Biomarkers and clinical staging in psychiatry

Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well‐established, largely chronic illness, do not support a pre‐emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre‐emptive psychiatry.     

The long-term prognosis of pre-term infants

The dramatic increases in the survival rate of prematurely born, very low birth weight infants (<1500 g) have created concern about the possible sequelae experienced by these children, in terms of both severe problems and less severe learning and behavior problems. The methodological difficulties involved in answering questions about the outcomes of these children, including the choice of appropriate outcome measures, the analysis of individual variation, the problems associated with dropouts, the relevant comparison groups, the importance of survival rate, and the question of correcting for the degree of prematurity, are considered. In spite of the difficulties in interpreting the studies, the research indicates that many premature children have learning disabilities, particularly in the perceptual and visual motor functioning and some aspects of language and reading. In addition, ethical issues related to prematurity are discussed, including parents’ rights, decision-making, and cost and treatment. Finally, some solutions are proposed involving the use of risk indices for the early detection of developmental problems.     

Estimation of mental effort in learning visual search by measuring pupil response

Perceptual learning refers to the improvement of perceptual sensitivity and performance with training. In this study, we examined whether learning is accompanied by a release from mental effort on the task, leading to automatization of the learned task. For this purpose, we had subjects conduct a visual search for a target, defined by a combination of orientation and spatial frequency, while we monitored their pupil size. It is well known that pupil size reflects the strength of mental effort invested in a task. We found that pupil size increased rapidly as the learning proceeded in the early phase of training and decreased at the later phase to a level half of its maximum value. This result does not support the simple automatization hypothesis. Instead, it suggests that the mental effort and behavioral performance reflect different aspects of perceptual learning. Further, mental effort would be continued to be invested to maintain good performance at a later stage of training.     

Pre-academic and early academic achievement in children with velocardiofacial syndrome (del22q11.2) of borderline or normal intelligence

School-aged children with del22q11.2 tend to show a typical learning and neuropsychological profile, which is characterised by a VIQ-PIQ discrepancy (in favour of the VIQ) and significantly better scores for reading (decoding) and spelling compared to mathematics. To the best of our knowledge, there exists no systematic research on the pre-academic and early academic skills that might underpin these learning difficulties. The purpose of the current study was to investigate more systematically these pre-academic and early academic skills in borderline to normal intelligent (FSIQ > 70) children with del22q11.2 in the last year of kindergarten and first grade of primary school in Flanders. In the kindergarten group, meta-linguistic awareness and counting skills were examined. In the group of first graders, children were tested on reading, spelling and mathematics. Thirteen children (mean age: 6 years 4 months (SD = 0.84); 9 boys, 4 girls) participated in this study. In the present study, there were no differences in intelligence and academic outcomes between boys and girls, and no differences in IQ and academic achievement between children with cardiac defects or severe velopharyngeal insufficiency (VPI) and children without these deficits. With regard to pre-academic achievement in general, a characteristic profile with clearly better results for meta-linguistic awareness in comparison to counting skills was found, but this difference is not statistically significant. Concerning early academic achievement, children with del22q11.2, as a group, perform (despite their somewhat lower general intelligence) on average compared with their age-related peers. However, at an individual level--especially within the domain of counting skills and mathematics--there is a wide variability, with some children showing remarkable learning difficulties already at an early age.     

Prepared social learning about dangerous animals in children

Natural selection is likely to have shaped developmental systems for rapid acquisition of knowledge about environmental dangers, including dangerous animals. However, learning about dangerous animals through direct encounters can be costly and potentially fatal. In social species such as humans, the presence of stored information about danger in the minds of conspecifics might favor the evolution of prepared social learning mechanisms that cause children to preferentially attend to and remember culturally transmitted information about danger. Here we use an experimental learning task to show that children from two very different cultures exhibit prepared social learning about dangerous animals: city-dwelling children from Los Angeles, who face relatively little danger from animals, and Shuar children from the Amazon region of Ecuador, to whom dangerous animals pose a much greater threat. Both populations exhibited similar prepared learning effects. Danger information was learned in a single trial without feedback, immediately entered long-term memory, and was recalled with only minor attenuation a week later, while other information presented at the same time (animal names and diets) was immediately forgotten. We discuss the significance of these design features of prepared learning in light of the phylogeny and function of danger learning systems.     

