April Hargreaves
Trinity College Dublin, Psychiatry, Post-Doc
- National College of Ireland, Psychology, Adjunctadd
BACKGROUND: Deficits in facial emotion recognition have been associated with functional impairments in patients with Schizophrenia (SZ). Whilst a strong ecological argument has been made for the use of both dynamic facial expressions and... more
BACKGROUND:
Deficits in facial emotion recognition have been associated with functional impairments in patients with Schizophrenia (SZ). Whilst a strong ecological argument has been made for the use of both dynamic facial expressions and varied emotion intensities in research, SZ emotion recognition studies to date have primarily used static stimuli of a singular, 100%, intensity of emotion. To address this issue, the present study aimed to investigate accuracy of emotion recognition amongst patients with SZ and healthy subjects using dynamic facial emotion stimuli of varying intensities. To this end an emotion recognition task (ERT) designed by Montagne (2007) was adapted and employed.
METHODS:
47 patients with a DSM-IV diagnosis of SZ and 51 healthy participants were assessed for emotion recognition. Results of the ERT were tested for correlation with performance in areas of cognitive ability typically found to be impaired in psychosis, including IQ, memory, attention and social cognition.
RESULTS:
Patients were found to perform less well than healthy participants at recognising each of the 6 emotions analysed. Surprisingly, however, groups did not differ in terms of impact of emotion intensity on recognition accuracy; for both groups higher intensity levels predicted greater accuracy, but no significant interaction between diagnosis and emotional intensity was found for any of the 6 emotions. Accuracy of emotion recognition was, however, more strongly correlated with cognition in the patient cohort.
DISCUSSION:
Whilst this study demonstrates the feasibility of using ecologically valid dynamic stimuli in the study of emotion recognition accuracy, varying the intensity of the emotion displayed was not demonstrated to impact patients and healthy participants differentially, and thus may not be a necessary variable to include in emotion recognition research.
Deficits in facial emotion recognition have been associated with functional impairments in patients with Schizophrenia (SZ). Whilst a strong ecological argument has been made for the use of both dynamic facial expressions and varied emotion intensities in research, SZ emotion recognition studies to date have primarily used static stimuli of a singular, 100%, intensity of emotion. To address this issue, the present study aimed to investigate accuracy of emotion recognition amongst patients with SZ and healthy subjects using dynamic facial emotion stimuli of varying intensities. To this end an emotion recognition task (ERT) designed by Montagne (2007) was adapted and employed.
METHODS:
47 patients with a DSM-IV diagnosis of SZ and 51 healthy participants were assessed for emotion recognition. Results of the ERT were tested for correlation with performance in areas of cognitive ability typically found to be impaired in psychosis, including IQ, memory, attention and social cognition.
RESULTS:
Patients were found to perform less well than healthy participants at recognising each of the 6 emotions analysed. Surprisingly, however, groups did not differ in terms of impact of emotion intensity on recognition accuracy; for both groups higher intensity levels predicted greater accuracy, but no significant interaction between diagnosis and emotional intensity was found for any of the 6 emotions. Accuracy of emotion recognition was, however, more strongly correlated with cognition in the patient cohort.
DISCUSSION:
Whilst this study demonstrates the feasibility of using ecologically valid dynamic stimuli in the study of emotion recognition accuracy, varying the intensity of the emotion displayed was not demonstrated to impact patients and healthy participants differentially, and thus may not be a necessary variable to include in emotion recognition research.
Abstract BACKGROUND: Cognitive remediation (CR) training has emerged as a promising approach to improving cognitive deficits in schizophrenia and related psychosis. The limited availability of psychological services for psychosis is a... more
Abstract
BACKGROUND:
Cognitive remediation (CR) training has emerged as a promising approach to improving cognitive deficits in schizophrenia and related psychosis. The limited availability of psychological services for psychosis is a major barrier to accessing this intervention however. This study investigated the effectiveness of a low support, remotely accessible, computerised working memory (WM) training programme in patients with psychosis.
