Difficulties in coping with the unknown, or intolerance of uncertainty (IU), has been established as an important risk factor for anxiety and other mental health problems. However, the conceptualisation so far is primarily based on self-report data from younger populations. Informed by theories on both anxiety and aging, the current study examined self-report IU and behavioural decisions made under uncertainty, across adulthood. A total of 300 participants between the age of 20-79 years were recruited from the community. They completed the self-reported Intolerance of Uncertainty Scale (IUS-12) and the behavioural Balloon Analogue Risk Task (BART). Results suggested that young adults had higher self-report prospective IU than older adults, and there were no differences on IUS-12 scores between middle-aged versus young/older adults. However, older adults had higher certainty-prone behaviours on the BART (less pumps and bursts) than both young and middle-aged adults. Exploratory modelling analysis on the BART responses suggested that young adults had both lower loss aversion and lower sensitivity to risk changes in the environment. The results are discussed in line with previous theories; whilst one's belief about their general ability to manage uncertainty in daily life increases with age, so does one's behavioural conservatism in the context of new (i.e., uncertain) situations. The results have practical implications for working with adults of various ages, in terms of needing to tailor uncertainty management and emotion regulation to the developmental stage of the person.

Loneliness is a significant issue among older adults. However, few studies have explored the brain mechanisms underlying changes in social behavior related to loneliness among older adults. Therefore, this study aimed to examine how loneliness affects the response towards social exclusion among community-dwelling older people. The sample consisted of 37 older adults who made up the lonely (n = 21) and not-lonely control (n = 16) groups based on their scores on a loneliness scale. All participants underwent fMRI scanning whilst completing the classic Cyberball task. We found that the lonely group showed greater brain activation compared to those of the not-lonely group in response to the exclusion condition of the Cyberball task (versus inclusion condition), including the prefrontal lobes and anterior cingulate cortex. Based on the existing literature on Cyberball studies (including meta-analysis), the activations may represent a state of interoceptive reflection with a painful experience during the Cyberball task for the lonely older adults. The results contribute to improving our understanding of social experiences of older adults, and further unpack the potential negative consequences associated with loneliness.

Current measures of prosociality primarily utilize text-based scales that can be susceptible to response bias. To enhance the ecological validity of such measures and provide a more intuitive assessment of prosociality, we developed and validated a picture-based measure of prosociality (PB-Prosocial). Based on a comprehensive model of prosociality, this measure encompasses helping, sharing, and comforting. Each item features a photograph of an individual in need of help in a naturalistic setting, followed by a question asking about the likelihood of providing help. Content validity was established via a Delphi procedure (Study 1). Twenty-six experts from 10 countries reached consensus after two rounds of survey. The factor structure was validated via exploratory and confirmatory factor analysis (Study 2). This measure demonstrated excellent reliability, with McDonald's Omega values of 0.92 for helping, 0.95 for sharing, and 0.92 for comforting. The test-retest reliability was robust, with coefficients of 0.77 for helping, 0.88 for sharing, and 0.74 for comforting. It also exhibited good convergent validity with altruism, empathic concern, perspective taking, and uncaring traits, as well as good discriminant validity with fantasy and expressive suppression. The PB-Prosocial can be used in diverse settings following appropriate further validations to deepen the understanding of prosociality.

Previous research has indicated that older adults are more likely than younger adults to share money, suggesting more prosociality. However, the extent to which older adults exhibit prosociality in other forms, such as helping and comforting, remains unclear due to the absence of a comprehensive measure. This study addresses this gap by validating a novel picture-based measure of prosociality (PB-Prosocial) in older adults, which showed good psychometric properties. Using this measure, we examined age-related differences in prosociality and underlying mediators. Older adults were found to be more prosocial in sharing, but not in helping or comforting, compared with younger adults. The age difference in sharing appeared to result from older adults being more familiar with the situations and perceiving a lower cost of sharing than younger adults. Taken together, our study provides a validated measure of prosociality and demonstrates that older adults’ increased prosociality is specific to sharing.

