Background Availability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs. Methods Data were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE. Results There were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not. Conclusion After more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.

Functional impairment is a core feature of both autism and schizophrenia spectrum disorders. While diagnostically independent, they can co-occur in the same individual at both the trait and diagnostic levels. The effect of such co-occurrence is hypothesized to worsen functional impairment. The diametric model, however, suggests that the disorders are etiologically and phenotypically diametrical, representing the extreme of a unidimensional continuum of cognition and behavior. A central prediction of this model is that functional impairment would be attenuated in individuals with mixed symptom expressions or genetic liability to both disorders. We tested this hypothesis in two clinical populations and one healthy population. In individuals with chronic schizophrenia and in individuals with first episode psychosis we evaluated the combined effect of autistic traits and positive psychotic symptoms on psychosocial functioning. In healthy carriers of alleles of copy number variants (CNVs) that confer risk for both autism and schizophrenia, we also evaluated whether variation in psychosocial functioning depended on the combined risk conferred by each CNV. Relative to individuals with biased symptom/CNV risk profiles, results show that functional impairments are attenuated in individuals with relatively equal levels of positive symptoms and autistic traits-and specifically stereotypic behaviors-, and in carriers of CNVs with relatively equal risks for either disorder. However, the pattern of effects along the "balance axis" varied across the groups, with this attenuation being generally less pronounced in individuals with high-high symptom/risk profile in the schizophrenia and CNV groups, and relatively similar for low-low and high-high individuals in the first episode psychosis group. Lower levels of functional impairments in individuals with "balanced" symptom profile or genetic risks would suggest compensation across mechanisms associated with autism and schizophrenia. CNVs that confer equal risks for both disorders may provide an entry point for investigations into such compensatory mechanisms. The co-assessment of autism and schizophrenia may contribute to personalized prognosis and stratification strategies.

Thought action fusion (TAF), whereby internal thoughts are perceived to exert equivalent effects to external actions, is a form of magical thinking. Psychiatric disorders associated with TAF (e.g. schizophrenia; obsessive compulsive disorder) can feature atypical social cognition. We explored relationships between TAF and empathy in 273 healthy young adults. TAF was directly correlated with higher personal distress, but not perspective taking, fantasy or empathic concern. TAF moral (the belief that thinking about an action/behaviour is morally equivalent to actually performing that behaviour) was predicted by emotion contagion, alexithymia and need for closure. TAF likelihood (the belief that simply having a thought about an event makes that event more likely to occur) was predicted by personal distress, sense of agency and alexithymia. Both cognitive (TAF and negative sense of agency) and emotional (emotion contagion, alexithymia) factors contributed to personal distress. TAF, negative sense of agency and personal distress mediated the effect of emotion contagion on alexithymia. Our findings reveal complex relationships between emotional processes and TAF, shedding further light on the social cognitive profile of disorders associated with magical thinking. Furthermore, they emphasise the potential importance of alexithymia and emotion contagion as mediators or potential risk factors in the development of psychiatric symptoms linked to TAF, such as intrusive thoughts about harm to others.

Age-related decline in theory of mind (ToM) may be due to waning executive control, which is necessary for resolving conflict when reasoning about other individuals’ mental states. We assessed how older (n = 50) and younger (n = 50) adults were affected by three theoretically relevant sources of conflict within ToM: competing self-other perspectives, competing cued locations, and outcome knowledge. We examined which best accounted for age-related difficulty with ToM. Our data show unexpected similarity between age groups when people are representing a belief incongruent with their own. Individual differences in attention and response speed best explained the degree of conflict experienced through incompatible self-other perspectives. However, older adults were disproportionately affected by managing conflict between cued locations. Age and spatial working memory were most relevant for predicting the magnitude of conflict elicited by conflicting cued locations. We suggest that previous studies may have underestimated older adults’ ToM proficiency by including unnecessary conflict in ToM tasks.

We explored factors associated with performance on the Reading the Mind in the Eyes Test (RMET). 180 undergraduate students completed the human RMET requiring forced-choice mental state judgment; a control human Age Eyes Test (AET) requiring age judgment; a Cat Eyes Test (CET) requiring mental state judgment; and measures of executive function, empathy and psychopathology. Versions of the CET and AET were created that matched the RMET for difficulty (accuracy 71%). RMET and CET performance were strongly correlated after accounting for AET performance. Working memory, schizotypal personality and empathy predicted RMET accuracy but not CET scores. Liking dogs predicted higher accuracy on all eyes tasks, whereas liking cats predicted greater mentalizing but reduced emotional expression. Importantly, we replicated our core findings relating to accuracy and correlations between the CET and RMET in a second sample of 228 students. In conclusion, people can apply similar skills when interpreting cat and human expressions. As RMET and CET performance were found to be differentially affected by executive function and psychopathology, the use of social cognitive measures featuring non-human animals may be of particular use in future clinical research.

