1
|
Strauss GP, Zamani Esfahlani F, Raugh IM, Luther L, Sayama H. Markov chain analysis indicates that positive and negative emotions have abnormal temporal interactions during daily life in schizophrenia. J Psychiatr Res 2023; 164:344-349. [PMID: 37399755 PMCID: PMC10389280 DOI: 10.1016/j.jpsychires.2023.06.025] [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: 11/10/2022] [Revised: 05/30/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Abstract
Abnormalities in positive and negative emotional experience have been identified in laboratory-based studies in schizophrenia (SZ) and associated with poorer clinical outcomes. However, emotions are not static in daily life-they are dynamic processes that unfold across time and are characterized by temporal interactions. Whether these temporal interactions are abnormal in SZ and associated with clinical outcomes is unclear (i.e., whether the experience of positive/negative emotions at time t increases or decreases the intensity of positive/negative emotions at time t+1). In the current study, participants with SZ (n = 48) and healthy controls (CN; n = 52) completed 6 days of ecological momentary assessment (EMA) surveys that sampled state emotional experience and symptoms. The EMA emotional experience data was submitted to Markov chain analysis to evaluate transitions among combined positive and negative affective states from time t to t+1. Results indicated that: (1) In SZ, the emotion system is more likely to stay in moderate or high negative affect states, regardless of positive affect level; (2) SZ transition to co-activated emotional states more than CN, and once emotional co-activation occurs, the range of emotional states SZ transition to is more variable than CN; (3) Maladaptive transitions among emotional states were significantly correlated with greater positive symptoms and poorer functional outcome in SZ. Collectively, these findings clarify how emotional co-activation occurs in SZ and its effects on the emotion system across time, as well as how negative emotions dampen the ability to sustain positive emotions across time. Treatment implications are discussed.
Collapse
Affiliation(s)
| | | | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Hiroki Sayama
- Departments of Systems Science and Industrial Engineering, Binghamton University, Binghamton, NY, USA
| |
Collapse
|
2
|
Schormann ALA, Pillny M, Haß K, Lincoln TM. "Goals in Focus"-a targeted CBT approach for motivational negative symptoms of psychosis: study protocol for a randomized-controlled feasibility trial. Pilot Feasibility Stud 2023; 9:72. [PMID: 37131247 PMCID: PMC10152726 DOI: 10.1186/s40814-023-01284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 03/28/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The reduction of goal-directed behavior is the main characteristic in motivational negative symptoms of psychosis as it accounts for the long-term decline in psychological well-being and psychosocial functioning. However, the available treatment options are largely unspecific and show only small effects on motivational negative symptoms. Interventions that directly target the relevant psychological mechanisms are likely to be more effective. For "Goals in Focus", we translated findings from basic clinical research on mechanisms underlying motivational negative symptoms into a tailored and comprehensive novel psychological outpatient treatment program. With this study, we will test the feasibility of the therapy manual and the trial procedures. We also aim to examine first estimates of the effect size that can be expected from "Goals in Focus" to inform the sample size calculation of a subsequent fully powered trial. METHODS Thirty participants diagnosed with a schizophrenia spectrum disorder and at least moderate motivational negative symptoms will be randomly assigned to either 24 sessions of "Goals in Focus" over the course of 6 months (n = 15) or to a 6-month wait-list control group (n = 15). Single-blind assessments will be conducted at baseline (t0) and 6 months after baseline completion (t1). Feasibility outcomes include patient recruitment, retention, and attendance rates. Acceptability will be rated by trial therapists and by participants at end of treatment. Primary outcome for effect size estimation is the motivational negative symptom subscale sum score of the Brief Negative Symptom Scale at t1 corrected for baseline values. Secondary outcomes include psychosocial functioning, psychological well-being, depressive symptoms, expressive negative symptoms, negative symptom factor scores, and goal pursuit in everyday life. DISCUSSION The feasibility and acceptability data will be used to improve trial procedures and the "Goals in Focus" intervention where necessary. The treatment effect on the primary outcome will provide the basis for the sample size calculation for a fully powered RCT. TRIAL REGISTRATION 1) ClinicalTrials.gov, NCT05252039 . Registered on 23 February 2022. 2) Deutsches Register Klinischer Studien, DRKS00018083 . Registered on 28 August 2019.
Collapse
Affiliation(s)
- Alisa L A Schormann
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany.
| | - Matthias Pillny
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany
| | - Katharina Haß
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Germany
| |
Collapse
|
3
|
Yada H, Odachi R, Adachi K, Abe H, Yonemoto F, Fujiki T, Fujii M, Katoh T. Validity and reliability of Psychiatric Nurse Self-Efficacy Scales: cross-sectional study. BMJ Open 2022; 12:e055922. [PMID: 34996799 PMCID: PMC8744105 DOI: 10.1136/bmjopen-2021-055922] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity. DESIGN We developed the Improved Self-Efficacy Scale (ISES) and Decreased Self-Efficacy Scale (DSES) using existing evidence. Statistical analysis was conducted on the data to test reliability and validity. SETTING The study's setting was psychiatric facilities in three prefectures in Japan. PARTICIPANTS Data from 514 valid responses were extracted of the 786 responses by psychiatric nurses. OUTCOME MEASURES The study measured the reliability and validity of the scales. RESULTS The ISES has two factors ('Positive changes in the patient' and 'Prospect of continuing in psychiatric nursing') and the DSES has three ('Devaluation of own role as a psychiatric nurse', 'Decrease in nursing ability due to overload' and 'Difficulty in seeing any results in psychiatric nursing'). With regard to scale reliability, the Cronbach's alpha coefficient was 0.634-0.845. With regard to scale validity, as the factorial validity of the ISES and DSES, for the ISES, χ2/df (110.625/37) ratio=2.990 (p<0.001), goodness-of-fit index (GFI)=0.962, adjusted GFI (AGFI)=0.932, comparative fit index (CFI)=0.967 and root mean square error of approximation (RMSEA)=0.062; for the DSES, χ2/df (101.982/37) ratio=2.756 (p<0.001), GFI=0.966, AGFI=0.940, CFI=0.943, RMSEA=0.059 and Akaike Information Criterion=159.982. The concurrent validity of the General Self-Efficacy Scale was r=0.149-0.446 (p<0.01) for ISES and r=-0.154 to -0.462 (p<0.01) for DSES, and the concurrent validity of the Stress Reaction Scale was r=-0.128 to 0.168 for ISES, r=0.214-0.398 for DSES (p<0.01).Statistical analyses showed the scales to be reliable and valid measures. CONCLUSIONS The ISES and DSES can accurately assess psychiatric nurses' self-efficacy. Using these scales, it is possible to formulate programmes for improving psychiatric nurses' feelings of self-efficacy.
