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The Vancouver Obsessional Compulsive Inventory–Mental Contamination scale (VOCI-MC) and the Contamination Thought–Action Fusion scale (CTAF) are two self-report instruments that assess symptoms of mental contamination and fusion between thoughts, and feelings and behaviours associated with contamination, respectively. The aim of this study was to investigate the psychometric properties of the French version of these two scales in non-clinical and clinical samples. We included 79 participants diagnosed with obsessive-compulsive disorder (OCD), 31 diagnosed with anxiety disorders, who were recruited from the University Department of Adult Psychiatry in Montpellier, and 320 non-clinical participants recruited from the general population. Psychometric properties of the French VOCI-MC and CTAF were investigated. Results showed that the French versions of the VOCI-MC and the CTAF had high internal consistency, good convergent and divergent validity, as well as good temporal stability. Exploratory and confirmatory factor analyses showed a one-factor structure for the two scales in both non-clinical and OCD samples. Adequate discriminative validity was established by comparing OCD patients with contamination-related symptoms and OCD patients who did not report contamination-related symptoms. The French VOCI-MC and CTAF are valid and appropriate tools for measuring mental contamination in both clinical and research contexts.

Flashbulb memories are autobiographical memories for important and emotional events, which have the particularity of being at the intersection of personal and public events. Autobiographical memory impairments are highly prevalent in schizophrenia, a psychiatric condition intrinsically linked to self-disorders. Thus, we aimed to evaluate flashbulb and event memory functioning in individuals with schizophrenia. Twenty-four individuals diagnosed with schizophrenia and 25 control participants were tested on a flashbulb memory questionnaire about the July 14th, 2016, Nice (France) terrorist attack, including questions on flashbulb and event memory, certainty, vividness, rehearsal, emotion, novelty, consequentiality, implication, and importance. Participants also underwent cognitive assessments. Analysis showed lower scores for both flashbulb and event memories in patients compared to control participants. Subjective ratings of the phenomenological characteristics of flashbulb memory were similar between the two groups overall. However, individuals with schizophrenia reported having higher levels of emotion when they first learned about the attack compared to the control group. Our results replicate findings of impaired autobiographical memory functioning in schizophrenia and extend these findings to public events. Our findings also indicate that flashbulb memories may lead to substantial contextual recall in schizophrenia patients and that collective memories, such as a terrorist attack, can have a profound emotional impact on patients.

The current literature has largely highlighted a deficit of effort-based decision-making for reward in schizophrenia. However, not all studies have dissociated effort from reward, while other studies emphasize that difficulty is the main determinant of effort rather than reward. In this study, 33 individuals with schizophrenia and 32 healthy controls were recruited to perform a decision-making isometric force task. According to motivational intensity theory, task difficulty (i.e., required force) but not reward was manipulated from easy to impossible. Accuracy between force exerted and force required, and choice to perform a task or not were our effort measures. Clinical variables including depression, defeatist beliefs, and apathy were assessed. Our results demonstrated that the schizophrenia group chose to perform easy, moderate, and difficult tasks and exerted the necessary effort to succeed similarly to the non-clinical group. No association between effort and clinical variables was found. Our findings provide new understandings related to effort mechanisms in schizophrenia.

Resume La psychologie anglo-saxonne a produit un nombre consequent d’etudes mettant en evidence l’implication de mecanismes psychologiques dans le developpement et le maintien des hallucinations acoustico-verbales (HAVs), aussi appelees phenomene d’entente de voix. S’il est souvent considere, pour des raisons historiques, que les HAVs sont une des caracteristiques principales des troubles psychotiques et notamment schizophreniques, les etudes epidemiologiques montrent que celles-ci sont egalement extremement prevalentes dans de nombreuses autres populations cliniques (e.g. trouble bipolaire, trouble de stress post-traumatique, trouble de personnalite borderline) et neurologiques (e.g. Maladie de Parkinson), tout comme au sein de la population generale. Cependant, les HAVs restent encore, en pratique courante, associees a la psychose, et d’un point de vue etiologique a des « dysfonctionnements neurobiologiques complexes ». L’objectif principal de cette revue est de faire une synthese narrative et integrative des differents modeles psychologiques faisant actuellement consensus sur les HAVs. Plus precisement, nous decrirons (1) le role des croyances a propos de l’experience d’entente de voix et les croyances a propos de soi, (2) l’experience d’entente de voix comme devant etre comprise comme un phenomene fondamentalement relationnel entre l’entendeur de voix et la voix elle-meme, (3) le role des emotions et des strategies de regulation emotionnelle, et (4) le role des experiences passees traumatiques et de la dissociation. Nous terminons cette revue par une breve critique argumentee de la conception des HAVs telle qu’elle est actuellement adoptee en psychiatrie.

