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Duggirala SX, Schwartze M, Goller LK, Linden DEJ, Pinheiro AP, Kotz SA. Hallucination Proneness Alters Sensory Feedback Processing in Self-voice Production. Schizophr Bull 2024; 50:1147-1158. [PMID: 38824450 PMCID: PMC11349023 DOI: 10.1093/schbul/sbae095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
BACKGROUND Sensory suppression occurs when hearing one's self-generated voice, as opposed to passively listening to one's own voice. Quality changes in sensory feedback to the self-generated voice can increase attentional control. These changes affect the self-other voice distinction and might lead to hearing voices in the absence of an external source (ie, auditory verbal hallucinations). However, it is unclear how changes in sensory feedback processing and attention allocation interact and how this interaction might relate to hallucination proneness (HP). STUDY DESIGN Participants varying in HP self-generated (via a button-press) and passively listened to their voice that varied in emotional quality and certainty of recognition-100% neutral, 60%-40% neutral-angry, 50%-50% neutral-angry, 40%-60% neutral-angry, 100% angry, during electroencephalography (EEG) recordings. STUDY RESULTS The N1 auditory evoked potential was more suppressed for self-generated than externally generated voices. Increased HP was associated with (1) an increased N1 response to the self- compared with externally generated voices, (2) a reduced N1 response for angry compared with neutral voices, and (3) a reduced N2 response to unexpected voice quality in sensory feedback (60%-40% neutral-angry) compared with neutral voices. CONCLUSIONS The current study highlights an association between increased HP and systematic changes in the emotional quality and certainty in sensory feedback processing (N1) and attentional control (N2) in self-voice production in a nonclinical population. Considering that voice hearers also display these changes, these findings support the continuum hypothesis.
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Affiliation(s)
- Suvarnalata Xanthate Duggirala
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health and Medical Sciences, Maastricht University, Maastricht, Netherlands
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Lisa K Goller
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - David E J Linden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health and Medical Sciences, Maastricht University, Maastricht, Netherlands
- Maastricht University Medical Center, Maastricht, Netherlands
| | - Ana P Pinheiro
- Department of Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
| | - Sonja A Kotz
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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2
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Poletti M, Raballo A. Ontogenesis of self-disorders in the schizophrenia spectrum: A phenomenological neuro-developmental model. Schizophr Res 2024; 272:26-35. [PMID: 39181008 DOI: 10.1016/j.schres.2024.08.007] [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: 03/28/2024] [Revised: 06/28/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
The concept of basic Self-disorders (SD) captures the experiential aspects associated with vulnerability to schizophrenia spectrum disorders (SSD). SD emerge prior to, and constitute the underlying structure for, the emergence of major diagnostic symptoms, including positive psychotic ones. SD are also detectable in populations with familial risk for SSD. This paper proposes a two-stage phenomenological-developmental model, exploring the early deficit in multisensory integration and their impact on the ontogeny of the Minimal Self in the first years of life. It also examines subsequent emergence of schizotaxic vulnerability, which later manifests as typical anomalies of subjectivity, such as basic symptoms and self-disorders.
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Affiliation(s)
- Michele Poletti
- Department of Mental Health and Pathological Addiction, Child and Adolescent Neuropsychiatry Service, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Raballo
- Chair of Psychiatry, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Cantonal Sociopsychiatric Organisation, Public Health Division, Department of Health and Social Care, Repubblica e Cantone Ticino, Mendrisio, Switzerland.
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3
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Rimvall MK, Rask CU, Jensen JS, Olsen EM, Clemmensen L, Skovgaard AM, Verhulst F, van Os J, Jeppesen P. Exploring the interplay between psychotic experiences, functional somatic symptoms and health anxiety in childhood and adolescence - A longitudinal cohort study. Schizophr Res 2024; 267:322-329. [PMID: 38613863 DOI: 10.1016/j.schres.2024.03.028] [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: 10/04/2023] [Revised: 02/20/2024] [Accepted: 03/18/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Similarities exist between contemporary explanatory models underlying psychosis development, functional somatic symptoms, and health anxiety. The current study aimed to examine the potential interplay between psychotic experiences (and alternate measures of anomalous self-experiences and aberrant attribution of salience) and functional somatic symptoms on the outcome of health anxiety in youths. METHODS In a prospective general-population birth cohort, the Copenhagen Child Cohort 2000 (CCC2000), data from two time-points were available for 1122 individuals. We assessed the associations between psychotic experiences and functional somatic symptoms with health anxiety both cross-sectionally at ages 11- and 16-years, and longitudinally from age 11 to 16. Further, we examined if there was an interaction between these two domains on the outcome of health anxiety using the interaction contrast ratio. RESULTS Functional somatic symptoms and psychotic experiences were strongly cross-sectionally associated with health anxiety at both ages 11 and 16, even after adjustment for general psychopathology. In the longitudinal analyses, functional somatic symptoms, and psychotic experiences at age 11 were not individually associated with health anxiety at age 16 but having both functional somatic symptoms and psychotic experiences was: odds ratio 3.90, 95%CI 1.7-8.9, with suggestion of evidence for interaction beyond the additive effects. This association was attenuated after adjustment for general psychopathology: odds ratio 2.6, 95 % CI 1.0-6.4. CONCLUSION The strong associations between the domains support the idea of possible overlapping mechanisms underlying psychotic experiences, functional somatic symptoms, and health anxiety.
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Affiliation(s)
- Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Charlotte Ulrikka Rask
- Aarhus University Hospital Psychiatry, Department of Child and Adolescent Psychiatry, Research Unit, Aarhus, Denmark; Aarhus University, Department of Clinical Medicine, Aarhus, Denmark
| | - Jens Søndergaard Jensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Else Marie Olsen
- Psychiatric Center Ballerup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Clinical Research and Prevention, the Capital Region of Denmark, Denmark
| | - Lars Clemmensen
- VIRTU Research Group, Copenhagen Research Center on Mental Health (CORE), Copenhagen University Hospital, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
| | - Frank Verhulst
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Child Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jim van Os
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| | - Pia Jeppesen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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4
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Rask CU, Duholm CS, Poulsen CM, Rimvall MK, Wright KD. Annual Research Review: Health anxiety in children and adolescents-developmental aspects and cross-generational influences. J Child Psychol Psychiatry 2024; 65:413-430. [PMID: 37909255 DOI: 10.1111/jcpp.13912] [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] [Accepted: 09/14/2023] [Indexed: 11/03/2023]
Abstract
Health anxiety involves excessive worries about one's health along with beliefs one has an illness or may contract a serious disease. Concerning evidence suggests that health anxiety is on the rise in society, possibly further fueled by the COVID-19 pandemic. Recent classification systems acknowledge that impairing health-related worries and beliefs can emerge in early childhood with significant levels of symptoms persisting throughout childhood, and possibly continuous with diagnostic considerations in adulthood. This narrative review summarizes recent research advances in health anxiety in children and adolescents, focusing on various developmental aspects of health anxiety and related concepts in youths. Findings suggest that health anxiety symptoms in young age groups are associated with impairment, distress, and increased healthcare use, as well as substantial comorbidity with mainly other emotional problems and disorders. Furthermore, longitudinal studies suggest that childhood health anxiety can persist across adolescence, perhaps with links to chronic courses in adulthood. The growing literature was further reviewed, thus extending our understanding of early risk factors, including the potential role of exposure to serious illness and transgenerational transmission of health anxiety. Learning more about developmental trajectories will be highly relevant to inform strategies for early detection and prevention. While modified cognitive behavioral therapies in adults are successful in treating health anxiety, specific interventions have not yet been tested in youths. Given substantial overlaps with other psychopathology, it could be important to develop and explore more transdiagnostic and scalable approaches that take advantage of common factors in psychotherapy, while also including a wider perspective on potential familiar maladaptive illness cognitions and behaviors.
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Affiliation(s)
- Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Charlotte Steen Duholm
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Kristi D Wright
- Department of Psychology, University of Regina, Regina, SK, Canada
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5
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Feyaerts J, Sass L. Self-Disorder in Schizophrenia: A Revised View (1. Comprehensive Review-Dualities of Self- and World-Experience). Schizophr Bull 2024; 50:460-471. [PMID: 38069912 PMCID: PMC10919772 DOI: 10.1093/schbul/sbad169] [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] [Indexed: 03/09/2024]
Abstract
A growing body of research supports the role of self-disorders as core phenotypic features of schizophrenia-spectrum disorders. Self-disorders comprise various alterations of conscious experience whose theoretical understanding continues to present a challenge. The following 2 articles aim to provide further clarification of the nature of self-disorders in schizophrenia by offering a comprehensive review (article 1) and theoretical revision (article 2) of the currently most influential model of altered selfhood in schizophrenia: the basic-self-disturbance or ipseity-disorder model (IDM). This article presents a state-of-the-art overview of the current self-disturbance model and critically assesses its descriptive adequacy with respect to the clinical variability and heterogeneity of the alterations in self- and world-awareness characteristic of schizophrenia. Special attention is paid to experiences of exaggerated basic self, increased "grip" or "hold" on the world, and paradoxical combinations. The next article proposes a theoretical revision of the self-disturbance model by considering how hyperreflexivity might form the crucial common thread or generating factor that unifies the phenomenologically heterogeneous, and sometimes even contradictory features of schizophrenic self-disorders. We outline the implications of our revised model for explanatory research, therapeutic practice, and our general understanding of the abnormalities in question.
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Affiliation(s)
- Jasper Feyaerts
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Louis Sass
- Department of Psychoanalysis and Clinical Consulting, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, USA
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6
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Gawęda Ł, Kowalski J, Aleksandrowicz A, Bagrowska P, Dąbkowska M, Pionke-Ubych R. A systematic review of performance-based assessment studies on cognitive biases in schizophrenia spectrum psychoses and clinical high-risk states: A summary of 40 years of research. Clin Psychol Rev 2024; 108:102391. [PMID: 38301343 DOI: 10.1016/j.cpr.2024.102391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 02/03/2024]
Abstract
Cognitive models of psychosis have stimulated empirical studies on cognitive biases involved in schizophrenia spectrum psychoses and their symptoms. This systematic review aimed to summarize the studies on the role of cognitive biases as assessed in different performance-based tasks in schizophrenia spectrum psychoses and clinical high-risk states. We focused on five cognitive biases linked to psychosis, i.e., aberrant salience, attentional biases, source monitoring biases, jumping to conclusions, and bias against disconfirmatory evidence. We identified N = 324 studies published in N = 308 articles fulfilling inclusion criteria. Most studies have been cross-sectional and confirmed that the schizophrenia spectrum psychoses are related to exaggerated cognitive biases compared to healthy controls. On the contrary, less evidence suggests a higher tendency for cognitive biases in the UHR sample. The only exceptions were source monitoring and jumping to conclusions, which were confirmed to be exaggerated in both clinical groups. Hallucinations and delusions were the most frequent symptoms studied in the context of cognitive biases. Based on the findings, we presented a hypothetical model on the role of interactions between cognitive biases or additive effects of biases in shaping the risk of psychosis. Future research is warranted for further development of cognitive models for psychosis.