Collapse
Affiliation(s)
- Hironori Yada
- Department of Nursing, Faculty of Fukuoka Medical Technology, Teikyo University, Omuta, Fukuoka, Japan
| | - Ryo Odachi
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Keiichiro Adachi
- Department of Fundamental Nursing, Yamaguchi University, Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Hiroshi Abe
- Department of Clinical Psychology, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Fukiyo Yonemoto
- Department of Nursing, Faculty of Fukuoka Medical Technology, Teikyo University, Omuta, Fukuoka, Japan
| | | | - Mika Fujii
- Sakuragaoka Hospital, Chuo-ku, Kumamoto, Japan
| | - Takahiko Katoh
- Department of Public Health, Kumamoto University, Chuo-ku, Kumamoto, Japan
| |
Collapse
|
4
|
Nguyen A, Frobert L, Kollbrunner A, Favrod J. An Evaluation of an Online Training Platform for Teaching Positive Emotions for People With Schizophrenia. Front Psychiatry 2022; 13:798019. [PMID: 35197875 PMCID: PMC8859160 DOI: 10.3389/fpsyt.2022.798019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The dissemination of new interventions in clinical practice remains challenging. E-learning may provide wide access in various settings and allow tailored learning trajectories and an adapted training pace. This study evaluates an online platform to train professionals to lead the Positive Emotion Program for Schizophrenia (PEPS) for patients with anhedonia. This study aims to test the reception provided by clinicians to the platform and its perceived usefulness and investigate whether e-PEPS training improves knowledge about the facilitation of PEPS. MATERIALS AND METHODS Participants were recruited through advertisements. All participants provided their informed consent on a registration form and completed two pre-test questionnaires, a knowledge test on negative symptoms in schizophrenia, learning strategies and the partnership relationship, and a test on the ability to savor pleasant moments. After the training, they completed the same questionnaire and an evaluation form of the training and its application in personal and professional life. RESULTS Two-hundred and ten participants were registered to participate into the study, 185 received the access to the platform, and 101 participants completed the training and the post-test assessments. Satisfaction with training was high. The results showed that the participants significantly improved their knowledge about PEPS and increased the skills taught in their personal repertoire after the training. The training allows most clinicians to plan to lead a PEPS group in the year following training. DISCUSSION As a result of this study, training has been improved and is now freely available to all interested clinicians.
Collapse
Affiliation(s)
- Alexandra Nguyen
- School of Nursing, La Source, University of Applied Sciences and Arts of Western Switzerland, Lausanne (HES-SO), Lausanne, Switzerland
| | - Laurent Frobert
- School of Nursing, La Source, University of Applied Sciences and Arts of Western Switzerland, Lausanne (HES-SO), Lausanne, Switzerland
| | - Aurélien Kollbrunner
- School of Nursing, La Source, University of Applied Sciences and Arts of Western Switzerland, Lausanne (HES-SO), Lausanne, Switzerland
| | - Jérôme Favrod
- School of Nursing, La Source, University of Applied Sciences and Arts of Western Switzerland, Lausanne (HES-SO), Lausanne, Switzerland
| |
Collapse
|
5
|
Nguyen A, Frobert L, Ismailaj A, Monteiro S, Favrod J. Qu’est-ce que les professionnels dévoilent d’eux-mêmes dans la relation thérapeutique avec les personnes atteintes de schizophrénie ? PRAT PSYCHOL 2021. [DOI: 10.1016/j.prps.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
6
|
Dimick MK, Hird MA, Fiksenbaum LM, Mitchell RHB, Goldstein BI. Severe anhedonia among adolescents with bipolar disorder is common and associated with increased psychiatric symptom burden. J Psychiatr Res 2021; 134:200-207. [PMID: 33412423 DOI: 10.1016/j.jpsychires.2020.12.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/06/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Anhedonia, a deficit in the ability to experience pleasure, is a cardinal symptom of major depressive episodes. In contrast to adolescent major depressive disorder, there is limited research examining anhedonia in the context of depression among adolescents with bipolar disorder (BD). We therefore examined clinical characteristics of anhedonia in a large sample of adolescents with BD. METHODS Participants were 197 adolescents, aged 13-20 years old, with BD type I, II or not otherwise specified. Diagnoses were determined using a semi-structured interview. Anhedonia severity was rated from one to six on the Depression Rating Scale (DRS). Adolescents were divided into "severe" and "non-severe" anhedonia groups based on the DRS item scoring. The association of anhedonia with clinical and demographic variables was evaluated in univariate analyses followed by logistic regression analyses for variables with p ≤ 0.1. RESULTS Threshold anhedonia was evident among 90.9% during their most severe depressive episode. Significant factors associated with severe most severe lifetime anhedonia ("lifetime anhedonia") included: female sex, lifetime history of self-injurious behavior, physical abuse, affective lability, higher lifetime depression severity, comorbid anxiety disorders, family history of ADHD, and second-generation antipsychotic use. In regression analyses, severe lifetime anhedonia was independently associated with female sex, comorbid anxiety disorders, most severe lifetime mania severity, and lifetime second-generation antipsychotic use. CONCLUSION The vast majority of adolescents with BD experience anhedonia. More severe anhedonia is associated with indicators of greater illness severity. Future research is warranted to evaluate the neurobiological underpinnings of anhedonia among adolescents with BD.