Lecture 35. Types of Thinking. Thinking and Sensory Cognition

For many years our secondary schools have been oriented toward the "average" pupil. Of course, individual differences have, of necessity, been taken into account in work with retarded children and poor achievers. But children with a high receptivity to learning usually have not drawn attention to themselves. However, there is no doubt that some pupils display especially favorable conditions for mental development and the preconditions for uncommon intellectual abilities quite early.     

Human-like, population-level specialization in the manufacture of pandanus tools by New Caledonian crows Corvus moneduloides

The main way of gaining insight into the behaviour and neurological faculties of our early ancestors is to study artefactual evidence for the making and use of tools, but this places severe constraints on what knowledge can be obtained. New Caledonian crows, however, offer a potential analogous model system for learning about these difficult-to-establish aspects of prehistoric humans. I found new evidence of human-like specialization in crows' manufacture of hook tools from pandanus leaves: functional lateralization or 'handedness' and the shaping of these tools to a rule system. These population-level features are unprecedented in the tool behaviour of free-living non-humans and provide the first demonstration that a population bias for handedness in tool-making and the shaping of tools to rule systems are not concomitant with symbolic thought and language. It is unknown how crows obtain their tool behaviour. Nevertheless, at the least they can be studied in order to learn about the neuropsychology associated with early specialized and/or advanced population features in tool-making such as hook use, handedness and the shaping of tools to rule systems.     

Animal models of social anxiety disorder and their validity criteria

Anxiety disorders pose one of the largest threats to global mental health, and they predominantly emerge early in life. Social anxiety disorder, also known as social phobia, is the most common of all anxiety disorders. Moreover, it has severe consequences and is a disabling disorder that can cause an individual to be unable to perform the tasks of daily life. Social anxiety disorder is associated with the subsequent development of major depression and other mental diseases, as well as increased substance abuse. Although some neurobiological alterations have been found to be associated with social anxiety disorder, little is known about this disorder. Animal models are useful tools for the investigation of this disorder, as well as for finding new pharmacological targets for treatment. Thus, this review will highlight the main animal models of anxiety associated with social phobia.     

The Neural Bases of Directed and Spontaneous Mental State Attributions to Group Agents

In daily life, perceivers often need to predict and interpret the behavior of group agents, such as corporations and governments. Although research has investigated how perceivers reason about individual members of particular groups, less is known about how perceivers reason about group agents themselves. The present studies investigate how perceivers understand group agents by investigating the extent to which understanding the ‘mind’ of the group as a whole shares important properties and processes with understanding the minds of individuals. Experiment 1 demonstrates that perceivers are sometimes willing to attribute a mental state to a group as a whole even when they are not willing to attribute that mental state to any of the individual members of the group, suggesting that perceivers can reason about the beliefs and desires of group agents over and above those of their individual members. Experiment 2 demonstrates that the degree of activation in brain regions associated with attributing mental states to individuals—i.e., brain regions associated with mentalizing or theory-of-mind, including the medial prefrontal cortex (MPFC), temporo-parietal junction (TPJ), and precuneus—does not distinguish individual from group targets, either when reading statements about those targets'' mental states (directed) or when attributing mental states implicitly in order to predict their behavior (spontaneous). Together, these results help to illuminate the processes that support understanding group agents themselves.     

Intelligence is universal in life.

