Melissa Parlar

Theory of mind performance in women with posttraumatic stress disorder related to childhood abuse.

Key questions remain unaddressed concerning the nature of interpersonal functioning in trauma survivors, including the ability to understand and interpret other peoples thoughts and feelings. Here, we investigate theory of mind (ToM) performance of women with PTSD related to childhood abuse in comparison to healthy controls.

Alterations in empathic responding among women with posttraumatic stress disorder associated with childhood trauma

Although studies increasingly point toward problems with social cognition among individuals with posttraumatic stress disorder (PTSD), few studies have assessed empathic responding. The aim of the current study was to investigate empathic responding in women with PTSD related to childhood trauma, and the contribution of parental bonding to empathic abilities in this sample.

Effects of electroconvulsive therapy on cognitive functioning in patients with depression: protocol for a systematic review and meta-analysis.

Introduction Depression is the leading cause of disability worldwide, affecting approximately 350 million people. Evidence indicates that only 60–70% of persons with major depressive disorder who tolerate antidepressants respond to first-line drug treatment; the remainder become treatment resistant. Electroconvulsive therapy (ECT) is considered an effective therapy in persons with treatment-resistant depression. The use of ECT is controversial due to concerns about temporary cognitive impairment in the acute post-treatment period. We will conduct a meta-analysis to examine the effects of ECT on cognition in persons with depression. Methods This systematic review and meta-analysis has been registered with PROSPERO (registration number: CRD42014009100). We developed our methods following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We are searching MEDLINE, PsychINFO, EMBASE, CINAHL and Cochrane from the date of database inception to the end of October 2014. We are also searching the reference lists of published reviews and evidence reports for additional citations. Comparative studies (randomised controlled trials, cohort and case–control) published in English will be included in the meta-analysis. Three clinical neuropsychologists will group the cognitive tests in each included article into a set of mutually exclusive cognitive subdomains. The risk of bias of randomised controlled trials will be assessed using the Jadad scale. We will supplement the Jadad scale with additional questions based on the Cochrane risk of bias tool. The risk of bias of cohort and case–control studies will be assessed using the Newcastle-Ottawa Scale. We will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the strength of evidence. Statistical analysis Separate meta-analyses will be conducted for each ECT treatment modality and cognitive subdomain using Comprehensive Meta-Analysis V.2.0.

Dissociative symptoms are associated with reduced neuropsychological performance in patients with recurrent depression and a history of trauma exposure

Background Although preliminary work suggests that dissociative symptoms may impact neuropsychological performance in trauma-exposed populations, the relation between dissociation and cognitive performance has not been explored in patients with depression. Objective The present study examined dissociative symptoms in relation to neuropsychological performance in participants with a primary diagnosis of recurrent major depressive disorder (MDD) and a history of trauma exposure. Method Twenty-three participants with MDD and 20 healthy controls who did not differ in age, sex, education, or IQ were assessed. In addition to a standardized neuropsychological battery assessing frontotemporally mediated cognitive processes, participants completed clinical measures assessing dissociative symptoms, illness severity, and past history of trauma exposure. Results Among participants with MDD, greater severity of derealization was associated with reduced performance on measures of delayed visuospatial recall and recognition on a task of verbal memory recognition. In addition, more severe depersonalization was associated with slower processing speed and a response style lending itself toward better performance in a less active environment. Conclusions These findings point toward dissociative symptoms as a transdiagnostic factor associated with neuropsychological dysfunction in patients with depression and a history of trauma. Limitations and recommendations for future research are discussed.

