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PloS One 2015Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their... (Meta-Analysis)
Meta-Analysis
Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their emotions. The work of Abrams and Taylor and their development of the Rating Scale for Emotional Blunting in the late 1970's was an early indicator that blunted affect could indeed be assessed reliably. Since then, several new instruments assessing negative symptoms with subscales measuring blunted affect have been developed. In light of this, we aim to provide researchers and clinicians with a systematic review of the different instruments used to assess blunted affect by providing a comparison of the type, characteristics, administration and psychometric properties of these instruments. Studies reporting on the psychometric properties of instruments assessing blunted affect in patients with schizophrenia were included. Reviews and case studies were excluded. We reviewed 30 full-text articles and included 15 articles and 10 instruments in this systematic review. On average the instruments take 15-30 minutes to administer. We found that blunted affect items common across all instruments assess: gestures, facial expressions and vocal expressions. The CAINS Self-report Expression Subscale, had a low internal consistency score. This suggests that this sub-scale does not reliably assess patients' self-reported blunted affect symptoms and is likely due to the nature of blunted affect. Instruments correlated minimally with instruments measuring positive symptoms and more importantly with depression suggesting that the instruments distinguish between seemingly similar symptoms.
Topics: Depression; Facial Expression; Humans; Psychiatric Status Rating Scales; Psychometrics; Reproducibility of Results; Schizophrenia; Schizophrenic Psychology; Self Report
PubMed: 26035179
DOI: 10.1371/journal.pone.0127740 -
Schizophrenia Research Jun 2020Negative symptoms reflect one of the most debilitating aspects of one of the most debilitating diseases known to humankind. As yet, our treatments for negative symptoms...
Negative symptoms reflect one of the most debilitating aspects of one of the most debilitating diseases known to humankind. As yet, our treatments for negative symptoms are palliative at best and our understanding of their causes is relatively superficial. To address this, we are developing objective ambulatory tools for digitally phenotyping their severity which can be used outside the confines of the traditional clinical and research settings. The present study evaluated the feasibility, reliability and validity of ambulatory vocal acoustic and facial emotion expression analysis. Videos were provided by 25 patients with schizophrenia or schizoaffective disorder and 27 nonpsychiatric controls using inexpensive, non-invasive ambulatory recording methods. Controls provided 411 video recordings, and patients provided 377 video recordings; an average of 15.22 and 14.50 per participant per group respectively. The vast majority (over 80%) of these videos were usable for analysis. An empirically-supported, limited-feature vocal (7 features) and facial (3 features) set was examined. Within participants, these features varied considerably over time, but showed moderate to good test-retest reliability in many cases once contextual factors (e.g., activity involved in at the time of testing) were accounted for. Vocal and facial features showed statistically significant convergence with a "gold standard" negative symptom measure. Ambulatory vocal/facial features were more strongly associated with engagement in social or work activities in patients than negative symptom ratings. These data support the use of ambulatory vocal/facial analytic technologies for digital phenotyping of these negative symptoms.
Topics: Affect; Aphasia; Facial Expression; Humans; Psychotic Disorders; Reproducibility of Results; Schizophrenia
PubMed: 32247747
DOI: 10.1016/j.schres.2020.03.043 -
Revista Brasileira de Psiquiatria (Sao... Sep 2006Apathy is the most common neuropsychiatry syndrome in Alzheimer's disease affecting 30-60% of patients. It can be defined as a loss of motivation and manifests in... (Review)
Review
Apathy is the most common neuropsychiatry syndrome in Alzheimer's disease affecting 30-60% of patients. It can be defined as a loss of motivation and manifests in affect, cognition and behavioral changes, determining blunted emotional response, lack of insight and social retraction, respectively. In this paper, the clinical features and the therapeutic perspectives of apathy are presented. There is considerable overlap between apathy and depression in Alzheimer's disease, but both are considered discrete syndromes. Pharmacological interventions for apathy include psychostimulants, such as methylphenidate, dopaminergic agents and cholinesterase inhibitors, but the results are controversial and there is no established treatment.
Topics: Alzheimer Disease; Caregivers; Cholinesterase Inhibitors; Depression; Diagnosis, Differential; Humans; Mood Disorders; Motivation; Positron-Emission Tomography; Syndrome
PubMed: 16816880
DOI: 10.1590/s1516-44462006000300017 -
Annals of General Psychiatry Oct 2023In Kalhbaum's first characterization of catatonia, the emotional symptoms, such as decreased or restricted expression of feelings and emotions, which is described as...
