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(https://www.psypost.org/severe-covid-19-infection-might-cause-changes-in-brain-metabolism-study-finds/) Severe COVID-19 infection might cause changes in brain metabolism, study finds
Aug 7th 2024, 10:00

A neuroimaging study in Serbia found that individuals who survived a more severe COVID-19 infection had lower levels of creatine and N-acetylaspartate levels in several regions of the brain. The ratio of choline and creatine levels was heightened in survivors of more severe COVID-19 infections. The research, published in the (https://doi.org/10.3390/jcm13144128) Journal of Clinical Medicine, sheds light on the potential long-term neurological impacts of severe COVID-19 infections, highlighting changes in brain metabolism that could contribute to cognitive and neurological symptoms observed in patients post-recovery.
COVID-19 is an infectious disease caused by the coronavirus SARS-CoV-2. This infection in humans emerged in late 2019 and quickly spread around the world, causing a global pandemic. While many individuals experienced a COVID-19 infection with few or almost no symptoms, the infection proved deadly for many others. Estimates indicate that it infected over 700 million people worldwide, killing around 7 million during the 2020-2022 pandemic.
Symptoms of COVID-19 range from mild to severe and life-threatening. They can include fever, cough, difficulty breathing, fatigue, and loss of taste or smell. Aftereffects, often referred to as “long COVID,” can include lingering fatigue, respiratory issues, cognitive impairments, and other health problems. Studies have indicated that the virus responsible for the infection invades many different organs, including the nervous system. In many cases, individuals recovering from COVID-19 developed various neurological and psychiatric symptoms.
Study author Jelena Ostojić and her colleagues wanted to investigate whether COVID-19 affects specific brain metabolism markers and whether the severity of the COVID-19 infection is associated with this effect. They focused on the subcortical white matter, anterior cingulate cortex, deep frontal white matter, and posterior cingulate cortex regions of the brain, applying magnetic resonance spectroscopy.
Magnetic resonance spectroscopy is a non-invasive diagnostic technique that uses magnetic fields and radio waves to measure the concentration of specific chemicals, or metabolites, within tissues, providing detailed information about their biochemical composition. The authors of this study focused on levels of brain metabolites N-acetylaspartate, choline, and creatine, and their relative concentrations.
N-acetylaspartate is a marker of neuronal health and function, with decreased levels indicating neuronal loss or dysfunction. Elevated choline can indicate increased cell membrane turnover or malignancy. Creatine levels are typically stable and serve as a reference for other metabolites.
Study participants were 81 individuals who recovered from COVID-19 6-12 months before the study. Forty-one of these participants were female, and their ages ranged between 40 and 60 years. These individuals reported various neurological or neurocognitive symptoms associated with acute COVID-19 infection, such as headaches, dizziness, disorders of smell or taste, forgetfulness, and issues with concentration and attention. These individuals underwent magnetic resonance imaging and spectroscopy.
The study authors divided participants into three groups depending on the severity of COVID-19 symptoms they experienced during the infection. The mild group consisted of outpatients with milder symptoms who experienced at least one COVID-19 symptom during the acute phase but did not need supplemental oxygen.
The moderate group included hospitalized patients with moderate to severe symptoms who required standard oxygen support during the acute phase. The severe group was made up of hospitalized patients with severe symptoms, necessitating more intensive oxygen support, such as high-flow nasal cannula (HFNC) therapy, non-invasive and invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).
Results showed that levels of N-acetylaspartate and creatinine were lower in all studied regions of the brain in individuals who went through a more severe COVID-19 infection compared to participants who only had a mild form of COVID-19. Ratios of choline to creatine concentrations were increased.
“Both in grey and white matter, the decrease in NAA [N-acetylaspartate] suggests the neuronal loss and/or dysfunction following direct neuronal injury caused by virus per se or indirect neuronal loss caused by the neuroinflammatory processes triggered by systemic inflammation. One of the most interesting findings is the instability of Cr [creatine], with detected decrease reflecting the severity of the clinical condition possibly indicating an increased risk of neurological complications such as dementia following severe COVID-19 infection,” the study authors concluded.
“Finally, we observed relatively stable or even decreasing Cho [choline] in the more severe clinical presentations potentially speaking in favor of neuroplasticity in observed voxels [areas of the brain]. The alterations in brain metabolites observed in our study may be attributed to a combination of direct viral effects, systemic inflammation, oxidative stress, mitochondrial dysfunction, and hypoxia.”
The study sheds light on the likely aftereffects of COVID-19 infections on neural health. However, it should be noted that the study authors did not have participants’ data from before COVID-19. Therefore, it remains unknown whether these brain metabolism alterations developed as a consequence of the infection or if these individuals had altered brain metabolism even before that.
The paper, “(https://doi.org/10.3390/jcm13144128) Decreased Cerebral Creatine and N-Acetyl Aspartate Concentrations after Severe COVID-19 Infection: A Magnetic Resonance Spectroscopy Study,” was authored by Jelena Ostojić, Dusko Kozić, Sergej Ostojić, Aleksandra DJ Ilić, Vladimir Galic,  Jovan Matijašević, Dušan Dragićević, Otto Barak, and Jasmina Boban.