Collapse
Affiliation(s)
- Mikaela K Dimick
- Department of Pharmacology, University of Toronto, ON, Canada; Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Megan A Hird
- Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, ON, Canada
| | - Lisa M Fiksenbaum
- Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rachel H B Mitchell
- Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, ON, Canada
| | - Benjamin I Goldstein
- Department of Pharmacology, University of Toronto, ON, Canada; Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, ON, Canada.
| |
Collapse
|
7
|
Pina I, Braga CDM, de Oliveira TFR, de Santana CN, Marques RC, Machado L. Positive psychology interventions to improve well-being and symptoms in people on the schizophrenia spectrum: a systematic review and meta-analysis. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:430-437. [PMID: 33331497 PMCID: PMC8352741 DOI: 10.1590/1516-4446-2020-1164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/18/2020] [Indexed: 01/07/2023]
Abstract
Objective: Positive psychology interventions (PPIs) incorporate principles of personal strengths with the view that mental health recovery transcends symptom relief. Severe psychiatric conditions, such as schizophrenia, may benefit from such interventions. This study aims to gather the current evidence on the impact of PPIs on increasing well-being in patients on the schizophrenia spectrum and assess reductions in negative or positive symptoms. Methods: A systematic review of PPI studies with schizophrenia-spectrum patients was carried out following PRISMA recommendations. The PubMed, PsycINFO, Web of Science, and Scopus databases were searched for relevant publications in order to understand the possible effects of these interventions on well-being measures and psychotic symptoms in this population. Results: Nine studies (four controlled) were included. Meta-analysis of the controlled studies showed a significant effect (p = 0.04) for improvement of well-being (Z = 2.01). Overall, the reviewed evidence suggests well-being improvement. The effect on reduction of negative symptoms was unclear. Conclusion: Used as an adjunctive therapy, PPIs appear to be a promising resource for patients on the schizophrenia spectrum, with possible effects on well-being and symptom reduction.
Collapse
Affiliation(s)
- Isabela Pina
- Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Catarina de M Braga
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
| | | | - Camila N de Santana
- Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Rodrigo C Marques
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
| | - Leonardo Machado
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
| |
Collapse
|
8
|
A cognitive model of diminished expression in schizophrenia: The interface of metacognition, cognitive symptoms and language disturbances. J Psychiatr Res 2020; 131:169-176. [PMID: 32979692 PMCID: PMC8100971 DOI: 10.1016/j.jpsychires.2020.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/06/2020] [Accepted: 09/11/2020] [Indexed: 12/20/2022]
Abstract
The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown that higher levels of diminished expression relate to deficits in metacognitive capacity. We propose a more complex model in which diminished expression occurs when impairments in metacognitive self-reflectivity, alterations in higher-order language structure, and cognitive symptoms interact and thus interfere with persons' ability to understand and express emotions in ways others can recognize. Individuals with schizophrenia-spectrum disorders (N = 201) provided personal narratives detailing their life story and reflections about their mental illness. Self-reflectivity was measured with the Metacognition Assessment Scale-Abbreviated, and situation models were extracted from participants' personal narratives via Coh-Metrix 3.0, an automated program that calculates language indices. Diminished expression and cognitive symptoms were measured with the Positive and Negative Syndrome Scale. Structural equation models (SEM) examined whether self-reflectivity mediated the impact of cognitive symptoms and situation models on diminished expression. Results of the SEM revealed that self-reflectivity partially mediated the impact of situation models on diminished expression (β = -.073, p = .008, ±95% CI [-0.126, -0.019]). and fully mediated the influence of cognitive symptoms in diminished expression (β = 0.099, p = .001, ±95% CI [0.038, 0.160]). In conclusion, results suggest that self-reflectivity, linguistic cohesion, and cognitive symptoms may be useful targets for intervention in efforts to treat diminished expression in psychosis.
Collapse
|
9
|
Strauss GP, Esfahlani FZ, Granholm E, Holden J, Visser KF, Bartolomeo LA, Sayama H. Mathematically Modeling Anhedonia in Schizophrenia: A Stochastic Dynamical Systems Approach. Schizophr Bull 2020; 46:1191-1201. [PMID: 32103266 PMCID: PMC7505187 DOI: 10.1093/schbul/sbaa014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Anhedonia, traditionally defined as a diminished capacity for pleasure, is a core symptom of schizophrenia (SZ). However, modern empirical evidence indicates that hedonic capacity may be intact in SZ and anhedonia may be better conceptualized as an abnormality in the temporal dynamics of emotion. METHOD To test this theory, the current study used ecological momentary assessment (EMA) to examine whether abnormalities in one aspect of the temporal dynamics of emotion, sustained reward responsiveness, were associated with anhedonia. Two experiments were conducted in outpatients diagnosed with SZ (n = 28; n = 102) and healthy controls (n = 28; n = 71) who completed EMA reports of emotional experience at multiple time points in the day over the course of several days. Markov chain analyses were applied to the EMA data to evaluate stochastic dynamic changes in emotional states to determine processes underlying failures in sustained reward responsiveness. RESULTS In both studies, Markov models indicated that SZ had deficits in the ability to sustain positive emotion over time, which resulted from failures in augmentation (ie, the ability to maintain or increase the intensity of positive emotion from time t to t+1) and diminution (ie, when emotions at time t+1 are opposite in valence from emotions at time t, resulting in a decrease in the intensity of positive emotion over time). Furthermore, in both studies, augmentation deficits were associated with anhedonia. CONCLUSIONS These computational findings clarify how abnormalities in the temporal dynamics of emotion contribute to anhedonia.
