Mistreating Psychology in the Decades of the Brain

Explaining How Psychotherapy Affects the Brain Can Increase the Perceived Effectiveness of Psychotherapy: A Randomized Controlled Trial

Past studies repeatedly found that biological explanations of mental disorders cause laypeople and clinicians to doubt the effectiveness of psychotherapy. This could be clinically detrimental, as combined pharmacotherapy and psychotherapy is often optimal. The distrust of psychotherapy is theorized to stem from dualistic reasoning that psychotherapy, perceived as occurring in the mind, does not necessarily affect the brain. The current study aims to mitigate this belief in a randomized controlled trial. Participants (individuals with symptoms of depression (n = 262), the general public (n = 374), and mental health clinicians (n = 607)) rated the efficacy of psychotherapy for a depression case before and after learning that the case was biologically caused. Participants also received either an intervention passage describing how psychotherapy results in brain-level changes, an active control passage emphasizing the effectiveness of psychotherapy without explaining the underlying biological mechanisms, or no intervention. Unlike the active control and no-intervention control conditions, the intervention caused participants to judge psychotherapy as significantly more effective than at baseline even though they learned that depression was biologically caused. An intervention counteracting dualism can mitigate the belief that psychotherapy is less effective for biologically caused depression. Future research should examine the durability of this intervention in clinical settings.

The psychometric upgrade psychophysiology needs

Although biological measurements are constrained by the same fundamental psychometric principles as self-report measurements, these essential principles are often neglected in most fields of neuroscience, including psychophysiology. Potential reasons for this neglect could include a lack of understanding of appropriate measurement theory or a lack of accessible software for psychometric analysis. Generalizability theory is a flexible and multifaceted measurement theory that is well suited to handling the nuances of psychophysiological data, such as the often unbalanced number of trials and intraindividual variability of scores of event-related brain potential (ERP) data. The ERP Reliability Analysis Toolbox (ERA Toolbox) was designed for psychophysiologists and is tractable software that can support the routine evaluation of psychometrics using generalizability theory. Psychometrics can guide task refinement, data-processing decisions, and selection of candidate biomarkers for clinical trials. The present review provides an extensive treatment of additional psychometric characteristics relevant to studies of psychophysiology, including validity and validation, standardization, dimensionality, and measurement invariance. Although the review focuses on ERPs, the discussion applies broadly to psychophysiological measures and beyond. The tools needed to rigorously assess psychometric reliability and validate psychophysiological measures are now readily available. With the profound implications that psychophysiological research can have on understanding brain-behavior relationships and the identification of biomarkers, there is simply too much at stake to ignore the crucial processes of evaluating psychometric reliability and validity.

Individual-Specific Animated Profiles of Mental Health

How important is the timing of the pretreatment evaluation? If we consider mental health to be a relatively fixed condition, the specific timing (e.g., day, hour) of the evaluation is immaterial and often determined on the basis of technical considerations. Indeed, the fundamental assumption underlying the vast majority of psychotherapy research and practice is that mental health is a state that can be captured in a one-dimensional snapshot. If this fundamental assumption, underlying 80 years of empirical research and practice, is incorrect, it may help explain why for decades psychotherapy failed to rise above the 50% efficacy rate in the treatment of mental-health disorders, especially depression, a heterogeneous disorder and the leading cause of disability worldwide. Based on recent studies suggesting within-individual dynamics, this article proposes that mental health and its underlying therapeutic mechanisms have underlying intrinsic dynamics that manifest across dimensions. Computational psychotherapy is needed to develop individual-specific pretreatment animated profiles of mental health. Such individual-specific animated profiles are expected to improve the ability to select the optimal treatment for each patient, devise adequate treatment plans, and adjust them on the basis of ongoing evaluations of mental-health dynamics, creating a new understanding of therapeutic change as a transition toward a more adaptive animated profile.

Ethical considerations for integrating multimodal computer perception and neurotechnology

Background

Artificial intelligence (AI)-based computer perception technologies (e.g., digital phenotyping and affective computing) promise to transform clinical approaches to personalized care in psychiatry and beyond by offering more objective measures of emotional states and behavior, enabling precision treatment, diagnosis, and symptom monitoring. At the same time, passive and continuous nature by which they often collect data from patients in non-clinical settings raises ethical issues related to privacy and self-determination. Little is known about how such concerns may be exacerbated by the integration of neural data, as parallel advances in computer perception, AI, and neurotechnology enable new insights into subjective states. Here, we present findings from a multi-site NCATS-funded study of ethical considerations for translating computer perception into clinical care and contextualize them within the neuroethics and neurorights literatures.

Methods

We conducted qualitative interviews with patients (n = 20), caregivers (n = 20), clinicians (n = 12), developers (n = 12), and clinician developers (n = 2) regarding their perspective toward using PC in clinical care. Transcripts were analyzed in MAXQDA using Thematic Content Analysis.

Results

Stakeholder groups voiced concerns related to (1) perceived invasiveness of passive and continuous data collection in private settings; (2) data protection and security and the potential for negative downstream/future impacts on patients of unintended disclosure; and (3) ethical issues related to patients' limited versus hyper awareness of passive and continuous data collection and monitoring. Clinicians and developers highlighted that these concerns may be exacerbated by the integration of neural data with other computer perception data.