BACKGROUND:Children with attention deficit hyperactivity disorder (ADHD) experience high rates of sleep problems and have an increased risk of executive dysfunctions and physical inactivity. Physical activity (PA) may be protective; however, few studies have objectively measured PA, sleep parameters and executive functions (EFs) in ADHD populations. This study aimed to assess PA and sleep using wearable motion sensors and to examine the relationships with EFs in children with ADHD. METHODS:The ActiGraph GT9X Link accelerometer was used to measure PA and sleep parameters in 282 children with ADHD (age range: 6-12 years; mean age = 8.59 ± 1.35 years; 78.4% boys) over seven consecutive days. Sleep status was assessed using the Pittsburgh Sleep Quality Index (PSQI), with scores ≥5 indicating poor sleep quality. Core EFs (i.e., inhibitory control, working memory, and cognitive flexibility) were assessed using Inquisit Lab™ 5. RESULTS:Within this large, well-characterized ADHD cohort, approximately 60% of children exhibited sleep problems. Compared with children with ADHD without sleep problems, those with sleep problems demonstrated longer actigraphy-derived sleep latency, poorer performance on cognitive flexibility tasks, spent less time per day in moderate-to-vigorous physical activity (MVPA), and were less likely to meet the World Health Organization-recommended 60 minutes of MVPA. Self-reported sleep quality, sleep efficiency, daytime dysfunction, and MVPA guideline attainment were significantly associated with EFs in children with ADHD. The relationships between daytime dysfunction and cognitive flexibility were moderated by MVPA guideline attainment. CONCLUSIONS:Daytime dysfunction predicts poorer cognitive flexibility only in children with ADHD who engage in low PA levels. Further investigation is warranted to determine whether adherence to MVPA guidelines can mitigate sleep problems and executive dysfunction.

PURPOSE:Physical inactivity is a health concern for children and adolescents with neurodevelopmental disorders (NDDs) as it directly increases their risk of developing various health problems. Evidence on differences in accelerometer-assessed physical activity between children and adolescents with and without NDDs is inconclusive. And age- and body mass index (BMI)-related effects on physical activity remain unclear. METHODS:The systematic literature searches were performed in 6 databases up to March 2025. Methodological quality was evaluated by the Newcastle-Ottawa Scales. Data were pooled using a random-effects model. Hedges' g was used to express the effect size index with 95 % confidence interval (CI). Meta-regression on age and BMI was also performed to investigate the potential moderating effects. RESULTS:Out of the 2167 studies initially identified, 28 were included in the analysis, which comprised total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA) included in the meta-analysis, respectively. These studies involved 1060 children and adolescents with NDDs and 1820 without, aged 6.6-16.9 years. A small-to-moderate effect size exists for the difference in TPA (g=-0.299) and MVPA (g=-0.479) between children and adolescents with and without NDD, particularly indicating a difference in 12.7 min of MVPA daily. The difference in LPA was not significant (g=0.450, p = 0.125). The decline in MVPA with age was more pronounced in those with NDDs, and the difference in MVPA was smaller for those with lower BMI. CONCLUSION:The variation in MVPA differences by age and BMI highlights the need to develop better physical activity habits and reduce these disparities for children and adolescents with NDDs.

This study examined the effect of time delay on prospective memory (PM) by manipulating the interval between encoding and retrieval of an event-based PM task. Seventy-four participants were randomly assigned to one of three delay conditions (immediate, 1-day, and 1-week) and were instructed on a classic dual event-based PM task during the first online experimental session. They were then asked to undertake the PM task after the designated delay period based on their assigned experimental condition in the second online session. Significant main effects of delay on PM performance (measured in terms of remembrance and accuracy) were found. Post hoc test results revealed that, when compared to the no-delay condition, the 1-week delay condition impacted both remembrance as well as accuracy of the PM task, while the 1-day delay condition affected only accuracy but not remembrance. This study provides a unique contribution to the PM literature by including longer delay intervals between PM encoding and retrieval to improve ecological validity. In future research, this factor should be considered when studying PM in different groups of participants, including children, older individuals, and clinical populations.

