["Theory of mind" and its neuronal correlates in forensically relevant disorders]

Prediction of Disruptive Behavior over Time from Changes in Patients' Global Functioning in Acute Psychiatric Care

Disruptive behavior of patients in acute psychiatric care is a problem for both patients and staff. Preventing a patient's impending disruption requires recognizing and understanding early signals. There are indications that a change in a patient's global functioning may be such a signal. The global functioning of patients is a multidimensional view on their functioning. It captures a patient's psychological symptoms, social skills, symptoms of violence, and activities in daily living. The aim of this study was to gain insight into the predictive value of global functioning on the risk of disruptive behavior of patients in acute psychiatric care. Also assessed was the time elapsed between the change in global functioning and a patient's disruptive behavior, which is necessary to know for purposes of early intervention. In a longitudinal retrospective study, we used daily measurements with the Brøset Violence Checklist (BVC) and the Kennedy Axis V (K-As) of each patient admitted to two acute psychiatric units over a period of six years. Data from 931 patients for the first 28 days after their admission were used for survival analysis and cox regression analysis. Disruptive behavior was mostly observed during the first days of hospitalization. Global functioning predicted disruptive behavior from the very first day of hospitalization. A cut-off score of 48 or lower on the K-As on the first admission day predicted a higher risk of disruptive behavior. If functioning remained poor or deteriorated substantially over three days, this was an additional signal of increased risk of disruptive behavior. Improvement in global functioning was associated with a decreased risk of disruptive behavior. More attention is needed for early interventions on global functioning to prevent disruptive behavior.

The Link Between Creativity, Cognition, and Creative Drives and Underlying Neural Mechanisms

Having a creative mind is one of the gateways for achieving fabulous success and remarkable progress in professional, personal and social life. Therefore, a better understanding of the neural correlates and the underlying neural mechanisms related to creative ideation is crucial and valuable. However, the current literature on neural systems and circuits underlying creative cognition, and on how creative drives such as motivation, mood states, and reward could shape our creative mind through the associated neuromodulatory systems [i.e., the dopaminergic (DA), the noradrenergic (NE) and the serotonergic (5-HT) system] seems to be insufficient to explain the creative ideation and production process. One reason might be that the mentioned systems and processes are usually investigated in isolation and independent of each other. Through this review, we aim at advancing the current state of knowledge by providing an integrative view on the interactions between neural systems underlying the creative cognition and the creative drive and associated neuromodulatory systems (see Figure 1).

Sophisticated Deception in Junior Middle School Students: An ERP Study

Sophisticated deception refers to the deception of others based on inferences of their mental states (e.g., answering honestly when inferring that the other will not believe their answer). Studying the brain mechanism of sophisticated deception in junior middle school students can provide physiological evidence for deception detection and deceptive ability measurement. Sixteen junior middle school students were asked to engage in different trial types (i.e., instructed truth/lie and chosen truth/lie), during which we recorded their response times (RT) along with electroencephalographic data to calculate event-related potentials (ERPs). We observed significant differences in amplitude [N2, P3, N450, and medial frontal negativity (MFN)] between chosen reactions (sophisticated deception and simple deception) and instructed reactions (instructed truth and instructed lie) in both the stimulus presentation and feedback stages. In the former, the task scores of participants in the chosen condition were significantly and positively correlated with the N2 amplitude over the central brain area during sophisticated deception. In the latter, the task scores of participants in the chosen condition were negatively correlated with the MFN amplitude over the left frontal and left frontocentral regions. Overall, deception intention, rather than simply making counterfactual statements, appears to underlie the increased demand for cognitive control in deceivers. This can be attributed to deceivers' need to strongly consider their opponent's mental state-the better the deceivers' deceptive ability, the more they will make conjectures about the mental state of their opponent with sophisticated deception and monitor conflict; the less conflict they experience while answering honestly with the intention to deceive, the more conflict may arise when the results of their deception are inconsistent with these conjectures.

