Mechanisms of improvement in generalized anxiety disorder: A mediation and moderated mediation analysis from a randomized controlled trial.

BACKGROUND: Generalized anxiety disorder (GAD) is associated with the lowest treatment response rate among all anxiety disorders. Understanding mechanisms of improvement may help to develop more effective and personalized treatments. AIM: The objective of the study was to investigate different improvement mechanisms in the treatment of individuals diagnosed with GAD. DESIGN: We reported data from a randomized controlled trial that evaluated three different GAD treatments (mindfulness-based intervention, BMT; fluoxetine, FLX; and an active comparison group, QoL) for 8 weeks. METHOD: Mediation analyses were performed evaluating the association between worry symptoms at baseline and anxiety scoring at the endpoint, considering self-compassion or mindfulness or its dimensions at mid-treatment as mediators for the whole sample (assessing GAD improvement mechanism) and the different interventions as moderators. RESULTS: Contrary to mindfulness state scoring (C = .06; 95% CI = -.05 to .20), self-compassion (C = .11; 95% CI = .01 to .28) and non-judgement of inner experience (C = .10; 95% CI = .004 to .21) mediated the association between worry symptoms at baseline and anxiety at the endpoint. When comparing BMT to FLX, the intervention modality did not moderate these associations. CONCLUSION: Self-compassion and non-judgement of inner experience seem to be essential targets in GAD treatment, contrary to the mindfulness state itself. Although no difference was found considering the intervention modality, future research may assess how to boost these dimensions in specific treatments for GAD.

A preliminary neuroimaging investigation of the effects of mindfulness training on attention reorienting and amygdala reactivity to emotional faces in adolescent and adult females.

INTRODUCTION: Adolescence is a time of increased emotional reactivity and improving cognitive control. Mindfulness meditation training may foster adolescents' cognitive control and emotional regulation skills; however little is known about the impact of mindfulness training in adolescents compared to adults. We examined the effect of mindfulness meditation versus a closely matched active control condition (relaxation training) on behavioral and neural measures of cognitive control and emotional reactivity in a small group of adolescents and adults. METHODS: Structural and functional magnetic resonance imaging data were collected before and after 8 weeks of training in 26 adolescent (12-14 years) and 17 adult (23-33 years) female participants in the United Kingdom while they completed an n-back task with emotional face distractors and an attentional control task. Participants of each group chose a class date/time and the classes were then randomly allocated to mindfulness or relaxation conditions. RESULTS: Compared to relaxation training, mindfulness training led to an increase in the speed of reorienting attention across age groups. In addition, there was preliminary evidence for reduced amygdala response to emotional face distractors in adolescents after mindfulness training. CONCLUSIONS: An 8-week mindfulness program showed similar facilitative effects in adolescent and adult females on the reorienting of attention, a skill that is repeatedly practiced during mindfulness meditation. Mindfulness also reduced left amygdala reactivity to emotional face distractors in adolescents only. Mindfulness meditation practice can therefore have a facilitative effect on female adolescents' attentional control, and possibly attenuate their emotional reactivity.

Effects of the Interculturality and Mindfulness Program (PIM) on University Students: A Quasi-Experimental Study.

Rates of mental health issues have been increasing among university students. This study investigates the effects of the Interculturality and Mindfulness Program (PIM) on academic students on mindfulness, emotional regulation, depression, anxiety, stress, life satisfaction, optimism, positive solitude, and loneliness. A quasi-experimental research was conducted, with pre- and post-test comparative measurements in three groups: in-person (IG), synchronous online (OG), and passive control (CG). A diverse group of students (n = 150; mean age = 25.4 ± 8.31) participated from two universities in Portugal. When compared to the CG, both active groups (IG and OG) demonstrated a beneficial interaction effect in acceptance, positive solitude, optimism, and mindfulness. The IG demonstrated a positive interaction effect in awareness and satisfaction with life, whereas the OG indicated a favorable interaction effect in impulse. When analyzing the intra-group effects, both active groups presented a significant improvement in stress, emotion regulation, mindfulness, positive solitude, and optimism. The OG demonstrated an improvement in awareness and loneliness. The main limitations of this research are that students were not randomly assigned, and groups were heterogeneous in nationality, education level, and sex. Nonetheless, PIM has indicated beneficial results in both IG and OG, and is a promising intervention for the prevention of mental health issues (e.g., stress, difficulties in emotional regulation, and loneliness), as well as for the promotion of well-being (e.g., positive solitude, mindfulness, life satisfaction, and optimism).

