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Papastylianou AD, Travasaros T. Patients' Perspective on the Important Therapeutic Factors in Integrated Systemic Group Therapy: A Phenomenological Approach. Int J Group Psychother 2024; 74:33-77. [PMID: 38451504 DOI: 10.1080/00207284.2024.2303087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
This qualitative research refers to the patients' perspective on the therapeutic factors operating in long-term group therapy of an integrated systemic orientation (ISO). Semi-structured interviews of members of two long-term ISO psychotherapy groups were conducted in three phases: the first, second, and third year of their group psychotherapy. The research sample consisted of 13 participants. The data was analyzed through an interpretative phenomenological analysis. The results confirmed the classification of Yalom's therapeutic factors. However, an additional therapeutic factor emerged, the "development of pluralistic perspectives" that appears more clearly from the second year of therapy onward. Moreover, from the second year onward, the categories "existential factors" and "interpersonal learning" get strengthened. Limitations and future directions are discussed.
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2
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Monferrer M, García AS, Ricarte JJ, Montes MJ, Fernández-Caballero A, Fernández-Sotos P. Facial emotion recognition in patients with depression compared to healthy controls when using human avatars. Sci Rep 2023; 13:6007. [PMID: 37045889 PMCID: PMC10097677 DOI: 10.1038/s41598-023-31277-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/09/2023] [Indexed: 04/14/2023] Open
Abstract
The negative, mood-congruent cognitive bias described in depression, as well as excessive rumination, have been found to interfere with emotional processing. This study focuses on the assessment of facial recognition of emotions in patients with depression through a new set of dynamic virtual faces (DVFs). The sample consisted of 54 stable patients compared to 54 healthy controls. The experiment consisted in an emotion recognition task using non-immersive virtual reality (VR) with DVFs of six basic emotions and neutral expression. Patients with depression showed a worst performance in facial affect recognition compared to healthy controls. Age of onset was negatively correlated with emotion recognition and no correlation was observed for duration of illness or number of lifetime hospitalizations. There was no correlation for the depression group between emotion recognition and degree of psychopathology, excessive rumination, degree of functioning, or quality of life. Hence, it is important to improve and validate VR tools for emotion recognition to achieve greater methodological homogeneity of studies and to be able to establish more conclusive results.
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Affiliation(s)
- Marta Monferrer
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain
| | - Arturo S García
- Departmento de Sistemas Informáticos, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain
| | - Jorge J Ricarte
- Departmento de Psicología, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
| | - María J Montes
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain
| | - Antonio Fernández-Caballero
- Departmento de Sistemas Informáticos, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health, Instituto de Salud Carlos III), 28016, Madrid, Spain
| | - Patricia Fernández-Sotos
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain.
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health, Instituto de Salud Carlos III), 28016, Madrid, Spain.
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3
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Huang P, Chan SY, Ngoh ZM, Nadarajan R, Chong YS, Gluckman PD, Chen H, Fortier MV, Tan AP, Meaney MJ. Functional connectivity analysis of childhood depressive symptoms. Neuroimage Clin 2023; 38:103395. [PMID: 37031637 PMCID: PMC10120398 DOI: 10.1016/j.nicl.2023.103395] [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: 10/02/2022] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Childhood depression is a highly distinct and prevalent condition with an unknown neurobiological basis. We wish to explore the resting state fMRI data in children for potential associations between neural connectivity and childhood depressive symptoms. METHODS A longitudinal birth cohort study with neuroimaging data obtained at 4.5, 6.0 and 7.5 years of age and the Children Depression Inventory 2 (CDI) administered between 8.5 and 10.5 years was used. The CDI score was used as the dependent variable and tested for correlation, both simple Pearson and network based statistic, with the functional connectivity values obtained from the resting state fMRI. Cross-validated permutation testing with a general linear model was used to validate that the identified functional connections were indeed implicated in childhood depression. RESULTS Ten functional connections and four brain regions (Somatomotor Area B, Temporoparietal Junction, Orbitofrontal Cortex and Insula) were identified as significantly associated with childhood depressive symptoms for girls at 6.0 and 7.5 years. No significant functional connections were found in girls at 4.5 years or for boys at any timepoint. Network based statistic and permutation testing confirmed these findings. CONCLUSIONS This study revealed significant sex-dependent associations of neural connectivity and childhood depressive symptoms. The regions identified are implicated in speech/language, social cognition and information integration and suggest unique pathways to childhood depressive symptoms.
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Affiliation(s)
- Pei Huang
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore.
| | - Shi Yu Chan
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore
| | - Zhen Ming Ngoh
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ranjani Nadarajan
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore; Department of Obstetrics & Gynaecology, National University Hospital Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore; Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore; Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore; Department of Diagnostic Imaging, National University Hospital Singapore, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Agency for Science and Technology, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Brain - Body Initiative, Agency for Science and Technology, Singapore
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4
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Feeling low and unhappy together? An actor-partner-interdependence model uncovering the linkage between different operationalizations of relationship quality and depression in different-sex couples. PLoS One 2022; 17:e0274756. [DOI: 10.1371/journal.pone.0274756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Some studies suggest a bi-directional association between low relationship quality and depression. However, the social impact of depression and the potential preventative effects of healthy relationships are not yet sufficiently understood, as studies have shown heterogenous results for effects in both directions. Therefore, the main aim of this study was to differentiate the actor and partner effects of this association more comprehensively using two measures to capture characteristics of relationship quality–firstly regarding general aspects of social system quality and secondly considering specific aspects of the romantic relationship. 110 different-sex couples were included, being separated in partners with highly pronounced depressive symptoms in women (Cw/DW) versus partners with low depressive symptoms (LDCs). We investigated effects cross-sectionally using multi-group analyses to predict relationship (couple specific questionnaire: PFB) versus system quality (general system quality questionnaire: EVOS) in a step-by-step approach, modelling actor and partner effects with variation within and across both groups and then comparing the results to models with equal actor and partner effects. Depression was measured with the PHQ-9. With regard to the relationship between depressive symptoms and system quality, the model that constrained actor and partner effects to be equal across both groups was preferred and showed negative significant actor effects across gender and groups. Concerning the association between depressive symptoms and relationship quality, the model constraining actor and partner effects to be equal within groups had the best fit to the data and revealed a negative partner effect in LDCs.
Conclusions
Controlling for the moderating variable of clinically relevant depressive symptoms, we found evidence for actor and partner effects, which differed between the two relationship measures. This underlines the importance to reflect how relationship quality is operationalized. The negative partner effect on relationship quality in LDCs emphasizes that even in a non-clinical context, depressive symptoms negatively impact the perceived relationship quality of both women and men. This suggests that addressing the relationship is important in non-clinical preventive contexts and calls for integrating the partner into counselling or trainings.
