The neural basis of congitive-emotional processing in people with an at-risk mental state for developing psychosis

Schizophrenia affectts individuals in their personal, social and occupational
development and functioning. Besides cognitive deficits it is characterized by
deficits in emotional processing and regulation. There is an increasing
interest in the role of social cognitive processes in schizophrenia. Deficits
in social function are present throughout the course of the disorder and are
even present before onset of psychosis and have been shown to contribute to the
rate of relapse. A crucual finding is that performance on social cognition
tasks predicts social functioning, and that this assocaion cannot be accounted
for by general cognitive deficits. There is also neuroantomical evidence of
abormalities in brain circuits subserving social cognition in schizophrenia
(at-risk mental state for schizoprhenia, ARMS). Such research can uncover the
mechanisms involved in tranisition to psychosis and schizophrenia. This might
ultimately enable the development of prevention strategies, which would have
very significant implications in terms of mental health care.

The objective of this study is threefold. First, to investigate neural
correlates of cognitive-emotional processing in an ARMS sample, i.e.
help-seeking young people with an at-risk mental state (this will be addressed
in the base-line measurement). Second, we will investigate putative changes
after 8 months. This will give us information regarding the neural correlates
of symptom changes over time. In addition, it wil allow us to compare the
effects of interventions that have been applied, be it treatment as usual or
cognitive therapy (the intervention is not part of the present study, but
concerns an already ongoing project at the psychiatric institute). Finally, we
want to conduct diagnostic interviews and symptom evaluations 2 years after the
first fMRI-scan, to evalute whether fMRI activation is predicitive of the
clinical state 2 years later.

Using functional magnetic resonance imaging (fMRI) we will investigate the
neural basis of 3 cognitive processes that are highly relevant; reality
monitoring, emotion regulation and self-reflection. After 8 months subjects
will be scanned a second time, using the same tasks. Finally, we want to
conduct diagnostic interviews and symptom evaluations 2 years after the first
scan, to evaluate whether fMRI activation is predictive of the clinical state 2
years later.

Participants will be exposed to a 3 T magnetic field. No side effects have been
described so far. On rare occasions, a peripheral nerve (abdomen) is stimulated
by the changing magnetic gradients, this will cause an itchy feeling, but is
not harmful.