Changes In Arousal Research Articles

Examining the associations between posttraumatic stress disorder symptom clusters across cognitive processing therapy.

Cognitive processing therapy (CPT) is a well-known trauma-focused treatment that aims to generate more adaptive posttrauma cognitions and emotions. Changes in cognitions are theorized to be the mechanism by which CPT leads to improvement in posttraumatic stress disorder (PTSD) symptoms. The present study aimed to explore associations between changes in PTSD symptom clusters during CPT. We hypothesized that early changes in negative alterations in cognitions and mood (NACM) would correlate with later changes in other symptom clusters. Data were collected from 296 veterans participating a 7-week PTSD residential treatment program at a U.S. Veterans Affairs medical center. PTSD symptoms were assessed at pretreatment (Week 1), midtreatment (Week 4), and posttreatment (Week 7). Cross-lagged path analyses demonstrated that pretreatment-to-midtreatment improvement in NACM was correlated with midtreatment-to-posttreatment improvement in avoidance, β =.52, though this association was bidirectional, suggesting pretreatment-to-midtreatment improvements in either cluster may be correlated with midtreatment-to-posttreatment improvements. Similarly, pretreatment-to-midtreatment improvement in intrusions, β =.40, and arousal, β =.49, were correlated with later improvement in avoidance, suggesting avoidance may improve after improvement in other clusters. Interestingly, pretreatment-to-midtreatment arousal improvement was significantly correlated with midtreatment-to-posttreatment NACM improvement, β =.27, though the reverse was nonsignificant, whereas a bidirectional association between arousal and intrusions emerged, β =.34, β =.53. Early changes in arousal were correlated with later changes in several other symptom clusters, whereas other clusters demonstrated bidirectional associations. These results may inform understanding of symptom improvement timing across CPT, which may aid in treatment selection and planning.

Mechanisms of psilocybin on the treatment of posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) is a condition that can develop after a traumatic event, causing distressing symptoms, including intrusive re-experiencing symptoms, alterations in mood and cognition, and changes in arousal and reactivity. Few treatment options exist for patients who find conventional psychotherapy and pharmacotherapy to be inaccessible, ineffective, or intolerable. We explore psilocybin as a potential treatment option for PTSD by examining the neurobiology of PTSD as well as psilocybin's mechanism of action. Based on both pharmacodynamic and psychoanalytic principles, psilocybin may be an underexplored treatment option for patients with PTSD, though further research is required.

Mindfulness meditation alters neural oscillations independently of arousal

Neuroscience has identified that mindfulness meditation induces a state of relaxed alertness, characterised by changes in theta and alpha oscillations and reduced sympathetic arousal, although the underlying mechanisms remain unclear. This study aims to address this gap by examining changes in neural oscillations and arousal during mindfulness meditation using both traditional and data-driven methods. Fifty-two healthy young adults underwent electroencephalography (EEG) and skin conductance level (SCL) recordings during resting baseline and mindfulness meditation conditions, both conducted with eyes closed. The EEG data revealed a significant decrease in traditional alpha (8–13 Hz) amplitude during mindfulness meditation compared to rest. However, no significant differences were observed between conditions in traditional delta, theta, beta, or gamma amplitudes. Frequency Principal Components Analysis (fPCA) was employed as a data-driven approach, identifying six components consistent across conditions. A complex delta-theta-alpha component significantly increased during mindfulness meditation. In contrast, low alpha (~9.5 Hz) and low alpha-beta (~11 Hz) components decreased significantly during mindfulness meditation. No significant differences were observed between conditions in the delta, high alpha, and high alpha-beta components. Additionally, there were no significant differences in SCL between conditions, nor were there correlations between traditional alpha or fPCA components and SCL. These findings support the conceptualisation of mindfulness meditation as a state of relaxed alertness, characterised by changes in neural oscillations likely associated with attention and awareness. However, the observed changes do not appear to be driven by arousal.

