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Vaskinn A, Ueland T, Melle I, Sundet K. Sex differences in social cognition among individuals with schizophrenia and in healthy control participants: a secondary analysis of published data. Arch Womens Ment Health 2024:10.1007/s00737-024-01422-8. [PMID: 38244033 DOI: 10.1007/s00737-024-01422-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE Sex differences are present among individuals experiencing schizophrenia. Whether these differences extend to social cognition is unclear. In this study, we investigated sex differences in emotion perception, social perception and theory of mind (ToM). METHODS We examined sex differences between males and females with schizophrenia on five social cognitive tests. Healthy male and female control participants were included to examine if any sex difference was illness-specific. Emotion perception was measured with Pictures of Facial Affect (PFA) and Emotion in Biological Motion (EmoBio); social perception with the Relationships Across Domains Test (RAD); and ToM with the Movie for the Assessment of Social Cognition (MASC) and Hinting Task. RESULTS Two-way analyses of variance revealed overall group differences for all tests, with healthy controls outperforming individuals with schizophrenia. Significant sex effects were present for PFA and Hinting Task. There were no significant interaction effects. Within-group independent samples t-tests yielded one significant sex difference, i.e., among healthy controls for PFA. CONCLUSIONS Females had better facial emotion perception than males. This sex difference was statistically significant among healthy controls and medium-large among individuals experiencing schizophrenia. There were no significant sex differences for other social cognitive domains. The study did not find evidence for a general female advantage in social cognition.
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Affiliation(s)
- Anja Vaskinn
- Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, PO Box 4956, Nydalen, 0424, Oslo, Norway.
- Institute of Clinical Medicine, Norwegian Centre for Mental Disorders Research, University of Oslo, Oslo, Norway.
| | - Torill Ueland
- Department of Psychology, University of Oslo, Oslo, Norway
- Psychosis Research Section, Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- Institute of Clinical Medicine, Norwegian Centre for Mental Disorders Research, University of Oslo, Oslo, Norway
- Psychosis Research Section, Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, Oslo, Norway
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2
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López-Carrilero R, Lo Monaco M, Frígola-Capell E, Ferrer-Quintero M, Díaz-Cutraro L, Verdaguer-Rodríguez M, García-Mieres H, Vila-Badia R, Punsoda-Puche P, Birulés I, Peláez T, Pousa E, Grasa E, Barajas A, Ruiz-Delgado I, Barrigón ML, Gonzalez-Higueras F, Lorente-Rovira E, Gutiérrez-Zotes A, Cid J, Legido T, Ayesa-Arriola R, Moritz S, Ochoa S. Cognitive insight in first-episode psychosis: Exploring the complex relationship between executive functions and social cognition. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00009-7. [PMID: 38219901 DOI: 10.1016/j.sjpmh.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
Social cognition (SC) and executive function (EF) have been described as important variables for social functioning and recovery of patients with psychosis. However, the relationship between SC and EF in first-episode psychosis (FEP) deserves further investigation, especially focusing on gender differences. AIMS To investigate the relationship between EF and different domains of SC in FEP patients and to explore gender differences in the relationship between these domains. METHODS A cross-sectional study of 191 patients with new-onset psychosis recruited from two multicenter clinical trials. A comprehensive cognitive battery was used to assess SC (Hinting Task, Face Test and IPSAQ) and EF (TMT, WSCT, Stroop Test and digit span - WAIS-III). Pearson correlations and linear regression models were performed. RESULTS A correlation between Theory of Mind (ToM), Emotional Recognition (ER) and EF was found using the complete sample. Separating the sample by gender showed different association profiles between these variables in women and men. CONCLUSIONS A relationship between different domains of SC and EF is found. Moreover, women and men presented distinct association profiles between EF and SC. These results should be considered in order to improve the treatment of FEP patients and designing personalized interventions by gender.
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Affiliation(s)
- Raquel López-Carrilero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercedes Lo Monaco
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Eva Frígola-Capell
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Marta Ferrer-Quintero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Helena García-Mieres
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Regina Vila-Badia
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain
| | - Trinidad Peláez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Esther Pousa
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Salut Mental Parc Taulí, Sabadell, Hospital Universitari, UAB Universitat Autònoma de Barcelona, Sabadell, Spain; Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana Barajas
- Serra Húnter Programme, Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Centre d'Higiene Mental Les Corts, Department of Research, Barcelona, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | - María Luisa Barrigón
- Departamento de Psiquiatría, Hospital Universitario Virgen del Rocio, Sevilla, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | | | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Teresa Legido
- Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unidad de Investigación en Psiquiatría (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Susana Ochoa
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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McGuire N, Gumley A, Hasson-Ohayon I, Allan S, Aunjitsakul W, Aydin O, Bo S, Bonfils KA, Bröcker AL, de Jong S, Dimaggio G, Inchausti F, Jansen JE, Lecomte T, Luther L, MacBeth A, Montag C, Pedersen MB, Pijnenborg GHM, Popolo R, Schwannauer M, Trauelsen AM, van Donkersgoed R, Wu W, Wang K, Lysaker PH, McLeod H. Investigating the relationship between negative symptoms and metacognitive functioning in psychosis: An individual participant data meta-analysis. Psychol Psychother 2023; 96:918-933. [PMID: 37530433 DOI: 10.1111/papt.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/24/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Negative symptoms are a persistent, yet under-explored problem in psychosis. Disturbances in metacognition are a potential causal factor in negative symptom development and maintenance. This meta-analysis uses individual participant data (IPD) from existing research to assess the relationship between negative symptoms and metacognition treated as summed scores and domains. METHODS Data sets containing individuals with negative symptoms and metacognition data, aged 16+ with psychosis, were identified according to pre-specific parameters. IPD integrity and completeness were checked and data were synthesized in two-stage meta-analyses of each negative symptoms cluster compared with metacognition in seemingly unrelated regression using restricted maximum likelihood estimation. Planned and exploratory sensitivity analyses were also conducted. RESULTS Thirty-three eligible data sets were identified with 21 with sufficient similarity and availability to be included in meta-analyses, corresponding to 1301 participants. The strongest relationships observed were between summed scores of negative symptoms and metacognition. Metacognitive domains of self-reflectivity and understanding others' minds, and expressive negative symptoms emerged as significant in some meta-analyses. The uncertainty of several effect estimates increased significantly when controlling for covariates. CONCLUSIONS This robust meta-analysis highlights the impact of using summed versus domain-specific scores of metacognition and negative symptoms, and relationships are not as clear-cut as once believed. Findings support arguments for further differentiation of negative symptom profiles and continued granular exploration of the relationship between metacognition and negative symptoms.
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Affiliation(s)
| | | | | | | | | | - Orkun Aydin
- International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Sune Bo
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Kelsey A Bonfils
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | | | - Steven de Jong
- Lentis Psychiatric Institute, Groningen, The Netherlands
| | | | - Felix Inchausti
- Department of Mental Health, Servicio Riojano de Salud, Logroño, Spain
| | | | | | | | | | | | - Marlene Buch Pedersen
- Early Psychosis Intervention Centre, Psychiatry East, Region Zealand, Roskilde, Denmark
| | | | | | | | - Anne-Marie Trauelsen
- Assessment and Brief Treatment Team (Newham), East London Foundation Trust, London, UK
| | | | | | - Kai Wang
- Anhui Medical University, Hefei, China
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McGuire N, Gumley A, Hasson-Ohayon I, Allan S, Aunjitsakul W, Aydin O, Bo S, Bonfils KA, Bröcker AL, de Jong S, Dimaggio G, Inchausti F, Jansen JE, Lecomte T, Luther L, MacBeth A, Montag C, Pedersen MB, Pijnenborg GHM, Popolo R, Schwannauer M, Trauelsen AM, van Donkersgoed R, Wu W, Wang K, Lysaker PH, McLeod H. Investigating the relationship between specific negative symptoms and metacognitive functioning in psychosis: A systematic review. Psychol Psychother 2023. [PMID: 37864383 DOI: 10.1111/papt.12505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/20/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Disrupted metacognition is implicated in development and maintenance of negative symptoms, but more fine-grained analyses would inform precise treatment targeting for individual negative symptoms. AIMS This systematic review identifies and examines datasets that test whether specific metacognitive capacities distinctly influence negative symptoms. MATERIALS & METHODS PsycINFO, EMBASE, Medline and Cochrane Library databases plus hand searching of relevant articles, journals and grey literature identified quantitative research investigating negative symptoms and metacognition in adults aged 16+ with psychosis. Authors of included articles were contacted to identify unique datasets and missing information. Data were extracted for a risk of bias assessment using the Quality in Prognostic Studies tool. RESULTS 85 published reports met criteria and are estimated to reflect 32 distinct datasets and 1623 unique participants. The data indicated uncertainty about the relationship between summed scores of negative symptoms and domains of metacognition, with significant findings indicating correlation coefficients from 0.88 to -0.23. Only eight studies investigated the relationship between metacognition and individual negative symptoms, with mixed findings. Studies were mostly moderate-to-low risk of bias. DISCUSSION The relationship between negative symptoms and metacognition is rarely the focus of studies reviewed here, and negative symptom scores are often summed. This approach may obscure relationships between metacognitive domains and individual negative symptoms which may be important for understanding how negative symptoms are developed and maintained. CONLCLUSION Methodological challenges around overlapping participants, variation in aggregation of negative symptom items and types of analyses used, make a strong case for use of Individual Participant Data Meta-Analysis to further elucidate these relationships.
