"More support, less distress?": Examining the role of social norms in alleviating practitioners' psychological distress in the context of assisted dying services.

This study explores how providing assisted dying services affects the psychological distress of practitioners. It investigates the influence of professional norms that endorse such services within their field. Study 1 included veterinarians (N = 137, 75.2% female, Mage = 43.1 years, SDage = 12.7 years), and Study 2 health practitioner students (N = 386, 71.0% female, Mage = 21.0 years, SDage = 14.4 years). In both studies, participants indicated their degree of psychological distress following exposure to scenarios depicting assisted dying services that were relevant to their respective situations. In Study 1, we found that higher willingness to perform animal euthanasia was associated with lower distress, as were supportive norms. In Study 2, a negative association between a greater willingness to perform euthanasia and lower psychological distress occurred only when the provision of such services was supported by professional norms. In conclusion, psychological distress is buffered by supportive professional norms.

Cognitive distortions mediate relationships between early maladaptive schemas and aggression in women and men.

Difficult childhood experiences can lead to the development of early maladaptive schemas (EMS) that cause emotional and behavioral problems later in life. The present study examined the role of cognitive distortions in mediating relationships between EMS and aggression in adults as a function of sex. Participants were 59 women (Mage = 34.7 years, standard deviation [SD] = 8.0) and 86 men (Mage = 39.3 years, SD = 13.2) who completed the Young Schema Questionnaire-Short Form-V3, the How I Think Questionnaire of cognitive distortions, and the Buss-Warren Aggression Questionnaire. Multiple mediation analysis identified EMS domain impaired limits to be uniquely and directly related to aggression, and the domain impaired autonomy to be indirectly related via a range of cognitive distortions. Multigroup analyses revealed no sex differences in these relationships, and analysis of covariance with age as a covariate revealed no sex differences in levels of EMS, cognitive distortion, or aggression. The results suggest that impaired limits and impaired autonomy are EMS domains of relevance to aggression regardless of sex. Furthermore, in the case of impaired autonomy, self-serving, proaggression cognitive distortions appear to be involved. Interventions for aggression may thus benefit by focusing on clients with entitlement/grandiosity traits indicative of impaired limits, and vulnerability/dependence traits indicative of impaired autonomy, and in the latter case consider addressing the self-serving cognitions that enable the expression of aggression in these clients.

Using Latent Profile Analysis to Understand Health Practitioners' Attitudes Toward Voluntary Assisted Dying.

Prior work has documented considerable diversity among health practitioners regarding their support for voluntary assisted dying (VAD). We examined whether their attitudes are characterised by different combinations of personal support, normative support by other health practitioners, and whether they are predisposed to vicariously experience others' emotions (i.e., empathy). We also examined whether these profiles experienced different mental health outcomes (i.e., burnout and posttraumatic stress) in relation to VAD. To test this, 104 Australian health practitioners were surveyed after VAD was legalised in Victoria, Australia in 2019. Results indicated that practitioners' attitudes were characterised by three profiles: 1) strong personal and normative support (strong VAD supporters), 2) moderate personal and normative support (moderate VAD supporters), and 3) lower personal and normative support (apprehensive practitioners). However, each profile reported similar mental health outcomes. Findings suggest that the normative environments in which health practitioners operate may explain their diverse attitudes on VAD.

Attitudes Toward and Experience With Assisted-Death Services and Psychological Implications for Health Practitioners: A Narrative Systematic Review.

A narrative systematic review was conducted to review studies that examine mental health implications of involvement in assisted-death services among health practitioners. Qualitative and quantitative studies were included to understand health practitioners' attitudes and experiences with assisted dying services, as well as to identify the mental health consequences. We identified 18 articles from 1591 articles drawn from seven major scientific databases (i.e., PubMed, MEDLINE, CINAHL, PsycINFO, Embase, Web of Science, and Scopus). Two raters independently evaluated the exclusion and inclusion decisions of the articles and examined methodological flaws in the selected articles. We found that engagement in assisted death services were not reliably associated with mental health outcomes such as anxiety and moral distress. Both positive and negative outcomes were reported, and psychological outcomes for practitioners were shown to vary based on factors including social support for health practitioners' views; their perceived capacity to care for the patients; and legislation.

The neuroscience of intergroup threat and violence.

