Cross-cultural adaptation and clinical application of the Perth Empathy Scale.

OBJECTIVE: Alterations of empathy have been observed in patients with various mental disorders. The Perth Empathy Scale (PES) was recently developed to measure a multidimensional construct of empathy across positive and negative emotions. However, its psychometric properties and clinical applications have not been examined in the Chinese context. METHODS: The Chinese version of the PES was developed and administered to a large Chinese sample (n = 1090). Factor structure, internal consistency, test-retest reliability, and convergent, discriminant, as well as concurrent validity were examined. Moreover, 50 patients with major depressive disorder (MDD) and 50 healthy controls were recruited to explore the clinical utility of the PES. RESULTS: Confirmatory factor analyses supported a theoretically congruent three-factor structure of empathy, namely Cognitive Empathy, Negative Affective Empathy and Positive Affective Empathy. The PES showed good to excellent internal consistency reliability, good convergent and discriminant validity, acceptable concurrent validity, and moderate to high test-retest reliability. Patients with MDD had significantly lower PES scores compared to healthy controls. Linear discriminant function comprised of the three factors correctly differentiated 71% of participants, which further verified the clinical utility of the PES. CONCLUSIONS: Our findings indicated that the Chinese version of the PES is a reliable and valid instrument to measure cognitive and affective empathy across negative and positive emotions, and could therefore be used in both research and clinical practice.

Effective Connectivity of Right Amygdala Subregions Predicts Symptom Improvement Following 12-Week Pharmacological Therapy in Major Depressive Disorder.

The low rates of treatment response still exist in the pharmacological therapy of major depressive disorder (MDD). Exploring an optimal neurological predictor of symptom improvement caused by pharmacotherapy is urgently needed for improving response to treatment. The amygdala is closely related to the pathological mechanism of MDD and is expected to be a predictor of the treatment. However, previous studies ignored the heterogeneousness and lateralization of amygdala. Therefore, this study mainly aimed to explore whether the right amygdala subregion function at baseline can predict symptom improvement after 12-week pharmacotherapy in MDD patients. We performed granger causality analysis (GCA) to identify abnormal effective connectivity (EC) of right amygdala subregions in MDD and compared the EC strength before and after 12-week pharmacological therapy. The results show that the abnormal EC mainly concentrated on the frontolimbic circuitry and default mode network (DMN). With relief of the clinical symptom, these abnormal ECs also change toward normalization. In addition, the EC strength of right amygdala subregions at baseline showed significant predictive ability for symptom improvement using a regularized least-squares regression predict model. These findings indicated that the EC of right amygdala subregions may be functionally related in symptom improvement of MDD. It may aid us to understand the neurological mechanism of pharmacotherapy and can be used as a promising predictor for symptom improvement in MDD.

Antidepressant Treatment-Induced State-Dependent Reconfiguration of Emotion Regulation Networks in Major Depressive Disorder.

Deficits in emotion regulation are the main clinical features, common risk factors, and treatment-related targets for major depressive disorder (MDD). The neural bases of emotion regulation are moving beyond specific functions and emphasizing instead the integrative functions of spatially distributed brain areas that work together as large-scale brain networks, but it is still unclear whether the dynamic interactions among these emotion networks would be the target of clinical intervention for MDD. Data were collected from 70 MDD patients and 43 sex- and age-matched healthy controls. The dynamic functional connectivity (dFC) between emotion regions was estimated via a sliding-window method based on resting-state functional magnetic resonance imaging (R-fMRI). A k-means clustering method was applied to classify all time windows across all participants into several dFC states reflecting recurring functional interaction patterns among emotion regions over time. The results showed that four dFC states were identified in the emotion networks. Their alterations of state-related occurrence proportion were found in MDD and subsequently normalized following 12-week antidepressant treatment. Baseline strong dFC could predict the reduction rate of Hamilton Depression Rating Scale (HAMD) scores. These findings highlighted the state-dependent reconfiguration of emotion regulation networks in MDD patients owing to antidepressant treatment.

Is quarantine related to immediate negative psychological consequences during the 2009 H1N1 epidemic?

OBJECTIVE: To investigate whether being quarantined to contain H1N1 flu transmission is related to immediate negative psychological consequences or not. METHODS: Immediate psychological consequences were evaluated with the 20-item Self-Report Questionnaire (SRQ-20) and the Impact of Event Scale-Revised (IES-R) among 419 undergraduate students (176 being quarantined and 243 being nonquarantined). RESULTS: No significant difference was found between the quarantined group and the nonquarantined group for IES-R screening-positive rate or SRQ-20 screening-positive rate. Multinomial logistic regression analyses indicated that dissatisfaction with control measures was the significant predictor of both SRQ-20 positive screening (OR=2.22) and IES-R positive screening (OR=2.22). CONCLUSION: These results are consistent with the conclusion that quarantine does not have negative psychological effects under these circumstances.

[Prevalence and predictors of acute stress disorder after earthquake: findings from Wenchuan earthquake in China].

OBJECTIVE: To investigate the prevalence and predictors of acute stress disorder (ASD) in the victims affected by Wenchuan earthquake in China. METHODS: A random clustered sampling method was used. Of 891 victims enrolled in the study, 874 were completely assessed with the ASD constructive questionnaire and diagnosed with DSM-IV criteria. Sociodemographic variables were obtained. Also, the major symptoms of ASD (i.e., general symptoms to a traumatic event; dissociative symptoms; re-experiencing symptoms; hyper-arousal symptoms; avoidance symptoms) were recorded. RESULTS: The incidence rate of ASD was 12.59% (110/874). The incidence rates of ASD for female and male were 15.16% (72/475) and 9.52% (38/399) respectively. There was a significant difference between female and male on the incidence rate of ASD (chi(2) = 6.26, P = 0.01). Logistic regression indicated that the ASD diagnosis was predicted by gender (beta = 0.58, P = 0.01, OR = 1.79), the condition of casualties of family members (beta = 0.60, P = 0.01, OR = 1.82), and the condition of sharp properties loss (beta = 1.02, P = 0.01, OR = 2.76). CONCLUSION: The major earthquake should have great influence on mental health of victims. The efforts to reduce casualties and property loss might help to prevent ASD. Further research is needed on gender difference among traumatic events.