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Lee HS, Sangimino M, Baxter T, Buck L, Bodenheimer B, Park S. Self-other boundary under social threat in schizophrenia. Schizophr Res 2024; 274:182-188. [PMID: 39332243 PMCID: PMC12057532 DOI: 10.1016/j.schres.2024.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 08/19/2024] [Accepted: 09/11/2024] [Indexed: 09/29/2024]
Abstract
Spatial representation of the self plays a vital role constructing our sense of bodily self-boundary that distinguishes the self from others. This perceptual border, known as the peripersonal space (PPS), has been suggested to be altered in individuals with schizophrenia (SZ). PPS represents a protective defensive zone that triggers alarm signals upon threat detection; thus disrupted PPS could lead to social interactional difficulties. However, very little is known about the impact of threat on PPS. To address this gap, a visual-tactile response-time (RT) experiment was conducted in immersive virtual reality (VR) for SZ and matched controls (CO). Participants were asked to detect a tactile vibration on their hand while an avatar (either threatening or neutral) approached them. Avatars were presented at different distance from the participants. PPS size and slope were estimated by identifying significant RT drop at the hypothesized self-other boundary. We also examined the relationship between PPS parameters, clinical symptoms and social disconnection. There was no overall group difference in PPS size. Perceived social threat posed in the avatars sharpened the self-boundary in CO but not in SZ. In SZ, shallower PPS slope was associated with delusion, persecution, negative symptoms and loneliness but not in CO. These results show that the regulation of self-other boundary in response to impending social threat may be maladaptive in SZ. Further research is needed on the causal mechanisms between self-disturbance and social impairments.
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Affiliation(s)
- Hyeon-Seung Lee
- Department of Psychology, Vanderbilt University, Nashville, USA.
| | | | - Tatiana Baxter
- Department of Psychology, Vanderbilt University, Nashville, USA
| | - Lauren Buck
- School of Engineering, Vanderbilt University, Nashville, USA; Division of Games, University of Utah, Utah, USA
| | | | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, USA
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2
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Lee HS, Holt DJ, Park S. Altered representation of peripersonal and interpersonal space in psychopathology. Clin Psychol Rev 2024; 114:102509. [PMID: 39581136 PMCID: PMC12079853 DOI: 10.1016/j.cpr.2024.102509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 08/08/2024] [Accepted: 10/23/2024] [Indexed: 11/26/2024]
Abstract
The space surrounding the body, and the regulation of this buffer zone play a central role in adaptive behavior, with direct implications for psychopathology. The physical distance that we choose to maintain between ourselves and others for social comfort is known as Interpersonal Distance (IPD), whereas the action space that marks the perceptual border between the self and the external world is known as Peripersonal Space (PPS ). While both IPD and PPS represent personal space, they are distinct constructs, each associated with different methodologies. Here we review the existing literature on IPD and PPS to elucidate their distinct and common contributions to psychiatric conditions including schizophrenia, autism, anxiety, and others. Altered representation and regulation of IPD and PPS were associated with clinical symptoms and social impairments across a wide range of psychiatric disorders, underscoring the important role of the self-other boundary and personal space regulation in adaptive social behavior. Future research should clarify the relationship between IPD and PPS and specify risk factors for self-other boundary dysregulation and associated psychopathologies.
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Affiliation(s)
- Hyeon-Seung Lee
- Department of Psychology, Vanderbilt University, Nashville, USA
| | - Daphne J Holt
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Brigham Hospital, Boston, MA, USA
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, USA.
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Margariti MM, Vlachos II, Mpourazana D, Aristotelidis P, Selakovic M, Ifanti M, Papageorgiou C. Psychotic Arousal and the Psychopathology of Acute Schizophrenia: An Exploratory Study of the Experiential Emotional State in Acute Psychosis. J Clin Med 2024; 13:5477. [PMID: 39336964 PMCID: PMC11432037 DOI: 10.3390/jcm13185477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 09/08/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Increasing research data suggest that the dysfunction of emotional brain systems may be an important contributor to the pathophysiology of schizophrenia. However, contemporary psychopathology consistently underestimates the role of emotions in the phenomenology of the disease. Psychotic arousal (PA) is a conceptually defined psychopathological construct aiming to portray the experiential emotional state of acute psychosis. The concept provides an explanatory model for the emergence of psychosis, and the formation and maintenance of delusions based on neurobiological models on the formation of core consciousness and subjectivity. This is the first exploratory study of the major assumptions, endorsed in the project summarized as follows: (1) psychotic arousal is a discrete state, eligible for investigation; (2) abnormal experiential feelings are an integral part of this state; and (3) the state is responsive to antipsychotic intervention during the first weeks of treatment. Methods: We developed the Psychotic Arousal Scale (PAS) accordingly, explored its first psychometric properties and tested its relation to other psychopathological measures. Fifty-five acute schizophrenia patients were evaluated with the PAS, the Positive and Negative Syndrome Scale, the Brown Assessment of Beliefs Scale, the Hamilton Anxiety Scale, and the Calgary Depression Scale. Cronbach α coefficients, t-test analysis, correlations and mixed linear regression models were applied for testing the internal reliability of the scale, associations between parameters and sensitivity to change in three time periods during therapeutic intervention. Results: The results of the study support that (PA) is eligible for investigation as a discrete psychopathological state. Abnormal experiential feelings are an integral part of this state, presenting high affinity with other affective measures; their degree of severity relates to the delusions' conviction and are amenable to antipsychotics early in treatment during the acute psychotic episode. Conclusions: The findings of this exploratory study are connotative of the presence of an emotional arousal permeated by abnormal experiential feelings during acute psychosis, largely overlooked by contemporary psychopathology.
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Affiliation(s)
- Maria M Margariti
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Ilias I Vlachos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Dimitra Mpourazana
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Aristotelidis
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Mirjana Selakovic
- Department of Psychiatry, "Sismanogleio" General Hospital, 15126 Athens, Greece
| | - Maria Ifanti
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
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Hennig-Fast K, Meissner D, Steuwe C, Dehning S, Blautzik J, Eilert DW, Zill P, Müller N, Meindl T, Reiser M, Möller HJ, Falkai P, Driessen M, Buchheim A. The Interplay of Oxytocin and Attachment in Schizophrenic Patients: An fMRI Study. Brain Sci 2023; 13:1125. [PMID: 37626482 PMCID: PMC10452454 DOI: 10.3390/brainsci13081125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/02/2023] [Accepted: 07/18/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Attachment theory offers an important framework for understanding interpersonal interaction experiences. In the present study, we examined the neural correlates of attachment patterns and oxytocin in schizophrenic patients (SZP) compared to healthy controls (HC) using fMRI. We assumed that male SZP shows a higher proportion of insecure attachment and an altered level of oxytocin compared to HC. On a neural level, we hypothesized that SZP shows increased neural activation in memory and self-related brain regions during the activation of the attachment system compared to HC. METHODS We used an event-related design for the fMRI study based on stimuli that were derived from the Adult Attachment Projective Picture System to examine attachment representations and their neural and hormonal correlates in 20 male schizophrenic patients compared to 20 male healthy controls. RESULTS A higher proportion of insecure attachment in schizophrenic patients compared to HC could be confirmed. In line with our hypothesis, Oxytocin (OXT) levels in SZP were significantly lower than in HC. We found increasing brain activations in SZP when confronted with personal relevant sentences before attachment relevant pictures in the precuneus, TPJ, insula, and frontal areas compared to HC. Moreover, we found positive correlations between OXT and bilateral dlPFC, precuneus, and left ACC in SZP only. CONCLUSION Despite the small sample sizes, the patients' response might be considered as a mode of dysregulation when confronted with this kind of personalized attachment-related material. In the patient group, we found positive correlations between OXT and three brain areas (bilateral dlPFC, precuneus, left ACC) and may conclude that OXT might modulate within this neural network in SZP.
