Emotional Processing Difficulties Research Articles

Mentalized Affectivity, Helicopter Parenting, and Psychopathological Risk in Emerging Adults: A Network Analysis

Emerging adulthood represents a critical stage characterized by heightened risks for anxiety, depression, and somatization symptoms development. Research has shown that difficulties in emotional identification, expression, and processing, as well as dysfunctional parenting styles, may exacerbate symptoms in emerging adults. The present study aimed at examining the interplay between mentalized affectivity (i.e., emotional identification, processing, and expression), helicopter parenting, and psychopathological risk in 913 Italian cisgender emerging adults (M = 24.34, SD = 2.81; 71.20% assigned female at birth), using network analysis. The results indicated moderate to strong associations between psychopathological symptoms, with emotional processing difficulties significantly associated with general anxiety, depression, and, to a lesser extent, somatization. Additionally, increased degrees of helicopter parenting from mothers were linked to increased psychopathology and higher emotional processing difficulties. These findings emphasize the importance of addressing the interconnection between symptoms and emotional processing to prevent and treat psychopathological risks in emerging adults. Moreover, interventions targeting intrusive and overprotecting parenting behaviors may promote well-being among emerging adults.

DIFFERENCES IN ACADEMIC ORIENTATIONS, EMOTIONAL PROCESSING DIFFICULTIES, AND TEST ANXIETY BETWEEN HIGH AND LOW-ACHIEVING COLLEGE STUDENTS

This study aimed to investigate differences in positive academic orientations, emotional processing difficulties, and test anxiety between high- and low-achieving college students. The sample includes four hundred students from Kafrelsheikh University. The study also aimed to detect gender differences in these variables. Measures of academic orientations, emotional processing, and test anxiety were used to collect the required data. The descriptive approach and statistical analysis were relied upon using SPSS. The study revealed statistically significant gender and achievement differences between positive academic orientations among university students in favor of high-achieving females. The study also revealed statistically significant gender and achievement differences in emotional processing difficulties in the direction of low-achieving males. In addition, significant gender and achievement differences in test anxiety were found in the direction of low-achieving females. Some implications, suggestions, and limitations were addressed.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0307/a.php" alt="Hit counter" /></p>

Emotion Recognition and Self-Reported Emotion Processing in Alcohol and Cannabis Co-Using Young Adults.

Alcohol and cannabis use are each associated with impairments in emotion recognition accuracy, which may promote interpersonal problems. It is unclear if emotion recognition or self-reported emotion processing differs between young adult alcohol and cannabis co-users (ACCs) and healthy controls (HCs). This study examined whether ACCs and HCs differed in their emotion recognition across two different behavioral tasks with static or dynamic faces and determined if there were differences in self-reported socio-emotional processing and alexithymia. 22 ACCs (mean age = 21.27 ± 1.75) and 25 HCs (mean age = 21.48 ± 2.68), matched on age, sex, and IQ, completed the Metrisquare Emotion Recognition Task and CANTAB Emotion Recognition Task. The ACCs and HCs were compared on task accuracy and self-reported measures, including the Social Emotional Questionnaire (SEQ) and the Perth Alexithymia Questionnaire (PAQ). No significant main effects of the Group variable or the Emotion-Group interaction variable were present for either task. The ACCs had lower SEQ (p = 0.014) and higher PAQ (p = 0.024) scores relative to the HCs, indicating greater difficulties in socio-emotional processing and identifying one's own emotions, respectively. Understanding the behavioral correlates of the self-reported difficulties in emotion processing reported by ACCs is needed to develop interventions to reduce these symptoms and promote healthy socio-emotional functioning in this population.