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5
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Nestor BA, Sutherland S, Garber J. Theory of mind performance in depression: A meta-analysis. J Affect Disord 2022; 303:233-244. [PMID: 35176344 PMCID: PMC8961451 DOI: 10.1016/j.jad.2022.02.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Theory of mind (ToM) is a social-cognitive skill that involves the ability to understand the thoughts and feelings of others. Evidence is mixed regarding the extent of ToM ability in individuals with depression. METHODS We conducted a meta-analysis of 43 studies to investigate the strength of the association between ToM and depression. RESULTS Results indicated significant, small- to moderate impairment in ToM with a medium overall effect size (g = -0.398) in individuals with depression. Moderator analyses compared effect sizes across groups for the following variables: ToM content, process, and sample type. Additionally, meta-regression analyses tested age and gender as continuous moderators. LIMITATIONS The cross-sectional nature of included studies limits this meta-analysis from clarifying temporal or bidirectional relations. CONCLUSIONS We discuss findings in the context of the extant developmental, cognitive, social, and clinical literatures. We also suggest several possible explanations for these findings and offer implications for intervention.
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Affiliation(s)
- Bridget A. Nestor
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Susanna Sutherland
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Judy Garber
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
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6
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Mônego BG, Fonseca RP, Teixeira AL, Barbosa IG, Souza LCD, Bandeira DR. Transtorno Depressivo Maior: Um Estudo Comparativo sobre Cognição Socioemocional e Funções Executivas. PSICOLOGIA: TEORIA E PESQUISA 2022. [DOI: 10.1590/0102.3772e38217.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resumo O objetivo deste estudo foi avaliar a cognição socioemocional e as funções executivas em pacientes com Transtorno Depressivo Maior unipolar. A amostra incluiu 22 pacientes entre 36 e 93 anos de idade (M = 59,32; DP = 12,89) e 23 indivíduos controles entre 30 e 81 anos de idade (M = 63,00; DP = 13,56). Além de dados demográficos, foram avaliados sintomas de ansiedade e de depressão, empatia, teoria da mente, reconhecimento de emoções, controle inibitório, flexibilidade cognitiva e fluência verbal. Não houve diferença estatística significativa entre os grupos quanto à idade e à escolaridade. Os pacientes apresentaram significativamente mais ansiedade, depressão e angústia pessoal do que os controles. Indivíduos com sintomas depressivos mais graves apresentaram menor velocidade de processamento.
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7
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Friðriksson E, Gylfason HF, Vésteinsdóttir V, Sigurdsson JF. Trusting behavior and depressive symptoms. NORDIC PSYCHOLOGY 2021. [DOI: 10.1080/19012276.2021.1945948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Elvar Friðriksson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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8
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Monferrer M, Ricarte JJ, Montes MJ, Fernández-Caballero A, Fernández-Sotos P. Psychosocial remediation in depressive disorders: A systematic review. J Affect Disord 2021; 290:40-51. [PMID: 33991945 DOI: 10.1016/j.jad.2021.04.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/16/2021] [Accepted: 04/25/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social functioning impairment has been described in several psychiatric illness, including depressive disorders. It is associated with a deterioration in global functioning and quality of life, thus there is a growing interest in psychosocial functioning remediation interventions. This systematic review aims to review all psychotherapeutic, pharmacological and biological social functioning interventions in depressive disorders. METHODS A systematic search was conducted on PubMed, PsycINFO and Scopus from the first articles to 2019 following the PRISMA guidelines. 72 original papers were extracted from an initial number of 1827, based on the selected eligibility criteria. RESULTS A growing body of research was observed in the last 10 years, with most studies showing a low level of scientific evidence. The main diagnosis found was major depressive disorder and the principal social cognition domains assessed were emotional processing and attributional style. The type of intervention most found was the pharmacological one, followed by psychotherapeutic interventions classified as "non-specific. The efficacy of treatments showed an improvement in depressive symptoms and positive results for emotional processing and attributional style. LIMITATIONS Because there is a lack of well-controlled designs and really few interventions focusing on its remediation, and low homogeneity on the assessment of social aspects across, a comparison of results and the extraction of general conclusions is quite difficult. CONCLUSIONS Although a promising body of literature has been developed in recent years on the improvement of psychosocial functioning in patients with depressive disorders, more studies are needed to clarify relevant aspects in this area.
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Affiliation(s)
- Marta Monferrer
- Mental Health Service, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain
| | - Jorge J Ricarte
- Department of Psychology, Faculty of Medicine, Universidad de Castilla La Mancha, Albacete, Spain
| | - María J Montes
- Mental Health Service, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain
| | - Antonio Fernández-Caballero
- CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Departamento de Sistemas Informáticos, Universidad de Castilla-La Mancha, Albacete, Spain; Instituto de Investigación en Informática de Albacete, Albacete, Spain
| | - Patricia Fernández-Sotos
- Mental Health Service, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Mental Health Service, Hospital Virgen de la Luz, Cuenca, Spain.
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9
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Disrupted communication of the temporoparietal junction in patients with major depressive disorder. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:1276-1296. [PMID: 34100255 DOI: 10.3758/s13415-021-00918-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 12/24/2022]
Abstract
Patients with major depressive disorder (MDD) suffer impairment in the transmission and integration of internal and external information sources. Accumulating evidence suggests that the temporoparietal junction (TPJ) is important for multiple cognitive and social functions and may act as a key node for the integration of internal and external information. Therefore, the TPJ's aberrant interaction mechanism may underpin MDD psychopathology. To answer this question, we conducted a comprehensive study using resting-state functional magnetic imaging data recorded from 74 patients with MDD and 69 normal controls. First, we examined whether TPJ was the most prominent region with altered functional/effective connectivity with multiple depression-related regions/networks, based on either zero-lag correlations or temporal mutual information (total interdependence and Granger causality) measurements. Accordingly, we derived a network model that depicts alterations of TPJ-connectivity in patients with MDD. Lastly, we performed a cross-approach comparison demonstrating more conducive indicators in delineating the network alteration model. Functional/effective connectivity between the TPJ and major functional networks that govern internal and external-driven information resources was attenuated in patients with MDD. TPJ acts like a key node for information-inflow and integration of multiple information streams. Therefore, dysfunctional connectivity indicators may serve as effective biomarkers for MDD. MDD is associated with the breakdown of the TPJ interaction model and its connections with the default mode network and the task-positive network.