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Affiliation(s)
| | | | | | | | | | - Orkun Aydin
- International University of Sarajevo, Sarajevo, Bosnia and Herzegovinia
| | - Sune Bo
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Kelsey A Bonfils
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | | | - Steven de Jong
- Lentis Psychiatric Institute, Groningen, The Netherlands
| | | | - Felix Inchausti
- Department of Mental Health, Servicio Riojano de Salud, Logroño, Spain
| | - Jens Einar Jansen
- Mental Health Center Copenhagen, Capital Region, Copenhagen, Denmark
| | | | | | | | | | - Marlene Buch Pedersen
- Early Psychosis Intervention Centre, Psychiatry East, Region Zealand, Roskilde, Denmark
| | | | | | | | | | | | - Weiming Wu
- Anhui Medical University, Hefei City, China
| | - Kai Wang
- Anhui Medical University, Hefei City, China
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5
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Sun Y, Wang M, Yu H, Su H, Zhou Y. The relationship between self-esteem and mental disability in patients with schizophrenia: the mediating role of resilience and the moderating role of gender. PSYCHOL HEALTH MED 2023; 28:1985-1996. [PMID: 36101933 DOI: 10.1080/13548506.2022.2124294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
This study aims to verify the mediating role of resilience between self-esteem and mental disability and to analyze the moderating role of gender in the relationship between resilience and mental disability in patients with schizophrenia. Patients with schizophrenia have been selected from Harbin Psychiatric (Baiyupao) Hospital and Daqing Third Hospital in Heilongjiang Province from January to December 2021. The study recruited a total of 220 patients with schizophrenia, including 120 males and 100 females to measure their self-esteem, resilience and mental disability. The results were as follows: Self-esteem and resilience are important protective factors that have a buffering effect on mental disability. The mediating effect of resilience on self-esteem and mental disability is stronger in males than in females. The results provide new ideas for delaying mental disability and for formulating intervention programs and applying them to clinical practice. The study indicates that psychiatric medical staff should not only treat the patients with schizophrenia psychotic symptoms but also improve their self-esteem and resilience through effective intervention to reduce the occurrence of mental disability.
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Affiliation(s)
- Yujing Sun
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | | | - Hong Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Hong Su
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Yuqiu Zhou
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
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Fagerbakk SA, Sørhøy SH, Nilsen T, Laugen NJ. Does clinical training improve mentalization skills in future therapists? A comparison of first and last year students of clinical psychology and of engineering. Front Psychol 2023; 14:1066154. [PMID: 36755673 PMCID: PMC9900102 DOI: 10.3389/fpsyg.2023.1066154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
Objective Mentalization has been suggested as a therapist skill that might be important for therapeutic success. The aim of this study was to explore whether the mentalization capacity of students of clinical psychology differs from other students, and whether last-year students differ from first-year students. Method A total of 297 students participated in this study, recruited from first and last years of psychology and engineering study programs. All participants filled out the MentS, a self-report measure of mentalization capacity. Results No significant differences were found in self-reported mentalization capacity between first and last year students of clinical psychology. The results did however show that first year students of psychology had significantly higher self-reported mentalization skills compared to students of engineering, and higher MentS-scores were associated with gender (female) and higher age. Conclusion The finding that students of clinical psychology rate themselves as having a higher capacity to mentalize compared to students of engineering might suggest that individuals with a higher capacity to mentalize are more likely to engage in clinical psychology and become therapists. However, the lack of significant difference in self-reported mentalization capacity in last year students of clinical psychology compared to first year students might indicate that the Norwegian education in clinical psychology does not succeed in enhancing mentalization in future therapists. Clinical psychology study programs might benefit from targeted mentalization training.
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Kubota R, Okubo R, Ikezawa S, Matsui M, Adachi L, Wada A, Fujimaki C, Yamada Y, Saeki K, Sumiyoshi C, Kikuchi A, Omachi Y, Takeda K, Hashimoto R, Sumiyoshi T, Yoshimura N. Sex Differences in Social Cognition and Association of Social Cognition and Neurocognition in Early Course Schizophrenia. Front Psychol 2022; 13:867468. [PMID: 35496257 PMCID: PMC9051335 DOI: 10.3389/fpsyg.2022.867468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Both impairment and sex differences in social cognition and neurocognition have been documented in schizophrenia. However, whether sex differences exist in the association between social cognition and neurocognition are not known. We aimed to investigate the contribution of areas of neurocognition to theory of mind (ToM) and hostility bias, representing social cognition, according to sex in early course schizophrenia. Methods In this cross-sectional study, we assessed neurocognition using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS) and assessed the ToM and hostility bias subdomains of social cognition using the Social Cognition Screening Questionnaire (SCSQ) in 131 participants (65 female, 66 male) diagnosed with schizophrenia within 5 years of onset. Sex differences were analyzed using t-tests. The associations of neurocognitive subdomains with ToM and hostility bias according to sex were analyzed using multiple regression analysis. Results were adjusted by age, estimated premorbid intelligence quotient, and symptomatology. Results No sex differences were found in ToM (p = 0.071) or hostility bias (p = 0.057). Higher verbal fluency was significantly associated with higher ToM in females (p < 0.01), whereas higher executive function was significantly associated with higher ToM in males (p < 0.05). Higher verbal fluency was significantly associated with lower hostility bias in females (p < 0.05), whereas neurocognition and hostility bias were not significantly associated in males. Conclusion The results suggest that neurocognition associated with social cognition differ according to sex. These differences should be considered for more effective treatment of social cognition.
