An Investigation of Behavioural and Self-Reported Cognitive Empathy Deficits in Adolescents With Autism Spectrum Disorders and Adolescents With Behavioural Difficulties

© 2021 Vilas, Reniers and Ludlow. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/Deficits in empathy have been considered hallmarks in individuals with autism spectrum disorders (ASD) but are also considered to underlie antisocial behaviour associated with individuals with callous unemotional traits (CU). Research has suggested that individuals with autism spectrum disorders show more difficulties with cognitive empathy, and that individuals diagnosed with behaviours difficulties, characterised by CU traits and antisocial behaviour, demonstrate low affective empathy. In the current manuscript we present findings of two studies. The first study describes the validation of a new stimulus set developed for the empathic accuracy task, focused on its cognitive component. The second study compares the performance of 27 adolescents with ASD, 27 age matched typically developing adolescents and 17 adolescents with behavioural difficulties on the empathic accuracy task and a self-report measure of empathy. While, no differences were observed between the three groups across the empathy accuracy task, the adolescents with ASD and CD showed deficits in their cognitive empathy across the self-report measure. Adolescents with ASD showed lower scores in particularly their perspective taking abilities, whereas the adolescences with behavioural difficulties showed more difficulties with their online simulation. No differences in self-reported affective empathy across the three groups were observed. Clinical implications of the findings are discussed.Peer reviewedFinal Published versio

Prevalence and assessment of self-disorders in the schizophrenia spectrum : a systematic review and meta-analysis

Self-disorders have been proposed as the "clinical core" of the schizophrenia spectrum. This has been explored in recent studies using self-disorder assessment tools. However, there are few systematic discussions of their quality and utility. Therefore, a literature search was performed on Medline, Embase, PsychINFO, PubMed and the Web of Science. Studies using these assessment tools to explore self-disorders within schizophrenia spectrum disorders (SSDs) were included. A meta-analysis was performed on the outcomes of total self-disorder score and odds ratios of self-disorders, using Comprehensive Meta-Analysis software. Weighted pooled effect sizes in Hedge's g were calculated using a random-effects model. 15 studies were included, giving a sample of 810 participants on the schizophrenia spectrum. Self-disorders showed a greater aggregation within schizophrenia spectrum groups compared to non-schizophrenia spectrum groups, as measured with the Bonn Scale for the Assessment of Basic Symptoms (Hedge's g = 0.774, p < 0.01) and Examination of Anomalous Self-Experiences (Hedge's g = 1.604, p < 0.01). Also, self-disorders had a greater likelihood of occurring within SSDs (odds ratio = 5.435, p < 0.01). These findings help to validate self-disorders as a core clinical feature of the broad schizophrenia spectrum

Checklist for co-creating safe spaces with young people participating in research

Creating safe spaces in research As researchers, it is imperative that we provide safe spaces for young people to participate in research. This is particularly relevant to the field of mental health research, where participants may be asked to engage in activities that require them to discuss or reflect on experiences of poor mental health. Such activities can be upsetting for participants and so it is important to consider what actions can be taken to best reduce risks of negative experience for participants. This will also lead to improved research data quality. Currently, there is limited information to inform the creation of safe spaces for young people participating in research. We felt that there was a need to address this gap through the creation of a new checklist resource that was co-developed with young people. To facilitate this, we worked with the Institute for Mental Health’s Youth Advisory Group (IMH YAG), based at the University of Birmingham. The IMH YAG is made up of young people aged 18-25 with lived experience of mental health difficulty or experience of supporting a young person with lived experience of mental health difficulty. We identified three key themes: confidentiality and consent, fostering trust and feeling safe. Our checklist centres around how to best accommodate these needs and we have presented practical tips on how this can be addressed at three different stages of research participation: before, during and after.  We hope that this checklist will support researchers to consider what steps can be taken to ensure that children and young people participate in research that makes them feel safe and empowered.</p

The impact of psychotic experiences in the early stages of mental health problems in young people

Abstract Background Anxiety and depressive symptoms and psychotic experiences constitute common features of emerging mental disorders in young people. Psychotic experiences and the ultra-high risk (UHR) state for psychosis appear to have a particular importance for clinical presentation, progression of symptomatology, quality of life and functioning, but the impact of psychotic experiences in individuals seeking help at non-UHR services, compared to UHR services, is under-researched. Methods Sixty-nine young people (Mage ± SD at baseline = 20.8 ± 2.6, range 16–26 years, 48 females) presenting to mental health services were grouped according to UHR and non-UHR status. They were assessed at baseline for anxiety and depressive symptoms, psychological distress, psychosocial functioning and quality of life. They were followed up at three, six, and 12 months. Data were analysed using mixed linear modelling. Results UHR individuals reported higher levels of depressive symptoms and psychological distress, and lower levels of role functioning and quality of life compared to non-UHR individuals. No differences were reported for anxiety symptoms or social functioning. Decline in psychosocial functioning was not associated with clinical deterioration or reduction of quality of life. Conclusions Psychotic experiences appear to be particularly associated with depressive symptoms and psychological distress, impaired role functioning and quality of life in help-seeking young people in the medium-term. It is therefore important to pay special attention to psychotic experiences in the early stages of mental health problems even if psychotic symptoms are not the main motivation for help-seeking

Aberrant salience network functional connectivity in auditory verbal hallucinations::a first episode psychosis sample

Auditory verbal hallucinations (AVH) often lead to distress and functional disability, and are frequently associated with psychotic illness. Previously both state and trait magnetic resonance imaging (MRI) studies of AVH have identified activity in brain regions involving auditory processing, language, memory and areas of default mode network (DMN) and salience network (SN). Current evidence is clouded by research mainly in participants on long-term medication, with chronic illness and by choice of seed regions made 'a priori'. Thus, the aim of this study was to elucidate the intrinsic functional connectivity in patients presenting with first episode psychosis (FEP). Resting state functional MRI data were available from 18 FEP patients, 9 of whom also experienced AVH of sufficient duration in the scanner and had symptom capture functional MRI (sc fMRI), together with 18 healthy controls. Symptom capture results were used to accurately identify specific brain regions active during AVH; including the superior temporal cortex, insula, precuneus, posterior cingulate and parahippocampal complex. Using these as seed regions, patients with FEP and AVH showed increased resting sb-FC between parts of the SN and the DMN and between the SN and the cerebellum, but reduced sb-FC between the claustrum and the insula, compared to healthy controls.It is possible that aberrant activity within the DMN and SN complex may be directly linked to impaired salience appraisal of internal activity and AVH generation. Furthermore, decreased intrinsic functional connectivity between the claustrum and the insula may lead to compensatory over activity in parts of the auditory network including areas involved in DMN, auditory processing, language and memory, potentially related to the complex and individual content of AVH when they occur