Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis – a secondary analysis of a randomized-controlled therapy trial

Mehl, Stephanie; Hesse, Klaus; Schmidt, Anna-Christine; Landsberg, Martin W.; Soll, Daniel; Bechdolf, Andreas; Herrlich, Jutta; Kircher, Tilo; Klingberg, Stefan; Müller, Bernhard; Wiedemann, Georg; Wittorf, Andreas; Wölwer, Wolfgang; Wagner, Michael

doi:10.1186/s12888-020-2482-z

Cited by 6 publications

(3 citation statements)

References 93 publications

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“…Deficient recognition of angry and neutral faces has been tied to impaired social functioning, difficulty in establishing a therapeutic relationship with a clinician, and illness severity ( 1 , 3 , 17 , 51 – 53 ). Therefore, this training program’s potential to improve recognition of angry and neutral faces could significantly impact the lives of individuals with Parkinson’s disease and individuals who are at risk for schizophrenia, as they both struggle with recognizing angry and neutral faces ( 4 , 10 – 12 , 17 – 21 ).…”

Section: Discussionmentioning

confidence: 99%

Social cognition training improves recognition of distinct facial emotions and decreases misattribution errors in healthy individuals

et al. 2022

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Facial emotion recognition is a key component of social cognition. Impaired facial emotion recognition is tied to poor psychological wellbeing and deficient social functioning. While previous research has demonstrated the potential for social cognition training to improve overall facial emotion recognition, questions remain regarding what aspects of emotion recognition improve. We report results from a randomized controlled trial that evaluates whether computerized social cognition training can improve recognition of distinct facial emotions in healthy participants. This investigation was designed to better understand the therapeutic potential of social cognition training for individuals with neuropsychiatric disorders. Fifty-five healthy adult participants were randomly assigned to an internet-based intervention during which they either completed social cognition training (SCT) or played control computer games (CON) for 10.5 h over 2–3 weeks. Facial emotion recognition was measured with the Penn ER-40, which was conducted before and after training. The following variables were collected and analyzed: facial emotion recognition accuracy for each emotion (i.e., anger, fear, happy, neutral (no emotional expression), and sad), reaction times for each emotion, and response error types (i.e., frequency of an emotion being chosen incorrectly, frequency of an emotion being missed, and frequency of an emotion being confused for another particular emotion). ANOVAs and t-tests were used to elucidate intervention effects both within and between groups. Results showed that the SCT group improved their accuracy for angry and neutral faces. They also improved their reaction times for neutral, fearful, and sad faces. Compared to the CON group, the SCT group had significantly faster reaction times to neutral faces after training. Lastly, the SCT group decreased their tendency to confuse angry faces for no emotional expression and to confuse no emotional expression for sad faces. In contrast, the CON group did not significantly improve their accuracy or reaction times on any emotional expression, and they did not improve their response error types. We conclude that social cognition training can improve recognition of distinct emotions in healthy participants and decrease response error patterns, suggesting it has the potential to improve impaired emotion recognition and social functioning in individuals with facial emotion recognition deficits.

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Section: Discussionmentioning

confidence: 99%

Social cognition training improves recognition of distinct facial emotions and decreases misattribution errors in healthy individuals

et al. 2022

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“…The relationship between nicotinic signaling and schizophrenia is complex, given the number of subunit combinations of this neurotransmitter receptor possibly involved and their distribution within the central nervous system. However, although the involvement of nicotinic signaling in the general cognitive decline in schizophrenia spectrum disorders is clear 57,120,132 , as is its potential to modestly improve cognition, this alone is insufficient to suggest participation of the nicotinic type of neurotransmission in delusions, as there is no consensus on the relationship between cognitive deficits of schizophrenia and the genesis and maintenance of delusional thinking 133,134 . It is also clear that a4β2 receptors are specifically upregulated in the striatum in smokers in general but not at all or at least not to the same degree in smokers with schizophrenia spectrum disorders 135,136 .…”

Section: Ach In Schizophrenia Spectrum Disordersmentioning

confidence: 99%

The role of nicotinic cholinergic neurotransmission in delusional thinking

2020

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Delusions are a difficult-to-treat and intellectually fascinating aspect of many psychiatric illnesses. Although scientific progress on this complex topic has been challenging, some recent advances focus on dysfunction in neural circuits, specifically in those involving dopaminergic and glutamatergic neurotransmission. Here we review the role of cholinergic neurotransmission in delusions, with a focus on nicotinic receptors, which are known to play a part in some illnesses where these symptoms appear, including delirium, schizophrenia spectrum disorders, bipolar disorder, Parkinson, Huntington, and Alzheimer diseases. Beginning with what we know about the emergence of delusions in these illnesses, we advance a hypothesis of cholinergic disturbance in the dorsal striatum where nicotinic receptors are operative. Striosomes are proposed to play a central role in the formation of delusions. This hypothesis is consistent with our current knowledge about the mechanism of action of cholinergic drugs and with our abstract models of basic cognitive mechanisms at the molecular and circuit levels. We conclude by pointing out the need for further research both at the clinical and translational levels.

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“…Impaired emotion perception in schizophrenia has been well-documented. Individuals with schizophrenia have deficits in identifying or discriminating emotions in others from facial expressions ( 1 – 3 ) and tone of the voice ( 4 , 5 ). Furthermore, they have a reduced ability to integrate facial (visual) and vocal (auditory) emotional information.…”

Section: Introductionmentioning

confidence: 99%

Effects of an Audiovisual Emotion Perception Training for Schizophrenia: A Preliminary Study

et al. 2021

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Individuals with schizophrenia show a reduced ability to integrate facial and vocal information in emotion perception. Although emotion perception has been a target for treatment, no study has yet examined the effect of multimodal training on emotion perception in schizophrenia. In the present study, we developed an audiovisual emotion perception training and test in which a voice and a face were simultaneously presented, and subjects were asked to judge whether the emotions of the voice and the face matched. The voices were either angry or happy, and the faces were morphed on a continuum ranging from angry to happy. Sixteen patients with schizophrenia participated in six training sessions and three test sessions (i.e., pre-training, post-training, and generalization). Eighteen healthy controls participated only in pre-training test session. Prior to training, the patients with schizophrenia performed significantly worse than did the controls in the recognition of anger; however, following the training, the patients showed a significant improvement in recognizing anger, which was maintained and generalized to a new set of stimuli. The patients also improved the recognition of happiness following the training, but this effect was not maintained or generalized. These results provide preliminary evidence that a multimodal, audiovisual training may yield improvements in anger perception for patients with schizophrenia.

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Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis – a secondary analysis of a randomized-controlled therapy trial

Cited by 6 publications

References 93 publications

Social cognition training improves recognition of distinct facial emotions and decreases misattribution errors in healthy individuals

Social cognition training improves recognition of distinct facial emotions and decreases misattribution errors in healthy individuals

The role of nicotinic cholinergic neurotransmission in delusional thinking

Effects of an Audiovisual Emotion Perception Training for Schizophrenia: A Preliminary Study

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