Social functioning in major depressive disorder. Neurosci Biobehav Rev. 2016;69:313-332. [PMID: 27395342 DOI: 10.1016/j.neubiorev.2016.07.002]

Youth's school experience: Testing the role of symptoms of anxiety and co-occurring symptoms of depression

Although symptoms of anxiety often coexist with symptoms of depression, little is known on how such coexistence affects youth's school experiences.

OBJECTIVES

We tested how the two types of behaviors, when coexisting, were associated with youth's negative attitude toward teachers, school, and poor peer relations.

METHOD

Data were collected from 203 ethnically and socioeconomically diverse youth (male: 24.6%; mean = 15.8 years, standard deviation = 2.4) with the 3rd edition of the Behavioral Assessment for Children: Self-Report of Personality.

RESULTS

Scores for symptoms of depression alone explained negative attitude toward teachers (β = .28; R²  = 17.88%), negative attitude toward school (β = .27; R²  = 14.74%), and poor peer relations (β = .42; R²  = 44.60%) as effectively as scores for both types of behaviors did.

CONCLUSION

The coexistence of symptoms of anxiety and depression did not appear to impair youth's attitude toward teachers, school and peer relations more than symptoms of depression did alone.

Study protocol for a parallel-group, double-blinded, randomized, controlled, noninferiority trial: the effect and safety of hybrid electroconvulsive therapy (Hybrid-ECT) compared with routine electroconvulsive therapy in patients with depression

BACKGROUND

Electroconvulsive therapy (ECT) is the most rapid and effective treatment for patients with depression, ECT can achieve remarkable antidepressant effects in the initial 3-4 sessions, but significant side effects limit its use. However, recent low-charge electrotherapy (LCE) studies have demonstrated antidepressant or antipsychotic effects with significantly fewer side effects. The aim of this study is to propose a novel two-step charge set strategy for ECT treatment, referred to as Hybrid-ECT, to decrease side effects by using a low charge while preserving treatment efficacy.

METHODS/DESIGN

A randomized, double-blinded, standard-controlled, parallel-group design will be carried out. We plan to enroll 112 inpatients diagnosed with depression (unipolar or bipolar) and randomly assign them to conventional ECT (control group) or to Hybrid-ECT (treatment group, 3 ECT sessions followed by LCE sessions (approximately 2.8 joules per session)). We will evaluate participants across a wide variety of domains including clinical symptoms, cognitive, psychological and functional metrics. We will also perform magnetic resonance imaging (MRI) and event-related potential (ERPs) assessments during treatment to explore brain function differences between ECT and LCE.

DISCUSSION

This research proposes a simple but completely novel ECT strategy that aims to rapidly relieve depressive symptoms and minimize side effects. The mechanism of ECT and LCE will be further discussed.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, Number: ChiCTR1900022905 (Registration date: April 30, 2019).

Event-related potentials to task-irrelevant sad faces as a state marker of depression

Negative bias in face processing has been demonstrated in depression, but there are no longitudinal investigations of negative bias in symptom reduction. We recorded event-related potentials (P1 and N170) to task-irrelevant facial expressions in depressed participants who were later provided with a psychological intervention and in never depressed control participants. Follow-up measurements were conducted for the depressed group two and 39 months later. Negative bias was found specifically in the depression group, and was demonstrated as enlarged P1 amplitude to sad faces, which normalized in the follow-up measurements when the participants had fewer symptoms. Because the P1 amplitude recorded at the baseline did not differ between the depression group that recovered and the group that did not recover after the intervention, this brain response did not show potential as a biomarker for treatment response. It could have potential, however, to serve as a state-marker of depression.

Neurocognitive Adaptation and Mental Health Vulnerability Following Maltreatment: The Role of Social Functioning

Childhood maltreatment is associated with a lifetime increase in risk of mental health disorder. We propose that such vulnerability may stem in large part from altered patterns of social functioning. Here, we highlight key findings from the psychological and epidemiological literature indicating that early maltreatment experience compromises social functioning and attenuates social support in ways that increase mental health vulnerability. We then review the extant neuroimaging studies of children and adolescents, focusing on three domains implicated in social functioning: threat processing, reward processing, and emotion regulation. We discuss how adaptations in these domains may increase latent vulnerability to mental health problems by impacting on social functioning via increased stress susceptibility as well as increased stress generation. Finally, we explore how computational psychiatry approaches, alongside systematically reported measures of social functioning, can complement studies of neural function in the creation of a mechanistic framework aimed at informing approaches to prevention and intervention.

Individual differences in social network size linked to nucleus accumbens and hippocampal volumes in functional neurological disorder: A pilot study

BACKGROUND

In the biopsychosocial formulation of functional neurological (conversion) disorder (FND), little is known about relationships between social behavior and brain anatomy. We hypothesized that social behavior would relate to brain areas implicated in affiliative behaviors and that social network size would correlate with symptom severity and predisposing vulnerabilities in FND.

METHODS

This neuroimaging pilot probed how social network size, as measured by the Social Network Index, related to structural brain profiles in 23 patients with motor FND (15 woman and 8 men). FreeSurfer cortical thickness and subcortical volumetric analyses were performed correcting for multiple comparisons. Stratified analyses compared FND patients with a low social network size to matched healthy controls. Secondary exploratory analyses in an expanded sample of 38 FND patients investigated relationships between social network size, risk factors and patient-reported symptom severity.

RESULTS

Adjusting for age and gender, neuroimaging analyses showed that social network size positively correlated with left nucleus accumbens and hippocampal volumes in patients with FND; stratified analyses did not show any group-level differences. In individuals with FND, social network size correlated with health-related quality of life, graduating college, working full-time and a non-epileptic seizure diagnosis; social network size inversely related to lifetime trauma burden, post-traumatic stress disorder severity and age.

LIMITATIONS

Only patient-reported scales were used and social network size information was not collected for healthy subjects.

CONCLUSIONS

This neuroimaging pilot adds to the literature linking affiliation network brain areas to pro-social behaviors and enhances the biopsychosocial conceptualization of FND.

Comparative Analysis of Spouse’s Burden and Quality of Life in Major Depressive Disorder and Bipolar I Disorder

Background:

Spouses of patients with bipolar disorder may experience a different quality of life and burden than seen with major depressive disorder.

Objective:

This study was conducted to comparatively analyse spouse’s burden and quality of life in major depressive and bipolar disorders.

Methods:

This cross-sectional study was conducted on 220 spouses of patients with major depressive and bipolar disorders in the city of Hamadan in Iran, in 2018. Data collection tools included Zarit Burden and QOL-BREF questionnaires. Data were analyzed by a t-test using SPSS -16.

Results:

The findings showed that 11.8% of spouses of patients with depression and 85.5% of spouses of patients with bipolar disorder experienced severe burden (P < 0.001). The quality of life of spouses of patients with bipolar disorder was lower than with depressive disorder (P < 0.05). In both the groups, a negative correlation was found between burden and QOL.

Conclusion:

The spouses of patients with bipolar disorder experience more burden and lower quality of life than depression. In both the groups, burden has a negative impact on the quality of life. Professional help and supportive intervention can be provided to the spouses of patients with major depressive and bipolar I disorders to reduce their burden, strengthen their coping skill and thus improve their QOL.

Neurophysiological and Psychological Predictors of Social Functioning in Patients with Schizophrenia and Bipolar Disorder

OBJECTIVE

The aim of this study is to examine social functioning in patients with schizophrenia and bipolar disorder and explore the psychological and neurophysiological predictors of social functioning.