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Affiliation(s)
- Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Joachim Kowalski
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Adrianna Aleksandrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Paulina Bagrowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Małgorzata Dąbkowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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7
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Krcmar M, Wannan CMJ, Lavoie S, Allott K, Davey CG, Yuen HP, Whitford T, Formica M, Youn S, Shetty J, Beedham R, Rayner V, Murray G, Polari A, Gawęda Ł, Koren D, Sass L, Parnas J, Rasmussen AR, McGorry P, Hartmann JA, Nelson B. The self, neuroscience and psychosis study: Testing a neurophenomenological model of the onset of psychosis. Early Interv Psychiatry 2024; 18:153-164. [PMID: 37394278 DOI: 10.1111/eip.13448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/17/2023] [Accepted: 06/07/2023] [Indexed: 07/04/2023]
Abstract
AIM Basic self disturbance is a putative core vulnerability marker of schizophrenia spectrum disorders. The primary aims of the Self, Neuroscience and Psychosis (SNAP) study are to: (1) empirically test a previously described neurophenomenological self-disturbance model of psychosis by examining the relationship between specific clinical, neurocognitive, and neurophysiological variables in UHR patients, and (2) develop a prediction model using these neurophenomenological disturbances for persistence or deterioration of UHR symptoms at 12-month follow-up. METHODS SNAP is a longitudinal observational study. Participants include 400 UHR individuals, 100 clinical controls with no attenuated psychotic symptoms, and 50 healthy controls. All participants complete baseline clinical and neurocognitive assessments and electroencephalography. The UHR sample are followed up for a total of 24 months, with clinical assessment completed every 6 months. RESULTS This paper presents the protocol of the SNAP study, including background rationale, aims and hypotheses, design, and assessment procedures. CONCLUSIONS The SNAP study will test whether neurophenomenological disturbances associated with basic self-disturbance predict persistence or intensification of UHR symptomatology over a 2-year follow up period, and how specific these disturbances are to a clinical population with attenuated psychotic symptoms. This may ultimately inform clinical care and pathoaetiological models of psychosis.
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Affiliation(s)
- Marija Krcmar
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Cassandra M J Wannan
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Suzie Lavoie
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly Allott
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher G Davey
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Thomas Whitford
- School of Psychology, University of New South Wales (UNSW), Kensington, New South Wales, Australia
| | - Melanie Formica
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Youn
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jashmina Shetty
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Beedham
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Victoria Rayner
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Graham Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Andrea Polari
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Dan Koren
- Psychology Department, University of Haifa, Haifa, Israel
| | - Louis Sass
- Department of Clinical Psychology, GSAPP-Rutgers University, Piscataway, New Jersey, USA
| | - Josef Parnas
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark
| | - Andreas R Rasmussen
- Orygen, Parkville, Parkville, Victoria, Australia
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Patrick McGorry
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica A Hartmann
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Barnaby Nelson
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
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8
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Strachan LP, Paulik G, Preece DA, McEvoy PM. Pathways from trauma to unusual perceptual experiences: Modelling the roles of insecure attachment, negative affect, emotion regulation and dissociation. Psychol Psychother 2023; 96:934-951. [PMID: 37493351 DOI: 10.1111/papt.12486] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND A range of traumas have been linked to voices (auditory verbal hallucinations) and unusual perceptual experiences (UPEs) in other perceptual-sensory domains. Models of PTSD and positive symptoms of psychosis are insufficient in explaining the relationship between trauma and voices. The trauma-related voices (TRV) model was developed to generate novel research in this area. AIMS This study aimed to investigate pathways from trauma to the frequency of UPEs based on a subset of hypothesised relationships in the TRV model. MATERIALS The PTSD Diagnostic Scale for DSM-5, State Adult Attachment Measure, Depression Anxiety and Stress Scales-21, Perth Emotion and Regulation Competency Inventory, Dissociative Experiences Measure Oxford, and Multi-modality Unusual Perceptual Experiences Questionnaire. METHODS We used path analysis in a non-clinical sample (N = 528) to model indirect effects from diverse trauma experiences to the frequency of multi-sensory UPEs via a subset of mediators within the TRV model: insecure attachment, emotion regulation deficits, negative affect and dissociation. RESULTS Our model was an excellent fit to the data and accounted for 37.1% of variance in UPE frequency, and all direct (βs = .14-.61) and indirect pathways (βs = .01-.08) were significant (ps < .001). DISCUSSION Our findings suggest that insecure attachment may link diverse trauma experiences to emotion regulation deficits and negative affect, which are linked to UPE frequency via dissociation. CONCLUSION Our findings provide preliminary evidence for a subset of relationships within the TRV model. Future studies are needed to gather stronger evidence of temporality and causation between these factors, and to test broader pathways within the TRV model.
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Affiliation(s)
- Laura P Strachan
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Georgie Paulik
- School of Psychology, Murdoch University, Perth, Western Australia, Australia
- Perth Voices Clinic, Perth, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - David A Preece
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Peter M McEvoy
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
- Centre for Clinical Interventions, Perth, Western Australia, Australia
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Hasan SM, Huq MS, Chowdury AZ, Baajour S, Kopchick J, Robison AJ, Thakkar KN, Haddad L, Amirsadri A, Thomas P, Khatib D, Rajan U, Stanley JA, Diwadkar VA. Learning without contingencies: A loss of synergy between memory and reward circuits in schizophrenia. Schizophr Res 2023; 258:21-35. [PMID: 37467677 PMCID: PMC10521382 DOI: 10.1016/j.schres.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 02/09/2023] [Accepted: 06/11/2023] [Indexed: 07/21/2023]
Abstract
Motivational deficits in schizophrenia may interact with foundational cognitive processes including learning and memory to induce impaired cognitive proficiency. If such a loss of synergy exists, it is likely to be underpinned by a loss of synchrony between the brains learning and reward sub-networks. Moreover, this loss should be observed even during tasks devoid of explicit reward contingencies given that such tasks are better models of real world performance than those with artificial contingencies. Here we applied undirected functional connectivity (uFC) analyses to fMRI data acquired while participants engaged in an associative learning task without contingencies or feedback. uFC was estimated and inter-group differences (between schizophrenia patients and controls, n = 54 total, n = 28 patients) were assessed within and between reward (VTA and NAcc) and learning/memory (Basal Ganglia, DPFC, Hippocampus, Parahippocampus, Occipital Lobe) sub-networks. The task paradigm itself alternated between Encoding, Consolidation, and Retrieval conditions, and uFC differences were quantified for each of the conditions. Significantly reduced uFC dominated the connectivity profiles of patients across all conditions. More pertinent to our motivations, these reductions were observed within and across classes of sub-networks (reward-related and learning/memory related). We suggest that disrupted functional connectivity between reward and learning sub-networks may drive many of the performance deficits that characterize schizophrenia. Thus, cognitive deficits in schizophrenia may in fact be underpinned by a loss of synergy between reward-sensitivity and cognitive processes.
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Affiliation(s)
- Sazid M Hasan
- Oakland University William Beaumont School of Medicine, USA
| | - Munajj S Huq
- Michigan State University, College of Osteopathic Medicine, USA
| | - Asadur Z Chowdury
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - Shahira Baajour
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - John Kopchick
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - A J Robison
- Dept. of Physiology, Michigan State University, USA
| | | | - Luay Haddad
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - Alireza Amirsadri
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - Patricia Thomas
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - Dalal Khatib
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - Usha Rajan
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - Jeffrey A Stanley
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA
| | - Vaibhav A Diwadkar
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, USA.
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10
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Chen EYH, Wong SMY, Tang EYH, Lei LKS, Suen YN, Hui CLM. Spurious Autobiographical Memory of Psychosis: A Mechanistic Hypothesis for the Resolution, Persistence, and Recurrence of Positive Symptoms in Psychotic Disorders. Brain Sci 2023; 13:1069. [PMID: 37509001 PMCID: PMC10376952 DOI: 10.3390/brainsci13071069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Psychotic disorders are complex disorders with multiple etiologies. While increased dopamine synthesis capacity has been proposed to underlie psychotic episodes, dopamine-independent processes are also involved (less responsive to dopamine receptor-blocking medications). The underlying mechanism(s) of the reduction in antipsychotic responsiveness over time, especially after repeated relapses, remain unclear. Despite the consistent evidence of dopamine overactivity and hippocampal volume loss in schizophrenia, few accounts have been provided based on the interactive effect of dopamine on hippocampal synapse plasticity mediating autobiographical memory processes. The present hypothesis builds upon previous works showing the potential effects of dopamine overactivity on hippocampal-mediated neuroplasticity underlying autobiographical memory, alongside known patterns of autobiographical memory dysfunction in psychosis. We propose that spurious autobiographical memory of psychosis (SAMP) produced during active psychosis may be a key mechanism mediating relapses and treatment non-responsiveness. In a hyperdopaminergic state, SAMP is expected to be generated at an increased rate during active psychosis. Similar to other memories, it will undergo assimilation, accommodation, and extinction processes. However, if SAMP fails to integrate with existing memory, a discontinuity in autobiographical memory may result. Inadequate exposure to normalizing experiences and hyposalience due to overmedication or negative symptoms may also impede the resolution of SAMP. Residual SAMP is hypothesized to increase the propensity for relapse and treatment non-responsiveness. Based on recent findings on the role of dopamine in facilitating hippocampal synapse plasticity and autobiographical memory formation, the SAMP hypothesis is consistent with clinical observations of DUP effects, including the repetition of contents in psychotic relapses as well as the emergence of treatment non-responsiveness after repeated relapses. Clinical implications of the hypothesis highlight the importance of minimizing active psychosis, integrating psychosis memory, avoiding over-medication, and fostering normalizing experiences.
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Affiliation(s)
- Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Stephanie M Y Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Eric Y H Tang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lauren K S Lei
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yi-Nam Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Christy L M Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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11
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Sasaki J, Muranaka S, Arahata K, Sato A. Developing and validating the Japanese version of the Referential Thinking Scale: A cross-sectional study. PLoS One 2023; 18:e0283416. [PMID: 37418436 PMCID: PMC10328373 DOI: 10.1371/journal.pone.0283416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/08/2023] [Indexed: 07/09/2023] Open
Abstract
It has been shown that ideas of reference in the context of paranoia (IoR-P) and schizophrenia spectrum disorders (IoR-S) are caused by different psychological constructs. Although it is well known that both IoR-P and IoR-S are frequently evoked during the same period of life, how they interact with each other is unknown. The purpose of the present study was to develop the Japanese version of the Referential Thinking Scale (J-REF) to assess IoR-S, examine its validity and reliability, and explore the predictors of IoR-P and IoR-S. In this study, several subgroups of Japanese individuals in their 20s were included in the analysis. The J-REF had high internal consistency, high test-retest reliability, good convergent, and discriminant validity. Two hierarchical regression analyses showed that public self-consciousness predicted the manifestation of IoR-P, while the dimensions of schizotypy predicted that of IoR-S. Moreover, social anxiety and negative moods could cause IoR-P and IoR-S. This study directly showed the existence of two different types of ideas of reference in terms of their predictors. It is also significant in that it first examined referential thinking using the REF scale in the context of Asia and showed that there may not be much difference in the frequency of ideas of reference from other cultures. Future research directions are also discussed.
