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Páleník J. What does it mean for consciousness to be multidimensional? A narrative review. Front Psychol 2024; 15:1430262. [PMID: 38966739 PMCID: PMC11222411 DOI: 10.3389/fpsyg.2024.1430262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 06/10/2024] [Indexed: 07/06/2024] Open
Abstract
A recent development in the psychological and neuroscientific study of consciousness has been the tendency to conceptualize consciousness as a multidimensional phenomenon. This narrative review elucidates the notion of dimensionality of consciousness and outlines the key concepts and disagreements on this topic through the viewpoints of several theoretical proposals. The reviewed literature is critically evaluated, and the main issues to be resolved by future theoretical and empirical work are identified: the problems of dimension selection and dimension aggregation, as well as some ethical considerations. This narrative review is seemingly the first to comprehensively overview this specific aspect of consciousness science.
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Affiliation(s)
- Julie Páleník
- First Department of Neurology, St. Anne’s University Hospital and Medical Faculty of Masaryk University, Brno, Czechia
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2
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Ricci V, Maina G, Martinotti G. The Loss of Spatiality and Temporality in Twilight Consciousness: The Emergence of Exogenous Psychosis Induced by Novel Psychoactive Substances. Psychopathology 2024; 57:248-258. [PMID: 38631303 DOI: 10.1159/000536076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/29/2023] [Indexed: 04/19/2024]
Abstract
BACKGROUND The state of twilight consciousness is marked by a focused narrowing of awareness, maintaining vigilance and attention while simultaneously experiencing perceptual shifts in the surrounding environment. It is crucial to recognize that this twilight state represents not just a contraction but also an expansion of conscious experience. SUMMARY Substances of abuse, particularly new psychoactive substances, play a significant role in inducing this twilight state. They achieve this by deconstructing essential components of consciousness, such as the perception of time and space. KEY MESSAGE This paper aimed to explore the phenomenon of the twilight state of consciousness and shed light on how new psychoactive substances can alter the perception of time and space during this twilight phase, potentially triggering exogenous psychosis. This comprehensive inquiry employs a phenomenological approach to the study of consciousness, recognizing it as the primary tool for ascribing significance to this intricate yet often overlooked aspect of psychopathology.
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Affiliation(s)
- Valerio Ricci
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Giuseppe Maina
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università Degli Studi G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Calciu C, Macpherson R, Chen SY, Zlate M, King RC, Rees KJ, Soponaru C, Webb J. Dissociation and recovery in psychosis - an overview of the literature. Front Psychiatry 2024; 15:1327783. [PMID: 38645417 PMCID: PMC11026677 DOI: 10.3389/fpsyt.2024.1327783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/12/2024] [Indexed: 04/23/2024] Open
Abstract
Background The relationship between dissociation and recovery from psychosis is a new topic, which could attract the interest of the researchers in the field of dissociation due to its relevance to their daily clinical practice. This review brings together a diversity of international research and theoretical views on the phenomenology of dissociation, psychosis and recovery and provides a synthesis by narrative and tabulation of the existing knowledge related to these concepts. Aims The objective was to make a synthesis by narrative and tabulation about what is known on the topic. Methods The systematic search was conducted according to the PRISMA-statement in the databases Medline, PsycInfo, PubMed and Google Scholar. 2110 articles were selected according to the inclusion and exclusion criteria detailed in the methods, and 19 records were included in the review. Outcomes None of the included publications put together, in the same conceptualisation or hypothesis, dissociation and the recovery from an episode of psychosis, therefore this matter remains unstudied at this time. Conclusion The process of reviewing the existing scientific literature in the field of dissociation and recovery from psychosis has been very useful for charting the direction that future research will take.
