High-definition transcranial direct current stimulation (HD-tDCS) has the potential to improve cognitive functioning following neurological injury and in neurodegenerative conditions. In this case report, we present the first use of HD-tDCS in a person with severe anterograde amnesia following carbon monoxide poisoning.

The participant underwent two rounds of HD-tDCS that were separated by 3 months (Round 1 = 30 sessions; Round 2 = 31 sessions). We used finite element modeling of the participant’s structural MRI to develop an individualized montage that targeted multiple brain regions involved in memory encoding, as identified by Neurosynth.

Overall, the participant’s objective cognitive functioning improved significantly following Round 1, declined during the 2 months without HD-tDCS, and again improved following Round 2. Subjective informant reports from family and medical personnel followed this same pattern of improvement following each round with a decline in between rounds. We also provide preliminary evidence of altered brain activity during a learning/memory task using functional near-infrared spectroscopy, which may help establish the physiological effects of HD-tDCS in future work.

Overall, these findings reinforce the potential value of HD-tDCS as a user-friendly method of enhancing cognition following anoxic/hypoxic brain injury.

Research suggests that most mental health conditions have their onset in the critically social period of adolescence. Yet, we lack understanding of the potential social processes underlying early psychopathological development. We propose a conceptual model where daily-life social interactions and social skills form an intermediate link between known risk and protective factors (adverse childhood experiences, bullying, social support, maladaptive parenting) and psychopathology in adolescents – that is explored using cross-sectional data.

N = 1913 Flemish adolescent participants (Mean age = 13.8; 63% girls) were assessed as part of the SIGMA study, a large-scale, accelerated longitudinal study of adolescent mental health and development. Self-report questionnaires (on risk/protective factors, social skills, and psychopathology) were completed during class time; daily-life social interactions were measured during a subsequent six-day experience-sampling period.

Registered uncorrected multilevel linear regression results revealed significant associations between all risk/protective factors and psychopathology, between all risk/protective factors and social processes, and between all social processes and psychopathology. Social processes (social skills, quantity/quality of daily social interactions) were uniquely predicted by each risk/protective factor and were uniquely associated with both general and specific types of psychopathology. For older participants, some relationships between social processes and psychopathology were stronger.

Unique associations between risk/protective factors and psychopathology signify the distinct relevance of these factors for youth mental health, whereas the broad associations with social processes support these processes as broad correlates. Results align with the idea of a social pathway toward early psychopathology, although follow-up longitudinal research is required to verify any mediation effect.

Despite major advances in research into the neurobiological basis of mental illness, there have been hardly any new developments in new drug therapies. As there are approximately 30% of affected individuals that do not respond sufficiently to available treatments, there is a significant unmet medical need for new therapeutic approaches. About 90% of novel substances that have shown promise in animal studies are not effective in clinical trials. Recent research on human induced pluripotent stem cells (hiPSC) could lead to the use of more human-tailored models in this field. IPSC-derived cell models and organoids may be very attractive for preclinical screening and bridge the gap between in vitro and in vivo studies, reducing animal testing. However, the next steps must first demonstrate the validity and reproducibility of the initial functional results from the hIPSC models of mental illness. In our own studies on neuronal cell models of patients with attention-deficit/hyperactivity disorder (ADHD) with rare PARK2 gene variants, we were able to show evidence of mitochondrial dysfunction and impaired energy metabolism. Additionally, we have first hints at a oxidative dysbalance which could be as well targeted by medication. In a model of cortical development of ADHD patients with common variants in the ADGRL3 gene, we found first evidence for altered neuronal maturation as well as abnormalities in calcium metabolism and glutamatergic functionality compared to cells from healthy controls. In summary, these first results are promising that hIPSC models can contribute new insights into cellular pathomechanisms of mental and neurodevelopmental disorders and the development of new, individualised therapeutic approaches.

S. Kittel-Schneider Grant / Research support from: The studies are funded by IZKF Wuerzburg and BBRF fund (to SKS and RMcN). SKS received speaker’s honoraria from Takeda, Medice and Janssen.