The Reporting of Observational Clinical Functional Magnetic Resonance Imaging Studies: A Systematic Review

Introduction Complete reporting assists readers in confirming the methodological rigor and validity of findings and allows replication. The reporting quality of observational functional magnetic resonance imaging (fMRI) studies involving clinical participants is unclear. Objectives We sought to determine the quality of reporting in observational fMRI studies involving clinical participants. Methods We searched OVID MEDLINE for fMRI studies in six leading journals between January 2010 and December 2011.Three independent reviewers abstracted data from articles using an 83-item checklist adapted from the guidelines proposed by Poldrack et al. (Neuroimage 2008; 40: 409–14). We calculated the percentage of articles reporting each item of the checklist and the percentage of reported items per article. Results A random sample of 100 eligible articles was included in the study. Thirty-one items were reported by fewer than 50% of the articles and 13 items were reported by fewer than 20% of the articles. The median percentage of reported items per article was 51% (ranging from 30% to 78%). Although most articles reported statistical methods for within-subject modeling (92%) and for between-subject group modeling (97%), none of the articles reported observed effect sizes for any negative finding (0%). Few articles reported justifications for fixed-effect inferences used for group modeling (3%) and temporal autocorrelations used to account for within-subject variances and correlations (18%). Other under-reported areas included whether and how the task design was optimized for efficiency (22%) and distributions of inter-trial intervals (23%). Conclusions This study indicates that substantial improvement in the reporting of observational clinical fMRI studies is required. Poldrack et al.s guidelines provide a means of improving overall reporting quality. Nonetheless, these guidelines are lengthy and may be at odds with strict word limits for publication; creation of a shortened-version of Poldracks checklist that contains the most relevant items may be useful in this regard.

Neural and behavioural correlates of autobiographical memory retrieval in patients with major depressive disorder and a history of trauma exposure

ABSTRACT Alterations in autobiographical memory (AM) performance have been identified in major depressive disorder (MDD) and in trauma‐related disorders, however, the neural and behavioural correlates of AM retrieval in patients with MDD and a co‐morbid history of trauma remain unexplored. Here, we used behavioural and neuroimaging techniques to investigate AM in this patient group and in matched healthy comparison subjects (HCs). Twenty patients with MDD and trauma exposure and 20 HCs underwent fMRI scanning while recalling positive, negative, and neutral events. Participants were subsequently administered the Autobiographical Interview (Levine et al., 2002), allowing for separation of episodic and non‐episodic details of memories. Key clinical variables, including illness severity, dissociative (e.g., depersonalization, derealization) symptoms, and history of parental bonding, were assessed. Compared to controls, patients showed reduced activation in the left parahippocampus and left anterior insula during retrieval of positive memories. Among patients, greater specificity of positive AM recall on the Autobiographical Interview was related to reduced activation of the left anterior insula during retrieval of positive memories. Moreover, increased left parahippocampal activation during negative memory recall was related to heightened levels of paternal care among the patient group. Taken together, these findings point towards potential alterations in key neural processes (e.g., episodic vividness and embodiment) associated with AM retrieval among MDD patients with a history of co‐morbid trauma exposure. These alterations appear unrelated to illness severity, but instead are associated with parental bonding. HighlightsPatients and controls differ in their neural correlates of positive memory recall.Patients show less activation in the left hippocampus and left anterior insula.Behavioural memory performance is related to neural correlates of memory recall.Neural correlates of memory recall are related to self‐reported paternal care.

Relation between patterns of intrinsic network connectivity, cognitive functioning, and symptom presentation in trauma-exposed patients with major depressive disorder

The present study investigated resting fMRI connectivity within the default mode (DMN), salience (SN), and central executive (CEN) networks in relation to neurocognitive performance and symptom severity in trauma‐exposed patients with major depressive disorder (MDD).

Parental bonding and neuropsychological performance are associated with episodic simulation of future events in trauma-exposed patients with major depressive disorder.

Major depressive disorder (MDD) and trauma‐related disorders are associated with deficits in remembering the past and imagining the future (i.e., episodic simulation). We examined parental bonding and neuropsychological performance in relation to episodic simulation in trauma‐exposed patients with recurrent MDD.

Normal-Range Verbal-Declarative Memory in Schizophrenia.

