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Langenbach BP, Koelkebeck K, Knoch D. Mentalising and depression: a mini-review on behavior, neural substrates, and treatment options. Front Psychiatry 2023; 14:1116306. [PMID: 37398589 PMCID: PMC10308027 DOI: 10.3389/fpsyt.2023.1116306] [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: 12/05/2022] [Accepted: 05/24/2023] [Indexed: 07/04/2023] Open
Abstract
Major depression is one of the most common mental disorders, affecting millions of people around the globe. In recent years, researchers increasingly investigated social cognition in depression and discovered pronounced alterations. A special focus has been put on mentalising or Theory of Mind, the ability to recognize and understand another person's thoughts and feelings. While there is behavioral evidence for deficits in this ability in patients with depression as well as specialized therapeutic interventions, the neuroscientific substrates are only beginning to be understood. In this mini-review, we take a social neuroscience perspective to analyse the importance of altered mentalising in depression and whether it can help to understand the origins and perpetuation of the disorder. We will put a special focus on treatment options and corresponding neural changes to identify relevant paths for future (neuroscientific) research.
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Affiliation(s)
- Benedikt P. Langenbach
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Katja Koelkebeck
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Daria Knoch
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern, Switzerland
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2
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Antoniou G, Lambourg E, Steele JD, Colvin LA. The effect of adverse childhood experiences on chronic pain and major depression in adulthood: a systematic review and meta-analysis. Br J Anaesth 2023; 130:729-746. [PMID: 37087334 PMCID: PMC10251130 DOI: 10.1016/j.bja.2023.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Adverse childhood experiences have been linked to increased multimorbidity, with physical and mental health consequences throughout life. Chronic pain is often associated with mood disorders, such as major depressive disorder (MDD); both have been linked to adverse childhood experiences. It is unclear how the effect of adverse childhood experiences on neural processing impacts on vulnerability to chronic pain, MDD, or both, and whether there are shared mechanisms. We aimed to assess evidence for central neural changes associated with adverse childhood experiences in subjects with chronic pain, MDD, or both using systematic review and meta-analysis. METHODS Electronic databases were systematically searched for neuroimaging studies of adverse childhood experiences, with chronic pain, MDD, or both. Two independent reviewers screened title, abstracts, and full text, and assessed quality. After extraction of neuroimaging data, activation likelihood estimate meta-analysis was performed to identify significant brain regions associated with these comorbidities. RESULTS Forty-nine of 2414 studies were eligible, of which 43 investigated adverse childhood experiences and MDD and six investigated adverse childhood experiences and chronic pain. None investigated adverse childhood experiences, chronic pain, and MDD together. Functional and structural brain abnormalities were identified in the superior frontal, lingual gyrus, hippocampus, insula, putamen, superior temporal, inferior temporal gyrus, and anterior cerebellum in patients with MDD exposed to adverse childhood experiences. In addition, brain function abnormalities were identified for patients with MDD or chronic pain and exposure to adverse childhood experiences in the cingulate gyrus, inferior parietal lobule, and precuneus in task-based functional MRI studies. CONCLUSIONS We found that adverse childhood experiences exposure can result in different functional and structural brain alterations in adults with MDD or chronic pain compared with those without adverse childhood experiences. SYSTEMATIC REVIEW PROTOCOL PROSPERO CRD42021233989.
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Affiliation(s)
- Georgia Antoniou
- Division of Population Health and Genomics, Medical Research Institute, University of Dundee, Dundee, UK.
| | - Emilie Lambourg
- Division of Population Health and Genomics, Medical Research Institute, University of Dundee, Dundee, UK
| | - J Douglas Steele
- Division of Imaging Science and Technology, Medical School, University of Dundee, Dundee, UK
| | - Lesley A Colvin
- Division of Population Health and Genomics, Medical Research Institute, University of Dundee, Dundee, UK
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3
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Nikolic M, Pezzoli P, Jaworska N, Seto MC. Brain responses in aggression-prone individuals: A systematic review and meta-analysis of functional magnetic resonance imaging (fMRI) studies of anger- and aggression-eliciting tasks. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110596. [PMID: 35803398 DOI: 10.1016/j.pnpbp.2022.110596] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022]
Abstract
Reactive aggression in response to perceived threat or provocation is part of humans' adaptive behavioral repertoire. However, high levels of aggression can lead to the violation of social and legal norms. Understanding brain function in individuals with high levels of aggression as they process anger- and aggression-eliciting stimuli is critical for refining explanatory models of aggression and thereby improving interventions. Three neurobiological models of reactive aggression - the limbic hyperactivity, prefrontal hypoactivity, and dysregulated limbic-prefrontal connectivity models - have been proposed. However, these models are based on neuroimaging studies involving mainly non-aggressive individuals, leaving it unclear which model best describes brain function in those with a history of aggression. We conducted a systematic literature search (PubMed and Psycinfo) and Multilevel Kernel Density meta-analysis (MKDA) of nine functional magnetic resonance imaging (fMRI) studies (eight included in the between-group analysis [i.e., aggression vs. control groups], five in the within-group analysis). Studies examined brain responses to tasks putatively eliciting anger and aggression in individuals with a history of aggression alone and relative to controls. Individuals with a history of aggression exhibited greater activity in the superior temporal gyrus and in regions comprising the cognitive control and default mode networks (right posterior cingulate cortex, precentral gyrus, precuneus, right inferior frontal gyrus) during reactive aggression relative to baseline conditions. Compared to controls, individuals with a history of aggression exhibited increased activity in limbic regions (left hippocampus, left amygdala, left parahippocampal gyrus) and temporal regions (superior, middle, inferior temporal gyrus), and reduced activity in occipital regions (left occipital cortex, left calcarine cortex). These findings lend support to the limbic hyperactivity model in individuals with a history of aggression, and further indicate altered temporal and occipital activity in anger- and aggression-eliciting conditions involving face and speech processing.
