Cognitive Neuropsychiatry最新文献

Introduction: People with psychosis place greater confidence in errors and less confidence in accurate judgements relative to controls. This overconfidence in errors bias is theorised to contribute to the formation and maintenance of delusions. However, no research has examined whether people with psychosis have an impaired ability to judge whether they are confident or not, known as resolution. This study aimed to establish whether psychosis populations show a resolution deficit.

Method: We used hierarchical Bayesian modelling and Type 2 Signal Detection Theory to explore whether participants with schizophrenia (n = 25) had poorer resolution and higher overconfidence than high delusion-prone (n = 25) and low delusion-prone participants (n = 25) when making confidence judgements. A discrimination index and over/underconfidence statistic examined resolution and overconfidence, respectively.

Results: While all participants showed a low discrimination index, schizophrenia participants had a meaningfully lower discrimination index than low delusion-prone participants, indicating poorer resolution. All groups were overconfident, with schizophrenia participants showing the greatest level of overconfidence.

Conclusions: Results suggest schizophrenia patients show impairments in using confidence judgements to discriminate between correct and incorrect judgements. Resolution deficits in psychosis could have theoretical and clinical implications for our approach towards delusions.

Background: Sentiment in the speech of people with schizophrenia spectrum disorder (SSD) may reflect psychosis severity. Previous research examines speech from semi-structured interviews or self-narrative prompts, where differences in measured sentiment may be driven by differences in life experiences. We measured sentiment in speech evoked from standardised stimuli among participants with a psychotic disorder.

Methods: Two cohorts (N = 97) participated in this study. Symptom domains were assessed using the Brief Psychiatric Rating Scale and were represented as Anxious Depression, Hostile Suspiciousness, Thought Disturbance, and Withdrawal Retardation. Participant speech during picture description tasks was quantified for sentiments: Valence, Arousal, Dominance, Happiness, Sadness, Anger, Fear, Disgust, and Surprise. Correlations between clinical and sentiment measures were conducted separately for the two cohorts and two timepoints in Cohort 1. Within-participant longitudinal relationships were examined with linear mixed models.

Results: Several replicable relationships between sentiment and symptom severity were found: two replicable findings among Cohorts 1 and 2 and three replicable findings across Cohort 1 timepoints. Five findings were also generalised to within-participant longitudinal relationships.

Conclusions: Sentiment measures were related to the four symptom domains in the context of standardised stimuli, suggesting a disruption in emotion processing among people with a psychotic disorder.

Introduction: Autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) share some symptoms. We conducted machine learning classification to determine if common screeners used for research in non-clinical and subclinical populations, the Autism-Spectrum Quotient (AQ) and Schizotypal Personality Questionnaire - Brief Revised (SPQ-BR), could identify non-overlapping symptoms.

Methods: 1,397 undergraduates completed the SPQ-BR and AQ. Random forest classification modelled whether SPQ-BR item scores predicted AQ scores and factors, and vice versa. The models first used all item scores and then the least/most important features.

Results: Robust trait overlap allows for the prediction of AQ from SPQ-BR and vice versa. Results showed that AQ item scores predicted 2 of 3 SPQ-BR factors (disorganised, interpersonal), and SPQ-BR item scores successfully predicted 2 of 5 AQ factors (communication, social skills). Importantly, classification model failures showed that AQ item scores could not predict the SPQ-BR cognitive-perceptual factor, and the SPQ-BR item scores could not predict 3 AQ factors (imagination, attention to detail, attention switching).

Conclusions: Overall, the SPQ-BR and AQ measure overlapping symptoms that can be isolated to some factors. Importantly, where we observe model failures, we capture distinctive factors. We provide guidance for leveraging existing screeners to avert misdiagnosis and advancing specific/selective biomarker identification.

Introduction: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary condition primarily caused by mutations on the NOTCH3 gene, leading to hypoperfusion and ischaemic events, with two-thirds of cases having lacunar infarcts mostly within the basal ganglia, thalamus, and brainstem. Here, we focus on an individual with CADASIL who had a thalamic stroke, which preceded symptoms of visual and somatic disturbances.

Methods: A single-case report is used to describe the visual and somatic disturbances experienced by a 52-year-old gentleman following a left-sided thalamic stroke, who is genetically heterozygous for c449A > G p.(Tyr150Cys) mutation in the NOTCH3 gene consistent with CADASIL, as well as their response to various psychotropic medications, through information gathered from the patient's clinical records.

Results: After trialling several antidepressants, and a trial of a cholinesterase inhibitor, there was no perceived benefit reported; with only lamotrigine, previously prescribed for thalamic pain, and olanzapine, providing the least amount of distress associated with their symptoms.

Conclusions: As the management of CADASIL appears to focus on symptom control, this case highlights the need for further research to elucidate the mechanisms driving such unusual perceptual disturbances to inform potential future treatments.

Introduction: Hoarding disorder represents a considerable health concern that warrants further investigation of its associated neuropsychological components. The present study examined a key aspect of the cognitive-behavioural model of hoarding, information processing (memory, attention, decision making, categorisation). Mixed findings in the literature on the presence of cognitive deficits may be attributable to the use of assessment tools with low ecological validity. Thus, novel virtual reality (VR) environments were developed to examine the information-processing components with improved ecological validity.

Methods: Two groups (i.e., with hoarding disorder, n = 36; without hoarding disorder, n = 40) similar in age and gender were recruited from the community to complete a series of standardised and novel VR memory and decision-making tasks, and to complete a categorisation task for objects in a messy VR home office.

Results: Higher attentional difficulties related to ADHD symptoms, poorer category efficiency, and poorer trait, but not state, memory confidence, were reported in the hoarding group. There was no evidence of memory and decision-making impairments specific to the hoarding group.

