Schizotypy and mixed-handedness revisited

Ambiguous handedness and visuospatial pseudoneglect in schizotypy in physical and computer-generated virtual environments

Virtual reality (VR) technology has increased clinical attention in the health care of schizophrenia spectrum disorders in both diagnoses of the symptoms and assessment of schizotypal traits. However, the exact nature of VR-induced positive treatment effect in schizotypy is still unknown. In this study, VR technology was used as a non-invasive neurocognitive trigger to test the asymmetric visuospatial representational instability found in individuals with high schizotypy. The study aimed to reveal the brain functional hemispheric laterality in physical and virtual realities in individuals with schizotypal traits. Fifty-one healthy, right-handed participants (24 males and 27 females) were enrolled through public advertisements. Hemispheric functional asymmetry was measured by the Line Bisection Task (LBT). The results revealed that (a) LBT bias in the physical reality showed a handedness-related leftward pseudoneglect, however, similar handedness-related pseudoneglect in VR has not been found. (b) Comparing LBT bias in physically real and VR environments showed rightward drift in VR environments independently to the degree of handedness. (c) The schizotypy has no association with handedness, however, the cognitive schizotypy is related to the LBT bias. Higher cognitive schizotypy in VR associated with left hemispatial pseudoneglect. In conclusion, schizotypy is associated with ambiguous behavioral and cognitive functional laterality. In individuals with high cognitive schizotypy, the VR environment enhanced the representational articulation of the left hemispace. This effect may be originated from the enhancement of the right hemisphere overactivation and is followed by a lower mental control of the overt behavior.

Handedness and schizotypy: The potential effect of changing the writing-hand

Mixed-handedness, which has been associated with schizotypy in recent studies, might exist for at least two different reasons: it is innate or it has been forced. We examined whether the association between mixed-handedness and schizotypy differs depending on its source. We enrolled 3485 college students in Taiwan. We used both the Perceptual Aberration Scale and Schizotypal Personality Questionnaire to assess schizotypy, and the Annett Hand Preference Questionnaire to assess handedness. Two ways of classifying handedness were examined: the three-way classification based on Annett's categories and mixed- vs. non-mixed-handedness based on Degree of Handedness. Both mixed-handedness groups showed higher positive schizotypy scores. Among mixed handers, those who had been required to change their writing hand from left to right had higher positive schizotypy scores. Being forced to change writing hand seemed to be related to a higher level of schizotypy. The potential effect of the social pressure against using the left hand for writing is discussed.

Motor behavior reflects reduced hemispheric asymmetry in the psychosis risk period

BACKGROUND

A body of work focusing on brain connectivity, language dominance, and motor laterality research suggests that reduced hemispheric asymmetry is a core feature in schizophrenia. However, there is little consensus about whether reduced dominance is present in those at ultrahigh risk (UHR) for psychosis.

METHODS

A total of 94 demonstrated right-handed neuroleptic free participants (38 UHR and 56 matched healthy controls) were assessed with structured clinical interviews and completed an innovative handwriting task using a digital tablet computer. A laterality quotient (LQ) was calculated using kinematic variables from the participant's left and right hands. A subset of the sample (26 UHR and 29 controls) returned after 12-months to complete clinical interviews in order to examine relationships between handwriting laterality and progression of psychosis risk symptoms.

RESULTS

The UHR group showed decreased dextrality compared to healthy controls. At the 12-month follow-up, decreased dextrality accounted for 8% of the variance in worsened positive symptoms within the UHR group.

CONCLUSION

The current results suggest that disrupted cerebral dominance is also present in the ultrahigh risk period and that decreased dextrality may serve as a novel biomarker for the progression of psychosis risk.

Deeper into schizotypy and motor performance: Investigating the nature of motor control in a non-psychiatric sample

Numerous studies have demonstrated that motor control deficits are characteristic of patients diagnosed with schizophrenia and those at-risk for the development of the disorder. Recent advances in the quantification of motor dysfunction have confirmed this, but these methods fail to consider an important aspect of subject performance: the qualitative nature of their psychomotor dyscontrol. We report on a novel technique used to quantify the qualitative nature of psychomotor performance and its relation to schizotypy. Control (n = 35) and schizotypic subjects (n = 47) completed a line-drawing task that yields metrics for psychomotor control and predominant frequency. Schizotypes evidenced greater psychomotor dyscontrol and lower predominant frequencies than controls. These results are interpreted as evidence of reduced visual-motor integration, self-monitoring capacity, or adherence to basic motor principles in schizotypes. The potential use of these metrics as putative endophenotypes for the liability for schizophrenia and the implications of these findings for the relationship between schizophrenia and schizotypy are discussed.