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Affiliation(s)
- Kristina Hennig-Fast
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
- Department of Psychiatry and Psychotherapy, University of Bielefeld, 33615 Bielefeld, Germany
| | - Dominik Meissner
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Carolin Steuwe
- Department of Psychiatry and Psychotherapy, University of Bielefeld, 33615 Bielefeld, Germany
| | - Sandra Dehning
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Janusch Blautzik
- Department of Radiology, Ludwig-Maximilians University, 81377 Munich, Germany
| | - Dirk W. Eilert
- Department of Psychology, University Innsbruck, 6020 Innsbruck, Austria
| | - Peter Zill
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Norbert Müller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Thomas Meindl
- Department of Radiology, Ludwig-Maximilians University, 81377 Munich, Germany
| | - Maximilian Reiser
- Department of Radiology, Ludwig-Maximilians University, 81377 Munich, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, University of Bielefeld, 33615 Bielefeld, Germany
| | - Anna Buchheim
- Department of Psychology, University Innsbruck, 6020 Innsbruck, Austria
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Stoyanov D. Perspectives before incremental trans-disciplinary cross-validation of clinical self-evaluation tools and functional MRI in psychiatry: 10 years later. Front Psychiatry 2022; 13:999680. [PMID: 36304557 PMCID: PMC9595022 DOI: 10.3389/fpsyt.2022.999680] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
Translational validity (or trans-disciplinary validity) is defined as one possible approach to achieving incremental validity by combining simultaneous clinical state-dependent measures and functional MRI data acquisition. It is designed under the assumption that the simultaneous administration of the two methods may produce a dataset with enhanced synchronization and concordance. Translational validation aims at "bridging" the explanatory gap by implementing validated psychometric tools clinically in the experimental settings of fMRI and then translating them back to clinical utility. Our studies may have identified common diagnostic task-specific denominators in terms of activations and network modulation. However, those common denominators need further investigation to determine whether they signify disease or syndrome-specific features (signatures), which, at the end of the day, raises one more question about the poverty of current conventional psychiatric classification criteria. We propose herewith a novel algorithm for translational validation based on our explorative findings. The algorithm itself includes pre-selection of a test based on its psychometric characteristics, adaptation to the functional MRI paradigm, exploration of the underpinning whole brain neural correlates in healthy controls as compared to a patient population with certain diagnoses, and finally, investigation of the differences between two or more diagnostic classes.
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Affiliation(s)
- Drozdstoy Stoyanov
- Department of Psychiatry and Medical Psychology and Research Institute, Plovdiv Medical University, Plovdiv, Bulgaria
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Kesby JP, Murray GK, Knolle F. Neural Circuitry of Salience and Reward Processing in Psychosis. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 3:33-46. [PMID: 36712572 PMCID: PMC9874126 DOI: 10.1016/j.bpsgos.2021.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 02/01/2023] Open
Abstract
The processing of salient and rewarding stimuli is integral to engaging our attention, stimulating anticipation for future events, and driving goal-directed behaviors. Widespread impairments in these processes are observed in psychosis, which may be associated with worse functional outcomes or mechanistically linked to the development of symptoms. Here, we summarize the current knowledge of behavioral and functional neuroimaging in salience, prediction error, and reward. Although each is a specific process, they are situated in multiple feedback and feedforward systems integral to decision making and cognition more generally. We argue that the origin of salience and reward processing dysfunctions may be centered in the subcortex during the earliest stages of psychosis, with cortical abnormalities being initially more spared but becoming more prominent in established psychotic illness/schizophrenia. The neural circuits underpinning salience and reward processing may provide targets for delaying or preventing progressive behavioral and neurobiological decline.
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Affiliation(s)
- James P. Kesby
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia,Address correspondence to James Kesby, Ph.D.
| | - Graham K. Murray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Franziska Knolle
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany,Franziska Knolle, Ph.D.
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Lee HS, Hong SJJ, Baxter T, Scott J, Shenoy S, Buck L, Bodenheimer B, Park S. Altered Peripersonal Space and the Bodily Self in Schizophrenia: A Virtual Reality Study. Schizophr Bull 2021; 47:927-937. [PMID: 33844019 PMCID: PMC8266616 DOI: 10.1093/schbul/sbab024] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Self-disturbances such as an anomalous perception of one's own body boundary are central to the phenomenology of schizophrenia (SZ), but measuring the spatial parameters of the hypothesized self-other boundary has proved to be challenging. Peripersonal space (PPS) refers to the immediate zone surrounding the body where the self interacts physically with the environment; the space that corresponds to hypothesized self-other boundary. PPS is represented by enhanced multisensory integration and faster reaction time (RT) for objects near the body. Thus, multisensory RT tasks can be used to estimate self-other boundary. We aimed to quantify PPS in SZ using an immersive virtual reality visuotactile RT paradigm. Twenty-four participants with SZ and 24 demographically matched controls (CO) were asked to detect tactile vibration while watching a ball approaching them, thrown by either a machine (nonsocial condition) or an avatar (social condition). Parameters of PPS were estimated from the midpoint of the spatial range where the tactile RT decreased most rapidly (size) and the gradient of the RT change at this midpoint (slope). Overall, PPS was smaller in participants with SZ compared with CO. PPS slope for participants with SZ was shallower than CO in the social but not in nonsocial condition, indicating an increased uncertainty of self-other boundary across an extended zone in SZ. Social condition also increased false alarms for tactile detection in SZ. Clinical symptoms were not clearly associated with PPS parameters. These findings suggest the context-dependent nature of weakened body boundary in SZ and underscore the importance of reconciliating objective and subjective aspects of self-disturbances.