METHODS

Twenty-seven patients with schizophrenia and thirty patients with bipolar disorder, as well as twenty-five healthy controls, completed measures of social functioning (questionnaire of social functioning), neurocognition (Verbal fluency, Korean-Auditory Verbal Learning Test), and social cognition (basic empathy scale and Social Attribution Task-Multiple Choice), and the childhood trauma questionnaire (CTQ). For neurophysiological measurements, mismatch negativity and heart rate variability (HRV) were recorded from all participants. Multiple hierarchical regression was performed to explore the impact of factors on social functioning.

RESULTS

The results showed that CTQ-emotional neglect significantly predicted social functioning in schizophrenia group, while HRV-high frequency significantly predicted social functioning in bipolar disorder patients. Furthermore, emotional neglect and HRV-HF still predicted social functioning in all of the subjects after controlling for the diagnostic criteria.

CONCLUSION

Our results implicated that even though each group has different predictors of social functioning, early traumatic events and HRV could be important indicators of functional outcome irrespective of what group they are.

Psychological burden of PTSD, depression, and their comorbidity in the U.S. veteran population: Suicidality, functioning, and service utilization

BACKGROUND

Emerging evidence suggests that comorbid posttraumatic stress disorder (PTSD) and major depressive disorder (PTSD/MDD) may impose an even greater burden than either disorder alone. However, nearly all previous studies examining these associations have relied on treatment-seeking samples. This study examined the mental health burden associated with co-occurring PTSD/MDD compared to PTSD and MDD alone using a nationally representative sample of U.S. veterans.

METHODS

Data were analyzed from National Health and Resilience in Veterans Study, a nationally representative survey of U.S. veterans (n = 2,732). Analyses (a) estimated the current prevalence of PTSD only, MDD only, and comorbid PTSD/MDD; (b) compared demographic/military variables by PTSD/MDD status; and (c) examined associations between PTSD/MDD status and suicidality, functioning, psychiatric comorbidities, and service utilization.

RESULTS

The current prevalences of probable PTSD only, probable MDD only, and probable comorbid PTSD/MDD were 1.7%, 4.8%, and 3.4%. Compared to all other groups, the PTSD/MDD group was more likely to screen positive for current suicidal ideation, lifetime suicide attempts, probable generalized anxiety and social anxiety disorders, and ever utilize mental health services. They also scored lower on measures of mental health functioning (d = 1.49), cognitive functioning (d = 1.03), and quality of life (d = 0.84). Veterans with comorbid PTSD/MDD were more than twice as likely as those with PTSD only to have attempted suicide.

LIMITATIONS

The cross-sectional design of this study precludes causal inference.

CONCLUSIONS

Results provide a population-based characterization of the psychological burden of PTSD/MDD comorbidity in U.S. veterans. Findings further underscore the importance of screening, monitoring, and treatment of the comorbid manifestation of these disorders.

The association of depression, anxiety, and stress with caring for a child with Congenital Zika Syndrome in Brazil; Results of a cross-sectional study

BACKGROUND

Zika virus (ZIKV) infection in pregnancy can cause microcephaly and a wide spectrum of severe adverse outcomes, collectively called "Congenital Zika Syndrome" (CZS). Parenting a child with disabilities can have adverse mental health impacts, but these associations have not been fully explored in the context of CZS in Brazil.

METHODOLOGY/PRINCIPAL FINDINGS

A cross-sectional study was undertaken in Recife and Rio de Janeiro, including 163 caregivers of a child with CZS (cases) and 324 caregivers with an unaffected child (comparison subjects), identified from existing studies. The primary caregiver, almost always the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-DASS-21), social support (Medical Outcomes Study Social Support Scale-MOS-SSS), and socio-demographic data. Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. A high proportion of mothers reported experiencing severe or extremely severe levels of depression (18%), anxiety (27%) and stress (36%). Mothers of children with CZS were more likely to experience symptoms of depression, anxiety andstress, compared to mothers of comparison children. These associations were more apparent among mothers living in Rio de Janeiro. These differences were reduced after adjustment for socio-economic status and social support. Among mothers of children with CZS, low social support was linked to higher levels of depression, anxiety and stress, but there was no association with socio-economic status.

CONCLUSIONS/SIGNIFICANCE

Depression, anxiety and stress were very common among mothers of young children in Brazil, regardless of whether they were parenting a child with disabilities. Mothers of children with CZS may be particularly vulnerable to poor mental health, and this association may be buffered through better social support.

Social Dysfunction in Older Age and Relationships with Cognition, Depression, and Apathy: The GreatAGE Study

BACKGROUND

Most studies focused on only one measure of social dysfunction in older age, without proper validation and distinction across different dimensions including subjectivity, structural, and functional aspects.

OBJECTIVE

We sought to validate the Social Dysfunction Rating Scale (SDRS) and its factorial structure, also determining the association of SDRS with cognitive functions, global psychopathology, and social deprivation.

METHODS

The SDRS was administered to 484 Italian community-dwelling elderly, recruited in the GreatAGE study, a population-based study on aging conducted in Castellana Grotte, Bari, Southern Italy. We determined objective and subjective psychometric properties of SDRS against the gold standard evaluation of social dysfunction according to the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID-I) criterion.

RESULTS

The SDRS showed a moderate accuracy with an optimal cut-off of 26 maximized with higher sensitivity (0.74,95% CI:0.63-0.84) than specificity (0.57,95% CI:0.50-0.64). A five-factor structure was carried out and five dimensions of SDRS were identified (loneliness; social isolation; feeling of contribution/uselessness; lack of leisure activities; anxiety for the health). Education and global cognitive functions were inversely correlated to SDRS, while a direct association with global psychopathology, depression, and apathy was found. The prevalence of higher SDRS scores was major in subjects with current psychiatric disorders versus other subjects.∥Conclusion: The SDRS could be a valid instrument to capture both size and quality of social dysfunction, both in subjects with psychiatric disorders and in normal subjects. Several categories of social dysfunction differed only in the degree of health deprivation, not in social or material deprivation.

Depression and anxiety in parents of children with intellectual and developmental disabilities: A systematic review and meta-analysis

INTRODUCTION

Although caring for a child with intellectual and developmental disabilities (IDD) can have positive outcomes, parents may be at a greater risk of depression and anxiety, due to a number of associated stressors, such as increased caregiver demands and financial strain. This systematic review updates previous data, exploring the relationship between parenting a child with IDD and parental depression and anxiety.

METHODS

Five electronic databases were searched for eligible English-language articles, published between January 2004 and July 2018. All epidemiological study designs were eligible, provided the level of depression and/or anxiety was compared between parents of children (aged <18) with and without IDD. No limit was placed on geographic location. The proportion of positive associations between parenting a child with IDD and depression/anxiety were disaggregated by disability type, geographic region, and sample size. The percentage of parents at risk of moderate depression or anxiety were calculated using recognised clinical cut-off scores for each screening tool. Meta-analyses, in which pooled effect sizes of elevated depression and anxiety symptoms were calculated, were conducted across two IDD conditions, autism and cerebral palsy.