Season of birth, mixed-handedness, and psychometric schizotypy: preliminary results from a prospective study

Season of birth and hand preference were examined in a sample of 42 (7 males, 35 females) individuals who were identified as schizotypic based on their scores on selected scales of the Chapman Psychosis Proneness Scales (CPPS) and a matched comparison sample of 42 individuals with non-deviant CPPS scores. Presence or absence of schizotypy was analyzed using chi square tests of independence with the presence or absence of each risk factor serving as the independent variable. Further analyses incorporated independent means t tests to examine mean scores on the CPPS with the presence or absence of each risk factor again serving as the independent variable. Results supported the hypothesis that winter/early-spring birth would be associated with psychometric schizotypy, although the results for mixed-handedness fell just short of statistical significance. However, mixed hand preference was associated with higher scores on MagId and PerAb scales of the CPPS, but not the RSA scale, which suggests that mixed laterality is associated with the more cognitive-perceptual aspects of schizotypy. Results are discussed in relation to previous literature and their relevance to the prediction of schizophrenia-related psychosis.

How are autism and schizotypy related? Evidence from a non-clinical population

Both autism spectrum conditions (ASCs) and schizophrenia spectrum conditions (SSCs) involve altered or impaired social and communicative functioning, but whether these shared features indicate overlapping or different etiological factors is unknown. We outline three hypotheses (overlapping, independent, and diametric) for the possible relationship between ASCs and SSCs, and compare their predictions for the expected relationships between autistic and schizotypal phenotypes using the Autism Spectrum Quotient and the Schizotypal Personality Questionnaire-Brief Revised from a large non-clinical sample of undergraduate students. Consistent with previous research, autistic features were positively associated with several schizotypal features, with the most overlap occurring between interpersonal schizotypy and autistic social and communication phenotypes. The first component of a principal components analysis (PCA) of subscale scores reflected these positive correlations, and suggested the presence of an axis (PC1) representing general social interest and aptitude. By contrast, the second principal component (PC2) exhibited a pattern of positive and negative loadings indicative of an axis from autism to positive schizotypy, such that positive schizotypal features loaded in the opposite direction to core autistic features. These overall PCA patterns were replicated in a second data set from a Japanese population. To evaluate the validity of our interpretation of the PCA results, we measured handedness and mental rotation ability, as these are established correlates of SSCs and ASCs, respectively. PC2 scores were significantly associated with hand preference, such that increasingly 'schizotypal' scores predicted reduced strength of handedness, which is consistent with previous research. PC1 scores were positively related to performance on the mental rotation task, suggesting trade-offs between social skills and visual-spatial ability. These results provide novel evidence for an autism-positive schizotypy axis, and highlight the importance of recognizing that psychological variation involving reduced social interest and functioning may have diverse causes.

Psychotic-like symptoms and positive schizotypy are associated with mixed and ambiguous handedness in an adolescent community sample

The objective of this study was to replicate the association between atypical handedness and psychosis-proneness in a representative sample of adolescents from the general population. It expands previous studies by (1) analyzing a variety of atypical handedness indexes (left, mixed, ambiguous, and inconsistent), (2) measuring comprehensively the multidimensionality of psychosis-proneness, and (3) analyzing the association of different patterns of atypical handedness with nonclinical dimensions of both trait (schizotypy) and sub-clinical symptom (psychotic-like experiences) levels. Seven hundred and twenty-eight adolescents were assessed for handedness by the 12-item self-report Annett Hand Preference Questionnaire and for psychosis-proneness by the Oxford-Liverpool Inventory of Feelings and Experiences and the Community Assessment of Psychic Experiences scales. Writing-hand alone did not detect associations between laterality and psychosis-proneness. Mixed- rather than left-handedness was related to psychosis-proneness, and this was more evident when analyzing subjects with ambiguous handedness exclusively. When analysis was restricted to subjects with non-ambiguous handedness, strong left-handedness was related to psychosis-proneness. The positive dimension showed a stronger association than the negative one with atypical handedness. Results partially support mixed-handedness as a marker of developmental disorders underlying both atypical lateralization and psychosis-proneness. Among various possible mixed-handedness patterns, inconsistent hand use across primary actions, and for the same action across time, seems particularly related to psychosis-proneness and thus requires further exploration.