Discussion

Our findings suggest that the integration of neurotechnologies with existing computer perception technologies raises novel concerns around dignity-related and other harms (e.g., stigma, discrimination) that stem from data security threats and the growing potential for reidentification of sensitive data. Further, our findings suggest that patients' awareness and preoccupation with feeling monitored via computer sensors ranges from hypo- to hyper-awareness, with either extreme accompanied by ethical concerns (consent vs. anxiety and preoccupation). These results highlight the need for systematic research into how best to implement these technologies into clinical care in ways that reduce disruption, maximize patient benefits, and mitigate long-term risks associated with the passive collection of sensitive emotional, behavioral and neural data.

Theories of psychopathology: Potential to promote clinical science, empowerment, and justice

This invited commentary evaluates eight target articles that offer ambitious theoretical frameworks intended to advance psychopathology research. We discuss their consideration of the perspectives and priorities of treatment-seekers, including respect for and promotion of individuals' agency and self-determination; their positioning of individuals within dynamic social systems and their consideration of interventions beyond the individual level; their assumptions and proposals about the relationship between psychological and biological concepts and phenomena, relative to the reductionism that has been dominant but unsuccessful in the psychopathology literature in recent decades; and their implications for clinical care and for individual and community health. Despite some overlapping features, the articles cover very different ground and offer different challenges to the status quo, which has seen strikingly slow progress for decades. None of the proposed theories is comprehensive, but each has unique appeals; each has limitations, and each warrants consideration and development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Neurolaw: Challenges and limits

This chapter canvasses the current relevance of behavioral neuroscience to the law, especially to issues of criminal responsibility and competence. It begins with an explanation of the legal doctrines at stake. I then explore the source of the often-inflated claims for the legal relevance of neuroscience. The next section discusses the scientific status of behavioral neuroscience. Then, it addresses two radical challenges to current conceptions of criminal responsibility that neuroscience allegedly poses: determinism and the death of agency. The question of the specific relevance of neuroscience to criminal law doctrine, practice, and institutions is considered next. This is followed by a discussion of how neuroscience evidence is being used in criminal cases in five different countries, including the United States. The penultimate section points to some areas warranting modest optimism. A brief conclusion suggests that neuroscience is at present of limited legal relevance, and advances in the science might alter that judgment.

Psychology: Where history, culture, and biology meet

This article argues that the same epistemological assumptions cannot be confidently applied in the transition from the biological to the social arenas of psychology, as a consequence of the sociocultural instability resulting from human linguistic and technological flair. To illustrate this contention, reference is made to historicist theses within critical and sociocultural psychology, the work of Ian Hacking and Norbert Elias, the centrality of language and technology to sociocultural instability, and the illustrative issues raised by cultural neuroscience and replication studies.

Studying Mental Health Problems as Systems, Not Syndromes

Despite decades of clinical, sociopolitical, and research efforts, progress in understanding and treating mental health problems remains disappointing. I discuss two barriers that have contributed to a problematic oversimplification of mental illness. The first is diagnostic literalism, mistaking mental health problems (complex within-person processes) for the diagnoses by which they are classified (clinically useful idealizations to facilitate treatment selection and prognosis). The second is reductionism, the isolated study of individual elements of mental disorders. I propose conceptualizing people’s mental health states as outcomes emerging from complex systems of biological, psychological, and social elements and show that this systems perspective explains many robust phenomena, including variability within diagnoses, comorbidity among diagnoses, and transdiagnostic risk factors. It helps us understand diagnoses and reductionism as useful epistemological tools for describing the world, rather than ontological convictions about how the world is. It provides new lenses through which to study mental illness (e.g., attractor states, phase transitions), and new levers to treat them (e.g., early warning signals, novel treatment targets). Embracing the complexity of mental health problems requires opening our ivory towers to theories and methods from other fields with rich traditions, including network and systems sciences.

Brentano's psychology and Kazimierz Twardowski School: implications for the empirical study of psychological phenomena today

The article presents the most important and almost forgotten theses of Franz Brentano's empirical psychology, which have significance for conceptualization and the method of psychological research. The psychology programme, introduced as early as 1874, remains on the fringes of mainstream empirical psychology, but it was the starting point for Kazimierz Twardowski and his students. The continuation and development of Brentano's thought in the twentieth century can significantly enrich and broaden psychology's theoretical and empirical perspective. This applies primarily to reductionism and the social dimension of mental phenomena.

Recentering neuroscience on behavior: The interface between brain and environment is a privileged level of control of neural activity

Despite the huge and constant progress in the molecular and cellular neuroscience fields, our capability to understand brain alterations and treat mental illness is still limited. Therefore, a paradigm shift able to overcome such limitation is warranted. Behavior and the associated mental states are the interface between the central nervous system and the living environment. Since, in any system, the interface is a key regulator of system organization, behavior is proposed here as a unique and privileged level of control and orchestration of brain structure and activity. This view has relevant scientific and clinical implications. First, the study of behavior represents a singular starting point for the investigation of neural activity in an integrated and comprehensive fashion. Second, behavioral changes, accomplished through psychotherapy or environmental interventions, are expected to have the highest impact to specifically reorganize the complexity of the human mind and thus achieve a solid and long-lasting improvement in mental health.