Resume Les hallucinations acoustico-verbales (HAVs) ou phenomene d’entente de voix doivent etre considerees comme relevant d’un continuum entre le normal et le pathologique et cliniquement comme un phenomene transdiagnostique. Les etudes sur le sujet montrent que l’on retrouve ce phenomene aussi bien en population generale que dans des troubles mentaux n’appartenant pas a la sphere des psychoses comme le stress post-traumatique ou le trouble de la personnalite borderline. Les traitements pharmacologiques, notamment les neuroleptiques, sont actuellement consideres comme les traitements de premiere intention des HAVs. Il s’avere cependant qu’un nombre consequent d’individus sous neuroleptiques continuent d’entendre des voix, phenomene souvent associe a une forte detresse emotionnelle. L’objectif de cette revue est de presenter et discuter l’efficacite des interventions psychologiques de type comportemental et cognitif dans la prise en charge des HAVs, principalement en complement des traitements pharmacologiques. Ces interventions comprennent principalement des techniques d’autogestion des voix et des techniques classiques issues des therapies comportementales et cognitives (TCC) comme : (1) la modification des croyances envers les voix (notamment les voix qui ordonnent, qui sont percues comme malveillantes, omniscientes et omnipotentes), et les croyances negatives envers soi ; et (2) a modifier les comportements interpersonnels entre l’entendeur de voix et celles-ci, notamment en augmentant les comportements d’assertivite, via des techniques de jeux de roles ou l’utilisation de nouvelles technologies interactives (therapie par avatar). Enfin, les barrieres a l’implementation des TCC des HAVs sont discutees et les auteurs proposent un ensemble de recommandations pratiques sur la TCC des voix a l’adresse des cliniciens.

This work was funding by local grant (Clinical research funding from CHU Montpellier), CNRS RHIAPS Project and DGA (Direction Générale des Armées).; International audience; The goal of this study was to analyze the interpersonal coordination of patients suffering from schizophrenia (SZ) using a humanoid robot NAO. NAO was controlled by a neurally-inspired model that enables motions synchronization between robot and human. Using a robot has the advantage in that it can be modified and controlled without being influenced by the human with whom they are interacting. More specifically, we were interested in non-intentional interpersonal coordination which has been found in previous studies to be preserved for SZ. We performed an experiment in which we asked patients and control participants to jointly perform fitness movements with the robot which was programmed to either synchronize with the human (a bidirectional condition) or move at a fixed frequency with them (a unidirectional condition). We showed that non-intentional interpersonal coordination was preserved for SZ during Human/Robot interaction (as for human/human interaction). Also, the best synchronization, stability and the best performance in term of speed were obtained with the bidirectional condition. Our results showed that, in this specific context of an interaction at preferential frequency of subject, there were only a few differences between SZ and controls in terms of interpersonal synchronization skills. Nevertheless, we observed more variability for SZ which could partly be explained by the weaker intrapersonal coordination that they exhibited.

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.

