Corpus callosum microstructural organization mediates the effects of physical neglect on social cognition in schizophrenia.

Exposure to early life adversity is associated with both increased risk of developing schizophrenia and poorer performance on measures of social cognitive functioning. In this study, we examined whether interleukin-6 (IL-6) and Corpus Callosum (CC) microstructure mediated the association between childhood physical neglect and social cognition. Fifty-eight patients with a diagnosis of schizophrenia were included. The CANTAB emotion recognition task (unbiased hit rate) was used to assess social cognition. We found that the microstructural organization of the CC significantly mediated the association between physical neglect and emotion recognition. Furthermore, in a sequential mediation analysis that also considered the role of inflammatory response, the association between physical neglect, and lower emotion recognition performance was sequentially mediated by higher IL-6 and lower fractional anisotropy of the CC. This mediating effect of IL-6 was only present when simultaneously considering the effects of CC microstructural organization and remained significant while controlling for the effects of sex, BMI and medication dosage (but not age). Overall, the findings suggest that the association between physical neglect and poorer emotion recognition in schizophrenia occurs, at least in part, via its association with white matter microstructure.

Bilateral anterior corona radiata microstructure organisation relates to impaired social cognition in schizophrenia.

OBJECTIVE: The Corona Radiata (CR) is a large white matter tract in the brain comprising of the anterior CR (aCR), superior CR (sCR), and posterior CR (pCR), which have associations with cognition, self-regulation, and, in schizophrenia, positive symptom severity. This study tested the hypothesis that the microstructural organisation of the aCR, as measured by Fractional Anisotropy (FA) using Diffusion Tensor Imaging (DTI), would relate to poorer social cognitive outcomes and higher positive symptom severity for people with schizophrenia, when compared to healthy participants. We further hypothesised that increased positive symptoms would relate to poorer social cognitive outcomes. METHODS: Data were derived from n = 178 healthy participants (41 % females; 36.11 ± 12.36 years) and 58 people with schizophrenia (30 % females; 42.4 ± 11.1 years). The Positive and Negative Symptom Severity Scale measured clinical symptom severity. Social Cognition was measured using the Reading the Mind in the Eyes Test (RMET) Total Score, as well as the Positive, Neutral, and Negative stimuli valence. The ENIGMA-DTI protocol tract-based spatial statistics (TBSS) was used. RESULTS: There was a significant difference in FA for the CR, in individuals with schizophrenia compared to healthy participants. On stratification, both the aCR and pCR were significantly different between groups, with patients showing reduced white matter tract microstructural organisation. Significant negative correlations were observed between positive symptomatology and reduced microstructural organisation of the aCR. Performance for RMET negative valence items was significantly correlated bilaterally with the aCR, but not the sCR or pCR, and no relationship to positive symptoms was observed. CONCLUSIONS: These data highlight specific and significant microstructural white-matter differences for people with schizophrenia, which relates to positive clinical symptomology and poorer performance on social cognition stimuli. While reduced FA is associated with higher positive symptomatology in schizophrenia, this study shows the specific associated with anterior frontal white matter tracts and reduced social cognitive performance. The aCR may have a specific role to play in frontal-disconnection syndromes, psychosis, and social cognitive profile within schizophrenia, though further research requires more sensitive, specific, and detailed consideration of social cognition outcomes.

A 20-Year Systematic Review of the 'Reading the Mind in the Eyes' Test across Neurodegenerative Conditions.

Social cognition has a broad theoretical definition, which includes the ability to mentalise, i.e., recognise and infer mental states to explain and predict another's behaviour. There is growing recognition of the clinical, diagnostic, and prognostic value of assessing a person's ability to perform social cognitive tasks, particularly aspects of theory of mind, such as mentalising. One such measure of mentalising is the 'Reading the Mind in the Eyes' test (RMET). This systematic review and meta-analysis consider performance on the RMET, applied to people with neurodegenerative conditions in matched control studies, since its publication in 2001. Overall, this review includes 22 papers with data from N = 800 participants with neurodegenerative conditions: Alzheimer's disease, n = 31; Parkinson's disease, n = 221; Lewy body dementia, n = 33; motor neuron disease, n = 218; Huntington's disease n = 80; multiple sclerosis, n = 217; and N = 601 matched typical controls. Our meta-analyses show that deficits in mentalising, as measured by the RMET, are consistently reported across neurodegenerative conditions, with participants in both early and late disease stages being affected. Social cognition is an emerging field of cognitive neuroscience requiring specific and sensitive measurement across each subdomain. Adult-based meta-normative data feature, for which future groups or individuals could be compared against, and hypotheses relating to the source of these mentalising deficits are further discussed. This review was registered with PROSPERO (CRD42020182874).

Corpus Callosum Microstructural Tract Integrity Relates to Longer Emotion Recognition Reaction Time in People with Schizophrenia.