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Affiliation(s)
- Claudia Calciu
- General Adult Psychiatry, Gloucestershire Health and Care NHS Foundation Trust, Gloucester, United Kingdom
- Psychology Faculty, School of Psychology and Educational Sciences, “Alexandru Ioan Cuza” University, Iasi, Romania
| | - Rob Macpherson
- General Adult Psychiatry, Gloucestershire Health and Care NHS Foundation Trust, Gloucester, United Kingdom
| | - Sui Yung Chen
- General Adult Psychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Madalina Zlate
- Later Life, Avon and Wiltshire Mental Health Partnership NHS Trust, North Somerset, United Kingdom
| | - Rosemary C. King
- Child and Adolescent Mental Health Service, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Kerry J. Rees
- Psychology Department, School of Natural and Social Sciences, University of Gloucestershire, Gloucester, United Kingdom
| | - Camelia Soponaru
- Psychology Faculty, School of Psychology and Educational Sciences, “Alexandru Ioan Cuza” University, Iasi, Romania
| | - Jackie Webb
- General Adult Psychiatry, Gloucestershire Health and Care NHS Foundation Trust, Gloucester, United Kingdom
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Friston K. Computational psychiatry: from synapses to sentience. Mol Psychiatry 2023; 28:256-268. [PMID: 36056173 PMCID: PMC7614021 DOI: 10.1038/s41380-022-01743-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 01/09/2023]
Abstract
This review considers computational psychiatry from a particular viewpoint: namely, a commitment to explaining psychopathology in terms of pathophysiology. It rests on the notion of a generative model as underwriting (i) sentient processing in the brain, and (ii) the scientific process in psychiatry. The story starts with a view of the brain-from cognitive and computational neuroscience-as an organ of inference and prediction. This offers a formal description of neuronal message passing, distributed processing and belief propagation in neuronal networks; and how certain kinds of dysconnection lead to aberrant belief updating and false inference. The dysconnections in question can be read as a pernicious synaptopathy that fits comfortably with formal notions of how we-or our brains-encode uncertainty or its complement, precision. It then considers how the ensuing process theories are tested empirically, with an emphasis on the computational modelling of neuronal circuits and synaptic gain control that mediates attentional set, active inference, learning and planning. The opportunities afforded by this sort of modelling are considered in light of in silico experiments; namely, computational neuropsychology, computational phenotyping and the promises of a computational nosology for psychiatry. The resulting survey of computational approaches is not scholarly or exhaustive. Rather, its aim is to review a theoretical narrative that is emerging across subdisciplines within psychiatry and empirical scales of investigation. These range from epilepsy research to neurodegenerative disorders; from post-traumatic stress disorder to the management of chronic pain, from schizophrenia to functional medical symptoms.
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Affiliation(s)
- Karl Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, WC1N 3AR, UK.
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Uyan TT, Baltacioglu M, Hocaoglu C. Relationships between childhood trauma and dissociative, psychotic symptoms in patients with schizophrenia: a case–control study. Gen Psychiatr 2022; 35:e100659. [PMID: 35146333 PMCID: PMC8796255 DOI: 10.1136/gpsych-2021-100659] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Childhood trauma (CT) is an important risk factor in the emergence and clinical course of psychiatric disorders. In the latest literature, an association exists between CT and patients with schizophrenia. There is also a strong relationship between the dissociative symptoms of schizophrenia and the presence of CT. Aims The aim of this study is to examine the relationship between CT and dissociative, positive and negative symptoms in patients with schizophrenia. Methods One hundred patients with schizophrenia and 100 healthy volunteers were included in the study. The Sociodemographic Data Form, Dissociative Experiences Scale (DES), Positive and Negative Syndrome Scale (PANSS), and Childhood Trauma Questionnaire (CTQ) were administered to all participants. Results The CTQ and DES scores of the schizophrenia group were significantly higher than those of the control group. In patients with schizophrenia, a positive association was found between positive symptoms and DES scores. In terms of negative symptoms, a positive association was found between apathetic social withdrawal and CTQ-emotional neglect (EN), CTQ-physical neglect (PN) and CTQ total scores. There was a significant positive correlation between CTQ-EN scores and negative symptoms and PANSS scores. No significant relationship was found between negative symptoms and DES scores. Conclusions High rates of CT and dissociative symptoms are seen in patients with schizophrenia. In addition, the findings of the relationship between CT and dissociative, positive and negative symptoms are also noteworthy. Therefore, it may be important for clinicians to assess trauma history during the psychiatric evaluation of patients with schizophrenia.