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Affiliation(s)
- Maja Nikolic
- McGill University, Montreal, QC, Canada; McMaster University, Hamilton, ON, Canada.
| | - Patrizia Pezzoli
- University College London, London, United Kingdom; University of Ottawa's Institute of Mental Health Research at The Royal, Ottawa, ON, Canada.
| | - Natalia Jaworska
- University of Ottawa's Institute of Mental Health Research at The Royal, Ottawa, ON, Canada; Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Michael C Seto
- University of Ottawa's Institute of Mental Health Research at The Royal, Ottawa, ON, Canada.
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4
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Hevia-Orozco J, Reyes-Aguilar A, Pasaye EH, Barrios FA. Participation of visual association areas in social processing emerges when rTPJ is inhibited. eNeurologicalSci 2022; 27:100407. [PMID: 35669231 PMCID: PMC9162944 DOI: 10.1016/j.ensci.2022.100407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/03/2022] [Accepted: 05/21/2022] [Indexed: 10/29/2022] Open
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5
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Nestor BA, Sutherland S, Garber J. Theory of mind performance in depression: A meta-analysis. J Affect Disord 2022; 303:233-244. [PMID: 35176344 PMCID: PMC8961451 DOI: 10.1016/j.jad.2022.02.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Theory of mind (ToM) is a social-cognitive skill that involves the ability to understand the thoughts and feelings of others. Evidence is mixed regarding the extent of ToM ability in individuals with depression. METHODS We conducted a meta-analysis of 43 studies to investigate the strength of the association between ToM and depression. RESULTS Results indicated significant, small- to moderate impairment in ToM with a medium overall effect size (g = -0.398) in individuals with depression. Moderator analyses compared effect sizes across groups for the following variables: ToM content, process, and sample type. Additionally, meta-regression analyses tested age and gender as continuous moderators. LIMITATIONS The cross-sectional nature of included studies limits this meta-analysis from clarifying temporal or bidirectional relations. CONCLUSIONS We discuss findings in the context of the extant developmental, cognitive, social, and clinical literatures. We also suggest several possible explanations for these findings and offer implications for intervention.
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Affiliation(s)
- Bridget A. Nestor
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Susanna Sutherland
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Judy Garber
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
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6
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Hillmann K, Neukel C, Krauch M, Spohn A, Schnell K, Herpertz SC, Bertsch K. Cognitive and Affective Theory of Mind in Female Patients With Borderline Personality Disorder. J Pers Disord 2021; 35:672-690. [PMID: 33107807 DOI: 10.1521/pedi_2020_34_490] [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: 11/20/2022]
Abstract
Empirical studies have identified deficits in cognitive and affective theory of mind (ToM) in patients with borderline personality disorder (BPD), but results remain heterogeneous and not much is known about the role of childhood trauma. The current study assessed cognitive and affective ToM in 80 patients with BPD and 41 healthy controls in a false-belief cartoon task. Childhood trauma was measured with the Childhood Trauma Questionnaire (CTQ). Patients with BPD responded slower in all experimental conditions in false-belief situations, but not when false beliefs were resolved; made more errors in the cognitive ToM condition; and reported worse affective states more often in and after false-belief situations. No significant correlations between ToM and childhood trauma could be found. The current study revealed deficits in cognitive and affective ToM in patients with BPD that may be related to a more negative affective state raised by the false-belief stories.
