Cognitive Neuropsychiatry

Numerous studies have been published on the psychosis prodrome and have explored a wide array of its many aspects. However, the set of risk factors identified by these various efforts is not homogenous across studies. This could be due to unique population factors or relatively small sample sizes. Only few studies were conducted on Asian populations, whose socio-cultural characteristics differ – in some cases remarkably – from those in western populations. Singapore is a highly dense city-state in South-east Asia, with low rates of substance abuse. The Longitudinal Youth at Risk Study (LYRIKS) commenced in Singapore in 2008, designed to comprehensively assess a group of ultra high risk (UHR) individuals and identify clinical, social, neuropsychological and biological risk factors unique to the local population. 173 UHR individuals were recruited from this single-site study over 4 years. Here, we detail aspects of the study methodology and report on the baseline social and clinical characteristics of the sample population. 78% of the UHR sample suffered from a psychiatric disorder, with Major Depressive Disorder present in more than half of the sample. The mean Global Assessment of Functioning (GAF) score was 57.4, which indicated a moderate level of impairment. Although the recruited sample did not differ significantly by social and clinical characteristics when compared to previously published reports, the conversion rate to psychosis was 3.5% (n = 6) at 6 months. Follow-up measures are currently underway to assess longitudinal incidence of psychosis and impact of risk factors on cognition, functioning and remission.

Most contemporary text books of neurology and of psychology pay little attention to the function of the cerebellum beyond noting it to be an organ of motor control. A historical overview of research on cerebellar function is presented, from pre-Sherrinton suggestions of sensory and motor function, through the post-Sherrinton and dominant 20 th . Century view of "motor" function, to the 21 st . century perspective of "sensorimotor" function. The intrinsic capability of the cerebellum is briefly considered in terms of: its size/complexity/capacity; its information representation/processing characteristics (with "a particular computational function"); its sensory information processing capability; and, its role in sensorimotor regulatory control. It is suggested that the cerebellum can process sensorimotor stimulus information in a statistical (connectionist type) manner and respond to in on the basis of its own learning based sensorimotor representations, albeit at a "level" that does not necessarily involve cerebral "awareness".

Aim: To provide normative values for the healthy ethnic Chinese Singaporean population and a large sample of patients with schizophrenia for the Continuous Performance Task-Identical Pairs (CPT-IP). Participants Data were collected on 1011 healthy ethnic Chinese and 654 patients diagnosed with schizophrenia, all between 21 and 55 years of age. Methods: Data were stratified by age and gender. The effects of age, gender and education were explored in patients and controls. Performance indices were assessed in their ability to predict group inclusion. Controls' performance was compared with that reported in a US sample. Results: Performance was affected by age, sex, and education, with youth, male sex and higher education providing a performance advantage. Patients' performance was lower than controls' by more than 1 standard deviation, with the 3-digit d′ score most significantly discriminating between controls and patients. The effects of sociodemographic factors on performance were in line with those conducted in the US and previously reported in the literature. Conclusions: This is the largest norming study ever conducted on the CPT-IP. It will enable investigators and clinicians to select appropriate indices to assess severity of cognitive decline and/or evaluate cognitive remediation therapy outcomes after taking into account age, gender and education factors.

This preliminary study was performed to test the reliability and validity of the Brief Assessment of Cognition in Schizophrenia (BACS) as an assessment tool in a Japanese-language version (BACS-J). The subjects for the present study were 30 outpatients with chronic schizophrenia. Each subject gave written informed consent to participate in the research. Cronbach's alpha for the BACS-J was 0.77. The BACS-J composite score was significantly correlated with all primary measures of BACS-J (verbal memory, working memory, motor speed, verbal fluency, attention, and executive function). All BACS-J primary measures and the composite score were significantly correlated between two assessments. The mean score of the Digit Sequencing Task and composite score on the second assessment were significantly larger than those on the first assessment. All BACS-J primary measures except the Symbol Coding Task were significantly correlated with relevant standard neurocognitive tests. Also, the BACS-J composite score was significantly correlated with all standard neurocognitive tests except the Continuous Performance Test. A principal components analysis with varimax rotation resulted in a three-factor solution (executive function and memory; motor speed and general cognitive functions; and working memory). This preliminary study indicates that the BACS-J is a reliable and practical scale to evaluate cognitive function.