The COVID-19 pandemic led to a global increase in hate crimes and xenophobia. In these uncertain times, real or imaginary threats can easily lead to intergroup conflict. Here, we integrate social neuroscience findings with classic social psychology theories into a framework to better understand how intergroup threat can lead to violence. The role of moral disengagement, dehumanization, and intergroup schadenfreude in this process are discussed, together with their underlying neural mechanisms. We outline how this framework can inform social scientists and policy makers to help reduce the escalation of intergroup conflict and promote intergroup cooperation. The critical role of the media and public figures in these unprecedented times is highlighted as an important factor to achieve these goals.

A comprehensive assessment of poststroke social cognitive function.

OBJECTIVE: Stroke-related social cognitive impairment is now well established, but studies vary considerably in the nature and magnitude of the deficits reported, as well as whether there are potential areas of preservation. Because these discrepancies may reflect clinical heterogeneity between the contributing research participants, this study provides the first concurrent assessment of all four core social cognitive domains (theory of mind, emotion perception, social behavior, and affective empathy) in the same stroke cohort. A secondary goal was to test whether the degree of social cognitive impairment varied as a function of the tasks' ecological validity, on the basis that tasks with greater realism may provide a better indication of the implications of any stroke-related difficulties for everyday social interactions. METHOD: Participants included 35 people with first-time, ischemic or hemorrhagic stroke (as confirmed via MRI or CT) aged between 29 and 87 years (M = 64.69; SD = 12.92), and 35 controls matched for age, sex, and years of education. All participants completed a comprehensive social cognitive test battery as well as measures to broadly characterize neurocognitive function and well-being. RESULTS: Relative to controls, affective empathy was selectively preserved (d = 0.02), but stroke-related deficits were identified for theory of mind (d = -0.42), emotion perception (d = -0.48), and social behavior (d = -0.59). The degree of social cognitive impairment did not vary as a function of the tasks' ecological validity. CONCLUSIONS: These data enhance understanding of stroke-related social cognitive impairment and inform the development of tailored, evidence-based rehabilitation efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A 16-week aerobic exercise and mindfulness-based intervention on chronic psychosocial stress: a pilot and feasibility study.

OBJECTIVES: Researchers have begun delivering mindfulness and aerobic exercise training concurrently on the premise that a combination intervention will yield salutary outcomes over and above each intervention alone. An estimate of the effect of combination training on chronic psychosocial stress in a nonclinical population has not been established. The objective of this study was to establish protocol feasibility in preparation of a definitive RCT targeting healthy individuals, and to explore the preliminary effect of combination training on reducing chronic psychosocial stress in this population. METHODS: Twenty-four participants were allocated to a single-arm pre-post study and subjected to 16 weeks of concurrent mindfulness psychoeducation and aerobic exercise training. Feasibility criteria were collected and evaluated. Within-group changes in chronic psychosocial stress, mindfulness, emotion regulation, and cardiorespiratory fitness were also assessed. Primary analyses were based on 17 participants. RESULTS: Retention rate, response rate, recruitment rate, and sample size analyses indicate a definitive trial is feasible for detecting most effects with precision. There was also a decline in our primary dependent measure of chronic psychosocial stress (dpretest = -0.56, 95% CI [ -1.14,-0.06]). With regard to secondary measures, there was an increase in the use of cognitive reappraisal, and a reduction in use of maladaptive emotion regulation strategies. We are insufficiently confident to comment on changes in mindfulness and aerobic capacity [Formula: see text]. However, there were subgroup improvements in aerobic economy at submaximal exercise intensities. CONCLUSIONS: We recommend a definitive trial is feasible and should proceed. TRIAL REGISTRATION: ANZCTR (ID: ACTRN12619001726145 ). Retrospectively registered December 9, 2019.

The neural mechanisms of threat and reconciliation efforts between Muslims and non-Muslims.

To reduce the escalation of intergroup conflict, it is important that we understand the processes related to the detection of group-based threat and reconciliation. In the present study, we investigated the neural mechanisms of such processes using functional Magnetic Resonance Imaging (fMRI). Functional neuroimaging techniques may shed light on quick, automatic responses to stimuli that happen outside of conscious awareness and are thus increasingly difficult to quantify relying only on participants' self-reported experiences. They may further provide invaluable insight into physiological processes occurring in situations of sensitive nature, whereby participants-deliberately or not-may withhold their honest responses due to social desirability. Non-Muslim Western Caucasian participants watched short video clips of stereotypical Middle-Eastern Muslim males threatening their ingroup, offering reconciliation to the ingroup, or making a neutral statement. Threatening statements led to increased activation in the amygdala, insula, supramarginal gyrus, and temporal lobe. Reconciliation efforts led to increased activation in the prefrontal cortex, anterior cingulate gyrus, and caudate. The results suggest that threat detection is a relatively automatic process while evaluating and responding to reconciliation offers requires more cognitive efforts. The implications of these findings and future research directions are discussed.