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Affiliation(s)
- Karen Hillmann
- Department of General Psychiatry, Heidelberg University, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Heidelberg University, Germany
| | - Marlene Krauch
- Department of General Psychiatry, Heidelberg University, Germany.,Central Institute of Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Angelika Spohn
- Central Institute of Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Knut Schnell
- Asklepios Center for Psychiatry and Psychotherapy Göttingen, Göttingen, Germany
| | | | - Katja Bertsch
- Department of General Psychiatry, Heidelberg University, Germany
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7
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Eidenmueller K, Grimm F, Hermann D, Frischknecht U, Montag C, Dziobek I, Kiefer F, Bekier NK. Exploring Influences on Theory of Mind Impairment in Opioid Dependent Patients. Front Psychiatry 2021; 12:721690. [PMID: 34887783 PMCID: PMC8649648 DOI: 10.3389/fpsyt.2021.721690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Theory of mind (ToM) is an aspect of social cognition impaired in different addictive disorders, including opioid addiction. This study aimed at replicating ToM deficits in opioid dependent patients undergoing opioid maintenance treatment (OMT) and exploring the influence of substance use related variables, executive functions and childhood maltreatment on ToM in opioid dependent patients. 66 opioid dependent patients were tested using the Movie for Assessment of Social Cognition (MASC) and compared with the data of healthy controls. Furthermore, the opioid dependent patients underwent testing for executive functions and filled in the Childhood Trauma Questionnaire (CTQ). Performance on the MASC was significantly poorer in the opioid dependence group than in the control group, even when recent additional drug use and psychiatric comorbidities were controlled for. No correlations were found between ToM and substance use related factors. Aspects of ToM performance in opioid dependent patients correlated significantly with different EF domains. ToM correlated significantly with the CTQ scales for physical maltreatment. The results confirm impaired ToM in opioid dependent patients and highlight executive functions and childhood maltreatment as influential factors. The lack of associations between ToM and substance use related variables and the association with childhood maltreatment suggest that ToM impairments might be a risk factor predating substance abuse.
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Affiliation(s)
- Katharina Eidenmueller
- Department of Addictive Behaviors and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Franz Grimm
- Department of Addictive Behaviors and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | | | - Ulrich Frischknecht
- Department of Addictive Behaviors and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany.,German Institute of Addiction and Prevention Research, Catholic University of Applied Sciences Nordrhein-Westfalen, Koeln, Germany
| | - Christiane Montag
- Department of Psychiatry and Neurosciences, Charité University Medicine, Berlin, Germany
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Institute of Psychology, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Falk Kiefer
- Department of Addictive Behaviors and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Nina Kim Bekier
- Department of Addictive Behaviors and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
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8
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Tekin U, Erermiş HS, Satar A, Aydın AN, Köse S, Bildik T. Social cognition in first episode adolescent depression and its correlation with clinical features and quality of life. Clin Child Psychol Psychiatry 2021; 26:140-153. [PMID: 33246372 DOI: 10.1177/1359104520973254] [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] [Indexed: 11/15/2022]
Abstract
Research has suggested that patients with depression have deficits in social cognition, however they provide limited data regarding adolescent depression. Moreover, the relationship of social cognition with clinical features and quality of life is less studied. This study investigated social cognition in depressive adolescents and the correlations of social cognition with clinical features and quality of life. Thirty-five depressed adolescents and 37 healthy controls were assessed. Emotion perception and decoding ToM, quality of life and clinical variables were evaluated. No significant differences were found between depression and control groups regarding social cognitive tests. The results indicated that examined clinical features were not correlated significantly with social cognitive tests. Results suggest that social cognitive abilities are not disturbed in adolescents with first depressive episode.
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Affiliation(s)
- Uğur Tekin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Hatice Serpil Erermiş
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ayşegül Satar
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ayşe Nur Aydın
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Sezen Köse
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
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9
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Xiong N, Liu Q, Lv X, Leonhart R, Tian H, Wei J, Zhang K, Zhu G, Chen Q, Wang G, Wang X, Zhang N, Huang Y, Si T, Yu X. Demographic and Psychosocial Variables Could Predict the Occurrence of Major Depressive Disorder, but Not the Severity of Depression in Patients with First-episode Major Depressive Disorder in China. J Affect Disord 2020; 274:103-111. [PMID: 32469792 DOI: 10.1016/j.jad.2020.05.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/18/2020] [Accepted: 05/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND This study aimed to investigate the association between psychosocial variables and depression severity among Chinese patients with first-episode major depressive disorder (MDD). METHODS This multicenter case-control study enrolled patients with first-episode MDD and healthy controls (HCs) from nine sites in China. Depressive symptoms, clinical features, and psychosocial variables were evaluated. Based on the total score of the Hamilton Rating Scale of Depression (HRSD-17), patients with MDD were classified into three subgroups of severity (mild, moderate and severe). The logistic regression analyses were conducted to investigate the independent risk factors of MDD and different severities of depression. RESULTS Overall, 598 MDD patients and 467 HCs were included. The proportions of patients with mild, moderate, and severe depression were 260 (29.5%), 443 (50.2%), and 179 (20.3%), respectively. The logistic regression model revealed that the demographic and psychosocial factors could explain 50.6% of the total variance of occurrence of MDD in the whole sample with HCs. However, in the subsample of MDD patients, only older age [OR=1.03 (95%CI: 1.02-1.05)], stressful social events [OR=1.04 (95%CI: 1.02-1.06)], and melancholic feature [OR=2.68 (95%CI: 1.91-3.74)] were independent risk factors for moderate and severe depression; these factors combined to explain only 10.2% of the total variance. LIMITATIONS Only patients with first-episode MDD were included in this study, leaving the associated factors for the severity of recurrent depression uninvestigated. CONCLUSION Demographic and psychosocial variables had satisfactory performance in predicting the occurrence of MDD, but showed inadequate value in predicting the depression severity of MDD patients.
