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PTSD is frequent in prison, with a lifetime prevalence of 17.8% among male inmates, and of 40.1% among female inmates. Despite those high rates, only a limited number of studies have been published about this disorder in the prison population, and PTSD is still widely underdiagnosed in jail. We conducted a review of the literature to identify the PTSD sociodemographic characteristics and specificities among incarcerated populations. Some epidemiological characteristics of PTSD are identical in both the general and the prison populations, with a higher prevalence among women than men, high rates of comorbidity with depression and anxiety disorders, and high suicide rates. PTSD after committing a violent crime seems to be common but is greatly underdiagnosed, mostly because of a lack of knowledge about this entity. The occurrence is especially high when the offender suffers from a severe mental illness at the time of the offence. Homicidal crimes are the most at risk to lead to PTSD. Every inmate should be screened for this diagnosis by psychiatrists practicing in prisons. Inmates are exposed to many traumatic events during their time in detention. Yet, little is known about the mental health consequences of imprisonment. PTSD after exposure to a traumatic event while in detention should be systematically explored, and future studies need to consider this matter. The high levels of PTSD among imprisoned people could be explained by the exposition of prisoners to repetitive traumatic events, especially during childhood, and by the multiple risk factors for PTSD found in this population. In France, screening for and treatment of PTSD in prison are insufficient. Strategies must be elaborated by the institutions created in 2019 (Centre National de Ressource et de Resilience et Centre Regionaux de Psychotraumatismes) to improve the health of inmates suffering from PTSD. Complex PTSD should also be studied in the prison population.

Background Depersonalization is a complex phenomenological experience initially described as a psychological disturbance of self-awareness. Among the different dimensions underlying depersonalization, emotional numbing appears to be a key symptom but remains a poorly understood phenomenon. Method We conducted a systematic review, following PRISMA guidelines, of studies investigating electrodermal activity, a well-documented marker of bodily arousal expression of emotion. Studies were selected from the PubMed, Scopus, Web of Science and PsychINFO databases. Results Among the 64 studies initially identified, 11 were finally included, involving 148 patients with depersonalization disorder and 173 healthy subjects for whom depersonalization symptoms were assessed. The main results of these studies suggest that depersonalization is marked by a high skin conductance level and attenuated skin conductance responses to negative stimuli. Limitations Due to discrepancies in methodology, we were not able to conduct quantitative analyses. Moreover, the studies included had limited sample sizes, restricting the generalizability of the results. Conclusion Though further evidence is required, it appears from electrodermal studies that depersonalization is associated with hypervigilance and emotional detachment during threatening situations. However, because emotional numbing might not be restricted to negative events, we proposed perspectives for future research, stressing the need to explore emotional responses of patients with depersonalization to positive situations.

Rationale Severe alcohol use disorder (SAUD) is a psychiatric condition linked to cerebral and cognitive consequences. SAUD is notably characterized by an overactivation of the reflexive/reward system when confronted with alcohol-related cues. Such overreactivity generates a preferential allocation of attentional resources toward these cues, labeled as attentional biases (AB). Theoretical assumptions have been made regarding the characteristics of AB and their underlying processes. While often considered as granted, these assumptions remain to be experimentally validated. Aims We first identify the theoretical assumptions made by previous studies exploring the nature and role of AB. We then discuss the current evidence available to establish their validity. We finally propose research avenues to experimentally test them. Methods Capitalizing on a narrative review of studies exploring AB in SAUD, the current limits of the behavioral measures used for their evaluation are highlighted as well as the benefits derived from the use of eye-tracking measures to obtain a deeper understanding of their underlying processes. We describe the issues related to the theoretical proposals on AB and propose research avenues to test them. Four experimental axes are proposed, respectively, related to the determination of (a) the genuine nature of the mechanisms underlying AB; (b) their stability over the disease course; (c) their specificity to alcohol-related stimuli and (d) their reflexive or controlled nature. Conclusions This in-depth exploration of the available knowledge related to AB in SAUD, and of its key limitations, highlights the theoretical and clinical interest of our innovative experimental perspectives capitalizing on eye-tracking measures.

General Hospital Psychiatry - Sous presse. Epreuves corrigees par l'auteur. Disponible en ligne depuis le mercredi 30 juin 2021

Many studies have reported negative outcomes of the COVID‐19 pandemic on people's mental health. Notably, high prevalence rates of posttraumatic stress disorder (PTSD) symptoms have been described in healthcare workers (26.9% [20.3%‐33.,6%]), individuals with COVID‐19 (23.8% [16.6%‐31.0%]) and in the general population (19.3% [15.3%‐23.2%]) (1).

The COVID-19 pandemic and quarantine measures have sparked debate regarding their traumatic nature. This cross-sectional study reports the prevalence rate of probable post-traumatic stress syndrome (PTSD) and associated factors among French university students. A total of 22,883 students completed the online questionnaire. The prevalence rate of probable PTSD, assessed using the PTSD Checklist for DSM-5, was 19.5% [19.0–20.0]. Female (1.32 [1.21–1.45]) or non-binary gender (1.76 [1.35–2.31]), exposure to a non-COVID-19-related traumatic event (3.37 [3.08–3.67]), having lived through quarantine alone (1.22 [1.09–1.37]), poor quality of social ties (2.38 [2.15–2.62]), loss of income (1.20 [1.09–1.31]), poor quality housing (1.90 [1.59–2.26]), low-quality of the information received (1.50 [1.35–1.66]) and a high level of exposure to COVID-19 (from 1.38 [1.24–1.54] to 10.82 [2.33–76.57] depending on the score) were associated with PTSD. Quarantine was considered potentially traumatic by 78.8% of the students with probable PTSD. These findings suggest the pandemic context and lockdown measures could have post-traumatic consequences, stimulating debate on the nosography of PTSD.

