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Bogaert L, Hallford D, Loyen E, D'Argembeau A, Raes F. Recalling and anticipating positive events to improve the positive affect and mental health of adolescents: A cluster randomized controlled trial in secondary schools. Behav Res Ther 2024; 179:104543. [PMID: 38744140 DOI: 10.1016/j.brat.2024.104543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024]
Abstract
This cluster randomized controlled trial examined the effectiveness of Positive Events Training (PET), a combined group training aimed at simultaneously improving positive autobiographical memory (AM) and episodic future thinking (EFT) among adolescents (12-16 years). Delivered as a universal school-based program, PET was compared with an active (creative writing) control group (CREAT). Effects on resilience, wellbeing, positive emotions, emotional response styles towards positive emotions (savoring, dampening), anhedonia, depressive symptoms, and multiple AM and EFT indices were examined. Adolescents (NPET = 95, NCREAT = 93) completed self-report scales at baseline, post-training and two-month follow-up. Multilevel models revealed that PET led to significant improvements in certain AM and EFT skills. Moreover, a decrease in anhedonia was observed at post-training. However, this effect did not withstand correction for multiple testing. Absence of changes in the other outcomes should be interpreted within the context of the universal school-based approach and the potential limited scope for detectable changes. Exploratory analyses suggest the importance of further investigating PET's potential in addressing positive affect dysregulations in indicated samples, and exploring perceived likelihood of generated future events and dampening as potential underlying mechanisms. Study limitations and future directions to maximize the demonstrated potential of PET are discussed.
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Affiliation(s)
- L Bogaert
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
| | - D Hallford
- School of Psychology, Deakin University, 1 Gheringhap Road, Geelong, Australia
| | - E Loyen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
| | - A D'Argembeau
- Psychology and Neuroscience of Cognition Research Unit, Department of Psychology, University of Liège, Belgium
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
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Pillny M, Hallford DJ, Böge K. The Nature of Mental Imagery and Its Relationship With Amotivational Psychopathology in People With Schizophrenia Spectrum Disorders. Behav Ther 2024; 55:885-897. [PMID: 38937057 DOI: 10.1016/j.beth.2024.01.009] [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] [Received: 04/14/2023] [Revised: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 06/29/2024]
Abstract
Many people with schizophrenia spectrum disorders (SSDs) experience profound amotivation, which is strongly related to anticipatory anhedonia. Yet, the neuropsychological fundamentals of anticipatory anhedonia and amotivation are barely understood, resulting in a lack of effective treatments for these patients. Aberrancies in positive mental imagery may interfere with the anticipation of pleasure and could thus explain anticipatory anhedonia and amotivation. However, the nature of mental imagery and its relationship with amotivational psychopathology in SSD is largely unknown. In this preregistered study, we therefore examined mental imagery characteristics and their relation to anticipatory anhedonia, amotivation, and daily life activity in SSD. TheN = 86 participants included individuals with SSD (n = 43) and demographically matched healthy controls (n = 43). Mental imagery, anticipatory pleasure, amotivation, and activity engagement were assessed with structured interviews and self-report questionnaires. Ecological momentary assessment was used to measure state anticipatory pleasure and activity engagement in daily life (n = 81). Compared to the control group, the SSD group showed comparable quantity, but less vividness of mental imagery. Reduced vividness of mental imagery in SSD was significantly associated with higher anticipatory anhedonia, amotivation, and low activity engagement in cross-sectional and prospective analyses. Reduced mental imagery vividness may cause a lack of internal incentive to seek pleasurable experiences and could explain amotivation. Interventions aiming to improve mental imagery vividness and related anticipatory pleasure responses in SSD may be effective in targeting amotivation.
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Gkintoni E, Skokou M, Gourzis P. Integrating Clinical Neuropsychology and Psychotic Spectrum Disorders: A Systematic Analysis of Cognitive Dynamics, Interventions, and Underlying Mechanisms. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:645. [PMID: 38674291 PMCID: PMC11051923 DOI: 10.3390/medicina60040645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: The study aims to provide a comprehensive neuropsychological analysis of psychotic spectrum disorders, including schizophrenia, bipolar disorder, and depression. It focuses on the critical aspects of cognitive impairments, diagnostic tools, intervention efficacy, and the roles of genetic and environmental factors in these disorders. The paper emphasizes the diagnostic significance of neuropsychological tests in identifying cognitive deficiencies and their predictive value in the early management of psychosis. Materials and Methods: The study involved a systematic literature review following the PRISMA guidelines. The search was conducted in significant databases like Scopus, PsycINFO, PubMed, and Web of Science using keywords relevant to clinical neuropsychology and psychotic spectrum disorders. The inclusion criteria required articles to be in English, published between 2018 and 2023, and pertinent to clinical neuropsychology's application in these disorders. A total of 153 articles were identified, with 44 ultimately included for detailed analysis based on relevance and publication status after screening. Results: The review highlights several key findings, including the diagnostic and prognostic significance of mismatch negativity, neuroprogressive trajectories, cortical thinning in familial high-risk individuals, and distinct illness trajectories within psychosis subgroups. The studies evaluated underline the role of neuropsychological tests in diagnosing psychiatric disorders and emphasize early detection and the effectiveness of intervention strategies based on cognitive and neurobiological markers. Conclusions: The systematic review underscores the importance of investigating the neuropsychological components of psychotic spectrum disorders. It identifies significant cognitive impairments in attention, memory, and executive function, correlating with structural and functional brain abnormalities. The paper stresses the need for precise diagnoses and personalized treatment modalities, highlighting the complex interplay between genetic, environmental, and psychosocial factors. It calls for a deeper understanding of these neuropsychological processes to enhance diagnostic accuracy and therapeutic outcomes.
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Affiliation(s)
- Evgenia Gkintoni
- Department of Psychiatry, University General Hospital of Patras, 26504 Patras, Greece; (M.S.); (P.G.)
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Lakshmi PM, Kishore MT, Roopesh BN, Jacob P, Rusanov D, Hallford DJ. Future thinking and anticipatory pleasure in adolescents with major depression: Association with depression symptoms and executive functions. Clin Child Psychol Psychiatry 2024; 29:526-539. [PMID: 37807910 DOI: 10.1177/13591045231205004] [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: 10/10/2023]
Abstract
OBJECTIVE Impairments in episodic future thinking and anticipatory pleasure were noted to explain the depressive symptoms in adults however similar studies are not there in adolescents. This study examined whether there are impairments in episodic future thinking and anticipatory pleasure in clinically-depressed adolescents as compared to non-depressed adolescents, and their association with depression when controlled for executive functions and anxiety symptoms among the depressed adolescents. METHODS The study included 29 adolescents with major depression and 29 adolescents from local schools through convenient sampling technique. All the participants were assessed with standardized measures of depression and anxiety, episodic future thinking, anticipatory pleasure and executive functioning. RESULTS Depressed adolescents significantly differed from the non-depressed adolescents in autobiographical memory specificity, anticipatory pleasure, and specific dimensions of executive functions. The ANCOVAs indicated executive function slightly attenuated group differences on future specificity which were still non-significant (all p's > .05). For memory specificity and for anticipatory pleasure, group differences were still significant at p < .05 level. CONCLUSION Adolescents with major depressive episode may display similar, but less pronounced, impairments in future thinking than what is previously reported in adults. Though, autobiographical specificity is prominent. The deficits are attributable to depression than executive functioning deficits.