The role of emotional factors in face processing abilities in autism spectrum conditions

Facial emotion recognition is considered atypical in individuals with autism spectrum conditions (ASC), but emotion recognition abilities vary widely in autistic people, and there are inconsistent findings on the causes of these differences. Research indicates alexithymia may result in facial emotion recognition differences in ASC. Alternatively, mood disorders have been linked to atypical facial emotional expression recognition abilities in neurotypical adults. Investigating both the effects of alexithymia and mood disorders (depression and anxiety) is necessary to establish which of these factors may cause atypical facial emotion recognition in ASC. This study aimed to examine whether alexithymia or mood disorder symptomology is a predictor of atypical facial emotion recognition in individuals with ASC. Ninety-eight non-autistic adults and 80 autistic adults were recruited. Participants completed an online facial processing task to examine emotion and identity recognition abilities, the AQ-28, the TAS-20, and the HADS to measure autism severity, alexithymia symptoms, and depression and anxiety symptoms. Regression-based analyses found that autistic traits and autistic group membership did not predict facial emotion processing abilities after accounting for demographic variables, alexithymia and mood disorders: however, neither alexithymia nor mood disorder symptoms predicted variance in face processing abilities either. Our results concur with previous meta-analyses of facial emotion processing in autism spectrum disorder which report that studies do not always report deficits in face processing in autism: our findings are also not supportive of the model that argues that alexithymia explains facial emotion processing difficulties in autism.

Alexithymia modulates emotion concept activation during facial expression processing.

Alexithymia is characterized by difficulties in emotional information processing. However, the underlying reasons for emotional processing deficits in alexithymia are not fully understood. The present study aimed to investigate the mechanism underlying emotional deficits in alexithymia. Using the Toronto Alexithymia Scale-20, we recruited college students with high alexithymia (n = 24) or low alexithymia (n = 24) in this study. Participants judged the emotional consistency of facial expressions and contextual sentences while recording their event-related potentials. Behaviorally, the high alexithymia group showed longer response times versus the low alexithymia group in processing facial expressions. The event-related potential results showed that the high alexithymia group had more negative-going N400 amplitudes compared with the low alexithymia group in the incongruent condition. More negative N400 amplitudes are also associated with slower responses to facial expressions. Furthermore, machine learning analyses based on N400 amplitudes could distinguish the high alexithymia group from the low alexithymia group in the incongruent condition. Overall, these findings suggest worse facial emotion perception for the high alexithymia group, potentially due to difficulty in spontaneously activating emotion concepts. Our findings have important implications for the affective science and clinical intervention of alexithymia-related affective disorders.

Syntactic and affective prosody recognition: Schizophrenia vs. Autism spectrum disorders.

Patients with a recent diagnosis of schizophrenia and individuals receiving a diagnosis of autism spectrum disorder without accompanying intellectual impairment (ASD w/o intellectual impairment) during their adulthood share several clinical characteristics. Exploring under-investigated aspects of these two clinical conditions may shed light on their possible connection and facilitate differential diagnosis at very early stages. To this end, we explored the ability of 15 adults with a recent diagnosis of schizophrenia, 15 individuals diagnosed with ASD w/o intellectual impairment as adults, and 15 healthy adults to resolve sentence ambiguities with the use of syntactic prosody, and to decode happiness, anger, sadness, surprise, fear, and neutrality based on affective prosody. Results revealed intact perception of syntactic prosody in adults with schizophrenia, but impaired affective prosody recognition, which could be attributed, however, to emotion processing difficulties overall. On the other hand, individuals with ASD w/o intellectual impairment were impaired on prosody comprehension per se, as evidenced in the most challenging conditions, namely the subject-reading condition and the emotion of surprise. The differences in prosody comprehension ability between the two clinical conditions may serve as an indicator, among other signs, during the diagnostic evaluation.

Reducing alexithymia and increasing interoceptive awareness: A randomized controlled trial comparing mindfulness with dyadic socio-emotional app-based practice