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10
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Zurlo MC, Ruggiero M. Assessing Pragmatic Language Skills in Adults with Major Depressive Disorder: An Exploratory Study. Psychopathology 2021; 54:78-91. [PMID: 33690229 DOI: 10.1159/000513270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 11/20/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There is increasing evidence that major depressive disorder (MDD) is associated with significant pragmatic language impairments. However, there is a lack of studies that use standardized tools and simultaneously investigate all pragmatic language skills among MDD patients. The aim of this study was to propose a more thorough investigation of all pragmatic language skills in patients with MDD. METHODS Twenty adults (aged 22-65) with a DSM-5 diagnosis of MDD were assessed using BLED Santa Lucia (Batteria sul Linguaggio dell'Emisfero Destro Santa Lucia), a battery designed to evaluate pragmatic language skills (comprehension of inferences, of picture and written metaphors, of indirect requests, of humoristic expressions, and of prosody). The performance of the MDD participants on all BLED Santa Lucia subscales was compared to 20 healthy control subjects (aged 20-60) matched for gender, age, years of education, and employment status. RESULTS MDD patients performed poorer than controls in comprehension of inferences (p < 0.01), picture metaphors (p < 0.001), written metaphors (p < 0.001), indirect requests (p < 0.01), humoristic expression (p < 0.05), and prosody (p < 0.05). CONCLUSIONS All pragmatic language skills can be significantly impaired in MDD patients. A valid assessment of all pragmatic language skills can allow, for each patient, the definition of a specific profile of risk and protective factors before and during psychotherapy.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy,
| | - Maura Ruggiero
- Department of Humanities, University of Naples Federico II, Naples, Italy
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11
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Tekin U, Erermiş HS, Satar A, Aydın AN, Köse S, Bildik T. Social cognition in first episode adolescent depression and its correlation with clinical features and quality of life. Clin Child Psychol Psychiatry 2021; 26:140-153. [PMID: 33246372 DOI: 10.1177/1359104520973254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research has suggested that patients with depression have deficits in social cognition, however they provide limited data regarding adolescent depression. Moreover, the relationship of social cognition with clinical features and quality of life is less studied. This study investigated social cognition in depressive adolescents and the correlations of social cognition with clinical features and quality of life. Thirty-five depressed adolescents and 37 healthy controls were assessed. Emotion perception and decoding ToM, quality of life and clinical variables were evaluated. No significant differences were found between depression and control groups regarding social cognitive tests. The results indicated that examined clinical features were not correlated significantly with social cognitive tests. Results suggest that social cognitive abilities are not disturbed in adolescents with first depressive episode.
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Affiliation(s)
- Uğur Tekin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Hatice Serpil Erermiş
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ayşegül Satar
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ayşe Nur Aydın
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Sezen Köse
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
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12
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Hudson AR, Orlemann C, Van Tricht T, Brass M, Mueller SC. Depression, trauma and mentalizing: No influence of depressive symptoms on spontaneous theory of mind in a subclinical sample. Int J Soc Psychiatry 2020; 66:442-451. [PMID: 32308084 DOI: 10.1177/0020764020914918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depressive symptoms are associated with impaired social functioning, arguably because of reduced mentalizing abilities. However, findings in persons with depressive symptoms and/or major depressive disorder (MDD) are presently mixed, finding evidence both for and against the hypothesis of reduced mentalizing abilities. AIMS This study investigated spontaneous cognitive mentalizing in 36 age-, sex- and education-matched students with depressive symptoms and 45 comparisons with minimal depressive symptoms. METHOD To assess spontaneous mentalizing, we used the implicit theory of mind (ToM) task, which looks specifically at spontaneous computation of false belief. RESULTS Bayesian analysis did not support the hypothesis of impaired mentalizing; in fact, it suggested that the results were 3.90 times more likely to have occurred under the null hypothesis. Results remained stable when comparing depressed and non-depressed individuals without maltreatment exposure but were inconclusive in the maltreatment-exposed groups. CONCLUSION The findings suggest no effect of spontaneous mentalizing in a high-functioning depressed sample. Moreover, the findings also emphasize the need to control for childhood maltreatment experiences in future ToM and social functioning research, as these may constitute subgroups within depressed samples. Tailored therapy for maltreated depression individuals may be beneficial.
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Affiliation(s)
- Anna R Hudson
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Corinne Orlemann
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tine Van Tricht
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Marcel Brass
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
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13
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Klein HS, Springfield CR, Bass E, Ludwig K, Penn DL, Harvey PD, Pinkham AE. Measuring mentalizing: A comparison of scoring methods for the hinting task. Int J Methods Psychiatr Res 2020; 29:e1827. [PMID: 32385868 PMCID: PMC7301277 DOI: 10.1002/mpr.1827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/19/2020] [Accepted: 04/12/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The Social Cognition Psychometric Evaluation (SCOPE) study supported the utility and practicality of the Hinting task as a measure of social cognition/mentalizing in clinical trials, specifically with the SCOPE authors' stringent scoring system. However, it remains unclear whether the SCOPE scoring system is necessary for the task to be judged as psychometrically sound. METHOD Independent raters rescored data from the three phases of SCOPE using the Hinting task's original scoring criteria. Psychometric properties of the task when scored with the original criteria versus more stringent SCOPE criteria were compared in a large sample of individuals with chronic schizophrenia (n = 397) and matched controls (n = 300) as well as a smaller sample of individuals with early psychosis (n = 38) and controls (n = 39). RESULTS In both samples, SCOPE criteria resulted in lowered average scores and reduced ceiling effects. Further, revised scoring resulted in strengthened relationships between the hinting task and outcome measures in the chronic sample, and better differentiated early psychosis patients from controls. Conversely, test-retest reliability and internal consistency estimates were not improved using revised scoring and remained suboptimal, particularly for healthy controls. CONCLUSION Overall, SCOPE scoring criteria improved some psychometric properties and clinical utility, suggesting that these criteria should be considered for implementation.
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Affiliation(s)
- Hans S Klein
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
| | - Cassi R Springfield
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
| | - Emily Bass
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.,Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Kelsey Ludwig
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.,Research Service, Miami VA Healthcare System, Miami, Florida, USA
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas, USA
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14
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Mirabel H, Guinet V, Voltzenlogel V, Pradier S, Hennion S. Social cognition in epilepsy: State of the art and perspectives. Rev Neurol (Paris) 2020; 176:468-479. [PMID: 32418700 DOI: 10.1016/j.neurol.2020.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The neuropsychology of epilepsy has been a major area of study for almost a century and cognitive impairments are an integral part of the new definition of epilepsy. Among such impairments, social cognition (SC) dysfunctions are of relatively recent interest. SC abilities refer to the body of knowledge and processes involved in establishing satisfying and appropriate social interactions. In particular, they allow the recognition of emotions in others, emotional experiences which are suitably adapted to social situations, and the ability to infer mental states in oneself and others. METHODS An overeview was conducted of the available data within the literature, with the objective of presenting the SC disorders associated with certain types of epilepsy and the possible risk factors already explored i.e., localisation of epileptic focus, age of onset/duration of the disease, and effects of treatments including surgery. Studies investigating the potential repercussions of these disorders on patients' daily life have also been included. RESULTS Social cognition disorders are an integral part of the cognitive disorders traditionally described in epilepsy. Indeed, a growing number of studies highlight the increased prevalence of SC disorders in various domains, and some patients appear to be more at risk than others. These disorders could be a major determining factor in the deterioration of patients' quality of life (QOL), particularly patients' support and social integration. This highlights the importance of assessing and managing these disorders in patients with epilepsy (PWE). Perspectives in the field of research and clinical practice are also evoked, such as exploring the links between disruptions in SC abilities and treatments, or developing specific tools for assessment and rehabilitation within the context of epilepsy.