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Affiliation(s)
- Pooja M Lakshmi
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - M Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Bangalore N Roopesh
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Preeti Jacob
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Hallford D, Woolfit M, Follett A, Jones E, Harrison O, Austin D. Guided recall of positive autobiographical memories increases anticipated pleasure and psychological resources, and reduces depressive symptoms: a replication and extension of a randomised controlled trial of brief positive cognitive-reminiscence therapy. Memory 2024; 32:465-475. [PMID: 38588666 DOI: 10.1080/09658211.2024.2333510] [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: 08/27/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
Reminiscence-based interventions focus on recalling autobiographical memories and reflective reasoning to develop a healthy and adaptive view of oneself and one's life. This study aimed to replicate the effects of a three-session, group-based, positive-memory version of cognitive-reminiscence therapy (CRT) on psychological resources and mental well-being and extend the findings to anticipated pleasure. The participants (N = 75, Mage = 43.7 (SD = 16.7), 60% females) were randomised to CRT or control group. Anticipated pleasure, psychological resources (schemas of positive self-esteem, self-efficacy, meaning in life, optimism), mental well-being (depression, anxiety, and stress symptoms) and theorised change processes (automatic negative thoughts, awareness of narrative identity) were assessed. Relative to the control group, the CRT group reported significantly higher anticipated pleasure (d = 0.76-0.93) and psychological resources of self-esteem, self-efficacy, and optimism (d's = 0.58-0.99) at post-CRT and follow-up, and lower depressive symptoms post-CRT and at follow-up (d = 0.56-0.67). Findings on meaning in life and negative automatic thinking were partially replicated. This study replicates findings of the effectiveness of this intervention for improving psychological resources such as self-worth, confidence and optimism and depressive symptoms, and indicates additional effects on anticipated pleasure. CRT may serve as a standalone intervention, or as an adjunct "memory booster" for interventions focused on future thinking and related anticipated reward.
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Affiliation(s)
- David Hallford
- School of Psychology, Deakin University, Geelong, Victoria, Melbourne, Australia
| | - Meg Woolfit
- School of Psychology, Deakin University, Geelong, Victoria, Melbourne, Australia
| | - Alicia Follett
- School of Psychology, Deakin University, Geelong, Victoria, Melbourne, Australia
| | - Elizabeth Jones
- School of Psychology, Deakin University, Geelong, Victoria, Melbourne, Australia
| | - Ollie Harrison
- School of Psychology, Deakin University, Geelong, Victoria, Melbourne, Australia
| | - David Austin
- School of Psychology, Deakin University, Geelong, Victoria, Melbourne, Australia
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Ji JL, MacLeod C. Less bang for my buck: Diminished anticipated enjoyment contributes to dysphoria-linked deficit in activity behavioural engagement choice. Behav Res Ther 2024; 177:104526. [PMID: 38598897 DOI: 10.1016/j.brat.2024.104526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/04/2024] [Accepted: 03/27/2024] [Indexed: 04/12/2024]
Abstract
This study experimentally investigated the role of anticipated enjoyment and effort in mediating dysphoria-related deficit in activity engagement behavioural choice. Using a novel activity information processing task (about a fictional "new" Nintendo Wii sports game called "Tornado Ball"), N = 249 participants (n = 95 High Dysphoria; n = 154 Low Dysphoria) were presented information about the benefits (enjoyable features) and costs (mental and physical effort barriers) as product reviews from another player. The order of cost vs. benefit information was manipulated such that participants either heard cost information before benefit information, or vice versa. They then rated what their anticipated enjoyment and effort will be if they were to play Tornado Ball, before being given the opportunity to choose to try it themselves or not. The High Dysphoria group reported lower anticipated enjoyment (but not higher effort) relative to the Low Dysphoria group, but only when cost information was presented first. Importantly, a moderated mediation showed that the High Dysphoria group reported lower tendency to choose activity engagement (game play) as a function of having lower anticipated enjoyment, but only when cost information was presented first. The present finding indicate that reduced anticipated enjoyment may causally contribute to dysphoria-linked deficits in activity engagement behavioural choice.
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Affiliation(s)
- Julie L Ji
- School of Psychology, University of Plymouth, UK; Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia.
| | - Colin MacLeod
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia
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Loyen E, Bogaert L, Hallford DJ, D'Argembeau A, Raes F. Study protocol for a randomized controlled trial of the RASPERA project: recalling and anticipating specific positive events to boost resilience in adolescents. Front Public Health 2023; 11:1216988. [PMID: 38074707 PMCID: PMC10704171 DOI: 10.3389/fpubh.2023.1216988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background Many stress-related mental health problems, like depression and anxiety, emerge during adolescence, with some recent studies suggesting numbers are increasing. One possible way to reduce adolescents' vulnerability to stress-related mental health problems is to increase their resilience by training them in recalling specific positive memories and anticipating specific positive future events. Therefore, an innovative combi-training (called Positive Events Training; PET) was developed, focusing on the enhancement of the specificity of both past and future positive autobiographical events in adolescents. Its effects on adolescents' resilience and mental wellbeing will be examined. Methods A cluster randomized controlled trial with a 2 (condition) × 3 (time-point) factorial design was conducted. Classes of adolescents were randomized to either a PET program (intervention) or a CREAtive writing Training (CREAT) program (active control). Both trainings consisted of four sessions of 50 min (one session, weekly, for four consecutive weeks) and were delivered in schools. Before (pre-training, T1), immediately after (post-training, T2), and 2 months after the training (follow-up, T3), participants completed a series of self-report questionnaires. Primary outcomes are resilience and mental wellbeing. Secondary outcomes are positive affect, positive affect regulation and anhedonia. CONSORT criteria for conducting and reporting RCTs will be used. Ethics and dissemination Ethical approval was obtained from the Social and Societal Ethics Committee (SMEC) and the study has been preregistered on Open Science Framework (OSF) and ClinicalTrials.gov (Trial registration number: NCT05757180). We plan to develop a free, online, web-based self-directed PET protocol for teachers if the study provides evidence for the effectiveness of the PET program in increasing adolescents' resilience and mental wellbeing, so teachers can deliver the program to future students without the need of professional external trainers.
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Affiliation(s)
- Eline Loyen
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- KU Leuven Child and Youth Institute, KU Leuven, Leuven, Belgium
| | - Liesbeth Bogaert
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- KU Leuven Child and Youth Institute, KU Leuven, Leuven, Belgium
| | | | - Arnaud D'Argembeau
- Psychology and Neuroscience of Cognition Research Unit, Department of Psychology, University of Liège, Liège, Belgium
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- KU Leuven Child and Youth Institute, KU Leuven, Leuven, Belgium
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Tsilosani A, Chan K, Steffens A, Bolton TB, Kowalczyk WJ. Problematic social media use is associated with depression and similar to behavioral addictions: Physiological and behavioral evidence. Addict Behav 2023; 145:107781. [PMID: 37356318 DOI: 10.1016/j.addbeh.2023.107781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/19/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
While many studies have examined the relationship between problematic social media use (PSMU) and mental health disorders, little is known about reward responsiveness mechanisms that might be driving this relationship and the neurophysiological characteristics of PSMU. We surveyed 96 undergraduate students at a private liberal arts college in upstate NY. PSMU was assessed using the Social Media Disorder Scale. Fourteen Individuals endorsing in five or more and three or less categories on the Social Media Disorder Scale were offered and underwent resting state QEEG. Mental health was assessed with the Center for Epidemiological Studies Depression Scale Short Form, Social Interaction Anxiety Scale, Penn State Worry Questionnaire, the 10-item Perceived Stress Scale, and a locally developed measure of Substance Use Disorder. Reward and motivational systems were studied using the Brief Sensation Seeking Scale, Behavioral Inhibition/Behavioral Activation Scale, and Temporal Experience of Pleasure Scale. SMDS scores were associated with poorer mental health on all measures except substance use. SMDS scores were positively associated with the behavioral inhibition scale, and the anticipatory pleasure scale. QEEG results revealed a negative association of high PSMU and right central and frontal lobeta, right central beta, and a positive association with frontal alpha asymmetry. The study replicates findings that PSMU is associated with mental health issues. Further the pattern of reward response is different compared with other addictive behaviors. QEEG results are consistent with previous work in substance use and depression.
