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Sağdıç M, Izgi B, Yapici Eser H, Ercis M, Üçok A, Kuşçu K. Face and emotion recognition in individuals diagnosed with schizophrenia, ultra-high risk for psychosis, unaffected siblings, and healthy controls in a sample from Turkey. Schizophr Res Cogn 2024; 36:100301. [PMID: 38328022 PMCID: PMC10848035 DOI: 10.1016/j.scog.2024.100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/09/2024]
Abstract
Face and emotion recognition are crucial components of social cognition. We aimed to compare them in patients diagnosed with schizophrenia (SCZ), ultra-high risk for psychosis (UHR), unaffected siblings of schizophrenia patients (SIB), and healthy controls (HC). METHODS One hundred sixty-six participants (45 SCZ, 14 UHR, 45 SIB, and 62 HC) were interviewed with the Structured Clinical Interview for DSM-5 (SCID-5). Positive and Negative syndrome scale (PANSS), PennCNB Facial Memory (CPF), and Emotion Recognition Task (ER40) were applied. RESULTS In CPF, SCZ performed significantly lower than SIB and HC. SIB was also significantly lower than HC for total correct responses. The sample size of the UHR group was small, and the statistical comparisons did not reach a significance, however, a trend towards decreased performance between the SCZ and SIB was found. In ER40, SCZ performed significantly lower than HC and SIB in all domains, except for the insignificant findings for angry ER between SIB and SCZ. SIB also performed significantly lower than HC for angry, negative, and total ER. UHR was similar to SCZ for happy and sad ER and performed significantly lower than HC for happy ER. The effect of SCZ diagnosis on the efficiency of CPF and ER40 was significant when corrected for age and education. For SCZ, PANSS also significantly affected the CPF and ER40. CONCLUSION Our findings suggest varying levels of face and emotion recognition deficits in individuals with SCZ, UHR, and SIB. Face and emotion recognition deficits are promising schizophrenia endophenotypes related to social cognition.
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Affiliation(s)
- Meylin Sağdıç
- Marmara University, School of Medicine, Department of Psychiatry, İstanbul, Turkey
| | - Busra Izgi
- Koç University, Graduate School of Health Sciences, Istanbul, Turkey
- Koç University Research Center for Translational Medicine, İstanbul, Turkey
| | - Hale Yapici Eser
- Koç University, Graduate School of Health Sciences, Istanbul, Turkey
- Koç University, School of Medicine, Department of Psychiatry, İstanbul, Turkey
| | - Mete Ercis
- İstanbul University, Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
| | - Alp Üçok
- İstanbul University, Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
| | - Kemal Kuşçu
- Koç University, School of Medicine, Department of Psychiatry, İstanbul, Turkey
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Abreu-Fernández G, Murillo-García N, Ortiz-García de la Foz V, Magdaleno Herrero R, Yorca-Ruiz Á, Ayesa-Arriola R. Theory of Mind as an endophenotype for schizophrenia spectrum disorder: Study in first episode of psychosis patients and first-degree relatives. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00039-X. [PMID: 38591834 DOI: 10.1016/j.sjpmh.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Deficits in Theory of Mind (ToM) had been suggested as a possible endophenotype for unaffected relatives of first episode of psychosis (FEP) patients. There are a limited number of studies which have evaluated ToM deficits among the siblings and parents of FEP patients. AIM This study aimed to explore ToM deficits and its correlates among FEP patients, their siblings, parents, and controls. METHODOLOGY FEP patients (N=102), their parents (N=135), siblings (N=97), and controls (N=167) were evaluated on ToM performance with the Reading the Mind in the Eyes Test (Eyes Test). Interview for sociodemographic variables of age, sex, years of education, and IQ estimation and neurocognitive tests were administered to all groups. RESULTS FEP patients had a significantly lower performance on the Eyes Test compared to their siblings and controls. However, no significant differences were found between siblings and parents or siblings and controls. CONCLUSION Attending our results, we found no evidence for ToM deficits as an endophenotype of SSDs. Furthermore, ToM accuracy may be mediated by interaction with other cognitive domains and play a protective role against psychosis in unaffected siblings.
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Affiliation(s)
- Georgelina Abreu-Fernández
- Research Group on Mental Illnessess, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain
| | - Nancy Murillo-García
- Research Group on Mental Illnessess, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain
| | - Víctor Ortiz-García de la Foz
- Research Group on Mental Illnessess, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Rebeca Magdaleno Herrero
- Research Group on Mental Illnessess, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain
| | - Ángel Yorca-Ruiz
- Research Group on Mental Illnessess, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain
| | - Rosa Ayesa-Arriola
- Research Group on Mental Illnessess, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla, Santander, Spain.
