Intersections and Divergences Between Empathizing and Mentalizing: Development, Recent Advancements by Neuroimaging and the Future of Animal Modeling

Parental Neglect and Childhood Obesity Amidst COVID-19: A Developmental Psychopathology Perspective on Health and Developmental Risks

The COVID-19 pandemic has profoundly impacted the mental health and developmental trajectories of children and adolescents, catalyzing a range of psychological and behavioral issues due to enforced lockdowns and other restrictions. This text explores these impacts through the lens of developmental psychopathology, which integrates clinical psychology and developmental science to examine the emergence and evolution of psychological disorders across a lifespan. This paper highlights how pandemic-related disruptions have exacerbated conditions such as anxiety and depression and, notably, increased childhood obesity due to changes in lifestyle and reductions in physical activity. The analysis includes a discussion of how isolation has not only restricted access to educational and psychological resources but also increased the risk of parental mental illness and related familial stress, thereby intensifying issues of neglect and their consequent impact on child health. By employing a developmental psychopathology framework, this paper argues for the necessity of targeted interventions that address these complex interplays of genetic, environmental, and psychological factors. Such interventions aim to support children through structured educational and health-oriented strategies, ensuring their well-being amidst the ongoing challenges posed by the pandemic. This approach underscores the importance of early, multifaceted strategies involving parents, educators, and healthcare providers to foster healthier developmental outcomes for children facing unprecedented global health crises.

Exploring transgenerational inheritance in epigenotypes of DAT heterozygous rats: Circadian anomalies and attentional vulnerability

Dopamine (DA) is mainly involved in locomotor activity, reward processes and maternal behaviors. Rats with KO gene for dopamine transporter (DAT), coding for a truncated DAT protein, are in hyperdopaminergic conditions and thus develop stereotyped behaviors and hyperactivity. Our aim was to test the prior transgenerational modulation of wild and truncated alleles as expressed in heterozygous DAT rats: specifically, we addressed the possible sequelae due to genotype and gender of the ancestors, with regard to behavioral differences in F1, F2, F3 rats. We studied non-classical DAT heterozygotes (HETs) based on two specular lines, with putative grand-maternal vs. grand-paternal imprinting. MAT females (F1; offspring of KO male and WT female) mated with a KO male to generate MIX offspring (F2). Specularly, PAT females (F1; offspring of KO female and WT male) mated with a KO male to generate PIX offspring (F2). Similarly to PAT, we obtained MUX (F2; HET offspring of MAT sire and KO dam); we also observed the F3 (MYX: HET offspring of KO male and MUX female, thus with DAT-KO maternal grandmother like also for PIX). We studied their circadian cycle of locomotor activity and their behavior in the elevated-plus-maze (EPM). Locomotor hyper-activity occurs in F1, the opposite occurs in F2, with MYX rats appearing undistinguishable from WT ones. Open-arm preference emerged in PIX and MIX rats. Only MAT and MYX rats showed a significant vulnerability for ADHD-like inattentive symptoms (duration of rearing in the EPM; Viggiano et al., 2002). A risk-taking profile is evident in the F2 phenotype, while inattentiveness from F1 progeny tends to be transferred to F3. We hypothesize that DAT-related phenotypes result from effective inheritance through pedigree of imprints that are dependent on grandparents, suggesting a protective role for gestation within a hyperdopaminergic uterus. For major features, similar odd (F1, F3) generations appear opposed to even (F2) ones; for minor specific features, the phenotype transfer may affect the progenies with a male but not a female DAT-KO ancestor.

Neuronal, affective, and sensory correlates of targeted helping behavior in male and female Sprague Dawley rats

Introduction

Empathic behaviors are driven by the ability to understand the emotional states of others along with the motivation to improve it. Evidence points towards forms of empathy, like targeted helping, in many species including rats. There are several variables that may modulate targeted helping, including sex, sensory modalities, and activity of multiple neural substrates.

Methods

Using a model of social contact-independent targeted helping, we first tested whether sex differences exist in helping behavior. Next, we explored sex differences in sensory and affective signaling, including direct visualization and an analysis of ultrasonic vocalizations made between animal pairs. Finally, we examined the neural activity in males and females of multiple regions of interest across time. Here, we aim to examine any behavioral differences in our lab's social contact independent targeted helping task between males and females.