Behaviorists assume that living things memorize random atoms of information (engrams), "reinforced" by success, just as in the neo-Darwinian mutation-selection process. On the contrary we have to recognize the existence of organized and systematic responses in the learning process (Krechevsky). The animals seek desperately to "understand the meaning" of the world around them, by widening its context. Intelligence is not an exclusive prerogative of human mind. The minds of insects operate in the same way as that of man. Even a cell has a sort of intelligence (Cuenot). Consciousness is a state of awareness associated with enhanced mental activity. It occurs also in other "higher" animals (Thorpe). However human themselves are non conscious of their basic underlying motivations. Unconscious or ineffable knowledge plays a great role in shaping our world-view and in determining our influence on the Gaian hierarchy.     

Small worlds and semantic network growth in typical and late talkers

Network analysis has demonstrated that systems ranging from social networks to electric power grids often involve a small world structure-with local clustering but global ac cess. Critically, small world structure has also been shown to characterize adult human semantic networks. Moreover, the connectivity pattern of these mature networks is consistent with lexical growth processes in which children add new words to their vocabulary based on the structure of the language-learning environment. However, thus far, there is no direct evidence that a child's individual semantic network structure is associated with their early language learning. Here we show that, while typically developing children's early networks show small world structure as early as 15 months and with as few as 55 words, children with language delay (late talkers) have this structure to a smaller degree. This implicates a maladaptive bias in word acquisition for late talkers, potentially indicating a preference for "oddball" words. The findings provide the first evidence of a link between small-world connectivity and lexical development in individual children.     

Cognitive brain–Computer interface and probable aspects of its practical application

A new type of brain-computer interface was elaborated. It considers a variety of brain activity parameters to determine the type of mental operation being performed at the moment. The corresponding algorithm previously developed in the lab was modified for real-time application. The possibility of interface application for cognitive skills training was investigated. In the proposed paradigm, as soon as the EEG spectral pattern was adequate for the current task, some clue to the solution was presented. As we supposed, such positive biofeedback should facilitate memorization of the current brain state. After just one learning session, the differences in EEG spectra, corresponding to two types of tasks, were concentrated in more narrow frequency ranges. It indicates a decrease in mental effort. Moreover, the majority of subjects succeeded in solving the tasks faster, which is evidence of increased efficiency. The developed interface could be used for the new type of training, based on objective features of brain activity.     

The life histories of American stepfathers in evolutionary perspective

This paper presents an analysis of the characteristics of men who become stepfathers, and their subsequent fertility patterns and lifetime reproductive success. Because women who already have children are ranked lower in the marriage market than women without children, men who marry women with children (e.g., stepfathers) are likely to have lower rankings in the marriage market as well. Using retrospective fertility and marital histories from the Panel Study of Income Dynamics (PSID), I show that men who become stepfathers have lower levels of education, less income, and are more likely to have been divorced before and to already have children, all characteristics that lower their rankings in the marriage market. Men with one or two stepchildren are just as likely to have children within a marriage as non-stepfathers, although men with three stepchildren show decreased fertility. Among men age 45 and older, stepfathers have lower lifetime fertility than non-stepfathers, although the difference disappears when men’s age at first marriage is controlled for. Additionally, stepfathers have significantly higher fertility than men who never marry. The results suggest that some men become stepfathers to procure mates and fertility benefits that they would otherwise have been unlikely to obtain; for these men, raising other men’s children serves as a form of mating effort. Preliminary versions of this paper were presented at the Evolution and Human Adaptation Program at the University of Michigan, and the Human Behavior and Evolution Society’s annual meeting at Amherst. Kermyt G. Anderson received his Ph.D. in anthropology from the University of New Mexico in 1999. He is currently a Mellon Postdoctoral Research Fellow at the Population Studies Center of the Institute for Social Research at the University of Michigan. His current research examines the relationship between family structure, parental investment, and children’s educational and employment outcomes in South Africa.     