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Affiliation(s)
| | | | - Cicek Hocaoglu
- Department of Psychiatry, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
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Affiliation(s)
- Karl J Friston
- Wellcome Centre for Human Neuroimaging and Queen Square Institute of Neurology, University College London; and National Hospital for Neurology and Neurosurgery, London
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Hobson JA, Gott JA, Friston KJ. Minds and Brains, Sleep and Psychiatry. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2020; 3:12-28. [PMID: 35174319 PMCID: PMC8834904 DOI: 10.1176/appi.prcp.20200023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/14/2020] [Indexed: 11/30/2022] Open
Abstract
Objective This article offers a philosophical thesis for psychiatric disorders that rests upon some simple truths about the mind and brain. Specifically, it asks whether the dual aspect monism—that emerges from sleep research and theoretical neurobiology—can be applied to pathophysiology and psychopathology in psychiatry. Methods Our starting point is that the mind and brain are emergent aspects of the same (neuronal) dynamics; namely, the brain–mind. Our endpoint is that synaptic dysconnection syndromes inherit the same dual aspect; namely, aberrant inference or belief updating on the one hand, and a failure of neuromodulatory synaptic gain control on the other. We start with some basic considerations from sleep research that integrate the phenomenology of dreaming with the neurophysiology of sleep. Results We then leverage this treatment by treating the brain as an organ of inference. Our particular focus is on the role of precision (i.e., the representation of uncertainty) in belief updating and the accompanying synaptic mechanisms. Conclusions Finally, we suggest a dual aspect approach—based upon belief updating (i.e., mind processes) and its neurophysiological implementation (i.e., brain processes)—has a wide explanatory compass for psychiatry and various movement disorders. This approach identifies the kind of pathophysiology that underwrites psychopathology—and points to certain psychotherapeutic and psychopharmacological targets, which may stand in mechanistic relation to each other. The ‘mind’ emerges from Bayesian belief updating in the ‘brain’ Psychopathology can be read as aberrant belief updating. Aberrant belief updating follows from any neuromodulatory synaptopathy
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Affiliation(s)
- J. Allan Hobson
- Division of Sleep Medicine Harvard Medical School Boston Massachusetts
| | - Jarrod A. Gott
- Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen
| | - Karl J. Friston
- The Wellcome Centre for Human Neuroimaging University College London London
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Magnetic resonance diffusion tensor imaging in psychiatry: a narrative review of its potential role in diagnosis. Pharmacol Rep 2020; 73:43-56. [PMID: 33125677 PMCID: PMC7862529 DOI: 10.1007/s43440-020-00177-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/04/2020] [Accepted: 10/14/2020] [Indexed: 12/28/2022]
Abstract
Diffusion tensor imaging (DTI) is an imaging technique that uses magnetic resonance. It measures the diffusion of water molecules in tissues, which can occur either without restriction (i.e., in an isotropic manner) or limited by some obstacles, such as cell membranes (i.e., in an anisotropic manner). Diffusion is most often measured in terms of, inter alia, fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). DTI allows us to reconstruct, visualize, and evaluate certain qualities of white matter. To date, many studies have sought to associate various changes in the distribution of diffusion within the brain with mental diseases and disorders. A better understanding of white matter integrity disorders can help us recognize the causes of diseases, as well as help create objective methods of psychiatric diagnosis, identify biomarkers of mental illness, and improve pharmacotherapy. The aim of this work is to present the characteristics of DTI as well as current research on its use in schizophrenia, affective disorders, and other mental disorders.
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Enhanced Molecular Appreciation of Psychiatric Disorders Through High-Dimensionality Data Acquisition and Analytics. Methods Mol Biol 2019; 2011:671-723. [PMID: 31273728 DOI: 10.1007/978-1-4939-9554-7_39] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The initial diagnosis, molecular investigation, treatment, and posttreatment care of major psychiatric disorders (schizophrenia and bipolar depression) are all still significantly hindered by the current inability to define these disorders in an explicit molecular signaling manner. High-dimensionality data analytics, using large datastreams from transcriptomic, proteomic, or metabolomic investigations, will likely advance both the appreciation of the molecular nature of major psychiatric disorders and simultaneously enhance our ability to more efficiently diagnose and treat these debilitating conditions. High-dimensionality data analysis in psychiatric research has been heterogeneous in aims and methods and limited by insufficient sample sizes, poorly defined case definitions, methodological inhomogeneity, and confounding results. All of these issues combine to constrain the conclusions that can be extracted from them. Here, we discuss possibilities for overcoming methodological challenges through the implementation of transcriptomic, proteomic, or metabolomics signatures in psychiatric diagnosis and offer an outlook for future investigations. To fulfill the promise of intelligent high-dimensionality data-based differential diagnosis in mental disease diagnosis and treatment, future research will need large, well-defined cohorts in combination with state-of-the-art technologies.
