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Titre du projet:

Cross-cultural neuropsychological assessment of social cognition

Sujet

Ecole Doctorale: ED 261 - Cognition, Comportements, Conduites Humaines

Titre du projet:

Cross-cultural neuropsychological assessment of social cognition

Structure d’accueil principale:

Laboratoire Mémoire Cerveau et Cognition (MC 2 Lab, UPR 7536), UFR - Institut de Psychologie, Université de Paris

Structure d’accueil secondaire:

Neurology Department (The multicultural Memory clinic) and Alzheimer Center Erasmus MC-University Medical Center, Rotterdam, Netherlands

Directeur·ice de thèse pressenti·e

Nom: Narme

Prénom: Pauline

Adresse électronique: pauline.narme@u-paris.fr

Co-directeur·ice de thèse pressenti·e (le cas échéant)

Nom:

Prénom:

Adresse électronique: pauline.narme@u-paris.fr

Encadrant·e dans la structure d’accueil secondaire

Nom: PAPMA

Prénom: Janne

Adresse électronique: j.papma@erasmusmc.nl

Description

Description du projet de thèse:

Social cognition is a multidimensional concept that includes several processes involved in the perception, understanding and inference of social information extracted from others. Although social cognitive impairments observed in several neurological and psychiatric diseases have been quite precisely described over the past few years, some theoretical and clinical pitfalls remain. From a theoretical point of view, very few studies have investigated the role of environmental factors (e.g. social and cultural context) on the individual’s social cognitive functioning. Culture has seldom been considered in the literature on social cognition, despite its considerable influence on neuropsychological performance overall. Considering the impact of educational level and/or culture on cerebral plasticity and cognitive functioning, their influence on social cognitive processes can be hypothesized. From a clinical point of view, the assessment of social cognition is a crucial aspect since social cognitive deficits can contribute to the appearance of behavioral disorders. Yet, they remain underexamined in clinical practice mainly due to a lack of reliable tools. Neuropsychological tests have been developed by and for western and educated populations. In France, as in Europe, the proportion of people with no schooling and/or a low level of literacy still remains high and the proportion of patients from other cultures or minority ethnic groups increases in daily practice. These characteristics pose challenges to neuropsychologists since using ill-adapted or unreliable tests for these populations leads to a higher risk of false positive and diagnostic errors, which means inequalities in terms of the possibilities of receiving health care (i.e. public health and ethical issues). A recent survey confirmed the lack of appropriate tools, especially to assess social cognition.

Among social cognitive processes, facial emotion recognition may be less impacted by the educational level and culture than other processes. Unlike classical tests that ask participants to choose a verbal label that best describes a facial expression shown in black and white photographs, we plan to adapt the procedure in order to reduce the use of linguistic skills. In a first study, data from the general population will be collected in adults aged from 18 to 85 with a low level of education and/or of multicultural origin, in order to study the effects of culture on task performance and to provide norms. Then, data will be collected in patients with neurodegenerative diseases to investigate the task’s sensitivity and specificity to detect patients with social behavioral disorders.

In parallel, we plan to design another emotion recognition task that will be more ecological. Previous studies have highlighted methodological limitations in the available social cognitive tasks, especially their lack of ecological validity. This bias may artificially increase the probability of observing inter-individual differences or deficits in pathology. Thus, the development of social cognition tests closer to daily life conditions, based on dynamic, multimodal, and interactive environments is of special interest. The technological possibilities offered by virtual reality (VR) can meet these objectives. In a second study, therefore, in order to enhance ecological validity as much as possible, we plan to use VR with this specific population by adapting the technology on a touch pad (simple intuitive use). We will design an emotion recognition task combining facial, postural and contextual cues thanks to avatars. After pre-tests, a normalization study will be conducted in France and at the European level in healthy participants in order to further investigate the effect of literacy, cultural factors and educational level on emotion recognition. This study will be followed by a validation study in neurological diseases to determine the task’s psychometric properties. This study will make it possible to specify whether the cultural effects we hypothesized to observe on the classical emotion recognition task can be reduced or even removed when using a more ecological assessment context that alleviates the need for other non-social cognitive resources and potential methodological artefacts.

