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International audience; Recent evidence suggests that people with schizophrenia are at high risk for severe COVID-19 and should be prioritized for vaccination. However, impaired decision-making capacities could negatively affect the uptake of COVID-19 vaccination in this population. Capacity to consent to COVID-19 vaccination was assessed in 80 outpatients with schizophrenia. Using the MacArthur Competence Assessment Tool for Treatment, 56.3% of the sample were classified as having diminished capacity to consent to the vaccination. Diminished capacity to consent to COVID-19 vaccination was associated with lower vaccination rates, poorer cognition and higher level of psychotic symptoms. Developing interventions for enhancing informed consent for vaccination is urgent within this population.

Avolition defined as a lack of interest or engagement in goal-directed behavior plays a key role in everyday functioning in schizophrenia and is considered as one of the main contributors to the burden of disease. The aim of this study was to 1) validate the self-report BIRT Motivation Questionnaire (BMQ-S) seldom used before in schizophrenia 2) examine the degree of agreement between the BMQ-S and its informant-report version 3) to assess its ability to predict real-world outcome at 12 month follow-up.One hundred and twenty-two (51.9% inpatients) adults with a diagnosis of schizophrenia were included. Exploratory Factor analysis was performed on the BMQ-S to identify the underlying structure. Real life functioning was measured with the Global Assessment of Functioning scale (GAF). Convergent validity was assessed with the Scale for Assessment of Negative Symptom (SANS) and the Lille Apathy Rating Scale (LARS).The main psychometric properties of the BMQ-S (internal consistency, test-retest reliability) were satisfactory. Exploratory factorial analysis revealed a 4-factor model which explained 76% of the overall variance. The BMQ-S correlated significantly with the LARS and the SANS avolition subscore suggesting adequate convergent validity. The correlation between the BMQ-S and the clinician-report version was 0.48. The global score and in particular the Initiation/disorganisation dimension was a significant predictor of global functioning at 12-months even when adjusted for age, chlorpromazine intake and depression.Our findings indicate that the BMQ-S has satisfactory psychometric properties and that schizophrenia patients can reliably assess their lack of motivation. Self-evaluation of avolition should be considered in the overall prediction of real-world functioning in schizophrenia.

Background Obsessive-compulsive disorder (OCD) has long been considered as an anxiety disorder, disgust is the dominant emotion in contamination-based OCD. However, disgust seems resistant to exposure with response prevention partly due to the fact that disgust is acquired through evaluative conditioning. Aims The present research investigates a counter-conditioning intervention in treating disgust-related emotional responses in two groups of individuals with high (High contamination concerns, HCC, n = 24) and low (Low contamination concerns LCC, n = 23) contamination concerns. Methods The two groups completed a differential associative learning task in which neutral images were followed by disgusting images (conditioned stimulus; CS+), or not (CS-). Following this acquisition phase, there was a counter-conditioning procedure in which CS+ was followed by a very pleasant unconditional stimulus while CS- remained unreinforced. Results Following counter-conditioning, both groups reported significant reduction in their expectancy of US occurrence and reported less disgust with CS+. For both expectancy and disgust, reduction was lower in the HCC group than in the LCC group. Disgust sensitivity was highly correlated with both acquisition and maintenance of the response acquired, while US expectation was predicted by anxiety. Conclusion Counter-conditioning procedure reduces both expectations and conditioned disgust.

Purpose Beyond the effects of the coronavirus pandemic on the public's health, the length of lockdown and its possible psychological impacts on populations is heavily debated. However, the consequences of lockdown on psychotic symptoms have been poorly investigated. Methods An online survey was run from April 13 to May 11, 2020; a total of 728 French subjects from the general population were included in the study. We assessed the perceived impact of the COVID-19 outbreak, length of isolation, diagnosis/symptoms/hospitalisation related to the COVID-19 (oneself and family). Paranoid ideations and hallucination-like experiences were assessed via the Paranoia Scale and the Cardiff Anomalous Perceptions Scale, respectively. Self-reported measures of negative affect, loneliness, sleep difficulties, jumping to conclusion bias, repetitive thoughts, among others, were also included. Results Final regression model for paranoia indicated that socio-demographic variables (age, sex and education), loneliness, cognitive bias, anxiety, experiential avoidance, repetitive thoughts and hallucinations were associated with paranoia (R2 = 0.43). For hallucinations, clinical variables as well as the quality of sleep, behavioural activation, repetitive thoughts, anxiety and paranoia were associated with hallucinations in our sample (R2 = 0.27). Neither length of isolation nor the perceived impact of the COVID-19 pandemic were associated with psychotic experiences in the final models. Conclusions No evidence was found for the impact of isolation on psychotic symptoms in the general population in France one month after the lockdown. It nevertheless confirms the preeminent role of several factors previously described in the maintenance and development of psychotic symptoms in the context of a pandemic and lockdown measures.

Background Fatigue is a well-known common clinical feature of numerous chronic diseases including various forms of cancer, neurological disorders such as multiple sclerosis, and psychiatric disorders. A significant proportion of people with schizophrenia (30–60%) reportedly experience fatigue, which impacts negatively on participation in various activities, including work, study, leisure, and social pursuits. Causes of fatigue in schizophrenia are poorly understood and there are no established treatments. Several evidence-based interventions for fatigue syndrome including psychoeducation, cognitive behavioral therapy, and graded exercise therapy have been shown to be effective in other medical conditions and could be adapted to address fatigue in schizophrenia patients. As there are no psychosocial or pharmacological interventions with proved efficacy for fatigue in schizophrenia, there is an urgent need for the development of strategies to improve fatigue management in schizophrenia. The aim of this project is to evaluate in a single blind randomized clinical trial the efficacy of a cognitive-behavioral therapy (CBT) intervention compared to treatment as usual (TAU) on fatigue as the main outcome in schizophrenia patients. Clinical symptoms, physical functioning, major cognitive functions, quality of life and functioning, treatment dosage, daily motor activity, biological markers with inflammatory markers are also considered as secondary outcomes. Methods/design Two hundred patients meeting the inclusion criteria will be randomized to either of the study arms (intervention or TAU). The ENERGY intervention will be delivered according to a standardized treatment manual comprising six modules addressing fatigue and sleep over 14 individual therapy sessions. The treatment encompasses core CBT principles of psycho-education, behavioral activation, behavioral experiments, cognitive restructuring, problem-solving, and relapse prevention. Sessions will follow the traditional CBT structure of agenda setting, review of homework tasks, and introduction of a new concept/technique with collaborative discussions on how to implement such strategies in the participant’s day-to-day environment. Our primary endpoint will be the severity of fatigue assessed at baseline and at the 9-month follow-up using the “Multidimensional Fatigue Inventory” (MFI). Discussion The trial will provide the first test of CBT intervention for fatigue for patients with schizophrenia. This study will also test to what extent the treatment can be implemented in everyday practice. Trial registration ClinicalTrials.govNCT04332601. Registered on 10 April 2020.

Introduction: To explain motivational difficulties in schizophrenia (SZ), attention has focused on the reward system and effort-based decision-making deficits. However, according to motivational in...

The concept of "Self-Defining Future Projections" (SDFPs) has been recently introduced to better explore the link between future thinking and identity. To date, SDFPs have only been examined in young adults and it remains unknown how self-defining future thoughts evolve in aging. In this cross-sectional study, 43 young adults (age range = 19-28; mean age = 23.06) and 43 older adults (age range 60-80; mean age = 69.46) were asked to generate three SDFPs. Our results indicated that SDFPs were less specific in older adults compared to young adults, but there was no difference between the two groups concerning autobiographical reasoning. However, regarding subjective experience, older adults rated imagined future events as containing more sensory details and contextual information and reported a higher feeling of pre-experiencing the personal future. Additionally, older participants described future events that were more positive and less distant in the future, with fewer narratives about future achievements but more narratives describing leisure time, with a similar probability between the two groups that the event will occur in the future. Our study extends previous aging research and adds to the literature by better understanding how future event representations are formed in older adults.