Ten simple rules to study distractor suppression

Distractor suppression refers to the ability to filter out distracting and task-irrelevant information. Distractor suppression is essential for survival and considered a key aspect of selective attention. Despite the recent and rapidly evolving literature on distractor suppression, we still know little about how the brain suppresses distracting information. What limits progress is that we lack mutually agreed upon principles of how to study the neural basis of distractor suppression and its manifestation in behavior. Here, we offer ten simple rules that we believe are fundamental when investigating distractor suppression. We provide guidelines on how to design conclusive experiments on distractor suppression (Rules 1-3), discuss different types of distractor suppression that need to be distinguished (Rules 4-6), and provide an overview of models of distractor suppression and considerations of how to evaluate distractor suppression statistically (Rules 7-10). Together, these rules provide a concise and comprehensive synopsis of promising advances in the field of distractor suppression. Following these rules will propel research on distractor suppression in important ways, not only by highlighting prominent issues to both new and more advanced researchers in the field, but also by facilitating communication between sub-disciplines.

Building causal knowledge in behavior genetics

Behavior genetics is a controversial science. For decades, scholars have sought to understand the role of heredity in human behavior and life-course outcomes. Recently, technological advances and the rapid expansion of genomic databases have facilitated the discovery of genes associated with human phenotypes such as educational attainment and substance use disorders. To maximize the potential of this flourishing science, and to minimize potential harms, careful analysis of what it would mean for genes to be causes of human behavior is needed. In this paper, we advance a framework for identifying instances of genetic causes, interpreting those causal relationships, and applying them to advance causal knowledge more generally in the social sciences. Central to thinking about genes as causes is counterfactual reasoning, the cornerstone of causal thinking in statistics, medicine, and philosophy. We argue that within-family genetic effects represent the product of a counterfactual comparison in the same way as average treatment effects (ATEs) from randomized controlled trials (RCTs). Both ATEs from RCTs and within-family genetic effects are shallow causes: They operate within intricate causal systems (non-unitary), produce heterogeneous effects across individuals (non-uniform), and are not mechanistically informative (non-explanatory). Despite these limitations, shallow causal knowledge can be used to improve understanding of the etiology of human behavior and to explore sources of heterogeneity and fade-out in treatment effects.

Ten simple rules to study distractor suppression

Distractor suppression refers to the ability to filter out distracting and task-irrelevant information. Distractor suppression is essential for survival and considered a key aspect of selective attention. Despite the recent and rapidly evolving literature on distractor suppression, we still know little about how the brain suppresses distracting information. What limits progress is that we lack mutually agreed upon principles of how to study the neural basis of distractor suppression and its manifestation in behavior. Here, we offer ten simple rules that we believe are fundamental when investigating distractor suppression. We provide guidelines on how to design conclusive experiments on distractor suppression (Rules 1–3), discuss different types of distractor suppression that need to be distinguished (Rules 4–6), and provide an overview of models of distractor suppression and considerations of how to evaluate distractor suppression statistically (Rules 7–10). Together, these rules provide a concise and comprehensive synopsis of promising advances in the field of distractor suppression. Following these rules will propel research on distractor suppression in important ways, not only by highlighting prominent issues to both new and more advanced researchers in the field, but also by facilitating communication between sub-disciplines.

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Distractor suppression is the ability to filter out irrelevant information.

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At present, we know little about how the brain suppresses distraction.

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We offer ten rules that are fundamental when investigating distractor suppression.

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Following the rules will propel research and foster interaction between disciplines.

Epilepsy, violence, and crime. A historical analysis

In the 19th and early 20th century, epilepsy was one of the most investigated disorders in forensic psychiatry and psychology. The possible subsidiary symptoms of epilepsy (such as temporal confusion, alterations of consciousness, or increased aggression) played pivotal roles in early forensic and criminal psychological theories that aimed to underscore the problematic medical, social and legal status of epileptic criminals. These criminals were considered extremely violent and capable of committing sudden, brutal acts. Although the theory of "epileptic criminality" was refuted due to 20th-century developments in medicine, forensic psychiatry, and criminal psychology, some suppositions related to the concept of epileptic personality have lingered. This paper explores the lasting influence of the theory of epileptic personality by examining the evolution of the theories of epileptic criminality both in the international and the Hungarian context. Specifically, it calls attention to the twentieth-century revival of the theory of epileptic personality in the works of Leopold Szondi, István Benedek and Norman Geschwind. The paper shows that the issue of epileptic personality still lingers in neuropsychology. In doing so, biological reductionist trends in medical-psychological thinking are traced, and attention is drawn to questions that arise due to changing cultural and medical representations.

The Neuroscientification of Psychology: The Rising Prevalence of Neuroscientific Concepts in Psychology From 1965 to 2016

The apparent convergence of psychology and brain science has been the subject of both celebration and critique, but it has never been systematically charted. We examined historical trends in the representation of neuroscientific concepts in a corpus of 798,402 psychology journal articles published over the past half century, from 1965 to 2016. A dictionary of 522 uniquely neuroscience-related terms was developed, and the percentage of article abstracts in which at least one term appeared was calculated for each year. This percentage grew from 9.15% to 16.45% over the study period, whereas the percentage containing a subset of 199 terms containing the prefix "neur-" rose much more steeply, from 2.30% to 10.06%. From the mid-1970s, the growing representation of neuroscience in psychology was linear. Proportions were highest among journals covering neuropsychology and physiological psychology and behavioral neuroscience, lowest in those covering social psychology and developmental and educational psychology, and intermediate in those covering experimental and cognitive psychology and clinical psychology. The steepest rises were found in social and clinical psychology journals. Changes in the most salient neuroscientific terms revealed historical shifts in technology, topic, and anatomical focus, which may contribute to our understanding of relationships among mind, brain, and behavior.