BACKGROUND
In Kalhbaum's first characterization of catatonia, the emotional symptoms, such as decreased or restricted expression of feelings and emotions, which is described as blunted affect, are related to the motor symptoms. In later years, the affective domain was excluded from the concept of catatonia and was not included among the diagnostic criteria in the various Diagnostic Statistical Manual (DSM) versions. In recent times, some authors have proposed the proposition of reevaluating the notion of catatonia through the reintroduction of the affective domain. The objective of this study was to examine the correlation between catatonic-like behavior (CLB), such as emotional withdrawal, blunted affect, and psychomotor slowing, and inflammatory markers, namely the neutrophil/lymphocytes ratio (NLR) and lymphocytes/monocytes ratio (LMR), in individuals diagnosed with schizophrenia.
METHOD
A sample of 25 patients with schizophrenia (10 females, 15 males) was recruited, and the Brief Psychiatric Rating Scale (BPRS) was used to assess the severity of emotional withdrawal, blunted affect, and psychomotor slowing.
FINDINGS
The correlation analysis (Spearman ρ) revealed a robust direct association between blunted affect and psychomotor slowing (ρ = 0.79, P = 0.001), and a significant direct correlation between CLB (emotional withdrawal, ρ = 0.51, P = 0.05; blunted affect ρ = 0.58, P = 0.05; motor retardation, ρ = 0.56, P = 0.05) and LMR (ρ = 0.53, P = 0.05). In addition, patients with a duration of illness (DOI) older than five years had a higher presence of CLB and a higher LMR than patients with a more recent diagnosis of the disease. Likely, patients with positive symptoms and in the prodromal and active stages of the disease have a different immune profile than patients in the residual stage and with a predominance of negative symptoms.
CONCLUSIONS
Psychomotor slowing and blunted affect are two significantly related features, representing the two-faced Janus of immobility. Furthermore, aggregating them in CLB is more predominant the longer the duration of schizophrenia and is associated with different a specific pattern of immune activation.
PubMed: 37821904
DOI: 10.1186/s12991-023-00471-0 -
Psychoneuroendocrinology Jul 2021Sleep disturbances and insufficient sleep are highly prevalent. Both clinical sleep disorders and multiple forms of experimental sleep loss predict heightened... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Sleep disturbances and insufficient sleep are highly prevalent. Both clinical sleep disorders and multiple forms of experimental sleep loss predict heightened inflammation. As such, it is necessary to investigate potential protective factors. Given that trait positive affect (PA) is associated with reduced inflammation, and buffers the proinflammatory effects of stress, it is possible that high trait positive affect might protect individuals from an inflammatory response to sleep disruption. The present study tested this hypothesis in an experimental sleep disruption paradigm with assessment of cellular inflammation.
METHODS
Data were drawn from good sleeping adults (n = 79) who participated in a randomized, within-subjects crossover experiment comparing the effects of two nights of sleep disruption versus two nights of uninterrupted sleep. Stimulated monocytic production of intracellular proinflammatory cytokines tumor necrosis factor (TNF) and interleukin-6 (IL-6) were assayed using flow cytometric methods and indexed as the percentage of monocytes expressing TNF, IL-6, or co-expressing both. Hypotheses were evaluated using linear mixed effects models.
RESULTS
Controlling for negative affect, body mass index, age, and sex, PA significantly moderated the associations between sleep condition and stimulated monocyte production of IL-6 (b = -1.03, t = -2.02, p = .048) and its co-expression with TNF (b = -0.93, t = -2.00, p = .049), such that inflammatory responses were blunted among those high in PA with increases principally among those low in PA. The effect on TNF was similar in terms of effect size, but marginally significant.
CONCLUSIONS
Activation of cellular inflammation in response to sleep disruption is buffered by PA independent of negative affect. Interventions that promote PA might protect persons from the inflammatory activation following sleep loss, with the potential to mitigate the adverse health consequences of sleep disturbance.