system can selectively attend to the sensorimotor information input that it receives from naturomorphic system The sensorimotor input from the naturomorphic system may be in the form of visuomotor 'imagery' experienced as virtual reality, and it may include 'inner speech' or the 'inner voice'

Pour citer cet article : Graux J, et al. Les cénesthopathies : un trouble des émotions d'arrière plan. Regards croisés des sciences cognitives et de la phénoménologie. Encephale (2010), Résumé Les notions de cénesthésie et cénesthopathie ont eu une influence considérable sur la psychiatrie du xix e et du début du xx e siècle. La cénesthésie caractérise une forme de perception globale, implicite et affective du corps. Les cénesthopathies sont une entité clinique résultant d'une forme d'altération de la cénesthésie, qui se caractérise par des sensations corporelles anormales ou étranges. Dans cette revue de la littérature, nous reprenons l'histoire et l'évolution de ces deux concepts, pour évaluer leur influence contemporaine dans la clinique, la nosographie, la phénoménologie et les neurosciences cognitives. Aujourd'hui, si les notions de cénesthésie et cénesthopathie ont en grande partie perdu leur usage en psychiatrie, il en demeure cependant des traces dans notre clinique et nos nosographies contemporaines parfois sous le nom de nouveaux concepts. Plus encore, ces concepts sont actuellement redécouverts au profit des recherches entreprises dans le champ des neurosciences, notamment à travers les modèles de la neuropsychiatrie cognitive des délires.

The drive for a theoretical integration of psychotherapy arises out of is dissatisfaction with the inadequacy of single systems/theories. It has been suggested that there is a need for a 'meta-theory' that provides a framework to integrate different psychotherapy theories in terms of some shared construct. The theoretical integration should take into account behaviour, emotion, cognition, and interpersonal factors. In addition, trans-theoretical considerations should include theory and data from neurology and psychiatry. Some different integrative 'frameworks' are noted, including Clarkson's 'Systemic Integrative Psychotherapy'. Some neuroscience based frameworks for integration are also mentioned. It is proposed that homeostasis could serve as a meta-theory that encapsulates principles in terms of which to 'systematically' integrate aspects of psychotherapy, including trans-theoretical dimensions.

Introduction. The Empathy Quotient (EQ) is a self-report questionnaire that was developed to measure the cognitive, affective, and behavioural aspects of empathy. We evaluated its cross-cultural validity in an Italian sample. Methods. A sample of 18-to 30-year-old undergraduate students of both sexes (N0256, males0118) were invited to fill in the Italian version of the EQ, as well as other measures of emotional competence and psychological distress. Results. The EQ had an excellent reliability (Cronbach's alpha0.79; testÁretest at 1 month: Pearson's r0.85), and was normally distributed. Females scored higher than males, and more males (n014, 11.9%) than females (n04, 2.9%) scored lower than 30, the cutoff score that best differentiates autism spectrum conditions from controls. EQ was negatively related to the Toronto Alexithymia Scale (TAS) and positively related to the Marlowe-Crowne Social Desirability Scale (SDS). Principal component analysis retrieved the three-factor structure of the EQ. Lower emotional reactivity correlated with higher scores in measures of risk in both the schizophrenia-like (Peters et al. Delusions Inventory) and the bipolar (Hypomanic Personality Scale) spectra. Conclusions. The Italian version of the EQ has good validity, with an acceptable replication of the original three-factor solution, yielding three subscales with high internal and testÁretest reliability.

Qigong is a formidable art, part of Chinese medicine and Western cognitive neurology (cognitive neuroscience), to prevent and treat diseases, improve health, delay aging and enhance latent potential of human beings. It is focused on the Chi movement.  Qigong origins date back to at least 3000 years ago. Qigong practice contributes to the growth of the Qi (Chi) essential substance, increasing human body energy and delaying aging....

Disturbances in social cognition are a core feature of schizophrenia. While most research in the field has focused on emotion perception, social knowledge, theory of mind, and attribution styles, the domain of social perception has received little specific attention. In this paper, we suggest that this issue can be explained by the lack of a precise and unitary definition of the concept, this leads to the existence of different competing uses of the concept and their conflation with other domains of social cognition. Relying on resources coming from the ecological approach to psychology and the phenomenological tradition in psychiatry, we propose that the concept of Social Perception should be used to refer to low-level pre-reflective processes underlying the awareness of interpersonal interactions with and between others. Clinical data suggests that people with schizophrenia have problems perceiving social situations as opportunities for social engagement, so, in order to fulfil this explanatory need, we propose that the term should be used to capture this important-yet neglected-domain of social cognition. We conclude with the discussion of some future directions for research derived from our proposal.