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Affiliation(s)
- Nana Xiong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qi Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xiaozhen Lv
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Rainer Leonhart
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Hongjun Tian
- Nankai University Affiliated Anding Hospital, Tianjin Mental Health Center, Tianjin, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Gang Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Qiaoling Chen
- Department of Psychiatry, Dalian Seventh People's Hospital, Dalian, China
| | - Gang Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xueyi Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Mental Health Institute of Hebei Medical University, Shijiazhuang, China
| | - Nan Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yu Huang
- National Engineering Research Center for Software Engineering, Peking University, Beijing, China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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10
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Hudson AR, Orlemann C, Van Tricht T, Brass M, Mueller SC. Depression, trauma and mentalizing: No influence of depressive symptoms on spontaneous theory of mind in a subclinical sample. Int J Soc Psychiatry 2020; 66:442-451. [PMID: 32308084 DOI: 10.1177/0020764020914918] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depressive symptoms are associated with impaired social functioning, arguably because of reduced mentalizing abilities. However, findings in persons with depressive symptoms and/or major depressive disorder (MDD) are presently mixed, finding evidence both for and against the hypothesis of reduced mentalizing abilities. AIMS This study investigated spontaneous cognitive mentalizing in 36 age-, sex- and education-matched students with depressive symptoms and 45 comparisons with minimal depressive symptoms. METHOD To assess spontaneous mentalizing, we used the implicit theory of mind (ToM) task, which looks specifically at spontaneous computation of false belief. RESULTS Bayesian analysis did not support the hypothesis of impaired mentalizing; in fact, it suggested that the results were 3.90 times more likely to have occurred under the null hypothesis. Results remained stable when comparing depressed and non-depressed individuals without maltreatment exposure but were inconclusive in the maltreatment-exposed groups. CONCLUSION The findings suggest no effect of spontaneous mentalizing in a high-functioning depressed sample. Moreover, the findings also emphasize the need to control for childhood maltreatment experiences in future ToM and social functioning research, as these may constitute subgroups within depressed samples. Tailored therapy for maltreated depression individuals may be beneficial.
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Affiliation(s)
- Anna R Hudson
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Corinne Orlemann
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tine Van Tricht
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Marcel Brass
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
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11
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Antonucci LA, Pergola G, Passiatore R, Taurisano P, Quarto T, Dispoto E, Rampino A, Bertolino A, Cassibba R, Blasi G. The interaction between OXTR rs2268493 and perceived maternal care is associated with amygdala-dorsolateral prefrontal effective connectivity during explicit emotion processing. Eur Arch Psychiatry Clin Neurosci 2020; 270:553-565. [PMID: 31471679 DOI: 10.1007/s00406-019-01062-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/23/2019] [Indexed: 12/15/2022]
Abstract
Previous studies have indicated a link between socio-emotional processing and the oxytocin receptor. In this regard, a single nucleotide polymorphism in the oxytocin receptor coding gene (OXTR rs2268493) has been linked with lower social functioning, increased risk for autism spectrum disorders (ASDs) and with post-mortem OXTR mRNA expression levels. Indeed, the levels of expression of OXTR in brain regions involved in emotion processing are also associated with maternal care. Furthermore, maternal care has been associated with emotional correlates. Taken together, these previous findings suggest a possible combined effect of rs2268493 and maternal care on emotion-related brain phenotypes. A crucial biological mechanism subtending emotional processing is the amygdala-dorsolateral prefrontal cortex (DLPFC) functional connection. On this basis, our aim was to investigate the interaction between rs2268493 and maternal care on amygdala-DLPFC effective connectivity during emotional evaluation. We characterized through dynamic causal modeling (DCM) patterns of amygdala-DLPFC effective connectivity during explicit emotion processing in healthy controls (HC), profiled based on maternal care and rs2268493 genotype. In the whole sample, right top-down DLPFC-to-amygdala pattern was the most likely directional model of effective connectivity. This pattern of connectivity was the most likely for all rs2268493/maternal care subgroups, except for thymine homozygous (TT)/low maternal care individuals. Here, a right bottom-up amygdala-to-DLPFC was the most likely directional model. These results suggest a gene by environment interaction mediated by the oxytocin receptor on biological phenotypes relevant to emotion processing.
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Affiliation(s)
- Linda A Antonucci
- Section for Neurodiagnostic Applications, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians Universität, 80336, Munich, Germany.,Department of Educational Science, Psychology and Communication Science, University of Bari "Aldo Moro", 70121, Bari, Italy.,Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Giulio Pergola
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Roberta Passiatore
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Paolo Taurisano
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy.,IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, 71013, Foggia, Italy
| | - Tiziana Quarto
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Eleonora Dispoto
- Department of Educational Science, Psychology and Communication Science, University of Bari "Aldo Moro", 70121, Bari, Italy
| | - Antonio Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy.,Psychiatry Unit, Bari University Hospital, 70124, Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy.,Psychiatry Unit, Bari University Hospital, 70124, Bari, Italy
| | - Rosalinda Cassibba
- Department of Educational Science, Psychology and Communication Science, University of Bari "Aldo Moro", 70121, Bari, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124, Bari, Italy. .,Psychiatry Unit, Bari University Hospital, 70124, Bari, Italy.
