Assessment of social cognition in bipolar disorder

Background: Impairment in social cognition may contribute to deficits in social functioning in patients with bipolar disorder (BD). In this study, a complex social cognition task was administered during a neuroimaging session. The behavioral and neural correlates of social cogniton in patients with BD were compared to healthy comparison (HC) subjects. Methods: The task was administered to 25 HC and 25 patients with depression scores ranging from euthymic to depressed at the time of assessment. The task required participants to evaluate situations that were “enhancing” or “threatening” to self-esteem, directed at both oneself, and at other people. For instance, self-esteem enhancing scenarios involved vignettes of activities such as receiving praise during a sports game, while a threatening scenario involved, for example, receiving criticism at a party. Participants were then required to evaluate characters in the scenarios on the basis of positive (“kind”) or negative (“mean”) descriptors. Evaluations were classified from extremely negative to extremely positive. The frequencies of behavioral responses were analyzed using chi-square tests and fMRI data were analyzed using Statistical Parametric Mapping software. Results: Patients differed significantly from HCs in their evaluation of threatening scenarios, directed at both oneself and at other people (p<0.001). Patients had a lower proportion of responses in the neutral category, and more responses in the positive and negative categories, relative to HCs. Neuroimaging results reveal differential patterns of prefrontal-cortical and limbic-subcortical activation in BDs throughout the task [p<0.05 (unc.)]. Conclusions: Findings will contribute to understanding difficulty in interpersonal functioning in patients with BD.

Internet use by patients with bipolar disorder:results from an international multisite survey

There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with bipolar disorder diagnosis in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.

A relação entre transtorno da insônia e funções executivas em adultos

The insomnia disorder is defined as a difficulty initiating or maintaining sleep or waking up earlier than expected unable to return to sleep, followed by a feeling of nonrestorative and poor quality sleep, present for at least three months, with consequences on daytime functioning. Studies have shown that insomnia affects cognitive function, especially executive functions. However, researches that sought to investigate the relationship between primary insomnia and executive functioning were quite inconsistent from a methodological point of view, especially in regard to the variability of the used methods, the heterogeneity of diagnostic criteria for insomnia and the control of sleep altering drugs. In this sense, the present study aimed to investigate the relationship between insomnia and executive functions in adults. The participants were 29 people, from both genders, aged 20-55 years old. Participants were divided into three groups, one composed of 10 people with primary insomnia who used sleep medication (GIM), nine people with primary insomnia who did not use medication (GInM) and 10 healthy people who composed the control group (CG). The research was conducted in two stages. The first one involved a diagnostic evaluation for insomnia disorder through a clinical interview and the application of the following protocols: the Athens Insomnia Scale, the Insomnia Severity Index, Sleep Journal (for 14 days), Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Test, depression and anxiety Beck inventories, and Lipp’s Iventory of stress symptoms for adults. After this stage, the evaluation of executive functions was performed by applying a battery of neuropsychological tests composed by the following tests: Wisconsin, Stoop Test, Colored trails Test, the Tower of London Test, Iowa Gambling Task (IGT) and WAIS III subtest digit span, which measured selective attention, inhibitory control, cognitive flexibility, planning, problem solving, decision making and working memory, respectively. The results showed that insomniacs (GIM and GInM) showed higher sleep latency, shorter sleep duration and lower sleep efficiency compared to the CG. In regard to the performance in executive functions, no statistically significant difference between groups was observed in the evaluated modalities. However, the data show evidence that, compared to GInM and GC, the performance of GIM was lower on tasks that required quick responses and changes in attention focus. On the other hand, GInM, when compared to GIM and GC, showed a better performance on tasks involving cognitive flexibility. Furthermore, impaired sleep measures were correlated with the worst performance of insomniacs in all components evaluated. In conclusion, people with the insomnia disorder showed a performance similar to healthy people’s in components of the executive functioning. Thus, one can infer that there is a relationship between primary insomnia and executive functions in adults.

