Preliminary evidence that fatigue contributes to anhedonia in stable individuals diagnosed with schizophrenia

ObjectivesAnhedonia and fatigue are trans-diagnostic symptoms commonly observed in schizophrenia. Anhedonia is a core negative symptom with a strong relationship with depression and is associated with diminished global functioning. Similarly, fatigue is also associated to depression and research across psychiatric illnesses indicate that fatigue may persist even when primary symptoms are treated. Although fatigue is common in people diagnosed with schizophrenia, it is under studied within this population. The objective of this exploratory study was to investigate the association of fatigue and anhedonia by controlling for depression in a sample of individuals diagnosed with schizophrenia.MethodFifty-one stable individuals diagnosed with schizophrenia from the University Department of Adult Psychiatry in Montpellier took part in this study. Participants completed questionnaires on fatigue impact and depression, and were assessed for symptom severity. Following data collection, statistical analyses were conducted in order to explore associations between clinical variables and fatigue impact. Based on the results obtained, a hierarchical linear regression was conducted in order to investigate whether fatigue impact contributed to the variance of negative symptoms.ResultsThe hierarchical linear regression indicated that when controlling for depression, fatigue impact contributes to ~20% of the variance of anhedonia. Together the social impact of fatigue and depression contribute to 24% of the variation of anhedonia.ConclusionTo the best of our knowledge, this exploratory study is the first to investigate and show that fatigue impact may contribute to anhedonia. We recommend further research to investigate fatigue, its impact on symptomatology, and better categorization of negative symptoms in hopes of developing targeted fatigue treatment interventions

Role of Gaze Cues in Interpersonal Motor Coordination: Towards Higher Affiliation in Human-Robot Interaction

Background The ability to follow one another's gaze plays an important role in our social cognition; especially when we synchronously perform tasks together. We investigate how gaze cues can improve performance in a simple coordination task (i.e., the mirror game), whereby two players mirror each other's hand motions. In this game, each player is either a leader or follower. To study the effect of gaze in a systematic manner, the leader's role is played by a robotic avatar. We contrast two conditions, in which the avatar provides or not explicit gaze cues that indicate the next location of its hand. Specifically, we investigated (a) whether participants are able to exploit these gaze cues to improve their coordination, (b) how gaze cues affect action prediction and temporal coordination, and (c) whether introducing active gaze behavior for avatars makes them more realistic and human-like (from the user point of view). Methodology/Principal Findings 43 subjects participated in 8 trials of the mirror game. Each subject performed the game in the two conditions (with and without gaze cues). In this within-subject study, the order of the conditions was randomized across participants, and subjective assessment of the avatar's realism was assessed by administering a post-hoc questionnaire. When gaze cues were provided, a quantitative assessment of synchrony between participants and the avatar revealed a significant improvement in subject reaction-time (RT). This confirms our hypothesis that gaze cues improve the follower's ability to predict the avatar's action. An analysis of the pattern of frequency across the two players' hand movements reveals that the gaze cues improve the overall temporal coordination across the two players. Finally, analysis of the subjective evaluations from the questionnaires reveals that, in the presence of gaze cues, participants found it not only more human-like/realistic, but also easier to interact with the avatar. Conclusion/Significance This work confirms that people can exploit gaze cues to predict another person's movements and to better coordinate their motions with their partners, even when the partner is a computer-animated avatar. Moreover, this study contributes further evidence that implementing biological features, here task-relevant gaze cues, enable the humanoid robotic avatar to appear more human-like, and thus increase the user's sense of affiliation

Apathy and Emotion-Based Decision-Making in Amnesic Mild Cognitive Impairment and Alzheimer’s Disease

Background. Apathy and reduced emotion-based decision-making are two behavioral modifications independently described in Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI). Objectives. The aims of this study were to investigate decision-making based on emotional feedback processing in AD and aMCI and to study the impact of reduced decision-making performances on apathy. Methods. We recruited 20 patients with AD, 20 participants with aMCI, and 20 healthy controls. All participants completed the Lille apathy rating scale (LARS) and the Iowa gambling task (IGT). Results. Both aMCI and AD participants had reduced performances on the IGT and were more apathetic compared to controls without any difference between aMCI and AD groups. For the entire sample, LARS initiation dimension was related to IGT disadvantageous decision-making profile. Conclusions. We provide the first study showing that both aMCI and AD individuals make less profitable decisions than controls, whereas aMCI and AD did not differ. Disadvantageous decision-making profile on the IGT was associated with higher level of apathy on the action initiation dimension. The role of an abnormal IGT performance as a risk factor for the development of apathy needs to be investigated in other clinical populations and in normal aging