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Affiliation(s)
- Hyeon-Seung Lee
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Seok-Jin J Hong
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Tatiana Baxter
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Jason Scott
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Sunil Shenoy
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Lauren Buck
- School of Engineering, Vanderbilt University, Nashville, TN, USA
| | | | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Neumann SR, Glue P, Linscott RJ. Aberrant salience and reward processing: a comparison of measures in schizophrenia and anxiety. Psychol Med 2021; 51:1507-1515. [PMID: 32148214 DOI: 10.1017/s0033291720000264] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Aberrant salience may contribute to the development of schizophrenia symptoms via alterations in reward processing and motivation. However, tests of this hypothesis have yielded inconsistent results. These inconsistencies may reflect problems with the validity and specificity of measures of aberrant salience in schizophrenia. Therefore, we investigated relationships among measures of aberrant salience, reward, and motivation in schizophrenia and anxiety. METHOD Individuals with schizophrenia (n = 30), anxiety (n = 33) or unaffected by mental disorder (n = 30) completed measures of aberrant salience [Aberrant Salience Inventory (ASI), Salience Attribution Test (SAT)], motivation (Effort Expenditure for Reward Task), and reinforcer sensitivity (Stimulus Chase Task). RESULTS Schizophrenia participants scored higher than anxiety (d = 0.71) and unaffected (d = 1.54) groups on the ASI and exhibited greater aberrant salience (d = 0.60) and lower adaptive salience (d = 0.98) than anxious participants on the SAT. There was no evidence of a correlation between measures of aberrant salience. Schizophrenia was associated with related deficits in motivated behaviour and maladaptive reward processing. However, these differences in reward processing did not correlate with aberrant salience measures. CONCLUSIONS The results suggest that key measures of aberrant salience have limited specificity and validity. These problems may account for inconsistent findings reported in the literature.
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Affiliation(s)
| | - Paul Glue
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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He Y, Wu S, Chen C, Fan L, Li K, Wang G, Wang H, Zhou Y. Organized Resting-state Functional Dysconnectivity of the Prefrontal Cortex in Patients with Schizophrenia. Neuroscience 2020; 446:14-27. [PMID: 32858143 DOI: 10.1016/j.neuroscience.2020.08.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/23/2020] [Accepted: 08/16/2020] [Indexed: 12/25/2022]
Abstract
Schizophrenia has prominent functional dysconnectivity, especially in the prefrontal cortex (PFC). However, it is unclear whether in the same group of patients with schizophrenia, PFC functional dysconnectivity appears in an organized manner or is stochastically located in different subregions. By investigating the resting-state functional connectivity (rsFC) of each PFC subregion from the Brainnetome atlas in 40 schizophrenia patients and 40 healthy subjects, we found 24 altered connections in schizophrenia, and the connections were divided into four categories by a clustering analysis: increased connections within the PFC, increased connections between the inferior PFC and the thalamus/striatum, reduced connections between the PFC and the motor control areas, and reduced connections between the orbital PFC and the emotional perception regions. In addition, the four categories of rsFC showed distinct cognitive engagement patterns. Our findings suggest that PFC subregions have specific functional dysconnectivity patterns in schizophrenia and may reflect heterogeneous symptoms and cognitive deficits in schizophrenia.
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Affiliation(s)
- Yuwen He
- CAS Key Laboratory of Behavioral Science & Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Shihao Wu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Cheng Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Lingzhong Fan
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Kaixin Li
- Harbin University of Science and Technology, Harbin 150080, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yuan Zhou
- CAS Key Laboratory of Behavioral Science & Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of the Chinese Academy of Sciences, Beijing 100049, China.
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Kandilarova S, Stoyanov D, Stoeva M, Latypova A, Kherif F. Functional MRI in Depression—Multivariate Analysis of Emotional Task. J Med Biol Eng 2020; 40:535-544. [DOI: 10.1007/s40846-020-00547-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/24/2020] [Indexed: 02/06/2023]
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Comparelli A, Corigliano V, Montalbani B, Bargagna P, Forcina F, Cocco G, Erbuto D, De Carolis A, Pompili M. Relationship between aberrant salience and positive emotion misrecognition in acute relapse of schizophrenia. Asian J Psychiatr 2020; 49:101975. [PMID: 32114376 DOI: 10.1016/j.ajp.2020.101975] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/14/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Aberrant salience is the incorrect assignment of salience or significance to innocuous stimuli, and been hypothesized to be a central mechanism in the development of psychosis. In addition to aberrant salience, social-cognitive models of psychosis suggest that the way people process information about the self is important in all stages of psychosis. The aim of the present study is to explore the relationship between aberrant salience and emotion processing in schizophrenia patients with psychotic relapse. METHODS A sample of 42 patients with relapse was recruited. Aberrant salience was measured with the Aberrant Salience Inventory (ASI). Assessment of social cognition was carried out using the Facial Emotion Identification Test (FEIT). Partial correlations were controlled for possible confounding variables. RESULTS The ASI factors "increase in meaning" and "heightened cognition" positively correlated with impaired recognition of positive emotions, and ASI total score inversely correlated to time to response to task. Most of incorrect answers corresponded to misclassification of positive emotions. CONCLUSION Our findings show that there is evidence for a relationship between aberrant salience and emotion processing during a psychotic episode; we propose that aberrant salience and alterations in emotion processing trigger the loss of modulating feedback from the external world to produce a self-referential mental state.
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Affiliation(s)
- Anna Comparelli
- Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
| | | | - Benedetta Montalbani
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Paride Bargagna
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Francesca Forcina
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Gabriele Cocco
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Denise Erbuto
- Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - Antonella De Carolis
- Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - Maurizio Pompili
- Dept. of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sant'Andrea Hospital, Sapienza University of Rome, Italy
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Barnby JM, Deeley Q, Robinson O, Raihani N, Bell V, Mehta MA. Paranoia, sensitization and social inference: findings from two large-scale, multi-round behavioural experiments. ROYAL SOCIETY OPEN SCIENCE 2020; 7:191525. [PMID: 32269791 PMCID: PMC7137981 DOI: 10.1098/rsos.191525] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/10/2020] [Indexed: 05/09/2023]
Abstract
The sensitization model suggests that paranoia is explained by over-sensitivity to social threat. However, this has been difficult to test experimentally. We report two preregistered social interaction studies that tested (i) whether paranoia predicted overall attribution and peak attribution of harmful intent and (ii) whether anxiety, interpersonal sensitivity and worry predicted the attribution of harmful intent. In Study 1, we recruited a large general population sample (N = 987) who serially interacted with other participants in multi-round dictator games and matched to fair, partially fair or unfair partners. Participants rated attributions of harmful intent and self-interest after each interaction. In Study 2 (N = 1011), a new sample of participants completed the same procedure and additionally completed measures of anxiety, worry and interpersonal sensitivity. As predicted, prior paranoid ideation was associated with higher and faster overall harmful intent attributions, whereas attributions of self-interest were unaffected, supporting the sensitization model. Contrary to predictions, neither worry, interpersonal sensitivity nor anxiety was associated with harmful intent attributions. In a third exploratory internal meta-analysis, we combined datasets to examine the effect of paranoia on trial-by-trial attributional changes when playing fair and unfair dictators. Paranoia was associated with a greater reduction in harmful intent attributions when playing a fair but not unfair dictator, suggesting that paranoia may also exaggerate the volatility of beliefs about the harmful intent of others.