International audience; Objective: Apathy, defined as reduced goal-directed behavior, is a frequent symptom in mental and neurological disorders but has been poorly studied in individuals with obsessive-compulsive disorder (OCD). The primary aim of this study was to examine levels of apathy between individuals with OCD, healthy control subjects, and individuals with schizophrenia, a mental disorder with high levels of apathy. The second aim was to assess whether the psychological factors that have been previously shown as underlying apathy in other mental disorders were associated with apathy in patients with OCD.Methods: This exploratory study included 25 individuals with OCD, 24 individuals with schizophrenia, and 24 healthy control subjects. Apathy was assessed using the Lille Apathy Rating Scale. Measures of depression, sensibility to punishment and reward, defeatist performance beliefs, and cognitive functioning were also assessed.Results: Individuals diagnosed with OCD and schizophrenia scored significantly higher than healthy control subjects on the apathy total score. Levels of apathy among OCD patients were mainly associated with depression but also dysexecutive functioning and defeatist beliefs.Conclusions: These findings suggest that motivational deficits could play a central role in disability caused by OCD. Similar to other mental disorders, various psychological factors, including depression, defeatist beliefs, and dysexecutive functioning, are involved in apathetic manifestations. However, the fact that depression is the variable most associated with apathy indicates that apathetic symptoms in patients with OCD must be considered mainly as secondary rather than primary symptoms.

Cognitive models of psychopathology were applied to inform the relationships between paranoid cognitions, perceptions of workplace bullying, and intentions of workplace deviance in UK and French teachers. Sixty-six UK teachers and 50 French teachers were asked to fill in an online survey comprised of the Green Paranoia Thought Scales, Negative Acts Questionnaire, Depression, Anxiety and Stress scales, and Workplace Deviance Scale. The variables in this study were conceptualized as cognitions and not as facts because the study used self-report questionnaires of paranoid ideation, workplace bullying, and workplace deviance. Mann-Whitney tests showed that UK teachers report significantly more perceptions of work-related bullying and intentions of workplace deviance than French teachers. However, there was no statistically significant difference between UK and French teachers for the report of paranoid ideation. Mediation analyses showed that paranoia impacted on intentions of workplace deviance but perceptions of workplace bullying and negative affect did not mediate this association in UK and French teachers. Culturally tailored psycho-social interventions should be implemented targeting teachers' paranoid thinking and workplace bullying in order to deter teachers from engaging in workplace deviance and to promote their well-being.

International audience; Most individuals with schizophrenia will be confronted with some form of stigma. In recent years, clinicians and family members have increasingly contested the term "schizophrenia". Many of them discuss changing this name, as a means to fight stigma. Up until now, surprisingly, most research has been conducted using self-reports and behavioral research is lacking. The aim of our study was to assess through an experimental design if the term "schizophrenia" itself modifies social behaviours. Forty participants were asked to engage in a synchronization task with a dot displayed on a screen and moved by another person. Non-clinicians participants had to synchronize their movements as accurately as possible with either a "schizophrenia" patient, a patient with "neuro-emotional integration disorder" or a "healthy" subject, kept out of sight. Each condition was counterbalanced between participants. In fact, the movements of the dot were pre-recorded (five trajectories) and were therefore identical for all three conditions. Measuring the error between the displayed and performed trajectories, participants exhibited more errors when they thought they were interacting with a patient in comparison to the "healthy" subject. Post-hoc analysis revealed an even higher difference between "schizophrenia" and "healthy" conditions. Altogether, our results show a significant behavioral impact of the term "schizophrenia" with possibly negative consequences on social interactions. The effect of changing the name reduces this impact but remains unclear.

In a break with categorical and dimensional approaches and thus the classical medical model, the network approach applied to psychopathology constitutes a holistic approach to mental disorders. In this approach, mental disorders are conceived as an interconnected system of symptoms in which symptoms are the cause of each other. It is suggested that the interaction between the different symptoms would result in a feedback loop that leads to the installation and maintenance of these symptoms/disorders. In addition, this approach proposes that co-morbidities are the result of symptom-symptom interactions that cross the diagnostic boundary and interact with symptoms from other psychiatric disorders. A growing number of studies have applied the network approach to elucidate causal interactions within the symptoms of depression, post-traumatic stress disorder, schizophrenia, or anxiety disorders. The overall objective of this review is to raise awareness among researchers and clinicians in psychiatry and clinical psychology of the network approach applied to psychopathology. To do this, we present the main concepts and principles of the network approach and its application in post-traumatic stress disorder. We also discuss recent criticisms of this approach and its clinical applications.

This study examined the relationship between abusive supervision and non-clinical paranoia and explored which cognitive mechanisms are mediating this association (i.e. rumination, cognitive avoidance and negative affect). A sample of two hundred and five French-speaking workers currently in employment in France was recruited to fill in a battery of online questionnaires comprising of the French adaptations of the Abusive Supervision Scale, the State Social Paranoia Scales, the Depression and Anxiety and Stress Scales, the Cognitive Avoidance Questionnaire and the Mini-Cambridge Exeter Repetitive Thought Scale. Mediation analyses showed that the experience of supervisory abuse directly influences state paranoia, however, there were significant mediation effects. Abusive supervision impacted on cognitive avoidance that led to more rumination, which in its turn increased negative affect and this increased state paranoia. Rumination impacted on state paranoia but through the effect of negative affect only. This study showed that abusive supervision works together with cognitive and affective factors to impact on non-clinical paranoia. It is recommended that Cognitive and Behavioural therapy (CBT) is tailored to help workers to cope with experiences of supervisory abuse and associated paranoid thoughts by focusing on replacing rumination and cognitive avoidance strategies for more adaptive cognitive strategies and on how to manage depression.

Resume Les symptomes negatifs tels que l’apathie, l’anhedonie ou l’emoussement des affects ont des effets deleteres sur la qualite de vie et le devenir fonctionnel de l’individu. Aucun traitement, qu’il soit pharmacologique, via les techniques de stimulations transcrâniennes, ou psychologique, n’a clairement demontre une efficacite quant a leur prise en charge. Toutefois, des donnees recentes suggerent que certaines approches cognitivo-comportementales pourraient avoir des effets positifs dans l’amelioration des symptomes negatifs. L’objectif de cet article est de presenter ces prises en charge, en detaillant les modeles theoriques sous-jacents ainsi que les preuves empiriques mettant en evidence leur efficacite. Ces interventions seront presentees selon differents axes de prise en charge : cognitif, comportemental, emotionnel et motivationnel. Bien que les traitements TCC soient prometteurs pour le traitement des symptomes negatifs, certaines limitations existent, notamment concernant la conceptualisation et la prise en compte de la complexite des differents symptomes negatifs, ainsi que le manque de modeles psychologiques integratifs proposes dans la litterature. Comme recommandation clinique, il nous apparait important de souligner qu’une formulation psychologique fonctionnelle de chaque symptome negatif est necessaire avant toute prise en charge, afin de determiner l’influence et les interactions entre les differents facteurs psychologiques, biologiques et environnementaux a l’œuvre. Nous fournirons dans cet article un exemple et un modele d’analyse fonctionnelle des symptomes negatifs. Par ailleurs, une approche integrative et individualisee, melant rehabilitation neuropsychologique, habiletes sociales et therapie cognitive, nous semble etre particulierement prometteuse pour la prise en charge des symptomes negatifs dans la schizophrenie.

Synchronization of behavior such as gestures or postures is assumed to serve crucial functions in social interaction but has been poorly studied to date in schizophrenia. Using a virtual collaborative environment (VCS), we tested 1) whether synchronization of behavior, i.e., the spontaneous initiation of gestures that are congruent with those of an interaction partner, was impaired in individuals with schizophrenia compared with healthy participants; 2) whether mimicry of the patients’ body movements by the virtual interaction partner was associated with increased behavioral synchronization and rapport. 19 patients and 19 matched controls interacted with a virtual agent who either mimicked their head and torso movements with a delay varying randomly between 0.5 s and 4 s or did not mimic, and rated feelings of rapport toward the virtual agent after each condition. Both groups exhibited a higher and similar synchronization behavior of the virtual agent forearm movements when they were in the Mimicry condition rather than in the No-mimicry condition. In addition, both groups felt more comfortable with a mimicking virtual agent rather than a virtual agent not mimicking them suggesting that mimicry is able to increase rapport in individuals with schizophrenia. Our results suggest that schizophrenia cannot be considered anymore as a disorder of imitation, particularly as regards behavioral synchronization processes in social interaction contexts.