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Affiliation(s)
- Jun Sasaki
- Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Seiji Muranaka
- Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Kotomi Arahata
- Toyama Prefectural Mental Health Center, Toyama, Toyama, Japan
| | - Atsushi Sato
- Graduate School of Humanities, Arts, and Social Sciences, University of Toyama, Toyama, Toyama, Japan
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12
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Martin LAL, Melchert D, Knack M, Fuchs T. Relating movement markers of schizophrenia to self-experience-a mixed-methods study. Front Psychiatry 2023; 14:1212508. [PMID: 37415694 PMCID: PMC10319999 DOI: 10.3389/fpsyt.2023.1212508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/29/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Basic self-disorders on the one hand and motor symptoms on the other hand are discussed as endophenotypes of schizophrenia psychopathology. However, the systematic interaction between motor symptoms and the self-experience of patients is rarely studied. Methods In a previous study we defined motor markers of schizophrenia via a data-driven analysis of patients' gait patterns. In this study, we related the movement markers to measures of basic self-disorder obtained with EASE interviews. We substantiated the correlations with a qualitative content analysis of the interviews of a subset of four patients. We related qualitative and quantitative data on an intra- and interpersonal level. Results Our results suggest an association between the previously defined, theory-independent movement markers and basic self-disorders, specifically in the domain of cognition, self-experience and bodily experiences. While movement marker manifestation was not precisely reflected in the individuals' descriptions of anomalous self- and body experience, we found clear trends of more and more intense descriptions with increasing movement marker scores, when looking at specific experiences, such as hyper reflexivity. Discussion These results foster an integrated view of the patient and could stimulate therapeutic approaches aiming at an improvement of self- and body-experience of patients with schizophrenia.
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Affiliation(s)
- Lily A. L. Martin
- Department of Psychology, Faculty of Behavioral and Cultural Studies, University of Heidelberg, Heidelberg, Germany
- Department of General Psychiatry, Centre for Psychosocial Medicine, Academic Medical Center, University of Heidelberg, Heidelberg, Germany
- Research Institute for Creative Arts Therapies (RIArT), Department of Therapy Sciences, Alanus University of Arts and Social Sciences, Alfter, Germany
| | - David Melchert
- Department of Educational Science and Psychology, Free University Berlin, Berlin, Germany
| | - Monika Knack
- Department of Philosophy, Faculty of Philosophy, University of Heidelberg, Heidelberg, Germany
| | - Thomas Fuchs
- Department of General Psychiatry, Centre for Psychosocial Medicine, Academic Medical Center, University of Heidelberg, Heidelberg, Germany
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13
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Kyzar EJ, Denfield GH. Taking subjectivity seriously: towards a unification of phenomenology, psychiatry, and neuroscience. Mol Psychiatry 2023; 28:10-16. [PMID: 36460728 PMCID: PMC10130907 DOI: 10.1038/s41380-022-01891-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022]
Abstract
Nearly all psychiatric diseases involve alterations in subjective, lived experience. The scientific study of the biological basis of mental illness has generally focused on objective measures and observable behaviors, limiting the potential for our understanding of brain mechanisms of disease states and possible treatments. However, applying methods designed principally to interpret objective behavioral measures to the measurement and extrapolation of subjective states presents a number of challenges. In order to help bridge this gap, we draw on the tradition of phenomenology, a philosophical movement concerned with elucidating the structure of lived experience, which emerged in the early 20th century and influenced philosophy of mind, cognitive science, and psychiatry. A number of early phenomenologically-oriented psychiatrists made influential contributions to the field, but this approach retreated to the background as psychiatry moved towards more operationalized disease classifications. Recently, clinical-phenomenological research and viewpoints have re-emerged in the field. We argue that the potential for phenomenological research and methods to generate productive hypotheses about the neurobiological basis of psychiatric diseases has thus far been underappreciated. Using specific examples drawing on the subjective experience of mania and psychosis, we demonstrate that phenomenologically-oriented clinical studies can generate novel and fruitful propositions for neuroscientific investigation. Additionally, we outline a proposal for more rigorously integrating phenomenological investigations of subjective experience with the methods of modern neuroscience research, advocating a cross-species approach with a key role for human subjects research. Collaborative interaction between phenomenology, psychiatry, and neuroscience has the potential to move these fields towards a unified understanding of the biological basis of mental illness.
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Affiliation(s)
- Evan J Kyzar
- Department of Psychiatry, Columbia University, New York, NY, USA. .,Research Foundation for Mental Hygiene, Menands, NY, USA. .,New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, USA.
| | - George H Denfield
- Department of Psychiatry, Columbia University, New York, NY, USA. .,Research Foundation for Mental Hygiene, Menands, NY, USA. .,New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, USA.
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14
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Sánchez C, Moskalewicz M. Kinesthesia and Temporal Experience: On the 'Knitting and Unknitting' Process of Bodily Subjectivity in Schizophrenia. Diagnostics (Basel) 2022; 12:2720. [PMID: 36359562 PMCID: PMC9689052 DOI: 10.3390/diagnostics12112720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/30/2022] [Accepted: 10/30/2022] [Indexed: 01/03/2024] Open
Abstract
This paper proposes a phenomenological hypothesis that psychosis entails a disturbance of the two-fold process of the indication function of kinesthesia and the presentification function of touch that affects the constitution of bodily subjectivity. Recent functional connectivity studies showed that the increased synchrony between the right anterior insula and the default mode network are associated with psychosis. This association is proposed to be correlated with the disrupted dynamics between the pre-reflective and reflective temporal experience in psychotic patients. The paper first examines the dynamic nature of kinesthesia and the influence touch and vision exert on it, and then the reciprocal influence with temporal experience focusing on the body's cyclic sense of temporality and its impact on physiology and phenomenology. Affectivity and self-affection are considered in their basic bodily expressions mainly through the concepts of responsivity and receptivity. The overall constitutive processes referred to throughout the article are proposed as a roadmap to develop body-based therapeutic work.
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Affiliation(s)
- Camilo Sánchez
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Marcin Moskalewicz
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznan, Poland
- Institute of Philosophy, Marie Sklodowska-Curie University, 20-400 Lublin, Poland
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15
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Eckstein KN, Rosenbaum D, Zehender N, Pleiss S, Platzbecker S, Martinelli A, Herrmann ML, Wildgruber D. Induced feelings of external influence during instructed imaginations in healthy subjects. Front Psychol 2022; 13:1005479. [PMID: 36389532 PMCID: PMC9664387 DOI: 10.3389/fpsyg.2022.1005479] [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: 07/28/2022] [Accepted: 10/14/2022] [Indexed: 01/25/2023] Open
Abstract
The psychopathological phenomenon of delusions of influence comprises variable disturbances of the self-environment-border leading to the feeling of external influence on thoughts, feelings, impulses or behaviors. Delusions of influence are a hallmark in psychotic illness, but nevertheless, attenuated forms can also appear in healthy individuals. Here we present a newly developed paradigm to induce and assess feelings of external influence during instructed imaginations in healthy individuals. In the current study, we asked 60 healthy individuals to visually imagine different objects. To induce feelings of external influence, we applied one of three different physical setups (low-amplitude transcranial direct current stimulation, eye contact, or skin-to-skin hand touch), and informed the participants whether or not an external influence was attempted during the respective trial. The physical setup (setup vs. no setup, Z = -3.847, p < 0.001, r = 0.497) as well as the information given to the participants (confirmation vs. negation, Z = -5.218, p < 0.001, r = 0.674) alone were able to modulate the feeling of external influence in all three interventions. The impact of information (whether influence was attempted or not attempted) significantly exceeded the impact of the physical setup on the ratings of experienced external influence (Z = -2.394, p = 0.016, r = 0.310). Moreover, the response latency correlated with the estimated feeling of external influence (r S = 0.392, p = 0.002). Additional analyses addressed the influence of the emotional content of imagined objects and examined the intensity and emotional valence of the imaginations. Further supplemental analyses correlated external influence estimation of the participants with other psychopathological measures (trait markers for supernatural beliefs, proneness to hallucinations, and delusions and attributional style). In conclusion, this study endorses a quantitative model of psychopathological characteristics, in this case feelings of external influence that can be induced by external cues.
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Affiliation(s)
- Kathrin N. Eckstein
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany,*Correspondence: Kathrin N. Eckstein,
| | - David Rosenbaum
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Nadine Zehender
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany,Department of Psychiatry and Psychotherapy, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sonja Pleiss
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Sharon Platzbecker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Anne Martinelli
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany,School of Psychology, Fresenius University of Applied Sciences, Frankfurt am Main, Germany
| | - Matthias L. Herrmann
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany,Department of Neurology and Neuroscience, Medical Center, University of Freiburg, Freiburg, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
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16
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Dourron HM, Strauss C, Hendricks PS. Self-Entropic Broadening Theory: Toward a New Understanding of Self and Behavior Change Informed by Psychedelics and Psychosis. Pharmacol Rev 2022; 74:982-1027. [DOI: 10.1124/pharmrev.121.000514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/22/2022] Open
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17
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Tonna M, Lucarini V, Lucchese J, Presta V, Paraboschi F, Marsella F, Daniel BD, Vitale M, Marchesi C, Gobbi G. Posture, gait and self‐disorders: An empirical study in individuals with schizophrenia. Early Interv Psychiatry 2022; 17:447-461. [PMID: 37156494 DOI: 10.1111/eip.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/17/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022]
Abstract
AIM In schizophrenia, subjectively perceived disruptions of the sense of the Self (also referred to as "self-disorders") seem to be intimately associated with a perturbation of the implicit awareness of one's own body. Indeed, an early impairment of the motor system, including posture and gait, is now considered a marker of schizophrenia neurodevelopmental substrate and appears more pronounced in early-onset schizophrenia. Therefore, the present study was aimed at: (1) investigating a possible relationship between self-disorders, symptom dimensions and postural and gait profile in schizophrenia; (2) identifying a specific motor profile in early-onset conditions. METHODS A total of 43 schizophrenia outpatients and 38 healthy controls underwent an exhaustive investigation of posture and gait pattern. The positive and negative syndrome scale (PANSS), the examination of anomalous self experience scale (EASE) and the abnormal involuntary movement scale (AIMS) were administered to the schizophrenia group. Subsequently, schizophrenia patients were divided into early and adult-onset subgroups and compared with respect to their motor profile. RESULTS We found an association between specific postural patterns (impaired sway area), a general disruption of the gait cycle and subjective bodily experiences (concerning the loss of bodily integrity, cohesion and demarcation). Only motor parameters (increased sway area and gait cadence reduction) differentiated between early and adult-onset patients. CONCLUSION The results of the present study hint at a link between motor impairment and self-disturbances in schizophrenia and candidate a specific motor profile as a possible marker of early-onset forms.