Our previous work defended that the motor theory is modulated by task load, claiming that motoric participation in phonological processing plays a changing and complementary role with the "auditory part" of the phonological processing system from perception to production: the LIFG being increasingly relevant and the LSTG, decreasingly relevant. We previously targeted the LIFG with tDCS and observed behavioural and functional connectivity patterns which were consistent with our model. Here we investigated whether neurostimulation of the LSTG with the same tasks would reverse the profile of functional connectivity responses previously obtained for the LIFG. With a within-subject design, we administered categorical perception, lexical decision and word naming tasks in three sessions (under cathodal, anodal and sham). This range of tasks was considered to be decreasingly relevant for the LSTG. The network we focused on consisted of the dorsal stream (LIFG and LSTG) and its right homologues (right inferior frontal gyrus and right superior temporal gyrus). Functional connectivity was analysed with partial correlations. C-tDCS LSTG inhibition and A-tDCS LSTG excitation should have a positive relationship with the relevance of the task to the target (task load). C-tDCS was expected to trigger compensation by other nodes in conditions of low task load, evidenced by a higher count of significant connections than in higher task load conditions or under A-tDCS. Overall, results met predictions. For example, CtDCS in conditions of lower task load, such as with the word naming task, triggered the highest count of significant connections, suggesting compensation by other nodes.

Motor participation in phonological processing can be modulated by task nature across the speech perception to speech production range. The pars opercularis of the left inferior frontal gyrus (LIFG) would be increasingly active across this range, because of changing motor demands. Here, we investigated with simultaneous tDCS and fMRI whether the task load modulation of tDCS effects translates into predictable patterns of functional connectivity. Findings were analysed under the “multi-node framework”, according to which task load and the network structure underlying cognitive functions are modulators of tDCS effects. In a within-subject study, participants ( N = 20) performed categorical perception, lexical decision and word naming tasks [which differentially recruit the target of stimulation (LIFG)], which were repeatedly administered in three tDCS sessions (anodal, cathodal and sham). The LIFG, left superior temporal gyrus and their right homologues formed the target network subserving phonological processing. C-tDCS inhibition and A-tDCS excitation should increase with task load. Correspondingly, the larger the task load, the larger the relevance of the target for the task and smaller the room for compensation of C-tDCS inhibition by less relevant nodes. Functional connectivity analyses were performed with partial correlations, and network compensation globally inferred by comparing the relative number of significant connections each condition induced relative to sham. Overall, simultaneous tDCS and fMRI was adequate to show that motor participation in phonological processing is modulated by task nature. Network responses induced by C-tDCS across phonological processing tasks matched predictions. A-tDCS effects were attributed to optimisation of network efficiency.

The commonly used paradigm to investigate Dennet's 'intentional stance' compares neural activation when participants compete with a human versus a computer. This paradigm confounds whether the opponent is natural or artificial and whether it is intentional or an automaton. This functional magnetic resonance imaging study is, to our knowledge, the first to investigate the intentional stance by orthogonally varying perceptions of the opponents' intentionality (responding actively or passively according to a script) and embodiment (human or a computer). The mere perception of the opponent (whether human or computer) as intentional activated the mentalizing network: the temporoparietal junction (TPJ) bilaterally, right temporal pole, anterior paracingulate cortex (aPCC) and the precuneus. Interacting with humans versus computers induced activations in a more circumscribed right lateralized subnetwork within the mentalizing network, consisting of the TPJ and the aPCC, possibly reflective of the tendency to spontaneously attribute intentionality to humans. The interaction between intentionality (active versus passive) and opponent (human versus computer) recruited the left frontal pole, possibly in response to violations of the default intentional stance towards humans and computers. Employing an orthogonal design is important to adequately capture Dennett's conception of the intentional stance as a mentalizing strategy that can apply equally well to humans and other intentional agents.