International audience; Background The COVID-19 pandemic has raised concerns regarding its psychological effect on university students, especially healthcare students. We aimed at assessing the risk of mental health problems according to the type of university studies, by adjusting for potential confounders. Methods We used data from the COSAMe study, a national cross-sectional survey including 69,054 French university students during the first quarantine. The mental health outcomes evaluated were suicidal thoughts, severe self-reported distress (as assessed by the Impact of Events Scale-Revised), stress (Perceived Stress Scale), anxiety (State-Trait Anxiety Inventory, State subscale), and depression (Beck Depression Inventory). Multivariable logistic regression analyzes were performed to test the association between the type of university studies (healthcare studies: medical and non-medical, and non-healthcare studies) and poor mental health outcomes, adjusted for sociodemographic characteristics, precariousness indicators, health-related data, quality of social relationships, and data about media consumption. Results Compared to non-healthcare students (N = 59,404), non-medical healthcare (N = 5,431) and medical students (N = 4,193) showed a lower risk of presenting at least one poor mental health outcome (adjusted OR [95%CI] = 0.86[0.81-0.92] and 0.87[0.81-0.93], respectively). Compared to non-healthcare students, medical students were at lower risk of suicidal thoughts (0.83[0.74-0.93]), severe self-reported distress (0.75[0.69-0.82]) and depression (0.83[0.75-0.92]). Non-medical healthcare students were at lower risk of severe selfreported distress (0.79[0.73-0.85]), stress (0.92[0.85-0.98]), depression (0.83[0.76-0.91]), and anxiety (0.86[0.80-0.92]). Limitations This is a large but not representative cross-sectional study, limited to the first confinement. Conclusions Being a healthcare student is a protective factor for mental health problems among confined students. Mediating factors still need to be explored.

International audience; Background: Dominant theoretical models consider that attentional biases (AB) towards alcohol-related stimuli play a key role in the development and maintenance of alcohol use disorder (AUD). Their assessment has however showed high inconsistencies and has been mostly based on unreliable behavioral measures. This study evaluated the presence and extent of alcohol-related AB in recently detoxified inpatients with severe AUD by combining the visual probe task (VPT) paradigm with eye-tracking measures, known to improve the VPT reliability in subclinical populations.Methods: We recruited 24 patients and 27 matched healthy controls. They performed the VPT (measuring reaction time when processing visual targets preceded by alcoholic and matched non-alcoholic pictures) combined with eye-tracking measures (dwell time, first fixation direction/duration, second fixation direction) during two sessions. Estimates of internal consistency, split-half reliability, and test-retest reliability were measured.Results: Patients showed shorter dwell time for alcohol cues (p = .004, d=.853) and reduced number of fixations towards alcohol after a first fixation on non-alcohol cues (p = .012, d=.758) compared to controls. These findings suggest the presence of alcohol-related avoidance AB in detoxified patients with severe AUD. The VPT achieved excellent reliability for these eye-tracking measures. Reaction times and first fixation measures did not indicate any AB pattern and showed poor reliability.Conclusions: The VPT, when combined with dwell time and second fixation direction, constitutes a reliable method for assessing AB in detoxified patients. It showed the presence of an alcohol-related avoidance bias in this clinical population, in contradiction with the approach bias predicted by theoretical models.

International audience; No abstract available

Visuoperceptive deficits are frequently reported in severe alcohol use disorder (SAUD) and are considered as pervasive and persistent in time. While this topic of investigation has previously driven researchers' interest, far fewer studies have focused on visuoperception in SAUD since the '90s, leaving open central questions regarding the origin and implications of these deficits. To renew research in the field and provide a solid background to work upon, this paper reviews the neural correlates of visuoperception in SAUD, based on data from neuroimaging and electrophysiological studies. Results reveal structural and functional changes within the visual system but also in the connections between occipital and frontal areas. We highlight the lack of integration of these findings in the dominant models of vision which stress the dynamic nature of the visual system and consider the presence of both bottom-up and top-down cerebral mechanisms. Visuoperceptive changes are also discussed in the framework of long-lasting debates regarding the influence of demographic and alcohol-related factors, together stressing the presence of inter-individual differences. Capitalizing on this review, we provide guidelines to inform future research, and ultimately improve clinical care.

While severe alcohol use disorder (SAUD) is classically characterized as a compulsion to seek and consume alcohol and a reduced ability to control these behaviors, a growing number of studies shows social cognition difficulties among recently detoxified patients. The present chapter proposes an overview of this literature by presenting the main findings regarding emotional experience and emotion regulation, social cues processing, theory of mind, empathy and social emotions processing. From this literature, we propose that patients with SAUD show an increased sensibility to socio-emotional stimuli that directly concern them and a reduced ability to process those stimuli when they concern other individuals. We also propose new research avenues that may ultimately help to better understand social cognition deficits and their role in SAUD and to urge scientists and clinicians to consider rehabilitating these abilities in the early steps of detoxification programs.

Objective To assess the prevalence of and risk factors for posttraumatic stress disorder (PTSD) in patients with COVID-19. Methods We conducted a cohort study between March and May 2020 at the Lille University Hospital (France), including all patients with laboratory-confirmed COVID-19. Psychological distress symptoms were measured 3 weeks after onset of COVID-19 symptoms using the Impact of Event Scale-6 items (IES-6). The evaluation of PTSD symptoms using the PTSD Checklist for DSM-5 (PCL-5) took place 1 month later. Bivariate analyses were performed to analyze the relationship between PCL-5 scores and the demographic and health variables. The significant variables were then introduced into a multivariable linear regression analysis to establish their relative contributions to the severity of PTSD symptoms. Results 180 patients were included in this study, and 138 patients completed the 2 evaluations. Among the 180 patients, 70.4% patients required hospitalization, and 30.7% were admitted to the intensive care unit. The prevalence of PTSD was 6.5%, and the predictive factors of PTSD included psychological distress at the onset of the illness and a stay in an intensive care unit. Conclusions The prevalence of PTSD in patients with COVID-19 is not as high as that reported among patients during previous epidemics. Initial psychological responses were predictive of a PTSD diagnosis, even though most patients showing acute psychological distress (33.5% of the sample) improved in the following weeks. PTSD symptoms also increased following a stay in an intensive care unit. Future studies should assess the long-term consequences of COVID-19 on patients' mental health.

So far, stress detection technology usually uses supervised learning methods combined with a series of physiological, physical, or behavioral signals and has achieved promising results. However, the problem of label collection such as the latency of stress response and subjective uncertainty introduced by the questionnaires has not been effectively solved. This paper proposes an unsupervised learning method with K-means clustering for exploring students' autonomic responses to medical simulation training in an ambulant environment. With the use of wearable sensors, features of electrodermal activity and heart rate variability of subjects are extracted to train the K-means model. The Silhouette Score of 0.49 with two clusters was reached, proving the difference in students' mental stress between baseline stage and simulation stage. Besides, with the aid of external ground truth which could be associated with either the baseline phase or simulation phase, four evaluation metrics were calculated and provided comparable results concerning supervised and unsupervised learning methods. The highest classification performance of 70% was reached with the measure of precision. In the future, we will integrate context information or facial image to provide more accurate stress detection.