Collapse
Affiliation(s)
| | - Farnaz Zamani Esfahlani
- Department of Systems Science and Industrial Engineering, Binghamton University Binghamton, NY
| | - Eric Granholm
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Psychology Service, Veterans Affairs San Diego Healthcare System San Diego, CA
| | - Jason Holden
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Psychology Service, Veterans Affairs San Diego Healthcare System San Diego, CA
| | | | | | - Hiroki Sayama
- Department of Systems Science and Industrial Engineering, Binghamton University Binghamton, NY
| |
Collapse
|
10
|
Pillny M, Schlier B, Lincoln TM. "I just don't look forward to anything". How anticipatory pleasure and negative beliefs contribute to goal-directed activity in patients with negative symptoms of psychosis. Schizophr Res 2020; 222:429-436. [PMID: 32389616 DOI: 10.1016/j.schres.2020.03.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/16/2020] [Accepted: 03/27/2020] [Indexed: 01/18/2023]
Abstract
Anticipatory pleasure refers to a state of positive affect in anticipation of future events that has been found to motivate goal-directed behavior. Previous research has indicated that patients with negative symptoms of psychosis show reduced goal-directed behavior because 'demotivating beliefs' impede anticipatory pleasure. This study aims to link demotivating beliefs and anticipatory pleasure to patients' motivation in everyday life. Using the Experience Sampling Method, we examined the motivational process of goal-directed activity in the daily lives of 35 patients with negative symptoms and 36 healthy controls. We tested whether the mechanism underlying goal-directed behavior differs between patients and healthy controls and whether demotivating beliefs interfere with goal-directed behavior by impeding anticipatory pleasure. Multilevel analyses revealed that anticipatory pleasure mediated the association between goal-intentions and goal-directed activity in both groups (indirect effects: 24-30%). In the patient group, however, the association between social goal-intentions and anticipatory pleasure was weaker (b = -0.09, SE = 0.05, p ≤ .01, [-0.17;-0.04]) than in the controls, but this was not found for goal-intentions related self-care or recreational activites. Also, demotivating beliefs were more pronounced in the patient sample. (F(1,70) = 72.11, p ≤ .001) and moderated the effect of goal-intentions on anticipatory pleasure for social activities in the whole sample (b = -0.12, SE = 0.05, p ≤ .01, [-0.20;-0.08]). Our results support the assumption that a set of demotivating beliefs prevents patients with negative symptoms from looking forward to social activities and thus provide a possible psychological explanation for the social withdrawal of patients with negative symptoms.
Collapse
Affiliation(s)
- Matthias Pillny
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Hamburg, Germany..
| | - Björn Schlier
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Hamburg, Germany
| |
Collapse
|
11
|
Valencia S, Trujillo N, Trujillo S, Acosta A, Rodríguez M, Ugarriza JE, López JD, García AM, Parra MA. Neurocognitive reorganization of emotional processing following a socio-cognitive intervention in Colombian ex-combatants. Soc Neurosci 2020; 15:398-407. [PMID: 32107978 DOI: 10.1080/17470919.2020.1735511] [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] [Indexed: 10/24/2022]
Abstract
Ex-combatants often exhibit atypical Emotional Processing (EP) such as reduced emphatic levels and higher aggressive attitudes. Social Cognitive Training (SCT) addressing socio-emotional components powerfully improve social interaction among Colombian ex-combatants. However, with narrow neural evidence, this study offers a new testimony. A sample of 28 ex-combatants from Colombian illegal armed groups took part in this study, split into 15 for SCT and 13 for the conventional program offered by the Governmental Reintegration Route. All of them were assessed before and after the intervention with a protocol that included an EP task synchronized with electroencephalographic recordings. We drew behavioral scores and brain connectivity (Coherency) metrics from task performance. Behavioral scores yielded no significant effects. Increased post-intervention connectivity in the delta band was observed during negative emotional processing only SCT group. Positive emotions exposed distinctive gamma band connectivity that differentiate groups. These results suggest that SCT can trigger covert neurofunctional reorganization in ex-combatants embarked on the reintegration process even when overt behavioral improvements are not yet apparent. Such covert functional changes may be the neural signature of compensatory mechanisms necessary to reshape behaviors adaptively. This novel framework may inspire cutting-edge translational research at the crossing of neuroscience, sociology, and public policy-making.
Collapse
Affiliation(s)
- S Valencia
- Grupo De Investigación En Salud Mental, Facultad Nacional De Salud Pública, Universidad De Antioquia UdeA , Medellín, Colombia.,Corporación Académica De Ciencias Básicas Biomédicas, Universidad De Antioquia UdeA , Medellín, Colombia
| | - N Trujillo
- Grupo De Investigación En Salud Mental, Facultad Nacional De Salud Pública, Universidad De Antioquia UdeA , Medellín, Colombia
| | - S Trujillo
- Doctoral Program in Psychology, Department of Experimental Psychology, University of Granada , Granada, Spain
| | - A Acosta
- Department of Experimental Psychology and Physiology of Behavior, University of Granada , Granada, Spain
| | - M Rodríguez
- SISTEMIC, Facultad De Ingeniería, Universidad De Antioquia UdeA , Medellín, Colombia
| | - J E Ugarriza
- Facultad De Jurisprudencia, Universidad Del Rosario , Bogotá, Colombia
| | - J D López
- SISTEMIC, Facultad De Ingeniería, Universidad De Antioquia UdeA , Medellín, Colombia
| | - A M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University , Buenos Aires, Argentina.,National Scientific and Technical Research Council CONICET , Buenos Aires, Argentina.,Faculty of Education, National University of Cuyo UNCuyo , Mendoza, Argentina.,Departamento de Lingüística y Literatura, Universidad de Santiago de Chile , Santiago, Chile
| | - M A Parra
- School of Psychological Sciences and Health, University of Strathclyde , Glasgow, UK
| |
Collapse
|
12
|
Pillny M, Lincoln TM. The demotivating effect of social exclusion: An experimental test of a psychosocial model on the development of negative symptoms in psychosis. Schizophr Res 2020; 215:330-336. [PMID: 31623964 DOI: 10.1016/j.schres.2019.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 01/19/2023]
Abstract
The impairment in social functioning of patients with psychotic disorders is mainly driven by motivational negative symptoms with a widely unknown etiology. Building on the well-confirmed link between specific social risk factors and psychosis, the current study tested the postulated effect of immediate social exclusion on the development of motivational negative symptoms and the association of repeated social exclusion experiences with demotivating beliefs in a community sample (N = 84). Repeated social exclusion experiences and demotivating beliefs were assessed at baseline. We randomized the participants to either an exclusion or an inclusion condition of a virtual ball tossing game. Motivation and anticipatory pleasure were measured before and after the manipulation via self-report and via a behavioral effort paradigm. We found a significant multivariate effect of social exclusion on self-reported motivation (F(4,79) = 4.25, p < .01, η2 = .18), but not on behavioral effort (F(1,82) = 1.24, p = .27, η2 = .02). Repeated social exclusion was significantly associated with demotivating beliefs (r = .58, p < .01) and negative symptoms (r = .43, p < .001). Our findings support the notion that reduced motivation, anticipatory anhedonia and demotivating beliefs can be understood as motivational and cognitive consequences of social exclusion. We also discuss the implications for psychological interventions and for further research on the etiology of negative symptoms.
