Cognitive Neuropsychiatry最新文献

Introduction: Cotard delusion-the delusional belief "I am dead"-is named after the French psychiatrist who first described it: Jules Cotard. Ramachandran and Blakeslee proposed that the idea "I am dead" comes to mind when a neuropathological condition has resulted in complete abolition of emotional responsivity to the world. The idea would arise as a putative explanation: if "I am dead" were true, there would be no emotional responsivity to the world.

Methods: We scrutinised the literature on people who expressed the delusional belief "I am dead", looking for data on whether such patients are reported as entirely lacking in emotional responsivity.

Results: In numerous cases, patients with Cotard delusion are described as experiencing emotions including anxiety, fear, guilt, distress, euphoria and worry.

Conclusions: We conclude that complete absence of emotional responsivity cannot be what prompts the delusional idea that one is dead. We propose that, in at least some cases, the idea "I am dead" comes to mind in response to symptoms of depersonalisation or derealisation, often present in cases of Cotard delusion, and give examples of Cotard patients with abnormalities in various neural areas that could be responsible for the presence of such symptoms.

Introduction: Relationships between subjective cognitive functioning (SCF), objective cognitive functioning (OCF), and depressive symptoms are poorly understood in treatment-resistant psychosis (TRP). This study (a) compares SCF in TRP using positively and negatively worded scales, (b) assess these scales' accuracy, and (c) explores the association between these scales and depressive symptoms. We hypothesised that both SCF scales would be highly correlated, minimally associated with OCF, and similarly associated with depressive symptoms. Methods: Archival clinical data from 52 TRP inpatients was utilised. OCF composite scores were derived from a broad neuropsychological battery. SCF was assessed using the norm-referenced PROMIS 2.0 Cognitive Abilities (positively worded) and Concerns (negatively worded) subscales. A depressive symptom score was derived from the Positive and Negative Syndrome Scale. Results: SCF ratings were higher in patients than OCF. There was a small but significant correlation between PROMIS subscales (r = .30). Neither PROMIS subscale was associated with OCF (r = -.11, r = .01). Depressive symptoms were correlated with the positively (r = -.29) but not negatively worded scale (r = -.13). Conclusion: Individuals with TRP inaccurately rate their cognitive functioning and tend to overestimate their ability. Positively and negatively worded SCF scales associate variably with depressive symptoms, indicating they may not be used interchangeably in TRP.

Introduction: Depression and anxiety symptoms are highly prevalent in schizophrenia-spectrum disorders and are commonly associated with schizotypy in non-clinical samples. However, it remains unclear what factors could be contributing to the relationships between schizotypy and anxiety and depression symptoms. Using path analysis, we explored the complex interplay between schizotypy, metacognitive beliefs, cognitive insight, and symptoms of emotional distress.Methods: Self-report data of schizotypy, metacognitive beliefs, cognitive insight, depression, and anxiety symptoms were collected from 344 participants from a predominantly student sample.Results: Path analysis confirmed unique associations between schizotypy dimensions, metacognitive beliefs, and cognitive insight. Furthermore, negative beliefs about worry mediated the link between the schizotypy dimensions, unusual experiences, cognitive disorganisation, and introvertive anhedonia and both depression and anxiety symptoms. Lack of cognitive confidence also mediated the relationship between cognitive disorganisation and depression symptoms. Finally, the cognitive insight subcomponent self-reflectiveness mediated the relationship between unusual experiences and cognitive disorganisation and anxiety.Conclusions: This study significantly furthers our understanding of the complex relationship between schizotypy, metacognitive processes, and emotional distress. Our findings also provide support for interventions which modify metacognitive beliefs and self-reflectiveness, which may prove beneficial for treatment in clinical settings.

Introduction: The aim of this study was to estimate ADHD persistence in a European clinical sample of children diagnosed with ADHD and followed prospectively for 10 years into young adulthood.

Methods: We assessed 85 children with ADHD at baseline (M_age= 11.6, SD = 2.1, 54% male) and re-assessed 59 at 10-year follow-up (M_age= 21.4, SD = 2.3, 54% male). ADHD symptoms at baseline were assessed with a semi-structured clinical interview (Kiddie-Schedule for Affective Disorders and Schizophrenia/Present and lifetime version) and parent rating scales (ADHD Rating Scale IV, Child Behavior Checklist). ADHD symptoms at 10-year follow-up were assessed with a semi-structured clinical interview (MINI-Plus) and self-report scales (ADHD Self-Report Scale version 1.1 screener, Adult Self Report). Functional impairment at 10-year follow-up was assessed with the Global Assessment of Functioning scale.

Results: At 10-year follow-up, 39% met ADHD symptom thresholds based on clinical evaluation using MINI-Plus or the ADHD Self-Report Scale version 1.1 screener or the Adult Self Report together with clinicians' rating of functional impairment.

Conclusion: ADHD persistence rates in this European clinical sample match previous estimates and indicate that a significant proportion of those diagnosed with ADHD as children still exhibit clinical levels of ADHD symptoms in adulthood.