Deprivation is widely known in children and adolescents and means a lack of social, emotional, or sensory stimuli, due to disabilities such as deafness, but also social isolation and reduced parental care. It may cause developmental disorders such as impaired language, motoric and social development. Little is known of the impact of social deprivation in demented patients.Stimulus shielding, which is a widespread option for psychiatric symptoms of dementia such as agitation, vocalization and aggressive behavior may – if frequently used- have similar effects on demented patients.

We report the case of a 71-year-old patient with dementia caused by PSP (Progressive Supranuclear Palsy), who was in inpatient treatment due to continuous undirected vocalizations. She presented with inability to walk, dysarthria, aphasia, and hearing difficulties beside major mnestic impairment. In a prior hospitalization and in her residency, she was frequently isolated from other patients due to loud screaming and vocalizations in terms of stimulus shielding by suspected overstimulation. In order to that, for four months, she developed progressive difficulties to speak, hear, understand, as well as gait disorders. In addition, the vocalizations increased.

We rated the symptoms due to deprivation, triggered by lack of mobilization, social experiences, visual, tactile and acoustic stimuli following a vicious circle of anxiety, vocalizations and recurrent isolations. Therefore, a multimodal therapy assessment was implemented, including daily physical therapy, mobilization, basal stimulation, social reintegration and basal conversation training.

After a few days of high intensity treatment, speech reappeared in form of one- word sentences and proceeded to the ability to have short conversations. Mobility increased, starting from severe gait disorder, including the use of a wheelchair and emerged to the ability of walking up to 50 metres. Additionally, the undirected vocalizations improved and were reduced. In addition, hearing ability improved during the four-week treatment.

This case highlights the impact of deprivation in demented patients. Especially it shows that these symptoms can be reversible under a high intensity multimodal and multi- professional treatment within a few weeks. Therefore, stimulus shielding, should be carefully evaluated in order to prevent deprivation – and thus deterioration of the symptoms – in demented patients.

None Declared

BPSD is typically treated as a singular entity. Yet it is heterogeneous and challenges simple phenotyping by behavioral inventory. Some investigators recognize BPSD more as ‘obstreperous,’ disruptive behavior, or unwanted behavior. Others conceptualize it as a neuropsychiatric entity with an underlying pathobiology, or as the expression of an unmet need. Treatments for BPSD have been challenging since before the first clinical trials with chlorpromazine.

We systematically reviewed interventional studies to understand the successes, limitations, and knowledge gaps in terms of methodology that might misinform practice. Questions addressed included: What do these studies look like? How is BPRS operationalized, and does it vary between studies? What interventions have been tested? How are we measuring eligibility and outcomes? Are there methodological factors that influence the outcomes and validity of these trials? Are the trials methods fit for purpose and how can we better test interventions?

From a search yielding 6497 candidate studies, we included 474 of which 413 were randomized, 340 parallel group, 197 double-blinded, 51 unblinded. About 30% were in nursing homes only and 20% outpatient only. Most NH studies were drug studies; most outpatient studies were non-pharmacological. Over time, study durations consolidated to 6–12-week treatment periods and samples grew exceptionally large, involving 400 to 1200 participants.

Of studies that specified a target, 171 were for ‘agitation.’ 50 investigated sleep disturbance, 25 apathy, 25 depression, 21 psychosis. 150 described only ‘BPSD’ or ‘neuropsychiatric symptoms.’ Two-thirds of the agitation studies were single drug interventions; most used a scale score cut-off to define agitation. Important characteristics, secular trends in design, and quality of the BPSD studies will be detailed.

The important trends in methods for interventions and assessment of BPSD are not necessarily toward quality. Eligibility criteria have become designed for convenience, are misspecified relying on the same scales used for outcomes, although randomization is the rule, allocation concealment and treatment blinding is poor. There is marked autoregression of outcomes. Studies have become larger and designed to detect small effects even when clinical meaning is uncertain. BPSD studies need reconsideration and a few simple fixes to better discover effective treatments. Only a little care is needed to improve the quality and reliability of studies. This includes study management that is independent of patient selection and outcomes and from most procedures, and truly blinded assessments.

Bridging the gap between clinical practice and research in health care is a challenging task. Living Labs are academic practice partnerships to stress the ambition to start up a longstanding collaboration, which have been developed and implemented in the Netherlands (Verbeek et al., 2020). The “PraWiDem” (“Living Lab Dementia”) project aims to adapt the Maastricht Living Lab approach to long-term dementia care in different regions in Germany.