International audience; Despite the increasing number of researchers interested in self-face, so far, no study has summarized the behavioral findings that contribute to the debate on self-face advantage. Most studies have focused on neural correlates of the self, although functional uniqueness can also be considered an important criterion for determining whether a stimulus is unique. The present meta-analysis systematically compared reaction time (RT) responses for self-face with other face identities across 54 studies. Different moderator factors were tested: familiarity, identity, head angle, laterality, and culture. We used a three-level meta-analytic approach, which is the best approach to account for the dependency of effect sizes. Results showed a significant (Hedges’s gav = −0.298) effect size, indicating faster RT for self-face than for other faces in general. Except for culture, none of the moderators employed significantly impacted on the main effect. Regarding culture, results showed that participants from Western cultures tend to respond faster to their own face than to other people’s faces, while for participants from Eastern cultures, the effect was not significant. In summary, our results indicate that the self-face benefits from an advantage in terms of reaction time and may be considered a unique stimulus. Implications and limitations of the results are discussed.

Recent research has supported the mediating role of dissociation in the relationship between childhood trauma (CT) and voice hearing in clinical and nonclinical populations. However, this mediating role has not yet been explored with regard to seeing visions (visual hallucinations). This study aimed to explore the mediating effect of dissociation on the relationship between CT and seeing visions. In total, 425 voluntary participants recruited from the general population completed an online survey evaluating CT, dissociative experiences, and the experience of hearing voices and seeing things. The findings showed that defensive dissociation mediated the association between CT and the experience of seeing visions. A similar model in terms of pathways and the model's predictive accuracy was found for hearing voices. Therefore, seeing visions may partly reflect dissociated traumatic events intruding into consciousness. Trauma-based interventions for seeing visions may be beneficial in improving distress associated with these experiences.

International audience; Self-face recognition is crucial for sense of identity and for maintaining a coherent sense of self. Most of our daily life experiences with the image of our own face happen when we look at ourselves in the mirror. However, to date, mirror self-perception in schizophrenia has received little attention despite evidence that face recognition deficits and self abnormalities have been described in schizophrenia. Thus, this study aims to investigate mirror self-face perception in schizophrenia patients and its correlation with clinical symptoms. Twenty-four schizophrenia patients and twenty-five healthy controls were explicitly requested to describe their image in detail during 2min whilst looking at themselves in a mirror. Then, they were asked to report whether they experienced any self-face recognition difficulties. Results showed that schizophrenia patients reported more feelings of strangeness towards their face compared to healthy controls (U=209.5, p=0.048, r=0.28), but no statistically significant differences were found regarding misidentification (p=0.111) and failures in recognition (p=0.081). Symptoms such as hallucinations, somatic concerns and depression were also associated with self-face perception abnormalities (all p-values>0.05). Feelings of strangeness toward one's own face in schizophrenia might be part of a familiar face perception deficit or a more global self-disturbance, which is characterized by a loss of self-other boundaries and has been associated with abnormal body experiences and first rank symptoms. Regarding this last hypothesis, multisensorial integration might have an impact on the way patients perceive themselves since it has an important role in mirror self-perception.

International audience; The relationships between the valence (positive or negative) of future imagined events and personality dimensions were examined in patients with schizophrenia. Correlational analyses showed that Extraversion was positively associated with the simulation of more positive future events whereas a statistical trend between Neuroticism and negative emotional valence was found. As in nonclinical individuals, personality is related to characteristics of mental time travel in schizophrenia patients.

International audience; Destination memory refers to the ability to remember to whom a piece of information was previously transmitted. Our paper assessed this ability in schizophrenia. Twenty-five patients with schizophrenia and 25 control participants told proverbs (e.g., "send a thief to catch a thief") to pictures of celebrities (e.g., Elvis Presley). Afterward, participants had to indicate to which celebrity they had previously said the proverbs. Participants also completed a binding task in which they were required to associate letters with their corresponding context (i.e., location). Analysis revealed worse destination memory and binding in patients with schizophrenia than in controls. In both populations, destination memory was significantly correlated with performances on the binding task. Our findings suggest difficulty in the ability to attribute information to its appropriate destination in schizophrenia. This difficulty may be related to compromise in binding separate cues together to form a coherent representation of an event in memory.

We present novel, low-cost and non-invasive potential diagnostic biomarkers of schizophrenia. They are based on the ‘mirror-game’, a coordination task in which two partners are asked to mimic each other’s hand movements. In particular, we use the patient’s solo movement, recorded in the absence of a partner, and motion recorded during interaction with an artificial agent, a computer avatar or a humanoid robot. In order to discriminate between the patients and controls, we employ statistical learning techniques, which we apply to nonverbal synchrony and neuromotor features derived from the participants’ movement data. The proposed classifier has 93% accuracy and 100% specificity. Our results provide evidence that statistical learning techniques, nonverbal movement coordination and neuromotor characteristics could form the foundation of decision support tools aiding clinicians in cases of diagnostic uncertainty., Mirror game test could detect schizophrenia A new test of movement and social interaction could detect markers of schizophrenia, and help to diagnose and manage the condition. In an effort to establish reliable indicators of schizophrenia, Piotr Slowinski at the University of Exeter, UK and colleagues developed a test that could detect deficits in movement and social interactions, both characteristics of the disorder. They asked people to perform movements alone, and to mirror the movements of a computer avatar or a humanoid robot. Automated analysis of the movements allowed to distinguish people with schizophrenia from healthy participants with accuracy and specificity slightly better than clinical interviews and comparable to test based on much more expensive neuroimaging methods. The technique could help with diagnosis of schizophrenia and to monitor patients’ responses to treatment, but needs to be tested in clinical trials before being applied in clincal practice.

Background Recent studies suggest that parents' awareness of their offspring's schizophrenia could influence their offspring's insight. Low patient insight is linked to impairment of specific cognitive abilities, and biological parents of schizophrenia patients have impaired capacities in these same domains. However, little is known about what specific socio-demographic, affective or cognitive factors may influence biological parents' awareness of their offspring's disease. Method Data were drawn from 41 patient–parent dyads. Insight was assessed with a modified version of Amador's Scale to assess Unawareness of Mental Disorders, exploring dimensions of parents' awareness and attribution of their offspring's illness and symptoms. Results Higher educational levels, better working memory and executive functioning of parents were associated with better attribution of their offspring's symptoms to schizophrenia. Conclusions Parents' insight into their offspring's schizophrenia is associated with cognitive abilities. This must be taken into account when developing family interventions.

International audience; Objective We previously developed normative data for a French version of the Hayling Sentence Completion Test (f-HSCT) for adults and elderly people. The present study aimed to evaluate the clinical utility of the f-HSCT norms in two clinical populations in which inhibition dysfunction has been largely documented, i.e., Parkinson's disease (PD) and schizophrenia. Method Eighty-five non-demented patients with idiopathic PD and 64 out-patients with schizophrenia completed the automatic and inhibition conditions of the f-HSCT. Time latencies and errors raw data of each patient were compared to the norms previously developed by the authors. Results In the automatic condition, errors were rare in both clinical groups and time latencies on this condition felt within the normative data range. Compared with the standardized norms, 46% of patients with PD and 61% of patients with schizophrenia had a deviant performance (i.e., borderline or deficit) for the inhibition error score. The proportion of patients with a deviant performance on the inhibition response time score was similar in both clinical samples (respectively, 25% and 23%). Finally, slightly more than half of patients with PD and more than two-thirds of patients with schizophrenia had a deviant performance on at least one of the f-HSCT inhibition measures. Conclusions Our results suggest that the f-HSCT has a strong potential for characterizing inhibition of prepotent responses in PD and schizophrenia. Furthermore, it requires only a short administration time so it may be ideal to detect response inhibition in clinical populations with cognitive fatigue.