O comportamento pró-social de crianças com sintomatologia do transtorno da conduta

Pro-social behaviors are seen regularly throughout our daily lives, as we often witness people giving alms, helping a neighbor move, donating blood, or taking care of a friend's children, among others. From an evolutionary perspective, such behaviors occur because they have a high adaptive value to our species, precisely due to our high degree of dependence on group living for survival. Probably, for this same reason, since children have shown a preference for prosocial behaviors over antisocial behaviors, this preference becomes more visible as we grow. However, children with symptoms of conduct disorder show a pattern of aggressive, impulsive and more selfish behaviors than children without such symptoms. Furthermore, these children also experience environments in which antisocial behaviors are more frequent and intense compared to the general population. Priming experiments are one way of measuring the influence of simple environmental cues on our behavior. For example, driving faster when listening to music, religious people help more on religious elements, like the bible, and children are more cooperative after playing games of an educational nature. Thus, the objectives of the current study were to: evaluate whether there is any difference in generosity, through sharing behavior, among children with and without symptoms of conduct disorder; analyze the influence of prosocial priming on sharing behavior on children with and without symptoms of conduct disorder; and finally, analyze from an evolutionary perspective, the reasons given by children with and without symptoms of conduct disorder for sharing or not sharing with their best friend in a classroom environment. To address this question, the teachers of these children were asked to respond to an inventory that was designed to signal the presence or absence of symptoms of conduct disorder. Children identified as having or not having symptoms of conduct disorder could then undergo an experimental (with priming) or control (no priming) condition. Under the experimental condition, the children were asked to watch two short videos showing scenes of helping and sharing among peers, to perform a distraction activity, and finally to chose two of four different materials presented by the researcher and decide how much of these two materials they would like to share with their best friend in the classroom. Then the children were asked about their reasons for sharing or not sharing. Children subjected to the control condition performed the same activities as in the xi experimental condition, but did not watch the video first. The results showed a notable difference in the effect of priming in accordance with the child's stage of development; a difference in the amount of material donated to a best friend by children with and without symptoms of conduct disorder, and a change in this observed difference with the influence of pro-social priming; and finally, a convergence in the thinking of children regarding their reasons for sharing with evolutionary theory. The results of this study also indicate the importance of individual factors, developmental stage, environmental and evolutionary conditions in the pro-social behavior of children with and without symptoms of conduct disorder.

Características psicológicas do paciente obeso grave e suas implicações pós-operatórias na cirurgia bariátrica

Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach – Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compulsão Alimentar Periódica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group – and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.

A criança com transtorno do espectro autista (TEA) e o professor: uma proposta de intervenção baseada na experiência de aprendizagem mediada (EAM)

The presence of students with Autism Spectrum Disorder (ASD) in regular schools has increased and with it, the need to develop interventional strategies that enhance their learning. One of the tools that can facilitate this process is Mediated Learning, defined as an interaction style where the teacher selects, modifies, enhances, and interprets environmental stimuli in order to promote student learning. In recent years several studies have used the Mediated Learning Experience Scale (MLE; Lidz, 1991) as a tool to assess the mediator behavior. These studies have suggested that the EAM Scale can provide important guidelines for planning educational interventions, particularly those involving students with special needs. In order to extend these findings, this study aimed to evaluate the effects of an intervention based on the Mediated Learning Experience on social / academic skills of a child with ASD, enrolled in the 4th grade of a regular elementary school. This collaborative study was held in the city of Parnamirim, state of Rio Grande do Norte, in 2014. A 9-year old boy with ASD and his teacher participated in the study. The research used a quasi-experimental A-B design (baseline and treatment) to evaluate the teacher's behavior. Qualitative procedures were also used to analyze the dyad´s responses. Teacher and student behaviors were observed in three school routines during baseline. Based on the results of this phase, a training program was designed for the teacher. Dyad behavior was analyzed again after training in the same routines. The results of this phase showed qualitative and quantitative changes in levels of teacher mediation. Additionally, data indicated that the child enhanced his social and academic skills during the intervention.

A relação entre memória de trabalho e competência leitora em crianças em risco de transtorno de aprendizagem do Projeto Acerta: um estudo exploratório

Reading and writing are essential rights, which involve individual and social aspects; in addition, these skills are important when it comes to socio economic and political development, critical thinking and an active participation in society (UNESCO 2005). From a neurobiological standpoint, our brain is not prepared for reading, and this practice must be deliberately acquired via instructional guidance (DEHAENE 2009). However, reading disorders and deficits within executive functions, such as low working memory capacity, can make reading arduous. The aim of this study is to investigate the development of reading skills within 45 third grade students from public schools in the city of Natal – RN and its connection to working memory capacity, through information gathered from the Provinha Brasil, data generated from working memory tasks (Portuguese version of AWMA - Automated Working Memory Assessment) and fluid intelligence measures RAVEN. Based on this main objective, we attempted to answer the following research questions: (a) What are the correlations between working memory and reading scores?; (b) What characterizes the relationship between working memory capacity and the risk of reading disabilities amongst the participants in this study?; Following a quantitative research methodology, the Provinhas Brasil from 3rd grade students belonging to the six public schools members of Project ACERTA - Avaliação de Crianças em Risco de Transtornos de Aprendizagem (CAPES/OBEDUC)- were analyzed and compared to the scores from the working memory tests and the fluid intelligence ones. Results indicate that reading skills within children at risk of reading disabilities are directly linked to working memory capacity, especially with regards to the phonological component. It is also evident that the participants with less working memory capacity show more difficulties in the reading abilities that demand interpretation skills. Thus, we intend to contribute to the discussion regarding the diagnosis of reading disabilities and possible intervention strategies.

