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Dassing R, Offerlin-Meyer I, Cugnot A, Danion JM, Krasny-Pacini A, Berna F. Improving autobiographical memory in schizophrenia using wearable cameras: A single-case experimental study. Neuropsychol Rehabil 2024; 34:103-132. [PMID: 36520673 DOI: 10.1080/09602011.2022.2155668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
Autobiographical memory (AM) impairments influence both sense of identity and social functioning of patients with schizophrenia. However, cognitive remediation methods addressing these difficulties do not sufficiently consider the heterogeneity of this disorder and frequently face methodological limitations. The aim of the present study was to evaluate the efficacy of a method using a wearable camera (NarrativeClip®), through an alternating treatments design across two types of AM training. In parallel, repeated measures were used to appreciate the efficacy, specificity, and generalizability of the programme's benefits. Three patients were invited to wear the camera during 24 personal events. Ten of these events memories were trained by visual cueing (wearable camera condition), 10 others by verbal cueing (written diary condition) and 4 were not trained (control condition). Using pictures collected by the wearable camera seemed particularly relevant, since it promoted more detailed recalls than the diary method, from the first training session and until the end of a one-year follow-up. In addition, the repeated measures performed revealed (1) the efficacy (improvement in AM capacities after participating in the programme), (2) specificity (persistence of working memory deficits), and (3) generalizability (improvement in measures of episodic memory) of our cognitive remediation programme's effects.
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Affiliation(s)
- Romane Dassing
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Isabelle Offerlin-Meyer
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Alice Cugnot
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Jean-Marie Danion
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Agata Krasny-Pacini
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- University of Strasbourg, Strasbourg, France
- University Rehabilitation Institute Clemenceau, Strasbourg, France
| | - Fabrice Berna
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
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Herold CJ, Duval CZ, Schröder J. Autobiographical memory in chronic schizophrenia: A follow-up study. Neuropsychologia 2023; 191:108707. [PMID: 37890662 DOI: 10.1016/j.neuropsychologia.2023.108707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/31/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
Chronic schizophrenia is a very disabling disease and patient's social integration remains difficult. One important aspect is autobiographical memory (AM) as it is impaired in schizophrenia and highly correlated to patient's outcome, since its closely linked to self and identity. Reduced specificity and lack of details are characteristics of patients' AM, but its longitudinal course in schizophrenia remains unclear. We examined 21 patients who underwent our protocol twice with an interval of 7 years. AM was assessed using a semi-structured interview, covering four periods of life and addressing semantic knowledge and autobiographical episodes as well as their details. The results can be divided into three parts, separating semantic memories, specific autobiographical memories and details describing the latter. While a significant deterioration of semantic AM over time could be revealed, the specificity of the free recalled autobiographical episodes remained rather stable - albeit on a low level. In contrast, unique events were remembered with significantly less details at follow-up than at the first examination. While floor-effects given a relatively small number of unique events have to be considered, semantic AM and episodic details seem to be a valuable target for AM remediation given their further deterioration over time.
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Affiliation(s)
- Christina J Herold
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Voßstr. 4, 69115, Heidelberg, Germany.
| | - Céline Z Duval
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Voßstr. 4, 69115, Heidelberg, Germany
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Voßstr. 4, 69115, Heidelberg, Germany
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Herold CJ, Lässer MM, Schröder J. Autobiographical memory impairment in chronic schizophrenia: Significance and clinical correlates. J Neuropsychol 2023; 17:89-107. [PMID: 36065152 DOI: 10.1111/jnp.12288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/29/2022] [Accepted: 08/09/2022] [Indexed: 11/30/2022]
Abstract
Previous studies of autobiographical memory (AM) in schizophrenia yielded a reduction of specificity, richness of details and conscious recollection, which indicate both, quantitative and qualitative AM changes. However, their associations with psychopathological symptoms and neuropsychological deficits were not resolved. Therefore, we sought to investigate AM with respect to psychopathology and neuropsychology in patients with chronic schizophrenia to rule out the influence of different courses of the disease. AM of four lifetime periods was examined in 75 patients and 50 healthy controls by using a semi-structured interview. The recalled episodes were rated for memory specificity. Subsequently, one single event of each period of life was rated for details and experiential aspects of reliving (originality, vividness/visual imagery, emotional re-experiencing and emotional valence). When contrasted with healthy controls, patients recalled a significantly reduced number of episodes and personal semantic facts; moreover, memory specificity of AM was significantly lower in patients than controls. While the richness of details calculated for single events showed only minor, non-significant group differences, vividness and emotional re-experiencing were significantly less pronounced in the patient group. Along with this, AM performance correlated significantly with negative symptoms including apathy as well as verbal memory and executive functions. Our results underline the significance of overgenerality as a key feature of AM in schizophrenia as well as a dissociation between intact number of details of single events and reduced vividness and emotional re-experiencing. The extent of negative symptoms including apathy and impairments of verbal memory/executive functions may explain AM deficits in chronic schizophrenia.
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Affiliation(s)
- Christina J Herold
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Marc M Lässer
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.,Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
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“I remember the attack”: a pilot study investigating flashbulb memory in individuals with schizophrenia. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04276-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AbstractFlashbulb memories are autobiographical memories for important and emotional events, which have the particularity of being at the intersection of personal and public events. Autobiographical memory impairments are highly prevalent in schizophrenia, a psychiatric condition intrinsically linked to self-disorders. Thus, we aimed to evaluate flashbulb and event memory functioning in individuals with schizophrenia. Twenty-four individuals diagnosed with schizophrenia and 25 control participants were tested on a flashbulb memory questionnaire about the July 14th, 2016, Nice (France) terrorist attack, including questions on flashbulb and event memory, certainty, vividness, rehearsal, emotion, novelty, consequentiality, implication, and importance. Participants also underwent cognitive assessments. Analysis showed lower scores for both flashbulb and event memories in patients compared to control participants. Subjective ratings of the phenomenological characteristics of flashbulb memory were similar between the two groups overall. However, individuals with schizophrenia reported having higher levels of emotion when they first learned about the attack compared to the control group. Our results replicate findings of impaired autobiographical memory functioning in schizophrenia and extend these findings to public events. Our findings also indicate that flashbulb memories may lead to substantial contextual recall in schizophrenia patients and that collective memories, such as a terrorist attack, can have a profound emotional impact on patients.
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Allé MC, Rubin DC, Berntsen D. Autobiographical memory and the self on the psychosis continuum: investigating their relationship with positive- and negative-like symptoms. Memory 2023; 31:518-529. [PMID: 36724996 DOI: 10.1080/09658211.2023.2173236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Autobiographical memory is severely impaired in schizophrenia, but previous work has largely treated both as unitary concepts. Here, we examined how various dimensions of autobiographical memory relate to different aspects of psychosis. Participants were recruited from the general population (Study 1, N = 264) and a university subject pool (Study 2, N = 305). We examined different measures of autobiographical memory and self (i.e., involuntary memory, autobiographical recollection, self-knowledge and self-awareness), at the trait level in Study 1 and both trait and state levels in Study 2, as a function of positive-and negative-like symptoms of psychosis. Across both studies, positive and negative dimensions of psychosis were found to be related to an increase in involuntary memories (i.e., the spontaneous recall of personal memories), and to lower self-concept clarity and insight. Positive and negative dimensions of psychosis correlated differently with autobiographical recollection characteristics, measured at both trait (Studies 1 and 2) and state levels (Study 2). Positive-like symptoms (in particular hallucination-proneness) showed a stronger and more consistent pattern of correlations than negative-like symptoms. These findings call for a dimensional approach to the relationship between autobiographical memory and psychosis symptoms in clinical and non-clinical individuals, to better understand the breakdown of autobiographical memory in the psychopathology of psychosis.
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Affiliation(s)
- Mélissa C Allé
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, University of Lille, Lille, France.,Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - David C Rubin
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.,Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Kronbichler L, Stelzig-Schöler R, Lenger M, Weber S, Pearce BG, Reich LA, Aichhorn W, Kronbichler M. Preserved intention understanding during moral judgments in schizophrenia. PLoS One 2021; 16:e0251180. [PMID: 34010340 PMCID: PMC8133419 DOI: 10.1371/journal.pone.0251180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 04/22/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Although there is convincing evidence for socio-cognitive impairments in schizophrenia spectrum disorder (SSD), little evidence is found for deficient moral cognition. We investigated whether patients with SSD showed altered moral judgments in a story task where the protagonist either had a neutral or malicious intention towards another person. This paradigm examined whether SSD relates to altered moral cognition in general or specifically to impaired integration of prior information (such as beliefs) in moral judgments. METHODS 23 patients and 32 healthy controls read vignettes created in a 2 x 2 design. The protagonist in each story either had a neutral or negative intention towards another person which, as a result, either died (negative outcome) or did not die (neutral outcome). Participants rated the moral permissibility of the protagonist's action. Standard null hypothesis significance testing and equivalent Bayes analyses are reported. RESULTS Schizophrenia patients did not differ significantly in permissibility ratings from healthy controls. This finding was supported by the Bayes analyses which favoured the null hypothesis. Task performance was not related to symptom severity or medication. CONCLUSIONS The current findings do not support the notion that moral judgments are deficient in schizophrenia. Furthermore, the current study shows that patients do not have observable difficulties in integrating the protagonist's belief in the rating of the moral permissibility of the action-outcome.
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Affiliation(s)
- Lisa Kronbichler
- Neuroscience Institute, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Renate Stelzig-Schöler
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Stefanie Weber
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Brandy-Gale Pearce
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Luise-Antonia Reich
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Aichhorn
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Martin Kronbichler
- Neuroscience Institute, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
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Canty AL, Cao Y, Neumann D, Shum DHK. The functional significance of cognitive empathy and theory of mind in early and chronic schizophrenia. Psychiatry Res 2021; 299:113852. [PMID: 33761402 DOI: 10.1016/j.psychres.2021.113852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/28/2021] [Indexed: 02/04/2023]
Abstract
Theoretical models suggest that it is the interplay between social cognitive processes that result in adaptive social functioning in schizophrenia. This study explored the relative contributions of, and interplay between, cognitive empathy, affective theory of mind (ToM), neurocognition, and severity of clinical symptoms, in predicting the social functioning of individuals with schizophrenia. Clinical participants (early schizophrenia n = 26, chronic schizophrenia n = 32) were administered an ecologically valid measure of ToM (viz., the Virtual Assessment of Mentalising Ability or VAMA) and the Empathy Quotient (EQ) as part of a larger neuropsychological and social functioning assessment battery. Results indicated that individuals with early schizophrenia reported significantly better cognitive empathy than individuals with chronic schizophrenia. ToM was found to have added value in predicting both community functioning and functional capacity that was beyond that accounted for by cognitive empathy, clinical symptoms, and neurocognition for both clinical groups. Further, our results indicated that the capacity to demonstrate empathic understanding of another's situation (i.e., cognitive empathy) mediates the relationship between ToM and social functioning. Together, our findings highlight the intricate and compounding nature of social cognition constructs, and their effect on social functioning for individuals with schizophrenia.