Open monitoring meditation alters the EEG gamma coherence in experts meditators: The expert practice exhibit greater right intra-hemispheric functional coupling.

AIM: This study investigated the differences in frontoparietal EEG gamma coherence between expert meditators (EM) and naïve meditators (NM). MATERIAL AND METHODS: This is a cross-sectional study with a sample of twenty-one healthy adults divided under two groups (experts meditators vs. naive-meditators), with analyzing the intra-hemispheric coherence of frontoparietal gamma oscillations by electroencephalography during the study steps: EEG resting-state 1, during the open presence meditation practice, and EEG resting-state 2. RESULTS: The findings demonstrated greater frontoparietal EEG coherence in gamma for experts meditators in the Fp1-P3, F4-P4, F8-P4 electrode pairs during rest 1 and rest 2 (p ≤ 0.0083). In addition, we evidenced differences in the frontoparietal EEG coherence for expert meditators in F4-P4, F8-P4 during the meditation (p ≤ 0.0083). CONCLUSION: Our results can support evidence that the connectivity of the right frontoparietal network acts as a biomarker of the enhanced Open monitoring meditation training.

COVID-19 and mental health: A review and the role of telehealth and virtual reality.

On March 12, 2020, with more than 20,000 confirmed cases and almost 1000 deaths in the European Region, the World Health Organization classified the COVID-19 outbreak as a pandemic. As of August 15, 2020, there are 21.5 million confirmed cases of COVID-19 and over 766,000 deaths from the virus, worldwide. Most governments have imposed quarantine measures of varied degrees of strictness on their populations in attempts to stall the spread of the infection in their communities. However, the isolation may have inflicted long-term psychological injury to the general population and, in particular, to at-risk groups such as the elderly, the mentally ill, children, and frontline healthcare staff. In this article, we offer the most up-to-date review of the effects of COVID-19 confinement on all the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. We make data-driven predictions of the impact of COVID-19 confinement on mental health outcomes and discuss the potential role of telemedicine and virtual reality in mental health screening, diagnosis, treatment, and monitoring, thus improving the above outcomes in such a difficult time.

Mindfulness em ambientes escolares: adaptações e protocolos emergentes / Mindfulness in school settings: adjustments and emerging protocols / Mindfulness en el ambiente escolar: adaptaciones y protocolos emergentes

Estudos têm demonstrado o impacto positivo das Mindfulness Based Interventions (MBIs) no tratamento de doenças e transtornos mentais em adultos. Recentemente, as MBIs estão sendo adaptadas para crianças e adolescentes em ambiente escolar. O objetivo deste artigo é discutir as adaptações necessárias, o papel da Autocompaixão, os efeitos das intervenções e o treinamento de professores através de três MBIs adaptadas para escolas: Dot-Be, MindUp e Learning to Breath. Os resultados indicam que MBIs para escolas devem ter menor duração das sessões; maior integração das práticas com o quotidiano; maior exploração dos cinco sentidos; maior utilização de metáforas, linguagem visual e tecnologia; e envolvimento de familiares, professores e educadores. Tanto o conceito quanto as práticas de Autocompaixão são utilizadas nestas MBIs, afetando a estrutura das intervenções e a escolha das práticas, e os efeitos nos desfechos pesquisados. Evidências sugerem que os efeitos do treinamento de Mindfulness em ambientes educacionais podem ser semelhantes àqueles verificados em adultos em contextos de saúde. Entretanto, com a proliferação de protocolos de treinamento para professores e gestores educacionais, as evidências de efetividade de MBIs neste contexto não podem ser generalizadas. Visando contribuir com esse processo, apresenta-se um modelo de treinamento em Mindfulness para a equipe educacional.(AU)