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Affiliation(s)
- Matteo Tonna
- Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
| | | | - Jacopo Lucchese
- Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
| | - Valentina Presta
- Department of Medicine and Surgery, Human Anatomy, University of Parma, Parma, Italy
| | | | - Filippo Marsella
- Department of Mental Health, Local Health Service, Reggio Emilia, Italy
| | | | - Marco Vitale
- Department of Medicine and Surgery, Human Anatomy, University of Parma, Parma, Italy
- Department of Medicine and Surgery, Movement Analysis Laboratory (LAM), University of Parma, Parma, Italy
| | - Carlo Marchesi
- Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
| | - Giuliana Gobbi
- Department of Medicine and Surgery, Human Anatomy, University of Parma, Parma, Italy
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18
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Damiani S, Donadeo A, Bassetti N, Salazar‐de‐Pablo G, Guiot C, Politi P, Fusar‐Poli P. Understanding source monitoring subtypes and their relation to psychosis: a systematic review and meta-analysis. Psychiatry Clin Neurosci 2022; 76:162-171. [PMID: 35124869 PMCID: PMC9313862 DOI: 10.1111/pcn.13338] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 11/29/2022]
Abstract
AIMS Source monitoring (SM) is the metacognitive ability to determine the origin of one's experiences. SM is altered in primary psychiatric psychosis, although relationships between SM subtypes, other cognitive domains and symptoms are unclear. Our aims were to synthesize evidence comparing psychosis -with and without hallucinations- and healthy controls classifying SM subtypes by source discrimination (internal/external/reality monitoring) and stimulus modality (visual/auditory/imagined/performed). METHODS This systematic review adopted Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Meta-analyses Of Observational Studies in Epidemiology and Population, Intervention, Comparison and Outcomes guidelines. Core demographical and clinical parameters were extracted. Newcastle-Ottawa Scale was used as quality check. SM differences between (i) psychosis patients versus healthy controls and (ii) patients with versus without hallucinations were investigated via random-effect model meta-analysis. The primary effect size measure was standardized mean difference (SMD) in each SM subtype performance (error or accuracy). Heterogeneity, publication biases and meta-regressions were assessed. RESULTS Five thousand two hundred and fifty-six records were screened to finally include 44 studies (1566 patients, 1175 controls). Mean Newcastle-Ottawa score was 7.41 out of 9. Few studies measured SM associations with cognition (n = 9) and symptoms (n = 19), with heterogeneous findings. SM performance across all measures was reduced in psychosis versus healthy controls (SMD = 0.458). Internal SM (SMD: errors = 0.513; accuracy = 0.733) and imagined stimuli (SMD: errors = 0.688; accuracy = 0.978) were specifically impaired. Patients with versus without hallucinations showed SM deficits only for externalizing (SMD = 0.410) and imagined/auditory (SMD = 0.498/0.277) errors. CONCLUSION The proposed classifications highlight specific SM deficits for internal/imagined stimuli in psychosis, providing evidence-based indications to design and interpret future studies.
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Affiliation(s)
- Stefano Damiani
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Alberto Donadeo
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Nicola Bassetti
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Gonzalo Salazar‐de‐Pablo
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis StudiesInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- Child and Adolescent Mental Health ServicesSouth London and the Maudsley NHS Foundation TrustLondonUK
| | - Cecilia Guiot
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Pierluigi Politi
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Paolo Fusar‐Poli
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis StudiesInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- OASIS service, South London and Maudsley NHS Foundation TrustLondonUK
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19
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Amorim M, Roberto MS, Kotz SA, Pinheiro AP. The perceived salience of vocal emotions is dampened in non-clinical auditory verbal hallucinations. Cogn Neuropsychiatry 2022; 27:169-182. [PMID: 34261424 DOI: 10.1080/13546805.2021.1949972] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Introduction: Auditory verbal hallucinations (AVH) are a cardinal symptom of schizophrenia but are also reported in the general population without need for psychiatric care. Previous evidence suggests that AVH may reflect an imbalance of prior expectation and sensory information, and that altered salience processing is characteristic of both psychotic and non-clinical voice hearers. However, it remains to be shown how such an imbalance affects the categorisation of vocal emotions in perceptual ambiguity.Methods: Neutral and emotional nonverbal vocalisations were morphed along two continua differing in valence (anger; pleasure), each including 11 morphing steps at intervals of 10%. College students (N = 234) differing in AVH proneness (measured with the Launay-Slade Hallucination Scale) evaluated the emotional quality of the vocalisations.Results: Increased AVH proneness was associated with more frequent categorisation of ambiguous vocalisations as 'neutral', irrespective of valence. Similarly, the perceptual boundary for emotional classification was shifted by AVH proneness: participants needed more emotional information to categorise a voice as emotional.Conclusions: These findings suggest that emotional salience in vocalisations is dampened as a function of increased AVH proneness. This could be related to changes in the acoustic representations of emotions or reflect top-down expectations of less salient information in the social environment.
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Affiliation(s)
- Maria Amorim
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Magda S Roberto
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands.,Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ana P Pinheiro
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal.,Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands
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20
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Poletti M, Pelizza L, Azzali S, Garlassi S, Scazza I, Paterlini F, Chiri LR, Pupo S, Raballo A. Subjective experience of aberrant salience in young people at Ultra-High Risk (UHR) for psychosis: a cross-sectional study. Nord J Psychiatry 2022; 76:129-137. [PMID: 34185607 DOI: 10.1080/08039488.2021.1942547] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Aberrant salience (AS) is conceptualized as a potential predisposing factor for psychotic states of mind. Despite several studies in the general population, research on AS in the early phases of psychosis is still relatively scarce. The aim of this cross-sectional study is (1) to evaluate the AS subjective experience in Ultra-High Risk (UHR) adolescents and young adults compared to help-seeking peers with First Episode Psychosis (FEP) and (2) to assess any significant association of baseline AS with psychopathology and functioning in UHR participants. MATERIALS AND METHODS Participants (87 UHR and 139 FEP), aged 13-35 years, completed the Comprehensive Assessment of At-Risk Mental States (CAARMS), the Aberrant Salience Inventory (ASI) and the brief version of the Schizotypal Personality Questionnaire (SPQ-B). Within the UHR subgroup, Spearman correlation and multiple linear regression analyses among psychopathological parameters were performed. RESULTS No difference in baseline AS subjective levels was found between UHR and FEP participants (median [interquartile range]: 14.50 [7-19] vs 14 [9-21]; z = -1.576; p = 0.115). In UHR individuals, the ASI total score was significantly associated with attenuated positive symptoms (ρ = 0.284, p = 0.008), depression (ρ = 0.256; p = 0.018) and specific schizotypal personality traits (i.e. cognitive-perceptual deficits and disorganization [respectively, ρ = 0.487, p = 0.001, and ρ = 0.295, p = 0.008]). CONCLUSIONS AS is clinically relevant in UHR subjects, comparable to FEP patients. Moreover, it seems to mutually interact with schizotypy in the clinical manifestation of attenuated positive psychopathology.
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Affiliation(s)
- Michele Poletti
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sara Garlassi
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ilaria Scazza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Federica Paterlini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Rocco Chiri
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Primary Care, Azienda USL di Parma, Parma, Italy
| | - Simona Pupo
- Intensive Care Unit, Guastalla Civil Hospital, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Service of Anesthesiology and Resuscitaton, Azienda Ospedaliera-Universitaria di Parma, Parma, Italy
| | - Andrea Raballo
- Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
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Pionke-Ubych R, Frydecka D, Cechnicki A, Krężołek M, Nelson B, Gawęda Ł. Integrating trauma, self-disturbances, cognitive biases, and personality into a model for the risk of psychosis: a longitudinal study in a non-clinical sample. Eur Arch Psychiatry Clin Neurosci 2022; 272:1073-1085. [PMID: 34859297 PMCID: PMC9388435 DOI: 10.1007/s00406-021-01355-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/08/2021] [Indexed: 11/28/2022]
Abstract
The hypothesis of the psychosis continuum enables to study the mechanisms of psychosis risk not only in clinical samples but in non-clinical as well. The aim of this longitudinal study was to investigate self-disturbances (SD), a risk factor that has attracted substantial interest over the last two decades, in combination with trauma, cognitive biases and personality, and to test whether SD are associated with subclinical positive symptoms (PS) over a 12-month follow-up period. Our study was conducted in a non-clinical sample of 139 Polish young adults (81 females, age M = 25.32, SD = 4.51) who were selected for frequent experience of subclinical PS. Participants completed self-report questionnaires for the evaluation of SD (IPASE), trauma (CECA.Q), cognitive biases (DACOBS) and personality (TCI), and were interviewed for subclinical PS (CAARMS). SD and subclinical PS were re-assessed 12 months after baseline measurement. The hypothesized model for psychosis risk was tested using path analysis. The change in SD and subclinical PS over the 12-month period was investigated with non-parametric equivalent of dependent sample t-tests. The models with self-transcendence (ST) and harm avoidance (HA) as personality variables were found to be well-fitted and explained 34% of the variance in subclinical PS at follow-up. Moreover, we found a significant reduction of SD and subclinical PS after 12 months. Our study suggests that combining trauma, cognitive biases, SD and personality traits such as ST and HA into one model can enhance our understanding of appearance as well as maintenance of subclinical PS.
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Affiliation(s)
- Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Jaracza 1, 00-378 Warsaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Medical College Jagiellonian University, Krakow, Poland
| | - Martyna Krężołek
- II Department of Psychiatry, The Medical University of Warsaw, Warszaw, Poland
| | - Barnaby Nelson
- Orygen, Parkville, VIC Australia ,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC Australia
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Jaracza 1, 00-378, Warsaw, Poland.
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22
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Shiramatsu TI, Mori K, Ishizu K, Takahashi H. Auditory, Visual, and Cross-Modal Mismatch Negativities in the Rat Auditory and Visual Cortices. Front Hum Neurosci 2021; 15:721476. [PMID: 34602996 PMCID: PMC8484534 DOI: 10.3389/fnhum.2021.721476] [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] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/24/2021] [Indexed: 12/04/2022] Open
Abstract
When the brain tries to acquire an elaborate model of the world, multisensory integration should contribute to building predictions based on the various pieces of information, and deviance detection should repeatedly update these predictions by detecting “errors” from the actual sensory inputs. Accumulating evidence such as a hierarchical organization of the deviance-detection system indicates that the deviance-detection system can be interpreted in the predictive coding framework. Herein, we targeted mismatch negativity (MMN) as a type of prediction-error signal and investigated the relationship between multisensory integration and MMN. In particular, we studied whether and how cross-modal information processing affected MMN in rodents. We designed a new surface microelectrode array and simultaneously recorded visual and auditory evoked potentials from the visual and auditory cortices of rats under anesthesia. Then, we mapped MMNs for five types of deviant stimuli: single-modal deviants in (i) the visual oddball and (ii) auditory oddball paradigms, eliciting single-modal MMN; (iii) congruent audio-visual deviants, (iv) incongruent visual deviants, and (v) incongruent auditory deviants in the audio-visual oddball paradigm, eliciting cross-modal MMN. First, we demonstrated that visual MMN exhibited deviance detection properties and that the first-generation focus of visual MMN was localized in the visual cortex, as previously reported in human studies. Second, a comparison of MMN amplitudes revealed a non-linear relationship between single-modal and cross-modal MMNs. Moreover, congruent audio-visual MMN exhibited characteristics of both visual and auditory MMNs—its latency was similar to that of auditory MMN, whereas local blockage of N-methyl-D-aspartic acid receptors in the visual cortex diminished it as well as visual MMN. These results indicate that cross-modal information processing affects MMN without involving strong top-down effects, such as those of prior knowledge and attention. The present study is the first electrophysiological evidence of cross-modal MMN in animal models, and future studies on the neural mechanisms combining multisensory integration and deviance detection are expected to provide electrophysiological evidence to confirm the links between MMN and predictive coding theory.