Background : The aim of this study was to find the sociodemographic and clinical characteristics of major depressive episode (MDE) with (MDE-HPS+) and without a history of psychotic symptoms (MDE-HPS) in the general population. Methods : The Mental Health in the General Population survey interviewed 38,694 individuals in France by using the MINI. The prevalence and sociodemographic and clinical correlates of MDE-HPS+ were assessed. Results : Of the sample, 11.2% were diagnosed with current MDE and among them, 39.3% presented a history of at least one psychotic symptom (hallucination or delusion). Patients with MDE-HPS+ were younger with more severe social impairment than those with MDE-HPS-. We also found a higher proportion of three generations of migrants in the MDE-HPS+ group. Comorbid psychiatric disorders such as a history of a manic episode, alcohol use disorder, social anxiety, generalized anxiety disorder, and a personal history of a suicide attempt were more frequent in patients with MDE-HPS+ than in those with MDE-HPS-. Finally, we found a specific gradient of severity for psychiatric comorbid disorders depending on the number of psychotic symptoms lifetime in MDE. Limitations : The study also has an observational cross-sectional design that does not permit causal inferences, and it is difficult to eliminate recall bias and reporting errors. Conclusion : In the general population, patients with MDE-HPS+, when compared to MDE-HPS-, presented with a more severe clinical profile, with increased rates of psychiatric comorbidities, particularly a history of bipolar disorder and a history of a suicide attempt.

International audience; Background: Severe alcohol use disorder (SAUD) is associated with social cognition deficits. Patients with SAUD are impaired for the recognition of emotional facial expressions, particularly at early stages of abstinence. These deficits damage interpersonal relations and increase relapse risk. However, uncertainties still abound on their variation across emotions and on the heterogeneity of emotional impairments across patients. We addressed these questions by exploring how the deficit varies according to emotions' type/intensity and patients' heterogeneity.Methods: Sixty-five recently detoxified patients with SAUD and 65 matched healthy controls performed the Facial Emotion Recognition Test, assessing the ability to identify six emotions (anger, contempt, disgust, fear, happiness, sadness) displayed by morphed faces with various intensities. Accuracy scores and detection thresholds were collected for each emotion. Beyond group comparisons, multiple single-case analyses determined the percentage of patients presenting decoding deficits for each emotion.Results: When current depression and anxiety symptoms were controlled for, patients did not present a general emotion decoding deficit, but were rather characterized by specific deficits for disgust/contempt in accuracy, and for disgust in detection threshold scores. Single-case analyses showed that only a third of patients presented a clinically significant emotional deficit.Conclusions: Patients with SAUD only present emotional decoding deficits for specific interpersonal emotions (disgust/contempt) when subclinical psychopathological states are controlled for, and show no general emotional impairment. This goes against the proposal of a generalized social cognition deficit in this population. This group effect moreover masks a massive heterogeneity across patients, which has implications at experimental and clinical levels.

Substance use disorders (SUDs) are associated with impairments of cognitive functions, and cognitive training programs are thus rapidly developing in SUD treatment. However, neuropsychological impairments observed early after withdrawal (i.e., early impairments), that is, approximately in the first six months, may be widespread. Consequently, it might not be possible to train all the identified early impairments. In these situations, we propose that the priority of cognitive training should be given to the early impairments found to be associated with early dropout or relapse (i.e., relapse-related impairments). However, substance-specific relapse-related impairments have not been singled out among all early impairments so far. Using a systematic literature search, we identified the types of established early impairments for all SUDs, and we assessed the extent to which these early impairments were found to be associated with relapse-related impairments. All cognitive functions were investigated according to a classification based on current neuropsychological models, distinguishing classical cognitive, substance-bias, and social cognition systems. According to the current evidence, demonstrated relapse-related impairments in alcohol use disorder comprised impulsivity, long-term memory, and higher-order executive functions. For cannabis use disorder, the identified relapse-related impairments were impulsivity and working memory. For stimulant use disorder, the identified relapse-related impairments were attentional abilities and higher-order executive functions. For opioid use disorder, the only identified relapse-related impairments were higher executive functions. However, many early impairments were not explored with respect to dropout/relapse, particularly for stimulant and opioid use disorders. The current literature reveals substance-specific relapse-related impairments, which supports a pragmatic patient-tailored approach for defining which early impairments should be prioritized in terms of training among patients with SUDs.

SummaryPrevious reports suggest that adverse events during childhood could be related to an array of psychiatric problems. Here, we question the relationship between childhood traumatic experiences and the sensory complexity of hallucinations in a cohort of 75 children and adolescents. We evidence a positive link between the number of sensory modalities involved in hallucinations and history of childhood trauma, even after controlling for the co-occurrence of suicidal ideation or the number of ICD-10 diagnoses. These findings support initiatives in which a routine exploration of traumatic events in childhood is performed when multimodal hallucinations are present.

Objectives: Concussions affect the processing of emotional stimuli. This study aimed to investigate how sex interacts with concussion effects on early event-related brain potentials (ERP) measures (P1, N1) of emotional facial expressions (EFE) processing in asymptomatic, multi-concussion athletes during an EFE identification task. Methods: Forty control athletes (20 females and 20 males) and 43 multi-concussed athletes (22 females and 21 males), recruited more than 3 months after their last concussion, were tested. Participants completed the Beck Depression Inventory II, the Beck Anxiety Inventory, the Post-Concussion Symptom Scale, and an Emotional Facial Expression Identification Task. Pictures of male and female faces expressing neutral, angry, and happy emotions were randomly presented and the emotion depicted had to be identified as fast as possible during EEG acquisition. Results: Relative to controls, concussed athletes of both sex exhibited a significant suppression of P1 amplitude recorded from the dominant right hemisphere while performing the emotional face expression identification task. The present study also highlighted a sex-specific suppression of the N1 component amplitude after concussion which affected male athletes. Conclusions: These findings suggest that repeated concussions alter the typical pattern of right-hemisphere response dominance to EFE in early stages of EFE processing and that the neurophysiological mechanisms underlying the processing of emotional stimuli are distinctively affected across sex. (JINS, 2018, 24, 1–11)