Prazosin Treatment of Sleep Problems in Youth with PTSD

Post traumatic stress disorder (PTSD) is a condition characterized by reexperiencing symptoms, persistent avoidance, negative alterations in cognition and mood, and changes in arousal and reactivity in response to a traumatic event (American Psychiatric Association, 2013). The pathophysiology of PTSD is not fully understood but likely related to dysregulation of fear‐processing. Currently, the gold standard of treatment is trauma‐focused cognitive behavioral therapy (TF‐CBT). SSRIs are the only FDA‐approved pharmacologic treatments for PTSD in adults and there are no FDA approved medications to treat pediatric PTSD. Unlike studies in adults, double‐blinded randomized control trials (RCTs) did not show any efficacy for SSRIs in pediatric patients diagnosed with PTSD (Hudson et al., 2021). While estimates of pediatric PTSD prevalence varies, the prevalence of PTSD at age 18 is 7.8% (Rolling et al., 2023). Sleep disturbances such as insomnia, night‐time awakenings, and nightmares often persist despite treatment with TF‐CBT or SSRIs. Left untreated, sleep disturbances are predictive of PTSD persistence and comorbid psychiatric complications (Rolling et al., 2023). There is evidence supporting the use of the medication prazosin in alleviating pediatric PTSD sleep disturbances including nightmares and insomnia. Anywhere from 20–80% of children with PTSD report nightmares compared to a prevalence of 10–20% in the general pediatric population (Kovachy et al., 2013). There is a growing need for pharmacologic therapy given the paucity of providers trained in TF‐CBT and a need for symptomatic management. In this review, we will examine sleep disturbances in pediatric PTSD patients and discuss the feasibility of prazosin as an adjunct treatment option.

Pupil contagion variation with gaze, arousal, and autistic traits

Pupillary contagion occurs when one’s pupil size unconsciously adapts to the pupil size of an observed individual and is presumed to reflect the transfer of arousal. Importantly, when estimating pupil contagion, low level stimuli properties need to be controlled for, to ensure that observations of pupillary changes are due to internal change in arousal rather than the external differences between stimuli. Here, naturalistic images of children’s faces depicting either small or large pupils were presented to a group of children and adolescents with a wide range of autistic traits, a third of whom had been diagnosed with autism. We examined the extent to which pupillary contagion reflects autonomic nervous system reaction through pupil size change, heart rate and skin conductance response. Our second aim was to determine the association between arousal reaction to stimuli and degree of autistic traits. Results show that pupil contagion and concomitant heart rate change, but not skin conductance change, was evident when gaze was restricted to the eye region of face stimuli. A positive association was also observed between pupillary contagion and autistic traits when participants’ gaze was constrained to the eye region. Findings add to a broader understanding of the mechanisms underlying pupillary contagion and its association with autism.

Environmental context sculpts spatial and temporal visual processing in thalamus.

Behavioral state modulates neural activity throughout the visual system; this is largely due to changes in arousal that alter internal brain state. However, behaviors are constrained by the external environmental context, so it remains unclear if this context itself dictates the regime of visual processing, apart from ongoing changes in arousal. Here, we addressed this question in awake head-fixed mice while they passively viewed visual stimuli in two different environmental contexts: either a cylindrical tube, or a circular running wheel. We targeted high-density silicon probe recordings to the dorsal lateral geniculate nucleus (dLGN) and simultaneously measured several electrophysiological and behavioral correlates of arousal changes, and thus controlled for them across contexts. We found surprising differences in spatial and temporal processing in dLGN across contexts, even in identical states of alertness and stillness. The wheel context (versus tube) showed elevated baseline activity, faster visual responses, and smaller but less selective spatial receptive fields. Further, arousal caused similar changes to visual responsiveness across all conditions, but the environmental context mainly changed the overall set-point for this relationship. Together, our results reveal an unexpected influence of the physical environmental context on fundamental aspects of visual processing in the early visual system.

Understanding allostasis: Early-life self-regulation involves both up- and down-regulation of arousal.