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12
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Humphreys KL, LeMoult J, Wear JG, Piersiak HA, Lee A, Gotlib IH. Child maltreatment and depression: A meta-analysis of studies using the Childhood Trauma Questionnaire. CHILD ABUSE & NEGLECT 2020; 102:104361. [PMID: 32062423 PMCID: PMC7081433 DOI: 10.1016/j.chiabu.2020.104361] [Citation(s) in RCA: 230] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Researchers have documented that child maltreatment is associated with adverse long-term consequences for mental health, including increased risk for depression. Attempts to conduct meta-analyses of the association between different forms of child maltreatment and depressive symptomatology in adulthood, however, have been limited by the wide range of definitions of child maltreatment in the literature. OBJECTIVE We sought to meta-analyze a single, widely-used dimensional measure of child maltreatment, the Childhood Trauma Questionnaire, with respect to depression diagnosis and symptom scores. PARTICIPANTS AND SETTING 192 unique samples consisting of 68,830 individuals. METHODS We explored the association between total scores and scores from specific forms of child maltreatment (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and depression using a random-effects meta-analysis. RESULTS We found that higher child maltreatment scores were associated with a diagnosis of depression (g = 1.07; 95 % CI, 0.95-1.19) and with higher depression symptom scores (Z = .35; 95 % CI, .32-.38). Moreover, although each type of child maltreatment was positively associated with depression diagnosis and scores, there was variability in the size of the effects, with emotional abuse and emotional neglect demonstrating the strongest associations. CONCLUSIONS These analyses provide important evidence of the link between child maltreatment and depression, and highlight the particularly larger association with emotional maltreatment in childhood.
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Affiliation(s)
| | | | - John G Wear
- Western University of Health Sciences, United States
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13
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Cracco E, Hudson AR, Van Hamme C, Maeyens L, Brass M, Mueller SC. Early interpersonal trauma reduces temporoparietal junction activity during spontaneous mentalising. Soc Cogn Affect Neurosci 2020; 15:12-22. [PMID: 32248239 PMCID: PMC7171375 DOI: 10.1093/scan/nsaa015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 01/09/2023] Open
Abstract
Experience of interpersonal trauma and violence alters self-other distinction and mentalising abilities (also known as theory of mind, or ToM), yet little is known about their neural correlates. This fMRI study assessed temporoparietal junction (TPJ) activation, an area strongly implicated in interpersonal processing, during spontaneous mentalising in 35 adult women with histories of childhood physical, sexual, and/or emotional abuse (childhood abuse; CA) and 31 women without such experiences (unaffected comparisons; UC). Participants watched movies during which an agent formed true or false beliefs about the location of a ball, while participants always knew the true location of the ball. As hypothesised, right TPJ activation was greater for UCs compared to CAs for false vs true belief conditions. In addition, CAs showed increased functional connectivity relative to UCs between the rTPJ and dorsomedial prefrontal cortex. Finally, the agent's belief about the presence of the ball influenced participants' responses (ToM index), but without group differences. These findings highlight that experiencing early interpersonal trauma can alter brain areas involved in the neural processing of ToM and perspective-taking during adulthood.
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Affiliation(s)
- Emiel Cracco
- Department of Experimental Psychology, Ghent University, 9000 Ghent, Belgium
| | - Anna R Hudson
- Department of Experimental Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium
| | - Charlotte Van Hamme
- Department of Experimental Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium
| | - Lien Maeyens
- Department of Experimental Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium
| | - Marcel Brass
- Department of Experimental Psychology, Ghent University, 9000 Ghent, Belgium
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, 48007 Bilbao, Spain
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Simon M, Németh N, Gálber M, Lakner E, Csernela E, Tényi T, Czéh B. Childhood Adversity Impairs Theory of Mind Abilities in Adult Patients With Major Depressive Disorder. Front Psychiatry 2019; 10:867. [PMID: 31920739 PMCID: PMC6928114 DOI: 10.3389/fpsyt.2019.00867] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/04/2019] [Indexed: 02/01/2023] Open
Abstract
Background: Patients with major depressive disorder (MDD) have various theory of mind (ToM) impairments which often predict a poor outcome. However, findings on ToM deficits in MDD are inconsistent and suggest the role of moderating factors. Child abuse and neglect are strong predictors of adult MDD and are often associated with a poorer clinical course trajectory. Objective: Because early-life adversities result in various forms of ToM deficits in clinical and nonclinical samples, our aim was to investigate if they are significant confounding factors of ToM impairments in MDD. Methods: We investigated 60 mildly or moderately depressed, nonpsychotic adult patients with MDD during an acute episode, and 32 matched healthy controls. The mental state decoding subdomain of ToM was examined with the Reading the Mind in the Eyes Test (RMET). Childhood adversities were assessed with the childhood trauma questionnaire (CTQ) and the early trauma inventory. Results: There was no difference between the control and MDD groups in RMET performance. However, when we divided the MDD group into two subgroups, one (N = 30) with high and the other (N = 30) with low levels of childhood adversities, a significant difference emerged between the controls and the highly maltreated MDD subgroup in RMET performance. A series of 3 (group) × 3 (valence) mixed-model analyses of covariance (ANCOVAs) revealed that childhood emotional and physical neglect had a significant negative impact on the response accuracy in RMET in general, whereas emotional abuse specifically interfered with the accuracy in the positive and negative valences if it co-occurred with early-life neglect. To test the dose-response relationship between the number of childhood adversities and RMET capacities, we subjected RMET data of the MDD group to multiple hierarchical regressions: the number of childhood adversities was a significant predictor of RMET total scores and RMET scores in the negative valence after controlling for age, sex, years of education, and the severity of current depression. Conclusion: Childhood adversities impair ToM capacities in MDD. Exposure to early-life emotional abuse and neglect have a negative impact on the performance in the emotional valences of RMET. Multiple early-life adversities have a dose-dependent association with mental state decoding deficits.
