Perceived organizational affiliation and its effects on patient trust: Role modeling with embodied conversational agents

ObjectiveVerbal and non-verbal behaviors, which are known as “relational contextualization cues”, relay information about relationships and how they are structured. We developed a computer-simulated provider conducting an informed consent process for clinical research to investigate the effects of a provider’s alignment of interests with a patient, the research team, or a neutral party on patient trust in the provider.MethodsParticipants (N = 43) interacted with a simulated provider for a research informed consent process in a three-arm, counterbalanced, within-subjects experiment. Participants reported their trust in the simulated provider after each treatment.ResultsParticipants successfully recognized the alignment manipulation, and perceived the patient-aligned provider as more trustworthy than the other providers. Participants were also more satisfied with the patient-aligned provider, liked this provider more, expressed more desire to continue working with this provider, and stated that they were significantly more likely to sign the consent form after interacting with this provider compared to the other two.ConclusionRelational contextualization that aligns with the patient increases trust, satisfaction, and willingness to enroll in the context of research informed consent.Practice implicationsHealth providers should align themselves with patients’ interests.     

Value-based design for the elderly: An application in the field of mobility aids

In the aging society, the need for the elderly to remain mobile and independent is higher than ever. However, many aids supporting mobility often fail to target real needs and lack acceptance. The aim of this study is to demonstrate how value-based design can contribute to the design of mobility aids that address real needs and thus, lead to high acceptance. We elicited values, facilitators, and barriers of mobility of older adults via ten in-depth interviews. Next, we held co-creation sessions, resulting in several designs of innovative mobility aids, which were evaluated for acceptance via nine in-depth interviews. The interviews resulted in a myriad of key values, such as “independence from family” and “doing their own groceries.” Design sessions resulted in three designs for a wheeled walker. Their acceptance was rather low. Current mobility device users were more eager to accept the designs than non-users. The value-based approach offers designers a close look into the lives of the elderly, thereby opening up a wide range of innovation possibilities that better fit their actual needs. Product service systems seem to be a promising focus for targeting human needs in mobility device design.     

The Meaning of Embodiment

There is substantial disagreement among philosophers of embodied cognitive science about the meaning of embodiment. In what follows, I describe three different views that can be found in the current literature. I show how this debate centers around the question of whether the science of embodied cognition can retain the computer theory of mind. One view, which I will label body functionalism, takes the body to play the functional role of linking external resources for problem solving with internal biological machinery. Embodiment is thus understood in terms of the role the body plays in supporting the computational circuits that realize cognition. Body enactivism argues by contrast that no computational account of cognition can account for the role of commonsense knowledge in our everyday practical engagement with the world. I will attempt a reconciliation of these seemingly opposed views.     

II. A Brief Introduction to the thought of Armando B. Ferrari

This paper describes the work of Armando Bianco Ferrari whose central tenet is the very direct relationship between the body (Concrete Original Object) and the mind to which it gives rise, but which is also mind's first and essentially only real object. Ferrari's approach offers an important avenue of approach to the treatment of psychosis, psychosomatic illness and anorexia, for instance, as is recorded in a by now growing Anglophone literature. The direct relationship between body and mind is in contrast to the object relations model in which this relationship is mediated through the breast. The paper starts with a short biological sketch of Ferrari's life before describing his theoretical position. This is largely concerned with the relationship between the mind and its body, the so‐called ‘vertical axis’, and that with the external world which he calls, the ‘horizontal axis’. The relationship between body and mind is achieved through the means of a ‘contact net’ (as opposed to Bion's contact barrier) and the evolution of ‘language registers’ out of patterns of bodily experience. Ferrari's formulation also involves modifications of the ways he conceives the ego and the oedipal situation (‘Oedipal constellation’), especially in the light of what he takes to be an innate femininity and masculinity in either sex, as well as the way in which he frames ideas about health and illness. The fact that the emphasis is directed towards the subject's direct apperception of the sensational and emotional life of his body rather than one mediated exclusively via the object involves a parallel shift away from the transference as always necessarily central to interpretation, without of course dispensing with it or suggesting that it is not ubiquitous. This is one of the various clinical implications of Ferrari's model which is discussed before offering an illustrative clinical vignette, and finally relating Ferrari's thought to some other current theoretical and clinical formulations.     

Capacities for theory of mind,metacognition, and neurocognitive function are independently related to emotional recognition in schizophrenia

While many with schizophrenia spectrum disorders experience difficulties understanding the feelings of others, little is known about the psychological antecedents of these deficits. To explore these issues we examined whether deficits in mental state decoding, mental state reasoning and metacognitive capacity predict performance on an emotion recognition task. Participants were 115 adults with a schizophrenia spectrum disorder and 58 adults with substance use disorders but no history of a diagnosis of psychosis who completed the Eyes and Hinting Test. Metacognitive capacity was assessed using the Metacognitive Assessment Scale Abbreviated and emotion recognition was assessed using the Bell Lysaker Emotion Recognition Test. Results revealed that the schizophrenia patients performed more poorly than controls on tests of emotion recognition, mental state decoding, mental state reasoning and metacognition. Lesser capacities for mental state decoding, mental state reasoning and metacognition were all uniquely related emotion recognition within the schizophrenia group even after controlling for neurocognition and symptoms in a stepwise multiple regression. Results suggest that deficits in emotion recognition in schizophrenia may partly result from a combination of impairments in the ability to judge the cognitive and affective states of others and difficulties forming complex representations of self and others.     