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Affiliation(s)
- Akaki Tsilosani
- Hartwick College, Department of Psychology, 1 Hartwick Dr, Oneonta, NY 13820, United States; Albany Medical College, Department of Regenerative and Cancer Cell Biology, 43 New Scotland Ave, Albany, NY 12208, United States.
| | - KinHo Chan
- Hartwick College, Department of Psychology, 1 Hartwick Dr, Oneonta, NY 13820, United States; Hamilton College, 198 College Hill Road, Clinton, NY 13323, United States.
| | - Adriana Steffens
- Mind Matters Regional Neurofeedback Centers, 189 Main Street, Oneonta, NY 13820, United States.
| | - Thomas B Bolton
- Hamilton College, 198 College Hill Road, Clinton, NY 13323, United States.
| | - William J Kowalczyk
- Hartwick College, Department of Psychology, 1 Hartwick Dr, Oneonta, NY 13820, United States.
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Fung ACO, Zhang RT, Yip SSL, Poon GKS, Cheng CW, Yang TX, Lui SSY, Chan RCK. Prospection deficits in patients with first-episode schizophrenia: a cross-sectional comparative study. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:36. [PMID: 37270630 DOI: 10.1038/s41537-023-00365-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/15/2023] [Indexed: 06/05/2023]
Abstract
Prospection refers to the ability to simulate and pre-experience future events. Schizophrenia patients have difficulty in anticipating pleasure in future events, but previous studies examined prospection deficits in chronic schizophrenia patients. This study aimed to investigate prospection deficits in first-episode schizophrenia patients. Thirty first-episode schizophrenia patients and 31 healthy controls completed the Affective Prospection Task, which utilized pictorial cues to involve positive, neutral and negative prospection. Participants' ratings regarding the phenomenal characteristics of their prospected events were collected, and their prospected narratives were coded using a valid scoring manual. We also assessed intelligence, working memory and logical memory. The results showed, in all participants, valence of the cues significantly influenced participants' sense of pre-experience, temporal distance, emotion experience, vividness and participation of the prospected events, as well as the richness of sensory details. The two groups did not differ in self-report phenomenal characteristics of their prospected events. For coded characteristics, schizophrenia patients' prospected narratives were less rich in thought/emotion than controls, even after controlling for intelligence and memory deficits. We extended empirical evidence for prospection deficits from chronic schizophrenia samples to first-episode schizophrenia patients.
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Affiliation(s)
| | - Rui-Ting Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, Hunan Normal University, Chansha, China
- Cognition and Human Behaviour Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Stanley S L Yip
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Grace K S Poon
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Chi-Wai Cheng
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Tian-Xiao Yang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Schormann ALA, Pillny M, Haß K, Lincoln TM. "Goals in Focus"-a targeted CBT approach for motivational negative symptoms of psychosis: study protocol for a randomized-controlled feasibility trial. Pilot Feasibility Stud 2023; 9:72. [PMID: 37131247 PMCID: PMC10152726 DOI: 10.1186/s40814-023-01284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 03/28/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The reduction of goal-directed behavior is the main characteristic in motivational negative symptoms of psychosis as it accounts for the long-term decline in psychological well-being and psychosocial functioning. However, the available treatment options are largely unspecific and show only small effects on motivational negative symptoms. Interventions that directly target the relevant psychological mechanisms are likely to be more effective. For "Goals in Focus", we translated findings from basic clinical research on mechanisms underlying motivational negative symptoms into a tailored and comprehensive novel psychological outpatient treatment program. With this study, we will test the feasibility of the therapy manual and the trial procedures. We also aim to examine first estimates of the effect size that can be expected from "Goals in Focus" to inform the sample size calculation of a subsequent fully powered trial. METHODS Thirty participants diagnosed with a schizophrenia spectrum disorder and at least moderate motivational negative symptoms will be randomly assigned to either 24 sessions of "Goals in Focus" over the course of 6 months (n = 15) or to a 6-month wait-list control group (n = 15). Single-blind assessments will be conducted at baseline (t0) and 6 months after baseline completion (t1). Feasibility outcomes include patient recruitment, retention, and attendance rates. Acceptability will be rated by trial therapists and by participants at end of treatment. Primary outcome for effect size estimation is the motivational negative symptom subscale sum score of the Brief Negative Symptom Scale at t1 corrected for baseline values. Secondary outcomes include psychosocial functioning, psychological well-being, depressive symptoms, expressive negative symptoms, negative symptom factor scores, and goal pursuit in everyday life. DISCUSSION The feasibility and acceptability data will be used to improve trial procedures and the "Goals in Focus" intervention where necessary. The treatment effect on the primary outcome will provide the basis for the sample size calculation for a fully powered RCT. TRIAL REGISTRATION 1) ClinicalTrials.gov, NCT05252039 . Registered on 23 February 2022. 2) Deutsches Register Klinischer Studien, DRKS00018083 . Registered on 28 August 2019.
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Affiliation(s)
- Alisa L A Schormann
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany.
| | - Matthias Pillny
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany
| | - Katharina Haß
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany
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11
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Depping MS, Köhler-Ipek L, Ullrich P, Hauer K, Wolf RC. [Late-life depression and frailty-Epidemiological, clinical and neurobiological associations]. DER NERVENARZT 2023; 94:234-239. [PMID: 36799956 PMCID: PMC9992046 DOI: 10.1007/s00115-023-01444-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Depression is the most common mental disorder in older adults and is influenced by age-related processes. Frailty is a well-established clinical expression of ageing that implies a state of increased vulnerability to stressor events as well as increased risks of disability, hospitalization and death. Neurobiological findings will disentangle the comorbidity of frailty and depression and may inform future management of depression in old age. OBJECTIVE This narrative review provides an overview of the comorbidity of late-life depression and frailty, with a focus on neuroscientific findings that are organized within the research domain criteria (RDoC) framework. RESULTS More than one third of old people with depression are affected by frailty, which results in more chronic depression and in poorer efficacy and tolerability of antidepressant medication. Depression and frailty share motivational and psychomotor characteristics, particularly apathy, decreased physical activity and fatigue. In patients with frailty, altered activity of the supplementary motor cortex is associated with motor performance deficits. Patients with late-life depression and apathy are characterized by abnormal structure and altered functional connectivity of the reward network and the salience network, along with altered functional connectivity of these networks with premotor brain areas. CONCLUSION Identifying frailty in older adults with depression is relevant for prognostic assessment and treatment. A better understanding of the neuronal mechanisms of comorbidity will provide potential targets for future personalized therapeutic interventions.