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Tucci AA, Schroeder A, Noël C, Shvetz C, Yee J, Howard AL, Keshavan MS, Guimond S. Social cognition in youth with a first-degree relative with schizophrenia: A systematic scoping review. Psychiatry Res 2023; 323:115173. [PMID: 36989908 DOI: 10.1016/j.psychres.2023.115173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/31/2023]
Abstract
Social-cognitive deficits are present in individuals at familial high-risk (FHR) for schizophrenia and may play a role in the onset of the illness. No literature review has examined the social-cognitive profiles of youth at FHR who are within the peak window of risk for developing schizophrenia, which could provide insight on the endophenotypic role of social cognition. This systematic scoping review (1) summarizes the evidence on social-cognitive deficits in youth at FHR, (2) explores brain correlates, and (3) describes social-cognitive deficits and prodromal symptom associations. We searched PsycInfo and PubMed for studies investigating social cognition in FHR youth aged 35 or younger and included 19 studies (FHR=639; controls=689). Studies report that youth at FHR have difficulty recognizing negative emotions, particularly fear. Youth at FHR also have difficulty performing complex theory of mind tasks. Abnormality in corticolimbic and temporoparietal regions are observed in youth at FHR during social-cognitive tasks, but results are inconsistent. Finally, there is evidence for negative associations between prodromal symptoms and performance on emotion regulation and theory of mind tasks, but the research is scarce. This review highlights the need for studies on youth at FHR using longitudinal designs and extensive social-cognitive, brain imaging and clinical measures.
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Affiliation(s)
- Alexandra A Tucci
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Alexandra Schroeder
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Chelsea Noël
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Cecelia Shvetz
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Jasmin Yee
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Andrea L Howard
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Synthia Guimond
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Psychology, Carleton University, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada; Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
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Zonp Z, Bilgin H. The effectiveness of metacognitive training on impairments in social cognition in patients with schizophrenia: mental health nursing practice in a community mental health center. Nord J Psychiatry 2022; 76:295-306. [PMID: 34428118 DOI: 10.1080/08039488.2021.1965653] [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: 10/20/2022]
Abstract
BACKGROUND Social cognition is an independent structure from the positive symptoms of schizophrenia and contributes to negative symptoms, neurocognitive impairment, and social functioning. AIM To examine the effectiveness of the metacognitive training intervention on social cognition in people with schizophrenia. DESIGN This study was conducted as a randomized quasi-experimental (pre-test/post-test and follow-up) design with a control group. METHODS Thirty-nine patients with schizophrenia were enrolled and randomly assigned to either the control group (n = 19) or the metacognitive training group (n = 20). A 10-week metacognitive training program was offered to the intervention group. The study involved a pre-test/post-test design with a 3-month follow-up assessment. The primary outcome was social cognition, as measured by the Facial Emotion Discrimination/Identification Tests, Reading the Mind in the Eyes Test, and Attributional Style Questionnaire. The secondary outcome was measured by the metacognitive training subjective efficacy form. RESULTS Completion at follow-up was high (92.3%). The results show that the changes over time in the False Belief Task 1st level, Attributional Style Questionnaire negative events global-specific dimension, and positive events stable-unstable dimension mean scores, time interaction, were statistically significant. Metacognitive Training was efficacious on the theory of mind and in performing more functional attributions. Patients in the intervention group showed high-level positive feedback. CONCLUSION Metacognitive Training applied by psychiatric and mental health nurses demonstrated a user and practitioner-friendly, safe and effective program on social cognition. Also, the social and cultural feasibility and effectiveness of the Metacognitive Training program were shown for the first time in a Turkish population.