Acute alcohol intoxication and alcohol use disorders are characterized by a wide range of psychological and cerebral impairments, which have been widely explored using neuropsychological and neuroscientific techniques. Eye tracking has recently emerged as an innovative tool to renew this exploration, as eye movements offer complementary information on the processes underlying perceptive, attentional, memory or executive abilities. Building on this, the present systematic and critical literature review provides a comprehensive overview of eye tracking studies exploring cognitive and affective processes among alcohol drinkers. Using PRISMA guidelines, 36 papers that measured eye movements among alcohol drinkers were extracted from three databases (PsycINFO, PubMed, Scopus). They were assessed for methodological quality using a standardized procedure, and categorized based on the main cognitive function measured, namely perceptive abilities, attentional bias, executive function, emotion and prevention/intervention. Eye tracking indexes showed that alcohol-related disorders are related to: (1) a stable pattern of basic eye movement impairments, particularly during alcohol intoxication; (2) a robust attentional bias, indexed by increased dwell times for alcohol-related stimuli; (3) a reduced inhibitory control on saccadic movements; (4) an increased pupillary reactivity to visual stimuli, regardless of their emotional content; (5) a limited visual attention to prevention messages. Perspectives for future research are proposed, notably encouraging the exploration of eye movements in severe alcohol use disorders and the establishment of methodological gold standards for eye tracking measures in this field.

Attentional bias towards alcohol-related stimuli is a core characteristic of alcohol use disorders (AUD), playing a crucial role in their development and persistence. Many behavioral studies have shown an increased allocation of attentional resources towards alcohol-related stimuli in patients with AUD, but have also revealed a direct link between the bias and key alcohol-related variables like craving, alcohol consumption and relapse. Nevertheless, the extent of the bias in subclinical populations is still poorly documented. The present study used eye-tracking measures to: – investigate the presence of attentional bias in a specific population presenting subclinical excessive alcohol consumption (i.e. binge drinking); – determine the time course of the bias, by disentangling the role played by early and late processing stages; – clarify whether the bias is specifically associated with alcohol-related stimuli or can be generalized towards other appetitive stimulations (i.e. high-caloric food stimuli); – explore the role played by craving in the intensity of the bias. Forty-two binge drinkers and 43 matched controls performed a visual probe task, which required the processing of visual targets preceded by pairs of pictures related to three comparisons (alcohol vs. soft, alcohol vs. high-calories food, salty or sugary food vs. low-calories food). While no difference was observed across conditions for early processing (i.e. first area of interest visited), a group difference for dwell time highlighted the presence of a bias towards soft drinks and healthy food among control participants, without any bias towards alcohol and high-caloric food in binge drinkers. Centrally, complementary analyses indicated that a bias towards alcohol and high-calories food was observed among binge drinkers only in the presence of high craving levels. It thus appears that the attentional bias towards alcohol repeatedly reported in severe AUD is only found in binge drinkers in the presence of elevated craving, and is generalized towards other appetitive cues.

The widespread cognitive and cerebral consequences of prenatal alcohol exposure have been established during the last decades, through the exploration of fetal alcohol spectrum disorders (FASD) using neuropsychological and neuroscience tools. This research field has recently benefited from the emergence of innovative measures, among which eye tracking, allowing a precise measure of the eye movements indexing a large range of cognitive functions. We propose a comprehensive review, based on PRISMA guidelines, of the eye tracking studies performed in populations with FASD. Studies were selected from the PsycINFO, PubMed and Scopus databases, and were evaluated through a standardized methodological quality assessment. Studies were classified according to the eye tracking indexes recorded (saccade characteristics, initial fixation, number of fixations, dwell time, gaze pattern) and the process measured (perception, memory, executive functions). Eye tracking data showed that FASD are mostly associated with impaired ocular perceptive/motor abilities (i.e., altered eye movements, centrally for saccade initiation), lower accuracy as well as increased error rates in saccadic eye movements involving working memory abilities, and reduced inhibitory control on saccades. After identifying the main limitations presented by the reviewed studies, we propose guidelines for future research, underlining the need to increase the standardization of diagnosis and evaluation tools, and to improve the methodological quality of eye tracking measures.

Binge drinking (i.e. excessive episodic alcohol consumption) among young adults has been associated with deleterious consequences, notably at the cognitive and brain levels. These behavioural impairments and brain alterations have a direct impact on psychological and interpersonal functioning, but they might also be involved in the transition towards severe alcohol use disorders. Development of effective rehabilitation programs to reduce these negative effects as they emerge thus constitutes a priority in subclinical populations. The present study tested the behavioural and electrophysiological impact of neurocognitive stimulation (i.e. transcranial direct current stimulation (tDCS) applied during a cognitive task) to improve attention and inhibition abilities in young binge drinkers. Two groups (20 binge drinkers and 20 non-binge drinkers) performed two sessions in a counterbalanced order. Each session consisted of an inhibition task (i.e. Neutral Go/No-Go) while participants received left frontal tDCS or sham stimulation, immediately followed by an Alcohol-related Go/No-Go task, while both behavioural and electrophysiological measures were recorded. No significant differences were observed between groups or sessions (tDCS versus sham stimulation) at the behavioural level. However, electrophysiological measurements during the alcohol-related inhibition task revealed a specific effect of tDCS on attentional resource mobilization (indexed by the N2 component) in binge drinkers, whereas later inhibition processes (indexed by the P3 component) remained unchanged in this population. The present findings indicate that tDCS can modify the electrophysiological correlates of cognitive processes in binge drinking. While the impact of such brain modifications on actual neuropsychological functioning and alcohol consumption behaviours remains to be determined, these results underline the potential interest of developing neurocognitive stimulation approaches in this population.

Eye tracking has emerged as a reliable neuroscience tool indexing the eye movements' correlates of impairments resulting from alcohol-use disorders, ranging from perceptive abilities to high-level cognitive functions. This systematic review, following PRISMA guidelines, encompasses all human studies using eye tracking in participants presenting acute alcohol consumption. A literature search was conducted in PsycINFO, PubMed and Scopus, and a standardized methodological quality assessment was performed. Eye tracking studies were classified according to the processes measured (perception, attentional bias, memory, executive functions, prevention message processing). Eye tracking data centrally showed a global visuo-motor impairment (related to reduced cerebellar functioning) following alcohol intoxication, together with reduced memory and inhibitory control of eye movements. Conversely, the impact of such intoxication on alcohol-related attentional bias is still debated. The limits of this literature have been identified, leading to the emergence of new research avenues to increase the understanding of eye movements during alcohol intoxication, and to the proposal of guidelines for future research. Copyright © 2019 Elsevier Ltd. All rights reserved.