The relationship between social cognitive difficulties in the acute stages of stroke and later functional outcomes.

Although social cognitive difficulties are common following stroke, the extent to which such difficulties observed in the acute phase are related to long-term socioemotional outcomes remains poorly understood. To address this question empirically, 53 stroke patients completed a measure of Theory of Mind (The Reading the Mind in the Eyes Test) and a cognitive flexibility measure that has been related to social cognitive processes (a Reversal Learning Task) at hospital bedside. These participants then completed measures of socioemotional functioning at a 6-month follow-up. Baseline difficulties on the two measures were found to predict distinct types of socioemotional difficulties. The RMET uniquely predicted self-reported depression and loneliness whereas the Reversal Learning task uniquely predicted peer-reported social behavior, specifically social inappropriateness and stereotyping and prejudice. Importantly, a measure of general cognitive function did not explain variance in these outcome measures, suggesting that social cognitive difficulties are linked to poor socioemotional outcomes. By showing for the first time that social cognitive deficits observed acutely post-stroke are related to longer term functional outcomes, these findings reinforce the importance of including brief social cognitive measures as part of routine post-stroke clinical assessment.

Fluency and rule breaking behaviour in the frontal cortex.

Design (DF) and phonemic fluency tests (FAS; D-KEFS, 2001) are commonly used to investigate voluntary generation. Despite this, several important issues remain poorly investigated. In a sizeable sample of patients with focal left or right frontal lesion we established that voluntary generation performance cannot be accounted for by fluid intelligence. For DF we found patients performed significantly worse than healthy controls (HC) only on the switch condition. However, no significant difference between left and right frontal patients was found. In contrast, left frontal patients were significantly impaired when compared with HC and right frontal patients on FAS. These lateralization findings were complemented, for the first time, by three neuroimaging; investigations. A traditional frontal subgrouping method found significant differences on FAS between patients with or without Left Inferior Frontal Gyrus lesions involving BA 44 and/or 45. Parcel Based Lesion Symptom Mapping (PLSM) found lower scores on FAS were significantly associated with damage to posterior Left Middle Frontal Gyrus. An increase in rule break errors, so far only anecdotally reported, was associated with damage to the left dorsal anterior cingulate and left body of the corpus callosum, supporting the idea that conflict resolution and monitoring impairments may play a role. Tractwise statistical analysis (TSA) revealed that patients with disconnection; in the left anterior thalamic projections, frontal aslant tract, frontal; orbitopolar tract, pons, superior longitudinal fasciculus I and II performed significantly worse than patients without disconnection in these tracts on FAS. In contrast, PLSM and TSA analyses did not reveal any significant relationship between lesion location and performance on the DF switch condition. Overall, these findings suggest DF may have limited utility as a tool in detecting lateralized frontal executive dysfunction, whereas FAS and rule break behavior appears to be linked to a set of well localized left frontal grey matter regions and white matter tracts.

Structural and functional brain correlates of theory of mind impairment post-stroke.

The ability to understand the mental states of others - also known as Theory of Mind (ToM) - is critical for normal social interactions. We combine behavioural probes with structural and functional brain imaging to provide the first comprehensive analysis of ToM deficits following stroke using the Reading the Mind in the Eyes Test (RMET). First, fMRI was used to identify the functional brain network involved in a non-clinical cohort. Results indicated that, relative to a control task, the RMET increased activity in a widespread functional bilateral network comprising frontal and temporo-parietal areas. To investigate how damage to grey and white matter components of this network can lead to ToM impairment, parcel-based lesion-symptom mapping (PLSM), white-matter tract-wise statistical analysis (TSA) and disconnectome symptom mapping (DSM) were performed using structural images from 64 stroke patients. PLSM results revealed that low scores on the RMET were associated with damage centered around the right posterior frontal gyrus and insula. TSA and DSM results further revealed that low RMET scores were associated with damage to white-matter tracts connecting frontal and temporo-parietal components of the RMET functional network. Together, these findings suggest that making judgements about the mental states of others imposes demands on a large functional network that can easily be disrupted, both by damage to grey matter areas that form part of the network directly, or the white-matter pathways that connect them.

