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Guthrie AJ, Paredes-Echeverri S, Bleier C, Adams C, Millstein DJ, Ranford J, Perez DL. Mechanistic studies in pathological health anxiety: A systematic review and emerging conceptual framework. J Affect Disord 2024; 358:222-249. [PMID: 38718945 PMCID: PMC11298870 DOI: 10.1016/j.jad.2024.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 04/02/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Pathological health anxiety (PHA) (e.g., hypochondriasis and illness anxiety disorder) is common in medical settings and associated with increased healthcare costs. However, the psychological and neurobiological mechanisms contributing to the development and maintenance of PHA are incompletely understood. METHODS We performed a systematic review to characterize the mechanistic understanding of PHA. PubMed, PsycINFO, and Embase databases were searched to find articles published between 1/1/1990 and 12/31/2022 employing a behavioral task and/or physiological measures in individuals with hypochondriasis, illness anxiety disorder, and PHA more broadly. RESULTS Out of 9141 records identified, fifty-seven met inclusion criteria. Article quality varied substantially across studies, and was overall inadequate. Cognitive, behavioral, and affective findings implicated in PHA included health-related attentional and memory recall biases, a narrow health concept, threat confirming thought patterns, use of safety-seeking behaviors, and biased explicit and implicit affective processing of health-related information among other observations. There is initial evidence supporting a potential overestimation of interoceptive stimuli in those with PHA. Neuroendocrine, electrophysiology, and brain imaging research in PHA are particularly in their early stages. LIMITATIONS Included articles evaluated PHA categorically, suggesting that sub-threshold and dimensional health anxiety considerations are not contextualized. CONCLUSIONS Within an integrated cognitive-behavioral-affective and predictive processing formulation, we theorize that sub-optimal illness and health concepts, altered interoceptive modeling, biased illness-based predictions and attention, and aberrant prediction error learning are mechanisms relevant to PHA requiring more research. Comprehensively investigating the pathophysiology of PHA offers the potential to identify adjunctive diagnostic biomarkers and catalyze new biologically-informed treatments.
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Affiliation(s)
- Andrew J Guthrie
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sara Paredes-Echeverri
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cristina Bleier
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Caitlin Adams
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel J Millstein
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessica Ranford
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Occupational Therapy, Massachusetts General Hospital, Boston, MA, USA
| | - David L Perez
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Rosenberg BM, Barnes-Horowitz NM, Zbozinek TD, Craske MG. Reward processes in extinction learning and applications to exposure therapy. J Anxiety Disord 2024; 106:102911. [PMID: 39128178 PMCID: PMC11384290 DOI: 10.1016/j.janxdis.2024.102911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 07/08/2024] [Accepted: 07/26/2024] [Indexed: 08/13/2024]
Abstract
Anxiety disorders are common and highly distressing mental health conditions. Exposure therapy is a gold-standard treatment for anxiety disorders. Mechanisms of Pavlovian fear learning, and particularly fear extinction, are central to exposure therapy. A growing body of evidence suggests an important role of reward processes during Pavlovian fear extinction. Nonetheless, predominant models of exposure therapy do not currently incorporate reward processes. Herein, we present a theoretical model of reward processes in relation to Pavlovian mechanisms of exposure therapy, including a focus on dopaminergic prediction error signaling, coinciding positive emotional experiences (i.e., relief), and unexpected positive outcomes. We then highlight avenues for further research and discuss potential strategies to leverage reward processes to maximize exposure therapy response, such as pre-exposure interventions to increase reward sensitivity or post-exposure rehearsal (e.g., savoring, imaginal recounting strategies) to enhance retrieval and retention of learned associations.
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Affiliation(s)
- Benjamin M Rosenberg
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
| | - Nora M Barnes-Horowitz
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
| | - Tomislav D Zbozinek
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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3
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Konegen K, Halbeisen G, Paslakis G. A second chance for first impressions: evidence for altered impression updating in borderline personality disorder. Borderline Personal Disord Emot Dysregul 2024; 11:15. [PMID: 39026374 PMCID: PMC11256375 DOI: 10.1186/s40479-024-00259-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Individuals with borderline personality disorder (BPD) frequently alter between idealizing and devaluing other persons, which has been linked to an increased tendency to update self-relevant beliefs and impressions. We hypothesized that increased impression updating could stem from reduced attitude contextualization, i.e., a process in which impression-disconfirming information is linked to contextual cues. METHODS Individuals diagnosed with BPD and controls (recruited online, with unknown diagnostic status) completed an impression formation paradigm. They first learned about the positive or negative behaviors of others in one Context A (e.g., Person 1 is helpful), followed by learning about behaviors of the opposite valence in a second Context B (Person 1 is rude). We also manipulated between participants whether the observed behaviors were directed toward the study participants (self-relevant) or, more generally, at other people (other-relevant). The contexts were marked by differently-colored backgrounds (e.g., yellow vs. blue), to avoid influences of prior knowledge or experiences. After exposure to information in both contexts, participants rated their impressions of the persons in Context A, Context B, and, crucially, a previously unknown Context C (white background). We examined whether the initial or an updated impression (re-)emerged in Context C. RESULTS Initial impressions remained stable and dominated the ratings of controls across contexts A, B, and C for both self-relevant and other-relevant behaviors, consistent with contextualizing impression-disconfirming information. As expected, however, individuals with BPD only showed updated impression ratings in Context C for self-relevant behaviors, consistent with the assumed reduced tendency to contextualize impression-disconfirming self-relevant information. Further exploratory analyses suggest that more severe BPD symptoms predicted more pronounced impression updating in the self-relevant condition. CONCLUSIONS The findings help to illuminate the mechanisms underlying interpersonal problems in individuals with BPD. People with BPD are not just more inclined to discard positive first impressions but to re-evaluate disliked others when they behave positively, contributing to the volatility of interactions with others. Contextualization has known and modifiable antecedents, and the study may thus provide potential targets for therapeutic intervention. Future studies will need to replicate the findings with specified controls.
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Affiliation(s)
- Kevin Konegen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Virchowstr. 65, 32312, Luebbecke, Germany
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Virchowstr. 65, 32312, Luebbecke, Germany.
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Virchowstr. 65, 32312, Luebbecke, Germany
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4
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Perdomo Sandoval LA, Goberna-Tricas J. Sexual health beliefs and prevention of sexually transmitted infections among cisgender women sex workers in Colombia. PLoS One 2024; 19:e0305293. [PMID: 38865312 PMCID: PMC11168633 DOI: 10.1371/journal.pone.0305293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION The stigma and social discrimination against cisgender women sex workers lead many of them to live in conditions characterized by social inequality, marginalization, persecution, and limited opportunities for sexual health literacy. Consequently, they are often compelled to establish a framework of preventive beliefs with little scientific validity, which they use to identify, mitigate, or avoid sexual health risks arising from their interactions with clients. This study investigates the sexual health beliefs that influence self-care practices aimed at preventing sexually transmitted infections among cisgender women sex workers in Colombia. METHODS We conducted a qualitative study framed in Hermeneutic Phenomenology. In-depth interviews and discussion groups were conducted with 34 cisgender women sex workers over 18 years of age in the center of the cities of Bogotá and Barranquilla in Colombia. RESULTS Seven themes emerged from the reflective and inductive thematic analysis of the narratives: (1) popular habits for the prevention of contagion, (2) ocular assessment of genitals, (3) condom lubrication, (4) suspicion of a hidden infection in the client, (5) saliva and oral contact as a source of contagion, (6) avoidance of semen contact, (7) and trust in God as protection. CONCLUSIONS The findings reflect the need for health and social professionals to promote participatory and inclusive cooperation with sex workers to update the framework of preventive beliefs that help them guide sexual health self-care with autonomy and self-efficacy, strengthening favorable beliefs and negotiating unfavorable ones. It is also essential to have a sex worker-informed sexual health policy that guides the promotion of sexual health that is sensitive to the needs and consistent with the risks of sex work and ensures friendly and non-oppressive preventive care environments for sex workers.
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Affiliation(s)
- Luis Albeiro Perdomo Sandoval
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing. Doctoral Program in Nursing and Health, University of Barcelona, Barcelona, Spain
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing. ADHUC. Research Center for Theory, Gender, Sexuality. University of Barcelona, Barcelona, Spain
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Beron JC, Solovey G, Ferrelli IA, Pedreira ME, Fernández RS. Large environmental changes reduce valence-dependent belief updating. Sci Rep 2024; 14:10429. [PMID: 38714776 PMCID: PMC11076288 DOI: 10.1038/s41598-024-61207-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/02/2024] [Indexed: 05/10/2024] Open
Abstract
When updating beliefs, humans tend to integrate more desirable information than undesirable information. In stable environments (low uncertainty and high predictability), this asymmetry favors motivation towards action and perceived self-efficacy. However, in changing environments (high uncertainty and low predictability), this process can lead to risk underestimation and increase unwanted costs. Here, we examine how people (n = 388) integrate threatening information during an abrupt environmental change (mandatory quarantine during the COVID-19 pandemic). Given that anxiety levels are associated with the magnitude of the updating belief asymmetry; we explore its relationship during this particular context. We report a significant reduction in asymmetrical belief updating during a large environmental change as individuals integrated desirable and undesirable information to the same extent. Moreover, this result was supported by computational modeling of the belief update task. However, we found that the reduction in asymmetrical belief updating was not homogeneous among people with different levels of Trait-anxiety. Individuals with higher levels of Trait-anxiety maintained a valence-dependent updating, as it occurs in stable environments. On the other hand, updating behavior was not associated with acute anxiety (State-Anxiety), health concerns (Health-Anxiety), or having positive expectations (Trait-Optimism). These results suggest that highly uncertain environments can generate adaptive changes in information integration. At the same time, it reveals the vulnerabilities of individuals with higher levels of anxiety to adapt the way they learn.