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Affiliation(s)
- M S Depping
- Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Voßstr. 4, 69115, Heidelberg, Deutschland.
| | - L Köhler-Ipek
- Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Voßstr. 4, 69115, Heidelberg, Deutschland
| | - P Ullrich
- Geriatrisches Zentrum an der Medizinischen Fakultät der Universität Heidelberg, Agaplesion Bethanien Krankenhaus Heidelberg, Rohrbacher Str. 149, 69126, Heidelberg, Deutschland
| | - K Hauer
- Geriatrisches Zentrum an der Medizinischen Fakultät der Universität Heidelberg, Agaplesion Bethanien Krankenhaus Heidelberg, Rohrbacher Str. 149, 69126, Heidelberg, Deutschland
| | - R C Wolf
- Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Voßstr. 4, 69115, Heidelberg, Deutschland
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12
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Oh J, Lee E, Cha EJ, Seo HJ, Choi KH. Community-based multi-site randomized controlled trial of behavioral activation for patients with negative symptoms of schizophrenia. Schizophr Res 2023; 252:118-126. [PMID: 36640745 DOI: 10.1016/j.schres.2022.12.051] [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] [Received: 03/18/2022] [Revised: 07/13/2022] [Accepted: 12/30/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Negative symptoms are closely related to the poor prognosis of schizophrenia, for which there is no effective treatment to date. Behavioral activation (BA), which is an effective treatment for depression, is a behavioral approach that targets low levels of response-contingent positive reinforcement. This study aimed to explore BA as an effective intervention for relieving the negative symptoms of schizophrenia. METHODS This was a randomized single-blind controlled trial. Eighty-four patients with schizophrenia were enrolled in community mental health settings. Excluding 14 patients who opted out of the study, 70 were randomly assigned to receive BA in addition to treatment-as-usual (BA + TAU) or treatment-as-usual (TAU) only. Negative symptoms were assessed using the Clinical Assessment Interview for Negative Symptoms (CAINS) and Brief Negative Symptom Scale (BNSS) at baseline, post-treatment, and 6-months follow-up. RESULTS Significant differences between the BA + TAU and TAU only groups were observed in the measures of negative symptoms post-treatment. The total score of CAINS was significantly decreased after BA treatment (η2 = 0.13). The tendency of the BA + TAU treatment effect was also observed for the BNSS total score and PANSS negative symptom subscale (η2 = 0.10 and η2 = 0.11, respectively). However, the difference between the two groups was not sustained at the six-month follow-up. CONCLUSIONS Our findings suggest that BA could be a promising time-limited and structured psychosocial intervention for schizophrenia-associated negative symptoms with the merit of easy dissemination. Further studies are needed to examine the factors involved in sustaining improvement.
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Affiliation(s)
- Jihye Oh
- Department of Psychiatry, Catholic University of Korea, College of Medicine, Republic of Korea
| | - Eunbyeol Lee
- Department of Psychology, Korea University, Republic of Korea
| | - Eun Ji Cha
- Department of Psychology, Korea University, Republic of Korea
| | - Ho-Jun Seo
- Department of Psychiatry, St. Vincent's Hospital, Catholic University of Korea, College of Medicine, Republic of Korea.
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Republic of Korea.
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Ren J, Wu Z, Peng D, Huang J, Xia W, Xu J, Wang C, Cui L, Fang Y, Zhang C. Changes of anhedonia and cognitive symptoms in first episode of depression and recurrent depression, an analysis of data from NSSD. J Affect Disord 2023; 321:47-55. [PMID: 36273683 DOI: 10.1016/j.jad.2022.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/05/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Anhedonia and cognitive impairment are core features of major depressive disorder (MDD), and are essential to the treatment and prognosis. Here, we aimed to investigate anhedonia and its cognitive correlates between first episode of depression (FED) and recurrent depression (RD), which was part of the National Survey on Symptomatology of Depression. METHODS In this study, 1400 drug naïve FED patients and 487 on medicine RD patients were included. Differences of anhedonia, cognitive symptoms and other clinical characteristics between groups were compared via Student's t-test, or the chi-square test as appropriate. Partial correlation analysis was used to analyze the correlations between anhedonia and cognitive symptoms after adjusting for potential confounders. A stepwise logistic regression analysis was performed to identify relapse risk factors among symptomatic variables, demographic factors, clinical characteristics and medication use. RESULTS Compared to FED, RD patients displayed more comprehensive depressive, impaired cognitive and anhedonia symptoms. Cognitive symptoms were significantly related with the anhedonia symptoms with varying aspects. Patients taking emotional stabilizers displayed more abnormal cognitive symptoms, followed by benzodiazepines, and finally SSRIs, SNRIs and TCAs. The effect of drug use on anhedonia is not as extensive as that of cognitive symptoms. CONCLUSION Collectively, the results of this investigation advance the knowledge on changes in anhedonia and cognitive symptoms in MDD. LIMITATIONS As this is a cross sectional study, it is difficult to draw any causal conclusions between cognitive impairment and anhedonia in MDD, and to ascertain the worse cognitive performances identified here were induced by current drug use.
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Affiliation(s)
- Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiguo Wu
- Shanghai Yangpu District Mental Health Center, Shanghai, China; Clinical Research Center in Mental Health, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Daihui Peng
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia Huang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiping Xia
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Xu
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenglei Wang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lvchun Cui
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Fang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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McIntyre RS, Ismail Z, Watling CP, Weiss C, Meehan SR, Musingarimi P, Thase ME. Patient-reported outcome measures for life engagement in mental health: a systematic review. J Patient Rep Outcomes 2022; 6:62. [PMID: 35689159 PMCID: PMC9187792 DOI: 10.1186/s41687-022-00468-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/17/2022] [Indexed: 01/07/2023] Open
Abstract
Background Life engagement in the context of mental health is a broad term that describes positive health aspects relating to cognition, vitality, motivation and reward, and the ability to feel pleasure—concepts that are meaningful to patients. The aim of this systematic literature review was to identify validated patient-reported outcomes (PROs) that can assess any aspect of life engagement in adults, in the field of general mental health. Methods This was a systematic literature review of articles in English from the MEDLINE database (date of search: September 9, 2020). The search strategy had three components: (1) terms to capture PROs; (2) terms to capture mental health; and (3) terms to capture aspects of life engagement. Articles were eligible if they included a PRO that: (1) is named; (2) can be used across mental health disorders; (3) is used to assess any aspect of life engagement; and (4) has undergone psychometric validation and/or qualitative content validation. A list of PROs was extracted. Results A total of 1585 records were screened and 233 articles were eligible for inclusion. Within these 233 articles, 49 distinct PROs were identified, two of which specifically captured their authors’ interpretation of life engagement: the Engaged Living Scale (ELS) and the Life Engagement Test (LET). However, while the ELS and LET covered motivation and reward, life fulfillment, and value-based living, neither scale captured the cognitive or vitality aspects of life engagement. The remaining identified PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy–apathy, pleasure–anhedonia, and mental/psychological well-being. Conclusion Numerous PROs are available that may capture aspects of life engagement. However, a need remains for a new PRO that can be used in clinical trials to provide a more comprehensive description of the improvements in life engagement that patients with mental health disorders may experience with successful treatment.
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Hallford DJ, Rusanov D, Yeow JJE, Austin DW, D’Argembeau A, Fuller-Tyszkiewicz M, Raes F. Reducing Anhedonia in Major Depressive Disorder with Future Event Specificity Training (FEST): A Randomized Controlled Trial. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10330-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background
Improving future thinking, such as characteristics of specificity, detail, and use of mental imagery, may be one means to reduce anhedonia, particularly in a Major Depressive Episode (MDE) in which future thinking is impaired. The current study aimed to test this using a validated program, Future Event Specificity Training (FEST).
Methods
Participants (N = 177; 80.8% women; M age = 43.7, SD = 11.8) with a current depressive episode with anhedonia and high symptom severity were randomized to FEST or no FEST. Future thinking, anhedonia-related variables, and other clinical outcomes were assessed at baseline, one- and three-month follow-up.
Results
Relative to the control group, FEST was associated with significantly improved future thinking characteristics, a reduced likelihood of anhedonia (35.1% vs. 61.1%, p = .015), improvements on other anhedonia-related variables such as anticipatory (d = 0.63, p = .004) and anticipated pleasure for future events (d = 0.77, p < .001), and desirable clinical outcomes such as less people meeting criteria for an MDE (37.8% vs. 64.8%, p = .011), higher behavioural activation (d = 0.71, p = .001) and improved global functioning (d = 0.52, p = .017). Changes in future thinking were found to mediate the effect of FEST on anhedonia.