International audience; The ability to project oneself into the future contributes to development and maintenance of a coherent sense of identity. If recent research has revealed that schizophrenia is associated with difficulties envisioning the future, little is known about patients' future self-representations. In this study, 27 participants with schizophrenia and 26 healthy controls were asked to simulate mental representations of plausible and highly significant future events (self-defining future projections, SDFPs) that they anticipate to happen in their personal future. Main results showed that schizophrenia patients had difficulties in reflecting on the broader meaning and implications of imagined future events. In addition, and contrary to our hypothesis, a large majority of SDFPs in schizophrenia patients were positive events, including achievements, relationship, and leisure contents. Interestingly, patients and controls did not differ on the perceived probability that these events will occur in the future. Our results suggest that schizophrenia patients have an exaggerated positive perception of their future selves. Together, these findings lend support to the idea that past and future self-defining representations have both similar and distinct characteristics in schizophrenia.

International audience; Apathy defined as a mental state characterized by a lack of goal-directed behavior is prevalent and associated with poor functioning in older adults. The main objective of this study was to identify factors contributing to the distinct dimensions of apathy (cognitive, emotional, and behavioral) in older adults without dementia. One hundred and fifty participants (mean age, 80.42) completed self-rated questionnaires assessing apathy, emotional distress, anticipatory pleasure, motivational systems, physical functioning, quality of life, and cognitive functioning. Data were analyzed using partial least squares variance-based structural equation modeling in order to examine factors contributing to the three different dimensions of apathy in our sample. Overall, the different facets of apathy were associated with cognitive functioning, anticipatory pleasure, sensitivity to reward, and physical functioning, but the contribution of these different factors to the three dimensions of apathy differed significantly. More specifically, the impact of anticipatory pleasure and physical functioning was stronger for the cognitive than for emotional apathy. Conversely, the impact of sensibility to reward, although small, was slightly stronger on emotional apathy. Regarding behavioral apathy, again we found similar latent variables except for the cognitive functioning whose impact was not statistically significant. Our results highlight the need to take into account various mechanisms involved in the different facets of apathy in older adults without dementia, including not only cognitive factors but also motivational variables and aspects related to physical disability. Clinical implications are discussed.

International audience; Apathy, described as impaired motivation and goal-directed behavior, is ă a common yet often overlooked multidimensional psychopathological state ă in schizophrenia. Its underlying cognitive processes remain largely ă unexplored. Data was drawn from a longitudinal hospital study of ă patients with a DSM-IV diagnosis of schizophrenia; 137 (82.5%) ă participated at the 1-month follow-up and 81 (59.1%) at the 1-year ă follow-up. Apathy was assessed with the Lille Apathy Rating Scale, ă validated in French and in schizophrenia. Severe apathy, overall (total ă score > -13) and on 4 previously identified distinct dimensions, was ă considered. Episodic verbal learning was assessed with the California ă Verbal Learning Test, executive functioning with the Trail Making Test, ă the Six Element Test and the Stop Signal Paradigm and working memory ă with the Letter-Number Sequencing Test. After controlling for ă confounding variables, only episodic verbal learning was associated with ă severe overall apathy in the cross-sectional study. At 1 year, working ă memory was associated with an increased risk of severe overall apathy, ă adjusting for baseline apathy. Using a dimensional approach to apathy, ă specific types of cognition were found to be associated with specific ă dimensions of apathy. Our findings confirm the need for a ă multidimensional approach of negative symptoms in schizophrenia. ă Moreover, cognitive functioning could be a risk factor for developing ă severe apathy. Cognitive remediation may thus be a useful ă non-pharmacological intervention for treating apathy in schizophrenia ă patients.

International audience; BACKGROUND: The use of humanoid robots to play a therapeutic role in helping individuals with social disorders such as autism is a newly emerging field, but remains unexplored in schizophrenia. As the ability for robots to convey emotion appear of fundamental importance for human-robot interactions, we aimed to evaluate how schizophrenia patients recognize positive and negative facial emotions displayed by a humanoid robot.METHODS: We included 21 schizophrenia outpatients and 17 healthy participants. In a reaction time task, they were shown photographs of human faces and of a humanoid robot (iCub) expressing either positive or negative emotions, as well as a non-social stimulus. Patients' symptomatology, mind perception, reaction time and number of correct answers were evaluated.RESULTS: Results indicated that patients and controls recognized better and faster the emotional valence of facial expressions expressed by humans than by the robot. Participants were faster when responding to positive compared to negative human faces and inversely were faster for negative compared to positive robot faces. Importantly, participants performed worse when they perceived iCub as being capable of experiencing things (experience subscale of the mind perception questionnaire). In schizophrenia patients, negative correlations emerged between negative symptoms and both robot's and human's negative face accuracy.CONCLUSIONS: Individuals do not respond similarly to human facial emotion and to non-anthropomorphic emotional signals. Humanoid robots have the potential to convey emotions to patients with schizophrenia, but their appearance seems of major importance for human-robot interactions.

Background:Research suggests that exposure to music may enhance autobiographical recall in Alzheimer's Disease (AD) patients. This study investigated whether exposure to music could enhance the production of self-defining memories, that is, memories that contribute to self-discovery, self-understanding, and identity in AD patients.Methods:Twenty-two mild-stage AD patients and 24 healthy controls were asked to produce autobiographical memories in silence, while listening to researcher-chosen music, and to their own-chosen music.Results:AD patients showed better autobiographical recall when listening to their own-chosen music than to researcher-chosen music or than in silence. More precisely, they produced more self-defining memories during exposure to their own-chosen music than to researcher-chosen music or during silence. Additionally, AD patients produced more self-defining memories than autobiographical episodes or personal-semantics during exposure to their own-chosen music. This pattern contrasted with the poor production of self-defining memories during silence or during exposure to researcher-chosen music. Healthy controls did not seem to enjoy the same autobiographical benefits nor the same self-defining memory enhancement in the self-chosen music condition.Conclusions:Poor production of self-defining memories, as observed in AD, may somehow be alleviated by exposure to self-chosen music.

International audience; INTRODUCTION: Although delusions and hallucinations are relatively common symptoms in individuals with Alzheimer's disease (AD), very little is known regarding underlying mechanisms. We examined whether these manifestations could be underpinned by psychological distress and executive impairments. METHODS: Thirty-one participants with probable mild AD and 33 healthy older adults were administered a neuropsychological and clinical battery assessing delusions, hallucinations, anxiety, depression, episodic memory and executive functions (shifting, updating and inhibition). RESULTS: Prevalence of delusions and hallucinations were significantly higher in AD participants compared to control participants. Further, hallucinations in AD participants were significantly correlated with poor inhibition, with the latter uniquely predicting the former, as compared to other variables. In addition, hallucinations in AD participants were associated with depression, a relationship that was further mediated by inhibition. CONCLUSION: Hallucinations in individuals with AD seem to be related to difficulties suppressing irrelevant thoughts, resulting in these irrelevant thoughts becoming confused with ongoing reality.

International audience; What leads healthy individuals to abnormal feelings of contact with schizophrenia patients remains obscure. Despite recent findings that human bonding is an interactive process influenced by coordination dynamics, the spatiotemporal organization of the bodily movements of schizophrenia patients when interacting with other people is poorly understood. Interpersonal motor coordination between dyads of patients (n = 45) or healthy controls (n = 45), and synchronization partners (n = 90), was assessed with a hand-held pendulum task following implicit exposure to pro-social, non-social, or anti-social primes. We evaluated the socio-motor competence and the feeling of connectedness between participants and their synchronization partners with a measure of motor coordination stability. Immediately after the coordination task, all participants were also asked to rate the likeableness of their interacting partner. Our results showed greater stability during interpersonal synchrony in schizophrenia patients who received pro-social priming, inducing in their synchronization partner greater feelings of connectedness towards patients. This greater feeling of connectedness was positively correlated with stronger motor synchronization between participants suggesting that motor coordination partly underlies patients' social interactions and feelings of contact with others. Pro-social priming can have a pervasive effect on abnormal social interactions in schizophrenia patients.