(https://www.psypost.org/ketamine-as-an-entactogen-scientists-reveal-intriguing-impact-on-social-pleasure-and-empathy/) Ketamine as an entactogen: Scientists reveal intriguing impact on social pleasure and empathy
Aug 7th 2024, 06:00

Ketamine treatment not only alleviates symptoms of treatment-resistant depression but also enhances social pleasure and empathetic behaviors, according to new research published in the (https://doi.org/10.1176/appi.ajp.20230980) American Journal of Psychiatry. This discovery provides evidence that ketamine can have entactogenic effects.
Empathy is crucial for social cohesion among mammals, including humans. It encompasses cognitive, emotional, and compassionate dimensions, enabling individuals to understand, share, and act upon the emotions of others. Disordered empathy is a common feature in various psychiatric conditions such as major depression, autism spectrum disorder, and antisocial personality disorder.
For individuals with major depression, an imbalance in empathy can lead to profound loneliness and despair due to an inability to connect socially. Despite the significant impact of disordered empathy, there are currently no approved medications specifically designed to enhance empathy.
Recent interest in psychedelic compounds like MDMA, LSD, and psilocybin has shown promise in facilitating social cohesion and empathy. However, regulatory hurdles and time constraints pose significant challenges for their clinical use. This study aimed to bridge this gap by investigating whether ketamine, an already approved medication for treatment-resistant depression, possesses entactogenic properties.
“I am generally interested in the effects of rapid-acting antidepressant drugs, their mechanisms, and their translation between humans and animal models,” said study author Todd Gould, a professor of psychiatry, pharmacology, and neurobiology at the University of Maryland School of Medicine.
The study involved 68 participants aged 18 to 65, all diagnosed with either major depressive disorder or bipolar disorder and currently experiencing a major depressive episode. These individuals had not responded to at least one antidepressant during their current episode. Conducted at the National Institute of Mental Health, the study used a double-blind, placebo-controlled, crossover design. Each participant received both a ketamine infusion (0.5 mg/kg over 40 minutes) and a placebo infusion, administered two weeks apart in random order. The study did not include structured psychotherapy.
The researchers assessed the participants’ pleasure from social interactions using the Snaith-Hamilton Pleasure Scale (SHAPS). This scale includes items that measure enjoyment from social activities. The Montgomery-Åsberg Depression Rating Scale (MADRS) was also used to evaluate overall depressive symptoms before and after each infusion.
Ketamine increased the likelihood of participants reporting pleasure from social interactions compared to the placebo. Specifically, participants reported greater enjoyment from being with family, seeing smiling faces, helping others, and receiving praise. These effects were observed up to one week after the ketamine infusion. Interestingly, when controlling for overall antidepressant effects (as measured by MADRS), the specific enhancement of social pleasure was not distinguishable, indicating that these prosocial effects might be intertwined with the general mood-lifting properties of ketamine.
To further understand ketamine’s effects on empathy, researchers used a rodent model involving the Harm Aversion Task (HAT). In this experiment, rats were trained to press a lever to receive a sucrose pellet. During HAT sessions, pressing the lever also delivered a mild electric shock to a cage mate, creating a situation where the rat could choose to forgo the reward to prevent harm to its companion. Researchers measured the rats’ willingness to press the lever after receiving either saline or ketamine injections.
In the rodent model, ketamine-treated rats demonstrated increased empathetic behavior. They were more likely to forgo pressing the lever, thus protecting their cage mate from shocks, compared to saline-treated rats. This effect persisted for up to six days post-treatment, suggesting a lasting impact of ketamine on empathetic behavior. Importantly, this increased harm aversion was not linked to changes in sucrose-seeking behavior, indicating a specific enhancement of empathy rather than a general increase in reward sensitivity.
“We suspected that empathy may be modulated by ketamine, and assessed this both in a human data set of individuals who received ketamine treatment for depression and in a rat model of empathy,” Gould said.
Despite these promising findings, the study has limitations. The SHAPS does not directly measure changes in social behavior, only self-reported pleasure. Future research should include behavioral assessments to determine if ketamine-treated patients are more likely to engage in prosocial behaviors.
“Ketamine treats a number of symptoms associated with depression, including depressed mood, anhedonia, and suicidality,” Gould explained. “Thus, its effects on measures of empathy are non-specific. Further, our studies utilized a rating scale to measure anhedonia and selected specific questions related to empathy. It will be helpful for future studies to utilize assessments better equipped to comprehensively assess components of empathy. Long-term goals include the use of ketamine and other drugs to selectively treat symptoms, independent of DSM diagnoses.”
The study, “(https://psychiatryonline.org/doi/10.1176/appi.ajp.20230980) Entactogen Effects of Ketamine: A Reverse-Translational Study,” was authored by Evan M. Hess, Dede K. Greenstein, Olivia L. Hutchinson, Carlos A. Zarate, and Todd D. Gould.

