Cognitive Neuropsychiatry最新文献

Background: Delirium is prevalent among hospitalised patients, especially in critically ill patients. Preventing delirium by recognising its modifiable risk factors could improve life quality, decrease mortality and restrain its devastating consequences.

Method: We investigated 50 patients who had been hospitalised in the general ICU and monitored them for developing delirium. We employed CAM and CAM-ICU Scales to assess delirium, RASS score to determine the consciousness level, HADS questionnaire for anxiety and depression, and the demographic data questionnaire.

Results: We found that 20% of ICU patients developed delirium and found a meaningful correlation between the incident delirium, older ages, visual impairment, and higher anxiety and depression scores (HADS) of first and second days of hospitalisation. By utilising logistic regression, we found that older ages, visual impairment, higher anxiety and depression scores (HADS) of the first day of hospitalisation were statistically significant to predict the risk model of developing delirium.

Conclusion: Depressive and anxiety symptoms were associated with higher odds of transitioning to delirium; so, at the admission time, it may be useful to screen patients for the symptoms of affective disorders, particularly, who are at higher risks for developing delirium.

Introduction: Decision-making deficits in individuals with alcohol use disorder (AUD) may be partly related to their decreased interoceptive awareness (IA), which is associated with some aspects of mindfulness.

Methods: 52 abstinent male inpatients with AUD (current severity: moderate or severe) and 52 healthy male volunteers performed the heart rate tracking task and a computerised version of the Iowa gambling task (IGT). Trait mindfulness was evaluated with the mindful attention awareness scale (MAAS).

Results: Heartbeat perception (HBP), MAAS, and IGT scores of patients with AUD were significantly lower than those of healthy controls. The difference between groups with respect to IGT scores did not remain significant after controlling for the covariates, and HBP scores were linked significantly to the subjects' IGT performance. HBP scores significantly predicted IGT scores of both the overall sample and patients. MAAS scores did not correlate significantly with HBP and IGT scores in either the patient or control group.

Conclusion: It is possible that IA plays a role in decision-making and decreased interoceptive accuracy is a predictor of impaired decision-making in individuals with AUD. More empirical data are needed to develop a better insight into the relationship between IA and multi-dimensional nature of mindfulness.

Introduction: Several arguments suggest that motivated reasoning (occurring when beliefs are not solely shaped by accuracy, but also by other motives such as promoting self-esteem or self-protection) is important in delusions. However, classical theories of delusion disregard the role of motivated reasoning. Thus, this role remains poorly understood.Methods: To explore the role of motivated reasoning in delusions, here we propose a computational model of delusion based on a Bayesian decision framework. This proposes that beliefs are not only evaluated based on their accuracy (as in classical theories), but also based on the cost (in terms of reward and punishment) of rejecting them.Results: The model proposes that, when the values at stake are high (as often it is the case in the context of delusion), a belief might be endorsed because rejecting it is evaluated as too costly, even if the belief is less accurate. This process might contribute to the genesis of delusions.Conclusions: Our account offers an interpretation of how motivated reasoning might shape delusions. This can inspire research on the affective and motivational processes supporting delusions in clinical conditions such as in psychosis, neurological disorders, and delusional disorder.

Introduction: The ability to suppress inappropriate prepotent response and to overcome the interference of irrelevant information are two important components of inhibitory control. Little is known, however, about the relevant contributions in these two components of inhibitory control to depression. The aim of the present study was to assess the prepotent response inhibition and interference control simultaneously in a group of patients diagnosed with major depression disorder (MDD).

Methods: A clinical group of patients with MDD (n = 41) and a control group of healthy volunteers (n = 39) were recruited and assessed using the stop-signal task and the Flanker task respectively.

Results: The results showed longer stop-signal reaction time in patients with MDD in the stop-signal task. Regarding the interference control function, the analysis showed the response accuracy under the incongruent condition was significantly lower in patients with MDD than healthy individuals.

Conclusions: In conclusion, patients with MDD showed impairments both in prepotent response inhibition and interference control. The present findings provide a better understanding of the mechanism of depression-related deficits in inhibition and have great implications for the development of cognitive training programmes to remediate cognitive dysfunction in depression.

Introduction: Relational memory (RM) is severely impaired in schizophrenia. Unitisation can circumvent RM impairments in clinical populations as measured by the transverse-patterning (TP) task, a well-established measure of RM capacity. We compared memory performance on a new ecological RM measure, the Relational Trip Task (RTT), to that of TP at baseline and examined the effects of a unitisation intervention in RTT performance. RTT involves learning relational information of real-life stimuli, such as the relationship between people and places or objects.

Methods: TP and RTT performances were examined in 45 individuals with schizophrenia. TP-impaired participants (n = 22) were randomised to either the intervention or an active control group. TP and RTT were administered again after unitisation training. Task validity and reliability were assessed. Intervention group's pre- and post-RTT accuracies were compared and contrasted to that in the control group.

Results: RTT and TP were moderately correlated. TP non-learners had inferior performance in RTT at baseline. Improvement in RTT performance after unitisation training was observed in the intervention group; no pre-post improvement was observed in the control group.

Conclusion: RTT has an acceptable criterion validity and excellent alternate-form reliability. Unitisation seemed to be successfully generalized to support associations of real-life stimuli.

Background: Individuals with psychotic disorders often report feelings of loneliness, fewer social contacts and less satisfaction with their social support prior to diagnosis. However, temporal relationships between these variables remain unclear. The primary aim of this study was to examine whether subjective and objective social factors predict, or are predicted by, psychotic-like experiences (PLEs) in healthy young adults.