Collapse
Affiliation(s)
- Matthias Pillny
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Hamburg, Germany.
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement, Universität Hamburg, Hamburg, Germany
| |
Collapse
|
13
|
Pillny M, Lincoln TM. [Modern cognitive behavior therapy of psychotic disorders]. DER NERVENARZT 2019; 91:43-49. [PMID: 31828353 DOI: 10.1007/s00115-019-00831-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The current treatment guidelines recommend several effective psychotherapeutic approaches for different indications or aims in the therapy of patients with psychotic disorders. In particular, cognitive behavior therapy (CBTp) is recommended for the treatment of positive and general symptoms in all phases of the disorder without any restriction. Although CBTp could be easily implemented in routine care, very few of the affected patients have access to this evidence-based procedure in inpatient or outpatient settings. The interventions in CBTp directly address the psychotic symptoms themselves as well as the factors involved in the development and maintenance of symptoms. The core features of CBTp are a normalizing attitude of the therapist towards symptoms, an individualized approach and cognitive interventions. Recent developments include symptom-specific, metacognitive as well as mindfulness and acceptance-based approaches. Moreover, the reduction of comorbid symptoms can add to the benefit of the treatment. This article provides an overview of the basic CBTp techniques and of some of the latest developments in this field. It is hoped that this will contribute to the training of therapists and to the better implementation of evidence-based and guideline-based psychotherapy in the care of patients with psychotic disorders.
Collapse
Affiliation(s)
- Matthias Pillny
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Deutschland.
| | - Tania M Lincoln
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146, Hamburg, Deutschland
| |
Collapse
|
14
|
Li X, Chu MY, Lv QY, Hu HX, Li Z, Yi ZH, Wang JH, Zhang JY, Lui SSY, Cheung EFC, Shum DHK, Chan RCK. The remediation effects of working memory training in schizophrenia patients with prominent negative symptoms. Cogn Neuropsychiatry 2019; 24:434-453. [PMID: 31583951 DOI: 10.1080/13546805.2019.1674644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Introduction: Negative symptoms, particularly amotivation and anhedonia, are important predictors of poor functional outcome in patients with schizophrenia. There has been interest in the efficacy and mechanism of non-pharmacological interventions to alleviate these symptoms. The present study aimed to examine the remediation effect of working memory (WM) training in patients with schizophrenia with prominent negative symptoms.Methods: Thirty-one schizophrenia patients with prominent negative symptoms were recruited and assigned to either a WM training group or a treatment-as-usual (TAU) control group. The WM training group underwent 20 sessions of training using the dual n-back task over one month. A functional neuroimaging paradigm of the Affective Incentive Delay (AID) task was administered before and after the training intervention to evaluate the remediation effect of the intervention.Results: Our results showed that the WM training group demonstrated significant improvement in the WM training task and inattention symptoms. Compared with the TAU group, increased brain activations were observed at the right insula and the right frontal sub-gyral after WM training in the training group.Conclusions: These findings support the efficacy of WM training in ameliorating hedonic dysfunction in schizophrenia patients with prominent negative symptoms.
Collapse
Affiliation(s)
- Xu Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China.,Key Laboratory of Adolescent Cyberpsychology and Behavior(CCNU), Ministry of Education, School of Psychology, Central China Normal University, Wuhan, People's Republic of China
| | - Min-Yi Chu
- Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Qin-Yu Lv
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Hui-Xin Hu
- Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zhi Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Zheng-Hui Yi
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jin-Hong Wang
- MRI Center, Shanghai Mental Health Centre, Shanghai, People's Republic of China
| | - Jian-Ye Zhang
- MRI Center, Shanghai Mental Health Centre, Shanghai, People's Republic of China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, People's Republic of China.,Castle Peak Hospital, Hong Kong Special Administration Region, People's Republic of China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administration Region, People's Republic of China
| | - David H K Shum
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, People's Republic of China.,Menzies Health Institute Queensland and School of Applied Psychology, Griffith University, Gold Coast, Australia.,Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China.,Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Menzies Health Institute Queensland and School of Applied Psychology, Griffith University, Gold Coast, Australia
| |
Collapse
|
15
|
Li X, Zhang YT, Huang ZJ, Chen XL, Yuan FH, Sun XJ. Diminished Anticipatory and Consummatory Pleasure in Dysphoria: Evidence From an Experience Sampling Study. Front Psychol 2019; 10:2124. [PMID: 31607980 PMCID: PMC6761272 DOI: 10.3389/fpsyg.2019.02124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/02/2019] [Indexed: 01/15/2023] Open
Abstract
Anhedonia, the experience of diminished pleasure, is a core feature of major depressive disorder and is often present long before the diagnosis of depression. Most previous studies have investigated anhedonia with self-report measures of trait anhedonia or with behavioral paradigms using laboratory stimuli, and the real-time characteristics of hedonic processing in subclinical depression remain under-investigated. We used the experience sampling method to evaluate momentary experience of hedonic feelings in the context of daily life. Dysphoric (n = 49) and non-dysphoric (n = 51) college students completed assessments of their current positive affect (PA), as well as state anticipatory and consummatory pleasure, 3 or 4 times a day every day for 2 weeks. The results showed that dysphoric individuals reported less state anticipatory and consummatory pleasure compared with non-dysphoric individuals. Moreover, significant time-lagged associations between anticipatory pleasure and follow-up consummatory pleasure were found in the whole sample, after adjustment for current PA. The current findings thus hold considerable promise in advancing our understanding of anhedonia as well as the important role of state anticipatory pleasure in relation to depression.