Topics: Adult; Affect; Cross-Over Studies; Female; Happiness; Humans; Inflammation; Interleukin-6; Male; Monocytes; Pleasure; Protective Factors; Sleep; Sleep Deprivation; Tumor Necrosis Factor-alpha
PubMed: 33975149
DOI: 10.1016/j.psyneuen.2021.105240 -
Journal of Perinatal Medicine Jul 2023Apparently, there is a broad scope of legal issues affecting the work with embryonic stem cells. I cannot address them all. I would like to focus on two fields of law... (Review)
Review
Apparently, there is a broad scope of legal issues affecting the work with embryonic stem cells. I cannot address them all. I would like to focus on two fields of law and discuss, rather in the overview, some salient issues of German constitutional and administrative law framing the scientific research process. Compared to the sophisticated scientific work we discuss here, legal arguments and operations remain blunt and awkward, addressing rather the identity of a society than the fluid frontiers of science and technology.
Topics: Humans; Embryonic Stem Cells; Stem Cell Research
PubMed: 36935569
DOI: 10.1515/jpm-2022-0511 -
Journal of Clinical Child and... 2019Blunted reward processing is evident in and may contribute to the onset of major depressive disorder. However, it is unclear what mechanisms contribute to the...
Blunted reward processing is evident in and may contribute to the onset of major depressive disorder. However, it is unclear what mechanisms contribute to the development of blunted reward-response prior to depression onset. The current study examined how individual differences in the tendency to dampen positive affect, an affect regulation strategy that decreases positive affect, are associated with reward responding and related brain activation in 39 healthy children (ages 7-10; 51% female; 79% White). To do this, we examined neural responses to winning a reward (candy) within the context of a previous loss, win, or neutral outcome. Whole-brain regression analyses revealed that self-reported tendencies to engage in dampening were associated with blunted striatum and thalamic activation during a winning outcome when following a previous loss outcome, as compared to when following a neutral outcome. This finding was above and beyond the influence of current depressive symptoms. However, tendencies to dampen positive affect were not associated with neural activity during the second of 2 consecutive win outcomes, and thus did not support the notion that dampening is associated with an inability to maintain reward responding. In youth, tendencies to dampen positive affect may be associated with less ability to flexibly upregulate neural reward responding following a loss, possibly leading to the development of affective inflexibility and increased vulnerability to depression. Dampening positive affect may be one mechanism that contributes to aberrant neural reward responding via affective inflexibility and may be a target for prevention in youth.
Topics: Affect; Brain; Child; Depressive Disorder, Major; Facial Expression; Female; Humans; Magnetic Resonance Imaging; Male; Psychomotor Performance; Reward
PubMed: 27819484
DOI: 10.1080/15374416.2016.1233502 -
Journal of Anxiety Disorders Jan 2023Recent research has attempted to elucidate the relationship between blood-based biomarkers (e.g., endocannabinoids; eCBs: including N-arachidonoylethanolamine [AEA] and...
BACKGROUND
Recent research has attempted to elucidate the relationship between blood-based biomarkers (e.g., endocannabinoids; eCBs: including N-arachidonoylethanolamine [AEA] and 2-arachidonoylglycerol [2-AG]) and mental health outcomes in psychiatric populations such as posttraumatic stress disorder (PTSD). Prior research suggests that adults with PTSD may have altered circulating eCB tone and a blunted mobilization of eCBs (particularly 2-AG) in response to stress (e.g., aerobic exercise), although our understanding has been limited in part due to heterogenous samples and small sample sizes.
METHODS
A subset of data was pooled from five studies in which women with and without PTSD (N = 98) completed questionnaires related to mood states and a blood draw prior to and following a bout of moderate-intensity aerobic exercise in order to determine: 1) whether circulating eCBs differ between groups and whether depressive and PTSD symptom severity are associated with baseline eCBs, 2) whether a bout of aerobic exercise increases circulating eCBs in adult women with PTSD, and 3) whether circulating eCBs are associated with overall mood states and exercise-induced improvements in mood states in women with and without PTSD.
RESULTS
PTSD diagnoses were not associated with baseline concentrations of eCBs. Greater depressive symptom severity and PTSD symptom severity within the negative alteration in cognition and mood cluster were associated with lower circulating AEA. Circulating AEA significantly increased following aerobic exercise for both groups, whereas circulating 2-AG only increased in women without PTSD. Greater circulating AEA within the PTSD group was associated with lower depressive mood, confusion, and total mood disturbance.