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Affiliation(s)
- Allana L Canty
- School of Applied Psychology, Griffith University, Queensland, Australia
| | - Yuan Cao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - David Neumann
- School of Applied Psychology, Griffith University, Queensland, Australia
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
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Hegde RR, Guimond S, Bannai D, Zeng V, Padani S, Eack SM, Keshavan MS. Theory of Mind impairments in early course schizophrenia: An fMRI study. J Psychiatr Res 2021; 136:236-243. [PMID: 33621908 DOI: 10.1016/j.jpsychires.2021.02.010] [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: 10/20/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 10/22/2022]
Abstract
Theory of Mind (ToM) refers to the ability to perceive others' mental states. Lower ToM has often been associated with poorer functional outcomes in schizophrenia, making it an important treatment target. However, little is known about the underlying neural mechanisms associated with ToM impairments in early course schizophrenia. This study aimed to validate the False Belief task to measure ToM in schizophrenia and to identify aberrant brain activity associated with impairments. 36 individuals with early course schizophrenia and 17 controls were administered the Hinting Task and performed a functional magnetic resonance imaging (fMRI) False Belief task. Between-group differences were examined in a priori regions of interest (ROIs) known to be associated with ToM tasks: medial prefrontal cortex, ventral medial prefrontal cortex, and both the left and right temporal parietal junction (TPJ). We observed a significant positive association between Hinting Task performance and False Belief accuracy, validating the False Belief task as a measure of ToM. Compared to controls, individuals with schizophrenia exhibited reduced brain activation in all four ROIs during the fMRI False Belief task. Furthermore, task-related activations in bilateral TPJs were shown to be positively associated with ToM abilities regardless of diagnosis. Individuals with schizophrenia with lower performance on the False Belief task showed significant reductions in task-related activation in the bilateral TPJ compared to controls, while reductions were not significant for those with higher performance. Our findings suggest that lower neural activity in the bilateral TPJ are associated with ToM impairments observed in individuals with early course schizophrenia.
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Affiliation(s)
- Rachal R Hegde
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Synthia Guimond
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, The Royal's Institute of Mental Health Research, University of Ottawa, ON, Canada; Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Deepthi Bannai
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Victor Zeng
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Shezal Padani
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Shaun M Eack
- Department of Psychiatry and School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Thibaudeau É, Cellard C, Turcotte M, Achim AM. Functional Impairments and Theory of Mind Deficits in Schizophrenia: A Meta-analysis of the Associations. Schizophr Bull 2021; 47:695-711. [PMID: 33433606 PMCID: PMC8084438 DOI: 10.1093/schbul/sbaa182] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Schizophrenia is associated with major functioning difficulties. Theory of mind (ToM), the ability to infer the mental states of others, is an important determinant of functioning. However, the contribution of ToM to each specific domain of functioning remains to be better understood. The objectives of this meta-analysis were to document and compare the magnitude of the associations between ToM and (1) different domains of functioning (social functioning, productive activities, and instrumental activities of daily living), each assessed separately for functional performance and functional outcome and (2) different aspects of functioning (functional performance and functional outcome) in schizophrenia. Fifty-nine studies (N = 4369) published between 1980 and May 2019 targeting patients with schizophrenia or schizoaffective disorder aged between 18 and 65 years old were included. Studies were retrieved from seven databases. Correlations were extracted from the articles, transformed into effect sizes Zr and combined as weighted and unweighted means. The strength of the associations between the domains and aspects of functioning were compared using focused tests. A moderate association was observed between ToM and all domains of functioning, with a stronger association between ToM and productive activities compared with social functioning (only for functional outcome [χ2(2) = 6.43, P = 0.040]). Regarding the different aspects of functioning, a stronger association was observed between ToM and functional performance, compared with functional outcome, for overall functioning (χ2(1) = 13.77, P < 0.001) and social functioning (χ2(1) = 18.21, P < 0.001). The results highlight a stronger association of ToM with productive activities and with functional performance, which should be considered in future studies to improve functional recovery in schizophrenia.
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Affiliation(s)
- Élisabeth Thibaudeau
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,To whom correspondence should be addressed; Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, local 1528, Québec, QC G1V 0A6, Canada; tel: 418-656-2131, e-mail:
| | - Caroline Cellard
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada
| | | | - Amélie M Achim
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,Département de psychiatrie et neurosciences, Université Laval, Québec, Québec, Canada
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Dassing R, Allé MC, Cerbai M, Obrecht A, Meyer N, Vidailhet P, Danion JM, Mengin AC, Berna F. Cognitive Intervention Targeting Autobiographical Memory Impairment in Patients With Schizophrenia Using a Wearable Camera: A Proof-of-Concept Study. Front Psychiatry 2020; 11:397. [PMID: 32528320 PMCID: PMC7247825 DOI: 10.3389/fpsyt.2020.00397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/20/2020] [Indexed: 12/22/2022] Open
Abstract
Autobiographical memory (AM) impairment in schizophrenia affects the richness of detail in personal memories and is one of the major predictors of patients' social functioning. Despite the empirical evidence attributing these difficulties to a defective encoding process, cognitive remediation interventions targeting AM in schizophrenia often focus on the remote past, making it difficult to address the consequences of poor encoding. Our study evaluated the efficacy of an innovative approach using a wearable camera (NarrativeClip®) in reinforcing the encoding of recent daily life events in patients with schizophrenia. Seventeen patients with schizophrenia and 15 control participants wore the camera during four consecutive days. Then, memories of events experienced during these days were reinforced using different types of retrospective, i.e. interventions designed to promote a re-encoding of the event. We evaluated two types of retrospective using the camera pictures: a simple visual retrospective and a visual retrospective associated with a specific event-cueing (VisR+EC). These two techniques were compared to a verbal retrospective and to the absence of retrospective. Our results showed that the VisR+EC allowed patients to retrieve as many details as the control group at a two-week interval. However, patients' memories remained impaired when a simple visual or a verbal retrospective was used. Our study provides encouraging results to foster the use of a wearable camera in individualized cognitive remediation programs for AM impairment in schizophrenia.
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Affiliation(s)
- Romane Dassing
- INSERM U1114 Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Mélissa C. Allé
- INSERM U1114 Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Mathieu Cerbai
- INSERM U1114 Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Alexandre Obrecht
- Hôpitaux Universitaires de Strasbourg, Service de Psychiatrie, Santé Mentale et Addictologie, Strasbourg, France
| | - Nicolas Meyer
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Département de Santé Publique, Strasbourg, France
- Université de Strasbourg, Laboratoire de Biostatistique et Informatique Médicale, iCUBE UMR 7357, Illkirch, France
| | - Pierre Vidailhet
- INSERM U1114 Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Service de Psychiatrie, Santé Mentale et Addictologie, Strasbourg, France
| | - Jean-Marie Danion
- INSERM U1114 Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Service de Psychiatrie, Santé Mentale et Addictologie, Strasbourg, France
| | - Amaury C. Mengin
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Service de Psychiatrie, Santé Mentale et Addictologie, Strasbourg, France
| | - Fabrice Berna
- INSERM U1114 Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Service de Psychiatrie, Santé Mentale et Addictologie, Strasbourg, France
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Mehl S, Hesse K, Schmidt AC, Landsberg MW, Soll D, Bechdolf A, Herrlich J, Kircher T, Klingberg S, Müller BW, Wiedemann G, Wittorf A, Wölwer W, Wagner M. Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis - a secondary analysis of a randomized-controlled therapy trial. BMC Psychiatry 2020; 20:59. [PMID: 32041577 PMCID: PMC7011563 DOI: 10.1186/s12888-020-2482-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/04/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Cognitive models of psychosis postulate an important role of Theory of mind (ToM) in the formation and maintenance of delusions, but research on this plausible conjecture has gathered conflicting findings. In addition, it is still an open question whether problems in emotion recognition (ER) are associated with delusions. We examined the association of problems in ToM and ER with different aspects of delusions in a large sample of patients with psychosis enrolled in a therapy trial. This also enabled us to explore the possible impact of ToM and ER on one part of patients' social life: the quality of their therapeutic relationship. METHODS Patients with psychotic disorders and delusions and/or hallucinations (n = 185) and healthy controls (n = 48) completed a ToM picture sequencing task and an ER task. Subsequently, patients were enrolled in a randomized-controlled Cognitive Behavior Therapy (CBT) trial (ISRCTN29242879). Patients and therapists rated the quality of the therapeutic relationship during the first five sessions of therapy. RESULTS In comparison to controls, patients were impaired in both ToM and ER. Patients with deficits in ER experienced more severe delusional distress, whereas ToM problems were not related to delusions. In addition, deficits in ER predicted a less favorable therapeutic relationship and interactional problems viewed by the therapist. Impaired ER also moderated (increased) the negative influence of delusions on the therapeutic relationship and interactional difficulties viewed by the therapist. CONCLUSIONS Cognitive models on the formation and maintenance of delusions should consider ER as a potential candidate that might be related to the formation and maintenance of delusional distress, whereas problems in ToM might not be directly related to delusions and secondary dimensions of delusions. In addition, problems in ER in patients with psychosis might have an impact on the quality of the therapeutic relationship and patients with problems in ER are more likely to be viewed as problematic by their therapists. Nevertheless, training ER might be a way to improve the quality of the therapeutic relationship and potentially the effectiveness of CBT or other interventions for patients with psychosis.