Article disponible en ligne à l'adresse : http://www.tandfonline.com/doi/full/10.1080/09658211.2015.1021257; International audience; Destination memory is the ability to remember the destination to which a piece of information has been addressed (e.g., “Did I tell you about the promotion?”). This ability is found to be impaired in normal ageing. Our work aimed to link this deterioration to the decline in theory of mind. Forty younger adults (M age = 23.13 years, SD = 4.00) and 36 older adults (M age = 69.53 years, SD = 8.93) performed a destination memory task. They also performed the False-belief test addressing cognitive theory of mind and the Reading the mind in the eyes test addressing affective theory of mind. Results showed significant deterioration in destination memory, cognitive theory of mind and affective theory of mind in the older adults. The older adults’ performance on destination memory was significantly correlated with and predicted by their performance on cognitive theory of mind. Difficulties in the ability to interpret and predict others’ mental states are related to destination memory decline in older adults.

International audience

International audience; Face perception depends both on the face and on the individual who perceives it. Some factors such as gender, ethnicity or age may influence face perception processing. For instance, recognition memory for faces of one's own age group is often superior to memory for other-age group faces. This bias is known as the Own-Age-Bias (OAB). OAB has been extensively studied in healthy subjects. However, to our knowledge, no article has been published on elder adults suffering from Alzheimer Disease (AD). Therefore, the present research aimed at studying the OAB in patients with AD in comparison with healthy old adults and healthy young adults. Sixty participants were included: 20 young adults, 20 healthy old adults, and 20 elder patients who met NINCDS-ADRDA criteria for probable AD. Participants performed an age estimation task followed by a face recognition task. Indeed, for each photograph, subjects were asked to say if the face looked young or old and to give a yes/no judgment of familiarity (after an encoding phase). Participants also completed a questionnaire assessing their frequency of contact with young and old adults. Although estimates of sensitivity indicated no age bias in AD patients, when memory bias was corrected according to their performance we found evidence in favor of an OAB in this group. Both healthy groups presented an OAB, in particular when the corrected memory bias was considered. However, no significant correlations were found between their frequency of contact with young/older people and the number of correctly identified faces, false alarms, sensitivity and corrected memory bias. Therefore, although AD patients present a deficit in face-memory, they still present memory bias towards same-age group faces when their difficulties in face memory are controlled.

Aricle disponible en ligne à l'adresse : http://www.nature.com/articles/srep08156; International audience; What leads healthy individuals to abnormal feelings of contact with schizophrenia patients remains obscure. Despite recent findings that human bonding is an interactive process influenced by coordination dynamics, the spatiotemporal organization of the bodily movements of schizophrenia patients when interacting with other people is poorly understood. Interpersonal motor coordination between dyads of patients (n = 45) or healthy controls (n = 45), and synchronization partners (n = 90), was assessed with a hand-held pendulum task following implicit exposure to pro-social, non-social, or anti-social primes. We evaluated the socio-motor competence and the feeling of connectedness between participants and their synchronization partners with a measure of motor coordination stability. Immediately after the coordination task, all participants were also asked to rate the likeableness of their interacting partner. Our results showed greater stability during interpersonal synchrony in schizophrenia patients who received pro-social priming, inducing in their synchronization partner greater feelings of connectedness towards patients. This greater feeling of connectedness was positively correlated with stronger motor synchronization between participants suggesting that motor coordination partly underlies patients' social interactions and feelings of contact with others. Pro-social priming can have a pervasive effect on abnormal social interactions in schizophrenia patients.

International audience; Facial emotion processing has been extensively studied in schizophrenia patients while general face processing has received less attention. The already published reviews do not address the current scientific literature in a complete manner. Therefore, here we tried to answer some questions that remain to be clarified, particularly: are the non-emotional aspects of facial processing in fact impaired in schizophrenia patients? At the behavioral level, our key conclusions are that visual perception deficit in schizophrenia patients: are not specific to faces; are most often present when the cognitive (e.g. attention) and perceptual demands of the tasks are important; and seems to worsen with the illness chronification. Although, currently evidence suggests impaired second order configural processing, more studies are necessary to determine whether or not holistic processing is impaired in schizophrenia patients. Neural and neurophysiological evidence suggests impaired earlier levels of visual processing, which might involve the deficits in interaction of the magnocellular and parvocellular pathways impacting on further processing. These deficits seem to be present even before the disorder out-set. Although evidence suggests that this deficit may be not specific to faces, further evidence on this question is necessary, in particularly more ecological studies including context and body processing.

Resume L’apathie est presente lors des differentes phases de la schizophrenie. Ses consequences sur le fonctionnement global des patients sont importantes. Actuellement, la definition de l’apathie dans la schizophrenie est encore sujette a de nombreuses questions et notamment celle de son amalgame avec d’autres symptomes tels que l’avolition, l’apragmatisme, ou l’athymhormie. En effet, dans la litterature, certains auteurs decrivent les patients apathiques en utilisant le terme d’avolition ou d’apragmatisme. Mais l’apathie est un syndrome qui necessite pour sa comprehension une approche multidimensionnelle. Or les autres symptomes s’attardent uniquement sur l’observation d’un comportement ou les processus emotionnels, cognitifs et d’auto-activation ne sont tous pris en compte. Par ailleurs, non seulement l’apathie est souvent confondue avec ces symptomes, mais sa distinction avec la depression demeure problematique, d’autant l’absence de donnees dans la schizophrenie. L’evaluation de l’apathie se fait avec des outils specifiques et non specifiques fondes sur des conceptions divergentes, faisant peu reference a des modeles valides et operatoires. Ni la definition, ni les echelles d’evaluation de l’apathie ne prennent en compte les raisons d’un comportement apathique, seules ses consequences fonctionnelles sont evaluables. L’objectif de cette revue est par consequent d’apporter un eclaircissement clinique sur le syndrome d’apathie mais egalement de proposer des pistes de recherches et d’interventions.

Recent literature has shown the role of social factors, such as childhood negative experiences and attachment styles, in the genesis of psychotic symptoms. So far, despite this association with childhood negative experiences and a wide range of psychiatric disorders, no study has yet attempted to assess early maladaptive schemas (EMSs) in patients with schizophrenia as primary diagnosis. A sample of 48 patients diagnosed with schizophrenia and 44 control participants answered the schema questionnaire short form's French validation, and were assessed with the positive and negative syndrome scale as well as a scale of depression symptomatology. Results showed that, after controlling for depression, patients with schizophrenia achieved higher scores than control subjects on six EMSs. The EMSs were associated with positive, but not negative, symptomatology. After controlling for depression, only the Mistrust/Abuse schema was a significant predictor of positive symptoms accounting for a small portion (12.4%) of the variance. The results highlight the importance of focusing not only on the schizophrenic symptoms but also on the person and his or her subjective development of self. Therefore, these results suggest that Young's schema theory may be applied to schizophrenic patients.

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.

article i nfo Article history: The processes underlying the ability to make decisions about recommended treatments remain poorly understood in schizophrenia. The aim of this study was to explore the relationships between capacity to consent to medication and cognitive biases in 60 schizophrenia patients. Main measures included the MacArthur Competence Assessment tool forTreatment (MacCAT-T) and the Beck Cognitive Insight Scale(BCIS). After Bonferroni's correction for multiple correlations, the Self-Reflectiveness dimension of the BCIS was significantly associated with the dimension "Reason- ing" of the MacCAT-T. Cognitive therapy, by enhancing patients' Self-Reflectiveness and considering alternative explanations, could lead to better capacity to consent to treatment in schizophrenia.

International audience; It has been demonstrated that motor coordination of interacting people plays a crucial role in the success of social exchanges. Abnormal movements have been reported during interpersonal interactions of patients suffering from schizophrenia and a motor coordination breakdown could explain this social interaction deficit, which is one of the main and earliest features of the illness. Using the dynamical systems framework, the goal of the current study was (i) to investigate whether social motor coordination is impaired in schizophrenia and (ii) to determine the underlying perceptual or cognitive processes that may be affected. We examined intentional and unintentional social motor coordination in participants oscillating hand-held pendulums from the wrist. The control group consisted of twenty healthy participant pairs while the experimental group consisted of twenty participant pairs that included one participant suffering from schizophrenia. The results showed that unintentional social motor coordination was preserved while intentional social motor coordination was impaired. In intentional coordination, the schizophrenia group displayed coordination patterns that had lower stability and in which the patient never led the coordination. A coupled oscillator model suggests that the schizophrenia group coordination pattern was due to a decrease in the amount of available information together with a delay in information transmission. Our study thus identified relational motor signatures of schizophrenia and opens new perspectives for detecting the illness and improving social interactions of patients.