Éléments de validation du Protocole d’Évaluation de la Cognition Sociale de Bordeaux (PECS-B) en population générale et dans la schizophrénie

ObjectivesIn recent years, social cognition has received growing interest in the international psychiatric and neurologic literature. Social cognition impairments are described in many different conditions and are associated with a poor functional outcome. Consequently, an accurate and valid assessment of social cognition abilities is necessary in clinical practice, so as to better understand individual functioning and define corresponding therapeutic interventions. The aim of the present study was to provide further elements of validation to the Bordeaux Social Cognition Assessment Protocol (Protocole d’Evaluation de la Cognition Sociale de Bordeaux: PECS-B) in the general population and in one with schizophrenia.MethodsA total of 131 healthy controls and 101 participants with schizophrenia or schizoaffective disorders between 18 and 60 years old were included. Sociodemographic variables (i.e., age, education level, sex), social cognition (i.e., emotional fluency, facial emotion recognition, theory of mind, emotional awareness and alexithymia with the PECS-B), neurocognition (i.e., processing speed, episodic verbal memory, short-term memory, working memory, selective and sustained attention, spontaneous and reactive flexibility), anxiety and depressive mood were assessed in both samples.ResultsResults show a good discriminative power for the PECS-B within the same population. Only “Attribution of Intention” and “Faux-Pas” tasks show ceiling effects in both samples. Structural validity is satisfactory in the general population sample and suggests that the social cognition structure consists of four factors: facial emotion recognition (1), emotional lexicon (2), explicit processing of sophisticated emotional information (3) and theory of mind (4). Structure validity is also satisfactory in the schizophrenia sample, after removal of the variable “Emotional fluency-Percentage of sophisticated words”. In this case, the social cognition structure consists of two factors: general social cognition (1) and explicit processing of sophisticated emotional information (2). Results show a good divergent validity in both populations, between close constructs such as neurocognition and anxiety/depression. Nevertheless, correlations between social cognition and neurocognition are more frequent in the schizophrenia sample. Internal consistency is satisfying in both samples. Finally, results reveal some effects of sociodemographic variables (i.e., age, education level and sex) both in the general population and schizophrenia samples. Norms are also presented for adults aged between 18 and 60.ConclusionStructural validity, divergent validity and internal consistency of the PECS-B are satisfactory in the general population and the schizophrenia one. The PECS-B presents with good psychometric qualities that permit its use for the assessment of adults’ social cognition in clinical practice as much as research.     

Impaired Theory of Mind and psychosocial functioning among pediatric patients with Type I versus Type II bipolar disorder

Deficits in Theory of Mind (ToM) have been documented among pediatric patients with Bipolar Disorder (BD). However, fewer studies have directly examined differences between type I and type II patients and whether or not ToM deficits are related to psychosocial difficulties. Therefore, the aim of this study was to compare type I versus type II pediatric bipolar patients and matched Healthy Controls (HC) on ToM and interpersonal functioning tasks. All participants completed the Revised Mind in the Eyes Task (MET), the Cognitive and Emotional Perspective Taking Task (CEPTT), and the Index of Peer Relations (IPR). Type I BD patients reported greater peer difficulties on the IPR compared to HC, and also performed more poorly on the MET and the cognitive condition of the CEPTT, but did not differ significantly on the emotional condition. There were no significant group differences between type II BD patients and HC. More impaired ToM performance was associated with poorer interpersonal functioning. Type I BD patients show deficits in the ability to understand another's mental state, irrespective of emotional valence. Deficits in understanding others' mental states could be an important treatment target for type I pediatric patients with BD.     

Knowing the Meaning of a Word by the Linguistic and Perceptual Company It Keeps

Debates on meaning and cognition suggest that an embodied cognition account is exclusive of a symbolic cognition account. Decades of research in the cognitive sciences have, however, shown that these accounts are not at all mutually exclusive. Acknowledging cognition is both symbolic and embodied generates more relevant questions that propel, rather than divide, the cognitive sciences: questions such as how computational symbolic findings map onto experimental embodied findings, and under what conditions cognition is relatively more symbolic or embodied in nature. The current paper revisits the Symbol Interdependency Hypothesis, which argues that language encodes perceptual information and that language users rely on these language statistics in cognitive processes. It argues that the claim that words are abstract, amodal, and arbitrary symbols and therefore must always be grounded to become meaningful is an oversimplification of the language system. Instead, language has evolved such that it maps onto the perceptual system, whereby language users rely on language statistics, which allow for bootstrapping meaning also when grounding is limited.     

The impact of bilateral cerebellar damage on theory of mind,empathy and decision making

The extensive infarction affecting the posterior vermis and the medial and posterior regions of both cerebellar hemispheres, as well as the small central pontine lesion, seems to have disrupted multiple cerebral and brainstem cerebellar loops. These loops process information related to many cognitive domains, behavior and emotion, including decision making, empathy and theory of mind.