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Affiliation(s)
- J. M. Barnby
- Social and Cultural Neuroscience Research Group, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Author for correspondence: J. M. Barnby e-mail:
| | - Q. Deeley
- Social and Cultural Neuroscience Research Group, Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - O. Robinson
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - N. Raihani
- Psychology and Language Sciences, University College London, London, UK
| | - V. Bell
- Social and Cultural Neuroscience Research Group, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Research Department of Clinical, Educational, and Healthy Psychology, University College London, London, UK
| | - M. A. Mehta
- Social and Cultural Neuroscience Research Group, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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Neumann SR, Linscott RJ. The relationships among aberrant salience, reward motivation, and reward sensitivity. Int J Methods Psychiatr Res 2018; 27:e1615. [PMID: 29691918 PMCID: PMC6877145 DOI: 10.1002/mpr.1615] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 01/21/2018] [Accepted: 02/27/2018] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Change in reward processing and motivation may mediate the relationship between dopaminergic dysregulation and positive symptoms of schizophrenia. We sought to investigate the measurement of aberrant salience and its relationship with behavioural measures of reward and motivation. METHODS Participants (n = 82) completed measures of aberrant salience (Aberrant Salience Inventory and Salience Attribution Task), motivation (Effort Expenditure for Rewards Task), and reinforcer sensitivity (Stimulus Chase Task). Hypotheses were tested using correlation and generalised linear modelling. RESULTS Results indicated no relationship between aberrant salience measures. The Aberrant Salience Inventory was positively related to effort expenditure for lower less likely rewards and predicted the use of probability alone in decision-making. The only significant relationship between reward and motivation was a positive relationship between gain sensitivity and motivated behaviour for higher more likely rewards. CONCLUSIONS Although some support for a relationship between measures of reward motivation and aberrant salience were found, there was no evidence that the aberrant salience measures had concurrent validity. Our results suggest caution is warranted when interpreting measures of aberrant salience.
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Knolle F, Ermakova AO, Justicia A, Fletcher PC, Bunzeck N, Düzel E, Murray GK. Brain responses to different types of salience in antipsychotic naïve first episode psychosis: An fMRI study. Transl Psychiatry 2018; 8:196. [PMID: 30242202 PMCID: PMC6154975 DOI: 10.1038/s41398-018-0250-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/16/2018] [Accepted: 07/24/2018] [Indexed: 02/07/2023] Open
Abstract
Abnormal salience processing has been suggested to contribute to the formation of positive psychotic symptoms in schizophrenia and related conditions. Previous research utilising reward learning or anticipation paradigms has demonstrated cortical and subcortical abnormalities in people with psychosis, specifically in the prefrontal cortex, the dopaminergic midbrain and the striatum. In these paradigms, reward prediction errors attribute motivational salience to stimuli. However, little is known about possible abnormalities across different forms of salience processing in psychosis patients, and whether any such abnormalities involve the dopaminergic midbrain. The aim of our study was, therefore, to investigate possible alterations in psychosis in neural activity in response to various forms of salience: novelty, negative emotion, targetness (task-driven salience) and rareness/deviance. We studied 14 antipsychotic naïve participants with first episode psychosis, and 37 healthy volunteers. During fMRI scanning, participants performed a visual oddball task containing these four forms of salience. Psychosis patients showed abnormally reduced signalling in the substantia nigra/ventral tegmental area (SN/VTA) for novelty, negative emotional salience and targetness; reduced striatal and occipital (lingual gyrus) signalling to novelty and negative emotional salience, reduced signalling in the amygdala, anterior cingulate cortex and parahippocamal gyrus to negative emotional salience, and reduced cerebellar signalling to novelty and negative emotional salience. Our results indicate alterations of several forms of salience processing in patients with psychosis in the midbrain SN/VTA, with additional subcortical and cortical regions also showing alterations in salience signalling, the exact pattern of alterations depending on the form of salience in question.
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Affiliation(s)
- Franziska Knolle
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
| | - Anna O Ermakova
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
| | - Azucena Justicia
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
- IMIM (Hospital del Mar Medical Research Institute)., Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Paul C Fletcher
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Nico Bunzeck
- Institute of Psychology, University of Lübeck, Lübeck, Germany
| | - Emrah Düzel
- Otto-von-Guericke University Magdeburg, Institute of Cognitive Neurology and Dementia Research, Magdeburg, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Graham K Murray
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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15
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Kandilarova S, Stoyanov D, Popivanov ID, Kostianev S. Application of functional magnetic resonance imaging in psychiatric clinical evaluation: Controversies and avenues. J Eval Clin Pract 2018; 24:807-814. [PMID: 29532566 DOI: 10.1111/jep.12906] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 01/02/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES In this study, we have attempted to replicate the findings of altered emotional processing in depressed patients compared with healthy controls by means of functional magnetic resonance imaging during passive viewing of positive, negative, and neutral pictures from the International Affective Pictures System. METHODS Nineteen medicated depressed patients and 19 sex and age-matched healthy controls underwent functional magnetic resonance imaging during presentation of affective pictures in a block design. The differences between the blood oxygen level dependent signal elicited in the tree conditions were compared. Within-group and between-group analyses were performed with stringent criteria for statistical inference (P < .05 with family-wise error correction). RESULTS In medicated depressed patients, positive pictures compared with neutral pictures activated predominantly the posterior cingulate cortex and precuneus, as well as occipital and middle temporal areas mainly on the left side, while in healthy controls, only the occipito-temporal areas demonstrated significant activation. The negative pictures elicited stronger activation of occipital and temporal regions in both groups and of inferior frontal gyrus only in control subjects. The difference between the groups did not reach statistical significance. Positive correlation was demonstrated between activation levels of clusters located in left precuneus/posterior cingulate cortex and left inferior/middle occipital gyrus and Montgomery-Asberg Depression Rating Scale scores in patients while viewing positive compared with neutral pictures. CONCLUSIONS Although the within-group analysis demonstrated significant activations in both groups with apparent discrepancies, the between-group analysis did not reach statistical significance under the stringent criteria for statistical inference. These results are further contextualized in the critical debate on the methodological issues of clinical evaluation in psychiatry, more specifically the validity and consistency of the applied methods and the limitations existing in the attempts to provide sound cross-disciplinary validation of the diagnostic tools by means of neuroscience.