The increase of pathological Internet use recently led to the identification of an “Internet addiction” disorder. While its diagnosis criteria remain unclear, the behavioral consequences of Internet addiction have been widely explored. Its cerebral correlates have also been investigated using electroencephalography, but obtained results have not yet been integrated in a sound theoretical framework. This paper aims at reviewing these studies and at analyzing their results through a dual-process perspective. A systematic literature search was conducted using Pubmed to identify studies in English exploring neural oscillations and/or event-related potentials in individuals displaying problematic Internet use. The 14 articles finally selected show that Internet addiction shares essential features with other addictive states, mainly a joint hypo-activation of the reflective system (decreased executive control abilities) and hyper-activation of the automatic-affective one (excessive affective processing of addiction-related cues). Despite the currently limited data, dual-process models thus appear useful to conceptualize the imbalance between cerebral systems in Internet addiction. We finally propose that future electrophysiological studies should better characterize this disequilibrium between controlled-deliberate and automatic-affective networks, notably by using event-related potentials paradigms focusing on each system separately and on their interactions, but also by better specifying the potential differences between sub-categories of Internet addiction.

Key Points Question What is the mental health state of university students in France who were confined during the coronavirus disease 2019 (COVID-19) pandemic, and what factors are associated with the development of mental health symptoms? Findings This survey study of 69 054 students who experienced quarantine found high prevalence rates of severe self-reported mental health symptoms. Among risk factors identified, female or nonbinary gender, problems with income or housing, history of psychiatric follow-up, symptoms compatible with COVID-19, social isolation, and low quality of information received were associated with altered mental health. Meaning The findings of this study suggest that students’ mental health is a public health issue that has become even more critical in the context of a pandemic, underlining the need to reinforce prevention, surveillance, and access to care., This survey study measures the prevalence of self-reported mental health symptoms, identifies associated factors, and assesses care seeking among university students in France who experienced quarantine during the coronavirus disease 2019 (COVID-19) pandemic., Importance The coronavirus disease 2019 (COVID-19) pandemic and quarantine measures have raised concerns regarding their psychological effects on populations. Among the general population, university students appear to be particularly susceptible to experiencing mental health problems. Objectives To measure the prevalence of self-reported mental health symptoms, to identify associated factors, and to assess care seeking among university students who experienced the COVID-19 quarantine in France. Design, Setting, and Participants This survey study collected data from April 17 to May 4, 2020, from 69 054 students living in France during the COVID-19 quarantine. All French universities were asked to send an email to their students asking them to complete an online questionnaire. The targeted population was approximately 1 600 000 students. Exposure Living in France during the COVID-19 quarantine. Main Outcomes and Measures The rates of self-reported suicidal thoughts, severe distress, stress, anxiety, and depression were assessed using the 22-item Impact of Events Scale–Revised, the 10-item Perceived Stress Scale, the 20-item State-Trait Anxiety Inventory (State subscale), and the 13-item Beck Depression Inventory, respectively. Covariates were sociodemographic characteristics, precariousness indicators (ie, loss of income or poor quality housing), health-related data, information on the social environment, and media consumption. Data pertaining to care seeking were also collected. Multivariable logistic regression analyses were performed to identify risk factors. Results A total of 69 054 students completed the survey (response rate, 4.3%). The median (interquartile range) age was 20 (18-22) years. The sample was mainly composed of women (50 251 [72.8%]) and first-year students (32 424 [47.0%]). The prevalence of suicidal thoughts, severe distress, high level of perceived stress, severe depression, and high level of anxiety were 11.4% (7891 students), 22.4% (15 463 students), 24.7% (17 093 students), 16.1% (11 133 students), and 27.5% (18 970 students), respectively, with 29 564 students (42.8%) reporting at least 1 outcome, among whom 3675 (12.4%) reported seeing a health professional. Among risk factors identified, reporting at least 1 mental health outcome was associated with female gender (odds ratio [OR], 2.10; 95% CI, 2.02-2.19; P

Background Severe alcohol use disorder (SAUD) is associated with impaired discrimination of emotional expressions. This deficit appears increased in crossmodal settings, when simultaneous inputs from different sensory modalities are presented. However, so far, studies exploring emotional crossmodal processing in SAUD relied on static faces and unmatched face/voice pairs, thus offering limited ecological validity. Our aim was therefore to assess emotional processing using a validated and ecological paradigm relying on dynamic audio-visual stimuli, manipulating the amount of emotional information available. Method Thirty individuals with SAUD and 30 matched healthy controls performed an emotional discrimination task requiring to identify five emotions (anger, disgust, fear, happiness, sadness) expressed as visual, auditory, or auditory-visual segments of varying length. Sensitivity indices (d’) were computed to get an unbiased measure of emotional discrimination and entered in a Generalized Linear Mixed Model. Incorrect emotional attributions were also scrutinized through confusion matrices. Results Discrimination levels varied across sensory modalities and emotions, and increased with stimuli duration. Crucially, performances also improved from unimodal to crossmodal conditions in both groups, but discrimination for anger crossmodal stimuli and fear crossmodal/visual stimuli remained selectively impaired in SAUD. These deficits were not influenced by stimuli duration, suggesting that they were not modulated by the amount of emotional information available. Moreover, they were not associated with systematic emotional error patterns reflecting specific confusions between emotions. Conclusions These results clarify the nature and extent of crossmodal impairments in SAUD and converge with earlier findings to ascribe a specific role for anger and fear in this pathology.

International audience; Emotional processing is known to be modulated by several psychopathological dimensions. In particular, anxious behavior is associated with an attentional bias toward emotional informationoften characterized by contradictory manifestations at neural and behavioral levels. In healthy participants, the emotional visual stimuli have been shown to capture differently the attentionalresources when presented in central (CV) or in peripheral vision (PV). Hence, it seems interesting to use the model of CV vs PV presentation in order to explore the impact of emotional stimulations in anxious individuals as compared to healthy controls. The aimof this presentation was to analyze the magnetoencephalography (MEG) and behavioral data illustrating the impact of emotional pictures presented in CV (0) vs PV (-12and +12), in healthy controls, in sub-clinical anxious individuals, and in patients with generalized anxiety disorder (GAD). Main results revealed that 1/emotional information presented at peripheral eccentricities grabs attentional resources needed for the performance in the center of thevisual field, 2/ state-anxiety modulates the CV impact of emotional saliency occurring in PV, 3/ patients with GAD showed greater efficiency in emotional condition than HC. In brief, patients with GAD exacerbate the processing of emotional information appearing in the CV and PV. The high level of alertness for emotional cues in PV could help to understand the causation and maintenance of anxiety disorders.

