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Pehlivanidis A, Papanikolaou K, Korobili K, Kalantzi E, Mantas V, Pappa D, Papageorgiou C. Trait-Based Dimensions Discriminating Adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and, Co-occurring ADHD/ASD. Brain Sci 2020; 11:E18. [PMID: 33375278 PMCID: PMC7824158 DOI: 10.3390/brainsci11010018] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
This study assessed the co-occurrence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in newly diagnosed adults of normal intelligence and the contribution of trait-based dimensions deriving from the Barkley Adult ADHD Rating Scale-IV (BAARS-IV), the Autism-Spectrum Quotient (AQ), and the Empathy Quotient (EQ) to the differentiation of patients with ADHD, ASD, and ADHD/ASD. A total of 16.1% of patients with ADHD received a co-occurring ASD diagnosis, while 33.3% of patients with ASD received an ADHD diagnosis. Subjects with ADHD or ADHD/ASD had higher scores in all ADHD traits compared to ASD subjects. Compared to the ADHD group, the ASD group had AQ scores that were significantly greater, except for attention to detail. ADHD/ASD co-occurrence significantly increased the score of attention to detail. The total EQ score was greater in the ADHD group. In the stepwise logistic regression analyses, past hyperactivity, current inattention and impulsivity, attention switching, communication, imagination, and total EQ score discriminated ADHD patients from ASD patients. Attention to detail, imagination, and total EQ score discriminated ADHD cases from ADHD/ASD cases, while past hyperactivity and current impulsivity discriminated ASD subjects from ADHD/ASD subjects. Our findings highlight the importance of particular trait-based dimensions when discriminating adults with ADHD, ASD, and co-occurring ADHD/ASD.
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Affiliation(s)
- Artemios Pehlivanidis
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece; (K.K.); (E.K.); (V.M.); (D.P.); (C.P.)
| | - Katerina Papanikolaou
- Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, “Agia Sophia” Children’s Hospital, 11527 Athens, Greece;
| | - Kalliopi Korobili
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece; (K.K.); (E.K.); (V.M.); (D.P.); (C.P.)
| | - Eva Kalantzi
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece; (K.K.); (E.K.); (V.M.); (D.P.); (C.P.)
| | - Vasileios Mantas
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece; (K.K.); (E.K.); (V.M.); (D.P.); (C.P.)
| | - Dimitra Pappa
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece; (K.K.); (E.K.); (V.M.); (D.P.); (C.P.)
| | - Charalambos Papageorgiou
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece; (K.K.); (E.K.); (V.M.); (D.P.); (C.P.)
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Haut KM, Dodell-Feder D, Guty E, Nahum M, Hooker CI. Change in Objective Measure of Empathic Accuracy Following Social Cognitive Training. Front Psychiatry 2019; 10:894. [PMID: 31920748 PMCID: PMC6914938 DOI: 10.3389/fpsyt.2019.00894] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/13/2019] [Indexed: 01/27/2023] Open
Abstract
Background: The capacity for empathy plays an important role in interpersonal relationships and social functioning, and impairments in empathy can have negative effects on social interactions and overall social adjustment. This suggests that empathy may be a critical target for intervention in individuals who struggle with social interactions, yet it is unclear if the skills required for empathy are malleable. This study investigates the efficacy of targeted social cognitive training for improving empathic skills. Methods: Forty-five individuals (mean age = 24) were included in this study. Twenty-four individuals were allocated to the active social cognition training group and 21 individuals were allocated to a computer games control condition. Subjects completed approximately 10.5 h of training over two weeks. Pre- and post- training, they completed measures of empathy and emotion recognition, including the Interpersonal Reactivity Inventory (IRI) and an empathic accuracy task. ANOVA and regression analyses tested changes in participants' performance on the empathic accuracy task and scores on the IRI subscales were used to assess the effect of the social cognitive training. Results: Repeated measures ANOVA show that there is a significant group by timepoint interaction on the Empathic Accuracy task, with individuals who completed the social cognition training showing a significant improvement in performance following training. There were no significant changes for either group on any of the self-report IRI subscales. Individuals in the active training group show significant improvement on negative valence videos and a trend towards improvement on positive valence videos. In addition, individuals in social cognition active training group who reported higher intrinsic motivation demonstrated greater improvement on the Empathic Accuracy task. Conclusions: Individuals who completed a computerized social cognition training program demonstrated improved performance on a rater objective measure of empathic accuracy while individuals who completed a computer game control condition did not demonstrate any significant changes in their performance on the empathic accuracy task. These results suggest that targeted training in social cognition may increase empathic abilities, even in healthy individuals, and that this training may be beneficial to individuals with social cognitive deficits.