Prosocial behaviors (PB), referring to voluntary acts intended to benefit others, have become increasingly prevalent online due to advancements in Internet and technology, providing opportunities to benefit people globally. Moreover, previous research suggests that age is a crucial determinant of PB, although the findings are mixed. This study explored the types of online prosocial behaviors (OPB) preferred by different age groups among a sample of 31 Hong Kong Chinese aged 20-70. The participants included a roughly equal number of females and males, recruited through social media platforms. Participants engaged in four focus group discussions, sharing their experiences and thoughts on OPB. The thematic analysis was guided by a recently developed classification of prosociality, distinguishing between interpersonal prosociality (direct PB with immediate feedback) and ideological prosociality (indirect benefits toward collectives without immediate outcomes). Inductive codes that could not be allocated to either type were grouped as a new theme. Three themes emerged: (i) interpersonal OPB (e.g., helping others online for specific goals), (ii) ideological OPB (e.g., concern about injustice and environmental issues), and (iii) mixed OPB (e.g., saving animals, updating COVID-19 information). We found that attention to interpersonal prosociality was highest among older adults (aged 60+), while younger adults (aged 18-29) exhibited greater concern for ideological OPB compared to their older counterparts. Our findings contribute to the conceptual framework of prosociality and underscore the importance of age-related factors in future quantitative research on OPB and on the design of online charity campaigns.

Learning and memory, as fundamental components of human cognition, are heritable traits that are highly variable between individuals and within populations. Investigation into the genetic basis of cognition is a prominent area of research, with genetic associations being previously reported for a wide range of cognitive phenotypes. Here we utilise a genome-wide association study (GWAS) approach to evaluate the contribution of genetic variation to learning and memory phenotypes in a comprehensively phenotyped, well-characterised, healthy, and unrelated cohort of individuals (n = 613). Cognitive phenotypes were assessed using nine comprehensive test batteries consisting of twenty-one cognitive performance assessments including IQ, five measures for visual and verbal learning, and fifteen measures for semantic, working, episodic and prospective memory. Principal component analysis was utilised to amalgamate correlated test scores into additional new cognitive phenotypes. Our study identified genome wide significant associations for 13 loci across all phenotypes. A novel association was identified between the rs817826 SNP at 9q31.2 and verbal learning discrimination (p = 2.71 × 10− 9). GWAS of cognitive PCs identified three variants in the vicinity of thiamine (Vitamin B1) transporter gene SLC19A3 (most significant SNP rs12105620, p = 2.17 × 10− 9), a 3’ UTR variant in PPARD (rs9658167, p = 1.47 × 10− 8), and an intronic variant in RBFOX1 (rs17138790, p = 4.24 × 10− 8) associated with the cognitive PC related to visual and verbal learning. The cognitive PC relating to prospective and retrospective memory revealed a locus containing a synonymous variant in NXPE3 (rs2305990, p = 6.56 × 10− 9) and intronic variants in RD3 (rs17189035, p = 2.71 × 10− 8) and WLS/GNG12-AS1 (rs17130484, p = 4.13 × 10− 8). Pathway analysis identified olfactory, vitamin A, and cadherin pathways as being significantly overrepresented across multiple cognitive domains. The novel associations identified provide candidates for further investigation and necessitate replication in similarly characterised independent cohorts.

Recent anatomical studies have shown that, compared to other primates, the human frontal pole (FP) contains a unique lateral subdivision (FPl). This area provides an important target for understanding the uniqueness of human intelligence. Paradoxically, patients with FP lesions often perform normally on standard neuropsychological tests, while experiencing problems in real-life or simulated situations. This paper aims to review the complex functions of the FPl that may account for the dysfunctions observed in these patients. First, we consider studies of FP lesion patients that reveal deficits in analogical reasoning and prospective memory. Second, we review, mainly based on neuroimaging and neurostimulation studies, the FPl's involvement in exploratory decision making, information integration and the representation of abstract rules. We argue that these functions primarily stem from the FPl's capacity to manage multiple sources of information and to reduce that information into simpler features for guiding behaviour. Finally, we propose a model of the FPl that emphasizes its role in decomposing high-dimensional information to enhance decision making processes in conjunction with connected regions, including the posterior cingulate cortex, anterior cingulate cortex, and dorsolateral prefrontal cortex.

