Virtual reality for the rehabilitation and prevention of intimate partner violence - From brain to behavior: A narrative review.

Rehabilitation and prevention strategies to reduce intimate partner violence (IPV) have limited effectiveness in terms of improving key risk factors and reducing occurrence. Accumulated experimental evidence demonstrates that virtual embodiment, which results in the illusion of owning a virtual body, has a large impact on people's emotional, cognitive, and behavioral responses. This narrative review discusses work that has investigated how embodied perspective - taking in virtual reality has been used as a tool to reduce bias, to enhance recognition of the emotional state of another, and to reduce violent behaviors, in particular in the realm of IPV. Some of the potential neurological mechanisms behind these affective and behavioral changes are also discussed. The process of rehabilitation and prevention is complex and not always effective, but the integration of neuroscience-inspired and validated state-of-the-art technology into the rehabilitation process can make a positive contribution.

Being the Victim of Intimate Partner Violence in Virtual Reality: First- Versus Third-Person Perspective.

Immersive virtual reality is widely used for research and clinical purposes. Here we explored the impact of an immersive virtual scene of intimate partner violence experienced from the victim's perspective (first person), as opposed to witnessing it as an observer (third person). We are ultimately interested in the potential of this approach to rehabilitate batterers and in understanding the mechanisms underlying this process. For this, non-offender men experienced the scene either from the perspective of the victim's virtual body (a female avatar), which moved synchronously with the participants' real movements, or from the perspective of an observer, while we recorded their behavior and physiological responses. We also evaluated through questionnaires, interviews and implicit association tests their subjective impressions and potential pre/post changes in implicit gender bias following the experience. We found that in all participants, regardless of perspective, the magnitude of the physiological reactions to virtual threatening stimuli was related to how vulnerable they felt for being a woman, the sensation that they could be assaulted, how useful the scene could be for batterer rehabilitation, and how different it would have been to experience the scenario on TV. Furthermore, we found that their level of identification with the female avatar correlated with the decrease in prejudice against women. Although the first-person perspective (1PP) facilitated taking the scene personally, generated a sensation of fear, helplessness, and vulnerability, and tended to induce greater behavioral and physiological reactions, we show that the potential for batterer rehabilitation originates from presence and identification with the victim, which in turn is more easily, but not exclusively, achieved through 1PP. This study is relevant for the development of advanced virtual reality tools for clinical purposes.

Distribution of GABAergic Neurons and VGluT1 and VGAT Immunoreactive Boutons in the Ferret (Mustela putorius) Piriform Cortex and Endopiriform Nucleus. Comparison With Visual Areas 17, 18 and 19.

We studied the cellular organization of the piriform network [comprising the piriform cortex (PC) and endopiriform nucleus (EP)] of the ferret (Mustela putorius)-a highly excitable region prone to seizures-and, more specifically, the distribution and morphology of different types of gamma-aminobutyric acid (GABA)ergic neurons, and the distribution and ratio of glutamatergic and GABAergic boutons, and we compared our findings to those in primary visual area 17, and secondary areas 18 and 19. We accomplished this by using cytochrome oxidase and immunohistochemistry for mature neuronal nuclei (NeuN), GABAergic neurons [glutamic acid decarboxylase-67 (GAD67), calretinin (CR) and parvalbumin (PV)], and for excitatory (vesicular glutamate transporter 1; VGluT1) and inhibitory (vesicular GABA transporter; VGAT) boutons. In the ferret, the cellular organization of the piriform network is similar to that described in other species such as cats, rats and opossums although some differences also exist. GABAergic immunolabeling showed similarities between cortical layers I-III of the PC and visual areas, such as the relative distribution of GABAergic neurons and the density and area of VGluT1- and VGAT-immunoreactive boutons. However, multiple differences between the piriform network and visual areas (layers I-VI) were found, such as the percentage of GABAergic neurons with respect to the total number of neurons and the ratio of VGluT1- and VGAT-immunoreactive boutons. These findings are relevant to better understand the high excitability of the piriform network.

Emotional Contagion is not Altered in Mice Prenatally Exposed to Poly (I:C) on Gestational Day 9.