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Affiliation(s)
- Maria Simon
- Neurobiology of Stress Research Group, János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Department of Psychiatry and Psychotherapy, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Nándor Németh
- Neurobiology of Stress Research Group, János Szentágothai Research Center, University of Pécs, Pécs, Hungary
| | - Mónika Gálber
- Neurobiology of Stress Research Group, János Szentágothai Research Center, University of Pécs, Pécs, Hungary
| | - Elza Lakner
- Neurobiology of Stress Research Group, János Szentágothai Research Center, University of Pécs, Pécs, Hungary
| | - Eszter Csernela
- Neurobiology of Stress Research Group, János Szentágothai Research Center, University of Pécs, Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Boldizsár Czéh
- Neurobiology of Stress Research Group, János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Department of Laboratory Medicine, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
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15
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Raisa ZH, Karuppali S, Bhat JS, Bajaj G. Thinking about what he thinks of what I think: Assessing higher theory of mind abilities in Indian bilingual children between 3.0 and 8.11 years of age. Indian J Psychiatry 2019; 61:167-176. [PMID: 30992612 PMCID: PMC6425799 DOI: 10.4103/psychiatry.indianjpsychiatry_115_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
CONTEXT The competence in theory of mind (ToM) abilities occurs in parallel with the development of language. To gain a deeper discernment about its proficiency, tasks tapping on higher-order ToM abilities have been implemented. AIMS This study aims to explore the development of higher-order ToM abilities in bilingual Indian children between 3.0 and 8.11 years of age, to achieve an insight into the influence of language on ToM abilities. SETTINGS AND DESIGN The current study followed a cross-sectional design along with an employment of a random convenient sampling procedure. The study was conducted in regular English medium schools with each participant individually being assessed. MATERIALS AND METHODS The study was done on 60 Kannada-English bilingual children, with each participant being assessed using two sets of stories (English and Kannada) that were constructed based on two different central themes which were verbally narrated. The stimulus of each set consisted of questions tapping on three levels (first-second-third orders) of ToM abilities. STATISTICAL ANALYSIS Descriptive statistics determined the mean and standard deviation of the total ToM scores (in both languages). Wilcoxon Signed-Rank and Mann-Whitney U-tests were done to determine the level of significance across and between the age groups (in both languages), respectively. RESULTS The results revealed a significant difference across the age groups. In addition, a significant difference between the responses in English and Kannada were obtained. CONCLUSIONS The development of metalinguistic abilities is influenced by socioenvironmental factors as well as the language maturity of the child.
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Affiliation(s)
- Zeba Hussain Raisa
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Sudhin Karuppali
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Jayashree Sunil Bhat
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Gagan Bajaj
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka, India
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16
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Childhood emotional abuse, physical abuse, and neglect are associated with theory of mind decoding accuracy in young adults with depression. Psychiatry Res 2018; 268:501-507. [PMID: 30165325 DOI: 10.1016/j.psychres.2018.07.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 06/29/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022]
Abstract
The current study is the first to examine the relation of childhood abuse and neglect history to theory of mind decoding accuracy as moderated by depression. Fifty-five young adults with current or lifetime unipolar depression diagnosis and 70 never-depressed young adults completed the 'Reading the Mind in the Eyes task,' (RMET). Childhood emotional abuse, physical abuse, and neglect were assessed with a gold-standard contextual interview with standardized, independent ratings. Poorer RMET accuracy was associated with a history of emotional abuse in the depressed group and a history of physical abuse in the non-depressed group. In contrast, across both groups, those with a history of neglect showed significantly enhanced theory of mind decoding accuracy compared to those without. Further, differential accuracy across positive, negative, and neutral valenced stimuli in the RMET was observed in each model. These findings indicate that distinct theory of mind performance results from early experiences of threat versus deprivation, and suggest that early intervention may be most successful in preventing negative interpersonal outcomes of maltreatment by focusing on remediating theory of mind deficits resulting from abuse, and tempering heightened sensitivity in those exposed to neglect.