Transcranial direct current stimulation (tDCS) effects in cognition are inconsistent across studies. This study aimed to discuss why typical models might be insufficient to explain these effects, and to investigate a brain state factor, task load, with behavioral experiments on phonological processing. The motor theory of speech perception states that motor codes for articulation take part in speech perception, a view sharpened by neuroimaging findings, which show that the motor role in phonological processing is weighted by the nature of the tasks. Three groups of 20 participants, each under a different tDCS condition (anodal, cathodal, or sham), performed a categorical perception (CP), a lexical decision (LD), and a word naming (WN) task while stimulated on the pars opercularis of the left inferior frontal gyrus, a language area typically involved with the motor role. These tasks were assumed to be subserved by a network of nodes which included the target, believed to be increasingly relevant for performance from speech perception to speech production. A‐tDCS facilitation and C‐tDCS downregulation should directly increase with the relevance of the target for the task. Downregulation of a low relevance node could result in facilitation by compensation from other nodes. Overall, our brain stimulation findings support the neuroimaging literature in that motor participation in phonological processing depends on task nature and show that tDCS effects are modulated by task load relative to the target. Outcomes such as the improved performance following cathodal tDCS in CP and WN suggest that compensatory mechanisms may take place when the tasks involve more complex neuronal networks.

Findings of neuroimaging and brain stimulation research suggest that the motor system takes part in phonological processing at least to some extent in healthy speakers. Phonological processing involves a core network of brain regions, the dorsal pathway, where motoric aspects of speech sounds are analysed by the left inferior frontal gyrus (LIFG) and auditory aspects by the left superior temporal gyrus (LSTG). The extent to which each node of the dorsal pathway takes part in phonological processing has been shown to depend on the nature of the task and on the functional integrity of the network. Tasks of speech production rely more on the LIFG, and tasks of speech perception rely more on the LSTG. Persons with dyslexia (PWD) are known to present a deficit in phonological processing. Neuroimaging research has shown that dyslexia typically affects the LSTG, with hypoactivation, and the LIFG, with hyperactivation. Transcranial direct current stimulation (tDCS) has been widely used for cognitive research in humans. It has been recently suggested in the literature that perturbations induced by brain stimulation can cause the weights of nodes in cognitive networks to transiently rearrange. In this study we used tDCS and functional magnetic resonance imaging (fMRI) to investigate the functioning of the dorsal pathway for phonological processing in PWD with tasks of speech production and speech perception. We targeted the LIFG with anodal, cathodal and sham tDCS. For healthy speakers, cathodal tDCS should downregulate performance when the target had high relevance for the task, such as the LIFG for speech production. For targets of smaller relevance, improved performance should be observed due to compensation by the most relevant node(s). Anodal tDCS should improve performance as a function of the relevance of the target for the task. PWD were expected to deviate from this pattern to some extent, especially when compensation by the LSTG was needed during cathodal tDCS of the LIFG for a task of speech perception. Results corroborated the theoretical claim that codes for articulation take part in the processing of speech sounds. However, our findings showed that the PWD pattern of response to tDCS for phonological processing in tasks of speech production and speech perception differed from that expected for healthy speakers. Anodal tDCS of the LIFG induced larger facilitation for the speech perception than for the speech production task, as well as larger compensation for the latter under cathodal tDCS. Findings indicate that tDCS is a promising diagnosis tool for the investigation of alterations in phonological processing caused by dyslexia.

In our previous studies we supported the claim that the motor theory is modulated by task load. Motoric participation in phonological processing increases from speech perception to speech production, with the endpoints of the dorsal stream having changing and complementary weightings for processing: the left inferior frontal gyrus (LIFG) being increasingly relevant and the left superior temporal gyrus (LSTG) being decreasingly relevant. Our previous results for neurostimulation of the LIFG support this model. In this study we investigated whether our claim that the motor theory is modulated by task load holds in (frontal) aphasia. Person(s) with aphasia (PWA) after stroke typically have damage on brain areas responsible for phonological processing. They may present variable patterns of recovery and, consequently, variable strategies of phonological processing. Here these strategies were investigated in two PWA with simultaneous fMRI and tDCS of the LIFG during speech perception and speech production tasks. Anodal tDCS excitation and cathodal tDCS inhibition should increase with the relevance of the target for the task. Cathodal tDCS over a target of low relevance could also induce compensation by the remaining nodes. Responses of PWA to tDCS would further depend on their pattern of recovery. Responses would depend on the responsiveness of the perilesional area, and could be weaker than in controls due to an overall hypoactivation of the cortex. Results suggest that the analysis of motor codes for articulation during phonological processing remains in frontal aphasia and that tDCS is a promising diagnostic tool to investigate the individual processing strategies.

