"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.

Increased Moral Sensitivity for Outgroup Perpetrators Harming Ingroup Members.

From an evolutionary perspective, one should be more sensitive when outgroup members attack the ingroup but less so when ingroup or outgroup members fight among themselves. Indeed, previous behavioral and neuroimaging research demonstrated that people show greater sensitivity for the suffering of ingroup compared with outgroup members. However, the question still remains whether this is always the case regardless of who is the agent causing the harm. To examine the role of agency and group membership in perception of harm, 48 participants were scanned while viewing ingroup or outgroup perpetrators intentionally harming ingroup or outgroup members. Behavioral results showed greater moral sensitivity for ingroup versus outgroup victims, but only when the perpetrator was from the outgroup. In support of this finding, fMRI data showed greater activity in left orbitofrontal cortex (OFC) for ingroup victims when they were harmed by outgroup individuals. In addition, effective connectivity analyses documented an increased coupling between left OFC and left amygdala and insula for ingroup harm, when the perpetrator was from the outgroup. Together these results indicate that we are highly sensitive to harm perpetrated by outgroup members and that increased sensitivity for ingroup victims is dependent on who is the agent of the action.

Individual differences in local gray matter density are associated with differences in affective and cognitive empathy.

The understanding of empathy from a neuroscientific perspective has recently developed quickly, with numerous functional MRI studies associating different brain regions with different components of empathy. A recent meta-analysis across 40 fMRI studies revealed that affective empathy is most often associated with increased activity in the insula, whereas cognitive empathy is most often associated with activity in the midcingulate cortex and adjacent dorsomedial prefrontal cortex (MCC/dmPFC). To date, however, it remains unclear whether individual differences in brain morphometry in these regions underlie different dispositions in affective and cognitive empathy. In order to test this hypothesis, voxel-based morphometry (VBM) was used to examine the extent to which gray matter density predicts scores from an established empathy measure (Questionnaire of Cognitive and Affective Empathy; QCAE). One hundred and seventy-six participants completed the QCAE and underwent MRI in order to acquire a high-resolution, three-dimensional T1-weighted structural scans. A factor analysis of the questionnaire scores revealed two distinct factors of empathy, affective and cognitive, which confirmed the validity of the QCAE. VBM results revealed gray matter density differences associated with the distinct components of empathy. Higher scores on affective empathy were associated with greater gray matter density in the insula cortex and higher scores of cognitive empathy were associated with greater gray matter density in the MCC/dmPFC. Taken together, these results provide validation for empathy being a multi-component construct, suggesting that affective and cognitive empathy are differentially represented in brain morphometry as well as providing convergent evidence for empathy being represented by different neural and structural correlates.

The influence of group membership and individual differences in psychopathy and perspective taking on neural responses when punishing and rewarding others.

Understanding how neural processes involved in punishing and rewarding others are altered by group membership and personality traits is critical in order to gain a better understanding of how socially important phenomena such as racial and group biases develop. Participants in an fMRI study (n = 48) gave rewards (money) or punishments (electroshocks) to in-group or out-group members. The results show that when participants rewarded others, greater activation was found in regions typically associated with receiving rewards such as the striatum and medial orbitofrontal cortex, bilaterally. Activation in those regions increased when participants rewarded in-group compared to out-group members. Punishment led to increased activation in regions typically associated with Theory of Mind including the medial prefrontal cortex and posterior superior temporal sulcus, as well as regions typically associated with perceiving others in pain such as the dorsal anterior cingulate cortex, anterior insula and lateral orbitofrontal cortex. Interestingly, in contrast to the findings regarding reward, activity in these regions was not moderated by whether the target of the punishment was an in- or out-group member. Additional regression analysis revealed that participants who have low perspective taking skills and higher levels of psychopathy showed less activation in the brain regions identified when punishing others, especially when they were out-group members. In sum, when an individual is personally responsible for delivering rewards and punishments to others, in-group bias is stronger for reward allocation than punishments, marking the first neuroscientific evidence of this dissociation.

Seeing is believing: neural mechanisms of action-perception are biased by team membership.

