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Lemmers-Jansen I, Velthorst E, Fett AK. The social cognitive and neural mechanisms that underlie social functioning in individuals with schizophrenia - a review. Transl Psychiatry 2023; 13:327. [PMID: 37865631 PMCID: PMC10590451 DOI: 10.1038/s41398-023-02593-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 10/23/2023] Open
Abstract
In many individuals with a diagnosis of schizophrenia social functioning is impaired across the lifespan. Social cognition has emerged as one of the possible factors that may contribute to these challenges. Neuroimaging research can give further insights into the underlying mechanisms of social (cognitive) difficulties. This review summarises the evidence on the associations between social cognition in the domains of theory of mind and emotion perception and processing, and individuals' social functioning and social skills, as well as associated neural mechanisms. Eighteen behavioural studies were conducted since the last major review and meta-analysis in the field (inclusion between 7/2017 and 1/2022). No major review has investigated the link between the neural mechanisms of social cognition and their association with social functioning in schizophrenia. Fourteen relevant studies were included (from 1/2000 to 1/2022). The findings of the behavioural studies showed that associations with social outcomes were slightly stronger for theory of mind than for emotion perception and processing. Moreover, performance in both social cognitive domains was more strongly associated with performance on social skill measures than questionnaire-based assessment of social functioning in the community. Studies on the underlying neural substrate of these associations presented mixed findings. In general, higher activation in various regions of the social brain was associated with better social functioning. The available evidence suggests some shared regions that might underlie the social cognition-social outcome link between different domains. However, due to the heterogeneity in approaches and findings, the current knowledge base will need to be expanded before firm conclusions can be drawn.
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Affiliation(s)
- Imke Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (iBBA) Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eva Velthorst
- GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands
| | - Anne-Kathrin Fett
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Psychology, City, University of London, London, UK.
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Vucurovic K, Raucher-Chéné D, Obert A, Gobin P, Henry A, Barrière S, Traykova M, Gierski F, Portefaix C, Caillies S, Kaladjian A. Activation of the left medial temporal gyrus and adjacent brain areas during affective theory of mind processing correlates with trait schizotypy in a nonclinical population. Soc Cogn Affect Neurosci 2023; 18:6701589. [PMID: 36107738 PMCID: PMC9949503 DOI: 10.1093/scan/nsac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/31/2022] [Accepted: 09/13/2022] [Indexed: 11/12/2022] Open
Abstract
Schizophrenia, a severe psychiatric disorder, is associated with abnormal brain activation during theory of mind (ToM) processing. Researchers recently suggested that there is a continuum running from subclinical schizotypal personality traits to fully expressed schizophrenia symptoms. Nevertheless, it remains unclear whether schizotypal personality traits in a nonclinical population are associated with atypical brain activation during ToM tasks. Our aim was to investigate correlations between fMRI brain activation during affective ToM (ToMA) and cognitive ToM (ToMC) tasks and scores on the Schizotypal Personality Questionnaire (SPQ) and the Basic Empathy Scale in 39 healthy individuals. The total SPQ score positively correlated with brain activation during ToMA processing in clusters extending from the left medial temporal gyrus (MTG), lingual gyrus and fusiform gyrus to the parahippocampal gyrus (Brodmann area: 19). During ToMA processing, the right inferior occipital gyrus, right MTG, precuneus and posterior cingulate cortex negatively correlated with the emotional disconnection subscore and the total score of self-reported empathy. These posterior brain regions are known to be involved in memory and language, as well as in creative reasoning, in nonclinical individuals. Our findings highlight changes in brain processing associated with trait schizotypy in nonclinical individuals during ToMA but not ToMC processing.