Several studies have demonstrated the positive impact of Mindfulness-Based Interventions (MBIs) in treatment of diseases and mental disorders in adults. MBIs are being adapted on children and adolescents in school environment. This paper aims to discuss the necessary adaptations, the role of self-compassion, the interventions effects and the teacher training, through three MBIs adapted for schools: Dot-Be, MindUp, and Learning to Breath. The results indicate that MBIs for schools should be structured with shorter duration of sessions; greater integration of mindfulness exercises with daily activities; further exploration of the five senses; increased use of metaphors, visual language and technology; and the involvement of family members, teachers and educators. Both the concept and the practices of self-compassion are used in these MBIs, affecting the structure, the choice of practices and the effects on assessed outcomes. Evidence suggests that the effects of Mindfulness training in educational environments may be similar to those observed in adults in health contexts. However, with the proliferation of training protocols to teachers and educational managers, the evidence of MBIs effectiveness in the educational context should not be generalized. In order to contribute to this process, this paper presents a general training framework in Mindfulness for educational staff.(AU)

Estudios han demostrado el impacto positivo de Mindfulness Based Interventions (MBIs) en tratamiento de enfermedades y trastornos mentales en adultos. MBIs están siendo adaptadas para niños y adolescentes en ambiente escolar. El objetivo es analizar cambios necesarios, papel de la autocompasión, efectos de las intervenciones y formación del profesorado, a través de tres MBIs adaptados para escuelas: Dot-Be, MindUp y Learnig to Breath. Resultados indican que MBIs para escuelas deben tener sesiones de menor duración; mayor integración de las prácticas en la rutina diaria; mayor exploración de los cinco sentidos; mayor uso de metáforas, lenguaje visual y tecnología; y participación de la familia, profesores y personal educativo. Tanto el concepto y las prácticas de auto-compasión son utilizados en estos MBIs, afectando la estructura de intervenciones, la elección de práticas y los efectos sobre resultados. Evidencias sugieren que los efectos del entrenamiento en Mindfulness en entornos educativos pueden ser similares a los observados en adultos. Sin embargo, con la proliferación de protocolos de entrenamiento para maestros y administradores de la educación, evidencias de eficacia de los instrumentos no se pueden generalizar. Para contribuir a la optimización de las MBIs para escuelas, se presenta un modelo de formación para el personal educativo.(AU)

Mindfulness em ambientes escolares: adaptações e protocolos emergentes / Mindfulness in school settings: adjustments and emerging protocols / Mindfulness en el ambiente escolar: adaptaciones y protocolos emergentes

Estudos têm demonstrado o impacto positivo das Mindfulness Based Interventions (MBIs) no tratamento de doenças e transtornos mentais em adultos. Recentemente, as MBIs estão sendo adaptadas para crianças e adolescentes em ambiente escolar. O objetivo deste artigo é discutir as adaptações necessárias, o papel da Autocompaixão, os efeitos das intervenções e o treinamento de professores através de três MBIs adaptadas para escolas: Dot-Be, MindUp e Learning to Breath. Os resultados indicam que MBIs para escolas devem ter menor duração das sessões; maior integração das práticas com o quotidiano; maior exploração dos cinco sentidos; maior utilização de metáforas, linguagem visual e tecnologia; e envolvimento de familiares, professores e educadores. Tanto o conceito quanto as práticas de Autocompaixão são utilizadas nestas MBIs, afetando a estrutura das intervenções e a escolha das práticas, e os efeitos nos desfechos pesquisados. Evidências sugerem que os efeitos do treinamento de Mindfulness em ambientes educacionais podem ser semelhantes àqueles verificados em adultos em contextos de saúde. Entretanto, com a proliferação de protocolos de treinamento para professores e gestores educacionais, as evidências de efetividade de MBIs neste contexto não podem ser generalizadas. Visando contribuir com esse processo, apresenta-se um modelo de treinamento em Mindfulness para a equipe educacional.

Several studies have demonstrated the positive impact of Mindfulness-Based Interventions (MBIs) in treatment of diseases and mental disorders in adults. MBIs are being adapted on children and adolescents in school environment. This paper aims to discuss the necessary adaptations, the role of self-compassion, the interventions effects and the teacher training, through three MBIs adapted for schools: Dot-Be, MindUp, and Learning to Breath. The results indicate that MBIs for schools should be structured with shorter duration of sessions; greater integration of mindfulness exercises with daily activities; further exploration of the five senses; increased use of metaphors, visual language and technology; and the involvement of family members, teachers and educators. Both the concept and the practices of self-compassion are used in these MBIs, affecting the structure, the choice of practices and the effects on assessed outcomes. Evidence suggests that the effects of Mindfulness training in educational environments may be similar to those observed in adults in health contexts. However, with the proliferation of training protocols to teachers and educational managers, the evidence of MBIs effectiveness in the educational context should not be generalized. In order to contribute to this process, this paper presents a general training framework in Mindfulness for educational staff.

