Lemmers-Jansen Imke L J, Fett Anne-Kathrin J, Van Doesum Niels J, Van Lange Paul A M, Veltman Dick J, Krabbendam Lydia
Section of Educational Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Section Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Front Hum Neurosci. 2019 Feb 13;13:47. doi: 10.3389/fnhum.2019.00047. eCollection 2019.
Psychosis is characterized by problems in social functioning and trust, the assumed glue to positive social relations. But what helps building trust? A prime candidate could be social mindfulness: the ability and willingness to see and consider another person's needs and wishes during social decision making. We investigated whether first-episode psychosis patients (FEP) and patients at clinical high-risk (CHR) show reduced social mindfulness, and examined the underlying neural mechanisms. Twenty FEP, 17 CHR and 46 healthy controls, aged 16-31, performed the social mindfulness task (SoMi) during fMRI scanning, spontaneously and after the instruction "to keep the other's best interest in mind." As first of two people, participants had to choose one out of four products, of which three were identical and one was unique, differing in a single aspect (e.g., color). FEP tended to choose the unique item (unmindful choice) more often than controls. After instruction, all groups significantly increased the number of mindful choices compared to the spontaneous condition. FEP showed reduced activation of the caudate and medial prefrontal cortex (mPFC) during mindful, and of the anterior cingulate cortex (ACC), mPFC, and left dorsolateral prefrontal cortex (dlPFC) during unmindful decisions. CHR showed reduced activation of the ACC compared to controls. FEP showed a trend toward more unmindful choices. A similar increase of mindful choices after instruction indicated the ability for social mindfulness when prompted. Results suggested reduced sensitivity to the rewarding aspects of social mindfulness in FEP, and reduced consideration for the other player. FEP (and CHR to a lesser extent) might perceive unmindful choices as less incongruent with the automatic mindful responses than controls. Reduced socially mindful behavior in FEP may hinder the building of trust and cooperative interactions.
精神病的特征是社交功能和信任方面存在问题，而信任被认为是积极社会关系的粘合剂。但什么有助于建立信任呢？一个主要候选因素可能是社会正念：即在社会决策过程中看到并考虑他人需求和愿望的能力与意愿。我们调查了首发精神病患者（FEP）和临床高危患者（CHR）是否表现出社会正念降低，并研究了其潜在的神经机制。20名FEP患者、17名CHR患者和46名年龄在16至31岁之间的健康对照者在功能磁共振成像扫描期间进行了社会正念任务（SoMi），先是自发进行，然后在接到“考虑对方的最大利益”的指令后进行。作为两人中的第一个，参与者必须从四种产品中选择一种，其中三种是相同的，一种是独特的，仅在一个方面有所不同（例如颜色）。FEP患者比对照组更倾向于选择独特的物品（不考虑他人的选择）。接到指令后，与自发状态相比，所有组的考虑他人的选择数量均显著增加。在考虑他人的决策过程中，FEP患者尾状核和内侧前额叶皮质（mPFC）的激活减少，在不考虑他人的决策过程中，前扣带回皮质（ACC）、mPFC和左侧背外侧前额叶皮质（dlPFC）的激活减少。与对照组相比，CHR患者ACC的激活减少。FEP患者表现出更多不考虑他人选择的趋势。接到指令后考虑他人选择的类似增加表明，在得到提示时他们具有社会正念能力。结果表明，FEP患者对社会正念的奖励方面敏感性降低，对他人的考虑减少。FEP患者（CHR患者程度较轻）可能比对照组更不认为不考虑他人的选择与自动的考虑他人的反应不一致。FEP患者社会正念行为的减少可能会阻碍信任和合作互动的建立。