A relação entre memória de trabalho e competência leitora em crianças em risco de transtorno de aprendizagem do Projeto Acerta: um estudo exploratório

Reading and writing are essential rights, which involve individual and social aspects; in addition, these skills are important when it comes to socio economic and political development, critical thinking and an active participation in society (UNESCO 2005). From a neurobiological standpoint, our brain is not prepared for reading, and this practice must be deliberately acquired via instructional guidance (DEHAENE 2009). However, reading disorders and deficits within executive functions, such as low working memory capacity, can make reading arduous. The aim of this study is to investigate the development of reading skills within 45 third grade students from public schools in the city of Natal – RN and its connection to working memory capacity, through information gathered from the Provinha Brasil, data generated from working memory tasks (Portuguese version of AWMA - Automated Working Memory Assessment) and fluid intelligence measures RAVEN. Based on this main objective, we attempted to answer the following research questions: (a) What are the correlations between working memory and reading scores?; (b) What characterizes the relationship between working memory capacity and the risk of reading disabilities amongst the participants in this study?; Following a quantitative research methodology, the Provinhas Brasil from 3rd grade students belonging to the six public schools members of Project ACERTA - Avaliação de Crianças em Risco de Transtornos de Aprendizagem (CAPES/OBEDUC)- were analyzed and compared to the scores from the working memory tests and the fluid intelligence ones. Results indicate that reading skills within children at risk of reading disabilities are directly linked to working memory capacity, especially with regards to the phonological component. It is also evident that the participants with less working memory capacity show more difficulties in the reading abilities that demand interpretation skills. Thus, we intend to contribute to the discussion regarding the diagnosis of reading disabilities and possible intervention strategies.

Implementações metodológicas para o estudo eletrofisiológico e comportamental em um modelo animal de autismo

O autismo é um transtorno do desenvolvimento que se manifesta nos primeiros anos de vida e apresenta semiologia heterogênea. Esta patologia afeta a maturação do encéfalo e produz alterações sensoriais, de linguagem e de interação social no início na infância. O modelo experimental de autismo utilizando ácido valproico (VPA) durante o período gestacional tem sido demonstrado ter alta validade de face e permitir estudos tanto das bases neuropatológicas quanto neuro-funcionais durante o desenvolvimento. A despeito do recente interesse por este modelo como instrumento de compreensão dos aspectos básicos da fisiopatologia do autismo, a maioria dos estudos experimentais têm se concentrado nos aspectos comportamentais, histológicos e celulares. Neste trabalho, foram propostas estratégias experimentais de avaliação comportamental associadas a eletrofisiologia \textit{in vivo}, uma técnica que nunca fora utilizada para avaliação desse modelo. Animais controles e experimentais, submetidos previamente a um procedimento cirúrgico para implante de eletrodos crônicos, participaram de experimentos de livre exploração, interação social e condicionamento ao medo.

System to predict bipolar disorder crises analysing massive data

Durante el desarrollo del proyecto he aprendido sobre Big Data, Android y MongoDB mientras que ayudaba a desarrollar un sistema para la predicción de las crisis del trastorno bipolar mediante el análisis masivo de información de diversas fuentes. En concreto hice una parte teórica sobre bases de datos NoSQL, Streaming Spark y Redes Neuronales y después diseñé y configuré una base de datos MongoDB para el proyecto del trastorno bipolar. También aprendí sobre Android y diseñé y desarrollé una aplicación de móvil en Android para recoger datos para usarlos como entrada en el sistema de predicción de crisis. Una vez terminado el desarrollo de la aplicación también llevé a cabo una evaluación con usuarios.

Online information seeking by patients with bipolar disorder:results from an international multisite survey

Background: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.