RESULTS

Of the 5,839 unique records screened, 19 studies fulfilled the inclusion criteria. The majority of studies were conducted in high-income (n = 8, 42%) or upper-middle income countries (n = 10, 53%). Of the 19 studies, 69% focused on parents of children with cerebral palsy (n = 7, 37%) or autism (n = 6, 32%). Nearly all studies found a positive association between parenting a child with IDD and depression (n = 18, 95%) and anxiety (n = 9, 90%) symptoms. Factors associated with higher levels of depression symptoms amongst parents of children with IDD included disability severity (n = 8, 78%) and lower household income (n = 4, 80%). Approximately one third (31%) of parents of children with IDD reach the clinical cut-off score for moderate depression, compared with 7% of parents of children without IDD. 31% of parents of children with IDD reach the cut-off score for moderate anxiety, compared with 14% of parents of children without IDD. The meta-analyses demonstrated moderate effect sizes for elevated depression amongst parents of children with autism and cerebral palsy.

CONCLUSIONS

Results indicate elevated levels of depressive symptoms amongst parents of children with IDD. Quality concerns amongst the existing literature support the need for further research, especially in low- and middle-income countries.

High perceived stress and social interaction behaviour among young adults. A study based on objective measures of face-to-face and smartphone interactions

Stress and mental health problems impede social functioning and may also complicate relationship formation with peers. The aim was to investigate whether high perceived stress among young adults is associated with social interaction behaviour both via face-to-face interaction and via smartphone interaction. The data was derived from the Copenhagen Network Study, where 535 first-year students (mean age 21.3, 77% male) self-reported on perceived stress at baseline and were subsequently followed for three months with continuous Bluetooth recordings of face-to-face interactions and smartphone interactions (calls and texts) measuring the network size, frequency, and duration of interactions. Logistic regression was used to assess associations between perceived stress (high/low) and social interactions adjusting for sex, age, and personality traits. Participants with high perceived stress were more likely to engage in a larger call and text network and have a higher call and text frequency compared to individuals with low perceived stress. We found a non-statistically significant tendency that participants with a high perceived stress level spend less time meeting face to face with peers. Stressed students engage in frequent smartphone interaction which may be explained by a social support seeking behaviour, or it may be that accommodating a large network via the smartphone is stress-inducing.

Depressive symptoms are associated with blunted reward learning in social contexts

Depression is characterized by a marked decrease in social interactions and blunted sensitivity to rewards. Surprisingly, despite the importance of social deficits in depression, non-social aspects have been disproportionally investigated. As a consequence, the cognitive mechanisms underlying atypical decision-making in social contexts in depression are poorly understood. In the present study, we investigate whether deficits in reward processing interact with the social context and how this interaction is affected by self-reported depression and anxiety symptoms in the general population. Two cohorts of subjects (discovery and replication sample: N = 50 each) took part in an experiment involving reward learning in contexts with different levels of social information (absent, partial and complete). Behavioral analyses revealed a specific detrimental effect of depressive symptoms-but not anxiety-on behavioral performance in the presence of social information, i.e. when participants were informed about the choices of another player. Model-based analyses further characterized the computational nature of this deficit as a negative audience effect, rather than a deficit in the way others' choices and rewards are integrated in decision making. To conclude, our results shed light on the cognitive and computational mechanisms underlying the interaction between social cognition, reward learning and decision-making in depressive disorders.

Targeting opioid dysregulation in depression for the development of novel therapeutics

Since the serendipitous discovery of the first class of modern antidepressants in the 1950's, all pharmacotherapies approved by the Food and Drug Administration for major depressive disorder (MDD) have shared a common mechanism of action, increased monoaminergic neurotransmission. Despite the widespread availability of antidepressants, as many as 50% of depressed patients are resistant to these conventional therapies. The significant length of time required to produce meaningful symptom relief with these medications, 4-6 weeks, indicates that other mechanisms are likely involved in the pathophysiology of depression which may yield more viable targets for drug development. For decades, no viable candidate target with a different mechanism of action to that of conventional therapies proved successful in clinical studies. Now several exciting avenues for drug development are under intense investigation. One of these emerging targets is modulation of endogenous opioid tone. This review will evaluate preclinical and clinical evidence pertaining to opioid dysregulation in depression, focusing on the role of the endogenous ligands endorphin, enkephalin, dynorphin, and nociceptin/orphanin FQ (N/OFQ) and their respective receptors, mu (MOR), delta (DOR), kappa (KOR), and the N/OFQ receptor (NOP) in mediating behaviors relevant to depression and anxiety. Finally, putative opioid based antidepressants that are under investigation in clinical trials, ALKS5461, JNJ-67953964 (formerly LY2456302 and CERC-501) and BTRX-246040 (formerly LY-2940094) will be discussed. This review will illustrate the potential therapeutic value of targeting opioid dysregulation in developing novel therapies for MDD.

Validation and extension of the Questionnaire of Cognitive and Affective Empathy in the Chinese setting

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a commonly used instrument in empathy research. However, this scale has not been validated in the Chinese context. We examined the psychometric properties and structure of the QCAE in a Chinese sample consisting of 1224 college students. The whole sample was split into two halves for exploratory factor analysis (EFA; n = 617) and confirmatory factor analysis (CFA; n = 607). A subsample (n = 351) completed the Chinese versions of the Interpersonal Reactivity Index (IRI) to examine convergent validity and the Revised Social Anhedonia Scale (RSAS) to examine the discriminate validity. Finally, 79 participants of the above subsample were retested after a 4-week interval. Results from EFA and CFA suggested a five-factor model, namely Perspective Taking, Online Simulation, Emotional Contagion, Proximal Responsivity, and Peripheral Responsivity. The internal consistency was .86 and test-retest reliability was .76. Scores on the QCAE positively correlated with scores on the IRI and negatively correlated with scores on the RSAS. The Chinese version of the QCAE exhibited good factor structure, reliability, and validity. Specific relationships between empathy and social anhedonia were also demonstrated.

Efficacy and feasibility of a humor training for people suffering from depression, anxiety, and adjustment disorder: a randomized controlled trial

BACKGROUND

Humor trainings have positive effects on mental health and well-being. However, studies investigating the effects of humor trainings in clinical samples are still rare. This study investigated the efficacy and feasibility of a humor training for people suffering from depression, anxiety and adjustment disorders.

METHODS

Based on a diagnostic interview (SCID I and II), 37 people were randomized into a training (n = 19) or wait list control group (n = 18) and completed questionnaires at pre, post, and 1 month follow-up. After the training group had completed its training and evaluation measures, the wait list control group received the training and the outcomes of the group were additionally evaluated (post2 and follow-up2).

RESULTS

After training, improvements in humor-related outcomes were observed for the training group, but these were relativized when compared to the wait list control group. Secondary outcomes remained unaffected by the training. In addition, the training group reported interpersonal difficulties. Within-group analyses of the wait list control group after completion of their training showed effects on almost all primary and secondary outcomes and feedback indicated a better atmosphere.

CONCLUSIONS

In summary, the different outcomes of the two groups are surprising and can show potential moderators of efficacy, such as interpersonal and group-specific climate variables. Since moderators of humor trainings in clinical samples have not been investigated at all, future studies should consider integrating them into their design.

TRIAL REGISTRATION

The study was retrospectively registered in the German Clinical Trials Register ( DRKS00012443 ) on May 16, 2017.