The validation of social cognition assessment tools will offer a strong methodological background in neuropsychology to the PhD student. From a societal point of view, there is also an urgent need to better understand human cognitive functioning, by reducing Western scientific ethnocentrism (i.e. 96% of participants in psychological studies are from the west) and by adopting a more cross-cultural view to pathology, guided by the understanding of universal phenomena, and consequently, by a more human vision, to reduce inequalities in the access to health services. This aspect of the project will require an interdisciplinary approach based on social psychology. The proposed studies will be conducted in France and in the Netherlands. The idea of comparing different European countries here is guided by the objective to adopt a new cross-cultural approach in neuropsychology. This project is also innovative by using VR associated to the neuropsychological testing of social cognition. This technology greatly enhances ecological validity and we hypothesize that it will reduce the potential bias due to the involvement of language and other non-social cognitive skills found in classical tests. The expertise of the main host institution in the use of VR technology will guarantee the scientific and technical support of the second part of this project. Furthermore, the expertise in neuropsychology of social cognition of the thesis advisor (in France) and the expertise of the second supervisor (in the Netherlands) will ensure high-quality training to the PhD student in the field of the cross-cultural neuropsychology.

Fichier de description du projet de thèse:

Description de l’équipe d’encadrement principale:

The Phd advisor (Pauline Narme) is an Assistant Professor in neuropsychology since September 2012 (22 publications in peer-reviewed journals; H-index 10; Number of citations: n=438) and a member of the MC2Lab (UPR 7536, University of Paris). Her research focuses on cognitive and clinical neuropsychology and deals with the processes involved in social cognition. More specifically, she has demonstrated the importance of investigating social cognitive processes in clinical practice (i.e. for clinical diagnosis), the contribution of several brain structures in these processes using a neuropsychological approach and how social cognitive impairments account for behavioral disorders in neurological diseases. Her experience in neuropsychological examination and scientific expertise in social cognition will ensure high-quality training in neuropsychology of social cognition and crosscultural neuropsychology to the PhD student.

Since 2012, she has been involved in four projects directly linked to the present PhD project: (i) the development of a French Battery for the assessment of social cognition in neurology (in charge of the norms in healthy populations; Principal investigators: Pr. O. Godefroy in France & Pr. F. Collette in Belgium); (ii) the development of a more ecological task to assess sociocognitive processes in a integrative manner using virtual reality (as the project coordinator); (iii) the development and validation of neuropsychological tests adapted to low-educated and/or multicultural populations (in charge of the executive tests; : Dr C. Belin); (iv) Think tank on cross-cultural neuropsychological assessment in Europe (as a French expert; PI: S. Franzen in The Netherlands & T.R. Nielsen in Denmark). Since her accreditation to supervise PhDs (February 2019), two PhD theses are ongoing about humor processing disorders and moral cognition disorders in neurological diseases.

For the present PhD project, she will be the principal advisor. The team involved in the principal host institution will be:

  • (i) her colleagues from the MC2Lab for some specific strands: Eva-Flore Msika (PhD Student under her supervision) to collect data; Pascale Piolino (Professor and Head of the MC2Lab) for the scientific conception as an international expert in VR; Alexandre Gaston-Bellegarde (research engineer) for the development of the virtual environment and technical assistance with the touchpad implementation;
  • (ii) her clinical collaborations providing possibilities to recruit patients in neurological and geriatric departments in France (N. Ehrlé, neuropsychologist – PhD, Department of Neurology, Reims Hospital and associate member of the MC2Lab; Prof. M. Verny, Department of geriatric medicine, Pitié-Salpêtrière Hospital);
  • (iii) her team regularly works with approximately 12 Master's students in neuropsychology per year, ensuring ongoing access to the inclusion of healthy controls and patients;
  • (iv) other collaborations ensuring access to a specific population with a low level of education and/or from a multicultural origin (‘Centre d’Examens de Santé de la Caisse Primaire d’Assurance Maladie de la Seine-Saint-Denis’ in Bobigny for the healthy population and Dr B. Garcin, neurologist, Department of Neurology, Avicenne Hospital, for patients with neurodegenerative diseases and similar demographic characteristics). Data from European partners who frequently conduct neuropsychological examinations in ethnic minority groups will also be included (especially S. Franzen, Rotterdam; see the following section).