(https://www.psypost.org/people-with-dark-personalities-feel-more-satisfied-in-romantic-relationships-with-partners-who-also-exhibit-similar-dark-traits/) People with dark personalities feel more satisfied in romantic relationships with partners who also exhibit similar dark traits
Aug 6th 2024, 15:00

A new study indicates that individuals who exhibit Dark Triad traits tend to be more content in their romantic relationships when their partner also possesses similar traits. The research has been published in the (https://onlinelibrary.wiley.com/doi/full/10.1111/jopy.12857) Journal of Personality.
The Dark Triad refers to a group of three antagonistic personality traits: psychopathy, Machiavellianism, and narcissism. Psychopathy is characterized by impulsivity, antagonism, sensation-seeking, and low empathy. Machiavellianism involves self-interest, manipulation, and exploitation of others. Narcissism is characterized by grandiosity, entitlement, and a lack of empathy.
These traits have been found to have negative effects on various aspects of life. In particular, they have been associated with harmful outcomes in romantic relationships. Psychopathy, for example, is damaging to romantic relationships as it is linked to exploitative and aggressive behaviors, infidelity, and a lack of commitment and intimacy.
Machiavellianism is associated with emotionally detached relationships, reluctance to commit, and controlling behavior. Individuals high in narcissism tend to have little empathy, take advantage of others, and have low relationship commitment.
The researchers wanted to understand the effects of the Dark Triad traits on relationship outcomes from both partners’ perspectives. They considered not only how an individual’s Dark Triad traits influence their own relationship outcomes but also how these traits affect their partner’s outcomes. They aimed to improve the understanding of how these traits impact relationships by considering the experiences of both partners.
“The Dark Triad personality traits are generally associated to negative relationship outcomes, such as lower satisfaction, quality and stability,” said study author (https://portal.uniri.hr/Portfolio/939) Igor Kardum, a tenured psychology professor at the University of Rijeka in Croatia. “On the other hand, there is now increasing evidence that romantic couples are similar in these traits, and often more similar than in other personality traits, like those from the Big Five model. So, we wanted to see if the couples who are similar in Dark Triad traits, are also more satisfied with their romantic relationships using state-of-the art statistical approach.”
“We wanted to see if there is any merit to two popular beliefs regarding the mate selection process, which are completely opposite. The first is that similar partners are more attracted to each other and that this is beneficial for the relationship. The other is that ‘opposites attract’ and that partners that are not similar are better suited for one another,” added co-author Nermina Mehić.
In addition, “we wanted to examine not just the simple actor and partner effects (i.e., the effect of own personality trait and the effect of partner’s personality trait) on relationship satisfaction. More specifically, we wanted to see if the interplay of both partner’s Dark triad personality traits predicts relationship satisfaction using state-of-the-art statistical approach.”
The researchers conducted their study using a convenience sample of 205 heterosexual couples. They recruited participants by distributing research announcements to friends, colleagues, and students.
To be included in the study, the participants had to meet certain criteria, including being over 18 years old and being in a relationship for at least 1 year. The participants’ ages ranged from 18 to 56 years, and their relationship lengths ranged from 1 to 22 years. Most of the participants had a high school education, and a majority of the men and a significant portion of the women were employed. About 30% of the couples had at least one child.
The research assistants administered questionnaires to each member of the couple separately. The participants rated themselves and their partners on various traits using pen and paper. The order of the measures and the subject of assessment (self or partner) were counterbalanced across participants. The participants were informed that the research aimed to study the characteristics of romantic couples.