Results and Discussion

These findings are the first to intimate that, like other prosocial behaviors, males and females may exhibit similar social-independent targeted helping behavior, but the underlying sensory communication in males and females may differ. In addition, this is the first set of experiments that explore the neural correlates of social-independent targeted helping in both males and females. These results lay the groundwork for future studies to explore the similarities and differences that drive targeted helping in both sexes.

Neural correlates of altered emotional responsivity to infant stimuli in mothers who use substances

Mothers who use substances during pregnancy and postpartum may have altered maternal behavior towards their infants, which can have negative consequences on infant social-emotional development. Since maternal substance use has been associated with difficulties in recognizing and responding to infant emotional expressions, investigating mothers' subjective responses to emotional infant stimuli may provide insight into the neural and psychological processes underlying these differences in maternal behavior. In this study, 39 mothers who used substances during the perinatal period and 42 mothers who did not underwent functional magnetic resonance imaging while viewing infant faces and hearing infant cries. Afterwards, they rated the emotional intensity they thought each infant felt ('think'-rating), and how intensely they felt in response to each infant stimulus ('feel'-rating). Mothers who used substances had lower 'feel'-ratings of infant stimuli compared to mothers who did not. Brain regions implicated in affective processing (e.g., insula, inferior frontal gyrus) were less active in response to infant stimuli, and activity in these brain regions statistically predicted maternal substance-use status. Interestingly, 'think'-ratings and activation in brain regions related to cognitive processing (e.g., medial prefrontal cortex) were comparable between the two groups of mothers. Taken together, these results suggest specific neural and psychological processes related to emotional responsivity to infant stimuli may reflect differences in maternal affective processing and may contribute to differences in maternal behavior in mothers who use substances compared to mothers who do not. The findings suggest potential neural targets for increasing maternal emotional responsivity and improving child outcomes.

Mothers with Dysregulated Eating and Their Offspring's Emotional/Behavioral Functioning during the COVID-19 Pandemic: A Descriptive Study

OBJECTIVE

Research on the psychopathological effects of the COVID-19 pandemic has not specifically focused on mothers with dysregulated eating and their children.

METHODS

This study aimed to observe whether the symptoms of mothers with binge eating episodes (assessed through the SCL-90/R and the TFEQ-R18) worsened from the pre-pandemic period (T1) to the pandemic period (T2). In addition, we sought to assess whether the levels of internalizing/externalizing and dysregulation symptoms in children (assessed through the CBCL 6-18) worsened from T1 to T2.

RESULTS

Our results showed that the values obtained for mothers in the SCL-90/R were significantly higher at T2 (during the pandemic), particularly for Depression, Phobic Anxiety, Interpersonal Sensitivity, and Obsessive-Compulsive subscales. Moreover, in both the Emotional Eating and Uncontrolled Eating subscales of the TFEQ-R18, mothers at T2 scored substantially higher than mothers at T1. The emotional/behavioral functioning of children was more maladaptive at T2, according to mothers, especially for the subscales of Withdrawn, Anxious/Depressed, and Aggressive Behavior. Children also had significantly higher scores on the Internalizing and Externalizing subscales, as well as greater symptoms of dysregulation.

CONCLUSIONS

This study contributes to demonstrating that the COVID-19 pandemic may have had increased maladaptive emotional/behavioral functioning in children and their mothers with dysregulated eating.

Predictors of Mental Health Literacy in a Sample of Health Care Major Students: Pilot Evaluation Study

BACKGROUND

The numerous mental health awareness campaigns during the COVID-19 pandemic have shifted our understanding and perception of mental health.

OBJECTIVE

The purpose of this study is to evaluate predictors of mental health literacy (MHL), that is, one's knowledge and beliefs about mental disorders. We evaluate whether digital health literacy, empathy, and mentalizing contribute to MHL.

METHODS

Our sample consisted of 89 health care major students, aged between 17 and 32 years, studying at a university in Lebanon. The Mental Health Literacy Scale for Healthcare Students (MHLS-HS), the eHealth Literacy Questionnaire (eHLQ), the Basic Empathy Scale (BES), and the Reflective Functioning Questionnaire-8 (RFQ-8) were used.

RESULTS

Multiple regression analyses revealed that the Engagement in Own Health subscale of digital health literacy constituted a predictor of MHL. While empathy and mentalizing did not directly predict MHL, they were found to predict components of MHL.