Psychotherapy outcome research: Implications of a new clinical taxonomy

Since the publication of DSM-III in 1980, the scientist-practitioner gap in clinical psychology has expanded, as almost all outcome research in clinical psychology has been on diagnosed mental disorders within a medical model using drug trial methodologies, whereas most practising clinicians undertake functional analyses and case formulations of clinical psychological problems (CPPs) and then apply tailored interventions within an ongoing hypothesis-testing methodology. But comparatively reliable assessment and generalizable conclusions in psychotherapy outcome research require a comprehensive theory-derived conception or operational definition of 'CPPs', standardized functional analyses, and a taxonomy of CPPs comparable to DSM's listings of mental disorders. An alternative conception and taxonomy of CPPs have recently been proposed, offering improvements in the reliability and generalizability of case formulation-based psychotherapy outcome research. It conceives of CPPs as instances of the formation and operation of self-sustaining problem-maintaining circles (PMCs) of psychological-level causal elements-that is, at the level of cognitions, behaviours, emotions, and events or situations (stimuli). The paper describes this new conception of CPPs, a subsequent nascent taxonomy of evidence-based PMCs which standardizes the underlying mechanisms that maintain CPPs, and ensuing benefits to research (as well as to practice) in clinical psychology. These benefits include being able to encompass all treatment-worthy CPPs, not just diagnosable mental disorders; to assess theory-derived intervention strategies, not just arbitrary therapy bundles; and to directly feed back into psychological theories, not just expand an atheoretical list of patented "evidence supported therapies."

Mapping the field of psychology: Trends in research topics 1995–2015

We map the topic structure of psychology utilizing a sample of over 500,000 abstracts of research articles and conference proceedings spanning two decades (1995–2015). To do so, we apply structural topic models to examine three research questions: (i) What are the discipline’s most prevalent research topics? (ii) How did the scientific discourse in psychology change over the last decades, especially since the advent of neurosciences? (iii) And was this change carried by high impact (HI) or less prestigious journals? Our results reveal that topics related to natural sciences are trending, while their ’counterparts’ leaning to humanities are declining in popularity. Those trends are even more pronounced in the leading outlets of the field. Furthermore, our findings indicate a continued interest in methodological topics accompanied by the ascent of neurosciences and related methods and technologies (e.g. fMRI’s). At the same time, other established approaches (e.g. psychoanalysis) become less popular and indicate a relative decline of topics related to the social sciences and the humanities.

Back to Basics: The Importance of Measurement Properties in Biological Psychiatry

Biological psychiatry is a major funding priority for organizations that fund mental health research (e.g., National Institutes of Health). Despite this, some have argued that the field has fallen short of its considerable promise to meaningfully impact the classification, diagnosis, and treatment of psychopathology. This may be attributable in part to a paucity of research about key measurement properties ("physiometrics") of biological variables as they are commonly used in biological psychiatry research. Specifically, study designs informed by physiometrics are more likely to be replicable, avoid poor measurement that results in misestimation, and maximize efficiency in terms of time, money, and the number of analyses conducted. This review describes five key physiometric principles (internal consistency, dimensionality, method-specific variance, temporal stability, and temporal specificity), illustrates how lack of understanding about these characteristics imposes meaningful limitations on research, and reviews examples of physiometric studies featuring a variety of popular biological variables to illustrate how this research can be done and substantive conclusions drawn about the variables of interest.

The levels problem in psychopathology

Psychiatric disorders are studied at multiple levels, but there is no agreement on how these levels are related to each other, or how they should be understood in the first place. In this paper, I provide an account of levels and their relationships that is suited for psychopathology, drawing from recent debates in philosophy of science. Instead of metaphysical issues, the focus is on delivering an understanding of levels that is relevant and useful for scientific practice. I also defend a pragmatic approach to the question of reduction, arguing that even in-principle reductionists should embrace pluralism in practice. Finally, I discuss the benefits and challenges in integrating explanations and models of different levels.

The Tension Between Cognitive and Regulatory Flexibility and Their Associations With Current and Lifetime PTSD Symptoms

In recent years, researchers have tried to unpack the meaning of the term flexibility and test how different constructs of flexibility are associated with various psychopathologies. For example, it is apparent that high levels of flexibility allow individuals to adaptively cope and avoid psychopathology following traumatic events, but the precise nature of this flexibility is ambiguous. In this study we focus on two central constructs: cognitive flexibility - the ability to recognize and implement possible responses to a situation- and regulatory flexibility - the ability to modulate emotional expression and experience across situations. We aim to explore the connection between cognitive and regulatory flexibility and evaluate their relative effect on PTSD symptoms. Trauma-exposed college students (N = 109, M age = 25.31, SD = 4.59) were assessed for cognitive and regulatory flexibility and current and lifetime PTSD symptoms. We predicted and found a relatively weak, yet significant, overlap between participants' cognitive and regulatory flexibility. Importantly, while both cognitive and regulatory flexibility were associated with lifetime PTSD symptoms, only cognitive flexibility was associated with current PTSD symptoms. The findings illuminate the possible value of differentiating between constructs of flexibility in predicting short and long-term effects of traumatic exposure and may pave the ground for developing personalized intervention methods.