Prenatal immune activation has been associated with increased risk of developing schizophrenia. The polyinosinic-polycytidylic acid (Poly(I:C)) mouse model replicates some of the endophenotype characteristic of this disorder but the social deficits observed in schizophrenia patients have not been well studied in this model. Therefore we aimed to investigate social behavior, in particular emotional contagion for pain, in this mouse model. We injected pregnant mouse dams with Poly(I:C) or saline (control) on gestation day 9 (GD9) and we evaluated their offspring in the pre-pulse inhibition (PPI) test at age 50-55 days old to confirm the reliability of our model. Mice were then evaluated in an emotional contagion test immediately followed by the light/dark test to explore post-test anxiety-like behavior at 10 weeks of age. In the emotional contagion test, an observer (prenatally exposed to Poly(I:C) or to saline) witnessed a familiar wild-type (WT) mouse (demonstrator) receiving electric foot shocks. Our results replicate the sensory gating impairments in the Poly(I:C) offspring but we only observed minor group differences in the social tasks. One of the differences we found was that demonstrators deposited fewer feces in the presence of control observers than of observers prenatally exposed to Poly(I:C), which we suggest could be due to the observers' behavior. We discuss the findings in the context of age, sex and day of prenatal injection, suggesting that Poly(I:C) on GD9 may be a valuable tool to assess other symptoms or symptom clusters of schizophrenia but perhaps not comprising the social domain.

Alterations in event-related potential responses to empathy for pain in schizophrenia.

Lack of empathy is a critical factor impacting on social functioning and quality of life in schizophrenia. There is, however, a paucity of research into the underlying neurophysiological correlates of empathy deficits in this disorder. Accordingly, we sought: (1) to identify whether dysfunctional empathic abilities in schizophrenia are related to alterations in early or late brain processes, and (2) to explore the potential relationship between brain activity and mood, self-reported empathy and symptom severity. Eighteen patients with schizophrenia and 21 healthy matched controls performed an empathy-for-pain paradigm where photographs of hands in neutral or painful situations were shown while we recorded their electroencephalography (EEG), and we examined mood, empathic concern for others and symptom severity. Significant group differences between patients and controls emerged in early (50-150ms after stimulus onset) and late (after 300ms) timeframes. Moreover, brain activity was related with unpleasantness ratings in all participants, with self-reported empathic concern only in controls and with negative mood and personal distress only in patients. Differences in social behavior in schizophrenia may be explained by early as well as late differences, affecting mostly the early frontocentral ERPs, i.e. those suggested to correspond to the emotional sharing component of empathy.

Sex-dependent effects of stress on brain correlates to empathy for pain.

Empathy is a fundamental attribute required for appropriate social functioning. The extent to which we empathize with others in pain is influenced by numerous factors. Being highly social species, humans face social stress on a regular basis, which undoubtedly affects how we react to our environment. It is not yet known how social stress may modulate our neural mechanisms when we empathize with others in painful circumstances, and its effects on empathic behavior are still unclear. For this reason, we recorded the electroencephalography (EEG) of healthy men and women, half of which were previously exposed to psychosocial stress, while they observed photographs of hands in painful and neutral situations. At the behavioral level, stress induced higher unpleasantness ratings to painful stimuli, and lower ratings to neutral pictures, independent of sex. At the neurophysiological level, we found that early (N110 over fronto-central sites) event-related potentials (ERPs) were not affected by stress, while late (P3 over centro-parietal regions) components showed a sex-dependent differential effect of stress. Correlation analyses further indicated a strong association between N110 with trait markers of empathy in all participants, while P3 was associated with the change in cortisol in stressed males. Our findings suggest that sex-dependent effects of social stress on the neural responses to empathy for pain give rise to comparable behaviors in men and women in the paradigm we employed, implying that each sex may engage in distinct mechanisms to cope with stress. Moreover, stress seems to modulate late neural mechanisms of empathy but not our early perception.

Reward modulates the mirror neuron system in schizophrenia: A study into the mu rhythm suppression, empathy, and mental state attribution.

Impairments in the mirror neuron system (MNS) have been implicated as a possible underlying neurological basis for deficits in higher-level social cognition in schizophrenia. Previous work testing this hypothesis has used the electroencephalographic mu rhythm as an index of MNS activity, with studies showing mixed results. Here we investigated the role that reward plays in modulating the mu rhythm, and its association with empathy and emotional mental state reasoning. A group of schizophrenia patients and a healthy control group completed an action observation paradigm in which they watched actions that were financially rewarding, punishing, or neutral. Patients showed intact reward-related modulation of the mu rhythm, and greater mu suppression was associated with greater negative symptoms. There was also a trend for reduced mu suppression in patients. Furthermore, both empathy and emotional mental state reasoning were associated with the degree of mu suppression, but only in healthy controls. These findings confirm the association between the mu suppression and high-level social cognition. It is possible that schizophrenia patients utilize different cognitive routes to infer mental states. The demonstration that reward influences the degree of mu suppression in schizophrenia patients may help to account for previous conflicting findings in the literature.