Optimal performance lies at intermediate autonomic arousal, but no previous research has examined whether the emergence of endogenous control associates with changes in children's up-regulation from hypo-arousal, as well as down-regulation from hyper-arousal. We used wearables to take day-long recordings from N = 58, 12-month-olds (60% white/58% female); and, in the same infants, we measured self-regulation in the lab with a still-face paradigm. Overall, our findings suggest that infants who showed more self-regulatory behaviors in the lab were more likely to actively change their behaviors in home settings moment-by-moment "on the fly" following changes in autonomic arousal, and that these changes result in up- as well as down-regulation. Implications for the role of atypical self-regulation in later psychopathology are discussed.

Do I sound anxious? Emotional arousal is linked to changes in vocalisations in domestic chicks (Gallus gallus dom.)

A major goal in animal welfare science is the development of methods that quantify or ‘read-out’ current affective states in freely behaving animals. In mammalian models, changes in acoustic parameters within vocalisations have been linked to differences in emotional arousal, although there are very few studies showing changes in vocalisations that act as indicators of valence (positive or negative affect). Currently, there are very few studies on vocal indicators of emotion in birds. To determine the link between acoustic parameters within vocalisations and emotion in domestic chicks (Gallus gallus dom.), we used a well-validated paradigm that purports to elicit two distinct, negative emotional states: anxiety and depression. In this paradigm, chicks in social isolation initially show high rates of distress calls (anxiety-like phase: high arousal/negative affect) that decrease over the next 20–30 minutes to a depression-like phase (low arousal/negative affect). We analysed acoustic parameters of distress vocalisations from Legbar chicks (4–7 days old) that were placed in social isolation for 30 minutes, either with or without a mirror (Isolated: n=18; Mirror: n=16), (a mirror is known to reduce the negative behavioural and physiological indicators of isolation). Chicks in the Isolated condition produced louder calls, of a higher frequency, and calls were individually longer, and more ‘degraded’ (higher entropy and lower harmonics-to-noise ratio) compared to the Mirror condition. However, the call rate did not drop below 50 % of the initial rate in either condition, indicating the chicks in this study did not reach the criteria for the depression-like phase of the paradigm. To investigate further we analysed vocalisations at times during a trial when calls were at a high rate per minute (indicating a higher level of emotional arousal at that point in time) and we found those vocalisations were louder, more ‘degraded’, longer and higher in frequency across both conditions. These results are consistent with findings across several species of mammal, indicating that changes in emotional arousal in negatively valanced situations give rise to consistent changes in vocal parameters across a wide range of species. Indeed, further work could look to see if the same links are found in groups such as chelonians, crocodilians and geckos, as their vocal production mechanisms share some similarities. There could also be scope to use these changes to automatically detect shifts in emotion in captive animals.

Impact of emotional states on tinnitus sound therapy efficacy based on ECG signals and emotion recognition model

BackgroundDiagnosis and severity assessment of tinnitus are mostly based on the patient's descriptions and subjective questionnaires, which lacks objective means of diagnosis and assessment bases, the accuracy of which fluctuates with the clarity of the patient's description. This complicates the timely modification of treatment strategies or therapeutic music to improve treatment efficacy. New methodWe employed a novel random convolutional kernel-based method for electrocardiogram (ECG) signal analysis to identify patients' emotional states during Music Tinnitus Sound Therapy (Music-TST) sessions. Then analyzed correlations between emotional changes in different treatment phase and Tinnitus Handicap Inventory (THI) score differences to determine the impact of emotions on tinnitus treatment efficacy. ResultsThis study revealed a significant correlation between patients' emotion changes during Music-TST and the therapy's effectiveness. Changes in arousal and dominance dimension, were strongly linked to THI variations. These findings highlight the substantial impact of emotional responses on sound therapy's efficacy, offering a new perspective for understanding and optimizing tinnitus treatment. Comparison with existing methodsCompared to existing methods, we proposed an objective indicator to assess the progress of sound therapy, the indicator could also be used to provide feedback to optimize sound therapy music. ConclusionsThis study revealed the critical role of emotion changes in tinnitus sound therapy. By integrating objective ECG-based emotion analysis with traditional subjective scale like THI, we present an innovative approach to assess and potentially optimize therapy effectiveness. This finding could lead to more personalized and effective treatment strategies for tinnitus sound therapy.