BackgroundEmotion processing deficits of alexithymia are a transdiagnostic risk factor. While such deficits are malleable, the differential efficacy of brief scalable digital mental trainings remains understudied. MethodsThis randomized controlled trial probed the efficacy of mindfulness-based (MB) and partner-based socio-emotional Affect Dyad (SE) practice, both supported by weekly coaching sessions, in reducing alexithymia in 285 adult participants. We investigated the predictive role of interoceptive awareness assessed a) before and after daily practice, b) in ecological momentary assessment (EMA) before and after the intervention, and c) weekly during the 10-week intervention. ResultsBoth interventions reduced emotion processing difficulties on the Toronto Alexithymia Scale (TAS-20). Similarly, both interventions improved interoceptive awareness immediately after daily practice and after the intervention period, yet SE outperformed MB training in EMA assessments. Further, only Dyad practice led to increases in body listening and self-regulatory aspects of the Multidimensional Assessment of Interoceptive Awareness (MAIA) over time, with the latter explaining a decrease in alexithymia. LimitationsGiven the subclinical study sample, findings are limited in their generalizability to clinical samples. ConclusionsFindings suggest that app-based socio-emotional and mindfulness-based practices, supported by online coaching sessions, are effective in reducing emotion processing deficits. Dyad training showed advantages on some measures of body awareness, which predicted observed changes in alexithymia. This highlights the potential of using app-based dyadic approaches in the development of emotion awareness and regulation.

Evaluation of multidimensional pediatric-psychosomatic inpatient therapy: a pilot study comparing two treatment modalities.

Multidimensional pediatric-psychosomatic inpatient treatment should be considered a highly relevant concept in the German healthcare system. This treatment concept has been successfully integrated to support youth with mental disorders and patients with chronic somatic conditions. Studies on treatment impact and empirical evidence of pediatric-psychosomatic inpatient therapies are rare, despite their clinical significance. Therefore, the study aims to provide initial indications of what constitutes to enhanced treatment effectiveness by comparing two different pediatric-psychosomatic inpatient treatment concepts. The clinics are comparable regarding the treated disorders, which include: dissociative, mood, and somatoform disorders, and psychological factors associated with chronic somatic conditions. Multidimensional treatment in both clinics include components of individual and family therapy, along with group-, art-, music-, creative-, and physio-therapy. Both clinics differed regarding their treatment philosophy in which; Clinic A practiced psychodynamic behavioral elements more strongly, while Clinic B rooted itself more strongly with psychoanalysis and family-dynamic practices. Each clinic recruited 25 patients for the study. They completed two questionnaires both at admission and discharge, which measured general behavioral and emotional problems (YSR); and, respectively, difficulties in emotion perception and processing (TAS-26). The effectiveness of the treatment was examined by conducting one-sample t-test and effect sizes for each clinic. To obtain information on differentiating treatment effects, mixed ANOVAs were calculated. For estimating its influence, the treatment duration was taken into account as a covariate calculating an ANCOVA. In both settings, treatment effects can be observed regarding internalizing problems. For alexithymia, no effects were seen in Clinic B, while in Clinic A, there was a significant reduction. When comparing both clinics, the ANOVAs showed significant interaction effects displaying advantages for Clinic A in the reduction of internalizing, total behavioral problems and alexithymia. Taking into account the treatment duration as a covariate, those effects level out. Significant differences between the clinics were no longer statistically detectable. The present study provides substantial preliminary indications on the effectiveness of multidimensional pediatric-psychosomatic inpatient therapy, which seems suitable for alleviating the general symptom burden and problems by identifying and processing emotions. Furthermore, the results indicate that an extended treatment duration may contribute to more pronounced effects.

Reliability and validity of the brief version of the difficulties in emotion regulation scale in a sample of Turkish adolescents

BackgroundDifficulty in regulating emotions increases during adolescence and can be associated with psychopathology. It is thus crucial to develop tools to identify adolescents at risk of having emotional difficulties. This study aimed to investigate the reliability and validity of a brief questionnaire in a sample of Turkish adolescents.MethodsA total of 256 participants (mean age = 15.51 ± 0.85) were recruited. They completed the original form of the Difficulties in Emotion Regulation Scale (DERS-36), a brief version of DERS (DERS-16), the Barrett Impulsivity Scale (BIS-11), and the Toronto Alexithymia Scale (TAS). Psychometric properties of DERS-16 were investigated by confirmatory factor analysis, Cronbach’s alpha, and Pearson correlational analysis.ResultsA five-factor model and second-order bifactor model of DERS-16 were confirmed. Cronbach’s alpha values for the subscales varied between 0.69 and 0.88, while the reliability of the factors Difficulties in Emotional Processing and Difficulties in Emotion Regulation were 0.75 and 0.90, respectively. DERS-16 subscales were positively correlated with the BIS-11 and TAS. In addition, there were only minimal differences between the DERS-16 and DERS-36.ConclusionThe DERS-16 is a valid and reliable scale for Turkish adolescents. The fact that it has fewer items than DERS-36, but has similar reliability and validity and can be used as two factors, provides significant advantages in terms of applicability.

