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Pérez-Vigil A, Ilzarbe D, Garcia-Delgar B, Morer A, Pomares M, Puig O, Lera-Miguel S, Rosa M, Romero M, Calvo Escalona R, Lázaro L. Theory of mind in neurodevelopmental disorders: beyond autistic spectrum disorder. Neurologia 2024; 39:117-126. [PMID: 38272257 DOI: 10.1016/j.nrleng.2024.01.005] [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] [Received: 11/16/2020] [Accepted: 04/06/2021] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group. METHODS Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n = 19), TS (n = 14), or ASD (n = 18), and a control group (n = 20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the "Stories from everyday life" task and the "Reading the mind in the eyes" test). RESULTS Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls. CONCLUSIONS ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS.
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Affiliation(s)
- A Pérez-Vigil
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - D Ilzarbe
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - B Garcia-Delgar
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Morer
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain
| | - M Pomares
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - O Puig
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - S Lera-Miguel
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Rosa
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Romero
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Calvo Escalona
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - L Lázaro
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Knopp M, Burghardt J, Oppenauer C, Meyer B, Moritz S, Sprung M. Affective and cognitive Theory of Mind in patients with alcohol use disorder: Associations with symptoms of depression, anxiety, and somatization. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209227. [PMID: 37992810 DOI: 10.1016/j.josat.2023.209227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/23/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Theory of Mind (ToM) is the ability to ascribe thoughts (cognitive ToM) and feelings (affective ToM) to others. Ample evidence exists for impairments of affective and cognitive ToM in individuals with alcohol use disorder (AUD); however, evidence regarding changes of these impairments during AUD treatment and their possible relationship to comorbid symptoms is ambiguous. The current study analyzed changes in ToM during treatment and tested associations with comorbid symptoms of depression, anxiety, somatization, and social functioning. METHODS We analyzed data from 175 individuals with AUD. The study assessed ToM and comorbid symptoms of depression, anxiety, somatization, and social functioning at the time of admission and at the time of discharge from an approximately 60 days long abstinence-oriented inpatient treatment. We assessed affective and cognitive ToM using the Movie for the Assessment of Social Cognition, a measure with high ecological validity. RESULTS All symptoms, total and cognitive ToM improved following treatment; however, affective ToM did not improve. Moreover, cognitive ToM at the beginning of treatment was associated with improved symptoms of depression and somatization, while affective ToM was not. CONCLUSIONS Our study shows improvements in total and cognitive ToM as well as symptoms of depression, anxiety, somatization, and social functioning following long-term treatment. Furthermore, cognitive ToM was related to improvements in comorbid symptoms. This finding suggests that ToM may be an important treatment target in patients with AUD.
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Affiliation(s)
- Magdalena Knopp
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Ludwig-Maximilians-Universität München, Faculty of Psychology and Educational Sciences, Department of Psychology, Leopoldstraße 13, 80802 München, Germany.
| | - Juliane Burghardt
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Claudia Oppenauer
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Bernhard Meyer
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany
| | - Manuel Sprung
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Ludwig-Maximilians-Universität München, Faculty of Psychology and Educational Sciences, Department of Psychology, Leopoldstraße 13, 80802 München, Germany; University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany; Psychiatric Rehabilitation Clinic Gars am Kamp, Psychosomatisches Zentrum Waldviertel, Kremserstraße 656, 3571 Gars am Kamp, Austria
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3
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Carpita B, Nardi B, Bonelli C, Massimetti E, Amatori G, Cremone IM, Pini S, Dell’Osso L. Presence and correlates of autistic traits among patients with social anxiety disorder. Front Psychiatry 2024; 14:1320558. [PMID: 38312918 PMCID: PMC10834675 DOI: 10.3389/fpsyt.2023.1320558] [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: 10/12/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Due to their similar behavioral presentation, it can sometimes be challenging to distinguish between a social anxiety disorder (SAD) and the social avoidance that is frequently described in autism spectrum disorder (ASD). Moreover, a growing body of evidences is reporting that a significant proportion of subjects with ASD also meet the requirements for SAD and, vice versa, subjects with SAD tend to exhibit a higher prevalence of autistic traits. Aim In this framework, the current study aims to evaluate prevalence and correlates of autistic traits in a sample of adult subjects diagnosed with SAD and healthy controls (HC), also evaluating which autism spectrum dimensions may statistically predict higher SAD symptoms. Methods 56 subjects with a clinical diagnosis of SAD and 56 gender and age matched HC were recruited from the Psychiatric Clinic of the University of Pisa. Subjects were assessed with the SCID-5, the Social Anxiety Spectrum - Short Version (SHY- SV) and the Adult Autism Subthreshold Spectrum (AdAS Spectrum). Results SAD group scored significantly higher in all AdAS Spectrum and SHY-SV domains and total score compared to the HC group with no significant gender difference. SHY-SV total and domain scores, were strongly and positively and strongly correlated with all AdAS Spectrum domains and total score. AdAS Spectrum total score and Childhood/Adolescence, Non-Verbal Communication, Empathy and Restricted interests and Rumination domain scores score were significant predictors of higher SHY-SV score. Conclusion Our results confirm the link between SAD and autistic traits also in adult population, describing not only high levels of autistic traits in SAD adults, but also significant correlations between many core features of the two disorders and a predictive role of autistic traits on higher SAD symptoms.
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Affiliation(s)
- Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chiara Bonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Massimetti
- North-Western Tuscany Region NHS Local Health Unit, Department of Psychiatry, Pisa, Italy
| | - Giulia Amatori
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ivan Mirko Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Uğurpala C, Tükel R, Ziylan EÇ, Ertekin E, Berberoğlu E. Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder. J Nerv Ment Dis 2023; 211:828-834. [PMID: 37432028 DOI: 10.1097/nmd.0000000000001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
ABSTRACT In recent years, social cognition and one of its dimensions, the theory of mind, have been more commonly investigated in patients with social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD). In this study, SAD, ADHD, comorbid SAD-ADHD, and healthy control (HC) groups, each consisting of 30 participants, were included and compared in terms of social cognition and functionality. Mean global functioning assessment scores were found to be significantly higher in the HC group compared with the other three groups and in the ADHD group compared with the SAD and SAD-ADHD groups. Mean Dokuz Eylül Theory of Mind Index total scores were found to be significantly higher in the HC group compared with the other three groups and in the SAD and SAD-ADHD groups compared with the ADHD group. These findings suggest that SAD patients with or without ADHD show better social cognition but worse functioning compared with pure ADHD patients.
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Affiliation(s)
- Can Uğurpala
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ege Çağın Ziylan
- Physiology and Pharmacology Laboratory, Beykent University Faculty of Medicine, Beykent University, Büyükçekmece, Istanbul, Turkey
| | - Erhan Ertekin
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ertuğ Berberoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
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Davion JB, Tard C, Kuchcinski G, Fragoso L, Wilu-Wilu A, Maurage P, Nguyen The Tich S, Defebvre L, D'Hondt F, Delbeuck X. Characterization of theory of mind performance in patients with myotonic dystrophy type 1. Cortex 2023; 168:181-192. [PMID: 37742438 DOI: 10.1016/j.cortex.2023.07.008] [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: 04/25/2023] [Revised: 06/30/2023] [Accepted: 07/25/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION Myotonic dystrophy type 1 (DM1) is associated with motor dysfunction as well as psychological and cognitive impairments, including altered social cognition. Theory of mind (ToM) impairments have been reported in this disease but their nature and their cognitive/cerebral correlates have yet to be determined. METHODS Fifty DM1 patients and 50 healthy controls were assessed using the Movie for the Assessment of Social Cognition, which quantifies impairments in affective and cognitive components of ToM through the depiction of everyday situations. We also measured the study participants' cognitive, behavioral and social abilities, quality of life, and brain MRI characteristics. RESULTS DM1 patients presented a significant impairment in ToM performance compared to controls (p < .001). The patients' errors were related to hypomentalizations (p < .001 vs controls) but not to hypermentalizations (p = .95). The affective component was affected (p < .001 vs controls) but not the cognitive component (p = .09). The ToM impairment was associated with demographic variables (older age and a lower educational level), genetic findings (a larger CTG triplets repeat expansion) and cognitive scores (slower information processing speed). Associations were also found with brain MRI variables (lower white matter and supratentorial volumes) but not with behavioral or social variables. DISCUSSION DM1 patients display a ToM impairment, characterized by predominant hypomentalizations concerning the affective component. This impairment might result from structural brain abnormalities observed in DM1.
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Affiliation(s)
- Jean-Baptiste Davion
- U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France; Department of Neurology, CHU Lille, Lille, France; Reference Centre for Neuromuscular Diseases Nord/Est/Ile-de-France, CHU Lille, Lille, France; Department of Pediatric Neurology, CHU Lille, Lille, France.
| | - Céline Tard
- U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France; Department of Neurology, CHU Lille, Lille, France; Reference Centre for Neuromuscular Diseases Nord/Est/Ile-de-France, CHU Lille, Lille, France
| | - Grégory Kuchcinski
- U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France; Department of Neuroradiology, CHU Lille, Lille, France
| | - Loren Fragoso
- Reference Centre for Neuromuscular Diseases Nord/Est/Ile-de-France, CHU Lille, Lille, France
| | - Amina Wilu-Wilu
- Reference Centre for Neuromuscular Diseases Nord/Est/Ile-de-France, CHU Lille, Lille, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Sylvie Nguyen The Tich
- Reference Centre for Neuromuscular Diseases Nord/Est/Ile-de-France, CHU Lille, Lille, France; Department of Pediatric Neurology, CHU Lille, Lille, France
| | - Luc Defebvre
- U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France; Department of Neurology, CHU Lille, Lille, France
| | - Fabien D'Hondt
- U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France; Department of Psychiatry, CHU Lille, Lille, France; Lille-Paris National Resource and Resilience Center (CN2R), Lille, France
| | - Xavier Delbeuck
- U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France; Department of Neurology, CHU Lille, Lille, France
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Öztürk Y, Özyurt G, Turan S, Tufan AE, Akay AP. Emotion dysregulation and social communication problems but not ToM properties may predict obsessive-compulsive disorder symptom severity. Nord J Psychiatry 2023; 77:778-787. [PMID: 37665655 DOI: 10.1080/08039488.2023.2251953] [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: 03/30/2023] [Revised: 07/06/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Studies have shown that theory of mind, emotion regulation and pragmatic abilities are negatively affected in people with obsessive-compulsive disorder (OCD). We aimed to investigate theory of mind (ToM) abilities, social responsiveness, pragmatic language, and emotion regulation skills in children with OCD and to compare them to healthy controls. METHODS This study was designed as a single-center, cross-sectional, case-control study. ToM abilities were evaluated via "Reading the Mind in the Eyes Test" (RMET), "Faces Test", "Faux-Pas Test", "Comprehension Test" and "Unexpected Outcomes Test". Social responsiveness, pragmatic language and emotion regulation were evaluated by Social Responsiveness Scale (SRS), Children's Communication Checklist- Second Edition (CCC-2), Difficulties in Emotion Regulation Scale (DERS) and Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Within the study period, we enrolled 85 adolescents (42 with OCD and 43 controls). RESULTS The OCD group performed significantly lower than healthy controls in the Faux Pass and Comprehension tests (p = 0.003 for both). We found a statistically significant difference between groups in terms of the goal, strategy, non-acceptance subscales of the DERS (p < 0.001, p = 0.006, p = 0.008, respectively) as well as the total DERS score (p < 0.001). CY-BOCS total scores correlated significantly and negatively with Comprehension, Faux Pas and Unexpected Outcomes tests, and positively with CCC total, SRS total and DERS total scores. In regression analysis the DERS, SRS and CCC tests emerged as significant predictors of CY-BOCS total score. CONCLUSION Addressing ToM, pragmatic, and ER difficulties when planning the treatment of young people with OCD may contribute to positive outcomes.