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17
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Stevelink R, Abramovic L, Verkooijen S, Begemann MJH, Sommer IEC, Boks MP, Mandl RCW, van Haren NEM, Vinkers CH. Childhood abuse and white matter integrity in bipolar disorder patients and healthy controls. Eur Neuropsychopharmacol 2018; 28:807-817. [PMID: 29866576 DOI: 10.1016/j.euroneuro.2018.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/04/2018] [Accepted: 05/17/2018] [Indexed: 10/14/2022]
Abstract
Childhood trauma has a negative impact on the developing brain and increases the risk for almost all psychiatric disorders including bipolar disorder. White matter abnormalities may play a role in the persistently increased risk for bipolar disorder following childhood trauma. We therefore examined the influence of childhood abuse and neglect on white matter integrity using diffusion tensor imaging (DTI), quantified as fractional anisotropy (FA), in patients with bipolar I disorder (N = 251) and healthy controls (N = 163). Bipolar patients experienced more childhood abuse (30.6% vs 8.0%; p< 0.001) and childhood neglect (36.3% vs 22.7%; p = 0.003) than controls. Childhood abuse had different effects on whole brain FA in patients with bipolar disorder compared to healthy individuals (F[1,410] = 3.060; p = 0.006). Specifically, whereas patients with bipolar disorder with childhood abuse had lower FA in widespread regions of the brain relative to patients without childhood abuse (t[249] = 2.28; p = 0.024), no differences were found between healthy individuals with and without abuse (t[161]=-0.18; p = 0.986). Differences in mean FA significantly mediated the association between childhood abuse and bipolar disorder. In contrast, childhood neglect was not significantly associated with FA in patients with bipolar disorder nor in healthy controls. Together, these results show that childhood abuse but not neglect is associated with lower integrity of white matter microstructure across the brain in patients with bipolar I disorder but not in healthy individuals. Therefore, white matter integrity might be involved the relationship between childhood abuse and bipolar disorder, even though the directionality cannot be proven due to the cross-sectional design of our study.
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Affiliation(s)
- Remi Stevelink
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne Verkooijen
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marieke J H Begemann
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris E C Sommer
- Department of Neuroscience, UMC Groningen, The Netherlands; Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Marco P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rene C W Mandl
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
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18
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Quidé Y, Cohen-Woods S, O'Reilly N, Carr VJ, Elzinga BM, Green MJ. Schizotypal personality traits and social cognition are associated with childhood trauma exposure. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 57:397-419. [PMID: 29923348 DOI: 10.1111/bjc.12187] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Childhood trauma is a common risk factor for adult psychiatric disorders, such as schizophrenia (SZ) and bipolar-I disorder (BD). However, its association with schizotypal personality traits, as well as cognitive and social cognitive abilities, is less well studied in these populations. METHODS In a cohort of 79 SZ cases, 84 BD cases, and 75 healthy controls (HCs), clinically significant levels of childhood trauma exposure (according to scores on the Childhood Trauma Questionnaire; CTQ) were evident in 54 SZ, 55 BD, and 26 HC individuals. Trauma-exposed and non-exposed groups were compared on schizotypal personality features (schizotypy) measured with the Schizotypal Personality Questionnaire (SPQ). Cognitive assessments included executive function, working memory, attention, and immediate and delayed memory. Social cognitive measures assessed facial emotion processing and theory-of-mind abilities. RESULTS Trauma-exposed participants showed higher levels of schizotypy, especially suspiciousness, relative to non-exposed individuals, regardless of clinical or HC status. Furthermore, trauma-exposed individuals showed deficits specifically in social cognitive, but not general cognitive abilities, regardless of clinical or HC status. These trauma-related results were found in the context of higher schizotypy levels in both SZ and BD relative to HC, and lower cognitive and social cognitive performance in SZ, relative to BD and HC groups. CONCLUSIONS These findings suggest that childhood trauma exposure impacts long-term schizotypy outcomes, especially paranoid ideation (suspiciousness), as well as complex social cognitive abilities in both healthy and psychotic populations. However, cognitive deficits associated with psychotic illness may not be distinguishable from those related to trauma exposure in previous studies. PRACTITIONER POINTS Findings Childhood trauma exposure is associated with increased schizotypal features (in particular paranoid ideation) and complex social cognitive abilities, independently of the diagnosis of psychotic disorder. Cognitive and social cognitive deficits were larger in schizophrenia compared to bipolar-I cases and healthy controls, but increased schizotypal features were observed in both schizophrenia and bipolar-I disorder relative to healthy controls. Limitations We were unable to distinguish the specific effects of particular childhood trauma exposures due to the high rate of exposure to more than one type of maltreatment. Retrospective assessment of childhood trauma in adulthood cannot be externally validated, and associations with behavioural traits in later life may be confounded by other factors not studied here.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.,Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Sarah Cohen-Woods
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Nicole O'Reilly
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.,Neuroscience Research Australia, Randwick, New South Wales, Australia.,Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Bernet M Elzinga
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, the Netherlands.,Clinical, Health and Neuropsychology Unit, Leiden University, the Netherlands
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.,Neuroscience Research Australia, Randwick, New South Wales, Australia
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19
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Rokita KI, Dauvermann MR, Donohoe G. Early life experiences and social cognition in major psychiatric disorders: A systematic review. Eur Psychiatry 2018; 53:123-133. [DOI: 10.1016/j.eurpsy.2018.06.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 11/29/2022] Open
Abstract
AbstractObjective:To present a systematic review of the literature on the associations between early social environment, early life adversity, and social cognition in major psychiatric disorders, including schizophrenia, bipolar disorder, borderline personality disorder, major depressive disorder and posttraumatic stress disorder.Method:Relevant studies were identified via electronic and manual searches of the literature and included articles written in English and published in peer-reviewed journals up to May 2018. Quality assessment was performed using the quality evaluation scale employed in previous systematic reviews.Results:A total of 25 studies were included in the systematic review with the quality assessment scores ranging from 3 to 6 (out of 6). The vast majority of the studies reviewed showed a significant association between early childhood social experience, including both insecure attachment and adversity relating to neglect or abuse, and poorer social cognitive performance.Conclusion:We discuss these findings in the context of an attachment model, suggesting that childhood social adversity may result in poor internal working models, selective attention toward emotional stimuli and greater difficulties with emotional self-regulation. We outline some of the steps required to translate this understanding of social cognitive dysfunction in major psychiatric disorders into a target for interventions that mitigate the adverse effects of childhood maltreatment and poor parental attachment on social cognition.