Objective: Schizophrenia is a complex functionally debilitating neurodevelopmental disorder, with associated social cognitive impairment. Corpus Callosum (CC) white matter tracts deficits are reported for people with schizophrenia; however, few studies focus on interhemispheric processing relative to social cognition tasks. This study aimed to determine if a relationship between the CC and social cognition exists. Method: In this cross-section study, a sample of n = 178 typical controls and n = 58 people with schizophrenia completed measures of mentalising (Reading the Mind in the Eyes), emotion recognition outcome and reaction time (Emotion Recognition Test), and clinical symptoms (Positive and Negative Symptom Scale), alongside diffusion-based tract imaging. The CC and its subregions, i.e., the genu, body, and splenium were the regions of interest (ROI). Results: Reduced white matter tract integrity was observed in the CC for patients when compared to controls. Patients performed slower, and less accurately on emotion recognition tasks, which significantly and negatively correlated to the structural integrity of the CC genu. Tract integrity further significantly and negatively related to clinical symptomatology. Conclusions: People with schizophrenia have altered white matter integrity in the genu of the CC, compared to controls, which relates to cognitive deficits associated with recognising emotional stimuli accurately and quickly, and severity of clinical symptoms.

Community immersion project to enhance medical students understanding of the health needs of the most vulnerable in the community.

AIM: A group of eight fourth year medical students formed the 'UBMS public health crew' to conduct a community immersion project within elderly ethnic minority communities. The aim of the study was to understand their health perceptions regarding influenza vaccinations and learn about the enablers and barriers in accessing the vaccination. METHODOLOGY: Interviews were held by the students at community lunch clubs with the help of questionnaires. RESULTS: 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey. CONCLUSION: This project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care. RESULTS: 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey. this project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care. METHODS: Interviews were held by the students at community lunch clubs with the help of questionnaires. 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey which found that this project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care. AIM: A group of eight fourth year medical students formed the 'UBMS public health crew' to conduct a community immersion project within elderly ethnic minority communities. The aim of the study was to understand their health perceptions regarding influenza vaccinations and learn about the enablers and barriers in accessing the vaccination. Interviews were held by the students at community lunch clubs with the help of questionnaires. 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey which found that this project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care.

Experiences of living with Lynch Syndrome: A reflexive thematic analysis.

PURPOSE: Lynch Syndrome is one of the most common hereditary cancer syndromes, arising from DNA mismatch repair. Lynch Syndrome carriers are at increased lifetime risk of developing certain cancers, such as colorectal and endometrial. This increased risk can result in adverse psychological outcomes. The present qualitative study explores the experiences of individuals with Lynch Syndrome when accessing and managing healthcare in the period after learning of their Lynch Syndrome status. METHODS: Twelve interviews were conducted with Lynch Syndrome carriers in Ireland, with recruitment occurring predominantly online through closed social media platforms. This was coordinated by Lynch Syndrome Ireland, a patient representative group. Reflexive thematic analysis was used to analyse the data. There was significant Public and Patient Involvement in this study, with the committee members (N = 2) of Lynch Syndrome Ireland acting on the panel. The involvement of the PPI panel began from initial project idea conception and continued throughout the study. RESULTS: Lynch Syndrome carriers highlighted the lack of adequate information from medical professionals regarding their diagnosis. Furthermore, participants spoke of the significant lack of knowledge amongst medical professionals about Lynch Syndrome. A theme depicting guilt was also noted regarding passing Lynch Syndrome to their children, and the worry experienced when children underwent genetic testing. CONCLUSIONS: This study highlighted the experiences of having a Lynch Syndrome diagnosis and demonstrates a need for further psychological and medical support for the Lynch Syndrome community, including a clear need for improvements in genetic cancer services in this field.

Predictors of PTSD and CPTSD in UK firefighters.

Background: Globally, professional firefighters are often exposed to traumatic events and are at high risk of developing posttraumatic stress disorder (PTSD) symptoms. Objective: With the publication of the 11th edition of the International Classification of Diseases (ICD-11) there arose a need for research based on the new diagnostic criteria, and the associated disorder, Complex PTSD (CPTSD). Method: Participants were 1300 former or present firefighters from the UK. Prevalence rates of PTSD and CPTSD were estimated using International Trauma Questionnaire in accordance with ICD-11 criteria, and service related and personal trauma exposure were also assessed using an anonymous online questionnaire. Multinomial logistic regression was performed to assess how service and personal trauma exposure predicted PTSD and CPTSD. Results: CPTSD criteria were met by 18.23% (95% CI 16.13-20.33%) and PTSD criteria were met by 5.62% (95% CI 4.37-6.87%) of the sample. Experiencing higher levels of service-related trauma significantly increased the risk for both PTSD and CPTSD, and nonwork related trauma uniquely predicted CPTSD but not PTSD. Conclusions: This study provided the first examination of the new ICD-11 criteria for PTSD and CPTSD in a large sample of firefighters, and CPTSD was more common than PTSD. Exposure to multiple different types of trauma increased the odds of PTSD and CPTSD.