The apolipoprotein E (APOE) ɛ4 allele is the primary genetic risk factor that influences lipid metabolism and contributes to distinctive Alzheimer's disease pathologies, including increased hippocampal atrophy and accelerated cognitive decline. Synaptic dysfunction can occur in APOE4 carriers even before the appearance of any clinical symptoms. Recent evidence has suggested that this genetic risk factor impacts males and females differently. The sex-specific vulnerability for females to cognitive decline, particularly memory, intensifies post-menopause and emphasizes the need for further investigation. White matter abnormalities, APOE4 allele and disruptions in default mode network connectivity serve as early indicators that are crucial for better understanding Alzheimer's disease progression. This study aims to explore relationships between biological sex, APOE4, default mode network-white matter activity and memory function as measured by the Selective Reminding Test. Participants were categorized by risk level on their APOE4 status. Using longitudinal data from the Harvard Aging Brain Study, we examined sex differences in default mode network-white matter engagement among older individuals with and without the APOE4 allele. Our findings demonstrated a significant reduction in default mode network-white matter activity in the right posterior corona radiata in the high-risk group compared to the low-risk group. High-risk females showed reduction in default mode network-white matter activity in the right superior longitudinal fasciculus, which positively correlated with free recall performance, compared to their low-risk counterparts. Unlike females, males showed no significant changes between the low- and high-risk groups. These results underscore the effectiveness of white matter engagement mapping in differentiating longitudinal changes in memory function related to the genetic risk factor APOE4 and biological sex.

Theory of mind (ToM) is centrally important in everyday social communication and interactions, and a growing number of studies have focused on this social-cognitive construct in school-aged children. This study explored age-related changes in ToM abilities and cross-cultural differences between children from China and Australia. We recruited 126 children from China and 83 children from Australia. The children's cognitive and affective ToM were measured by four tests. The findings showed that although there were no cultural differences in Interpretive ToM and Faux Pas performances, Chinese children performed poorer in Reading Mind in the Eyes and Strange Stories than Australian children.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting about 5

BackgroundMental health needs in the community surged during the pandemic, with concerning reports of increased negative mood symptoms among youth. At the same time, preventive psychoeducational interventions were insufficient within frontline youth mental health services in Hong Kong, and research specifically addressing youth loneliness remained limited on an international scale. Given the association between loneliness and other mental health symptoms, psychoeducational programs that empower adolescents to cope with emotions may help address both the research gap and local demand. As such, Tuned In, a previously validated intervention program originally developed in Australia, was introduced to the local context. Cultural adaptations and an added focus on loneliness were incorporated into the project to enhance its acceptability and test its effectiveness. ObjectiveThis study aims to evaluate an adapted version of the Tuned In music-based psychoeducation program, designed to reduce loneliness, depression, and anxiety symptoms among young people in Hong Kong by enhancing their emotion regulation skills. MethodsParticipants aged 16-19 years will be randomly assigned to either the experimental or control group. The experimental group will receive an online, group-based psychoeducation program focused on emotion recognition and management, delivered weekly over 4 consecutive weeks. The intervention is grounded in Russell’s emotion circumplex model and music psychology, and program content included: The 2D model and characteristics of emotions from different quadrants (session 1); happiness and loneliness (session 2); high-arousal and negative-valence emotions, for example, stress and anxiety (sessions 3); and anxiety, perfectionism, and a celebration of achievement (session 4). Both therapist- and participant-selected music will be used in the intervention to provide a rich repertoire for group discussion, psychoeducation, reflection, and the practice of social skills. The main outcome measures will be assessed using the Emotion Regulation Questionnaire, the Difficulties in Emotion Regulation Scale, the Depression Anxiety Stress Scale, and the De Jong Gierveld Loneliness Scale. Feedback on the project arrangement will be gathered through qualitative input. A mixed methods analysis will be conducted following data collection. ResultsThe project was successfully funded in February 2023 by the Health and Medical Research Fund in Hong Kong and commenced in August 2023. As of September 16, 2024, a total of 316 completed questionnaires had been received through Qualtrics for screening purposes, with 89 participants deemed eligible for the program. The project is scheduled to conclude in August 2025, with results to be published thereafter. ConclusionsParticipants are expected to show improvements in emotion regulation, along with reductions in mood symptoms and loneliness, following the intervention. Trial RegistrationClinicalTrials.gov NCT06147297; https://clinicaltrials.gov/study/NCT06147297 International Registered Report Identifier (IRRID)DERR1-10.2196/67764