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Affiliation(s)
- H Mirabel
- Neurology department, CHU de Toulouse, hôpital Pierre-Paul Riquet, Toulouse, France.
| | - V Guinet
- Department of functional neurology and epileptology, hospices civils de Lyon, Lyon, France
| | - V Voltzenlogel
- CERPPS, EA 7411, department of psychology, university of Toulouse, Toulouse, France
| | - S Pradier
- Functional explorations of the nervous system, clinical neurosciences center, university hospital center Pellegrin, Bordeaux, France
| | - S Hennion
- U1171 degenerative and vascular cognitive disorders, Inserm, epilepsy unit, reference center rare epilepsies, CHU Lille, university Lille, Lille, France
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15
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Venkatesan UM, Lancaster K, Lengenfelder J, Genova HM. Independent contributions of social cognition and depression to functional status after moderate or severe traumatic brain injury. Neuropsychol Rehabil 2020; 31:954-970. [PMID: 32314644 DOI: 10.1080/09602011.2020.1749675] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Impairments in cognitive processing related to social understanding and communication (i.e., "social cognition") are well documented after moderate or severe traumatic brain injury (TBI) and can contribute to negative functional outcome. Depression is also a common feature of TBI with detrimental functional consequences. We evaluated relationships between social cognition, depression symptom severity, and functional status in individuals with chronic TBI (>1 year post injury; n = 25) and healthy controls (n = 30) using objective tests of social cognition as well as self-reported depression (Beck Depression Inventory-II) and functional status (Functional Behavior Profile). Results revealed significant relationships between depression and functional status across the sample, and relationships between social cognition and functional status specific to TBI. In the TBI group only, social cognition significantly predicted both overall and social functional status above and beyond depression. Group differences in functional status were independently mediated by social cognition and, especially, depression. Our findings suggest that social cognitive impairments and depression are distinct, functionally relevant TBI sequelae. Interventions to improve social functioning in this population may be most effective when contextualized within treatments for emotional disturbances.
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Affiliation(s)
| | - Katie Lancaster
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Jean Lengenfelder
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Helen M Genova
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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16
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Weightman MJ, Knight MJ, Baune BT. A systematic review of the impact of social cognitive deficits on psychosocial functioning in major depressive disorder and opportunities for therapeutic intervention. Psychiatry Res 2019; 274:195-212. [PMID: 30807971 DOI: 10.1016/j.psychres.2019.02.035] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/01/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
Abstract
Social cognition is the ability to identify, perceive and interpret socially relevant information from the external world. It is an important adaptive trait, but is frequently affected in major depressive disorder by a mood-congruent interpretive bias. The present review examined the existing body of literature to determine (i) the impact social cognitive deficits in depression have on psychosocial functioning; and (ii) the utility of psychotropic, psychological and procedural interventions employed to target these deficits. A total of 107 studies met inclusion criteria for review. Social cognitive performance was found to adversely impact depressed patients' psychosocial functioning across the key domains of general cognitive functioning and quality of life. Secondly, many current therapies were found to have a normalising effect on the social cognitive abilities of subjects with major depressive disorder, both at a neural and functional level. In particular, certain anti-depressant medications corrected facial affect recognition deficits, while several psychotherapeutic approaches improved impairments in theory of mind and negative interpretive bias.
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Affiliation(s)
- Michael James Weightman
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Matthew James Knight
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Bernhard Theodor Baune
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia 5005, Australia; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria 3010, Australia; Department of Psychiatry, University of Münster, Münster, Germany.
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17
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Working definitions, subjective and objective assessments and experimental paradigms in a study exploring social withdrawal in schizophrenia and Alzheimer’s disease. Neurosci Biobehav Rev 2019; 97:38-46. [DOI: 10.1016/j.neubiorev.2018.06.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 04/10/2018] [Accepted: 06/21/2018] [Indexed: 11/24/2022]
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18
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Abstract
Depression is marked by rigid thinking and the inability to generate different and more positive views on the self. The current study conceptualises this a perspective-taking deficit, which is defined as a deficit in the ability to overcome one's egocentrism. Previous research has demonstrated that individuals with depression are impaired in Theory of Mind reasoning and empathy - two social cognitions that involve cognitive and affective perspective-taking. Here, it was investigated whether these deficits generalise to visuo-spatial perspective-taking. To test this, a convenience sample (N = 268; n = 62 high depressive symptoms; n = 206 healthy control participants) completed a test-battery including measures of cognitive and visuo-spatial perspective-taking and closely matched cognitive and visuo-spatial control tasks. The results showed that individuals exhibiting high levels of depressive symptoms were specifically impaired on both perspective-taking tasks but performed equally well on the control tasks. Interventions to combat rigid thinking in depression are discussed.
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Affiliation(s)
- Thorsten M Erle
- a Department of Psychology , University of Cologne , Richard-Strauss-Straße 2, 50931 Köln , Germany
| | - Niklas Barth
- b Department of Psychology , University of Würzburg , Würzburg , Germany
| | - Sascha Topolinski
- a Department of Psychology , University of Cologne , Richard-Strauss-Straße 2, 50931 Köln , Germany
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19
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Hudson CC, Shamblaw AL, Wilson GA, Roes MM, Sabbagh MA, Harkness KL. Theory of Mind, Excessive Reassurance-Seeking, and Stress Generation in Depression: A Social-Cognitive-Interpersonal Integration. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2018. [DOI: 10.1521/jscp.2018.37.9.725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: According to the interpersonal model of depression, individuals with depression engage in excessive reassurance-seeking (ERS) about others’ beliefs regarding their self-worth, which can ultimately result in interpersonal rejection. We present the novel hypothesis that maladaptive ERS behaviors in depression may be driven by difficulties with “theory of mind”—the foundational ability to decode and reason about others’ mental states. Method: Participants included 31 young adults in a current episode of a unipolar depressive disorder, and 91 never-depressed adults. Theory of mind was assessed with standard, objective laboratory tasks. Stressful life events were assessed with a gold-standard contextual interview and independent rating system. Results: Consistent with hypotheses, in the depressed group only, lower accuracy of theory of mind decoding was associated with greater ERS, which was significantly associated with exposure to greater interpersonal, but not non-interpersonal, stress. Surprisingly, higher accuracy of theory of mind reasoning was associated with greater ERS. Discussion: The intriguing dissociation is discussed in terms of expanding the interpersonal model of depression to include the foundational social cognitive processes that underlie effective social communication.
