together, this dissertation presents a comprehensive account of oscillatory processes during memory performance and the changes they undergo in healthy aging. It introduces novel methods for investigation and possible intervention in healthy older adults and patients. In future work, these findings could be extended to investigate memory- relevant EEG signatures and their modulation in patient groups to develop effective interventions in memory-impaired populations in a home-based setting.

PsychArchives is a disciplinary repository for psychological science and neighboring disciplines.

Although variation in effect sizes and predicted values among studies of similar phenomena is inevitable, such variation far exceeds what might be produced by sampling error alone. One possible explanation for variation among results is differences among researchers in the decisions they make regarding statistical analyses. A growing array of studies has explored this analytical variability in different fields and has found substantial variability among results despite analysts having the same data and research question. Many of these studies have been in the social sciences, but one small “many analyst” study found similar variability in ecology. We expanded the scope of this prior work by implementing a large-scale empirical exploration of the variation in effect sizes and model predictions generated by the analytical decisions of different researchers in ecology and evolutionary biology. We used two unpublished datasets, one from evolutionary ecology (blue tit, Cyanistes caeruleus, to compare sibling number and nestling growth) and one from conservation ecology (Eucalyptus, to compare grass cover and tree seedling recruitment). The project leaders recruited 174 analyst teams, comprising 246 analysts, to investigate the answers to prespecified research questions. Analyses conducted by these teams yielded 141 usable effects (compatible with our meta-analyses and with all necessary information provided) for the blue tit dataset, and 85 usable effects for the Eucalyptus dataset. We found substantial heterogeneity among results for both datasets, although the patterns of variation differed between them. For the blue tit analyses, the average effect was convincingly negative, with less growth for nestlings living with more siblings, but there was near continuous variation in effect size from large negative effects to effects near zero, and even effects crossing the traditional threshold of statistical significance in the opposite direction. In contrast, the average relationship between grass cover and Eucalyptus seedling number was only slightly negative and not convincingly different from zero, and most effects ranged from weakly negative to weakly positive, with about a third of effects crossing the traditional threshold of significance in one direction or the other. However, there were also several striking outliers in the Eucalyptus dataset, with effects far from zero. For both datasets, we found substantial variation in the variable selection and random effects structures among analyses, as well as in the ratings of the analytical methods by peer reviewers, but we found no strong relationship between any of these and deviation from the meta-analytic mean. In other words, analyses with results that were far from the mean were no more or less likely to have dissimilar variable sets, use random effects in their models, or receive poor peer reviews than those analyses that found results that were close to the mean. The existence of substantial variability among analysis outcomes raises important questions about how ecologists and evolutionary biologists should interpret published results, and how they should conduct analyses in the future.

Antidepressant medication (ADM) and psychotherapy are effective treatments for major depressive disorder (MDD). It is unclear, however, if treatments differ in their effectiveness at the symptom level and whether symptom information can be utilised to inform treatment allocation. The present study synthesises comparative effectiveness information from randomised controlled trials (RCTs) of ADM versus psychotherapy for MDD at the symptom level and develops and tests the Symptom-Oriented Therapy (SOrT) metric for precision treatment allocation.

Background: The gut microbiota (GM) plays a critical role in systemic health, influencing immune, metabolic, and neurological functions. Emerging evidence suggests that moxibustion, a traditional thermal therapy, may modulate GM to restore microbial homeostasis, yet its exclusive effects remain undifferentiated from combined therapies like acupuncture. Prior meta-analyses lack mechanistic specificity, necessitating a focused evaluation of moxibustion’s impact on microbial ecology. Objective: This systematic review and meta-analysis protocol aims to quantify moxibustion-induced changes in GM diversity, taxonomic composition, and functional metabolites (e.g., short-chain fatty acids [SCFAs]). Methods: We will systematically search PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases from inception through December 31, 2024, using keywords such as “moxibustion,” “gut microbiota,” and “intestinal flora.” Eligible preclinical (animal) and clinical (human) studies evaluating standalone moxibustion interventions on gut microbiota will be included. Primary outcomes include microbial α-diversity indices (Shannon, Simpson) and relative abundance of key taxa (e.g., Firmicutes, Bacteroidetes). Risk of bias will be assessed using SYRCLE for animal studies and modified CAMARADES criteria for human trials. Pooled effect estimates for continuous outcomes (e.g., diversity indices, taxa ratios) will be calculated using the ratio of means (ROM) with 95% confidence intervals. Statistical analyses will be conducted in RevMan 5.4 and R (metafor package), with data archived on Figshare for reproducibility. Results: As of March 2025, the literature search and screening have been completed, and 31 studies meeting the inclusion criteria have been identified. The comprehensive analysis is scheduled to be completed by October 2025, with results anticipated to be published in late 2025. The anticipated findings suggest that moxibustion may reduce pathogenic genera such as Ruminococcus while enhancing beneficial genera, effects that are expected to be associated with improved intestinal barrier integrity and anti-inflammatory responses. Conclusions: This protocol provides a rigorous framework to evaluate moxibustion’s unique role in GM modulation, bridging traditional medicine with microbiome science. Results will inform optimized, non-pharmacological strategies for managing microbiome-associated chronic diseases and guide future research priorities. Clinical Trial: Prospero CRD42025639714.