Article disponible en ligne à l'adresse : http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0029772; International audience

International audience; Schizophrenia is characterized by heterogeneous brain abnormalities involving cerebral regions implied in the executive functioning. The dysexecutive syndrome is one of the most prominent and functionally cognitive features of schizophrenia. Nevertheless, it is not clear to what extend executive deficits are heterogeneous in schizophrenia patients. Furthermore, it is still unknown if the executive impairments observed in schizophrenia are better characterized as specific or as reflecting generalized cognitive factors. The four executive processes (i.e. updating, inhibition, shifting and divided attention) described in Miyake et al.’s (2000) theoretical model were examined in 62 individuals with schizophrenia and 49 healthy controls. At group level, impairments in all four executive processes confirmed the marked impairment in executive functioning in patients with schizophrenia. Statistical analysis indicated that executive performances in schizophrenia patients were more heterogeneous than in healthy controls. Compared with standardized norms, 94% of patients exhibited impairment in at least one of the executive tasks. Twenty-one percent of patients exhibited impairment in one executive task, 27% in two tasks, 23% in three executive tasks and 23% exhibited impairments in the four executive tasks. Six percent of patients had normal executive profile. Regression analysis indicated that only premorbid intellectual quotient and a general slowing in processing speed predicted the executive dysfunction severity. Executive functioning was not affected by age, duration of illness, psychotic status, or by antipsychotic dosage. Our results emphasize the heterogeneity of the dysexecutive syndrome in schizophrenia when individual profile analysis is considered, and extend the view that individual cognitive differences in schizophrenia are largely underlined by general cognitive factors such as intellectual level and general processing speed.

Document disponible en ligne : http://www.sciencedirect.com/science/article/pii/S0738399110003095; International audience; Objective“Michael's Game” is a card game which aims at familiarizing healthcare professionals and patients with cognitive therapy of psychotic symptoms. The present study tests the feasibility and the impact of the intervention in naturalistic settings.Methods135 patients were recruited in 11 centres. They were assessed pre- and post-tests with the Beck Cognitive Insight Scale (BCIS) and the Peters Delusion Inventory-21 items (PDI-21).ResultsData about 107 patients were included in the entire analyses. Significant improvements were observed on BCIS subscales as well as a reduction of severity of conviction and preoccupation scores on the PDI-21. The intervention has a moderate effect on the PDI-21 preoccupation and conviction as well as the BCIS subscales. Patients who benefit the most from the program are patients who have a low degree of self-reflectiveness and patients who are concomitantly preoccupied by their symptoms.ConclusionThe present study supports the feasibility and effectiveness of “Michael's Game” in naturalistic settings.Practical implicationsThe game seems to be a useful tool for patients with psychotic disorders.

Previous studies have shown that patients with schizophrenia are impaired in recalling specific events from their personal past. However, the relationship between autobiographical memory impairments and disturbance of the sense of identity in schizophrenia has not been investigated in detail. In this study the authors investigated schizophrenic patients' ability to recall self-defining memories; that is, memories that play an important role in building and maintaining the self-concept. Results showed that patients recalled as many specific self-defining memories as healthy participants. However, patients with schizophrenia exhibited an abnormal reminiscence bump and reported different types of thematic content (i.e., they recalled less memories about past achievements and more memories regarding hospitalisation and stigmatisation of illness). Furthermore, the findings suggest that impairments in extracting meaning from personal memories could represent a core disturbance of autobiographical memory in patients with schizophrenia.

Objective: The Beck Cognitive Insight Scale (BCIS) evaluates patients' self-report of their ability to detect and correct misinterpretation. Our study aims to confirm the factor structure and the convergent validity of the original scale in a French-speaking environment. Method: Outpatients ( n = 158) suffering from schizophrenia or schizoaffective disorders fulfilled the BCIS. The 51 patients in Montpellier were equally assessed with the Positive and Negative Syndrome Scale (PANSS) by a psychiatrist who was blind of the BCIS scores. Results: The fit indices of the confirmatory factor analysis validated the 2-factor solution reported by the developers of the scale with inpatients, and in another study with middle-aged and older outpatients. The BCIS composite index was significantly negatively correlated with the clinical insight item of the PANSS. Conclusions: The French translation of the BCIS appears to have acceptable psychometric proprieties and gives additional support to the scale, as well as cross-cultural validity for its use with outpatients suffering from schizophrenia or schizoaffective disorders. The correlation between clinical and composite index of cognitive insight underlines the multidimensional nature of clinical insight. Cognitive insight does not recover clinical insight but is a potential target for developing psychological treatments that will improve clinical insight.

International audience; It has been suggested that patients with schizophrenia experience a distorted sense of continuity of self across time. However, temporal aspects of self-processing have received little empirical attention in schizophrenia. In this study, the authors investigated schizophrenic patients' ability to generate specific mental images of their personal past and future. Results showed that patients recalled fewer specific past events than did healthy controls and were even more impaired in generating specific future events. These deficits were associated with positive symptoms but were not associated with negative symptoms or with performances on verbal fluency tasks. It is suggested that schizophrenic patients' failures to project themselves into specific past and future episodes might be related to difficulties in retrieving contextual details from memory, as well as disturbance of the sense of subjective time.

