Background Some individuals diagnosed with schizophrenia report vivid, immersive inner scenarios that may resemble maladaptive daydreaming (MD). However, the organisation, psychological functions, and relationships of such experiences with psychotic phenomena remain poorly understood. Aim This study examined the phenomenology and psychological functions of immersive imaginative experiences in individuals with schizophrenia and compared these experiences with published phenomenological descriptions of MD. Method A theory-driven comparative case-series design was used. Three individuals with schizophrenia reporting immersive fantasy experiences participated in semi-structured clinical interviews. Cases were analysed across dimensions of agency and control, reality attribution and perceptual qualities, psychological function, and relationships with psychotic phenomena, and then compared across cases and with published descriptions of MD. Results Prolonged, immersive fantasies differed substantially in their organisation. Patrick and Kate showed limited agency over intrusive, often distressing imaginative content that could unfold autonomously and become intertwined with hallucinations and delusional interpretations. Dominic retained authorship and awareness of the imagined nature of his technical visualisations but had difficulty regulating and disengaging from them. Across cases, content reflected emotionally salient concerns and different psychological functions, including the expression of conflict and emotional compensation. Features overlapping with MD included prolonged absorption and difficulty regulating engagement, whereas reduced agency over content and believing that imagined interactions or communications were genuinely occurring more clearly distinguished Patrick’s and Kate’s experiences. Conclusions Similarities with MD may coexist with marked differences in agency, reality attribution, and relationships with other psychopathological phenomena, suggesting that their diagnostic significance depends on how these features are configured.
Identifying objective cognitive markers in the preclinical stage of Alzheimer's disease (AD), particularly in Subjective Cognitive Decline (SCD), is critical for early intervention. While executive function comprises three core components (inhibition, updating/switching), their impairment trajectory during the SCD-to-Mild Cognitive Impairment (MCI) progression remains unclear. This study aims to systematically compare these components among Cognitively Normal (NC), SCD, and MCI individuals to determine the earliest sensitive cognitive indicators of AD pathology.Community-dwelling adults aged ≥50 years were classified into NC, SCD, and MCI groups based on comprehensive screening (MoCA, SCD-Q, CDR, ADL). All participants completed standardized computerized tasks assessing inhibition (Oddball, Stop Signal Task), updating (spatial 1-back, VWM task), and switching (task-cue paradigm). One-way ANOVA with post-hoc tests compared group differences in accuracy and reaction time.SCD showed no difference from NC in inhibition but intermediate switch costs; crucially, SCD’s spatial 1-back performance was significantly worse than NC and comparable to MCI, indicating early MCI-level updating deficits. Visuospatial storage capacity showed gradual impairment. Updating ability (visuospatial working memory) is the earliest and stably impaired indicator in SCD, serving as a sensitive marker for ultra-early AD screening.These findings suggest that updating ability, particularly visuospatial working memory, is the earliest and most stable impaired executive component, making it a sensitive behavioral marker for identifying high-risk SCD and enabling ultra-early AD screening. In contrast, significant impairments in inhibition and switching are delayed or progressive. This provides new scientific evidence for early assessment and targeted cognitive intervention.
Background: Internet gaming disorder (IGD) involves dysregulated incentive processing, yet precise neural substrates remain inconsistent. While the Monetary Incentive Delay (MID) task assesses reward systems, traditional analyses conflate reward valence (Value) and motivational salience, masking process-specific neural alterations. This study evaluated which neural features-from localized activity to large-scale connectivity-most effectively characterize IGD clinical phenotypes. Methods: We analyzed fMRI data from 90 regular gamers, including 45 participants in the IGD group and 45 matched recreational game users (RGU), who performed a MID task with five reward/loss levels. Applying the Orthogonal-Decoding (DeCoP) framework, we dissociated anticipation BOLD signals into independent Value and Salience components. We compared localized activation (GLM), multivariate spatial patterns (Searchlight MVPA), and task-modulated functional connectivity (gPPI). Connectome-based Predictive Modeling (CPM) identified neural signatures predicting symptom severity and craving. An exploratory subsample (n = 15; 3 IGD and 12 RGU) completed clinical assessments approximately 12 months later. Results: Localized activation and spatial patterns showed no significant group differences across either anticipation or feedback. However, positive Value-modulated connectivity during anticipation significantly predicted IGD symptom severity (66 stable edges, rho = .317, p = .002) and craving (37 stable edges, rho = .348, p < .001). The intersection of these positive connectome models revealed a shared Value network (16 stable edges) anchored in a medial frontal-cerebellar circuit. Exploratory follow-up analysis showed that baseline shared-network strength was associated with 12-month craving (rho = .724, p = .002). Conclusions: Our findings suggest the neurobiological core of IGD is linked to aberrant network-level coordination during reward anticipation, rather than regional hyper-reactivity or feedback processing deficits. We identify anticipatory valuation dysregulation as a key feature of IGD, offering a process-specific connectomic signature of IGD symptomatology.