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20
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Wang YY, Wang Y, Zou YM, Ni K, Tian X, Sun HW, Lui SSY, Cheung EFC, Suckling J, Chan RCK. Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder. Schizophr Res 2018; 197:349-356. [PMID: 29122405 DOI: 10.1016/j.schres.2017.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/30/2017] [Accepted: 11/01/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although Theory of Mind (ToM) impairment has been observed in patients with a wide range of mental disorders, the similarity and uniqueness of these deficits across diagnostic groups has not been thoroughly investigated. METHODS We recruited 35 participants with schizophrenia (SCZ), 35 with bipolar disorder (BD), 35 with major depressive disorder (MDD), and 35 healthy controls in this study. All participants were matched in age, gender proportion and IQ estimates. The Yoni task, capturing both the cognitive and affective components of ToM at the first- and second-order level was administered. Repeated-measure ANOVA and MANOVA were conducted to compare the group differences in ToM performance. A network was then constructed with ToM performances, psychotic and depressive symptoms, and executive function as nodes exploring the clinical correlates of ToM. RESULTS Overall, ToM impairments were observed in all patient groups compared with healthy controls, with patients with SCZ performing worse than those with BD. In second-order conditions, patients with SCZ and MDD showed deficits in both cognitive and affective conditions, while patients with BD performed significantly poorer in cognitive conditions. Network analysis showed that second-order affective ToM performance was associated with psychotic and depressive symptoms as well as executive dysfunction, while second-order affective ToM performance and negative symptoms showed relatively high centrality in the network. CONCLUSIONS Patients with SCZ, MDD and BD exhibited different types and severity of impairments in ToM sub-components. Impairment in higher-order affective ToM appears to be closely related to clinical symptoms in both psychotic and affective disorders.
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Affiliation(s)
- Yan-Yu Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, Weifang Medical University, Shandong 261053, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China.
| | - Ying-Min Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China
| | - Ke Ni
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China; Mental Health Center of Qiqihar city, Heilongjiang 161006, China
| | - Xue Tian
- Department of Psychology, Weifang Medical University, Shandong 261053, China
| | - Hong-Wei Sun
- Department of Psychology, Weifang Medical University, Shandong 261053, China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - John Suckling
- Department of Psychiatry, University of Cambridge and Cambridgeshire and Peterborough NHS Trust, Cambridge CB2 0SZ, United Kingdom
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China.
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21
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Carelli L, Solca F, Faini A, Madotto F, Lafronza A, Monti A, Zago S, Doretti A, Ciammola A, Ticozzi N, Silani V, Poletti B. The Complex Interplay Between Depression/Anxiety and Executive Functioning: Insights From the ECAS in a Large ALS Population. Front Psychol 2018; 9:450. [PMID: 29674987 PMCID: PMC5895754 DOI: 10.3389/fpsyg.2018.00450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/19/2018] [Indexed: 02/02/2023] Open
Abstract
Introduction: The observed association between depressive symptoms and cognitive performances has not been previously clarified in patients with amyotrophic lateral sclerosis (pALS). In fact, the use of cognitive measures often not accommodating for motor disability has led to heterogeneous and not conclusive findings about this issue. The aim of the present study was to evaluate the relationship between cognitive and depressive/anxiety symptoms by means of the recently developed Edinburgh Cognitive and Behavioral ALS Screen (ECAS), a brief assessment specifically designed for pALS. Methods: Sample included 168 pALS (114 males, 54 females); they were administered two standard cognitive screening tools (FAB; MoCA) and the ECAS, assessing different cognitive domains, including ALS-specific (executive functions, verbal fluency, and language tests) and ALS non-specific subtests (memory and visuospatial tests). Two psychological questionnaires for depression and anxiety (BDI; STAI/Y) were also administered to patients. Pearson's correlation coefficient was used to assess the degree of association between cognitive and psychological measures. Results: Depression assessment negatively correlated with the ECAS, more significantly with regard to the executive functions subdomain. In particular, Sentence Completion and Social Cognition subscores were negatively associated with depression levels measured by BDI total score and Somatic-Performance symptoms subscore. Conversely, no significant correlations were observed between depression level and cognitive functions as measured by traditional screening tools for frontal abilities (FAB) and global cognition (MoCA) assessment. Finally, no significant correlations were observed between state/trait anxiety and the ECAS. Discussion and conclusion: This represents the first study focusing on the relationship between cognitive and psychological components in pALS by means of the ECAS, the current gold standard for ALS cognitive-behavioral assessment. If confirmed by further investigations, the observed association between depression and executive functions suggests the need for a careful screening and treatment of depression, to avoid overestimation of cognitive involvement and possibly improve cognitive performances in ALS.
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Affiliation(s)
- Laura Carelli
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Federica Solca
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Fabiana Madotto
- Research Centre on Public Health, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Annalisa Lafronza
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Alessia Monti
- Department of Neurorehabilitation Sciences, Casa di Cura Privata del Policlinico, Milan, Italy
| | - Stefano Zago
- Department of Neuroscience and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Alberto Doretti
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Andrea Ciammola
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Nicola Ticozzi
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Barbara Poletti
- Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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22
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Wehebrink KS, Koelkebeck K, Piest S, de Dreu CKW, Kret ME. Pupil mimicry and trust - Implication for depression. J Psychiatr Res 2018; 97:70-76. [PMID: 29202275 DOI: 10.1016/j.jpsychires.2017.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/10/2017] [Accepted: 11/17/2017] [Indexed: 11/15/2022]
Abstract
Individuals suffering from depression often have difficulty trusting others. Previous research has shown a relationship between trust formation and pupil mimicry - the synchronization of pupil sizes between individuals. The current study therefore examined whether pupil mimicry is weaker in depressed individuals and an underlying factor of their low levels of trust. Forty-two patients with major depressive disorder (MDD) and 40 healthy control subjects played trust games with virtual partners. Images of these partners' eye regions were presented to participants before they had to make a monetary investment decision. Partners' pupils either dilated, constricted, or remained static over the course of 4-s interactions. During the task, participants' pupil sizes were recorded with eye-tracking equipment to assess mimicry. The results confirm that patients with MDD were somewhat less trusting than controls and used another's pupillary cues differently when deciding to trust. Specifically, whereas healthy controls trusted partners with dilating pupils more than partners with constricting pupils, patients with MDD particularly trusted partners whose pupils changed in size less, regardless of whether partners' pupils were dilating or constricting. This difference in investment behavior was unrelated to differences in pupil mimicry, which was equally apparent in both groups and fostered trust to the same extent. Whereas lower levels of trust observed in patients with MDD could not be explained by differences in pupil mimicry, our data show that pupil dilation mimicry might help people to trust. These findings provide further evidence for the important role of pupil size and pupil mimicry in interpersonal trust formation and shed light on the pathophysiology of clinically low trust in patients with MDD.