The objective of this thesis is articulated around two axes: on the one hand the validation and the adaptation of a multidimensional assessment disgust tool in French and on the other hand the evaluation of the effectiveness of an extinction strategy of a disgust reaction by a counter conditioning procedure in nonclinical and analogue populations suffering from obsessive compulsive disorder.A first psychometric study was conducted with a sample of 282 participants to validate in French the disgust propensity and sensibility scale, a factorial scale for assessing disgust outside of specific contextual triggers. This scale measures individual responses to concerns about the autonomic reactions typically associated with disgust (eg nausea): disgust sensitivity and the frequency and intensity with which an individual can be disgusted: disgust propensity. Two central dimensions in understanding the emotion of disgust. Our analyzes validate the original factorial structure with two factors after removing two items of the sensitivity factor more oriented toward a self-directed disgust sensitivity. Correlation analyzes showed distinct associations of the two constructs, propensity was more related to the behavioral dimensions of obsessive-compulsive disorder while the sensitivity was more related to cognitive dimensions and concerns about the cognitive, social and physiological consequences of anxiety. The regression analyzes have above all shown that, controlling the different dimensions of anxiety and negative affects, washing behavior was exclusively explained by disgust propensity. Our data confirm the two-dimensional factor structure of the emotion of disgust and the specific link that each of them has with different manifestations of obsessive-compulsive disorder. They also emphasize the unique role of disgust in fear of contamination beyond different constructs of anxiety. The validation of this scale allowed us to explore these dimensions of disgust in an experimental study, differentiating predictive learning (the anticipation of an unconditional stimulus after a neutral stimulus) and evaluative learning (valence transfer from an unconditional stimulus towards a neutral stimulus). This experiment was designed to test the effectiveness of a counter-conditioning procedure on the extinction of a disgust reaction acquired in two groups of participants with high or low concerns about dirt and contamination. Analysis of variance shows that the counter-conditioning procedure succeeds in significantly reducing the anticipation of the disgusting unconditioned stimulus and the valence transferred to the neutral conditioned stimulus. The reduction in anticipation and valence was more moderate in the group with high concerns about dirt and contamination than in the group with low concerns. Correlation analyzes show that the dimension of disgust sensitivity self-reported is strongly correlated with the acquisition and maintenance of a conditioned disgust response, while the anticipation of the unconditional stimulus is predicted by the intensity of the self-reported anxiety. The observed data confirm the differential nature of predictive and evaluative learning. Preliminary results show that counter conditioning is a strategy that reduces the associations of occurrence and valence transfer from disgusting unconditional stimuli to initially neutral stimuli.In the light of its results, we can consider that disgust is a multidimensional construct, whose factors have a unique and specific impact in contamination obsessions, dissociable from that of anxiety. Disgust represents a therapeutic target to be privileged, the dimensional aspect is to be taken into account in order to propose adapted management strategies. Its means of desensitization are specific and must favor strategies that take into account the mechanisms of evaluative learning.; L’objectif de cette thèse s’articule autour de deux axes : la validation et l’adaptation d’un outil multidimensionnel du dégoût en langue française et l’évaluation de l’efficacité d’une stratégie d’extinction d’une réaction de dégoût dans des populations non cliniques et analogues au trouble obsessionnel compulsif.Une première étude psychométrique a été menée auprès d’un échantillon de 282 participants pour réaliser la validation en langue française de la disgust propension and sensibility scale, une échelle factorielle d’évaluation du dégoût en dehors de déclencheurs contextuels spécifiques. Cette échelle permet de mesurer les réponses individuelles aux préoccupations concernant les réactions autonomiques typiquement associées au dégoût : la sensibilité au dégoût, ainsi que la fréquence et l’intensité avec laquelle un individu peut être dégouté : la propension au dégoût, deux dimensions centrales dans la compréhension de l’émotion de dégoût. Nos analyses ont permis de valider la structure factorielle originale à deux facteurs après la suppression de deux items du facteur sensibilité. Les analyses de corrélations ont montré des associations distinctes des deux construits, la propension était plus liée aux dimensions comportementales du trouble obsessionnel compulsif alors que la sensibilité était plus liée aux dimensions cognitives et aux préoccupations concernant les conséquences cognitives, sociales et physiologiques de l’anxiété. Les analyses de régression ont surtout montré que, contrôlant les différentes dimensions de l’anxiété et les affects négatifs, les conduites de lavage étaient exclusivement expliquées par la propension au dégoût. Nos données confirment la structure factorielle à deux dimensions de l’émotion de dégoût et le lien spécifique que chacune d’entre elles entretient avec différentes manifestations du trouble obsessionnel compulsif. Elles soulignent aussi le rôle unique du dégoût dans la peur de la contamination par-delà différents construits de l’anxiété. La validation de cette échelle nous a permis d’explorer ces dimensions du dégoût dans une étude experimentale différenciant l’apprentissage prédictif (l’anticipation d’un stimulus inconditionnel après un stimulus neutre) et l’apprentissage évaluatif (le transfert de valence d’un stimulus inconditionnel vers un stimulus neutre). Cette expérience a été conçue pour tester l’efficacité d’une procédure de contre conditionnement sur l’extinction d’une réaction de dégoût acquise auprès de deux groupes de participants ayant de fortes ou de faibles préoccupations concernant la saleté et la contamination. Les analyses de variance montrent que la procédure de contre conditionnement parvient à réduire significativement l’anticipation du stimulus inconditionnel dégoutant et la valence transférée au stimulus neutre conditionné. Les analyses de corrélation montrent que la dimension de sensibilité au dégoût auto-rapporté est fortement corrélée avec l’acquisition et le maintien d’une réponse de dégoût conditionnée, alors que l’anticipation du stimulus inconditionnel est prédite par l’intensité de l’anxiété auto-rapportée. Les données observées confirment la nature différentielle des apprentissages prédictifs et évaluatifs. Les résultats préliminaires montrent que le contre conditionnement est une stratégie qui permet de réduire les associations d’occurrence et de transfert de valence des stimuli inconditionnels dégoutants vers des stimuli initialement neutres.A la lumière de ces résultats, nous pouvons considérer que le dégoût est un construit multidimensionnel, dont les facteurs ont un impact unique et spécifique dans les obsessions de contamination, dissociable de celui de l’anxiété. L’aspect dimensionnel du dégoût est à prendre en compte pour proposer des stratégies de prise en charge adaptées. Ses moyens de désensibilisation doivent privilégier des stratégies qui tiennent compte des mécanismes de l’apprentissage évaluatif.

This thesis aims at exploring the perceived stigmatization towards persons possibly leaving with Alzheimer’s disease among the population of the family caregivers – grown-up children and spouses. Not only do we have observed sources of stigmatizations aimed at patients possibly leaving with Alzheimer’s disease, in relation with emotional reactions and either affiliation behavior, or social distancing from the family and social circle, but we have also observed factors of stigmatization leading to variations in patients’ quality of life. Amongst family caregivers, we have studied factors of stigmatization leading to changes in the associated depressive symptoms and the increased caregiver burden. With respect to the relationship induced, we have given attention to the moderating role of social support. Our results show that, among patients, the negative emotions and the social distancing behavior from social circle can be linked to the frequency of behavioral symptoms related to the depression. With respect to this observation, we show an variation in the patients’ quality of life according to the places they live in. At home, we have noted increased social distancing behavior from the social circle. Amongst the relatives caregivers, we have also noticed that social support has a moderating influence on the effects of negative emotions, the social distancing behavior from the social circle towards the patient, the symptoms and the burden of care felt by the caregivers. However, the social support exacerbates the relation between positive emotions among the relatives and the burden of care. This thesis gives us the opportunity to objectify the stigmatization process with respect to Alzheimer’s disease amongst patients and their relatives caregivers. Our results could open the way to specific communications promoting the necessity for social support in favor of the entire population concerned by Alzheimer’s disease.; L'objectif de cette thèse est d'explorer la stigmatisation perçue liée à la maladie d'Alzheimer (MA) parmi une population d'aidants familiaux (enfants adultes ou conjoints) accompagnant leurs proches (conjoints ou parents) vivant avec une probable MA. Parmi les patients, non seulement, il est examiné les sources de stigmatisation envers les personnes vivant avec une probable MA associées aux réactions émotionnelles et comportementales d'affiliation ou de distance sociale de l'entourage. Mais encore il est observé les facteurs de stigmatisation qui prédisent une variation de leur qualité de vie. Parmi, leurs aidants familiaux, il est étudié les facteurs de stigmatisation qui prédisent une variation de la symptomatologie dépressive et du fardeau de soins. Dans cette relation, il est étudié le rôle modérateur du soutien social. Nos résultats indiquent parmi les patients, que la fréquence des symptômes comportementaux liés à la dépression prédisent les émotions négatives et les comportements de distance sociale de l'entourage. Aussi, nous observons que la qualité de vie du patient varie selon son lieu de résidence. Au domicile, il est observé davantage de comportements de distance sociale venant de l'entourage. Parmi les proches aidants, il est constaté que soutien social modère les effets entre les émotions négatives, les comportements de distance sociale de l'entourage envers le patient, et la symptomatologie, le fardeau de soins des aidants. Mais que le soutien social exacerbe les effets entre les émotions positives de l'entourage et le fardeau de soins. Cette thèse permet d'objectiver la stigmatisation liée à la maladie d'Alzheimer parmi les patients et leurs proches aidants. Les résultats obtenus justifieraient l'élaboration d'actions de communication centrées sur la nécessité du soutien social auprès de l'ensemble des personnes affectées par la maladie d'Alzheimer.