Schizotypal trait in healthy women is associated with a shift away from dextrality on a spatial motor control task, but not on a force control task

It is generally acknowledged that schizophrenia and schizotypy lie on the same continuum, while there is an ongoing debate as to whether schizotypy represents true dimension or quasi-dimension. Evidence suggests that reduced hemispheric lateralization and mixed handedness are associated with both schizophrenia and schizotypy. However, the possible relationship of schizotypy with laterality as assessed with motor function tasks has not been well documented. A few studies using fine motor control tasks have demonstrated the relationship between schizotypy and reduced laterality among student populations, yet little has been done in community samples. Here we employed 249 healthy women and examined the association between schizotypal traits assessed with the Schizotypal Personality Questionnaire and motor functions assessed with the Purdue Pegboard test (as a measure of spatial motor control) and a handgrip force test. Correlational and categorical analyses both showed that schizotypal traits were significantly associated with leftward and bilateral bias in the fine motor control task, but not in the handgrip force test. Schizotypy did not significantly affect the performance level on either of these tasks. These results indicate that schizotypal traits in healthy women are associated with a shift away from dextrality, supporting the fully dimensional model of schizotypy.

The cross-cultural nature of the relationship between schizotypy and mixed-handedness

Positive schizotypy is associated with non-right-handedness, which includes left- and mixed-handedness. However, because the underlying mechanisms might be different, it is important to examine whether both left- and mixed-handedness are associated with a high incidence of schizotypy. During 2009-2010, we used both the Perceptual Aberration Scale and Schizotypal Personality Questionnaire to assess 1315 undergraduate students in Taiwan for schizotypy and the Annett handedness questionnaire to assess handedness. Among the three-way classifications based on Annett's grouping, the fully left-handed group appeared to have the lowest score of positive schizotypy; next was the fully right-handed group and then the mixed-handed. Among the three-way classifications driven from cluster analysis, mixed-handers showed highest score of positive schizotypy. When handedness was treated continuously, both direction (e.g., Hand Preference Index) and consistency (e.g., Either hand use score) indicators were significantly correlated with schizotypy. The results of regression analyses showed that the quadratic handedness measure were negatively associated with schizotypy. The results remained similar after correcting for social pressure on left-handedness. In conclusion, the relationship between schizotypy and mixed-handedness appears to be cross-cultural. The dichotomous classification of handedness, right- vs. non-right-handedness, appears to be insufficient. Additional studies on the distinct mechanisms of mixed- and left-handedness are warranted.

Going beyond students: an association between mixed-hand preference and schizotypy subscales in a general population

Research on the sub-clinical condition of schizotypy suggests that it is associated with mixed handedness. To date, however, this research has focussed on undergraduate populations. If the association between schizotypy and mixed-handedness is the result of an underlying neurological trait, it is important to demonstrate that the effect extends to the general population. With this in mind, 699 participants were drawn from a wide community sample. Schizotypy was measured using the Psychosis Proneness Questionnaire and handedness was assessed using the Annett inventory. To avoid the sometimes arbitrary definitions of left-, right- and mixed-handed, regression analyses were used to explore the data. There was no evidence of a difference in schizotypy between individuals with a left- or right-hand preference. People with a mixed-hand preference, however, had higher scores on PER-MAG (Perceptual Aberration and Magical Ideation) and HYP-IMP (Hypomania and Impulsive Non-Conformity) scales (positive traits). No effect was observed for the SAN (Social Anhedonia) and PAN (Physical Anhedonia) scales (negative traits). The nature of the association between schizotypy and handedness observed in the current study is similar to that reported for student populations. The possibility that the association is related to response biases or a biological mechanism is discussed.

