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Giordano GM, Pezzella P, Giuliani L, Fazio L, Mucci A, Perrottelli A, Blasi G, Amore M, Rocca P, Rossi A, Bertolino A, Galderisi S. Resting-State Brain Activity Dysfunctions in Schizophrenia and Their Associations with Negative Symptom Domains: An fMRI Study. Brain Sci 2023; 13:brainsci13010083. [PMID: 36672064 PMCID: PMC9856573 DOI: 10.3390/brainsci13010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
The aim of the present study was to examine the neurobiological correlates of the two negative symptom domains of schizophrenia, the Motivational Deficit domain (including avolition, anhedonia, and asociality) and the Expressive Deficit domain (including blunted affect and alogia), focusing on brain areas that are most commonly found to be associated with negative symptoms in previous literature. Resting-state (rs) fMRI data were analyzed in 62 subjects affected by schizophrenia (SZs) and 46 healthy controls (HCs). The SZs, compared to the HCs, showed higher rs brain activity in the right inferior parietal lobule and the right temporoparietal junction, and lower rs brain activity in the right dorsolateral prefrontal cortex, the bilateral anterior dorsal cingulate cortex, and the ventral and dorsal caudate. Furthermore, in the SZs, the rs brain activity in the left orbitofrontal cortex correlated with negative symptoms (r = -0.436, p = 0.006), in particular with the Motivational Deficit domain (r = -0.424, p = 0.002), even after controlling for confounding factors. The left ventral caudate correlated with negative symptoms (r = -0.407, p = 0.003), especially with the Expressive Deficit domain (r = -0.401, p = 0.003); however, these results seemed to be affected by confounding factors. In line with the literature, our results demonstrated that the two negative symptom domains might be underpinned by different neurobiological mechanisms.
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Affiliation(s)
- Giulia Maria Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-0815666512
| | - Leonardo Fazio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
- Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
| | - Mario Amore
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, 10126 Turin, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L’Aquila, 67100 L’Aquila, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Eddy CM. The Transdiagnostic Relevance of Self-Other Distinction to Psychiatry Spans Emotional, Cognitive and Motor Domains. Front Psychiatry 2022; 13:797952. [PMID: 35360118 PMCID: PMC8960177 DOI: 10.3389/fpsyt.2022.797952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/14/2022] [Indexed: 01/18/2023] Open
Abstract
Self-other distinction refers to the ability to distinguish between our own and other people's physical and mental states (actions, perceptions, emotions etc.). Both the right temporo-parietal junction and brain areas associated with the human mirror neuron system are likely to critically influence self-other distinction, given their respective contributions to theory of mind and embodied empathy. The degree of appropriate self-other distinction will vary according to the exact social situation, and how helpful it is to feel into, or remain detached from, another person's mental state. Indeed, the emotional resonance that we can share with others affords the gift of empathy, but over-sharing may pose a downside, leading to a range of difficulties from personal distress to paranoia, and perhaps even motor tics and compulsions. The aim of this perspective paper is to consider how evidence from behavioral and neurophysiological studies supports a role for problems with self-other distinction in a range of psychiatric symptoms spanning the emotional, cognitive and motor domains. The various signs and symptoms associated with problematic self-other distinction comprise both maladaptive and adaptive (compensatory) responses to dysfunction within a common underlying neuropsychological mechanism, compelling the adoption of more holistic transdiagnostic therapeutic approaches within Psychiatry.
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Affiliation(s)
- Clare M Eddy
- Birmingham and Solihull Mental Health NHS Foundation Trust, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Garcia-Leon MA, Fuentes-Claramonte P, Valiente-Gómez A, Natividad C, Salgado-Pineda P, Gomar JJ, Guerrero-Pedraza A, Portillo F, Ortiz-Gil J, Alonso-Lana S, Maristany T, Raduà J, Salvador R, Sarró S, Pomarol-Clotet E. Altered brain responses to specific negative emotions in schizophrenia. NEUROIMAGE: CLINICAL 2021; 32:102894. [PMID: 34911198 PMCID: PMC8640102 DOI: 10.1016/j.nicl.2021.102894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/29/2022] Open
Abstract
Scenic stimuli might offer a better understanding of emotional processing than faces. Emotional scenes were presented to schizophrenia patients and healthy controls. Schizophrenia patients tend to misclassify emotional images as fear. Schizophrenia patients hyperactivated regions involved in fear and disgust processing. Patients’ brain response did not differ from controls in response to happy and sad scenes.