Introduction. -Increasing knowledge of the anatomical structures and cellular processes underlying psychiatric disorders may help bridge the gap between clinical signs and basic physiological processes. Accordingly, considerable insight has been gained in recent years into a common psychiatric condition, i.e., chronic alcoholism. Material and methods. -We reviewed various physiological parameters that are altered in chronic alcoholic patients compared to healthy individuals -continuous electroencephalogram, oculomotor measures, cognitive event-related potentials and event-related oscillations -to identify links between these physiological parameters, altered cognitive processes and specific clinical symptoms.

Executive function and attention are highly complex cognitive constructs that typically reveal evidence of impairment in people with schizophrenia. Studies in this area have traditionally utilised abstract tests of cognitive function and the importance of using more ecologically valid tests has not been extensively recognised. In addition, there has been little previous examination of the relationship between these key cognitive abilities and social functioning and quality of life in this population. Thirty-six schizophrenic patients and 15 controls were assessed on the Behavioural Assessment of the
Dysexecutive Syndrome (BADS) test, three subtests from the Test of Everyday Attention (TEA), a measure of social functioning and a quality of life measure. Analysis of subtest scores revealed that patients were impaired on all attentional measures, but only one BADS subtest score in addition to the BADS profile score. However, 23 patients demonstrated no impairment in their BADS profile scores whilst being impaired on at least one attentional measure. Only the BADS profile score predicted social functioning and quality of life in schizophrenic patients. We conclude that ecologically valid tests of attention and executive function can play an important role in defining the cognitive deficits in schizophrenia and how such deficits relate to social function and quality of life.

Persons with schizophrenia often appraise other individuals as threatening or persecutory. To evaluate social appraisal in schizophrenia, we probed brain networks with a task in which subjects judged whether or not they liked face stimuli with emotional expressions. We predicted that appraising negative expressions would engage patients, more than controls, and negative faces would be related to higher levels of negative affect and produce increased activity in the medial frontal cortex, an area involved in social appraisal. Twenty-one stable outpatients with chronic non-affective psychosis (16 schizophrenic, 5 schizoaffective) and 21 healthy subjects underwent functional magnetic resonance imaging. Compared with the control subjects, patients were slower to respond, but particularly slow when they judged negatively-valenced faces, a slowness correlated with negative affect in the psychosis patients. Appraisal activated the medial prefrontal cortex (mPFC) across all face valences. For negative expressions, patients exhibited greater activation of the dorsal anterior cingulate cortex (dACC). A psychophysiological interaction analysis of the dACC revealed co-modulation of the mPFC in controls, significantly less in patients, and a trend for co-modulation of occipital cortex in the patients. Activity in occipital cortex correlated with poor social adjustment and impaired social cognition, and co-modulation of the occipital gyrus by the dACC was correlated with poorer social cognition. The findings link appraisal of negative affect with aberrant activation of the medial frontal cortex, while early sensory processing of this social cognitive task was linked with poor social function, reflecting either top-down or bottom-up influences.

Background Although cognitive behavioural therapy (CBT) is claimed to be effective in schizophrenia, major depression and bipolar disorder, there have been negative findings in well-conducted studies and meta-analyses have not fully considered the potential influence of blindness or the use of control interventions.

Method We pooled data from published trials of CBT in schizophrenia, major depression and bipolar disorder that used controls for non-specific effects of intervention. Trials of effectiveness against relapse were also pooled, including those that compared CBT to treatment as usual (TAU). Blinding was examined as a moderating factor.

Results CBT was not effective in reducing symptoms in schizophrenia or in preventing relapse. CBT was effective in reducing symptoms in major depression, although the effect size was small, and in reducing relapse. CBT was ineffective in reducing relapse in bipolar disorder.

Conclusions CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates. It is effective in major depression but the size of the effect is small in treatment studies. On present evidence CBT is not an effective treatment strategy for prevention of relapse in bipolar disorder.