Introduction: Social anhedonia (SocAnh) predicts increased risk of schizophrenia-spectrum disorders, with evidence that these disorders are associated with increased creativity. However, it is still largely unknown whether SocAnh is associated with one central aspect of creative thinking, convergent thinking.Methods: In two studies, college students with either extreme levels of SocAnh (n = 44 and n = 70) or controls with an average level of SocAnh (n = 111 and n = 100) completed a convergent thinking task, the Remote Associates Test, and also completed measures of current affect. In the second study, participants also completed a divergent thinking task.Results: In both studies, the SocAnh group had better performance than controls on the convergent thinking task. Further, this group difference remained after removing shared variance with current affect. In Study 2, groups did not differ on divergent thinking.Conclusions: Overall, consistent with research linking schizophrenia-spectrum disorders and creativity, the current research suggests that SocAnh is associated with increases in some aspects of creativity.

Objective: Anorexia nervosa (AN) is a serious eating disorder associated with several cognitive difficulties including poor cognitive flexibility (i.e. difficulties in effectively adapting to changes in the environment and/or changing task demands). AN research has primarily assessed cognitive flexibility using neurocognitive tests, and little is known about the differences or similarities between self-report and neurocognitive assessments of cognitive flexibility. This study investigated the relationship between self-report and neurocognitive assessments of cognitive flexibility in people with no history of an eating disorder (n = 207) and people with a self-reported lifetime diagnosis of AN (n = 19).Methods: Participants completed self-report and neurocognitive assessments of cognitive flexibility through an online study.Results: No significant correlations were found between self-report and neurocognitive assessments of cognitive flexibility for either group of the sample, suggesting that these assessments may evaluate different aspects of cognitive flexibility. Further, negative mood and self-reported eating disorder symptoms were found to significantly relate to self-reported cognitive flexibility, but were not associated with performance on neurocognitive tests of cognitive flexibility.Conclusions: To provide a comprehensive understanding of perceived and objective cognitive flexibility in AN, future research and clinical assessments should include both self-report and neurocognitive assessments.

Introduction: Low-pleasure beliefs are found in both patients with schizophrenia (SZ) and individuals with high social anhedonia (SocAnh), and are associated with anhedonia. However, little is known about the development and maintenance of these low-pleasure beliefs in the clinical and subclinical populations. We investigated whether patients with SZ and individuals with high SocAnh have deficits in updating their beliefs, which may contribute to the understanding of the formation and maintenance of low-pleasure beliefs.

Methods: The Modified Belief Updating Task was administered to assess belief-updating patterns in a clinical sample (36 SZ patients and 30 matched controls) and a subclinical sample (27 individuals with high SocAnh and 30 matched controls).

Results: We found that compared with controls, SZ patients updated their beliefs to a greater extent and more frequently when receiving bad news for positive life events, but not for negative life events. Moreover, individuals with high SocAnh also exhibited similar patterns in updating their beliefs for positive life events after controlling depressive symptoms.

Conclusions: Our findings suggest that negative belief-updating patterns for positive events may play an important role in the formation and maintenance of low-pleasure beliefs in patients with SZ and individuals with high SocAnh.

Introduction: Individuals experiencing auditory hallucinations (AH) tend to perceive voices when exposed to random noise. However, the factors driving this tendency remain unclear. The present study examined the interaction of a top-down (expectations) and bottom-up (type of noise) process to better understand the mechanisms that underlie AH.

Methods: Fifty-two healthy individuals (29 with high proneness and 23 with low proneness to AH) completed a signal detection task, in which they listened to pre-recorded sentences. The last word was either masked by noise or only noise was presented without the word. Two types of noise existed (speech-related versus speech-unrelated frequencies) and words were characterised by either high or low levels of semantic expectation.

Results: Participants with high proneness to AH showed a more liberal decision bias (i.e., they were more likely to report having heard a word) and poorer discrimination ability as compared to participants with low proneness to AH - but only when the word was masked by speech-related noises and the level of expectation was high. Further, the more liberal decision bias correlated negatively with the tendency to experience AH.

Conclusion: This novel paradigm demonstrated an interaction between top-down (level of expectation) and bottom-up (type of noise) processes, supporting current theoretical models of AH.

Objective: We investigated intentionally fabricated autobiographical memories in Alzheimer's Disease (AD).

Method: We invited AD patients and control participants to construct real events as well as fabricated events describing fictitious personal events that occurred in the past.

Results: Results demonstrated slower retrieval time for intentionally fabricated memories than for real ones in both AD patients and control participants. The analysis also showed similar vividness for intentionally fabricated memories and real ones in AD patients but lower vividness for intentionally fabricated memories than for real ones in control participants.

Conclusions: The slow retrieval time of intentionally fabricated memories may be attributed to the cognitive effort required to retrieve elements from autobiographical memory and edit them to construct a new memory. We suggest that the vividness of intentionally fabricated memories observed in AD may induce confusion with real memories. In addition to the experimental approach of our study, we offer a theoretical rationale for intentionally fabricated autobiographical memories by situating them in the wider context of different facets of false memories in AD (e.g. confabulations, source monitoring errors).