Estudios han demostrado el impacto positivo de Mindfulness Based Interventions (MBIs) en tratamiento de enfermedades y trastornos mentales en adultos. MBIs están siendo adaptadas para niños y adolescentes en ambiente escolar. El objetivo es analizar cambios necesarios, papel de la autocompasión, efectos de las intervenciones y formación del profesorado, a través de tres MBIs adaptados para escuelas: Dot-Be, MindUp y Learnig to Breath. Resultados indican que MBIs para escuelas deben tener sesiones de menor duración; mayor integración de las prácticas en la rutina diaria; mayor exploración de los cinco sentidos; mayor uso de metáforas, lenguaje visual y tecnología; y participación de la familia, profesores y personal educativo. Tanto el concepto y las prácticas de auto-compasión son utilizados en estos MBIs, afectando la estructura de intervenciones, la elección de práticas y los efectos sobre resultados. Evidencias sugieren que los efectos del entrenamiento en Mindfulness en entornos educativos pueden ser similares a los observados en adultos. Sin embargo, con la proliferación de protocolos de entrenamiento para maestros y administradores de la educación, evidencias de eficacia de los instrumentos no se pueden generalizar. Para contribuir a la optimización de las MBIs para escuelas, se presenta un modelo de formación para el personal educativo.

Mapping Depression in Schizophrenia: A Functional Magnetic Resonance Imaging Study.

Depressive symptoms are common in schizophrenia, often left untreated, and associated with a high relapse rate, suicidal ideation, increased mortality, reduced social adjustment and poor quality of life. The neural mechanisms underlying depression in psychosis are poorly understood. Given reports of altered brain response to negative facial affect in depressive disorders, we examined brain response to emotive facial expressions in relation to levels of depression in people with psychosis. Seventy outpatients (final N= 63) and 20 healthy participants underwent functional magnetic resonance imaging during an implicit affect processing task involving presentation of facial expressions of fear, anger, happiness as well as neutral expressions and a (no face) control condition. All patients completed Beck Depression Inventory (BDI-II) and had their symptoms assessed on the Positive and Negative Syndrome Scale (PANSS). In patients, depression (BDI-II) scores associated positively with activation of the left thalamus, extending to the putamen-globus pallidus, insula, inferior-middle frontal and para-post-pre-central gyri during fearful expressions. Furthermore, patients with moderate-to-severe depression had significantly higher activity in these brain regions during fearful expressions relative to patients with no, minimal, or mild depression and healthy participants. The study provides first evidence of enhanced brain response to fearful facial expressions, which signal an uncertain source of threat in the environment, in patients with psychosis and a high level of self-reported depression.

What and who? Mindfulness in the mental health setting.

A strong and growing evidence base exists for the use of mindfulness-based interventions to prevent relapse in major depression and for the self-management of chronic physical health conditions (e.g. pain), but the evidence in other domains of mental health work is still emerging. Much work is being conducted outside the evidence base and standardised protocols, and by individuals with varied levels of experience and training. The (mis)perception of mindfulness as a 'simple technique' belies the complexity and skill needed to deliver a mindfulness training that has real therapeutic and transformative power. We propose a framework to help clinicians think through the suitability of mindfulness for their particular client group with the intention of providing guidance for thoughtful decision-making.

A Neurophysiological and Neuropsychological Consideration of Mindful Movement: Clinical and Research Implications.

In this article, we present ideas related to three key aspects of mindfulness training: the regulation of attention via noradrenaline, the importance of working memory and its various components (particularly the central executive and episodic buffer), and the relationship of both of these to mind-wandering. These same aspects of mindfulness training are also involved in the preparation and execution of movement and implicated in the pathophysiology of psychosis. We argue that by moving in a mindful way, there may be an additive effect of training as the two elements of the practice (mindfulness and movement) independently, and perhaps synergistically, engage common underlying systems (the default mode network). We discuss how working with mindful movement may be one route to mindfulness training for individuals who would struggle to sit still to complete the more commonly taught mindfulness practices. Drawing on our clinical experience working with individuals with severe and enduring mental health conditions, we show the real world application of these ideas and how they can be used to help those who are suffering and for whom current treatments are still far from adequate.