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Affiliation(s)
- Ryotaro Kubota
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
- *Correspondence: Ryo Okubo,
| | - Satoru Ikezawa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Satoru Ikezawa,
| | - Makoto Matsui
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Leona Adachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ayumu Wada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Chinatsu Fujimaki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Yuji Yamada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Koji Saeki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Chika Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Akiko Kikuchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshie Omachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Kazuyoshi Takeda
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoki Yoshimura
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
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8
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Seitz KI, Ehler N, Schmitz M, Schmitz SE, Dziobek I, Herpertz SC, Bertsch K. Affective and cognitive theory of mind in posttraumatic stress, major depressive, and somatic symptom disorders: Association with childhood trauma. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:680-700. [PMID: 35102575 DOI: 10.1111/bjc.12357] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/12/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Childhood trauma constitutes a major risk factor for adult psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and somatic symptom disorder (SSD). One potential mechanism linking childhood trauma to adult psychopathology may be alterations in theory of mind (ToM). Given the lack of transdiagnostic studies on the association between childhood trauma and ToM, further research is needed to elucidate whether and how childhood trauma relates to ToM impairments across and within diagnostic boundaries. DESIGN A cross-sectional study design was applied. METHODS A total of 137 individuals with varying levels of childhood trauma took part in this study, encompassing individuals with PTSD (n = 33), MDD (n = 33), SSD (n = 36), and healthy volunteers (HVs; n = 35). To assess ToM performance and childhood trauma, the Movie for the Assessment of Social Cognition was administered along with the Childhood Trauma Questionnaire. RESULTS Only individuals with PTSD, but not individuals with MDD or SSD, showed a worse ToM performance compared to HVs. In the whole sample, childhood trauma correlated negatively with ToM performance. Exploratory group-specific analyses revealed higher levels of childhood trauma to be associated with more excessive ToM errors in individuals with SSD, and notably with an enhanced ToM performance in individuals with MDD. CONCLUSIONS Our results indicate associations between childhood trauma and ToM impairments in a large, transdiagnostic sample. Provided replication in future studies, our findings suggest ToM capacities as a promising treatment target for individuals exposed to severe childhood trauma, at least or particularly with a diagnosis of PTSD. PRACTITIONER POINTS Our results suggest that individuals with a history of severe childhood trauma, at least or particularly with a clinical diagnosis of posttraumatic stress disorder, may benefit from therapeutic approaches targeting theory of mind capacities. Our findings indicate that higher levels of childhood trauma may be linked to a specific 'hypermentalizing' bias in somatic symptom disorder. Our findings further point towards an association between higher levels of childhood trauma and a heightened - rather than a diminished - sensitivity towards interpersonal cues in major depressive disorder. Provided further confirmatory evidence, our findings may support diagnosis-specific approaches in ameliorating theory of mind abilities in individuals with different mental disorders and a history of severe childhood trauma.
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Affiliation(s)
- Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Nicola Ehler
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
| | - Sara E Schmitz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Germany.,Department of Psychology, Humboldt Universität zu Berlin, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
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9
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Zhu Y, Xu L, Wang W, Guo Q, Chen S, Zhang C, Zhang T, Hu X, Enck P, Li C, Sheng J, Wang J. Gender differences in attentive bias during social information processing in schizophrenia: An eye-tracking study. Asian J Psychiatr 2021; 66:102871. [PMID: 34619492 DOI: 10.1016/j.ajp.2021.102871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 09/06/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
Interpersonal communication is a specific scenario in which patients with psychiatric symptoms may manifest different behavioral patterns due to psychopathology. This was a pilot study by eye-tracking technology to investigate attentive bias during social information processing in schizophrenia. We enrolled 39 patients with schizophrenia from Shanghai Mental Health Center and 42 age-, gender- and education-matched healthy controls. The experiment was a free-viewing task, in which pictures with three types of degree of interpersonal communication were shown. We used two measures: 1) initial fixation duration, 2) total gaze duration. The Positive and Negative Syndrome Scale (PANSS) was used to determine symptom severity. The ratio of first fixation duration for pictures of communicating vs. non-communicating persons was significantly lower in patients than in controls (Mann-Whitney U = 512, p = 0.004). We found that male patients showed a significantly lower ratio of first fixation duration than male controls (Mann-Whitney U = 190, p = 0.028), while it was marginally lower in female patients than female controls (Mann-Whitney U = 77, p = 0.057). The ratio of first fixation duration for pictures of communicating persons vs. no persons was negatively correlated with PANSS negative symptoms in male patients (rho = -0.458, p = 0.024). In contrast, it was negatively correlated with PANSS positive symptoms in female patients (-0.701, p = 0.004). These findings suggest altered attentive bias during social information processing with a pattern of avoidance at first sight towards pictures of communicating persons in schizophrenia. It is worthwhile to note that social functioning impairment is associated with the severity of symptoms.
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Affiliation(s)
- Yikang Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wenzheng Wang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qian Guo
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Shan Chen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Caidi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Paul Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, PR China
| | - Jianhua Sheng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, PR China.
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10
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Abstract
The aim of this study was to explore gender differences in social cognition in a sample of first-episode psychosis (FEP). An observational descriptive study was performed with 191 individuals with FEP. Emotion perception was assessed using the Faces Test, theory of mind was assessed using the Hinting Task, and attributional style was assessed using the Internal, Personal and Situational Attributions Questionnaire. No gender differences were found in any of the social cognitive domains. Our results suggest that men and women with FEP achieve similar performances in social cognition. Therefore, targeting specific needs in social cognition regarding gender may not be required in early interventions for psychosis.
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11
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Firmin RL, Zalzala AB, Hamm JA, Luther L, Lysaker PH. How psychosis interrupts the lives of women and men differently: a qualitative comparison. Psychol Psychother 2021; 94:704-720. [PMID: 33215851 DOI: 10.1111/papt.12317] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 07/15/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Psychosis disrupts how persons experience themselves and their lives. Despite knowledge that gender differences have been noted in presentation and course of psychosis symptoms, little is known about differences in how men and women experience these disruptions. METHOD The narratives of 26 men and 27 women diagnosed with psychosis, matched on age, education, and race, of the impact of psychosis on one's life, were compared. Using secondary data from semi-structured interviews, themes were identified using inductive, phenomenological qualitative analyses. RESULTS Women and men discussed psychosis-related interruptions to the roles and relationships that shape their identity. Both genders discussed the impact of psychosis on their sense of self, work, and relationships. Nuanced gender differences emerged, informing unique areas of challenge related to (1) parenting and loss of parenting roles, (2) work and loss or changes in work trajectories, (3) isolation and strain on interpersonal relationships, and (4) manifestations of stigma. CONCLUSIONS Psychosis may disrupt distinct aspects of life for men and women. Each gender faces the intersection of socially informed expectations that impact one's experiences of stigma, expectations of others, and manifestations of losses felt in one's role and sense of identity. Findings inform important considerations for therapy and other services. PRACTITIONER POINTS Gender-based socialized expectations, losses, and challenges that accompany psychosis are important areas for therapeutic consideration. Current treatments may neglect challenges that are more commonly experienced by women with psychosis.
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Affiliation(s)
- Ruth L Firmin
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, Rhode Island, USA.,Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Aieyat B Zalzala
- Department of Psychiatry, The Institute of the Living at Hartford Hospital, Hartford, Connecticut, USA
| | - Jay A Hamm
- Midtown Community Mental Health Center, Eskenazi Hospital, Indianapolis, Indiana, USA
| | - Lauren Luther
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul H Lysaker
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Roudebush VA Medical Center, Indianapolis, Indiana, USA
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12
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Group and sex differences in social cognition in bipolar disorder, schizophrenia/schizoaffective disorder and healthy people. Compr Psychiatry 2021; 109:152258. [PMID: 34252633 DOI: 10.1016/j.comppsych.2021.152258] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Impairment of social cognition is documented in bipolar disorder (BD) and schizophrenia/schizoaffective disorder (SCH). In healthy individuals, women perform better than men in some of its sub-domains. However, in BD and SCH the results are mixed. Our aim was to compare emotion recognition, affective Theory of Mind (ToM) and first- and second-order cognitive ToM in BD, SCH and healthy subjects, and to investigate sex-related differences. METHODS 120 patients (BD = 60, SCH = 60) and 40 healthy subjects were recruited. Emotion recognition was assessed by the Pictures of Facial Affect (POFA) test, affective ToM by the Reading the Mind in the Eyes Test (RMET) and cognitive ToM by several false-belief stories. Group and sex differences were analyzed using parametric (POFA, RMET) and non-parametric (false-belief stories) tests. The impact of age, intelligence quotient (IQ) and clinical variables on patient performance was examined using a series of linear/logistic regressions. RESULTS Both groups of patients performed worse than healthy subjects on POFA, RMET and second-order false-belief (p < 0.001), but no differences were found between them. Instead, their deficits were related to older age and/or lower IQ (p < 0.01). Subthreshold depression was associated with a 6-fold increased risk of first-order false-belief failure (p < 0.001). Sex differences were only found in healthy subjects, with women outperforming men on POFA and RMET (p ≤ 0.012), but not on first/second-order false-belief. LIMITATIONS The cross-sectional design does not allow for causal inferences. CONCLUSION BD and SCH patients had deficits in emotion recognition, affective ToM, and second-order cognitive ToM, but their performance was comparable to each other, highlighting that the differences between them may be subtler than previously thought. First-order cognitive ToM remained intact, but subthreshold depression altered their normal functioning. Our results suggest that the advantage of healthy women in the emotional and affective aspects of social cognition would not be maintained in BD and SCH.