Background:Assessing an individual’s capacity to consent to treatment is a complex and challenging task for psychiatrists and health-care professionals. Diminished capacity to consent to pharmacological treatment is a common concern in individuals with schizophrenia. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) is the most common tool used in individuals with schizophrenia to evaluate the decision-making abilities for judgments about competence to consent to treatment. This instrument assesses patients’ competence to make treatment decisions by examining their capacities in 4 areas: understanding information relevant to their condition and the recommended treatment, reasoning about the potential risks and benefits of their choices, appreciating the nature of their situation and the consequences of their choices, and expressing a choice. Despite its importance, there is no French version of this scale. Furthermore, its factor structure has never been explored, although validated measures are strongly needed to further detect deficits in patients’ decision-making abilities. The goal of this study was thus to empirically validate a French version of the MacCAT-T in a French sample of individuals with schizophrenia.Method:In this cross-sectional study, we included 125 inpatients with a diagnosis of schizophrenia from the University Department of Adult Psychiatry in Montpellier. The MacCAT-T was administered to patients by a trained psychologist. Patients were also assessed for severity of symptoms, insight into illness, and depressive and anxiety symptoms. Inter-rater reliability and psychometric properties including internal consistency, construct validity, and discriminant and divergent validity were also investigated.Results:The MacCAT-T’s internal consistency was high (Cronbach α of 0.91). A high degree of inter-rater reliability was found for all the areas of the MacCAT-T (intraclass correlation coefficient range, 0.92 to 0.98). Exploratory factor analysis revealed a 2-factor model. The factor analysis explained 50.03% of the total score variation. Component 1 included all subparts of “understanding.” Component 2 included all subparts of “appreciation” and “reasoning” and was therefore labeled “reflexivity.” After Bonferroni corrections, decision-making capacity was positively associated with insight and the severity of psychotic symptoms but not with sociodemographic variables except for education.Conclusions:The MacCAT-T demonstrated a high degree of inter-rater reliability and strong psychometric properties. The French version of the MacCAT-T is a valid instrument to assess the decision-making capacity to consent to treatment in a French sample of individuals with schizophrenia.

Resume Introduction Bien que consideree comme une emotion de base, le degout a recu peu d’attention des recherches issues de la psychologie des emotions par rapport a d’autres emotions comme la peur ou la tristesse. Resultats de la litterature De nombreuses donnees empiriques et experimentales suggerent pourtant que le degout joue un role determinant non seulement dans notre capacite a nous adapter a notre environnement mais aussi dans le maintien et le developpement de certains etats psychopathologiques comme les troubles obsessionnels compulsifs. L’objectif de cet article est de presenter, selon une approche epistemologique behavioriste et cognitiviste, une revue narrative des donnees de la litterature concernant le construit du degout, notamment dans ses deux dimensions fondamentales que sont la propension au degout et la sensibilite au degout. Une premiere partie sera consacree a l’acquisition du degout dans le cadre de l’apprentissage evaluatif et pavlovien, nous decrirons ensuite en detail les outils d’evaluation disponibles dans la litterature permettant d’en evaluer les differentes dimensions, puis nous aborderons le continuum de l’experience de degout allant du degout normal au degout pathologique et ciblerons particulierement son role dans les obsessions dysfonctionnelles de contamination et de detresse emotionnelle. Discussion Si, d’un point de vue theorique, la comprehension des mecanismes sous-jacent des reactions de degout pathologique s’ameliore, les propositions de prises en charge permettant d’attenuer ces reactions restent rares. Des pistes nouvelles de prises en charge seront decrites afin de permettre le developpement d’interventions psychologiques empiriquement fondees. Conclusion La reconnaissance d’influences emotionnelles allant au-dela de l’anxiete dans le trouble obsessionnel compulsif decoule de l’importance fondamentale d’une approche dimensionnelle de la psychopathologie et la soutien. Les donnees accumulees suggerent que l’inclusion du degout dans les modeles theoriques du trouble obsessionnel compulsif, en particulier dans le TOC de contamination, pourront ainsi ameliorer notre comprehension et le traitement de ce trouble.

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.