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Affiliation(s)
- Katharina S Wehebrink
- Leiden University, Cognitive Psychology Unit, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition (LIBC), 2300 UC Leiden, The Netherlands; University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, A9, 48149 Muenster, Germany
| | - Katja Koelkebeck
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, A9, 48149 Muenster, Germany
| | - Simon Piest
- Martin-Luther-University Halle-Wittenberg, School of Law and Economics, Große Steinstrasse 73, 06108 Halle (Saale), Germany
| | - Carsten K W de Dreu
- Leiden University, Department of Social Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition (LIBC), 2300 UC Leiden, The Netherlands
| | - Mariska E Kret
- Leiden University, Cognitive Psychology Unit, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden Institute for Brain and Cognition (LIBC), 2300 UC Leiden, The Netherlands.
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23
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Caputi M, Pantaleo G, Scaini S. Do Feelings of Loneliness Mediate the Relationship between Sociocognitive Understanding and Depressive Symptoms During Late Childhood and Early Adolescence? The Journal of Genetic Psychology 2017; 178:207-216. [DOI: 10.1080/00221325.2017.1317629] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Marcella Caputi
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Giuseppe Pantaleo
- UniSR-Social.Lab, Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Simona Scaini
- Faculty of Psychology, Sigmund Freud University, Milan, Italy
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24
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MacQueen GM, Memedovich KA. Cognitive dysfunction in major depression and bipolar disorder: Assessment and treatment options. Psychiatry Clin Neurosci 2017; 71:18-27. [PMID: 27685435 DOI: 10.1111/pcn.12463] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/02/2016] [Accepted: 09/23/2016] [Indexed: 12/19/2022]
Abstract
Cognitive dysfunction is a recognized feature of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). Cognitive impairment is associated with poor overall functional outcome and is therefore an important feature of illness to optimize for patients' occupational and academic outcomes. While generally people with BD appear to have a greater degree of cognitive impairment than those with MDD, direct comparisons of both patient groups within a single study are lacking. There are a number of methods for the assessment of cognitive function, but few are currently used in clinical practice. Current symptoms, past course of illness, clinical features, such as the presence of psychosis and comorbid conditions, may all influence cognitive function in mood disorders. Despite the general lack of assessment of cognitive function in clinical practice, clinicians are increasingly targeting cognitive symptoms as part of comprehensive treatment strategies. Novel pharmacological agents may improve cognitive function, but most studies of standard mood stabilizers, such as lithium and the anticonvulsants, have focused on whether or not the medications impair cognition. Non-pharmacological strategies, such as cognitive remediation and exercise, are increasingly studied in patients with mood disorders. Despite the growing interest in strategies to manage cognitive function, there is a paucity of high-quality trials examining either pharmacological or non-pharmacological modes of intervention.
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Affiliation(s)
- Glenda M MacQueen
- Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Katherine A Memedovich
- Bachelor's of Health Sciences Program, Cumming School of Medicine, University of Calgary, Calgary, Canada
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25
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McKinnon MC, Boyd JE, Frewen PA, Lanius UF, Jetly R, Richardson JD, Lanius RA. A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions. Neuropsychologia 2016; 90:210-34. [DOI: 10.1016/j.neuropsychologia.2016.07.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 06/16/2016] [Accepted: 07/16/2016] [Indexed: 01/01/2023]
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26
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Schmidt T, Roser P, Juckel G, Brüne M, Suchan B, Thoma P. Social cognition and social problem solving abilities in individuals with alcohol use disorder. J Clin Exp Neuropsychol 2016; 38:974-90. [DOI: 10.1080/13803395.2016.1180346] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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27
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Bora E, Berk M. Theory of mind in major depressive disorder: A meta-analysis. J Affect Disord 2016; 191:49-55. [PMID: 26655114 DOI: 10.1016/j.jad.2015.11.023] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/02/2015] [Accepted: 11/15/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Social cognitive deficits can contribute to risk for depression and to psychosocial impairment during depression. However, available evidence suggests that emotion recognition is only marginally impaired in major depressive disorder (MDD). Recent studies have investigated theory of mind (ToM) abilities, a cognitively more demanding aspect of social cognition. METHODS We conducted a meta-analysis of studies comparing ToM abilities in MDD and healthy controls. 18 studies comparing 613 patients with MDD and 529 healthy controls were included. RESULTS MDD patients significantly underperformed healthy controls in ToM (d=0.51-0.58). ToM impairment in MDD was evident in response to different types of ToM tasks (verbal/visual and cognitive/affective and reasoning/decoding). ToM impairment was significantly related to severity of depressive symptoms. CONCLUSION Theory of mind abilities are impaired during depression and can potentially contribute to psychosocial difficulties during depression. There is a need to investigate ToM abilities in different subtypes and stages of depression, especially in remitted patients.
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Affiliation(s)
- Emre Bora
- The Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia.
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Faculty of Health, Geelong, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, The Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
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28
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Berecz H, Tényi T, Herold R. Theory of Mind in Depressive Disorders: A Review of the Literature. Psychopathology 2016; 49:125-34. [PMID: 27351561 DOI: 10.1159/000446707] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/08/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Theory of mind (ToM) is the ability to infer the mental states of others in order to understand and predict their behaviour. This ability is thought to be essential to social functioning and interpersonal relationships. As major depression is characterized by considerable social and interpersonal difficulties, exploration of the quality of ToM functioning can be particularly relevant in this and in related disorders. We aim to review the current state of research on ToM in depressive disorders in order to find out the extent to which ToM impairment is associated with these illnesses. METHODS An internet database search was carried out to collect all publications on the subject. RESULTS A total of 32 publications in English met our inclusion criteria: (a) 17 studies on ToM in major depression, (b) 4 studies on ToM in psychotic depression, (c) 3 studies on ToM in dysphoria or mild depression, (d) 4 studies on ToM in euthymic major depression, (e) 2 studies on ToM in chronic versus episodic depression, and (f) 2 studies on ToM in another psychiatric disorder with comorbid major depression. CONCLUSIONS Despite an increased interest in the research of the topic in recent years, no firm conclusions can be drawn, as the reviewed articles present some conflicting results. Acutely depressed patients have been found to be impaired on tasks involving both ToM social-perceptual and social-cognitive components. On the other hand, a number of studies have not reported significant between-group differences between depressed patients and healthy controls or have found minimal differences. Further research is needed in order to confirm and extend these results.