Uncertainty Promotes Neuroreductionism: A Behavioral Online Study on Folk Psychological Causal Inference from Neuroimaging Data

INTRODUCTION

Increased efforts in neuroscience try to understand mental disorders as brain disorders. In the present study, we investigate how common a neuroreductionist inclination is among highly educated people. In particular, we shed light on implicit presuppositions of mental disorders little is known about in the public, exemplified here by the case of body integrity dysphoria (BID) that is considered a mental disorder for the first time in ICD-11.

METHODS

Identically graphed, simulated data of mind-brain correlations were shown in 3 contexts with presumably different presumptions about causality. 738 highly educated lay people rated plausibility of causality attribution from the brain to mind and from mind to the brain for correlations between brain structural properties and mental phenomena. We contrasted participants' plausibility ratings of causality in the contexts of commonly perceived brain lesion-induced behavior (aphasia), behavior-induced training effects (piano playing), and a newly described mental disorder (BID).

RESULTS

The findings reveal the expected context-dependent modulation of causality attributions in the contexts of aphasia and piano playing. Furthermore, we observed a significant tendency to more readily attribute causal inference from the brain to mind than vice versa with respect to BID.

CONCLUSION

In some contexts, exemplified here by aphasia and piano playing, unidirectional causality attributions may be justified. However, with respect to BID, we critically discuss presumably unjustified neuroreductionist inclinations under causal uncertainty. Finally, we emphasize the need for a presupposition-free approach in psychiatry.

Mindsets in the clinic: Applying mindset theory to clinical psychology

Beliefs about the malleability of attributes, also known as mindsets, have been studied for decades in social-personality psychology and education. Here, I review the many applications of mindset theory to clinical psychology and psychotherapy. First, I review social psychological and cognitive neuroscience evidence that mindsets and mindset-related messages are, to a large extent, focused on emotional tolerance. Specifically, the growth mindset, or the belief that attributes are malleable, encourages confronting and tolerating anxiety, frustration, and disappointment in healthy and adaptive ways that promote resilience, whereas the fixed mindset and related messages discourage the experience of these emotions and often leads to helplessness. Second, I review the emerging research on the anxiety mindset and discuss its relevance to clinical work. A model is proposed illustrating connections between mindsets, emotion regulation strategies, treatment preferences, and outcomes. Case examples are used to illustrate practical applications. I conclude that mindsets can inform psychotherapy, research, and public policy.

A process-based approach to psychological diagnosis and treatment:The conceptual and treatment utility of an extended evolutionary meta model

For half a century, the dominant paradigm in psychotherapy research has been to develop syndrome-specific treatment protocols for hypothesized but unproved latent disease entities, as defined by psychiatric nosological systems. While this approach provided a common language for mental health problems, it failed to achieve its ultimate goal of conceptual and treatment utility. Process-based therapy (PBT) offers an alternative approach to understanding and treating psychological problems, and promoting human prosperity. PBT targets empirically established biopsychosocial processes of change that researchers have shown are functionally important to long terms goals and outcomes. By building on concepts of known clinical utility, and organizing them into coherent theoretical models, an idiographic, functional-analytic approach to diagnosis is within our grasp. We argue that a multi-dimensional, multi-level extended evolutionary meta-model (EEMM) provides consilience and a common language for process-based diagnosis. The EEMM applies the evolutionary concepts of context-appropriate variation, selection, and retention to key biopsychosocial dimensions and levels related to human suffering, problems, and positive functioning. The EEMM is a meta-model of diagnostic and intervention approaches that can accommodate any set of evidence-based change processes, regardless of the specific therapy orientation. In a preliminary way, it offers an idiographic, functional analytic, and clinically useful alternative to contemporary psychiatric nosological systems.

Toward a multimodal measurement model for the neurobehavioral trait of affiliative capacity

A growing body of research supports the value of a multimodal assessment approach, drawing on measures from different response modalities, for clarifying how core biobehavioral processes relate to various clinical problems and dimensions of psychopathology. Using data for 507 healthy adults, the current study was undertaken to integrate self-report and neurophysiological (brain potential) measures as a step toward a multimodal measurement model for the trait of affiliative capacity (AFF) - a biobehavioral construct relevant to adaptive and maladaptive social-interpersonal functioning. Individuals low in AFF exhibit a lack of interpersonal connectedness, deficient empathy, and an exploitative-aggressive social style that may be expressed transdiagnostically in antagonistic externalizing or distress psychopathology. Specific aims were to (1) integrate trait scale and brain potential indicators into a multimodal measure of AFF and (2) evaluate associations of this multimodal measure with criterion variables of different types. Results demonstrated (1) success in creating a multimodal measure of AFF from self-report and neural indicators, (2) effectiveness of this measure in predicting both clinical-diagnostic and neurophysiological criterion variables, and (3) transdiagnostic utility of the multimodal measure at both specific-disorder and broad symptom-dimension levels. Our findings further illustrate the value of psychoneurometric operationalizations of biobehavioral trait dimensions as referents for clarifying transdiagnostic relationships between biological systems variables and empirically defined dimensions of psychopathology.

Stressors and chemical imbalances: Beliefs about the causes of depression in an acute psychiatric treatment sample

BACKGROUND

Public perceptions of mental illness are increasingly construed in neurobiological and genetic terms. Accumulating evidence suggests there are some unintended consequences of these explanations, including reduced optimism for recovery among individuals with depression. However, little is known about how these beliefs relate to treatment process and outcomes in a psychiatric treatment setting, a gap this study aimed to fill.