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Affiliation(s)
- Yusuf Öztürk
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Gonca Özyurt
- Department of Child and Adolescent Psychiatry, Izmir Katip Çelebi University Medical Faculty, İzmir, Turkey
| | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludağ University Medical Faculty, Bursa, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Medical Faculty, Izmir, Turkey
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Wise T, Charpentier CJ, Dayan P, Mobbs D. Interactive cognitive maps support flexible behavior under threat. Cell Rep 2023; 42:113008. [PMID: 37610871 PMCID: PMC10658881 DOI: 10.1016/j.celrep.2023.113008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/11/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023] Open
Abstract
In social environments, survival can depend upon inferring and adapting to other agents' goal-directed behavior. However, it remains unclear how humans achieve this, despite the fact that many decisions must account for complex, dynamic agents acting according to their own goals. Here, we use a predator-prey task (total n = 510) to demonstrate that humans exploit an interactive cognitive map of the social environment to infer other agents' preferences and simulate their future behavior, providing for flexible, generalizable responses. A model-based inverse reinforcement learning model explained participants' inferences about threatening agents' preferences, with participants using this inferred knowledge to enact generalizable, model-based behavioral responses. Using tree-search planning models, we then found that behavior was best explained by a planning algorithm that incorporated simulations of the threat's goal-directed behavior. Our results indicate that humans use a cognitive map to determine other agents' preferences, facilitating generalized predictions of their behavior and effective responses.
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Affiliation(s)
- Toby Wise
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA.
| | - Caroline J Charpentier
- Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA; Department of Psychology, University of Maryland, College Park, MD, USA; Brain and Behavior Institute, University of Maryland, College Park, MD, USA
| | - Peter Dayan
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany; University of Tübingen, Tübingen, Germany
| | - Dean Mobbs
- Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA; Computation and Neural Systems Program, California Institute of Technology, Pasadena, CA, USA
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Baez S, Tangarife MA, Davila-Mejia G, Trujillo-Güiza M, Forero DA. Performance in emotion recognition and theory of mind tasks in social anxiety and generalized anxiety disorders: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1192683. [PMID: 37275989 PMCID: PMC10235477 DOI: 10.3389/fpsyt.2023.1192683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Social cognition impairments may be associated with poor functional outcomes, symptoms, and disability in social anxiety disorder (SAD) and generalized anxiety disorder (GAD). This meta-analysis aims to determine if emotion recognition and theory of mind (ToM) are impaired in SAD or GAD compared to healthy controls. A systematic review was conducted in electronic databases (PubMed, PsycNet, and Web of Science) to retrieve studies assessing emotion recognition and/or ToM in patients with SAD or GAD, compared to healthy controls, up to March 2022. Meta-analyses using random-effects models were conducted. We identified 21 eligible studies: 13 reported emotion recognition and 10 ToM outcomes, with 585 SAD patients, 178 GAD patients, and 753 controls. Compared to controls, patients with SAD exhibited impairments in emotion recognition (SMD = -0.32, CI = -0.47 - -0.16, z = -3.97, p < 0.0001) and ToM (SMD = -0.44, CI = -0.83 -0.04, z = -2.18, p < 0.01). Results for GAD were inconclusive due to the limited number of studies meeting the inclusion criteria (two for each domain). Relevant demographic and clinical variables (age, sex, education level, and anxiety scores) were not significantly correlated with emotion recognition or ToM impairments in SAD and GAD. Further studies employing ecological measures with larger and homogenous samples are needed to better delineate the factors influencing social cognition outcomes in both SAD and GAD.
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Affiliation(s)
| | | | | | | | - Diego A. Forero
- School of Health and Sport Sciences, Fundación Universitaria del Área Andina, Bogotá, Colombia
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Yilmaz G, Yildirim EA, Tabakcı AS. Comparison of Social-Evaluative Anxiety and Theory of Mind Functions in Social Anxiety Disorder, Schizophrenia, and Healthy Controls. Psychopathology 2023; 56:440-452. [PMID: 37062284 DOI: 10.1159/000529880] [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: 04/24/2022] [Accepted: 02/20/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION Despite the similarities in poor social competence and clinical manifestations of poor social behavior, no study has compared the theory of mind performance between social anxiety disorder (SAD) and schizophrenia, considering the effect of social-evaluative anxiety and neurocognitive functions. In our study, we aimed to compare the theory of mind functions and social-evaluative anxiety between patients with SAD and schizophrenia and healthy controls and to examine the relationship between the theory of mind, neurocognitive skills, and social-evaluative anxiety. METHODS Thirty-four consecutive patients with schizophrenia, 29 patients with SAD, and 30 controls matched by age, education level, and sex were enrolled in the study. Structured Clinical Interview for DSM, Beck Depression Inventory, Liebowitz Social Anxiety Scale, Theory of Mind measures (Reading the Mind in the Eyes Test, Hinting Task, Faux Pas Test), Social Appearance Anxiety Scale, Fear of Positive Evaluation Scale, Fear of Negative Evaluation Scale-Short Form, and neuropsychological tests were administered to all participants. RESULTS A greater significant deterioration in theory of mind and neurocognitive functions was found in patients with schizophrenia compared to those with SAD and healthy controls. Social evaluation anxiety was highest in patients with SAD. Although social-evaluative anxiety was associated with the theory of mind function in schizophrenia, only fear of positive evaluation was associated with SAD. In all groups, neither theory of mind nor neurocognitive ability measures were correlated with social anxiety levels and related symptoms. CONCLUSIONS The impaired theory of mind functioning detected in our study is more prominent in the schizophrenia group and largely independent of anxiety in schizophrenia and SAD. Although social evaluation anxiety, as a transdiagnostic concept, seems to be independent of theory of mind function in general, fear of positive evaluation seems to be associated with hinting in both disorders.
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Affiliation(s)
- Gorkem Yilmaz
- Private Practice, Psychiatry Department, Istanbul, Turkey
| | - Ejder Akgun Yildirim
- Department of Psychiatry, Psychotherapy Outpatient Clinic, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Abdulkadir Sencer Tabakcı
- Department of Psychiatry, Psychotherapy Outpatient Clinic, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
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Chevalier V, Simard V, Achim J. Meta-analyses of the associations of mentalization and proxy variables with anxiety and internalizing problems. J Anxiety Disord 2023; 95:102694. [PMID: 36905852 DOI: 10.1016/j.janxdis.2023.102694] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/15/2022] [Accepted: 02/28/2023] [Indexed: 03/13/2023]
Abstract
Mentalization, the high-order function of detecting and interpreting one's own and others' mental states, has gained interest in the fields of clinical and developmental psychopathology. However, little is known about mentalization's associations with anxiety and broader internalizing problems. Using the framework of the multidimensional model of mentalization, the aim of this meta-analysis was to quantify the strength of the association between mentalization and anxiety/internalizing problems and to identify potential moderators of this association. A systematic review of the literature led to the inclusion of 105 studies (N = 19,529) covering all age groups. The global effect analysis showed a small negative association between mentalization and the overall anxious and internalizing symptomatology (r = -0.095, p = .000). Various effect sizes were found for associations between mentalization and specific outcomes (unspecified anxiety, social anxiety, generalized anxiety, and internalizing problems). The methods of assessment of mentalization and anxiety moderated their association. Findings support the presence of modest impairments in the mentalizing capacities of anxious individuals, likely influenced by their vulnerability to stress and the context in which they mentalize. Further studies are needed to draw a clear profile of mentalizing capacities with regard to specific anxious and internalizing symptomatologies.
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Affiliation(s)
- Valérie Chevalier
- Department of Psychology, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil J4K 0A8, QC, Canada
| | - Valérie Simard
- Department of Psychology, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil J4K 0A8, QC, Canada; Charles-Le Moyne Research Center, 150 Place Charles-Le Moyne, Suite 200, Longueuil J4K 0A8, QC, Canada; Research Center of the Sainte-Justine University Hospital, 3175 Côte-Sainte-Catherine Road, Montréal, QC H3T 1C5, Canada.