Conclusion
The quality of future thinking can be enhanced in Major Depression, and this leads to a substantially reduced likelihood of anhedonia, other significant clinical effects, and functional gains.
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16
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Lüdtke T, Westermann S. Negative expectations regarding interpersonal interactions in daily life are associated with subclinical depressive symptoms in a student sample: A prospective experience sampling study. MOTIVATION AND EMOTION 2022. [DOI: 10.1007/s11031-022-09985-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractDysfunctional expectations and interpersonal problems are associated with depression, so we measured expected emotions towards interaction partners and compared them with actual emotions. We hypothesized that, between persons, individuals with higher subclinical depression would display stronger, more stable, and less accurate negative expectations. Within persons, we hypothesized that momentary negative expectations would predict subsequent negative affect. Fifty-three students completed 6 days of Experience Sampling, consisting of one morning expectation-assessment (9 am), three assessments on actual interpersonal emotions (1 pm, 5 pm, 9 pm), and six random affect-assessments. We regressed expected emotions, experienced emotions, expectation fluctuations, and expectation violations on subclinical depression. Using mixed model analyses, we further examined whether negative expectations preceded negative affect, and whether expectation violations preceded adjustments of expectations. Higher subclinical depression predicted more negative expectations. Within persons, worse-than-expected interpersonal interactions preceded negative affect whereas better-than-expected interactions preceded reductions of negative expectations. Despite problems with skewed data, our approach appears well-suited to examine interpersonal expectations in vivo.
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17
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van Os J, Pries LK, Ten Have M, de Graaf R, van Dorsselaer S, Delespaul P, Bak M, Kenis G, Lin BD, Luykx JJ, Richards AL, Akdede B, Binbay T, Altınyazar V, Yalınçetin B, Gümüş-Akay G, Cihan B, Soygür H, Ulaş H, Cankurtaran EŞ, Kaymak SU, Mihaljevic MM, Petrovic SA, Mirjanic T, Bernardo M, Mezquida G, Amoretti S, Bobes J, Saiz PA, García-Portilla MP, Sanjuan J, Aguilar EJ, Santos JL, Jiménez-López E, Arrojo M, Carracedo A, López G, González-Peñas J, Parellada M, Maric NP, Atbaşoğlu C, Ucok A, Alptekin K, Saka MC, Arango C, O'Donovan M, Rutten BPF, Guloksuz S. Evidence, and replication thereof, that molecular-genetic and environmental risks for psychosis impact through an affective pathway. Psychol Med 2022; 52:1910-1922. [PMID: 33070791 DOI: 10.1017/s0033291720003748] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation. METHODS We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls. RESULTS The impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: -0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465). CONCLUSIONS The results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.
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Affiliation(s)
- Jim van Os
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Margreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- FACT, Mondriaan Mental Health, Maastricht, The Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- FACT, Mondriaan Mental Health, Maastricht, The Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bochao D Lin
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- GGNet Mental Health, Apeldoorn, The Netherlands
| | - Alexander L Richards
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Berna Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tolga Binbay
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Vesile Altınyazar
- Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Berna Yalınçetin
- Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Güvem Gümüş-Akay
- Department of Physiology, School of Medicine, Ankara University, Ankara, Turkey
- Brain Research Center, Ankara University, Ankara, Turkey
| | - Burçin Cihan
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Haldun Soygür
- Turkish Federation of Schizophrenia Associations, Ankara, Turkey
| | - Halis Ulaş
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey (Discharged by statutory decree No:701 at 8 July 2018 because of signing 'Peace Petition')
| | | | | | - Marina M Mihaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Sanja Andric Petrovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Tijana Mirjanic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Julio Bobes
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Pilar A Saiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - María Paz García-Portilla
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Julio Sanjuan
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Eduardo J Aguilar
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - José Luis Santos
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
| | - Estela Jiménez-López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel Carracedo
- Grupo de Medicina Genómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
- Fundación Pública Galega de Medicina Xenómica (SERGAS), IDIS, Santiago de Compostela, Spain
| | - Gonzalo López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier González-Peñas
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nadja P Maric
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alp Ucok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Meram Can Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Celso Arango
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Michael O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Metamotivation in people diagnosed with schizophrenia: A conceptual introduction and qualitative study. Schizophr Res 2022; 243:317-321. [PMID: 34325963 PMCID: PMC9115774 DOI: 10.1016/j.schres.2021.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/22/2021] [Accepted: 06/14/2021] [Indexed: 11/22/2022]
Abstract
Negative symptoms, such as avolition, are considered to be some of the most debilitating symptoms of schizophrenia, yet the mechanisms that contribute to their formation and persistence are poorly understood. In this article, we introduce a novel concept, metamotivation, as having potential implications for avolition, a core negative symptom. Metamotivation is defined as the ability to identify, monitor, and self-regulate motivation in service of goal attainment. In order to explore the potential applicability of metamotivation to schizophrenia spectrum populations, qualitative data from semi-structured interviews were thematically analyzed from 21 people diagnosed with schizophrenia or schizoaffective disorder. Four core themes emerged from the analysis: motivation as unmalleable, motivation as self- regulated primarily through rewards and/or a focus on task outcome, motivation as effortless actions, and motivation as a pleasurable feeling. We discuss these findings with respect to potential inadequacies/errors in motivational knowledge that may occur in people with schizophrenia, which may in turn be implicated in the development and maintenance of avolition. We conclude that metamotivation is a valuable concept for understanding schizophrenia with important research and clinical implications.
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Abram SV, Weittenhiller LP, Bertrand CE, McQuaid JR, Mathalon DH, Ford JM, Fryer SL. Psychological Dimensions Relevant to Motivation and Pleasure in Schizophrenia. Front Behav Neurosci 2022; 16:827260. [PMID: 35401135 PMCID: PMC8985863 DOI: 10.3389/fnbeh.2022.827260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Motivation and pleasure deficits are common in schizophrenia, strongly linked with poorer functioning, and may reflect underlying alterations in brain functions governing reward processing and goal pursuit. While there is extensive research examining cognitive and reward mechanisms related to these deficits in schizophrenia, less attention has been paid to psychological characteristics that contribute to resilience against, or risk for, motivation and pleasure impairment. For example, psychological tendencies involving positive future expectancies (e.g., optimism) and effective affect management (e.g., reappraisal, mindfulness) are associated with aspects of reward anticipation and evaluation that optimally guide goal-directed behavior. Conversely, maladaptive thinking patterns (e.g., defeatist performance beliefs, asocial beliefs) and tendencies that amplify negative cognitions (e.g., rumination), may divert cognitive resources away from goal pursuit or reduce willingness to exert effort. Additionally, aspects of sociality, including the propensity to experience social connection as positive reinforcement may be particularly relevant for pursuing social goals. In the current review, we discuss the roles of several psychological characteristics with respect to motivation and pleasure in schizophrenia. We argue that individual variation in these psychological dimensions is relevant to the study of motivation and reward processing in schizophrenia, including interactions between these psychological dimensions and more well-characterized cognitive and reward processing contributors to motivation. We close by emphasizing the value of considering a broad set of modulating factors when studying motivation and pleasure functions in schizophrenia.