METHODS:
Ninety patients were enrolled into a single blind randomised controlled trial of CR. Effectiveness of the intervention was assessed in terms of neuropsychological performance, social and occupational function, and functional MRI 2 weeks post-intervention, with neuropsychological and social function again assessed 3-6 months post-treatment.
RESULTS:
Patients who completed the intervention showed significant gains in both neuropsychological function (measured using both untrained WM and episodic task performance, and a measure of performance IQ), and social function at both 2-week follow-up and 3-6-month follow-up timepoints. Furthermore, patients who completed MRI scanning showed improved resting state functional connectivity relative to patients in the placebo condition.
CONCLUSIONS:
CR training has already been shown to improve cognitive and social function in patient with psychosis. This study demonstrates that, at least for some chronic but stable outpatients, a low support treatment was associated with gains that were comparable with those reported for CR delivered entirely on a 1:1 basis. We conclude that CR has potential to be delivered even in services in which psychological supports for patients with psychosis are limited.
BACKGROUND:
Cognitive remediation (CR) training has emerged as a promising approach to improving cognitive deficits in schizophrenia and related psychosis. The limited availability of psychological services for psychosis is a major barrier to accessing this intervention however. This study investigated the effectiveness of a low support, remotely accessible, computerised working memory (WM) training programme in patients with psychosis.
METHODS:
Ninety patients were enrolled into a single blind randomised controlled trial of CR. Effectiveness of the intervention was assessed in terms of neuropsychological performance, social and occupational function, and functional MRI 2 weeks post-intervention, with neuropsychological and social function again assessed 3-6 months post-treatment.
RESULTS:
Patients who completed the intervention showed significant gains in both neuropsychological function (measured using both untrained WM and episodic task performance, and a measure of performance IQ), and social function at both 2-week follow-up and 3-6-month follow-up timepoints. Furthermore, patients who completed MRI scanning showed improved resting state functional connectivity relative to patients in the placebo condition.
CONCLUSIONS:
CR training has already been shown to improve cognitive and social function in patient with psychosis. This study demonstrates that, at least for some chronic but stable outpatients, a low support treatment was associated with gains that were comparable with those reported for CR delivered entirely on a 1:1 basis. We conclude that CR has potential to be delivered even in services in which psychological supports for patients with psychosis are limited.
Cognitive deficits are a core feature of schizophrenia and related psychotic disorders and are associated with decreased levels of functioning. Behavioural interventions have shown success in remediating these deficits; determining how... more
Cognitive deficits are a core feature of schizophrenia and related psychotic disorders and are associated with decreased levels of functioning. Behavioural interventions have shown success in remediating these deficits; determining how best to maximise this benefit while minimising the cost is an important next step in optimising this intervention for clinical use. To examine the effects of a novel working-memory focused cognitive remediation (CR) training on cognitive difficulties based on internet delivery of training and weekly telephone support. Participants with a diagnosis of psychosis (n=56) underwent either 8weeks of CR (approximately 20h) or 8weeks of treatment as usual (TAU). General cognitive ability, working memory and episodic memory were measured both pre and post intervention for all participants. In addition to improvements on trained working memory tasks, CR training was associated with significant improvements in two tests of verbal episodic memory. No association ...