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Affiliation(s)
- Sevdalina Kandilarova
- Research Complex for Translational Neuroscience, Medical University of Plovdiv (MUP), Plovdiv, Bulgaria
- Department of Psychiatry and Medical Psychology, MUP, Plovdiv, Bulgaria
| | - Drozdstoy Stoyanov
- Research Complex for Translational Neuroscience, Medical University of Plovdiv (MUP), Plovdiv, Bulgaria
- Department of Psychiatry and Medical Psychology, MUP, Plovdiv, Bulgaria
| | - Ivo D Popivanov
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
| | - Stefan Kostianev
- Research Complex for Translational Neuroscience, Medical University of Plovdiv (MUP), Plovdiv, Bulgaria
- Department of Pathophysiology, MUP, Plovdiv, Bulgaria
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16
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Geraets CNW, van Beilen M, Pot-Kolder R, Counotte J, van der Gaag M, Veling W. Social environments and interpersonal distance regulation in psychosis: A virtual reality study. Schizophr Res 2018; 192:96-101. [PMID: 28442248 DOI: 10.1016/j.schres.2017.04.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/14/2017] [Accepted: 04/16/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Experimentally studying the influence of social environments on mental health and behavior is challenging, as social context is difficult to standardize in laboratory settings. Virtual Reality (VR) enables studying social interaction in terms of interpersonal distance in a more ecologically valid manner. Regulation of interpersonal distance may be abnormal in patients with psychotic disorders and influenced by environmental stress, symptoms or distress. AIMS To investigate interpersonal distance in people with a psychotic disorder and at ultrahigh risk for psychosis (UHR) compared to siblings and controls in virtual social environments, and explore the relationship between clinical characteristics and interpersonal distance. METHODS Nineteen UHR patients, 52 patients with psychotic disorders, 40 siblings of patients with a psychotic disorder and 47 controls were exposed to virtual cafés. In five virtual café visits, participants were exposed to different levels of social stress, in terms of crowdedness, ethnicity and hostility. Measures on interpersonal distance, distress and state paranoia were obtained. Baseline measures included trait paranoia, social anxiety, depressive, positive and negative symptoms. RESULTS Interpersonal distance increased when social stressors were present in the environment. No difference in interpersonal distance regulation was found between the groups. Social anxiety and distress were positively associated with interpersonal distance in the total sample. CONCLUSION This VR paradigm indicates that interpersonal distance regulation in response to environmental social stressors is unaltered in people with psychosis or UHR. Environmental stress, social anxiety and distress trigger both people with and without psychosis to maintain larger interpersonal distances in social situations.
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Affiliation(s)
- Chris N W Geraets
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30 001, 9700 RB Groningen, The Netherlands.
| | - Marije van Beilen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30 001, 9700 RB Groningen, The Netherlands
| | - Roos Pot-Kolder
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands; VU University, Department of Clinical Psychology, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
| | - Jacqueline Counotte
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands
| | - Mark van der Gaag
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands; VU University, Department of Clinical Psychology, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30 001, 9700 RB Groningen, The Netherlands; Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands; Maastricht University, Department of Psychiatry and Neuropsychology, PO Box 616, 6200 MD Maastricht, The Netherlands
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Grossberg S. Desirability, availability, credit assignment, category learning, and attention: Cognitive-emotional and working memory dynamics of orbitofrontal, ventrolateral, and dorsolateral prefrontal cortices. Brain Neurosci Adv 2018; 2:2398212818772179. [PMID: 32166139 PMCID: PMC7058233 DOI: 10.1177/2398212818772179] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 03/16/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prefrontal cortices play an essential role in cognitive-emotional and working memory processes through interactions with multiple brain regions. METHODS This article further develops a unified neural architecture that explains many recent and classical data about prefrontal function and makes testable predictions. RESULTS Prefrontal properties of desirability, availability, credit assignment, category learning, and feature-based attention are explained. These properties arise through interactions of orbitofrontal, ventrolateral prefrontal, and dorsolateral prefrontal cortices with the inferotemporal cortex, perirhinal cortex, parahippocampal cortices; ventral bank of the principal sulcus, ventral prearcuate gyrus, frontal eye fields, hippocampus, amygdala, basal ganglia, hypothalamus, and visual cortical areas V1, V2, V3A, V4, middle temporal cortex, medial superior temporal area, lateral intraparietal cortex, and posterior parietal cortex. Model explanations also include how the value of visual objects and events is computed, which objects and events cause desired consequences and which may be ignored as predictively irrelevant, and how to plan and act to realise these consequences, including how to selectively filter expected versus unexpected events, leading to movements towards, and conscious perception of, expected events. Modelled processes include reinforcement learning and incentive motivational learning; object and spatial working memory dynamics; and category learning, including the learning of object categories, value categories, object-value categories, and sequence categories, or list chunks. CONCLUSION This article hereby proposes a unified neural theory of prefrontal cortex and its functions.
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Affiliation(s)
- Stephen Grossberg
- Center for Adaptive Systems, Graduate Program in Cognitive and Neural Systems, Departments of Mathematics & Statistics, Psychological & Brain Sciences, Biomedical Engineering, Boston University, Boston, MA, USA
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18
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Möller HJ. New aspects of the vulnerability stress model in general, its relevance in schizophrenic psychoses and the place of antipsychotics. Eur Arch Psychiatry Clin Neurosci 2017; 267:485-486. [PMID: 28725951 DOI: 10.1007/s00406-017-0825-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Premkumar P, Onwumere J, Albert J, Kessel D, Kumari V, Kuipers E, Carretié L. The relation between schizotypy and early attention to rejecting interactions: The influence of neuroticism. World J Biol Psychiatry 2015; 16:587-601. [PMID: 26452584 PMCID: PMC4732428 DOI: 10.3109/15622975.2015.1073855] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/07/2015] [Accepted: 07/13/2015] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Schizotypy relates to rejection sensitivity (anxiety reflecting an expectancy of social exclusion) and neuroticism (excessive evaluation of negative emotions). Positive schizotypy (e.g., perceptual aberrations and odd beliefs) and negative schizotypy (e.g., social and physical anhedonia) could relate to altered attention to rejection because of neuroticism. METHODS Forty-one healthy individuals were assessed on positive and negative schizotypy and neuroticism, and event-related potentials during rejecting, accepting and neutral scenes. Participants were categorised into high, moderate and low neuroticism groups. Using temporo-spatial principal components analyses, P200 (peak latency = 290 ms) and P300 amplitudes (peak latency = 390 ms) were measured, reflecting mobilisation of attention and early attention, respectively. RESULTS Scalp-level and cortical source analysis revealed elevated fronto-parietal N300/P300 amplitude and P200-related dorsal anterior cingulate current density during rejection than acceptance/neutral scenes. Positive schizotypy related inversely to parietal P200 amplitude during rejection. Negative schizotypy related positively to P200 middle occipital current density. Negative schizotypy related positively to parietal P300, where the association was stronger in high and moderate, than low, neuroticism groups. CONCLUSIONS Positive and negative schizotypy relate divergently to attention to rejection. Positive schizotypy attenuates, but negative schizotypy increases rejection-related mobilisation of attention. Negative schizotypy increases early attention to rejection partly due to elevated neuroticism.