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Affiliation(s)
- Juan Cruz Beron
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIByNE)-CONICET, Buenos Aires, Argentina
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Guillermo Solovey
- Facultad de Ciencias Exactas y Naturales, Instituto de Cálculo, UBA-CONICET, Buenos Aires, Argentina
| | - Ignacio A Ferrelli
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIByNE)-CONICET, Buenos Aires, Argentina
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - María E Pedreira
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIByNE)-CONICET, Buenos Aires, Argentina
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Rodrigo S Fernández
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIByNE)-CONICET, Buenos Aires, Argentina.
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.
- Laboratorio de Neurociencia de la Memoria, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires IFIByNE, CONICET, Ciudad Universitaria (C1428EHA), Buenos Aires, Argentina.
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Sloan AF, Kittleson AR, Torregrossa LJ, Feola B, Rossi-Goldthorpe R, Corlett PR, Sheffield JM. Belief Updating, Childhood Maltreatment, and Paranoia in Schizophrenia-Spectrum Disorders. Schizophr Bull 2024:sbae057. [PMID: 38701234 DOI: 10.1093/schbul/sbae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
BACKGROUND AND HYPOTHESIS Exposure to childhood maltreatment-a risk factor for psychosis is associated with paranoia-may impact one's beliefs about the world and how beliefs are updated. We hypothesized that increased exposure to childhood maltreatment is related to volatility-related belief updating, specifically higher expectations of volatility, and that these relationships are strongest for threat-related maltreatment. Additionally, we tested whether belief updating mediates the relationship between maltreatment and paranoia. STUDY DESIGN Belief updating was measured in 75 patients with schizophrenia-spectrum disorders and 76 nonpsychiatric controls using a 3-option probabilistic reversal learning (3PRL) task. A Hierarchical Gaussian Filter (HGF) was used to estimate computational parameters of belief updating, including prior expectations of volatility (μ03). The Childhood Trauma Questionnaire (CTQ) was used to assess cumulative maltreatment, threat, and deprivation exposure. Paranoia was measured using the Positive and Negative Syndrome Scale (PANSS) and the revised Green et al. Paranoid Thoughts Scale (R-GPTS). RESULTS Greater exposure to childhood maltreatment is associated with higher prior expectations of volatility in the whole sample and in individuals with schizophrenia-spectrum disorders. This was specific to threat-related maltreatment, rather than deprivation, in schizophrenia-spectrum disorders. Paranoia was associated with both exposure to childhood maltreatment and volatility priors, but we did not observe a significant indirect effect of volatility priors on the relationship between maltreatment and paranoia. CONCLUSIONS Our study suggests that individuals with schizophrenia-spectrum disorders who were exposed to threatening experiences during childhood expect their environment to be more volatile, potentially facilitating aberrant belief updating and conferring risk for paranoia.
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Affiliation(s)
- Ali F Sloan
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew R Kittleson
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lénie J Torregrossa
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Philip R Corlett
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Haim-Nachum S, Kube T, Rozenkrantz L, Lazarov A, Levy-Gigi E, Michael T, Neria Y, Sopp MR. Does disconfirmatory evidence shape safety-and danger-related beliefs of trauma-exposed individuals? Eur J Psychotraumatol 2024; 15:2335788. [PMID: 38626065 PMCID: PMC11022916 DOI: 10.1080/20008066.2024.2335788] [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: 11/24/2023] [Accepted: 03/11/2024] [Indexed: 04/18/2024] Open
Abstract
Recent accounts of predictive processing in posttraumatic stress disorder (PTSD) suggest that trauma-exposed individuals struggle to update trauma-related hypotheses predicting danger, which may be involved in the etiology and maintenance of this disorder. Initial research supports this account, documenting an association between trauma-exposure, impaired expectation updating, and PTSD symptoms. Yet, no study to date has examined biased belief updating in PTSD using a scenario-based approach.Objective: Here, we examined the predictive processing account among trauma-exposed and non-trauma-exposed individuals using a modified Trauma-Related version of the Bias Against Disconfirmatory Evidence task.Method: The task presents both danger-and safety-related scenarios highly relevant for trauma-exposed individuals. For each scenario, participants viewed several explanations and rated their plausibility. Their ability to update their initial interpretation following new-contradictory information was assessed.Results: Preregistered analyses did not reveal any significant findings. Based on indications that our sample may not have been sufficiently powered, we conducted exploratory analyses in an extended sample of participants. These analyses yielded a significant association between reduced belief updating and PTSD symptoms which was evident for disconfirming both safety and danger scenarios. However, the effect sizes we found were in the small-to-medium range.Conclusion: Although preliminary, our current findings support initial evidence that individuals with higher PTSD symptoms show a higher resistance to update their beliefs upon new disconfirmatory evidence. Our results should be interpreted cautiously in light of the extended sample and the limitations of the current study.
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Affiliation(s)
- Shilat Haim-Nachum
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Tobias Kube
- Department of Clinical Psychology and Psychotherapy, RPTU University of Kaiserslautern-Landau, Landau, Germany
| | | | - Amit Lazarov
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv, Israel
| | - Einat Levy-Gigi
- Faculty of Education and the Brain Science Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Yuval Neria
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - M. Roxanne Sopp
- Division of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
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8
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Duda JM, Fineberg SK, Deng W, Ma Y, Everaert J, Cannon TD, Joormann J. Borderline personality disorder features are associated with inflexible social interpretations. J Affect Disord 2024; 348:78-87. [PMID: 38110156 DOI: 10.1016/j.jad.2023.12.036] [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: 08/26/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is thought to involve aberrant social learning, including impaired revision of social interpretations with new evidence (social interpretation inflexibility). However, this topic has received little empirical attention outside of specific literatures, such as moral inference or behavioral economics. Further, the contribution of comorbid depression to BPD-related interpretation inflexibility has not yet been assessed. METHODS In two independent samples (Study 1: N = 213; Study 2: N = 210, oversampled for BPD features), we assessed the associations between BPD symptoms, depressive symptoms, and task-based measures of social interpretation flexibility. RESULTS We found that BPD symptoms, particularly volatility of identity and relationships, were associated with less revision of social interpretations with both positive and negative evidence. Meanwhile, depressive symptoms were associated with a pattern of less revision of social interpretations with positive versus negative information. LIMITATIONS The use of cross-sectional, crowdsourced samples limits causal interpretations. Translation to clinical populations should be assessed in future studies. CONCLUSIONS Results suggest that inflexible social interpretations across valences may be a feature of BPD-related pathology, and could be connected to symptoms involving volatility in social contexts. Future studies should investigate whether treatments geared toward increasing the flexibility of social interpretations are effective in treating BPD symptoms, especially those involving interpersonal difficulties.
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Affiliation(s)
- Jessica M Duda
- Department of Psychology, Yale University, New Haven, CT, USA.
| | - Sarah K Fineberg
- Department of Psychiatry, Yale University, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
| | - Wisteria Deng
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Yvette Ma
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Jonas Everaert
- Department of Medical and Clinical Psychology, Tilburg University, the Netherlands; Research Group of Quantitative Psychology and Individual Differences, KU, Leuven, Belgium
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
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Meyer T, Sickinghe M, Matera V, Morina N. Comparison standards shape everyday judgments of low and high wellbeing in individuals with and without psychopathology: a diary-based investigation. Sci Rep 2024; 14:4063. [PMID: 38374170 PMCID: PMC10876573 DOI: 10.1038/s41598-024-54681-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/15/2024] [Indexed: 02/21/2024] Open
Abstract
People can easily rate and express their current levels of wellbeing, but the cognitive foundations for such judgments are poorly understood. We examined whether comparisons to varying standards underlie fluctuating wellbeing judgments within-person (i.e., throughout daily episodes) and between-person (i.e., high vs. low levels of psychopathology). Clinical and non-clinical participants recorded subjective affect for each distinct episode for one week. Participants briefly described current, best, and worst daily episodes, which we coded for presence and type of comparison standard (social, past temporal, criteria-based, counterfactual, prospective temporal, and dimensional). Participants also rated their engagement with these standards and the respective affective impact. During best episodes, participants reported more downward (vs. upward) comparisons that resulted in positive affective impact. In worst episodes, upward (vs. downward) comparisons were more frequent. In best and worst episodes, we most frequently identified past-temporal and criteria-based comparisons, respectively. The clinical group engaged more often with all potential standard types during worst daily episodes and was more negatively affected by comparative thoughts, amid consistently more negative affect levels across all episode types. Our data suggest that judgments of affect and wellbeing may indeed rely on comparative thinking, whereby certain standards may characterize states of negative affect and poor mental health.
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Affiliation(s)
- Thomas Meyer
- Institute of Psychology, University of Münster, Münster, Germany.
| | - Marthe Sickinghe
- Institute of Psychology, University of Münster, Münster, Germany
| | - Vanessa Matera
- Institute of Psychology, University of Münster, Münster, Germany
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
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Li J, Chen L, Zhou D, Tang E, Zheng J, Huang X, Zhong BL, Guan C, Liu H, Shen M, Chen H. Flexibility Retained: Unimpaired Updating of Expectations in Schizophrenia. Behav Sci (Basel) 2024; 14:41. [PMID: 38247693 PMCID: PMC10812936 DOI: 10.3390/bs14010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Flexibly and actively updating expectations based on feedback is crucial for navigating daily life. Previous research has shown that people with schizophrenia (PSZ) have difficulty adjusting their expectations. However, there are studies suggesting otherwise. To explore this further, we used a novel trial-based expectation updating paradigm called attribute amnesia. In the task, the participants needed to report the location of a target stimulus among distractors in pre-surprise trials. In the surprise trial, they were unexpectedly asked to report the identity of the target before reporting its location. Afterward, control trials were conducted whereby the participants were asked the same questions as in the surprise trial. Notably, the surprise trial and control trials were nearly identical, except that the participants expected to be asked about identity information in the control trials but not in the surprise trial. Thus, an improvement in identity reporting accuracy in the control trials in comparison with the surprise trial indicated active updating of expectations. In the current study, a total of 63 PSZ and 60 healthy control subjects (HCS) were enrolled. We found that both the PSZ and the HCS were unable to report information that they had fully attended to (i.e., identity) in the surprise trial. However, both groups showed a significant improvement in reporting identity information even in the first control trial. Critically, there was no significant difference in the magnitude of improvement between the two groups. The current findings indicate that PSZ have the ability to update their expectations as quickly and flexibly as HCS, at least in the context of the current task. The possible factors that might contribute to the discrepancy regarding expectation updating are discussed.