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13
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Thibaudeau É, Cellard C, Turcotte M, Achim AM. Functional Impairments and Theory of Mind Deficits in Schizophrenia: A Meta-analysis of the Associations. Schizophr Bull 2021; 47:695-711. [PMID: 33433606 PMCID: PMC8084438 DOI: 10.1093/schbul/sbaa182] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Schizophrenia is associated with major functioning difficulties. Theory of mind (ToM), the ability to infer the mental states of others, is an important determinant of functioning. However, the contribution of ToM to each specific domain of functioning remains to be better understood. The objectives of this meta-analysis were to document and compare the magnitude of the associations between ToM and (1) different domains of functioning (social functioning, productive activities, and instrumental activities of daily living), each assessed separately for functional performance and functional outcome and (2) different aspects of functioning (functional performance and functional outcome) in schizophrenia. Fifty-nine studies (N = 4369) published between 1980 and May 2019 targeting patients with schizophrenia or schizoaffective disorder aged between 18 and 65 years old were included. Studies were retrieved from seven databases. Correlations were extracted from the articles, transformed into effect sizes Zr and combined as weighted and unweighted means. The strength of the associations between the domains and aspects of functioning were compared using focused tests. A moderate association was observed between ToM and all domains of functioning, with a stronger association between ToM and productive activities compared with social functioning (only for functional outcome [χ2(2) = 6.43, P = 0.040]). Regarding the different aspects of functioning, a stronger association was observed between ToM and functional performance, compared with functional outcome, for overall functioning (χ2(1) = 13.77, P < 0.001) and social functioning (χ2(1) = 18.21, P < 0.001). The results highlight a stronger association of ToM with productive activities and with functional performance, which should be considered in future studies to improve functional recovery in schizophrenia.
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Affiliation(s)
- Élisabeth Thibaudeau
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,To whom correspondence should be addressed; Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, local 1528, Québec, QC G1V 0A6, Canada; tel: 418-656-2131, e-mail:
| | - Caroline Cellard
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada
| | | | - Amélie M Achim
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,Département de psychiatrie et neurosciences, Université Laval, Québec, Québec, Canada
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14
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Kuis DJ, van de Giessen T, de Jong S, Sportel BE, Boonstra N, van Donkersgoed R, Lysaker PH, Hasson-Ohayon I, Pijnenborg GHM. Empathy and Its Relationship With Social Functioning in Individuals at Ultra-High Risk for Psychosis. Front Psychiatry 2021; 12:730092. [PMID: 34858222 PMCID: PMC8632546 DOI: 10.3389/fpsyt.2021.730092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/21/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Social functioning is often impaired in the ultra-high-risk (UHR) phase of psychosis. There is some evidence that empathy is also impaired in this phase and that these impairments may underlie difficulties in social functioning. The main aim of this study was to investigate whether cognitive and affective empathy are lower in people in the UHR phase of psychosis in comparison to healthy controls, and whether possible impairments have the same magnitude as in people with schizophrenia. A second aim was to examine whether there is a relationship between empathy and social functioning in individuals in the UHR phase. Method: Forty-three individuals at UHR for psychosis, 92 people with a schizophrenia spectrum disorder, and 49 persons without a psychiatric disorder completed the Interpersonal Reactivity Index (IRI), Questionnaire of Cognitive and Affective Empathy (QCAE), and Faux Pas as instruments to measure empathy. The Time Use survey was used to measure social functioning. MAN(C)OVA was used to analyse differences between groups on empathy and social functioning, and correlations were calculated between empathy measures and social functioning for each group. Results: The UHR group presented significantly lower levels of self-reported cognitive empathy than the healthy controls, but not compared to patients with SSD, while performance-based cognitive empathy was unimpaired in the UHR group. On the affective measures, we found that people with UHR and patients with SSD had significantly higher levels of self-reported distress in interpersonal settings compared to healthy controls. In the UHR group, perspective-taking was negatively associated with time spent on structured social activities. In the SSD group, we found that structured social activities were positively associated with perspective-taking and negatively associated with personal distress in interactions with others. Lastly, in people without mental illness, social activities were positively associated with performance-based perspective-taking. Conclusion: Impairments in subjective cognitive empathy appear to be present in the UHR phase, suggesting that difficulties in interpreting the thoughts and feelings of others precede the onset of psychotic disorders. This can inform future interventions in the UHR phase.
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Affiliation(s)
- Daan Jan Kuis
- Geestelijke Gezondheidszorg (GGZ) Drenthe Mental Health Institute, Department of Psychotic Disorders, GGZ Drenthe, Assen, Netherlands
| | - Tara van de Giessen
- Geestelijke Gezondheidszorg (GGZ) Drenthe Mental Health Institute, Department of Psychotic Disorders, GGZ Drenthe, Assen, Netherlands
| | - Steven de Jong
- Lentis Research, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Bouwina Esther Sportel
- Geestelijke Gezondheidszorg (GGZ) Drenthe Mental Health Institute, Department of Psychotic Disorders, GGZ Drenthe, Assen, Netherlands
| | - Nynke Boonstra
- Research Group Care and Innovation in Psychiatry, NHL Stenden University for Applied Sciences, Leeuwarden, Netherlands.,KieN Early Intervention Service, Leeuwarden, Netherlands
| | - Rozanne van Donkersgoed
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences (BSS), University of Groningen, Groningen, Netherlands
| | - Paul H Lysaker
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States
| | | | - Gerdina Hendrika Maria Pijnenborg
- Geestelijke Gezondheidszorg (GGZ) Drenthe Mental Health Institute, Department of Psychotic Disorders, GGZ Drenthe, Assen, Netherlands.,Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences (BSS), University of Groningen, Groningen, Netherlands
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15
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Lysaker PH, Chernov N, Moiseeva T, Sozinova M, Dmitryeva N, Alyoshin V, Kukla M, Wiesepape C, Karpenko O, Kostyuk G. The association of metacognition with emotion recognition and perspective taking in a Russian sample with psychosis. J Clin Psychol 2020; 77:1034-1044. [PMID: 33085987 DOI: 10.1002/jclp.23076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/10/2020] [Accepted: 10/09/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Schizophrenia may reflect an interactive network of disturbances in cognition. In this study we have examined the relationship between two forms of cognition: metacognition and social cognition among a sample with schizophrenia (n = 41), early episode psychosis (n = 37), and major depression (n = 30) gathered in Moscow, Russia. METHODS Metacognition was assessed with the Metacognition Assessment Scale-Abbreviated. Social cognition was assessed with the Ekman 60 Faces Test and the Interpersonal Reactivity Index. Verbal memory and global psychopathology were included as potential covariates. RESULTS Partial correlations controlling for demographics, neurocognition, and psychopathology revealed greater metacognitive capacity was linked to better facial emotion recognition and perspective taking in the prolonged schizophrenia group. Greater metacognitive capacity in the early psychosis group was linked with greater facial emotion recognition. Metacognition and social cognition were not related to one another in the depression group. CONCLUSIONS Social cognition and metacognition may be uniquely related in psychosis.