Prism adaptation has a long history as an experimental paradigm used to investigate the functional and neural processes that underlie sensorimotor control. In the neuropsychology literature, prism adaptation behaviour is typically explained by reference to a traditional cognitive psychology framework that distinguishes putative functions, such as 'strategic control' versus 'spatial realignment'. This theoretical framework lacks conceptual clarity, quantitative precision and explanatory power. Here, we advocate for an alternative computational framework that offers several advantages: 1) an algorithmic explanatory account of the computations and operations that drive behaviour; 2) expressed in quantitative mathematical terms; 3) embedded within a principled theoretical framework (Bayesian decision theory, state-space modelling); 4) that offers a means to generate and test quantitative behavioural predictions. This computational framework offers a route towards mechanistic neurocognitive explanations of prism adaptation behaviour. Thus it constitutes a conceptual advance compared to the traditional theoretical framework. In this paper, we illustrate how Bayesian decision theory and state-space models offer principled explanations for a range of behavioural phenomena in the field of prism adaptation (e.g. visual capture, magnitude of visual versus proprioceptive realignment, spontaneous recovery and dynamics of adaptation memory). We argue that this explanatory framework can advance understanding of the functional and neural mechanisms that implement prism adaptation behaviour, by enabling quantitative tests of hypotheses that go beyond merely descriptive mapping claims that 'brain area X is (somehow) involved in psychological process Y'.

Background We previously uncovered behavioural impairments in social cognition in Huntington’s Disease (HD) on the Animations Task, which requires participants to describe video-clips in terms of the movements and social interactions of geometric shapes. Few previous studies have explored neural responses to dynamic visual social stimuli in HD. Aims This fMRI study explored neural activity in HD while patients viewed video-clips from the Animations Task. We expected to observe aberrant activity in brain areas involved in visual processing, motor function and social cognition in HD. Methods Participants were 32 individuals with the HD gene, compared to 28 healthy controls. Three kinds of video-clips were shown during fMRI: random movement of two triangles (e.g. drifting), simple interactions (e.g. dancing) and complex social interactions (e.g. persuasion) between triangles. Participants categorised each video-clip as random movement/simple interaction/complex interaction. Results Patients made more errors than controls when categorising complex interactions. For random movement clips, patients showed greater activity than controls in areas linked to visuo-spatial imagery, memory and perspective taking (precuneus; parahippocampal gyrus; paracingulate gyrus). For animations involving simple or complex interactions, hypoactivation was found in HD in brain regions linked to visual processing (occipital cortex), executive function (middle frontal gyrus), agency detection/mirror neurons (superior parietal lobe; premotor cortex), and social cognition (lateral orbitofrontal cortex; temporo-parietal junction). Contrasts based on video-clip type revealed reduced differentiation in neural responses according to the social content of the video-clips in HD. Viewing social interaction was associated with hypoactivation in brain areas crucial for social cognition alongside increased activity in areas involved in executive function. Conclusions These findings highlight a loss of spontaneous neural sensitivity to dynamic visual social stimuli in HD. This could reflect reduced connectivity between brain areas involved in visual, motor and social-emotional processing, leading to poor recognition of non-verbal social cues and impaired inferences about social behaviour.

Visual attention allows the allocation of limited neural processing resources to stimuli based on their behavioral priorities. The selection of task-relevant visual targets entails the processing of multiple competing stimuli and the suppression of distractors that may be either perceptually salient or perceptually similar to targets. The posterior parietal cortex controls the interaction between top–down (task-driven) and bottom–up (stimulus-driven) processes competing for attentional selection, as well as spatial distribution of attention. Here, we examined whether biparietal transcranial direct current stimulation (tDCS) would modulate the interaction between top–down and bottom–up processes in visual attention. Visual attention function was assessed with a visual discrimination task, in which a lateralized target was presented alone or together with a contralateral, similar or salient, distractor. The accuracy and RTs were measured before and during three stimulation sessions (sham, right anodal/left cathodal, left anodal/right cathodal). The analyses demonstrated (i) polarity-dependent effects of tDCS on the accuracy of target discrimination, but only when the target was presented with a similar distractor; (ii) the tDCS-triggered effects on the accuracy of discriminating targets, accompanied by a similar distractor, varied according to the target location; and (iii) overall detrimental effects of tDCS on RTs were observed, regardless of target location, distractor type, and polarity of the stimulation. We conclude that the observed polarity, distractor type, and target location-dependent effects of biparietal tDCS on the accuracy of target detection resulted from both a modulation of the interaction between top–down and bottom–up attentional processes and the interhemispheric competition mechanisms guiding attentional selection and spatial deployment of attention.