Methods: 196 undergraduates completed baseline and 3-month follow-up assessments for PLEs, loneliness, social support size, and satisfaction. Cross-lagged panel models were conducted to investigate the temporal relationships between these variables.

Results: Higher loneliness scores, fewer social contacts, and being less satisfied with social support at both time points were significantly associated with higher endorsement of PLEs. Furthermore, after controlling for baseline levels, cross-lagged analyses revealed that individuals who reported feeling more lonely and having less social support at baseline, predicted higher PLEs three months later but not vice versa. No cross-lagged effect was found between the satisfaction of social support and PLEs.

Conclusion: The study highlights the significant relationships between loneliness, social support and PLEs. Higher levels of loneliness and smaller social support networks predicted future PLEs. These findings need to be given full consideration in future clinical practice and intervention for young adults with PLEs.

Introduction: Although most studies report neurocognitive deficits in patients with obsessive-compulsive disorder (OCD), important exceptions exist, highlighting the possible role of mediators (e.g., poor motivation). This study investigated neurocognitive functioning and potential influences affecting performance in OCD.

Methods: Forty-three participants (13 OCD patients, 30 healthy controls) were assessed using a battery of neurocognitive tests. During the assessment, the examiner completed the Impact on Performance Scale (IPS) which measures variables that may impact neurocognitive performance.

Results: Pooled neurocognitive performance was lower in OCD patients versus healthy controls at a moderate effect size. Patients performed more poorly on the IPS, particularly the Well-Being During Assessment subscale. Performance differences across the two groups were attenuated to a non-significant small-to-medium effect when the IPS was entered as a covariate. A total of 34% of patients showed scores greater than one standard deviation below the mean compared to 9.63% in healthy individuals. Yet, when a conservative impairment criterion (≥2 standard deviations below the mean) was applied, less than 10% of patients displayed deficits.

Conclusions: Neurocognitive impairment in OCD is likely exaggerated. In addition to considering important mediators researchers should report the percentage of participants displaying performance deficits rather than mean group differences alone; the latter obscures the high percentage of patients without impairment and thus may unduly foster stigma in this population.

Background: Social cognition, including emotion perception, is impaired in people with serious mental illnesses (SMI), and is associated with cognitive and community functioning. Cognitive remediation can improve neurocognition, but the impact on emotion perception has been less well studied. The current study aimed to evaluate the efficacy of a cognitive remediation programme in improving emotion perception.Methods: Thirty-seven people with SMI and a history of difficulties obtaining employment were randomised to either vocational rehabilitation only, or vocational rehabilitation combined with cognitive remediation. Participants were assessed at baseline and post-treatment on a neurocognitive battery, work history, and emotion perception.Results: The cognitive remediation group did not improve more than the vocational rehabilitation only group on either measure of emotion perception, despite significantly greater gains in cognitive functioning. Baseline emotion identification, but not discrimination, was significantly associated with cognition and work history.Conclusions: Despite associations between social and neurocognition, there was no evident transfer of cognitive gains to performance on measures of emotion perception. The findings, though limited by a small sample size, are important in expanding the research indicating that the effects of cognitive remediation tend to be limited to the specific cognitive domains targeted in the program.

Introduction: For the past two decades, virtual reality (VR) has proven to be an innovative approach for the assessment of state paranoia. However, the use of VR remains costly, and avatars are still far from realistic in terms of facial and bodily expressions. The present study aimed to test the validity of three 360° immersive videos (360IVs) as an accessible and realistic alternative for the assessment of non-clinical state paranoia.Method: Three 360IVs were created (a Lift, a Library and a Bar) and included actors behaving naturally. One hundred and fifty healthy students were assessed in terms of their proneness towards trait paranoia, were then exposed to one of the three 360IVs, and finally completed measures of state paranoia, sense of presence and cybersickness.Results: Results revealed the presence of various interpretations about the actor's attitudes in the three 360IVs. Also, paranoid thoughts were predicted by proneness towards trait paranoia in two out of the three 360IVs. Furthermore, moderate levels of sense of presence and low levels of cybersickness were observed for each 360IV.Conclusion: The present study provides evidence in favour of the use of 360IVs as a new accessible, realistic, and standardised tool to assess state paranoia in non-clinical samples.

Introduction: Many neuropsychiatric and neurodegenerative disorders produce Theory of Mind impairment. We aimed to implement a Brazilian Portuguese version of the Faux Pas Recognition Test (FPRT) and evaluate its psychometric properties.Methods: We first completed an English-Brazilian Portuguese translation and adaptation to obtain an FPRT Brazilian Portuguese version. We performed a multicentric study with 153 healthy participants (68.6% women), mean age of 38.8 years (SD = 14.6) and 12.9 years of schooling (SD = 4.5). Linear regression analysis was performed to evaluate the association of social class, age, schooling, and FPRT scores. The psychometric analyses comprised item analysis, exploratory factor analysis, reliability, and validity analysis.Results: Normative data in a Brazilian population is presented. A positive correlation of scores with years of schooling, social class, and an inverse relation with age was found. The exploratory factorial analysis found a two-component structure, one component, consisting of questions 1 through 6 (Eigenvalue 5.325) and another component, consisting of questions 7 and 8 (Eigenvalue 1.09). Cronbach's alpha of the 20 stories was .72. All control stories had a poor discriminative index.Conclusion: The FPRT Brazilian Portuguese version demonstrated good internal consistency and, psychometric properties and is adequate for use even in lower educational contexts in Brazil.