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Affiliation(s)
- Kristen M. Haut
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - David Dodell-Feder
- Department of Psychology, University of Rochester, Rochester, NY, United States
| | - Erin Guty
- Department of Psychology, Pennsylvania State University, State College, PA, United States
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem,Israel
| | - Christine I. Hooker
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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Crespi B, Dinsdale N. Autism and psychosis as diametrical disorders of embodiment. Evol Med Public Health 2019; 2019:121-138. [PMID: 31402979 PMCID: PMC6682708 DOI: 10.1093/emph/eoz021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/11/2019] [Indexed: 12/12/2022] Open
Abstract
Humans have evolved an elaborate system of self-consciousness, self-identity, self-agency, and self-embodiment that is grounded in specific neurological structures including an expanded insula. Instantiation of the bodily self has been most-extensively studied via the 'rubber hand illusion', whereby parallel stimulation of a hidden true hand, and a viewed false hand, leads to the felt belief that the false hand is one's own. Autism and schizophrenia have both long been regarded as conditions centrally involving altered development of the self, but they have yet to be compared directly with regard to the self and embodiment. Here, we synthesize the embodied cognition literature for these and related conditions, and describe evidence that these two sets of disorders exhibit opposite susceptibilities from typical individuals to the rubber hand illusion: reduced on the autism spectrum and increased in schizophrenia and other psychotic-affective conditions. Moreover, the opposite illusion effects are mediated by a consilient set of associated phenomena, including empathy, interoception, anorexia risk and phenotypes, and patterns of genetic correlation. Taken together, these findings: (i) support the diametric model of autism and psychotic-affective disorders, (ii) implicate the adaptive human system of self-embodiment, and its neural bases, in neurodevelopmental disorders, and suggest new therapies and (iii) experimentally ground Bayesian predictive coding models with regard to autism compared with psychosis. Lay summary: Humans have evolved a highly developed sense of self and perception of one's own body. The 'rubber hand illusion' can be used to test individual variation in sense of self, relative to connection with others. We show that this illusion is reduced in autism spectrum disorders, and increased in psychotic and mood disorders. These findings have important implications for understanding and treatment of mental disorders.
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Affiliation(s)
- Bernard Crespi
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada
| | - Natalie Dinsdale
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
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Silberstein J, Harvey PD. Impaired introspective accuracy in schizophrenia: an independent predictor of functional outcomes. Cogn Neuropsychiatry 2019; 24:28-39. [PMID: 30477401 PMCID: PMC6370513 DOI: 10.1080/13546805.2018.1549985] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Individuals with schizophrenia present across a spectrum of symptomatology. Disability remains a debilitating reality across varying disease presentations and remains pervasive despite psychiatric medications. Cognition (neuro/social cognition) and negative symptoms have emerged as the strongest predictors of real-world disability, but account for <50% of the variance in outcomes. METHODS Our attempts to determine what accounts for the remaining 50% of variance has shown that poor introspective accuracy (IA) may be the most potent predictor of functional outcomes 25% of individuals with schizophrenia. We define IA as the adequacy of self-assessments of ability, skills, performance, or decisions. We suggest that IA is a progression of metacognition and can extend beyond cognition to include misestimation of prior and likely future performance in social or other adaptively relevant situations. RESULTS Additionally, IA is bidirectional and self-orientated. Emerging research has found that IA of neurocognitive ability better predicts everyday functional deficits than scores on performance-based measures or neurocognitive skills and has found that IA of social cognition accounts unique variance in real-world disability above social cognitive performance. DISCUSSION We argue that impaired IA, affecting 25-50% of patients with schizophrenia, in the absence or minimal presence of other impairments might be the most powerful predictor of functional outcomes.
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Affiliation(s)
| | - Philip D. Harvey
- University of Miami Miller School of Medicine, Miami, FL, USA 33136,Research Service, Bruce W. Cater VA Medical Center, Miami VA Healthcare System. Miami, FL, USA
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Labayru G, Arenzana I, Aliri J, Zulaica M, López de Munain A, Sistiaga A. A. Social cognition in myotonic dystrophy type 1: Specific or secondary impairment? PLoS One 2018; 13:e0204227. [PMID: 30248121 PMCID: PMC6152965 DOI: 10.1371/journal.pone.0204227] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 09/05/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS The cognitive profile of Myotonic Dystrophy type 1 (DM1) has been described in recent decades. Moreover, DM1 patients show lowered social engagement and difficulties in social-cognitive functions. The aim of the present study is to explore whether social cognition impairment is present in DM1 taking into account the overall cognitive condition. METHOD 38 patients and a control group paired in age and gender participated in the study. All the participants had an IQ within the normal range. Subjects were administered an abbreviated neuropsychological battery which comprised a facial emotion recognition test (POFA) and Faux Pas Test, as well as a self-report questionnaire on cognitive and affective empathy (TECA). RESULTS Statistically significant differences were found only for facial emotion recognition (U = 464.0, p = .006) with a moderate effect size (.31), with the controls obtaining a higher score than the patients. Analyzing each emotion separately, DM1 patients scored significantly lower than controls on the recognition of anger and disgust items. Emotion recognition did not correlate with genetic load, but did correlate negatively with age. No differences were found between patients and controls in any of the other variables related to Theory of Mind (ToM) and empathy. CONCLUSION DM1 does not manifest specific impairments in ToM since difficulties in this area predominantly rely on the cognitive demand of the tasks employed. However, a more basic process such as emotion recognition appears as a core deficit. The role of this deficit as a marker of aging related decline is discussed.