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Abstract
This article describes the conclusions of an investigation done with 120 Spanish patients: the finding of a new psychopathological profile within a subgroup of patients suffering from schizophrenia. The patients were evaluated through different questionnaires about sociodemographic data, traumatic events, the severity index (both clinical and psychopathological), self-esteem and consciousness of the illness. From the scores obtained on a scale of dissociative experiences, they were classified into two groups: high dissociative symptomatology or HD, and low dissociative symptomatology or LD. The HD group contained 44 patients (36.7% of the total population). The groups LD and HD show meaningful differences with respect to dissociative symptomatology levels, general psychopathology and level of traumatic events suffered. The percentage of patients with low self-esteem was higher in group HD than in group LD (M=25.52 front 28.76 of group LD; t (118)=2.94, p=.00). In addition, the group HD was more conscious of having a mental disorder, of the beneficial effects of medication and of the social consequences of their illness: F (1)=10.929, p=.001; ƞ2pt=0.083; 1-β=0.907. The results show the existence of a subgroup of schizophrenic patients with higher levels of dissociation and trauma that were related with higher levels of symptomatology, lower self-esteem and higher consciousness of the illness, building a population of higher severity in which it would make sense to implement coadjutant treatments specifically oriented to these variables and, in addition, opening a therapeutic possibility for the patients with refractory schizophrenia.
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Pec O, Bob P, Simek J, Raboch J. Dissociative states in borderline personality disorder and their relationships to psychotropic medication. Neuropsychiatr Dis Treat 2018; 14:3253-3257. [PMID: 30538483 PMCID: PMC6260192 DOI: 10.2147/ndt.s179091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND According to recent data, dissociation may play an important role in borderline personality disorder (BPD), nevertheless specific influences of psychotropic medication on dissociative symptoms in BPD and their therapeutic indications are largely unknown. The purpose of this study was to assess relationships of dissociative symptoms in BPD patients with levels of psychotropic medication and compare these results with a subgroup of patients with schizophrenia. MATERIALS AND METHODS In this study, we investigated 52 BPD patients and compared the results with a control group of 36 schizophrenia patients. In all participants, we assessed actual day doses of antipsychotic medication in chlorpromazine equivalents and antidepressant medication in fluoxetine equivalents. Dissociative symptoms were measured by Dissociative Experiences Scale (DES), and other psychopathological symptoms were measured using Health of the Nation Outcome Scales. RESULTS Results indicate that dissociative symptoms measured by DES were significantly correlated with antipsychotic medication (Spearman R=0.45, P<0.01) in chlorpromazine equivalents and antidepressant medication in fluoxetine equivalents (0.36, P<0.01). These relationships between medication and dissociative symptoms were not found in the control group of schizophrenia patients. CONCLUSION The results suggest that levels of antipsychotic medication and antidepressant medication are significantly associated with dissociative symptoms in BPD but not in schizophrenia.
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Affiliation(s)
- Ondrej Pec
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, .,Psychotherapeutic and Psychosomatic Clinic ESET, Prague, Czech Republic
| | - Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, .,Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic,
| | - Jakub Simek
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic,
| | - Jiri Raboch
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic,
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COMT genotype is associated with plasticity in sense of body ownership: a pilot study. PSYCHOLOGICAL RESEARCH 2017; 82:634-644. [PMID: 28251370 DOI: 10.1007/s00426-017-0849-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
The sense of body ownership constantly adapts to new environments, and awareness of a distinction between oneself and others is a fundamental ability. However, it remains unclear whether plasticity in the sense of body ownership is dependent on genetic factors. The present study investigated the influence of the catechol-O-methyltransferase (COMT) Val158Met genotype on illusory learning of a sense of body ownership and dissociation. 76 healthy Japanese participants experienced the rubber hand illusion (RHI), which is produced by sensory integration of conflicting modalities, with the intent to experimentally alter objective perceived locations and subjective ownership ratings. We found that Val/Val homozygous participants had more intense RHI experiences than Val/Met heterozygous and Met homozygous participants. Furthermore, RHI sensation was correlated with a dissociative personality trait in Val/Val homozygous participants. Our findings indicate an interaction between COMT genotype, RHI sensation, and dissociative personality traits: Val/Val genotypes were associated with RHI induction and greater vulnerability to dissociation. The findings suggest that Val/Val homozygous individuals may be more flexible regarding self-attribution/body ownership and that biological factors may contribute to reduced awareness regarding the distinction between self and others.