METHODS

We examined etiological beliefs about depression in a sample of patients (N = 279) seeking acute treatment in a behaviorally-based therapy program at a psychiatric hospital and examined relations with treatment expectations and outcomes.

RESULTS

We found that although psychosocial explanations of depression were most popular, biogenetic beliefs, particularly the belief that depression is caused by a chemical imbalance, were prevalent in this sample. Further, the chemical imbalance belief related to poorer treatment expectations. This relationship was moderated by symptoms of depression, with more depressed individuals showing a stronger relationship between chemical imbalance beliefs and lower treatment expectations. Finally, the chemical imbalance belief predicted more depressive symptoms after the treatment program ended for a 2-week measure of depression (but not for a 24-hour measure of depression), controlling for psychiatric symptoms at admission, inpatient hospitalizations, and treatment expectations.

LIMITATIONS

The sample was homogenous in terms of race and ethnicity and we did not assess how patients came to their beliefs.

CONCLUSIONS

Together, the results illustrate the correlates and possible impacts of etiological beliefs in a real-world clinical setting and invite a critical discussion about predominant messages about the etiology of depression.

From Neuroscience to Law: Bridging the Gap

Since our moral and legal judgments are focused on our decisions and actions, one would expect information about the neural underpinnings of human decision-making and action-production to have a significant bearing on those judgments. However, despite the wealth of empirical data, and the public attention it has attracted in the past few decades, the results of neuroscientific research have had relatively little influence on legal practice. It is here argued that this is due, at least partly, to the discussion on the relationship of the neurosciences and law mixing up a number of separate issues that have different relevance on our moral and legal judgments. The approach here is hierarchical; more and less feasible ways in which neuroscientific data could inform such judgments are separated from each other. The neurosciences and other physical views on human behavior and decision-making do have the potential to have an impact on our legal reasoning. However, this happens in various different ways, and too often appeal to any neural data is assumed to be automatically relevant to shaping our moral and legal judgments. Our physicalist intuitions easily favor neural-level explanations to mental-level ones. But even if you were to subscribe to some reductionist variant of physicalism, it would not follow that all neural data should be automatically relevant to our moral and legal reasoning. However, the neurosciences can give us indirect evidence for reductive physicalism, which can then lead us to challenge the very idea of free will. Such a development can, ultimately, also have repercussions on law and legal practice.

Pharmacodynamic elucidation of glutamate & dopamine in ketamine-induced anaesthesia

General anaesthetics are some of the most widely used and essential therapeutic agents. However, despite over a century of research, the molecular mechanisms of general anaesthesia in the central nervous system remain elusive. Ketamine (ketamine hydrochloride) has been approved for use in general anaesthesia either alone or in combination with other medications. It is a superb drug for use in short-term medical procedures that do not require skeletal muscle relaxation, and it has approval for the induction of general anaesthesia as a pre-anaesthetic to other general anaesthetic agents. However, Several questions remain unsolved, including the exact identification of the neural substrate of consciousness and its components, the pharmacodynamic interactions between anaesthetic agents, the mechanisms of cognitive alterations that follow an anaesthetic procedure, the identification of an eventual unitary mechanism of anaesthesia-induced alteration of consciousness, the relationship between network effects and the biochemical targets of anaesthetic agents, leading to difficulties in between-studies comparisons. Thus, the glutamate and dopamine systems play distinct roles in terms of neuronal signalling, yet both have proposed to contribute significantly to the pathophysiology of neuropsychiatric diseases. Imaging of the glutamate system and other aspects of research on the dopamine system have produced less consistent findings, potentially due to methodological limitations and the heterogeneity of the disorder. In this review, we discuss the neural circuits through which the two systems interact and how their disruption may cause psychotic symptoms. We also summarize from a molecular perspective of mechanisms of action of ketamine as general anaesthetics on ligand-gated ion channels mediated modulation of dopamine in the brain region.

Psychomotor Slowing in Schizophrenia: Implications for Endophenotype and Biomarker Development

Motor abnormalities (e.g., dyskinesia, psychomotor slowing, neurological soft signs) are core features of schizophrenia that occur independent of drug treatment and are associated with the genetic vulnerability and pathophysiology for the illness. Among this list, psychomotor slowing in particular is one of the most consistently observed and robust findings in the field. Critically, psychomotor slowing may serve as a uniquely promising endophenotype and/or biomarker for schizophrenia considering it is frequently observed in those with genetic vulnerability for the illness, predicts transition in subjects at high-risk for the disorder, and is associated with symptoms and recovery in patients. The purpose of the present review is to provide an overview of the history of psychomotor slowing in psychosis, discuss its possible neural underpinnings, and review the current literature supporting slowing as a putative endophenotype and/or biomarker for the illness. This review summarizes substantial evidence from a diverse array of methodologies and research designs that supports the notion that psychomotor slowing not only reflects genetic vulnerability, but is also sensitive to disease processes and the pathophysiology of the illness. Furthermore, there are unique deficits across the cognitive (prefix "psycho") and motor execution (root word "motor") aspects of slowing, with cognitive processes such as planning and response selection being particularly affected. These findings suggest that psychomotor slowing may serve as a promising endophenotype and biomarker for schizophrenia that may prove useful for identifying individuals at greatest risk and tracking the course of the illness and recovery.