Dynamic Communications Between GABAA Switch, Local Connectivity, and Synapses During Cortical Development: A Computational Study

Several factors regulate cortical development, such as changes in local connectivity and the influences of dynamical synapses. In this study, we simulated various factors affecting the regulation of neural network activity during cortical development. Previous studies have shown that during early cortical development, the reversal potential of GABA_A shifts from depolarizing to hyperpolarizing. Here we provide the first integrative computational model to simulate the combined effects of these factors in a unified framework (building on our prior work: Khalil et al., 2017a,b). In the current study, we extend our model to monitor firing activity in response to the excitatory action of GABA_A. Precisely, we created a Spiking Neural Network model that included certain biophysical parameters for lateral connectivity (distance between adjacent neurons) and nearby local connectivity (complex connections involving those between neuronal groups). We simulated different network scenarios (for immature and mature conditions) based on these biophysical parameters. Then, we implemented two forms of Short-term synaptic plasticity (depression and facilitation). Each form has two distinct kinds according to its synaptic time constant value. Finally, in both sets of networks, we compared firing rate activity responses before and after simulating dynamical synapses. Based on simulation results, we found that the modulation effect of dynamical synapses for evaluating and shaping the firing activity of the neural network is strongly dependent on the physiological state of GABA_A. Moreover, the STP mechanism acts differently in every network scenario, mirroring the crucial modulating roles of these critical parameters during cortical development. Clinical implications for pathological alterations of GABAergic signaling in neurological and psychiatric disorders are discussed.

Social decision making in autism: On the impact of mirror neurons, motor control, and imitative behaviors

The Mirror Neuron System (MNS) plays a crucial role in action perception and imitative behavior, which is suggested to be impaired in Autism Spectrum Disorders (ASDs). In this review, we discuss the plausibility and empirical evidence of a neural interaction between the MNS, action perception, empathy, imitative behavior, and their impact on social decision making in ASDs. To date, there is no consensus regarding a particular theory in ASDs and its underlying mechanisms. Some theories have completely focused on social difficulties, others have emphasized sensory aspects. Based on the current studies, we suggest a multilayer neural network model including the MNS on a first layer and transforming this information to a higher layer network responsible for reasoning. Future studies with ASD participants combining behavioral tasks with neuroimaging methods and transcranial brain stimulation as well as computational modeling can help validate and complement this suggested model. Moreover, we propose applying the behavioral paradigms, and the neurophysiological markers mentioned in this review article for evaluating psychiatric treatment approaches in ASDs. The investigation of modulating effects of different treatment approaches on the neurophysiological markers of the MNS can help find specific subgroups of ASDs patients and support tailored psychiatric interventions.

Why Is 10 Past 10 the Default Setting for Clocks and Watches in Advertisements? A Psychological Experiment

Have you ever noticed that in watch advertisements the time is usually set at 10:10? The reasons and psychological effects of this default time setting are elusive. In Experiment 1, we hypothesized that watches showing a time setting resembling a smiling face (10:10) would enhance emotional valence and intention to buy compared to a neutral time setting (11:30), whereas a time setting resembling a sad face (8:20) would have the opposite effect. Moreover, we investigated a possible interaction effect with the gender of the participants. In Experiment 2, we directly tested the hypotheses that watches set at 10:10 resemble a smiling face, whereas watches set at 8:20 resemble a sad face. The data of the first experiment reveal that watches set at 10:10 showed a significant positive effect on the emotion of the observer and the intention to buy. However, watches set at 8:20 did not show any effect on the emotion or the intention to buy. Moreover, watches set at 10:10 induced in women significantly stronger ratings of pleasure than in men. The data of the second experiment show that participants consistently perceive high resemblance between watches set at 10:10 and a smiling face as well as high resemblance between watches set at 8:20 and a sad face. This study provides for the first time empirical evidence for the notion that using watches with a time setting resembling a smiling face (like 10:10) can positively affect the emotional response of the observers and their evaluation of a seen watch, even though they are not aware of the fact that the shown time setting is inducing this effect. Practical implications of the observed findings and alternative explanations are discussed.

Neuronal correlates of voluntary facial movements

Whereas the somatotopy of finger movements has been extensively studied with neuroimaging, the neural foundations of facial movements remain elusive. Therefore, we systematically studied the neuronal correlates of voluntary facial movements using the Facial Action Coding System (FACS, Ekman et al., 2002). The facial movements performed in the MRI scanner were defined as Action Units (AUs) and were controlled by a certified FACS coder. The main goal of the study was to investigate the detailed somatotopy of the facial primary motor area (facial M1). Eighteen participants were asked to produce the following four facial movements in the fMRI scanner: AU1+2 (brow raiser), AU4 (brow lowerer), AU12 (lip corner puller) and AU24 (lip presser), each in alternation with a resting phase. Our facial movement task induced generally high activation in brain motor areas (e.g., M1, premotor cortex, supplementary motor area, putamen), as well as in the thalamus, insula, and visual cortex. BOLD activations revealed overlapping representations for the four facial movements. However, within the activated facial M1 areas, we could find distinct peak activities in the left and right hemisphere supporting a rough somatotopic upper to lower face organization within the right facial M1 area, and a somatotopic organization within the right M1 upper face part. In both hemispheres, the order was an inverse somatotopy within the lower face representations. In contrast to the right hemisphere, in the left hemisphere the representation of AU4 was more lateral and anterior compared to the rest of the facial movements. Our findings support the notion of a partial somatotopic order within the M1 face area confirming the “like attracts like” principle (Donoghue et al., 1992). AUs which are often used together or are similar are located close to each other in the motor cortex.