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Affiliation(s)
- Paul H Lysaker
- Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Nikita Chernov
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Tatyana Moiseeva
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Marta Sozinova
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | | | - Vitaliy Alyoshin
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Marina Kukla
- Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Courtney Wiesepape
- Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Department of Psychology, Indiana State University, Terra Haute, Indiana, USA
| | - Olga Karpenko
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Georgiy Kostyuk
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
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17
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García-Mieres H, Montesano A, Villaplana A, Trujillo A, Salla M, Paz C, Ochoa S, Feixas G. Common and differential dimensions of personal identity between psychosis and depression: The relevance of gender and depressive mood. J Psychiatr Res 2020; 127:48-56. [PMID: 32480046 DOI: 10.1016/j.jpsychires.2020.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/15/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022]
Abstract
Disturbances in personal identity are recognized in psychosis and depression. However, it is unknown whether these disruptions share common processes across clinical groups, or whether there are unique alterations by group or between men and women within each clinical group. To advance on this question, we compared personal identity dimensions in psychosis and depression and investigated the effects of gender and depressive mood. This study assessed dimensions of personal identity using the repertory grid technique among 85 outpatients with psychosis, 85 outpatients with depressive disorders and 85 healthy controls who were matched by age. Data regarding depressive mood and general functioning was also collected. Results showed that self-discrepancies were higher in psychosis and depression than in controls, and were associated with depressive mood. Interpersonal dichotomous thinking was more prevalent in women in both clinical groups. Women with psychosis showed higher ideal-others discrepancy and had a more complex structure of personal identity than their male counterparts. To conclude, alterations in self-ideal and self-others discrepancies may be transdiagnostic dimensions related to depressive mood. Interpersonal dichotomous thinking may also be a common dimensional characteristic in psychosis and depression but more specific to women. Finally, critical views of others and a higher complexity of personal identity may be more specific to women than men with psychosis. Our results are consistent with other studies pointing to the need for person-focused treatments promoting the recovery of a full sense of personal identity, rather than just focusing on specific thoughts and feelings.
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Affiliation(s)
- H García-Mieres
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, The Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
| | - A Montesano
- Department of Psychology and Educational Sciences, Open University of Catalonia, Barcelona, Spain
| | - A Villaplana
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - A Trujillo
- Faculty of Psychology, Universidad El Bosque, Bogotá, Colombia
| | - M Salla
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, The Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain
| | - C Paz
- Clara Paz: School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - S Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
| | - G Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, The Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain
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18
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Etchepare A, Roux S, Destaillats JM, Cady F, Fontanier D, Couhet G, Prouteau A. Éléments de validation du Protocole d’Évaluation de la Cognition Sociale de Bordeaux (PECS-B) en population générale et dans la schizophrénie. ANNALES MEDICO-PSYCHOLOGIQUES 2020. [DOI: 10.1016/j.amp.2018.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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19
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Wang WL, Zhou YQ, Chai NN, Li GH, Liu DW. Mediation and moderation analyses: exploring the complex pathways between hope and quality of life among patients with schizophrenia. BMC Psychiatry 2020; 20:22. [PMID: 31941476 PMCID: PMC6964047 DOI: 10.1186/s12888-020-2436-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the moderated effect of sex in this well-established association. METHODS Two hundred seven patients diagnosed with schizophrenia were administered a questionnaire battery that measured hope, depression, resilience and QOL. A multiple mediation model was used to examine the mediating effect of resilience and depression on the association between hope and QOL. A subgroup analysis was performed and a moderated mediation model was examined to find and test the moderated effect of sex on the mediation model. We used Mplus to perform moderation and mediation analyses so that the mediators and moderator could function together in the same model. RESULT Sex was the moderator on the direct path between hope and QOL. The relationship between hope and QOL was mediated by resilience and depression in both sexes. When compared with female patients, the effect of hope on QOL was completely mediated by resilience and depression in males. In female patients, the model was partially mediated, and the direct effect of hope on QOL was significantly negatively correlated with the level of hope. CONCLUSION We present a conceptual model containing the mediated effects of resilience and depression and the moderated effect of sex between hope and QOL, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve QOL.
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Affiliation(s)
- Wei-Liang Wang
- grid.410736.70000 0001 2204 9268School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang China
| | - Yu-Qiu Zhou
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang, China.
| | - Nan-Nan Chai
- grid.443353.60000 0004 1798 8916School of Nursing, Chifeng University, Chifeng, the Autonomous Region China
| | - Guo-Hua Li
- Chifeng Anding Hospital, Chifeng, the Autonomous Region China
| | - Dong-Wei Liu
- grid.410736.70000 0001 2204 9268School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang China
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20
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Davies G, Greenwood K. A meta-analytic review of the relationship between neurocognition, metacognition and functional outcome in schizophrenia. J Ment Health 2018; 29:496-505. [DOI: 10.1080/09638237.2018.1521930] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Geoff Davies
- Department of Psychology, University of Sussex, Brighton, UK
- R&D Department, Sussex Partnership NHS Foundation Trust, Hove, UK
- University of Surrey, Faculty of Health and Medical Sciences, Surrey, United Kingdom
| | - Kathryn Greenwood
- Department of Psychology, University of Sussex, Brighton, UK
- R&D Department, Sussex Partnership NHS Foundation Trust, Hove, UK
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21
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Walsh-Messinger J, Stepanek C, Wiedemann J, Goetz D, Goetz RR, Malaspina D. Normal sexual dimorphism in theory of mind circuitry is reversed in Schizophrenia. Soc Neurosci 2018; 14:583-593. [PMID: 30373474 DOI: 10.1080/17470919.2018.1536613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The ability to mentalize, or theory of mind (ToM), is sexually dimorphic in humans and impaired in schizophrenia. This sex-stratified study probed cognitive (indexed by intelligence) and affective (indexed by olfactory tasks) contributions to ToM performance in 37 individuals with schizophrenia and 31 healthy controls. The schizophrenia group showed impairments in mental state identification and inferring intentions compared to controls. Higher intelligence was correlated with mental state identification and inferring intentions in healthy females, whereas better smell identification was associated with mental state identification in healthy males. Conversely, higher intelligence was associated with mental state identification and inferring intentions in schizophrenia males, while better smell identification was correlated with mental state identification in schizophrenia females. These findings suggest that for ToM circuitry, the cognitive influences in healthy females and affective influences in healthy males are reversed in schizophrenia and may be displaced to lower circuitries by disease pathology. Symptom associations with emotion and cognition are also dimorphic, plausibly due to similar pathology superimposed on normal sex-specific circuitries. Males appear to rely on limbic processing for ToM, and disruption to this circuitry may contribute to development of negative symptoms. These findings highlight the importance of utilizing sex-stratified designs in schizophrenia research.
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Affiliation(s)
- Julie Walsh-Messinger
- a Department of Psychology, University of Dayton , Dayton , OH , USA.,b Department of Psychiatry, Wright State University Boonshoft School of Medicine , Dayton , OH , USA
| | - Christine Stepanek
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Julia Wiedemann
- a Department of Psychology, University of Dayton , Dayton , OH , USA
| | - Deborah Goetz
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Raymond R Goetz
- d New York State Psychiatric Institute, Columbia University Medical Center , New York , NY , USA
| | - Dolores Malaspina
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Navarra-Ventura G, Fernandez-Gonzalo S, Turon M, Pousa E, Palao D, Cardoner N, Jodar M. Gender Differences in Social Cognition: A Cross-Sectional Pilot Study of Recently Diagnosed Patients with Schizophrenia and Healthy Subjects. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:538-546. [PMID: 29216439 PMCID: PMC6099750 DOI: 10.1177/0706743717746661] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study had 2 objectives: First, to explore the gender-related differences in emotional processing (EP) and theory of mind-both cognitive (CToM) and affective (AToM)-in patients with schizophrenia and in a control group of healthy subjects; and, second, to examine, from a gender perspective, the possible association between EP and CToM in the AToM performance. METHODS Forty patients with schizophrenia/schizoaffective disorder were recruited and matched by gender, age and years of education with 40 healthy subjects. EP was measured by the pictures of facial affect (POFA) test. CToM was measured using first- and second-order false-belief (FB) stories. AToM was measured by the reading the mind in the eyes test (RMET). Group and gender differences in CToM were analysed using the X2 test, whereas EP and AToM were analysed using the non-parametric Mann-Whitney U Test and a general linear model. Results were adjusted by intelligence quotient and negative symptomatology. RESULTS Patients with schizophrenia underperformed against healthy subjects in the POFA test, second-order FB, and RMET, but not in first-order FB. No significant gender differences were found. However, there was a trend showing that females outperformed males in the POFA ( P = 0.056). Group ( P < 0.001), POFA ( P < 0.001) and second-order FB ( P = 0.022) were the best factors predicting RMET performance (adjusted R2 = 0.584). CONCLUSIONS Our results suggest that the illness is the main factor related to the deficit in social cognition, except for the basic aspects of the CToM that were unimpaired in most patients. Nevertheless, the influence of female gender in EP should not be neglected in any group. Finally, the hierarchal interaction between these domains is discussed.