Noradrenergic tuning of arousal is coupled to coordinated movements.

Matching arousal level to the motor activity of an animal is important for efficiently allocating cognitive resources and metabolic supply in response to behavioral demands, but how the brain coordinates changes in arousal and wakefulness in response to motor activity remains an unclear phenomenon. We hypothesized that the locus coeruleus (LC), as the primary source of cortical norepinephrine (NE) and promoter of cortical and sympathetic arousal, is well-positioned to mediate movement-arousal coupling. Here, using a combination of physiological recordings, fiber photometry, optogenetics, and behavioral tracking, we show that the LCNE activation is tightly coupled to the return of organized movements during waking from an anesthetized state. Moreover, in an awake animal, movement initiations are coupled to LCNE activation, while movement arrests, to LCNE deactivation. We also report that LCNE activity covaries with the depth of anesthesia and that LCNE photoactivation leads to sympathetic activation, consistent with its role in mediating increased arousal. Together, these studies reveal a more nuanced, modulatory role that LCNE plays in coordinating movement and arousal.

Beyond bias: A registered examination of the validity of using line bisection to measure non-lateralised attention.

Line bisection is a task widely used to assess lateral asymmetries of attention, in which participants are asked to mark the midpoint of a horizontal line. The directional bisection error (DBE) from the objective midpoint of the line is the traditional measure of performance. However, an alternative method of studying the bisection behaviour, the endpoint weightings method, has been proposed. This method produces two measures of performance: endpoint weightings bias (EWB) and endpoint weightings sum (EWS). While EWB measures attentional asymmetry, it has been suggested that EWS quantifies the total (non-lateralised) attention allocated to the task. If EWS provides a valid index of non-lateralised attention, then changes in tonic and phasic arousal should systematically affect EWS. In this article, we formally tested this prediction, using time on task to manipulate tonic arousal and unpredictable auditory tones, presented simultaneously with line stimuli, to manipulate phasic arousal. Our registered analyses revealed that neither of our manipulations for tonic or phasic arousal significantly influenced EWS. Therefore, the null hypotheses cannot be rejected. An exploratory analysis of all trials and conditions revealed a significant reduction in EWS with time spent on task. However, the lack of any significant effect of the alerting tone on EWS suggests that EWS may not be a valid measure of generalised attention to the task.

Functional changes in sleep-related arousal after ketamine administration in individuals with treatment-resistant depression

The glutamatergic modulator ketamine is associated with changes in sleep, depression, and suicidal ideation (SI). This study sought to evaluate differences in arousal-related sleep metrics between 36 individuals with treatment-resistant major depression (TRD) and 25 healthy volunteers (HVs). It also sought to determine whether ketamine normalizes arousal in individuals with TRD and whether ketamine’s effects on arousal mediate its antidepressant and anti-SI effects. This was a secondary analysis of a biomarker-focused, randomized, double-blind, crossover trial of ketamine (0.5 mg/kg) compared to saline placebo. Polysomnography (PSG) studies were conducted one day before and one day after ketamine/placebo infusions. Sleep arousal was measured using spectral power functions over time including alpha (quiet wakefulness), beta (alert wakefulness), and delta (deep sleep) power, as well as macroarchitecture variables, including wakefulness after sleep onset (WASO), total sleep time (TST), rapid eye movement (REM) latency, and Post-Sleep Onset Sleep Efficiency (PSOSE). At baseline, diagnostic differences in sleep macroarchitecture included lower TST (p = 0.006) and shorter REM latency (p = 0.04) in the TRD versus HV group. Ketamine’s temporal dynamic effects (relative to placebo) in TRD included increased delta power earlier in the night and increased alpha and delta power later in the night. However, there were no significant diagnostic differences in temporal patterns of alpha, beta, or delta power, no ketamine effects on sleep macroarchitecture arousal metrics, and no mediation effects of sleep variables on ketamine’s antidepressant or anti-SI effects. These results highlight the role of sleep-related variables as part of the systemic neurobiological changes initiated after ketamine administration. Clinical Trials Identifier: NCT00088699.