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Affiliation(s)
- Stephanie Mehl
- Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105, Bonn, Germany. .,Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Straße 8, 35039, Marburg, Germany.
| | - Klaus Hesse
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Anna-Christine Schmidt
- grid.10388.320000 0001 2240 3300Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
| | - Martin W. Landsberg
- grid.10388.320000 0001 2240 3300Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
| | - Daniel Soll
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Straße 8, 35039 Marburg, Germany
| | - Andreas Bechdolf
- grid.6190.e0000 0000 8580 3777Department of Psychiatry and Psychotherapy, University of Cologne, Gleuler Straße, 50931 Köln, Germany ,Department of Psychiatry and Psychotherapy, Vivantes Hospital Berlin, Dieffenbachstraße 1, 10967 Berlin, Germany
| | - Jutta Herrlich
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatic and Psychotherapy, University of Frankfurt, Heinrich-Hoffmann-Straße 10, 60528 Frankfurt am Main, Germany
| | - Tilo Kircher
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Straße 8, 35039 Marburg, Germany
| | - Stefan Klingberg
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Bernhard W. Müller
- grid.5718.b0000 0001 2187 5445Department of Psychiatry and Psychotherapy, University of Duisburg- Essen, Virchowstraße 147, 45147 Essen, Germany
| | - Georg Wiedemann
- Department of Psychiatry and Psychotherapy, Hospital Fulda, Pacelliallee 4, 36043 Fulda, Germany
| | - Andreas Wittorf
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Wolfgang Wölwer
- grid.411327.20000 0001 2176 9917Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University of Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
| | - Michael Wagner
- grid.10388.320000 0001 2240 3300Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
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12
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Thibaudeau É, Achim AM, Parent C, Turcotte M, Cellard C. A meta-analysis of the associations between theory of mind and neurocognition in schizophrenia. Schizophr Res 2020; 216:118-128. [PMID: 31899095 DOI: 10.1016/j.schres.2019.12.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/27/2022]
Abstract
Theory of mind (ToM) refers to the ability to infer the mental states of others. ToM is impaired in schizophrenia and these deficits seem to hinder functional recovery. ToM is thus an important, but complex treatment target, supported by several processes. A large number of studies report significant associations between ToM and neurocognition (e.g. memory, attention), but the neurocognitive domains that are most closely linked to ToM remain to be identified. A meta-analysis was conducted to estimate the magnitude of the associations between ToM and neurocognition in people with schizophrenia. Correlations were extracted from the relevant literature, transformed into effect sizes Zr and pooled as weighted means. Focused-tests were employed to test for differences between neurocognitive domains and for differences linked to the characteristics of ToM tasks. Ninety-one studies (N = 5462) were included. Moderate associations emerged between ToM and each neurocognitive domain (Zrs 0.27-0.43), with no significant difference between domains (χ2(8) = 11.89, p = 0.156). Within the domain of executive functions, abstraction showed a stronger association with ToM (χ2(4) = 18.93, p = 0.001). Several ToM tasks characteristics (e.g. modality of stimuli, type of mental state), were significantly related to the magnitude of the associations between ToM and executive functions, visuospatial/problem solving, attention and episodic memory. These results suggest that ToM is linked to a wide range of neurocognitive abilities in schizophrenia, and that ToM tasks are a significant moderator of these associations. The assessment and treatment of ToM should consider the neurocognitive profile of each patient to understand his difficulties and to tailor interventions.
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Affiliation(s)
- Élisabeth Thibaudeau
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Québec, Canada.
| | - Amélie M Achim
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050 avenue de la Médecine, local 4873, G1V 0A6 Québec, Québec, Canada.
| | - Carolane Parent
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050 avenue de la Médecine, local 4873, G1V 0A6 Québec, Québec, Canada.
| | - Mélissa Turcotte
- École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Québec, Canada.
| | - Caroline Cellard
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Québec, Canada.
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13
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Zhang Y, Kuhn SK, Jobson L, Haque S. A review of autobiographical memory studies on patients with schizophrenia spectrum disorders. BMC Psychiatry 2019; 19:361. [PMID: 31727046 PMCID: PMC6857214 DOI: 10.1186/s12888-019-2346-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 10/27/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patients suffering from schizophrenia spectrum disorders demonstrate various cognitive deficiencies, the most pertinent one being impairment in autobiographical memory. This paper reviews quantitative research investigating deficits in the content, and characteristics, of autobiographical memories in individuals with schizophrenia. It also examines if the method used to activate autobiographical memories influenced the results and which theoretical accounts were proposed to explain the defective recall of autobiographical memories in patients with schizophrenia. METHODS PsycINFO, Web of Science, and PubMed databases were searched for articles published between January 1998 and December 2018. Fifty-seven studies met the inclusion criteria. All studies implemented the generative retrieval strategy by inducing memories through cue words or pictures, the life-stage method, or open-ended retrieval method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines were followed for this review. RESULTS Most studies reported that patients with schizophrenia retrieve less specific autobiographical memories when compared to a healthy control group, while only three studies indicated that both groups performed similarly on memory specificity. Patients with schizophrenia also exhibited earlier reminiscence bumps than those for healthy controls. The relationship between comorbid depression and autobiographical memory specificity appeared to be independent because patients' memory specificity improved through intervention, but their level of depression remained unchanged. The U-shaped retrieval pattern for memory specificity was not consistent. Both the connection between the history of attempted suicide and autobiographical memory specificity, and the relationship between psychotic symptoms and autobiographical memory specificity, remain inconclusive. Patients' memory specificity and coherence improved through cognitive training. CONCLUSIONS The overgeneral recall of autobiographical memory by patients with schizophrenia could be attributed to working memory, the disturbing concept of self, and the cuing method implemented. The earlier reminiscence bump for patients with schizophrenia may be explained by the premature closure of the identity formation process due to the emergence of psychotic symptoms during early adulthood. Protocol developed for this review was registered in PROSPERO (registration no: CRD42017062643).
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Affiliation(s)
- Yujia Zhang
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan Malaysia
| | - Sara K. Kuhn
- Department of Psychology, University of North Dakota, Grand Forks, North Dakota USA
| | - Laura Jobson
- Turner Institute of Brain and Mental Health and School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Wellington Road, Melbourne, Melbourne, VIC 3800 Australia
| | - Shamsul Haque
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan Malaysia
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14
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Kronbichler L, Stelzig-Schöler R, Pearce BG, Tschernegg M, Said-Yürekli S, Crone JS, Uscatescu LC, Reich LA, Weber S, Aichhorn W, Perner J, Kronbichler M. Reduced spontaneous perspective taking in schizophrenia. Psychiatry Res Neuroimaging 2019; 292:5-12. [PMID: 31472416 DOI: 10.1016/j.pscychresns.2019.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 12/30/2022]
Abstract
Judgments about another person's visual perspective are impaired when the self-perspective is inconsistent with the other-perspective. This is a robust finding in healthy samples as well as in schizophrenia (SZ). Studies show evidence for the existence of a reverse effect, where an inconsistent other-perspective impairs the self-perspective. Such spontaneous perspective taking processes are not yet explored in SZ. In the current fMRI experiment, 24 healthy and 24 schizophrenic participants performed a visual perspective taking task in the scanner. Either a social or a non-social stimulus was presented and their visual perspectives were consistent or inconsistent with the self-perspective of the participant. We replicated previous findings showing that healthy participants show increased reaction times when the human avatar's perspective is inconsistent to the self-perspective. Patients with SZ, however, did not show this effect, neither in the social nor in the non-social condition. BOLD responses revealed similar patterns in occipital areas and group differences were identified in the middle occipital gyrus. These findings suggest that patients with SZ are less likely to spontaneously compute the visual perspectives of others.
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Affiliation(s)
- Lisa Kronbichler
- Neuroscience Institute, Christian Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria.
| | - Renate Stelzig-Schöler
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria
| | - Brandy-Gale Pearce
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria
| | - Melanie Tschernegg
- Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - Sarah Said-Yürekli
- Neuroscience Institute, Christian Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - Julia Sophia Crone
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Lavinia-Carmen Uscatescu
- Neuroscience Institute, Christian Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - Luise Antonia Reich
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
| | - Stefanie Weber
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria
| | - Wolfgang Aichhorn
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria
| | - Josef Perner
- Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - Martin Kronbichler
- Neuroscience Institute, Christian Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer Straße 79, 5020 Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
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15
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Wright AC, Davies G, Fowler D, Greenwood KE. Self-defining Memories Predict Engagement in Structured Activity in First Episode Psychosis, Independent of Neurocognition and Metacognition. Schizophr Bull 2019; 45:1081-1091. [PMID: 30388257 PMCID: PMC6737466 DOI: 10.1093/schbul/sby155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Self-defining memories (SDMs) are vivid personal memories, related to narrative identity. Individuals with schizophrenia report less specific, more negative, and extract less meaning from these memories compared to control groups. SDMs have been shown to be predicted by neurocognition, associated with metacognition, and linked to goal outcomes in healthy controls. As neurocognition and metacognition are known predictors of poor functioning in psychosis, SDMs may also be a predictor. No study has assessed the relationship to functioning or pattern of SDMs in first episode psychosis (FEP). METHODS This was a cross-sectional study involving 71 individuals with FEP and 57 healthy controls who completed an SDM questionnaire. FEP participants completed measures of neurocognition, metacognition (Metacognitive Assessment Interview), functional capacity (The University of California, San Diego [UCSD] Performance-Based Skills Assessment), and functional outcome (Time-Use Survey). RESULTS SDMs reported by individuals with FEP were less integrated compared to healthy controls. Within the FEP sample, holding less specific memories was associated with engagement in significantly fewer hours of structured activity per week and specificity of SDMs mediated the relationship between neurocognition and functional outcome, independent of metacognition. CONCLUSION This is the first study to assess SDMs in FEP and to explore the important role of SDMs on clinical outcomes, compared to healthy controls. This study suggests that elaborating on specific SDMs is a valid therapeutic target and may be considered a tool to improve daily functioning in FEP.
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Affiliation(s)
- Abigail C Wright
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
- Sussex Partnership NHS Foundation Trust, Swandean, West Sussex, United Kingdom
- To whom correspondence should be addressed; School of Psychology, University of Sussex, Brighton, BN19RH, UK; tel: +44(0)1273 877698, e-mail:
| | - Geoff Davies
- Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
- Sussex Partnership NHS Foundation Trust, Swandean, West Sussex, United Kingdom
| | - Kathryn E Greenwood
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
- Sussex Partnership NHS Foundation Trust, Swandean, West Sussex, United Kingdom
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16
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Barry TJ, Hernández-Viadel JV, Fernández D, Ros L, Ricarte JJ, Berna F. Retrieval of negative autobiographical memories is associated with hostile attributions in ambiguous situations amongst people with schizophrenia. Sci Rep 2019; 9:12564. [PMID: 31467374 PMCID: PMC6715746 DOI: 10.1038/s41598-019-49058-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/13/2019] [Indexed: 11/15/2022] Open
Abstract
Schizophrenia is characterised by difficulty understanding the thoughts and intentions of other people. Misunderstandings could lead people to attribute hostility to others' actions. Theories suggest that we use our autobiographical memories to inform our understanding of other people but no study has examined the relation between memory and hostile attributions in schizophrenia. People with (n = 42) and without (n = 34) schizophrenia diagnoses completed The Ambiguous Intentions and Hostility Questionnaire (AIHQ) to assess their tendency to attribute hostility to other people's actions and the Autobiographical Memory Test (AMT) to assess their ability to recall specific positive and negative autobiographical memories. In linear regressions the interaction between diagnostic group and the proportion of specific negative memories participants retrieved explained significant variance in each AIHQ index. Follow-up correlation analyses showed that participants with schizophrenia who retrieved more negative memories also attributed greater hostility to other people's actions (r = 0.47) and reported that they would respond with greater aggression (r = 0.59). These correlations were in the opposite direction for controls. People with schizophrenia may use their memories for negative past events to understand the actions and intentions of other people, leading to attributions of hostility for otherwise benign actions.