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Affiliation(s)
- Jian Li
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Luo Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | | | - Enze Tang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Jiewei Zheng
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Xiaoqi Huang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430022, China
| | - Chenxiao Guan
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Huiying Liu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Mowei Shen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Hui Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
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11
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Kirschner H, Nassar MR, Fischer AG, Frodl T, Meyer-Lotz G, Froböse S, Seidenbecher S, Klein TA, Ullsperger M. Transdiagnostic inflexible learning dynamics explain deficits in depression and schizophrenia. Brain 2024; 147:201-214. [PMID: 38058203 PMCID: PMC10766268 DOI: 10.1093/brain/awad362] [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: 07/13/2023] [Revised: 09/25/2023] [Accepted: 10/10/2023] [Indexed: 12/08/2023] Open
Abstract
Deficits in reward learning are core symptoms across many mental disorders. Recent work suggests that such learning impairments arise by a diminished ability to use reward history to guide behaviour, but the neuro-computational mechanisms through which these impairments emerge remain unclear. Moreover, limited work has taken a transdiagnostic approach to investigate whether the psychological and neural mechanisms that give rise to learning deficits are shared across forms of psychopathology. To provide insight into this issue, we explored probabilistic reward learning in patients diagnosed with major depressive disorder (n = 33) or schizophrenia (n = 24) and 33 matched healthy controls by combining computational modelling and single-trial EEG regression. In our task, participants had to integrate the reward history of a stimulus to decide whether it is worthwhile to gamble on it. Adaptive learning in this task is achieved through dynamic learning rates that are maximal on the first encounters with a given stimulus and decay with increasing stimulus repetitions. Hence, over the course of learning, choice preferences would ideally stabilize and be less susceptible to misleading information. We show evidence of reduced learning dynamics, whereby both patient groups demonstrated hypersensitive learning (i.e. less decaying learning rates), rendering their choices more susceptible to misleading feedback. Moreover, there was a schizophrenia-specific approach bias and a depression-specific heightened sensitivity to disconfirmational feedback (factual losses and counterfactual wins). The inflexible learning in both patient groups was accompanied by altered neural processing, including no tracking of expected values in either patient group. Taken together, our results thus provide evidence that reduced trial-by-trial learning dynamics reflect a convergent deficit across depression and schizophrenia. Moreover, we identified disorder distinct learning deficits.
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Affiliation(s)
- Hans Kirschner
- Institute of Psychology, Otto-von-Guericke University, D-39106 Magdeburg, Germany
| | - Matthew R Nassar
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI 02912-1821, USA
- Department of Neuroscience, Brown University, Providence, RI 02912-1821, USA
| | - Adrian G Fischer
- Department of Education and Psychology, Freie Universität Berlin, D-14195 Berlin, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, D-39106 Magdeburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen 52074, Germany
- German Center for Mental Health (DZPG), D-39106 Magdeburg, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, D-39106 Magdeburg, Germany
| | - Gabriela Meyer-Lotz
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, D-39106 Magdeburg, Germany
| | - Sören Froböse
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, D-39106 Magdeburg, Germany
| | - Stephanie Seidenbecher
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, D-39106 Magdeburg, Germany
| | - Tilmann A Klein
- Institute of Psychology, Otto-von-Guericke University, D-39106 Magdeburg, Germany
- Center for Behavioral Brain Sciences, D-39106 Magdeburg, Germany
| | - Markus Ullsperger
- Institute of Psychology, Otto-von-Guericke University, D-39106 Magdeburg, Germany
- German Center for Mental Health (DZPG), D-39106 Magdeburg, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, D-39106 Magdeburg, Germany
- Center for Behavioral Brain Sciences, D-39106 Magdeburg, Germany
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12
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The relationship between multiple traumatic events and the severity of posttraumatic stress disorder symptoms – evidence for a cognitive link. Eur J Psychotraumatol 2023; 14:2165025. [PMID: 37052097 PMCID: PMC9879173 DOI: 10.1080/20008066.2023.2165025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Previous research has shown that multiple traumatic experiences cumulatively increase the risk for the development of severe symptoms of posttraumatic stress disorder (PTSD). Yet, little is known about the specific psychological mechanism through which this increased risk comes about.Objective: In the present study, we examined a possible cognitive link between multiple traumatic events and PTSD symptom severity through dysfunctional cognitions and expectations.Methods: A sample of patients with a diagnosed PTSD (N = 70; MAge = 42.06; 82% female) and high symptom burden (IES-R M = 79.24) was examined. On average, patients had experienced 5.31 different traumatic events. In a structural equation model, we tested the hypothesis that the relationship between multiple traumatic experiences and PTSD symptom severity is mediated through dysfunctional general cognitions and dysfunctional situation-specific expectations. General trauma-related cognitions were assessed with the Posttraumatic Cognition Inventory (PTCI) and trauma-related situational expectations were assessed with the Posttraumatic Expectations Scale (PTES).Results: The direct effect of the number of traumatic events on PTSD symptom severity was non-significant. Instead, as hypothesised, there was evidence for a significant indirect effect via dysfunctional general cognitions and situation-specific expectations.Conclusions: The current results further specify the cognitive model of PTSD by indicating that the relationship between the number of traumatic events and PTSD symptom severity is mediated through dysfunctional cognitions and expectations. These findings emphasise the importance of focused cognitive treatment approaches that seek to modify dysfunctional cognitions and expectations in people with multiple traumatic experiences.
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Kirchner L, Kube T, D'Astolfo L, Strahler J, Herbstreit R, Rief W. How to modify expectations of social rejection? An experimental study using a false-feedback paradigm. J Behav Ther Exp Psychiatry 2023; 81:101859. [PMID: 37182428 DOI: 10.1016/j.jbtep.2023.101859] [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: 03/31/2022] [Revised: 01/16/2023] [Accepted: 04/14/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Negative expectations (NEs) are fundamental to various mental disorders. Finding ways to modulate NEs would help to improve clinical treatment. The present study investigated how previously formed expectations of social rejection are revised in the context of novel positive social experiences, and whether their revision can be modulated by differentially shifting participants' attentional focus. METHODS Our sample of 124 healthy participants was randomly assigned to four experimental conditions and received manipulated social feedback in multiple alleged webcam conferences. All groups went through three experimental phases that began with predominantly negative social feedback, then either transitioned to predominantly positive social feedback or continued to predominantly negative social feedback, and ultimately transitioning to a phase with no explicit social feedback. The experimental conditions differed in what they were instructed to focus on when receiving positive social feedback. RESULTS Receiving novel positive social feedback led to substantial changes in social expectations, but this effect was not modulated by the instructions the participants were given. Descriptive trends revealed that both instructions improved NE modification, although this effect was not robust to extinction in one condition. LIMITATIONS To prevent our cover story from being compromised, we could not perform an immediate manipulation check of the instructions given. Nevertheless, some of the sample seemed suspicious about the cover story. CONCLUSION Our results suggest that established expectations of social rejection can be revised when unexpectedly experiencing social acceptance. Nevertheless, more research is needed on potential instructions that could be used to optimize the modification of NEs.
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Affiliation(s)
- Lukas Kirchner
- Philipps-University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany.
| | - Tobias Kube
- University of Koblenz-Landau, Ostbahnstraße 10, 76829, Landau, Germany
| | - Lisa D'Astolfo
- Philipps-University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
| | - Jana Strahler
- Albert-Ludwigs-University of Freiburg, Sandfangweg 4, 79102, Freiburg, Germany
| | - René Herbstreit
- Philipps-University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
| | - Winfried Rief
- Philipps-University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
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14
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Polack RG, Bronstein MV, Questel M, Edelman A, Vinogradov S, Kober H, Joormann J, Everaert J. Social interpretation inflexibility moderates emotional reactions to social situations in children and adolescents. Dev Psychopathol 2023; 35:2352-2364. [PMID: 37466071 PMCID: PMC10796842 DOI: 10.1017/s0954579423000834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Interpretation biases and inflexibility (i.e., difficulties revising interpretations) have been linked to increased internalizing symptoms. Although adolescence is a developmental period characterized by novel social situations and increased vulnerability to internalizing disorders, no studies have examined interpretation inflexibility in adolescents. Additionally, no studies (on adolescents or adults) have examined interpretation flexibility as a protective factor against adverse outcomes of interpersonal events. Using a novel task and a 28-day diary we examined relations among interpretation bias and inflexibility, internalizing symptoms, and negative interpersonal events in a sample of children and adolescents (N = 159, ages 9-18). At baseline, negative interpretation bias was positively correlated with social anxiety symptoms, and positive interpretation bias negatively correlated with social anxiety and depressive symptoms. Inflexible positive interpretations were correlated with higher social anxiety and depressive symptoms, while inflexible negative interpretations were correlated with higher social anxiety. Finally, interpretation inflexibility moderated daily associations between negative interpersonal events and depressive symptoms in daily life, such that higher inflexibility was associated with stronger associations between interpersonal events and subsequent depressive symptoms, potentially increasing depressive symptom instability. These results suggest that interpretation biases and inflexibility may act as both risk and protective factors for adolescent anxiety and depression.