Pan-cortical 2-photon mesoscopic imaging and neurobehavioral alignment in awake, behaving mice.

The flow of neural activity across the neocortex during active sensory discrimination is constrained by task-specific cognitive demands, movements, and internal states. During behavior, the brain appears to sample from a broad repertoire of activation motifs. Understanding how these patterns of local and global activity are selected in relation to both spontaneous and task-dependent behavior requires in-depth study of densely sampled activity at single neuron resolution across large regions of cortex. In a significant advance toward this goal, we developed procedures to record mesoscale 2-photon Ca2+ imaging data from two novel in vivo preparations that, between them, allow for simultaneous access to nearly all 0f the mouse dorsal and lateral neocortex. As a proof of principle, we aligned neural activity with both behavioral primitives and high-level motifs to reveal the existence of large populations of neurons that coordinated their activity across cortical areas with spontaneous changes in movement and/or arousal. The methods we detail here facilitate the identification and exploration of widespread, spatially heterogeneous neural ensembles whose activity is related to diverse aspects of behavior.

Pan-cortical 2-photon mesoscopic imaging and neurobehavioral alignment in awake, behaving mice

The flow of neural activity across the neocortex during active sensory discrimination is constrained by task-specific cognitive demands, movements, and internal states. During behavior, the brain appears to sample from a broad repertoire of activation motifs. Understanding how these patterns of local and global activity are selected in relation to both spontaneous and task-dependent behavior requires in-depth study of densely sampled activity at single neuron resolution across large regions of cortex. In a significant advance toward this goal, we developed procedures to record mesoscale 2-photon Ca2+ imaging data from two novel in vivo preparations that, between them, allow for simultaneous access to nearly all 0f the mouse dorsal and lateral neocortex. As a proof of principle, we aligned neural activity with both behavioral primitives and high-level motifs to reveal the existence of large populations of neurons that coordinated their activity across cortical areas with spontaneous changes in movement and/or arousal. The methods we detail here facilitate the identification and exploration of widespread, spatially heterogeneous neural ensembles whose activity is related to diverse aspects of behavior.

Cortical Networks Relating to Arousal Are Differentially Coupled to Neural Activity and Hemodynamics.

Even in the absence of specific sensory input or a behavioral task, the brain produces structured patterns of activity. This organized activity is modulated by changes in arousal. Here, we use wide-field voltage imaging to establish how arousal relates to cortical network voltage and hemodynamic activity in spontaneously behaving head-fixed male and female mice expressing the voltage-sensitive fluorescent FRET sensor Butterfly 1.2. We find that global voltage and hemodynamic signals are both positively correlated with changes in arousal with a maximum correlation of 0.5 and 0.25, respectively, at a time lag of 0 s. We next show that arousal influences distinct cortical regions for both voltage and hemodynamic signals. These include a broad positive correlation across most sensory-motor cortices extending posteriorly to the primary visual cortex observed in both signals. In contrast, activity in the prefrontal cortex is positively correlated to changes in arousal for the voltage signal while it is a slight net negative correlation observed in the hemodynamic signal. Additionally, we show that coherence between voltage and hemodynamic signals relative to arousal is strongest for slow frequencies below 0.15 Hz and is near zero for frequencies >1 Hz. We finally show that coupling patterns are dependent on the behavioral state of the animal with correlations being driven by periods of increased orofacial movement. Our results indicate that while hemodynamic signals show strong relations to behavior and arousal, these relations are distinct from those observed by voltage activity.

What the eyes, confidence, and partner's identity can tell about change of mind.