CONCLUSIONS

This is the first study to evaluate digital health literacy, empathy, and mentalizing as predictors of MHL in Lebanon, a country where mental health is still considered taboo. Moreover, this pilot study is the first to provide some support for the predictive role of some digital health literacy subscales on MHL in light of the rise of the digital era following the COVID-19 pandemic.

Breastfeeding Apps: A Descriptive Report

BACKGROUND

Women are increasingly using breastfeeding apps to facilitate and organize breastfeeding; however, no study has so far focused on maternal psychopathological risk and on the quality of dyadic exchanges in this field.

AIM AND METHODS

This preliminary, descriptive study aimed at evaluating levels of psychopathological symptoms (through the SCL-90/R) and for the quality of the interactions they have with their children during feeding (through the SVIA) in mothers who use breastfeeding apps with different grades of engagement.

RESULTS

Data analyses showed that mothers with a mild use of the apps present a higher quality of dyadic interactions during feeding and lower psychopathological risk.

CONCLUSIONS

The cross-sectional and descriptive nature of this study does not allow any causal conclusions. However, results suggest that the higher the engagement and use of breastfeeding apps, the lower the quality of feeding interactions and the higher the maternal psychopathological risk.

Epidemiology, Etiology and Intervention Strategies for Peri-Partum Depression in Mothers

The prevalence of peri-partum depression (PPD) varies widely across countries, with rates ranging from 10% to 15% depending on the screening method used and the country studied [...].

Hemodynamic correlates of emotion regulation in frontal lobe epilepsy patients and healthy participants

The ability to regulate emotions is indispensable for maintaining psychological health. It heavily relies on frontal lobe functions which are disrupted in frontal lobe epilepsy. Accordingly, emotional dysregulation and use of maladaptive emotion regulation strategies have been reported in frontal lobe epilepsy patients. Therefore, it is of clinical and scientific interest to investigate emotion regulation in frontal lobe epilepsy. We studied neural correlates of upregulating and downregulating emotions toward aversive pictures through reappraisal in 18 frontal lobe epilepsy patients and 17 healthy controls using functional magnetic resonance imaging. Patients tended to report more difficulties with impulse control than controls. On the neural level, patients had diminished activity during upregulation in distributed left-sided regions, including ventrolateral and dorsomedial prefrontal cortex, angular gyrus and anterior temporal gyrus. Patients also showed less activity than controls in the left precuneus for upregulation compared to downregulation. Unlike controls, they displayed no task-related activity changes in the left amygdala, whereas the right amygdala showed task-related modulations in both groups. Upregulation-related activity changes in the left inferior frontal gyrus, insula, orbitofrontal cortex, anterior and posterior cingulate cortex, and precuneus were correlated with questionnaire data on habitual emotion regulation. Our results show that structural or functional impairments in the frontal lobes disrupt neural mechanisms underlying emotion regulation through reappraisal throughout the brain, including posterior regions involved in semantic control. Findings on the amygdala as a major target of emotion regulation are in line with the view that specifically the left amygdala is connected with semantic processing networks.

Personality and mentalization: A latent profile analysis of mentalizing problematics in adult patients

BACKGROUND

The aim of this study was to investigate the relationship between patients' mentalizing problematics and their personality; specifically, it aimed to identify clusters of individuals characterized by specific patterns of mentalizing imbalances and to analyze the relationship between these and diagnosis of personality disorder (PD), nonmentalizing modes, emotion dysregulation, and interpersonal reactivity.

METHODS

Four hundred therapeutic dyads were recruited. A part of these (n = 183) only completed clinician-report measures, Mentalization Imbalances Scale, and Modes of Mentalization Scale, while others (n = 217) also completed patients' self-report measures, which were Reflective Functioning Questionnaire, Difficulties in Emotion Regulation Scale, and Interpersonal Reactivity Index.

RESULTS

A latent profile analysis enlightened the presence of four clusters with problematics in the dimensions of mentalization, indicated by cluster names: (1) Affective-self-automatic profile (ASA-P) (with higher percentage of PDs); (2) External profile (E-P) (with lower percentage of PDs); (3) Others-automatic-affective profile (OAA-P); (4) Cognitive-self-automatic profile (CSA-P). Multivariate analysis of variances confirmed that the four clusters differed in relation to the quality of mentalization, emotional dysregulation and interpersonal reactivity, with higher levels of nonmentalization modes, uncertainty about mental states and emotion dysregulation in ASA-P, higher levels of good mentalization in E-P, lower impulsivity in CSA-P, and greater empathic concern in OAA-P.