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Affiliation(s)
- Tom J Barry
- Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong
- Department of Psychology, The Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Dolores Fernández
- Department of Psychology, Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain
| | - Laura Ros
- Department of Psychology, Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain
| | - Jorge J Ricarte
- Department of Psychology, Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain.
| | - Fabrice Berna
- Hopitaux Universitaires de Strasbourg, 1 Place de l'Hopital, Strasbourg, Cedex, France
- INSERM U-1114, 1 Place de l'Hopital, Clinique Psychiatrique, Strasbourg, Cedex, France
- Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, Strasbourg, France
- FMTS, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
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17
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Bitsch F, Berger P, Nagels A, Falkenberg I, Straube B. Impaired Right Temporoparietal Junction-Hippocampus Connectivity in Schizophrenia and Its Relevance for Generating Representations of Other Minds. Schizophr Bull 2019; 45:934-945. [PMID: 30239972 PMCID: PMC6581138 DOI: 10.1093/schbul/sby132] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Schizophrenia is associated with impaired and exaggerated Theory of Mind processes, pointing on alterations in generating a representation of another person's mind. Despite recent work on healthy subjects suggesting that a coupling between the right temporoparietal junction (rTPJ) and the hippocampus is relevant for building representations of others' intentions, the neural basis of related dysfunctions in patients with schizophrenia remains unclear. Therefore, we used structural and functional magnetic resonance imaging together with a modified prisoner's dilemma game to test the hypotheses, that patients show dysfunctional social updating on behavioral level accompanied by altered rTPJ-hippocampus coupling on a functional and a structural level. During the task, 31 patients with schizophrenia and 20 healthy controls interacted with 3 playing partners, who behaved according to stable strategies competitively, cooperatively, or randomly. Our data show that patients adapted their social behavior less flexibly to the playing partners than healthy controls, indicating differences in forming mental representations of the counterparts' intentions. Patients showed lower functional connectivity between the rTPJ and temporal lobe regions such as the hippocampus, the fusiform gyrus, and the middle temporal gyrus, indicating that in patients the rTPJ fails to integrate memory-informed processing streams during mental state inferences. Remarkably, the rTPJ-hippocampus coupling accounted for the participants' adaptive social behavior in the task, suggesting that a neural pathway relevant for updating social knowledge and forming forward predictions in social interactions is altered in schizophrenia.
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Affiliation(s)
- Florian Bitsch
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Philipp Berger
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Arne Nagels
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
- Department of English and Linguistics, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
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18
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Nieto M, Latorre JM, García‐Rico MA, Hernández‐Viadel JV, Ros L, Ricarte JJ. Autobiographical memory specificity across life periods in people with schizophrenia. J Clin Psychol 2019; 75:1011-1021. [DOI: 10.1002/jclp.22746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 12/18/2018] [Accepted: 12/27/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Marta Nieto
- Department of PsychologyFaculty of Medicine, University of Castilla La ManchaAlbacete Spain
| | - José Miguel Latorre
- Department of PsychologyFaculty of Medicine, University of Castilla La ManchaAlbacete Spain
| | | | | | - Laura Ros
- Department of PsychologyFaculty of Medicine, University of Castilla La ManchaAlbacete Spain
| | - Jorge Javier Ricarte
- Department of PsychologyFaculty of Medicine, University of Castilla La ManchaAlbacete Spain
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19
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Allé MC, Giersch A, Potheegadoo J, Meyer N, Danion JM, Berna F. From a Lived Event to Its Autobiographical Memory: An Ecological Study Using Wearable Camera in Schizophrenia. Front Psychiatry 2019; 10:699. [PMID: 31636574 PMCID: PMC6787264 DOI: 10.3389/fpsyt.2019.00699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/30/2019] [Indexed: 11/16/2022] Open
Abstract
Cognitive disorders are considered as a core symptom of schizophrenia. Importantly, episodic autobiographical memory deficits are strongly related to patients' social dysfunction. Although the cognitive mechanisms underlying autobiographical memory deficit are highly important to open the door for specific cognitive remediation, they are yet to be understood. The present study focused on event segmentation to check to which extent possible impairments in temporal ordering and segmenting in patients hinder memories construction. Twenty-seven patients with schizophrenia and 27 matched controls took part in an outdoor circuit while wearing a wearable camera. A week later, their memory and the temporal organization of this event have been assessed. Results showed that patients, compared with control participants, reported a reduced amount of details, especially less actions with interaction related to the event. Contrary to our initial hypotheses, event segmentation abilities in patients were not affected. The relationship between event segmentation and memory is discussed.
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Affiliation(s)
- Mélissa C Allé
- Inserm U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France.,FMTS: Fédération de Médcine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France
| | - Anne Giersch
- Inserm U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France.,FMTS: Fédération de Médcine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France
| | - Jevita Potheegadoo
- Inserm U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France.,FMTS: Fédération de Médcine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
| | - Nicolas Meyer
- FMTS: Fédération de Médcine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
| | - Jean-Marie Danion
- Inserm U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France.,FMTS: Fédération de Médcine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
| | - Fabrice Berna
- Inserm U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France.,FMTS: Fédération de Médcine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
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20
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Barry TJ, Del Rey F, Ricarte JJ. Valence‐related impairments in the retrieval of specific autobiographical memories amongst patients with schizophrenia. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 58:140-153. [DOI: 10.1111/bjc.12205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/29/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Tom J. Barry
- Department of Psychology The University of Hong Kong Hong Kong
- Department of Psychology The Institute of Psychiatry, Psychology & Neuroscience King's College London UK
| | - Francisco Del Rey
- Regional Ministry for Social Welfare of Castilla‐La Mancha Albacete Spain
| | - Jorge J. Ricarte
- Department of Psychology Faculty of Medicine University of Castilla‐La Mancha Albacete Spain
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21
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Riehle M, Mehl S, Lincoln TM. The specific social costs of expressive negative symptoms in schizophrenia: reduced smiling predicts interactional outcome. Acta Psychiatr Scand 2018; 138:133-144. [PMID: 29667181 DOI: 10.1111/acps.12892] [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] [Accepted: 03/26/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE We tested whether people with schizophrenia and prominent expressive negative symptoms (ENS) show reduced facial expressions in face-to-face social interactions and whether this expressive reduction explains negative social evaluations of these persons. METHOD We compared participants with schizophrenia with high ENS (n = 18) with participants with schizophrenia with low ENS (n = 30) and with healthy controls (n = 39). Participants engaged in an affiliative role-play that was coded for the frequency of positive and negative facial expression and rated for social performance skills and willingness for future interactions with the respective role-play partner. RESULTS Participants with schizophrenia with high ENS showed significantly fewer positive facial expressions than those with low ENS and controls and were also rated significantly lower on social performance skills and willingness for future interactions. Participants with schizophrenia with low ENS did not differ from controls on these measures. The group difference in willingness for future interactions was significantly and independently mediated by the reduced positive facial expressions and social performance skills. CONCLUSION Reduced facial expressiveness in schizophrenia is specifically related to ENS and has negative social consequences. These findings highlight the need to develop aetiological models and targeted interventions for ENS and its social consequences.
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Affiliation(s)
- M Riehle
- Institute of Psychology, Clinical Psychology & Psychotherapy, University of Hamburg, Hamburg, Germany
| | - S Mehl
- Department of Psychiatry and Psychotherapy & Marburg Center for Mind, Brain and Behavior (MCMBB), University of Marburg, Marburg, Germany.,Department of Health & Social Work, University of Applied Sciences, Frankfurt, Germany
| | - T M Lincoln
- Institute of Psychology, Clinical Psychology & Psychotherapy, University of Hamburg, Hamburg, Germany
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22
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Mehl S, Schlier B, Lincoln TM. Does CBT for Psychosis Have an Impact on Delusions by Improving Reasoning Biases and Negative Self-Schemas? ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2018. [DOI: 10.1027/2151-2604/a000335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract. Cognitive-behavioral therapy for psychosis (CBTp) builds on theoretical models that postulate reasoning biases and negative self-schemas to be involved in the formation and maintenance of delusions. However, it is unclear whether CBTp induces change in delusions by improving these proposed causal mechanisms. This study reports on a mediation analysis of a CBTp effectiveness trial in which delusions were a secondary outcome. Patients with psychosis were randomized to individualized CBTp (n = 36) or a waiting list condition (WL; n = 34). Reasoning biases (jumping to conclusions, theory of mind, attribution biases) and self-schemas (implicit and explicit self-esteem; self-schemas related to different domains) were assessed pre- and post-therapy/WL. The results reveal an intervention effect on two of four measures of delusions and on implicit self-esteem. Nevertheless, the intervention effect on delusions was not mediated by implicit self-esteem. Changes in explicit self-schemas and reasoning biases did also not mediate the intervention effects on delusions. More focused interventions may be required to produce change in reasoning and self-schemas that have the potential to carry over to delusions.