Deciphering reward-based decision-making in schizophrenia: a meta-analysis and behavioral modeling of the Iowa Gambling Task

Background: Patients with schizophrenia (SZP) have been reported to exhibit impairments in reward-based decision-making, but results are heterogeneous with multiple potential confounds such as age, intelligence level, clinical symptoms or medication, making it difficult to evaluate the robustness of these impairments. Methods: We conducted a meta-analysis of studies comparing the performance of SZP and healthy controls (HC) in the Iowa Gambling Task (IGT) as well as comprehensive analyses based on subject-level data (n = 303 SZP, n = 188 HC) to investigate reward-based decision-making in SZP. To quantify differences in the influence of individual deck features (immediate gain, gain frequency, net loss) between SZP and HC, we additionally employed a least-squares model. Results: SZP showed statistically significant suboptimal decisions as indicated by disadvantageous deck choices (d from 0.51 to −0.62) and lower net scores (d from −0.35 to −1.03) in a meta-analysis of k = 29 samples (n = 1127 SZP, n = 1149 HC) and these results were confirmed in a complementary subject-level analysis. Moreover, decision-making in SZP was characterized by a relative overweighting of immediate gain and net losses and an underweighting of gain frequency. Moderator analyses revealed that in part, decision-making in the IGT was moderated by intelligence level, medication and general symptom scores. Conclusion: Our results indicate robust impairments in reward-based decision-making in SZP and suggest that decreased cognitive resources, such as working memory, may contribute to these alterations

Mémoire autobiographique, identité et schizophrénie: les souvenirs définissant le soi et le voyage mental dans le temps

Notre thèse visait à mieux comprendre les liens entre identité et mémoire autobiographique dans la schizophrénie. Nous avons examiné comment les personnes affectées de schizophrénie rendaient compte de leur identité via la récupération de souvenirs définissant le soi, Nous avons également exploré leur capacité de voyager mentalement dans le futur. Les résultats ont montré que les souvenirs définissant le soi des personnes avec schizophrénie étaient moins cohérents et contenaient moins de raisonnements autobiographiques et de liens avec le self que les souvenirs des personnes de contrôle. Leur pic de réminiscence était plus précoce que celui des contrôles et les souvenirs à l'intérieur de ce pic étaient moins en lien avec la réussite et davantage avec des menaces sur la vie. Enfin, les personnes avec schizophrénie étaient moins capables de se projeter dans le futur de façon spécifique, ce déficit étant associé à une difficulté d'élaboration de scènes spatialement cohérentes

Remembering the Past and Imagining the Future in Schizophrenia

It has been suggested that patients with schizophrenia experience a distorted sense of continuity of self across time. However, temporal aspects of self-processing have received little empirical attention in schizophrenia. In this study, the authors investigated schizophrenic patients' ability to generate specific mental images of their personal past and future. Results showed that patients recalled fewer specific past events than did healthy controls and were even more impaired in generating specific future events. These deficits were associated with positive symptoms but were not associated with negative symptoms or with performances on verbal fluency tasks. It is suggested that schizophrenic patients' failures to project themselves into specific past and future episodes might be related to difficulties in retrieving contextual details from memory, as well as disturbance of the sense of subjective time

Face recognition in schizophrenia disorder: A comprehensive review of behavioral, neuroimaging and neurophysiological studies.

International audienceFacial emotion processing has been extensively studied in schizophrenia patients while general face processing has received less attention. The already published reviews do not address the current scientific literature in a complete manner. Therefore, here we tried to answer some questions that remain to be clarified, particularly: are the non-emotional aspects of facial processing in fact impaired in schizophrenia patients? At the behavioral level, our key conclusions are that visual perception deficit in schizophrenia patients: are not specific to faces; are most often present when the cognitive (e.g. attention) and perceptual demands of the tasks are important; and seems to worsen with the illness chronification. Although, currently evidence suggests impaired second order configural processing, more studies are necessary to determine whether or not holistic processing is impaired in schizophrenia patients. Neural and neurophysiological evidence suggests impaired earlier levels of visual processing, which might involve the deficits in interaction of the magnocellular and parvocellular pathways impacting on further processing. These deficits seem to be present even before the disorder out-set. Although evidence suggests that this deficit may be not specific to faces, further evidence on this question is necessary, in particularly more ecological studies including context and body processing