Collapse
Affiliation(s)
- Xu Li
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Central China Normal University, Wuhan, China
| | - Yu-Ting Zhang
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Central China Normal University, Wuhan, China
| | - Zhi-Jing Huang
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Central China Normal University, Wuhan, China
| | - Xue-Lei Chen
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Central China Normal University, Wuhan, China
| | - Feng-Hui Yuan
- School of Sociology, Central China Normal University, Wuhan, China
| | - Xiao-Jun Sun
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Central China Normal University, Wuhan, China
| |
Collapse
|
16
|
Abstract
Abstract
Positive psychology directs its research interests primarily to healthy people. The most important goal is to build a positive attitude towards yourself and the surrounding world. Recently, positive psychology has set a new area of research interest, which is clinical psychology. In recent years, several positive psychotherapy programs have been developed for people with schizophrenia experience. The article presents the latest trends in positive psychotherapy for people with schizophrenia. They involve taking into account the individual differences of each patient and the specificity of his / her psychopathology. As far as the therapeutic goals are concerned, there are interventions focused on strategies for enhancing positive emotions and wellbeing or the method of activating the strengths of character. Taking into account the methods of therapeutic work, they can be divided into training methods or those of the behavioral-cognitive psychotherapy as well as those that take into account the various aspects of meditation. The article presents the distribution of therapeutic programs in terms of the range of therapeutic goals in which the most important are: intensification of positive experiences, building of strengths of character and well-being. Therapeutic programs have been shown to focus not only on breaking down negative attitudes towards one’s own illness and life, but also on those that try to deal with the unsolved schizophrenia problem - negative symptoms.
Collapse
|
17
|
Favrod J, Nguyen A, Chaix J, Pellet J, Frobert L, Fankhauser C, Ismailaj A, Brana A, Tamic G, Suter C, Rexhaj S, Golay P, Bonsack C. Improving Pleasure and Motivation in Schizophrenia: A Randomized Controlled Clinical Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2019; 88:84-95. [PMID: 30783071 PMCID: PMC6518864 DOI: 10.1159/000496479] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 12/30/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Negative symptoms are frequent in patients with schizophrenia and are associated with marked impairments in social functioning. The efficacy of drug-based treatments and psychological interventions on primary negative symptoms remains limited. The Positive Emotions Programme for Schizophrenia (PEPS) is designed to improve pleasure and motivation in schizophrenia patients by targeting emotion regulation and cognitive skills relevant to apathy and anhedonia. The main hypothesis of this study is that patients who attend 8 one-hour sessions of PEPS and treatment as usual (TAU) will have lower total apathy-avolition and anhedonia-asociality composite scores on the Scale for the Assessment of Negative Symptoms (SANS) than patients who attend only TAU. METHODS Eighty participants diagnosed with schizophrenia or schizoaffective disorder were randomized to receive either TAU or PEPS + TAU. The participants were assessed by independent evaluators before randomization (T0), in a post-test after 8 weeks of treatment (T1) and at a 6-month follow-up (T2). RESULTS The post-test results and 6-month follow-up assessments according to an intention-to-treat analysis showed that the apathy and anhedonia composite scores on the SANS indicated statistically greater clinical improvements in PEPS participants than in non-PEPS participants. In the post-test, anhedonia but not apathy was significantly improved, thus favouring the PEPS condition. These results were sustained at the 6-month follow-up. CONCLUSIONS PEPS is an effective intervention to reduce anhedonia in schizophrenia. PEPS is a short, easy-to-use, group-based, freely available intervention that is easy to implement in a variety of environments (ClinicalTrials.gov ID: NCT02593058).
Collapse
Affiliation(s)
- Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland,
| | - Alexandra Nguyen
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Joséphine Chaix
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Joanie Pellet
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Laurent Frobert
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Caroline Fankhauser
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland,Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | | | | | | | - Caroline Suter
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Shyhrete Rexhaj
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Charles Bonsack
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| |
Collapse
|
18
|
Hallford DJ, Sharma MK. Anticipatory pleasure for future experiences in schizophrenia spectrum disorders and major depression: A systematic review and meta-analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 58:357-383. [PMID: 30854671 DOI: 10.1111/bjc.12218] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/27/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Deficits in anticipating pleasure may be an important dimension of anhedonia and functioning in psychiatric disorders, particularly schizophrenia and depression; however, inconsistent findings have limited the conclusions that can be drawn. We conducted the first systemic review and meta-analysis of the extant literature for research comparing psychiatric groups to healthy control groups on anticipatory pleasure. METHODS Academic Search Complete, Science Direct, and CINAHL databases were systematically searched up to 9 June 2018 for relevant peer-reviewed articles, book chapters, and dissertations. Reference lists were also hand searched. A total of 36 studies were included in the review. RESULTS A moderate-sized deficit was observed in schizophrenia spectrum disorders (k = 32, 1,851 patients and 1,449 controls, g = -0.42 [95% CI = -0.53 to -0.31], p < .001), and a large deficit in major depression (k = 415 patients and 506 controls, g = -0.87 [95% CI = -1.23 to -0.51], p < .001), with this effect being significantly larger for depression (p < .05). Meta-regression showed that heterogeneity was partially explained in schizophrenia spectrum by longer duration of illness and lower cognitive functioning predicting larger deficits. In depression, some evidence was found that ruling out a history of psychiatric illness in controls may be related to larger effects. There was evidence for small study bias inflating estimates in schizophrenia spectrum disorders. CONCLUSIONS Deficits in anticipatory pleasure are manifest in these disorders, and significantly more so in major depression. These findings indicate a possible therapeutic target to link cognitive, affective, and behavioural factors that precipitate and maintain disorder. PRACTITIONER POINTS Anticipatory pleasure is impaired in schizophrenia spectrum and major depression. A particular focus on enhancing anticipatory pleasure may improve motivation for rewarding behaviour and psychosocial functioning. The review contained only a small number of studies for major depression. Given the heterogeneity in effects, there are likely to be more moderators of anticipatory pleasure that require examination.