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Affiliation(s)
- Stephanie Mehl
- Department of Social Work and Health, University of Applied Sciences Frankfurt am Main, Germany
- Department of Psychiatry and Psychotherapy & Marburg Center for Mind, Brain and Behavior (MCMBB), Philipps-Universität Marburg, Germany
| | - Björn Schlier
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany
| | - Tania M. Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany
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23
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Alexiadou A, Bozikas VP, Kosmidis MH, Parlapani E, Kiosseoglou G, Fokas K. The effect of impaired verbal memory retrieval on autobiographical memory across different life periods in schizophrenia. Compr Psychiatry 2018; 80:81-88. [PMID: 29069623 DOI: 10.1016/j.comppsych.2017.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/01/2017] [Accepted: 09/05/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Autobiographical memory (AM) involves recollection of personal events and facts about one's life. Αim of the present study was to investigate AM in schizophrenia patients, and, in particular, patients' ability to recall autobiographical memories after controlling for verbal memory and verbal fluency deficits. METHOD Participants included 40 schizophrenia patients (23 male) and 40 healthy controls (23 male), matched for age, gender, educational level, and premorbid intellectual functioning. Participants' verbal memory (list learning and story recall) and verbal fluency were assessed. AM was evaluated by the Questionnaire of Autobiographical Memory, consisting of the Personal Semantic Memory scale and the Autobiographical Incidents scale. Furthermore, personal incidents' specificity was examined. RESULTS Schizophrenia patients showed deficits in verbal memory and verbal fluency, as well as in both semantic and episodic AM compared with healthy controls. Deficits were shown in episodic and semantic memories of events and facts dating to three different life periods (childhood, early adulthood and recent life). Regarding specificity of recalled events, patients reported fewer specific autobiographical incidents than controls. After controlling AM deficits for patients' verbal memory and verbal fluency impairment, it was shown that schizophrenia patients recalled fewer memories of autobiographical incidents dating only to recent life, compared with healthy controls. CONCLUSIONS Schizophrenia patients showed impaired AM after controlling for verbal memory and verbal fluency impairment only in regard with personal episodic memories from recent life. Current findings raise the important issue of cognitive remediation therapy in schizophrenia.
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Affiliation(s)
- Amalia Alexiadou
- 1st Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Vasilis P Bozikas
- 1st Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece.
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Eleni Parlapani
- 1st Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Grigoris Kiosseoglou
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Fokas
- 1st Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
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Berna F, Göritz AS, Schröder J, Coutelle R, Danion JM, Cuervo-Lombard CV, Moritz S. Self-Disorders in Individuals with Autistic Traits: Contribution of Reduced Autobiographical Reasoning Capacities. J Autism Dev Disord 2017; 46:2587-2598. [PMID: 27101235 DOI: 10.1007/s10803-016-2797-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present web-based study (N = 840) aimed to illuminate the cognitive mechanisms underlying self-disorders in autism. Initially, participants selected three self-defining memories. Then, we assessed their capacity to give meaning to these events (i.e., meaning making), their tendency to scrutinize autobiographical memory to better understand themselves (i.e., self-continuity function of autobiographical memory) and their clarity of self-concept. The results showed that individuals with high autistic traits (ATs) had a lower clarity of self-concept than control participants. Meaning making was also reduced in AT individuals and mediated the relation between AT and self-concept clarity. Our results suggest that the reduced clarity of self-concept in AT individuals is related to an impaired capacity to make meaning of important past life events.
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Affiliation(s)
- Fabrice Berna
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Anja S Göritz
- Department of Occupational and Consumer Psychology, Freiburg University, Freiburg, Germany
| | - Johanna Schröder
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Romain Coutelle
- INSERM U-1114, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.,Fondation FondaMental, Créteil, France
| | - Jean-Marie Danion
- INSERM U-1114, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.,Fondation FondaMental, Créteil, France
| | - Christine V Cuervo-Lombard
- Département de Psychiatrie, Centre Hospitalier Universitaire de Reims, Reims, France.,UFR de Psychologie, Université de Toulouse 2 Jean Jaurès, Toulouse, France
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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25
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Kronbichler L, Tschernegg M, Martin AI, Schurz M, Kronbichler M. Abnormal Brain Activation During Theory of Mind Tasks in Schizophrenia: A Meta-Analysis. Schizophr Bull 2017; 43:1240-1250. [PMID: 28575475 PMCID: PMC5737081 DOI: 10.1093/schbul/sbx073] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Social cognition abilities are severely impaired in schizophrenia (SZ). The current meta-analysis used foci of 21 individual studies on functional abnormalities in the schizophrenic brain in order to identify regions that reveal convergent under- or over-activation during theory of mind (TOM) tasks. Studies were included in the analyses when contrasting tasks that require the processing of mental states with tasks which did not. Only studies that investigated patients with an ICD or DSM diagnosis were included. Quantitative voxel-based meta-analyses were done using Seed-based d Mapping software. Common TOM regions like medial-prefrontal cortex and temporo-parietal junction revealed abnormal activation in schizophrenic patients: Under-activation was identified in the medial prefrontal cortex, left orbito-frontal cortex, and in a small section of the left posterior temporo-parietal junction. Remarkably, robust over-activation was identified in a more dorsal, bilateral section of the temporo-parietal junction. Further abnormal activation was identified in medial occipito-parietal cortex, right premotor areas, left cingulate gyrus, and lingual gyrus. The findings of this study suggest that SZ patients simultaneously show over- and under-activation in TOM-related regions. Especially interesting, temporo-parietal junction reveals diverging activation patterns with an under-activating left posterior and an over-activating bilateral dorsal section. In conclusion, SZ patients show less specialized brain activation in regions linked to TOM and increased activation in attention-related networks suggesting compensatory effects.
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Affiliation(s)
- Lisa Kronbichler
- Neuroscience Institute, Paracelsus Medical University, Christian-Doppler Clinic, Salzburg, Austria,To whom correspondence should be addressed; Neuroscience Institute Paracelsus Medical University, 5020 Salzburg, Austria; tel: +43-57255-56795, fax: +43-662-4483-3089, e-mail:
| | - Melanie Tschernegg
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria,Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Anna Isabel Martin
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria,Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Matthias Schurz
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria,Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Martin Kronbichler
- Neuroscience Institute, Paracelsus Medical University, Christian-Doppler Clinic, Salzburg, Austria,Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria,Department of Psychology, University of Salzburg, Salzburg, Austria
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26
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Les troubles de la mémoire autobiographique et du self dans la schizophrénie. Encephale 2017; 43:47-54. [DOI: 10.1016/j.encep.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 04/27/2015] [Indexed: 01/17/2023]
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27
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Allé MC, Manning L, Potheegadoo J, Coutelle R, Danion JM, Berna F. Wearable Cameras Are Useful Tools to Investigate and Remediate Autobiographical Memory Impairment: A Systematic PRISMA Review. Neuropsychol Rev 2017; 27:81-99. [DOI: 10.1007/s11065-016-9337-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
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28
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Ricarte JJ, Ros L, Latorre JM, Watkins E. Mapping autobiographical memory in schizophrenia: Clinical implications. Clin Psychol Rev 2016; 51:96-108. [PMID: 27846438 DOI: 10.1016/j.cpr.2016.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 10/11/2016] [Accepted: 11/07/2016] [Indexed: 01/08/2023]
Abstract
Increasing evidence suggests that impaired autobiographical memory (AM) mechanisms may be associated with the onset and maintenance of psychopathology. However, there is not yet a comprehensive review of the components of autobiographical memory in schizophrenic patients. The first aim of this review is a synthesis of evidence about the functioning of AM in schizophrenic patients. The main autobiographical elements reviewed in schizophrenic patients include the study of overgeneral memory (form); self-defining memories (contents); consciousness during the process of retrieval (awareness), and the abnormal early reminiscence bump (distribution). AM impairments have been involved in the clinical diagnosis and prognosis of other psychopathologies, especially depression. The second aim is to examine potential parallels between the mechanisms responsible for the onset and maintenance of disturbed AM in other clinical diagnosis and the mechanisms of disturbed autobiographical memory functioning in schizophrenic patients. Cognitive therapies for schizophrenic patients are increasingly demanded. The third aim is the suggestion of key elements for the adaptation of components of autobiographical recall in cognitive therapies for the treatment of symptoms and consequences of schizophrenia.
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Affiliation(s)
- J J Ricarte
- Department of Psychology, Faculty of Medicine, University of Castilla La Mancha, Albacete 02006, Spain
| | - L Ros
- Department of Psychology, Faculty of Medicine, University of Castilla La Mancha, Albacete 02006, Spain.
| | - J M Latorre
- Department of Psychology, Faculty of Medicine, University of Castilla La Mancha, Albacete 02006, Spain
| | - E Watkins
- School of Psychology, University of Exeter and Sir Henry Welcome Building for Mood Disorders Research, Exeter, EX4 4QG, UK
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29
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Ricarte JJ, Ros L, Latorre JM, Muñoz MD, Aguilar MJ, Hernandez JV. Role of anxiety and brooding in specificity of autobiographical recall. Scand J Psychol 2016; 57:495-500. [DOI: 10.1111/sjop.12323] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Jorge Javier Ricarte
- Department of Psychology; University of Castilla La Mancha; Spain
- Criminology and Applied Psychology Centre; Albacete Spain
| | - Laura Ros
- Department of Psychology; University of Castilla La Mancha; Spain
- Criminology and Applied Psychology Centre; Albacete Spain
| | - Jose Miguel Latorre
- Department of Psychology; University of Castilla La Mancha; Spain
- Criminology and Applied Psychology Centre; Albacete Spain
| | | | | | - Jose Vicente Hernandez
- Department of Psychology; University of Castilla La Mancha; Spain
- Mental Health Service of Castilla La Mancha; Cuenca Spain
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30
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Berna F, Potheegadoo J, Aouadi I, Ricarte JJ, Allé MC, Coutelle R, Boyer L, Cuervo-Lombard CV, Danion JM. A Meta-Analysis of Autobiographical Memory Studies in Schizophrenia Spectrum Disorder. Schizophr Bull 2016. [PMID: 26209548 PMCID: PMC4681554 DOI: 10.1093/schbul/sbv099] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Meta-analyses and reviews on cognitive disorders in schizophrenia have shown that the most robust and common cognitive deficits are found in episodic memory and executive functions. More complex memory domains, such as autobiographical memory (AM), are also impaired in schizophrenia, but such impairments are reported less often despite their negative impact on patients' outcome. In contrast to episodic memory, assessed in laboratory tasks, memories of past personal events are much more complex and directly relate to the self. The meta-analysis included 20 studies, 571 patients with schizophrenia spectrum disorder, and 503 comparison subjects. It found moderate-to-large effect sizes with regard to the 3 parameters commonly used to assess AM: memory specificity (g = -0.97), richness of detail (g = -1.40), and conscious recollection (g = -0.62). These effect sizes were in the same range as those found in other memory domains in schizophrenia; for this reason, we propose that defective memories of personal past events should be regarded as a major cognitive impairment in this illness.