Reversal effect of Riparin IV in depression and anxiety caused by corticosterone chronic administration in mice

Mental disorders have a multifactorial etiology and stress presents as one of the causal factors. In depression, it is suggested that high cortisol concentration contributes directly to the pathology of this disease. Based on that, the study aims to evaluate the potential antidepressant effect of Riparin IV (Rip IV) in mice submitted to chronic stress model by repeated corticosterone administration. Female Swiss mice were selected into four groups: control (Ctrl), corticosterone (Cort), Riparin IV (Cort + Rip IV) and fluvoxamine (Cort + Flu). Three groups were administrated subcutaneously (SC) with corticosterone (20 mg/kg) during twenty-one days, while the control group received only vehicle. After the fourteenth day, groups were administrated tested drugs: Riparin IV, fluvoxamine or distilled water, by gavage, 1 h after subcutaneous injections. After the final treatment, animals were exposed to behavioral models such as forced swimming test (FST), tail suspension test (TST), open field test (OFT), elevated plus maze (EPM) and sucrose preference test (SPT). The hippocampus was also removed for the determination of BDNF levels. Corticosterone treatment altered all parameters in behavioral tests, leading to a depressive- and anxious-like behavior. Riparin IV and fluvoxamine exhibit antidepressant effect in FST, TST and SPT. In EPM and OFT, treatment displayed anxiolytic effect without alteration of locomotor activity. Corticosterone administration decreased BDNF levels and Riparin IV could reestablish them, indicating that its antidepressant effect may be related to ability to ameliorate hippocampal neurogenesis. These findings suggest that Riparin IV improves the depressive and anxious symptoms after chronic stress and could be a new alternative treatment for patients with depression.

Dissociating Empathy From Perspective-Taking: Evidence From Intra- and Inter-Individual Differences Research

Humans have the capacity to share others' emotions, be they positive or negative. Elicited by the observed or imagined emotion of another person, an observer develops a similar emotional state herself. This capacity, empathy, is one of the pillars of social understanding and interaction as it creates a representation of another's inner, mental state. Empathy needs to be dissociated from other social emotions and, crucially, also from cognitive mechanisms of understanding others, the ability to take others' perspective. Here, we describe the conceptual distinctions of these constructs and review behavioral and neural evidence that dissociates them. The main focus of the present review lies on the intraindividual changes in empathy and perspective-taking across the lifespan and on interindividual differences on subclinical and clinical levels. The data show that empathy and perspective-taking recruit distinct neural circuits and can be discerned already during early and throughout adult development. Both capacities also vary substantially between situations and people. Differences can be systematically related to situational characteristics as well as personality traits and mental disorders. The clear distinction of affect sharing from other social emotions like compassion and from cognitive perspective-taking, argues for a clear-cut terminology to describe these constructs. In our view, this speaks against using empathy as an umbrella term encompassing all affective and cognitive routes to understanding others. Unifying the way we speak about these phenomena will help to further research on their underlying mechanisms, psychopathological alterations, and plasticity in training and therapy.

Environmental Programming of Susceptibility and Resilience to Stress in Adulthood in Male Mice

Epidemiological evidence identifies early life adversity as a significant risk factor for the development of mood disorders. Much evidence points to the role of early life experience in susceptibility and, to a lesser extent, resilience, to stress in adulthood. While many models of these phenomena exist in the literature, results are often conflicting and a systematic comparison of multiple models is lacking. Here, we compare effects of nine manipulations spanning the early postnatal through peri-adolescent periods, both at baseline and following exposure to chronic social defeat stress in adulthood, in male mice. By applying rigorous criteria across three commonly used measures of depression- and anxiety-like behavior, we identify manipulations that increase susceptibility to subsequent stress in adulthood and other pro-resilient manipulations that mitigate the deleterious consequences of adult stress. Our findings point to the importance of timing of early life stress and provide the foundation for future studies to probe the neurobiological mechanisms of risk and resilience conferred by variation in the early life environment.

Depression predicts interpersonal problems partially through the attitude towards social touch

INTRODUCTION

Depression is associated with difficulties in interpersonal relationships, of which communication is an integral part. Communication can not only be effected by verbal means, but also non-verbally by touch. Against this background, the aim of the present study was to investigate the relationship between depression, interpersonal problems and the attitude towards social touch.

METHODS

147 individuals (115 females; 21-71 years old) seeking treatment in a clinic for outpatient psychotherapy took part in the survey. Three questionnaires evaluating the level of depression (Beck Depression Questionnaire), the degree of interpersonal problems (Inventory of Interpersonal Problems) and the attitude towards social touch (Social Touch Questionnaire, were administered.

RESULTS

Highly depressed individuals had a more negative attitude towards social touch than non-to lowly depressed individuals. Highly depressed individuals particularly reported to dislike physical touch by not well-known people, but not by close ones. Highly depressed individuals also reported more interpersonal problems, with the level of depression predicting the degree of interpersonal problems. This relationship was partially mediated by the attitude towards social touch in general and, to a greater extent, by the dislike of physical touch by people not well-known in particular.

DISCUSSION

Given the role of social touch in the relationship between depression and interpersonal problems, the attitude towards touch may be taken into consideration in the therapy of depressed patients. We assume that a more positive attitude towards social touch can influence the ability to create and maintain interpersonal relationships.

Looking for the negative: Depressive symptoms in adolescent girls are associated with sustained attention to a potentially critical judge during in vivo social evaluation

Attention biases toward negative stimuli are implicated in the development and maintenance of depression. However, research is needed to understand how depression affects attention biases as they unfold in a dynamic social environment, particularly during adolescence when depression rates significantly increase due to enhanced reactivity to social stress. To examine attention biases in a live, socially evaluative environment, 26 adolescent girls from the community gave a speech in front of a potentially critical judge and a positive judge while wearing mobile eye tracking glasses. Girls' depressive symptoms were measured using the Moods and Feelings Questionnaire. Across the sample, girls looked at the positive judge more frequently and for longer periods of time compared with the potentially critical judge. In contrast, higher depressive symptoms were associated with looking at the potentially critical judge for longer periods of time. When directly comparing attention to the potentially critical judge relative to the positive judge, dysphoric girls looked at the potentially critical judge more frequently and for longer periods of time compared with the positive judge. Findings suggest that adolescent depressive symptoms are related to sustained attention toward potentially critical evaluation at the exclusion of positive evaluation. This novel approach allowed for an in vivo examination of attention biases as they unfold during social evaluation, which begins to illuminate the interpersonal significance of attention biases. If replicated and extended longitudinally, this research could be used to identify adolescents at high risk for future depression and potentially be leveraged clinically in attention bias modification treatment.

Aberrant cortical neurodevelopment in major depressive disorder

BACKGROUND

There is strong neuroimaging evidence that cortical alterations represent a core pathophysiological feature of major depressive disorder (MDD). Differential contributions of cortical features of neurodevelopmental origin, which may distinctly contribute to MDD vulnerability, disease-onset, or symptom expression, are unclear at present.

METHODS

We investigated distinct markers of cortical neurodevelopment, i.e. local cortical gyrification (LGI) and thickness (CT) in patients with MDD (n = 38) and healthy controls (HC, n = 22) using 3 T structural magnetic resonance imaging data and surface-based data analysis techniques. CT and LGI were computed using the Computational Anatomy Toolbox (CAT12). Analyses were performed for the entire cortical surface followed by a complementary regions-of-interest approach.

RESULTS

MDD patients showed significantly greater LGI in frontal, cingulate, parietal, temporal, and occipital regions compared to HC (FDR-corrected at p < 0.05 using threshold-free cluster enhancement). No significant differences of CT were found. In the MDD-group, correlations were found between duration of illness in years and number of depressive episodes and LGI of frontal, temporal, and parietal regions (p < 0.05).