Functional similarity of facial emotion processing between people with a first episode of psychosis and healthy subjects.

BACKGROUND: Neurofunctional and behavioral abnormalities in facial emotion processing (FEmoP) have been consistently found in schizophrenia patients, but studies assessing brain functioning in early phases are scarce and the variety of experimental paradigms in current literature make comparisons difficult. The present work focuses on assessing FEmoP in people experiencing a psychotic episode for the first time with different experimental paradigm approaches. METHODS: Twenty-two patients with a first psychotic episode (FPe) (13 males) took part in a functional magnetic resonance imaging study (1.5T) examining neural responses to explicit and implicit processing of fearful and happy facial expressions presented at two different intensities: 50% and 100%. Their brain activation was compared to that of 31 healthy subjects (15 males). RESULTS: Control subjects show differential patterns of brain activation regarding the task demands (implicit or explicit processing), the emotional content (happy or fear) and the intensities of the emotion (50% or 100%); such differences are not found in participants with a first psychotic episode (FPe). No interaction or group effects are seen between control and FPe participants with any of the emotional tasks assessed, although FPe subjects show worse behavioral performance. CONCLUSIONS: No brain areas recruited for FEmoP emerge as significantly different between people with a FPe and healthy subjects, independently on the demands of the task, the emotion processed, or the intensity of the emotion; but FPe participants show a limited recruitment of differential brain regions that could be associated with poor emotional processing in the short term. Our results outline the need of investigating the underlying processes that lead FPe participants to worse FEmoP performance.

Effects of facial emotion recognition remediation on visual scanning of novel face stimuli.

Previous research shows that emotion recognition in schizophrenia can be improved with targeted remediation that draws attention to important facial features (eyes, nose, mouth). Moreover, the effects of training have been shown to last for up to one month after training. The aim of this study was to investigate whether improved emotion recognition of novel faces is associated with concomitant changes in visual scanning of these same novel facial expressions. Thirty-nine participants with schizophrenia received emotion recognition training using Ekman's Micro-Expression Training Tool (METT), with emotion recognition and visual scanpath (VSP) recordings to face stimuli collected simultaneously. Baseline ratings of interpersonal and cognitive functioning were also collected from all participants. Post-METT training, participants showed changes in foveal attention to the features of facial expressions of emotion not used in METT training, which were generally consistent with the information about important features from the METT. In particular, there were changes in how participants looked at the features of facial expressions of emotion surprise, disgust, fear, happiness, and neutral, demonstrating that improved emotion recognition is paralleled by changes in the way participants with schizophrenia viewed novel facial expressions of emotion. However, there were overall decreases in foveal attention to sad and neutral faces that indicate more intensive instruction might be needed for these faces during training. Most importantly, the evidence shows that participant gender may affect training outcomes.

Brain imaging analysis can identify participants under regular mental training.

Multivariate pattern recognition approaches have become a prominent tool in neuroimaging data analysis. These methods enable the classification of groups of participants (e.g. controls and patients) on the basis of subtly different patterns across the whole brain. This study demonstrates that these methods can be used, in combination with automated morphometric analysis of structural MRI, to determine with great accuracy whether a single subject has been engaged in regular mental training or not. The proposed approach allowed us to identify with 94.87% accuracy (p<0.001) if a given participant is a regular meditator (from a sample of 19 regular meditators and 20 non-meditators). Neuroimaging has been a relevant tool for diagnosing neurological and psychiatric impairments. This study may suggest a novel step forward: the emergence of a new field in brain imaging applications, in which participants could be identified based on their mental experience.