Exploring relationships between executive functions and maladaptive cyclical patterns in a transdiagnostic sample

Executive functions are described as a set of neurocognitive processes underlying human mental processing, while maladaptive cyclical patterns are the dysfunctional psychological elements associated with psychological distress and symptomatology that tend to be recurrent. Both psychological constructs tend to be studied by different scientific fields and with different methods which limits a coherent theoretical integration. Therefore, the present study aims to explore the relationships between executive functions and maladaptive cyclical patterns. A sample was gathered (N = 96, Mage = 20.78, SD = 4.63), and completed several self-report questionnaires along with several neuropsychological tests for the assessment of executive functions. Results showed that behavioral inhibition correlated negatively with maladaptive cyclical patterns while cognitive inflexibility correlated positively. Regression analysis showed that behavioral inhibition, psychological inflexibility, and recurring states of mind predicted emotional processing difficulties. These results emphasize previous assumptions that a difference between self-report questionnaires and behavioral tasks may limit the integrated study of psychological and neurocognitive processes.

“But not the music”: psychopathic traits and difficulties recognising and resonating with the emotion in music

ABSTRACT Recognising and responding appropriately to emotions is critical to adaptive psychological functioning. Psychopathic traits (e.g. callous, manipulative, impulsive, antisocial) are related to differences in recognition and response when emotion is conveyed through facial expressions and language. Use of emotional music stimuli represents a promising approach to improve our understanding of the specific emotion processing difficulties underlying psychopathic traits because it decouples recognition of emotion from cues directly conveyed by other people (e.g. facial signals). In Experiment 1, participants listened to clips of emotional music and identified the emotional content (Sample 1, N = 196) or reported on their feelings elicited by the music (Sample 2, N = 197). Participants accurately recognised (t(195) = 32.78, p < .001, d = 4.69) and reported feelings consistent with (t(196) = 7.84, p < .001, d = 1.12) the emotion conveyed in the music. However, psychopathic traits were associated with reduced emotion recognition accuracy (F(1, 191) = 19.39, p < .001) and reduced likelihood of feeling the emotion (F(1, 193) = 35.45, p < .001), particularly for fearful music. In Experiment 2, we replicated findings for broad difficulties with emotion recognition (Sample 3, N = 179) and emotional resonance (Sample 4, N = 199) associated with psychopathic traits. Results offer new insight into emotion recognition and response difficulties that are associated with psychopathic traits.

Cannabis and emotion processing: A review of behavioral, physiological, and neural responses.

While previous research has indicated that alcohol use is associated with difficulties in emotion processing and socioemotional functioning, less is known about the effects of cannabis on these functions. The purpose of this review article is to provide the current state of knowledge on the effects of cannabis on emotion processing with regard to behavioral, physiological, and neural responses. This narrative review synthesizes previous research investigating the effects of cannabis on emotion processing across studies that have utilized a number of experimental approaches to determine both the acute and chronic effects of cannabis on emotion processing. Limitations of current research and steps for future directions are discussed. Existing research has shown that cannabis use is associated with difficulties in emotion processing, such as impairments in correctly identifying emotions and problems with emotion differentiation. Electroencephalography (EEG) studies have produced mixed findings, but have considered a number of variables, such as participant sex, and comorbid depression. In addition, while there are mixed findings for the effects of cannabis on amygdalar brain activity across functional magnetic resonance imaging studies, several studies indicate that cannabis use is linked with decreased brain response in the frontal lobe while viewing emotional stimuli. To our knowledge, this is one of the first critical review articles focused on an emerging research area of cannabis and emotion processing. Synthesizing the existing findings in this developing research field is important for future prevention and intervention studies focused on promoting healthy socioemotional functioning in cannabis users. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Intolerance of Uncertainty and Emotional Processing in Adolescence: Separating Between-Person Stability and Within-Person Change