Affective mirror and anti-mirror neurons relate to prosocial help in rats

Although empathic emotion is closely related to prosocial behavior, neuronal substrate that accounts for empathy-associated prosocial action remains poorly understood. We recorded neurons in the anterior cingulate cortex (ACC) and insular cortex (InC) in rats when they observed another rat in pain. We discovered neurons with anti-mirror properties in the ACC and InC, in addition to those with mirror properties. ACC neurons show higher coupling between activation of self-in-pain and others-in-pain, whereas the InC has a higher ratio of neurons with anti-mirror properties. During others-in-pain, ACC neurons activated more when actively nose-poking toward others and InC neurons activated more when freezing. To further illustrate prosocial function, we examined neuronal activities in the helping behavior test. Both ACC and InC neurons showed specific activation to rat rescuing which is contributed by mirror, but not anti-mirror neurons. Our work indicates the functional involvement of mirror neuron system in prosocial behaviors.

A Common Neural Account for Social and Nonsocial Decisions

To date, social and nonsocial decisions have been studied largely in isolation. Consequently, the extent to which social and nonsocial forms of decision uncertainty are integrated using shared neurocomputational resources remains elusive. Here, we address this question using simultaneous electroencephalography (EEG)-functional magnetic resonance imaging (fMRI) in healthy human participants (young adults of both sexes) and a task in which decision evidence in social and nonsocial contexts varies along comparable scales. First, we identify time-resolved build-up of activity in the EEG, akin to a process of evidence accumulation (EA), across both contexts. We then use the endogenous trial-by-trial variability in the slopes of these accumulating signals to construct parametric fMRI predictors. We show that a region of the posterior-medial frontal cortex (pMFC) uniquely explains trial-wise variability in the process of evidence accumulation in both social and nonsocial contexts. We further demonstrate a task-dependent coupling between the pMFC and regions of the human valuation system in dorso-medial and ventro-medial prefrontal cortex across both contexts. Finally, we report domain-specific representations in regions known to encode the early decision evidence for each context. These results are suggestive of a domain-general decision-making architecture, whereupon domain-specific information is likely converted into a "common currency" in medial prefrontal cortex and accumulated for the decision in the pMFC.SIGNIFICANCE STATEMENT Little work has directly compared social-versus-nonsocial decisions to investigate whether they share common neurocomputational origins. Here, using combined electroencephalography (EEG)-functional magnetic resonance imaging (fMRI) and computational modeling, we offer a detailed spatiotemporal account of the neural underpinnings of social and nonsocial decisions. Specifically, we identify a comparable mechanism of temporal evidence integration driving both decisions and localize this integration process in posterior-medial frontal cortex (pMFC). We further demonstrate task-dependent coupling between the pMFC and regions of the human valuation system across both contexts. Finally, we report domain-specific representations in regions encoding the early, domain-specific, decision evidence. These results suggest a domain-general decision-making architecture, whereupon domain-specific information is converted into a common representation in the valuation system and integrated for the decision in the pMFC.

Developmental Delays in Socio-Emotional Brain Functions in Persons with an Intellectual Disability: Impact on Treatment and Support

Intellectual disability is a neurodevelopmental disorder with a related co-occurrence of mental health issues and challenging behaviors. In addition to purely cognitive functions, socio-emotional competencies may also be affected. In this paper, the lens of developmental social neuroscience is used to better understand the origins of mental disorders and challenging behaviors in people with an intellectual disability. The current concept of intelligence is broadened by socio-emotional brain functions. The emergence of these socio-emotional brain functions is linked to the formation of the respective neuronal networks located within the different parts of the limbic system. Thus, high order networks build on circuits that process more basic information. The socio-emotional skills can be assessed and complement the results of a standardized IQ-test. Disturbances of the brain cytoarchitecture and function that occur at a certain developmental period may increase the susceptibility to certain mental disorders. Insights into the current mental and socio-emotional functioning of a person may support clinicians in the calibration of treatment and support. Acknowledging the trajectories of the socio-emotional brain development may result in a more comprehensive understanding of behaviors and mental health in people with developmental delays and thus underpin supports for promotion of good mental health in this highly vulnerable population.

Importance of communication in medical practice and medical education: An emphasis on empathy and attitudes and their possible influences

BACKGROUND

Healthcare professionals need to be prepared to promote healthy lifestyles and care for patients. By focusing on what students should be able to perform one day as clinicians, we can bridge the gap between mere theoretical knowledge and its practical application. Gender aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning curricula.