Health-related behaviors adopted during emerging adulthood have important implications for long-term health trajectories. While homophily has been widely documented for substance use, less is known about whether behavioral similarity arises from contagion or selection across a broader range of health-related behaviors. Distinguishing between these mechanisms has direct implications for intervention design. We conducted a fourwave longitudinal sociocentric cohort study of undergraduate freshmen at two universities in Guangzhou, China (October 2022-July 2024). Eligible participants from five schools completed online surveys at baseline and three follow-up waves. Measures included physical activity, fruit and vegetable consumption, sleep quality, smoking, drinking, sugar-sweetened beverage (SSB) consumption, and video gaming. Friendship networks were assessed using roster-based nominations. Stochastic Actor-Oriented Models were used to examine the co-evolution of networks and behaviors and to estimate the relative contributions of contagion and selection processes. Parameter estimates were pooled across schools using meta-analytic procedures. The analytic sample included 609 students at baseline (mean age = 18.7 years; 65.2% female). Significant contagion effects were observed for physical activity, fruit consumption, sleep quality, smoking, drinking, and video gaming. In contrast, homophily in SSB consumption was primarily explained by selection processes. Overall, contagion accounted for a larger share of observed homophily than selection, with stronger effects for health-risk behaviors than for healthpromoting behaviors. Mechanisms generating peer similarity vary by behavior. These findings suggest that mechanism-informed interventions, network diffusion strategies for influence-sensitive behaviors and structural or individual-level approaches for selection-driven behaviors, may help inform intervention design during the transition to university, although this study did not test network-based interventions.
Background Many virtual reality systems, including the fully immersive Cave Automatic Virtual Environment (CAVE), have been developed over the years. Although CAVE has been used primarily in domains such as research, training, and visualisation, its application in therapeutic interventions has also been explored. However, the extent to which specific characteristics of CAVE shape user experience and contribute to measurable health outcomes, including motor function, psychological well-being, and cognitive performance, in neurological, developmental and psychiatric conditions requires further review. Objective This review aims to identify CAVE's characteristics and to synthesise the user experience and health outcomes reported for interventions delivered through these systems in neurological, developmental, and psychiatric conditions. Method Eligible studies were sourced across six electronic databases, grey literature, trial registries, and hand-searching from 2014 to October 2024. Randomised controlled trials and quasi-experimental studies were eligible. Because of substantial heterogeneity in populations, system configurations, intervention content, and outcome measures, meta-analysis was not appropriate and a narrative synthesis was conducted. A narrative synthesis was conducted. Quality appraisal was conducted using Cochrane's Risk of Bias (RoB) tool and Joanna Briggs Institute (JBI) Checklist for Quasi-Experimental Studies. Results Fifteen studies (552 participants) were analysed, and most were appraised as moderate quality. Interventions were delivered through CAVE systems for diverse age groups, including children aged 6 months to 14 years, adults aged 18 and older, and older adults over 60. Interventions delivered through CAVE were associated with improvements in gait and balance in most studies, whereas findings for psychological well-being and cognitive function were drawn from a small number of small, heterogeneous studies and were inconsistent. Where user experience was assessed (four studies), participants generally described the environment as enjoyable and reported few side effects such as cybersickness, although one study rated presence and involvement lower than with a head-mounted display (HMD). Conclusion Interventions delivered through CAVE systems have demonstrated preliminary evidence of improving clinical outcomes in users with neurological, developmental, and psychiatric conditions. However, the current evidence base is small, heterogeneous in system configuration and intervention content, and largely of moderate quality. Compared to HMDs, CAVE systems may offer a less isolating experience due to their open, projection-based design. However, evidence on relative immersion is mixed. The risk of cybersickness appeared low across most included studies, though this varied by system design and participant population. Adequately powered trials, together with further development of CAVE for portability and group therapy, are needed to establish effectiveness and optimise scalability.
