Cognición social y procesamiento emocional en pacientes con esquizofrenia

La esquizofrenia es un síndrome severo y crónico que presenta un conjunto de síntomas positivos, negativos y cognitivos que pueden llegar a ser muy limitantes. Aunque los antipsicóticos han mostrado ser eficaces en el tratamiento de los síntomas positivos, su eficacia es más limitada en el caso de los síntomas negativos y cognitivos. Precisamente el funcionamiento cognitivo y no la sintomatología positiva ha mostrado ser una variable predictiva de la capacidad funcional de los pacientes diagnosticados con esquizofrenia. De hecho, el funcionamiento social disminuido ha sido propuesto como rasgo distintivo y objetivo de tratamiento en la esquizofrenia. En 2009, el encuentro titulado “The Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS)” puso de relieve que además de los déficit cognitivos “fríos” (independientes del contenido emocional), los pacientes con esquizofrenia sufren a menudo problemas en el procesamiento tanto social como emocional. Uno de los niveles de estudio de la cognición social es el reconocimiento facial de emociones, que ha mostrado tener un importante papel en las interacciones sociales. Según la literatura existente, los pacientes con esquizofrenia muestran limitaciones en su capacidad para interpretar estas señales emocionales. Sin embargo, existe poco consenso acerca de la causa, la naturaleza y las consecuencias de estas limitaciones. Con los estudios presentados en esta tesis esperamos poder aportar resultados de interés para un mayor conocimiento en este ámbito de investigación..

Bayesian reasoning with emotional material in patients with schizophrenia.

Delusions are one of the most classical symptoms described in schizophrenia. However, despite delusions are often emotionally charged, they have been investigated using tasks involving non-affective material, such as the Beads task. In this study we compared 30 patients with schizophrenia experiencing delusions with 32 matched controls in their pattern of responses to two versions of the Beads task within a Bayesian framework. The two versions of the Beads task consisted of one emotional and one neutral, both with ratios of beads of 60:40 and 80:20, considered, respectively, as the “difficult” and “easy” variants of the task. Results indicate that patients showed a greater deviation from the normative model, especially in the 60:40 ratio, suggesting that more inaccurate probability estimations are more likely to occur under uncertainty conditions. Additionally, both patients and controls showed a greater deviation in the emotional version of the task, providing evidence of a reasoning bias modulated by the content of the stimuli. Finally, a positive correlation between patients’ deviation and delusional symptomatology was found. Impairments in the 60:40 ratio with emotional content was related to the amount of disruption in life caused by delusions. These results contribute to the understanding of how cognitive mechanisms interact with characteristics of the task (i.e., ambiguity and content) in the context of delusional thinking. These findings might be used to inform improved intervention programs in the domain of inferential reasoning.post-print700 K

Learning of facial responses to faces associated with positive or negative emotional expressions

Subject to file availability and provided the posting includes a prominent statement of the full bibliographical details, a copyright notice in the name of the copyright holder (Cambridge University Press or the sponsoring Society, as appropriate), and a link to the online edition of the journal at Cambridge Journals Online.The possibility that facial expressions of emotion change the affective valence of faces through associative learning was explored using facial electromyography (EMG). In Experiment 1, EMG activity was registered while the participants (N = 57) viewed sequences of neutral faces (Stimulus 1 or S1) changing to either a happy or an angry expression (Stimulus 2 or S2). As a consequence of learning, participants who showed patterning of facial responses in the presence of angry and happy faces, that is, higher Corrugator Supercilii (CS) activity in the presence of angry faces and higher Zygomaticus Major (ZM) activity in the presence of happy faces, showed also a similar pattern when viewing the corresponding S1 faces. Explicit evaluations made by an independent sample of participants (Experiment 2) showed that evaluation of S1 faces was changed according to the emotional expression with which they had been associated. These results are consistent with an interpretation of rapid facial reactions to faces as affective responses that reflect the valence of the stimulus and that are sensitive to learned changes in the affective meaning of faces.This work was supported by Project SEJ2006-01576/PSIC, from the Spanish Ministerio de Ciencia y Tecnología. The participation of Francisco J. Román has been possible thanks to a FPI Grant (PSI2010- 20364) from the Spanish Ministerio de Ciencia y Tecnología

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

¿Dónde mirar cuando se mira a la cara?: el escaneo facial está determinado por el género, la expresión y las demandas de la tarea