BackgroundCognitive impairments are extremely common in schizophrenia and strongly predict deficits in daily functioning, poor management of medication, and multiple hospitalizations. Cognitive remediation is recognized to have a positive impact on cognitive impairments by engaging preserved cognitive functions or by implementing environmental supports that sustain independent living.Velligan et al. [1] developed and tested a manualized intervention, called Cognitive Adaptation Training (CAT). In this program, trained mental health specialists implemented compensatory techniques such as environmental supports in the individual’s living environment in order to live more independently and achieve greater self-sufficiency.However, implementing this program requires a lot of professionals and time to maintain CAT effect. This type of intervention is not widely available in community care which may explain the large number of patients who are dependent on family members for daily living activities. Training family members in this form of intervention would be an appropriate way to resolve these issues. Family expressed a real interest in these types of home-support strategies that CAT offers. Recently, Kidd et al. [2] developed a CAT version for Families and created a manual accessible to people without any knowledge of cognitive deficits. This manual helps families to select specific cognitive-adaptative strategies with their relative to achieve targeted goals. This method has been translated in French.The aim of this study is to examine whether Web-based Family Cognitive Adaptation Training can improve functioning, medication adherence and negative symptoms for individuals with schizophrenia as well as reduce burden for the family members.Methods/DesignA total of 60 Dyads consisting of one caregiver and one supported individual with schizophrenia will be randomized to either Web-based family cognitive adaptation training or an internet-based control condition (psycho-education). The primary outcome measure will be the total score on the life skills profile. Secondary outcome measures will include the global score of the Zarit burden Interview, the PANSS negative score, the CAINS score, patient medication adherence, and patient and caregiver quality of life.DiscussionWe hope that this type of intervention could be developed in territorial areas where professionals are not trained to cognitive remediation and therefore substantially lower the barrier to the deployment of cognitive interventions with other psychosocial interventions for individuals with schizophrenia and their caregivers.Trial registration: ClinicalTrials.gov Identifier: NCT04173598. Registered on November 22th 2019

Grandiose delusions (GDs) are defined as false beliefs about having an inflated worth, power, or a special identity which are firmly sustained despite undeniable evidence to the contrary. Although it is the second most commonly encountered delusional beliefs, GDs have received little attention. Thus, in this study, we explored the role of future expectations and sensitivity to reward in GDs in schizophrenia (SZ) disorder. In total, 115 SZ patients completed measures of positive and negative symptoms, sensitivity to reward, depression, and a task in which individuals were asked to estimate the probability that positive, negative and neutral events will occur in the future. Correlation and Linear Regression analyses were performed in order to determine whether sensitivity to reward and future expectations are associated with GDs. Regressions showed that hallucinations and future positive expectations were significantly associated with GDs. In conclusion, the present study showed that higher optimism regarding the future might be important psychological processes associated with the maintenance of GDs in SZ patients. Moreover, it is possible that patients experiencing hallucinations may interpret this phenomenon as a kind of special ability or power, resulting in turn in GDs maintenance. Implications of these findings and directions for future research are discussed.

Severe impairment of social functioning is the core feature of schizophrenia that persists despite treatment, and contributes to chronic functional disability. Abnormal non-verbal behaviors have been reported during interpersonal interactions but the temporal coordination of co-speech gestures with language abilities have been poorly studied to date in this pathology. Using the dynamical systems framework, the goal of the current study was to investigate whether gestures and speech synchrony is impaired in schizophrenia, exploring a new approach to report communicational skill disorders. Performing the first continuous kinematic-acoustic analysis in individuals with schizophrenia, we examined gesture-speech synchrony in solo spontaneous speech and in sensorimotor synchronization task. The experimental group consisted of twenty-eight participants with a diagnosis of schizophrenia and the control group consisted of twenty-four healthy participants age-gender-education matched. The results showed that spontaneous gesture-speech synchrony was preserved while intentional finger tapping-speech synchrony was impaired. In sensorimotor synchronization task, the schizophrenia group displayed greater asynchronies between finger tapping and syllable uttering and lower stability of coordination patterns. These findings suggest a specific deficit in time delay of information circulation and processing, especially in explicit functions. Thus, investigating intrapersonal coordination in schizophrenia may constitute a promising window into brain/behavior dynamic relationship.

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.