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Affiliation(s)
- Guillem Navarra-Ventura
- 1 Mental Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Parc Taulí, Sabadell, Barcelona, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Sol Fernandez-Gonzalo
- 3 Research Department, Fundació Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Parc Taulí, Sabadell, Barcelona, Spain.,4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain.,5 Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Marc Turon
- 3 Research Department, Fundació Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Parc Taulí, Sabadell, Barcelona, Spain.,6 Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain
| | - Esther Pousa
- 7 Mental Health Department, Hospital del Mar, Institut de Neuropsiquiatria i Addiccions, Universitat Autònoma de Barcelona, Hospital del Mar, Passeig Marítim, Barcelona, Spain
| | - Diego Palao
- 1 Mental Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Parc Taulí, Sabadell, Barcelona, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain
| | - Narcis Cardoner
- 1 Mental Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Parc Taulí, Sabadell, Barcelona, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain
| | - Merce Jodar
- 4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain.,5 Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,8 Neurology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Parc Taulí, Sabadell, Barcelona, Spain
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Davies G, Fowler D, Greenwood K. Metacognition as a Mediating Variable Between Neurocognition and Functional Outcome in First Episode Psychosis. Schizophr Bull 2017; 43:824-832. [PMID: 27590844 PMCID: PMC5472108 DOI: 10.1093/schbul/sbw128] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Neurocognitive and functional outcome deficits have long been acknowledged in schizophrenia and neurocognition has been found to account for functional disability to a greater extent than psychopathology. Much of the variance in functional outcome however still remains unexplained and metacognition may mediate the relationship between neurocognition, functional capacity, and self-reported social and occupational function. METHOD Eighty first episode psychosis participants were recruited and completed measures of neurocognition (memory, executive function, and intelligence quotient), metacognition (Beck Cognitive Insight Scale, Metacognitive Awareness Interview), psychopathology (PANSS), and both functional capacity (UPSA) and real-life social and occupational function (The Time Use Survey). Path analyses investigated the relationships between variables through structural equation modeling. RESULTS A series of path models demonstrated that metacognition partially mediates the relationship between neurocognition and functional capacity, and fully mediates the relationship between functional capacity and social and occupational function. CONCLUSION The present study findings identify that metacognition may be critical to translating cognitive and functional skills into real-world contexts, and this relationship is found at early stages of illness. Understanding how individuals translate cognitive and functional skills into the real-world (the competence-performance gap) may offer valuable guidance to intervention programs. This finding is important to models of recovery as it suggests that intervention programs that focus on enhancing metacognition abilities may have a greater impact than traditional rehabilitation programs focusing on cognitive abilities, on social and occupational outcomes.
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Affiliation(s)
- Geoff Davies
- Department of Psychology, University of Sussex, Falmer, Brighton BN1 9QH, UK;,R&D department, Sussex Partnership NHS Foundation Trust
| | - David Fowler
- Department of Psychology, University of Sussex, Falmer, Brighton BN1 9QH, UK;,R&D department, Sussex Partnership NHS Foundation Trust
| | - Kathryn Greenwood
- Department of Psychology, University of Sussex, Falmer, Brighton BN1 9QH, UK;,R&D department, Sussex Partnership NHS Foundation Trust
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Abstract
Age, race, and sex are linked to social cognitive performance among healthy individuals, but whether similar effects are evident in schizophrenia is unknown. Data from 170 individuals with schizophrenia or schizoaffective disorder and 98 healthy controls were used to examine relations between these demographic factors and performance across multiple domains and measures of social cognition. Sex was not related to performance on any domain, but older age was related to poorer emotion recognition from dynamic stimuli in both patients and controls. In patients, older age was also associated with better abilities to decipher hints. Both Caucasian patients and controls performed better than African American individuals on emotion recognition and mental state attribution tasks that use only Caucasian individuals as visual stimuli. Findings suggest rather limited influences of demographic factors but do demonstrate normative age and race effects among patients. Findings also highlight important methodological considerations for measurement of social cognition.
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25
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Dimitrijević A, Hanak N, Altaras Dimitrijević A, Jolić Marjanović Z. The Mentalization Scale (MentS): A Self-Report Measure for the Assessment of Mentalizing Capacity. J Pers Assess 2017; 100:268-280. [PMID: 28436689 DOI: 10.1080/00223891.2017.1310730] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The psychometric properties of a new 28-item self-report measure of mentalization, the Mentalization Scale (MentS), were examined in 2 studies: with a sample of employed adults and university students (N1 = 288 + 278) and with a sample of persons with borderline personality disorder (BPD) and matched controls (N2 = 62 + 62). Besides the MentS, both studies employed measures of attachment and the Big Five; Study 1 also included assessments of empathy and emotional intelligence. MentS whole-scale internal consistency was good in the community and acceptable in the clinical sample (α = .84 and .75, respectively). A principal components analysis of Study 1 data yielded 3 interpretable factors, or subscales: Self-Related Mentalization (MentS-S), Other-Related Mentalization (MentS-O), and Motivation to Mentalize (MentS-M). These showed acceptable reliabilities (α = .74-.79), except for MentS-M in the clinical sample (α = .60). MentS scores further exhibited a coherent pattern of correlations with cognate constructs and the Big Five, relating positively to empathy, trait and ability emotional intelligence, openness, extraversion, and conscientiousness, and negatively to attachment avoidance and anxiety, and neuroticism. Persons with BPD scored significantly lower on MentS total and MentS-S. The proposed scale is thus deemed suitable for quick, yet meaningful, assessments of mentalization in both individual differences research and clinical contexts.
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Affiliation(s)
- Aleksandar Dimitrijević
- a Department of Psychology , University of Belgrade , Serbia.,b International Psychoanalytic University , Berlin , Germany
| | - Nataša Hanak
- c Faculty of Special Education and Rehabilitation , Unviersity of Belgrade , Serbia
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Deficits of cognitive theory of mind and its relationship with functioning in individuals with an at-risk mental state and first-episode psychosis. Psychiatry Res 2016; 243:318-25. [PMID: 27434201 DOI: 10.1016/j.psychres.2016.06.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/11/2016] [Accepted: 06/26/2016] [Indexed: 01/09/2023]
Abstract
Disturbance of theory of mind (ToM) and its relationship with functioning in schizophrenia is well documented; however, this is unclear in spectrum disorders like at-risk mental state (ARMS) and first-episode psychosis (FEP). To assess mental state reasoning ability, the total score of the Theory of Mind Picture Stories Task questionnaire was compared among 36 Japanese individuals with ARMS, 40 with FEP, and 25 healthy controls (HC). Pearson's correlations between ToM performance and global and social functioning indices were examined. ToM performance for FEP and ARMS subjects was significantly lower than that for HC, though the significance of the difference between the ARMS and HC disappeared when controlling for premorbid IQ. ToM deficits in ARMS subjects were confirmed only in the comprehension of higher-order false belief. Only among FEP subjects were ToM performance and global functioning significantly correlated, though the significance disappeared when controlling for neurocognitive performance or dose of antipsychotics. No significant correlation between ToM performance and social functioning was observed in the FEP and ARMS groups. The current findings suggest that ToM deficits emerge in ARMS subjects confined within a higher-order domain, and that the relationship between ToM impairment and functional deterioration might be established after psychosis onset.