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Affiliation(s)
- Reuma Gadassi Polack
- Department of Psychology, Yale University, Connecticut, USA
- School of Behavioral Sciences, Tel-Aviv Yaffo Academic College, Tel-Aviv Yaffo, Israel
| | - Michael V. Bronstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minnesota, USA
| | - Marcia Questel
- Department of Psychology, Yale University, Connecticut, USA
| | - Audrey Edelman
- Department of Psychology, Yale University, Connecticut, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minnesota, USA
| | - Hedy Kober
- Department of Psychology, Yale University, Connecticut, USA
- Department of Psychiatry, Yale University, Connecticut, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, Connecticut, USA
| | - Jonas Everaert
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Belgium
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Oeberst A, Imhoff R. Toward Parsimony in Bias Research: A Proposed Common Framework of Belief-Consistent Information Processing for a Set of Biases. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1464-1487. [PMID: 36930530 PMCID: PMC10623627 DOI: 10.1177/17456916221148147] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
One of the essential insights from psychological research is that people's information processing is often biased. By now, a number of different biases have been identified and empirically demonstrated. Unfortunately, however, these biases have often been examined in separate lines of research, thereby precluding the recognition of shared principles. Here we argue that several-so far mostly unrelated-biases (e.g., bias blind spot, hostile media bias, egocentric/ethnocentric bias, outcome bias) can be traced back to the combination of a fundamental prior belief and humans' tendency toward belief-consistent information processing. What varies between different biases is essentially the specific belief that guides information processing. More importantly, we propose that different biases even share the same underlying belief and differ only in the specific outcome of information processing that is assessed (i.e., the dependent variable), thus tapping into different manifestations of the same latent information processing. In other words, we propose for discussion a model that suffices to explain several different biases. We thereby suggest a more parsimonious approach compared with current theoretical explanations of these biases. We also generate novel hypotheses that follow directly from the integrative nature of our perspective.
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Affiliation(s)
- Aileen Oeberst
- Department of Media Psychology, University of Hagen
- Leibniz-Institut für Wissensmedien, Tübingen
| | - Roland Imhoff
- Department of Social and Legal Psychology, Johannes Gutenberg University of Mainz
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16
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Sciarrillo A, Bevione F, Lepora M, Toppino F, Lacidogna MC, Delsedime N, Panero M, Martini M, Abbate Daga G, Preti A. The Nepean Belief Scale (NBS) as a tool to investigate the intensity of beliefs in anorexia nervosa: psychometric properties of the Italian version. Eat Weight Disord 2023; 28:92. [PMID: 37906328 PMCID: PMC10618389 DOI: 10.1007/s40519-023-01620-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/18/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND People with anorexia nervosa (AN) show a peculiar impairment of insight regarding their condition, often manifesting a denial of extreme emaciation and sometimes hiding or underreporting socially undesirable abnormal eating patterns. Sometimes the intensity of the beliefs held by patients with AN reach a delusional intensity. OBJECTIVES In this study, the Italian version of the Nepean Belief Scale was applied to a sample of patients diagnosed with AN to investigate the intensity of their beliefs and convictions and its clinical correlates. METHODS The Nepean Belief Scale (NBS) was translated and adapted to Italian and applied to a sample of patients diagnosed with AN based on the Structured Clinical Interview for DSM-5 (SCID-5). RESULTS The Italian version of the 5-item NBS showed excellent reliability. Convergent validity was proved by negative association with levels of insight measured with the Schedule for the Assessment of Insight in Eating Disorders. Beliefs of delusional intensity were reported by 10% of participants. Those with a greater intensity of beliefs, either overvalued or delusional ideas, were more likely to report poorer general cognitive performances on the Montreal Cognitive Assessment. No association was observed between NBS score and age, body mass index, symptoms of eating disorders, body dissatisfaction, or levels of depression. Fear of weight gain and control seeking were the most often reported themes at the NBS. CONCLUSIONS The Italian version of the NBS is a reasonably reliable, valid, and usable tool for the multidimensional assessment of insight in AN. Level of evidence Level III, Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Arianna Sciarrillo
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
| | - Francesco Bevione
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Marta Lepora
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Federica Toppino
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Maria Carla Lacidogna
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Nadia Delsedime
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Matteo Panero
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Matteo Martini
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Giovanni Abbate Daga
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Antonio Preti
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
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El Abed H, Ragala MEA, El Hilaly J, Zarrouq B, Ait-Taleb Lahsen H, Benjelloun MC, Halim K. Setting up and assessing a therapeutic education program for asthmatic patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:349. [PMID: 38144024 PMCID: PMC10743855 DOI: 10.4103/jehp.jehp_1868_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/03/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Asthma is a major public health issue. It remains uncontrolled, despite the availability of effective treatments. Appropriate education programs are required to improve the situation. The study aims to design and assess an educational program based on asthma patients' perceived needs. MATERIALS AND METHODS A cross-sectional prospective study was conducted in the pulmonology department of the Hassan II University Hospital in Fez. A convenience sample of asthma patients, whether hospitalized or not, was recruited. Two hundred and twenty adult asthma patients completed an educational needs survey (ENS). An asthma knowledge questionnaire for adult patients was used to assess the program on the criterion of improving asthma knowledge. Data collected by ENS was analyzed by standard descriptive statistics. The Student's T test for paired samples was used to compare the means of the Asthma Knowledge Questionnaire scores before and after therapeutic education. RESULTS Most patients were married and residing in urban areas. The illiteracy rate was 50%. One patient was a regular smoker. 125 patients (56.82%) reported non-compliance to treatment. The pathophysiology of asthma (chronic airway inflammation, bronchial hyperreactivity, and bronchial obstruction), causes and complications, treatment (inhalation technique), asthma attacks and environmental management, lifestyle, and psychological support were the patients' main perceived educational needs. Based on these findings, an instructional program was created and evaluated with 30 patients. After the program, asthma knowledge increased significantly. CONCLUSION Our results suggest that an educational intervention can improve asthma knowledge.
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Affiliation(s)
- Hanane El Abed
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health and Quality of Life, Biology Department, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Atlas, Fez, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Al Ghassani Hospital, Fez, Morocco
| | - Mohammed EA. Ragala
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health and Quality of Life, Biology Department, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Atlas, Fez, Morocco
- Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Bensouda, Fez, Morocco
| | - Jaouad El Hilaly
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRMEF) of Fez. Rue Koweit, Agdal, Fez, Morocco
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Route Oujda, Taza, Morocco
| | - Btissame Zarrouq
- Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Bensouda, Fez, Morocco
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Route Sidi Harazem, Fez, Morocco
| | - Hanaâ Ait-Taleb Lahsen
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health and Quality of Life, Biology Department, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Atlas, Fez, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Al Ghassani Hospital, Fez, Morocco
| | | | - Karima Halim
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health and Quality of Life, Biology Department, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Atlas, Fez, Morocco
- Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Bensouda, Fez, Morocco
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Kube T. Factors influencing the update of beliefs regarding controversial political issues. THE JOURNAL OF SOCIAL PSYCHOLOGY 2023:1-23. [PMID: 37660358 DOI: 10.1080/00224545.2023.2253981] [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: 08/15/2022] [Accepted: 08/05/2023] [Indexed: 09/05/2023]
Abstract
Selectively integrating new information contributes to belief polarization and compromises public discourse. To better understand factors that underlie biased belief updating, I conducted three pre-registered studies covering different controversial political issues. The main hypothesis was that cognitively devaluing new information hinders belief updating. Support for this hypothesis was found in only one of the three issues. The only factor that consistently influenced belief updating across issues was the discrepancy between prior beliefs and new information. These results suggest that usually people do use evidence to correct their beliefs, but may refuse to do so if doubts about its generalizability arise.
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Garrett N, Sharot T. There is no belief update bias for neutral events: failure to replicate Burton et al. (2022). JOURNAL OF COGNITIVE PSYCHOLOGY 2023; 35:876-886. [PMID: 38013976 PMCID: PMC10591604 DOI: 10.1080/20445911.2023.2245112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/01/2023] [Indexed: 11/29/2023]
Abstract
In a recent paper, Burton et al. claim that individuals update beliefs to a greater extent when learning an event is less likely compared to more likely than expected. Here, we investigate Burton's et al.'s, findings. First, we show how Burton et al.'s data do not in fact support a belief update bias for neutral events. Next, in an attempt to replicate their findings, we collect a new data set employing the original belief update task design, but with neutral events. A belief update bias for neutral events is not observed. Finally, we highlight the statistical errors and confounds in Burton et al.'s design and analysis. This includes mis-specifying a reinforcement learning approach to model the data and failing to follow standard computational model fitting sanity checks such as parameter recovery, model comparison and out of sample prediction. Together, the results find little evidence for biased updating for neutral events.
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Affiliation(s)
- Neil Garrett
- School of Psychology, University of East Anglia, Norwich, UK
| | - Tali Sharot
- Affective Brain Lab, Department of Experimental Psychology, University College London, London, UK
- The Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
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20
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Kube T. Biased belief updating in depression. Clin Psychol Rev 2023; 103:102298. [PMID: 37290245 DOI: 10.1016/j.cpr.2023.102298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/14/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
Cognitive approaches to depression have benefitted from recent research on belief updating, examining how new information is used to alter beliefs. This review presents recent advances in understanding various sources of bias in belief updating in depression. Specifically, research has demonstrated that people with depression have difficulty revising negative beliefs in response to novel positive information, whereas belief updating in depression is not related to an enhanced integration of negative information. In terms of mechanisms underlying the deficient processing of positive information, research has shown that people with depression use defensive cognitive strategies to devalue novel positive information. Furthermore, the disregard of novel positive information can be amplified by the presence of state negative affect, and the resulting persistence of negative beliefs in turn perpetuates chronically low mood, contributing to a self-reinforcing negative feedback loop of beliefs and affect. Synthesising previous research, this review proposes a coherent framework of when belief change is likely to occur, and argues that future research also needs to elucidate why people with depression hesitate to abandon negative beliefs. Recent insights from belief updating have not only improved the understanding of the psychopathology of depression, but also have the potential to improve its cognitive-behavioural treatment.