| | - Julie Achim
- Department of Psychology, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil J4K 0A8, QC, Canada; Charles-Le Moyne Research Center, 150 Place Charles-Le Moyne, Suite 200, Longueuil J4K 0A8, QC, Canada; Research Center of the Centre intégré universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal, Montréal Sacré-Coeur Hospital, 5400, Gouin Blvd West, Montreal H4J 1C5, QC, Canada
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OLGUN KAVAL N, ARKAR H. Sosyal Biliş Becerilerinin Sosyal Kaygı Üzerindeki Yordayıcı Etkisi. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1167103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Bu çalışmanın temel amacı sosyal kaygı ile sosyal biliş becerileri (duygu tanıma/ayırt etme, zihin kuramı, atıf yanlılığı, sosyal işlevsellik) arasındaki ilişkiyi incelemek ve sosyal biliş becerilerinin sosyal kaygıyı yordama gücünü araştırmaktır. Çalışmada ayrıca sosyal kaygı, sosyal biliş becerileri ve depresyon puanlarının cinsiyet, yaş, bildirilen tanı durumu ve sosyal kaygı düzeyine göre farklılaşıp farklılaşmadığı araştırılmıştır. Çalışmanın örneklemini, 18-60 yaşları arasında bulunan toplam 385 kişi oluşturmuştur. Araştırma verileri çevrimiçi olarak Liebowitz Sosyal Anksiyete Ölçeği, Yüzde Dışavuran Duyguların Tanınması ve Ayırt Edilmesi Testi, Gözlerden Zihin Okuma Testi, İçsel, Kişisel ve Durumsal Atıflar Ölçeği, Sosyal İşlevsellik Ölçeği, Beck Depresyon Envanteri ve Sosyodemografik Bilgi Formu kullanılarak katılımcılardan toplanmıştır. Sosyal kaygı ile duygu tanıma, duygu ayırt etme ve gözlerden zihin okuma arasında negatif, dışsallaştırma yanlılığı ve depresyon ile ise pozitif yönde anlamlı ilişki olduğu belirlenmiştir. Depresyon, duygu tanıma ve ayırt etme, gözlerden zihin okuma ve öncül sosyal etkinlikler ölçek puanlarının sosyal kaygıyı anlamlı düzeyde yordadığı bulunmuştur. Bu değişkenler sosyal kaygıya ilişkin toplam varyansın %52’sini açıklamaktadır. Ayrıca, depresyon etkisi kontrol edildiğinde sosyal biliş becerilerinin sosyal kaygıya ilişkin varyansın %32’sini açıkladığı görülmüştür. Sosyal biliş becerilerindeki bozulmanın ve depresyon puanlarının sosyal kaygının artışıyla ilişkili olduğu belirlenmiştir. Araştırmadan elde edilen sonuçlara göre, sosyal kaygıyı önlemeye yönelik önerilerde bulunulmuştur. Müdahale programları içerisinde bireylerin kişilerarası iletişimi için önemli olan sosyal biliş becerilerini geliştirmeye yönelik etkinliklere yer verilmesinin yararlı olacağı önerilmektedir.
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Affiliation(s)
| | - Haluk ARKAR
- Ege Üniversitesi, Edebiyat Fakültesi, Psikoloji Bölümü
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12
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Sloover M, van Est LAC, Janssen PGJ, Hilbink M, van Ee E. A meta-analysis of mentalizing in anxiety disorders, obsessive-compulsive and related disorders, and trauma and stressor related disorders. J Anxiety Disord 2022; 92:102641. [PMID: 36257080 DOI: 10.1016/j.janxdis.2022.102641] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The number of studies that have researched the ability to mentalize in individuals with anxiety and related disorders is limited. Often, no distinction is made between different anxiety and related disorders in the examination of mentalization. OBJECTIVE The goal of this study was to obtain insight into mentalization in anxiety and related disorders, and to compare this ability between these disorders. METHOD A systematic literature search was performed to identify studies in which performance on a mentalization task was compared between a patient group diagnosed with an anxiety or a related disorder, and a control group. Meta-analyses were performed on the included articles. RESULTS The initial search yielded 2844 articles, of which 26 studies on 1056 patients were included. Patients diagnosed with anxiety and related disorders showed a deficit in mentalization when compared to healthy controls (SMD = -0.60, p 0.001). A deficit was found in all patient groups: Patients with anxiety disorders (SMD = -0.39, p = 0.007), obsessive-compulsive and related disorders (SMD = -0.78, p = 0.01), and trauma and stressor related disorders showed significant deficits (SMD = -0.77, p = 0.02) as compared to healthy controls. CONCLUSION The results indicated impaired mentalization in anxiety and related disorders, with specific deficiencies in posttraumatic stress disorder, social anxiety, and obsessive-compulsive disorders. Mentalization could provide a clinical target in treatment of these disorders.
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Affiliation(s)
- Mèlanie Sloover
- Behavioural Science Institute, Radboud University Nijmegen, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands; Psychotraumacentrum Zuid Nederland, Reinier van Arkel, Bethaniëstraat 10, 5211 LJ 's-Hertogenbosch, the Netherlands.
| | - Leanne A C van Est
- Psychotraumacentrum Zuid Nederland, Reinier van Arkel, Bethaniëstraat 10, 5211 LJ 's-Hertogenbosch, the Netherlands; Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
| | - Petrus G J Janssen
- Behavioural Science Institute, Radboud University Nijmegen, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands; Psychotraumacentrum Zuid Nederland, Reinier van Arkel, Bethaniëstraat 10, 5211 LJ 's-Hertogenbosch, the Netherlands
| | - Mirrian Hilbink
- Psychotraumacentrum Zuid Nederland, Reinier van Arkel, Bethaniëstraat 10, 5211 LJ 's-Hertogenbosch, the Netherlands; Jeroen Bosch Academy Research, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ 's-Hertogenbosch, the Netherlands
| | - Elisa van Ee
- Behavioural Science Institute, Radboud University Nijmegen, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands; Psychotraumacentrum Zuid Nederland, Reinier van Arkel, Bethaniëstraat 10, 5211 LJ 's-Hertogenbosch, the Netherlands
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Bora E. Social cognition and empathy in adults with obsessive compulsive disorder: A meta-analysis. Psychiatry Res 2022; 316:114752. [PMID: 35961153 DOI: 10.1016/j.psychres.2022.114752] [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: 04/08/2020] [Revised: 07/18/2022] [Accepted: 07/27/2022] [Indexed: 10/16/2022]
Abstract
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts (obsessions) and compulsions and has been associated with psychosocial impairment. Indeed, a number of studies have highlighted impairments in both social cognitive functions and empathic skills in OCD, despite several inconsistencies. This study aimed to investigate social cognitive dysfunction and empathy deficits in patients with OCD using a meta-analytic approach. A literature search was conducted using the databases Pubmed, PsycINFO, ProQuest and Scopus to identify the relevant studies (January 1980 to March 2020). Following the systematic review of relevant OCD studies, a random-effects meta-analysis was conducted. The current meta-analysis included 25 studies consisting of 1161 patients with OCD and 1329 healthy controls. OCD was associated with decreased performance in theory of mind (ToM). In the facial emotion recognition domain, patients with OCD significantly underperformed healthy controls only in their recognition of disgust. OCD was significantly related to reduced cognitive empathy. OCD was associated with medium-sized impairments in ToM and cognitive empathy, which can likely contribute to psychosocial impairment in this disorder. Further studies are needed to investigate state and trait-related factors using experimental measures of empathy.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Dokuz Eylul University Medical School, Izmir 35340, Turkey; Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and, Melbourne Health, Carlton South, Victoria 3053, Australia.
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Alvi T, Kumar D, Tabak BA. Social anxiety and behavioral assessments of social cognition: A systematic review. J Affect Disord 2022; 311:17-30. [PMID: 35490878 PMCID: PMC9754122 DOI: 10.1016/j.jad.2022.04.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Social anxiety is highly prevalent and has increased in young adults during the COVID-19 pandemic. Since social anxiety negatively impacts interpersonal functioning, identifying aspects of social cognition that may be impaired can increase our understanding of the development and maintenance of social anxiety disorder. However, to date, studies examining associations between social anxiety and social cognition have resulted in mixed findings. METHODS The aim of this systematic review was to summarize the literature on the association between social anxiety and social cognition, while also considering several potential moderators and covariates that may influence findings. RESULTS A systematic search identified 52 studies. Results showed mixed evidence for the association between social anxiety and lower-level social cognitive processes (emotion recognition and affect sharing) and a trend for a negative association with higher-level social cognitive processes (theory of mind and empathic accuracy). Most studies examining valence-specific effects found a significant negative association for positive and neutral stimuli. LIMITATIONS Not all aspects of social cognition were included (e.g., attributional bias) and we focused on adults and not children, limiting the scope of the review. CONCLUSIONS Future studies would benefit from the inclusion of relevant moderators and covariates, multiple well-validated measures within the same domain of social cognition, and assessments of interpersonal functioning outside of the laboratory. Additional research examining the moderating role of attention or interpretation biases on social cognitive performance, and the potential benefit of social cognitive skills training for social anxiety, could inform and improve existing cognitive behavioral interventions.
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Affiliation(s)
| | | | - Benjamin A. Tabak
- Corresponding author at: Department of Psychology, Southern Methodist University, 6116 N. Central Expressway, Suite 1300, Dallas, TX 75206, USA
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15
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Salazar Kämpf M, Kanske P, Kleiman A, Haberkamp A, Glombiewski J, Exner C. Empathy, compassion, and theory of mind in obsessive-compulsive disorder. Psychol Psychother 2022; 95:1-17. [PMID: 34331362 DOI: 10.1111/papt.12358] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/20/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Individuals with obsessive-compulsive disorder (OCD) often suffer from impairments in social functioning. This study investigates differences in empathy, compassion, and Theory of Mind (ToM) in individuals with OCD as a possible cause for social functioning deficits. DESIGN Sixty-four individuals diagnosed with OCD and 62 healthy individuals completed a naturalistic behavioural task (EmpaToM) and a self-report measure (Interpersonal Reactivity Index, IRI). METHODS Three preregistered repeated measures analyses of variance (ANOVAs). RESULTS People with OCD exhibited higher empathy levels - namely increased sharing of others' suffering - in the EmpaToM task and reported more distress (IRI) compared with healthy individuals. Furthermore, no differences in compassion (EmpaToM) between both groups emerged, although people with OCD reported more concern for others (IRI) compared with healthy individuals. Concerning the ToM, no group differences were detected, neither in the behavioural task, nor self-report. CONCLUSION By investigating OCD with diverse scientific practices we shed light on the higher levels of empathy exhibited by individuals with OCD, which are relevant for clinical practice and our understanding of OCD symptomatology. PRACTITIONER POINTS ●People with obsessive-compulsive disorder show higher levels of empathy, that is the increased sharing of others' suffering, compared with healthy individuals in both a traditional self-report and a naturalistic task. ●Regarding compassion, that is caring for others, their self-reported compassion was higher in people with OCD. ●In Theory of Mind, that is cognitively understanding the situation of another person, no differences have been found neither at self-report nor in a naturalistic task compared with healthy individuals. ●Independent of traditional interventions, it could prove useful to improve emotion regulation skills so people with OCD learn to cope with empathic distress. Furthermore, it might strengthen the treatment gains and lower dropout rates if the social mind and consequently social relationships become a topic in the treatment and prevention of OCD.
