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Tang H, Shi J, Zhang S, Chen Y, Xiong T, Wang X, Chen Z, Dai Z, Yao Z, Lu Q. Specific Associations in the Alpha Frequency Between the Subcomponents of Rumination and the Subsystems of the Default Mode Network Among Bipolar I Disorder Patients. Brain Connect 2024; 14:542-549. [PMID: 39446966 DOI: 10.1089/brain.2023.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2024] Open
Abstract
Introduction: Rumination in bipolar disorder (BD) is well documented. Recent neuroimaging studies highlight the role of the default mode network (DMN) in rumination, while few studies have evaluated the DMN activity in BD rumination, particularly the underlying neuroelectrophysiology. Methods: A total of 44 patients with depressed bipolar I disorder (BD-I) and 46 healthy controls underwent resting-state magnetoencephalography. Two core hubs of the DMN, the posterior cingulate cortex (PCC), and anterior medial prefrontal cortex, together with the dorsal medial prefrontal cortex (dmPFC) and the medial temporal lobe (MTL) subsystems, were identified as the regions of interest. The power envelope method was used to determine the alpha band's cross-subsystem functional connectivity (FC). After comparing the rumination and DMN FC between the groups, Spearman partial correlation analysis was performed to evaluate the relationship between aberrant FC and rumination in BD-I patients. Results: BD-I patients demonstrated more global rumination, including higher subcomponent scores of brooding and reflection. In addition, the alpha frequency FC of the PCC-dmPFC and dmPFC-MTL subsystems within the DMN was dramatically increased in the BD-I group. The former was strongly associated with reflection, whereas the latter was related to brooding. Conclusion: The findings suggest that the reflection and brooding components of rumination are selectively related to the alpha frequency FC of the PCC-dmPFC and dmPFC-MTL subsystems, respectively. These associations highlight the significance of DMN activities in rumination among BD-I patients and have implications for future rumination interventions.
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Affiliation(s)
- Hao Tang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Department of Psychiatry, Nanjing Lishui District Third People's Hospital, Nanjing, China
| | - Jiabo Shi
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Siqi Zhang
- School of Biological Sciences & Medical Engineering, Child Development and Learning Science, Key Laboratory of Child Development and Learning Science, Ministry of Education, Research Center for Learning Science, Southeast University, Nanjing, China
| | - Yu Chen
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Tingting Xiong
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xumiao Wang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhilu Chen
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhongpeng Dai
- School of Biological Sciences & Medical Engineering, Child Development and Learning Science, Key Laboratory of Child Development and Learning Science, Ministry of Education, Research Center for Learning Science, Southeast University, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Child Development and Learning Science, Key Laboratory of Child Development and Learning Science, Ministry of Education, Research Center for Learning Science, Southeast University, Nanjing, China
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Adamis AM, Lebovitz JG, Oberlin L, Chen S, Phan D, Burns KC, Gunning FM, Burdick KE. Predictors of psychosocial impairment in a transdiagnostic sample: Unique effects of repetitive negative thinking. J Affect Disord 2024; 366:74-82. [PMID: 39142590 DOI: 10.1016/j.jad.2024.08.054] [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: 04/22/2024] [Revised: 08/09/2024] [Accepted: 08/11/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Repetitive negative thinking (RNT) is a transdiagnostic process involving perseverative, unproductive, and uncontrollable thoughts. Although RNT may impede adaptive psychosocial functioning by prolonging negative mood states, strengthening cognitive biases, and preventing effective problem-solving, the extent to which RNT is associated with risk for poor psychosocial outcomes is unclear. Given that this has clear transdiagnostic treatment implications, the present study aimed to isolate the unique relationship of RNT with social functioning and life satisfaction in a mixed clinical and non-clinical sample. METHODS In 201 mid-to-later life adult participants (27 with primary diagnoses of bipolar disorder, 84 with major depressive disorder, and 90 healthy volunteers), we measured RNT, social functioning, life satisfaction, trait rumination, DSM-5 diagnoses, depressive symptoms, manic symptoms, cognitive control performance, and global cognitive functioning. RESULTS Linear regression models revealed that RNT, but not rumination, was significantly associated with poorer social functioning (β = 0.42 p < .001) and reduced life satisfaction (β = -0.42, p < .001) after controlling for clinical and cognitive covariates. LIMITATIONS Limited demographic diversity, cross-sectional design, self-reporting of outcomes. CONCLUSIONS Results suggest that RNT may confer risk for key psychosocial outcomes during middle to later adulthood, over and above the effects of clinical and cognitive variables and independent of diagnostic status. Findings lend support to the notion of RNT as a transdiagnostic process and suggest that RNT may be an important therapeutic target for adults with poor social functioning and/or reduced life satisfaction.