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Affiliation(s)
| | - Kanato Mori
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Kotaro Ishizu
- Institute for Quantitative Biosciences, The University of Tokyo, Tokyo, Japan
| | - Hirokazu Takahashi
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
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23
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Neural Correlates of Aberrant Salience and Source Monitoring in Schizophrenia and At-Risk Mental States-A Systematic Review of fMRI Studies. J Clin Med 2021; 10:jcm10184126. [PMID: 34575237 PMCID: PMC8468329 DOI: 10.3390/jcm10184126] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/22/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023] Open
Abstract
Cognitive biases are an important factor contributing to the development and symptom severity of psychosis. Despite the fact that various cognitive biases are contributing to psychosis, they are rarely investigated together. In the current systematic review, we aimed at investigating specific and shared functional neural correlates of two important cognitive biases: aberrant salience and source monitoring. We conducted a systematic search of fMRI studies of said cognitive biases. Eight studies on aberrant salience and eleven studies on source monitoring were included in the review. We critically discussed behavioural and neuroimaging findings concerning cognitive biases. Various brain regions are associated with aberrant salience and source monitoring in individuals with schizophrenia and the risk of psychosis. The ventral striatum and insula contribute to aberrant salience. The medial prefrontal cortex, superior and middle temporal gyrus contribute to source monitoring. The anterior cingulate cortex and hippocampus contribute to both cognitive biases, constituting a neural overlap. Our review indicates that aberrant salience and source monitoring may share neural mechanisms, suggesting their joint role in producing disrupted external attributions of perceptual and cognitive experiences, thus elucidating their role in positive symptoms of psychosis. Account bridging mechanisms of these two biases is discussed. Further studies are warranted.
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24
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Trask CL, Matsui MM, Cohn JR, Klaunig MJ, Cicero DC. Anomalous self-experiences in cognition are negatively associated with neurocognitive functioning in schizophrenia. Cogn Neuropsychiatry 2021; 26:307-320. [PMID: 34058949 DOI: 10.1080/13546805.2021.1935225] [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] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Anomalous self-experiences (ASEs) are disturbances in the subjective experience of the self and are common in people with schizophrenia. Theorists have suggested that ASEs may underlie the neurocognitive deficits that are also common in people with schizophrenia; however, few studies have empirically investigated the relationship between these variables. Thus, the current study aimed to determine whether self-reported ASEs, particularly disturbances in cognitive or mental experiences, are meaningfully related to neurocognitive performance in individuals with schizophrenia. METHODS 48 individuals with schizophrenia and 34 healthy comparison participants completed the Inventory of Psychotic-Like Anomalous Experiences (IPASE), which is composed of five subscales including disturbances in cognition, and the MATRICS Consensus Cognitive Battery (MCCB). RESULTS Participants with schizophrenia performed worse than controls on each MCCB domain and had higher ASE scores on the total IPASE and all five subscales. Only the IPASE-Cognition subscale was associated with cognitive performance. Specifically, IPASE-Cognition was negatively correlated with scores in attention, visual learning, reasoning, and working memory. CONCLUSIONS These results suggest that self-reported subjective disturbances in cognition may be meaningfully associated with several objectively-measured domains of neurocognition. Severity of ASEs may therefore be an important consideration when analysing the extent of cognitive deficits in schizophrenia.
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Affiliation(s)
- Christi L Trask
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA.,Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Marina M Matsui
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Jonathan R Cohn
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA.,Department of Psychology, University of North Texas, Denton, TX, USA
| | - Mallory J Klaunig
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA.,Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - David C Cicero
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA.,Department of Psychology, University of North Texas, Denton, TX, USA
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25
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Chopra S, Francey SM, O’Donoghue B, Sabaroedin K, Arnatkeviciute A, Cropley V, Nelson B, Graham J, Baldwin L, Tahtalian S, Yuen HP, Allott K, Alvarez-Jimenez M, Harrigan S, Pantelis C, Wood SJ, McGorry P, Fornito A. Functional Connectivity in Antipsychotic-Treated and Antipsychotic-Naive Patients With First-Episode Psychosis and Low Risk of Self-harm or Aggression: A Secondary Analysis of a Randomized Clinical Trial. JAMA Psychiatry 2021; 78:994-1004. [PMID: 34160595 PMCID: PMC8223142 DOI: 10.1001/jamapsychiatry.2021.1422] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Altered functional connectivity (FC) is a common finding in resting-state functional magnetic resonance imaging (rs-fMRI) studies of people with psychosis, yet how FC disturbances evolve in the early stages of illness, and how antipsychotic treatment influences these disturbances, remains unknown. OBJECTIVE To investigate longitudinal FC changes in antipsychotic-naive and antipsychotic-treated patients with first-episode psychosis (FEP). DESIGN, SETTING, AND PARTICIPANTS This secondary analysis of a triple-blind, randomized clinical trial was conducted over a 5-year recruitment period between April 2008 and December 2016 with 59 antipsychotic-naive patients with FEP receiving either a second-generation antipsychotic or a placebo pill over a treatment period of 6 months. Participants were required to have low suicidality and aggression, to have a duration of untreated psychosis of less than 6 months, and to be living in stable accommodations with social support. Both FEP groups received intensive psychosocial therapy. A healthy control group was also recruited. Participants completed rs-fMRI scans at baseline, 3 months, and 12 months. Data were analyzed from May 2019 to August 2020. INTERVENTIONS Resting-state functional MRI was used to probe brain FC. Patients received either a second-generation antipsychotic or a matched placebo tablet. Both patient groups received a manualized psychosocial intervention. MAIN OUTCOMES AND MEASURES The primary outcomes of this analysis were to investigate (1) FC differences between patients and controls at baseline; (2) FC changes in medicated and unmedicated patients between baseline and 3 months; and (3) associations between longitudinal FC changes and clinical outcomes. An additional aim was to investigate long-term FC changes at 12 months after baseline. These outcomes were not preregistered. RESULTS Data were analyzed for 59 patients (antipsychotic medication plus psychosocial treatment: 28 [47.5%]; mean [SD] age, 19.5 [3.0] years; 15 men [53.6%]; placebo plus psychosocial treatment: 31 [52.5%]; mean [SD] age, 18.8 [2.7]; 16 men [51.6%]) and 27 control individuals (mean [SD] age, 21.9 [1.9] years). At baseline, patients showed widespread functional dysconnectivity compared with controls, with reductions predominantly affecting interactions between the default mode network, limbic systems, and the rest of the brain. From baseline to 3 months, patients receiving placebo showed increased FC principally within the same systems; some of these changes correlated with improved clinical outcomes (canonical correlation analysis R = 0.901; familywise error-corrected P = .005). Antipsychotic exposure was associated with increased FC primarily between the thalamus and the rest of the brain. CONCLUSIONS AND RELEVANCE In this secondary analysis of a clinical trial, antipsychotic-naive patients with FEP showed widespread functional dysconnectivity at baseline, followed by an early normalization of default mode network and cortical limbic dysfunction in patients receiving placebo and psychosocial intervention. Antipsychotic exposure was associated with FC changes concentrated on thalamocortical networks. TRIAL REGISTRATION ACTRN12607000608460.
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Affiliation(s)
- Sidhant Chopra
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia,Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Shona M. Francey
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Brian O’Donoghue
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kristina Sabaroedin
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia,Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Aurina Arnatkeviciute
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica Graham
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lara Baldwin
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Steven Tahtalian
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susy Harrigan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia,Department of Social Work, Monash University, Caulfield, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Stephen J. Wood
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia,University of Birmingham School of Psychology, Edgbaston, United Kingdom
| | - Patrick McGorry
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia,Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
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26
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Donati FL, Fecchio M, Maestri D, Cornali M, Derchi CC, Casetta C, Zalaffi M, Sinigaglia C, Sarasso S, D'Agostino A. Reduced readiness potential and post-movement beta synchronization reflect self-disorders in early course schizophrenia. Sci Rep 2021; 11:15044. [PMID: 34294767 PMCID: PMC8298598 DOI: 10.1038/s41598-021-94356-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 07/06/2021] [Indexed: 02/05/2023] Open
Abstract
Disturbances of conscious awareness, or self-disorders, are a defining feature of schizophrenia. These include symptoms such as delusions of control, i.e. the belief that one's actions are controlled by an external agent. Models of self-disorders point at altered neural mechanisms of source monitoring, i.e. the ability of the brain to discriminate self-generated stimuli from those driven by the environment. However, evidence supporting this putative relationship is currently lacking. We performed electroencephalography (EEG) during self-paced, brisk right fist closures in ten (M = 9; F = 1) patients with Early-Course Schizophrenia (ECSCZ) and age and gender-matched healthy volunteers. We measured the Readiness Potential (RP), i.e. an EEG feature preceding self-generated movements, and movement-related EEG spectral changes. Self-disorders in ECSCZ were assessed with the Examination of Anomalous Self-Experience (EASE). Patients showed a markedly reduced RP and altered post-movement Event-Related Synchronization (ERS) in the beta frequency band (14-24 Hz) compared to healthy controls. Importantly, smaller RP and weaker ERS were associated with higher EASE scores in ECSCZ. Our data suggest that disturbances of neural correlates preceding and following self-initiated movements may reflect the severity of self-disorders in patients suffering from ECSCZ. These findings point towards deficits in basic mechanisms of sensorimotor integration as a substrate for self-disorders.
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Affiliation(s)
- Francesco Luciano Donati
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Matteo Fecchio
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Padiglione 'LITA', Piano 5, Via Gian Battista Grassi, 74, 20157, Milan, MI, Italy
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Davide Maestri
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy
| | - Mattia Cornali
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy
| | | | - Cecilia Casetta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Maristella Zalaffi
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Padiglione 'LITA', Piano 5, Via Gian Battista Grassi, 74, 20157, Milan, MI, Italy
| | | | - Simone Sarasso
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Padiglione 'LITA', Piano 5, Via Gian Battista Grassi, 74, 20157, Milan, MI, Italy.
| | - Armando D'Agostino
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy
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27
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Hamilton A, Northoff G. Abnormal ERPs and Brain Dynamics Mediate Basic Self Disturbance in Schizophrenia: A Review of EEG and MEG Studies. Front Psychiatry 2021; 12:642469. [PMID: 33912085 PMCID: PMC8072007 DOI: 10.3389/fpsyt.2021.642469] [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: 12/16/2020] [Accepted: 03/11/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Interest in disordered sense of self in schizophrenia has recently re-emerged in the literature. It has been proposed that there is a basic self disturbance, underlying the diagnostic symptoms of schizophrenia, in which the person's sense of being a bounded individual continuous through time loses stability. This disturbance has been documented phenomenologically and at the level of cognitive tasks. However, the neural correlates of basic self disorder in schizophrenia are poorly understood. Methods: A search of PubMed was used to identify studies on self and schizophrenia that reported EEG or MEG data. Results: Thirty-three studies were identified, 32 using EEG and one using MEG. Their operationalizations of the self were divided into six paradigms: self-monitoring for errors, proprioception, self-other integration, self-referential processing, aberrant salience, and source monitoring. Participants with schizophrenia were less accurate on self-referential processing tasks and had slower response times across most studies. Event-related potential amplitudes differed across many early and late components, with reduced N100 suppression in source monitoring paradigms being the most replicated finding. Several studies found differences in one or more frequency band, but no coherent overall finding emerged in this area. Various other measures of brain dynamics also showed differences in single studies. Only some of the study designs were adequate to establish a causal relationship between the self and EEG or MEG measures. Conclusion: The broad range of changes suggests a global self disturbance at the neuronal level, possibly carried over from the resting state. Further studies that successfully isolate self-related effects are warranted to better understand the temporal-dynamic and spatial-topographic basis of self disorder and its relationship to basic self disturbance on the phenomenological level.