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Affiliation(s)
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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MOLDOVAN M, PRODAN N, COMAN AD, VISU-PETRA L. "Deep Dive into the Constructive Mind: Relating Interpretive Diversity Understanding to Anxiety Symptoms and Parental Practices in Middle Childhood". JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2022. [DOI: 10.24193/jebp.2022.1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The relation between the understanding of the mind as being constructive, anxiety, and parental factors is not fully elucidated. Interpretive diversity understanding represents an understanding that people can have a different interpretation of the same situation due to differences in beliefs, attitudes, and knowledge. We aim to bring together two approaches to this concept: the interpretive theory of mind (ToMi), and the constructivist theory of mind (ToMc) and relate them to anxiety symptoms and parental practices during middle childhood (8-12 years). In two studies, we used a restricted view paradigm to assess ToMi, a questionnaire to assess ToMc (the Constructivist Theory of Mind Interview, short written version in Study 1, and extended interview in Study 2) and parental and child reports of parental practices, as well as children’s anxiety symptoms. Results revealed that the two interpretive diversity understanding tasks were positively associated (Study 2). Overall, warm parental practices were positively associated with ToM tasks and a significant predictor for the ToMc interview answers. On the other hand, parental rejection and overprotection were negatively associated with performance on the ToMi task, with the ToMc score and positively with anxiety symptoms. Understanding the relationship between ToM, anxiety, and parental practices is essential for preventing early social and emotional difficulties during middle childhood.
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Seitz KI, Ehler N, Schmitz M, Schmitz SE, Dziobek I, Herpertz SC, Bertsch K. Affective and cognitive theory of mind in posttraumatic stress, major depressive, and somatic symptom disorders: Association with childhood trauma. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:680-700. [PMID: 35102575 DOI: 10.1111/bjc.12357] [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: 07/27/2021] [Revised: 01/12/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Childhood trauma constitutes a major risk factor for adult psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and somatic symptom disorder (SSD). One potential mechanism linking childhood trauma to adult psychopathology may be alterations in theory of mind (ToM). Given the lack of transdiagnostic studies on the association between childhood trauma and ToM, further research is needed to elucidate whether and how childhood trauma relates to ToM impairments across and within diagnostic boundaries. DESIGN A cross-sectional study design was applied. METHODS A total of 137 individuals with varying levels of childhood trauma took part in this study, encompassing individuals with PTSD (n = 33), MDD (n = 33), SSD (n = 36), and healthy volunteers (HVs; n = 35). To assess ToM performance and childhood trauma, the Movie for the Assessment of Social Cognition was administered along with the Childhood Trauma Questionnaire. RESULTS Only individuals with PTSD, but not individuals with MDD or SSD, showed a worse ToM performance compared to HVs. In the whole sample, childhood trauma correlated negatively with ToM performance. Exploratory group-specific analyses revealed higher levels of childhood trauma to be associated with more excessive ToM errors in individuals with SSD, and notably with an enhanced ToM performance in individuals with MDD. CONCLUSIONS Our results indicate associations between childhood trauma and ToM impairments in a large, transdiagnostic sample. Provided replication in future studies, our findings suggest ToM capacities as a promising treatment target for individuals exposed to severe childhood trauma, at least or particularly with a diagnosis of PTSD. PRACTITIONER POINTS Our results suggest that individuals with a history of severe childhood trauma, at least or particularly with a clinical diagnosis of posttraumatic stress disorder, may benefit from therapeutic approaches targeting theory of mind capacities. Our findings indicate that higher levels of childhood trauma may be linked to a specific 'hypermentalizing' bias in somatic symptom disorder. Our findings further point towards an association between higher levels of childhood trauma and a heightened - rather than a diminished - sensitivity towards interpersonal cues in major depressive disorder. Provided further confirmatory evidence, our findings may support diagnosis-specific approaches in ameliorating theory of mind abilities in individuals with different mental disorders and a history of severe childhood trauma.
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Affiliation(s)
- Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Nicola Ehler
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
| | - Sara E Schmitz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Germany.,Department of Psychology, Humboldt Universität zu Berlin, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
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18
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Metternich B, Wagner K, Geiger MJ, Schulze-Bonhage A, Hirsch M, Schönenberg M. Affective Empathy, Theory of Mind and Social Functioning in Patients With Focal Epilepsy. Front Psychiatry 2022; 13:887411. [PMID: 35898635 PMCID: PMC9309689 DOI: 10.3389/fpsyt.2022.887411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Social cognition comprises basic and more complex functions, such as theory of mind (ToM) and affective empathy. Although everyday social interactions may be impaired if such higher-order social cognitive functions are compromised, associations between social functioning and social cognition in people with focal epilepsy (PWFE) are still poorly understood. We used a novel, naturalistic approach to investigate ToM in PWFE by applying the Movie for the Assessment of Social Cognition (MASC). Furthermore, we studied affective empathy, the relationship between social cognitive parameters and measures of social functioning, as well as between epilepsy focus and ToM. METHODS Thirty patients with either temporal (TLE) or frontal lobe epilepsy (FLE) were compared to 29 healthy control subjects (HC). In addition to the MASC, we applied questionnaire measures assessing empathy and everyday social functioning. RESULTS PWFE, especially with FLE, performed significantly worse than HC on the MASC. Perceived social integration and social activities, but not affective empathy, were reduced in PWFE. Regression analyses revealed associations between perceived social integration, clinical group status, affective empathy and ToM. CONCLUSION PWFE displayed ToM deficits during a naturalistic task, whereas affective empathy was unimpaired. FLE may be associated with especially compromised ToM performance. Social cognition and social functioning appear to be interrelated in PWFE, whose self-perceived levels of social integration and social activities are lower than those of HC. More research into the association between social cognition and social functioning in PWFE is needed, in order to develop tailored intervention programs for these patients.
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Affiliation(s)
- Birgitta Metternich
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Kathrin Wagner
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Maximilian J Geiger
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Martin Hirsch
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Michael Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
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Pérez-Vigil A, Ilzarbe D, Garcia-Delgar B, Morer A, Pomares M, Puig O, Lera-Miguel S, Rosa M, Romero M, Calvo Escalona R, Lázaro L. Theory of mind in neurodevelopmental disorders: Beyond autistic spectrum disorder. Neurologia 2021; 39:S0213-4853(21)00086-4. [PMID: 34090719 DOI: 10.1016/j.nrl.2021.04.014] [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: 11/16/2020] [Revised: 03/21/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group. METHODS Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n=19), TS (n=14), or ASD (n=18), and a control group (n=20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the "Stories from everyday life" task and the "Reading the mind in the eyes" test). RESULTS Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls. CONCLUSIONS ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS.
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Affiliation(s)
- A Pérez-Vigil
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España.
| | - D Ilzarbe
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - B Garcia-Delgar
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - A Morer
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España
| | - M Pomares
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - O Puig
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - S Lera-Miguel
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - M Rosa
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - M Romero
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - R Calvo Escalona
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - L Lázaro
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
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20
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Malcolm A, Brennan SN, Grace SA, Pikoos TD, Toh WL, Labuschagne I, Buchanan B, Kaplan RA, Castle DJ, Rossell SL. Empirical evidence for cognitive subgroups in body dysmorphic disorder. Aust N Z J Psychiatry 2021; 55:381-390. [PMID: 33637003 DOI: 10.1177/0004867421998762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Current understanding of cognitive functioning in body dysmorphic disorder is limited, owing to few studies, small sample sizes and assessment across only limited cognitive domains. Existing research has also shown inconsistent findings, with both intact and impaired cognition reported in body dysmorphic disorder, which might point towards cognitive heterogeneity in the disorder. This study aimed to examine the cognitive profile of body dysmorphic disorder in a large sample across eight cognitive domains, and to explore whether cognitive subgroups might be identified within body dysmorphic disorder. METHOD Cognitive domains of inhibition/flexibility, working memory, speed of processing, reasoning and problem-solving, visual and verbal learning, attention/vigilance and social cognition were assessed and compared between 65 body dysmorphic disorder patients and 70 healthy controls. Then, hierarchical clustering analysis was conducted on the body dysmorphic disorder group's cognitive data. RESULTS Group-average comparisons demonstrated significantly poorer cognitive functioning in body dysmorphic disorder than healthy controls in all domains except for attention/vigilance and social cognition. Cluster analysis identified two divergent cognitive subgroups within our body dysmorphic disorder cohort characterised by (1) broadly intact cognitive function with mild selective impairments (72.3%), and (2) broadly impaired cognitive function (27.7%). However, the clusters did not significantly differ on clinical parameters or most sociodemographic characteristics. CONCLUSION Our findings demonstrate considerable cognitive heterogeneity among persons with body dysmorphic disorder, rather than uniform deficits. Poor performances in the broadly impaired subgroup may have driven group-level differences. However, our findings also suggest a dissociation between cognitive functioning and clinical characteristics in body dysmorphic disorder that has implications for current aetiological models. Additional research is needed to clarify why some people with body dysmorphic disorder demonstrate cognitive deficits while others do not.
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Affiliation(s)
- Amy Malcolm
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Sarah N Brennan
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia.,The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sally A Grace
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Toni D Pikoos
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Wei Lin Toh
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Izelle Labuschagne
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Ben Buchanan
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ryan A Kaplan
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia.,Sydney Body Dysmorphic Disorder & Body Image Clinic, Bondi Junction, NSW, Australia
| | - David J Castle
- Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia.,Department of Psychiatry, Faculty of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
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21
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Pittelkow MM, Aan Het Rot M, Seidel LJ, Feyel N, Roest AM. Social Anxiety and Empathy: A Systematic Review and Meta-analysis. J Anxiety Disord 2021; 78:102357. [PMID: 33588287 DOI: 10.1016/j.janxdis.2021.102357] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/26/2020] [Accepted: 01/05/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to clarify the association between social anxiety and affective (AE) and cognitive empathy (CE). METHODS 1442 studies from PsycINFO, Medline, and EMBASE (inception-January 2020) were systematically reviewed. Included studies (N = 48) either predicted variance in empathy using social anxiety scores or compared empathy scores between socially anxious individuals and a control group. RESULTS Social anxiety and AE were statistically significantly positively associated, k = 14, r = .103 (95%CI [.003, .203]), z = 2.03, p = .043. Sex (QM (2) = 18.79, p < .0001), and type of measures (QM (1 = 7.34, p = .007) moderated the association. Correlations were significant for male samples (rmale = .316, (95%CI [.200, .432])) and studies using self-report measures (rself-report = .162 (95%CI [.070, .254])). Overall, social anxiety and CE were not significantly associated, k = 52, r =-.021 (95%CI [-.075, .034]), z= -0.74, p = .459. Sample type moderated the association (QM (1) = 5.03, p < .0001). For clinical samples the association was negative (rclinical= -.112, (95%CI [-.201, -.017]). CONCLUSION There was evidence for a positive association between social anxiety and AE, but future studies are needed to verify the moderating roles of sex and type of measure. Besides, low CE might only hold for patients with SAD.