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Affiliation(s)
- Alexandra M Adamis
- Vanderbilt University, 111 21(st) Avenue South, Nashville, TN 37203, USA
| | - Julia G Lebovitz
- Vanderbilt University, 111 21(st) Avenue South, Nashville, TN 37203, USA
| | - Lauren Oberlin
- Joan & Sanford I. Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10065, USA
| | - Serena Chen
- Joan & Sanford I. Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10065, USA
| | - Dustin Phan
- Joan & Sanford I. Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10065, USA
| | - Katharine C Burns
- Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115, USA
| | - Faith M Gunning
- Joan & Sanford I. Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10065, USA
| | - Katherine E Burdick
- Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115, USA; Harvard Medical School, Boston, MA, USA.
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Hu Y, Wu X, Li S, Liu P, Wang D. Imagine before you leap: Episodic future thinking combined with transcranial direct current stimulation training for impulsive choice in repetitive negative thinking. Int J Clin Health Psychol 2024; 24:100455. [PMID: 38577657 PMCID: PMC10992705 DOI: 10.1016/j.ijchp.2024.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
Background Immediate reward preference in repetitive negative thinking (RNT) has a high clinical correlation with a variety of maladaptive behaviors, whereas episodic future thinking (EFT) may be conducive to dealing with non-adaptive thinking and decision-making. Objectives This study aimed to evaluate the efficacy of EFT training combined with transcranial direct current stimulation (tDCS) stimulation over the ventromedial PFC (vmPFC) in inhibiting impulsive choice of RNT individuals. Method Study 1 explored the effects of EFT on immediate reward preference of participants with high and low RNT (N = 48). Study 2 conducted a randomized controlled trial (RCT) to examine the treatment effect of the EFT-neural training on impulsive choice of high RNT individuals (N = 103). Results In study 1, individuals with high RNT were more likely to choose smaller and sooner (SS) rewards, however, there were no significant differences between the high-RNT group and the low-RNT group under the positive EFT condition. In study 2, a significant decrease was shown in the proportion of choosing SS rewards under the 8-week EFT-neural training, and the effect was maintained at 1 month follow-up. Conclusion RNT is a vulnerability factor for short-sighted behaviors, and EFT-neural training could be suitable for reducing RNT and improving immediate reward preference.
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Affiliation(s)
| | | | - Shuyi Li
- School of Psychology, Shandong Normal University, China
| | - Peiyao Liu
- School of Psychology, Shandong Normal University, China
| | - Dawei Wang
- School of Psychology, Shandong Normal University, China
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Kurnaz S, Durmaz O. The relationship between metacognitive processes and cognitive performances in older adults with no significant impairment: a cross-sectional study. Psychogeriatrics 2024; 24:322-328. [PMID: 38247025 DOI: 10.1111/psyg.13077] [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: 05/05/2023] [Revised: 11/30/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Metacognitive dysfunctions have been implicated in several neuropsychiatric conditions, while cognitive performances have been evaluated by measuring cognitive domains in older adults. This study investigated a relationship between metacognitive processes and cognitive performances in older adults. METHODS A sociodemographic form, the Standardised Mini-Mental State Examination (SMMSE) and the Metacognitions Questionnaire-30 (MCQ-30) were applied to participants aged >65 years who had no significant cognitive decline defined as normal or with mild cognitive impairment. RESULTS 'Negative beliefs about worry' and 'need to control thoughts' domains of MCQ-30 were related to cognitive performance measured with SMMSE. Increased negative beliefs about worry were a predicting factor for total cognitive performance as a means of contributing to cognitive impairment, whereas an increased need to control thoughts was related to having a less likely cognitive impairment. CONCLUSIONS Metacognitive dysfunctional processes, in particular about worry, might contribute to determining more decent outcomes for cognitive conditions in older adults with no significant cognitive dysfunction.