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Affiliation(s)
- Arthur Hamilton
- Department of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
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28
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Herbener ES, Harrow M. Course and symptom and functional correlates of passivity symptoms in schizophrenia: an 18-year multi-follow-up longitudinal study. Psychol Med 2021; 51:503-510. [PMID: 31839019 DOI: 10.1017/s0033291719003428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Change in the experience of oneself may lay the groundwork for the development of additional hallucinations and delusions in individuals with schizophrenia. However, to date, the course and symptom and functioning correlates of passivity symptoms (cf. thought insertion, thought withdrawal) have not been measured consistently over long periods of time. Information on the course and correlates of passivity symptoms is essential for developing models of their contribution to schizophrenic illness. METHOD Eighty-two individuals diagnosed with schizophrenia or schizoaffective disorder were recruited at an index hospitalization and reassessed at three or more follow-ups over the following 18 years. RESULTS The results indicate that a small group of participants report passivity symptoms at all follow-ups, many reported passivity symptoms at some follow-ups, and the majority of individuals never reported passivity symptoms. The prevalence of passivity symptoms was similar to that for delusions of reference and persecutory delusions. Notably, when individuals did experience passivity symptoms, they also had a greater number of additional psychotic symptoms than individuals without passivity symptoms. Further, the presence of passivity symptoms was associated with work impairment at some assessments. CONCLUSIONS Passivity symptoms present episodically, at a similar rate as delusions of reference and persecutory delusions, and when present, they are associated with having a higher number of additional psychotic symptoms, as well as having some impact on work functioning. These results suggest that passivity symptoms may increase vulnerability to additional psychotic symptoms and greater work impairment.
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Affiliation(s)
- Ellen S Herbener
- Department of Psychology, University of Illinois at Chicago, 1007 W Harrison St., Chicago, IL60607, USA
- Department of Psychiatry, University of Illinois at Chicago, 1601 W Taylor St., Chicago, IL60612, USA
| | - Martin Harrow
- Department of Psychiatry, University of Illinois at Chicago, 1601 W Taylor St., Chicago, IL60612, USA
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29
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Spark J, Gawęda Ł, Allott K, Hartmann JA, Jack BN, Koren D, Lavoie S, Li E, McGorry PD, Parnas J, Polari A, Sass LA, Whitford T, Nelson B. Distinguishing schizophrenia spectrum from non-spectrum disorders among young patients with first episode psychosis and at high clinical risk: The role of basic self-disturbance and neurocognition. Schizophr Res 2021; 228:19-28. [PMID: 33434729 DOI: 10.1016/j.schres.2020.11.061] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/14/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The distinction between the schizophrenia spectrum and other types of disorders may be clinically relevant in terms of its predictive validity as suggested by studies showing schizophrenia spectrum patients have more unfavourable outcomes compared to other psychotic disorders. The present study aimed to investigate whether basic self-disturbances and neurocognitive processes that have been linked to psychosis risk have discriminative power for schizophrenia spectrum disorders in patients presenting with first episode psychosis (FEP) and at ultra-high risk for psychosis (UHR). METHODS 38 FEP patients, 48 UHR patients, and 33 healthy controls were assessed for basic self-disturbances (using the Examination of Anomalous Self-Experience, EASE, interview), source monitoring and aberrant salience (behavioural tasks to measure neurocognitive constructs). Clinical groups were divided into patients with schizophrenia spectrum disorders and those with other non-spectrum disorders and were further compared on measures controlling for symptom severity and age. RESULTS Basic self-disturbances distinguished schizophrenia spectrum from non-spectrum disorders in the 'FEP only' sample, F = 19.76, p < 0.001, η2partial = 0.37, and also in the combined UHR/FEP sample, F = 23.56, p < 0.001, η2partial = 0.22. Additionally, some processes related to source monitoring deficits were elevated in schizophrenia spectrum disorders. In contrast, the two groups (schizophrenia spectrum vs other diagnoses) performed similarly in aberrant salience tasks. Comparable results were obtained for analyses performed with an FEP/UHR combined sample and the 'FEP only' sample. DISCUSSION Basic self-disturbances at the phenomenological level and source monitoring deficits on the neurocognitive level may be useful in identifying risk of schizophrenia spectrum disorders at the earliest clinical presentation.
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Affiliation(s)
- Jessica Spark
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Jessica A Hartmann
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Bradley N Jack
- School of Psychology, University of New South Wales, Sydney, Australia; Research School of Psychology, Australian National University, Canberra, Australia
| | - Dan Koren
- Psychology Department, University of Haifa, Haifa, Israel
| | - Suzie Lavoie
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Emily Li
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick D McGorry
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Andrea Polari
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen Youth Health Clinical Program, Melbourne, Australia
| | | | - Thomas Whitford
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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30
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Troubé S. Exploration of Everydayness in Schizophrenia: A Phenomenological Approach. Psychopathology 2021; 54:18-25. [PMID: 33316802 DOI: 10.1159/000512128] [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: 03/02/2020] [Accepted: 10/04/2020] [Indexed: 11/19/2022]
Abstract
This article explores everydayness as a specific form of experience of the world and its alterations in schizophrenia. In the field of phenomenological psychopathology, the transformations of subjective experience in schizophrenia have been the subject of a great deal of work, but the relationship between these alterations of subjective experience and the experience of the everyday remains largely unexplored. A phenomenological point of view leads us to explore everydayness as a constitutive framework of experience, one that may be impeded in schizophrenia. The question of the everyday allows us to bridge the gap between the descriptions of subjective experience proposed by phenomenological psychopathology and what is at stake in therapeutic treatment. It seems to us that the work of constructing an individual narrative of the everyday may be a useful psychotherapeutic approach for helping patients rebuild the framework of everydayness.
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Affiliation(s)
- Sarah Troubé
- Department of Psychology, Université Côte d'Azur, LIRCES, Nice, France,
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31
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Pelizza L, Azzali S, Garlassi S, Scazza I, Paterlini F, Chiri LR, Poletti M, Pupo S, Cicero DC, Preti A, Raballo A. Assessing aberrant salience in young community help‐seekers with early psychosis: The approved Italian version of the Aberrant Salience Inventory. J Clin Psychol 2020; 77:782-803. [DOI: 10.1002/jclp.23059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/29/2020] [Accepted: 09/05/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
- Department of Mental Health and Pathological Addiction Azienda USL di Parma Parma Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Sara Garlassi
- Department of Mental Health and Pathological Addiction Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Ilaria Scazza
- Department of Mental Health and Pathological Addiction Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Federica Paterlini
- Department of Mental Health and Pathological Addiction Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Luigi R. Chiri
- Department of Mental Health and Pathological Addiction Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
- Department of Primary Care Azienda USL di Parma Parma Italy
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Simona Pupo
- Intensive Care Unit, Guastalla Civil Hospital, Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy
- Service of Anesthesiology and Resuscitaton, Azienda Ospedaliera‐Universitaria di Parma Parma Italy
| | - David C. Cicero
- Department of Psychology University of North Texas Denton Texas USA
| | - Antonio Preti
- Center for Consultation‐Liason Psychiatry and Psychosomatics University Hospital of Cagliari Cagliari Italy
| | - Andrea Raballo
- Department of Medicine, Division of Psychiatry Clinical Psychology and Rehabilitation University of Perugia Perugia Italy
- Center for Translational, Phenomenological and Developmental Psychopathology Perugia University Hospital Perugia Italy
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Stern Y, Koren D, Moebus R, Panishev G, Salomon R. Assessing the Relationship between Sense of Agency, the Bodily-Self and Stress: Four Virtual-Reality Experiments in Healthy Individuals. J Clin Med 2020; 9:jcm9092931. [PMID: 32932793 PMCID: PMC7563244 DOI: 10.3390/jcm9092931] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023] Open
Abstract
The bodily-self, our experience of being a body, arises from the interaction of several processes. For example, embodied Sense of Agency (SoA), the feeling of controlling our body’s actions, is a fundamental facet of the bodily-self. SoA is disturbed in psychosis, with stress promoting its inception. However, there is little knowledge regarding the relationship between SoA, stress, and other facets of the bodily-self. In four experiments manipulating embodied SoA using a virtual hand (VH), we examined (1) How is embodied SoA related to other facets of the bodily-self?; and (2) How is SoA impacted by stress? We found that increased alteration of the VH significantly decreased subjective ratings of SoA and body ownership (Exp. 1), supporting the close relation between SoA and body ownership. Interoceptive accuracy and SoA were positively correlated (Exp. 3), connecting awareness to one’s actions and cardiac signals. Contrary to our expectations, SoA was not related to trait anxiety (Exp. 3), nor did induced stress impair SoA (Exp. 4). Finally, we found a negative correlation between self-reported prodromal symptoms and SoA. These results strongly support the connection between SoA and the bodily-self. Whereas, SoA was not impaired by stress, and weakly related to psychotic symptoms.
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Affiliation(s)
- Yonatan Stern
- Psychology Department, University of Haifa, Haifa 3498838, Israel;
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (R.M.); (G.P.); (R.S.)
- Correspondence:
| | - Danny Koren
- Psychology Department, University of Haifa, Haifa 3498838, Israel;
| | - Renana Moebus
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (R.M.); (G.P.); (R.S.)
| | - Gabriella Panishev
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (R.M.); (G.P.); (R.S.)
| | - Roy Salomon
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (R.M.); (G.P.); (R.S.)
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33
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Bechi M, Crespi SA, Agostoni G, Prudenziati F, Grgic RG, Giuliani M, Martoni R, Boccalini C, de'Sperati C, Cavallaro R. The role of agency in schizophrenia: A pilot study on gaze agency. Schizophr Res 2020; 222:465-466. [PMID: 32611511 DOI: 10.1016/j.schres.2020.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/16/2020] [Accepted: 06/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sofia Allegra Crespi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Agostoni
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | | | - Regina Gregori Grgic
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mattia Giuliani
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Martoni
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cecilia Boccalini
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Roberto Cavallaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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34
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Yang H, Wang M, Wu F, Li Q, Zheng Y, Qin P. Diminished self-monitoring in hallucinations - Aberrant anterior insula connectivity differentiates auditory hallucinations in schizophrenia from subjective tinnitus. Asian J Psychiatr 2020; 52:102056. [PMID: 32417745 DOI: 10.1016/j.ajp.2020.102056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
Auditory hallucinations in schizophrenia (SCZ-AH) and subjective tinnitus (TN) are two conditions that share a superficial resemblance, namely the presence of phantom sounds produced by the brain. A crucial difference between them lies in the self-processing of the phantom signals, which is intact in TN patients but lost in SCZ-AH. Our study sets out to investigate the potential neural mechanisms for this crucial psychotic symptom of SCZ-AH under the framework of self. We gathered resting-state fMRI data from three participant groups: SCZ-AH, TN and healthy controls. Focusing on predefined self-related regions-of-interest, we found that SCZ-AH had reduced degree centrality in the right anterior insula (rAI) compared to both TN and healthy controls. Further functional connectivity analysis showed a reduced connectivity between the rAI and right superior temporal gyrus. Our finding indicates that compromised self-processing in SCZ-AH could be due to aberrant connectivity in rAI, which interacted with the decreased connectivity between rAI and auditory cortex, and jointly contributed to the misattribution of the source of the phantom sound. Our findings provided preliminary evidence for the neural mechanism of self-disorder underlying SCZ-AH, and could provide implications for investigating other modalities of hallucinations in schizophrenia.
