1
|
Zhang Y, Yang T, He Y, Meng F, Zhang K, Jin X, Cui X, Luo X. Value of P300 amplitude in the diagnosis of untreated first-episode schizophrenia and psychosis risk syndrome in children and adolescents. BMC Psychiatry 2023; 23:743. [PMID: 37828471 PMCID: PMC10571359 DOI: 10.1186/s12888-023-05218-5] [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: 04/01/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Identifying the characteristic neurobiological changes of early psychosis is helpful for early clinical diagnosis. However, previous studies on the brain electrophysiology of children and adolescents with psychosis are rare. METHODS This study compared P300 amplitude at multiple electrodes between children and adolescents with first-episode schizophrenia (FES, n = 48), children and adolescents with psychosis risk syndrome (PRS, n = 24), and healthy controls (HC, n = 30). Receiver operating characteristic (ROC) analysis was used to test the ability of P300 amplitude to distinguish FES, PRS and HC individuals. RESULTS The P300 amplitude in the FES group were significantly lower than those in the HC at the Cz, Pz, and Oz electrodes. The P300 amplitude was also significantly lower in the prodromal group than in the HC at the Pz and Oz electrodes. ROC curve analysis showed that at the Pz electrode, the P300 amplitude evoked by the target and standard stimulus showed high sensitivity, specificity, accuracy, and area under the curve value for distinguishing FES from HC individuals. CONCLUSIONS This study found early visual P300 deficits in children and adolescents with FES and PRS, with the exclusion of possible influence of medication and chronic medical conditions, suggesting the value of P300 amplitude for the identification of early psychosis.
Collapse
Affiliation(s)
- Yaru Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Tingyu Yang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Yuqiong He
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Fanchao Meng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Kun Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Xingyue Jin
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Xilong Cui
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Xuerong Luo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| |
Collapse
|
2
|
Hennig-Fast K, Meissner D, Steuwe C, Dehning S, Blautzik J, Eilert DW, Zill P, Müller N, Meindl T, Reiser M, Möller HJ, Falkai P, Driessen M, Buchheim A. The Interplay of Oxytocin and Attachment in Schizophrenic Patients: An fMRI Study. Brain Sci 2023; 13:1125. [PMID: 37626482 PMCID: PMC10452454 DOI: 10.3390/brainsci13081125] [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: 06/03/2023] [Revised: 07/02/2023] [Accepted: 07/18/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Attachment theory offers an important framework for understanding interpersonal interaction experiences. In the present study, we examined the neural correlates of attachment patterns and oxytocin in schizophrenic patients (SZP) compared to healthy controls (HC) using fMRI. We assumed that male SZP shows a higher proportion of insecure attachment and an altered level of oxytocin compared to HC. On a neural level, we hypothesized that SZP shows increased neural activation in memory and self-related brain regions during the activation of the attachment system compared to HC. METHODS We used an event-related design for the fMRI study based on stimuli that were derived from the Adult Attachment Projective Picture System to examine attachment representations and their neural and hormonal correlates in 20 male schizophrenic patients compared to 20 male healthy controls. RESULTS A higher proportion of insecure attachment in schizophrenic patients compared to HC could be confirmed. In line with our hypothesis, Oxytocin (OXT) levels in SZP were significantly lower than in HC. We found increasing brain activations in SZP when confronted with personal relevant sentences before attachment relevant pictures in the precuneus, TPJ, insula, and frontal areas compared to HC. Moreover, we found positive correlations between OXT and bilateral dlPFC, precuneus, and left ACC in SZP only. CONCLUSION Despite the small sample sizes, the patients' response might be considered as a mode of dysregulation when confronted with this kind of personalized attachment-related material. In the patient group, we found positive correlations between OXT and three brain areas (bilateral dlPFC, precuneus, left ACC) and may conclude that OXT might modulate within this neural network in SZP.
Collapse
Affiliation(s)
- Kristina Hennig-Fast
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
- Department of Psychiatry and Psychotherapy, University of Bielefeld, 33615 Bielefeld, Germany
| | - Dominik Meissner
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Carolin Steuwe
- Department of Psychiatry and Psychotherapy, University of Bielefeld, 33615 Bielefeld, Germany
| | - Sandra Dehning
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Janusch Blautzik
- Department of Radiology, Ludwig-Maximilians University, 81377 Munich, Germany
| | - Dirk W. Eilert
- Department of Psychology, University Innsbruck, 6020 Innsbruck, Austria
| | - Peter Zill
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Norbert Müller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Thomas Meindl
- Department of Radiology, Ludwig-Maximilians University, 81377 Munich, Germany
| | - Maximilian Reiser
- Department of Radiology, Ludwig-Maximilians University, 81377 Munich, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, 80336 Munich, Germany (H.-J.M.); (P.F.)