Perceptual confidence reflects the ability to evaluate the evidence that supports perceptual decisions. It is thought to play a critical role in guiding decision-making. However, only a few empirical studies have actually investigated the function of perceptual confidence. To address this issue, we designed a perceptual task in which participants provided a confidence judgment on the accuracy of their perceptual decision. Then, they viewed the response of a machine or human partner, and they were instructed to decide whether to keep or change their initial response. We observed that confidence predicted participants' changes of mind more than task difficulty and perceptual accuracy. Additionally, interacting with a machine, compared to a human, decreased confidence and increased participants tendency to change their initial decision, suggesting that both confidence and changes of mind are influenced by contextual factors, such as the identity of a partner. Finally, variations in confidence judgments but not change of mind were correlated with pre-response pupil dynamics, indicating that arousal changes are linked to confidence computations. This study contributes to our understanding of the factors influencing confidence and changes of mind and also evaluates the possibility of using pupil dynamics as a proxy of confidence.

Étude longitudinale des changements éprouvés par les civils exposés aux attentats de novembre 2015 à Paris

IntroductionFollowing the attacks of November 13, 2015, Santé Publique France set up an epidemiological survey. A first phase was carried out in 2016 then repeated in 2020, in order to understand the post-traumatic impact of the attacks. The survey consisted of closed and open-ended questions. We present here the analysis of the answers to the following open-ended questions: “Would you say that the attacks that your experienced has changed you in any way? Could you explain how?” We compare the answers given in 2016 and 2020. ObjectiveTo understand the individual impact of terrorist attacks on civilians between 2016 and 2020. MethodBased on a qualitative analysis, we compare the results at two different times and observe the evolution of these responses. The material is composed of short testimonials related to the question of interest and are processed by thematic analysis inspired by grounded theory. We analyze the responses from 2016 and 2020 independently, and then compare the emerging themes. ResultsThe results highlight the presence of symptoms associated with post-traumatic stress disorder, with symptoms of intrusion, persistent avoidance of stimuli associated with the traumatic event, altered cognition and mood changes in arousal and reactivity related to the traumatic event, significant suffering, and sometimes dissociative elements. Five years after the attacks, disorders are still present in some subjects. The most distressed ones present a profile with no projection into the future, living from day to day, sometimes associated with risky behaviors. The meaning of their existence eludes them. Another part of the respondents tries to find meaning in their lives. They are looking for new life projects. The process of transforming their individuality is underway. Finally, for others whose profiles appear in the 2020 testimonials, changes have been made, they have been able to mourn their past life, who they were, and overcome their trauma. They are resilient and, in some cases, show psychic functioning suggestive of post-traumatic growth. ConclusionThe psychological impact of terrorist attacks on civilians is still very much present with important suffering, but some form of adaptation in the form of resilience or even post-traumatic growth is underway for some five years after the November 2015 attacks.

Short-Term Dorsal Genital Nerve Stimulation Increases Subjective Arousal in Women With and Without Spinal Cord Injury: A Preliminary Investigation

ObjectivesFemale sexual dysfunction (FSD) affects an estimated 40% of women. Unfortunately, FSD is understudied, leading to limited treatment options for FSD. Neuromodulation has shown some success in alleviating FSD symptoms. We developed a pilot study to investigate the short-term effect of electrical stimulation of the dorsal genital nerve and tibial nerve on sexual arousal in healthy women, women with FSD, and women with spinal cord injury (SCI) and FSD. Materials and MethodsThis study comprises a randomized crossover design in three groups: women with SCI, women with non-neurogenic FSD, and women without FSD or SCI. The primary outcome measure was change in vaginal pulse amplitude (VPA) from baseline. Secondary outcome measures were changes in subjective arousal, heart rate, and mean arterial pressure from baseline. Participants attended one or two study sessions where they received either transcutaneous dorsal genital nerve stimulation (DGNS) or tibial nerve stimulation (TNS). At each session, a vaginal photoplethysmography sensor was used to measure VPA. Participants also rated their level of subjective arousal and were asked to report any pelvic sensations. ResultsWe found that subjective arousal increased significantly from before to after stimulation in DGNS study sessions across all women. TNS had no effect on subjective arousal. There were significant differences in VPA between baseline and stimulation, baseline and recovery, and stimulation and recovery periods among participants, but there were no trends across groups or stimulation type. Two participants with complete SCIs experienced genital sensations. ConclusionsTo our knowledge, this is the first study to measure sexual arousal in response to short-term neuromodulation in women. This study indicates that short-term DGNS but not TNS can increase subjective arousal, but the effect of stimulation on genital arousal is inconclusive. This study provides further support for DGNS as a treatment for FSD.