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Affiliation(s)
- Ksenija Vucurovic
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Centre Rémois de Psychothérapie et Neuromodulation, 51100 Reims, France
| | - Delphine Raucher-Chéné
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France.,McGill University, Douglas Mental Health University Institute, 11290 Montreal, Canada
| | - Alexandre Obert
- Champollion National University Institute, Cognition Sciences, Technology & Ergonomics Laboratory, University of Toulouse, 81000 Albi, France
| | - Pamela Gobin
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Audrey Henry
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Sarah Barrière
- Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Martina Traykova
- Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Fabien Gierski
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France.,INSERM U1247 GRAP, Research Group on Alcohol and Drugs, Université de Picardie Jules Verne, 80000 Amiens, France
| | - Christophe Portefaix
- Radiology Department, Reims University Hospital, 51100 Reims, France.,University of Reims Champagne-Ardenne, CReSTIC Laboratory, 51100 Reims, France
| | - Stéphanie Caillies
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France
| | - Arthur Kaladjian
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France.,University of Reims Champagne-Ardenne Faculty of Medicine, 51100 Reims, France
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Raucher-Chéné D, Lavigne KM, Makowski C, Lepage M. Altered Surface Area Covariance in the Mentalizing Network in Schizophrenia: Insight Into Theory of Mind Processing. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:706-715. [PMID: 32919946 DOI: 10.1016/j.bpsc.2020.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Theory of mind (ToM), the cognitive capacity to attribute mental states to self and others, is robustly affected in schizophrenia. The neural substrates of ToM impairment have been largely studied with functional imaging, but little is known about structural abnormalities. We compared structural covariance (between-subjects correlations of brain regional measures) of magnetic resonance imaging-based cortical surface area between patients with schizophrenia and healthy control subjects and between schizophrenia subgroups based on the patients' ToM ability to examine ToM-specific effects on structural covariance in schizophrenia. METHODS T1-weighted structural images were acquired on a 3T magnetic resonance imaging scanner, and ToM was assessed with the Hinting Task for 104 patients with schizophrenia and 69 healthy control subjects. The sum of surface area was computed for 12 regions of interest selected and compared between groups to examine structural covariance within the often reported mentalizing network: rostral and caudal middle frontal gyrus, inferior parietal lobule, precuneus, and middle and superior temporal gyrus. High and low ToM groups were defined using a median split on the Hinting Task. RESULTS Cortical surface contraction was observed in the schizophrenia group, predominantly in temporoparietal regions. Patients with schizophrenia also exhibited significantly stronger covariance between the right rostral middle frontal gyrus and the right superior temporal gyrus than control subjects (r = 4.015; p < .001). Direct comparisons between high and low ToM subgroups revealed stronger contralateral frontotemporal covariances in the low ToM group. CONCLUSIONS Our results provide evidence for structural changes underlying ToM impairments in schizophrenia that need to be confirmed to develop new therapeutic perspectives.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Cognition, Health, and Society Laboratory EA 6291, University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, Etablissement Public de Santé Mentale de la Marne, Reims, France
| | - Katie M Lavigne
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Carolina Makowski
- Center for Multimodal Imaging and Genetics, University of California, San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California, San Diego School of Medicine, La Jolla, California
| | - Martin Lepage
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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Wisman-van der Teen A, Lemmers-Jansen ILJ, Oorschot M, Krabbendam L. Exploring the association between social behaviour, trust, and its neural correlates in first episode psychosis patients and in individuals at clinical high risk for psychosis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:629-646. [PMID: 34529860 PMCID: PMC9541290 DOI: 10.1111/bjc.12327] [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] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/09/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Psychosis is characterized by paranoid delusions, social withdrawal, and distrust towards others. Trust is essential for successful social interactions. It remains unknown which aspects of social functioning are associated with reduced trust in psychosis. Therefore, we investigated the association between social behaviour, trust, and its neural correlates in a group of individuals with psychotic symptoms (PS-group), consisting of first episode psychosis patients combined with individuals at clinical high risk. METHODS We compared 24 PS individuals and 25 healthy controls. Affect and social withdrawal were assessed using the Experience Sampling Method. Trust was measured during functional magnetic resonance imaging (fMRI) scanning, using a trust game with a cooperative and unfair counterpart. RESULTS The PS-group showed lower baseline trust compared to controls and reported less positive and more negative general affect. Social withdrawal did not differ between the groups. Social withdrawal and social reactivity in affect (i.e., changes in affect when with others compared to when alone) were not associated with trust. On the neural level, in controls but not in the PS-group, social withdrawal was associated with caudate activation during interactions with an unfair partner. An increase in positive social reactivity, was associated with reduced insula activation in the whole sample. CONCLUSIONS Social withdrawal and social reactivity were not associated with reduced initial trust in the PS-group. Like controls, the PS-group showed a positive response in affect when with others, suggesting a decrease in emotional distress. Supporting patients to keep engaging in social interactions, may alleviate their emotional distress. PRACTITIONER POINTS Individuals with psychotic symptoms show reduced initial trust towards unknown others. Trust in others is not associated with social withdrawal and reported affect when with others, nor when alone. Like controls, individuals with psychotic symptoms showed reduced negative affect and increased positive affect when with others compared to when alone. We emphasize to support individuals with psychotic symptoms to keep engaging in social interactions, given it may reduce social withdrawal and alleviate their emotional distress.