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Affiliation(s)
| | - Marije Aan Het Rot
- Department of Psychology, University of Groningen, Netherlands; School Behavioural and Cognitive Neuroscience, University of Groningen, Netherlands; Interdisciplinary Centre for Psychopathology and Emotion regulation (ICPE), University of Groningen, Netherlands
| | | | - Nils Feyel
- Department of Psychology, University of Groningen, Netherlands
| | - Annelieke M Roest
- Department of Psychology, University of Groningen, Netherlands; Interdisciplinary Centre for Psychopathology and Emotion regulation (ICPE), University of Groningen, Netherlands
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22
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Kir Y, Sayar-Akaslan D, Agtas-Ertan E, Kusman A, Baskak N, Baran Z, Munir K, Baskak B. Cortical activity during social acceptance and rejection task in social anxiety disorder: A controlled functional near infrared spectroscopy study. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110012. [PMID: 32553940 DOI: 10.1016/j.pnpbp.2020.110012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 05/30/2020] [Accepted: 06/09/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The cognitive and emotional vulnerability of individuals with social anxiety disorder (SAD) and their response to repeated experiences of social rejection and social acceptance are important factors for the emergence and maintenance of symptoms of the disorder. Functional neuroimaging studies of SAD reveal hyperactivity in regions involved in the fear circuit such as amygdala, insula, anterior cingulate, and prefrontal cortices (PFC) in response to human faces with negative emotions. Observation of brain activity, however, involving studies of responses to standardized human interaction of social acceptance and social rejection have been lacking. METHODS We compared a group of index subjects with SAD (N = 22, mean age:26.3 ± 5.4, female/male: 7/15) (SADG) with a group of healthy controls (CG) (N = 21, mean age:28.7 ± 4.5, female/male: 14/7) in measures of cortical activity during standardized experiences of human interaction involving social acceptance (SA) and social rejection (SR) video-simulated handshaking tasks performed by real actors. In a third, control condition (CC), the subjects were expected to press a switch button in an equivalent space. Subjects with a concurrent mood episode were excluded and the severity of subclinical depressive symptoms was controlled. 52-channel functional near-infrared spectroscopy (fNIRS) was used to measure cortical activity. RESULTS Activity was higher in the SAD subjects compared to healthy controls, in particular in channels that project to middle and superior temporal gyri (STG), frontal eye fields (FEF) and dorsolateral prefrontal cortex (DLPFC) in terms of both SA and SR conditions. Cortical activity during the CC was not different between the groups. Only in the SAD-group, activity in the pre-motor and supplementary motor cortices, inferior and middle temporal gyri and fronto-polar area was higher during the rejection condition than the other two conditions. Anxiety scores were correlated with activity in STG, DLPFC, FEF and premotor cortex, while avoidance scores were correlated with activity in STG and FEF. CONCLUSIONS SA and SR are represented differently in terms of cortical activity in SAD subjects compared to healthy controls. Higher activity in both social conditions in SAD subjects compared to controls may imply biological sensitivity to these experiences and may underscore the importance of increased cortical activity during social interaction experiences as a putative mediator of vulnerability to SAD. Higher cortical activity in the SADG may possibly indicate stronger need for inhibitory control mechanisms and higher recruitment of theory of mind functions during social stress. Higher activity during the SR compared to the SA condition in the SAD subjects may also suggest distinct processing of social cues, whether they involve acceptance or rejection.
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Affiliation(s)
- Yagmur Kir
- Ankara University, Department of Psychiatry, Brain Research Center, Ankara, Turkey
| | - Damla Sayar-Akaslan
- Ankara University, Department of Psychiatry, Brain Research Center, Ankara, Turkey
| | - Ece Agtas-Ertan
- Ankara University, Department of Psychiatry, Brain Research Center, Ankara, Turkey
| | - Adnan Kusman
- Ankara University, Department of Psychiatry, Brain Research Center, Ankara, Turkey
| | - Nilay Baskak
- Yenimahalle Hospital, Department of Psychiatry, Ankara, Turkey
| | - Zeynel Baran
- Hacettepe University, Department of Psychology, Ankara, Turkey
| | - Kerim Munir
- Harvard Medical School, Developmental Medicine Center, Boston Children's Hospital, Boston, USA
| | - Bora Baskak
- Ankara University, Department of Psychiatry, Brain Research Center, Ankara, Turkey; Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey.
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23
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Normann-Eide E, Antonsen BRT, Kvarstein EH, Pedersen G, Vaskinn A, Wilberg T. Are Impairments in Theory of Mind Specific to Borderline Personality Disorder? J Pers Disord 2020; 34:827-841. [PMID: 30785865 DOI: 10.1521/pedi_2019_33_417] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Impaired theory of mind (ToM) is an assumed feature of borderline personality disorder (BPD). Yet, no studies have compared ToM abilities in patients with BPD, other personality disorders, and healthy controls, or investigated the relationship between ToM and severity of psychopathology and interpersonal problems. In this study, ToM was investigated by the Movie for the Assessment of Social Cognition. No differences were found between the three groups in overall ToM abilities. The BPD group was, however, characterized by more excessive ToM (interpreted as hypermentalization). Yet, when differentiating between BPD and further severity indicators, excessive ToM was not specifically associated with a BPD diagnosis per se. Finally, there was a moderate association between hypermentalization and interpersonal problems in the BPD group. This study suggests that BPD patients tend to hypermentalize when they misinterpret social information, and that this tendency is related to the severity of their psychopathology.
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Affiliation(s)
- Eivind Normann-Eide
- Section for Personality Psychiatry, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Research Department, Division of Mental Health and Addiction, Vestfold Hospital Trust, Tonsberg, Norway
| | - Bj Rnar Torske Antonsen
- Section for Personality Psychiatry, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Lovisenberg Diaconal Hospital, Oslo
| | - Elfrida Hartveit Kvarstein
- Section for Personality Psychiatry, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, University of Oslo
| | - Geir Pedersen
- Section for Personality Psychiatry, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital
| | - Anja Vaskinn
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital
| | - Theresa Wilberg
- Institute for Clinical Medicine, University of Oslo.,Department of Research and Development, Clinic for Mental Health and Addiction, Oslo University Hospital
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24
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Chen J, Short M, Kemps E. Interpretation bias in social anxiety: A systematic review and meta-analysis. J Affect Disord 2020; 276:1119-1130. [PMID: 32777650 DOI: 10.1016/j.jad.2020.07.121] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 07/12/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Interpretation bias, which involves interpreting ambiguous social events negatively and catastrophising even mildly negative social events, has been suggested as a key maintenance factor of Social Anxiety Disorder. Although some individual studies and narrative reviews have demonstrated a role for negative interpretation bias in social anxiety (disorder), findings have been mixed. Given the lack of a quantitative synthesis of the evidence, the current systematic review and meta-analysis examined the strength of the relationship between interpretation bias and social anxiety. It also investigated potential moderators of this relationship (i.e., types of measures and stimuli, samples, and study designs). METHODS Five databases (PsycINFO, PubMed, Medline, Scopus, and CINAHL) were searched. Of 46 studies identified, 44 were suitable for meta-analysis (N = 3859). RESULTS There was a large effect for the relationship between social anxiety and interpretation bias (g = 0.83). Types of measures (subjective versus objective) and stimuli (verbal versus visual) were identified as significant moderators, with subjective measures and verbal stimuli particularly adept at capturing interpretation bias in socially anxious individuals. LIMITATIONS The effect sizes displayed significant heterogeneity between studies, which likely reflects some publication bias, and thus, the overall effect size may be inflated. CONCLUSION Findings may help to refine clinical models and interventions for Social Anxiety Disorder, which in turn may maximise evidence-based interventions that target negative interpretation bias in this disorder.
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Affiliation(s)
- Junwen Chen
- Research School of Psychology, The Australian National University, 39 Science Road, Canberra, ACT 2601, Australia; School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Michelle Short
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Eva Kemps
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
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25
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Maleki G, Zabihzadeh A, Richman MJ, Demetrovics Z, Mohammadnejad F. Decoding and reasoning mental states in major depression and social anxiety disorder. BMC Psychiatry 2020; 20:463. [PMID: 32972392 PMCID: PMC7517604 DOI: 10.1186/s12888-020-02873-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depression (MDD) and social anxiety (SAD) disorders are debilitating psychiatric conditions characterized by disturbed interpersonal relationships. Despite these impairments in social relationships, research has been limited in simultaneously evaluating the dysfunction in MDD or SAD within two aspects of theory of mind (ToM): decoding mental states (i.e., Affective ToM) and reasoning mental states (i.e., cognitive ToM). Taking this into consideration, the current study assesses both decoding and reasoning mental states abilities in MDD, SAD, and healthy controls (HC). METHODS Subjects included 37 patients with MDD, 35 patients with SAD, and 35 HCs. ToM was measured with the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Task, which assess decoding and reasoning mental states, respectively. RESULTS Results revealed that in decoding of mental states, both the SAD and MDD groups had lower scores than the HC group; there was no significant difference between the SAD and MDD groups in decoding mental states. Conversely, in reasoning mental states, the SAD and HC groups had higher scores than the MDD group; no differences were found between the SAD and HC groups. CONCLUSIONS Clinicians and researchers should further consider parsing generalized impairment in ToM into two aspects: decoding and reasoning of mental states by using the aforementioned measurements. By further understanding the two aspects, we can create a potentially new clinical profile for mental health disorders, such as in this context with both decoding and reasoning mental state impairment in MDD and just a decoding impairment in SAD.