International audience; Patients with severe alcohol use disorder (SAUD) frequently show cognitive deficits that can be efficiently identified using screening tools such as the Montreal Cognitive Assessment (MoCA) test. These cognitive deficits, which reduce the efficacy of therapeutic interventions and may contribute to dropout and relapse, could be, however, partly due to a treatable other cause. Accordingly, this exploratory study examined whether psychiatric comorbid disorders can induce a positive MoCA screening among recently detoxified SAUD subjects.One hundred recently detoxified patients with SAUD were divided into two groups according to whether they presented cognitive deficits using the MoCA. Groups were compared for demographic data, SAUD severity, impulsivity, and psychiatric comorbidities. The significant parameters were then introduced in a logistic regression model to establish their relative contributions in a positive MoCA status in SAUD subjects.Among the significant parameters revealed by the bivariable analyses, agoraphobia and current depressive episode were found to be significant predictors of the MoCA status in the multivariable comparisons.A positive MoCA screening for cognitive impairments among post-detoxification SAUD patients could also be related to comorbid agoraphobia and depressive episode rather than to SAUD itself. A comprehensive psychiatric assessment must be performed in SAUD patients so that other potential causes of cognitive deficits, in particular with regard to mood and anxiety disorders, can be identified and treated.

International audience

Objective The aim of this study was to develop a presurgical magnetoencephalography (MEG) protocol to localize and lateralize expressive and receptive language function as well as verbal memory in patients with epilepsy. Two simple language tasks and a different analytical procedure were developed. Methods Ten healthy participants and 13 epileptic patients completed two language tasks during MEG recording: a verbal memory task and a verbal fluency task. As a first step, principal component analyses (PCA) were performed on source data from the group of healthy participants to identify spatiotemporal factors that were relevant to these paradigms. Averaged source data were used to localize areas activated during each task and a laterality index (LI) was computed on an individual basis for both groups, healthy participants and patients, using sensor data. Results PCA revealed activation in the left temporal lobe (300ms) during the verbal memory task, and from the frontal lobe (210ms) to the temporal lobe (500ms) during the verbal fluency task in healthy participants. Averaged source data showed activity in the left hemisphere (250–750ms), in Wernicke's area, for all participants. Left hemisphere dominance was demonstrated better using the verbal memory task than the verbal fluency task ( F 1,19 =4.41, p =0.049 ). Cohen's kappa statistic revealed 93% agreement ( k =0.67, p =0.002) between LIs obtained from MEG sensor data and fMRI, the IAT, electrical cortical stimulation or handedness with the verbal memory task for all participants. At 74%, agreement results for the verbal fluency task did not reach statistical significance. Significance Analysis procedures yielded interesting findings with both tasks and localized language-related activation. However, based on source localization and laterality indices, the verbal memory task yielded better results in the context of the presurgical evaluation of epileptic patients. The verbal fluency task did not add any further information to the verbal memory task as regards language localization and lateralization for most patients and healthy participants that would facilitate decision making prior to surgery.

This study evaluated inhibition and performance-monitoring abilities through the explicit processing of alcohol cues. Twenty-two binge drinkers (BD) and 22 control participants performed a speeded Go/No-Go task using pictures of alcohol and soft cans as Go and No-Go targets. This task measures inhibitory control and performance monitoring (i.e., task adjustment through errors and feedback processing) during the explicit processing of alcohol cues. Groups did not significantly differ regarding inhibition abilities. However, BD had poorer performance-monitoring abilities, reflected by a difficulty to adjust after errors, especially when these errors were related to alcohol cues. These findings suggest that the explicit processing of alcohol cues negatively impacts cognitive abilities among BD.

OBJECTIVE: Performance monitoring, which allows efficient behavioral regulation using either internal (error processing) or external (feedback processing) cues, has not yet been explored in binge drinking despite its adaptive importance in everyday life, particularly in the regulation of alcohol consumption. Capitalizing on a theoretical model of risky behaviors, the present study aimed at determining the behavioral and electrophysiological correlates of the cognitive (inhibition) and motivational (reward sensitivity) systems during performance monitoring. METHODS: Event-related potentials were recorded from 20 binge drinkers and 20 non-binge drinkers during two experimental tasks, a speeded Go/No-Go Task [investigating internal error processing by Error-Related Negativity (ERN) and error positivity (Pe)] and a Balloon Analogue Risk Task [investigating external feedback processing by Feedback-Related Negativity (FRN) and P3]. RESULTS: While no group differences were observed at the behavioral level, electrophysiological results showed that binge drinkers, despite having intact feedback-related components, presented modified error-monitoring components (i.e. larger ERN amplitude, delayed Pe latency). CONCLUSIONS: Internal performance monitoring is impaired in binge drinkers, showing an abnormal automatic processing of response errors (ERN) and a decreased processing of their motivational significance (Pe). SIGNIFICANCE: These results suggest that the electrophysiological correlates of inhibitory control allow identifying the specific binge drinking consumption pattern.

Background Emotional and interpersonal impairments have been largely reported in alcohol-dependence, and their role in its development and maintenance is widely established. However, earlier studies have exclusively focused on group comparisons between healthy controls and alcohol-dependent individuals, considering them as a homogeneous population. The variability of socio-emotional profiles in this disorder thus remains totally unexplored. The present study used a cluster analytic approach to explore the heterogeneity of affective and social disorders in alcohol-dependent individuals. Methods 296 recently-detoxified alcohol-dependent patients were first compared with 246 matched healthy controls regarding self-reported emotional (i.e. alexithymia) and social (i.e. interpersonal problems) difficulties. Then, a cluster analysis was performed, focusing on the alcohol-dependent sample, to explore the presence of differential patterns of socio-emotional deficits and their links with demographic, psychopathological and alcohol-related variables. Results The group comparison between alcohol-dependent individuals and controls clearly confirmed that emotional and interpersonal difficulties constitute a key factor in alcohol-dependence. However, the cluster analysis identified five subgroups of alcohol-dependent individuals, presenting distinct combinations of alexithymia and interpersonal problems ranging from a total absence of reported impairment to generalized socio-emotional difficulties. Conclusions Alcohol-dependent individuals should no more be considered as constituting a unitary group regarding their affective and interpersonal difficulties, but rather as a population encompassing a wide variety of socio-emotional profiles. Future experimental studies on emotional and social variables should thus go beyond mere group comparisons to explore this heterogeneity, and prevention programs proposing an individualized evaluation and rehabilitation of these deficits should be promoted.

