Jonathan Del-Monte

A further evaluation of decision-making under risk and under ambiguity in schizophrenia.

Abnormal decision-making has been described as a key-concept to understand some behavioral disturbances in schizophrenia. However, whether schizophrenia patients display impairments in profitable decision-making on experimental designs is still controversial (1) to assess performance on decision-making paradigms under ambiguity and under risk conditions in a large sample of schizophrenia patients and (2) to study the impact of clinical variables on decision-making performance in schizophrenia. The Iowa gambling task (IGT) and the game of dice task (GDT) were administered to assess, respectively, decision-making under ambiguity and under risk in 63 schizophrenia patients and 67 healthy controls. In addition, clinical variables (e.g., schizophrenic symptoms, self-reported depression, and impulsivity) were evaluated using appropriate questionnaires the same day. Pharmacological treatments were reported. Schizophrenia patients had impaired performances on both IGT and GDT tasks. No correlation between the decision-making tasks performance and clinical variables was found. Lower gains on the GDT were associated with executive dysfunctioning in schizophrenia. These findings give evidence that schizophrenia patients display impairments in both decision-making under ambiguity and under risk.

Difficulty leading interpersonal coordination: towards an embodied signature of social anxiety disorder

Defined by a persistent fear of embarrassment or negative evaluation while engaged in social interaction or public performance, social anxiety disorder (SAD) is one of the most common psychiatric syndromes. Previous research has made a considerable effort to better understand and assess this mental disorder. However, little attention has been paid to social motor behavior of patients with SAD despite its crucial importance in daily social interactions. Previous research has shown that the coordination of arm, head or postural movements of interacting people can reflect their mental states or feelings such as social connectedness and social motives, suggesting that interpersonal movement coordination may be impaired in patients suffering from SAD. The current study was specifically aimed at determining whether SAD affects the dynamics of social motor coordination. We compared the unintentional and intentional rhythmic coordination of a SAD group (19 patients paired with control participants) with the rhythmic coordination of a control group (19 control pairs) in an interpersonal pendulum coordination task. The results demonstrated that unintentional social motor coordination was preserved with SAD while intentional coordination was impaired. More specifically, intentional coordination became impaired when patients with SAD had to lead the coordination as indicated by poorer (i.e., more variable) coordination. These differences between intentional and unintentional coordination as well as between follower and leader roles reveal an impaired coordination dynamics that is specific to SAD, and thus, opens promising research directions to better understand, assess and treat this mental disorder.

Social motor coordination in unaffected relatives of schizophrenia patients: a potential intermediate phenotype.

Intermediate endophenotypes emerge as an important concept in the study of schizophrenia. Although research on phenotypes mainly investigated cognitive, metabolic or neurophysiological markers so far, some authors also examined the motor behavior anomalies as a potential trait-marker of the disease. However, no research has investigated social motor coordination despite the possible importance of its anomalies in schizophrenia. The aim of this study was thus to determine whether coordination modifications previously demonstrated in schizophrenia are trait-markers that might be associated with the risk for this pathology. Interpersonal motor coordination in 27 unaffected first-degree relatives of schizophrenia patients and 27 healthy controls was assessed using a hand-held pendulum task to examine the presence of interpersonal coordination impairments in individuals at risk for the disorder. Measures of neurologic soft signs, clinical variables and neurocognitive functions were collected to assess the cognitive and clinical correlates of social coordination impairments in at-risk relatives. After controlling for potential confounding variables, unaffected relatives of schizophrenia patients had impaired intentional interpersonal coordination compared to healthy controls while unintentional interpersonal coordination was preserved. More specifically, in intentional coordination, the unaffected relatives of schizophrenia patients exhibited coordination patterns that had greater variability and in which relatives did not lead the coordination. These results show that unaffected relatives of schizophrenia patients, like the patients themselves, also present deficits in intentional interpersonal coordination. For the first time, these results suggest that intentional interpersonal coordination impairments might be a potential motor intermediate endophenotype of schizophrenia opening new perspectives for early diagnosis.

Nonverbal expressive behaviour in schizophrenia and social phobia.