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Affiliation(s)
| | - Jevita Potheegadoo
- INSERM U-1114, Strasbourg, France;,Hôpitaux Universitaires de Strasbourg, Pôle de Psychiatrie et Santé Mentale, Strasbourg, France;,FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Ismail Aouadi
- UFR Mathématique et Informatique, Université de Strasbourg, Strasbourg, France
| | - Jorge Javier Ricarte
- Department of Psychology, University of Castilla La Mancha, Albacete, Spain;,School of Medicine, Research Institute of Neurological Disabilities, Albacete, Spain
| | - Mélissa C. Allé
- INSERM U-1114, Strasbourg, France;,Faculté de Médecine, Université de Strasbourg, Strasbourg, France;,FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Romain Coutelle
- INSERM U-1114, Strasbourg, France;,Centre Psychothérapique de Nancy, Centre de Ressources Autisme de Lorraine, Laxou, France
| | - Laurent Boyer
- CHU Sainte-Marguerite, Pôle Psychiatrie Universitaire, Marseille, France;,Fondation FondaMental, Créteil, France
| | - Christine Vanessa Cuervo-Lombard
- Centre Hospitalier Universitaire de Reims, Département de Psychiatrie, Reims, France;,UFR de Psychologie, Université de Toulouse 2 Le Mirail, Toulouse, France
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31
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Metacognition in Relation to Cognitive and Social Functioning in Schizophrenia. JOURNAL OF EUROPEAN PSYCHOLOGY STUDENTS 2015. [DOI: 10.5334/jeps.df] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Ricarte JJ, Hernández JV, Latorre JM, Danion JM, Berna F. Rumination and autobiographical memory impairment in patients with schizophrenia. Schizophr Res 2014; 160:163-8. [PMID: 25464919 DOI: 10.1016/j.schres.2014.10.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/29/2014] [Accepted: 10/13/2014] [Indexed: 11/27/2022]
Abstract
Although patients with schizophrenia exhibit autobiographical memory impairment, which is considered to be a limiting factor in their daily life, the mechanisms underlying such impairment have been rarely studied. In the current study, we investigate whether rumination and, in particular, brooding, which is a form of maladaptive repetitive thinking, may be linked to the difficulty that patients with schizophrenia experience when attempting to access specific autobiographical memories. Our results indicate that patients reported less specific autobiographical memories compared to control participants. Patients also displayed a higher level of brooding and had more depressive symptoms. According to the CaR-FA-X model (Williams et al., 2007), depression and brooding were associated with memory specificity in control participants. In contrast, neither depression nor brooding was correlated with memory specificity in patients. These results suggest that depression and rumination may not be directly related to patients' difficulty to recall specific memories and that other factors, such as metacognitive deficits, must first be considered when seeking interventions aimed to improve autobiographical memory in patients with schizophrenia.
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Affiliation(s)
- J J Ricarte
- Department of Psychology, University of Castilla La Mancha, Spain; Research Institute of Neurological Disabilities, School of Medicine, Albacete, Spain.
| | - J V Hernández
- Department of Psychology, University of Castilla La Mancha, Spain; Research Institute of Neurological Disabilities, School of Medicine, Albacete, Spain; Mental Health Service of Castilla La Mancha, Cuenca, Spain
| | - J M Latorre
- Department of Psychology, University of Castilla La Mancha, Spain; Research Institute of Neurological Disabilities, School of Medicine, Albacete, Spain
| | - J M Danion
- Unité INSERM 1114, Physiopathologie et Psychopathologie Cognitive de la Schizophrénie, Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France; Université de Strasbourg, 4 rue Kirchleger, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, France
| | - F Berna
- Unité INSERM 1114, Physiopathologie et Psychopathologie Cognitive de la Schizophrénie, Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France; Université de Strasbourg, 4 rue Kirchleger, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, France
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33
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Sullivan S, Lewis G, Mohr C, Herzig D, Corcoran R, Drake R, Evans J. The longitudinal association between social functioning and theory of mind in first-episode psychosis. Cogn Neuropsychiatry 2014; 19:58-80. [PMID: 23777337 DOI: 10.1080/13546805.2013.799463] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION There is some cross-sectional evidence that theory of mind ability is associated with social functioning in those with psychosis but the direction of this relationship is unknown. This study investigates the longitudinal association between both theory of mind and psychotic symptoms and social functioning outcome in first-episode psychosis. METHODS Fifty-four people with first-episode psychosis were followed up at 6 and 12 months. Random effects regression models were used to estimate the stability of theory of mind over time and the association between baseline theory of mind and psychotic symptoms and social functioning outcome. RESULTS Neither baseline theory of mind ability (regression coefficients: Hinting test 1.07 95% CI -0.74, 2.88; Visual Cartoon test -2.91 95% CI -7.32, 1.51) nor baseline symptoms (regression coefficients: positive symptoms -0.04 95% CI -1.24, 1.16; selected negative symptoms -0.15 95% CI -2.63, 2.32) were associated with social functioning outcome. There was evidence that theory of mind ability was stable over time, (regression coefficients: Hinting test 5.92 95% CI -6.66, 8.92; Visual Cartoon test score 0.13 95% CI -0.17, 0.44). CONCLUSIONS Neither baseline theory of mind ability nor psychotic symptoms are associated with social functioning outcome. Further longitudinal work is needed to understand the origin of social functioning deficits in psychosis.
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Affiliation(s)
- Sarah Sullivan
- a Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine , University of Bristol , Bristol , UK
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Lincoln TM, Rief W, Westermann S, Ziegler M, Kesting ML, Heibach E, Mehl S. Who stays, who benefits? Predicting dropout and change in cognitive behaviour therapy for psychosis. Psychiatry Res 2014; 216:198-205. [PMID: 24602992 DOI: 10.1016/j.psychres.2014.02.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 02/04/2014] [Accepted: 02/07/2014] [Indexed: 12/26/2022]
Abstract
This study investigates the predictors of outcome in a secondary analysis of dropout and completer data from a randomized controlled effectiveness trial comparing CBTp to a wait-list group (Lincoln et al., 2012). Eighty patients with DSM-IV psychotic disorders seeking outpatient treatment were included. Predictors were assessed at baseline. Symptom outcome was assessed at post-treatment and at 1-year follow-up. The predictor×group interactions indicate that a longer duration of disorder predicted less improvement in negative symptoms in the CBTp but not in the wait-list group whereas jumping-to-conclusions was associated with poorer outcome only in the wait-list group. There were no CBTp specific predictors of improvement in positive symptoms. However, in the combined sample (immediate CBTp+the delayed CBTp group) baseline variables predicted significant amounts of positive and negative symptom variance at post-therapy and 1-year follow-up after controlling for pre-treatment symptoms. Lack of insight and low social functioning were the main predictors of drop-out, contributing to a prediction accuracy of 87%. The findings indicate that higher baseline symptom severity, poorer functioning, neurocognitive deficits, reasoning biases and comorbidity pose no barrier to improvement during CBTp. However, in line with previous predictor-research, the findings imply that patients need to receive treatment earlier.
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Affiliation(s)
- Tania M Lincoln
- Section for Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Von-Melle Park 5, 20146 Hamburg, Germany.
| | - Winfried Rief
- Section for Clinical Psychology and Psychotherapy, Faculty of Psychology, Philipps University Marburg, Germany
| | - Stefan Westermann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Switzerland
| | | | - Marie-Luise Kesting
- Clinic Rabenstein, Rehabilitation Clinic for Othopedics, Internal Medicine and Psychosomatics, Nidda, Germany
| | - Eva Heibach
- Section for Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Von-Melle Park 5, 20146 Hamburg, Germany
| | - Stephanie Mehl
- Department of Psychiatry, Faculty of Medicine, Philipps University Marburg, Germany
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35
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Effects of Specific Positive Events Training on Autobiographical Memories in People with Schizophrenia. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9610-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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36
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Kim WJ, Ha RY, Sun JY, Ryu V, Lee SJ, Ha K, Cho HS. Autobiographical memory and its association with neuropsychological function in bipolar disorder. Compr Psychiatry 2014; 55:290-7. [PMID: 24262122 DOI: 10.1016/j.comppsych.2013.09.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 08/26/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the overgeneralization of autobiographical memory (AM) in bipolar disorder (BD) and assess its association with multiple cognitive domains. METHOD Twenty-eight clinically stable bipolar I patients and an equal number of age- and gender-matched healthy controls (HC) were included. All participants were examined using the autobiographical memory test (AMT) and the neuropsychological battery including the general intelligence, attention, verbal memory, verbal fluency, visual memory, and executive functions domain. Demographic, clinical, and test variables were compared between BD and HC groups. Correlation analyses of AMT scores with cognitive functions were performed within each group, controlling for demographic and clinical variables. RESULTS Total and negative scores of AMT were significantly lower in BD patients compared to HC individuals. AMT scores were significantly correlated with WAIS similarities, WCST perseverative errors, and WCST categories completed in BD, whereas AMT scores were correlated with verbal memory and verbal fluency in HC. CONCLUSION Our findings suggest that overgeneral AM is a characteristic of BD and is related to executive function. Future studies should investigate the benefit of additional treatment focusing on overgeneral AM in BD.
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Affiliation(s)
- Woo Jung Kim
- Department of Psychiatry, College of Medicine, Yonsei University, Seoul, South Korea
| | - Ra Yeon Ha
- Department of Psychiatry, College of Medicine, Yonsei University, Seoul, South Korea
| | - Ja Yeun Sun
- Department of Psychiatry, College of Medicine, Yonsei University, Seoul, South Korea
| | - Vin Ryu
- Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Seoul, South Korea; Department of Psychiatry, College of Medicine, Konyang University, Daejeon, South Korea
| | - Su Jin Lee
- Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Seoul, South Korea
| | - Kyooseob Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea
| | - Hyun-Sang Cho
- Department of Psychiatry, College of Medicine, Yonsei University, Seoul, South Korea; Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Seoul, South Korea.