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Affiliation(s)
- Gheysar Maleki
- Department of Clinical Psychology, Shahid Behashti University, District 1, Evin, Daneshjou Boulevard, Tehran, 1983969411, Iran.
| | - Abbas Zabihzadeh
- Department of Clinical Psychology, Shahid Behashti University, District 1, Evin, Daneshjou Boulevard, Tehran, 1983969411 Iran
| | - Mara J. Richman
- grid.11804.3c0000 0001 0942 9821Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary ,Endeavor Psychology, Boston, MA USA ,grid.5591.80000 0001 2294 6276Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- grid.5591.80000 0001 2294 6276Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary ,grid.5591.80000 0001 2294 6276Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Fatemeh Mohammadnejad
- grid.411623.30000 0001 2227 0923Orthopedic Research Center, Mazandaran University of Medical Science, Sari, Iran
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26
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Senín-Calderón C, Perona-Garcelán S, Rodríguez-Testal JF. The dark side of Instagram: Predictor model of dysmorphic concerns. Int J Clin Health Psychol 2020; 20:253-261. [PMID: 32994798 PMCID: PMC7501442 DOI: 10.1016/j.ijchp.2020.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/19/2020] [Indexed: 11/29/2022] Open
Abstract
Dysmorphic concern are excessive preoccupation about one or several physical characteristics perceived as defects, usually unnoticeable by others. This study was intended to explore the relationship between Instagram use and dysmorphic concerns through appearance-related comparisons, ideas of reference and problems with emotion regulation, and find out whether this relationship is moderated by gender. METHOD The sample was comprised of 796 participants (Mage = 22.49; SD = 3.56; 54% women). RESULTS The results showed a non-significant direct effect between Instagram use and dysmorphic concerns. However, the relationship between these variables was statistically significant through appearance-related comparisons, ideas of reference about "laughing, commenting" and difficulties in emotion regulation. Gender did not moderate any relationship. CONCLUSIONS Men and women who made the most use of Instagram were equally vulnerable to dysmorphic concerns when they tended to compare their appearance with other users, had problems regulating their emotions, and showed interpretative biases related to the belief that others could make comments about them or laugh at them because of their imperfections. The implications of the study are discussed.
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Affiliation(s)
| | | | - Juan F Rodríguez-Testal
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Spain
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27
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Clarke A, Meredith PJ, Rose TA. Exploring mentalization, trust, communication quality, and alienation in adolescents. PLoS One 2020; 15:e0234662. [PMID: 32542008 PMCID: PMC7295212 DOI: 10.1371/journal.pone.0234662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 05/30/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION A growing body of evidence has demonstrated the importance of mentalization for adolescents' psychosocial functioning; however, further research is needed to understand links between mentalization and other socio-cognitive factors. The aim of this quantitative, cross-sectional study was to investigate the relationship between a teen's capacity to mentalize and three attachment-related factors: parent-teen trust, parent-teen communication, and parent-teen alienation. METHODS In an online survey, 82 (mainly) Australian adolescents (57 female; 23 male; 2 non-binary; mean age 17.09 years) completed: i) The Children's Eyes Test, which measured mentalization; and ii) The Inventory of Parent and Peer Attachment-45, which measured trust, communication quality, and alienation. RESULTS In teens' relationships with both mothers and fathers, trust and communication quality were significantly positively correlated (p = .001) when controlling for age and gender. Both were significantly negatively correlated with alienation (p = .001) with control variables included. Capacity to mentalize did not correlate with trust, communication quality, or alienation in relationships with either mothers or fathers (p ≤ .05). CONCLUSIONS Possible reasons are proposed for why no relationship was found between mentalization and trust, communication quality, or alienation. Implications for future research are discussed.
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Affiliation(s)
- Angela Clarke
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Pamela J. Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Tanya A. Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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28
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Schulte J, Dietel FA, Buhlmann U. Störungseinsicht bei körperdysmorpher Störung, Zwangsstörung und sozialer Angststörung. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00404-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Zusammenfassung
Hintergrund
Die körperdysmorphe Störung (KDS) geht mit einer geringen Störungseinsicht bis zu wahnhaft anmutenden Überzeugungen bezüglich wahrgenommener körperlicher Makel einher, die für andere nur leicht oder nicht sichtbar sind. Während die Einsicht bei der KDS bereits vielfach untersucht wurde und obwohl sie ein transdiagnostisch relevantes Merkmal ist, gibt es kaum vergleichende Studien.
Ziel der Arbeit
Es wird untersucht, inwiefern sich Personen mit einer KDS von Personen mit einer Zwangsstörung (ZS) und einer sozialen Angststörung (SAS) dimensional und kategorial hinsichtlich der Einsicht unterscheiden.
Material und Methode
Personen mit KDS (n = 36), ZS (n = 38) und SAS (n = 36) beantworteten diagnostische Interviews und Fragebogen. Die Einsicht wurde mithilfe eines teilstrukturierten Interviews, das verschiedene Facetten und Grade von Einsicht erfasst, beurteilt (Brown Assessment of Beliefs Scale).
Ergebnisse
In allen Gruppen lagen unterschiedliche Einsichtsgrade im gesamten Spektrum von exzellent bis fehlend vor. Bei den Betroffenen mit einer KDS entsprach der Gesamtmittelwert einer schlechten (M = 13,25, SD ± 6,32), bei Betroffenen mit einer SAS einer ausreichenden (M = 10,39, SD ± 5,70) und bei Betroffenen mit einer ZS einer guten Einsicht (M = 4,74, SD ± 5,49). Abgesehen von einer stärkeren Fixiertheit der Überzeugung bei KDS war die Einsicht bei KDS und SAS dimensional und kategorial nicht signifikant voneinander verschieden, jedoch bei beiden Störungen schlechter als bei ZS.
Diskussion
Die Ergebnisse bestätigen, dass die KDS mit geringer Einsicht einhergeht, dies jedoch fast gleichermaßen auf die SAS zutrifft. Die Störungseinsicht erscheint bei allen untersuchten Störungen relevant und sollte in der Psychotherapie von Beginn an diagnostisch und psychotherapeutisch berücksichtigt werden.
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29
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Allain P, Hamon M, Saoût V, Verny C, Dinomais M, Besnard J. Theory of Mind Impairments Highlighted With an Ecological Performance-Based Test Indicate Behavioral Executive Deficits in Traumatic Brain Injury. Front Neurol 2020; 10:1367. [PMID: 32038455 PMCID: PMC6987386 DOI: 10.3389/fneur.2019.01367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/10/2019] [Indexed: 12/13/2022] Open
Abstract
Background: In view of the recent literature, the negative impact of traumatic brain injury (TBI) on social cognition remains a debated issue. On one hand, a considerable number of studies reported significant impairments in emotion recognition, empathy, moral reasoning, social problem solving, and mentalizing or theory of mind (ToM) abilities in patients with TBI. On the other hand, the ecological validity of social cognition tasks is still a matter of concern and debate for clinicians and researchers. Objectives: The objectives of the present study were 2-fold: (1) to assess social cognition in TBI with an ecological performance-based test which focuses on ToM ability, and (2) to study the relationship between performances on this task and behavioral disorders. To this end, 47 patients with moderate to severe TBI in the chronic stage were assessed with a ToM task, the Movie for the Assessment of Social Cognition (MASC), a film displaying social interactions in natural settings and asking for an evaluation of the emotions, thoughts, and intentions of the characters. Behavioral disorders were assessed with the Behavioral Dysexecutive Syndrome Inventory (BDSI), a structured interview of an informant in assessing changes compared with previous behavior in 12 domains. Results: Patients were significantly less accurate in mental state attribution than a demographically matched group of 38 healthy control subjects. Significant others of patients also reported more behavioral executive problems than controls' relatives on most of the domains of the BDSI. In addition, social cognition performance in the MASC was significantly correlated with behavioral dysexecutive problems rated by proxies on the BDSI. Conclusions: This study is the first to find association between impairments in mentalizing abilities in the MASC and behavioral impairments in patients with TBI, confirming the added value of this ecological task and that the recognition of social signals is a key element for adequate behavioral functioning.
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Affiliation(s)
- Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), University of Angers, Angers, France.,Department of Neurology, Angers University Hospital, Angers, France
| | - Martin Hamon
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), University of Angers, Angers, France
| | | | - Christophe Verny
- Department of Neurology, Angers University Hospital, Angers, France
| | - Mickaël Dinomais
- Department of Physical and Rehabilitation Medicine, Angers University Hospital, Angers, France
| | - Jeremy Besnard
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), University of Angers, Angers, France
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30
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Jansen M, Overgaauw S, De Bruijn ERA. Social Cognition and Obsessive-Compulsive Disorder: A Review of Subdomains of Social Functioning. Front Psychiatry 2020; 11:118. [PMID: 32231594 PMCID: PMC7082418 DOI: 10.3389/fpsyt.2020.00118] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Disturbances in social cognitive processes such as the ability to infer others' mental states importantly contribute to social and functional impairments in psychiatric disorders. Yet, despite established social, emotional, and cognitive problems, the role of social cognition in obsessive-compulsive disorder is largely overlooked. The current review provides a first comprehensive overview of social (neuro)cognitive disturbances in adult patients with obsessive-compulsive disorder. Results of our review indicate various social cognitive alterations. Patients with obsessive-compulsive disorder show deficits in the recognition of affective social cues, specifically facial expressions of disgust, and more general deficits in theory of mind/mentalizing. Additionally, patients show heightened affective reactions and altered neural responding to emotions of self and others, as well as poor emotion regulation skills, which may contribute to poor social functioning of patients. However, the discrepancies in findings and scarcity of studies make it difficult to draw firm conclusions with regard to the specificity of social cognitive disturbances. The review offers directions for future research and highlights the need to investigate obsessive-compulsive disorder from an interactive social neurocognitive perspective in addition to the prevalent passive spectator perspective to advance our understanding of this intricate and burdensome disorder.
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Affiliation(s)
- Myrthe Jansen
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Sandy Overgaauw
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Ellen R A De Bruijn
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
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31
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Serum oxytocin levels are elevated in body dysmorphic disorder and related to severity of psychopathology. Psychoneuroendocrinology 2019; 113:104541. [PMID: 31862613 PMCID: PMC6939310 DOI: 10.1016/j.psyneuen.2019.104541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/27/2022]
Abstract
The neurobiological mechanisms underlying the pathophysiology of body dysmorphic disorder (BDD) are not well-understood. Oxytocin is a central nervous system peptide which regulates socioemotional functioning and may mediate physiologic processes in a range of psychiatric disorders, particularly those characterized by interpersonal dysfunction. Examining the role of oxytocin in the development and maintenance of BDD may elucidate new targets for intervention. The present study examined endogenous serum oxytocin levels in BDD. Given the prominent deficits in social functioning in BDD, we expected that BDD would be characterized by low basal serum oxytocin concentrations, relative to healthy controls, and that low oxytocin levels would be associated with BDD symptom severity as well as poor performance on measures of social cognition. Twenty individuals with BDD and 28 healthy controls completed a fasting blood draw consisting of frequent sampling every five minutes for one hour to measure pooled levels of oxytocin. Contrary to our hypotheses, people with BDD displayed higher concentrations of oxytocin, compared to their healthy control counterparts, and their oxytocin levels were positively correlated with BDD symptom severity. There were no associations between oxytocin levels and measures of social cognition. These findings suggest increased production of endogenous oxytocin in BDD. Prospective research is needed to determine whether this contributes to or is a consequence of BDD symptomatology.