Handedness and schizotypy in non-psychotic relatives of patients with schizophrenia

Existing studies have found the relationship between handedness and schizotypy to be inconsistent, and had limited generalisability since only highly homogeneous groups have been investigated. This study aimed to examine the relation between handedness and the four schizotypal factors identified from a previous confirmatory factor analysis in a population of high familial loading for schizophrenia. Study participants consisted of non-psychotic first-degree relatives (850 parents and 334 siblings) of sib-pairs who were co-affected with schizophrenia. All participants were interviewed with the Diagnostic Interview for Genetic Studies, which contains a section of the modified Structured Interview for Schizotypy, and the Annett handedness questionnaire. Both categorical and continuous indicators for handedness were examined. Non-right-handed siblings of schizophrenia patients displayed more positive schizotypal features than their right-handed counterparts when the two-way Annett's handedness classification was adopted. No association was found when handedness was treated as continuous. The relationship between handedness and schizotypy was insignificant for parents probably due to the strong social pressure against left-handedness. We concluded that categorical non-right-handedness was associated with positive schizotypy in non-psychotic siblings of schizophrenia patients. The results indicate that an atypical cerebral lateralisation underlying non-right-handedness may be also a contributing factor to positive schizotypy.

Positive schizotypy scores correlate with left visual field interference for negatively valenced emotional words: A lateralized emotional Stroop study

Fourteen men scoring high and 14 men scoring low on a positive schizotypy scale participated in a lateralized emotional Stroop task. Vocal reaction times for color naming of neutral, positive and negative emotional words were recorded. Across participants, the color naming of neutral and emotional words was slightly faster to right than to left visual field presentations. In men with high scores on positive schizotypy, the presentation of negative words to the left visual field (right hemisphere) resulted in significant affective interference with color naming, which was significantly larger than in men with low scores. Correlational analysis also showed that positive schizotypy was significantly associated with emotional interference in response to LVF negative words. The outcome is discussed in terms of right hemispheric engagement in negative emotions in high positive schizotypic men.

Hand-preference and population schizotypy: a meta-analysis

Language functions in schizophrenia patients are represented more bilateral, i.e. less lateralized than in healthy subjects. This decreased lateralization is also observed in individuals at increased risk for schizophrenia. Language lateralization is related to handedness; in that left- and mixed-handed individuals more frequently have decreased lateralization in comparison to right-handed subjects. Population schizotypy can be considered part of the schizophrenia spectrum disorders. In line with this, population schizotypy has repeatedly, though inconsistently, been associated with left-handedness. In order to define the exact association between handedness and schizotypy, we performed meta-analyses on the available literature. We found that non-right-handed subjects, but not strong left-handers, had higher scores on schizotypy questionnaires than right-handed subjects. Mixed-handers showed a trend towards higher schizotypy in comparison to strong left-handers. It is argued that the higher schizotypy in non-right-handed individuals reflects the higher incidence of bilateral language lateralization in this group. Bilateral language organisation may underlie loosening of association, possibly leading to higher schizotypy scores.

Handedness and schizotypal features in healthy subjects

BACKGROUND

An excess of mixed-handedness has been repeatedly reported in schizophrenia and schizotypy. Handedness is a measure of atypical cerebral lateralization, which is considered as a risk factor for schizophrenia. Several studies have attempted to identify correlations between handedness and dimensions of psychosis but the results obtained so far remain inconclusive.

OBJECTIVE

To explore a possible link between mixed-handedness and the three classical dimensions of psychosis. As speech and language disorders may be associated with cerebral lateralization, we predicted a correlation between mixed-handedness and disorganized dimension.

METHODS

We used the Schizotypal Personality Questionnaire (SPQ) and the Edinburgh Handedness Inventory (EHI) to study the correlation between mixed-handedness scores and positive, negative or disorganized dimensions in a sample of 62 healthy subjects.

RESULTS

We found a negative correlation between mixed-handedness and the disorganized dimension of schizotypy, as individuals with prominent mixed-handedness showed more severe disorganization.

CONCLUSION

We have identified a link between mixed-handedness and the disorganized dimension that may help to identify genetic vulnerability factors involved in psychosis.