The "Reading the Mind in the Eyes" test (henceforth, Eyes test) is a simple but advanced Theory of Mind test, and it is widely used across different cultures. This study assessed the reliability and construct (convergent and discriminant) validity of the Eyes test in Italy. A sample of 18- to 32-year-old undergraduate students of both sexes (N=200, males=46%) were invited to fill in the Italian version of the Eyes test, the Empathy Quotient (EQ), the Toronto Alexithymia Scale (TAS), and the Marlowe-Crowne Social Desirability Scale (SDS). Internal consistency (Cronbach's alpha) was .605. Confirmatory factor analysis provided evidence for a unidimensional model, with maximal weighted internal consistency reliability=.719. Test-retest reliability for the Eyes test, as measured by intraclass correlation coefficient, was .833 (95% confidence interval=.745 to .902). Females scored significantly higher than males on both the Eyes test and the EQ, replicating earlier work. Those participants who scored lower than 30 on the EQ (n=10) also scored lower on the Eyes test than those who did not (p<.05). Eyes test scores were not related to social desirability. This study confirms the validity of the Eyes test. Both internal consistency and test-retest stability were good for the Italian version of the Eyes test.

McGilchrist has written a book of breathtaking scope -a journey not just through the neurosciences but also philosophy, literature, the arts, archaeology and anthropology -in an attempt to answer whether the lateralisation of cerebral function has influenced history. The breadth of the source material is dazzling, from basic neuroscience experiments to Russian poetry -translations are helpfully provided for those of us who are not polyglots -and the actual writing is, at times, superlative. But is what he says true? Some may argue that it does not matter whether or not it is true. McGilchrist himself appears ambivalent. He opens with a desire to tell a story and concludes that he would not be unhappy if his thesis was eventually demonstrated to be a metaphor. Many in psychiatry might agree, and I suspect some will have a reverential approach to this work, but the more I read the more concerned I became. The credibility of this book is its foundation in neuroscience. We are interested because McGilchrist talks eruditely and, we hope, from a position of knowledge, about the scientific framework on which he based his more artistic interpretations. However, this foundation does not seem entirely sound and many of the conclusions presented go far, far beyond the available data. The impression of knowledge existing where there are only gaps is a recurrent theme.

High-functioning children with autism show a severe deficit in the development of pragmatics whereas their knowledge of syntax and morphology is relatively intact. In this study we investigated further their selective communication impairment by comparing them with children with specific language impairment (SLI) and normally developing children. We used a pragmatic task that involved the detection of utterances that violate conversational maxims (avoid redundancy, be informative, truthful, relevant, and polite). Most children with autism performed at chance on this task, whereas all children with SLI and all normal controls performed above chance. In addition, the success of children with autism on the pragmatics task was related to their ability to attribute false beliefs. These results are consistent with the idea that communication deficits in autism result from a selective impairment in representing propositional attitudes. Their implications for domain-specific views of cognitive development are discussed.

Self-harm, such as self-cutting, self-poisoning or jumping from height, regardless of intentions, is common among people with schizophrenia. We wished to investigate brain activations relating to self-harm, in order to test whether these activations could differentiate between schizophrenia patients with self-harm and those without. We used event-related functional MRI with a go/no-go response inhibition paradigm. Fourteen schizophrenia patients with a history of self-harm were compared with 14 schizophrenia patients without a history of self-harm and 17 healthy control participants. In addition, we used standard clinical measures and neuropsychological tests to assess risk factors associated with self-harm. The right dorsolateral prefrontal cortex (DLPFC) and the left posterior cingulate cortex differentiated all three groups; brain activation in these regions being greatest in the control group, and the self-harm patient group being greater than in the non-self-harm patient group. In the self-harm patient group, right DLPFC activity was positively correlated with severity of suicidal thinking. In addition, both patient groups showed less activation in the right orbitofrontal cortex, left ventral anterior cingulate cortex and right thalamus. This is the first study to report right DLPFC activation in association with self-harm and suicidal thinking in patients with schizophrenia. This area could be a target for future neuromodulation studies to treat suicidal thinking and self-harm behaviors in patients with schizophrenia.

A positive definition of mental health is explored in terms of homeostasis and its "cognitive" dimension, equilibration. Consistent with this are contemporary perspectives (e.g. DSM-5) which describe mental disorder in terms of disruption of normal (homeostatic) functioning, or dysfunction in regulatory systems.