CONCLUSIONS
These findings suggest that greater circulating AEA is associated with better overall mood and lower depressive and PTSD symptom severity, and that an acute bout of moderate-intensity aerobic exercise increases circulating AEA (but not 2-AG) in adult women with PTSD. These findings are consistent with the idea that greater eCB tone (particularly AEA) following pharmacological and/or non-pharmacological manipulations may be beneficial for improving psychological outcomes (e.g., mood, cognition) among PTSD, and possibly other psychiatric populations.
Topics: Adult; Humans; Female; Endocannabinoids; Stress Disorders, Post-Traumatic; Exercise; Affect; Mood Disorders
PubMed: 36469982
DOI: 10.1016/j.janxdis.2022.102656 -
World Psychiatry : Official Journal of... Feb 2017Negative symptoms have long been conceptualized as a core aspect of schizophrenia. They play a key role in the functional outcome of the disorder, and their management...
Negative symptoms have long been conceptualized as a core aspect of schizophrenia. They play a key role in the functional outcome of the disorder, and their management represents a significant unmet need. Improvements in definition, characterization, assessment instruments and experimental models are needed in order to foster research aimed at developing effective interventions. A consensus has recently been reached on the following aspects: a) five constructs should be considered as negative symptoms, i.e. blunted affect, alogia, anhedonia, asociality and avolition; b) for each construct, symptoms due to identifiable factors, such as medication effects, psychotic symptoms or depression, should be distinguished from those regarded as primary; c) the five constructs cluster in two factors, one including blunted affect and alogia and the other consisting of anhedonia, avolition and asociality. In this paper, for each construct, we report the current definition; highlight differences among the main assessment instruments; illustrate quantitative measures, if available, and their relationship with the evaluations based on rating scales; and describe correlates as well as experimental models. We conclude that: a) the assessment of the negative symptom dimension has recently improved, but even current expert consensus-based instruments diverge on several aspects; b) the use of objective measures might contribute to overcome uncertainties about the reliability of rating scales, but these measures require further investigation and validation; c) the boundaries with other illness components, in particular neurocognition and social cognition, are not well defined; and d) without further reducing the heterogeneity within the negative symptom dimension, attempts to develop successful interventions are likely to lead to great efforts paid back by small rewards.
PubMed: 28127915
DOI: 10.1002/wps.20385 -
Kidney International Reports Sep 2023Mesenchymal stem/stromal cell-derived extracellular vesicles (MSC-EVs) are paracrine vectors with therapeutic functions comparable to their parent cells. However, it...
INTRODUCTION
Mesenchymal stem/stromal cell-derived extracellular vesicles (MSC-EVs) are paracrine vectors with therapeutic functions comparable to their parent cells. However, it remains unclear if donor obesity affects their therapeutic functions. We tested the hypothesis that the curative effect of human adipose tissue-derived MSC-EVs (A-MSC-EVs) is blunted by obesity.
METHODS
MSC-EVs were isolated by ultracentrifugation from mesenchymal stem/stromal cells (MSCs) collected from abdominal subcutaneous fat of obese and lean human subjects (obese and lean-MSC-EVs, respectively) and injected into the aorta of mice 2 weeks after renal artery stenosis (RAS) induction. Magnetic resonance imaging studies were conducted 2 weeks after MSC-EVs delivery to determine renal function. The effect of MSC-EVs on tissue injury was assessed by histology and gene expression of inflammatory factors, including interleukin (IL)-1β, IL-6, monocyte chemotactic protein-1 (MCP-1), and tumor necrosis factor alpha (TNF-α). Oxidative damage, macrophage infiltration, plasma renin, and hypoxia inducible factor-1α (HIF-1α) were also assessed.
RESULTS
Tracking showed that MSC-EVs localized in the kidney tissue, including glomeruli and tubules. All MSC-EVs decreased systolic blood pressure (SBP) and plasma renin and improved the poststenotic kidney (STK) volume, but obese-MSC-EVs were less effective than lean-MSC-EVs in improving medullary hypoxia, fibrosis, and tubular injury. Lean-MSC-EVs decreased inflammation, whereas obesity attenuated this effect. Only lean-MSC-EVs decreased STK cortical HIF-1α expression.
CONCLUSION
Obesity attenuates the antihypoxia, antifibrosis, antiinflammation, and tubular repair functions of human MSC-EVs in chronic ischemic kidney disease. These observations may have implications for the self-repair potency of obese subjects and for the use of autologous MSC-EVs in regenerative medicine.
PubMed: 37705914
DOI: 10.1016/j.ekir.2023.06.009