Rationale Brain 5-HT2C receptors form part of a neural network that controls eating behaviour. 5-HT2C receptor agonists decrease food intake by activating proopiomelanocortin (POMC) neurons in the arcuate nucleus of the hypothalamus, but recent research in rodents has suggested that 5-HT2C receptor agonists may also act via dopaminergic circuitry to reduce the rewarding value of food and other reinforcers. No mechanistic studies on the effects of 5-HT2C agonists on food intake in humans have been conducted to date. Objectives The present study examined the effects of the 5HT2C receptor agonist meta-chlorophenylpiperazine (mCPP) on food consumption, eatingmicrostructure and blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) responses to food pictures in healthy female volunteers. Methods In a double-blind, placebo-controlled, crossover design, participants were randomized immediately after screening to receive oral mCPP (30mg) in a single morning dose, or placebo, in a counterbalanced order. Test foods were served from a Universal Eating Monitor (UEM) that measured eating rate and fMRI BOLD signals to the sight of food and non-food images were recorded. Results mCPP decreased rated appetite and intake of a palatable snack eaten in the absence of hunger but had no significant effect on the consumption of a pasta lunch (although pasta eating rate was reduced). mCPP also decreased BOLD fMRI responses to the sight of food pictures in areas of reward-associated circuitry. A post hoc analysis identified individual variability in the response to mCPP (exploratory responder-non-responder analysis). Some participants did not reduce their cookie intake after treatment with mCPP and this lack of response was associated with enhanced ratings of cookie pleasantness and enhanced baseline BOLD responses to food images in key reward and appetite circuitry. Conclusions These results suggest that 5-HT2C receptor activation in humans inhibits food reward-related responding and that further investigation of stratification of responding to mCPP and other 5-HT2C receptor agonists is warranted.

Atypical responses to salient information are a candidate endophenotype for both autism and psychosis spectrum disorders. The present study investigated the costs and benefits of such atypicalities for saliency-based selection in a large cohort of neurotypical adults in whom both autism and psychosis expressions were assessed. Two experiments found that autism tendencies and psychosis proneness interactively modulated the cost incurred in the presence of a task-irrelevant salient distractor. Specifically, expressions of autism and psychosis had opposing effects on responses to salient information such that the benefits associated with high expressions for autism offset costs associated with high expressions for psychosis. The opposing influences observed on saliency cost may be driven by distinct attentional mechanisms that are differentially affected by expressions for autism and psychosis.

Transcranial direct current stimulation (tDCS) combined with a cognitive task can enhance targeted aspects of cognitive functioning in clinical populations. The movement disorder Huntington's disease (HD) is associated with progressive cognitive impairment. Deficits in working memory (WM) can be apparent early in the disease and impact functional capacity. We investigated whether tDCS combined with cognitive training could improve WM in patients with HD, and if baseline clinical or cognitive measures may predict efficacy. Twenty participants with HD completed this crossover trial, undergoing 1.5 mA anodal tDCS over left dorsolateral prefrontal cortex and sham stimulation on separate visits. Participants and assessor were blinded to condition order, which was randomised across participants. All participants completed baseline clinical and cognitive assessments. Pre- and post-stimulation tasks included digit reordering, computerised n-back tests and a Stroop task. During 15 min of tDCS/sham stimulation, participants practiced 1- and 2-back WM tasks. Participants exhibited an increase in WM span on the digit re-ordering span task from pre- to post-stimulation after tDCS, but not after sham stimulation. Gains in WM were positively related to motor symptom ratings and negatively associated with verbal fluency scores. Patients with more severe motor symptoms showed greatest improvement, suggesting that motor symptom ratings may help identify patients who are most likely to benefit from tDCS. Conclusions: Dorsolateral prefrontal tDCS appears well tolerated in HD and enhances WM span compared to sham stimulation. Our findings strongly encourage further investigation of the extent to which tDCS combined with cognitive training could enhance everyday function in HD.