Pesquisas em cérebro e Práticas Contemplativas / Brain Research and Contemplative Practices

Introdução: Nos últimos anos tem havido um crescente interesse na investigação dos efeitos práticas de meditação na saúde mental e física. De alguma maneira, as habilidades treinadas durante as práticas meditativas, como o treinamento da atenção focada em um objeto específico, ou a monitoração dos padrões de pensamentos e emoções age modificando o funcionamento e a estrutura cerebrais. Recentemente, trabalhos na área de neuroimagem tem ajudado a elucidar possíveis mecanismo de ação das práticas meditativas no cérebro. Objetivo: revisar na literatura os estudos mais recentes sobre os efeitos da prática de meditação no cérebro e apresentar resultados de um protocolo com ressonância magnética funcional (fMRI) desenvolvido no Instituto do Cérebro do Hospital Israelita Albert Einstein (InCe-HIAE) sobre os efeitos da meditação na atenção. Método: revisão sobre estudos de neuroimagem funcional e estrutural e avaliação por fMRI de 39 sujeitos, 20 meditadores que realizam a prática há pelo menos 3 anos, por 3 vezes por semana e 20 sujeitos inexperientes em meditação. Resultados: estudos recentes têm mostrado alterações funcionais resultantes da prática de meditação, na atividade cerebral, bem como na estrutura do cérebro, como a espessura de áreas corticais. Nossos resultados preliminares corroboram com estes dados, mostrando que sujeitos que praticam meditação regularmente precisam recrutar menos áreas cerebrais, em especial frontais, do que pessoas inexperientes em meditação para ter o mesmo desempenho em uma tarefa atencional (o Stroop Word-Color Task). Conclusão: a prática de meditação pode trazer mudanças não apenas psicológicas, como mostram boa parte dos estudos, mas também modificações na fisiologia e anatomia cerebrais. Nosso estudo preliminar no InCe-HIAE indica que pessoas que praticam meditação regularmente podem apresentar um cérebro mais eficiente no desempenho de uma tarefa de atenção.

Meditation training increases brain efficiency in an attention task.

Meditation is a mental training, which involves attention and the ability to maintain focus on a particular object. In this study we have applied a specific attentional task to simply measure the performance of the participants with different levels of meditation experience, rather than evaluating meditation practice per se or task performance during meditation. Our objective was to evaluate the performance of regular meditators and non-meditators during an fMRI adapted Stroop Word-Colour Task (SWCT), which requires attention and impulse control, using a block design paradigm. We selected 20 right-handed regular meditators and 19 non-meditators matched for age, years of education and gender. Participants had to choose the colour (red, blue or green) of single words presented visually in three conditions: congruent, neutral and incongruent. Non-meditators showed greater activity than meditators in the right medial frontal, middle temporal, precentral and postcentral gyri and the lentiform nucleus during the incongruent conditions. No regions were more activated in meditators relative to non-meditators in the same comparison. Non-meditators showed an increased pattern of brain activation relative to regular meditators under the same behavioural performance level. This suggests that meditation training improves efficiency, possibly via improved sustained attention and impulse control.

Neural response to specific components of fearful faces in healthy and schizophrenic adults.

Perception of fearful faces is associated with functional activation of cortico-limbic structures, which has been found altered in individuals with psychiatric disorders such as schizophrenia, autism and major depression. The objective of this study was to isolate the brain response to the features of standardized fearful faces by incorporating principal component analysis (PCA) into the analysis of neuroimaging data of healthy volunteers and individuals with schizophrenia. At the first stage, the visual characteristics of morphed fearful facial expressions (FEEST, Young et al., 2002) were classified with PCA, which produced seven orthogonal factors, with some of them related to emotionally salient facial features (eyes, mouth, brows) and others reflecting non-salient facial features. Subsequently, these PCA-based factors were included into the functional magnetic resonance imaging (fMRI) analysis of 63 healthy volunteers and 32 individuals with schizophrenia performing a task that involved implicit processing of FEEST stimuli. In healthy volunteers, significant neural response was found to visual characteristics of eyes, mouth or brows. In individuals with schizophrenia, PCA-based analysis enabled us to identify several significant clusters of activation that were not detected by the standard approach. These clusters were implicated in processing of visual and emotional information and were attributable to the perception of eyes and brows. PCA-based analysis could be useful in isolating brain response to salient facial features in psychiatric populations.

Aspects of social cognition in anorexia nervosa: affective and cognitive theory of mind.