Expressive behaviour plays a crucial role in the success of social interactions. Abnormality of expressive behaviour has been reported in interpersonal interactions of patients suffering from schizophrenia and social phobia, two debilitating mental disorders with important social deficits. However, no study has compared the expressive behaviour in these two disorders. Thirty schizophrenia patients, 21 social phobia patients and 30 healthy controls were evaluated and compared on expressive, cognitive and clinical dimensions. Expressive behaviour was assessed using the Motor Affective subscale of the Motor-Affective-Social-Scale (MASS). Covariables include the Positive and Negative Syndrome Scale (PANSS), the anxiety level Liebowitz-Social-Anxiety-Scale (LSAS) and cognitive tasks. After controlling for depression, schizophrenia and social phobia patients both exhibited significantly fewer expressive behaviours compared to healthy controls. Moreover, our results showed specific signatures: schizophrenia patients performed fewer spontaneous gestures (hand gestures and smiles) whereas social phobia patients had an impaired ability to produce voluntary smiles in comparison to healthy controls. Interestingly, poor social functioning was significantly correlated with a decrease of expressive behaviour for schizophrenia patients. Expressive behaviour is impaired in different ways in social phobia and schizophrenia and is associated in schizophrenia with poorer social functioning. The Motor Affective subscale of the MASS is an interesting tool for assessing the dysfunction of interpersonal expressive behaviour in mental disorders.

Insight is not associated with insensitivity to future consequences in schizophrenia

In this study, we examined the association between insight and decision-making capacity in schizophrenia using the Iowa Gambling Task (IGT). No association was found between insight and IGT scores. Our results suggest that impaired decision-making ability in schizophrenia patients cannot be solely predicted by lack of insight.

Cognitive, Emotional, and Auto-Activation Dimensions of Apathy in Parkinson's Disease

Apathy is one of the most frequent non-motor manifestations in Parkinsons disease (PD) that can lead to a whole range of deleterious outcomes. In 2006, Levy and Dubois proposed a model that distinguishes three different apathy aetiologies in PD divided into three subtypes of disrupted processing: “emotional-affective,” “cognitive,” and “auto-activation.” These three dimensions associated with dopamine depletion present in the pathology would lead to the emergence of apathy in PD. The aim of this mini-review was to describe and discuss studies that have explore links between apathy and the three subtypes of disrupted processing proposed by Levy and Dubois (2006) and as well as the links between these dimensions and dopamine depletion in Parkinsons disease. The lack of consensus regarding the emotional-affective correlates of apathy and the lack of evidence supporting the hypothesis of the auto-activation deficit, do not clearly confirm the validity of Levy and Duboiss model. Furthermore, the suggested association between dopaminergic depletion and apathy must also be clarified.

Social priming increases nonverbal expressive behaviors in schizophrenia

Semantic priming tasks are classically used to influence and implicitly promote target behaviors. Recently, several studies have demonstrated that prosocial semantic priming modulated feelings of social affiliation. The main aim of this study was to determine whether inducing feelings of social affiliation using priming tasks could modulate nonverbal social behaviors in schizophrenia. We used the Scrambled Sentence Task to prime schizophrenia patients according to three priming group conditions: pro-social, non-social or anti-social. Forty-five schizophrenia patients, diagnosed according to DSM-IV-TR, were randomly assigned to one of the three priming groups of 15 participants. We evaluated nonverbal social behaviors using the Motor-Affective subscale of the Motor-Affective-Social-Scale. Results showed that schizophrenia patients with pro-social priming had significantly more nonverbal behaviors than schizophrenia patients with anti-social and non-social priming conditions. Schizophrenia patient behaviors are affected by social priming. Our results have several clinical implications for the rehabilitation of social skills impairments frequently encountered among individuals with schizophrenia.

1283 – Social motor coordinations: a study with schizophrenia and social phobic patients

Introduction Social interactions dysfunctions make up core symptoms of many mental disorders and have been extensively studied through cognitive paradigms gathered under the concept of social cognition. Nevertheless, a growing body of literature have demonstrated that motor coordination is an important feature of these human social interactions but has been little studied in the context of mental diseases. Objective In this study, we propose to compare the processes of inter-agent coordination in healthy and socially impaired clinical populations (e.g. schizophrenia and social phobia patients). Method 20 schizophrenia and 20 social phobia patients were compared to 20 healthy subjects using an hand-held pendulum paradigm in intentional and unintentional interpersonal motor coordination, with different leadership conditions. All participants had psychopathological and neuropsychological evaluations. Results Our results demonstrated that each group of subject was characterised by specific signature concerning interpersonal motor coordination. More specifically, instability of the coordination and temporal delay between patient and controls revealed that schizophrenia impaired intentional coordination but not spontaneous non-intentional coordination whereas social phobia only affected leader conditions. Conclusion Taken altogether, these preliminary results give evidence that motor control through motor coordination behaviours is a fundamental part of social interactions deficits in schizophrenia and social phobia. These results lead us to examine if the evaluation of motor coordination during a social interactions could help to discriminate the deficits in social interactions and to propose specific therapy for their rehabilitation. Acknowledgements This research was supported by an Agence Nationale de la Recherche grant (Project SCAD # ANR-09- BLAN-0405-03).