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Neurocognitive determinants of theory of mind across the adult lifespan. Brain Cogn 2019; 136:103588. [DOI: 10.1016/j.bandc.2019.103588] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 12/28/2022]
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Yazici KU, Yazici IP. Decreased theory of mind skills, increased emotion dysregulation and insight levels in adolescents diagnosed with obsessive compulsive disorder. Nord J Psychiatry 2019; 73:462-469. [PMID: 31403840 DOI: 10.1080/08039488.2019.1652341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: An abnormal interaction between cognition and emotion may contribute to the development of obsessive-compulsive disorder (OCD). Aims: In this study, we aimed to evaluate theory of mind and emotion regulation skills in adolescents diagnosed with OCD. In addition, the results were evaluated in accordance with patients' insight levels. Methods: This study was conducted with 50 patients, who were aged between 11 and 16 and who were newly diagnosed with OCD and 50 healthy individuals. The Turkish version of the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime was used to diagnose OCD and other comorbidities. The Children's Yale-Brown Obsessive Compulsive Scale, the Children's Depression Inventory, and the State-Trait Anxiety Inventory for Children were used for clinical evaluation. The intelligence levels were assessed using the Wechsler Intelligence Scale for Children-Revised Short Form. Reading the Mind in the Eyes Test was used in patients. The Difficulties in Emotion Regulation Scale was also used to evaluate the skills of regulating emotions. Results: Patients with OCD had lower ability with regard to reading minds in the eyes and emotion regulation than the healthy individuals. Patients with OCD, who had a poor insight, had more difficulty in reading minds in the eyes and emotion regulation than those with good insight. Conclusions: This study supports the idea that OCD is related to deficits in theory of mind and emotion regulation skills. Thus, further studies are required to confirm the findings of this study.
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Affiliation(s)
- Kemal Utku Yazici
- Department of Child and Adolescent Psychiatry, Firat University Medical Faculty , Elazig , Turkey
| | - Ipek Percinel Yazici
- Department of Child and Adolescent Psychiatry, Firat University Medical Faculty , Elazig , Turkey
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Eddy CM. What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations. Front Psychiatry 2019; 10:425. [PMID: 31354534 PMCID: PMC6636467 DOI: 10.3389/fpsyt.2019.00425] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.
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Affiliation(s)
- Clare M. Eddy
- Research and Innovation, BSMHFT National Centre for Mental Health, Birmingham, United Kingdom
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Calero Vivas D, Felipe-Castaño E, León B. Emotional Processing and Personality as Predictors of Obsessive-compulsive Symptoms in College Students. THE SPANISH JOURNAL OF PSYCHOLOGY 2019; 22:E32. [PMID: 31232251 DOI: 10.1017/sjp.2019.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The categorical definition of obsessive-compulsive disorder, and exclusive focus on thoughts and behaviors, have constrained the study and treatment of its symptoms. The present study's aim was to search for relationships among emotional processing dimensions, five major personality dimensions, and self-perceived obsessive-compulsive symptoms. The participants were 100 college students, and the questionnaires used were a selection of images from the International Affective Picture System (IAPS), the Self-assessment Manikin (SAM), the Dimensional Obsessive-Compulsive Scale (DOCS), and the NEO-FFI. We found differences in emotional processing dimensions between participants with high and low DOCS scores, grouped according to sex (d = .56); and evidence that the neuroticism and agreeableness dimensions predict self-perceived obsessive-compulsive symptoms. Emotional processing dimensions and personality are considered useful to comprehending obsessive-compulsive symptoms, which lends support to dimensional models of OC symptomatology, as well as planning and developing psychological interventions.
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Fang A, Lawson EA, Wilhelm S. Intranasal oxytocin modulates higher order social cognition in body dysmorphic disorder. Depress Anxiety 2019; 36:153-161. [PMID: 30614171 PMCID: PMC6501211 DOI: 10.1002/da.22876] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 11/29/2018] [Accepted: 12/10/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a psychiatric disorder with specific impairments in social cognition related to excessive concerns about one's appearance. Individuals with BDD have difficulty identifying emotional expressions and attribute internal factors for others' emotional expressions in self-referent (but not other-referent) scenarios. Given the role of oxytocin in regulating social approach behavior and social salience, we hypothesized that oxytocin would improve biases in emotion recognition, attributions, and threat interpretations in individuals with BDD, compared to healthy controls (HCs). This is the first study to examine the effects of oxytocin in people with BDD. METHODS Eighteen participants with BDD and 16 HCs received a single dose of 24 international units of intranasal oxytocin (Syntocinon®) or matching placebo in a randomized, placebo-controlled, within-subject crossover design. Participants completed the Emotion Recognition Task and Interpretation Questionnaire 45 min after administration. RESULTS Oxytocin, relative to placebo, did not improve emotion recognition accuracy in either self-referent or other-referent contexts for individuals with BDD. However, oxytocin led to greater internal attributions in other-referent contexts for those with BDD compared to HCs. Rather than reducing self-blame, oxytocin led to other-directed blame. Oxytocin did not impact threat interpretations in BDD. CONCLUSIONS Oxytocin may only impact specific aspects of higher order social cognition in BDD and may have unwanted effects on emotion attributions. Our results caution its clinical use in BDD.
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Affiliation(s)
- Angela Fang
- Department of Psychiatry, OCD and Related Disorders Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sabine Wilhelm
- Department of Psychiatry, OCD and Related Disorders Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Németh N, Mátrai P, Hegyi P, Czéh B, Czopf L, Hussain A, Pammer J, Szabó I, Solymár M, Kiss L, Hartmann P, Szilágyi ÁL, Kiss Z, Simon M. Theory of mind disturbances in borderline personality disorder: A meta-analysis. Psychiatry Res 2018; 270:143-153. [PMID: 30248485 DOI: 10.1016/j.psychres.2018.08.049] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/30/2018] [Accepted: 08/13/2018] [Indexed: 02/07/2023]
Abstract
Impairments of theory of mind (ToM) are widely accepted underlying factors of disturbed relatedness in borderline personality disorder (BPD). The aim of this meta-analysis a was to assess the weighted mean effect sizes of ToM performances in BPD compared to healthy controls (HC), and to investigate the effect of demographic variables and comorbidities on the variability of effect sizes across the studies. Seventeen studies involving 585 BPD patients and 501 HC were selected after literature search. Effect sizes for overall ToM, mental state decoding and reasoning, cognitive and affective ToM, and for task types were calculated. BPD patients significantly underperformed HC in overall ToM, mental state reasoning, and cognitive ToM, but had no deficits in mental state decoding. Affective ToM performance was largely task dependent in BPD. Comorbid anxiety disorders had a positive moderating effect on overall and affective ToM in BPD. Our results support the notion that BPD patients' have specific ToM impairments. Further research is necessary to evaluate the role of confounding factors, especially those of clinical comorbidities, neurocognitive functions, and adverse childhood life events. Complex ToM tasks with high contextual demands seem to be the most appropriate tests to assess ToM in patients with BPD.
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Affiliation(s)
- Nándor Németh
- Neurobiology of Stress Research Group, Szentágothai János Research Centre, University of Pécs, Pécs, Hungary
| | - Péter Mátrai
- Institute of Bioanalysis, University of Pécs, Medical School, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine and 1st Department of Medicine, University of Pécs, Medical School, Pécs, Hungary; Momentum Translational Gastroenterology Research Group, Hungarian Academy of Sciences University of Szeged, Szeged, Hungary
| | - Boldizsár Czéh
- Neurobiology of Stress Research Group, Szentágothai János Research Centre, University of Pécs, Pécs, Hungary; Department of Laboratory Medicine, University of Pécs, Medical School, Pécs, Hungary
| | - László Czopf
- Department of Cardiology, 1st Department of Medicine, University of Pécs, Medical School, Pécs, Hungary
| | - Alizadeh Hussain
- Department of Haematology, 1st Department of Medicine, University of Pécs, Medical School, Pécs, Hungary
| | - Judith Pammer
- Department of Haematology, 1st Department of Medicine, University of Pécs, Medical School, Pécs, Hungary
| | - Imre Szabó
- Department of Gastroenterology, 1st Department of Medicine, University of Pécs, Medical School, Pécs, Hungary
| | - Margit Solymár
- Institute for Translational Medicine, University of Pécs, Medical School, Pécs, Hungary
| | - Loránt Kiss
- Department of Pathophysiology, University of Szeged, Medical School, Szeged, Hungary
| | - Petra Hartmann
- Institute of Surgical Research, University of Szeged, Hungary
| | | | - Zoltán Kiss
- 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Maria Simon
- Neurobiology of Stress Research Group, Szentágothai János Research Centre, University of Pécs, Pécs, Hungary; Department of Psychiatry and Psychotherapy, University of Pécs, Medical School, Pécs, Hungary.
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Malcolm A, Labuschagne I, Castle D, Terrett G, Rendell PG, Rossell SL. The relationship between body dysmorphic disorder and obsessive-compulsive disorder: A systematic review of direct comparative studies. Aust N Z J Psychiatry 2018; 52:1030-1049. [PMID: 30238784 DOI: 10.1177/0004867418799925] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Current nosology conceptualises body dysmorphic disorder as being related to obsessive-compulsive disorder, but the direct evidence to support this conceptualisation is mixed. In this systematic review, we aimed to provide an integrated overview of research that has directly compared body dysmorphic disorder and obsessive-compulsive disorder. METHOD The PubMed database was searched for empirical studies which had directly compared body dysmorphic disorder and obsessive-compulsive disorder groups across any subject matter. Of 379 records, 31 met inclusion criteria and were reviewed. RESULTS Evidence of similarities between body dysmorphic disorder and obsessive-compulsive disorder was identified for broad illness features, including age of onset, illness course, symptom severity and level of functional impairment, as well as high perfectionism and high fear of negative evaluation. However, insight was clearly worse in body dysmorphic disorder than obsessive-compulsive disorder, and preliminary data also suggested unique visual processing features, impaired facial affect recognition, increased social anxiety severity and overall greater social-affective dysregulation in body dysmorphic disorder relative to obsessive-compulsive disorder. CONCLUSION Limitations included a restricted number of studies overall, an absence of studies comparing biological parameters (e.g. neuroimaging), and the frequent inclusion of participants with comorbid body dysmorphic disorder and obsessive-compulsive disorder. Risks of interpreting common features as indications of shared underlying mechanisms are explored, and evidence of differences between the disorders are placed in the context of broader research findings. Overall, this review suggests that the current nosological status of body dysmorphic disorder is somewhat tenuous and requires further investigation, with particular focus on dimensional, biological and aetiological elements.