LIMITATIONS

Main limitations are the relatively modest sample size and a cross-sectional study design. We did not control for early environmental factors potentially influencing neurodevelopment, such as childhood trauma. We report associations uncorrected for multiple comparisons.

CONCLUSIONS

The data suggest different local trajectories of cortical change in MDD. In addition, our data support the notion that aberrant cortical development may serve as a vulnerability marker of MDD, as well as a potential predictor of disease course.

Rationale, Methods, Feasibility, and Preliminary Outcomes of a Transdiagnostic Prevention Program for At-Risk College Students

PURPOSE

Early adulthood represents one period of increased risk for the emergence of a serious mental illness. The college campus provides a unique opportunity to assess and monitor individuals in this at-risk age group. However, there are no validated early detection programs that are widely implemented on college campuses. In an effort to address this gap, we designed and tested an early detection and prevention program tailored to college students. A transdiagnostic approach was employed because of evidence for shared risk factors across major mental illnesses.

DESIGN

Single arm, prospective study evaluating outcomes following a 4-week intervention.

METHOD

Three in-person mental health screenings were conducted on the campus of one university. Undergraduate students with at least mildly elevated, self-reported levels of depressive or subclinical psychotic symptoms, who were not receiving treatment for these symptoms, were invited to participate in a 4-session workshop focused on increasing self- and other- awareness and emotion regulation using established mindfulness, self-compassion, and mentalization principles and experiential exercises. Symptoms, resilience-promoting capacities, and aspects of social functioning were assessed pre- and post- intervention.

RESULTS

416 students were screened and a total of 63 students participated in the workshop. 91% attended at least 3 of the 4 sessions. The majority of participants found the workshop interesting and useful and would recommend it to a friend. Significant pre-to-post reductions in symptoms (depression, anxiety, and subclinical psychotic symptoms, ps < 0.004) and improvements in resilience-promoting capacities (self-compassion and self-efficacy, ps < 0.006) and indices of social functioning (social motivation, activity, and a measure of comfort with the physical presence of others, ps < 0.04) were observed. Moreover, the significant increases in resilience-promoting capacities correlated with the reductions in affective symptoms (ps < 0.03).

CONCLUSIONS

These findings suggest that an on-campus mental health screening and early intervention program is feasible, acceptable, and may be associated with improvements in resilience-related capacities and symptom reductions in young adults with non-impairing, subclinical symptoms of psychopathology. Follow-up work will determine whether this program can improve both shorter and longer-term mental health and functional outcomes in this at-risk population.

The relation between empathy and depressive symptoms in a Dutch population sample

BACKGROUND

Impairments in social functioning are common in individuals with (sub)clinical levels of depression. One possible underlying mechanism of this relationship is low empathy. The present study examined linear and non-linear associations between empathy and depressive symptoms, and whether these associations were moderated by gender.

METHODS

Using the Empathy Quotient scale, cognitive and affective empathy were assessed using a large convenience sample from the general Dutch population (N = 3076). Depressive symptoms were indexed by the Depression, Anxiety and Stress Scale (DASS) and the Quick Inventory of Depressive Symptomatology (QIDS-SR16).

RESULTS

Low cognitive empathy was associated with more depressive symptoms. There was a weak positive relation between affective empathy and depressive symptoms, indexed by the QIDS rather than the DASS.

LIMITATIONS

Generalizing results to the general population remains difficult with a convenience sample. Self-reported data may be affected by social-desirability or sex-stereotypical reporting biases.

CONCLUSIONS

Our results support a linear relationship between cognitive empathy and symptoms of depression. There was some evidence for non-linear associations and a moderating role of gender, but these patterns were not observed across all types of analysis.

MDMA Increases Cooperation and Recruitment of Social Brain Areas When Playing Trustworthy Players in an Iterated Prisoner's Dilemma

Social decision-making is fundamental for successful functioning and can be affected in psychiatric illness and by serotoninergic modulation. The Prisoner's Dilemma is the archetypal paradigm to model cooperation and trust. However, the effect of serotonergic enhancement is poorly characterized, and its influence on the effect of variations in opponent behavior unknown. To address this, we conducted a study investigating how the serotonergic enhancer 3,4-methylenedioxy-methamphetamine (MDMA) modulates behavior and its neural correlates during an iterated Prisoner's Dilemma with both trustworthy and untrustworthy opponents. We administered 100 mg MDMA or placebo to 20 male participants in a double-blind, placebo-controlled, crossover study. While being scanned, participants played repeated rounds with opponents who differed in levels of cooperation. On each round, participants chose to compete or cooperate and were asked to rate their trust in the other player. Cooperation with trustworthy, but not untrustworthy, opponents was enhanced following MDMA but not placebo (respectively: odds ratio = 2.01; 95% CI, 1.42-2.84, p < 0.001; odds ratio = 1.37; 95% CI, 0.78-2.30, not significant). Specifically, MDMA enhanced recovery from, but not the impact of, breaches in cooperation. During trial outcome, MDMA increased activation of four clusters incorporating precentral and supramarginal gyri, superior temporal cortex, central operculum/posterior insula, and supplementary motor area. There was a treatment × opponent interaction in right anterior insula and dorsal caudate. Trust ratings did not change across treatment sessions. MDMA increased cooperative behavior when playing trustworthy opponents. Underlying this was a change in brain activity of regions linked to social cognition. Our findings highlight the context-specific nature of MDMA's effect on social decision-making.SIGNIFICANCE STATEMENT We provide a detailed analysis of the effect of 3,4-methylenedioxy-methamphetamine (MDMA) on cooperative behavior during interpersonal interactions, as well as the neural correlates underlying these effects. We find that, following administration of MDMA, participants behave more cooperatively, but only when interacting with trustworthy partners. While breaches of trustworthy behavior have a similar impact following administration of MDMA compared with placebo, MDMA facilitates a greater recovery from these breaches of trust. Underlying this altered behavior are changes in brain activity during the viewing of opponents' behavior in regions whose involvement in social processing is well established. This work provides new insights into the impact of MDMA on social interactions, emphasizing the important role of the behavior of others toward us.

The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation

A wealth of evidence has implicated inflammation in the development of depression. Yet, the heterogeneous nature of depression has impeded efforts to understand, prevent, and treat the disease. The purpose of this integrative review is to summarize the connections between inflammation and established core features of depression that exhibit more homogeneity than the syndrome itself: exaggerated reactivity to negative information, altered reward processing, decreased cognitive control, and somatic syndrome. For each core feature, we first provide a brief overview of its relevance to depression and neurobiological underpinnings, and then review evidence investigating a potential role of inflammation. We focus primarily on findings from experimental paradigms of exogenously-induced inflammation. We conclude that inflammation likely plays a role in exaggerated reactivity to negative information, altered reward reactivity, and somatic symptoms. There is less evidence supporting an effect of inflammation on cognitive control as assessed by standard neuropsychological measures. Finally, we discuss implications for future research and recommendationsfor how to test the role of inflammation in the pathogenesis of heterogeneous psychiatric disorders.