Deficits in emotion processing are a core feature of schizophrenia, but their neurobiological bases are poorly understood. Previous research, mainly focused on emotional face processing and emotion recognition deficits, has shown controverted results. Furthermore, the use of faces has been questioned for not entailing an appropriate stimulus to study emotional processing. This highlights the importance of investigating emotional processing abnormalities using evocative stimuli. For the first time, we have studied the brain responses to scenic stimuli in patients with schizophrenia. We selected scenes from the IAPS that elicit fear, disgust, happiness, and sadness. Twenty-six patients with schizophrenia and thirty age-, sex- and premorbid IQ-matched healthy controls were included. Behavioral task results show that patients tended to misclassify disgust and sadness as fear. Brain responses in patients were different from controls in images eliciting disgust and fear. In response to disgust images, patients hyperactivated the right temporal cortex, which was not activated by the controls. With fear images, hyperactivation was observed in brain regions involved in fear processing, including midline regions from the medial frontal cortex to the anterior cingulate cortex, the superior frontal gyrus, inferior and superior temporal cortex, and visual areas. These results suggest that schizophrenia is characterized by hyper-responsivity to stimuli evoking high-arousal, negative emotions, and a bias towards fear in emotion recognition.
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Affiliation(s)
- Maria Angeles Garcia-Leon
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | | | | | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Jesús J Gomar
- Litwin-Zucker Alzheimer's Disease Center, Feinstein Institute, Manhassett, NY, USA
| | | | | | | | - Silvia Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Research Center and Memory Clinic, Fundació ACE Institut Català de Neurociències Aplicades - Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | | | - Joaquim Raduà
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Imaging of Mood- and Anxiety-Related Disorders(IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Early Psychosis: Interventions and Clinical-Detection (EPIC) Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King College London, London, UK; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
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Guessoum SB, Le Strat Y, Dubertret C, Mallet J. A transnosographic approach of negative symptoms pathophysiology in schizophrenia and depressive disorders. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109862. [PMID: 31927053 DOI: 10.1016/j.pnpbp.2020.109862] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Negative Symptoms (blunted affect, alogia, anhedonia, avolition and asociality) are observed in schizophrenia but also in depressive disorders. OBJECTIVE To gather cognitive, neuroanatomical, neurofunctional and neurobiological knowledge of negative symptoms in studies on schizophrenia, depressive disorder, and transnosographic studies. RESULTS Blunted affect in schizophrenia is characterized by amygdala hyperactivation and frontal hypoactivation, also found in depressive disorder. Mirror neurons, may be related to blunted affect in schizophrenia. Alogia may be related to cognitive dysfunction and basal ganglia area impairments in schizophrenia. Data surrounding alogia in depressive disorder is scarce; wider speech deficits are often studied instead. Consummatory Anhedonia may be less affected than Anticipatory Anhedonia in schizophrenia. Anhedonia is associated with reward impairments and altered striatal functions in both diagnostics. Amotivation is associated with Corticostriatal Hypoactivation in both disorders. Anhedonia and amotivation are transnosographically associated with dopamine dysregulation. Asociality may be related to oxytocin. CONCLUSION Pathophysiological hypotheses are specific to each dimension of negative symptoms and overlap across diagnostic boundaries, possibly underpinning the observed clinical continuum.
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Affiliation(s)
- Sélim Benjamin Guessoum
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France
| | - Yann Le Strat
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France.
| | - Caroline Dubertret
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France.
| | - Jasmina Mallet
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France.
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5
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Bradley ER, Seitz A, Niles AN, Rankin KP, Mathalon DH, O'Donovan A, Woolley JD. Oxytocin increases eye gaze in schizophrenia. Schizophr Res 2019; 212:177-185. [PMID: 31416746 PMCID: PMC6791758 DOI: 10.1016/j.schres.2019.07.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/23/2019] [Accepted: 07/25/2019] [Indexed: 12/18/2022]
Abstract
Abnormal eye gaze is common in schizophrenia and linked to functional impairment. The hypothalamic neuropeptide oxytocin modulates visual attention to social stimuli, but its effects on eye gaze in schizophrenia are unknown. We examined visual scanning of faces in men with schizophrenia and neurotypical controls to quantify oxytocin effects on eye gaze. In a randomized, double-blind, crossover study, 33 men with schizophrenia and 39 matched controls received one dose of intranasal oxytocin (40 IU) and placebo on separate testing days. Participants viewed 20 color photographs of faces while their gaze patterns were recorded. We tested for differences in fixation time on the eyes between patients and controls as well as oxytocin effects using linear mixed-effects models. We also tested whether attachment style, symptom severity, and anti-dopaminergic medication dosage moderated oxytocin effects. In the placebo condition, patients showed reduced fixation time on the eyes compared to controls. Oxytocin was associated with an increase in fixation time among patients, but a decrease among controls. Higher attachment anxiety and greater symptom severity predicted increased fixation time on the eyes on oxytocin versus placebo. Anti-dopaminergic medication dosage and attachment avoidance did not impact response to oxytocin. Consistent with findings that oxytocin optimizes processing of social stimuli, intranasal oxytocin enhanced eye gaze in men with schizophrenia. Further work is needed to determine whether changes in eye gaze impact social cognition and functional outcomes. Both attachment anxiety and symptom severity predicted oxytocin response, highlighting the importance of examining potential moderators of oxytocin effects in future studies.