Differential activation in temporal, cingulate and prefrontal cortices during response inhibition in bipolar disorder

Background: Increased impulsivity and aberrant response inhibition have been observed in bipolar disorder (BD). This study examined the functional abnormalities and underlying neural processes during response inhibition in BD, and its relationship to impulsivity. Methods: We assessed impulsivity using the Barratt Impulsiveness Scale (BIS) and, using functional magnetic resonance imaging (fMRI), measured neural activity in response to an Affective Go-NoGo Task, consisting of emotional facial stimuli (fear, happy, anger faces) and non-emotional control stimuli (neutral female and male faces) in euthymic BD (n=23) and healthy individuals (HI; n=25). Results: BD patients were significantly more impulsive, yet did not differ from HI on accuracy or reaction time on the emotional go/no-go task. Comparing neural patterns of activation when processing emotional Go versus emotional NoGo trials yielded increased activation in BD within temporal and cingulate cortices and within prefrontal-cortical regions in HI. Furthermore, higher BIS scores for BD were associated with slower reaction times, and indicative of compensatory cognitive strategies to counter increased impulsivity. Conclusions: These findings illustrate cognition-emotion interference in BD and the observed differences in neural activation indicate potentially altered emotion modulation. Increased activation in brain regions previously shown in emotion regulation and response inhibition tasks could represent a disease-specific marker for BD

Polymer Light-Emitting Electrochemical Cells with Embedded Bipolar Electrodes: Visualizing Bipolar Electrochemistry in Solid State

The work presented in this thesis examines the properties of BPEs of various configurations and under different operating conditions in a large planar LEC system. Detailed analysis of time-lapsed fluorescence images allows us to calculate the doping propagation speed from the BPEs. By introducing a linear array of BPEs or dispersed ITO particles, multiple light-emitting junctions or a bulk homojunction have been demonstrated. In conclusion, it has been observed that both applied bias voltages and sizes of BPEs affected the electrochemical doping from the BPE. If the applied bias voltage was initially not sufficiently high enough, a delay in appearance of doping from the BPE would take place. Experiments of parallel BPEs with different sizes (large, medium, small) demonstrate that the potential difference across the BPEs has played a vital role in doping initiation. Also, the p-doping propagation distance from medium-sized BPE has displayed an exponential growth over the time-span of 70 seconds. Experiments with a linear array of BPEs with the same size demonstrate that the doping propagation speed of each floating BPE was the same regardless of its position between the driving electrodes. Probing experiments under high driving voltages further demonstrated the potential of having a much more efficient light emission from an LEC with multiple BPEs.

Resolving conflict in bipolar societies: The fate of political settlements in Fiji and Northern Ireland

Ethnically divided societies that might be described as ‘balanced bicommunal’ (where there are two communities, each of which comes close to representing half of the population) pose a particular challenge to conventional principles of collective decision-making, and commonly threaten political stability. This article analyses the experience of two such societies – Northern Ireland and Fiji – with a view to exploring whether there are common processes in the route by which political stability has been pursued. We assess the manner in which a distinctive relationship with Great Britain and its political culture has interacted with local conditions to produce a highly competitive, bipolar party system. This leads to consideration of the devices that have been adopted in an effort to bridge the gap between the communities: the Fiji constitution as amended in 1997, and Northern Ireland’s Good Friday Agreement of 1998. We focus, in particular, on the use of unusual (preferential voting) formulas for the election of parliamentarians and of an inclusive principle in the selection of ministers, and consider the contribution of these institutional devices to the attainment of political stability. We find that, in both cases, the intervention of forces from outside the political system had a decisive impact, though in very different ways. In addition to being underpinned by solid institutional design, for political settlements to work effectively, some minimal level of trust between rival elites is required.

Adverse Childhood Life Events and Postpartum Psychosis in Bipolar Disorder

Background Women with bipolar disorder are at increased risk of postpartum psychosis. Adverse childhood life events have been associated with depression in the postpartum period, but have been little studied in relation to postpartum psychosis. In this study we investigated whether adverse childhood life events are associated with postpartum psychosis in a large sample of women with bipolar I disorder. Methods Participants were 432 parous women with DSM-IV bipolar I disorder recruited into the Bipolar Disorder Research Network (www.BDRN.org). Diagnoses and lifetime psychopathology, including perinatal episodes, were obtained via a semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry; Wing et al., 1990) and case-notes. Adverse childhood life events were assessed via self-report and case-notes, and compared between women with postpartum psychosis (n=208) and those without a lifetime history of perinatal mood episodes (n=224). Results There was no significant difference in the rate of any adverse childhood life event, including childhood sexual abuse, or in the total number of adverse childhood life events between women who experienced postpartum psychosis and those without a lifetime history of perinatal mood episodes, even after controlling for demographic and clinical differences between the groups. Limitations Adverse childhood life events were assessed in adulthood and therefore may be subject to recall errors. Conclusions We found no evidence for an association between adverse childhood life events and the occurrence of postpartum psychosis. Our data suggest that, unlike postpartum depression, childhood adversity does not play a significant role in the triggering of postpartum psychosis in women with bipolar disorder.