BackgroundCognitive rehabilitation is a highly individualised, non-pharmacological intervention for people with mild cognitive impairment (MCI) and dementia, which in recent years has also been developed for various IT platforms.MethodsIn this study, we aim to evaluate the effectiveness of the cognitive rehabilitation software GRADIOR in a multi-centre, single-blinded randomised controlled trial with people with MCI and mild dementia. A total of 400 people with MCI and mild dementia will be randomly allocated to one of four groups. This trial will compare the cognitive rehabilitation treatment using the GRADIOR programme with a psychosocial stimulation intervention (PSS) using the ehcoBUTLER platform, with a combined treatment consisting of GRADIOR and ehcoBUTLER, and with a group receiving treatment as usual during a period of 1 year.DiscussionThe outcomes of this clinical trial will be to determine any relevant changes in cognition, mood, quality of life, activities of daily living and quality of patient-carer relationship after 4 months and 1 year of intervention in a cross-sectional group comparison. Participants will be followed-up for 1 year to investigate potential long-term effects of the conducted treatments.Trial registrationCurrent Controlled Trials ISRCTN, ID: 15742788. Registered on 12 June 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2371-z) contains supplementary material, which is available to authorized users.

Background: Good reading skills are important for appropriate functioning in everyday life, scholastic performance, and the chances of acquiring a higher socioeconomic status. We conducted the first systematic review and meta-analysis to quantify possible deficits in specific reading skills in people with a variety of mental illnesses, including personality disorders. Methods: We performed a systematic search of databases (Academic Search Complete, CINAHL Plus, PsycInfo, PsycARTICLES, SocINDEX, MEDLINE, and PubMed) from inception until February 2020 and conducted random-effects meta-analyses. Results: The search yielded 34 studies with standardised assessments of reading skills in people with one or more mental illnesses. Of these, 19 studies provided data for the meta-analysis. Most studies (n=27; meta-analysis, n=17) were in people with schizophrenia and revealed large deficits in phonological processing (Hedge's g=-0.88, p<0.00001), comprehension (Hedge's g=-0.96, p<0.00001) and reading rate (Hedge's g=-1.22, p=0.002), relative to healthy controls; the single-word reading was less affected (Hedge's g=-0.70, p<0.00001). A few studies in affective disorders and non-forensic personality disorders suggested weaker deficits (for all, Hedge's g<-0.60). In forensic populations with personality disorders, there was evidence of marked phonological processing (Hedge's g=-0.85, p<0.0001) and comprehension deficits (Hedge's g=-0.95, p=0.0003). Conclusions: People with schizophrenia, and possibly forensic populations with personality disorders, demonstrate a range of reading skills deficits. Future studies are needed to establish how these deficits directly compare to those seen in developmental or acquired dyslexia and to explore the potential of dyslexia interventions to improve reading skills in these populations.

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The feelings of reward associated with social interaction help to motivate social behaviour and influence preferences for different types of social contact. In two studies conducted in a general population sample, we investigated self-reported and experimentally-assessed social reward processing in personality spectra with prominent interpersonal features, namely schizotypy and psychopathy. Study 1 (n = 154) measured social reward processing using the Social Reward Questionnaire, and a modified version of a Monetary and Social Incentive Delay Task. Study 2 (n = 42; a subsample of Study 1) investigated social reward processing using a Social Reward Subtype Incentive Delay Task. Our results show that schizotypy (specifically Cognitive-Perceptual dimension) and psychopathy (specifically Lifestyle dimension) are associated with diverging responses to social scenarios involving large gatherings or meeting new people (Sociability), with reduced processing in schizotypy and heightened processing in psychopathy. No difference, however, occurred for other social scenarios—with similar patterns of increased antisocial (Negative Social Potency) and reduced prosocial (Admiration, Sociability) reward processing across schizotypy and psychopathy dimensions. Our findings contribute new knowledge on social reward processing within these personality spectra and, with the important exception of Sociability, highlight potentially converging patterns of social reward processing in association with schizotypy and psychopathy.