The Utility of Event-Related Potentials in Clinical Psychology

Event-related potentials (ERPs) are direct measures of brain activity that can be leveraged for clinically meaningful research. They can relate robustly both to continuous measures of individual difference and to categorical diagnoses in ways that clarify similarities and distinctions between apparently related disorders and traits. ERPs can be linked to genetic risk, can act as moderators of developmental trajectories and responses to stress, and can be leveraged to identify those at greater risk for psychopathology, especially when used in combination with other neural and self-report measures. ERPs can inform models of the development of, and risk for, psychopathology. Finally, ERPs can be used as targets for existing and novel interventions and prevention efforts. We provide concrete examples for each of these possibilities by focusing on programmatic research on the error-related negativity and anxiety, and thus show that ERPs are poised to make greater contributions toward the identification, prediction, treatment, and prevention of mental disorders.

Messaging in Biological Psychiatry: Misrepresentations, Their Causes, and Potential Consequences

Most experts in the field of psychiatry recognize that neuroscience advances have yet to be translated into clinical practice. The main message delivered to laypeople, however, is that mental disorders are brain diseases cured by scientifically designed medications. Here we describe how this misleading message is generated. We summarize the academic studies describing how biomedical observations are often misrepresented in the scientific literature through various forms of data embellishment, publication biases favoring initial and positive studies, improper interpretations, and exaggerated conclusions. These misrepresentations also affect biological psychiatry and are spread through mass media documents. Exacerbated competition, hyperspecialization, and the need to obtain funding for research projects might drive scientists to misrepresent their findings. Moreover, journalists are unaware that initial studies, even when positive and promising, are inherently uncertain. Journalists preferentially cover them and almost never inform the public when those studies are disconfirmed by subsequent research. This explains why reductionist theories about mental health often persist in mass media even though the scientific claims that have been put forward to support them have long been contradicted. These misrepresentations affect the care of patients. Indeed, studies show that a neuro-essentialist conceptualization of mental disorders negatively affects several aspects of stigmatization, reduces the chances of patients' healing, and overshadows psychotherapeutic and social approaches that have been found effective in alleviating mental suffering. Public information about mental health should avoid these reporting biases and give equal consideration to the biological, psychological, and social aspects of mental health.

Effective connectivity between Broca's area and amygdala as a mechanism of top-down control in worry

Individuals higher in trait worry exhibit increased activation in Broca's area during inhibitory processing tasks. To identify whether such activity represents an adaptive mechanism supporting top-down control, functional and effective connectivity of Broca's area were investigated during a task of inhibitory control. fMRI data obtained from 106 participants performing an emotion-word Stroop task were examined using psychophysiological interaction and Granger Causality (GC) analyses. Findings revealed greater directed connectivity from Broca's to amygdala in the presence of emotional distraction. Furthermore, a predictive relationship was observed between worry and the asymmetry in effective connectivity, with worriers exhibiting greater directed connectivity from Broca's to amygdala. When performing the task, worriers with greater GC directional asymmetry were more accurate than worriers with less asymmetry. Present findings indicate that individuals with elevated trait worry employ a mechanism of top-down control in which communication from Broca's to amygdala fosters successful compensation for interference effects.

Schizophrenia spectrum and other psychotic disorders

Since its earliest conceptualization, schizophrenia has been considered a disorder of "young men." Contemporary research suggests that there are sex differences in schizophrenia that are both transdiagnostic and representative of general sex/gender differences across the psychopathology spectrum. This chapter selectively summarizes representative sex/gender differences in clinical expression, epidemiology, risk factors, treatment, as well as course and outcome in schizophrenia. The consistent sex differences found, such as onset age, generic brain anomalies, and hormonal involvement, are not specific to schizophrenia or necessarily to psychopathology. It is suggested that in working with those diagnosed as meeting the current criteria for schizophrenia, clinicians adopt a transdiagnostic framework informed by sex and gender role processes.

A new conception and subsequent taxonomy of clinical psychological problems

BACKGROUND

A taxonomy of the objects of study, theory, assessment, and intervention is critical to the development of all clinical sciences. Clinical psychology has been conceptually and administratively dominated by the taxonomy of an adjacent discipline - psychiatry's Diagnostic and statistical manual of mental disorders (DSM). Many have called for a 'paradigm shift' away from a medical nosology of diseases toward clinical psychology's own taxonomy of clinical psychological problems (CPPs), without being able to specify what is to be listed and classified.

MAIN TEXT

An examination of DSM's problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists actually do, leads to the proposal that: The critical psychological-level phenomenon underlying CPPs is the occurrence of 'problem-maintaining circles' (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. This concept provides an empirically-derived, theory-based, treatment-relevant, categorical, essentialist, parsimonious, and nonstigmatizing definition of CPPs. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to 'counseling', clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be 'cured' by PMC-breaking alone.

CONCLUSION

A subsequent classification and coding system of PMCs is proposed, and expected benefits to research, communication, and the quality of case formulation in clinical psychology are described, reliant upon a development effort of some meaningful fraction of that which has been devoted to the DSM.