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Potheegadoo J, Cordier A, Berna F, Danion JM. Effectiveness of a specific cueing method for improving autobiographical memory recall in patients with schizophrenia. Schizophr Res 2014; 152:229-34. [PMID: 24268933 DOI: 10.1016/j.schres.2013.10.046] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 09/27/2013] [Accepted: 10/30/2013] [Indexed: 11/19/2022]
Abstract
Autobiographical memory deficits in schizophrenia have a significant impact on patients' daily life. Our study was aimed at testing the effectiveness of a specific cueing (SC) method for improving autobiographical memory recall in patients with schizophrenia, particularly the phenomenological details of their memories. Twenty-five patients with schizophrenia and 25 comparison participants took part in the study. They recalled 6 specific autobiographical events which occurred during 3 different life periods. After each memory recall, participants were given a general cue which allowed them to add further information to their narration. The SC was then applied by means of a series of specific questions to elicit more precise memory detail. The overall memory specificity as well as the number and richness of 5 categories of memory detail (perceptual/sensory, temporal, contextual, emotional, and cognitive) were assessed before and after the SC phase. Before SC, patients' memories were less specific and less detailed. SC had a beneficial effect on patients' memory recall. The overall memory specificity of patients improved. The gain in the number and richness of memory details was comparable between patients and comparison participants. The difference between groups in terms of the number of memory details was not significant. Richness of details was still lower in patients, except for emotional and cognitive details, which were similarly rich in both groups. The cueing method reduces the autobiographical memory impairment of patients with schizophrenia and paves the way for developing specific cognitive remediation therapies to help patients in their daily life.
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Affiliation(s)
- Jevita Potheegadoo
- Unité INSERM 1114, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Département de Psychiatrie, 1 place de l'Hôpital, BP 426, 67091 Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, 67000 Strasbourg, France
| | - Adrian Cordier
- Unité INSERM 1114, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Département de Psychiatrie, 1 place de l'Hôpital, BP 426, 67091 Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, 67000 Strasbourg, France
| | - Fabrice Berna
- Unité INSERM 1114, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Département de Psychiatrie, 1 place de l'Hôpital, BP 426, 67091 Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, 67000 Strasbourg, France
| | - Jean-Marie Danion
- Unité INSERM 1114, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Département de Psychiatrie, 1 place de l'Hôpital, BP 426, 67091 Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, 67000 Strasbourg, France.
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Jung E, Wiesjahn M, Lincoln TM. Negative, not positive symptoms predict the early therapeutic alliance in cognitive behavioral therapy for psychosis. Psychother Res 2013; 24:171-83. [DOI: 10.1080/10503307.2013.851425] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Lee WK, Kim YK. Theory of mind in schizophrenia: correlation with clinical symptomatology, emotional recognition and ward behavior. Asia Pac Psychiatry 2013; 5:157-63. [PMID: 23857818 DOI: 10.1111/j.1758-5872.2012.00233.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 07/20/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Several studies have suggested the presence of a theory of mind (ToM) deficit in schizophrenic disorders. This study examined the relationship of emotion recognition, theory of mind, and ward behavior in patients with schizophrenia. METHODS Fifty-five patients with chronic schizophrenia completed measures of emotion recognition, ToM, intelligence, Positive and Negative Syndrome Scale (PANSS) and Nurse's Observation Scale for Inpatient Evaluation (NOSIE). RESULTS Theory of mind sum score correlated significantly with IQ, emotion recognition, and ward behavior. Ward behavior was linked to the duration of the illness, and even more so to theory of mind deficits. Theory of mind contributed a significant proportion of the amount of variance to explain social behavior on the ward. DISCUSSION Considering our study results, impaired theory of mind contributes significantly to the understanding of social competence in patients with schizophrenia.
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Affiliation(s)
- Woo Kyeong Lee
- Department of Counseling Psychology, Seoul Cyber University, Seoul, Korea.
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Moreau N, Viallet F, Champagne-Lavau M. Using memories to understand others: the role of episodic memory in theory of mind impairment in Alzheimer disease. Ageing Res Rev 2013; 12:833-9. [PMID: 23838323 DOI: 10.1016/j.arr.2013.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 06/26/2013] [Accepted: 06/27/2013] [Indexed: 11/16/2022]
Abstract
Theory of mind (TOM) refers to the ability to infer one's own and other's mental states. Growing evidence highlighted the presence of impairment on the most complex TOM tasks in Alzheimer disease (AD). However, how TOM deficit is related to other cognitive dysfunctions and more specifically to episodic memory impairment - the prominent feature of this disease - is still under debate. Recent neuroanatomical findings have shown that remembering past events and inferring others' states of mind share the same cerebral network suggesting the two abilities share a common process .This paper proposes to review emergent evidence of TOM impairment in AD patients and to discuss the evidence of a relationship between TOM and episodic memory. We will discuss about AD patients' deficit in TOM being possibly related to their difficulties in recollecting memories of past social interactions.
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Affiliation(s)
- Noémie Moreau
- Aix-Marseille Université, CNRS, LPL UMR 7309, 5 Avenue Pasteur, 13604 Aix-en-Provence, France; Centre hospitalier du Pays d'Aix, Department of Neurology, Avenue des Tamaris, 13616 Aix-en-Provence, France.
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Giovagnoli AR, Parente A, Villani F, Franceschetti S, Spreafico R. Theory of mind and epilepsy: what clinical implications? Epilepsia 2013; 54:1639-46. [PMID: 23808357 DOI: 10.1111/epi.12255] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Epilepsy can impair theory of mind (ToM), but the clinical significance of such a deficit is unknown. This study evaluated the influence of selective ToM deficits on self-appraisal, coping, and quality of life (QoL) in patients with focal epilepsy. METHODS Data were collected from 66 patients with temporal or frontal lobe epilepsy, and from 42 healthy controls. The Faux Pas Task (FPT), Multiple Ability Self-report Questionnaire (MASQ), Coping Responses Inventory-Adult (CRI-Adult), and World Health Organization QoL 100 (WHOQoL 100) evaluated ToM, self-rated cognitive abilities, coping to stressful events, and QoL. Different tests and inventories assessed other cognitive functions, depression, and anxiety. KEY FINDINGS Patients were impaired in the recognition and comprehension of social faux pas. The FPT scores contributed to predict the MASQ, CRI-Adult, and WHOQoL overall scores; the comprehension of others' mental states and interactions score exerted a prominent influence. SIGNIFICANCE In patients with focal epilepsy, selective ToM deficits may have clinical implications, with specific influence on self-appraisal, coping, and overall QoL. ToM evaluation may contribute in explaining some psychobehavioral difficulties and to plan nonpharmacological treatment.
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Affiliation(s)
- Anna Rita Giovagnoli
- Laboratory of Cognitive Neurology and Rehabilitation, Unit of Neurology and Neuropathology, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
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Sullivan S, Herzig D, Mohr C, Lewis G, Corcoran R, Drake R, Evans J. Theory of mind and social functioning in first episode psychosis. Cogn Neuropsychiatry 2013; 18:219-42. [PMID: 22803807 DOI: 10.1080/13546805.2012.698239] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION There is evidence of associations between social functioning and theory of mind performance and between social functioning and negative symptoms in chronic psychosis. This study investigates these associations in those with first episode psychosis who are unaffected by factors related to long-term mental illness. Our first hypothesis states that there is an association between theory of mind and social functioning. The second hypothesis states that there is no association between symptoms of psychosis and social functioning. METHODS Fifty-two individuals with first episode psychosis were assessed for social functioning, theory of mind ability (using the Hinting test with verbal stimuli and the Visual Cartoon test with pictorial stimuli), and symptoms of psychosis. Multivariable logistic regression was used to examine associations. RESULTS Social functioning and theory of mind were associated when measured by the Hinting test (OR 1.70, 95% CI 1.08, 2.66), but not with the Visual Cartoon test (ToM jokes OR 0.61, 95% CI 0.15, 2.53). There was no association between social functioning and symptoms (psychotic symptoms; OR 0.95, 95% CI 0.81, 1.12; selected negative symptoms; OR 1.33, 95% CI 0.78, 2.25). CONCLUSIONS Theory of mind assessed by verbal stimuli is associated with social functioning in a population with first episode psychosis. These findings may be related to language disorders in psychosis.
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Affiliation(s)
- Sarah Sullivan
- Academic Unit of Psychiatry, School of Experimental Psychology, University of Bristol, Bristol, UK.
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Bechi M, Spangaro M, Bosia M, Zanoletti A, Fresi F, Buonocore M, Cocchi F, Guglielmino C, Smeraldi E, Cavallaro R. Theory of Mind intervention for outpatients with schizophrenia. Neuropsychol Rehabil 2013; 23:383-400. [PMID: 23379271 DOI: 10.1080/09602011.2012.762751] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Social disability is one of the critical areas known to be a predictor of daily functioning in schizophrenia. Recent studies showed that impairments in Theory of Mind (ToM) contribute to real-world social functioning and are more strongly associated with community outcomes than other neuropsychological domains of cognition. Several experiments revealed an improving potential of social cognition targeted training, particularly through introduction of verbalisation and explicit manipulation of information about others' mental states. Based on these data, we evaluated longitudinally, with a controlled trial, the feasibility and efficacy of ToM training and the possible influences of daily functioning and IQ on the enhancement of ToM abilities. Thirty outpatients with schizophrenia were recruited and randomly allocated to two groups: ToM Intervention (ToMI), based on verbalisation of selected comic strips representing ToM scenarios, or active control group (ACG). Results showed a significant improvement of ToM abilities among subjects allocated to ToMI compared to ACG, confirming the hypothesis of the enhancing potential of training methods targeting ToM functions. Moreover, we observed no influences of neuropsychological and functional variables on ToM improvement. Development of future studies should take into account possible effects of ToM training on functional outcome, according to the strong associations between ToM abilities and real-world social functioning.
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Affiliation(s)
- Margherita Bechi
- San Raffaele Scientific Institute, Department of Clinical Neurosciences, Universitary Scientific Institute Hospital, Milan, Italy.
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Ricarte JJ, Hernández-Viadel JV, Latorre JM, Ros L. Effects of event-specific memory training on autobiographical memory retrieval and depressive symptoms in schizophrenic patients. J Behav Ther Exp Psychiatry 2012. [PMID: 23200426 DOI: 10.1016/j.jbtep.2011.06.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES This report describes the effects of a specific event group-based training programme on autobiographical memory, self-consciousness of memory retrieval, and depression symptoms in a sample of 24 schizophrenic patients (experimental group). METHODS Twenty-six matched schizophrenic patients who participated in social skills and occupational therapy group sessions constituted the active control group. Participants in the experimental group were trained to complete a diary with specific daily memories, followed by patients' ratings of the associated emotional arousal of those entries. During training, significant specific events from childhood, adolescence, adulthood and the previous year were also reviewed. RESULTS After 10 weeks of group-based sessions, the experimental group demonstrated an increase in their degree of specificity for autobiographical retrievals, had a higher level of consciousness of their memories and showed a decrease in their depression scores. Significant changes in measurements of retrieval specificity and autonoetic awareness were maintained when changes in emotional symptomatology were statistically controlled. LIMITATIONS The present study did not assess the impact of autobiographical memory training on the positive and negative symptoms of schizophrenia. CONCLUSIONS These results suggest that cognitive training strategies based on event-specific autobiographical memory training should be considered for inclusion in intervention programs for schizophrenic patients.