Although social functioning is clearly impaired in anorexia nervosa (AN), there has been limited empirical assessment of this domain in this illness. This study assesses social cognition in AN by examining performance on two 'theory of mind' (ToM) tasks; Baron-Cohen's "Reading the mind in the Eyes" task (RME) and Happé's cartoon task. These tasks probe affective and cognitive ToM, respectively. Forty-four female participants were recruited (AN N=22; healthy controls N=22) and completed both tasks, with concurrent clinical and intellectual functioning assessment. Compared with healthy controls, AN performed significantly worse on both the RME and the Cartoon task (both conditions). The mental state condition did not facilitate performance in the AN group, as it did in the healthy controls. The findings broadly replicate limited previous work [Tchanturia, K., Happé, F., Godley, J., Bara-Carill, N., Treasure, J., Schmidt, U., 2004. Theory of mind in AN. European Eating Disorders Review 12, 361-366] but in addition demonstrate abnormalities on a task requiring affective ToM interpretation. More detailed information about the components of ToM and the ToM difficulties demonstrated in AN sufferers may inform our understanding of the disorder as well as future social-cognitive based treatments.

Functional magnetic resonance imaging (fMRI) of attention processes in presumed obligate carriers of schizophrenia: preliminary findings.

BACKGROUND: Presumed obligate carriers (POCs) are the first-degree relatives of people with schizophrenia who, although do not exhibit the disorder, are in direct lineage of it. Thus, this subpopulation of first-degree relatives could provide very important information with regard to the investigation of endophenotypes for schizophrenia that could clarify the often contradictory findings in schizophrenia high-risk populations. To date, despite the extant literature on schizophrenia endophenotypes, we are only aware of one other study that examined the neural mechanisms that underlie cognitive abnormalities in this group. The aim of this study was to investigate whether a more homogeneous group of relatives, such as POCs, have neural abnormalities that may be related to schizophrenia. METHODS: We used functional magnetic resonance imaging (fMRI) to collect blood oxygenated level dependent (BOLD) response data in six POCs and eight unrelated healthy controls while performing under conditions of sustained, selective and divided attention. RESULTS: The POCs indicated alterations in a widely distributed network of regions involved in attention processes, such as the prefrontal and temporal (including the parahippocampal gyrus) cortices, in addition to the anterior cingulate gyrus. More specifically, a general reduction in BOLD response was found in these areas compared to the healthy participants during attention processes. CONCLUSION: These preliminary findings of decreased activity in POCs indicate that this more homogeneous population of unaffected relatives share similar neural abnormalities with people with schizophrenia, suggesting that reduced BOLD activity in the attention network may be an intermediate marker for schizophrenia.

Remediation of facial emotion perception in schizophrenia: concomitant changes in visual attention.

The study examined changes in visual attention in schizophrenia following training with a social-cognitive remediation package designed to improve facial emotion recognition (the Micro-Expression Training Tool; METT). Forty out-patients with schizophrenia were randomly allocated to active training (METT; n=26), or repeated exposure (RE; n=14); all completed an emotion recognition task with concurrent eye movement recording. Emotion recognition accuracy was significantly improved in the METT group, and this effect was maintained after one week. Immediately following training, the METT group directed more eye movements within feature areas of faces (i.e., eyes, nose, mouth) compared to the RE group. The number of fixations directed to feature areas of faces was positively associated with emotion recognition accuracy prior to training. After one week, the differences between METT and RE groups in viewing feature areas of faces were reduced to trends. However, within group analyses of the METT group revealed significantly increased number of fixations to, and dwell time within, feature areas following training which were maintained after one week. These results provide the first evidence that improvements in emotion recognition following METT training are associated with changes in visual attention to the feature areas of emotional faces. These findings support the contribution of visual attention abnormalities to emotion recognition impairment in schizophrenia, and suggest that one mechanism for improving emotion recognition involves re-directing visual attention to relevant features of emotional faces.

Empathy, systemizing, and autistic traits in anorexia nervosa: a pilot study.

OBJECTIVES: This pilot study examined whether patients with anorexia nervosa (AN) would display an empathizing-systemizing psychometric profile similar to that found in autism spectrum disorders (ASD), and whether people with AN would score highly on a measure of autistic traits. METHOD: Self-report measures of empathy, systemizing, and autistic traits were administered to 22 female AN patients and 45 female healthy controls (HC). RESULTS: AN patients and HCs did not differ significantly in their self-reported empathy and systemizing. AN patients scored significantly higher than HCs on the autism-spectrum quotient. CONCLUSIONS: Replication of these findings is required with larger samples and more sensitive measures.