A meta-analytic review of social cognitive function following stroke.

Although it is now widely recognised that social cognitive difficulties are often evident following stroke, important questions remain about the nature and magnitude of these difficulties, as well as the factors that determine the magnitude of this impairment. A meta-analysis of 58 datasets involving 2567 participants (937 with stroke, 1630 non-clinical controls) was therefore conducted. The results indicated that three of the four core domains of social cognitive function were significantly disrupted in people with stroke. Specifically, while the effect size for affective empathy failed to attain significance (r = -.33), moderate to large deficits were identified for theory of mind (r = -.44), social perception (r = -.55), and social behaviour (r = -.53). These deficits were robust across both left and right lateralized lesions, across social cognitive assessments that differed in their broader cognitive demands, as well as in tasks that varied in their modality of presentation. These data are discussed in the context of broader neuropsychological models of social cognitive function.

Immoral behaviour following brain damage: A review.

Despite the apparent sociability of human kind, immoral behaviour is ever present in society. The term 'immoral behaviour' represents a complex array of conduct, ranging from insensitivity to topics of conversation through to violent assault and murder. To better understand the neuroscience of immoral behaviour, this review investigates two clinical populations that commonly present with changes in moral behaviour - behavioural-variant frontotemporal dementia and acquired brain injuries. Based on evidence from these groups, it is argued that rather than a single underlying cause, immoral behaviour can result from three distinct types of cognitive failure: (1) problems understanding others; (2) difficulties controlling behaviour; or (3) deficits in the capacity to make appropriate emotional contributions. Each of these failures is associated with damage to different brain regions. A more nuanced approach to the neuroscience of immoral behaviour has important implications for our understanding of immoral behaviour in a wide range of clinical groups, as well as human society more broadly.

Insights From fMRI Studies Into Ingroup Bias.

Intergroup biases can manifest themselves between a wide variety of different groups such as people from different races, nations, ethnicities, political or religious beliefs, opposing sport teams or even arbitrary groups. In this review we provide a neuroscientific overview of functional Magnetic Resonance Imaging (fMRI) studies that have revealed how group dynamics impact on various cognitive and emotional systems at different levels of information processing. We first describe how people can perceive the faces, words and actions of ingroup and outgroup members in a biased way. Second, we focus on how activity in brain areas involved in empathizing with the pain of others, such as the dorsal anterior cingulate cortex (dACC) and anterior insula (AI), are influenced by group membership. Third, we describe how group membership influences activity in brain areas involved in mentalizing such as the medial prefrontal cortex (mPFC) and temporoparietal junction (TPJ). Fourth, we discuss the involvement of the lateral orbitofrontal cortex (lOFC) in increased moral sensitivity for outgroup threats. Finally, we discuss how brain areas involved in the reward system such as the striatum and medial orbitofrontal cortex (mOFC), are more active when experiencing schadenfreude for outgroup harm and when rewarding ingroup (versus outgroup) members. The value of these neuroscientific insights to better understand ingroup bias are discussed, as well as limitations and future research directions.

Lateral orbitofrontal cortex activity is modulated by group membership in situations of justified and unjustified violence.

The role of the orbitofrontal cortex (OFC) in moral decision-making is well established. However, OFC activity is highly context dependent. It is affected by the extent to which choices are morally justified and whom they concern. In the current study, we specifically focus on contextual factors and investigate the differential role of the OFC during justified and unjustified violence towards ingroup versus outgroup members. Muslims were chosen as the outgroup, as they are currently stereotypically seen as an outgroup and a potential threat by some Non-Muslims. Importantly, we also introduce a context where participants are the actual agents responsible for doing harm. During fMRI scanning, Non-Muslim participants had to decide to either shoot a Non-Muslim (i.e., ingroup member) or Muslim (outgroup member) depending on whether they believed the target was holding a gun or an object. Neuroimaging results showed increased activation in the lateral OFC (lOFC) in the three contrasts that were distressing: 1) during unjustifiable killing; 2) when being killed; and 3) when confronted by an outgroup member with a gun. Together, these results provide important insights into the neurocognitive mechanisms involved in intergroup violence and highlight the critical role of the lOFC in context dependent social decision-making.

Common and distinct neural networks involved in fMRI studies investigating morality: an ALE meta-analysis.