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Affiliation(s)
- Ellen R Bradley
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America.
| | - Alison Seitz
- University of California, San Francisco, CA, United States of America
| | - Andrea N Niles
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
| | | | - Daniel H Mathalon
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
| | - Aoife O'Donovan
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
| | - Joshua D Woolley
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
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6
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Mørch-Johnsen L, Agartz I, Jensen J. The Neural Correlates of Negative Symptoms in Schizophrenia: Examples From MRI Literature. Clin EEG Neurosci 2018; 49:12-17. [PMID: 29243527 DOI: 10.1177/1550059417746214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Negative symptoms of schizophrenia have a negative impact on psychosocial functioning and disease outcome. It is therefore important to investigate the pathophysiology underlying negative symptoms as this may aid the development of better treatment. In the current article, examples from studies investigating neural correlates of negative symptoms in schizophrenia are given. Investigations using both structural and functional magnetic resonance imaging are presented at different levels of symptomatology descriptions, from the more heterogenous construct of negative symptoms to more single discrete symptoms. Some methods to improve imaging studies of negative symptoms in schizophrenia are also suggested.
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Affiliation(s)
- Lynn Mørch-Johnsen
- 1 Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,2 NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- 1 Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,2 NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,3 Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jimmy Jensen
- 4 Centre for Psychology, Kristianstad University, Kristianstad, Sweden
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Tron T, Peled A, Grinsphoon A, Weinshall D. Differentiating facial incongruity and flatness in schizophrenia, using structured light camera data. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:2427-2430. [PMID: 28268815 DOI: 10.1109/embc.2016.7591220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Incongruity between emotional experience and its outwardly expression is one of the prominent symptoms in schizophrenia. Though widely reported and used in clinical evaluation, this symptom is inadequately defined in the literature and may be confused with mere affect flattening. In this study we used structured-light depth camera and dedicated software to automatically measure facial activity of schizophrenia patients and healthy individuals during an emotionally evocative task. We defined novel measures for the congruence of emotional experience and emotional expression and for Flat Affect, compared them between patients and controls, and examined their consistency with clinical evaluation. We found incongruity in schizophrenia to be manifested in a less specific range of facial expressions in response to similar emotional stimuli, while the emotional experience remains intact. Our study also suggests that when taking into consideration affect flatness, no contextually inappropriate facial expressions are evident.
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Potvin S, Tikàsz A, Mendrek A. Emotionally Neutral Stimuli Are Not Neutral in Schizophrenia: A Mini Review of Functional Neuroimaging Studies. Front Psychiatry 2016; 7:115. [PMID: 27445871 PMCID: PMC4916183 DOI: 10.3389/fpsyt.2016.00115] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 06/10/2016] [Indexed: 11/13/2022] Open
Abstract
Reliable evidence shows that schizophrenia patients tend to experience negative emotions when presented with emotionally neutral stimuli. Similarly, several functional neuroimaging studies show that schizophrenia patients have increased activations in response to neutral material. However, results are heterogeneous. Here, we review the functional neuroimaging studies that have addressed this research question. Based on the 36 functional neuroimaging studies that we retrieved, it seems that the increased brain reactivity to neutral stimuli is fairly common in schizophrenia, but that the regions involved vary considerably, apart from the amygdala. Prefrontal and cingulate sub-regions and the hippocampus may also be involved. By contrasts, results in individuals at risk for psychosis are less consistent. In schizophrenia patients, results are less consistent in the case of studies using non-facial stimuli, explicit processing paradigms, and/or event-related designs. This means that human faces may convey subtle information (e.g., trustworthiness) other than basic emotional expressions. It also means that the aberrant brain reactivity to neutral stimuli is less likely to occur when experimental paradigms are too cognitively demanding as well as in studies lacking statistical power. The main hypothesis proposed to account for this increased brain reactivity to neutral stimuli is the aberrant salience hypothesis of psychosis. Other investigators propose that the aberrant brain reactivity to neutral stimuli in schizophrenia results from abnormal associative learning, untrustworthiness judgments, priming effects, and/or reduced habituation to neutral stimuli. In the future, the effects of antipsychotics on this aberrant brain reactivity will need to be determined, as well as the potential implication of sex/gender.
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Affiliation(s)
- Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Andràs Tikàsz
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Adrianna Mendrek
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada; Department of Psychology, Bishop's University, Sherbrooke, QC, Canada
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