BACKGROUND: Alcohol-dependence is related to large-scale cognitive impairments, particularly for executive functions (EF). These deficits persist even after long-term abstinence and have a major impact on patients' everyday life and relapse risk. Earlier studies, based on multi-determined tasks, mostly focused on inhibition and did not offer a theoretically-grounded and exhaustive view of the differential deficit across EF. The present paper proposes a model-based exploration of EF in alcohol-dependent individuals (ALC), to precisely compare the specific deficit related to each executive subcomponent. METHODS: Forty-seven recently detoxified ALC were compared to 47 matched healthy participants on a nine-tasks validated neuropsychological battery, simultaneously exploring and comparing the three main executive subcomponents (shifting, updating, and inhibition). Psychopathological comorbidities were also controlled for. RESULTS: Reaction time indexes revealed a global slowing down among ALC, whatever the EF explored. Accuracy indexes revealed a moderate deficit for inhibition tasks but a massive impairment for shifting and updating ones. Complementary analyses indicated that the executive deficits observed were centrally related to alcohol-dependence, while comorbid depressive symptoms appeared to intensify the deficits observed. CONCLUSIONS: By offering a direct comparison between the three major EF, these results showed that alcohol-related executive deficits extend beyond the classically described inhibition impairment. This impairment encompasses each EF subcomponent, as ALC actually presented stronger deficits for updating and shifting abilities. This first observation of a multifaceted EF deficit stresses the need for an individualized evaluation and rehabilitation of EF during and/or after the detoxification process.

Objective: Familiarity is a subjective sensation that contributes to person recognition. This process is described as an emotion-based memory-trace of previous meetings and could be disrupted in schizophrenia. Consequently, familiarity disorders could be involved in the impaired social interactions observed in patients with schizophrenia. Previous studies have primarily focused on famous people recognition. Our aim was to identify underlying features, such as emotional disturbances, that may contribute to familiarity disorders in schizophrenia. We hypothesize that patients with familiarity disorders will exhibit a lack of familiarity that could be detected by a flattened skin conductance response. Method: The skin conductance response was recorded to test the hypothesis that emotional reactivity disturbances occur in patients with schizophrenia during the categorization of specific familiar, famous and unknown faces as male or female. Forty-eight subjects were divided into the following 3 matched groups with 16 subjects per group: control subjects, schizophrenic people with familiarity disorder and schizophrenic people without familiarity disorders. Results: Emotional arousal is reflected by the skin conductance measures. The control subjects and the patients without familiarity disorders experienced a differential emotional response to the specific familiar faces compared with that to the unknown faces. Nevertheless, overall, the schizophrenic patients without familiarity disorders showed a weaker response across conditions compared with the control subjects. In contrast, the patients with familiarity disorders did not show any significant differences in their emotional response to the faces, regardless of the condition. Conclusions: Only patients with familiarity disorders fail to exhibit a difference in emotional response between familiar and non-familiar faces. These patients likely emotionally process familiar faces similarly to unknown faces. Hence, the lower feelings of familiarity in schizophrenia may be a premise enabling the emergence of familiarity disorders.

International audience; Generalized Anxiety Disorder (GAD) is associated with an attentional bias toward emotional information leading to behavioral manifestations which need to be clarified. In healthy participants, the emotional visual stimuli have been shown to capture the attentional resources not only in central vision (CV) but also in impoverished visual conditions as those of the peripheral vision (PV). Hence, it seems necessary to study the processing of emotional information and its behavioral impact in both CV and PV. Objective: The aim of this study was to compare, in patients with GAD and in healthy controls (HC), the behavioral impact of theemotional value of natural scenes presented in CV or in PV. Method: Ten patients with GAD and ten HC matched for age, gender and education level were presented with standardized emotional pictures from the International affective Picture System (IAPS). Three groups of 300 pictures (unpleasant, neutral and pleasant) were presented at three visual eccentricities (CV: 0°; PV: -12° and +12°). The 900 trials were split into 4 blocks during which the participants had to fix a cross in the center of the screen and to report the location of the pictures (left, center or right) using a keypad. We analyzed the behavioral responses: reaction time, the accuracy and the Speed-Accuracy Composite Score (SACS) which measures the efficiency of the response, and the dynamic of the cerebral events using the magnetoencephalography(MEG). Results: The reaction times of patients with GAD were reduced when pictures were emotional while those of HC were increased. Besides, while HC showed a lower efficiency when discriminating the location of pictures appearing in CV, patients demonstrated an equal efficiency in CV and PV. An early occipital component (90 ms) was correlated with the emotional effect. Discussion and conclusion: Patients with GAD showed a high sensitivity to emotional visual information, revealed by an improvement of the efficiency when they responded to emotional pictures and by an early occipital activation. Furthermore, while patients showed similar efficiency regardless of the position of the pictures, HC seemed to expend more attentional resources to monitor the peripheral field which appeared detrimental to the CV. Therefore, our data suggest that a large distribution of attentional resources in visual space is easier for anxious patients than for controls.

Familiarity is a crucial aspect of recognition that may be perturbed in schizophrenia patients (SZP) and may lead to delusional disorders. However, there are no existing guidelines on how to assess and treat familiarity disorders in schizophrenia. Some experimental studies have investigated familiarity processing in SZP but have produced inconsistent results, which are likely a result of methodological issues. Moreover, these studies only assessed whether familiarity processing is preserved or impaired in SZP, but not the tendency of SZP to consider unfamiliar stimuli to be familiar. By using a familiarity continuum task based on the existence of the categorical perception effect, the objective of this study was to determine whether SZP present hyper- or hypo-familiarity. To this purpose, 15 SZP and 15 healthy subjects (HS) were presented with facial stimuli, which consisted of picture morphs of unfamiliar faces and faces that were personally familiar to the participants. The percentage of the familiar face contained in the morph ranged from 5 to 95%. The participants were asked to press a button when they felt familiar with the face that was presented. The main results revealed a higher percentage of familiarity responses for SZP compared with HS from the stimuli with low levels of familiarity in the morph and a lower familiarity threshold, suggesting a hyper-familiarity disorder in SZP. Moreover, the intensity of this "hyper-familiarity" was correlated with positive symptoms. This finding clearly suggests the need for a more systematic integration of an assessment of familiarity processing in schizophrenia symptoms assessments.