Age‐dependent song changes in a closed‐ended vocal learner: elevation of song performance after song crystallization

Birdsong is a sexual signal that serves as an indicator of male quality. There is already abundant evidence that song elaboration reflects early life‐history because early developmental stress affects neural development of song control systems, and leaves irreversible adverse effects on song phenotypes. Especially in closed‐ended vocal learners, song features crystallized early in life are less subject to changes in adulthood. This is why less attention has been paid to lifelong song changes in closed‐ended learners. However, in the eyes of female birds that gain benefits from choosing mates based on male songs, not only past but also current conditions encoded in songs would be meaningful, given that even crystallized songs in closed‐ended learners would not be identical in the long term. In this study, we examine within‐individual song changes in the Java sparrow Lonchura oryzivora, with the aim of shedding light on the relationship between song and long‐term life history. Specifically, we compared song length, tempo, and song complexity measures between the point just after song crystallization and around 1 yr later, and also compared those traits between fathers and sons to clarify the effect of vocal learning. While it is not surprising that song complexity did not differ depending on age or between fathers and sons, we found that song length and tempo increased with age. Follow‐up analyses have revealed that frequency bandwidth and peak frequency of song notes also elevated with age. Our results show that song performance related to motor skills can be improved even after song crystallization. We also suggest that song performance in closed‐ended vocal learners gives a reliable clue for mate choice by reflecting male quality with aging.     

The clinical characterization of the adult patient with depression aimed at personalization of management

Depression is widely acknowledged to be a heterogeneous entity, and the need to further characterize the individual patient who has received this diagnosis in order to personalize the management plan has been repeatedly emphasized. However, the research evidence that should guide this personalization is at present fragmentary, and the selection of treatment is usually based on the clinician's and/or the patient's preference and on safety issues, in a trial‐and‐error fashion, paying little attention to the particular features of the specific case. This may be one of the reasons why the majority of patients with a diagnosis of depression do not achieve remission with the first treatment they receive. The predominant pessimism about the actual feasibility of the personalization of treatment of depression in routine clinical practice has recently been tempered by some secondary analyses of databases from clinical trials, using approaches such as individual patient data meta‐analysis and machine learning, which indicate that some variables may indeed contribute to the identification of patients who are likely to respond differently to various antidepressant drugs or to antidepressant medication vs. specific psychotherapies. The need to develop decision support tools guiding the personalization of treatment of depression has been recently reaffirmed, and the point made that these tools should be developed through large observational studies using a comprehensive battery of self‐report and clinical measures. The present paper aims to describe systematically the salient domains that should be considered in this effort to personalize depression treatment. For each domain, the available research evidence is summarized, and the relevant assessment instruments are reviewed, with special attention to their suitability for use in routine clinical practice, also in view of their possible inclusion in the above‐mentioned comprehensive battery of measures. The main unmet needs that research should address in this area are emphasized. Where the available evidence allows providing the clinician with specific advice that can already be used today to make the management of depression more personalized, this advice is highlighted. Indeed, some sections of the paper, such as those on neurocognition and on physical comorbidities, indicate that the modern management of depression is becoming increasingly complex, with several components other than simply the choice of an antidepressant and/or a psychotherapy, some of which can already be reliably personalized.     

Rule-Based Category Learning in Children: The Role of Age and Executive Functioning

Rule-based category learning was examined in 4–11 year-olds and adults. Participants were asked to learn a set of novel perceptual categories in a classification learning task. Categorization performance improved with age, with younger children showing the strongest rule-based deficit relative to older children and adults. Model-based analyses provided insight regarding the type of strategy being used to solve the categorization task, demonstrating that the use of the task appropriate strategy increased with age. When children and adults who identified the correct categorization rule were compared, the performance deficit was no longer evident. Executive functions were also measured. While both working memory and inhibitory control were related to rule-based categorization and improved with age, working memory specifically was found to marginally mediate the age-related improvements in categorization. When analyses focused only on the sample of children, results showed that working memory ability and inhibitory control were associated with categorization performance and strategy use. The current findings track changes in categorization performance across childhood, demonstrating at which points performance begins to mature and resemble that of adults. Additionally, findings highlight the potential role that working memory and inhibitory control may play in rule-based category learning.     