 

The MC2Lab offers a rich and stimulating scientific environment by bringing together psychologists specialized in experimental psychology, neuropsychology and cognitive neuroscience who develop multidisciplinary research on memory functions and their interactions with other processes such as emotion, self and social cognition. The MC2Lab also offers several technologies with an immersive virtual reality platform, physiological measures, but also opportunities to collaborate with experts in cognitive evaluation and remediation methods in collaboration with clinical services. The PhD student will participate to research meetings and monthly laboratory seminars. He/She will be trained to the development of VR technology in experimental and clinical settings and will receive scientific and technical support thanks to the expertise of the Lab members using VR since many years.

Description de la structure d’accueil secondaire:

The secondary advisory team will consist of one established researcher (Janne Papma) and one combined clinician/researcher (Sanne Franzen) from Rotterdam, the Netherlands. Janne Papma is an Assistant Professor at the department of Neurology of the Erasmus Medical Center in Rotterdam, the Netherlands (h-index : 18, number of citations n=1245). She is the co-founder of the Alzheimer Center of the Erasmus Medical Center and served as its coordinator from 2011-2018. Over the course of her career in research, dr. Papma has received several large research grants (totaling >€2 million) ; the main focus of her research is the development of diagnostic tools and interventions that are tailored to the patient’s education level, cultural backgrounds, age, and type of symptoms. After securing funding for a pilot study in 2015, dr. Papma launched a dedicated multicultural memory clinic for culturally, educationally, and linguistically diverse patients as part of the Alzheimer Center. In 2017, together with her colleague Sanne Franzen, dr. Papma obtained a large governmental grant that allowed them to develop and validate a series of neuropsychological tests for patients with a diverse cultural and educational background (the TULIPA study). Dr. Papma and ms. Franzen are the lead investigators of this study ; the project, however, is in fact a collaboration of multicultural memory clinics across the Netherlands (e.g. Amsterdam, the Hague, Rotterdam, Enschede, Ede). Several hundreds of patients have been assessed using these newly developed instruments in the past years (2017-2020). This established collaborative network of multicultural memory clinics will provide the PhD student a unique opportunity for multicenter data collection.

Sanne Franzen has a combined position as a clinician and researcher, specializing in cross-cultural neuropsychological tests. She has worked as a neuropsychologist in the Alzheimer Center of the Erasmus Medical Center since 2015 and in addition has coordinated the multicultural memory clinic of the Alzheimer Center since its opening in 2015. She has developed/adapted several neuropsychological tests and published a number of papers on this topic, and she recently completed a study investigating cross-cultural neuropsychological assessment across the EU. She is an executive committee member of the Cultural Diversity & Psychology commission of the Dutch Association for Psychologists and an executive committee member of the Diversity and Disparities professional interest group of the International Society to Advance Alzheimer’s Research and Treatment.

Aside from the expertise gained through their work in the multicultural memory clinic, both dr. Papma and ms. Franzen have a significant track record in research focusing on frontotemporal dementias, a type of dementia that often first presents itself in the form of behavioral and sociocognitive changes. The Alzheimer Center of the Erasmus Medical Center is part of the GENFI consortium studying genetic frontotemporal dementia across the globe and is nationally and internationally recognized as a pioneer in measuring sociocognitive and behavioral changes in frontotemporal dementia.

In sum, the PhD student will benefit from the expertise and established collaborations of the team at the Erasmus Medical Center in both the fields of cross-cultural neuropsychological assessment and frontotemporal dementia. Dr. Papma will specifically contribute her knowledge and experience in research, and ms. Franzen will provide relevant clinical expertise and contribute her knowledge on the development, validation, and feasibility of neuropsychological tests in clinical practice. In addition, their large international networks will afford the PhD with extensive opportunities to gather data or implement study findings across a number of countries.