How culture shapes social cognition deficits in mental disorders: A review

Happiness Maximization Is a WEIRD Way of Living

Psychological science tends to treat subjective well-being and happiness synonymously. We start from the assumption that subjective well-being is more than being happy to ask the fundamental question: What is the ideal level of happiness? From a cross-cultural perspective, we propose that the idealization of attaining maximum levels of happiness may be especially characteristic of Western, educated, industrial, rich, and democratic (WEIRD) societies but less so for others. Searching for an explanation for why "happiness maximization" might have emerged in these societies, we turn to studies linking cultures to their eco-environmental habitat. We discuss the premise that WEIRD cultures emerged in an exceptionally benign ecological habitat (i.e., faced relatively light existential pressures compared with other regions). We review the influence of the Gulf Stream on the Northwestern European climate as a source of these comparatively benign geographical conditions. We propose that the ecological conditions in which WEIRD societies emerged afforded them a basis to endorse happiness as a value and to idealize attaining its maximum level. To provide a nomological network for happiness maximization, we also studied some of its potential side effects, namely alcohol and drug consumption and abuse and the prevalence of mania. To evaluate our hypothesis, we reanalyze data from two large-scale studies on ideal levels of personal life satisfaction-the most common operationalization of happiness in psychology-involving respondents from 61 countries. We conclude that societies whose members seek to maximize happiness tend to be characterized as WEIRD, and generalizing this across societies can prove problematic if adopted at the ideological and policy level.

Gaps in clinical research in frontotemporal dementia: A call for diversity and disparities-focused research

Frontotemporal dementia (FTD) is one of the leading causes of dementia before age 65 and often manifests as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). FTD's exact clinical presentation varies by culture, language, education, social norms, and other socioeconomic factors; current research and clinical practice, however, is mainly based on studies conducted in North America and Western Europe. Changes in diagnostic criteria and procedures as well as new or adapted cognitive tests are likely needed to take into consideration global diversity. This perspective paper by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment examines how increasing global diversity impacts the clinical presentation, screening, assessment, and diagnosis of FTD and its treatment and care. It subsequently provides recommendations to address immediate needs to advance global FTD research and clinical practice.

Mentalising and depression: a mini-review on behavior, neural substrates, and treatment options

Major depression is one of the most common mental disorders, affecting millions of people around the globe. In recent years, researchers increasingly investigated social cognition in depression and discovered pronounced alterations. A special focus has been put on mentalising or Theory of Mind, the ability to recognize and understand another person's thoughts and feelings. While there is behavioral evidence for deficits in this ability in patients with depression as well as specialized therapeutic interventions, the neuroscientific substrates are only beginning to be understood. In this mini-review, we take a social neuroscience perspective to analyse the importance of altered mentalising in depression and whether it can help to understand the origins and perpetuation of the disorder. We will put a special focus on treatment options and corresponding neural changes to identify relevant paths for future (neuroscientific) research.

Do subtle cultural differences sculpt face pareidolia?

Face tuning to non-face images such as shadows or grilled toasts is termed face pareidolia. Face-pareidolia images represent a valuable tool for investigation of social cognition in mental disorders. Here we examined (i) whether, and, if so, how face pareidolia is affected by subtle cultural differences; and (ii) whether this impact is modulated by gender. With this purpose in mind, females and males from Northern Italy were administered a set of Face-n-Thing images, photographs of objects such as houses or waves to a varying degree resembling a face. Participants were presented with pareidolia images with canonical upright orientation and display inversion that heavily affects face pareidolia. In a two-alternative forced-choice paradigm, beholders had to indicate whether each image resembled a face. The outcome was compared with the findings obtained in the Southwest of Germany. With upright orientation, neither cultural background nor gender affected face pareidolia. As expected, display inversion generally mired face pareidolia. Yet, while display inversion led to a drastic reduction of face impression in German males as compared to females, in Italians, no gender differences were found. In a nutshell, subtle cultural differences do not sculpt face pareidolia, but instead affect face impression in a gender-specific way under unusual viewing conditions. Clarification of the origins of these effects requires tailored brain imaging work. Implications for transcultural psychiatry, in particular, for schizophrenia research, are highlighted and discussed.