Liraglutide Activates mTORC1 Signaling and AMPA Receptors in Rat Hippocampal Neurons Under Toxic Conditions

The aim of the present study was to determine whether treatment with liraglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, would alter mammalian target of rapamycin complex 1 (mTORC1) signaling and/or α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor activity under dexamethasone-induced toxic conditions. Western blot analyses were performed to assess changes in mTORC1-mediated proteins, brain-derived neurotrophic factor (BDNF), and various synaptic proteins (PSD-95, synapsin I, and GluA1) in rat hippocampal cultures under toxic conditions induced by dexamethasone, which causes hippocampal cell death. Hippocampal dendritic outgrowth and spine formation were measured using immunostaining procedures. Dexamethasone significantly decreased the phosphorylation levels of mTORC1 as well as its downstream proteins. However, treatment with liraglutide prevented these reductions and significantly increased BDNF expression. The increase in BDNF expression was completely blocked by rapamycin and 2,3-dioxo-6-nitro-1,2,3,4-tetrahydrobenzo[f]quinoxaline-7-sulfonamide (NBQX). Liraglutide also recovered dexamethasone-induced decreases in the total length of hippocampal dendrites and reductions in spine density in a concentration-dependent manner. However, the positive effects of liraglutide on neural plasticity were abolished by the blockade of mTORC1 signaling and AMPA receptors. Furthermore, liraglutide significantly increased the expression levels of PSD-95, synapsin I, and GluA1, whereas rapamycin and NBQX blocked these effects. The present study demonstrated that liraglutide activated mTORC1 signaling and AMPA receptor activity as well as increased dendritic outgrowth, spine density, and synaptic proteins under toxic conditions in rat primary hippocampal neurons. These findings suggest that GLP-1 receptor (GLP-1R) activation by liraglutide may affect neuroplasticity through mTORC1 and AMPA receptors.

Zebrafish models for personalized psychiatry: Insights from individual, strain and sex differences, and modeling gene x environment interactions

Currently becoming widely recognized, personalized psychiatry focuses on unique physiological and genetic profiles of patients to best tailor their therapy. However, the role of individual differences, as well as genetic and environmental factors, in human psychiatric disorders remains poorly understood. Animal experimental models are a valuable tool to improve our understanding of disease pathophysiology and its molecular mechanisms. Due to high reproduction capability, fully sequenced genome, easy gene editing, and high genetic and physiological homology with humans, zebrafish (Danio rerio) are emerging as a novel powerful model in biomedicine. Mounting evidence supports zebrafish as a useful model organism in CNS research. Robustly expressed in these fish, individual, strain, and sex differences shape their CNS responses to genetic, environmental, and pharmacological manipulations. Here, we discuss zebrafish as a promising complementary translational tool to further advance patient-centered personalized psychiatry.

Stress-induced changes in social dominance are scaled by AMPA-type glutamate receptor phosphorylation in the medial prefrontal cortex

The establishment and maintenance of social dominance are critical for social stability and the survival and health of individual animals. Stress lead to depression and a decrease in the social status of depressed persons is a risk factor for suicide. Therefore, we explored the mechanistic and behavioral links among stress, depression, and social dominance and found that mice subjected to chronic restraint stress (CRS), an animal model of stress-induced depression, showed decreased social dominance as measured by a dominance tube test. Importantly, this submissive behavior was occluded by the antidepressant, fluoxetine, a selective serotonin reuptake inhibitor. It is known that social dominance is controlled by synaptic efficacy in the medial prefrontal cortex (mPFC) and that AMPA-type glutamate receptor (AMPA-R) is a key molecule for synaptic efficacy. We found that the phosphorylation on AMPA-R was bidirectionally changed by CRS and fluoxetine in the mPFC of mice with CRS. Moreover, we found a strong correlation between social dominance and AMPA-R phosphorylation that regulates synaptic efficacy by modulating the synaptic targeting of AMPA-R. Our correlational analysis of the behavior and biochemistry of the CRS model suggests that AMPA-R phosphorylation in the mPFC may serve as a biomarker of social dominance related to stress.

Opioid modulation of depression: A focus on imaging studies

Depression is the leading cause of disability worldwide, with over 300 million people affected. Almost all currently available antidepressant treatments target monoamine neurotransmitter systems and have a delayed onset of action up to several weeks that can be associated with low rates of treatment response. The endogenous opioid system has been identified as a potential target for the development of novel antidepressants due to its high opioid receptor concentrations in central limbic areas that are also implicated in physiological processes including regulation of mood and emotion. Genetic depletion, pharmacological manipulation, and preclinical models have been widely used to characterize the role of opioid transmission in depressive states. Neuroimaging studies have been carried out in clinical populations to investigate opioid transmission in mood and emotion in an attempt to identify those regional anatomical and functional brain changes that are associated with depression. Great insight has been provided into the cerebral structural and functional changes associated with depression but there remains a need to tie the functional theories of depression to anatomical localization and further neuroimaging studies are best placed to do this.

The Long-Term Impact of Natural Mentoring Relationships: A Counterfactual Analysis

Previous research suggests that youth's natural mentoring relationships are associated with better academic, vocational, and psychosocial functioning. However, little is known about the extent to which the impact of mentoring endures beyond adolescence and early adulthood. Furthermore, most natural mentoring research is confounded by selection bias. In this study, we examined the long-term impact of mentoring using the nationally representative, longitudinal Add Health dataset. We conducted counterfactual analysis, a more stringent test of causality than regression-based approaches. Compared to their unmentored counterparts, adults (ages 33-42) who had a natural mentor during adolescence or emerging adulthood reported higher educational attainment, more time spent volunteering, and more close friends, after controlling for a range of confounding factors. However, outcomes differed when mentors were classified as "strong ties" (e.g., grandparents, friends) or "weak ties" (e.g., teachers, coaches, employers). Having a strong-tie mentor was associated with having more close friends and a lower income. In contrast, having a weak-tie mentor was associated with higher educational attainment, higher income, and more time spent volunteering. These findings suggest that natural mentoring relationships can exert lasting influence on young people's developmental trajectories, providing strong rationale for efforts to expand their availability and scope.

Psychiatric symptoms and related dysfunction in a general population sample

Background

Along with the key clinical features of major psychiatric disorders such as psychosis, mania, and depression, these disorders are also associated with cognitive, social, and functional deficits. A growing body of evidence suggests that these disorders exist at the extreme end of a continuum of symptoms rather than as binary entities, so it is plausible that the associated cognitive, social, and functional deficits assume a similar pattern. Consistent with this approach, we sought to determine whether adults in the general population with psychiatric symptoms also demonstrate milder forms of the cognitive, social, and functional deficits that are often associated with the psychiatric disorders.

Methods

Using data from the Study of Resilience and Environmental Adversity in Midlife Health (STREAM), which includes survey responses of 811 individuals, we compared early academic achievement and self-reported social and functional outcomes between respondents who reported psychotic symptoms, manic symptoms, depressive symptoms, or no psychiatric symptoms (controls).

Results

Adults with psychotic symptoms had significantly poorer early academic performance (p = .04) and social and functional outcomes (self-reported marital status, p = .021, income, p = .001, and health, p < .001) than controls. Adults with depressive symptoms had significantly lower early academic performance and income and poorer health than controls (p's = 0.033, 0.037, 0.013 respectively), and adults with manic symptoms also reported significantly lower rates of marriage than controls (p = .006).

Conclusions

The results are consistent with the continuum view of the etiology of psychiatric disorders in which psychiatric disorders are dimensional and experienced in varying degrees of severity across the general and clinical population. Importantly, the results highlight the potential impact of psychiatric symptomatology on functional outcomes in the population.