A mixed methods approach was used to guide the adaptation of the Maastricht Living Lab. A focus group study investigated perspectives of people with dementia, informal carers and professionals on expectations and experiences concerning collaboration and networking between research and practice. A scoping review mapped international experiences in knowledge transfer practices and collaboration approaches in nursing care. Experts from the Maastricht Living Lab supported the research team in adapting the approach to the German national context. Parts of the German “Living Lab Dementia” concept were discussed with members of a recently formed research participation group of people with dementia (“experts by experience”).

In total, 10 focus groups and 5 individual interviews were conducted. Key themes include researchers’ and professionals’ skills, participation of people with dementia and informal carers, and multi-professional requirements. The scoping review identified 17 different approaches of knowledge translation and collaboration. Few approaches address the common development and implementation of knowledge and networking. Dutch experts recommend the early development of long-lasting strategies for collaboration. Experts by experience wish to participate, but traditional research methods may need to be adapted to allow their participation.

The “Living Lab Dementia” is currently under investigation in collaboration with institutional and community care services in three regions in Germany.

The coronavirus disease 2019 (COVID-19) pandemic deleteriously impacted physical and mental health. In the summer of 2020, return-to-learn plans were enacted, including virtual, hybrid, and in-person plans, impacting educators and students. We examined (1) how return-to-learn plan was related to depressive and social anxiety symptoms among educators and (2) how psychological flexibility related to symptoms.

Educators (N = 853) completed a survey via Qualtrics that assessed internalizing symptoms, psychological flexibility, and occupational characteristics. Two one-way analyses of variance (ANOVAs) examined between-group differences in return-to-learn plans across depression and social anxiety. Two hierarchical linear regressions examined the relation between psychological flexibility components and depressive and social anxiety symptoms.

Median T-scores were well above the national normative means for General Depression (median T-score: 81) and Social Anxiety (median T-score: 67). There were no significant differences between reopening plans in general depression nor social anxiety T-scores. Psychological flexibility accounted for 33% of the variance in depressive symptoms and 24% of the variance in social anxiety symptoms.

Results indicated high levels of psychiatric symptoms among educators during COVID-19, and psychological flexibility was associated with lower symptoms. Addressing educator mental health is of utmost importance in future research.

The institutions (i.e., hubs) making up the National Institutes of Health (NIH)-funded network of Clinical and Translational Science Awards (CTSAs) share a mission to turn observations into interventions to improve public health. Recently, the focus of the CTSAs has turned increasingly from translational research (TR) to translational science (TS). The current NIH Funding Opportunity Announcement (PAR-21-293) for CTSAs stipulates that pilot studies funded through the CTSAs must be “focused on understanding a scientific or operational principle underlying a step of the translational process with the goal of developing generalizable solutions to accelerate translational research.” This new directive places Pilot Program administrators in the position of arbiters with the task of distinguishing between TR and TS projects. The purpose of this study was to explore the utility of a set of TS principles set forth by NCATS for distinguishing between TR and TS.

Twelve CTSA hubs collaborated to generate a list of Translational Science Principles questions. Twenty-nine Pilot Program administrators used these questions to evaluate 26 CTSA-funded pilot studies.

Factor analysis yielded three factors: Generalizability/Efficiency, Disruptive Innovation, and Team Science. The Generalizability/Efficiency factor explained the largest amount of variance in the questions and was significantly able to distinguish between projects that were verified as TS or TR (t = 6.92, p < .001) by an expert panel.

The seven questions in this factor may be useful for informing deliberations regarding whether a study addresses a question that aligns with NCATS’ vision of TS.

The rapid development of civilization is accompanied by many changes affecting human functioning. Technological development, wide access to positive stimuli and the neglect of emotional control and self-awareness in the learning process make it difficult for individuals to control their behavior. Such a loss of control is associated with the development of addictions. Therapists, doctors and researchers more and more often encounter cases of compulsive behavior focused on a specific activity - apart from gambling or playing computer or internet games, more and more often the subjects of preoccupation are compulsive shopping, sexual activities and work (workaholism).

The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women.