Combining Neuropsychological Assessment with Neuroimaging to Distinguish Early-Stage Alzheimer's Disease from Frontotemporal Lobar Degeneration in Non-Western Tonal Native Language-Speaking Individuals Living in Taiwan: A Case Series

Neuropsychological tests (NPTs), which are routinely used in clinical practice for assessment of dementia, are also considered to be essential for differential diagnosis of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD), especially the behavioral variants of frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA) at their initial clinical presentations. However, the heterogeneous features of these diseases, which have many overlapping signs, make differentiation between AD and FTLD highly challenging. Moreover, NPTs were primarily developed in Western countries and for native speakers of non-tonal languages. Hence, there is an ongoing dispute over the validity and reliability of these tests in culturally different and typologically diverse language populations. The purpose of this case series was to examine which of the NPTs adjusted for Taiwanese society may be used to distinguish these two diseases. Since AD and FTLD have different effects on individuals' brain, we combined NPTs with neuroimaging. We found that participants diagnosed with FTLD had lower scores in NPTs assessing language or social cognition than AD participants. PPA participants also had lower measures in the Free and Cued Selective Reminding Test than those diagnosed with bvFTD, while bvFTD participants showed poorer performances in the behavioral measures than PPA participants. In addition, the initial diagnosis was supported by the standard one-year clinical follow-up.

Expanding the scope, reach, and impact of evidence-based psychological treatments

The development and evaluation of evidence-based treatments (EBTs) for mental disorders represent an enormous advance with continued progress designed to understand the techniques and increase their use in clinical practice. This article suggests ways of expanding research along several fronts including the extension of the types of randomized controlled trials that are conducted, the use of more diverse samples to encompass different cultures and countries, the expansion of assessments to better reflect client functioning in everyday life, consideration of the impact of treatments for mental disorders on physical health, the careful evaluation of exceptional responders, the use of mixed-methods research, and the development of versions of EBTs that can be scaled. EBTs have been studied in well-controlled settings and extended to clinical settings, albeit less often. The least attention has been accorded their evaluation on a large scale to reach a greater portion of people in need of services but who do not receive any treatment.

Good Performance of the Chinese Version of Mini Social Cognition and Emotional Assessment in the Early Diagnosis of Behavioral Variant Frontotemporal Dementia

Social cognition impairment has been recognized as an early and characteristic change in behavioral variant frontotemporal dementia (bvFTD). The Mini Social Cognition and Emotional Assessment (mini-SEA) is a clinical tool to rapidly evaluate social cognition. In this study, we explored the diagnostic value of social cognition by assessing the Chinese version of the mini-SEA and other standard neuropsychological tests in 22 patients with mild bvFTD, 26 patients with mild Alzheimer's disease (AD), including mild cognitive impairment (MCI) and mild dementia, and 30 control subjects. The discriminatory powers of these tests were evaluated and compared using the receiver operating characteristic curve (ROC). The mini-SEA scores of the bvFTD patients were significantly lower than those of the controls (Z = –6.850, adjusted P < 0.001) and AD patients (Z = –3.737, adjusted P = 0.001). ROC analysis showed that the mini-SEA had a high discriminatory power for differentiating bvFTD from the controls, with an area under the curve (AUC) value of 0.989 (95% CI = 0.905-1.000, P < 0.001). The AUC value of the mini-SEA for differentiating bvFTD from AD was 0.899 (95% CI = 0.777-0.967, P < 0.001), higher than that of the Auditory Verbal Learning Test Delayed Recall (AUC = 0.793), Boston Naming Test (AUC = 0.685) or Frontal Assessment Battery (AUC = 0.691). The Chinese version of mini-SEA is a good clinical tool for the early diagnosis of bvFTD, and has a high sensitivity and specificity to discriminate bvFTD from AD.

The conceptualization and assessment of social cognition in personality and common mental disorders

Social Cognition is a crucial transdiagnostic construct with clinical and functional relevance across a range of neuropsychiatric disorders. Most research has focused on schizophrenia and autism spectrum disorders and has informed frameworks for assessing social cognition in schizophrenia. The current review focuses on the more recent developments pertaining to personality and common mental disorders (PCMDs). Two main questions are addressed: 1. What are the important domains and patterns of social cognition impairments among the personality and common mental disorders? 2. What are the trends in the assessment of social cognition among personality and common mental disorders? We synthesize research findings on the conceptualization of SC and the application of these frameworks for assessment with PCMDs. We have outlined a typology of criteria and guidelines for selecting and developing measures of SC in the PCMDs. We conclude that there is a need for a reconceptualization of social cognition or PCMDs with a focus on higher-order processes and suggest that mentalization could be a suitable framework to understand and examine social cognition in the PCMDs. Future efforts to develop, adapt and use more complex, nuanced, sensitive, and culturally valid measures of social cognition in interpersonal contexts can aid the detection of subtle, context-dependent, and dynamic impairments across these disorders. Social cognition is a promising transdiagnostic construct and warrants more conceptual clarity and research on the varied patterns of impairments across disorders.