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Affiliation(s)
- Amanda Wisman-van der Teen
- Yulius Mental Health, Dordrecht, The Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (IBBA) Amsterdam, Vrije Universiteit Amsterdam, The Netherlands
| | - Imke L J Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (IBBA) Amsterdam, Vrije Universiteit Amsterdam, The Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (IBBA) Amsterdam, Vrije Universiteit Amsterdam, The Netherlands
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Kim NS, Lee TY, Hwang WJ, Kwak YB, Kim S, Moon SY, Lho SK, Oh S, Kwon JS. White Matter Correlates of Theory of Mind in Patients With First-Episode Psychosis. Front Psychiatry 2021; 12:617683. [PMID: 33746794 PMCID: PMC7973210 DOI: 10.3389/fpsyt.2021.617683] [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: 10/15/2020] [Accepted: 02/08/2021] [Indexed: 11/15/2022] Open
Abstract
Deficits in theory of mind (ToM) are considered as a distinctive feature of schizophrenia. Functional magnetic resonance imaging (fMRI) studies have suggested that aberrant activity among the regions comprising the mentalizing network is related to observed ToM deficits. However, the white matter structures underlying the ToM functional network in schizophrenia remain unclear. To investigate the relationship between white matter integrity and ToM impairment, 35 patients with first-episode psychosis (FEP) and 29 matched healthy controls (HCs) underwent diffusion tensor imaging (DTI). Using tract-based spatial statistics (TBSS), fractional anisotropy (FA) values of the two regions of interest (ROI)-the cingulum and superior longitudinal fasciculus (SLF)-were acquired, and correlational analysis with ToM task scores was performed. Among the patients with FEP, ToM strange story scores were positively correlated with the FA values of the left cingulum and left SLF. There was no significant correlation between FA and ToM task scores in HCs. These results suggest that the left cingulum and SLF constitute a possible neural basis for ToM deficits in schizophrenia. Our study is the first to demonstrate the white matter connectivity underlying the mentalizing network, as well as its relation to ToM ability in patients with FEP.
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Affiliation(s)
- Nahrie Suk Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
- Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
| | - Seowoo Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
| | - Sun-Young Moon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Silvia Kyungjin Lho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Sanghoon Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
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Sayar-Akaslan D, Baskak B, Kir Y, Kusman A, Yalcinkaya B, Çakmak IB, Munir K. Cortical activity measured by functional near infrared spectroscopy during a theory of mind task in subjects with schizophrenia, bipolar disorder and healthy controls. J Affect Disord 2021; 282:329-339. [PMID: 33421860 DOI: 10.1016/j.jad.2020.12.094] [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] [Received: 05/08/2020] [Revised: 12/12/2020] [Accepted: 12/22/2020] [Indexed: 12/26/2022]
Abstract
Theory of Mind (ToM) deficits interfere in social cognitive functioning in schizophrenia (SCZ) and are increasingly recognized to do so in bipolar disorder (BD), however their clinical and neurobiological correlates remain unclear. This study represents the first direct comparison of subjects with SCZ (N = 26), BD (N = 26) and healthy controls (N = 33) in cortical activity during the Reading the Mind in the Eyes Task (RMET) using functional Near Infrared Spectroscopy (fNIRS) with the control condition (CC) involving gender identification via the same stimuli. The three groups were compared with a comprehensive ToM battery and assessed in terms of the relationship of ToM performance with clinical symptoms, insight and functioning. The controls scored higher than the SCZ and BD groups in ToM assessments, with SCZ group showing the worse performance in terms of meta-representation and empathy. The SCZ group ToM scores inversely correlated with negative symptom severity and positively correlated with insight; BD group ToM scores negatively correlated with subclinical mania symptoms and projected functioning. Cortical activity was higher during the ToM condition compared to the CC in the pre-motor and supplementary-motor cortices, middle and superior temporal gyri, and the primary somatosensory cortex. Group x Condition interaction was detected whereby activity was higher during the ToM condition among controls with no detected difference between SCZ and BD groups. The results suggest that ToM is represented similarly in cortical activity in SCZ and BD compared to healthy controls pointing to possible neurobiological convergence of SCZ and BD in underlying impairments of social cognition.
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Affiliation(s)
- Damla Sayar-Akaslan
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Bora Baskak
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey; Neuroscience and Neurotechnology Center of Excellence, NÖROM, Ankara, Turkey.