Magical ideation is related to questionnaire but not behavioural measures of handedness

Magical ideation has repeatedly been shown to be related to handedness, with mixed-handers exhibiting higher levels of magical thinking. However, most previous research has assessed hand preference with a questionnaire measure, leaving open the possibility that the correlation reflects some aspect of questionnaire-taking behaviour and not an underlying neuropsychological relationship. The present study addressed this issue by administering the Magical Ideation Scale (Eckblad & Chapman, 1983), the Waterloo Handedness Questionnaire-Revised (Elias, Bryden, & Bulman-Fleming, 1998), and a manual dot-filling task (Tapley & Bryden, 1985) as a behavioural measure of handedness to an undergraduate student sample. The expected relationship between magical ideation and handedness as assessed by the questionnaire was observed. However, magical ideation was not related to the behavioural measure of handedness. Results cast doubt on a neuropsychological interpretation of the relationship between handedness and magical ideation in sub-clinical populations.

Crossed cerebral lateralization for verbal and visuo-spatial function in a pair of handedness discordant monozygotic twins: MRI and fMRI brain imaging

To examine the nature of hemispheric lateralization for neural processes underlying verbal fluency and visuo-spatial attention, we investigated a single pair of handedness discordant monozygotic (MzHd) twins. Imaging of the brain was undertaken using magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) in combination with manual performance tasks. The twins were discordant for MRI anatomical asymmetries of the pars triangularis and planum temporale, whose asymmetry was consistent with verbal laterality on fMRI. Thus, the right-handed twin had left lateralized verbal with right lateralized visuo-spatial attention, while the left-handed twin had right lateralized verbal with left lateralized visuo-spatial activation; these data lend further support for to the conclusions of Sommer et al.

Consistent association between mixed lateral preference and PTSD: confirmation among a national study of 2490 US Army Vietnam veterans

OBJECTIVE

To evaluate the research-based association between mixed lateral preference for handedness and risk for posttraumatic stress disorder (PTSD) in a large-scale sample of US Army Vietnam veterans exposed to war zone stressors.

METHOD

We used a national sample of 2490 male US Army veterans, who completed the Edinburgh Handedness Inventory (EHI), a measure ranging from -100 (pure left-handedness) to +100 (pure right-handedness). We developed several classifications representing levels of mixed laterality: a) an EHI -70 to +70 (EHI 70, moderate mixed); b) an EHI -50 to +50 (EHI 50, consistent mixed); and c) an EHI 0, plus reports of using either hand on > or =50% of the tasks assessed (EHI 0+, extreme mixed). We controlled for intelligence, race, Army entry age, and Army volunteer status, and we assessed the impact of combat exposure.

RESULTS

Although all three handedness measures were associated with current PTSD in bivariate analyses, only Edinburgh 0+ was associated with PTSD in the multivariate model (odds ratio (OR) = 2.1; p = .021). However, when we classified handedness by high combat exposure, all three measures were associated with PTSD, with ORs = 2.5, 2.8, and 4.7 for EHI 70, EHI 50, and EHI 0+, respectively (all p < .001). Veterans with mixed laterality and high combat exposure also had significantly increased PTSD symptoms (all p < .001).

CONCLUSION

Our study confirmed findings reported among mostly smaller clinical samples and suggested that mixed lateral preference was associated with PTSD, especially among those individuals exposed to more severe psychological trauma.

Mixed handedness is associated with the Disorganization dimension of schizotypy in a young male population

Within the ASPIS (Athens Study of Psychosis Proneness and Incidence of Schizophrenia) we sought out to examine in accordance with previous reports if a deviation from dextrality is associated with an augmented endorsement of self rated schizotypal personality traits in a large population of 1129 young male army recruits. Schizotypal traits were assessed using the Schizotypal Personality Questionnaire and hand preference membership was determined by applying stringent criteria derived from the Annett Handedness Questionnaire and the Porac-Coren questionnaire of lateral preferences. By adopting three different definitions of hand preference membership, we confirmed an association between mixed handedness and increased schizotypal personality traits, and in particular with Disorganization schizotypy that encompasses aspects of self perceived difficulties in verbal communication. Non-verbal cognitive ability, as indexed by measurement of non-verbal IQ, sustained attention and working memory was not associated with hand preference. We argue that a deviation from normal cerebral lateralization, as indexed by mixed handedness, is associated with mild sub clinical language dysfunction, rather than non-verbal cognitive ability, and this might be relevant to the expression of psychosis phenotype.