Visual scanning of faces was studied during categorization of expression and gender with the aim of revealing possible differences in the perceptual mechanisms that mediate analysis of these facial properties. A more distributed scanning pattern, with increased fixation in the lower face, was observed in the expression compared to the gender task. Distribution of fixations across the upper and lower face also varied depending on the specific gender and expression of the viewed faces, with female faces and faces showing anger attracting more fixations to the eye region. Variations reflecting an interaction between gender and expression were also observed. However, the nature of these modulations suggests a differential influence of perceptual interactions and social/affective value on eye movement measures and on pupil size. Collectively, these results show that the visual inspection of faces is determined in a complex manner by the specific demands of different categorization tasks and by the perceptual and social/affective properties of the emotional expressions shown by either male or female faces.Dónde mirar cuando miramos caras: el escaneo visual está determinado por el género, la expresión y las demandas de la tarea. Se ha estudiado la inspección visual de caras durante tareas de categorización de expresión y género con el objetivo de encontrar posibles diferencias en los mecanismos perceptuales que medían el análisis de las propiedades faciales. Se observó un patrón de inspección visual más distribuido con un incremento de fijaciones en la parte baja de la cara durante la tarea de expresión frente a la tarea de género. La distribución de las fijaciones en torno a la parte superior e inferior de la cara también varió dependiendo del género y de la expresión de las caras con un número mayor de fijaciones en la región de los ojos para las caras de ira femeninas. Los resultados indicaron también una interacción entre género y expresión. La naturaleza de estas modulaciones sugiere una influencia diferencial sobre las medidas oculares y el tamaño de la pupila dependientes del tipo de tarea y del valor socio-afectivo de los estímulos. En conjunto, estos resultados muestran que la inspección visual de caras está determinada de una manera compleja por las demandas específicas de diferentes tareas de categorización; por las propiedades perceptivas y por la naturaleza de las expresiones emocionales mostradas por caras masculinas y femeninas.Ministerio de Ciencia e Innovación (España)Depto. de Psicología Experimental, Procesos Cognitivos y LogopediaFac. de PsicologíaTRUEpu

Can you change your mind? An ERP study of cognitive flexibility and new evidence integration

Cognitive flexibility is an ability that allows individuals to integrate external evidence into previous expectancies. Individual differences in this ability were examined using Event-Related Potentials (ERPs), focusing on the fact that new evidence can either confirm or disprove an initial impression. Written scenarios prompted to make a prediction while either confirmatory or disconfirmatory evidence followed. A final sentence presented participants with a statement congruent with the prediction likely to have been formed based on the first statement or a statement rather congruent with corrective new evidence. A Bias Against Disconfirmatory Evidence (BADE) test rated participants in cognitive flexibility. ERPs revealed that whereas individuals overall typically reacted to unexpected endings (a classical N400 effect) within the confirmatory evidence condition, higher cognitive flexibility scores were associated with smaller N400 effects. Furthermore, individuals showed larger P600s for disconfirmatory than confirmatory evidence conditions, regardless of the final target ending. This result indexes reanalysis processes whenever disconfirmatory evidence was present. Regression analysis of BADE scores and ERP effects are presented and discussed. Late ERP components are sensitive enough to detect new evidence integration capabilities and thus provide a good implicit measure of cognitive flexibility.Ministerio de Ciencia, Innovación y Universidades (PGC2018-098876-B-100)Comunidad Autónoma de Madrid (H2019/HUM-5705)3.251 JCR (2020) Q2, 19/53 Behavioral Sciences1.023 SJR (2021) Q1, 15/67 Neuropsychology and Physiological PsychologyNo data IDR 2020UE

Discriminación del sexo y la expresión mostradas por una cara mediante una doble tarea

In order to test whether expression and gender can be attended to simultaneously without a cost in accuracy four experiments were carried out using a dual gender-expression task with male and female faces showing different emotional expressions that were backward masked by emotionally neutral faces. In the dual-facial condition the participants had to report both the gender and the expression of the targets. In two control conditions the participant reported either the gender or the expression of the face and indicated whether a surrounding frame was continuous or discontinuous. In Experiments 1–3, with angry and happy targets, asymmetric interference was observed. Gender discrimination, but no expression discrimination, was impaired in the dual-facial condition compared to the corresponding control. This effect was obtained with a between-subjects design in Experiment 1, with a within-subjects design in Experiment 2, and with androgynous face masks in Experiment 3. In Experiments 4a and 4b different target combinations were tested. No decrement of performance in the dual-facial task was observed for either gender or expression discrimination with fearful-disgusted (Experiment 4a) or fearful-happy faces (Experiment 4b). We conclude that the ability to attend simultaneously to gender and expression cues without a decrement in performance depends on the specific combination of expressions to be differentiated between. Happy and angry expressions are usually directed at the perceiver and command preferential attention. Under conditions of restricted viewing such as those of the present study, discrimination of these expressions is prioritized leading to impaired discrimination of other facial properties such as gender.MECDepto. de Psicología Experimental, Procesos Cognitivos y LogopediaFac. de PsicologíaTRUEpu