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Affiliation(s)
- Zeynep Zonp
- Postdoctoral Resesarch Fellow, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Health Science Faculty, Kocaeli University, Kocaeli, Turkey
| | - Hülya Bilgin
- Professor, Florence Nightingale School of Nursing, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Martin D, Croft J, Pitt A, Strelchuk D, Sullivan S, Zammit S. Systematic review and meta-analysis of the relationship between genetic risk for schizophrenia and facial emotion recognition. Schizophr Res 2020; 218:7-13. [PMID: 31932173 DOI: 10.1016/j.schres.2019.12.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/21/2019] [Accepted: 12/22/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recent research has highlighted that facial emotion recognition deficits are more common in people with schizophrenia, but the reason for this association is not well understood. Comparing facial recognition deficits in unaffected individuals at higher genetic risk for schizophrenia with individuals at lower genetic risk could increase our understanding of this relationship. METHODS We systematically reviewed studies reporting on the relationship between genetic risk of schizophrenia and facial emotion recognition deficits. Meta-analyses were performed where sufficient data were available, otherwise we conducted narrative summaries. Meta-analyses were performed both for generalised and specific facial emotion recognition deficits. RESULTS 34 studies were included in this review with 23 included in meta-analyses. Meta-analysis indicated strong evidence of a deficit in facial emotion recognition in first-degree relatives of people with schizophrenia compared with controls (SMD 0.38 95% CI 0.26 to 0.51, p ≤ 0.001). Further meta-analyses demonstrated strong evidence of a deficit in the recognition of negative valence facial expressions (SMD 0.19 CI 0.06 to 0.32, p = 0.004) but no evidence of deficit in the recognition of neutral or positive valance. CONCLUSIONS There is strong evidence of facial emotion recognition deficits in first-degree relatives of people with schizophrenia. Our findings suggest that such deficits in people with schizophrenia arise prior to the onset of the disorder, though cannot inform whether that association is causal or due to confounding. Emotion recognition deficits, particularly to negative emotions, might be useful predictors of schizophrenia risk.
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Affiliation(s)
- David Martin
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK.
| | - Jazz Croft
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Alice Pitt
- Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Daniela Strelchuk
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Sarah Sullivan
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Stan Zammit
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff CF24 4HQ, UK
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Giralt-López M, Miret S, Soler J, Campanera S, Parellada M, Fañanás L, Fatjó-Vilas M. The role of schizotypal traits and the OXTR gene in theory of mind in schizophrenia: A family-based study. Eur Psychiatry 2020; 63:e15. [PMID: 32093796 PMCID: PMC7315883 DOI: 10.1192/j.eurpsy.2019.17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is consistent evidence that theory of mind (ToM) is impaired in schizophrenia (SZ); however, it remains unclear whether such deficits are trait- or state-dependent. We evaluated ToM in patients with schizophrenia spectrum disorders (SSDs), their healthy first-degree relatives, and controls to test its suitability as an endophenotypic marker. We also studied the modifying effect of markers of clinical and genetic liability to SZ (schizotypy and genetic variability in the oxytocin receptor gene: OXTR) on ToM in healthy individuals. METHODS The sample included 38 stable SSD patients, 80 unaffected first-degree relatives, and 81 controls. ToM was assessed using the Hinting Task (HT) and schizotypy via the Schizotypal Personality Questionnaire-Brief (SPQ-B), which generates interpersonal (SPQ-IP), cognitive-perceptual (SPQ-CP), and disorganization (SPQ-D) scores. The polymorphism rs53576 of OXTR was genotyped. RESULTS Patients presented poorer HT performance than relatives and controls (p = 0.003 and p < 0.001). High SPQ-IP and SPQ-CP scores correlated with poorer ToM performance in relatives (p = 0.010 and p = 0.030), but not in controls. OXTR was not associated with HT scores, but it showed a modifying effect within controls; high SPQ-CP was related to HT poorer performance conditional to GG genotype (p = 0.007). CONCLUSIONS ToM deficits were present in patients but not in unaffected relatives or controls. However, our data indicate the usefulness of clinical and genetic liability markers to characterize differences in ToM abilities within healthy individuals. Then, the observed link between ToM and SZ liability suggests the putative role of ToM as an endophenotypic marker. Nevertheless, new analyses in larger samples are needed.