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Affiliation(s)
- Preethi Premkumar
- Division of Psychology, School of Social Sciences, Nottingham Trent University,
Nottingham,
UK
| | - Juliana Onwumere
- King’s College London, Department of Psychology, Institute of Psychiatry,
London,
UK
- NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust,
London,
UK
| | - Jacobo Albert
- Facultad De Psicología, Universidad Autónoma De Madrid,
Madrid,
Spain
- Instituto Pluridisciplinar, Universidad Complutense De Madrid,
Madrid,
Spain
| | - Dominique Kessel
- Facultad De Psicología, Universidad Autónoma De Madrid,
Madrid,
Spain
| | - Veena Kumari
- King’s College London, Department of Psychology, Institute of Psychiatry,
London,
UK
- NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust,
London,
UK
| | - Elizabeth Kuipers
- King’s College London, Department of Psychology, Institute of Psychiatry,
London,
UK
- NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust,
London,
UK
| | - Luis Carretié
- Facultad De Psicología, Universidad Autónoma De Madrid,
Madrid,
Spain
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20
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Modinos G, Tseng HH, Falkenberg I, Samson C, McGuire P, Allen P. Neural correlates of aberrant emotional salience predict psychotic symptoms and global functioning in high-risk and first-episode psychosis. Soc Cogn Affect Neurosci 2015; 10:1429-36. [PMID: 25809400 PMCID: PMC4590543 DOI: 10.1093/scan/nsv035] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/06/2015] [Accepted: 03/19/2015] [Indexed: 12/18/2022] Open
Abstract
Neurobiological and behavioral findings suggest that psychosis is associated with corticolimbic hyperactivity during the processing of emotional salience. This has not been widely studied in the early stages of psychosis, and the impact of these abnormalities on psychotic symptoms and global functioning is unknown. We sought to address this issue in 18 patients with first-episode psychosis (FEP), 18 individuals at ultra high risk of psychosis (UHR) and 22 healthy controls (HCs). Corticolimbic response and subjective ratings to emotional and neutral scenes were measured using functional magnetic resonance imaging. The clinical and functional impact of corticolimbic abnormalities was assessed with regression analyses. The FEP and UHR groups reported increased subjective emotional arousal to neutral scenes compared with HCs. Across groups, emotional vs neutral scenes elicited activation in the dorsomedial prefrontal cortex, inferior frontal gyrus/anterior insula and amygdala. Although FEP and UHR participants showed reduced activation in these regions when viewing emotional scenes compared with controls, this was driven by increased activation to neutral scenes. Corticolimbic hyperactivity to neutral scenes predicted higher levels of positive symptoms and poorer levels of functioning. These results indicate that disruption of emotional brain systems may represent an important biological substrate for the pathophysiology of early psychosis and UHR states.
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Affiliation(s)
- Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and
| | - Huai-Hsuan Tseng
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and
| | - Irina Falkenberg
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Carly Samson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and
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21
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Regenbogen C, Kellermann T, Seubert J, Schneider DA, Gur RE, Derntl B, Schneider F, Habel U. Neural responses to dynamic multimodal stimuli and pathology-specific impairments of social cognition in schizophrenia and depression. Br J Psychiatry 2015; 206:198-205. [PMID: 25573396 DOI: 10.1192/bjp.bp.113.143040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Individuals with schizophrenia and people with depression both show abnormal behavioural and neural responses when perceiving and responding to emotional stimuli, but pathology-specific differences and commonalities remain mostly unclear. AIMS To directly compare empathic responses to dynamic multimodal emotional stimuli in a group with schizophrenia and a group with depression, and to investigate their neural correlates using functional magnetic resonance imaging (fMRI). METHOD The schizophrenia group (n = 20), the depression group (n = 24) and a control group (n = 24) were presented with portrait-shot video clips expressing emotion through three possible communication channels: facial expression, prosody and content. Participants rated their own and the actor's emotional state as an index of empathy. RESULTS Although no group differences were found in empathy ratings, characteristic differences emerged in the fMRI activation patterns. The schizophrenia group demonstrated aberrant activation patterns during the neutral speech content condition in regions implicated in multimodal integration and formation of semantic constructs. Those in the depression group were most affected during conditions with trimodal emotional and trimodal neutral stimuli, in key regions of the mentalising network. CONCLUSIONS Our findings reveal characteristic differences in patients with schizophrenia compared with those with depression in their cortical responses to dynamic affective stimuli. These differences indicate that impairments in responding to emotional stimuli may be caused by pathology-specific problems in social cognition.
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Affiliation(s)
- Christina Regenbogen
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
| | - Thilo Kellermann
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
| | - Janina Seubert
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
| | - Daniel A Schneider
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
| | - Raquel E Gur
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
| | - Birgit Derntl
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
| | - Frank Schneider
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
| | - Ute Habel
- Christina Regenbogen, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; Thilo Kellermann, Dr. rer. medic., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Janina Seubert, Dr. rer. medic., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Daniel A. Schneider, MSc, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany; Raquel E. Gur, MD, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Birgit Derntl, Dr. rer. nat., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen and JARA Translational Brain Medicine, Jülich, Germany; Frank Schneider, MD, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, JARA Translational Brain Medicine, Jülich, Germany, and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ute Habel, Dr. rer. soc., Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, and JARA Translational Brain Medicine, Jülich, Germany
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Abstract
Patients with schizophrenia not only suffer from prototypical psychotic symptoms such as delusions and hallucinations and from cognitive deficits, but also from tremendous deficits in social functioning. However, little is known about the interplay between the cognitive and the social-cognitive deficits in schizophrenia. Our chapter gives an overview on behavioral, as well as functional imaging studies on social cognition in schizophrenia. Main findings on cognitive and motivational deficits in schizophrenia are reviewed and introduced within the context of the dopamine hypothesis of schizophrenia. The reviewed findings suggest that disturbed "social brain" functioning in schizophrenia, depending on the specific context, can either lead to a neglect of the emotions and intentions of others or to the false attribution of these emotions and intentions in an emotionally neutral social content. We integrate these findings with the current knowledge about aberrant dopaminergic firing in schizophrenia by presenting a comprehensive model explaining core symptoms of the disorder. The main implication of the presented model is that neither cognitive-motivational, nor social-cognitive deficits alone cause schizophrenia symptoms, but that symptoms only emerge by the interplay of disturbed social brain functioning with aberrant dopaminergic firing.