Reinforcement Emotion-Cognition System: A Teaching Words Task

The goal of this paper is to suggest a system for intelligent learning environments with robots modeling of emotion regulation and cognition based on quantitative motivation. A detailed interactive situation for teaching words is proposed. In this study, we introduce one bottom-up collaboration method for emotion-cognition interplay and behaviour decision-making. Integration with gross emotion regulation theory lets the proposed system adapt to natural interactions between students and the robot in emotional interaction. Four key ideas are advocated, and they jointly set up a reinforcement emotion-cognition system (RECS). First, the quantitative motivation is grounded on external interactive sensory detection, which is affected by memory and preference. Second, the emotion generation triggered by an initial motivation such as external stimulus is also influenced by the state in the previous time. Third, the competitive and cooperative relationship between emotion and motivation intervenes to make the decision of emotional expression and teaching actions. Finally, cognitive reappraisal, the emotion regulation strategy, is introduced for the establishment of emotion transition combined with personalized cognition. We display that this RECS increases the robot emotional interactive performance and makes corresponding teaching decision through behavioural and statistical analysis.

The value of clinical and translational neuroscience approaches to psychiatric illness

Borsboom et al. confuse biological approaches with extreme biological reductionism and common-cause models of psychopathology. In muddling these concepts, they mistakenly throw the baby out with the bathwater. Here, we highlight recent work underscoring the unique value of clinical and translational neuroscience approaches for understanding the nature and origins of psychopathology and for developing improved intervention strategies.

Networks, intentionality and multiple realizability: Not enough to block reductionism

Borsboom et al. propose that the network approach blocks reductionism in psychopathology. We argue that the two main arguments, intentionality and multiple realizability of mental disorders, are not sufficient to establish that mental disorders are not brain disorders, and that the specific role of networks in these arguments is unclear.

Inhibitory control of emotional processing: Theoretical and empirical considerations

Although inhibitory control appears to support successful emotion regulation (ER; Joorman and Gotlib, 2010; McCabe et al., 2010), few emotion inhibition studies position themselves in the literature on ER, and even fewer ER studies reference the role of emotion inhibition. Perhaps contributing to this, the ER literature is frequently divided into implicit or "automatic" (which subsumes emotion inhibition) and explicit or "effortful" control (Braunstein et al., 2017; Gyurak et al., 2011). The present paper evaluates relationships among constructs of inhibitory control, emotion inhibition, and ER to assess neural evidence for and against distinctions between implicit and explicit ER. We argue that, whereas the distinction between implicit and explicit ER may appear organizationally or conceptually helpful, such categorical distinctions are not supported by available research and in fact contribute to imbalances in the research literature.

Computational Models of Anxiety: Nascent Efforts and Future Directions

Computational approaches to understanding the algorithms of the mind are just beginning to pervade the field of clinical psychology. In the present article, we seek to explain in simple terms why this approach is indispensable to pursuing explanations of psychological phenomena broadly, and we review nascent efforts to use this lens to understand anxiety. We conclude with future directions that will be required to advance algorithmic accounts of anxiety. Ultimately, the surplus explanatory value of computational models of anxiety, above and beyond existing neurobiological models of anxiety, impugns the naively reductionist claim that neurobiological models are sufficient to explain anxiety.

Clinical, neurocognitive and demographic factors associated with functional impairment in the Australian Brain and Mind Youth Cohort Study (2008-2016)

OBJECTIVES

We sought to determine the unique and shared contributions of clinical, neurocognitive and demographic factors to functional impairment in a large, transdiagnostic, clinical cohort of adolescents and young adults.

DESIGN

Cross-sectional baseline data from a prospective, cohort study.

SETTING

Help-seeking youth referred from outpatient services were recruited to the Brain and Mind Youth Cohort (2008-2016) in Sydney, Australia.

PARTICIPANTS

In total, 1003 outpatients were recruited, aged between 12 and 36 years (mean= 20.4 years, 54% female), with baseline diagnoses of affective, psychotic, developmental or behavioural disorders.

INTERVENTIONS

Treatment as usual.

PRIMARY OUTCOME MEASURES

Social and occupational functioning was used to index level of functional impairment. Structural equation modelling was used to examine associations between neurocognition, core clinical symptoms and alcohol and substance use, and clinician-rated and researcher-rated functional impairment. Moderator analyses were conducted to determine the potential influence of demographic and clinical factors (eg, medication exposure).

RESULTS

Independent of diagnosis, we found that neurocognitive impairments, and depressive, anxiety and negative symptoms, were significantly associated with functioning. The association of neurocognition with social and occupational functioning remained significant even when constraining for age (15-25-year-olds only) or diagnosis (affective disorders only) in the final model.

CONCLUSIONS

This study demonstrated that, in a clinically representative sample of youth, the key determinants of functioning may not be disorder specific. Further, evidence of neurocognitive dysfunction suggests that interventions that target cognition and functioning should not necessarily be reserved just for older adults with established illness.

Biomedical Explanations of Psychopathology and Their Implications for Attitudes and Beliefs About Mental Disorders

Mental disorders are increasingly conceptualized as biomedical diseases, explained as manifestations of genetic and neurobiological abnormalities. Here, we discuss changes in the dominant explanatory accounts of psychopathology that have occurred over time and the driving forces behind these shifts, lay out some real-world evidence for the increasing ascendancy of biomedical explanations, and provide an overview of the types of attitudes and beliefs that may be affected by them. We examine theoretical and conceptual models that are relevant to understanding how biomedical conceptualizations might affect attitudes and beliefs about mental disorders, and we review some empirical evidence that bears on this question. Finally, we examine possible strategies for combatting potential negative effects of biomedical explanations and discuss important conclusions and directions for future research.