Objective: Cognitive impairment is prevalent and related to functional outcome in schizophrenia, but a significant minority of the patient population overlaps with healthy controls on many performance measures, including declarative-verbal-memory tasks. In this study, we assessed the validity, clinical, and functional implications of normal-range (NR), verbal-declarative memory in schizophrenia. Method: Performance normality was defined using normative data for 8 basic California Verbal Learning Test (CVLT-II; Delis, Kramer, Kaplan, & Ober, 2000) recall and recognition trials. Schizophrenia patients (n = 155) and healthy control participants (n = 74) were assessed for performance normality, defined as scores within 1 SD of the normative mean on all 8 trials, and assigned to normal- and below-NR memory groups. Results: NR schizophrenia patients (n = 26) and control participants (n = 51) did not differ in general verbal ability, on a reading-based estimate of premorbid ability, across all 8 CVLT-II-score comparisons or in terms of intrusion and false-positive errors and auditory working memory. NR memory patients did not differ from memory-impaired patients (n = 129) in symptom severity, and both patient groups were significantly and similarly disabled in terms of functional status in the community. Conclusion: These results confirm a subpopulation of schizophrenia patients with normal, verbal-declarative-memory performance and no evidence of decline from higher premorbid ability levels. However, NR patients did not experience less severe psychopathology, nor did they show advantage in community adjustment relative to impaired patients.

T89. DEFINING COGNITIVE “NORMALITY” IN SCHIZOPHRENIA: PREVALENCE OF BROAD AND NARROW CRITERIA AND RELATION TO CLINICAL AND FUNCTIONAL STATUS

Abstract Background Cognitive dysfunction is considered a core feature of schizophrenia. Nonetheless, patients with the illness overlap with healthy controls on many tasks, giving rise to the identification of subpopulations with relatively normal cognitive performance. However, the prevalence and implications of these subgroups for understanding schizophrenia are unclear because “normality” criteria vary. Estimates of the frequency of normal range performance in the patient population are as low as 0% and as high as 89%. This study examines the relation between different normality criteria and normality prevalence. It also assesses functional outcome and symptom severity in cognitively normal and impaired subgroups. Methods “Narrow” (IQ) and “broad” (MATRICS Consensus Cognitive Battery; MCCB) cognitive normality criteria were applied to data from schizophrenia (n = 99) and healthy control samples (n = 80). Functional outcome was assessed with the Multidimensional Scale of Independent Functioning (MSIF). The Positive and Negative Syndrome Scale (PANSS) was administered to measure symptom severity. Results Cognitive normality ranged from 13% (broad criterion) to 47% (narrow criterion) among patients. Patients meeting both broad (MCCB) and narrow (IQ) definitions were functionally disadvantaged compared to cognitively normal controls (t(63) = 7.05, p < .01; t(72) = 9.97, p < .01, respectively). However, cognitively normal patients showed no functional (MSIF) advantage relative to cognitively impaired patients based on both broad and narrow definitions of cognitive normality (t(95) = .43, p = .67; t(74) = -1.04, p = .30, respectively). Functioning did not differ between IQ and MCCB based cognitively normal patients (t(51) = .61, p = .55). Moreover, broad and narrow definitions of cognitive normality were not associated with differences in symptom severities relative to cognitively impaired patients. This held true for both positive (t(97) = 1.39, p = .17; t(76) = -.72, p = .47, broad and narrow definitions, respectively) and negative (t(97) = .98, p = .33; t(76) = -1.07, p = .29, broad and narrow definitions, respectively) symptom severity on the PANSS. Discussion Our data show that the prevalence of cognitive performance normality varies widely with the breadth of the normality criterion. However, regardless of the criterion applied, cognitively normal patients remain functionally disadvantaged relative to cognitively normal controls. Perhaps more importantly, however defined, cognitively normal patients demonstrate no advantage in functionality relative to cognitively impaired patients. Thus, patients meeting the broad definition of cognitive normality are not functionally advantaged relative to those meeting the narrow definition. We also found that varying definitions of cognitive normality/impairment have no implications for the severity of psychotic psychopathology in treated outpatients. Overall, the current study suggests that the reported prevalence of cognitive normality in schizophrenia is largely a product of definitional approaches. At the same time, the data cast doubt on the functional importance of preserved and proficient cognition regardless of definition and suggest that cognitive normality does not confer an advantage in terms of reduced symptom severity.