Persistent psychogenic déjà vu: a case report

Introduction: Déjà vu is typically a transient mental state in which a novel experience feels highly familiar. Although extensively studied in relation to temporal lobe epilepsy as part of simple partial seizures, déjà vu has been less studied in other clinical populations. A recent review of temporal lobe epilepsy suggested a possible link between clinical levels of anxiety and debilitating déjà vu, indicating further research is required. Here, for the first time in the literature, we present a case study of a young man with anxiety and depersonalisation who reported experiencing persistent and debilitating déjà vu. This report therefore adds to the limited literature on the relationship between anxiety and déjà vu. Case presentation: A 23-year-old White British man presented with a form of persistent déjà vu in 2010, approximately 3 years since symptom onset. He reported a history of anxiety and experiencing feelings of depersonalisation. Neurological assessment (electroencephalogram and magnetic resonance imaging) did not indicate any abnormalities. We assessed his recognition memory with a task used in patients with dementia who report similar experiences but lack awareness of their falseness. Conclusions: Our case' s memory performance was more conservative than controls but did not indicate a memory deficit. Unlike other patients with chronic déjà vu (for example, in dementia), he is fully aware of the false nature of his déjà vu and this presumably leads to his intact recognition memory performance. We suggest that his persistent déjà vu is psychogenic and conclude that déjà vu should be further studied in psychiatric disorders.</p

Shifted phase of EEG cross-frequency coupling in individuals with Phelan-McDermid syndrome

Background Phelan-McDermid Syndrome (PMS) is a rare condition caused by deletion or mutation of the SHANK3 gene. Individuals with PMS frequently present with intellectual disability, autism spectrum disorder, and other neurodevelopmental challenges. Electroencephalography (EEG) can provide a window into network-level function in PMS. Methods Here, we analyze EEG data collected across multiple sites in individuals with PMS (n = 26) and typically developing individuals (n = 15). We quantify oscillatory power, alpha-gamma phase-amplitude coupling strength, and phase bias, a measure of the phase of cross frequency coupling thought to reflect the balance of feedforward (bottom-up) and feedback (top-down) activity. Results We find individuals with PMS display increased alpha-gamma phase bias (U = 3.841, p < 0.0005), predominantly over posterior electrodes. Most individuals with PMS demonstrate positive overall phase bias while most typically developing individuals demonstrate negative overall phase bias. Among individuals with PMS, strength of alpha-gamma phase-amplitude coupling was associated with Sameness, Ritualistic, and Compulsive behaviors as measured by the Repetitive Behavior Scales-Revised (Beta = 0.545, p = 0.011). Conclusions Increased phase bias suggests potential circuit-level mechanisms underlying phenotype in PMS, offering opportunities for back-translation of findings into animal models and targeting in clinical trials

Childhood maltreatment is associated with increased neural response to ambiguous threatening facial expressions in adulthood: Evidence from the late positive potential

Childhood maltreatment increases lifetime vulnerability for psychopathology. One proposed mechanism for this association is that early maltreatment increases vigilance for and attention to subtle threat cues, persisting outside of the environment in which maltreatment occurs. To test this possibility, the present study examined neural responses to ambiguous and nonambiguous threatening facial expressions in a sample of 25 adults reporting a history of low-to-moderate levels of abuse in childhood and 46 reporting no or low levels of childhood maltreatment. The measure of neural response used was the late positive potential (LPP), a neural marker of sustained attention to motivationally salient information that is sensitive to subtle variation in emotional content. Participants passively viewed angry-neutral and fearful-neutral face blends and rated emotional intensity for each face. In the maltreated group, as fearful faces increased in emotional intensity, the LPP similarly increased, suggesting increased sensitivity to subtle variation in threatening content. Moreover, the LPP at each level of emotional intensity was not related to current symptoms of anxiety and depression. However, contrary to our hypotheses, adults with a history of abuse did not rate angry or fearful faces as more threatening, nor did they exhibit a larger LPP to angry faces, compared to controls. These findings suggest that childhood maltreatment may be associated with increased sensitivity to ambiguous threatening information in adulthood (c) Psychonomic Society, Inc. 2018

Clinicians’ Attitudes Toward Telepsychology in Addiction and Mental Health Services, and Prediction of Postpandemic Telepsychology Uptake: Cross-sectional Study

BackgroundThe COVID-19 pandemic has resulted in unprecedented uptake of telepsychology services; however, clinicians have mixed attitudes toward virtual technologies. ObjectiveThis study (1) explored clinicians’ experiences of and intentions to use video, telephone, and in-person services, and (2) tested the utility of the unified theory of acceptance and use of technology (UTAUT) to predict clinicians’ intentions to offer telepsychology after the COVID-19 pandemic. MethodsClinician satisfaction and therapeutic alliance were compared across in-person, video, and telephone services, while technology attitudes and intention to use after the pandemic were compared across video and telephone services among 118 addiction and mental health clinicians during the COVID-19 pandemic. ResultsClinicians reported more positive experiences with in-person services than both virtual technologies; further, clinicians reported greater positive experiences, attitudes, and intentions to use video services than telephone services across measures. Based on the UTAUT, performance expectancy positively predicted concurrent intentions to use video services (β=0.46; P<.001) and telephone services (β=0.35; P<.001) after the pandemic. Social influence (β=0.24; P=.004) and facilitating conditions (β=0.19; P=.03) additionally predicted the intention to use telephone services. ConclusionsClinicians rated in-person services more positively than virtual technologies, with video services perceived more positively than telephone services. Performance expectancy was the primary facilitator of the uptake of both virtual modalities

Cultural Beliefs and Disability: Implications for Rehabilitation Counsellors

This article discusses cultural beliefs and disability and how they can impact the rehabilitation process. It specifically addresses the importance of understanding and acknowledging how different cultures view disability. Diversity considerations for counsellors when working with clients from differing backgrounds are also discussed. Due to the ever-changing demographics of the world\u27s population, it is imperative that counsellors have a working knowledge of the cultural impact of disability. Acquiring, retaining and cultivating how different cultures respond to disability is an ongoing process for counsellors and for their multicultural competence development

Risk and Resilience in an Acute Stress Paradigm : Evidence From Salivary Cortisol and Time-Frequency Analysis of the Reward Positivity

Both abnormal stress and reward responsivity are consistently linked to multiple forms of psychopathology; however, the nature of the associations between stress and reward sensitivity remains poorly understood. In the present study, we examined associations between the hypothalamic-pituitary-adrenal-axis stress response and event-related potentials sensitive to the receipt of reward-related feedback in a pre–post experimental paradigm. Neural responses were recorded while male participants completed a simple monetary-reward guessing task before and after the Montreal Imaging Stress Task. Results demonstrated that acute psychosocial stress significantly reduced the magnitude of neural responses to feedback in the reward-sensitive delta-frequency band but not the loss-sensitive theta-frequency band. In addition, a larger delta-frequency response to rewards at baseline predicted reduced overall cortisol response in the stress condition. These findings suggest, therefore, that neural reward circuitry may be associated with both risk for and resilience to stress-related psychopathology.publishe