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Affiliation(s)
- Garazi Labayru
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
- Personality, Assessment and Psychological Treatment Department, Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Gipuzkoa, Spain
| | - Irati Arenzana
- Master’s in Child and Adult Neuropsychology, Autonoma University of Barcelona, Spain
| | - Jone Aliri
- Department of Social Psychology and Methodology of Behavioral Sciences, University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Gipuzkoa, Spain
| | - Miren Zulaica
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
| | - Adolfo López de Munain
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
- Neurology Department, Donostia University Hospital, Donostia-San Sebastian, Gipuzkoa, Spain
| | - Andone Sistiaga A.
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
- Personality, Assessment and Psychological Treatment Department, Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Gipuzkoa, Spain
- * E-mail:
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Vistoli D, Lavoie MA, Sutliff S, Jackson PL, Achim AM. Functional MRI examination of empathy for pain in people with schizophrenia reveals abnormal activation related to cognitive perspective-taking but typical activation linked to affective sharing. J Psychiatry Neurosci 2017; 42:262-272. [PMID: 28556774 PMCID: PMC5487273 DOI: 10.1503/jpn.160136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schizophrenia is associated with important disturbances in empathy that are related to everyday functioning. Empathy is classically defined as including affective (sharing others' emotions) and cognitive (taking others' cognitive perspectives) processes. In healthy individuals, studies on empathy for pain revealed specific brain systems associated with these sets of processes, notably the anterior middle cingulate (aMCC) and anterior insula (AI) for affective sharing and the bilateral temporoparietal junction (TPJ) for the cognitive processes, but the integrity of these systems in patients with schizophrenia remains uncertain. METHODS Patients with schizophrenia and healthy controls performed a pain empathy task while undergoing fMRI scanning. Participants observed pictures of hands in either painful or nonpainful situations and rated the level of pain while imagining either themselves (self) or an unknown person (other) in these situations. RESULTS We included 27 patients with schizophrenia and 21 healthy controls in our analyses. For the pain versus no pain contrast, patients showed overall typical activation patterns in the aMCC and AI, with only a small part of the aMCC showing reduced activation compared with controls. For the other versus self contrast, patients showed an abnormal modulation of activation in the TPJ bilaterally (extending to the posterior superior temporal sulcus, referred to as the TPJ/pSTS). LIMITATIONS The design included an unnecessary manipulation of the visual perspective that reduced the number of trials for analysis. The sample size may not account for the heterogeneity of schizophrenia. CONCLUSION People with schizophrenia showed relatively intact brain activation when observing others' pain, but showed abnormalities when asked to take the cognitive perspectives of others.
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Affiliation(s)
| | | | | | | | - Amélie M. Achim
- Correspondence to: A.M. Achim, Centre de recherche CERVO, 2601, de la Canardière, Québec QC G1J 2G3;
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Kar SK, Jain M. Current understandings about cognition and the neurobiological correlates in schizophrenia. J Neurosci Rural Pract 2016; 7:412-8. [PMID: 27365960 PMCID: PMC4898111 DOI: 10.4103/0976-3147.176185] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Schizophrenia is a severe mental disorder. Cognitive deficits are one of the core features of schizophrenia. Multiple domains of cognition (executive function, attention/vigilance, working memory, verbal fluency, visuospatial skills, processing speed, and social cognition) are affected in patients with schizophrenia. Deficits in cognition led to impairment in the real world functioning. Identifying the cognitive deficits and early intervention is required for better functional outcome. This review focuses on conceptual understanding of cognition with its neurobiological correlates in schizophrenia and its different clinical implications.