Introduction: Recent theoretical models and preliminary data suggest that shame is a central emotion in the context of auditory verbal hallucinations (AVH or voice-hearing). Nevertheless, all previous studies were correlational. Thus, the present study sought to explore whether simulated AVH experiences can trigger shame using an experimental design. Methods: 346 participants from the general population were randomised to one of 6 conditions. They had to read a vignette describing a character who was either in a situation alone or with a close friend. While reading the vignettes, participants also heard either negative or neutral simulated voices or non-voice neutral sounds. Subsequently, participants completed different measures, including shame. Results: Our results showed that both the negative and neutral simulated voice-hearing triggered higher levels of shame, but also other negative emotions when compared to ambient sound, regardless of the social context. Participants in the simulated voice-hearing conditions reported higher levels of maladaptive coping strategies and negative beliefs about voices than in the ambient sound condition. Conclusions: The simulation of neutral and negative voices trigger similar levels of subjective shame, indicating the effect is not specific to negative voices but rather associated with the experience per se. Nevertheless, it can also trigger other negative emotions.

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.

Resume Il est demontre par la recherche scientifique que les individus ayant recu un diagnostic de demence neurodegenerative de type Alzheimer comme leur entourage (famille, aidants familiaux) experimentent un phenomene de stigmatisation familiale dont les consequences sont nombreuses. Non seulement, ils peuvent eprouver des reactions emotionnelles telles que la peur, l’anxiete plus des symptomes depressifs, mais encore faire l’experience de discrimination avec un sentiment de fardeau de soins et se traduire par l’evitement des relations sociales. Ces effets conduisent a reduire la qualite de vie de la famille. Parallelement, les etudes scientifiques revelent que le stigmate agit a un niveau personnel, associatif (familial), public et structurel. Leur perception conjointe semble necessaire pour apprehender leur synergie et adapter les interventions. Cependant, dans le contexte de la MA, il n’existe aucun outil en langue francaise pour mesurer le stigmate familial percu aux differents niveaux. Pour combler cette lacune, nous avons analyse la validite de construit (validite intra-concept), un aspect de la validite divergente, validite concourante ainsi que la fiabilite de l’echelle de stigmatisation familiale de la MA (ESF-MA) dans le contexte francais. Les resultats de l’analyse en composante principale (n = 263 aidants familiaux principaux) revelent 10 facteurs repartis en 3 dimensions (intra-personnelle, publique et structurelle) expliquant 57 % de la variance totale. La validite de construit comme la fiabilite atteste de resultats satisfaisants. La mesure de la stigmatisation familiale par l’ESF-MA presente une opportunite pour completer les observations cliniques parmi les aidants familiaux de personnes ayant recu le diagnostic de MA.

International audience; Apathy is a frequent and debilitating condition with few treatment options available in schizophrenia patients. Despite evidence of its multidimensional structure, most of past studies have explored apathy through a categorical approach. The main objective of this study was to identify the cognitive, emotional, motivational, and clinical factors at baseline that best predicted the three subtypes of apathy dimensions at follow-up. In a longitudinal study, 137 participants diagnosed with schizophrenia underwent different assessments including clinical, motivational, affective and cognitive measurements, at 1-month (referred to as baseline) and 12-month follow-ups. Data were analyzed using partial least squares variance-based structural equation modeling. Three latent variables representing the three previously described domains of apathy reaching consensus in the literature were extracted from the Lille Apathy Rating Scale. Results showed that in addition to baseline apathy, positive symptoms, anticipatory pleasure and sensibility to punishment at baseline predicted cognitive apathy at follow-up. Likewise, both baseline apathy and sensibility to punishment predicted emotional apathy at follow-up. Finally, baseline anhedonia and episodic memory were the main variables the predicted behavioral apathy at follow-up. This is the first study to show specific associations between apathy subtypes and clinical and cognitive motivational dysfunction in individual with schizophrenia, indicating possible distinct underlying mechanisms to these demotivational symptoms. Treatment for apathy should address both types of processes. Importantly, our results demonstrate the interest of multidimensional approaches in the understanding of apathy in schizophrenia.