Neuropsychological predictors of performance-based measures of functional capacity and social skills in individuals with severe mental illness

Neuropsychological abilities may underlie successful performance of everyday functioning and social skills. We aimed to determine the strongest neuropsychological predictors of performance-based functional capacity and social skills performance across the spectrum of severe mental illness (SMI). Unemployed outpatients with SMI (schizophrenia, bipolar disorder, or major depression; n = 151) were administered neuropsychological (expanded MATRICS Consensus Cognitive Battery), functional capacity (UCSD Performance-Based Skills Assessment-Brief; UPSA-B), and social skills (Social Skills Performance Assessment; SSPA) assessments. Bivariate correlations between neuropsychological performance and UPSA-B and SSPA total scores showed that most neuropsychological tests were significantly associated with each performance-based measure. Forward entry stepwise regression analyses were conducted entering education, diagnosis, symptom severity, and neuropsychological performance as predictors of functional capacity and social skills. Diagnosis, working memory, sustained attention, and category and letter fluency emerged as significant predictors of functional capacity, in a model that explained 43% of the variance. Negative symptoms, sustained attention, and letter fluency were significant predictors of social skill performance, in a model explaining 35% of the variance. Functional capacity is positively associated with neuropsychological functioning, but diagnosis remains strongly influential, with mood disorder participants outperforming those with psychosis. Social skill performance appears to be positively associated with sustained attention and verbal fluency regardless of diagnosis; however, negative symptom severity strongly predicts social skills performance. Improving neuropsychological functioning may improve psychosocial functioning in people with SMI.

Effects of inflammation on social processes and implications for health

Although at first glance inflammation and social behavior may appear unrelated, research points to an important role for inflammation in shaping social processes. This review summarizes findings in this field, specifically highlighting work that provides support for the idea that inflammation can lead to (1) increases in sensitivity to negative, threatening social experiences and (2) increases in sensitivity to positive, socially rewarding experiences. These diverging sensitivities in response to inflammation may depend on context and be adaptive for recuperation and recovery from illness. This review also discusses the implications of these findings for health and future research, including implications for depression, loneliness, and inflammatory disorders.

Risk Factors for Depression: An Autobiographical Review

I have been given a priceless opportunity to reflect on my career in the remarkably productive field of risk factors for depression. Psychological research on depression exploded in the early years of my work. I try to give an account of the choices and challenges, and reflect on the influences, some calculated and some serendipitous, that determined the paths I have followed. I focus mostly on the robust depression risk factors that have influenced my research, including dysfunctional cognitions, stressful life events and circumstances, parental depression, interpersonal dysfunction, and being female, and I cover some of what I did but also the influential work of others. This is a selective review of depression research in the past 40 or so years, noting some of the big developments that set the stage for the remarkable activity that continues today. In the conclusion, there is a brief statement of aspirations for future developments in our field.

Tryptophan-kynurenine and lipid related metabolites as blood biomarkers for first-episode drug-naïve patients with major depressive disorder: An exploratory pilot case-control study

BACKGROUND

Early intervention in depression has been critical to prevent its negative impact including suicide. Recent blood biomarker studies for major depressive disorder (MDD) have suggested that tryptophan-kynurenine and lipid related metabolites are involved in the pathophysiology of MDD. However, there have been limited studies investigating these blood biomarkers in first-episode drug-naïve MDD, which are particularly important for early intervention in depression.

METHODS

As an exploratory pilot case-control study, we examined the above blood biomarkers, and analyzed how these biomarkers are associated with clinical variables in first-episode drug-naïve MDD patients, based on metabolome/lipidome analysis.

RESULTS

Plasma tryptophan and kynurenine levels were significantly lower in MDD group (N = 15) compared to healthy controls (HC) group (N = 19), and plasma tryptophan was the significant biomarker to identify MDD group (area under the curve = 0.740). Lower serum high density lipoprotein-cholesterol (HDL-C) was the predictive biomarker for severity of depression in MDD group (R² = 0.444). Interestingly, depressive symptoms were variously correlated with plasma tryptophan-kynurenine and lipid related metabolites. Moreover, plasma tryptophan-kynurenine metabolites and cholesteryl esters (CEs) were significantly correlated in MDD group, but not in HC group.

LIMITATIONS

This study had small sample size, and we did not use the multiple test correction.

CONCLUSIONS

This is the first study to suggest that not only tryptophan-kynurenine metabolites but also HDL-C and CEs are important blood biomarkers for first-episode drug-naïve MDD patients. The present study sheds new light on early intervention in clinical practice in depression, and further clinical studies especially large-scale prospective studies are warranted.

Childhood physical maltreatment, perceived social isolation, and internalizing symptoms: a longitudinal, three-wave, population-based study

A number of cross-sectional studies have consistently shown a correlation between childhood physical maltreatment, perceived social isolation and internalizing symptoms. Using a longitudinal, three-wave design, this study sought to assess the mediating role of perceived social isolation in adulthood in the association between childhood physical maltreatment and internalizing symptoms in adulthood. The study has a three-wave design. We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 4530), a representative prospective cohort study of men and women. Perceived social isolation was measured at a mean age of 54.7 years, and internalizing symptoms were measured at a mean age of 61.7 years. The difference-in-coefficients method was used to assess the indirect effects and the proportion (%) of mediated effects. Childhood physical maltreatment was associated with an up to 68% [relative risk (RR) = 1.68, 95% confidence interval (CI): 1.33-2.13] higher risk of perceived social isolation in adulthood. Childhood physical maltreatment and perceived social isolation in adulthood were associated with greater levels of internalizing symptoms in adulthood (p < 0.01). A dose-response association was observed between childhood physical maltreatment and internalizing symptoms in adulthood (p < 0.001). Perceived social isolation in adulthood mediated up to 14.89% (p < 0.05) of the association between childhood physical maltreatment and internalizing symptoms in adulthood. The results of this study indicate the need to take perceived social isolation into account when considering the impact of childhood physical maltreatment on internalizing symptoms.

Critical role of the right VLPFC in emotional regulation of social exclusion: a tDCS study

There is abundant evidence suggesting that the right ventrolateral prefrontal cortex (rVLPFC) plays an important role in down-regulating the emotional response to social exclusion. However, a causal relationship between rVLPFC function and explicit emotional regulation is not clear in the context of social exclusion. This study employed anodal transcranial direct current stimulation (tDCS) to activate rVLPFC while participants used emotional regulation to reappraise pictures of social exclusion. Forty-four participants were randomly assigned to an active tDCS group or a sham group. Both groups viewed social exclusion images under two conditions: in the no-reappraisal condition, participants were instructed to passively view social exclusion images; in the reappraisal condition, they reappraised the images to down-regulate negative emotional responses. Compared to sham stimulation, anodal tDCS over the rVLPFC resulted in less negative emotion ratings, and produced significantly smaller pupil diameter in the reappraisal, compared to no-reappraisal block. The tDCS also led to longer fixation durations to rejectees and shorter fixation durations to rejecters. Taken together, these findings suggest a causal role for rVLPFC in down-regulation of negative emotions produced by social exclusion. This study has implications for clinical interventions targeting emotional regulation deficits.