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Affiliation(s)
- Hajnalka Berecz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Px00E9;cs, Px00E9;cs, Hungary
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29
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Altamura AC, Caletti E, Paoli RA, Cigliobianco M, Zugno E, Grillo P, Prunas C, Caldiroli A, Zago S. Correlation between neuropsychological and social cognition measures and symptom dimensions in schizophrenic patients. Psychiatry Res 2015; 230:172-80. [PMID: 26350702 DOI: 10.1016/j.psychres.2015.08.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/23/2015] [Accepted: 08/17/2015] [Indexed: 12/22/2022]
Abstract
Neurocognitive and social cognition deficits have been largely reported in Schizophrenia (SKZ) but their association with psychopathology remains uncertain. Our purpose was to explore the relationship between symptom dimensions and neuropsychological performances. We enrolled 35 stabilized schizophrenic outpatients of the Department of Psychiatry of Policlinico Hospital, University of Milan, who completed psychiatric Rating Scales, the Brief Assessment of Cognition in Schizophrenia (BACS) and the Executive and Social Cognition Battery (ESCB). Disorganized dimension seems to have the most significant impact on cognition, being associated with performance in several BACS subtests (verbal memory, working memory, motor speed, symbol coding, Tower of London) and ESCB tasks (MET and Hotel task number of tasks attempted, number of broken MET rules, sum of deviations in Hotel Task). Positive dimension correlated with performance in verbal fluency, negative dimension with IOWA Test results, cognitive dimension with MET number of inefficiencies and Eyes test score. Impulsive-aggressive and depressive dimensions weakly correlated only with Faux Pas test. Our study supports the existence of a specific disorganized dimension in SKZ, separated from cognitive dimension evaluated through clinical instruments (e.g. PANSS), but capable of influencing cognitive abilities. Furthermore, it strengthens the validity of ecological tasks in evaluating cognition in SKZ.
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Affiliation(s)
- A Carlo Altamura
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisabetta Caletti
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo Augusto Paoli
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Cigliobianco
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Elisa Zugno
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Grillo
- Epidemiology Unit, Department of Preventive Medicine, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Prunas
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Caldiroli
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Zago
- Neurologic Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Yamada K, Inoue Y, Kanba S. Theory of mind ability predicts prognosis of outpatients with major depressive disorder. Psychiatry Res 2015; 230:604-8. [PMID: 26477953 DOI: 10.1016/j.psychres.2015.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 09/30/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
Abstract
A theory of mind (ToM) deficit in patients with major depressive episodes is associated with difficulty in social adjustment, and thus may indicate a poorer prognosis. We investigated the association between ToM deficits and the outcome in patients who had recovered from major depressive episodes. We evaluated ToM abilities of 100 patients with major depressive disorder during a period of remission. The patients were followed up for one year and their outcomes observed. After one year, patients who had a ToM deficit according to a second-order false belief question relapsed significantly more frequently than did patients who did not have a deficit (Fisher's exact test P<0.0001; relative risk (RR)=8.286; CI 2.608, 26.324). Significant differences between these two groups were shown in scores of the Global Assessment of Functioning Scale (P<0.0001). Our results suggest that a ToM deficit after symptom remission in patients with major depressive disorder predicts a higher relapse rate and lower social function one year after recovering from a major depressive episode.
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Affiliation(s)
- Kazuo Yamada
- Department of Psychiatry, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nishi-ogu, Arakawa-ku, Tokyo 116-8567, Japan.
| | - Yumiko Inoue
- Department of Psychiatry, Inogashira Hospital, Tokyo, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Nice or effective? Social problem solving strategies in patients with major depressive disorder. Psychiatry Res 2015; 228:835-42. [PMID: 26051176 DOI: 10.1016/j.psychres.2015.05.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 04/06/2015] [Accepted: 05/15/2015] [Indexed: 11/24/2022]
Abstract
Our study addressed distinct aspects of social problem solving in 28 hospitalized patients with Major Depressive Disorder (MDD) and 28 matched healthy controls. Three scenario-based tests assessed the ability to infer the mental states of story characters in difficult interpersonal situations, the capacity to freely generate good strategies for dealing with such situations and the ability to identify the best solutions among less optimal alternatives. Also, standard tests assessing attention, memory, executive function and trait empathy were administered. Compared to controls, MDD patients showed impaired interpretation of other peoples' sarcastic remarks but not of the mental states underlying other peoples' actions. Furthermore, MDD patients generated fewer strategies that were socially sensitive and practically effective at the same time or at least only socially sensitive. Overall, while the free generation of adequate strategies for difficult social situations was impaired, recognition of optimal solutions among alternatives was spared in MDD patients. Higher generation scores were associated with higher trait empathy and cognitive flexibility scores. We suggest that this specific pattern of impairments ought to be considered in the development of therapies addressing impaired social skills in MDD.
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Lahera G, Herrera S, Reinares M, Benito A, Rullas M, González-Cases J, Vieta E. Hostile attributions in bipolar disorder and schizophrenia contribute to poor social functioning. Acta Psychiatr Scand 2015; 131:472-82. [PMID: 25645449 DOI: 10.1111/acps.12399] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To compare the profile of attributional style of a group of out-patients with bipolar disorder (BD) and schizophrenia (SZ), and a group of healthy controls - along with other social cognition domains - such as emotion recognition and theory of mind (ToM). METHOD A total of 46 out-patients diagnosed with BD, 49 with SZ, and 50 healthy controls were assessed in attributional style (Ambiguous Intentions Hostility Questionnaire), facial emotion recognition (FEIT, FEDT, ER-40), and ToM (Hinting Task). Symptomatology, clinical variables and global functioning were also collected. RESULTS Both groups with SZ and BD showed hostile social cognitive biases, compared with the control group. Patients with BD also showed a capacity for emotional recognition similar to those with SZ and worse than control subjects. In contrast, patients with SZ showed poorer ToM. Subthreshold depressive symptoms and an attributional style toward hostility appeared as the factors with a strongest association to global functioning in BD. In SZ, PANSS score and a tendency to aggressiveness were the most relevant factors. CONCLUSION Attributional style (along with other domains of social cognition) is altered in out-patients with BD and SZ. The presence of residual symptoms and a hostile social cognitive bias may contribute to the functional impairment of both groups.
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Affiliation(s)
- G Lahera
- Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain
| | - S Herrera
- Usera Mental Health Center, Doce de Octubre University Hospital, Madrid, Spain
| | - M Reinares
- Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - A Benito
- Provincial Hospital of Toledo, Toledo, Spain
| | - M Rullas
- San Fernando Psychosocial Rehabilitation Center, EXTER., Madrid, Spain
| | - J González-Cases
- Alcalá de Henares Psychosocial Rehabilitation Center, EXTER., Madrid, Spain
| | - E Vieta
- Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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Nazarov A, Frewen P, Oremus C, Schellenberg EG, McKinnon MC, Lanius R. Comprehension of affective prosody in women with post-traumatic stress disorder related to childhood abuse. Acta Psychiatr Scand 2015; 131:342-9. [PMID: 25401486 DOI: 10.1111/acps.12364] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although deficits in memory and cognitive processing are evident in post-traumatic stress disorder (PTSD), difficulties with social cognition and the impact of such difficulties on interpersonal functioning are poorly understood. Here, we examined the ability of women diagnosed with PTSD related to childhood abuse to discriminate affective prosody, a central component of social cognition. METHOD Women with PTSD and healthy controls (HCs) completed two computer-based tasks assessing affective prosody: (i) recognition (categorizing foreign-language excerpts as angry, fearful, sad, or happy) and (ii) discrimination (identifying whether two excerpts played consecutively had the 'same' or 'different' emotion). The association of performance with symptom presentation, trauma history, and interpersonal functioning was also explored. RESULTS Women with PTSD were slower than HCs at identifying happiness, sadness, and fear, but not anger in the speech excerpts. The presence of dissociative symptoms was related to reduced accuracy on the discrimination task. An increased severity of childhood trauma was associated with reduced accuracy on the discrimination task and with slower identification of emotional prosody. CONCLUSION Exposure to childhood trauma is associated with long-term, atypical development in the interpretation of prosodic cues in speech. The findings have implications for the intergenerational transmission of trauma.