| | - Yagmur Kir
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Adnan Kusman
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Busra Yalcinkaya
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Işık Batuhan Çakmak
- University of Health Sciences, Ankara City Hospital, Department of Psychiatry, Turkey
| | - Kerim Munir
- Harvard Medical School, Developmental Medicine Center, Boston Children's Hospital, Boston, USA
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Fett AKJ, Mouchlianitis E, Gromann PM, Vanes L, Shergill SS, Krabbendam L. The neural mechanisms of social reward in early psychosis. Soc Cogn Affect Neurosci 2020; 14:861-870. [PMID: 31506672 PMCID: PMC6847053 DOI: 10.1093/scan/nsz058] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 05/08/2019] [Accepted: 07/23/2019] [Indexed: 12/28/2022] Open
Abstract
In chronic psychosis, reduced trust is associated with a neural insensitivity to social reward and reduced theory of mind (ToM). Here we investigate whether these mechanisms could underlie emerging social impairments in early psychosis. Twenty-two participants with early psychosis and 25 controls (male, 13–19 years) participated in two interactive trust games against a cooperative and unfair partner. Region of interest neuroimaging analyses included right caudate, medial prefrontal cortex (mPFC) and right temporoparietal junction (rTPJ), involved in reward and ToM processing. Both groups showed similar levels of trust (i.e. investments). However, individuals with psychosis failed to activate the caudate differentially in response to cooperation and unfairness while making decisions to trust. During cooperative returns, patients showed reduced and controls increased caudate activation. Patients demonstrated greater rTPJ activation than controls, possibly pointing towards compensatory mechanisms. Effects were associated with Wechsler Abbreviated Scale of Intelligence vocabulary scores. No group differences emerged in mPFC activation. Early psychosis is associated with an aberrant neural sensitivity to social reward. This could foster reduced social motivation and social isolation. Absent behavioural differences in early, relative to chronic psychosis could indicate that trust is achieved through increased compensatory demand on ToM.
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Affiliation(s)
- Anne-Kathrin J Fett
- Department of Psychology, City University of London, London ECIV 0HB, United Kingdom.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, SE5 8AF, London, United Kingdom.,Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London, United Kingdom
| | - Elias Mouchlianitis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, SE5 8AF, London, United Kingdom
| | - Paula M Gromann
- Department of Psychology, City University of London, London ECIV 0HB, United Kingdom
| | - Lucy Vanes
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, SE5 8AF, London, United Kingdom.,Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London, United Kingdom
| | - Sukhi S Shergill
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, SE5 8AF, London, United Kingdom
| | - Lydia Krabbendam
- Department of Developmental and Clinical Psychology, Faculty of Behavioural and Movement Sciences, VU Amsterdam, Van der Boechorststraat 1s, 1081 BT Amsterdam, the Netherlands
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White T, van der Ende J, Nichols TE. Beyond Bonferroni revisited: concerns over inflated false positive research findings in the fields of conservation genetics, biology, and medicine. CONSERV GENET 2019. [DOI: 10.1007/s10592-019-01178-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Lemmers-Jansen ILJ, Fett AKJ, Van Doesum NJ, Van Lange PAM, Veltman DJ, Krabbendam L. Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk. Front Hum Neurosci 2019; 13:47. [PMID: 30814943 PMCID: PMC6381043 DOI: 10.3389/fnhum.2019.00047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/29/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Psychosis is characterized by problems in social functioning and trust, the assumed glue to positive social relations. But what helps building trust? A prime candidate could be social mindfulness: the ability and willingness to see and consider another person’s needs and wishes during social decision making. We investigated whether first-episode psychosis patients (FEP) and patients at clinical high-risk (CHR) show reduced social mindfulness, and examined the underlying neural mechanisms. Methods: Twenty FEP, 17 CHR and 46 healthy controls, aged 16–31, performed the social mindfulness task (SoMi) during fMRI scanning, spontaneously and after the instruction “to keep the other’s best interest in mind.” As first of two people, participants had to choose one out of four products, of which three were identical and one was unique, differing in a single aspect (e.g., color). Results: FEP tended to choose the unique item (unmindful choice) more often than controls. After instruction, all groups significantly increased the number of mindful choices compared to the spontaneous condition. FEP showed reduced activation of the caudate and medial prefrontal cortex (mPFC) during mindful, and of the anterior cingulate cortex (ACC), mPFC, and left dorsolateral prefrontal cortex (dlPFC) during unmindful decisions. CHR showed reduced activation of the ACC compared to controls. Discussion: FEP showed a trend toward more unmindful choices. A similar increase of mindful choices after instruction indicated the ability for social mindfulness when prompted. Results suggested reduced sensitivity to the rewarding aspects of social mindfulness in FEP, and reduced consideration for the other player. FEP (and CHR to a lesser extent) might perceive unmindful choices as less incongruent with the automatic mindful responses than controls. Reduced socially mindful behavior in FEP may hinder the building of trust and cooperative interactions.
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Affiliation(s)
- Imke L J Lemmers-Jansen
- Section of Educational Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Section Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Anne-Kathrin J Fett
- Department of Psychology, City, University of London, London, United Kingdom
| | - Niels J Van Doesum
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Social and Organisational Psychology, Leiden University, Leiden, Netherlands
| | - Paul A M Van Lange
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Dick J Veltman
- Neuroscience Campus Amsterdam, Vrije Universiteit Amsterdam, VU Medical Center Amsterdam, Amsterdam, Netherlands
| | - Lydia Krabbendam
- Section Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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