Background: Spinal cord injury (SCI) affects millions of people worldwide and often results in impaired lower limb function and reduced mobility. Transcutaneous spinal cord stimulation (tSCS) has emerged as a promising neuromodulation technique that shows potential for enhancing motor recovery and walking ability in individuals with SCI. However, the effectiveness of tSCS for lower limb rehabilitation in this population remains unclear due to limited evidence from small sample sizes, heterogeneous protocols, and lack of long-term follow-up data. Objective: The primary objective of this systematic review and meta-analysis is to determine the effectiveness of tSCS, compared to sham stimulation, no intervention, or other active interventions, for improving lower limb motor function in individuals with SCI. Secondary objectives are to evaluate the effects of tSCS on walking ability (including speed, distance, and independence), spasticity, quality of life, and safety outcomes. Methods: This systematic review will be conducted according to the Cochrane Handbook for Systematic Reviews of Interventions and reported following the PRISMA 2020 statement. We will search electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, PEDro, and Scopus) from inception to August 2025, along with grey literature, trial registries, and hand-searching of key journals. We will include randomized controlled trials, quasi-RCTs, and non-randomized studies (case series with ≥5 participants) that evaluate the effects of tSCS applied over the spinal region on lower limb rehabilitation outcomes in adults with traumatic or non-traumatic SCI. The primary outcome will be lower limb motor function assessed by validated measures such as the Lower Extremity Motor Score (LEMS). Secondary outcomes will include walking ability, balance, functional independence, spasticity, quality of life, and adverse events. Two reviewers will independently screen studies, extract data, and assess risk of bias using the RoB 2 and ROBINS-I tools. Data will be synthesized using random-effects meta-analysis if appropriate, with planned subgroup analyses examining injury level (cervical vs. thoracic vs. lumbosacral), injury completeness (AIS A vs. B-D), stimulation site (cervical vs. thoracic vs. lumbosacral), and co-intervention effects (tSCS alone vs. tSCS plus training), along with sensitivity analyses to explore heterogeneity. The certainty of evidence will be evaluated using the GRADE approach (Grading of Recommendations Assessment, Development and Evaluation). Results: This is a protocol paper describing the planned methodology for the systematic review. The search strategy has been developed and the protocol has been registered with PROSPERO (CRD420250652270), with results expected by October 2025. Conclusions: This comprehensive systematic review and meta-analysis will address an important gap in the current literature by providing the first focused evaluation of tSCS effectiveness for lower limb rehabilitation in individuals with SCI. The results will inform clinical practice guidelines and guide future research directions in tSCS for SCI rehabilitation. Clinical Trial: Prospero CRD420250652270

Background: Choline is an essential micronutrient crucial for fetal neurodevelopment. Numerous rodent studies reveal that compared to maternal consumption of standard chow, maternal prenatal choline deficiency produces lifelong offspring cognitive deficits, and maternal choline supplementation produces lifelong improvements in offspring cognition. Few studies have evaluated this question in humans, with mixed results. Nonetheless, the available data raise concerns about the low choline intakes of pregnant women and highlight the need for knowledge of the functional consequences of various choline intakes during pregnancy. Objective: This study will evaluate the cognitive and affective functioning of adolescents born to women who participated in a randomized controlled trial (RCT) of 2 levels of choline intake during pregnancy, with the primary aim of assessing offspring attention and spatial memory. Methods: In a double-blind, randomized controlled choline feeding trial 26 women beginning their third trimester of pregnancy were randomly assigned to 2 groups: daily choline consumption at 480 or 930 mg/day. In this 14-year follow-up, the offspring (n=21) of these women will complete cognitive tests proctored over videoconferencing software. Cognitive function domains will be assessed using web-based software from the Cambridge Neuropsychological Test Automated Battery (CANTAB Connect). We will also assess facets of mental health using the Achenbach System of Empirically Based Assessment (ASEBA). These assessments will test the hypothesis that third-trimester maternal choline intake exerts lasting effects on offspring attention, memory, executive function, and mental health. Results: Between January 2009 and October 2010, 26 women beginning their third trimester of pregnancy from the Ithaca area were enrolled in the original controlled feeding study. We successfully re-recruited 21 (80%) of the original 26 offspring to this 14-year remote follow-up study. Recruitment started in August 2023 and was concluded in October 2023. Analysis is ongoing, and the first results are expected to be submitted for publication in the fall of 2025. We hypothesize that adolescent offspring born to women in the 930 mg/day group will perform better in domains of attention, memory, executive function, and mental health than offspring of women in the 480 mg/day group. This study is unique because the total maternal choline intake is precisely known, and the offspring are followed into adolescence, a time when group differences are indicative of lifelong effects of prenatal intervention. Conclusions: The findings will provide important new information concerning the lasting functional consequences of maternal choline intake during pregnancy for offspring neurobehavioral health, thereby informing dietary recommendations and supplementation policies for pregnant women. Clinical Trial: ClinicalTrials.gov: NCT05859126; https://clinicaltrials.gov/study/NCT05859126

, There is still no clear understanding of the relationship between sibship size and child outcomes. Research from across disciplines, and across settings, reports conflicting results suggesting that the relationship is complex and ecologically dependent. Evolutionary models predict that parents will make reproductive decisions based on their ability to invest in each child, but that this is not necessarily equal across children. Here we use data from the Next Steps study linked to National Pupil Database to examine the relationship between sibship size and Key Stage 4 (GCSE) maths and English grades in England for children born in 1989/1990. We were interested to further examine if and how associations might differ at the ends of the socioeconomic spectrum and we also tested if direct measures of parental investment could mitigate any negative impact of larger families. Multilevel ordinary least squares regression models with a random effect for school show that sibship sizes are associated with school grades, as is socioeconomic status. Moreover, the association between sibship size and grades holds true across the socioeconomic spectrum. Birth order was only weakly associated with school results, and only significant in some models. Parental investment is important, however, and might offset the some of the negative impact of larger families, for both maths and English attainment.