Collapse
Affiliation(s)
- David J Hallford
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Manoj K Sharma
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| |
Collapse
|
19
|
Timing matters in elaborative processing of positive stimuli: Gamma band reactivity in schizophrenia compared to depression and healthy adults. Schizophr Res 2019; 204:111-119. [PMID: 30121184 PMCID: PMC6377351 DOI: 10.1016/j.schres.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/12/2018] [Accepted: 08/08/2018] [Indexed: 11/24/2022]
Abstract
Some individuals with schizophrenia report similar feelings of positive affect "in the moment" compared to control participants but report decreased trait positive affect overall. One possible explanation for this disconnection between state and trait positive affect is the extent to which individuals with schizophrenia engage in elaborative processing of positive stimuli. To assess this, we examined evoked gamma band activity in response to positive words over several seconds in a group with schizophrenia, a group with major depressive disorder, and a healthy control group. From a pre-stimulus baseline to 2000 ms after onset of the stimulus (henceforth, "early period"), the schizophrenia group showed a reliable increase in gamma activity compared to both the control and depressed groups, who did not differ from each other. In contrast, the depressed group showed a reliable increase in gamma activity from 2001 to 8000 ms (henceforth, "late period") compared to the other groups, who did not differ from each other. At the same time, the schizophrenia group showed a reliable decrease from the early to late period while the depressed group showed the opposite pattern. In addition, self-reported depression and social anhedonia in the schizophrenia group were related to decreased gamma band activity over the entire processing window. Overall, these results suggest that schizophrenia is associated with increased initial reactivity but decreased sustained elaborative processing over time, which could be related to decreased trait positive affect. The results also highlight the importance of considering depressive symptomology and anhedonia when examining emotional abnormalities in schizophrenia.
Collapse
|
20
|
Favrod J, Nguyen A, Tronche AM, Blanc O, Dubreucq J, Chereau-Boudet I, Capdevielle D, Llorca PM. Impact of Positive Emotion Regulation Training on Negative Symptoms and Social Functioning in Schizophrenia: A Field Test. Front Psychiatry 2019; 10:532. [PMID: 31404331 PMCID: PMC6677145 DOI: 10.3389/fpsyt.2019.00532] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 07/09/2019] [Indexed: 12/23/2022] Open
Abstract
Background: The poor efficacy of drug or psychological treatments on the primary negative symptoms of schizophrenia has led to the development of new interventions. The Positive Emotions Program for Schizophrenia (PEPS) is an emotion regulation strategy training that aims to intensify positive emotions and develop positive performance beliefs. A randomized controlled trial showed that PEPS is effective in reducing the composite score of the reduction of experience syndrome (anhedonia and apathy). The present study is designed to evaluate its feasibility in natural conditions to measure external validity of PEPS. Materials and Methods: Twenty-one participants recruited through the French national network of expert centers followed eight sessions of PEPS and were assessed pre- and posttest with the Scale for Assessment of Negative Symptoms (SANS) and the Personal and Social Performance (PSP). The scales of the SANS were divided into a composite score of the reduction of the ability to experience and a composite score of the reduction of expression. Results: All participants followed the 8 sessions of PEPS, and both composite scores were significantly and clinically improved at posttest. Social functioning assessed with the PSP was also improved. Conclusions: This field test shows that participation in PEPS is accompanied by a reduction of negative symptoms and an improvement of social functioning. Both negative syndromes, reduction of expression and reduction of experience, are improved. Participants are younger than those in previous studies, which may explain this unexpected result. However, this calls for a controlled study with younger participants.
Collapse
Affiliation(s)
- Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Alexandra Nguyen
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Anne-Marie Tronche
- CHU Clermont Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France.,Fondation FondaMental, Créteil, France
| | - Olivier Blanc
- CHU Clermont Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France.,Fondation FondaMental, Créteil, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive, CH Alpes Isère, Grenoble, France
| | - Isabelle Chereau-Boudet
- CHU Clermont Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France.,Fondation FondaMental, Créteil, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France.,Département de Psychiatrie Adulte, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Pierre Michel Llorca
- CHU Clermont Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France.,Fondation FondaMental, Créteil, France
| |
Collapse
|
21
|
Ritsner MS, Ratner Y, Mendyk N, Gooding DC. The characterization of social anhedonia and its correlates in schizophrenia and schizoaffective patients. Psychiatry Res 2018; 270:922-928. [PMID: 30551345 DOI: 10.1016/j.psychres.2018.11.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/03/2018] [Accepted: 11/03/2018] [Indexed: 11/26/2022]
Abstract
Although social hedonic capacity is often assessed in clinical settings, its operational definitions have not been evaluated for concurrent validity. One hundred and twenty-five patients with schizophrenia and schizoaffective disorder were classified according to their self-reported social hedonic functioning into three groups on the basis of their total scores on the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). Participants were assessed before discharge using questionnaires and psychiatric rating scales. Using an empirically based cutoff score, we identified three groups: an intact social hedonic group (WNL), a socially anhedonic group (SA), and a socially hypohedonic group (i.e., those with scores intermediate between normal functioning and aberrantly low functioning, H). The SA patients were significantly different from the two other groups (WNL and H) by their higher severity of psychopathology, lower levels of self-efficacy, and less self-esteem. The SA patients also reported less perceived social support, poorer quality of life, and less subjective recovery. Our findings indicate that social anhedonia is a meaningful target for intervention. Further implications of our findings are discussed.
Collapse
Affiliation(s)
- Michael S Ritsner
- Shaar Menashe Mental Health Center, Israel; National Insurance Institute in Israel, Haifa, Israel
| | | | | | - Diane Carol Gooding
- Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson Street, Madison, WI 53706, United States.