Group identification can lead to a biased view of the world in favor of "in-group" members. Studying the brain processes that underlie such in-group biases is important for a wider understanding of the potential influence of social factors on basic perceptual processes. In this study, we used functional magnetic resonance imaging (fMRI) to investigate how people perceive the actions of in-group and out-group members, and how their biased view in favor of own team members manifests itself in the brain. We divided participants into two teams and had them judge the relative speeds of hand actions performed by an in-group and an out-group member in a competitive situation. Participants judged hand actions performed by in-group members as being faster than those of out-group members, even when the two actions were performed at physically identical speeds. In an additional fMRI experiment, we showed that, contrary to common belief, such skewed impressions arise from a subtle bias in perception and associated brain activity rather than decision-making processes, and that this bias develops rapidly and involuntarily as a consequence of group affiliation. Our findings suggest that the neural mechanisms that underlie human perception are shaped by social context.

Activation patterns during action observation are modulated by context in mirror system areas.

The role of the mirror system in action understanding has been widely debated. Some authors have suggested that the mirror system plays an important role in action understanding (Rizzolatti and Sinigaglia, 2010), whereas others have claimed that direct evidence to support this view is lacking (Hickok, 2009). If mirror neurons have an active role in action understanding rather than passive visuomotor transformation during action observation, they should respond differently to the observation of actions depending on the intentions of the observer. In this fMRI study, twenty participants observed identical actions under different instruction contexts. The task was either to understand the actions, identify the physical features of the actions, or passively observe the actions. A multi-voxel pattern analysis revealed unique patterns of activation in ventral premotor cortex and inferior parietal lobule across the different contexts. The results suggest that ventral premotor and inferior parietal areas respond differently to observed actions depending on the mindset of the observer. This is consistent with the view that these regions do not merely process observed actions passively, but play an active role in action understanding.

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 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.

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).

The role of the superior temporal sulcus and the mirror neuron system in imitation.

It has been suggested that in humans the mirror neuron system provides a neural substrate for imitation behaviour, but the relative contributions of different brain regions to the imitation of manual actions is still a matter of debate. To investigate the role of the mirror neuron system in imitation we used fMRI to examine patterns of neural activity under four different conditions: passive observation of a pantomimed action (e.g., hammering a nail); (2) imitation of an observed action; (3) execution of an action in response to a word cue; and (4) self-selected execution of an action. A network of cortical areas, including the left supramarginal gyrus, left superior parietal lobule, left dorsal premotor area and bilateral superior temporal sulcus (STS), was significantly active across all four conditions. Crucially, within this network the STS bilaterally was the only region in which activity was significantly greater for action imitation than for the passive observation and execution conditions. We suggest that the role of the STS in imitation is not merely to passively register observed biological motion, but rather to actively represent visuomotor correspondences between one's own actions and the actions of others.

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.

Convergence between lesion-symptom mapping and functional magnetic resonance imaging of spatially selective attention in the intact brain.

The parietal regions implicated in spatially selective attention differ between patient lesion studies and functional imaging of the intact brain. We aimed to resolve this discordance. In a voxel-based lesion-symptom mapping study in 20 ischemic stroke patients, we applied the same cognitive subtraction approach as in 23 healthy volunteers who underwent functional magnetic resonance imaging (fMRI) using identical tasks and stimuli. An instructive central cue directed attention to one visual quadrant. After a brief delay, a grating appeared in that quadrant together with an irrelevant grating in an uncued quadrant. Subjects had to discriminate the orientation of the grating in the cued quadrant. Patients with a right inferior parietal lesion were significantly more impaired during contralesional versus ipsilesional orienting when stimuli were bilateral and symmetrical than when stimuli occupied diagonally opposite quadrants or two quadrants within the same hemifield. In one area, the lesion-volume map overlapped with the activity map obtained in healthy volunteers: the lower bank of the middle third of the right intraparietal sulcus (IPS). In an additional 37 healthy fMRI subjects, we disentangled the effects of symmetry, bilaterality, and spatial configuration between stimuli on activity in the volume of overlap. Only the axis of configuration between stimuli had a significant effect, with highest activity when the configuration axis was horizontal. This constitutes converging evidence from patients and cognitively intact subjects that the lower bank of the middle third of the right IPS critically contributes to attentive selection between competing stimuli in a spatially anisotropic manner.

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.

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.

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.