Conclusions: Results from this research advance our understanding of the cognitive-behavioural components of hoarding and offer implications for future treatment and VR research initiatives.

Background: The potential link between metabolic syndrome (MetS) and the risk of dementia or cognitive impairment remains uncertain. This study aimed to assess the association between MetS and cognitive decline through a comprehensive review and meta-analysis of the existing literature.

Methods: A systematic search was conducted in Medline (PubMed), Web of Science, Scopus and Embase up to January 2023. Eligible studies included cohort and case-control designs. Statistical analyses were performed using STATA version 17.

Results: A total of 20 studies comprising 5,727,594 participants were included. The pooled relative risk (RR) of cognitive impairment among individuals with MetS was 1.34 (95% CI: 1.25-1.43), indicating a significant association. Subgroup analyses revealed that the NCEP-ATP III criteria more effectively identified this relationship compared to other diagnostic methods. The association appeared strongest in Asian populations, followed by European and American groups.

Conclusion: This meta-analysis supports a significant association between MetS and cognitive impairment. Geographic variation in the strength of this relationship may be influenced by differences in diagnostic criteria and lifestyle factors. The findings underscore the importance of early screening and the development of region-specific public health interventions to mitigate cognitive decline in individuals with MetS.

Background: Research into brain mechanisms and their impact on quality of life has gained significant traction, emphasising stress management, cognitive enhancement, and emotional well-being as essential components.

Objective: This study explores the relationship between brain health and overall wellness, focusing on neurobiological mechanisms and evidence-based interventions that enhance stress resilience in neurodivergent populations.

Methods: A comprehensive review of neuroscience and psychological literature was conducted, including neuroimaging and behavioural studies to assess the effectiveness of various interventions.

Results: Findings indicate that targeted strategies - such as Acceptance and Commitment Therapy (ACT), cognitive training, and lifestyle modifications - significantly improve stress resilience, cognitive abilities, and emotional regulation. Key brain regions involved include the amygdala, prefrontal cortex, and hippocampus.

Conclusions: Implementing evidence-based interventions fosters improved quality of life through enhanced brain wellness. Future research should focus on scalable approaches that are inclusive of diverse populations.

Introduction and method: Over the last few decades many studies have demonstrated that various populations with movement disorder exhibit a variety of difficulties with social cognition. This brief review paper summarises the major findings of social cognitive research conducted in various hypo- and hyper-kinetic movement disorders (Parkinson's disease, Huntington's disease and Tourette syndrome), with a focus on findings that may shed new light on the functions of the basal ganglia.Results: Task impairments include more predictable difficulties with embodied processes involving the motor system, such as problems with facial expressions and other non-verbal gestures. The cognitive and emotional changes associated with broader frontostriatal dysfunction may also explain some deficits, particularly difficulties with verbal tasks or perspective taking, with impacts varying according to the type of disorder and disease stage. Most intriguingly, transdiagnostic comparisons reveal patterns implying that the role of the basal ganglia in social cognition may be more important than previously recognised.Conclusions: Movement disorders show remarkable overlap in terms of atypical intention attribution across various tasks, as well as relationships between social cognition and behavioural or motivational symptoms (e.g., apathy; anhedonia; impulsivity). The possible mechanisms underlying these similarities are explored with a view to guiding future research.

Aim: Schizophrenia spectrum disorders (SSD) are associated with disturbances in emotional experience, but sex differences and comparisons to healthy controls (HC) remain poorly explored. This exploratory study used Experience Sampling Method (ESM) to examine emotional variability, instability and daily/hourly patterns of positive and negative emotions across sexes in SSD and HC.

Methods: A total of 103 SSD participants (47.9%) were compared to 112 HC (52.1%), matched for sex and age. Data on sociodemographics, clinical status, functioning and quality of life were collected. ESM assessed emotional experiences over one week.

Results: For positive emotions, HC males reported higher levels on weekdays and morning-to-midday hours, whereas no sex differences emerged in SSD. Males with SSD showed greater weekly variability in positive emotions than HC males, while no significant differences were found among females. For negative emotions, females with SSD exhibited greater daily variability than female HC, with no significant sex differences within HC or SSD. Regarding emotional instability, female HC displayed higher instability than HC males, while no significant sex differences emerged in SSD.

Conclusion: This study shows significant sex differences in emotional experiences among SSD and HC, with different sex patterns in SSD. Targeted, sex-specific interventions are crucial for improving emotional regulation and treatment outcomes in SSD.Trial registration: ISRCTN.org identifier: ISRCTN21141466.

Among people with schizophrenia (PSZ), positive symptoms such as hallucinations and delusions are often conceptualised as resulting from abnormal top-down modulation of sensory information. PSZ often exhibit reduced susceptibility to visual illusions compared to healthy control subjects (HCS), suggesting that top-down impairments yield enhanced perception of stimuli that would otherwise be distorted by contextualising visual elements. However, it remains unknown whether resistance to illusions is uniquely associated with positive symptoms, or if it is associated with some other aspect of serious mental illness. To examine this question, 77 PSZ, 50 HCS, and 40 individuals who hear voices and hold unusual beliefs but do not have a psychiatric illness (nonclinical voice hearers; NCVH) completed a hollow mask illusion task. HCS reported experiencing the illusion significantly more often than PSZ and more often than NCVH at the trend level, whereas the latter two groups did not differ from one another. Additionally, there was no consistent association between illusion perception and symptom severity for either PSZ or NCVH. We interpret these results to indicate that resistance to visual illusions may mark a vulnerability for experiencing voices and holding unusual beliefs; however, it may not be associated with the severity of these symptoms.