To assess the Dark Triad traits, the researchers used three different measures” the Self-Report Psychopathy Scale-III, the MACH-IV, and the Narcissistic Personality Inventory. The participants’ relationship satisfaction was measured using The Perceived Relationship Quality Components Questionnaire, which consisted of six items assessing different aspects of the relationship, such as love, passion, commitment, trust, satisfaction, and intimacy.
The results showed that dissimilarity in psychopathy had a detrimental effect on men’s relationship satisfaction. When men perceived their partners as having higher psychopathy levels, their own satisfaction was lower. Women’s psychopathy, whether self-reported or partner-reported, was consistently related to lower satisfaction in men. These findings suggest that living with a partner who has dissimilar levels of psychopathy can lead to communication problems and a lack of support within the relationship.
Regarding Machiavellianism, higher levels of both self-reported and partner-reported Machiavellianism were negatively related to both men’s and women’s relationship satisfaction. Perceiving one’s partner as higher in Machiavellianism was also linked to lower satisfaction for both the perceiver and their partner. These findings suggest that Machiavellian behaviors, such as taking advantage of others and lack of empathy, can decrease satisfaction in both partners.
Regarding narcissism, dissimilarity in narcissism was related to lower satisfaction for both partners. At both extremes of narcissism, satisfaction was increasingly lower. However, the results for narcissism were less consistent across assessment methods and sources. Men’s partner-reported narcissism was unexpectedly related to higher satisfaction for women, but this effect weakened at higher levels of narcissism.
Overall, the study found that dissimilarity in psychopathy and narcissism had negative effects on relationship satisfaction, while higher levels of Machiavellianism were consistently linked to lower satisfaction in both partners.
“Generally speaking, when choosing a partner, avoid candidates that seem high on psychopathy, Machiavellianism, and narcissism. However, if you are yourself ‘on the dark side,’ you might be more content with a similarly dark partner,” Kardum told PsyPost.
The researchers were surprised to find that women’s self-reported and partner-reported Dark Triad traits had a greater impact on both their own and their partners’ relationship satisfaction.
“We detected more negative effects of women’s Dark Triad traits, than of men’s Dark Triad traits, on both women’s and men’s relationship satisfaction,” Kardum said. “This was surprising because these personality characteristics are more pronounced and are usually considered more detrimental in men.”
One limitation of the study is its cross-sectional design, which means causal interpretations cannot be made. Longitudinal designs with multiple measurement points would provide a better understanding of how Dark Triad traits affect relationship satisfaction over time.
“First of all, we measured personality and relationship satisfaction in the same time point, which makes it harder to conclude that the direction of effect is from personality to satisfaction, and not the other way around,” Kardum explained. “Future studies should include longitudinal designs to tackle this issue.”
“Another problem that is quite common in couple research is that we usually get the most satisfied couples, since those with the most problematic relationship are not that eager to participate in studies. This lowers our ability to generalize the findings to other couples. A possible solution is to attempt to include participants that are in couple therapy, or that applied for divorce, etc.”
Nevertheless, the findings provide important insights into the relationship between Dark Triad traits and romantic preferences.
“Our general conclusion is that it is advisable to avoid forming partnerships with individuals who exhibit any of the Dark Triad traits, particularly psychopathy,” Mehić told PsyPost. “Additionally, as there is a greater likelihood of individuals who exhibit higher levels of the Dark Triad traits being attracted to each other compared to individuals with other personality traits, choosing a partner who shares these traits may further exacerbate relationship outcomes and negatively impact their offspring, creating unfavorable environments for their development.”
The study, “(https://onlinelibrary.wiley.com/doi/full/10.1111/jopy.12857) The dark triad traits and relationship satisfaction: Dyadic response surface analysis“, was authored by Igor Kardum, Jasna Hudek-Knezevic, Nermina Mehić, and Katarina Banov Trošelj.