Belief in Animal Mind among Spanish Primary School Children

Beliefs concerning the mental experiences of nonhuman animals have been related to how people treat, see, and take care of nonhuman animals. Whereas this issue has been the subject of several studies on adults, few have been conducted with children. Taking advantage of a recently published scale, the Child-BAM questionnaire, we aimed to explore the beliefs in animal minds of Spanish primary school children. The study also considered the effects of a child's age, school year group, gender, and pet ownership on their beliefs in animal mind. The Child-BAM questionnaire, concerning the mental capabilities of eight different species (human, chimpanzee, dog, cow, otter, sparrow, frog, and fish), was distributed at a primary school sited in Cordoba, Spain. A total of 416 participants were included aged between 6 and 13 years. Each child provided scores for animals’ ability to have intelligence, experience pain, fear, happiness, and sadness, and total scores for the eight species were calculated. The results showed that children's beliefs about animal minds differed depending on the type of animal, and that children were more likely to believe in the emotional capacities of animals rather than their cognitive capabilities. Dogs achieved similar scores to humans regarding all capabilities, and higher than any other species, while the cow, fish, and frog generally scored the lowest. Age, school year group, and having a companion animal at home affected beliefs in animal minds, whereas gender had no effect. This study highlights cultural similarities in children's beliefs about animal minds and the potential importance of this variable for future research in child–animal interactions.     

Training early visuo-spatial abilities: A controlled classroom-based intervention study

Visuo-spatial training is considered a promising approach to provide young children with a sound foundation for later mathematical learning. We developed and implemented a tablet-based visuo-spatial intervention in kindergarten classrooms aiming to foster the development of children’s visuo-spatial and numerical abilities. A sample of N?=?125 children participated in the present study, 68 children were part of the intervention group and participated in 20 training sessions of 20?min over a 10-week period, 57 children formed a business as usual control group. Results show that, at this young age, visuo-spatial and early math skills are already strongly interlinked. However, the training effects were domain-specific as they only improved visuo-spatial skills, but did not transfer to early math performance in the present setting.     

Use of auditory learning to manage listening problems in children

This paper reviews recent studies that have used adaptive auditory training to address communication problems experienced by some children in their everyday life. It considers the auditory contribution to developmental listening and language problems and the underlying principles of auditory learning that may drive further refinement of auditory learning applications. Following strong claims that language and listening skills in children could be improved by auditory learning, researchers have debated what aspect of training contributed to the improvement and even whether the claimed improvements reflect primarily a retest effect on the skill measures. Key to understanding this research have been more circumscribed studies of the transfer of learning and the use of multiple control groups to examine auditory and non-auditory contributions to the learning. Significant auditory learning can occur during relatively brief periods of training. As children mature, their ability to train improves, but the relation between the duration of training, amount of learning and benefit remains unclear. Individual differences in initial performance and amount of subsequent learning advocate tailoring training to individual learners. The mechanisms of learning remain obscure, especially in children, but it appears that the development of cognitive skills is of at least equal importance to the refinement of sensory processing. Promotion of retention and transfer of learning are major goals for further research.     

When It Hurts (and Helps) to Try: The Role of Effort in Language Learning

Compared to children, adults are bad at learning language. This is counterintuitive; adults outperform children on most measures of cognition, especially those that involve effort (which continue to mature into early adulthood). The present study asks whether these mature effortful abilities interfere with language learning in adults and further, whether interference occurs equally for aspects of language that adults are good (word-segmentation) versus bad (grammar) at learning. Learners were exposed to an artificial language comprised of statistically defined words that belong to phonologically defined categories (grammar). Exposure occurred under passive or effortful conditions. Passive learners were told to listen while effortful learners were instructed to try to 1) learn the words, 2) learn the categories, or 3) learn the category-order. Effortful learners showed an advantage for learning words while passive learners showed an advantage for learning the categories. Effort can therefore hurt the learning of categories.