# What are you thinking about? Ongoing thought in clinical contexts ###### 27/02/2023 ###### Will H. Strawson, Neuroscience, BSMS --- ### What do we mean by ongoing thought? - Integral part of the "Stream of Consciousness (James,1890)"  ---- ### What do we mean by ongoing thought? - Multidimensional - Heterogeneous (Changes across time, context, people, and has varied outcomes) - ###### See Smallwood & Schooler (2015) --- ## Thought and clinical diagnoses - Different diagnoses associated with differences in ongoing thought - By studying ongoing thought, we gain a window into the concious experience of patients --- ## My PhD so far... 1. Past: Thought in Autism (ADIE) 2. Present: Interaction between thoughts and hallucinations in BPD 3. Future: Thoughts in ADHD during neurofeedback; Thoughts in POTS during brain fog induction --- ## 1. Thought in Autism (ADIE) ---- ### N-Back task  ---- `` ## Multidimensional Experience Sampling  ---- ## Principle Components Analysis ##### To identify common patterns of thought, we used a dimension reduction technique called PCA on the z-scored ESQ data  ###### _Turnbull et al (2020)_ ----  ----  ----  #### The modality of autistic individuals thoughts are significanly less perturbed by changes in external context ---- ### Relationship between performance (IES), group and thoughts.  ---- ### Relationship between Autism characteristics (AQ), task difficulty and thoughts.  ---- #### In summary, we replicated and extended Adam's 2020 findings, demonstrating differences in thought in autistic individuals (Modality) that relate to performance in dissociable ways (Off-Task). Also showed that within the autistic group thought relates to traits in a context dependent manner (easy vs hard conditions). ---- ### Future directions... --- ## 2. Interaction Between Thoughts and Hallucinations in BPD ---- ### Aim 1: to understand how ongoing thought relates to phenomenological characteristics of Auditory Verbal Hallucinations (AVH) ### Aim 2: to understand how ongoing thoughts relate to the neural fingerpint associated with AVH ----  ----  ###### PCA on 98 responses (from 32 subjects) to 15 experience sampling questions . Four components - accounting for 54.1% of the total variance- were retained for analysis ----  ###### PCA on 53 responses from 18 subjects. Two components, accounting for 72.52% of the variance were retained ----  ----  ---- - ##### Phenomenological links between thoughts and hallucinations ##### A. More intense hallucinations = More negative memories ##### B. More externally located hallucinations = more spontaneous intrusive thoughts --- ### Aim 2: to understand how ongoing thoughts relate to differences in AVH-evoked BOLD signal ----  ---- - Highlights that features of participants' ongoing experience interacts with both subjective and neural features of AVH. - This work establishes a more integrated and comprehensive approach to studying how ongoing mental states contribute to hallucinatory phenomenon. --- # Upcoming projects... --- #### 1. Ongoing thoughts during brain fog induction in Postural tachycardia syndrome (PoTS) #### 2. The role of ongoing thoughts in attention-training neurofeedback #### 3. ThoughtSpace --- #### Studying ongoing thought in across clinically relevant situations provides us with a tool that allows us to learn about dynamic and multidimensional mental states  ---- Intsead of mind-wadnering = bad, we can move foreword