Previous research on the relation between Intolerance of Uncertainty (IU) and Emotional Processing (EP) during adolescence is limited. The present study aimed to clarify how IU and EP evolve over time, to what extent they are related, and whether changes in one precede or follow changes in the other. A total of 457 Italian adolescents (53.1% girls) aged 11 to 18 years (M = 14.1 ± 2.27) completed the IU and EP scales on three separate occasions three months apart (T1, T2, and T3). Data were modeled using a Random-Intercept Cross-Lagged Panel Model (RI-CLPM) that separates individual differences between individuals from intraindividual changes. Descriptive analyses showed that IU was relatively stable between T1 and T2 and decreased slightly between T2 and T3. Consistent with the view that emotion regulation improves as adolescents develop, EP difficulties were found to decrease between T1 and T2 and between T2 and T3. The RI-CLPM revealed a strong between-person effect, showing that individual differences in IU and EP remained consistent throughout the study. In addition, significant within-person change was found, with adolescents who increased their IU at T1 and T2 also increasing their EP difficulties at T2 and T3, respectively. The opposite effect had a smaller effect size. In sum, our study showed that IU and EP are intertwined in adolescents and that changes in IU precede corresponding changes in EP. These results suggest a priority of change between IU and EP and confirm the relationship between IU and emotion regulation problems in adolescence.

Disordered eating is related to deficits in emotional processing: A correlational study with a subclinical sample

BackgroundBoth clinical and non-clinical levels of disordered eating behaviours have been associated with deficits in emotional processing. MethodsThrough a correlational design, the present study examined the relationship between different types of disordered eating behaviours and various forms of emotional processing. N = 209 female undergraduate participants completed self-report measures of disordered eating behaviours, perceived emotion intensity, emotion regulation skills, and self-compassion. Four groups of participants were identified based on self-reported disordered eating behaviours: a healthy control group (n = 90), dieting group (n = 22), binging group (n = 59), and binging/purging group (n = 38). ResultsGreater severity of disordered eating was associated with greater emotional processing deficits including greater perceived emotion intensity, greater emotion regulation difficulties, and diminished self-compassion. Emotion regulation skills mediated the relationship between emotion intensity and disordered eating behaviours. A continuum of emotional processing deficits was observed wherein the healthy control group exhibited the fewest emotional processing deficits, and these deficits became increasingly severe among the dieting group, binging group, and binging/purging group, respectively. Each disordered eating type was associated with a specific profile of emotional processing difficulties. LimitationsThis study examined a subclinical sample of only female participants. ConclusionsFindings bear clinical importance for the prevention, treatment, and understanding of disordered eating behaviours.

What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders

ObjectiveWhile eating disorders (EDs) are more commonly diagnosed in females, there is growing awareness that men also experience EDs and may do so in a different way. Difficulties with emotion processing and emotion regulation are believed to be important in EDs, but as studies have involved predominantly female samples, it is unclear whether this is also true for males.MethodsIn a sample of 1604 participants (n = 631 males), we assessed emotion processing and emotion regulation in males with EDs (n = 109) and compared results to both females with EDs (n = 220) and males from the general population (n = 522). We also looked at whether emotion processing and emotion regulation difficulties predicted various aspects of eating psychopathology and whether this was moderated by sex. We assessed emotion processing with the Toronto Alexithymia Scale, emotion regulation with the Difficulties in Emotion Regulation Scale and the Emotion Regulation Questionnaire, and eating psychopathology with the Eating Disorder Examination Questionnaire.ResultsWe found that males with ED, like their female counterparts, suffered from emotion processing and emotion regulation deficits. We did find some sex differences, in that males with EDs tended to report more difficulties with their emotions as well as a more externally oriented thinking style compared to females with EDs. Difficulties with emotion processing and emotion regulation were strongly predictive of various aspects of eating psychopathology in both sexes. Importantly, we found that sex moderated the relationship between cognitive reappraisal and eating restraint. As such, low use of reappraisal was found to be associated with higher levels of restraint in females but not in males.DiscussionDifficulties with emotion processing and emotion regulation are associated with eating psychopathology in both males and females. Reappraisal was not found to be associated with reduced eating psychopathology in males, suggesting a cautious approach to interventions targeting this strategy. Research around explanatory mechanisms and interventions must adopt a broader viewpoint including those that are traditionally overlooked in EDs.

