Cinemotion, a Program of Cognitive Remediation to Improve the Recognition and Expression of Facial Emotions in Schizophrenia: A Pilot Study.

Objective: Patients with schizophrenia exhibit impaired social cognition, especially in the recognition and expression of facial emotions, aspects of communication profoundly interlinked in an embodied approach of cognition. Nevertheless, many training programs have been developed that focus on either of these deficits but not both. We therefore designed a training program, Cinemotion, intended to remedy the 2 deficits and investigated its feasibility and effects in patients with schizophrenia. Design: Thirty-one patients undergoing treatment for schizophrenia and presenting deficit in emotion recognition were randomized to a group of 16 to undergo Cinemotion training, delivered in weekly group sessions, and to a control treatment group of 15. At the conclusion of training or after 10 weeks in controls, we reassessed and compared original and final results to determine improvement. Methods: Facial emotions recognition (TREF), empathy (Questionnaire of Cognitive and Affective Empathy, QCAE), and attributional style (Ambiguous Intentions Hostility Questionnaire, AIHQ) were assessed before (T0) and after (T1) the program. External evaluators also assessed ability and accuracy of Cinemotion participants to self-generate facial emotion expression in response to verbal instruction. Results: Between T0 and T1, Cinemotion participants significantly improved total TREF, sadness, disgust, and anger scores, compared to findings in control treatment group. They also improved their ability and accuracy to self-generate facial expressions, especially sadness and fear, with no significant improvement in other components of social recognition. Conclusions: Our findings show the apparent efficacy of training using the Cinemotion program to improve the recognition and expression of facial emotions in schizophrenia.

Is there any Influence of Variations in Context on Object-Affordance Effects in Schizophrenia? Perception of Property and Goals of Action.

The simple perception of an object can potentiate an associated action. This affordance effect depends heavily on the action context in which the object is presented. In recent years, psychologists, psychiatrists, and phenomenologists have agreed that subjects with schizophrenia may not perceive the affordances of people or objects that could lead to a loss of ease in their actions. We examined whether the addition of contextually congruent elements, during the perception of everyday objects, could promote the emergence of object-affordance effects in subjects with schizophrenia and controls. Participants performed two Stimulus-Response-Compatibility tasks in which they were presented with semantic primes related to sense of property (Experiment 1) or goal of action (Experiment 2) prior to viewing each graspable object. Controls responded faster when their response hand and the graspable part of the object were compatibly oriented, but only when the context was congruent with the individual's needs and goals. When the context operated as a constraint, the affordance-effect was disrupted. These results support the understanding that object-affordance is flexible and not just intrinsic to an object. However, the absence of this object-affordance effect in subjects with schizophrenia suggests the possible impairment of their ability to experience the internal simulation of motor action potentialities. In such case, all activities of daily life would require the involvement of higher cognitive processes rather than lower level sensorimotor processes. The study of schizophrenia requires the consideration of concepts and methods that arise from the theories of embodied and situated cognition.

Behavioral predispositions to approach or avoid emotional words in schizophrenia.

Many data suggest a disjunction between decreased emotional expressions and relatively preserved experience of and ability to assess emotions in schizophrenia. Based in an embodied approach of cognition, several studies have highlighted affective stimulus-response congruency effect in healthy subjects that show a direct link between the perception of emotion and associated motor responses. This study investigated whether the categorization of emotional words involves an automatic sensorimotor simulation of approach and avoidance behaviors. We asked 28 subjects with schizophrenia and 28 controls to execute arm movements of approach or avoidance to categorize emotional words, according to their valence (positive or negative). Controls were faster to respond to a positive stimulus with a movement of approach and a negative stimulus with a movement of avoidance (congruent condition) than to perform the inverted response movements (incongruent condition). However, responses of patients with schizophrenia did not differ according to congruence condition. Our results support the apparent non-involvement of covert sensorimotor simulation of approach and avoidance in the categorization of emotional stimuli by patients with schizophrenia, despite their understanding of the emotional valence of words. This absence of affective stimulus-response compatibility effect would imply a decoupling between emotional and bodily states in patients with schizophrenia.