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Affiliation(s)
- Amy Malcolm
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Izelle Labuschagne
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - David Castle
- 2 Department of Psychiatry, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.,3 Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Gill Terrett
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Peter G Rendell
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Susan L Rossell
- 2 Department of Psychiatry, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.,4 Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
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Mısır E, Bora E, Akdede BB. Relationship between social-cognitive and social-perceptual aspects of theory of mind and neurocognitive deficits, insight level and schizotypal traits in obsessive-compulsive disorder. Compr Psychiatry 2018; 83:1-6. [PMID: 29499413 DOI: 10.1016/j.comppsych.2018.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The primary aim of the current study was to investigate different aspects of theory of mind (ToM), including social-cognitive (ToM-reasoning) and social-perceptual (ToM-decoding) in obsessive-compulsive disorder (OCD). We also aimed to investigate the relationship between ToM, neurocognition and a number of clinical variables including overvalued ideas, schizotypal personality traits, level of insight, and disease severity. METHOD Thirty-four patients who have been diagnosed with OCD according to DSM-IV and 30 healthy controls were included in the study. All participants were given a neuropsychological battery including tasks measuring ToM-reasoning, ToM-decoding and other neurocognitive functions. Schizotypal Personality Questionnaire (SPQ), Yale Brown Obsession and Compulsion Scale (YBOC-S) and Overvalued Ideas Scale (OVIS) were also administered to the participants. RESULTS Patients with OCD showed significant deficits in both aspects of ToM. ToM performances of patients showed a significant positive correlation with neurocognitive functions. When controlled for general cognition factor, patient-control difference for ToM-reasoning (F = 3,917; p = 0,05), but not ToM-decoding, remained statistically significant. ToM-reasoning impairment of patients was significantly related to the severity of OCD symptoms and poor insight (p = 0,026 and p = 0,045, respectively). On the other hand, general cognitive factor (β = 0,778; t = 3,146; p = 0,04) was found to be the only significant predictor of ToM-reasoning in OCD patients in the multiple linear regression model. CONCLUSION OCD is associated with ToM impairment, which is related to schizotypal traits, disease severity and poor insight, yet neurocognitive deficits also significantly contribute to this finding. However, ToM-reasoning impairment could be considered as a relatively distinct feature of OCD, which is partly separate from general cognitive deficits.
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Affiliation(s)
- Emre Mısır
- Dokuz Eylül Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Turkey.
| | - Emre Bora
- Dokuz Eylül Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Vic, Australia
| | - Berna Binnur Akdede
- Dokuz Eylül Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Turkey
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Cui Q, Vanman EJ, Long Z, Pang Y, Chen Y, Wang Y, Duan X, Chen H, Gong Q, Zhang W, Chen H. Social anxiety disorder exhibit impaired networks involved in self and theory of mind processing. Soc Cogn Affect Neurosci 2018; 12:1284-1295. [PMID: 28398578 PMCID: PMC5597891 DOI: 10.1093/scan/nsx050] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 04/02/2017] [Indexed: 02/05/2023] Open
Abstract
Most previous studies regarding social anxiety disorder (SAD) have focused on the role of emotional dysfunction, while impairments in self- and theory of mind (ToM)-processing have relatively been neglected. This study utilised functional connectivity density (FCD), resting-state functional connectivity (RSFC) and discriminant analyses to investigate impairments in self- and ToM-related networks in patients with SAD. Patients with SAD exhibited decreased long-range FCD in the right rostral anterior cingulate cortex (rACC) and decreased short-range FCD in the right superior temporal gyrus (STG)—key nodes involved in self- and ToM-processing, respectively. Decreased RSFC of the right rACC and STG with widespread frontal, temporal, posteromedial, sensorimotor, and somatosensory, regions was also observed in patients with SAD. Altered RSFC between the right rACC and bilateral superior frontal gyrus, between the right rACC and right middle frontal gyrus, and within the right STG itself provided the greatest contribution to individual diagnoses of SAD, with an accuracy of 84.5%. These results suggest that a lack of cognitive inhibition on emotional self-referential processing as well as impairments in social information integration may play critical roles in the pathomechanism of SAD and highlight the importance of recognising such features in the diagnosis and treatment of SAD.
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Affiliation(s)
- Qian Cui
- School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu, 611731, China.,Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Eric J Vanman
- School of Psychology, University of Queensland, St. Lucia, QLD, Australia
| | - Zhiliang Long
- Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yajing Pang
- Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yuyan Chen
- Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yifeng Wang
- Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Xujun Duan
- Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Heng Chen
- Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, West China School of Medicine, Chengdu, 610041, China
| | - Wei Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Huafu Chen
- Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China
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Ballespí S, Pérez-Domingo A, Vives J, Sharp C, Barrantes-Vidal N. Childhood behavioral inhibition is associated with impaired mentalizing in adolescence. PLoS One 2018; 13:e0195303. [PMID: 29596505 PMCID: PMC5875891 DOI: 10.1371/journal.pone.0195303] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 03/20/2018] [Indexed: 12/16/2022] Open
Abstract
Recent advances suggest that impairment in social cognition (SC) may play a role in the development of social anxiety (SA). However, very few studies have analyzed whether SA fosters poorer social-cognitive development as it leads to social avoidance. This study aimed to analyze whether retrospectively assessed behavioral inhibition (BI) (i.e., an early form of SA) in childhood is associated with a deficit in social cognition operationalized as impairment of mentalizing (MZ) in adolescence. A sample of 256 adolescents (range: 12-18 years; mean age: 14.7 years; SD = 1.7) from general population were assessed for MZ capacities and retrospective BI through self-report and interview measures. Results comparing three groups of adolescents with different levels of childhood BI (low, moderate or high) and controlling for concurrent SA and depression reveal that the higher the level of BI, the lower the level of MZ. These results were consistent for almost all mentalization measures, including when both extreme (i.e., high vs. low BI) and non-extreme (i.e., high vs. moderate BI) were compared in both self-report and interview measures and in both dimensions of MZ (i.e., MZ referred to others' and to own mental states). These findings support that childhood forms of SA are associated to deficit in SC in adolescence. A possible bi-directional relationship between SA and SC, and the role that it may play in the pathway to clinical SA are discussed.
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Affiliation(s)
- Sergi Ballespí
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Ariadna Pérez-Domingo
- Department of Mental Health, Fundació Sanitària Sant Pere Claver, Barcelona, Catalunya, Spain
- Institut Docent, Fundació Sanitària Sant Pere Claver, Barcelona, Catalunya, Spain
| | - Jaume Vives
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Carla Sharp
- Developmental Psychopathology Lab, University of Houston, Houston, Texas, United States of America
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
- Department of Mental Health, Fundació Sanitària Sant Pere Claver, Barcelona, Catalunya, Spain
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Wacker R, Bölte S, Dziobek I. Women Know Better What Other Women Think and Feel: Gender Effects on Mindreading across the Adult Life Span. Front Psychol 2017; 8:1324. [PMID: 28824503 PMCID: PMC5539187 DOI: 10.3389/fpsyg.2017.01324] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/19/2017] [Indexed: 12/02/2022] Open
Abstract
Research recurrently shows that females perform better than males on various mindreading tasks. The present study contributes to this growing body of literature by being the first to demonstrate a female own-gender mindreading bias using a naturalistic social cognition paradigm including female and male targets. We found that women performed better at reading others’ minds, and that they were specifically more capable to read female targets, an own-gender target effect absent in men. Furthermore, a non-linear negative effect of perceiver age on mindreading performance was examined within a sample covering the age range of 17–70 years, as indicated by a stronger performance decrease setting on by the age of 30 years and continuing throughout middle and old age. These findings add to a more comprehensive understanding of the contextual factors influencing mindreading performance in typically developing adults.
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Affiliation(s)
- Renata Wacker
- Department of Education and Psychology, Freie Universität BerlinBerlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu BerlinBerlin, Germany
| | - Sven Bölte
- Center of Neurodevelopmental Disorders, Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Karolinska InstitutetStockholm, Sweden
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt-Universität zu BerlinBerlin, Germany
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Maurage P, D'Hondt F, de Timary P, Mary C, Franck N, Peyroux E. Dissociating Affective and Cognitive Theory of Mind in Recently Detoxified Alcohol-Dependent Individuals. Alcohol Clin Exp Res 2016; 40:1926-34. [DOI: 10.1111/acer.13155] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 06/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Pierre Maurage
- Laboratory for Experimental Psychopathology; Psychological Sciences Research Institute; Université catholique de Louvain; Louvain-la-Neuve Belgium
| | - Fabien D'Hondt
- Laboratory for Experimental Psychopathology; Psychological Sciences Research Institute; Université catholique de Louvain; Louvain-la-Neuve Belgium
| | - Philippe de Timary
- Laboratory for Experimental Psychopathology; Psychological Sciences Research Institute; Université catholique de Louvain; Louvain-la-Neuve Belgium
- Department of Psychiatry; Saint-Luc University Hospital; Brussels Belgium
| | - Charlotte Mary
- Laboratory for Experimental Psychopathology; Psychological Sciences Research Institute; Université catholique de Louvain; Louvain-la-Neuve Belgium
| | - Nicolas Franck
- Centre de Neurosciences Cognitives; UMR 5229; CNRS; Bron Cedex France
- Service Universitaire de Réhabilitation; Centre Référent Lyonnais en Réhabilitation et en Remédiation Cognitive (SUR-CL3R); Centre Hospitalier Le Vinatier; Lyon France
- Université Claude Bernard Lyon 1; Villeurbanne Cedex France
| | - Elodie Peyroux
- Centre de Neurosciences Cognitives; UMR 5229; CNRS; Bron Cedex France
- Service Universitaire de Réhabilitation; Centre Référent Lyonnais en Réhabilitation et en Remédiation Cognitive (SUR-CL3R); Centre Hospitalier Le Vinatier; Lyon France
- GDR 3557; SHU-Centre Hospitalier Sainte-Anne; Paris France
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