The study was conducted among 556 women. The research was carried out with the use of the diagnostic survey method, using the questionnaire technique: the De Jong Gierveld Loneliness Scale, the Purchasing Behavior Scale, the Work Addiction Risk Test, Beck Depression Inventory and a questionnaire of our authorship.

Depressiveness is a mediator in the relationship between the feeling of loneliness and the degree of addiction to shopping (β = -0.0246, z = -2.03, p = 0.043) and in the relationship between the feeling of loneliness and the degree of addiction to work (β = -0.0722, z = -4.002, p < 0.001). The direct impact of the feeling of loneliness on the degree of addiction to shopping (p = 0.237) and work (p = 0.576) is statistically insignificant.

In the mediation model adopted, it was shown that depressiveness plays the role of a mediator between the feeling of loneliness and the degree of addiction to shopping and work. The increase in the level of depression increased the degree of addiction to shopping and work. The mediator’s participation lowered the level of the feeling of loneliness. Loneliness was not a significant predictor of addiction to shopping and work. There is a need to include activities aimed at identifying psychological factors influencing the occurrence of addictions to shopping and work among women. It seems important to be able to use psychological help when needed. It is also necessary to take institutional preventive measures to prevent the occurrence of behavioral addictions among women.

None Declared

Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic.

The aim of the study was to estimate the prevalence rate of insomnia and aggression and identify associated risk factors among healthcare workers during the COVID-19 pandemic

A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss-Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a questionnaire of our authorship.

The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p=0.038), marital (p=0.043) and parental status (p=0.004), and contact with patients suffering from COVID-19 (p=0.024) were statistically significant contributors to insomnia. Working time was found to significantly correlate with insomnia (r=0.124 p=0.044) and a physical aggression (r=0.168 p=0.006), anger (r=0.121 p=0.05), a verbal aggression (r=-0.132 p=0.032). Age was found to significantly correlate with total aggression (r=-0.133 p=0.031), verbal aggression (r=-0.138 p=0.025), anger (r=-0.151 p=0.014). Sex was found to be statistically significantly related to physical aggression (p=0.017), anger (p=0.032), and hostility (p=0.002).

A considerable proportion of HCWs experienced sleep disorders during the pandemic, emphasizing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and adjust interventions under pandemic conditions. Our findings confirm that insomnia and poor sleep quality are consistently associated with aggression.

None Declared

Behavioral addictions are a growing problem in the society. Digital technologies are used by people of different ages, and their number is increasing every year. The precise reasons for the development of addictions remain unknown. In the case of behavioral addictions, especially Internet addiction, the significance of personality traits and behaviors predisposing an individual to addiction, such as depressiveness, anxiety, hostile attitude, aggression, impulsiveness, psychotic behaviors, shyness and self-esteem disorders, are emphasized. Personality predispositions play an essential role in Internet addiction.

The aim of this study was a general assessment of the level of Internet addiction with regard to personality traits according to the Big Five model by Costa and McCrae among women from the West Pomeranian Voivodeship.

The study involved 556 women, whose average age was 34 years and who met the inclusion criteria: female sex, age of 18 years or above, place of residence in the West Pomeranian Voivodship, an informed consent for participation in the study, and completion of the set of questionnaires. The study was conducted using a diagnostic poll method with a questionnaire technique. To carry out the analysis both author’s own and standardized tools were used: the author’s questionnaire covering socio-demographic data, the NEO-Five Factor Inventory which assesses the levels of personality traits, and the Internet Addiction Test used to measure behaviors and characteristics related to compulsive use of the Internet.

Most (70.9%) of the women were average users of the Internet, 25% of respondents were at risk of addiction, and the least numerous group of women (4.1%) was addicted to the Internet. Conscientiousness negatively correlated with Internet addiction (r = -0.22; p < 0.001; R2 = 4.9%). Openness to experience was conducive to Internet addiction (r = 0.15; p < 0.001; R2 = 11.1%). A positive link between neuroticism and Internet addictions was established (r = 0.33; p < 0.001; R2 = 11.1%). No significant relationships between Internet addiction and extraversion (r = 0.03; p = 0.45) as well as agreeableness (r = -0.07; p = 0.10) were demonstrated.