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Affiliation(s)
- Samantha V. Abram
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | | | - Claire E. Bertrand
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
| | - John R. McQuaid
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Daniel H. Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Judith M. Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Susanna L. Fryer
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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20
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Pellas J, Renner F, Ji JL, Damberg M. Telephone-based behavioral activation with mental imagery for depression: A pilot randomized clinical trial in isolated older adults during the Covid-19 pandemic. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5646. [PMID: 34729823 PMCID: PMC8646381 DOI: 10.1002/gps.5646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 10/31/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To shield vulnerable persons, particularly the elderly, during the Covid-19 pandemic governments around the world have advised to use social distancing and self-isolation. Social isolation might put older adults at an increased risk for mental health problems such as depression. There is a need for brief, easy-accessible psychological treatments for depressive symptoms that can be delivered remotely. The aim of this study was to investigate the feasibility, acceptability, and preliminary efficacy of telephone-delivered Behavioral Activation with Mental Imagery (BA-MI) for the treatment of depressive symptoms in individuals 65 years and older living in isolation during the Covid-19 pandemic. METHODS In this open-label pilot randomized clinical trial, N = 41 individuals aged 65 years or older with clinically significant symptoms of depression were randomly assigned to either a BA-MI treatment condition, or an Attention-Assessment control condition delivered over the telephone over a 4-week period. RESULTS Depressive symptoms decreased more in the treatment condition compared to the control condition. At post-treatment, 2 out of 16 participants in the treatment condition met diagnostic criteria for depression compared to 9 out of 13 in the control condition. Most participants in the treatment condition were satisfied with the treatment and few adverse effects were observed. CONCLUSIONS This pilot study suggests that behavioral activation with mental imagery delivered over the telephone is feasible, acceptable, and potentially efficacious for the treatment of depressive symptoms in older individuals living in isolation. Replication in larger samples is needed.
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Affiliation(s)
- Johnny Pellas
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden,Centre for Clinical ResearchUppsala University, Västmanland County HospitalVästeråsSweden
| | - Fritz Renner
- Department of Clinical Psychology and PsychotherapyUniversity of FreiburgBreisgauGermany
| | - Julie L. Ji
- School of Psychological ScienceUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Mattias Damberg
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden,Centre for Clinical ResearchUppsala University, Västmanland County HospitalVästeråsSweden
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Krzyzanowski DJ, Wu S, Carnovale M, Agarwal SM, Remington G, Goghari V. Trait Anhedonia in Schizophrenia: A Systematic Review and Comparative Meta-analysis. Schizophr Bull 2021; 48:335-346. [PMID: 34891171 PMCID: PMC8886586 DOI: 10.1093/schbul/sbab136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Anhedonia, the reduced capacity to experience pleasure, has long been considered a prominent feature of schizophrenia spectrum disorders. Many domain-specific conceptualizations of anhedonia and pleasure capacity have been developed, and there currently exist a variety of self-report assessment tools that purport to assess these various domains. The current systematic review and meta-analysis (PROSPERO: CRD42020156169) aimed to quantify overall and domain-specific self-reported anhedonia in people with schizophrenia compared to nonpsychiatric controls. We performed a literature search of PsycINFO, MEDLINE, and Embase databases for dissertations and peer-reviewed articles published in English prior to June 2021. Studies employing a psychometrically validated self-report measure of anhedonia, pleasure experience or affect in people with schizophrenia, schizoaffective, or schizophreniform disorders; studies utilizing at least one clearly defined healthy or community control group for comparison; and studies providing sufficient data to calculate effect sizes were included in this review. Random and mixed effects meta-analyses, meta-regressions, and subgroup comparisons were run across domains of anhedonia to explore weighted mean effect sizes and their associated moderators. In total, 146 studies met inclusion criteria, yielding 390 Hedges' g effect sizes from the included comparisons. People with schizophrenia reported moderate-to-large elevations in overall and domain-specific anhedonia. A sensitivity analysis accounting for high risk of bias studies did not significantly impact results. Lastly, patient sex, education, negative symptom severity, antipsychotic class, and trait negative affect differentially moderated effect sizes across domains of anhedonia. Despite the heterogeneity inherent in schizophrenia spectrum disorders, self-reported anhedonia is ubiquitously reported across self-report measures in this population.
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Affiliation(s)
- Daniel J Krzyzanowski
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada,Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health, Toronto, ON, Canada,To whom correspondence should be addressed; Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, Canada M1C 1A4; tel: +1(416) 535 8501 Ext. 36092, e-mail:
| | - Sally Wu
- Centre for Addiction and Mental Health, Toronto, ON, Canada,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael Carnovale
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada,Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
| | - Sri Mahavir Agarwal
- Centre for Addiction and Mental Health, Toronto, ON, Canada,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gary Remington
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vina Goghari
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada,Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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22
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Walter H, Daniels A, Wellan SA. [Positive cognitive neuroscience : Positive valence systems of the Research Domain Criteria initiative]. DER NERVENARZT 2021; 92:878-891. [PMID: 34374803 PMCID: PMC8353935 DOI: 10.1007/s00115-021-01167-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 12/04/2022]
Abstract
In diesem Artikel werden die Domäne „positive Valenzsysteme“ (PVS) der Research-Domain-Criteria(RDoC)-Matrix sowie ihre Subkonstrukte dargestellt und erläutert. Unter PVS fallen im Wesentlichen verschiedene Formen und Prozesse der Belohnungsverarbeitung. Diese werden in der Psychiatrie schon seit Jahrzehnten im Bereich von Sucht, Schizophrenie und Depression untersucht und letztere sind daher nicht Gegenstand dieses Artikels. Hier soll vielmehr die heuristische Fruchtbarkeit der RDoC-Systematik für das Verständnis anderer Erkrankungen und Konstrukte dargestellt werden und zwar für das transdiagnostische Konstrukt der Anhedonie sowie für die Autismusspektrumstörung und die Gruppe der Essstörungen. Weiterhin wird gezeigt, wie die PVS-Domäne auch klinisch den Blick über die traditionelle Psychopathologie erweitert und wie sie die Entwicklung neuer behavioraler Messinstrumente angeregt hat. Abschließend wird auf Limitationen und mögliche zukünftige Erweiterungen des Ansatzes eingegangen.
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Affiliation(s)
- Henrik Walter
- Klinik für Psychiatrie und Psychotherapie CCM, Forschungsbereich Mind and Brain, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. .,Fakultät für Philosophie, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Deutschland.
| | - Anna Daniels
- Klinik für Psychiatrie und Psychotherapie CCM, Forschungsbereich Mind and Brain, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.,Fakultät für Philosophie, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Sarah A Wellan
- Klinik für Psychiatrie und Psychotherapie CCM, Forschungsbereich Mind and Brain, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.,Fakultät für Philosophie, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Deutschland
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23
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Why We Imagine Our Future: Introducing the Functions of Future Thinking Scale (FoFTS). JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09910-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Prospective mental imagery in depression: Impact on reward processing and reward-motivated behaviour. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e3013. [PMID: 36397959 PMCID: PMC9667131 DOI: 10.32872/cpe.3013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 02/08/2021] [Indexed: 01/11/2023] Open
Abstract
Background Mental imagery has long been part of cognitive behavioural therapies. More recently, a resurgence of interest has emerged for prospective mental imagery, i.e. future-directed imagery-based thought, and its relation to reward processing, motivation and behaviour in the context of depression. Method We conducted a selective review on the role of prospective mental imagery and its impact on reward processing and reward-motivated behaviour in depression. Results Based on the current literature, we propose a conceptual mechanistic model of prospective mental imagery. Prospective mental imagery of engaging in positive activities can increase reward anticipation and reward motivation, which can transfer to increased engagement in reward-motivated behaviour and more experiences of reward, thereby decreasing depressive symptoms. We suggest directions for future research using multimodal assessments to measure the impact of prospective mental imagery from its basic functioning in the lab to real-world and clinical implementation. Conclusion Prospective mental imagery has the potential to improve treatment for depression where the aim is to increase reward-motivated behaviours. Future research should investigate how exactly and for whom prospective mental imagery works. This review provides a selected update of the literature on prospective mental imagery. Prospective mental imagery might decrease depression via reward processing and reward-motivated behaviours. Suggestions for future research to investigate these hypotheses are provided.