Research Interests:
Classification in psychiatry is heavily dependent on clinical symptoms and illness course. This ignores the critical role that cognitive problems play in neuropsychiatric disorders affecting different domains across the lifespan, from... more
Classification in psychiatry is heavily dependent on clinical symptoms and illness course. This ignores the critical role that cognitive problems play in neuropsychiatric disorders affecting different domains across the lifespan, from ADHD and autism to schizophrenia and Alzheimers disease. At this point, it is unclear whether cognitive mechanisms are specific to disorders, whether multiple processes can contribute to the same disorder, or whether aberrant neural processing can result in many different phenotypic outcomes. Understanding this would allow us to better grasp normal as well as pathological brain function. This could inform diagnostics based on understanding of neurophysiological processes and the consequent development of new therapeutics. Genetics, and the development of genomic research, offers real opportunities to understand the molecular mechanisms relevant to cognition. This chapter defines and describes the main cognitive phenotypes, which are investigated in psychiatric disorders. We review evidence for their heritability and early progress in the field using cytogenetic, linkage and candidate gene-based research methodologies. With high-throughput genomics it is now possible to explore novel common and rare risk variants for psychiatric disorders and their role in cognitive function at a genome-wide level. We review the results of early genomic studies and discuss the novel insights that they are starting to provide. Finally, we review the analysis of whole-genome DNA sequence data and the challenges that this will bring for cognitive genomics research.
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OBJECTIVE The authors investigated the effects of recently identified genome-wide significant schizophrenia genetic risk variants on cognition and brain structure. METHOD A panel of six single-nucleotide polymorphisms (SNPs) was selected... more
OBJECTIVE The authors investigated the effects of recently identified genome-wide significant schizophrenia genetic risk variants on cognition and brain structure. METHOD A panel of six single-nucleotide polymorphisms (SNPs) was selected to represent genome-wide significant loci from three recent genome-wide association studies (GWAS) for schizophrenia and was tested for association with cognitive measures in 346 patients with schizophrenia and 2,342 healthy comparison subjects. Nominally significant results were evaluated for replication in an independent case-control sample. For SNPs showing evidence of association with cognition, associations with brain structural volumes were investigated in a large independent healthy comparison sample. RESULTS Five of the six SNPs showed no significant association with any cognitive measure. One marker in the major histocompatibility complex (MHC) region, rs6904071, showed independent, replicated evidence of association with delayed episodic memory and was significant when both samples were combined. In the combined sample of up to 3,100 individuals, this SNP was associated with widespread effects across cognitive domains, although these additional associations were no longer significant after adjusting for delayed episodic memory. In the large independent structural imaging sample, the same SNP was also associated with decreased hippocampal volume. CONCLUSIONS The authors identified a SNP in the MHC region that was associated with cognitive performance in patients with schizophrenia and healthy comparison subjects. This SNP, rs6904071, showed a replicated association with episodic memory and hippocampal volume. These findings implicate the MHC region in hippocampal structure and functioning, consistent with the role of MHC proteins in synaptic development and function. Follow-up of these results has the potential to provide insights into the pathophysiology of schizophrenia and cognition.
Research Interests: Schizophrenia, Magnetic Resonance Imaging, Adolescent, Ireland, Episodic Memory, and 15 moreGermany, Cross-Cultural Comparison, Hippocampus, Brain, Humans, Young Adult, Follow-up studies, Aged, Middle Aged, Genotype, Adult, Major histocompatibility complex, Cognition disorders, Case Control Studies, and Neuropsychological Tests
1. Schizophr Res. 2011 Feb;125(2-3):304-6. Epub 2010 Nov 26. A neuropsychological investigation of the genome wide associated schizophrenia risk variant NRGN rs12807809. Donohoe G, Walters J, Morris DW, Da Costa A, Rose E, Hargreaves A,... more
1. Schizophr Res. 2011 Feb;125(2-3):304-6. Epub 2010 Nov 26. A neuropsychological investigation of the genome wide associated schizophrenia risk variant NRGN rs12807809. Donohoe G, Walters J, Morris DW, Da Costa A, Rose E, Hargreaves A, Maher K, Hayes E, Giegling I, Hartmann AM, Möller HJ, Muglia P, Moskvina V, Owen MJ, O'Donovan MC, Gill M, Corvin A, Rujescu D. PMID: 21112188 [PubMed - indexed for MEDLINE]. Publication Types: Letter; Research Support, Non-US Gov't. MeSH Terms. ...