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, University of Bielefeld, 33615 Bielefeld, Germany
| | - Anna Buchheim
- Department of Psychology, University Innsbruck, 6020 Innsbruck, Austria
| |
Collapse
|
3
|
Eweida RS, Shaheen SHAEM, Abou-Elmaaty GM. "Feeling shattered and ephemeral": How do positive and negative symptoms affect self-concept clarity among individuals experiencing psychosis? Arch Psychiatr Nurs 2023; 44:18-25. [PMID: 37197857 DOI: 10.1016/j.apnu.2023.03.003] [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: 01/29/2022] [Revised: 01/06/2023] [Accepted: 03/11/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE Incoherence in sense of self in schizophrenia may mask individuals' ability to perceive reality accurately, and cause them to feel alienated from themselves and others. This descriptive correlational study investigates the relationship between positive and negative symptoms in relation to self-concept clarity (SCC) in schizophrenia. METHOD A sample of 200 inpatients with schizophrenia were recruited to complete the Self-Concept Clarity Scale and were rated on the Brief Psychiatric Rating Scale (BPRS-version 4.0). RESULTS A strong inverse correlation between positive and negative symptoms in relation to SCC (r = 0.242, P < 0.001, and r = 0.225, P = 0.001, respectively). CONCLUSION The overall BPRS scores were identified as independent precursors of low SCC.
Collapse
Affiliation(s)
- Rasha Salah Eweida
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Egypt; Psychiatric and Mental Health Specialty, Nursing Department, College of Health and Sport Sciences, University of Bahrain, Bahrain.
| | | | | |
Collapse
|
4
|
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
|
5
|
Resolving heterogeneity in schizophrenia through a novel systems approach to brain structure: individualized structural covariance network analysis. Mol Psychiatry 2021; 26:7719-7731. [PMID: 34316005 DOI: 10.1038/s41380-021-01229-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/15/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022]
Abstract
Reliable mapping of system-level individual differences is a critical first step toward precision medicine for complex disorders such as schizophrenia. Disrupted structural covariance indicates a system-level brain maturational disruption in schizophrenia. However, most studies examine structural covariance at the group level. This prevents subject-level inferences. Here, we introduce a Network Template Perturbation approach to construct individual differential structural covariance network (IDSCN) using regional gray-matter volume. IDSCN quantifies how structural covariance between two nodes in a patient deviates from the normative covariance in healthy subjects. We analyzed T1 images from 1287 subjects, including 107 first-episode (drug-naive) patients and 71 controls in the discovery datasets and established robustness in 213 first-episode (drug-naive), 294 chronic, 99 clinical high-risk patients, and 494 controls from the replication datasets. Patients with schizophrenia were highly variable in their altered structural covariance edges; the number of altered edges was related to severity of hallucinations. Despite this variability, a subset of covariance edges, including the left hippocampus-bilateral putamen/globus pallidus edges, clustered patients into two distinct subgroups with opposing changes in covariance compared to controls, and significant differences in their anxiety and depression scores. These subgroup differences were stable across all seven datasets with meaningful genetic associations and functional annotation for the affected edges. We conclude that the underlying physiology of affective symptoms in schizophrenia involves the hippocampus and putamen/pallidum, predates disease onset, and is sufficiently consistent to resolve morphological heterogeneity throughout the illness course. The two schizophrenia subgroups identified thus have implications for the nosology and clinical treatment.