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Affiliation(s)
- Haidi Yang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Mingxia Wang
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China; Psychological Applications Research Center, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Fengchun Wu
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Qingwei Li
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China.
| | - Pengmin Qin
- Psychological Applications Research Center, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China.
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35
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Deficits of subliminal self-face processing in schizophrenia. Conscious Cogn 2020; 79:102896. [DOI: 10.1016/j.concog.2020.102896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/21/2019] [Accepted: 02/01/2020] [Indexed: 01/26/2023]
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36
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Bolton TAW, Wotruba D, Buechler R, Theodoridou A, Michels L, Kollias S, Rössler W, Heekeren K, Van De Ville D. Triple Network Model Dynamically Revisited: Lower Salience Network State Switching in Pre-psychosis. Front Physiol 2020; 11:66. [PMID: 32116776 PMCID: PMC7027374 DOI: 10.3389/fphys.2020.00066] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/21/2020] [Indexed: 11/13/2022] Open
Abstract
Emerging evidence has attributed altered network coordination between the default mode, central executive, and salience networks (DMN/CEN/SAL) to disturbances seen in schizophrenia, but little is known for at-risk psychosis stages. Moreover, pinpointing impairments in specific network-to-network interactions, although essential to resolve possibly distinct harbingers of conversion to clinically diagnosed schizophrenia, remains particularly challenging. We addressed this by a dynamic approach to functional connectivity, where right anterior insula brain interactions were examined through co-activation pattern (CAP) analysis. We utilized resting-state fMRI in 19 subjects suffering from subthreshold delusions and hallucinations (UHR), 28 at-risk for psychosis with basic symptoms describing only self-experienced subclinical disturbances (BS), and 29 healthy controls (CTR) matched for age, gender, handedness, and intelligence. We extracted the most recurring CAPs, compared their relative occurrence and average dwell time to probe their temporal expression, and quantified occurrence balance to assess the putative loss of competing relationships. Our findings substantiate the pivotal role of the right anterior insula in governing CEN-to-DMN transitions, which appear dysfunctional prior to the onset of psychosis, especially when first attenuated psychotic symptoms occur. In UHR subjects, it is longer active in concert with the DMN and there is a loss of competition between a SAL/DMN state, and a state with insula/CEN activation paralleled by DMN deactivation. These features suggest that abnormal network switching disrupts one's capacity to distinguish between the internal world and external environment, which is accompanied by inflexibility and an excessive awareness to internal processes reflected by prolonged expression of the right anterior insula-default mode co-activation pattern.
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Affiliation(s)
- Thomas A W Bolton
- Institute of Bioengineering, École Polytechique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology and Medical Informatics, Université de Genève, Geneva, Switzerland
| | - Diana Wotruba
- Collegium Helveticum, ETH Zürich, Zurich, Switzerland.,The Zürich Program for Sustainable Development of Mental Health Services, Psychiatry University Hospital Zürich, Zurich, Switzerland
| | - Roman Buechler
- The Zürich Program for Sustainable Development of Mental Health Services, Psychiatry University Hospital Zürich, Zurich, Switzerland.,Department of Neuroradiology, University Hospital Zürich, Zurich, Switzerland
| | - Anastasia Theodoridou
- The Zürich Program for Sustainable Development of Mental Health Services, Psychiatry University Hospital Zürich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zürich, Zurich, Switzerland
| | - Lars Michels
- Department of Neuroradiology, University Hospital Zürich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zürich, Zurich, Switzerland
| | - Wulf Rössler
- Collegium Helveticum, ETH Zürich, Zurich, Switzerland.,The Zürich Program for Sustainable Development of Mental Health Services, Psychiatry University Hospital Zürich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zürich, Zurich, Switzerland.,Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Karsten Heekeren
- The Zürich Program for Sustainable Development of Mental Health Services, Psychiatry University Hospital Zürich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zürich, Zurich, Switzerland
| | - Dimitri Van De Ville
- Institute of Bioengineering, École Polytechique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology and Medical Informatics, Université de Genève, Geneva, Switzerland
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Robison A, Thakkar K, Diwadkar VA. Cognition and Reward Circuits in Schizophrenia: Synergistic, Not Separate. Biol Psychiatry 2020; 87:204-214. [PMID: 31733788 PMCID: PMC6946864 DOI: 10.1016/j.biopsych.2019.09.021] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/05/2019] [Accepted: 09/17/2019] [Indexed: 01/29/2023]
Abstract
Schizophrenia has been studied from the perspective of cognitive or reward-related impairments, yet it cannot be wholly related to one or the other process and their corresponding neural circuits. We posit a comprehensive circuit-based model proposing that dysfunctional interactions between the brain's cognitive and reward circuits underlie schizophrenia. The model is underpinned by how the relationship between glutamatergic and dopaminergic dysfunction in schizophrenia drives interactions between cognition and reward circuits. We argue that this interaction is synergistic: that is, deficits of cognition and reward processing interact, and this interaction is a core feature of schizophrenia. In adopting this position, we undertake a focused review of animal physiology and human clinical data, and in proposing this synergistic model, we highlight dopaminergic afferents from the ventral tegmental area to nucleus accumbens (mesolimbic circuit) and frontal cortex (mesocortical circuit). We then expand on the role of glutamatergic inputs to these dopamine circuits and dopaminergic modulation of critical excitatory pathways with attention given to the role of glutamatergic hippocampal outputs onto nucleus accumbens. Finally, we present evidence for how in schizophrenia, dysfunction in the mesolimbic and mesocortical circuits and their corresponding glutamatergic inputs gives rise to clinical and cognitive phenotypes and is associated with positive and negative symptom dimensions. The synthesis attempted here provides an impetus for a conceptual shift that links cognitive and motivational aspects of schizophrenia and that can lead to treatment approaches that seek to harmonize network interactions between the brain's cognition and reward circuits with ameliorative effects in each behavioral domain.
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Affiliation(s)
| | - Katharine Thakkar
- Dept. of Psychology, Michigan State University,Division of Psychiatry and Behavioral Medicine, Michigan State University
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Kéri S, Kelemen O. Christianity and Schizophrenia Redux: An Empirical Study. JOURNAL OF RELIGION AND HEALTH 2020; 59:452-469. [PMID: 27062727 DOI: 10.1007/s10943-016-0227-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper explores the relationship among schizophrenia, spirituality, and Christian religiosity. We interviewed 120 patients with schizophrenia and 120 control individuals (74.2 % of individuals with self-reported Christian religions). Patients with schizophrenia showed increases in positive spirituality and decreases in positive congregational support, as measured by the Brief Multidimensional Measure of Religiousness/Spirituality. There was no significant difference in Christian religiosity. Higher positive spirituality was predicted by more severe self-disorder, perceptual disorder, and positive clinical symptoms. Schizophrenia patients with religious delusions did not exhibit enhanced Christian beliefs and rituals. These results do not confirm the hypothesis of general hyper-religiosity in schizophrenia.
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Affiliation(s)
- Szabolcs Kéri
- Nyírő Gyula Hospital - National Institute of Psychiatry and Addictions, Budapest, Hungary.
- Department of Cognitive Science, Budapest University of Technology and Economics, Egry J. str. 1, Budapest, 1111, Hungary.
- Katharina Schütz Zell Center, Budapest, Hungary.
| | - Oguz Kelemen
- Department of Behavioral Sciences, University of Szeged, Szeged, Hungary
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Impaired action self-monitoring and cognitive confidence among ultra-high risk for psychosis and first-episode psychosis patients. Eur Psychiatry 2020; 47:67-75. [DOI: 10.1016/j.eurpsy.2017.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/29/2017] [Accepted: 09/07/2017] [Indexed: 01/06/2023] Open
Abstract
AbstractBackgroundSelf-monitoring biases and overconfidence in incorrect judgments have been suggested as playing a role in schizophrenia spectrum disorders. Little is known about whether self-monitoring biases may contribute to early risk factors for psychosis. In this study, action self-monitoring (i.e., discrimination between imagined and performed actions) was investigated, along with confidence in judgments among ultra-high risk (UHR) for psychosis individuals and first-episode psychosis (FEP) patients.MethodsThirty-six UHR for psychosis individuals, 25 FEP patients and 33 healthy controls (CON) participated in the study. Participants were assessed with the Action memory task. Simple actions were presented to participants verbally or non-verbally. Some actions were required to be physically performed and others were imagined. Participants were asked whether the action was presented verbally or non-verbally (action presentation type discrimination), and whether the action was performed or imagined (self-monitoring). Confidence self-ratings related to self-monitoring responses were obtained.ResultsThe analysis of self-monitoring revealed that both UHR and FEP groups misattributed imagined actions as being performed (i.e., self-monitoring errors) significantly more often than the CON group. There were no differences regarding performed actions as being imagined. UHR and FEP groups made their false responses with higher confidence in their judgments than the CON group. There were no group differences regarding discrimination between the types of actions presented (verbal vs non-verbal).ConclusionsA specific type of self-monitoring bias (i.e., misattributing imagined actions with performed actions), accompanied by high confidence in this judgment, may be a risk factor for the subsequent development of a psychotic disorder.
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40
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The neurophenomenology of early psychosis: An integrative empirical study. Conscious Cogn 2020; 77:102845. [DOI: 10.1016/j.concog.2019.102845] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 12/23/2022]
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41
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Perceptual biases and metacognition and their association with anomalous self experiences in first episode psychosis. Conscious Cogn 2020; 77:102847. [DOI: 10.1016/j.concog.2019.102847] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 01/19/2023]
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42
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Towards a new model of understanding – The triple network, psychopathology and the structure of the mind. Med Hypotheses 2019; 133:109385. [DOI: 10.1016/j.mehy.2019.109385] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/22/2019] [Accepted: 08/28/2019] [Indexed: 11/22/2022]
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Abstract
Structural and functional abnormalities of the cerebellum have been observed in schizophrenia since the first neuroimaging studies. More recently, the functions of the cerebellum have been extended beyond sensorimotor control to include participation in higher-level cognition and affective regulation. Consistently, the "cognitive dysmetria" theory posits that dysfunctions of cortical-subcortical-cerebellar circuitry may be crucial for the pathogenesis of different clinical features of schizophrenia. This conceptual framework offers a set of testable hypotheses, now that various tools to exert direct modulation of cerebellar activity are available. We conducted a systematic review of studies examining the effects of cerebellar modulation in schizophrenia. Two independent authors conducted a search within PubMed for articles published up to April 2019 and identified 10 studies (three randomized controlled trials, two open-label studies, two case reports, one preclinical study) describing the effects of cerebellar circuitry modulation in patients with schizophrenia or animal models. The majority of interventions were uncontrolled and used stimulation of the cerebellar vermis, using transcranial magnetic stimulation or transcranial direct-current stimulation. Most studies detected improvements after cerebellar modulation. Clinical changes mostly pertained the domains of negative symptoms, depressive symptoms and cognitive functions. In conclusion, few studies examined the effects of cerebellar modulation in schizophrenia but yielded promising results. This approach may hold therapeutic potential, pending further methodologically robust replication.