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Affiliation(s)
- M Giralt-López
- Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - S Miret
- Centre de Salut Mental d'Adults de Lleida, Servei de Psiquiatria, Salut Mental i Addiccions, Hospital Universitari Santa Maria, Lleida, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - J Soler
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - S Campanera
- Centre de Salut Mental d'Adults de Lleida, Servei de Psiquiatria, Salut Mental i Addiccions, Hospital Universitari Santa Maria, Lleida, Spain
| | - M Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departamento de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - L Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - M Fatjó-Vilas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
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7
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Kumar V, Tikka D, Das B. Social cognition in first-degree relatives of patients with schizophrenia and mania with psychotic symptoms: A comparative study. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2020. [DOI: 10.4103/jmhhb.jmhhb_6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Social cognitions in siblings of patients with schizophrenia: a comparison with patients with schizophrenia and healthy controls - a cross-sectional study. Asian J Psychiatr 2019; 43:24-33. [PMID: 31078092 DOI: 10.1016/j.ajp.2019.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/04/2019] [Accepted: 04/22/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND There are limited number of studies which have evaluated social cognitive deficits among the siblings of patients with schizophrenia. AIM This study aimed to evaluate the social cognitive deficits and its correlates among siblings of patients with schizophrenia. METHODOLOGY Patients of schizophrenia (N = 34), their siblings (N = 34) and healthy control subjects (N = 31) matched for age, gender, education and intelligence quotient were evaluated on social cognition rating tools in Indian setting (SOCRATIS). Patients were additionally evaluated on Positive and Negative Symptom Scale (PANSS). Siblings were assessed on Comprehensive Assessment for at risk mental state (CAARMS) scale and Short Wisconsin Schizotypy scale. Neurocognitive test battery was applied to all the groups. RESULTS Patients with schizophrenia performed the worst and the healthy controls performed the best, with siblings falling intermediate on all the subtests of social cognition (except for externalizing bias and personalized bias) and neurocognition. There were negative correlation between some of the domains of social cognition and various domains of CAARMS. Higher level of schizotypy was associated with higher level of social cognitive deficits. CONCLUSION Social cognitive deficits can act as an important endophenotype for estimating the risk of schizophrenia in at risk siblings. Further, social cognitive deficits must be considered as important target for intervention among the at risk siblings to improve their outcome.
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Aydın O, Balıkçı K, Çökmüş FP, Ünal Aydın P. The evaluation of metacognitive beliefs and emotion recognition in panic disorder and generalized anxiety disorder: effects on symptoms and comparison with healthy control. Nord J Psychiatry 2019; 73:293-301. [PMID: 31157577 DOI: 10.1080/08039488.2019.1623317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: The impairments in metacognitive functions and emotion recognition are considered as liable factors in anxiety disorders. Aims: The better understanding of these cognitive abilities might lead to develop more accurate treatment methods for patients who suffer from anxiety. Methods: Forty-four patients with panic disorder (PD), 37 individuals with generalized anxiety disorder (GAD) and 44 healthy control (HC) were participated in our study. Metacognition questionnaire-30 (MCQ-30), Reading The Mind From The Eyes Test and symptom severity tests were administered. Results: Statistical analyses estimated the dysfunctional metacognitive beliefs and disrupted emotion recognition in patients relative to HC. The 'need to control thoughts' aspect of metacognitive beliefs was accounted for symptom severity in GAD. Improper metacognitive beliefs were significantly predicted the PD and GAD. In addition, impoverished emotion recognition predicted the GAD. Conclusions: Our study revealed the role of inconvenient metacognitive beliefs and distorted emotion recognition in PD and GAD. These findings might facilitate the treatment management in cognitive therapies of anxiety disorders via pointing out more reasonable targets across improper cognitive fields.
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Affiliation(s)
- Orkun Aydın
- a Department of Psychology , International University of Sarajevo , Sarajevo , Bosnia and Herzegovina
| | - Kuzeymen Balıkçı
- b Department of Psychiatry, Faculty of Medicine , Near East University , Nicosia , Turkish Republic of Northern Cyprus
| | - Fikret Poyraz Çökmüş
- c Department of Psychiatry , Manisa Hospital of Mental Health and Disorders , Manisa , Turkey
| | - Pınar Ünal Aydın
- a Department of Psychology , International University of Sarajevo , Sarajevo , Bosnia and Herzegovina
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Etchepare A, Roux S, Destaillats JM, Cady F, Fontanier D, Couhet G, Prouteau A. What are the specificities of social cognition in schizophrenia? A cluster-analytic study comparing schizophrenia with the general population. Psychiatry Res 2019; 272:369-379. [PMID: 30599441 DOI: 10.1016/j.psychres.2018.12.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 12/28/2022]
Abstract
While social cognition (SC) is widely recognized as being impaired in schizophrenia, little is known about the potential heterogeneity in individuals' functioning. Using a wide range of SC measures and a cluster-analytic approach, we compared SC profiles in the general population and in people with schizophrenia. A total of 131 healthy controls and 101 participants with schizophrenia were included. Groups were compared on sociodemographic, neurocognition, anxiety and depressive mood variables. Three profiles were identified in healthy controls: one with good SC abilities (Homogeneous SC group) and two with specific weaknesses in complex Facial Emotion Recognition (Low FER group) or Affective Theory of Mind (Low AToM group). However, these patterns were not found in participants with schizophrenia, who were characterized rather by levels of SC functioning (i.e., Low, Medium and High SC groups). Importantly, while the High SC group (47.9% of the sample) exhibited normal performances, the two others were underpinned by different pathological processes (i.e., alexithymia for Medium SC group or neurocognition dysfunctioning for Low SC group). These results have important implications for future research as well as for clinical practice regarding assessment methodology and therapeutic interventions.