Emotion recognition, alexithymia, empathy, and emotion regulation in women with anorexia nervosa

PurposeAnorexia nervosa (AN) is associated with challenges in recognizing, understanding, and interpreting one’s own and other’s emotional states, feelings, and thoughts. It is unknown whether difficulties in emotion processing occur independently of common comorbid symptoms of AN and predict acute eating disorder characteristics. We aimed to examine emotion recognition, alexithymia, emotion regulation, and empathy in individuals with AN and to assess whether these predict eating disorder symptoms independently from comorbid symptoms.MethodsParticipants included 42 women with AN and 40 healthy control (HC) women between 18–30 years. Basic and complex emotion recognition was assessed with face photos and video clips. Alexithymia, empathy, emotion regulation, and comorbid symptoms (anxiety, depressive, and obsessive–compulsive symptoms and ASD traits) were assessed with self-assessment questionnaires.ResultsParticipants with AN exhibited difficulties in basic and complex emotion recognition, as well as increased alexithymia, decreased empathy, and challenges in emotion regulation when compared to HCs. After controlling for comorbid symptoms, differences remained only in complex emotion recognition. Challenges in emotion recognition were associated with lower body mass index, and increased alexithymia was associated with increased eating disorder symptoms. Increased challenges in emotion regulation were associated with a shorter duration of illness, higher body mass index, and increased eating disorder symptoms.ConclusionsParticipants with AN displayed widespread deficit in emotion processing, but only challenges in complex emotion recognition occurred independently from comorbid symptoms. Deficits in emotion processing may contribute to the illness severity and thus could be an important treatment target.Level of EvidenceLevel III, case-control analytic study.

A behavioral and brain imaging dataset with focus on emotion regulation of women with fibromyalgia

Fibromyalgia is a chronic condition characterized by widespread pain, as well as numerous symptoms related to central sensitization such as: fatigue, cognitive disturbances, constipation/diarrhea and sensory hypersensitivity. Furthermore, depression and anxiety are prevalent comorbidities, accompanied by emotion processing and regulation difficulties. Although fibromyalgia physiopathology is still not fully understood, neuroimaging research methods have shown brain structural and functional alterations as well as neuroinflammation abnormalities. We believe that open access to data may help fibromyalgia research advance more. Here, we present an open dataset of 33 fibromyalgia female patients and 33 paired healthy controls recruited from a Mexican population. Dataset includes demographic, clinical, behavioural and magnetic resonance imaging (MRI) data. The MRI data consists of: structural (T1- and T2- weighted) and functional (task-based and resting state) sequences. The task was an emotion processing and regulation task based on visual stimuli. The MRI data contained in the repository are unprocessed, presented in Brain Imaging Data Structure (BIDS) format and available on the OpenNeuro platform for future analysis.