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Friston K, Brown HR, Siemerkus J, Stephan KE. The dysconnection hypothesis (2016). Schizophr Res 2016; 176:83-94. [PMID: 27450778 PMCID: PMC5147460 DOI: 10.1016/j.schres.2016.07.014] [Citation(s) in RCA: 358] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/06/2016] [Accepted: 07/15/2016] [Indexed: 02/06/2023]
Abstract
Twenty years have passed since the dysconnection hypothesis was first proposed (Friston and Frith, 1995; Weinberger, 1993). In that time, neuroscience has witnessed tremendous advances: we now live in a world of non-invasive neuroanatomy, computational neuroimaging and the Bayesian brain. The genomics era has come and gone. Connectomics and large-scale neuroinformatics initiatives are emerging everywhere. So where is the dysconnection hypothesis now? This article considers how the notion of schizophrenia as a dysconnection syndrome has developed - and how it has been enriched by recent advances in clinical neuroscience. In particular, we examine the dysconnection hypothesis in the context of (i) theoretical neurobiology and computational psychiatry; (ii) the empirical insights afforded by neuroimaging and associated connectomics - and (iii) how bottom-up (molecular biology and genetics) and top-down (systems biology) perspectives are converging on the mechanisms and nature of dysconnections in schizophrenia.
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Affiliation(s)
- Karl Friston
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, UK.
| | - Harriet R. Brown
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, UK,Oxford Centre for Human Brain Activity, University of Oxford, UK
| | - Jakob Siemerkus
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland,Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Klaas E. Stephan
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
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Bob P, Pec O, Mishara AL, Touskova T, Lysaker PH. Conscious brain, metacognition and schizophrenia. Int J Psychophysiol 2016; 105:1-8. [DOI: 10.1016/j.ijpsycho.2016.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 04/20/2016] [Accepted: 05/09/2016] [Indexed: 01/04/2023]
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Crespi B, Leach E, Dinsdale N, Mokkonen M, Hurd P. Imagination in human social cognition, autism, and psychotic-affective conditions. Cognition 2016; 150:181-99. [DOI: 10.1016/j.cognition.2016.02.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 02/01/2016] [Accepted: 02/03/2016] [Indexed: 01/08/2023]
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Ceylan ME, Dönmez A, Ünsalver BÖ, Evrensel A. Neural synchronization as a hypothetical explanation of the psychoanalytic unconscious. Conscious Cogn 2016; 40:34-44. [PMID: 26744848 DOI: 10.1016/j.concog.2015.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 12/23/2015] [Accepted: 12/23/2015] [Indexed: 11/25/2022]
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McCarthy-Jones S, Longden E. Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions? Front Psychol 2015; 6:1071. [PMID: 26283997 PMCID: PMC4517448 DOI: 10.3389/fpsyg.2015.01071] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/13/2015] [Indexed: 11/13/2022] Open
Abstract
Auditory verbal hallucinations (AVH: ‘hearing voices’) are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual’s personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed ‘dissociative AVH’) and AVH in schizophrenia (so-called ‘psychotic AVH’) needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.
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Affiliation(s)
| | - Eleanor Longden
- Institute of Psychology, Health and Society, University of Liverpool Liverpool, UK
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Wang HLS, Rau CL, Li YM, Chen YP, Yu R. Disrupted thalamic resting-state functional networks in schizophrenia. Front Behav Neurosci 2015; 9:45. [PMID: 25762911 PMCID: PMC4340165 DOI: 10.3389/fnbeh.2015.00045] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 02/06/2015] [Indexed: 12/24/2022] Open
Abstract
The thalamus plays a key role in filtering or gating information and has extensive interconnectivity with other brain regions. Recent studies provide evidence of thalamus abnormality in schizophrenia, but the resting functional networks of the thalamus in schizophrenia is still unclear. We characterize the thalamic resting-state networks (RSNs) in 72 patients with schizophrenia and 73 healthy controls, using a standard seed-based whole-brain correlation. In comparison with controls, patients exhibited enhance thalamic connectivity with bilateral precentral gyrus, dorsal medial frontal gyrus, middle occipital gyrus, and lingual gyrus. Reduced thalamic connectivity in schizophrenia was found in bilateral superior frontal gyrus, anterior cingualte cortex, inferior parietal lobe, and cerebellum. Our findings question the “disconnectivity model” of schizophrenia by showing the over-connected thalamic network during resting state in schizophrenia and highlight the thalamus as a key hub in the schizophrenic network abnormality.