Mounting evidence indicates that posterolateral portions of the cerebellum (right Crus I/II) contribute to language processing, but the nature of this role remains unclear. Based on a well-supported theory of cerebellar motor function, which ascribes to the cerebellum a role in short-term prediction through internal modeling, we hypothesize that right cerebellar Crus I/II supports prediction of upcoming sentence content. We tested this hypothesis using event-related fMRI in male and female human subjects by manipulating the predictability of written sentences. Our design controlled for motor planning and execution, as well as for linguistic features and working memory load; it also allowed separation of the prediction interval from the presentation of the final sentence item. In addition, three further fMRI tasks captured semantic, phonological, and orthographic processing to shed light on the nature of the information processed. As hypothesized, activity in right posterolateral cerebellum correlated with the predictability of the upcoming target word. This cerebellar region also responded to prediction error during the outcome of the trial. Further, this region was engaged in phonological, but not semantic or orthographic, processing. This is the first imaging study to demonstrate a right cerebellar contribution in language comprehension independently from motor, cognitive, and linguistic confounds. These results complement our work using other methodologies showing cerebellar engagement in linguistic prediction and suggest that internal modeling of phonological representations aids language production and comprehension. SIGNIFICANCE STATEMENT The cerebellum is traditionally seen as a motor structure that allows for smooth movement by predicting upcoming signals. However, the cerebellum is also consistently implicated in nonmotor functions such as language and working memory. Using fMRI, we identify a cerebellar area that is active when words are predicted and when these predictions are violated. This area is active in a separate task that requires phonological processing, but not in tasks that require semantic or visuospatial processing. Our results support the idea of prediction as a unifying cerebellar function in motor and nonmotor domains. We provide new insights by linking the cerebellar role in prediction to its role in verbal working memory, suggesting that these predictions involve phonological processing.

There is increasing recognition of the co-occurrence of autism and schizophrenia spectrum disorders. However, the clinical significance of this on outcomes such as depression and suicidal thinking has not been explored. This study examines the association of autism spectrum traits, depressive symptoms and suicidal behaviour in individuals with psychotic experiences. In two cross sectional studies, individuals from a non-help seeking university student sample and patients with first episode psychosis (FEP) service completed standardized measures of autism spectrum traits, psychotic experiences, depressive symptoms and suicidal thinking. In healthy non-help seeking students, increased autism traits and increased subclinical psychotic experiences were significantly associated with depressive symptoms; a significant interaction effect suggests their combined presence has a greater impact on depression. In FEP, high autism traits and positive symptoms were associated with increased depression, hopelessness and suicidality, however there was no significant interaction effect. In FEP a multiple mediation model revealed that the relationship between autism traits and risk for suicidality was mediated through hopelessness. Young people with subclinical psychotic experiences and all patients with FEP should be screened for autism spectrum traits, which may have significant impact on clinical outcomes. Tailored interventions for patients with high levels of autistic spectrum co-morbidities in FEP should be a priority for future research.

Huntington's disease (HD) can impair social cognition. This study investigated whether patients with HD exhibit neural differences to healthy controls when they are considering mental and physical states relating to the static expressions of human eyes. Thirty-two patients with HD and 28 age-matched controls were scanned with fMRI during two versions of the Reading the Mind in the Eyes Task: The standard version requiring mental state judgments, and a comparison version requiring judgments about age. HD was associated with behavioral deficits on only the mental state eyes task. Contrasting the two versions of the eyes task (mental state > age judgment) revealed hypoactivation within left middle frontal gyrus and supramarginal gyrus in HD. Subgroup analyses comparing premanifest HD patients to age-matched controls revealed reduced activity in right supramarginal gyrus and increased activity in anterior cingulate during mental state recognition in these patients, while manifest HD was associated with hypoactivity in left insula and left supramarginal gyrus. When controlling for the effects of healthy aging, manifest patients exhibited declining activation within areas including right temporal pole. Our findings provide compelling evidence for a selective impairment of internal emotional status when patients with HD appraise facial features in order to make social judgements. Differential activity in temporal and anterior cingulate cortices may suggest that poor emotion regulation and emotional egocentricity underlie impaired mental state recognition in premanifest patients, while more extensive mental state recognition impairments in manifest disease reflect dysfunction in neural substrates underlying executive functions, and the experience and interpretation of emotion.