Unraveling Apathy in Korsakoff Syndrome Patients Receiving Long-Term Care With and Without Cerebrovascular Comorbidity

When Do Korsakoff Patients Justify Immoral Behaviors? The Influence of Premorbid Delinquency and Self-Other Perspectives in Moral Decision-Making and Moral Reasoning

Korsakoff's syndrome (KS) is a chronic neuropsychiatric disorder caused by a vitamin B1 deficiency. KS is characterized by profound amnesia and often accompanied by poor executive functioning, decreased social-cognitive abilities, and difficulties in behavioral regulation. As moral behaviors and attitudes may provide insight in socio-behavioral interactions, the current study aimed to evaluate everyday moral maturity by administering self- versus other-oriented moral dilemmas in a group of KS patients (n = 20) and healthy controls (n = 20). Responses were scored according to the Kohlberg stages of moral reasoning. Furthermore, we assessed premorbid delinquency and current neurocognitive functioning as possible relevant factors. Our results show that KS patients were prone to lower levels of moral maturity when confronted with moral dilemmas relating to themselves, compared to dilemmas relating to (un)personal others in KS patients, while healthy subjects showed an opposite pattern. Moral immaturity could find its origin already before the onset of the KS diagnosis, as suggested by the elevated premorbid levels of delinquent behavior and correlation between premorbid delinquency and moral maturity in KS. Lower moral maturity could therefore be a possible predisposing factor to both delinquency and later development of Korsakoff's syndrome.

Impaired Awareness in People with Severe Alcohol-Related Cognitive Deficits Including Korskoff's Syndrome: A Network Analysis

BACKGROUND

Impaired awareness of one's own functioning is highly common in people with Korsakoff's syndrome (KS). However, it is currently unclear how awareness relates to impairments in daily functioning and quality of life (QoL).

METHODS

We assessed how impaired awareness relates to cognitive, behavioral, physical, and social functioning and QoL by applying a network analysis. We used cross-sectional data from 215 patients with KS or other severe alcohol-related cognitive deficits living in Dutch long-term care facilities (LTCFs).

RESULTS

Apathy has the most central position in the network. Higher apathy scores relate positively to reduced cognition and to a greater decline in activities of daily living and negatively to social participation and the use of antipsychotic drugs. Impaired awareness is also a central node. It is positively related to a higher perceived QoL, reduced cognition and apathy, and negatively to social participation and length of stay in the LTCF. Mediated through apathy and social participation, impaired awareness is indirectly related to other neuropsychiatric symptoms.

CONCLUSIONS

Impaired awareness is closely related to other domains of daily functioning and QoL of people with KS or other severe alcohol-related cognitive deficits living in LTCFs. Apathy plays a central role. Network analysis offers interesting insights to evaluate the interconnection of different symptoms and impairments in brain disorders such as KS.

Anticipatory and Anticipated Emotions in Regular and Non-regular Exercisers - A Qualitative Study

Future-oriented emotions could influence our decisions in everyday life and help understand why some individuals are physically active whilst others are not. Current literature distinguishes between two future-oriented emotion constructs: anticipatory and anticipated emotions. While anticipatory emotions are currently experienced emotions about a future event, anticipated emotions refer to the emotions that a person is expected to experience when confronted with a future event. The main aims of the present study were (1) to identify and describe (a) categories of anticipatory emotions experienced before exercise, and (b) categories of anticipated emotions expected to be experienced during and after exercise, and (2) to develop a theoretical model of anticipated emotion categories. Sixteen participants (M age = 26.03, SD = 6.66) were recruited for semi-structured interviews, and their statements were analyzed using principles of the Grounded Theory. In total, 13 different anticipatory and anticipated emotion categories were identified, such as enjoyment, anxiety, pride, self-anger, and relief. Anticipatory emotions seem to reflect the current affective valence of exercising and may be influenced by daily factors. With regards to anticipated emotions, the results show that regular exercisers anticipated also negative emotions such as anxiety, disappointment, and self-anger, and non-regular exercisers also anticipated positive emotions such as enjoyment, pride, and satisfaction. Therefore, future research should not only focus on the valence of future-oriented emotions, but should investigate the possible impact of specific anticipated emotions on exercise behavior. In addition, a theoretical model of anticipated emotion categories in exercise behavior derived from the interviews. The model outlines different categories of anticipated emotions based on appraisal processes. In conclusion, we assume that this developmental process of anticipated emotions may be embedded in a broader, cyclical process within the context of exercising.

Exploring the Impact of Individual and Social Antecedents on Teachers' Teaching Innovation: Perspective of Goal-Oriented Behavior and Social Identity

Many scholars have investigated education management. Scholars in the education field have made significant achievements in contributing to multiple educational reform policies, while other scholars discuss teacher-related issues from the perspective of organizational behavior. The teaching innovation of high school teachers plays a critical role in students' learning attitude and motivation, especially in the context of the COVID-19 pandemic. Teachers need to utilize more diversified teaching methods to enable students to carry out effective learning. In order to examine teachers' teaching innovation, this study explores teaching innovation intentions and performance from the perspective of individual and social factors in combination with goal-oriented behavior and social identity theory. This study conducts questionnaires with a sample of Chinese coastal high school teachers, and obtains a total of 475 responses. The research results show that innovation attitude, positive anticipated emotion, group norms and social identity positively affect teachers' teaching innovation intention; furthermore, teachers' teaching innovation intention also positively affects their teaching innovation performance. Based on the comprehensive research findings, this research proposes corresponding theoretical and practical implications.

Behavioral, Emotional and Social Apathy in Alcohol-Related Cognitive Disorders

Apathy is a fundamental neuropsychiatric symptom of Korsakoff's syndrome (KS) and has also been reported in patients with alcohol use disorder with no (AUD) or less severe cognitive impairments (ARCI). However, research on the nature of apathy is limited in these groups. Aim of this study was to examine the multidimensional nature of apathy in patients with KS, ARCI and AUD. Moreover, we examined differences between apathy ratings by patients and their professional caregivers, and related apathy to everyday functioning and overall cognition. Twenty-five patients with KS, 25 patients with ARCI and 23 patients with AUD participated in this study. Apathy was measured using the apathy motivation index (AMI), which distinguishes behavioral, emotional and social apathy. Both patients and professional caregivers reported social apathy as the most prominent symptom, compared to behavioral and emotional apathy. Apathy ratings did not differ across the three patient groups. Discrepancies between patient and caregiver ratings were observed in patients with KS and ARCI, with more severe apathy reported by caregivers. Caregiver-reported behavioral and social, but not emotional, apathy was related to everyday functioning. These results show that apathy is present in a substantial proportion of patients with alcohol addiction with or without cognitive impairments.