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Affiliation(s)
| | - Chi-Lun Rau
- Department of Physical Medicine and Rehabilitation, Shuang-Ho Hospital, Taipei Medical University Taipei, Taiwan
| | - Yu-Mei Li
- Department of Special Education, National Taiwan Normal University Taipei, Taiwan
| | - Ya-Ping Chen
- Department of Physical Medicine and Rehabilitation, Shuang-Ho Hospital, Taipei Medical University Taipei, Taiwan
| | - Rongjun Yu
- Department of Psychology, National University of Singapore Singapore, Singapore ; Center for Life Sciences, Singapore Institute for Neurotechnology (SINAPSE), National University of Singapore Singapore, Singapore
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Tschiesner R, Basso D. Consciousness, not only intentionality, yields self-harming behavior. Front Hum Neurosci 2015; 9:69. [PMID: 25729359 PMCID: PMC4325902 DOI: 10.3389/fnhum.2015.00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/27/2015] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Demis Basso
- Faculty of Education, Free University of Bozen-BolzanoBolzano, Italy
- Centre for Applied Cognitive NeurosciencesRome, Italy
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The pre-reflective experience of “I” as a continuously existing being: The role of temporal functional binding. Conscious Cogn 2015; 31:98-114. [DOI: 10.1016/j.concog.2014.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 11/04/2014] [Accepted: 11/07/2014] [Indexed: 11/23/2022]
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Pec O, Bob P, Raboch J. Splitting in schizophrenia and borderline personality disorder. PLoS One 2014; 9:e91228. [PMID: 24603990 PMCID: PMC3946324 DOI: 10.1371/journal.pone.0091228] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/09/2014] [Indexed: 11/19/2022] Open
Abstract
Background Splitting describes fragmentation of conscious experience that may occur in various psychiatric disorders. A purpose of this study is to examine relationships between psychological process of splitting and disturbed cognitive and affective functions in schizophrenia and borderline personality disorder (BPD). Methods In the clinical study, we have assessed 30 patients with schizophrenia and 35 patients with BPD. The symptoms of splitting were measured using self-reported Splitting Index (SI). As a measure of semantic memory disorganization we have used verbal fluency test. Other psychopathological symptoms were assessed using Health of the Nation Outcome Scale (HoNOS). Results Main results show that SI is significantly higher in BPD group than in schizophrenia, and on the other hand, verbal fluency is significantly lower in schizophrenia group. Psychopathological symptoms measured by HoNOS are significantly higher in the BPD group than in schizophrenia. Significant relationship was found between verbal fluency and the SI “factor of others” (Spearman r = −0.52, p<0.01) in schizophrenia patients. Conclusions Processes of splitting are different in schizophrenia and BPD. In BPD patients splitting results to mental instability, whereas in schizophrenia the mental fragmentation leads to splitting of associations observed as lower scores of verbal fluency, which in principle is in agreement with Bleuler’s historical concept of splitting in schizophrenia.
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Affiliation(s)
- Ondrej Pec
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Psychotherapeutic and Psychosomatic Clinic ESET, Prague, Czech Republic
| | - Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- * E-mail:
| | - Jiri Raboch
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Bob P. Psychophysiology of dissociated consciousness. Curr Top Behav Neurosci 2014; 21:3-21. [PMID: 24850082 DOI: 10.1007/7854_2014_320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Recent study of consciousness provides an evidence that there is a limit of consciousness, which presents a barrier between conscious and unconscious processes. This barrier likely is specifically manifested as a disturbance of neural mechanisms of consciousness that through distributed brain processing, attentional mechanisms and memory processes enable to constitute integrative conscious experience. According to recent findings a level of conscious integration may change during certain conditions related to experimental cognitive manipulations, hypnosis, or stressful experiences that can lead to dissociation of consciousness. In psychopathological research the term dissociation was proposed by Pierre Janet for explanation of processes related to splitting of consciousness due to traumatic events or during hypnosis. According to several recent findings dissociation of consciousness likely is related to deficits in global distribution of information and may lead to heightened levels of "neural complexity" that reflects brain integration or differentiation based on numbers of independent neural processes in the brain that may be specifically related to various mental disorders.