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A systematic review comparing sex differences in cognitive function in schizophrenia and in rodent models for schizophrenia, implications for improved therapeutic strategies. Neurosci Biobehav Rev 2016; 68:979-1000. [DOI: 10.1016/j.neubiorev.2016.06.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 06/11/2016] [Accepted: 06/20/2016] [Indexed: 01/07/2023]
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28
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Sex differences in the effect of childhood trauma on the clinical expression of early psychosis. Compr Psychiatry 2016; 68:86-96. [PMID: 27234188 DOI: 10.1016/j.comppsych.2016.04.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 12/19/2022] Open
Abstract
Childhood trauma, a risk factor of psychosis, is associated the clinical expression of the illness (greater severity of psychotic symptoms; poorer cognitive performance). We aimed to explore whether there are sex differences in this relationship. We studied 79 individuals with a psychotic disorder (PD) with <3years of illness and 59 healthy subjects (HS). All participants were administered the MATRICS Cognitive Consensus Cognitive Battery (MCCB) to assess cognition. Depressive, positive and negative psychotic symptoms, and global functioning were also assessed. History of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Patients reported a greater history of childhood trauma on all CTQ domains (emotional, physical and sexual abuse, and physical and emotional neglect). A poorer cognitive performance was also observed in PD when compared to HS. No sex differences were found in the CTQ scores. In the relationship between childhood trauma and psychopathological symptoms, significant correlations were found between CTQ scores and positive and negative psychotic symptoms, depressive symptoms and poorer functionality, but only in women. Childhood trauma was associated with poorer social cognition in both men and women. Of all CTQ dimensions, emotional neglect and physical neglect were more clearly associated with a more severe psychopathological and cognitive profile. Our results suggest that childhood trauma, particularly emotional and physical neglect, is associated with the clinical expression of psychosis and that there are sex differences in this relationship.
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Mendrek A, Mancini-Marïe A. Sex/gender differences in the brain and cognition in schizophrenia. Neurosci Biobehav Rev 2015; 67:57-78. [PMID: 26743859 DOI: 10.1016/j.neubiorev.2015.10.013] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/17/2015] [Accepted: 10/26/2015] [Indexed: 01/03/2023]
Abstract
The early conceptualizations of schizophrenia have noted some sex/gender differences in epidemiology and clinical expression of the disorder. Over the past few decades, the interest in differences between male and female patients has expanded to encompass brain morphology and neurocognitive function. Despite some variability and methodological shortcomings, a few patterns emerge from the available literature. Most studies of gross neuroanatomy show more enlarged ventricles and smaller frontal lobes in men than in women with schizophrenia; finding reflecting normal sexual dimorphism. In comparison, studies of brain asymmetry and specific corticolimbic structures, suggest a disturbance in normal sexual dimorphism. The neurocognitive findings are somewhat consistent with this picture. Studies of cognitive functions mediated by the lateral frontal network tend to show sex differences in patients which are in the same direction as those observed in the general population, whereas studies of processes mediated by the corticolimbic system more frequently reveal reversal of normal sexual dimorphisms. These trends are faint and future research would need to delineate neurocognitive differences between men and women with various subtypes of schizophrenia (e.g., early versus late onset), while taking into consideration hormonal status and gender of tested participants.
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Affiliation(s)
- Adrianna Mendrek
- Department of Psychology, Bishop's University, Sherbrooke, QC, Canada; Department of Psychiatry, Université de Montréal, Montreal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Adham Mancini-Marïe
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada; Department of Psychiatry, Centre neuchâtelois de psychiatrie, Neuchâtel, Suisse
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30
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Vaskinn A, Antonsen BT, Fretland RA, Dziobek I, Sundet K, Wilberg T. Theory of mind in women with borderline personality disorder or schizophrenia: differences in overall ability and error patterns. Front Psychol 2015; 6:1239. [PMID: 26379577 PMCID: PMC4547009 DOI: 10.3389/fpsyg.2015.01239] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 08/04/2015] [Indexed: 11/13/2022] Open
Abstract
Although borderline personality disorder (BPD) and schizophrenia (SZ) are notably different mental disorders, they share problems in social cognition-or understanding the feelings, intentions and thoughts of other people. To date no studies have directly compared the social cognitive abilities of individuals with these two disorders. In this study, the social cognitive subdomain theory of mind was investigated in women with BPD (n = 25), women with SZ (n = 25) and healthy women (n = 25). An ecologically valid video-based measure (Movie for the Assessment of Social Cognition) was used. For the overall score, women with SZ performed markedly below both healthy women and women with BPD, whereas women with BPD did not perform significantly different compared to the healthy control group. A statistically significant error type × group interaction effect indicated that the groups differed with respect to kind of errors. Whereas women with BPD made mostly overmentalizing errors, women with SZ in addition committed undermentalizing errors. Our study suggests different magnitude and pattern of social cognitive problems in BPD and SZ.
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Affiliation(s)
- Anja Vaskinn
- Department of Psychology, University of Oslo , Oslo, Norway ; NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital , Oslo, Norway
| | - Bjørnar T Antonsen
- Institute for Clinical Medicine, University of Oslo , Oslo, Norway ; Department of Personality Psychiatry, Clinic of Mental Health and Addiction, Oslo University Hospital , Oslo, Norway
| | - Ragnhild A Fretland
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital , Oslo, Norway
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt University Berlin , Berlin, Germany
| | - Kjetil Sundet
- Department of Psychology, University of Oslo , Oslo, Norway ; NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital , Oslo, Norway
| | - Theresa Wilberg
- Department of Research and Development, Clinic of Mental Health and Addiction, Oslo University Hospital , Oslo, Norway
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31
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Abstract
Early formulations of schizophrenia suggested that the disorder involves a loss of ability to form integrated ideas about oneself, others, and the world, resulting in reductions in complex goal-directed behaviors. Exploring this position, the current review describes evidence that persons with schizophrenia experience decrements in their ability to form complex ideas about themselves and to ultimately use that knowledge to respond to psychological and social challenges. Studies are detailed that find greater levels of these impairments, defined as metacognitive deficits, in persons with schizophrenia in both early and later phases of illness as compared with other clinical and community groups. Furthermore, studies linking metacognitive deficits with poorer psychosocial functioning and other variables closely linked to outcomes are summarized. Clinical implications are also discussed.
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32
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Mokkonen M, Crespi BJ. Genomic conflicts and sexual antagonism in human health: insights from oxytocin and testosterone. Evol Appl 2015; 8:307-25. [PMID: 25926877 PMCID: PMC4408143 DOI: 10.1111/eva.12244] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 12/19/2022] Open
Abstract
We review the hypothesized and observed effects of two of the major forms of genomic conflicts, genomic imprinting and sexual antagonism, on human health. We focus on phenotypes mediated by peptide and steroid hormones (especially oxytocin and testosterone) because such hormones centrally mediate patterns of physical and behavioral resource allocation that underlie both forms of conflict. In early development, a suite of imprinted genes modulates the human oxytocinergic system as predicted from theory, with paternally inherited gene expression associated with higher oxytocin production, and increased solicitation to mothers by infants. This system is predicted to impact health through the incompatibility of paternal-gene and maternal-gene optima and increased vulnerability of imprinted gene systems to genetic and epigenetic changes. Early alterations to oxytocinergic systems have long-term negative impacts on human psychological health, especially through their effects on attachment and social behavior. In contrast to genomic imprinting, which generates maladaptation along an axis of mother–infant attachment, sexual antagonism is predicted from theory to generate maladaptation along an axis of sexual dimorphism, modulated by steroid and peptide hormones. We describe evidence of sexual antagonism from studies of humans and other animals, demonstrating that sexually antagonistic effects on sex-dimorphic phenotypes, including aspects of immunity, life history, psychology, and behavior, are commonly observed and lead to forms of maladaptation that are demonstrated, or expected, to impact human health. Recent epidemiological and psychiatric studies of schizophrenia in particular indicate that it is mediated, in part, by sexually antagonistic alleles. The primary implication of this review is that data collection focused on (i) effects of imprinted genes that modulate the oxytocin system, and (ii) effects of sexually antagonistic alleles on sex-dimorphic, disease-related phenotypes will lead to novel insights into both human health and the evolutionary dynamics of genomic conflicts.