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Affiliation(s)
- Samet Kurnaz
- Department of Psychiatry, Şehit Prof. Dr. İlhan Varank Sancaktepe Training & Research Hospital, Istanbul, Turkey
| | - Onur Durmaz
- Department of Psychiatry, Erenköy Mental Health and Neurology Training & Research Hospital, Istanbul, Turkey
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Hashimoto K. Arketamine for cognitive impairment in psychiatric disorders. Eur Arch Psychiatry Clin Neurosci 2023; 273:1513-1525. [PMID: 36786865 PMCID: PMC9925943 DOI: 10.1007/s00406-023-01570-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
Cognitive impairment has been observed in patients with various psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD). Although modern therapeutic drugs can improve certain symptoms (i.e., psychosis, depression) in these patients, these drugs have not been found to improve cognitive impairment. The N-methyl-D-aspartate receptor antagonist (R,S)-ketamine has attracted attention as a rapidly acting antidepressant. In addition to its robust antidepressant effects, (R,S)-ketamine has been suggested to improve cognitive impairment in patients with MDD and BD, despite causing cognitive impairment in healthy control subjects. (R,S)-ketamine is a racemic mixture of equal amounts of (R)-ketamine (or arketamine) and (S)-ketamine (or esketamine). Arketamine has been found to have more potent antidepressant-like actions than esketamine in rodents. Interestingly, arketamine, but not esketamine, has been suggested to improve phencyclidine-induced cognitive deficits in mice. Furthermore, arketamine has been suggested to ameliorate cognitive deficits in rodent offspring after maternal immune activation. In the current article, it is proposed that arketamine has therapeutic potential for treating cognitive impairment in patients with psychiatric disorders. Additionally, the potential role of the gut-microbiome-brain axis in cognitive impairment in psychiatric disorders is discussed.
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Affiliation(s)
- Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chiba, 260-8670, Japan.
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Martin S. Why using “consciousness” in psychotherapy? Insight, metacognition and self-consciousness. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2023.101015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Tu J, Sun Y, Tian D, Chen X, Shi S, Zhe X, Zhang S, Wang N, Hui Y, Gao F. Impact of metacognition on attitudes toward epilepsy in medical students. Epilepsy Behav 2023; 143:109243. [PMID: 37182501 DOI: 10.1016/j.yebeh.2023.109243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/02/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE This study evaluated medical students' knowledge and attitudes toward epilepsy and the influence of metacognition thereon. METHOD Valid questionnaires were administered to medical students including undergraduate, professional postgraduate, and standardized residency training students (N = 503). The questionnaire had 4 parts: demographic information, knowledge of epilepsy, attitudes toward epilepsy, and metacognitive assessment. The Chinese Public Attitudes Toward Epilepsy scale and 30-Item Metacognition Questionnaire were used to assess attitudes and metacognition, respectively. RESULTS Almost all participants had heard of epilepsy; 38.8% had witnessed a seizure and 25% were acquainted with a person with epilepsy. The proportion of correct answers to epilepsy-related knowledge ranged from 40.6% (Putting an object into the mouth of a person experiencing an epileptic seizure) to 97% (Convulsion is a symptom of epilepsy). However, knowledge of epilepsy was not able to affect attitudes toward epilepsy. Age, years of clinical experience, having witnessed a seizure, positive belief of worry, and need to control thinking were correlated with the different domains of attitude toward epilepsy. When participants were divided into 2 groups-i.e., those with high and low knowledge of epilepsy, participants in the former group who had a positive belief of worry or had not witnessed any seizures were more likely to have negative attitudes toward epilepsy. CONCLUSION Medical students showed good awareness of the etiology and symptoms of epilepsy. Overall, attitudes toward epilepsy were negative. A positive belief of worry was associated with a more negative attitude toward epilepsy among respondents with greater knowledge of epilepsy.