Compensating for memory losses throughout aging: validation and normalization of the memory compensation questionnaire (MCQ) for non-clinical French populations.

AIM: The MCQ is a seven-factor scale that measures individual differences in the tendency to select particular strategies and to overcome perceived or real memory losses. Our aim was to establish a French version of the MCQ and to evaluate its psychometric properties in a lifespan perspective. We first tested the underlying factor structure of the MCQ in a large sample of 749 adults from aged from 18 to 92 years. RESULTS: The results showed that the factor structure of the French version corresponded well with the one obtained in English-, Dutch- and Spanish-speaking samples, supporting the cross-national robustness of the MCQ. We confirmed a seven-factor order model that supports the construct validity of the questionnaire. The reliabilities of the scales were good (α>.70) to acceptable (α=.66 and .62). Criterion validity was verified by means of significant correlations between health composites and MCQ subscales. Gender and Age affected most of the MCQ subscales but not the Level of Education (LE). CONCLUSION: The MCQ revealed to be a heuristic tool for assessing daily compensatory behaviors that are developed in order to achieve successful aging. Thus, regression-based normative data and a user-friendly computer program were provided to facilitate scoring and norming by clinicians and researchers who need to assess daily compensatory behaviors.

Grasping the world: object-affordance effect in schizophrenia.

For schizophrenic patients, the world can appear as deprived of practical meaning, which normally emerges from sensory-motor experiences. However, no research has yet studied the integration between perception and action in this population. In this study, we hypothesize that patients, after having controlled the integrity of their visuospatial integration, would nevertheless present deficit in sensory-motor simulation. In this view, we compare patients to control subjects using two stimulus-response compatibility (SRC) tasks. Experiment 1 is performed to ensure that visuo-spatial integration is not impaired (Simon Effect). Experiment 2 replicates a study from Tucker and Ellis (1998) to explore the existence of sensory-motor compatibility between stimulus and response (Object Affordance). In control subjects, the SRC effect appears in both experiments. In schizophrenic patients, it appears only when stimuli and responses share the same spatial localization. This loss of automatic sensory-motor simulation could emerge from a lack of relation between the object and the subject's environment.

Is there any impact of cognitive remediation on an ecological test in schizophrenia?

INTRODUCTION: Cognitive deficits are commonly reported in schizophrenia and have a significant impact on the daily life of patients and on their social and work inclusion. Cognitive remediation therapies (CRT) may enhance the capabilities of schizophrenia patients. Although social and work integration is the ultimate goal of CRT, previous studies have failed to carry out a detailed assessment of the effects on everyday life. METHODS: Fifty-nine schizophrenia patients were randomised into two groups (remediation or usual treatment) to test the effects of a new remediation programme, which included both rehearsal and strategy learning, on cognitive functions. An ecological test was used to evaluate its transfer to daily living skills. RESULTS: Cognitive improvements are revealed in CRT patients, mainly in memory and executive functions. Patients showing some deficiencies to perform the ecological test had better scores after the CRT. Moreover, they significantly improve their social activity scores. CONCLUSIONS: CRT would facilitate mental load monitoring by enhancing or reallocating cognitive resources, facilitating the patient's organisation and autonomy. The rehearsal learning approach improves the ability to carry out automatic operations that are less demanding in terms of cognitive resources, thereby increasing the resources available for acquisition and efficient use of strategies provided during the strategy learning approach.

Action compatibility effects are hedonically marked and have incidental consequences on affective judgment.

Recent results from Cannon, Hayes, and Tipper (2010) have established that the Action Compatibility Effect (ACE) is hedonically marked and elicits a genuine positive reaction. In this work, we aim to show that the hedonic marking of the ACE has incidental consequences on affective judgment. For this, we used the affective priming paradigm principle (for a review, see Musch & Klauer, 2003): participants have to respond, as quickly as they can, regarding the pleasantness or unpleasantness character of a target word. In the priming phase, we do not present an affective stimulus; however, we present two different graspable objects, one after the other. The handles of the graspable objects are shown either both on the same side (i.e., perceptual action compatibility) or not (i.e., perceptual action incompatibility). In addition, the orientation of the handles of the objects are either compatible (i.e., action compatibility) or not (i.e., action compatibility) with the response hand used for the word evaluation. Consistent with our hypothesis, participants responded faster to positive words after perceptual action compatibility and action compatibility (thus demonstrating the ACE) than after incompatibility conditions.