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25
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Hallford DJ, Austin DW. Wanting and Liking: Testing the Factor Structure of The Temporal Experience of Pleasure Scale in Major Depression and Community Samples. Assessment 2021; 29:1033-1044. [PMID: 33729003 DOI: 10.1177/1073191121998767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Temporal Experience of Pleasure Scale (TEPS) is a multidimensional self-report measure that has been used to improve understanding of anticipation ("wanting") and consummation ("liking") of reward. The TEPS has been used to assess anhedonia in clinical depression, but its factor structure has not yet been confirmed in this population. This seems important given mixed findings on the model fit and factor structure of the TEPS in other clinical and community samples. To remedy this, the current study used confirmatory factor analysis to test models of the TEPS items across three studies: (a) in adults with major depression (n = 334), (b) in youth with major depression (n = 305), and (c) in a community sample (n = 320). In summary, the model fit of the two-factor TEPS scales was adequate in depressed and community Australian samples. Nevertheless, some items may require removal or revision based on cultural preferences for pleasurable experiences.
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Affiliation(s)
| | - David W Austin
- Deakin University, 1 Gheringhap Street, Geelong, Victoria, Australia
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26
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Rosebrock LE, Waite F, Diamond R, Collett N, Bold E, Chadwick E, Teale AL, Freeman D. Anticipatory pleasure in current psychosis: Cognitive and emotional correlates. Psychiatry Res 2021; 297:113697. [PMID: 33465523 DOI: 10.1016/j.psychres.2020.113697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 12/26/2020] [Indexed: 02/06/2023]
Abstract
Anticipation of pleasure - a key aspect of hedonic experience - is a motivating factor for engaging in activities. Low levels of anticipatory pleasure and activity are found in individuals with psychosis. Cognitive factors (e.g., working memory and IQ) have been a focus of explanation for anticipation of pleasure in psychosis. However, cognitive factors do not fully account for such difficulties. It is plausible that emotional factors (e.g., depression, self-beliefs) also contribute. We examined anticipatory pleasure in relation to cognitive and emotional processes in patients with current psychosis. 128 patients with persecutory delusions in the context of non-affective psychosis completed assessments of anticipatory pleasure, cognitive functioning, emotional processes, and activity. Lower anticipatory pleasure was significantly associated with depression, insomnia, negative-self beliefs, suicidal ideation, poorer psychological wellbeing, and paranoia-related avoidance. There were no significant associations with working memory, physical activity, or meaningful activity. Emotional factors may play a more significant role than cognitive difficulties in the experience of anhedonia in psychosis. However, the cross-sectional design precludes causal inferences. Future research should examine whether, for example, improving self-concept or reducing paranoia-related avoidance leads to improvement in anticipatory pleasure in patients with psychosis.
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Affiliation(s)
- Laina E Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom.
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Rowan Diamond
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Nicola Collett
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Emily Bold
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Eleanor Chadwick
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Ashley-Louise Teale
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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27
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Feller C, Dubois C, Eliez S, Schneider M. Episodic Future Thinking in Autism Spectrum Disorder and 22q11.2 Deletion Syndrome: Association with Anticipatory Pleasure and Social Functioning. J Autism Dev Disord 2021; 51:4587-4604. [PMID: 33586083 PMCID: PMC8592949 DOI: 10.1007/s10803-021-04903-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 02/03/2023]
Abstract
Episodic future thinking (EFT) has been suggested to underlie anticipatory pleasure (AP), itself known to play a crucial role in social functioning (SF). Both AP and SF are impaired in various clinical populations, including autism spectrum disorders (ASD) and 22q11.2 deletion syndrome (22q11DS). Therefore, the relationship between EFT, AP and SF was investigated, as well as the potential role of projecting oneself in a social vs. non-social context. Seventy-seven participants [24 with 22q11DS, 20 with ASD, 33 typically developing controls (TDs)] (aged 12–25) were included. They were assessed with a future thinking task in which they were asked to recall a memory and produce a likely event. Narratives were rated based of specificity, richness and imaginability. Participants completed questionnaires assessing AP and SF. Narratives from ASD and 22q11DS participants were rated as less vivid compared to TDs. However, the characteristics of the narratives differed between ASD and 22q11DS participants in terms of specificity and level of details, as well as in reaction to social condition. Moreover, correlations were found between AP and EFT in both ASD and 22q11DS participants, and between SF and EFT in ASD participants. These results point towards impairments in EFT in both ASD and 22q11DS participants but with a specific profile in each condition. The observed associations between EFT and AP suggest that decreased autonoetic consciousness might underlie AP impairments. In ASD individuals, the association between SF and EFT highlights the need to better characterize EFT since EFT could be another mechanism contributing to social difficulties.
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Affiliation(s)
- Clémence Feller
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d'Arve, 1205, Geneva, Switzerland.
| | - Charlotte Dubois
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d'Arve, 1205, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d'Arve, 1205, Geneva, Switzerland.,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
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28
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Yu L, Ni H, Wu Z, Fang X, Chen Y, Wang D, Zhang C. Association of Cognitive Impairment With Anhedonia in Patients With Schizophrenia. Front Psychiatry 2021; 12:762216. [PMID: 34925093 PMCID: PMC8674556 DOI: 10.3389/fpsyt.2021.762216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Anhedonia is considered as one of the five dimensions of negative symptoms and mainly refers to the reduction of the capacity of feeling pleasure. Increasing evidence suggests that anhedonia in schizophrenia may be partly explained by cognitive impairment. However, the associations between specific cognitive impairment and anhedonia are not fully investigated. The purpose of this study was to examine anticipatory anhedonia, consummatory anhedonia, and their cognitive associations in schizophrenia. A total number of 100 patients with schizophrenia and 67 healthy volunteers were recruited. The clinical symptoms of schizophrenia were assessed. Anticipatory pleasure, consummatory pleasure, and cognitive functions of each participant were measured. Multiple linear regression analysis was performed to investigate the influencing factors of anhedonia in schizophrenia. The results showed no significant differences in sex, age, education year, body mass index (BMI), and marital status between the schizophrenia group and healthy control group (all P > 0.05). Both anticipatory and consummatory pleasure in the schizophrenia group were significantly lower than those in the healthy control group (all P < 0.05). Immediate memory, visual spanning, language, attention, and delayed memory were significantly poorer in the schizophrenia group (all P < 0.05). The results showed that language deficit is an independent risk factor for anticipatory anhedonia (B' = 0.265, P = 0.008, 95% CI: 0.038-0.244), while delayed memory deficit is an independent risk factor for consummatory anhedonia (B' = 0.391, P < 0.001, 95% CI:0.085-0.237). To the best of our knowledge, this is the first study that reported the specific cognitive associations of anhedonia in schizophrenia. The findings have added new evidence on the influencing factors of anhedonia and provided clues for the associations between clinical manifestations of schizophrenia.
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Affiliation(s)
- Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Ni
- Shanghai Xuhui Mental Health Center, Shanghai, China
| | - Zenan Wu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Fang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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29
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Yamashita A, Sakai Y, Yamada T, Yahata N, Kunimatsu A, Okada N, Itahashi T, Hashimoto R, Mizuta H, Ichikawa N, Takamura M, Okada G, Yamagata H, Harada K, Matsuo K, Tanaka SC, Kawato M, Kasai K, Kato N, Takahashi H, Okamoto Y, Yamashita O, Imamizu H. Generalizable brain network markers of major depressive disorder across multiple imaging sites. PLoS Biol 2020; 18:e3000966. [PMID: 33284797 PMCID: PMC7721148 DOI: 10.1371/journal.pbio.3000966] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022] Open
Abstract
Many studies have highlighted the difficulty inherent to the clinical application of fundamental neuroscience knowledge based on machine learning techniques. It is difficult to generalize machine learning brain markers to the data acquired from independent imaging sites, mainly due to large site differences in functional magnetic resonance imaging. We address the difficulty of finding a generalizable marker of major depressive disorder (MDD) that would distinguish patients from healthy controls based on resting-state functional connectivity patterns. For the discovery dataset with 713 participants from 4 imaging sites, we removed site differences using our recently developed harmonization method and developed a machine learning MDD classifier. The classifier achieved an approximately 70% generalization accuracy for an independent validation dataset with 521 participants from 5 different imaging sites. The successful generalization to a perfectly independent dataset acquired from multiple imaging sites is novel and ensures scientific reproducibility and clinical applicability.