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Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Meha Jain
- District Mental Health Program, National Health Mission, Raebareli, Uttar Pradesh, India
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Crespi BJ, Go MC. Diametrical diseases reflect evolutionary-genetic tradeoffs: Evidence from psychiatry, neurology, rheumatology, oncology and immunology. Evol Med Public Health 2015; 2015:216-53. [PMID: 26354001 PMCID: PMC4600345 DOI: 10.1093/emph/eov021] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/17/2015] [Indexed: 12/21/2022] Open
Abstract
Tradeoffs centrally mediate the expression of human adaptations. We propose that tradeoffs also influence the prevalence and forms of human maladaptation manifest in disease. By this logic, increased risk for one set of diseases commonly engenders decreased risk for another, diametric, set of diseases. We describe evidence for such diametric sets of diseases from epidemiological, genetic and molecular studies in four clinical domains: (i) psychiatry (autism vs psychotic-affective conditions), (ii) rheumatology (osteoarthritis vs osteoporosis), (iii) oncology and neurology (cancer vs neurodegenerative disorders) and (iv) immunology (autoimmunity vs infectious disease). Diametric disorders are important to recognize because genotypes or environmental factors that increase risk for one set of disorders protect from opposite disorders, thereby providing novel and direct insights into disease causes, prevention and therapy. Ascertaining the mechanisms that underlie disease-related tradeoffs should also indicate means of circumventing or alleviating them, and thus reducing the incidence and impacts of human disease in a more general way.
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Affiliation(s)
| | - Matthew C Go
- Department of Biological Sciences; Department of Archaeology, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6 Present address: Department of Anthropology, University of Illinois at Urbana-Champaign, 109 Davenport Hall, 607 S Mathews Avenue, Urbana, IL 61801, USA
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Brown EC, Gonzalez-Liencres C, Tas C, Brüne M. Reward modulates the mirror neuron system in schizophrenia: A study into the mu rhythm suppression, empathy, and mental state attribution. Soc Neurosci 2015; 11:175-86. [DOI: 10.1080/17470919.2015.1053982] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Prevost M, Brodeur M, Onishi KH, Lepage M, Gold I. Judging Strangers' Trustworthiness is Associated with Theory of Mind Skills. Front Psychiatry 2015; 6:52. [PMID: 25941495 PMCID: PMC4403288 DOI: 10.3389/fpsyt.2015.00052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 03/27/2015] [Indexed: 11/18/2022] Open
Abstract
Trusting people requires evaluating them to assess their trustworthiness. Evaluating a stranger's intentions is likely to be one method of assessing trustworthiness. The present study tested the hypothesis that judgments of trustworthiness are associated with mind reading skills, also called theory of mind (ToM). We tested a group of healthy participants and a group of patients with paranoid schizophrenia. Both groups made ToM judgments and judged the trustworthiness of strangers. Participants were also assessed for their disposition to trust as well as levels of paranoid belief. As anticipated, healthy participants had a normal ToM scores and patients with paranoid schizophrenia had poor ToM scores. In paranoid patients, better ability to read others' minds was associated with judging others as more trustworthy, while the reverse was found in the healthy participants (better mind reading was associated with judging others as less trustworthy), suggesting a non-linear relationship between trust in others and being able to read their intentions.
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Affiliation(s)
- Marie Prevost
- Department of Philosophy, McGill University, Montreal, QC, Canada
| | - Mathieu Brodeur
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | | | - Martin Lepage
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Ian Gold
- Department of Philosophy, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
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Ferri F, Costantini M, Salone A, Ebisch S, De Berardis D, Mazzola V, Arciero G, Ferro FM, Di Giannantonio M, Romani GL, Gallese V. Binding action and emotion in first-episode schizophrenia. Psychopathology 2014; 47:394-407. [PMID: 25277690 DOI: 10.1159/000366133] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 07/24/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Several components of social cognition are compromised in schizophrenia (SCZ) from the early stage of the illness. In this study we first investigated whether mirror neuron-driven embodied simulation (mnES) is altered in first-episode SCZ. Second, we tested whether emotional cues impact on the mnES in SCZ patients. METHODS Twenty-two SCZ patients and 22 healthy controls (HCs) observed goal-related actions in either a neutral or emotional context during functional magnetic resonance imaging scanning. RESULTS Observation of neutral action elicited a lower activity in the frontoparietal network in SCZ patients, as compared to HCs. Particularly, activation in the left inferior parietal lobule in response to the same condition negatively correlated with patients' self-experience disturbances. Moreover, observation of an action performed by an angry agent produced poorer neural activity in the right anterior insula in SCZ patients as compared to HCs. This difference was mostly due to the negative β-values shown by SCZ patients, which positively correlated with their empathy scores. No differences were found contingent upon the observation of an action performed by a happy agent. CONCLUSION Our results show that emotional cues allow SCZ patients to partially recover mnES. However, their understanding of the emotional components of the actions of others will likely remain deficient.
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Affiliation(s)
- Francesca Ferri
- Mind, Brain Imaging and Neuroethics, University of Ottawa Institute of Mental Health Research, Ottawa, Ont., Canada
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