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Mitchell RLC, Rossell SL. Perception of emotion-related conflict in human communications: what are the effects of schizophrenia? Psychiatry Res 2014; 220:135-44. [PMID: 25149130 DOI: 10.1016/j.psychres.2014.07.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 11/18/2022]
Abstract
Our ability to make sense of emotional cues is of paramount importance for understanding state of mind and communicative intent. However, emotional cues often conflict with each other; this presents a significant challenge for people with schizophrenia. We conducted a theoretical review to determine the extent and types of impaired processing of emotion-related conflict in schizophrenia; we evaluated the relationship with medication and symptoms, and considered possible mediatory mechanisms. The literature established that people with schizophrenia demonstrated impaired function: (i) when passively exposed to emotion cues whilst performing an unrelated task, (ii) when selectively attending to one source of emotion cues whilst trying to ignore interference from another source, and (iii) when trying to resolve conflicting emotion cues and judge meta-communicative intent. These deficits showed associations with both negative and positive symptoms. There was limited evidence for antipsychotic medications attenuating impaired emotion perception when there are conflicting cues, with further direct research needed. Impaired attentional control and context processing may underlie some of the observed impairments. Neuroanatomical correlates are likely to involve interhemispheric transfer via the corpus callosum, limbic regions such as the amygdala, and possibly dorsolateral prefrontal and anterior cingulate cortex through their role in conflict processing.
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Affiliation(s)
- Rachel L C Mitchell
- Centre for Affective (PO Box 72), Department of Psychological Medicine, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK.
| | - Susan L Rossell
- Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Melbourne, Victoria, Australia
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24
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Abstract
Perception, cognition, and emotion do not operate along segregated pathways; rather, their adaptive interaction is supported by various sources of evidence. For instance, the aesthetic appraisal of powerful mood inducers like music can bias the facial expression of emotions towards mood congruency. In four experiments we showed similar mood-congruency effects elicited by the comfort/discomfort of body actions. Using a novel Motor Action Mood Induction Procedure, we let participants perform comfortable/uncomfortable visually-guided reaches and tested them in a facial emotion identification task. Through the alleged mediation of motor action induced mood, action comfort enhanced the quality of the participant’s global experience (a neutral face appeared happy and a slightly angry face neutral), while action discomfort made a neutral face appear angry and a slightly happy face neutral. Furthermore, uncomfortable (but not comfortable) reaching improved the sensitivity for the identification of emotional faces and reduced the identification time of facial expressions, as a possible effect of hyper-arousal from an unpleasant bodily experience.
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25
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Abstract
Impulsivity, risk-taking behavior, and elevated stress responsivity are prominent symptoms of mania, a behavioral state common to schizophrenia and bipolar disorder. Though inflammatory processes activated within the brain are involved in the pathophysiology of both disorders, the specific mechanisms by which neuroinflammation drives manic behavior are not well understood. Serotonin cell bodies originating within the dorsal raphe (DR) play a major role in the regulation of behavioral features characteristic of mania. Therefore, we hypothesized that the link between neuroinflammation and manic behavior may be mediated by actions on serotonergic neurocircuitry. To examine this, we induced local neuroinflammation in the DR by viral delivery of Cre recombinase into interleukin (IL)-1β(XAT) transgenic male and female mice, resulting in overexpressing of the proinflammatory cytokine, IL-1β. For assertion of brain-region specificity of these outcomes, the prefrontal cortex (PFC), as a downstream target of DR serotonergic projections, was also infused. Inflammation within the DR, but not the PFC, resulted in a profound display of manic-like behavior, characterized by increased stress-induced locomotion and responsivity, and reduced risk-aversion/fearfulness. Microarray analysis of the DR revealed a dramatic increase in immune-related genes, and dysregulation of genes important in GABAergic, glutamatergic, and serotonergic neurotransmission. Behavioral and physiological changes were driven by a loss of serotonergic neurons and reduced output as measured by high-performance liquid chromatography, demonstrating inflammation-induced serotonergic hypofunction. Behavioral changes were rescued by acute selective serotonin reuptake inhibitor treatment, supporting the hypothesis that serotonin dysregulation stemming from neuroinflammation in the DR underlies manic-like behaviors.
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26
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Mier D, Lis S, Zygrodnik K, Sauer C, Ulferts J, Gallhofer B, Kirsch P. Evidence for altered amygdala activation in schizophrenia in an adaptive emotion recognition task. Psychiatry Res 2014; 221:195-203. [PMID: 24434194 DOI: 10.1016/j.pscychresns.2013.12.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 06/29/2013] [Accepted: 12/03/2013] [Indexed: 01/05/2023]
Abstract
Deficits in social cognition seem to present an intermediate phenotype for schizophrenia, and are known to be associated with an altered amygdala response to faces. However, current results are heterogeneous with respect to whether this altered amygdala response in schizophrenia is hypoactive or hyperactive in nature. The present study used functional magnetic resonance imaging to investigate emotion-specific amygdala activation in schizophrenia using a novel adaptive emotion recognition paradigm. Participants comprised 11 schizophrenia outpatients and 16 healthy controls who viewed face stimuli expressing emotions of anger, fear, happiness, and disgust, as well as neutral expressions. The adaptive emotion recognition approach allows the assessment of group differences in both emotion recognition performance and associated neuronal activity while also ensuring a comparable number of correctly recognized emotions between groups. Schizophrenia participants were slower and had a negative bias in emotion recognition. In addition, they showed reduced differential activation during recognition of emotional compared with neutral expressions. Correlation analyses revealed an association of a negative bias with amygdala activation for neutral facial expressions that was specific to the patient group. We replicated previous findings of affected emotion recognition in schizophrenia. Furthermore, we demonstrated that altered amygdala activation in the patient group was associated with the occurrence of a negative bias. These results provide further evidence for impaired social cognition in schizophrenia and point to a central role of the amygdala in negative misperceptions of facial stimuli in schizophrenia.
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Affiliation(s)
- Daniela Mier
- Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany.
| | - Stefanie Lis
- Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | | | - Carina Sauer
- Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Jens Ulferts
- Justus-Liebig University of Giessen, Giessen, Germany
| | | | - Peter Kirsch
- Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
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27
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Winton-Brown TT, Fusar-Poli P, Ungless MA, Howes OD. Dopaminergic basis of salience dysregulation in psychosis. Trends Neurosci 2014; 37:85-94. [PMID: 24388426 DOI: 10.1016/j.tins.2013.11.003] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 12/30/2022]
Abstract
Disrupted salience processing is proposed as central in linking dysregulated dopamine function with psychotic symptoms. Several strands of evidence are now converging in support of this model. Animal studies show that midbrain dopamine neurons are activated by unexpected salient events. In psychotic patients, neurochemical studies have confirmed subcortical striatal dysregulation of dopaminergic neurotransmission, whereas functional magnetic resonance imaging (fMRI) studies of salience tasks have located alterations in prefrontal and striatal dopaminergic projection fields. At the clinical level, this may account for the altered sense of meaning and significance that predates the onset of psychosis. This review draws these different strands of evidence together in support of an emerging understanding of how dopamine dysregulation may lead to aberrant salience and psychotic symptoms.