This perspective aims at underlining the usefulness of event-related potentials (ERP) to better understand the brain correlates of Korsakoff’s syndrome (KS), a neuropsychiatric disease characterized by severe memory impairment and most frequently resulting as a neurological complication of alcohol-dependence (AD). While ERP have been broadly used in AD, it has up to now been very little applied in KS or in the comparison of KS and AD. Within the framework of dual-process models, an influential theory postulating that addictive states result from an imbalance between under-activated reflective system and over-activated automatic-affective one, this paper proposes: (1) a brief synthesis of the main results of ERP studies in AD and KS, and (2) new research avenues using ERP to identify the electrophysiological correlates of cognitive and emotional dysfunction in KS. These experimental perspectives aim at exploring the continuity hypothesis, which postulates a gradient of impairments from AD to KS. We conclude on the possibility of developing neuropsychological strategies with electrophysiological follow-up to ensure KS diagnosis and test the efficacy of patient’s neurocognitive rehabilitation.

Problematic behaviors have emerged with the exponential development of the Internet access, with some individuals failing to constrain their Internet use despite its negative impact on their daily lives. Recent neuropsychological and neuroscience studies have suggested that problematic Internet use is notably associated with increased cue-reactivity and reduced inhibitory control. This review of the electroencephalography (EEG) literature shows that most studies have found that impaired self-control abilities (i.e., inhibition and error monitoring) are associated with underactivated frontal regions in problematic Internet users (PIUs). However, some EEG studies in the domain have also demonstrated alterations in the processing of Internet-related cues and emotional stimuli. As a whole, these data therefore suggest that both reflective (top-down) and automatic/affective (bottom-up) systems, postulated by dual-process models as being determinants in decision making, are impaired among PIUs. On this basis, new research avenues are proposed to better understand the development and maintenance of problematic Internet use, according to six main directions respectively related to (1) the identification of vulnerability biomarkers, (2) the investigation of possible lower level cognitive impairments, (3) the exploration of core reflective and automatic/affective symptoms, (4) the evaluation of Internet use heterogeneity and comorbidities, (5) the development of new neuroscience strategies and (6) the elaboration of behavioral and cognitive interventions.

International audience; The objectives of the present study were to (i) better characterize visual emotional experience in patients with temporal lobe epilepsy (TLE), (ii) identify clinical risk factors that might be predictive of a change in emotional experience, and (iii) study the relationships between emotional experience and psychobehavioral/quality-of-life factors. Fifty patients with TLE and fifty matched controls evaluated the emotional content of unpleasant, pleasant, and neutral pictures with respect to their valence (unpleasant-to-pleasant) and arousal (low-to-high) levels. Demographic, cognitive, and psychobehavioral data were recorded for all participants, and clinical data and factors related to quality of life were also collected for patients with TLE. There were no significant differences between the group with TLE and the control group in terms of valence evaluations. However, arousal scores for neutral pictures were significantly higher in patients with TLE than in controls. There was also a nonsignificant trend towards lower arousal scores for pleasant pictures in patients with TLE than in controls. Although none of the recorded clinical factors were found to be related to emotional experience, the level of apathy was predictive of greater arousal experience for neutral pictures in patients with TLE. In conclusion, emotional experience appears to be modified in TLE and might be related to apathy. Changes in emotional experience should be taken into account in studies in which neutral stimuli are used to establish a baseline level when assessing emotional and cognitive processing.

Background The priority processing of peripherally presented affective stimuli was recently shown in healthy individuals to divert attentional resources dedicated to foveal processing. Here we investigated the influence of sub-clinical levels of anxiety and depression on this bias. Methods Eighty-four participants were submitted to psychological tests that evaluate anxiety and depression levels. Then, they had to make speeded responses to the direction of left- or right-oriented arrows that were presented foveally at fixation. Each arrow was preceded by a peripherally presented pair of pictures, one neutral and one emotional, unpleasant or pleasant. Thus, the direction of the foveal arrow was either congruent or not with the peripheral location of the previously presented emotional picture. Data analysis focused on the differences of reaction times between congruent and incongruent conditions, which assess the spatial response bias in the task. Results A main effect of state-anxiety was observed suggesting that the higher the level of state-anxiety, the greater the congruence effect. Limitations Since the obtained result relates to subclinical anxiety levels, its generalization to anxiety disorders remains tentative. Conclusions State-anxiety appears to modulate the propensity to be influenced by emotionally salient information occurring in peripheral vision, independently of its relevance to the ongoing behavior. The long-term persistence of a high level of alertness for emotional cues in visual periphery could contribute to the causation and the maintenance of anxiety disorders.

Many studies provided evidence that the emotional content of visual stimulations modulates behavioral performance and neuronal activity. Surprisingly, these studies were carried out using stimulations presented in the center of the visual field while the majority of visual events firstly appear in the peripheral visual field. In this study, we assessed the impact of the emotional facial expression of fear when projected in near and far periphery. Sixteen participants were asked to categorize fearful and neutral faces projected at four peripheral visual locations (15° and 30° of eccentricity in right and left sides of the visual field) while reaction times and event-related potentials (ERPs) were recorded. ERPs were analyzed by means of spatio-temporal principal component and baseline-to-peak methods. Behavioral data confirmed the decrease of performance with eccentricity and showed that fearful faces induced shorter reaction times than neutral ones. Electrophysiological data revealed that the spatial position and the emotional content of faces modulated ERPs components. In particular, the amplitude of N170 was enhanced by fearful facial expression. These findings shed light on how visual eccentricity modulates the processing of emotional faces and suggest that, despite impoverished visual conditions, the preferential neural coding of fearful expression of faces still persists in far peripheral vision. The emotional content of faces could therefore contribute to their foveal or attentional capture, like in social interactions.

Emotional deficits have been largely described in alcohol-dependence and play a crucial role in its development and maintenance. However, several subtle emotional decoding abilities remain to be investigated among alcohol-dependent individuals (ADI). Particularly, it is unknown whether ADI exhibit the categorical perception effect found in healthy populations during emotional …