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Affiliation(s)
- A Nazarov
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Mercedes Perez-Rodriguez M, Mahon K, Russo M, Ungar AK, Burdick KE. Oxytocin and social cognition in affective and psychotic disorders. Eur Neuropsychopharmacol 2015; 25:265-82. [PMID: 25153535 PMCID: PMC4443696 DOI: 10.1016/j.euroneuro.2014.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 07/10/2014] [Accepted: 07/19/2014] [Indexed: 12/22/2022]
Abstract
Impairments in social cognition are now recognized as core illness features in psychotic and affective disorders. Despite the significant disability caused by social cognitive abnormalities, treatments for this symptom dimension are lacking. Here, we describe the evidence demonstrating abnormalities in social cognition in schizophrenia, major depressive disorder, and bipolar disorder, as well as the neurobiology of social cognition including the role of oxytocin. We then review clinical trials of oxytocin administration in psychotic and affective disorders and the impact of this agent on social cognition. To date, several studies have demonstrated that oxytocin may improve social cognition in schizophrenia; too few studies have been conducted in affective disorders to determine the effect of oxytocin on social cognition in these disorders. Future work is needed to clarify which aspects of social cognition may be improved with oxytocin treatment in psychotic and affective disorders.
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Affiliation(s)
- M Mercedes Perez-Rodriguez
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Psychiatry Box # 1230 One Gustave L. Levy Place, New York, NY 10029, USA; The Mental Health Patient Care Center and the Mental Illness Research Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; CIBERSAM, Autonoma University of Madrid, Fundacion Jimenez Diaz Hospital, Spain.
| | - Katie Mahon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Psychiatry Box # 1230 One Gustave L. Levy Place, New York, NY 10029, USA
| | - Manuela Russo
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Psychiatry Box # 1230 One Gustave L. Levy Place, New York, NY 10029, USA
| | - Allison K Ungar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Psychiatry Box # 1230 One Gustave L. Levy Place, New York, NY 10029, USA
| | - Katherine E Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Psychiatry Box # 1230 One Gustave L. Levy Place, New York, NY 10029, USA
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Jakobsen JC, Gluud C, Kongerslev M, Larsen KA, Sørensen P, Winkel P, Lange T, Søgaard U, Simonsen E. Third-wave cognitive therapy versus mentalisation-based treatment for major depressive disorder: a randomised clinical trial. BMJ Open 2014; 4:e004903. [PMID: 25138802 PMCID: PMC4139625 DOI: 10.1136/bmjopen-2014-004903] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To compare the benefits and harms of third-wave cognitive therapy versus mentalisation-based therapy in a small sample of depressed participants. SETTING The trial was conducted at an outpatient psychiatric clinic for non-psychotic patients in Roskilde, Denmark. PARTICIPANTS 44 consecutive adult participants diagnosed with major depressive disorder. INTERVENTIONS 18 weeks of third-wave cognitive therapy (n=22) versus 18 weeks of mentalisation-based treatment (n=22). OUTCOMES The primary outcome was the Hamilton Rating Scale for Depression (HDRS) at end of treatment (18 weeks). Secondary outcomes were: remission (HDRS <8), Beck's Depression Inventory, Symptom Checklist 90 Revised and The WHO-Five Well-being Index 1999. RESULTS The trial inclusion lasted for about 2 years as planned but only 44 out of the planned 84 participants were randomised. Two mentalisation-based participants were lost to follow-up. The unadjusted analysis showed that third-wave participants compared with mentalisation-based participants did not differ significantly regarding the 18 weeks HDRS score (12.9 vs 17.0; mean difference -4.14; 95% CI -8.30 to 0.03; p=0.051). In the analysis adjusted for baseline HDRS score, the difference was favouring third-wave cognitive therapy (p=0.039). At 18 weeks, five of the third-wave participants (22.7%) were in remission versus none of the mentalisation-based participants (p=0.049). We recorded no suicide attempts or suicides during the intervention period in any of the 44 participants. No significant differences were found between the two intervention groups on the remaining secondary outcomes. CONCLUSIONS Third-wave cognitive therapy may be more effective than mentalisation-based therapy for depressive symptoms measured on the HDRS. However, more randomised clinical trials are needed to assess the effects of third-wave cognitive therapy and mentalisation-based treatment for depression. TRIAL REGISTRATION NUMBER Registered with Clinical Trials government identifier: NCT01070134.
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Affiliation(s)
- Janus Christian Jakobsen
- Psychiatric Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mickey Kongerslev
- Psychiatric Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Per Sørensen
- Mental Health Services,Psychotherapy Center Stolpegaard, Copenhagen, Denmark
| | - Per Winkel
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ulf Søgaard
- Department of Psychiatry, Psychiatric Clinic, Roskilde, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
PURPOSE OF REVIEW Social cognition represents a fundamental skill for effective social behavior. It is nowadays widely accepted that individuals suffering from serious mental illness are impaired in this domain. RECENT FINDINGS Studies published since June 2012 have been reviewed, with a particular focus on theory of mind, social perception, social knowledge, attributional bias, and emotion processing in patients suffering from schizophrenia and mood disorders. SUMMARY The reviewed literature supports previous studies on deficits in social cognition in schizophrenia, major depressive disorder and bipolar disorder, and underscores their relevance in the psychosocial context.
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Hollocks MJ, Jones CRG, Pickles A, Baird G, Happé F, Charman T, Simonoff E. The association between social cognition and executive functioning and symptoms of anxiety and depression in adolescents with autism spectrum disorders. Autism Res 2014; 7:216-28. [PMID: 24737743 DOI: 10.1002/aur.1361] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 01/12/2014] [Indexed: 12/28/2022]
Abstract
While high levels of anxiety and depression are now recognized as major co-occurring problems in children and young people with an autism spectrum disorder (ASD), research examining possible associations with individual differences in neurocognitive functioning has been limited. This study included 90 adolescents with an ASD aged 14-16 years with a full-scale IQ > 50. Using structural equation modeling, we examined the independent relationships between multiple measures of executive functioning and social cognition on severity of anxiety or depressive symptoms. Results indicated a significant association between poorer executive functioning and higher levels of anxiety, but not depression. In contrast, social cognition ability was not associated with either anxiety or depression. This study is the first to report significant associations between executive functions and anxiety in ASD. This may suggest that poor executive functioning is one factor associated with the high prevalence of anxiety disorder in children and adolescents with ASD.
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Affiliation(s)
- Matthew J Hollocks
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, United Kingdom
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