Theory of Mind impairment in focal versus generalized epilepsy.

Theory of Mind (ToM) is a critical component of social cognition, and thus, its impairment may adversely affect social functioning and quality of life. Recent evidence has suggested that it is impaired in epilepsy. What is not clear, however, is whether it is related to particular types of epilepsy or other factors. We undertook the present study to explore ToM in patients with focal versus those with generalized epilepsy, the particular pattern of ToM deficits, and the potential influence of antiepileptic medication load. Our sample included 149 adults: 79 patients with epilepsy (34 with generalized epilepsy and 45 with focal epilepsy) and 70 healthy controls. Theory of Mind tasks included a) comprehension of hinting, b) comprehension of sarcasm and metaphor, c) comprehension of false beliefs and deception, d) recognition of faux pas, and e) a visual ToM task in cartoon form. We found significant ToM impairment in the group with focal epilepsy relative to the performance of both the healthy group and the group with generalized epilepsy on all tasks, with the exception of faux pas, on which the group with generalized epilepsy also performed more poorly than the healthy group. Additionally, early age at seizure onset, but not antiepileptic drug (AED) load, was associated with ToM performance. Our findings suggest that focal temporal and frontal lobe, but not generalized, epilepsies were associated with impaired ToM. This may reflect the neuroanatomical abnormalities in the relevant neuronal networks and may have implications for differential cognitive-behavioral interventions based on epilepsy type.

Resilience Predicts Social Functioning in Clinically Stable Patients With Bipolar Disorder.

The current study focused on the association between resilience and social functioning in patients with bipolar disorder (BD). Forty clinically stable patients with BD type I and BD type II, as well as 40 healthy controls, matched for age, sex, and educational background were enrolled. Clinical status was assessed by the Montgomery-Åsberg Depression Rating Scale and the Young Mania Rating Scale. Functioning was evaluated by the Mini International Classification of Functioning, Disability and Health rating of activities and participation in mental illnesses, and the Social and Occupational Functioning Scale. Resilience was measured by the Connor-Davidson Resilience scale. Patients demonstrated significantly lower resilience levels compared with healthy individuals. A stepwise regression analysis indicated that only resilience contributed significantly to social functioning's outcome. Because resilience may constitute a social functioning moderator in clinically stable patients with BD, a paradigm shift toward protective factors could lead to implementation of resilience-oriented interventions designed specifically for patients with BD.

Social cognition in adults: the role of cognitive control.

AIM: This study aimed at examining the direct and indirect, via cognitive control and emotion recognition, effects of advancing age on adults' social cognition, and especially, on complex forms of it such as indirect speech, faux pas, and social mental verb understanding. METHOD: The sample comprised a total of 70 adults, aged from 18 to 83 years. Participants were almost equally distributed in each one of three age-groups (young, middle-aged, and older adults), according to their gender and educational level. Three tasks measuring the ability to interpret indirect speech, the ability to understand faux pas, and social mental verb understanding, respectively, were administered as measures of social cognition. Cognitive control, as inhibitory control, task switching, updating-monitoring, and planning, as well as basic emotion decoding from visual cues, were measured by four and one task respectively. RESULTS: After the confirmation of the factor structure of each one of the dimensions of social cognition, and the examination of the direct effects of age on them, the all-inclusive path model finally confirmed showed that age has a significant negative indirect effect, via cognitive control, on social cognition as ability to interpret indirect speech and faux pas. CONCLUSION: The decreased performance that cognitively healthy older adults exhibit, as regards specific complex dimensions of social cognition, could be attributed to negative effects of age on cognitive control. However, it is likely that some other complex dimensions of social cognition are not affected by frontal aging.

Autobiographical memory deficits in remitted patients with bipolar disorder I: The effect of impaired memory retrieval.

Autobiographical memory (AM) has been studied extensively in different psychiatric disorders. However, less is known about AM in bipolar disorder (BD). Aim of the present study was to investigate BD patients' ability to recall episodic and semantic autobiographical memories after controlling for the effect of other possible neurocognitive deficits. Participants included 30 clinically remitted outpatients with BD type I and 30 healthy controls, matched for age, gender and educational level. Autobiographical memory was examined by the Questionnaire of Autobiographical Memory. Premorbid intellectual functioning, verbal memory, verbal fluency, attention and working memory were also assessed. Bipolar patients were impaired in both episodic and semantic AM, compared with healthy individuals. Deficits involved recall of memories from childhood-adolescence, early adulthood and recent life. Additionally, patients were impaired in verbal memory compared with controls. Differences between study groups in both episodic and semantic AM remained significant even after controlling for the effect of verbal memory deficits. Remitted BD-I patients showed deficits in recalling personal episodic memories and facts dating to three different life periods. These deficits were independent of patients' lower verbal memory performance. Additional research is required to gain a better understanding of the pattern and the mechanisms underlying AM impairment in BD.

Inefficient understanding of non-factive mental verbs with social aspect in adults: comparison to cognitive factive verb processing.

INTRODUCTION: Mental verbs denote inner mental states and are an important link between language and Theory of Mind ability conceptualized as mental state understanding. Non-factive mental verbs denote an obligation or intention and constitute a discrete class of mental verbs which are characterized by their social aspect. This study aimed to examine adults' ability to understand non-factive mental verbs with the social aspect as compared to cognitive factive mental verbs which denote a true event. METHODS: A total of 94 participants, aged 18-95 years, were examined using two tasks measuring non-factive and factive verb processing, respectively, and a working memory test. RESULTS: The results indicated that non-factive verbs process is at a significantly lower level than those of cognitive factives. CONCLUSION: The inspection of the way adapted to process the non-factive verbs denoting obligation or intention, as well as the confirmation of a unifactorial structure of the task developed to measure non-factives' processing, showed that adults have a common pattern of non-factive mental verb understanding, which is based on heuristic ways of thinking and is not affected by working memory capacity and age.

The role of obsessive-compulsive symptoms in the perception of insincere speech in first-episode psychosis.

OBJECTIVES: The aim of the present study was to investigate the effects of comorbid obsessive-compulsive symptoms (OCS) on the perception of insincere speech (e.g., sarcasm and white lies) in patients with first-episode psychosis. DESIGN AND METHOD: Participants were 65 patients with nonaffective first-episode psychosis (FEP) and 47 healthy controls. The patient group was divided into two subgroups, those with (FEP+; n= 38) and those without OCS (FEP-; n = 27). The ability to process sarcasm and lie was assessed with the Perception of Social Inference Test (PESIT). Severity of psychotic symptoms and OCS was assessed with the Positive and Negative Syndrome Scale (PANSS) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), respectively. RESULTS: Deficits in the perception of sarcasm and lie were confirmed in patients with nonaffective first-episode psychosis compared to healthy controls. In patients, comorbidity with OCS was associated with worse performance on certain aspects of insincere speech (i.e., lie) compared to FEP- patients. Y-BOCS scores correlated significantly with the perception of lying. The cognitive factor of the PANSS predicted accuracy on the perception of sincere speech, paradoxical sarcasm, and white lies, while the presence of OCS predicted accuracy on the perception of sincere speech and white lies. CONCLUSIONS: Our finding of impaired counterfactual information processing in patients with first-episode psychosis suggests that these deficits are already present at illness onset. Presence of OCS appears to have additional deleterious effects on the successful interpretation of intentional lying, further supporting that these patients are characterized by more extensive cognitive impairment.