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Affiliation(s)
- Aurore Etchepare
- Laboratoire de Psychologie EA 4139, Université de Bordeaux, 3ter Place de la Victoire, 33 000 Bordeaux, France; Pôle de Soins de Réhabilitation de la Dordogne (PSRD), Centre Hospitalier Vauclaire, Lieu-dit Vauclaire, 24 700 Montpon-Ménestérol, France.
| | - Solenne Roux
- Laboratoire de Psychologie EA 4139, Université de Bordeaux, 3ter Place de la Victoire, 33 000 Bordeaux, France
| | - Jean-Marc Destaillats
- Département de Psychiatrie Adulte, Hôpital de Jonzac, Domaine des Fossés, 17 500 St Martial de Vitaterne, France
| | - Florian Cady
- Centre d'Evaluation et de Réhabilitation (CER), Centre Hospitalier Esquirol, 39 rue Jean-Baptiste Ruchaud, 87 000 Limoges, France
| | - David Fontanier
- Centre d'Evaluation et de Réhabilitation (CER), Centre Hospitalier Esquirol, 39 rue Jean-Baptiste Ruchaud, 87 000 Limoges, France
| | - Geoffroy Couhet
- Centre de Réhabilitation Psycho-Sociale (CRPS), Tour de Gassies, rue de la Tour-de-Gassies, 33 500 Bruges, France
| | - Antoinette Prouteau
- Laboratoire de Psychologie EA 4139, Université de Bordeaux, 3ter Place de la Victoire, 33 000 Bordeaux, France; Département de Psychiatrie Adulte, Hôpital de Jonzac, Domaine des Fossés, 17 500 St Martial de Vitaterne, France
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11
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Bina RW, Langevin JP. Closed Loop Deep Brain Stimulation for PTSD, Addiction, and Disorders of Affective Facial Interpretation: Review and Discussion of Potential Biomarkers and Stimulation Paradigms. Front Neurosci 2018; 12:300. [PMID: 29780303 PMCID: PMC5945819 DOI: 10.3389/fnins.2018.00300] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/18/2018] [Indexed: 01/06/2023] Open
Abstract
The treatment of psychiatric diseases with Deep Brain Stimulation (DBS) is becoming more of a reality as studies proliferate the indications and targets for therapies. Opinions on the initial failures of DBS trials for some psychiatric diseases point to a certain lack of finesse in using an Open Loop DBS (OLDBS) system in these dynamic, cyclical pathologies. OLDBS delivers monomorphic input into dysfunctional brain circuits with modulation of that input via human interface at discrete time points with no interim modulation or adaptation to the changing circuit dynamics. Closed Loop DBS (CLDBS) promises dynamic, intrinsic circuit modulation based on individual physiologic biomarkers of dysfunction. Discussed here are several psychiatric diseases which may be amenable to CLDBS paradigms as the neurophysiologic dysfunction is stochastic and not static. Post-Traumatic Stress Disorder (PTSD) has several peripheral and central physiologic and neurologic changes preceding stereotyped hyper-activation behavioral responses. Biomarkers for CLDBS potentially include skin conductance changes indicating changes in the sympathetic nervous system, changes in serum and central neurotransmitter concentrations, and limbic circuit activation. Chemical dependency and addiction have been demonstrated to be improved with both ablation and DBS of the Nucleus Accumbens and as a serendipitous side effect of movement disorder treatment. Potential peripheral biomarkers are similar to those proposed for PTSD with possible use of environmental and geolocation based cues, peripheral signs of physiologic arousal, and individual changes in central circuit patterns. Non-substance addiction disorders have also been serendipitously treated in patients with OLDBS for movement disorders. As more is learned about these behavioral addictions, DBS targets and effectors will be identified. Finally, discussed is the use of facial recognition software to modulate activation of inappropriate responses for psychiatric diseases in which misinterpretation of social cues feature prominently. These include Autism Spectrum Disorder, PTSD, and Schizophrenia-all of which have a common feature of dysfunctional interpretation of facial affective clues. Technological advances and improvements in circuit-based, individual-specific, real-time adaptable modulation, forecast functional neurosurgery treatments for heretofore treatment-resistant behavioral diseases.
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Affiliation(s)
- Robert W Bina
- Division of Neurosurgery, Banner University Medical Center, Tucson, AZ, United States
| | - Jean-Phillipe Langevin
- Neurosurgery Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
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