Antecedentes: A nivel mundial, los bomberos profesionales están con frecuencia expuestos a eventos traumáticos y están en alto riesgo de desarrollar síntomas del trastorno de estrés postraumático (TEPT).Objetivo: Con la publicación de la 11° edición de la Clasificación Internacional de Enfermedades (CIE-11) surgió la necesidad de realizar una investigación basada en los nuevos criterios diagnósticos y el trastorno asociado, el TEPT complejo (TEPT-C).Método: Los participantes fueron 1 300 bomberos, tanto en retiro como en servicio, del Reino Unido. Se estimaron las tasas de prevalencia del TEPT y del TEPT-C usando el Cuestionario Internacional de Trauma de acuerdo con los criterios de la CIE-11. También fueron evaluados la exposición a trauma personal y al relacionado con el servicio mediante un cuestionario anónimo en línea. Se realizó una regresión logística multinomial para evaluar cómo la exposición al trauma personal y del servicio predijeron el TEPT y el TEPT-C.Resultados: Los criterios del TEPT-C fueron cumplidos por el 18,23% (95% IC 16,13% - 20,33%) y los criterios del TEPT fueron cumplidos por el 5,62% (95% IC 4,37% −6,87%) de la muestra. Experimentar niveles más altos de trauma relacionado con el servicio aumentó significativamente tanto el riesgo del TEPT como del TEPT-C. El trauma no relacionado con el trabajo predijo de manera única el TEPT-C pero no el TEPT.Conclusiones: Este estudio proporcionó la primera evaluación de los nuevos criterios de la CIE-11 para el TEPT y el TEPT-C en una muestra grande de bomberos. Asimismo, el TEPT-C fue más común que el TEPT. La exposición a múltiples traumas de distintos tipos aumentó la probabilidad de desarrollar el TEPT y el TEPT-C.

Post-migration factors and mental health outcomes in asylum-seeking and refugee populations: a systematic review.

The present systematic review examined post-migration variables impacting upon mental health outcomes among asylum-seeking and refugee populations in Europe. It focuses on the effects of post-settlement stressors (including length of asylum process and duration of stay, residency status and social integration) and their impact upon post-traumatic stress disorder, anxiety and depression. Twenty-two studies were reviewed in this study. Length of asylum process and duration of stay was found to be the most frequently cited factor for mental health difficulties in 9 out of 22 studies. Contrary to expectation, residency or legal status was posited as a marker for other explanatory variables, including loneliness, discrimination and communication or language problems, rather than being an explanatory variable itself. However, in line with previous findings and as hypothesised in this review, there were statistically significant correlations found between family life, family separation and mental health outcomes.

La presente revisión sistemática examinó las variables posteriores a la migración que afectan los resultados de salud mental entre las poblaciones de refugiados y en búsqueda de asilo en Europa. Ésta se centra principalmente en los efectos de los factores estresantes posteriores al asentamiento (incluyendo la duración del proceso de asilo y la duración de la estadía, el estado de residencia y la integración social) y su impacto sobre el trastorno de estrés postraumático, ansiedad y depresión. Veintidós estudios fueron revisados en este estudio. La duración del proceso de asilo y la duración de la estadía fueron los factores más frecuentemente citados para las dificultades de salud mental en 9 de 22 estudios. Siete estudios reportaron asociaciones significativas entre los factores de riesgo y la salud mental, y éstos fueron moderados por el estado de residencia. Más bien, el efecto del estatus legal estaba más estrechamente ligado a otros factores posteriores a la migración; fue hallado actuando como un marcador de variables adicionales posteriores a la migración, incluyendo la soledad, la discriminación y los problemas de comunicación o idioma. También se encontró que las dificultades relacionadas a la familia estaban asociadas con la duración de la estadía y el estado legal, concurrente con la noción de que otras variables posteriores a la migración son más relevantes para los resultados de salud mental que la residencia y la duración de la estadía.

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT).

In this paper we present a description of the Horizon2020, Marie Sklodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology.

En este artículo presentamos una descripción de un nuevo programa de investigación y formación, Horizon2020, con fondos de Marie Sklodowska-Curie Action, llamado CONTEXT o 'Red coordinadora para la formación y la excelencia en psicotraumatología'. Se presentan los tres objetivos del programa y cada uno de los cuales hace referencia a un componente clave del programa CONTEXT. Primero, resumimos los doce proyectos individuales de investigación que se llevarán a cabo en tres poblaciones prioritarias: (i) refugiados y solicitantes de asilo, (ii) personal de respuesta en emergencias y (iii) perpetradores y sobrevivientes de violencia infantil y de género. En segundo lugar, detallamos el programa de tutoría y formación, eje central de CONTEXT. Finalmente, describimos cómo la investigación, junto con la formación, contribuirá a una mejor política, directrices y práctica en el campo de la psicoterapia.