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Affiliation(s)
- Mikael Mokkonen
- Department of Biological Sciences, Simon Fraser University Burnaby, BC, Canada ; Department of Biological and Environmental Science, University of Jyväskylä Jyväskylä, Finland
| | - Bernard J Crespi
- Department of Biological Sciences, Simon Fraser University Burnaby, BC, Canada
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Abu-Akel A, Fischer-Shofty M, Levkovitz Y, Decety J, Shamay-Tsoory S. The role of oxytocin in empathy to the pain of conflictual out-group members among patients with schizophrenia. Psychol Med 2014; 44:3523-3532. [PMID: 25065955 DOI: 10.1017/s003329171400097x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oxytocin (OT) is associated with our ability to empathize and has been shown to play a major role in mediating social behaviors within the context of intergroup dynamics. Schizophrenia is associated with impaired empathy, and with a dysfunctional oxytocinergic system. The effect of OT on the empathic responses of patients with schizophrenia within the context of intergroup relationships has not been studied. The present study examined the effect of OT on the patients' empathic responses to pain experienced by in-group, conflictual out-group and neutral out-group members. METHOD In a double-blind, placebo-controlled, within-subject cross-over design, the responses on the Pain Evaluation Task of 28 male patients with schizophrenia were compared to 27 healthy male controls. All participants received a single intranasal dose of 24 IU OT or placebo, 1 week apart. RESULTS OT induced an empathy bias in the healthy controls towards the conflictual out-group members. Although this effect was absent in the patient group, OT seems to heighten an empathic bias in the patient group towards the in-group members when rating non-painful stimuli. CONCLUSIONS The study demonstrates that the administration of OT can result in empathic bias towards adversary out-group members in healthy controls but not in patients with schizophrenia. However, the OT-induced bias in both the patients (in the no-pain condition towards the in-group members) and the healthy controls (in the no-pain and pain conditions towards the adversary out-group) suggests that OT enhances the distinction between conflictual in-group and out-group members.
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Affiliation(s)
- A Abu-Akel
- School of Psychology,University of Birmingham,UK
| | | | - Y Levkovitz
- The Emotion-Cognition Research Center,Shalvata Mental Health Care Center,Hod-Hasharon,Israel
| | - J Decety
- Department of Psychology,University of Chicago,USA
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Fogley R, Warman D, Lysaker PH. Alexithymia in schizophrenia: associations with neurocognition and emotional distress. Psychiatry Res 2014; 218:1-6. [PMID: 24794152 DOI: 10.1016/j.psychres.2014.04.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 02/18/2014] [Accepted: 04/07/2014] [Indexed: 11/27/2022]
Abstract
While alexithymia, or difficulties identifying and describing affect, has been commonly observed in schizophrenia, little is known about its causes and correlates. To test the hypothesis that deficits in emotion identification and expression result from, or are at least related to, deficits in neurocognition and affective symptoms, we assessed alexithymia using the Toronto Alexithymia Scale (TAS-20), symptoms using the Positive and Negative Syndrome Scale (PANSS), and neurocognition using the MATRICS battery among 65 adults with schizophrenia spectrum disorders in a non-acute phase of illness. Partial correlations controlling for the effects of social desirability revealed that difficulty identifying feelings and externally oriented thinking were linked with greater levels of neurocognitive deficits, while difficulty describing feelings was related to heightened levels of emotional distress. To explore whether neurocognition and affective symptoms were uniquely related to alexithymia, a multiple regression was conducted in which neurocognitive scores and affective symptoms were allowed to enter to predict overall levels of alexithymia after controlling for social desirability. Results revealed both processing speed and anxiety uniquely contributed to the prediction of the total score on the TAS-20. Results suggest that dysfunctions in both cognitive and affective processes may be related to alexithymia in schizophrenia independently of one another.
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Affiliation(s)
- Rebecca Fogley
- University of Indianapolis, School of Psychological Sciences, Indianapolis, IN, USA
| | - Debbie Warman
- University of Indianapolis, School of Psychological Sciences, Indianapolis, IN, USA
| | - Paul H Lysaker
- Roudebush VA Medical Center, Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA.
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35
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Remberk B, Bażyńska AK, Krempa-Kowalewska A, Rybakowski F. Adolescent insanity revisited: course and outcome in early-onset schizophrenia spectrum psychoses in an 8-year follow-up study. Compr Psychiatry 2014; 55:1174-81. [PMID: 24794640 DOI: 10.1016/j.comppsych.2014.03.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/22/2014] [Accepted: 03/25/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Despite inclusion of adolescent insanity-a concept proposed by Thomas Clouston in late XIX century-into the broader nosological entity of dementia praecox, the uniqueness of early psychosis is still discussed. The aim of the current study is the assessment of course and outcome in the large sample of early-onset psychosis subjects. METHOD Of 299 patients hospitalized in the period 1998-2008 in an adolescent psychiatry ward with schizophrenia spectrum diagnosis 158 completed a follow-up interview. Data concerning current diagnosis, further admissions, current treatment status and occupational and relationship outcome were analyzed after a mean of 8 years of follow-up. RESULTS Mean age at the index admission and the follow-up was 16.6 ± 1.2 and 24.5 ± 3.0 years respectively. After the subsequent discharge almost all subjects (97%) at least briefly continued psychiatric treatment and 75% of patients had been readmitted. Overall diagnostic stability was 42%. For schizophrenia spectrum disorders and schizophrenia diagnostic stability was 72% and 78%, respectively. At the follow-up assessment 119 (77.3%) of the traced subjects declared current psychiatric treatment and 110 (73.3%) were receiving pharmacotherapy. Almost half of the subjects (48%) were employed or studying and more than a third (35.8%) remained in a stable relationship. Different distributions of baseline diagnoses were observed in males and females, and the latter showed a better outcome. CONCLUSION Early-onset psychoses were characterized by limited diagnostic stability, a necessity for further treatment and hospitalizations and significant percentage of unfavorable functional outcomes. Baseline diagnosis of acute and transient psychotic disorders and female gender were associated with an overall better outcome.
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Affiliation(s)
- Barbara Remberk
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland.
| | - Anna Katarzyna Bażyńska
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland.
| | | | - Filip Rybakowski
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland; University of Social Sciences and Humanities, ul. Kutrzeby 10, Poznan, Poland.
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36
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Miralles C, Alonso Y, Verge B, Setó S, Gaviria AM, Moreno L, Cortés MJ, Gutiérrez-Zotes A, Vilella E, Martorell L. Personality dimensions of schizophrenia patients compared to control subjects by gender and the relationship with illness severity. BMC Psychiatry 2014; 14:151. [PMID: 24884428 PMCID: PMC4039307 DOI: 10.1186/1471-244x-14-151] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 05/16/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Personality traits and schizophrenia present gender differences; however, gender has not been considered in most studies on personality and schizophrenia. This study aims to identify the different personality dimensions of schizophrenia patients and healthy control subjects by gender and to explore the relationship between personality dimensions and illness severity variables by analyzing data for males and females separately. METHODS Temperament and Character Inventory-Revised dimensions were compared by gender between 161 schizophrenia patients and 214 healthy controls from a population-based sample using independent t-tests. We then investigated whether personality dimensions are related to illness severity variables using correlation analyses and bivariate logistic regression, also by gender. RESULTS The patients had significantly higher scores for harm avoidance (HA) and self-transcendence (ST) and lower scores for reward dependence (RD), cooperativeness (C), and self-directedness (SD) than the controls. Similar results were obtained when the sample was stratified by gender, however the differences were higher and more significant for HA among males and for RD among females. The number of admissions to a psychiatric hospital positively correlated with novelty seeking (NS) in males and negatively with SD in females. In males, SD and ST negatively correlated with the number of suicide attempts. CONCLUSIONS Male and female patients present difficulties for regulating and adapting behavior to achieve goals (SD) and for identifying and accepting others (C), as well as a great sense of spirituality and universe identification (ST). However, male patients are more characterized by being fearful, doubtful and easily fatigued (HA), while female patients are characterized by presenting difficulties maintaining and pursuing associated reward behaviors (RD). Furthermore, male and female patients who are frequently admitted to psychiatric hospitals and male patients who attempt suicide should be evaluated regarding their personality dimensions. Future studies assessing the relationship between personality dimensions and the clinical features of schizophrenia should consider gender differences.
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Affiliation(s)
- Carmen Miralles
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Yolanda Alonso
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Begoña Verge
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Sònia Setó
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Ana M Gaviria
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Lorena Moreno
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - María J Cortés
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Alfonso Gutiérrez-Zotes
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Elisabet Vilella
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
| | - Lourdes Martorell
- Unitat de Psiquiatria, Hospital Universitari Psiquiàtric Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, C/ SantLlorenç, 21, 43201 Reus, Spain
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