Morality is an important social construct necessary for understanding what is right and wrong. Neuroimaging studies investigating morality have used a wide variety of paradigms and implicated many different brain areas. Yet, it remains unclear whether differences amongst morality tasks are the cause for such heterogeneous findings. Therefore, in the present study, a series of activation likelihood estimation (ALE) meta-analyses were conducted on 123 datasets (inclusive of 1963 participants) to address this question. The ALE meta-analyses revealed a series of common brain areas associated with all moral tasks, including medial prefrontal cortex, lateral orbitofrontal cortex, amygdala, temporoparietal junction, and precuneus. However, individual and contrast analyses also revealed unique networks associated with each moral modality, suggesting that different moral tasks recruit specialised brain regions.

Why do people pirate? A neuroimaging investigation.

It is not uncommon for people to openly admit to pirating information from the internet despite the known legal consequences. Those same people are often less inclined to steal the same physical item from a shop. This raises the question, why do people have fewer reservations with stealing intangible items compared to tangible? Using questionnaires and fMRI we provide evidence across three studies as to the differences between tangible and intangible theft. In a questionnaire (Study 1), participants revealed that across different conditions they were more willing to steal intangible compared to tangible goods. Study 2a used fMRI to reveal that a network involved in imagining objects was more active when participants were representing intangible versus tangible objects, suggesting people have greater difficulty representing intangible items. Study 2b used fMRI to show that when stealing tangible objects versus intangible, participants had increased activation in left lateral orbitofrontal cortex, an area typically activated in response to morally laden situations. The findings from the current investigation provide novel insights into the higher prevalence of intangible theft and suggest that differential neural representation of tangible and intangible items may, in part, explain why people are more willing to steal intangible items.

Increased Pain Communication following Multiple Group Memberships Salience Leads to a Relative Reduction in Pain-Related Brain Activity.

Pain is a fundamental human experience that triggers a range of social and psychological responses. In this study, we present behavioral and fMRI data to examine the effect of multiple group memberships salience on reported and neural indices of pain. We found that participants expressed higher levels of pain when more social group memberships were salient. This is consistent with the notion that pain itself motivates people to communicate their pain, and more so when multiple psychological resources are salient. In addition, fMRI results reveal an interesting twist: when participants increased their pain reporting as group memberships increased (from one group to four), there was a corresponding relative reduction in dorsal anterior cingulate cortex and anterior insula activation. These results provide evidence for an adaptive response to pain: the more people make use of the social resources at their disposal when experiencing pain, the less pain areas are activated.

Neural correlates of metacognitive ability and of feeling confident: a large-scale fMRI study.

One important aspect of metacognition is the ability to accurately evaluate one's performance. People vary widely in their metacognitive ability and in general are too confident when evaluating their performance. This often leads to poor decision making with potentially disastrous consequences. To further our understanding of the neural underpinnings of these processes, this fMRI study investigated inter-individual differences in metacognitive ability and effects of trial-by-trial variation in subjective feelings of confidence when making metacognitive assessments. Participants (N = 308) evaluated their performance in a high-level social and cognitive reasoning task. The results showed that higher metacognitive accuracy was associated with a decrease in activation in the anterior medial prefrontal cortex, an area previously linked to metacognition on perception and memory. Moreover, the feeling of confidence about one's choices was associated with an increase of activation in reward, memory and motor related areas including bilateral striatum and hippocampus, while less confidence was associated with activation in areas linked with negative affect and uncertainty, including dorsomedial prefrontal and bilateral orbitofrontal cortex. This might indicate that positive affect is related to higher confidence thereby biasing metacognitive decisions towards overconfidence. In support, behavioural analyses revealed that increased confidence was associated with lower metacognitive accuracy.

Understanding the minds of others: A neuroimaging meta-analysis.

Theory of mind (ToM) is an important skill that refers broadly to the capacity to understand the mental states of others. A large number of neuroimaging studies have focused on identifying the functional brain regions involved in ToM, but many important questions remain with respect to the neural networks implicated in specific types of ToM tasks. In the present study, we conducted a series of activation likelihood estimation (ALE) meta-analyses on 144 datasets (involving 3150 participants) to address these questions. The ALE results revealed common regions shared across all ToM tasks and broader task parameters, but also some important dissociations. In terms of commonalities, consistent activation was identified in the medial prefrontal cortex and bilateral temporoparietal junction. On the other hand, ALE contrast analyses on our dataset, as well as meta-analytic connectivity modelling (MACM) analyses on the BrainMap database, indicated that different types of ToM tasks reliably elicit activity in unique brain areas. Our findings provide the most accurate picture to date of the neural networks that underpin ToM function.