This thesis aims at exploring the perceived stigmatization towards persons possibly leaving with Alzheimer’s disease among the population of the family caregivers – grown-up children and spouses. Not only do we have observed sources of stigmatizations aimed at patients possibly leaving with Alzheimer’s disease, in relation with emotional reactions and either affiliation behavior, or social distancing from the family and social circle, but we have also observed factors of stigmatization leading to variations in patients’ quality of life. Amongst family caregivers, we have studied factors of stigmatization leading to changes in the associated depressive symptoms and the increased caregiver burden. With respect to the relationship induced, we have given attention to the moderating role of social support. Our results show that, among patients, the negative emotions and the social distancing behavior from social circle can be linked to the frequency of behavioral symptoms related to the depression. With respect to this observation, we show an variation in the patients’ quality of life according to the places they live in. At home, we have noted increased social distancing behavior from the social circle. Amongst the relatives caregivers, we have also noticed that social support has a moderating influence on the effects of negative emotions, the social distancing behavior from the social circle towards the patient, the symptoms and the burden of care felt by the caregivers. However, the social support exacerbates the relation between positive emotions among the relatives and the burden of care. This thesis gives us the opportunity to objectify the stigmatization process with respect to Alzheimer’s disease amongst patients and their relatives caregivers. Our results could open the way to specific communications promoting the necessity for social support in favor of the entire population concerned by Alzheimer’s disease.; L'objectif de cette thèse est d'explorer la stigmatisation perçue liée à la maladie d'Alzheimer (MA) parmi une population d'aidants familiaux (enfants adultes ou conjoints) accompagnant leurs proches (conjoints ou parents) vivant avec une probable MA. Parmi les patients, non seulement, il est examiné les sources de stigmatisation envers les personnes vivant avec une probable MA associées aux réactions émotionnelles et comportementales d'affiliation ou de distance sociale de l'entourage. Mais encore il est observé les facteurs de stigmatisation qui prédisent une variation de leur qualité de vie. Parmi, leurs aidants familiaux, il est étudié les facteurs de stigmatisation qui prédisent une variation de la symptomatologie dépressive et du fardeau de soins. Dans cette relation, il est étudié le rôle modérateur du soutien social. Nos résultats indiquent parmi les patients, que la fréquence des symptômes comportementaux liés à la dépression prédisent les émotions négatives et les comportements de distance sociale de l'entourage. Aussi, nous observons que la qualité de vie du patient varie selon son lieu de résidence. Au domicile, il est observé davantage de comportements de distance sociale venant de l'entourage. Parmi les proches aidants, il est constaté que soutien social modère les effets entre les émotions négatives, les comportements de distance sociale de l'entourage envers le patient, et la symptomatologie, le fardeau de soins des aidants. Mais que le soutien social exacerbe les effets entre les émotions positives de l'entourage et le fardeau de soins. Cette thèse permet d'objectiver la stigmatisation liée à la maladie d'Alzheimer parmi les patients et leurs proches aidants. Les résultats obtenus justifieraient l'élaboration d'actions de communication centrées sur la nécessité du soutien social auprès de l'ensemble des personnes affectées par la maladie d'Alzheimer.

Schizophrenia (SZ) is a chronic psychiatric disease characterized by positive, negative, cognitive, disorganized, emotional and motor symptoms. The lack of positive results in the treatment of negative symptoms led us to be interested in apathy. Apathy is defined as a multidimensional psychopathological state (cognitive, emotional, and behavioral) manifesting as a reduction of voluntary behaviors directed toward one goal. Our aim is to provide a clarification of the concept of apathy by focusing on the relationship between apathy, anhedonia and BIS/BAS. The first study deals with the validation of the Lille Apathy Rating Scale (LARS), which is a multidimensional tool of apathy validated in Parkinson’s disease, in 112 SZ patients. The second study (cross-sectional study) focuses on the link between apathy, consummatory and anticipatory pleasure, social pleasure and BIS/BAS, in 112 SZ patients. Finally, the third study (one year longitudinal study) deals with the evolution of apathy and explores the emotional and behavioral derminants that could predict it. Ours results have shown that the LARS is structured in four factors and has good psychometric properties in SZ. The factor 1 is associated to the BAS and the social and anticipatory anhedonia. The factor 2 is linked to the BIS and the social anhedonia. Thirty-six percent of the patients have an apathy trait. Finally, only anticipatory pleasure predicts the factor 4. Therefore, apathy requires for its understanding a multidimensional approach.Anhedonia and the BIS/BAS cannot by themselves explain the emotional and the behavioral apathy. Consequently, others lines of research need to be explored.; La schizophrénie (SZ), maladie psychiatrique invalidante, est caractérisée par des symptômes positifs, négatifs, cognitifs, désorganisés, affectifs et moteurs. De par l’absence de résultats positifs dans la prise en charge des symptômes négatifs, nous avons décidé de nous intéresser à l’apathie dans la SZ. Elle se définit par une baisse des comportements dirigés vers un but ayant une origine cognitive, émotionnelle ou comportementale. Notre objectif est d’apporter un éclaircissement sur le concept d’apathie en s’intéressant aux liens entre apathie, anhédonie et BIS/BAS. Le protocole 1 porte sur la validation de la Lille Apathy Rating Scale (LARS), outil multidimensionnel de l’apathie validée dans la maladie de Parkinson, dans la SZ, auprès de 112 patients. Le protocole 2 (étude transversale) s’intéresse aux liens entre apathie, plaisir consommé, anticipatoire, sociale et BIS/BAS, auprès de 112 patients. Enfin, le protocole 3 (étude longitudinale d’un an) porte sur l’évolution de l’apathie et explore les déterminants émotionnels et comportementaux qui pourraient la prédire, auprès de 61 patients. Nos résultats ont mis en évidence une LARS à quatre facteurs avec de bonnes qualités psychométriques dans la SZ. Le facteur 1 est associé au BAS, à l’anhédonie sociale et anticipatoire. Le facteur 2 corrèle avec le BIS et l’anhédonie sociale. Trente-six pourcent des patients ont une apathie trait. Enfin, seul leplaisir anticipatoire prédit le facteur 4. L’apathie nécessite donc pour sa compréhension une approche multidimensionnelle. L’anhédonie et le BIS/BAS ne peuvent expliquer à eux seuls l’apathie émotionnelle et comportementale. D’autres pistes méritent donc d’être explorées.

Schizophrenia (SZ) is a chronic psychiatric disease characterized by positive, negative, cognitive, disorganized, emotional and motor symptoms. The lack of positive results in the treatment of negative symptoms led us to be interested in apathy. Apathy is defined as a multidimensional psychopathological state (cognitive, emotional, and behavioral) manifesting as a reduction of voluntary behaviors directed toward one goal. Our aim is to provide a clarification of the concept of apathy by focusing on the relationship between apathy, anhedonia and BIS/BAS. The first study deals with the validation of the Lille Apathy Rating Scale (LARS), which is a multidimensional tool of apathy validated in Parkinson’s disease, in 112 SZ patients. The second study (cross-sectional study) focuses on the link between apathy, consummatory and anticipatory pleasure, social pleasure and BIS/BAS, in 112 SZ patients. Finally, the third study (one year longitudinal study) deals with the evolution of apathy and explores the emotional and behavioral derminants that could predict it. Ours results have shown that the LARS is structured in four factors and has good psychometric properties in SZ. The factor 1 is associated to the BAS and the social and anticipatory anhedonia. The factor 2 is linked to the BIS and the social anhedonia. Thirty-six percent of the patients have an apathy trait. Finally, only anticipatory pleasure predicts the factor 4. Therefore, apathy requires for its understanding a multidimensional approach.Anhedonia and the BIS/BAS cannot by themselves explain the emotional and the behavioral apathy. Consequently, others lines of research need to be explored.; La schizophrénie (SZ), maladie psychiatrique invalidante, est caractérisée par des symptômes positifs, négatifs, cognitifs, désorganisés, affectifs et moteurs. De par l’absence de résultats positifs dans la prise en charge des symptômes négatifs, nous avons décidé de nous intéresser à l’apathie dans la SZ. Elle se définit par une baisse des comportements dirigés vers un but ayant une origine cognitive, émotionnelle ou comportementale. Notre objectif est d’apporter un éclaircissement sur le concept d’apathie en s’intéressant aux liens entre apathie, anhédonie et BIS/BAS. Le protocole 1 porte sur la validation de la Lille Apathy Rating Scale (LARS), outil multidimensionnel de l’apathie validée dans la maladie de Parkinson, dans la SZ, auprès de 112 patients. Le protocole 2 (étude transversale) s’intéresse aux liens entre apathie, plaisir consommé, anticipatoire, sociale et BIS/BAS, auprès de 112 patients. Enfin, le protocole 3 (étude longitudinale d’un an) porte sur l’évolution de l’apathie et explore les déterminants émotionnels et comportementaux qui pourraient la prédire, auprès de 61 patients. Nos résultats ont mis en évidence une LARS à quatre facteurs avec de bonnes qualités psychométriques dans la SZ. Le facteur 1 est associé au BAS, à l’anhédonie sociale et anticipatoire. Le facteur 2 corrèle avec le BIS et l’anhédonie sociale. Trente-six pourcent des patients ont une apathie trait. Enfin, seul leplaisir anticipatoire prédit le facteur 4. L’apathie nécessite donc pour sa compréhension une approche multidimensionnelle. L’anhédonie et le BIS/BAS ne peuvent expliquer à eux seuls l’apathie émotionnelle et comportementale. D’autres pistes méritent donc d’être explorées.