AIM

To determine sets of intellectual, personal, social, and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking, in order to identify training needs.

METHODS

An analysis of training clinicians’ conceptions with respect to optimal medical history taking was performed. The chosen study design also aimed to assess gender effects. Structured interviews with supervising clinicians were carried out in a descriptive study at the Medical University of Vienna. Results were analyzed by conducting a qualitative computer-assisted content analysis of the interviews. Inductive category formation was applied. The main questions posed to the supervisors dealt with (1) Observed competencies of students in medical history taking; and (2) The supervisor’s own conceptions of "ideal medical history taking".

RESULTS

A total of 33 training clinicians (n = 33), engaged in supervising medical students according to the MedUni Vienna’s curriculum standards, agreed to be enrolled in the study and met inclusion criteria. The qualitative content analysis revealed the following themes relevant to taking an anamnesis: (1) Knowledge; (2) Soft skills (relationship-building abilities, trust, and attitude); (3) Methodical skills (structuring, precision, and completeness of information gathering); and (4) Environmental/contextual factors (language barrier, time pressure, interruptions). Overall, health care professionals consider empathy and attitude as critical features concerning the quality of medical history taking. When looking at physicians’ theoretical conceptions, more general practitioners and psychiatrists mentioned attitude and empathy in the context of "ideal medical history taking", with a higher percentage of females. With respect to observations of students’ history taking, a positive impact from attitude and empathy was mainly described by male health care professionals, whereas no predominance of specialty was found. Representatives of general medicine and internal medicine, when observing medical students, more often emphasized a negative impact on history taking when students lacked attitude or showed non-empathetic behavior; no gender-specific difference was detected for this finding.

CONCLUSION

The analysis reveals that for clinicians engaged in medical student education, only a combination of skills, including adequate knowledge and methodical implementations, is supposed to guarantee acceptable performance. This study’s findings support the importance of concepts like relationship building, attitude, and empathy. However, there may be contextual factors in play as well, and transference of theoretical concepts into the clinical setting might prove challenging.

Overlapping and specific neural correlates for empathizing, affective mentalizing, and cognitive mentalizing: A coordinate-based meta-analytic study

While the discussion on the foundations of social understanding mainly revolves around the notions of empathy, affective mentalizing, and cognitive mentalizing, their degree of overlap versus specificity is still unclear. We took a meta-analytic approach to unveil the neural bases of cognitive mentalizing, affective mentalizing, and empathy, both in healthy individuals and pathological conditions characterized by social deficits such as schizophrenia and autism. We observed partially overlapping networks for cognitive and affective mentalizing in the medial prefrontal, posterior cingulate, and lateral temporal cortex, while empathy mainly engaged fronto-insular, somatosensory, and anterior cingulate cortex. Adjacent process-specific regions in the posterior lateral temporal, ventrolateral, and dorsomedial prefrontal cortex might underpin a transition from abstract representations of cognitive mental states detached from sensory facets to emotionally-charged representations of affective mental states. Altered mentalizing-related activity involved distinct sectors of the posterior lateral temporal cortex in schizophrenia and autism, while only the latter group displayed abnormal empathy related activity in the amygdala. These data might inform the design of rehabilitative treatments for social cognitive deficits.

Current rodent models for the study of empathic processes

Empathy is a complex phenomenon critical for group survival and societal bonds. In addition, there is mounting evidence demonstrating empathic behaviors are dysregulated in a multitude of psychiatric disorders ranging from autism spectrum disorder, substance use disorders, and personality disorders. Therefore, understanding the underlying drive and neurobiology of empathy is paramount for improving the treatment outcomes and quality of life for individuals suffering from these psychiatric disorders. While there is a growing list of human studies, there is still much about empathy to understand, likely due to both its complexity and the inherent limitations of imaging modalities. It is therefore imperative to develop, validate, and utilize rodent models of empathic behaviors as translational tools to explore this complex topic in ways human research cannot. This review outlines some of the more prevailing theories of empathy, lists some of the psychiatric disorders with disrupted empathic processes, describes rat and mouse models of empathic behaviors currently used, and discusses ways in which these models have elucidated social, environmental, and neurobiological factors that may modulate empathy. The research tools afforded to rodent models will provide an increasingly clear translational understanding of empathic processes and consequently result in improvements in care for those diagnosed with any one of the many psychiatric disorders.