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Affiliation(s)
- Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Ke Karlovu 11, 128 00, Prague, Czech Republic,
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Brébion G, Bressan RA, Ohlsen RI, David AS. A model of memory impairment in schizophrenia: cognitive and clinical factors associated with memory efficiency and memory errors. Schizophr Res 2013; 151:70-7. [PMID: 24113205 DOI: 10.1016/j.schres.2013.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 09/05/2013] [Accepted: 09/14/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND Memory impairments in patients with schizophrenia have been associated with various cognitive and clinical factors. Hallucinations have been more specifically associated with errors stemming from source monitoring failure. METHODS We conducted a broad investigation of verbal memory and visual memory as well as source memory functioning in a sample of patients with schizophrenia. Various memory measures were tallied, and we studied their associations with processing speed, working memory span, and positive, negative, and depressive symptoms. RESULTS Superficial and deep memory processes were differentially associated with processing speed, working memory span, avolition, depression, and attention disorders. Auditory/verbal and visual hallucinations were differentially associated with specific types of source memory error. CONCLUSIONS We integrated all the results into a revised version of a previously published model of memory functioning in schizophrenia. The model describes the factors that affect memory efficiency, as well as the cognitive underpinnings of hallucinations within the source monitoring framework.
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Affiliation(s)
- Gildas Brébion
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, United Kingdom; Unit of Research and Development, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Spain.
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Takahashi T. Complexity of spontaneous brain activity in mental disorders. Prog Neuropsychopharmacol Biol Psychiatry 2013; 45:258-66. [PMID: 22579532 DOI: 10.1016/j.pnpbp.2012.05.001] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 04/05/2012] [Accepted: 05/01/2012] [Indexed: 11/17/2022]
Abstract
Recent reports of functional and anatomical studies have provided evidence that aberrant neural connectivity lies at the heart of many mental disorders. Information related to neural networks has elucidated the nonlinear dynamical complexity in brain signals over a range of temporal scales. The recent advent of nonlinear analytic methods, which have served for the quantitative description of the brain signal complexity, has provided new insights into aberrant neural connectivity in many mental disorders. Although many studies have underpinned aberrant neural connectivity, findings related to complexity behavior are still inconsistent. This inconsistency might result from (i) heterogeneity in mental disorders, (ii) analytical issues, (iii) interference of typical development and aging. First, most mental disorders are heterogeneous in their clinical feature or intrinsic pathological mechanisms. Second, neurophysiologic output signals from complex brain connectivity might be characterized with multiple time scales or frequencies. Finally, age-related brain complexity changes must be considered when investigating pathological brain because typical brain complexity is not constant across generations. Future systematic studies addressing these issues will greatly expand our knowledge of neural connections and dynamics related to mental disorders.
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Affiliation(s)
- Tetsuya Takahashi
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.
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Nejad AB, Ebdrup BH, Glenthøj BY, Siebner HR. Brain connectivity studies in schizophrenia: unravelling the effects of antipsychotics. Curr Neuropharmacol 2013; 10:219-30. [PMID: 23449679 PMCID: PMC3468876 DOI: 10.2174/157015912803217305] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 06/27/2012] [Accepted: 07/05/2012] [Indexed: 11/22/2022] Open
Abstract
Impaired brain connectivity is a hallmark of schizophrenia brain dysfunction. However, the effect of drug treatment and challenges on the dysconnectivity of functional networks in schizophrenia is an understudied area. In this review, we provide an overview of functional magnetic resonance imaging studies examining dysconnectivity in schizophrenia and discuss the few studies which have also attempted to probe connectivity changes with antipsychotic drug treatment. We conclude with a discussion of possible avenues for further investigation.
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Affiliation(s)
- Ayna B Nejad
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark ; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Center Glostrup, Denmark
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