The type of personality of the studied women implicated relationships to Internet addiction. Neuroticism might be a personality trait that particularly predisposes to an increased risk of Internet addiction. Openness to experience was conducive to Internet Addiction. Low levels of conscientiousness more often become addicted to the Internet.

None Declared

Social network addicts may differ significantly from non-addicts in terms of personality traits, such as agreeableness, neuroticism, and conscientiousness. Addicts may be prone to negative emotions and unpleasant experiences, which may be associated with a higher level of neuroticism. Addicts often fail to cope in the real world, often experience negative emotions, quickly give up their goals, see themselves and others in a negative light, and escape into virtual reality. The virtual world is devoid of the anxiety that an individual faces in real life interactions, hence the tendency for addiction among people with higher levels of neuroticism. The primary cause of Internet Addiction may be innate temperamental traits (i.e., impulsiveness of behavior and impulsiveness of decisions) that influence the susceptibility to functional and chemical addictions. According to the concept of addictive personality, people who have this problem are prone to addiction as such, regardless of what they are addicted to.

The purpose of this study was to generally assess the degree of women’s dependence on social networking sites on the example of Facebook, taking into account personality traits according to the five-factor model of personality, the so-called Big Five by Costa and McCrae

The study included 556 women. This survey-based study was carried out using the questionnaire technique. The following research tools were used to analyze behavioral addictions in adult women: the Bergen Face- book Addiction Scale (BFAS), the NEO Five-Factor Inventory (NEO FFI) and the author’s questionnaire.

Among the surveyed women, 69.6% were average Facebook users, of whom 16.4% had scores indicating possible Facebook addiction, and 14.0% had scores indicating addiction. The higher the neuroticism, the more serious the Facebook addiction (r = 0.26; p < 0.001; R2 = 6.7%). A weak negative correlation was obtained for the agreeableness subscale e (r = -0.08; p < 0.05; R2 = 7.2%). A weak negative correlation was also obtained for the subscale of conscientiousness (r = -0.16; p < 0.001; R2 = 2.6%). There was no statistically significant correlation between the log10 score obtained on the BFAS and the score on the NEO-FFI subscales of extraversion (r = 0.04; p = 0.40) and openness to experience (r = 0.04; p = 0.30).

The personality types of the studied women indicated relationships in terms of behavioral addictions. Women characterized by neuroticism showed stronger addiction to Facebook. Women characterized by high conscientiousness were at lower risk of behavioral addictions, while agreeableness as a personality trait significantly protected the surveyed women against Facebook addiction.

None Declared

Serial position scores on verbal memory tests are sensitive to early Alzheimer’s disease (AD)-related neuropathological changes that occur in the entorhinal cortex and hippocampus. The current study examines longitudinal change in serial position scores as markers of subtle cognitive decline in older adults who may be in preclinical or at-risk states for AD.

This study uses longitudinal data from the Religious Orders Study and the Rush Memory and Aging Project. Participants (n = 141) were included if they did not have dementia at enrollment, completed follow-up assessments, and died and were classified as Braak stage I or II. Memory tests were used to calculate serial position (primacy, recency), total recall, and episodic memory composite scores. A neuropathological evaluation quantified AD, vascular, and Lewy body pathologies. Mixed effects models were used to examine change in memory scores. Neuropathologies and covariates (age, sex, education, APOE e4) were examined as moderators.

Primacy scores declined (β = −.032, p < .001), whereas recency scores increased (β = .021, p = .012). No change was observed in standard memory measures. Greater neurofibrillary tangle density and atherosclerosis explained 10.4% of the variance in primacy decline. Neuropathologies were not associated with recency change.

In older adults with hippocampal neuropathologies, primacy score decline may be a sensitive marker of early AD-related changes. Tangle density and atherosclerosis had additive effects on decline. Recency improvement may reflect a compensatory mechanism. Monitoring for changes in serial position scores may be a useful in vivo method of tracking incipient AD.

1. (1) To date, DBT treatment literature has focused almost exclusively on cisgender women, with only two of 253 DBT studies in current literature accounting for transgender and gender diverse (TGD) individuals.

2. (2) Recognize how gender minority stress may impact the prevalence of BPD among TGD individuals.

3. (3) Learn how future research initiatives can be employed to rectify this gap in the DBT literature.