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Potvin S, Gamache L, Lungu O. A Functional Neuroimaging Meta-Analysis of Self-Related Processing in Schizophrenia. Front Neurol 2019; 10:990. [PMID: 31572296 PMCID: PMC6749044 DOI: 10.3389/fneur.2019.00990] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 08/30/2019] [Indexed: 01/27/2023] Open
Abstract
Background: Schizophrenia is characterized by self-disturbances, including impaired self-evaluation abilities and source monitoring. The cortical midline structures (e.g., medial prefrontal cortex, anterior and posterior cingulate cortex, and precuneus) and the temporoparietal junction are known to play a key role in self-related processing. In theory, self-disturbances in schizophrenia may arise from impaired activity in these regions. We performed a functional neuroimaging meta-analysis to verify this hypothesis. Methods: A literature search was performed with PubMed and Google Scholar to identify functional neuroimaging studies examining the neural correlates of self-processing in schizophrenia, using self-other or source monitoring paradigms. Fourteen studies were retrieved, involving 245 patients and 201 controls. Using peak coordinates to recreate an effect-size map of contrast results, a standard random-effects variance weighted meta-analysis for each voxel was performed with the Seed-based d Mapping software. Results: During self-processing, decreased activations were observed in schizophrenia patients relative to controls in the bilateral thalamus and the left dorsal anterior cingulate cortex (dACC) and dorso-medial prefrontal cortex. Importantly, results were homogeneous across studies, and no publication bias was observed. Sensitivity analyses revealed that results were replicable in 93-100% of studies. Conclusion: The current results partially support the hypothesized impaired activity of cortical midline brain regions in schizophrenia during self-processing. Decreased activations were observed in the dACC and dorsomedial prefrontal cortex, which are involved in cognitive control and/or salience attribution, as well as decision-making, respectively. These alterations may compromise patients' ability to direct their attention toward themselves and/or others and to make the decision whether a certain trait applies to one's self or to someone else. In addition, decreased activations were observed in the thalamus, which is not a core region of the default-mode network, and is involved in information integration. These thalamic alterations may compromise self-coherence in schizophrenia.
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Affiliation(s)
- Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Lydia Gamache
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Ovidiu Lungu
- Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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45
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Kornmayer L, Leicht G, Mulert C. Attentional capture by physically salient stimuli in the gamma frequency is associated with schizophrenia symptoms. World J Biol Psychiatry 2019; 19:S52-S62. [PMID: 27844503 DOI: 10.1080/15622975.2016.1258491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Aberrant salience mainly is attributed to excessive dopaminergic processing in the ventral striatum. Increased gamma power during sensory processing of physical salience has been shown to be associated with positive trait schizotypy. In the present study, this is assessed in patients with schizophrenia. METHODS The early evoked visual gamma-band response (GBR) at 40 Hz was assessed for a schizophrenia patient group (N = 22) and a matched healthy control group (N = 22) applying EEG time-frequency analysis. The GBR was assessed for two conditions within a visual detection paradigm: a target with or without a physically salient distracter and evaluated in relation to the PANSS. RESULTS A 2 × 2 ANOVA revealed a significant main effect of condition and a trend interaction of group and condition for the GBR, with highest power for schizophrenia patients in the physically salient distracter condition. Moreover, evoked GBR power in this condition was correlated with positive (r = 0.664; P = 0.001**) and disorganised (r = 0.618; P = 0.002**) schizophrenia symptoms. CONCLUSIONS Evoked GBR power during processing of physical salience in schizophrenia was associated with positive symptoms. We suggest that abnormal processing of physically salient stimuli might be involved in the pathophysiological genesis of positive symptoms.
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Affiliation(s)
- Laura Kornmayer
- a Department of Psychiatry and Psychotherapy, Center of Psychosocial Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Gregor Leicht
- a Department of Psychiatry and Psychotherapy, Center of Psychosocial Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Christoph Mulert
- a Department of Psychiatry and Psychotherapy, Center of Psychosocial Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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46
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Koren D, Scheyer R, Reznik N, Adres M, Apter A, Parnas J, Seidman LJ. Basic self-disturbance, neurocognition and metacognition: A pilot study among help-seeking adolescents with and without attenuated psychosis syndrome. Early Interv Psychiatry 2019; 13:434-442. [PMID: 29052951 DOI: 10.1111/eip.12500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 07/19/2017] [Accepted: 08/20/2017] [Indexed: 11/29/2022]
Abstract
AIM The goal of this pilot study was to assess the association between basic self-disturbance (SD) and deficits in neurocognitive and metacognitive functioning among help-seeking adolescents with and without attenuated psychosis syndrome (APS). METHODS Sixty-one non-psychotic, help-seeking adolescents (age 13-18) were assessed with the examination of anomalous self-experience, the structured interview for prodromal syndromes and a new metacognitive approach to neurocognitive assessment applied to two non-social (executive functions and verbal memory) and two social (theory of mind and emotion recognition) domains. After each answer, subjects were also requested to indicate their level of confidence in the answer and to decide whether they desired it to be "counted" toward their total score on the task. Each volunteered answer earned a 5-cent gain if correct, but an equal fine if wrong. RESULTS As hypothesized, metacognitive monitoring and control had a significant contribution to the prediction of SD over and above neurocognitive functioning and attenuated psychotic symptoms. However, the direction of this association was positive rather than negative. Also, inconsistent with or hypothesis, it was not moderated by the presence of APS. CONCLUSIONS These pilot results provide preliminary support a modest association between SD and metacognition, which is not reducible to neurocognition and APS. In addition, they raise an intriguing possibility regarding metacognitive monitoring and control being indicators of hyper-reflectivity that characterizes individuals with SD. However, further research with larger samples and high-stress assessment conditions are needed to assess this possibility.
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Affiliation(s)
- Dan Koren
- Psychology Department, University of Haifa, Haifa, Israel
| | - Ravit Scheyer
- Psychology Department, University of Haifa, Haifa, Israel
| | - Noa Reznik
- Psychology Department, University of Haifa, Haifa, Israel
| | - Merav Adres
- Psychology Department, University of Haifa, Haifa, Israel
| | - Alan Apter
- Psychological Medicine Clinic, Schneider Children Medical Center, Petach Tikva, Israel
| | - Josef Parnas
- Psychiatric Center, Glostrup-Hvidovre, Faculty of Health and Medical Sciences, University of Copenhagen, Brøndby, Denmark.,Center for Subjectivity Research, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Larry J Seidman
- The Massachusetts Mental Health Center, Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Sterzer P, Voss M, Schlagenhauf F, Heinz A. Decision-making in schizophrenia: A predictive-coding perspective. Neuroimage 2019; 190:133-143. [DOI: 10.1016/j.neuroimage.2018.05.074] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 12/11/2022] Open
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Watson P, Pearson D, Wiers RW, Le Pelley ME. Prioritizing pleasure and pain: attentional capture by reward-related and punishment-related stimuli. Curr Opin Behav Sci 2019. [DOI: 10.1016/j.cobeha.2018.12.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gawęda Ł, Göritz AS, Moritz S. Mediating role of aberrant salience and self-disturbances for the relationship between childhood trauma and psychotic-like experiences in the general population. Schizophr Res 2019; 206:149-156. [PMID: 30545759 DOI: 10.1016/j.schres.2018.11.034] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/13/2018] [Accepted: 11/30/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The relationship between childhood trauma and the risk of psychosis is well established. However, the mechanisms of the relationship are still unknown. We investigated whether two factors involved in the risk of psychosis - self-disturbances and aberrant salience - mediate the relationship between childhood trauma and psychotic-like experiences in the general population. METHODS We tested parallel mediation models which assume that the relationship between childhood trauma (Childhood Trauma Questionnaire, the CTQ) and psychotic-like experiences (Prodromal questionnaire, PQ-16) is mediated by both self-disturbances and aberrant salience (Aberrant Salience Inventory, the ASI) in a general population sample (N = 649). Separate parallel mediation models were calculated for cumulative childhood trauma, exposure to abusive behaviors (emotional, physical and sexual abuse) and neglect (emotional and physical neglect) controlling for gender. RESULTS Childhood traumatic life events predicted psychotic-like experiences. Childhood trauma was also related to self-disturbances and aberrant salience. Self-disturbances and aberrant salience were related to psychotic-like experiences. Models of mediation for the relationship between cumulative childhood trauma and neglect and psychotic-like experiences revealed an indirect-only mediation by self-disturbances and aberrant salience. The model for childhood abuse suggested a complementary mediation and was affected by gender. CONCLUSIONS Our results provide tentative evidence that self-disturbances and aberrant salience are important factors in the translation of childhood trauma into the risk of psychosis in the general population. Causal relationships could not be inferred from this cross-sectional data. Hence, longitudinal studies on a clinical sample are warranted.
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Affiliation(s)
- Łukasz Gawęda
- II Department of Psychiatry, Medical University of Warsaw, Poland; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
| | - Anja S Göritz
- Department of Psychology, University of Freiburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
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Gawęda Ł, Pionke R, Arciszewska A, Prochwicz K, Frydecka D, Misiak B, Cechnicki A, Cicero DC, Nelson B. A combination of self-disturbances and psychotic-like experiences. A cluster analysis study on a non-clinical sample in Poland. Psychiatry Res 2019; 273:394-401. [PMID: 30684785 DOI: 10.1016/j.psychres.2019.01.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
We aimed to perform a cluster analysis to investigate the group structure of a combination of psychotic-like experiences (PLEs) and self-disturbances in a non-clinical sample. Non-clinical adults (n = 677) were assessed with the Community Assessment of Psychic Experiences (CAPE), the Davos Assessment of Cognitive Biases Scale (DACOBS) and the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE). Cluster analysis was conducted based on the positive and negative dimension of CAPE and a total score of IPASE. Four distinct groups were revealed by the cluster analysis. The High Profile group had the highest means, and the Low Profile had the lowest scores of positive and negative subscales of the CAPE and IPASE. The Positive Profile group had a significantly higher level of self-disturbances (in 'Cognition', 'Consciousnesses and 'Somatization' dimensions) from participants with the 'Negative Profile'. The High Profile group had more cognitive biases (i.e., inadequate cognitive inference about internal and external events) related to psychosis as assessed with DACOBS, had the highest means on each IPASE subscale and had a higher level of emotional distress. A combination of high level of PLEs and self-disturbances may capture the highest risk of psychosis in the general population associated with cognitive biases characteristic for psychosis.
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Affiliation(s)
- Łukasz Gawęda
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Poland, Rychlińskiego 1, 05-901 Ząbki, Poland.
| | - Renata Pionke
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Poland, Rychlińskiego 1, 05-901 Ząbki, Poland
| | - Aleksandra Arciszewska
- SWPS University of Social Sciences and Humanities, Sopot, Poland; Department of Community Psychiatry, Chair of Psychiatry, Medical College, Jagiellonian University, Krakow, Poland
| | | | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Poland
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Medical College, Jagiellonian University, Krakow, Poland
| | - David C Cicero
- Department of Psychology, University of Hawai'i at Manoa, Honolulu, United States
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
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