EEG-neurofeedback and psychodynamic psychotherapy in a case of adolescent anhedonia with substance misuse: Mood/theta relations

There is substantial evidence confirming the efficacy of neurofeedback with applications in clinical, educational and optimal performance domains. However, a psychodynamically informed NF-approach needs exploration. A male (19 y), college student whose first year was being seriously compromised after severe, 18-month, polydrug misuse, was treated with 11 sessions including a 2-month follow-up of neurofeedback combined with short-term psychodynamic psychotherapy. Pre/post-treatment and follow-up assessment with the Brief Psychiatric Rating Scale (BPRS) and the Montgomery–Asberg Depression Rating Scale confirmed that levels of psychopathology dropped almost to zero. Correlational evidence disclosed that SMR/theta training was positively associated with reduction in psychopathological ratings, largely due to theta amplitude reduction; the strongest relation being with reduced BPRS activation. Alpha/theta training was not correlated with clinical improvement. The combined treatment was found to be highly effective with the student who learned to deal with feelings of anhedonia and alienation. There was no relapse during the follow-up phase. Further research is recommended.     

Cognitive correlates of schizophrenia signs and symptoms: II. Emotional disturbances

We examined the cognitive and motor correlates of emotional disturbances in 47 schizophrenia spectrum individuals. Neither affective flattening nor anhedonia was significantly associated with tasks measuring working memory or attention/concentration, or with overall performance on tasks measuring fluency or episodic memory. In contrast, as expected, emotional disturbances were associated with patterns of hemispheric lateralization. Affective flattening and anhedonia were both associated with episodic memory laterality and there were similar trends with motor laterality. Anhedonia was also associated with medication motor side effects.     

Electroconvulsive stimulation reverses anhedonia and cognitive impairments in rats exposed to chronic mild stress

Electroconvulsive therapy remains the most effective treatment for depression including a fast onset of action. However, this therapeutic approach suffers from some potential drawbacks. In the acute phase this includes amnesia. Electroconvulsive stimulation (ECS) has previously been shown to reverse a depression-like state in the chronic mild stress model of depression (CMS), but the effect of ECS on cognition has not previously been investigated. In this study the CMS model was used to induce a depressive-like condition in rats. The study was designed to investigate the acute effect of ECS treatment on working memory and the chronic effect of repeated ECS treatments on depression-like behavior and working memory. The results indicated that, in the acute phase, ECS treatment induced a working memory deficit in healthy controls unexposed to stress, while repeated treatments reversed stress-induced decline in working memory, as well as recovering rats submitted to the CMS paradigm from the anhedonic-like state. Like in the clinical setting, a single ECS exposure was ineffective in inducing remission from a depression-like state.     

Chronic Mild Stress and Sucrose Consumption: Validity as a Model of Depression

Sucrose consumption and preference were examined in rats subjected to a 6-week regimen of unpredictable mild stressors, after Willner et al. [11]. These subjects were compared with groups exposed to: 1. only the food deprivation element of the stress protocol; or 2. the stress protocol without the food deprivation element. A control group was not exposed to stressors. Body weight and sucrose consumption were significantly reduced in stressed and food-deprived animals compared to the other 2 groups. These variables therefore appeared dependent on food deprivation and independent of other elements of the stress protocol. Neither sucrose consumption per gram body weight nor sucrose preference differed significantly among the 4 groups. These results indicate that food deprivation is not only necessary, but sufficient, to produce sucrose consumption deficits in rats. It is, therefore, likely that reduced sucrose consumption in stressed rats results solely from diminished body weight rather than exposure to the series of stressors. We conclude that sucrose consumption is not a valid index of reward responsiveness. Other measures (such as place-preference conditioning or intracranial self-stimulation threshold) should be evaluated also with respect to body weight change when considering the validity of stressor-based models of depressive disorder.     

Reflex Modification in Psychosis-Prone Young Adults

The present study examined modification of the startle reflex in psychosis-prone and normal control subjects, using a continuous pure tone prestimulus (S1) and an intense white noise startle stimulus (S2). Reflex modification conditions consisted of stimulus pairs with onset asynchronies of 60, 120, and 2000 ms with a startle-alone condition as control. Startle was indexed by the eyeblink, which was measured by vertical electro-oculography. Subjects were identified as psychosis-prone by their high scores on the Perceptual Aberration or the Physical Anhedonia scales. Group differences in blink magnitude inhibition were observed between perceptual aberration and control subjects during short stimulus onset asynchronies, with perceptual aberrators showing significantly less inhibition than controls at 120 ms. No differences were evident between anhedonic and control subjects at the two short onset asynchronies nor were there any significant between-group differences when the interval between stimuli was long (2000 ms). These results suggest that subjects with perceptual aberrations may share with schizophrenics and other schizophrenia-spectrum subjects an underdeveloped mechanism which in normal subjects is presumed to operate during preattentive processing and functions to protect sensory information from the interfering effects of subsequent stimuli.     

An examination of methodological refinements,clozapine and fluphenazine in the anhedonia paradigm

Previous work has shown that the reduction in operant response rate in rats treated repeatedly with pimozide is similar to the pattern of decline in rate occasioned by nonreward. This similarity, usually observed with a continuous reinforcement (CRF) schedule, has been interpreted in terms of the neuroleptics' reducing the rewarding quality of the reinforcer, i.e., anhedonia. Although retaining the CRF schedule, the present work departs from earlier methodologies in three major ways: retraining days were not interposed between drug or extinction days; the operant measure, response duration, was used to complement response rate in describing the drug and extinction effects; and, in addition to using pimozide (0.5 and 1.0 mg/kg), two other neuroleptics, clozapine (5.0 and 10.0 mg/kg) and fluphenazine hydrochloride (0.125 mg/kg), were examined in the anhedonia paradigm. Omission of the retraining days still resulted in declines in response rate and increases in response duration that were graphically similar for pimozide and extinction, but were significantly different in degree, with pimozide producing greater reductions in rate and lesser increases in duration than did extinction. Although clozapine, a low-motor-effect neuroleptic, reduced rate and elevated duration, no change was observed for repeated dosing at the 5.0 mg/kg dose level. The 10.0 mg/kg dose yielded a significant across-session increase (i.e., tolerance effect) in rates, an effect entirely the opposite of what would be indicative of anhedonia. Fluphenazine, a high potency, high-motor-effect phenothiazine, did produce a pattern of declining rate and increasing duration across the four days of dosing, and the 0.125 mg/kg of fluphenazine hydrochloride yielded greater effects than 1.0 mg/kg of pimozide. The extinction-like pattern of responding produced by fluphenazine and pimozide, but not by clozapine, suggests that anhedonia per se is insufficient to account for these results and that an as-yet-to-be-elucidated motor and/or associative process is involved.