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Affiliation(s)
- Ayumu Yamashita
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
| | - Yuki Sakai
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
| | - Takashi Yamada
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Noriaki Yahata
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Akira Kunimatsu
- Department of Radiology, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN) at the University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Ryuichiro Hashimoto
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
- Department of Language Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Hiroto Mizuta
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naho Ichikawa
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Go Okada
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Hirotaka Yamagata
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Kenichiro Harada
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Koji Matsuo
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
- Department of Psychiatry, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Saori C. Tanaka
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
| | - Mitsuo Kawato
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan
| | - Kiyoto Kasai
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN) at the University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Nobumasa Kato
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan
| | - Okito Yamashita
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan
| | - Hiroshi Imamizu
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International, Kyoto, Japan
- Department of Psychology, Graduate School of Humanities and Sociology, The University of Tokyo, Tokyo, Japan
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30
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Hallford DJ, Yeow JJE, Fountas G, Herrick CA, Raes F, D'Argembeau A. Changing the future: An initial test of Future Specificity Training (FeST). Behav Res Ther 2020; 131:103638. [PMID: 32416495 DOI: 10.1016/j.brat.2020.103638] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/24/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023]
Abstract
A range of psychiatric disorders are characterised by impairments in episodic future thinking (EFT), and particularly simulating specific, spatiotemporally-located future events. No study has examined whether training can lead to sustained improvement in specific EFT. In this study, participants (N = 60; M age = 31, SD = 13.2) were randomized to a two-session, group-based future thinking program (Future Specificity Training; FeST) or wait-list. At follow-up the training group, relative to wait-list, showed large, statistically-significant improvements in the ability to mentally simulate specific EFT (d = .82), increases in detail (d = 1.32), use of mental imagery (d = 1.32), anticipated (d = 1.78) and anticipatory pleasure (d = 1.07), perceived control (d = 1.20), and likelihood of occurrence (d = 1.09). Some effects were also observed on positive, generalised future self-states. In the context of inherent limitations of subjective reporting in trials, this study provides evidence that EFT specificity can be enhanced, and the effects of FeST indicate a possible avenue to disrupt psychopathological processes.
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Affiliation(s)
- D J Hallford
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Melbourne, Australia.
| | - J J E Yeow
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Melbourne, Australia
| | - G Fountas
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Melbourne, Australia
| | - C A Herrick
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Melbourne, Australia
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000, Leuven, Belgium
| | - A D'Argembeau
- Psychology and Neuroscience of Cognition Research Unit, Department of Psychology, University of Liège, Belgium and Fonds de La Recherche Scientifique (F.R.S.-FNRS), Belgium
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31
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Hallford DJ, Barry TJ, Austin DW, Raes F, Takano K, Klein B. Impairments in episodic future thinking for positive events and anticipatory pleasure in major depression. J Affect Disord 2020; 260:536-543. [PMID: 31539690 DOI: 10.1016/j.jad.2019.09.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/09/2019] [Accepted: 09/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Characteristic of the cardinal symptom of anhedonia, people with clinical depression report lower levels of anticipatory pleasure. However, the psychological mechanisms underlying these deficits are poorly understood. This is the first study to assess whether, and to what extent, phenomenological characteristics of episodic future thinking for positive future events are associated with anticipatory pleasure among depressed individuals. METHODS Individuals with a Major Depressive Episode (MDE; N = 117) and without (N = 47) completed ratings scales for depressive symptoms and trait anticipatory and consummatory pleasure. They then provided descriptions of personally-relevant positive future events and rated them for phenomenological characteristics and state anticipatory pleasure. RESULTS Between-groups analysis showed that those with MDE reported lower trait anticipatory and consummatory pleasure. They also simulated future events with less specificity, less detail/vividness, less use of mental imagery, less use of first-person perspective, less plausibility/perceived likelihood of occurring, and reported less associated state anticipatory pleasure. In regression analyses in the depressed group, lower scores for detail/vividness, mental imagery, and personal significance all uniquely predicted lower state anticipatory pleasure. LIMITATIONS Cognitive functioning was not assessed, which may help clarify deficits that underpin these findings. History of previous depressive episodes in the comparison group were not assessed, which may mean the observed between-group effects are underestimated. CONCLUSIONS This study provides further evidence of deficits in episodic future thinking and anticipatory pleasure in depressed individuals. It also establishes links between particular characteristics of episodic future thinking and state anticipatory pleasure, and indicates cognitive targets that may be amenable to intervention in order to reduce anhedonia.
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Affiliation(s)
- D J Hallford
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia.
| | - T J Barry
- Department of Psychology, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - D W Austin
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Leuven, Box 3712, 3000, Belgium
| | - K Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Geschwister-Scholl-Platz 1, München, 80539, Germany
| | - B Klein
- School of Health and Life Sciences, Federation University, University Dr, Mount Helen, VIC, 3350, Australia
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Bianchi R, da Silva Nogueira D. Burnout is associated with a depressive interpretation style. Stress Health 2019; 35:642-649. [PMID: 31475445 DOI: 10.1002/smi.2897] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/05/2019] [Accepted: 08/25/2019] [Indexed: 01/22/2023]
Abstract
The aim of this 188-participant study (65% female; mean age = 40.31) was to examine whether burnout and depression are associated with similar interpretation biases in the processing of emotional information. Burnout symptoms were assessed with the Maslach Burnout Inventory-General Survey and depressive symptoms with the 9-item depression module of the Patient Health Questionnaire. Interpretation bias toward emotional information was examined using an amended version of the Word-Sentence Association Paradigm (WSAP). In the WSAP, participants are asked to decide whether emotionally-valenced words are related to ambiguous sentences. Burnout and depression were each associated with a higher endorsement of negative interpretations and a higher ratio of negative interpretations to positive interpretations. Negative word endorsement and positive word endorsement interacted in such a way that negative word endorsement was predictive of burnout and depression only when positive word endorsement levels were relatively low. Our findings suggest that burnout and depression are associated with similar alterations in the interpretation of ambiguous information. This study supports the view that burned out individuals perceive the world with "depressive glasses." Cognitive bias modification techniques employed in the treatment of depressive conditions may constitute relevant therapeutic options for "burned out" individuals.
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Affiliation(s)
- Renzo Bianchi
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Daniel da Silva Nogueira
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
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Barry TJ, Hallford DJ, Del Rey F, Ricarte JJ. Differential associations between impaired autobiographical memory recall and future thinking in people with and without schizophrenia. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:154-168. [PMID: 31584204 DOI: 10.1111/bjc.12236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/27/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Tom J. Barry
- Department of Psychology The University of Hong Kong Hong Kong
- Department of Psychology The Institute of Psychiatry, Psychology & Neuroscience King's College London UK
| | | | - Francisco Del Rey
- Regional Ministry for Social Welfare of Castilla‐La Mancha Albacete Spain
| | - Jorge J. Ricarte
- Department of Psychology Faculty of Medicine University of Castilla‐La Mancha Albacete Spain
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