The Kind Nature Behind the Unsocial Semblance: ADHD and Justice Sensitivity-A Pilot Study

OBJECTIVE

Although ADHD is largely associated with antisocial behavior, those affected are often said to show pronounced justice sensitivity. To investigate this assumption, the authors compared participants with ADHD with healthy controls.

METHOD

An experimental game was used to investigate decisions associated with social justice. A questionnaire was used to measure four dimensions of justice sensitivity: observer, profiteer, perpetrator, and victim sensitivity.

RESULTS

Participants with ADHD produced higher values in observer and profiteer sensitivity than the control group. There were no differences in perpetrator sensitivity. Questionnaire results reveal that the inattentive subtype exhibited higher justice sensitivity than the hyperactive/impulsive and combined subtypes and the control group on all dimensions.

CONCLUSION

The results confirm that justice sensitivity is indeed more pronounced in people with ADHD, particularly in the inattentive subtype. It is suggested that pronounced justice sensitivity may be a coping strategy for inferring appropriate social behavior.

Reduced Responsiveness to Social Provocation in Autism Spectrum Disorder

Deficits in emotion processing and social interaction are prominent symptoms of autism spectrum disorder (ASD). ASD has also been associated with aggressive tendencies towards self and others. The prevalence of aggressive behavior in this disorder, its etiology and its impact on social life are still unclear. This study investigated behavioral and physiological effects of social provocation in patients with ASD and healthy controls. We used a modified Taylor Aggression Paradigm in 24 high-functioning patients with ASD and 24 healthy controls. Participants were instructed to play against a fictitious human opponent. Money withdrawals toward the participant represented provocation and money deduction by the participant denoted aggressive behavior. Throughout the measurement, electrodermal activity (EDA) was recorded. Healthy controls showed higher aggressive responses to high provocation compared to low provocation, which demonstrated the effectiveness of the used procedure in eliciting aggression. Patients' responses were not influenced by the level of social provocation, although in both groups aggression was higher after lost compared to won trials. Physiologically, controls showed fewer but higher EDA amplitudes when responding aggressively, whereas patients displayed the opposite pattern of more but lower EDA amplitudes. The modified Taylor Aggression Paradigm successfully elicited aggression and revealed different behavioral and neurophysiological responses in patients and healthy controls. Patients' aggressive behavior as well as their physiological responses were less modulated by level of provocation compared to controls. Therapeutic attempts for patients might concentrate on improving empathic abilities and the understanding of social situations, including provocation and aggressive behavior.

A bio-psycho-social model of violence related to mental health problems

BACKGROUND

Psychiatry is characterised by bio-psycho-social approaches and therapies. Thus there should be an interest in comprehensive theoretical models for didactic purposes.

METHODS

A narrative synthesis of key themes in the current literature on psychiatric aspects of violence was conducted with the aim of integrating biological, psychological and sociological ideas in this area.

RESULTS

Two didactical models are proposed for 1) individual disposition and for 2) acting in specific situations, each including available evidence-based knowledge.

CONCLUSIONS

The proposed models may be helpful for a comprehensive understanding of all relevant influencing factors in violent mentally ill people and for didactical purposes.

Neural correlates of moral reasoning in autism spectrum disorder

In our study, we tried to clarify whether patients with autism spectrum disorder (ASD) reveal different moral decision patterns as compared to healthy subjects and whether common social interaction difficulties in ASD are reflected in altered brain activation during different aspects of moral reasoning. 28 patients with high-functioning ASD and 28 healthy subjects matched for gender, age and education took part in an event-related functional magnetic resonance imaging study. Participants were confronted with textual dilemma situations followed by proposed solutions to which they could agree or disagree. On a neural level, moral decision making was associated with activation in anterior medial prefrontal regions, the temporo-parietal junction and the precuneus for both groups. However, while patients and healthy controls did not exhibit significant behavioral differences, ASD patients showed decreased activation in limbic regions, particularly the amygdala, as well as increased activation in the anterior and the posterior cingulate gyrus during moral reasoning. Alterations of brain activation in patients might thus indicate specific impairments in empathy. However, activation increases in brain regions associated with the 'default mode network' and self-referential cognition also provide evidence for an altered way of patients' cerebral processing with regard to decision making based on social information.