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Affiliation(s)
- Toby T Winton-Brown
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, SE58AF London, UK.
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, SE58AF London, UK; OASIS Prodromal Service, South London and Maudsley (SLaM) National Health Service (NHS) Foundation Trust, London, UK
| | - Mark A Ungless
- Medical Research Council Clinical Sciences Centre, Imperial College London, London, UK
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, SE58AF London, UK; Medical Research Council Clinical Sciences Centre, Imperial College London, London, UK
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28
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A negative emotional and economic judgment bias in major depression. Eur Arch Psychiatry Clin Neurosci 2013; 263:675-83. [PMID: 23377282 DOI: 10.1007/s00406-013-0392-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 01/15/2013] [Indexed: 02/03/2023]
Abstract
Although major depression is projected to be among the top three causes of disability-adjusted life years lost in 2030, relatively little is known concerning the extent to which depressed mood states can bias social-economic decision making away from optimal outcomes. One experimental framework to study the interaction between negative emotion and social-economic decisions is the ultimatum game (UG), where the fair, cooperative player altruistically punishes the unfair, non-cooperative player. To assess a potential susceptibility of altruistic punishment to depressed mood, we repeatedly administered the UG task to a cohort of 20 currently depressed patients with a diagnosis of recurrent major depressive disorder and 20 healthy controls. Furthermore, valence and arousal ratings of emotionally laden pictures were obtained from all participants in order to assess a depressed mood-related distortion of emotion judgments. Compared to healthy controls, depressed patients over-sanctioned unfair proposals in the UG and judged emotional stimuli too negatively. Thus, major depression is associated with a negative emotional bias that hampers social-economic decision making and produces large personal costs.
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29
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Bjorkquist OA, Herbener ES. Social perception in schizophrenia: evidence of temporo-occipital and prefrontal dysfunction. Psychiatry Res 2013; 212:175-82. [PMID: 23642469 DOI: 10.1016/j.pscychresns.2012.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 12/16/2012] [Accepted: 12/20/2012] [Indexed: 11/16/2022]
Abstract
Individuals with schizophrenia evidence deficits in social functioning such as difficulties in communication, maintaining employment, and functioning as a member of the community. Impairment in such functions has been linked with higher order social cognitive deficits, which, in turn, have been associated with abnormal brain function. However, it is unclear whether brain abnormalities are found specifically for higher order social cognitive functioning, or whether "lower order" social processing, such as perceiving social stimuli, might demonstrate abnormalities at the neural level. The current study used functional magnetic resonance imaging to explore the neural correlates of social perception in schizophrenia. Individuals with schizophrenia (n=14) and healthy comparison participants (n=14) viewed social (i.e., faces, people) and nonsocial (i.e., scenes, objects) images that varied in affective content (emotional, neutral). Schizophrenia patients showed decreased brain activation, compared to controls, in occipital and temporal regions associated with early visual processing, as well as increased cingulate activity, in response to emotional social relative to nonsocial images. Results indicate aberrant neural response during early stages of visual processing of social information, which may contribute to higher order social cognitive deficits characteristic of this population.
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Affiliation(s)
- Olivia A Bjorkquist
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Looking at the other side of the coin: a meta-analysis of self-reported emotional arousal in people with schizophrenia. Schizophr Res 2012; 142:65-70. [PMID: 23040736 PMCID: PMC3502689 DOI: 10.1016/j.schres.2012.09.005] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 09/02/2012] [Accepted: 09/05/2012] [Indexed: 11/22/2022]
Abstract
Abnormalities in emotional experience have long been viewed as core features of schizophrenia. Numerous studies indicate that people with schizophrenia report less pleasure than controls when reporting non-current feelings using trait, hypothetical, prospective, and retrospective emotional self-report formats; however, current research has demonstrated that schizophrenia patients and controls do not differ in their subjective reactions to emotional stimuli in most laboratory studies. Although substantial attention has been paid to studies examining self-reported valence in schizophrenia, subjective reports of arousal in response to affective stimuli have been neglected. Understanding the role of arousal in schizophrenia is imperative given that valence and arousal are differentially associated with physiological and behavioral responses. To understand the role of self-reported arousal, a meta-analysis of 26 published studies employing laboratory emotion induction paradigms in patients with schizophrenia and healthy controls was conducted. Medline, PsycINFO, Web of Science, and PubMed electronic databases and reference lists from identified articles were used as data sources. Using a random effects model, analyses demonstrated that controls and people with schizophrenia reported similar levels of subjective arousal in response to pleasant and unpleasant stimuli; however, people with schizophrenia reported experiencing greater arousal than controls in response to neutral stimuli. Furthermore, moderator analyses suggested that gender and methodological factors, such as rating scale and stimulus type, may affect these patterns of results and play a key role in determining whether patients and controls differ in self-reported arousal.
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31
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Yan C, Cao Y, Zhang Y, Song LL, Cheung EFC, Chan RCK. Trait and state positive emotional experience in schizophrenia: a meta-analysis. PLoS One 2012; 7:e40672. [PMID: 22815785 PMCID: PMC3399884 DOI: 10.1371/journal.pone.0040672] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 06/12/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Prior meta-analyses indicated that people with schizophrenia show impairment in trait hedonic capacity but retain their state hedonic experience (valence) in laboratory-based assessments. Little is known about what is the extent of differences for state positive emotional experience (especially arousal) between people with schizophrenia and healthy controls. It is also not clear whether negative symptoms and gender effect contribute to the variance of positive affect. METHODS AND FINDINGS The current meta-analysis examined 21 studies assessing state arousal experience, 40 studies measuring state valence experience, and 47 studies assessing trait hedonic capacity in schizophrenia. Patients with schizophrenia demonstrated significant impairment in trait hedonic capacity (Cohen's d = 0.81). However, patients and controls did not statistically differ in state hedonic (valence) as well as exciting (arousal) experience to positive stimuli (Cohen's d = -0.24 to 0.06). They also reported experiencing relatively robust state aversion and calmness to positive stimuli compared with controls (Cohen's d = 0.75, 0.56, respectively). Negative symptoms and gender contributed to the variance of findings in positive affect, especially trait hedonic capacity in schizophrenia. CONCLUSIONS Our findings suggest that schizophrenia patients have no deficit in state positive emotional experience but impairment in "noncurrent" hedonic capacity, which may be mediated by negative symptoms and gender effect.
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Affiliation(s)
- Chao Yan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Graduate School, Chinese Academy of Sciences, Beijing, China
| | - Yuan Cao
- Department of Applied Social Studies, City University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yang Zhang
- College of Life Science and Bio-engineering, Beijing University of Technology, Beijing, China
| | - Li-Ling Song
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Eric F. C. Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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