Oxidative stress in schizophrenia: a case-control study on the effects on social cognition and neurocognition.

BACKGROUND: Schizophrenia is a debilitating mental disorder that presents impairments in neurocognition and social cognition. Several studies have suggested that the etiology of schizophrenia can be partly explained by oxidative stress. However, our knowledge about the implications of oxidative stress on illness-related cognitive deficits is still far from being clear. The aim of this work was to study the role of oxidative stress molecules on social cognition and neurocognition in patients with schizophrenia. METHODS: We assessed the peripheral levels of several molecules associated with oxidative stress, namely nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH), homocysteine, superoxide dismutase (SOD) and neurotrophin 4/5 (NT4/5), in forty-one patients with schizophrenia and forty-three healthy participants. A battery of tests to measure neurocognition and social cognition was also administered to the schizophrenia group. RESULTS: We found that the schizophrenia group presented substantially higher levels of oxidative stress than the control group, as revealed by elevated quantities of the pro-oxidants NO and MDA, and decreased levels of the antioxidants GSH, SOD and NT4/5. Interestingly, the levels of NT4/5, which have been shown to have antioxidant effects, correlated with executive functioning, as measured by two distinct tests (WCST and TMT). However, social cognition and symptom severity were not found to be associated with oxidative stress. CONCLUSIONS: We propose a protective role of NT4/5 against oxidative stress, which appears to have a potentially beneficial impact on neurocognition in schizophrenia.

Emotional contagion in mice: the role of familiarity.

Empathy is a complex emotional process that involves sharing an emotional state with another organism. The extent to which nonhuman animals are capable of empathizing with others is still far from clear, partly due to a lack of empirical work in this domain, but also due to definitional confusion of empathy with emotional contagion and other related terms. In this study, an observer mouse witnessed a familiar cagemate or an unfamiliar non-cagemate receiving electric foot shocks in an experiment that consisted of three periods: baseline (no shocks), test (shocks) and recovery (no shocks). Freezing behavior in the observer was significantly increased in the cagemate, as opposed to the non-cagemate condition during the test period, but not during baseline or recovery, emphasizing the role of familiarity in empathy-like processes. In agreement with this, we also found a correlation that approached significance between the total number of fecal droppings of the observers, as an indication of distress, and those of the demonstrator in the cagemate, but not in the non-cagemate, condition. While the freezing behavior of the demonstrators increased with time, reaching a maximum at the recovery period, the observers froze the most during the test period while the demonstrators were receiving the electric foot shocks. The observation that the freezing response of the observers ceased when the shocks in the adjacent compartment stopped could be due to a decrease in saliency of the demonstrators' behavioral response. Finally, the presence of a cagemate, as compared to a stranger, possibly reduced the demonstrator's pain-induced behavior, suggesting an ameliorating effect of familiarity on stress responses.

Towards a neuroscience of empathy: ontogeny, phylogeny, brain mechanisms, context and psychopathology.

Empathy allows individuals to share the affective states of others, predict others' actions, and stimulate prosocial behavior. Whilst the proximate mechanisms of empathy, modulated in part by neuropeptides such as oxytocin, control the ways we interact with our social environment, the ultimate causes seem to have arisen along with the mechanisms involved in mammalian parental care. The conceptual boundaries of empathy, however, have been blurred by definitional inaccuracies of mechanisms that can be regarded as phylogenetic precursors or physiological prerequisites for empathy, including mimicry and emotion contagion. Contextual factors such as early experiences with primary care-givers (attachment), current mood states and other environmental contingencies are capable of modulating empathy. Moreover, evidence suggests that there is also a "dark side" of empathy, namely envy and schadenfreude (gloating) that are elicited by social comparison, competition and ingroup-outgroup distinction. This review aims at clarifying some of the open definitional questions related to empathy, and emphasizing the need for considering contextual factors in the study of empathy in both normal and abnormal psychology.