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Affiliation(s)
- Jing Tu
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Yanhui Sun
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Dandan Tian
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Xiuqing Chen
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Shaoting Shi
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Xiao Zhe
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Shijun Zhang
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | | | | | - Fei Gao
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China.
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Porta-Casteràs D, Cano M, Navarra-Ventura G, Serra-Blasco M, Vicent-Gil M, Solé B, Montejo L, Torrent C, Martinez-Aran A, Harrison BJ, Palao D, Vieta E, Cardoner N. Disrupted network switching in euthymic bipolar disorder: Working memory and self-referential paradigms. J Affect Disord 2023; 320:552-560. [PMID: 36202301 DOI: 10.1016/j.jad.2022.09.152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) frequently suffer from neurocognitive deficits that can persist during periods of clinical stability. Specifically, impairments in executive functioning such as working memory and in self-processing have been identified as the main components of the neurocognitive profile observed in euthymic BD patients. The study of the neurobiological correlates of these state-independent alterations may be a prerequisite to develop reliable biomarkers in BD. METHODS A sample of 27 euthymic BD patients and 25 healthy participants (HC) completed working memory and self-referential functional Magnetic Resonance Imaging (fMRI) tasks. Activation maps obtained for each group and contrast images (i.e., 2-back > 1-back/self > control) were used for comparisons between patients and HC. RESULTS Euthymic BD patients, in comparison to HC, showed a higher ventromedial prefrontal cortex activation during working memory, a result driven by the lack of deactivation in BD patients. In addition, euthymic BD patients displayed a greater dorsomedial and dorsolateral prefrontal cortex activation during self-reference processing. LIMITATIONS Pharmacotherapy was described but not included as a confounder in our models. Sample size was modest. CONCLUSION Our findings revealed a lack of deactivation in the anterior default mode network (aDMN) during a working memory task, a finding consistent with prior research in BD patients, but also a higher activation in frontal regions within the central executive network (CEN) during self-processing. These results suggest that an imbalance of neural network dynamics underlying external/internal oriented cognition (the CEN and the aDMN, respectively) may be one of the first reliable biomarkers in euthymic bipolar patients.
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Affiliation(s)
- D Porta-Casteràs
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Cano
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain.
| | - G Navarra-Ventura
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain; Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears, Palma, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - M Serra-Blasco
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Programa eHealth ICOnnecta't, Institut Català d'Oncologia, Barcelona, Spain
| | - M Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - B Solé
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - L Montejo
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - C Torrent
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - A Martinez-Aran
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - D Palao
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - E Vieta
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - N Cardoner
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
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Martin S, Oltra A, Del Monte J. Metacognition vulnerabilities in time of crisis: Who to protect from suicidal risk? Brain Behav 2022; 12:e2794. [PMID: 36366935 PMCID: PMC9759143 DOI: 10.1002/brb3.2794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/19/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION During stressful events, we are all trying to cope. We may not be equal depending on our emotional, psychological, and mental states. During the COVID-19 pandemic, we could try to avoid negative information processing and anxiogenics content to prevent unhealthy thinking processes. One of the processes we can observe regarding our way of thinking and its impact on our psychological well-being is Metacognition. METHODS We recruited 104 outpatients in 2018. In 2020, during the pandemic, we recruited 216 outpatients and 176 healthy controls. We assessed their level of metacognition with the MCQ30 scale together with Suicidal risk and Hopelessness. RESULTS All three groups showed significant differences, with the nonclinical sample having higher scores in MCQ30. Regression revealed the different profiles where Hopelessness was the only predictor for the clinical sample, whereas metacognition was an adjunctive predictor of suicidal risk for the nonclinical sample. CONCLUSION Our results showed that the COVID-19 crisis influenced metacognitive levels for the nonclinical sample but not for the clinical population. Moreover, Hopelessness predicted suicide risk for both populations, but Metacognition was also a predictive factor for the nonclinical sample. We conclude with the possible impact of preventive measures based on Metacognitive work that can be created out of these results.