(https://www.psypost.org/women-with-borderline-personality-disorder-experience-heightened-dissociation-symptoms-in-sexual-situations/) Women with borderline personality disorder experience heightened dissociation symptoms in sexual situations
Aug 6th 2024, 12:00

A study of women with borderline personality disorder in Germany found that they experience heightened dissociative symptoms in sexual situations. Compared to healthy women, this increase was most pronounced in symptoms of depersonalization and derealization. The findings were published in the journal (https://doi.org/10.1186/s40479-024-00251-6) Borderline Personality Disorder and Emotion Dysregulation.
Borderline personality disorder is a mental health condition characterized by intense emotional instability and difficulty in maintaining relationships. Individuals with this disorder frequently experience rapid mood swings, feelings of emptiness, and an intense fear of abandonment. They are also prone to impulsive behaviors, such as reckless spending or self-harm, as a way to cope with their emotional turmoil.
Romantic relationships for individuals with borderline personality disorder tend to be tumultuous, as they often swing between idealizing and devaluing their partners. Additionally, there is evidence that these individuals tend to experience dissociative symptoms in sexual situations. Dissociative symptoms involve a disconnection or disruption in a person’s thoughts, memory, identity, or sense of reality.
Common dissociative symptoms include feeling detached from oneself (depersonalization), experiencing the world as unreal or distorted (derealization), having significant memory gaps (dissociative amnesia), or expressing psychological distress through physical symptoms such as paralysis, blindness, or other neurological defects without a medical cause (conversion).
Study author Rose Gholami Mazinan and her colleagues sought to explore the severity of dissociative symptoms experienced by individuals with borderline personality disorder during sexual situations and their association with previous sexual abuse experiences and post-traumatic stress disorder symptoms.
They conducted two studies. In the first study, the researchers investigated a group of 114 women with borderline personality disorder recruited from the University Medical Center Hamburg-Eppendorf (UKE) and outpatient clinics in Hamburg and Munich, Germany. These participants were between 18 and 45 years old. The study also included a matched group of 114 healthy participants recruited through advertisements.
Study participants completed assessments of dissociative symptoms in sexual situations using an adapted version of the Dissociative Experiences Scale. They also completed measures of proneness to risky sexual behaviors (the Sexual Risk Survey), borderline personality disorder symptoms (the Borderline Symptom List), sexual abuse experiences in adulthood (the Adult Sexual Abuse Questionnaire), post-traumatic stress disorder symptoms (the International Trauma Questionnaire), and recalled childhood trauma experiences (the Childhood Trauma Questionnaire).
For the second study, 41 women with borderline personality disorder and 41 healthy women from the first study participated. In this study, participants listened to an audio clip through headphones designed to create sexual arousal. The audio clip featured a female narrator describing a female-initiated sexual interaction with a man from her perspective. After listening to the clip, participants completed an assessment of current dissociation symptoms using the Dissociation Tension Scale Acute.
Results showed that women with borderline personality disorder reported more dissociative symptoms than the healthy women. This difference was most pronounced in the severity of depersonalization symptoms. In the second study, women with borderline personality disorder also showed higher levels of dissociation symptoms after listening to the sexually arousing audio compared to healthy women. Again, the difference was most pronounced in the severity of depersonalization symptoms, followed by derealization.
A higher intensity of recalled childhood trauma experiences was associated with more depersonalization symptoms, while more reported sexual abuse experiences in adulthood were weakly associated with higher overall dissociation symptoms. Women with borderline personality disorder were also more prone to impulsive and uncommitted sexual behaviors.
“Increased level of depersonalization and conversion in sexual situations were best explained by BPD [borderline personality disorder] symptoms while derealization seemed to be mainly influenced by PTSD-symptoms [posttraumatic stress disorder symptoms] in patients with BPD. Meanwhile, higher impulsive and uncommitted sexual behavior in BPD were best explained by intensity of derealization during sexual situations, while conversion might somehow function as protective factor,” the study authors concluded.
The study sheds light on the specificities of sexual experiences of women with borderline personality disorder. However, the design of the study does not allow for any cause-and-effect inferences to be drawn from the data. Additionally, the study included only women, so the results may not be applicable to men.
The paper, “(https://doi.org/10.1186/s40479-024-00251-6) Borderline personality disorder and sexuality: causes and consequences of dissociative symptoms,” was authored by Rose Gholami Mazinan, Christina Dudek, Hannah Warkentin, Maja Finkenstaedt, Johanna Schröder, Richard Musil, Leonhard Kratzer, Johannes Fuss, and Sarah V. Biedermann.

Forwarded by:
Michael Reeder LCPC
Baltimore, MD

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