Subjective discomfort and lack of volitional drive with neuroleptic pharmacotherapy - a phenomenological case study

IntroductionIn comparison to extrapyramidal and metabolic side effects, the subjective aspects of neuroleptic treatment have been less extensively researched. Nevertheless, they are equally significant given their potential to influence adherence and functional outcome. Historically, terms such as “neuroleptic dysphoria,” “neuroleptic-induced psychic indifference,” and “neuroleptic-induced deficit syndrome” were used to characterize a range of unpleasant mood states on the one hand and a documented and observable motivational deficit on the other. The latter aligns with the findings from preclinical neuroscientific studies and animal models highlighting the significant involvement of mesolimbic dopamine in motivational processes. Despite an abundance of anecdotal data these adverse effects are often undetectable in large-scale clinical studies that utilize standardized assessment measures.ObjectivesTo present adverse subjective changes in arousal, mood and volitional drive resulting from neuroleptic intake from a patient’s perspective.MethodsThe subject is a patient, with no reported negative symptoms or lasting functional impairment described, who underwent a gradual 6-month discontinuation of risperidone in an outpatient setting following a complete recovery after a single psychotic episode. A semi-structured interview modelled after The Clinical Assessment Interview for Negative Symptoms (CAINS) was conducted. We aimed to elicit descriptions of the subjective experience while ensuring our approach remained non-suggestive.ResultsIn addition to describing potential akathisia and lethargy at higher doses, the subject reported a significant lack of motivation and a notably reduced willingness to exert effort towards achieving specific goals or engaging in activities that he still found rewarding or pleasurable. Furthermore, he consistently noted gradual improvements across various psycho-social aspects following the discontinuation of the medication. These adverse and unpleasant experiences were presented as the primary reason for wanting to discontinue pharmacological treatment.ConclusionsCertain adverse effects of antipsychotic medications can only be elucidated by the clinician through the examination of the patient’s subjective experiences. Medication induced dysphoria and volitional deficits have the potential to profoundly impact treatment adherence, leading to unrecommended discontinuation of neuroleptics, and can cause important functional impairment.Disclosure of InterestNone Declared

“Treat Me as Your Friend, Not a Virtual Being”: The Impact of Intelligent Virtual Agent’s Self-Disclosure of Different Emotions on Children’s Friendship

Intelligent virtual agents (IVAs) in virtual reality have become integral companions for children. They have gained prominence in children’s daily engagements by offering a rich interactive experience. In interpersonal relationships, self-disclosure, the process by which individuals share personal information and emotional experiences with others, plays a crucial role. In interactions with IVAs, self-disclosure not only influences the formation of relationships between children and IVAs but is also an important criterion for assessing whether IVAs can serve as effective interpersonal interaction partners. While self-disclosure plays a pivotal role in interpersonal relationships, its impact, especially when conveyed through varied emotional tones in IVAs, remains largely uncharted. This study investigated the intricate dynamics of how different emotional tones in IVAs’ self-disclosures influence children’s perceptions and relationship-building. By engaging 30 children in a structured experiment, we discovered that self-disclosure infused with high-valence emotions foster more profound connections. Interestingly, children exhibited muted sensitivity to arousal variations in high-valence emotions. However, their perceptions markedly shifted with arousal changes in low-valence emotions. Specifically, children resonated more with IVAs that showcased low-arousal negative self-disclosures. These findings not only shed light on the nuanced interplay of emotions in IVAs’ self-disclosure but also pave the way for more informed design strategies for child-oriented educational IVA.