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Affiliation(s)
- J J Ricarte
- Department of Psychology, Faculty of Medicine, University of Castilla La Mancha, Avda Almansa 14, 02006 Albacete, Spain.
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Scherzer P, Leveillé E, Achim A, Boisseau E, Stip E. A study of theory of mind in paranoid schizophrenia: a theory or many theories? Front Psychol 2012; 3:432. [PMID: 23162496 PMCID: PMC3497936 DOI: 10.3389/fpsyg.2012.00432] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 10/01/2012] [Indexed: 11/30/2022] Open
Abstract
Social cognitive psychologists (Frith, 1992; Hardy-Baylé et al., 2003) sought to explain the social problems and clarify the clinical picture of schizophrenia by proposing a model that relates many of the symptoms to a problem of metarepresentation, i.e., theory of mind (ToM). Given the differences in clinical samples and results between studies, and considering the wide range of what is considered to constitute ToM, one must ask if there a core function, or is ToM multifaceted with dissociable facets? If, there are dissociable dimensions or facets, which are affected in patients with paranoid schizophrenia? To answer these questions, a group of 21 individuals diagnosed with paranoid schizophrenia and 29 non-clinical control subjects, were tested on a battery of five different measures of ToM. The results confirmed that there was little difference in specificity of three of the tests in distinguishing between the clinical and non-clinical group, but there were important differences in the shared variance between the tests. Further analyses hint at two dimensions although a single factor with the same variance and the same contributing weights in both groups could explain the results. The deficits related to the attribution of cognitive and affective states to others inferred from available verbal and non-verbal information. Further analyses revealed that incorrect attributions of mental states including the attribution of threatening intentions to others, non-interpretative responses and incomplete answers, depending on the test of ToM.
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Affiliation(s)
- Peter Scherzer
- Département de Psychologie, Université du Québec à MontréalMontréal, QC, Canada
- Institut des Sciences Cognitives, Université du Québec à MontréalMontréal, QC, Canada
| | - Edith Leveillé
- Département de Psychologie, Université du Québec à MontréalMontréal, QC, Canada
| | - André Achim
- Département de Psychologie, Université du Québec à MontréalMontréal, QC, Canada
- Institut des Sciences Cognitives, Université du Québec à MontréalMontréal, QC, Canada
| | | | - Emmanuel Stip
- Centre de Recherche Fernand Séguin de l’Hôpital Louis H. LafontaineMontréal, QC, Canada
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Bechi M, Riccaboni R, Ali S, Fresi F, Buonocore M, Bosia M, Cocchi F, Smeraldi E, Cavallaro R. Theory of mind and emotion processing training for patients with schizophrenia: preliminary findings. Psychiatry Res 2012; 198:371-7. [PMID: 22425473 DOI: 10.1016/j.psychres.2012.02.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 02/02/2012] [Accepted: 02/06/2012] [Indexed: 02/07/2023]
Abstract
Impairments in social cognition are critical predictors of social functioning in patients with schizophrenia. Emotion processing (EP) and theory of mind (ToM) are hypothesized to influence real-world behavior more directly than basic cognition and represent important targets of intervention. The use of video scenes depicting human interactions could constitute an appropriate tool to enhance understanding of the characters' behavior and stimulate inferences on mental states. The aim of our pilot study was to evaluate longitudinally, with a controlled trial, the feasibility and the efficacy of a single-paradigm emotion recognition and ToM training designed for outpatients affected by schizophrenia, with the goal to create an ecological treatment, overcoming artificial laboratory biases, by the use of specific videotaped material. Fifty-two outpatients were randomly assigned to an EP and ToM video-based training (n=27) or to a standard social cognitive rehabilitation treatment (n=24). They were assessed before and after 12 weeks of intervention and compared to a time-matched control group (n=24). Our results show a statistically significant improvement in ToM abilities, confirming the hypothesis of the enhancing potential of social cognitive interventions, but no changes with respect to EP; despite the need for a deeper examination, these data support further development of this treatment approach.
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Affiliation(s)
- Margherita Bechi
- Department of Clinical Neurosciences, San Raffaele Universitary Scientific Institute Hospital, Vita-Salute San Raffaele University, Milano, Italy.
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Irani F, Seligman S, Kamath V, Kohler C, Gur RC. A meta-analysis of emotion perception and functional outcomes in schizophrenia. Schizophr Res 2012; 137:203-11. [PMID: 22341200 PMCID: PMC3351501 DOI: 10.1016/j.schres.2012.01.023] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 01/12/2012] [Accepted: 01/17/2012] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Emotion perception (EP) is impaired in schizophrenia, is stable across clinical state, resistant to antipsychotic treatment and linked to symptom severity. Given its pervasive nature, there is a need to quantitatively examine whether this dysfunction impacts functional outcomes. We used a meta-analytic strategy to combine results from several studies and examine synthesized effect sizes. METHODS A Meta-analysis of Observational Studies in Epidemiology standard was used to extract data following a PubMed and PsychInfo search. Studies reporting correlations between measures of EP and functional outcomes in schizophrenia spectrum disorders were selected. The impact of potential methodological (task type), demographic (sex, age, race, education, marital status) and clinical (age of onset, duration of illness, setting, symptoms, anti-psychotic medication) moderators on effect sizes were examined. RESULTS Twenty-five studies met inclusion criteria and included 1306 patients who were 37 years old, with 12 years of education, 64% male and 63% Caucasian. There was a significant relationship between EP and functional outcomes in individuals with schizophrenia or schizoaffective disorder, with effect sizes in the medium range. Medium to large range positive correlations were observed between emotion identification and functional outcome domains involving social problem solving, social skills and community functioning. Significant moderators included task type (emotion identification tasks), sex (% male in sample), race (% Caucasian in sample) and clinical symptoms (negative and positive). CONCLUSIONS Emotion identification deficits are associated with functional impairments in schizophrenia and moderated by sex, race and symptoms. This has implications for treatment efforts to improve outcomes.
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Affiliation(s)
- Farzin Irani
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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Thuaire F, Izaute M, Bacon E. Evidence of some strategic preservation of episodic learning in patients with schizophrenia. Psychiatry Res 2012; 195:27-31. [PMID: 21851990 DOI: 10.1016/j.psychres.2011.07.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Revised: 07/22/2011] [Accepted: 07/25/2011] [Indexed: 01/03/2023]
Abstract
The aim of this study was to gain a better understanding of schizophrenia patients' strategic use of learning time allocation during encoding, and determine whether they are able to use their monitoring and previous performances to adapt their learning behavior efficiently. Schizophrenia is considered to be a pathology of consciousness as well as being associated with impaired awareness of cognitive processes. In this study, after a learning session, individuals may express a Judgment of Learning (JOL), which reflects their sense of being able to retrieve the information later and which forms the basis for their decision whether or not to carry on learning. The introspective abilities of schizophrenia patients and subsequent strategic control of study time during the encoding of easy or difficult word pairs were investigated in 23 patients and 23 healthy comparison subjects. In spite of their memory impairment, patients were able to judge the difficulty of the word pairs with accuracy and adapt their learning time accordingly. Schizophrenia patients are sensitive to difficulty when rating JOLs and afterwards controlling study time. Monitoring their knowledge at the start helped patients to adapt their learning efficiently. These findings may be of value for cognitive remediation.
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Affiliation(s)
- Flavien Thuaire
- Clermont University, Blaise Pascal University, LAPSCO, BP 10448, F-63000 Clermont-Ferrand, France
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Brunet-Gouet E, Achim AM, Vistoli D, Passerieux C, Hardy-Baylé MC, Jackson PL. The study of social cognition with neuroimaging methods as a means to explore future directions of deficit evaluation in schizophrenia? Psychiatry Res 2011; 190:23-31. [PMID: 21185085 DOI: 10.1016/j.psychres.2010.11.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 11/12/2010] [Accepted: 11/27/2010] [Indexed: 11/27/2022]
Abstract
This article discusses the important advances in a recent field of science dealing with the brain processes implicated in understanding social situations and interacting with others. Many behavioral studies on schizophrenia have shown the impairment of these processes and their preferential relation with disorganization and negative syndromes. Brain imaging is a powerful method to identify brain systems participating in these processes in healthy subjects and will be used increasingly to study mental disorders such as schizophrenia. A few preliminary studies have opened this field of research and allowed for the drawing of some limited conclusions. We emphasize the importance of developing an integrated neurocognitive framework to account for the multifaceted nature of social cognition deficits in schizophrenia. Inspired by contemporary models of empathy and social cognition that identify different components such as shared representation, mentalizing, self/other distinction, we show how schizophrenia affects these components at the behavioral and functional levels. We also outline the interest of this model to understand putative abnormalities of contextual integration within the area of mentalization. Finally, we discuss how specialized measures of brain functions during the performance of these precisely defined mental processes might be used as outcome predictors.
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Affiliation(s)
- Eric Brunet-Gouet
- EA 4047, Université de Versailles Saint-Quentin, Service de Psychiatrie Adulte, Centre Hospitalier de Versailles, Fondation FondaMental, 177 route de Versailles, 78150 Le Chesnay, France.
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Abstract
OBJECTIVES Persecutory delusions are preceded and accompanied by negative emotions, which may be prolonged or even amplified by difficulties in the ability to regulate negative emotions. This study aims to gain insight into emotion regulation difficulties in persecutory ideation. DESIGN AND METHOD A correlational approach was adopted to explore bivariate and multivariate associations between emotion regulation difficulties and persecutory ideation in a subclinical sample. Furthermore, general psychopathology as well as positive symptoms of schizophrenia were assessed in order to estimate the specificity of emotion regulation difficulties. Data from 151 participants acquired via an Internet-based survey were analyzed. RESULTS There were substantial bivariate correlations between paranoid ideation and emotion regulation difficulties. However, only impulse control difficulties were specific to persecutory ideation after controlling for general psychopathology. Additionally, a multivariate analysis revealed unexpected positive associations between the acceptance of emotional responses and paranoid ideation as well as positive symptoms. CONCLUSIONS Besides the general difficulties in regulating emotion that are common to many clinical disorders and were associated with overall psychopathology, subclinical psychotic symptoms seem to be specifically associated with certain aspects of emotion regulation. Emotion regulation difficulties are likely to contribute to symptom formation and maintenance in persecutory delusions and might therefore present a valuable treatment target.
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