Gray matter volume reductions in patients with schizophrenia: A replication study across two cultural backgrounds

Structural gray matter (GM) volume reductions in patients with schizophrenia have rarely been replicated across two different sites, the impact of culture and clinical characteristics remains unresolved. Hence, we assessed GM volume reductions in patients with schizophrenia using 3 T magnetic resonace imaging to replicate results across two independent and culturally different backgrounds (Germany, Japan), and to investigate the impact of brain volume reductions on clinical characteristics. In total, 163 German (80 patients) and 203 Japanese (83 patients) participants were included in the analysis. Voxel-based morphometry (VBM) was used to investigate structural differences between the groups and across the two sites, comparing local GM volumes. Clinical variables were used to analyze effects unrelated to the socio-cultural background. Across both data sets, widespread GM reductions in frontal and temporal cortical parts were found between patients and controls, indicating strong effects of diagnosis and only small effects of site. The investigation of clinical characteristics revealed the strongest effects for chlorpromazine equivalents on GM volume reductions primarily in the Japanese sample. Although the effects of site are small, several brain regions do not overlap between the two groups. Thus, GM may be affected differently at the two sites in patients with schizophrenia.

Even subtle cultural differences affect face tuning

Culture shapes social cognition in many ways. Yet cultural impact on face tuning remains largely unclear. Here typically developing females and males from the French-speaking part of Switzerland were presented with a set of Arcimboldo-like Face-n-Food images composed of food ingredients and in different degree resembling a face. The outcome had been compared with previous findings obtained in young adults of the South-West Germany. In that study, males exhibit higher thresholds for face tuning on the Face-n-Food task than females. In Swiss participants, no gender differences exist in face tuning. Strikingly, males from the French-speaking part of Switzerland possess higher sensitivity to faces than their German peers, whereas no difference in face tuning occurs between females. The outcome indicates that even relatively subtle cultural differences as well as culture by gender interaction can modulate social cognition. Clarification of the nature of cultural impact on face tuning as well as social cognition at large is of substantial value for understanding a wide range of neuropsychiatric and neurodevelopmental conditions.

Cross-cultural and hemispheric laterality effects on the ensemble coding of emotion in facial crowds

In many social situations, we make a snap judgment about crowds of people relying on their overall mood (termed "crowd emotion"). Although reading crowd emotion is critical for interpersonal dynamics, the sociocultural aspects of this process have not been explored. The current study examined how culture modulates the processing of crowd emotion in Korean and American observers. Korean and American (non-East Asian) participants were briefly presented with two groups of faces that were individually varying in emotional expressions and asked to choose which group between the two they would rather avoid. We found that Korean participants were more accurate than American participants overall, in line with the framework on cultural viewpoints: Holistic versus analytic processing in East Asians versus Westerners. Moreover, we found a speed advantage for other-race crowds in both cultural groups. Finally, we found different hemispheric lateralization patterns: American participants were more accurate to perceive the facial crowd to be avoided when it was presented in the left visual field than the right visual field, indicating a right hemisphere advantage for processing crowd emotion of both European American and Korean facial crowds. However, Korean participants showed weak or nonexistent laterality effects, with a slight right hemisphere advantage for European American facial crowds and no advantage in perceiving Korean facial crowds. Instead, Korean participants showed positive emotion bias for own-race faces. This work suggests that culture plays a role in modulating our crowd emotion perception of groups of faces and responses to them.

Dynamic Changes in Amygdala Psychophysiological Connectivity Reveal Distinct Neural Networks for Facial Expressions of Basic Emotions

The quest to characterize the neural signature distinctive of different basic emotions has recently come under renewed scrutiny. Here we investigated whether facial expressions of different basic emotions modulate the functional connectivity of the amygdala with the rest of the brain. To this end, we presented seventeen healthy participants (8 females) with facial expressions of anger, disgust, fear, happiness, sadness and emotional neutrality and analyzed amygdala's psychophysiological interaction (PPI). In fact, PPI can reveal how inter-regional amygdala communications change dynamically depending on perception of various emotional expressions to recruit different brain networks, compared to the functional interactions it entertains during perception of neutral expressions. We found that for each emotion the amygdala recruited a distinctive and spatially distributed set of structures to interact with. These changes in amygdala connectional patters characterize the dynamic signature prototypical of individual emotion processing, and seemingly represent a neural mechanism that serves to implement the distinctive influence that each emotion exerts on perceptual, cognitive, and motor responses. Besides these differences, all emotions enhanced amygdala functional integration with premotor cortices compared to neutral faces. The present findings thus concur to reconceptualise the structure-function relation between brain-emotion from the traditional one-to-one mapping toward a network-based and dynamic perspective.