How is creativity related to health and mental illness? What is the relationship between the nature of the unconscious and the predisposition to both creativity and mental illness? These questions are explored with reference to research on: creativity, imagination and primary process thinking, intuition and unconscious processes, dream sleep, and aspects of schizophrenia. A positive model of mental health that sees creativity as an aspect of self-realisation is outlined in terms of homeostasis and the importance of information flow between neuropsychological systems. The role of executive function and attention in controlling information flow between the cerebellar unconscious and the cerebral conscious is noted, with reference to

"The MATRICS Consensus Cognitive Battery (MCCB) was developed to provide a reliable, valid, and standard battery for clinical trials on cognitive enhancers in schizophrenia.

In this study we tested the applicability of the MCCB to Singapore’s English speakers. Healthy ethnic Chinese, Malay, and Indian English speakers (N = 171) of both genders were recruited within three age groups and three levels of education to match as closely as possible the US norming sample, and were administered the MCCB. Descriptive data, T scores, age, gender, education, and ethnicity effects on performance were explored and compared with the US norming study. Age, education, and ethnicity affected the battery’s composite scores, with young and highly educated participants generally outperforming the old, less-educated ones. Male participants outperformed their female counterparts in two out of seven cognitive domains. Although generally lower when compared to the US norming sample, Singaporean scores reflected the same relationship with age, education, and gender, with the exception of a substantially worse performance in the social cognition domain. Differences among the ethnic groups in Singapore—and the poorer performance measured in these groups with respect to the US sample—call for the necessity of an extended norming study in Singapore."

Since the dawn of time, men have used music to express and share emotions, Shamans, curators, therapists of every place and time, they have could not ignore the manifestations with which music has always influenced our cultures, our hearts and our minds. The human being is an emotional animal, with some of a divine, some of special, into the conceptual schema of uniqueness that our world has for everything...

A historical "dual systems" perspectives on dreaming is revisited. Some contemporary perspectives are outlined in which dreams are considered in terms of : virtual reality simulations; memory processing; a way of "thinking". Reference is made to recent research indicating that REM sleep is involved in information processing of memories, learning, and problem solving. The traditional role of the brain stem in relation to the neurophysiological "origins" of dreaming is summaried. Some research and opinions indicating that the cerebellum may be a contributor to D/REM sleep are listed. Finally, iIt is proposed that the cerebellum is the very source of the sensorimotor information sequence that is exported, via the brain stem, to the cerebral cortex, and which is experienced in its reception at cerebral level as a dream.

The organ of Corti, consisting of a layer of hair cells, that is long and thin, receives the vibrations transmitted in the fluid of the cochlea and transmits them, through their lower extremities which are in contact with the nerve endings (neurons) of the acoustic nerve , to the membrane, which has the important characteristic of tonotopicity ( Tonotopia (from the Greek tone- and topos = place of sounds) is a spatial distribution of where sounds are perceived, transmitted or received ...

Introduction. Chronic schizophrenia patients have previously demonstrated performance deficits in contour integration tasks. The purpose of this study was to investigate whether schizophrenia patients, spanning a range of illness severity, would demonstrate responsiveness to manipulations that recruit top-down processing strategies involving learning and sequencing effects in a contour integration task. Methods. We administered a contour integration test over four consecutive days and in two different presentation conditions each day. In one condition, the stimuli were administered in order of increasing difficulty, and in the other they were presented in random order. The order in which these two conditions were presented was counterbalanced across days and participants. In addition, a nonschizophrenia psychotic disorders control group was included to determine if past findings of a contour integration deficit in schizophrenia could be replicated in the presence of a symptomatically similar control group. Results. All groups demonstrated similar learning curves across the four days and generally similar overall levels of performance, with the exception of the group of the most chronic schizophrenia patients. In addition, the order in which the stimuli were presented to subjects affected their performance, with higher scores achieved Correspondence should be addressed to Steven Silverstein, who is now at

Over the past decades, delusions have become the subject of growing and productive research spanning clinical and cognitive neurosciences. Despite this, the nature of belief, which underpins the construct of delusions, has received little formal investigation. No account of delusions, however, would be complete without a cognitive level analysis of belief per se. One reason for this neglect is the assumption that, unlike more established and accessible modular psychological process (e.g., vision, audition, face-recognition, language-processing, and motor-control systems), beliefs comprise more distributed and therefore less accessible central cognitive processes. In this paper, we suggest some defining characteristics and functions of beliefs. Working back from cognitive accounts of delusions, we consider potential candidate cognitive processes that may be involved in normal belief formation. Finally, we advance a multistage account of the belief process that could provide the basis...