Explicit and implicit emotional processing modifications in pharmacoresistant left temporal lobe epilepsy and anxiodepressive disorders.

We examined whether anxiodepressive patients with left temporal lobe epilepsy could be differentiated from those with depression but without epilepsy on tasks that investigate attentional bias toward and explicit judgment of emotional stimuli. Eight depressive patients, eight anxiodepressive patients with epilepsy, and eight controls participated in the present study. Anxiodepressive with epilepsy and depressive patients had comparable depression scores and the same cognitive profile. Two distinct emotional tasks were used: the decision lexical task and the number comparison task. Three emotional connotations were presented: neutral, positive, and negative. The pattern of results showed an attentional bias toward negative words and pictures in depressive patients and only toward negative words in anxiodepressive patients with epilepsy. Moreover, depressive patients explicitly judged negative stimuli with lower intensity and anxiodepressive patients judged neutral stimuli with higher intensity. The present study specifies the emotional functioning in depression with or without left temporal lobe epilepsy.

Modulation of the default mode network is task-dependant in chronic schizophrenia patients.

The activity of brain regions of the so-called default mode network (DMN) attenuates during the performance of goal-directed tasks. These activity decreases (named task-induced deactivations; TID) are though to reflect the reallocation of cognitive resources from the DMN to areas implicated in the execution of the task. Recently, DMN activity suppression has been studied in schizophrenia patients. Although these works showed that TID are altered in schizophrenia, they also revealed inconsistent findings. We hypothesized that reallocation of resources is altered in schizophrenia patients and is context or task specific. We investigated TID using functional MRI in 26 schizophrenic patients and 13 control subjects while performing two different goal-directed tasks (the Hayling Sentence Completion Test and the N-Back task). Both whole brain and region of interest conjunction analyses were conducted to investigate brain areas commonly deactivated in the two tasks (task unspecific deactivations). Task-unspecific deactivations were not observed in the schizophrenia group, although these were strongly significant in the control group. Differences between patient and control participants were observed in different regions of the DMN depending whether the subjects performed the Hayling or the N-back task. These results suggest that reallocation of cognitive resources is altered in our patient sample. Moreover, TID were task-unspecific indicating that resources reallocation is context dependent in schizophrenia. DMN activity attenuates differently in schizophrenia patients depending on the cognitive processes involved in the task.

Brain activation during executive processes in schizophrenia.

Schizophrenia patients show some deficits in executive processes (impaired behavioural performance and abnormal brain functioning). The aim of this study is to explore the brain activity of schizophrenia patients during different inhibitory tasks. We used functional magnetic resonance imaging to investigate to investigate the restraint and deletion aspects of inhibition in 19 patients with schizophrenia and 12 normal subjects during the performance of the Hayling and the N-back tasks. The patients demonstrated impaired performance (more errors and longer reaction times) in the Hayling task. Schizophrenia subjects activated the same fronto-parietal network as the control subjects but demonstrated stronger parietal activations. For the N-back task, the deficit shown by the patients was limited to the number of target omissions. The reaction times and the number of false alarms did not differ in the two groups. We interpret this pattern of deficit as an alteration of working memory processes (and unaltered inhibition). Schizophrenia subjects showed higher activations in a fronto-parietal network. Since schizophrenia patients reached normal inhibitory performances in the N-back task and not in the Hayling task, the frontal hyperactivation may reflect an increased effort or a compensatory mechanism that facilitates the performance of executive tasks. During the Hayling task, this frontal hyperactivation was not achieved, and its absence was associated with a performance deficit relative to the performance of normal subjects.