Mourning and psychotic disorders: A different way to experience the loss

IntroductionWe present the case of a 48-year-old female patient diagnosed with schizoaffective disorder whose father passed away recently. The patient was facing an appalling mourning which was expressed in the form of behavior disorder and positive psychotic symptoms. Mourning is a natural reaction to the loss of a loved one which involves an internal world transformation, affecting both images of the self and the perceived environment.ObjectivesTo analyse the guidelines for mourning approach in chronic psychotic patients.MethodsA case report is presented alongside a review of the relevant literature regarding mourning in patients with chronic psychotic conditions.ResultsAccepting the loss, working through disruptive emotions, adjusting to a world without the deceased and finding an enduring connection with the loved one are the four tasks of mourning described by Worden. In our case, the patient was immersed in the first two tasks. Difficulties in accepting the loss, tolerating harmful emotions and establishing new affective links were observed, as well as massive projection of unbearable emotions such as sadness, anger, fear and guilt. The available literature identifies these idiosyncrasies as common in the grief processing in patients with chronic psychotic disorders.ConclusionsIn patients with psychosis, difficulties in symbolization, emotional processing and social bonding could have repercussions in the development of grief. However, these features do not imply a pathologic mourning. Tolerating mourning as a normal reaction in psychotic patients is needed, even if the patient expresses non-typical symptoms such as acute psychosis symptoms, hallucinations or behavior disorder.DisclosureNo significant relationships.

Acceptance and potential clinical added value of biocueing in forensic psychiatric patients with autism spectrum disorder and/or intellectual disability

Autism spectrum disorder (ASD) and intellectual disability (ID) are prevalent in forensic psychiatric samples. People with ASD and/or ID often experience difficulties in emotion processing which can lead to aggressive or self-harming behavior. The use of biocueing (using wearable technology to constantly monitor and provide feedback on bodily changes) shows promise for improving emotion processing and, thus, potentially reducing aggressive behavior in this population. Both qualitative and quantitative methods were used to examine the feasibility and acceptance of Sense-IT, a biocueing application, in a sample of forensic psychiatric patients with ASD and/or ID and their forensic psychiatric nurses. To our knowledge, the current study is the first to examine first-person experiences with biocueing in forensic psychiatric patients with ASD and/or ID. Results show that, in general, participants experienced the biocueing application as positive and are willing to use biocueing. This is an important finding since forensic patients are often unmotivated to engage with therapeutic techniques. An exploration of trends in aggression and self-harm prior to and during the use of biocueing showed no significant changes. Future research should focus on the way biocueing can be implemented in clinical practice.

Human Fetal Brain Magnetic Resonance Imaging (MRI) Tells Future Emergence of Autism Spectrum Disorders

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder which can result from a range of observed symptoms pertaining to social, emotional, and cognitive processing difficulties especially regarding communication of their own feelings, opinions, and thoughts with others. Although a diagnosis received by 1 in 68 children in the United States, a cause for autism is still unknown. Both genetic and environmental factors during prenatal and postnatal development are believed to account for the emergence of ASD. It is known that early treatment improves language and cognitive abilities later. However, currently, the earliest diagnosis of ASD can be made only around 18 months of age. It is critical to be aware of an altered initial brain anatomy in ASD for better predicting what aspects of brain function will likely preferentially and precociously deteriorate, which would allow for potentially earlier/better prevention and treatment. We hypothesized that prospective ASD patients will show region‐specific abnormalities in developmental stages. We have used retrospective clinical brain MRI of the fetuses who were diagnosed as ASD in later age to obtain earliest MRI‐based regional volumetric biomarkers. Thirty‐nine fetuses (mean age 24.87 ± 5.05 gestational week [GW]) were included in this study (9 prospective ASD patients, 20 neurotypical controls, 6 non‐ASD controls with neurological comorbidities observed in the prospective ASD patients, and 4 non‐ASD controls with non‐neurological comorbidities observed in the prospective ASD patients. After preprocessing, the images were segmented automatically with an atlas‐based automated anatomical labeling method. A set of three‐factor ANOVA was performed for lobar and regional comparisons of the segmented brain regions. The insula/insular lobe showed statistically significantly larger volume in ASD than that in all three control groups in the lobar comparison. In the regional comparison, the ASD group had statistically significantly larger amygdala, hippocampal commissure, and insula compared to the non‐ASD controls with neurological and non‐neurological comorbidities. Our results suggest that an increased volume of the insula/insular lobe may be a strong prenatal MRI biomarker that could predict the emergence of ASD later in life. The larger amygdala and hippocampal commissure could be additional biomarkers for identifying such prospective ASD patients.