| |
Collapse
|
22
|
Golay P, Thonon B, Nguyen A, Fankhauser C, Favrod J. Confirmatory Factor Analysis of the French Version of the Savoring Beliefs Inventory. Front Psychol 2018. [PMID: 29515496 PMCID: PMC5825911 DOI: 10.3389/fpsyg.2018.00181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The Savoring Beliefs Inventory (SBI) is a measure designed to assess attitudes toward savoring positive experience within three temporal orientations: the past (reminiscence), the present moment (present enjoyment), and the future (anticipation). The aim of this study was to validate the structure of the SBI—French version. The scale was tested with 335 French-speaking participants. Two models were estimated: a one-factor model representing a general construct of savoring and a three-factor model differentiating between anticipation, present enjoyment, and reminiscence. Several indicators of model fit were used: the root mean square error of approximation (RMSEA), the comparison fit index (CFI), the Tucker–Lewis fit index (TLI), and the standardized root mean residual (SRMR). A chi-square difference test was used to compare the two models. The model fit of the three-factor model assessed by the SRMR showed to be excellent, while it could be considered as satisfactory according to the CFI and TLI coefficients. RMSEA, however, was slightly less adequate. The model fit for the one-factor model seemed less adequate than the three-factor solution. Further, the chi-square difference test revealed that the three-factor model had significantly better fit than the one-factor model. Finally, the reliability of the four scores (anticipating pleasure, present moment pleasure, reminiscing pleasure, and total score) was very good. These results show that the French version of the SBI is a valid and valuable scale to measure attitudes regarding the ability to savor positive experience, whether it be in anticipation, reminiscence, or the present moment.
Collapse
Affiliation(s)
- Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Bénédicte Thonon
- Psychology and Neuroscience of Cognition Research Unit, Department of Psychology, University of Liège, Liège, Belgium
| | - Alexandra Nguyen
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Caroline Fankhauser
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| |
Collapse
|
23
|
Chaix J, Golay P, Fankhauser C, Nguyen A, Gooding DC, Favrod J. Confirmatory Factor Analysis of the French Version of the Anticipatory and Consummatory Interpersonal Pleasure Scale. Front Psychol 2017; 8:1296. [PMID: 28804473 PMCID: PMC5532448 DOI: 10.3389/fpsyg.2017.01296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/17/2017] [Indexed: 11/13/2022] Open
Abstract
The Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS), a measure specifically designed to assess hedonic capacity for social and interpersonal pleasure, was used to evaluate the presence of social anhedonia in patients as well as the general population. The first goal of this study was to validate the structure of the French version of the ACIPS. The second objective was to verify whether a one, two or three factor solution is most appropriate for the ACIPS scale. The French version of the ACIPS was tested on 263 French-speaking pre-graduate students or professional volunteers. For the confirmatory factor analysis, data were treated as categorical ordinal and all the models were estimated using a robust weighted least squares estimator with adjustments for the mean and variance. Three models were estimated. A one-factor model representing a general undifferentiated "pleasure" latent construct was first tested on the 17 ACIPS items. A two-factor model distinguishing anticipatory-pleasure and consummatory-pleasure was tested next. Finally, a three-factor model including subdomains of intimate social interactions, group social interactions, and social bonding was tested. The one and two-factor models showed a somewhat poor fit to the data. However, the goodness of fit of the three factor model was adequate. These results suggest that individuals who enjoyed interaction in one of these three subdomains were more likely to enjoy doing so in the two other domains. However, on the basis of the comparison between the one and three factor models, these three types of interactions may not be considered as indistinguishable. Rather, they represent distinct and theoretically meaningful dimensions. These results show the French version of the ACIPS is a useful and valid scale to measure the capacity of savoring different kinds of social relationships.
Collapse
Affiliation(s)
- Joséphine Chaix
- School of Nursing Sciences La Source, University of Applied Sciences and Arts of Western SwitzerlandLausanne, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, University Hospital CenterLausanne, Switzerland
| | - Caroline Fankhauser
- School of Nursing Sciences La Source, University of Applied Sciences and Arts of Western SwitzerlandLausanne, Switzerland
| | - Alexandra Nguyen
- School of Nursing Sciences La Source, University of Applied Sciences and Arts of Western SwitzerlandLausanne, Switzerland
| | - Diane C Gooding
- Department of Psychology, University of Wisconsin-Madison, MadisonWI, United States
| | - Jérôme Favrod
- School of Nursing Sciences La Source, University of Applied Sciences and Arts of Western SwitzerlandLausanne, Switzerland.,Community Psychiatry Service, Department of Psychiatry, University Hospital CenterLausanne, Switzerland
| |
Collapse
|
24
|
Gooding DC, Padrutt ER, Pflum MJ. The Predictive Value of the NEO-FFI Items: Parsing the Nature of Social Anhedonia Using the Revised Social Anhedonia Scale and the ACIPS. Front Psychol 2017; 8:147. [PMID: 28223956 PMCID: PMC5293811 DOI: 10.3389/fpsyg.2017.00147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/20/2017] [Indexed: 11/16/2022] Open
Abstract
The goal was to examine the nature of social anhedonia using two validated measures and study their relationship to scores on the NEO-Five Factor Inventory (NEO-FFI). Nearly 1,900 college-aged participants completed the Chapman Revised Social Anhedonia Scale (RSAS), Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS), and the NEO-FFI. Although both the RSAS and ACIPS were associated with the NEO-FFI domains of Extraversion, Agreeableness, and Neuroticism, linear regression analyses revealed that the RSAS and ACIPS were differentially predicted by NEO-FFI item clusters. The RSAS scores were predicted by Sociability, Nonantagonistic Orientation, Positive Affect, and Activity item clusters. The ACIPS scores were predicted by Sociability, Prosocial Orientation, Activity, and Positive Affect item clusters in addition to gender. In summary, it appears that social anhedonia is multidimensional, associated with various personality domains encompassing social approach and withdrawal.
Collapse
Affiliation(s)
- Diane C Gooding
- Department of Psychology, University of Wisconsin-Madison, MadisonWI, USA; Department of Psychiatry, University of Wisconsin-Madison, MadisonWI, USA
| | - Emily R Padrutt
- Department of Psychology, University of Wisconsin-Madison, Madison WI, USA
| | - Madeline J Pflum
- Department of Psychology, University of Wisconsin-Madison, Madison WI, USA
| |
Collapse
|
25
|
Gooding DC, Pflum MJ. The ACIPS: Moving forward in the assessment of negative symptoms. Schizophr Res 2016; 176:327-328. [PMID: 27372254 DOI: 10.1016/j.schres.2016.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Diane Carol Gooding
- Department of Psychology, University of Wisconsin-, Madison, USA; Department of Psychiatry, University of Wisconsin-, Madison, USA.
| | | |
Collapse
|