International audience; The aim of our study was to compare the performance of three different instruments measuring clinical and cognitive dimensions of insight. Data on 182 outpatients with schizophrenia and one-year follow-up assessments was drawn from the FACE-SZ cohort. Awareness of clinical state (« clinical insight ») was measured using both a clinician-rated measure (the Scale to assess Unawareness of Mental Disorder (SUMD)), and a self-report measure (the Birchwood Insight Scale (BIS). Cognitive insight was measured using a self-report measure (the Beck Cognitive Insight Scale (BCIS)). For each scale, change in insight was examined at the follow-up. Correlations between SUMD and BIS subscales measuring same dimensions were significant. BIS-BCIS correlations were weak for all combinations except between BIS illness dimension and BCIS composite score. At the follow-up, BIS and SUMD awareness of treatment need improved whereas illness and symptom awareness increased only on the SUMD. Conversely, cognitive insight composite scores decreased. Despite relatively good overall agreement between the two clinical insight instruments, considerable variability for similar insight dimensions measured by different instruments was found. Agreement between cognitive and clinical insight is moderate. Our study strengthens the argument that insight is harder to operationalize than other symptoms and may explain why it is so seldom explicitly targeted in schizophrenia treatment.

Article consultable en ligne : https://www.nature.com/articles/s41598-017-14773-3; International audience; Rapid progress in the area of humanoid robots offers tremendous possibilities for investigating and improving social competences in people with social deficits, but remains yet unexplored in schizophrenia. In this study, we examined the influence of social feedbacks elicited by a humanoid robot on motor coordination during a human-robot interaction. Twenty-two schizophrenia patients and twenty-two matched healthy controls underwent a collaborative motor synchrony task with the iCub humanoid robot. Results revealed that positive social feedback had a facilitatory effect on motor coordination in the control participants compared to non-social positive feedback. This facilitatory effect was not present in schizophrenia patients, whose social-motor coordination was similarly impaired in social and non-social feedback conditions. Furthermore, patients’ cognitive flexibility impairment and antipsychotic dosing were negatively correlated with patients’ ability to synchronize hand movements with iCub. Overall, our findings reveal that patients have marked difficulties to exploit facial social cues elicited by a humanoid robot to modulate their motor coordination during human-robot interaction, partly accounted for by cognitive deficits and medication. This study opens new perspectives for comprehension of social deficits in this mental disorder.

The main goal of the present study was to explore the associations between several key variables that have been shown to partially mediate the link between specific trauma exposure and auditory hallucinations (AH), that is, maladaptive schemas and dissociation in the general population.In total, 425 voluntary participants were recruited from the general population and completed online the Childhood Trauma Questionnaire, the Young schema questionnaire, the Dissociative Experiences Scale, and the Launay-Slade Hallucination Scale. Data were analysed using Partial Least Squares Structural Equation Modelling.Our model showed that: (1) sexual and emotional abuse impact on AH both through the effect of maladaptive schemas and dissociation; (2) physical abuse impact on AH only through the effect of dissociation. More specifically, we found that four maladaptive schemas impact on AH: Abandonment, Vulnerability, Self-sacrifice and Subjugation.Overall, our findings indicate that specific early maladaptive schemas may play a fundamental role in the association between exposure to trauma and auditory hallucination together with dissociation symptoms in the general population. Consequently, our study suggest considering maladaptive schemas as an important therapeutic target when working with individuals experiencing AH with or without a psychiatry disorder.

Objective The Hayling Sentence Completion Test (HSCT) measures prepotent response inhibition, useful to assess inhibition deficit in a variety of clinical conditions. Despite its extensive use by numerous clinical and research groups in France, normative data for the HSCT are not yet available for French speakers. Method A French version of the HCST was administered to a sample of 426 healthy community-dwelling French speaking adults (20-87 years of age). Normative data were calculated using a regression-based approach. Results Regression analyses indicated that both age and education were associated with response latency and number of errors in the inhibition condition. Equations to calculate Z scores are provided for clinical use. In addition, we provided a clear guideline for the error scoring of the inhibition condition by establishing a corpus of errors adjusted for the linguistic and cultural realities of the French population. Using this guideline, a good inter-rater reliability was observed. Because of the restricted ranges of response latency and number of errors in the automatic condition, the relationship between these scores and demographic factors was not explored. By consequence, no norms were proposed for this condition. Conclusions We provide normative data of a French version of the HSCT for adults and elderly patients. These normative data obtained will be extremely useful for clinical practice and research purposes.

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.