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Affiliation(s)
- Tobias Kube
- Department of Clinical Psychology and Psychotherapy, RPTU Kaiserslautern-Landau, Germany.
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21
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If the discrepancy between expectations and actual information is too large, expectation change decreases - A replication study. J Behav Ther Exp Psychiatry 2023; 79:101831. [PMID: 36521199 DOI: 10.1016/j.jbtep.2022.101831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/17/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Mental disorders have been related to aberrations in using novel positive information to revise established negative beliefs. Previous research used to make a binary distinction between belief-confirming vs. -disconfirming information, but recently it has been examined how varying levels of positive information is used to update beliefs. The present study aimed to replicate a recent finding suggesting that positive information that deviates to a large extent from people's prior expectations raises doubts about the credibility of new information and therefore hardly leads to change in expectations. METHODS In a heterogenous sample (N = 144), participants were provided with slightly positive, moderately positive, or extremely positive information in relation to their prior expectations about other people's behaviour. RESULTS Replicating previous research, the present study found that expectation change was greatest for moderately positive information. It also provided evidence for a possible mechanism underlying the inverse U-shaped relationship between the positivity of new information and change in expectations: Extremely positive information was devalued through defensive cognitive strategies, referred to as cognitive immunisation. LIMITATIONS Unlike previous research, the belief update task used in this study did not show any association with depressive symptoms, so it is questionable how suitable it is to study biased belief updating in depression. CONCLUSIONS Unlike traditional learning models, the present results suggest a tipping point above which the discrepancy between expectation and outcome is suspiciously large, so that the degree of expectation change decreases.
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Fromm SP, Wieland L, Klettke A, Nassar MR, Katthagen T, Markett S, Heinz A, Schlagenhauf F. Computational mechanisms of belief updating in relation to psychotic-like experiences. Front Psychiatry 2023; 14:1170168. [PMID: 37215663 PMCID: PMC10196365 DOI: 10.3389/fpsyt.2023.1170168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/07/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Psychotic-like experiences (PLEs) may occur due to changes in weighting prior beliefs and new evidence in the belief updating process. It is still unclear whether the acquisition or integration of stable beliefs is altered, and whether such alteration depends on the level of environmental and belief precision, which reflects the associated uncertainty. This motivated us to investigate uncertainty-related dynamics of belief updating in relation to PLEs using an online study design. Methods We selected a sample (n = 300) of participants who performed a belief updating task with sudden change points and provided self-report questionnaires for PLEs. The task required participants to observe bags dropping from a hidden helicopter, infer its position, and dynamically update their belief about the helicopter's position. Participants could optimize performance by adjusting learning rates according to inferred belief uncertainty (inverse prior precision) and the probability of environmental change points. We used a normative learning model to examine the relationship between adherence to specific model parameters and PLEs. Results PLEs were linked to lower accuracy in tracking the outcome (helicopter location) (β = 0.26 ± 0.11, p = 0.018) and to a smaller increase of belief precision across observations after a change point (β = -0.003 ± 0.0007, p < 0.001). PLEs were related to slower belief updating when participants encountered large prediction errors (β = -0.03 ± 0.009, p = 0.001). Computational modeling suggested that PLEs were associated with reduced overall belief updating in response to prediction errors (βPE = -1.00 ± 0.45, p = 0.028) and reduced modulation of updating at inferred environmental change points (βCPP = -0.84 ± 0.38, p = 0.023). Discussion We conclude that PLEs are associated with altered dynamics of belief updating. These findings support the idea that the process of balancing prior belief and new evidence, as a function of environmental uncertainty, is altered in PLEs, which may contribute to the development of delusions. Specifically, slower learning after large prediction errors in people with high PLEs may result in rigid beliefs. Disregarding environmental change points may limit the flexibility to establish new beliefs in the face of contradictory evidence. The present study fosters a deeper understanding of inferential belief updating mechanisms underlying PLEs.
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Affiliation(s)
- Sophie Pauline Fromm
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lara Wieland
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Arne Klettke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthew R. Nassar
- Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Department of Neuroscience, Brown University, Providence, RI, United States
| | - Teresa Katthagen
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
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23
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Malkki VK, Rosenström TH, Jokela MM, Saarni SE. Associations between specific depressive symptoms and psychosocial functioning in psychotherapy. J Affect Disord 2023; 328:29-38. [PMID: 36773764 DOI: 10.1016/j.jad.2023.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/21/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Psychotherapy for depression aims to reduce symptoms and to improve psychosocial functioning. We examined whether some symptoms are more important than others in the association between depression and functioning over the course of psychotherapy treatment. METHODS We studied associations between specific symptoms of depression (PHQ-9) and change in social and occupational functioning (SOFAS), both with structural equation models (considering liabilities of depression and each specific symptom) and with logistic regression models (considering the risk for individual patients). The study sample consisted of adult patients (n = 771) from the Finnish Psychotherapy Quality Registry (FPQR) who completed psychotherapy treatment between September 2018 and September 2021. RESULTS Based on our results of logistic regression analyses and SEM models, the baseline measures of depression symptoms were not associated with changes in functioning. Changes in depressed mood or hopelessness, problems with sleep, feeling tired, and feeling little interest or pleasure were associated with improved functioning during psychotherapy. The strongest evidence for symptom-specific effects was found for the symptom of depressed mood or hopelessness. LIMITATIONS Due to our naturalistic study design containing only two measurement points, we were unable to study the causal relationship between symptoms and functioning. CONCLUSIONS Changes in certain symptoms during psychotherapy may affect functioning independently of underlying depression. Knowledge about the dynamics between symptoms and functioning could be used in treatment planning or implementation. Depressed mood or hopelessness appears to have a role in the dynamic relationship between depression and functioning.
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Affiliation(s)
- Veera K Malkki
- Psychiatry, Helsinki University Hospital and University of Helsinki, Finland.
| | - Tom H Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Markus M Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Suoma E Saarni
- Psychiatry, Helsinki University Hospital and University of Helsinki, Finland
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24
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Scheunemann J, Jelinek L, Biedermann SV, Lipp M, Yassari AH, Kühn S, Gallinat J, Moritz S. Can you trust this source? Advice taking in borderline personality disorder. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-022-01539-w. [PMID: 36629942 DOI: 10.1007/s00406-022-01539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
Research suggests that patients with borderline personality disorder (BPD) share a range of cognitive biases with patients with psychosis. As the disorder often manifests in dysfunctional social interactions, we assumed associated reasoning styles would be exaggerated in a social setting. For the present study, we applied the Judge-Advisor System by asking participants to provide initial estimates of a person's age and presumed hostility based on a portrait photo. Afterwards, we presented additional cues/advice in the form of responses by anonymous previous respondents. Participants could revise their estimate, seek additional advice, or make a decision. Contrary to our preregistered hypothesis, patients with BPD (n = 38) performed similarly to healthy controls (n = 30). Patients sought the same number of pieces of advice, were equally confident, and used advice in similar ways to revise their estimates. Thus, patients with BPD did trust advice. However, patients gave higher hostility ratings to the portrayed persons. In conclusion, patients with BPD showed no cognitive biases in seeking, evaluating, and integrating socially provided information. While the study implies emotional rather than cognitive biases in the disorder, cognitive biases may still prove to be useful treatment targets in order to encourage delaying and reflecting on extreme emotional responses in social interactions.
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Affiliation(s)
- Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah V Biedermann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Lipp
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amir H Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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25
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Association of pessimism with cardiovascular events and all-cause mortality. Prog Cardiovasc Dis 2023; 76:91-98. [PMID: 36462555 DOI: 10.1016/j.pcad.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022]
Abstract
Poor psychological health is associated with Takotsubo cardiomyopathy, cardiac syndrome X, coronary microcirculatory dysfunction, peripheral artery disease, or spontaneous coronary artery dissection. Data regarding pessimism, cardiovascular disease (CVD) events and mortality and all-cause mortality remained inconclusive. This systematic review and meta-analysis aim to provide an overview of the association between pessimism, CVD outcomes and mortality. A systematic search of electronic databases was conducted from inception through July 2022 for studies evaluating pessimism and adverse outcomes. A total of 17 studies published between 1966 and July 2022 met our inclusion criteria, for a total of 232,533 individuals. Pooled hazard ratios were calculated in random-effects meta-analyses. Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.13 (95% CI 1.07-1.19) for all-cause mortality with minimal heterogeneity (I2 = 28.5%). Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.30 (95% CI 0.43-3.95) for CHD mortality, adjusted HR of 1.41 (95% CI 1.05-1.91) for CVD mortality, and adjusted HR of 1.43 (95% CI 0.64-3.16) for stroke. In conclusion, pessimism seems to be significantly associated with a higher risk for and poorer outcomes from CVD events than optimistic styles. There are genetic and other bases for these life approaches, but behavioral, cognitive and meditative interventions can modify patients' level of pessimism, hopefully leading to better medical outcomes. Testing this theory would yield highly useful and practical data for clinical care.