Neural correlates of reduced depressive symptoms following cognitive training for chronic traumatic brain injury

Depression is the most frequent comorbid psychiatric condition among individuals with traumatic brain injury (TBI). Yet, little is known about changes in the brain associated with reduced depressive symptoms following rehabilitation for TBI. We identified whether cognitive training alleviates comorbid depressive symptoms in chronic TBI (>6 months post-injury) as a secondary effect. Further, we elucidated neural correlates of alleviated depressive symptoms following cognitive training. A total of seventy-nine individuals with chronic TBI (53 depressed and 26 non-depressed individuals, measured using the Beck Depressive Inventory [BDI]), underwent either strategy- or information-based cognitive training in a small group for 8 weeks. We measured psychological functioning scores, cortical thickness, and resting-state functional connectivity (rsFC) for these individuals before training, immediately post-training, and 3 months post-training. After confirming that changes in BDI scores were independent of training group affiliation, we identified that the depressive-symptoms group showed reductions in BDI scores over time relative to the non-depressed TBI controls (p < .01). Within the depressive-symptoms group, reduced BDI scores was associated with improvements in scores for post-traumatic stress disorder, TBI symptom awareness, and functional status (p < .00625), increases in cortical thickness in four regions within the right prefrontal cortex (p_vertex  < .01, p_cluster <.05), and decreases in rsFC with each of these four prefrontal regions (p_vertex  < .01, p_cluster  < .0125). Overall, these findings suggest that cognitive training can reduce depressive symptoms in TBI even when the training does not directly target psychiatric symptoms. Importantly, cortical thickness and brain connectivity may offer promising neuroimaging markers of training-induced improvement in mental health status in TBI.

Subclinical maternal depressive symptoms modulate right inferior frontal response to inferring affective mental states of adults but not of infants

BACKGROUND

Being a mother of young children increases the risk of depression characterised by deficits in inferring what a person is feeling, i.e., affective theory of mind (aToM). Despite the adverse consequences for mothers, children, families, and society as a whole, little is known of how the brain functions underlying aToM ability are affected by subclinical maternal depressive symptoms, and act as a risk indicator for major depressive disorders (MDD).

METHODS

Thirty healthy mothers with varying levels of depressive symptoms underwent functional magnetic resonance imaging (fMRI) while performing mind-reading tasks based on the emotional expressions of adult eyes and infant faces.

RESULTS

In the adult eyes-based mind-reading task, mothers with more severe depressive symptoms showed less activation in the right inferior frontal gyrus (IFG), a central part of the putative mirror neuron system (pMNS). This was unrelated to behavioural performance decline in the task. However, brain activation involved in the infant face-based mind-reading task was not affected by depressive symptoms.

LIMITATIONS

Although aToM ability, assessed by mind-reading tasks, can be distinguished from empathy, these can be interacting functions of the pMNS, wherein they could mutually affect each other.

CONCLUSION

These findings suggest that functional activation of the right IFG, which underlies aToM ability, has variable vulnerability to maternal depressive symptoms according to the type of social signal. This functional decline of the right IFG may be a risk indicator for clinical maternal depression, which is associated with impaired social functioning and communication conflicts with family members and other social supporters.

Functional connectivity changes following interpersonal reactivity

Attachment experiences substantially influence emotional and cognitive development. Narratives comprising attachment-dependent content were proposed to modulate activation of cognitive-emotional schemata in listeners. We studied the effects after listening to prototypical attachment narratives on wellbeing and countertransference-reactions in 149 healthy participants. Neural correlates of these cognitive-emotional schema activations were investigated in a 7 Tesla rest-task-rest fMRI-study (23 healthy males) using functional connectivity (FC) analysis of the social approach network (seed regions: left and right Caudate Nucleus, CN). Reduced FC between left CN and bilateral dorsolateral prefrontal cortex (DLPFC) represented a general effect of prior auditory stimulation. After presentation of the insecure-dismissing narrative, FC between left CN and bilateral temporo-parietal junction, and right dorsal posterior Cingulum was reduced, compared to baseline. Post-narrative FC-patterns of insecure-dismissing and insecure-preoccupied narratives differed in strength between left CN and right DLPFC. Neural correlates of the moderating effect of individual attachment anxiety were represented in a reduced CN-DLPFC FC as a function of individual neediness-levels. These findings suggest specific neural processing of prolonged mood-changes and schema activation induced by attachment-specific speech patterns. Individual desire for interpersonal proximity was predicted by attachment anxiety and furthermore modulated FC of the social approach network in those exposed to such narratives.

Pupil mimicry and trust - Implication for depression

Individuals suffering from depression often have difficulty trusting others. Previous research has shown a relationship between trust formation and pupil mimicry - the synchronization of pupil sizes between individuals. The current study therefore examined whether pupil mimicry is weaker in depressed individuals and an underlying factor of their low levels of trust. Forty-two patients with major depressive disorder (MDD) and 40 healthy control subjects played trust games with virtual partners. Images of these partners' eye regions were presented to participants before they had to make a monetary investment decision. Partners' pupils either dilated, constricted, or remained static over the course of 4-s interactions. During the task, participants' pupil sizes were recorded with eye-tracking equipment to assess mimicry. The results confirm that patients with MDD were somewhat less trusting than controls and used another's pupillary cues differently when deciding to trust. Specifically, whereas healthy controls trusted partners with dilating pupils more than partners with constricting pupils, patients with MDD particularly trusted partners whose pupils changed in size less, regardless of whether partners' pupils were dilating or constricting. This difference in investment behavior was unrelated to differences in pupil mimicry, which was equally apparent in both groups and fostered trust to the same extent. Whereas lower levels of trust observed in patients with MDD could not be explained by differences in pupil mimicry, our data show that pupil dilation mimicry might help people to trust. These findings provide further evidence for the important role of pupil size and pupil mimicry in interpersonal trust formation and shed light on the pathophysiology of clinically low trust in patients with MDD.

Neural Correlates of Social Inclusion in Borderline Personality Disorder

Humans engage in social interactions and have a fundamental need and motivation to establish and maintain social connections. Neuroimaging studies particularly focused on the neural substrates of social exclusion in healthy subjects (HC), borderline personality disorder (BPD), and major depression (MD). However, there is evidence regarding neural alterations also during social inclusion in BPD that we intended to elucidate in our study. Considering that patients with BPD often have comorbid MD, we investigated patients with BPD, and comorbid MD, patients with MD without BPD, and a sample of HC. By investigating these two clinical samples within one study design, we attempted to disentangle potential confounds arising by psychiatric disorder or medication and to relate neural alterations under social inclusion specifically to BPD. We investigated 48 females (15 BPD and MD, 16 MD, and 17 HC) aged between 18 and 40 years by fMRI (3T), using the established cyberball paradigm with social exclusion, inclusion, and passive watching conditions. Significant group-by-condition interaction effects (p < 0.05, FWE-corrected on cluster level) were observed within the dorsolateral (dlPFC) and dorsomedial prefrontal cortex (dmPFC), the temporo-parietal junction (TPJ), the posterior cingulate cortex (PCC), and the precuneus. Comparisons of estimated neural activations revealed that significant interaction effects were related to a relative increase in neural activations during social inclusion in BPD. In detail, we observed a significant increase in differential (social inclusion vs. passive watching) neural activation within the dmPFC and the PCC in BPD compared to both, MD and HC. However, significant interaction effects within the dlPFC and the TPJ could not specifically be linked to BPD considering that they did not differ significantly between the two clinical groups in post-hoc comparisons. Our study supports previous results on effects of social and inclusion in BPD, and provides further evidence regarding disorder specific neural alterations in BPD for brain regions associated with self-referential and mentalizing processes during social inclusion.