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20
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Schnell K, Herpertz SC. Emotion Regulation and Social Cognition as Functional Targets of Mechanism-Based Psychotherapy in Major Depression With Comorbid Personality Pathology. J Pers Disord 2018; 32:12-35. [PMID: 29388896 DOI: 10.1521/pedi.2018.32.supp.12] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article characterizes functional systems as targets of integrated modular psychotherapy for episodes of major depression (MD) with a comorbid condition of borderline personality disorder (BPD) or chronic depression (CD). Both types of comorbidities to MD are conceptualized as a trait-like concept dominated by impairments in interpersonal functioning. Despite differences in psychopathology, existing data show significant similarities in impairments of emotion regulation and social cognition in BPD and CD, thought to reflect common disease mechanisms linked to early-life adversity. The preexistence of BPD and CD and related functional impairments inhibits the remission of episodic MD and calls for mechanism-based interventions that complement existing treatments of MD by targeting these dysfunctions. Contemporary methods of psychotherapy already provide interventions to address such complicated states of comorbidity by specifically improving dysfunctions of emotion regulation and social cognition. We suggest a layout of modular interventions that can address identified dysfunctions in comorbid MD.
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Affiliation(s)
- Knut Schnell
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Asklepios Center for Psychiatry and Psychotherapy Göttingen, Göttingen, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
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21
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Quidé Y, Ong XH, Mohnke S, Schnell K, Walter H, Carr VJ, Green MJ. Childhood trauma-related alterations in brain function during a Theory-of-Mind task in schizophrenia. Schizophr Res 2017; 189:162-168. [PMID: 28215391 DOI: 10.1016/j.schres.2017.02.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/06/2017] [Accepted: 02/09/2017] [Indexed: 01/03/2023]
Abstract
Childhood trauma is a risk factor for schizophrenia that affects brain functions associated with higher cognitive processes, including social cognition. Alterations in Theory-of-Mind (ToM), or mentalizing skills, are a hallmark feature of schizophrenia, and are also evident in individuals exposed to childhood trauma. However, the impact of childhood trauma exposure on brain function during social cognition in schizophrenia remains unclear. We thus examined the association between childhood trauma and brain function during the performance of a ToM task in 47 patients diagnosed with schizophrenia or schizoaffective disorder. All participants completed the Childhood Trauma Questionnaire (CTQ) and underwent functional magnetic resonance imaging while performing an established visual-cartoon affective ToM task. Whole-brain multiple regression analysis was performed on ToM-related brain activation, with CTQ total score as regressor of interest, while accounting for the effects of age, sex, diagnosis, symptom severity, behavioural performance, intelligence and medications levels. First, using a small-volume correction approach within a mask made of key regions for ToM [including bilateral temporo-parietal junctions (TPJ), medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC)/precuneus], total CTQ scores were positively associated with activation of the PCC/precuneus. Second, exploratory analyses for the rest of the brain (i.e., ROIs masked-out), revealed a positive association between trauma exposure and activation of the dorsomedial prefrontal cortex (dmPFC), and a negative association with activation of the anterior section of the TPJ. These results suggest that childhood trauma exposure may, at least partially, contribute to functional alterations of brain regions essential for effective mental state inference in schizophrenia.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales Research Unit for Schizophrenia Epidemiology Randwick, NSW Australia; Neuroscience Research Australia, Randwick, NSW, Australia.
| | - Xin H Ong
- Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Sebastian Mohnke
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Knut Schnell
- Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales Research Unit for Schizophrenia Epidemiology Randwick, NSW Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales Research Unit for Schizophrenia Epidemiology Randwick, NSW Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia; ARC Centre for Cognition and its Disorders (CCD), Macquarie University, Sydney, NSW, Australia
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