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26
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Schamong I, D'Astolfo L, Bollmann S, Brakemeier E, Kube T. How expectations and therapeutic style influence counselling outcome. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Isabel Schamong
- Department of Clinical Psychology and Psychotherapy Philipps University Marburg Marburg Germany
| | - Lisa D'Astolfo
- Department of Clinical Psychology and Psychotherapy Philipps University Marburg Marburg Germany
| | - Simon Bollmann
- Department of Clinical Psychology and Psychotherapy Philipps University Marburg Marburg Germany
| | - Eva‐Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy Philipps University Marburg Marburg Germany
- Department of Clinical Psychology and Psychotherapy University of Greifswald Greifswald Germany
| | - Tobias Kube
- Department of Clinical Psychology and Psychotherapy Philipps University Marburg Marburg Germany
- Department of Clinical Psychology and Psychotherapy University of Landau Landau Germany
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27
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Calabro R, Lyu Y, Leong YC. Trial-by-trial fluctuations in amygdala activity track motivational enhancement of desirable sensory evidence during perceptual decision-making. Cereb Cortex 2022; 33:5690-5703. [PMID: 36398723 DOI: 10.1093/cercor/bhac452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
People are biased toward seeing outcomes that they are motivated to see. For example, wanting their favored team to prevail biases sports fans to perceive an ambiguous foul in a manner that is favorable to the team they support. Here, we test the hypothesis that such motivational biases in perceptual decision-making are associated with amygdala activity. We used monetary incentives to experimentally manipulate participants to want to see one percept over another while they performed a categorization task involving ambiguous images. Participants were more likely to categorize an image as the category we motivated them to see, suggesting that wanting to see a particular percept biased their perceptual decisions. Heightened amygdala activity was associated with motivation consistent categorizations and tracked trial-by-trial enhancement of neural activity in sensory cortices encoding the desirable category. Analyses using a drift diffusion model further suggest that trial-by-trial amygdala activity was specifically associated with biases in the accumulation of sensory evidence. In contrast, frontoparietal regions commonly associated with biases in perceptual decision-making were not associated with motivational bias. Altogether, our results suggest that wanting to see an outcome biases perceptual decisions via distinct mechanisms and may depend on dynamic fluctuations in amygdala activity.
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Affiliation(s)
- Ren Calabro
- 5848 S University Avenue, Department of Psychology, University of Chicago , Chicago, IL 60637 , USA
| | - Yizhou Lyu
- 5848 S University Avenue, Department of Psychology, University of Chicago , Chicago, IL 60637 , USA
| | - Yuan Chang Leong
- 5848 S University Avenue, Department of Psychology, University of Chicago , Chicago, IL 60637 , USA
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28
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Cognitive Reactivity Amplifies the Activation and Development of Negative Self-schema: A Revised Mnemic Neglect Paradigm and Computational Modelling. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10332-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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29
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Seitz RJ, Angel HF, Paloutzian RF, Taves A. Believing and social interactions: effects on bodily expressions and personal narratives. Front Behav Neurosci 2022; 16:894219. [PMID: 36275855 PMCID: PMC9584167 DOI: 10.3389/fnbeh.2022.894219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
The processes of believing integrate external perceptual information from the environment with internal emotional states and prior experience to generate probabilistic neural representations of events, i.e., beliefs. As these neural representations manifest mostly below the level of a person's conscious awareness, they may inadvertently affect the spontaneous person's bodily expressions and prospective behavior. By yet to be understood mechanisms people can become aware of these representations and reflect upon them. Typically, people can communicate the content of their beliefs as personal statements and can summarize the narratives of others to themselves or to other people. Here, we describe that social interactions may benefit from the consistency between a person's bodily expressions and verbal statements because the person appears authentic and ultimately trustworthy. The transmission of narratives can thus lay the groundwork for social cooperation within and between groups and, ultimately, between communities and nations. Conversely, a discrepancy between bodily expressions and narratives may cause distrust in the addressee(s) and eventually may destroy social bonds.
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Affiliation(s)
- Rüdiger J. Seitz
- Department of Neurology, Centre of Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Hans-Ferdinand Angel
- Institute of Catechetic and Pedagogic of Religion, Karl Franzens University Graz, Graz, Austria
| | | | - Ann Taves
- Department of Religious Studies, University of California, Santa Barbara, CA, United States
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30
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Herzog P, Kube T, Fassbinder E. How childhood maltreatment alters perception and cognition - the predictive processing account of borderline personality disorder. Psychol Med 2022; 52:2899-2916. [PMID: 35979924 PMCID: PMC9693729 DOI: 10.1017/s0033291722002458] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/24/2022] [Accepted: 07/18/2022] [Indexed: 01/05/2023]
Abstract
Borderline personality disorder (BPD) is a severe mental disorder, comprised of heterogeneous psychological and neurobiological pathologies. Here, we propose a predictive processing (PP) account of BPD to integrate these seemingly unrelated pathologies. In particular, we argue that the experience of childhood maltreatment, which is highly prevalent in BPD, leaves a developmental legacy with two facets: first, a coarse-grained, alexithymic model of self and others - leading to a rigidity and inflexibility concerning beliefs about self and others. Second, this developmental legacy leads to a loss of confidence or precision afforded beliefs about the consequences of social behavior. This results in an over reliance on sensory evidence and social feedback, with concomitant lability, impulsivity and hypersensitivity. In terms of PP, people with BPD show a distorted belief updating in response to new information with two opposing manifestations: rapid changes in beliefs and a lack of belief updating despite disconfirmatory evidence. This account of distorted information processing has the potential to explain both the instability (of affect, self-image, and interpersonal relationships) and the rigidity (of beliefs about self and others) which is typical of BPD. At the neurobiological level, we propose that enhanced levels of dopamine are associated with the increased integration of negative social feedback, and we also discuss the hypothesis of an impaired inhibitory control of the prefrontal cortex in the processing of negative social information. Our account may provide a new understanding not only of the clinical aspects of BPD, but also a unifying theory of the corresponding neurobiological pathologies. We conclude by outlining some directions for future research on the behavioral, neurobiological, and computational underpinnings of this model, and point to some clinical implications of it.
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Affiliation(s)
- Philipp Herzog
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, D-23562 Lübeck, Germany
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University of Kiel, Niemannsweg 147, D-24105 Kiel, Germany
- Department of Psychology, University of Koblenz-Landau, Ostbahnstr. 10, 76829 Landau, Germany
| | - Tobias Kube
- Department of Psychology, University of Koblenz-Landau, Ostbahnstr. 10, 76829 Landau, Germany
| | - Eva Fassbinder
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University of Kiel, Niemannsweg 147, D-24105 Kiel, Germany
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31
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Hertel P, Acuff MC, Hernandez J, Poppe E. Challenging depressive beliefs: Habitual and recollective components of stability or change. J Behav Ther Exp Psychiatry 2022; 76:101742. [PMID: 35738689 DOI: 10.1016/j.jbtep.2022.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 01/25/2022] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Depressed people tend to hold stable negative beliefs that resist challenges. Two experiments investigated the cognitive bases of belief change or resistance to change following the provision of supportive or challenging pseudo-evidence. METHOD Students scoring high and low on a measure of depressed state read belief statements, each followed by invented experimental evidence to either verify or discount them. Two days later, they read all the belief statements again, together with new statements, this time rating belief. RESULTS The students agreed that the statements described common beliefs and that the evidence was plausible. Discounted statements were believed less than new statements on the test. Also, dysphoric students believed discounted and new statements less than verified statements, but that difference was larger for the nondysphoric students. Parameter estimates of the habitual basis for belief ratings, obtained with process-dissociation procedures, were higher in the dysphoric group, and estimates of evidence recollection were lower. The latter finding was conceptually supported by deficient recognition of the gist of the discounting evidence in the dysphoric group (Experiment 2). LIMITATIONS Experiment 2 results replicated the rating effects in Experiment 1, but not the parameter differences, due to low power as a consequence of the university response to the pandemic. CONCLUSIONS We interpret these results in the context of other evidence regarding belief change and depressive cognition, such as habitual rumination and deficient cognitive control.
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32
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D'Mello AM, Bach P, Corlett PR, Rozenkrantz L. Editorial: Predictive mechanisms in action, perception, cognition, and clinical disorders. Front Hum Neurosci 2022; 16:1005905. [PMID: 36118963 PMCID: PMC9472117 DOI: 10.3389/fnhum.2022.1005905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Anila M. D'Mello
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States
- *Correspondence: Anila M. D'Mello
| | - Patric Bach
- School of Psychology, University of Aberdeen, Aberdeen, Scotland
| | - Philip R. Corlett
- Department of Psychiatry, Yale University, New Haven, CT, United States
- Department of Psychology, Yale University, New Haven, CT, United States
- Wu Tsai Institute, Yale University, New Haven, CT, United States
| | - Liron Rozenkrantz
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Liron Rozenkrantz
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33
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Van Dessel P, Boddez Y, Hughes S. Nudging societally relevant behavior by promoting cognitive inferences. Sci Rep 2022; 12:9201. [PMID: 35654869 PMCID: PMC9161190 DOI: 10.1038/s41598-022-12964-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/19/2022] [Indexed: 12/05/2022] Open
Abstract
Effective behavioral interventions are essential to address urgent societal challenges. Over the past decade, nudging interventions (i.e., arranging the environment to promote adaptive behavioral choices) have surged in popularity. Importantly, effective application of the nudging approach requires clear guiding principles with a firm basis in behavioral science. We present a framework for nudging interventions that builds on evidence about the goal-directed inferential processes underlying behavior (i.e., processes that involve context-dependent inferences about goals and the actions available to achieve these goals). We used this framework to develop nudging interventions that target context-relevant cognitive inferences. We examined the effectiveness of these inference nudging interventions for promoting two important types of societal behavior: pro-environmental actions and adherence to COVID-19 guidelines. As predicted, two online studies revealed that inference nudging interventions successfully increased energy conservation (Study 1) as well as social distancing during the COVID-19 crisis (Study 2). A field experiment found that inference nudging interventions increased hand disinfection in a real-life store during the COVID-19 crisis (Study 3). Our findings highlight the importance of applying state-of-the-art insights about the (inferential) determinants of behavior in behavior change interventions.