Reduced visual surround suppression in schizophrenia shown by measuring contrast detection thresholds.

Visual perception in schizophrenia is attracting a broad interest given the deep knowledge that we have about the visual system in healthy populations. One example is the class of effects known collectively as visual surround suppression. For example, the visibility of a grating located in the visual periphery is impaired by the presence of a surrounding grating of the same spatial frequency and orientation. Previous studies have suggested abnormal visual surround suppression in patients with schizophrenia. Given that schizophrenia patients have cortical alterations including hypofunction of NMDA receptors and reduced concentration of GABA neurotransmitter, which affect lateral inhibitory connections, then they should be relatively better than controls at detecting visual stimuli that are usually suppressed. We tested this hypothesis by measuring contrast detection thresholds using a new stimulus configuration. We tested two groups: 21 schizophrenia patients and 24 healthy subjects. Thresholds were obtained using Bayesian staircases in a four-alternative forced-choice detection task where the target was a grating within a 3∘ Butterworth window that appeared in one of four possible positions at 5∘ eccentricity. We compared three conditions, (a) target with no-surround, (b) target embedded within a surrounding grating of 20∘ diameter and 25% contrast with same spatial frequency and orthogonal orientation, and (c) target embedded within a surrounding grating with parallel (same) orientation. Previous results with healthy populations have shown that contrast thresholds are lower for orthogonal and no-surround (NS) conditions than for parallel surround (PS). The log-ratios between parallel and NS thresholds are used as an index quantifying visual surround suppression. Patients performed poorly compared to controls in the NS and orthogonal-surround conditions. However, they performed as well as controls when the surround was parallel, resulting in significantly lower suppression indices in patients. To examine whether the difference in suppression was driven by the lower NS thresholds for controls, we examined a matched subgroup of controls and patients, selected to have similar thresholds in the NS condition. Patients performed significantly better in the PS condition than controls. This analysis therefore indicates that a PS raised contrast thresholds less in patients than in controls. Our results support the hypothesis that inhibitory connections in early visual cortex are impaired in schizophrenia patients

Cognitive versus emotional modulation within a Stroop paradigm in patients with schizophrenia

Background: Schizophrenia is a complex disorder involving deficits in both cognitive and emotional processes. Specifically, a marked deficit in cognitive control has been found, which seems to increase when dealing with emotional information. Aims: With the aim of exploring the possible common links behind cognitive and emotional deficits, two versions of the emotional Stroop task were administered. Method: In the cognitive-emotional task, participants had to name the ink colour (while ignoring the meaning) of emotional words. In contrast, the emotional-emotional task consisted of emotional words superimposed on emotional faces, and the participants had to indicate the emotional valence of the faces. Fifty-eight participants (29 in-patients diagnosed with schizophrenia and 29 controls) took part in the study. Results: Patients and controls showed similar response times in the cognitive-emotional task; however, patients were significantly slower than controls in the emotional-emotional task. This result supports the idea that patients show a more pronounced impairment in conflict modulation with emotional content. Besides, no significant correlations between the tasks and positive or negative symptoms were found. This would indicate that deficits are relatively independent of the clinical status of patients. However, a significant correlation between the emotional-emotional task and cognitive symptoms was found. Conclusions: These findings suggest a restricted capacity of patients with schizophrenia to deal with the attentional demands arising from emotional stimuli.Spanish Ministerio de Ciencia, Innovación y Universidades (PSI2018-098876-B-100Instituto de Salud Carlos III (PI16/00359)Instituto de Salud Carlos III (PI19/00766)5.165 JCR (2021) Q2, 56/155 Psychiatry1.214 SJR (2021) Q1, 106/556 Psychiatry and Mental HealthNo data IDR 2021UE