Background Individuals with schizophrenia spectrum disorders often experience less pleasure during social interaction and frequently demonstrate reduced social motivation. This research examines the extent to which these behaviours may be linked to reduced social reward reactivity and sensitivity, and aims to clarify whether schizophrenia spectrum traits are associated with reduced behavioural and neural responsiveness to social rewards. It includes a systematic review and meta-analyses of social reward sensitivity research in schizophrenia, and also provides preliminary data (participant n = 50) on a novel avatar-based social incentive delay task that was created to further investigate the links between schizophrenia spectrum traits and social reward reactivity. Methods First, a systematic review and meta-analyses (literature database search conducted November 2019) found six studies that investigated social reward anticipation and consumption within the schizophrenia continuum (total participant n = 440). Four investigated social reward sensitivity in clinical samples with schizophrenia diagnoses, and two studied the links between social anhedonia traits and social reward responding in normative samples. The novel social incentive delay task presents participants with the opportunity to win animated avatar-based monetary or social rewards by responding to a cued target. Results The narrative review and meta-analyses of behavioural data from clinical and normative samples found that individuals with schizophrenia diagnoses or traits demonstrate significantly reduced behavioural anticipation of social rewards in comparison to healthy controls. Furthermore, this reduced reward reactivity was more pronounced for social rewards than for monetary rewards. This effect was also mirrored at neural levels, with individuals with schizophrenia demonstrating reduced social reward-related activation in areas such as the ventral striatum and anterior cingulate cortex. Preliminary behavioural data from the social incentive delay task suggest that, in normative samples, more pronounced negative schizotypal traits are associated with reduced anticipation and consumption of social rewards. Like in the reviewed studies, this reduced anticipation was more marked for social rewards than for monetary rewards. Discussion This research suggests that schizophrenia spectrum traits are associated with reduced reactivity and sensitivity to social rewards. It also highlights that this reduced reactivity is demonstrated at behavioural and neural levels, and is more marked for social rewards than for monetary rewards. We consider the implications of these findings for treatment programmes that target atypical social behaviour within schizophrenia spectrum conditions. A series of methodological recommendations for future work investigating social reward reactivity in schizophrenia are also included.

Previous behavioural data indicate lower word‐nonword recognition accuracy in association with a high level of positive schizotypy, psychopathy, or motor impulsivity traits, each with some unique contribution, in the general population. This study aimed to examine the neural underpinnings of these associations using functional magnetic resonance imaging (fMRI) in a volunteer sample. Twenty‐two healthy English‐speaking adults completed self‐report measures of schizotypy (Oxford‐Liverpool Inventory of Feelings and Experiences [O‐LIFE]), psychopathy (Triarchic Psychopathy Measure [TriPM]), and impulsivity (Barratt Impulsiveness Scale [BIS‐11]) and underwent whole‐brain fMRI while performing a lexical decision task (LDT) featuring high and low‐frequency words, real nonwords, and pseudohomophones. Higher positive schizotypy (Unusual Experiences) was associated with lower cerebellum activity during identification of low‐frequency words (over real nonwords). Higher Boldness (fearless dominance) and Meanness (callous aggression) facets of psychopathy were associated with lower striatal and posterior cingulate activity when identifying nonwords over words. Higher Motor Impulsivity was associated with lower activity in the fusiform (bilaterally), inferior frontal (right‐sided), and temporal gyri (bilaterally) across all stimuli‐types over resting baseline. Positive schizotypy, psychopathy, and impulsivity traits influence word‐nonword recognition through distinct neurocognitive mechanisms. Positive schizotypy and psychopathy appear to influence LDT performance through brain areas that play only a supportive (cerebellum) or indirect role in reading‐related skills. The negative association between Motor Impulsivity and activations typically found for phonological processing and automatic word identification indicates a reduced bilateral integration of the meaning and sound of mental word representations, and inability to select the appropriate outputs, in impulsive individuals.