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Affiliation(s)
- Pieter Van Dessel
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000, Ghent, Belgium.
| | - Yannick Boddez
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000, Ghent, Belgium
| | - Sean Hughes
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000, Ghent, Belgium
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34
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Kube T, Körfer K, Riecke J, Glombiewski JA. How expectancy violations facilitate learning to cope with pain - An experimental approach. J Psychosom Res 2022; 157:110807. [PMID: 35390722 DOI: 10.1016/j.jpsychores.2022.110807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Expectations of painful sensations constitute a core feature of chronic pain. An important clinical question is whether such expectations are revised when disconfirming experiences are made (e.g., less pain than expected). This study examined how people adjust their pain expectations when the experience of decreasing pain is expected vs. unexpected. METHODS In a novel randomized between-subjects design, a subclinical sample of people who frequently experience pain was provided with painful thermal stimulations. Unbeknownst to participants, the temperature applied was decreased from trial to trial. Based on the experimental instructions provided, this experience of decreasing pain was expected in one condition (expectation-confirmation; n = 34), whereas it was unexpected in another (expectation-disconfirmation; n = 39). RESULTS Perceived pain intensity was lower in the expectation-confirmation condition than in the expectation-disconfirmation condition (p = .014, ηp2 = 0.083). The expectation-confirmation condition also showed a greater adjustment of their pain expectations than the expectation-disconfirmation condition (p = .046, ηp2 = 0.047). Across groups, large expectation violations (i.e., less pain than expected) were associated with increases in pain tolerance and the ability to cope with pain at a one-week follow-up. CONCLUSIONS In terms of assimilation, perceived pain intensity was shaped in the direction of pain expectations. The greater adjustment of expectations in the expectation-confirming condition is consistent with a confirmation bias in pain perception. Though participants who experienced large discrepancies between expected and experienced pain were hesitant to adjust their pain expectations immediately, expectation violations increased their ability to cope with pain one week later, suggesting some beneficial longer-term effects of expectation violations.
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Affiliation(s)
- Tobias Kube
- Pain and Psychotherapy Research Lab, University of Koblenz-, Landau, Germany.
| | - Karoline Körfer
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany
| | - Jenny Riecke
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany
| | - Julia A Glombiewski
- Pain and Psychotherapy Research Lab, University of Koblenz-, Landau, Germany
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35
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Sopp MR, Haim-Nachum S, Wirth BE, Bonanno GA, Levy-Gigi E. Leaving the door open: Trauma, updating, and the development of PTSD symptoms. Behav Res Ther 2022; 154:104098. [DOI: 10.1016/j.brat.2022.104098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 02/09/2022] [Accepted: 04/08/2022] [Indexed: 02/07/2023]
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36
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Mokady A, Reggev N. The Role of Predictions, Their Confirmation, and Reward in Maintaining the Self-Concept. Front Hum Neurosci 2022; 16:824085. [PMID: 35399356 PMCID: PMC8987106 DOI: 10.3389/fnhum.2022.824085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
The predictive processing framework posits that people continuously use predictive principles when interacting with, learning from, and interpreting their surroundings. Here, we suggest that the same framework may help explain how people process self-relevant knowledge and maintain a stable and positive self-concept. Specifically, we recast two prominent self-relevant motivations, self-verification and self-enhancement, in predictive processing (PP) terms. We suggest that these self-relevant motivations interact with the self-concept (i.e., priors) to create strong predictions. These predictions, in turn, influence how people interpret information about themselves. In particular, we argue that these strong self-relevant predictions dictate how prediction error, the deviation from the original prediction, is processed. In contrast to many implementations of the PP framework, we suggest that predictions and priors emanating from stable constructs (such as the self-concept) cultivate belief-maintaining, rather than belief-updating, dynamics. Based on recent findings, we also postulate that evidence supporting a predicted model of the self (or interpreted as such) triggers subjective reward responses, potentially reinforcing existing beliefs. Characterizing the role of rewards in self-belief maintenance and reframing self-relevant motivations and rewards in predictive processing terms offers novel insights into how the self is maintained in neurotypical adults, as well as in pathological populations, potentially pointing to therapeutic implications.
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Affiliation(s)
- Aviv Mokady
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - Niv Reggev
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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37
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Petereit P, Jessen S, Goregliad Fjaellingsdal T, Krämer UM. Social Context and Rejection Expectations Modulate Neural and Behavioral Responses to Social Feedback. J Cogn Neurosci 2022; 34:823-845. [PMID: 35139190 DOI: 10.1162/jocn_a_01829] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
When meeting other people, some are optimistic and expect to be accepted by others, whereas others are pessimistic and expect mostly rejections. How social feedback is evaluated in situations that meet or do not meet these biases and how people differ in their response to rejection and acceptance depending on the social situation are unknown. In this study, participants experienced rejection and acceptance by peers in two different social contexts, one with high (negative context) and the other with low probability of rejection (positive context). We examined how the neural and behavioral responses to rejection are altered by this context and whether it depends on the individual's sensitivity to rejection. Behavioral results show that, on average, people maintain an optimistic bias even when mostly experiencing rejection. Importantly, personality differences in rejection sensitivity affected both prior expectations to be rejected in the paradigm and the extent to which expectations changed during the paradigm. The context also strongly modulated ERPs and theta responses to rejection and acceptance feedback. Specifically, valence effects on neural responses were enhanced in the negative context, suggesting a greater relevance to monitor social feedback in such a situation. Moreover, midfrontal theta predicted how expectations were changed in response to prediction errors, stressing a role for theta in learning from social feedback. Surprisingly, interindividual differences in rejection sensitivity did not affect neural responses to feedback. Our results stress the importance of considering the interaction between subjective expectations and the social context for behavioral and neural responses to social rejection.
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Hobbs C, Vozarova P, Sabharwal A, Shah P, Button K. Is depression associated with reduced optimistic belief updating? ROYAL SOCIETY OPEN SCIENCE 2022; 9:190814. [PMID: 35127107 PMCID: PMC8808098 DOI: 10.1098/rsos.190814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/07/2022] [Indexed: 05/04/2023]
Abstract
When asked to evaluate their probability of experiencing a negative life event, healthy individuals update their beliefs more following good news than bad. This is referred to as optimistic belief updating. By contrast, individuals with depression update their beliefs by a similar amount, showing reduced optimism. We conducted the first independent replication of this effect and extended this work to examine whether reduced optimistic belief updating in depression also occurs for positive life events. Replicating previous research, healthy and depression groups differed in belief updating for negative events (β = 0.71, 95% CI: 0.24, 1.18). Whereas healthy participants updated their beliefs more following good news than bad, individuals experiencing depression lacked this bias. However, our findings for positive events were inconclusive. While we did not find statistical evidence that patterns of belief updating between groups varied by valence (β = -0.51, 95% CI: -1.16, 0.15), mean update scores suggested that both groups showed largely similar updating for positive life events. Our results add confidence to previous findings that depression is characterized by negative future expectations maintained by reduced updating in response to good news. However, further research is required to understand the specificity of this to negative events, and into refining methods for quantifying belief updating in clinical and non-clinical research.
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Affiliation(s)
- Catherine Hobbs
- Department of Psychology, University of Bath, 10 West, Bath BA2 7AY
| | - Petra Vozarova
- Department of Psychology, University of Bath, 10 West, Bath BA2 7AY
| | | | - Punit Shah
- Department of Psychology, University of Bath, 10 West, Bath BA2 7AY
| | - Katherine Button
- Department of Psychology, University of Bath, 10 West, Bath BA2 7AY
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No Evidence for the Involvement of Cognitive Immunisation in Updating Beliefs About the Self in Three Non-Clinical Samples. COGNITIVE THERAPY AND RESEARCH 2022; 46:43-61. [PMID: 34345057 PMCID: PMC8323093 DOI: 10.1007/s10608-021-10256-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cognitive immunisation against disconfirmatory evidence (i.e., devaluing expectation-disconfirming information through cognitive mechanisms) has recently been discussed as an obstacle to the revision of dysfunctional beliefs in mental disorders such as depression. Yet, it is unclear whether cognitive immunisation is also involved in belief updating in non-clinical samples. METHODS Using a three-group modulation protocol (promotion vs. inhibition of cognitive immunisation vs. control group), we examined how cognitive immunisation influences belief updating in response to performance feedback in three non-clinical samples. In Experiments 1 (N = 99) and 2 (N = 93), participants received unexpectedly negative feedback, whereas participants from Experiment 3 (N = 118) received unexpectedly positive feedback. Depressive symptoms and dispositional optimism were examined as additional predictors of belief updating. RESULTS In all experiments, participants adjusted their expectations in line with the feedback received, but this effect was not influenced by the cognitive immunisation manipulation. In Experiment 3, expectation change remained stable over 2 weeks. Depressive symptoms were associated with a reduced integration of positive feedback, but not with an increased sensitivity to negative feedback. CONCLUSIONS Whereas previous research has shown that cognitive immunisation contributes to persistent beliefs in clinical populations, the present findings suggest that it does not affect belief updating in non-clinical samples. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10608-021-10256-y.
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40
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Henss L, Pinquart M. Dispositional and situational predictors of coping with violated achievement expectations. Q J Exp Psychol (Hove) 2021; 75:1121-1134. [PMID: 34507506 DOI: 10.1177/17470218211048108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Most students experience expectation violations during their academic career, such as unexpected failed tests. However, contradictory evidence does not always result in expectation change (accommodation). Expectations often persist through stronger efforts to fulfil the expectation (assimilation) or ignoring the discrepancy (immunisation). Our study addresses possible situational and dispositional predictors that may be decisive influences on the use of the three coping strategies. We conducted an experimental study with n = 439 students who experienced an expectation violation in an achievement test. Dispositional coping tendencies, valence of expectation violation, and the interaction of valence and degree of expectation violation were found to predict situational coping. Furthermore, higher need for cognitive closure predicted stronger accommodation, and a large degree of expectation violation predicted stronger immunisation. Thus, our study provides initial evidence on which situational and dispositional factors predict coping with expectation violations in an educational context. Expectation violation in a performance context mainly resulted in stronger efforts to protect positive achievement expectations.
