The present functional neuroimaging study focuses on the iconography of mourning. A culture-specific pattern of body postures of mourning individuals, mostly suggesting withdrawal, emerged from a survey of visual material. When used in different combinations in stylized drawings in our neuroimaging study, this material activated cortical areas commonly seen in studies of social cognition (temporo-parietal junction, superior temporal gyrus, and inferior temporal lobe), empathy for pain (somatosensory cortex), and loss (precuneus, middle/posterior cingular gyrus). This pattern of activation developed over time. While in the early phases of exposure lower association areas, such as the extrastriate body area, were active, in the late phases activation in parietal and temporal association areas and the prefrontal cortex was more prominent. These findings are consistent with the conventional and contextual character of iconographic material, and further differentiate it from emotionally negatively valenced and high-arousing stimuli. In future studies, this neuroimaging assay may be useful in characterizing interpretive appraisal of material of negative emotional valence.

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The human attachment system is activated in situations of danger such as potential separation, threats of loss of a significant other and potential insecurity on the availability of the attachment figure. To date, however, a precise characterization of the neural correlates of the attachment system in healthy individuals is lacking. This functional magnetic resonance imaging (fMRI) study aims at characterizing the distinctive neural substrates activated by the exposure to attachment vs. non-attachment scenes. Healthy participants (N = 25) were presented scenes from the Adult Attachment Projective Picture System (AAP), a validated set of standardized attachment-related pictures extended by a control picture stimulus set consisting of scenes without attachment-related content. When compared to the control neutral pictures, attachment scenes activated the inferior parietal lobes (IPLs), the middle temporal gyrus (MTG), and the anterior medial prefrontal cortex (mPFC). These areas are associated with reasoning about mental representations, semantic memory of social knowledge, and social cognition. This neural activation pattern confirms the distinctive quality of this stimulus set, and suggests its use as a potential neuroimaging probe to assess social cognition/mentalizing related to attachment in healthy and clinical populations.

BackgroundInpatient psychosomatic rehabilitation is a key treatment for patients with mental health issues. However, knowledge about critical success factors for beneficial treatment outcomes is scarce. The aim of this study was to evaluate the association of mentalizing and epistemic trust with the improvement of psychological distress during rehabilitation.MethodsIn this naturalistic longitudinal observational study, patients completed routine assessments of psychological distress (BSI), health-related quality of life (HRQOL; WHODAS), mentalizing (MZQ), and epistemic trust (ETMCQ) before (T1) and after (T2) psychosomatic rehabilitation. Repeated measures ANOVA (rANOVAs) and structural equation models (SEMs) were calculated to investigate the association of mentalizing and epistemic trust with the improvement in psychological distress.ResultsA total sample of n = 249 patients were included in the study. Improvement in mentalizing was correlated with improvement in depression (r = 0.36), anxiety (r = 0.46), and somatization (r = 0.23), as well as improved cognition (r = 0.36), social functioning (r = 0.33), and social participation (r = 0.48; all p < 0.001). Mentalizing partially mediated changes in psychological distress between T1 and T2: the direct association decreased from β = 0.69 to β = 0.57 and the explained variance increased from 47 to 61%. Decreases in epistemic mistrust (β = 0.42, 0.18–0.28; p < 0.001) and epistemic credulity (β = 0.19, 0.29–0.38; p < 0.001) and increases in epistemic trust (β = 0.42, 0.18–0.28; p < 0.001) significantly predicted improved mentalizing. A good model fit was found (χ2 = 3.248, p = 0.66; CFI = 0.99; TLI = 0.99; RMSEA = 0.000).ConclusionMentalizing was identified as a critical success factor in psychosomatic inpatient rehabilitation. A key component to increase mentalizing in this treatment context is the improvement of epistemic mistrust.

Healthy individuals show a tendency towards positive cognitions that is reversed during depression. This tendency is revealed by the Scrambled Sentences Task (SST), an experimental procedure that was also shown to be associated with vulnerability to suffer from depressive episodes. Here, we used the SST to map the prevalence of negative cognitions across the personality domains of criterion B of the Alternative Model of Personality Disorder (AMPD) of the DSM-5 in healthy individuals. The AMPD was developed to characterize personality in a dimensional approach spanning both healthy and pathological individuals. We expected negative cognitions to be more frequent among individuals with high negative affectivity and detachment scores, as these dimensions are thought to be associated with disorders of affect. This association was stable and significant in three separate experiments and persisted for detachment after adjusting for current depression levels. In the Five-Factor Model of Personality (FFM), in contrast, only openness failed to show any association with negative cognitions. Negative affectivity and detachment differed in the preferential association with negative and positive cognitions, respectively. This finding suggests a possible role of motivational factors related to sensitivity to negative and positive incentives in linking personality dimensions and cognitive tendencies, with an anhedonic dimension of negative cognitions being present alongside current depressive symptoms.