Recent research has emphasized the continuum of depression, highlighting the significance of early intervention for subclinical depression. However, previous studies often focused on specific populations or lacked comparisons across participants and intervention characteristics in the effectiveness of cognitive behavioral therapy (CBT). This systematic review and meta-analysis (CRD42024498284) aimed to address these gaps by examining the effectiveness of CBT in managing subclinical depression and its potential for preventing the transition to major depression. A comprehensive search across seven databases from inception to March 2025, identified 23 randomized controlled trials (RCTs) involving 5877 participants. Meta-regression, sensitivity analysis, and funnel plots were utilized to assess heterogeneity, publication bias, and study quality. CBT significantly improved subclinical depressive symptoms (at postassessment: g = -0.89; 95% confidence interval (CI) = -1.57 to -0.20 and follow-up: g = -0.56; 95% CI: -0.93 to -0.18) and anxiety symptoms (at postassessment: g = -0.92; 95% CI: -1.84 to -0.00 and follow-up: g = -0.70; 95% CI: -1.15 to -0.25), but had no notable impact on quality of life. Meta-regression analysis identified the number of CBT sessions as factors influencing CBT effectiveness in managing depressive symptoms. While there are statistically significant results (RR = 0.62; 95% CI = 0.50-0.77) indicating CBT's preventive efficacy in transitioning from subclinical to major depression, evidences were limited by the self-reporting data. The majority of included studies came from Europe which limited generalizability, and comparisons between different types of CBT, education levels, and CBT components were limited. In general, CBT has been demonstrated to be effective in managing depressive symptoms over time. Additional research, particularly from diverse regions and comparative studies between CBT and alternative treatments, is imperative to overcome the current study's limitations.

Background:Social Anhedonia (SA) is recognised as a negative symptom of the schizophrenia spectrum. Despite the emerging evidence of general impairment in Theory of Mind (ToM), the behavioural manifestation and underlying neural mechanisms of ToM deficits in SA remain unclear. The current study therefore adopted a multidimensional assessment approach to examine the effect of SA on ToM ability behaviourally and using fMRI. Methods:A total of 47 participants with high SA (Mage = 21.43 years, SD = 4.23) and 46 with low SA (Mage = 22.70, SD = 2.91) were recruited to complete an adapted version of the Virtual Assessment of Mentalising Ability to evaluate ToM. Group differences were analysed using 2 (Type: Cognitive vs Affective ToM) × 2 (Order: First- vs Second-Order ToM) × 2 (Group: high vs low SA) repeated measures ANOVA. fMRI data were examined with general linear models and group comparisons, including ROI analyses to assess correlations between brain activation and behavioural measures. Results:The participants with low SA showed better performance for first-order ToM than for second-order ToM. However, those with high SA did not show such a differential effect. Based on the fMRI results, the low SA group showed more activation than the high SA group in the medial frontal cortex and posterior cingulate cortex in second-order ToM than in first-order ToM. Conclusion:The results demonstrate the impairment of ToM performance among those with high SA and highlight that it is crucial to examine the pattern of results rather than solely focusing on general ToM.

Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population remains unclear. Moreover, no review has focused on understanding the unique contributions of IU and aging to anxiety and mental health in older adults. This scoping review and meta-analysis addressed this gap and provided a comprehensive understanding of the relationship between IU, aging, and mental health. Among 45 studies reviewed, 37 were included in the meta-analysis using mixed effect analysis to examine the relationship between IU and age across adulthood. The remaining eight studies, along with seven selected from the meta-analysis, were included in the scoping review to evaluate the relationship between IU, anxiety, and mental health. Among these, 12 studies focused on late adulthood, two on overall adulthood, and one included both late and overall adulthood. Results of the meta-analysis revealed an overall significant age difference in IU throughout adulthood. Moreover, results of the scoping review indicated a direct correlation between IU and anxiety, and other psychological issues in elderly. These findings provide insights for future research and interventions aimed at reducing IU and improving mental health among older adults.

Schizophrenia is associated with impairments in theory of mind (ToM), the ability to understand and attribute mental states. However, the nature of the deficits across ToM subconstructs (viz., first- and second-order cognitive ToM, and first- and second-order affective ToM) remains unclear, partly due to assessment issues. The current study aimed to first adapt an ecologically valid ToM assessment tool, namely, the Virtual Assessment of Mentalizing Ability (VAMA), for use among healthy Chinese individuals (Study 1). We then compared 39 schizophrenia patients with 37 controls, and 48 individuals with high social anhedonia (SA) with 54 individuals with low SA (Study 2) using the adapted version of VAMA and Yoni Task. Results of Study 1 showed that the adapted VAMA demonstrated acceptable reliability (item-total correlation and test-retest reliability for total score, r = 0.731, pFDR < 0.01) and construct validity (main effect of Order and Type). In Study 2, schizophrenia patients performed significantly worse than controls, making more “hypermentalizing” and “no mentalizing” ToM errors. Moreover, hypermentalizing error in the patient group was found to be significantly associated with their negative symptoms (r = 0.388, pFDR < 0.05). Interestingly, the VAMA results differed from those of the Yoni Task, possibly due to differences in task complexity. Finally, individuals with high SA showed impairments in second-order cognitive ToM compared to the controls. Overall, our findings suggest that the VAMA can be adapted for use in China, and is sensitive to ToM impairments in clinical and at-risk groups. Limitations on the psychometric properties were discussed.

Playing mahjong is a popular intellectual and social leisure activity in Asian countries. It is culturally believed that this activity is beneficial to cognitive and psychological functioning in older adults. However, empirical evidence of the benefits of playing mahjong is scant and scattered across the Western and Asian literature. This scoping review comprehensively examined previous studies of the relationships between playing mahjong and cognitive, psychological, and functional abilities in older adults, highlighted gaps in the literature, and identified directions for future research. A systematic search of the literature was conducted across thirteen Western and Asian databases. Fifty-three studies, including forty-seven observational and six intervention studies, were identified. Overall, the results of the observational studies suggested that more mahjong-playing experience was associated with better cognitive, psychological, and functional abilities. As an intervention, playing mahjong was found to enhance general cognitive abilities and short-term memory and relieve depressive symptoms. However, because most of the reviewed studies adopted a correlational methodology, the neural mechanism underlying the benefits of playing mahjong awaits further elucidation. The findings of this review suggest that more randomized controlled trials should be conducted to explore the effects of playing mahjong on higher-level cognitive functioning in older populations.

This study examined the effectiveness of a multiple group membership intervention for reducing the negative effects of age-based stereotype threat (ABST) on older adults' objective memory performance and subjective memory concerns. Healthy older adults (N = 68) were randomly allocated to an ABST + threat-removal (ABST+TR) or ABST + active-control (ABST+AC) condition. After activating ABST, the ABST+TR condition completed a group-listing task and the ABST+AC condition completed a meal-listing task. Participants then completed the Rey Auditory Verbal Learning Test (RAVLT) and Everyday Memory Questionnaire - Revised. One significant difference was found in memory performance between conditions; specifically, after controlling for age, gender, and number of items listed, those in the ABST+TR condition performed significantly better on the RAVLT memory interference trial. Further, listing a greater number of group memberships was associated with better memory performance in the ABST+TR condition. No significant difference was found in subjective memory concerns between the ABST+TR condition and the ABST+AC condition. Overall, the current findings indicated that raising the salience of multiple group memberships offered limited protection for older adults' cognitive test performance in the context of ABST.