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Affiliation(s)
- Larissa Henss
- Department of Psychology, Philipps University of Marburg, Marburg, Germany
| | - Martin Pinquart
- Department of Psychology, Philipps University of Marburg, Marburg, Germany
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41
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Rozenkrantz L, D'Mello AM, Gabrieli JDE. Enhanced rationality in autism spectrum disorder. Trends Cogn Sci 2021; 25:685-696. [PMID: 34226128 DOI: 10.1016/j.tics.2021.05.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022]
Abstract
Challenges in social cognition and communication are core characteristics of autism spectrum disorder (ASD), but in some domains, individuals with ASD may display typical abilities and even outperform their neurotypical counterparts. These enhanced abilities are notable in the domains of reasoning, judgment and decision-making, in which individuals with ASD often show 'enhanced rationality' by exhibiting more rational and bias-free decision-making than do neurotypical individuals. We review evidence for enhanced rationality in ASD, how it relates to theoretical frameworks of information processing in ASD, its implications for basic research about human irrationality, and what it may mean for the ASD community.
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Affiliation(s)
- Liron Rozenkrantz
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 01239, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 01239, USA.
| | - Anila M D'Mello
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 01239, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 01239, USA
| | - John D E Gabrieli
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 01239, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 01239, USA
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42
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Sauerland M, Otgaar H. Teaching psychology students to change (or correct) controversial beliefs about memory works. Memory 2021; 30:753-762. [PMID: 33533691 DOI: 10.1080/09658211.2021.1874994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Therapists, judges, law enforcement, and students often believe in the existence of automatic and unconscious repression. Such a belief can be perilous as it might lead therapists to suggestively search for repressed memories leading to false memories. Recovering therapy-induced false memories of criminal acts can have serious consequences. Here, we tested whether erroneous beliefs in repressed memories can be corrected. Surveying two cohorts of Forensic and Legal Psychology Master's students, we examined whether education about the science of (eyewitness) memory can correct erroneous beliefs in repressed memories. Students assessed memory statements before taking a course on eyewitness memory, six weeks after the course exam, and 18 or 6 months later, respectively (Ns = 33-74 per cohort and measurement). As expected, students in both cohorts on average initially strongly agreed with the statement that memories of traumatic events can be unconsciously blocked, but strongly disagreed with the statement after the course. Belief-corrections also persisted after the longer delay. These findings show that educating people about the science of (eyewitness) memory can be effective in correcting false and controversial memory beliefs in general and the existence of repressed memories in specific.
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Affiliation(s)
- Melanie Sauerland
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Henry Otgaar
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Faculty of Law, Catholic University of Leuven, Leuven, Belgium
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Ho SS, Nakamura Y, Swain JE. Compassion As an Intervention to Attune to Universal Suffering of Self and Others in Conflicts: A Translational Framework. Front Psychol 2021; 11:603385. [PMID: 33505336 PMCID: PMC7829669 DOI: 10.3389/fpsyg.2020.603385] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 12/09/2020] [Indexed: 01/09/2023] Open
Abstract
As interpersonal, racial, social, and international conflicts intensify in the world, it is important to safeguard the mental health of individuals affected by them. According to a Buddhist notion "if you want others to be happy, practice compassion; if you want to be happy, practice compassion," compassion practice is an intervention to cultivate conflict-proof well-being. Here, compassion practice refers to a form of concentrated meditation wherein a practitioner attunes to friend, enemy, and someone in between, thinking, "I'm going to help them (equally)." The compassion meditation is based on Buddhist philosophy that mental suffering is rooted in conceptual thoughts that give rise to generic mental images of self and others and subsequent biases to preserve one's egoism, blocking the ultimate nature of mind. To contextualize compassion meditation scientifically, we adopted a Bayesian active inference framework to incorporate relevant Buddhist concepts, including mind (buddhi), compassion (karuna), aggregates (skandhas), suffering (duhkha), reification (samaropa), conceptual thoughts (vikalpa), and superimposition (prapañca). In this framework, a person is considered a Bayesian Engine that actively constructs phenomena based on the aggregates of forms, sensations, discriminations, actions, and consciousness. When the person embodies rigid beliefs about self and others' identities (identity-grasping beliefs) and the resulting ego-preserving bias, the person's Bayesian Engine malfunctions, failing to use prediction errors to update prior beliefs. To counter this problem, after recognizing the causes of sufferings, a practitioner of the compassion meditation aims to attune to all others equally, friends and enemies alike, suspend identity-based conceptual thoughts, and eventually let go of any identity-grasping belief and ego-preserving bias that obscure reality. We present a brain model for the Bayesian Engine of three components: (a) Relation-Modeling, (b) Reality-Checking, and (c) Conflict-Alarming, which are subserved by (a) the Default-Mode Network (DMN), (b) Frontoparietal Network (FPN) and Ventral Attention Network (VAN), and (c) Salience Network (SN), respectively. Upon perceiving conflicts, the strengthening or weakening of ego-preserving bias will critically depend on whether the SN up-regulates the DMN or FPN/VAN, respectively. We propose that compassion meditation can strengthen brain regions that are conducive for suspending prior beliefs and enhancing the attunements to the counterparts in conflicts.
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Affiliation(s)
- S. Shaun Ho
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, United States
| | - Yoshio Nakamura
- Department of Anesthesiology, Division of Pain Medicine, Pain Research Center, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - James E. Swain
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, United States
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Haarsma J, Harmer CJ, Tamm S. A continuum hypothesis of psychotomimetic rapid antidepressants. Brain Neurosci Adv 2021; 5:23982128211007772. [PMID: 34017922 PMCID: PMC8114748 DOI: 10.1177/23982128211007772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/08/2021] [Indexed: 01/10/2023] Open
Abstract
Ketamine, classical psychedelics and sleep deprivation are associated with rapid effects on depression. Interestingly, these interventions also have common psychotomimetic actions, mirroring aspects of psychosis such as an altered sense of self, perceptual distortions and distorted thinking. This raises the question whether these interventions might be acute antidepressants through the same mechanisms that underlie some of their psychotomimetic effects. That is, perhaps some symptoms of depression can be understood as occupying the opposite end of a spectrum where elements of psychosis can be found on the other side. This review aims at reviewing the evidence underlying a proposed continuum hypothesis of psychotomimetic rapid antidepressants, suggesting that a range of psychotomimetic interventions are also acute antidepressants as well as trying to explain these common features in a hierarchical predictive coding framework, where we hypothesise that these interventions share a common mechanism by increasing the flexibility of prior expectations. Neurobiological mechanisms at play and the role of different neuromodulatory systems affected by these interventions and their role in controlling the precision of prior expectations and new sensory evidence will be reviewed. The proposed hypothesis will also be discussed in relation to other existing theories of antidepressants. We also suggest a number of novel experiments to test the hypothesis and highlight research areas that could provide further insights, in the hope to better understand the acute antidepressant properties of these interventions.
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Affiliation(s)
- Joost Haarsma
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Catherine J Harmer
- Department of Psychiatry and Oxford Health NHS Foundation Trust, Warneford Hospital, University of Oxford, Oxford, UK
| | - Sandra Tamm
- Department of Psychiatry and Oxford Health NHS Foundation Trust, Warneford Hospital, University of Oxford, Oxford, UK
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Kesner L, Horáček J. Global Adversities, the Media, and Mental Health. Front Psychiatry 2021; 12:809239. [PMID: 35082704 PMCID: PMC8785246 DOI: 10.3389/fpsyt.2021.809239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/08/2021] [Indexed: 12/14/2022] Open
Abstract
Global communities are currently confronted with a number of complex problems and threats, the reality of which is amplified by the media. These environmental and socio-political stressors have been accompanied by the spread of problematic psychological and behavioural tendencies, such as the growing polarisation of opinions and values, online radicalisation and extremism, deepening xenophobia and nationalism, the proliferation of irrational beliefs and conspiracy theories, and resistance to rational public policy measures. Here we argue that although they fall outside the scope of psychopathology, they nevertheless currently constitute a major challenge for psychiatry as a research domain and a clinical practise. To substantiate this claim, we outline the mechanisms by which media-transmitted stressors impact mental well-being and possibly psychopathology. The common denominator of these global problems and the media's construction of reality is the increase in uncertainty, unpredictability, and uncontrollability, which prompts defensive responding and, in predisposed individuals, functions as a potent source of chronic stress. These contribute to cognitive inflexibility, a strong predisposing factor for the development of rigid beliefs and attitudes, which to varying degrees underlie the adverse psychological and behavioural tendencies mentioned above. We suggest that the tightening of beliefs and ideas that is the result of cognitive rigidity may correspond to the clinical characteristics of induced delusional disorder. This can be seen as a (ultimately maladaptive) defensive strategy for coping with a high degree of uncertainty and unpredictability. We conclude by briefly outlining the possible ways in which psychiatry can face this challenge.
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Affiliation(s)
- Ladislav Kesner
- National Institute of Mental Health, Klecany, Czechia.,Faculty of Arts, Masaryk University, Brno, Czechia
| | - Jiří Horáček
- National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
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46
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Murray H, El-Leithy S. Behavioural Experiments in Cognitive Therapy for Posttraumatic Stress Disorder: Why, When, and How? VERHALTENSTHERAPIE 2020; 31:50-60. [PMID: 34334983 DOI: 10.1159/000511921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Behavioural experiments are an integral component of cognitive therapy (CT) for posttraumatic stress disorder (PTSD), but they can be overlooked due to practical constraints and therapist concerns. Here we describe why behavioural experiments are an important part of CT, where they fit into different elements of treatment for PTSD, how to design and implement effective experiments including coping with unexpected outcomes, and how to incorporate behavioural experiments when therapy is delivered remotely. Clinical case examples are used to illustrate a range of idiosyncratic and creative behavioural experiments.
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Affiliation(s)
- Hannah Murray
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, and Oxford Health NHS Foundation Trust, Oxford, UK
| | - Sharif El-Leithy
- Traumatic Stress Service, South-West London & St George's NHS Trust, London, UK
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