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Affiliation(s)
- Sylvia Martin
- Psycho.TCCE, Private Practice, Nîmes, France.,Center for Research and Bioetchics, Uppsala University, Uppsala, Sweden
| | | | - Jonathan Del Monte
- Psychosocial Laboratory, Aix-Marseille and Nîmes Universities, Nîmes, France
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Exploring Clinical Correlates of Metacognition in Bipolar Disorders Using Moderation Analyses: The Role of Antipsychotics. J Clin Med 2021; 10:jcm10194349. [PMID: 34640367 PMCID: PMC8509459 DOI: 10.3390/jcm10194349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/17/2022] Open
Abstract
The determinants of metacognition are still poorly understood in bipolar disorders (BD). We aimed to examine the clinical determinants of metacognition, defined as the agreement between objective and subjective cognition in individuals with BD. The participants consisted of 281 patients with BD who underwent an extensive neuropsychological battery and clinical evaluation. To assess subjective cognition, participants provided a general rating of their estimated cognitive difficulties. Clinical characteristics of BD were also recorded, along with medication. We studied the potential moderation of the association between cognitive complaints and global objective cognitive performance by several clinical variables with ordinal logistic regressions. Depression and impulsivity were associated with greater cognitive complaints. The only variable that moderated the relationship between objective and subjective cognition in the global model was the prescription of antipsychotics. Patients taking antipsychotics had a poorer association between cognitive complaints and objective neuropsychological performance. This result suggests a role for dopamine in the modulation of metacognitive performance, and calls for the systematic control of antipsychotic medication in future studies documenting metacognitive deficits in severe and persistent mental disorders. Depression and impulsivity should be investigated as potential therapeutic targets for individuals with BD and cognitive complaints, before proposing an extensive neuropsychological evaluation.
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Batmaz S, Altinoz AE, Sonkurt HO. Cognitive attentional syndrome and metacognitive beliefs as potential treatment targets for metacognitive therapy in bipolar disorder. World J Psychiatry 2021; 11:589-604. [PMID: 34631463 PMCID: PMC8474997 DOI: 10.5498/wjp.v11.i9.589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/16/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
Most treatment guidelines emphasize the use of psychotropic drugs for both the acute and maintenance treatment of bipolar disorder (BD). However, relying only on psychotropics without adjunctive psychosocial interventions may be insufficient in treating patients with BD. Given its unique view in the explanation of psychopathological states, metacognitive therapy (MCT) might be helpful for BD. Metacognitive theory posits that psychopathology is a result of the cognitive attentional syndrome (CAS) and that it is influenced and maintained by dysfunctional metacognitive beliefs, perseverative thinking, attentional biases, and dysfunctional coping strategies. In this review, literature data regarding these areas in BD are examined. Studies suggest that perseverative thinking might be among the emotion regulation strategies endorsed in individuals with BD. Regarding attentional biases, literature data show that state-dependent, mood-changing attentional biases and a ruminative self-focused attention are present. Studies also suggest that cognitive self-consciousness is higher in BD compared to controls. It is seen that maladaptive coping strategies are frequently reported in BD, and that these strategies are associated with depression severity, negative affect and relapse risk. Studies focusing on dysfunctional metacognitive beliefs in BD reported that individuals with BD had higher scores for negative metacognitive beliefs, self-consciousness, need to control thoughts, and a lack of cognitive confidence. Also, dysfunctional metacognitive beliefs were associated with depressive symptomatology. These findings suggest that the components of CAS and dysfunctional metacognitive beliefs are evident in BD. For a subgroup of patients with BD who fail to respond to evidence-based psychopharmacological and adjunctive psychotherapeutic interventions, MCT might be an alternative way to consider as a treatment option. In conclusion, taken the available data together, we propose a sequential treatment protocol for BD, mainly based on the MCT treatment plan of depressive disorders.
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Affiliation(s)
- Sedat Batmaz
- Department of Psychiatry, School of Medicine, Tokat Gaziosmanpasa University, Tokat 60100, Turkey
| | - Ali Ercan Altinoz
- Department of Psychiatry, School of Medicine, Eskisehir Osmangazi University, Eskisehir 26000, Turkey
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