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Lee HS, Hong SJJ, Baxter T, Scott J, Shenoy S, Buck L, Bodenheimer B, Park S. Altered Peripersonal Space and the Bodily Self in Schizophrenia: A Virtual Reality Study. Schizophr Bull 2021; 47:927-937. [PMID: 33844019 PMCID: PMC8266616 DOI: 10.1093/schbul/sbab024] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Self-disturbances such as an anomalous perception of one's own body boundary are central to the phenomenology of schizophrenia (SZ), but measuring the spatial parameters of the hypothesized self-other boundary has proved to be challenging. Peripersonal space (PPS) refers to the immediate zone surrounding the body where the self interacts physically with the environment; the space that corresponds to hypothesized self-other boundary. PPS is represented by enhanced multisensory integration and faster reaction time (RT) for objects near the body. Thus, multisensory RT tasks can be used to estimate self-other boundary. We aimed to quantify PPS in SZ using an immersive virtual reality visuotactile RT paradigm. Twenty-four participants with SZ and 24 demographically matched controls (CO) were asked to detect tactile vibration while watching a ball approaching them, thrown by either a machine (nonsocial condition) or an avatar (social condition). Parameters of PPS were estimated from the midpoint of the spatial range where the tactile RT decreased most rapidly (size) and the gradient of the RT change at this midpoint (slope). Overall, PPS was smaller in participants with SZ compared with CO. PPS slope for participants with SZ was shallower than CO in the social but not in nonsocial condition, indicating an increased uncertainty of self-other boundary across an extended zone in SZ. Social condition also increased false alarms for tactile detection in SZ. Clinical symptoms were not clearly associated with PPS parameters. These findings suggest the context-dependent nature of weakened body boundary in SZ and underscore the importance of reconciliating objective and subjective aspects of self-disturbances.
Collapse
Affiliation(s)
- Hyeon-Seung Lee
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Seok-Jin J Hong
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Tatiana Baxter
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Jason Scott
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Sunil Shenoy
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Lauren Buck
- School of Engineering, Vanderbilt University, Nashville, TN, USA
| | | | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
8
|
Dondé C, Laprévote V, Lavallé L, Haesebaert F, Fakra E, Brunelin J. Cognitive insight in individuals with an at-risk mental state for psychosis: A meta-analysis. Early Interv Psychiatry 2021; 15:449-456. [PMID: 32452629 DOI: 10.1111/eip.12993] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/09/2020] [Accepted: 04/28/2020] [Indexed: 01/01/2023]
Abstract
AIM To compare cognitive insight abilities measured with the Beck Cognitive Insight Scale (BCIS) between individuals with an at-risk mental state (ARMS) and healthy controls. METHOD Review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS A search for articles investigating cognitive insight in ARMS in the MEDLINE and ScienceDirect databases revealed five studies including 303 ARMS and 376 controls. Regarding BCIS subscales, ARMS individuals displayed significant higher scores for self-certainty than controls with a small-to-moderate effect size (ESg = 0.45 [0.23;0.67], P < .005), whereas no significant difference was observed for self-reflectiveness (ESg = -0.56 [-0.18;1.29], P = .14). No significant differences were observed between ARMS and controls for overall cognitive insight abilities as indexed by the BCIS composite score (ESg = -0.24 [-0.43;0.91], P = .45). CONCLUSIONS Self-certainty abnormalities seem to predate the expression of full-blown psychotic episode and to be higher in ARMS than in healthy controls. By contrast, ARMS did not display abnormal self-reflectiveness and overall cognitive insight abilities.
Collapse
Affiliation(s)
- Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Vincent Laprévote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France.,INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.,Faculté de Médecine, Université de Lorraine, Nancy, France
| | - Layla Lavallé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Eric Fakra
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jerome Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| |
Collapse
|
9
|
Damme KSF, Sloan RP, Bartels MN, Ozsan A, Ospina LH, Kimhy D, Mittal VA. Psychosis risk individuals show poor fitness and discrepancies with objective and subjective measures. Sci Rep 2021; 11:9851. [PMID: 33972634 PMCID: PMC8110757 DOI: 10.1038/s41598-021-89301-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/20/2021] [Indexed: 11/25/2022] Open
Abstract
Exercise is a promising intervention for individuals at clinical high-risk for psychosis (CHR). However, these youth may not be reliable reporters on fitness. There have been no investigations that utilized objective fitness assessment in this population. The present study objectively characterizes the level of fitness in CHR youth, compares the accuracy of self-report measures to objective fitness indices, and explores clinical factors that may influence the accuracy of self-reported measures of fitness. Forty CHR individuals completed an exercise survey and objective indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed objective indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness. CHR youth showed greater BMI and lowered VO2max compared to healthy volunteers. In the CHR group, self-report items (perceived fitness) did not reflect objective indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with objective fitness measurements. Exploratory analyses suggested that symptoms (grandiosity and avolition) related to errors in self-perception. Results indicate that CHR individuals are less fit than controls as indexed by objective measures of fitness and that it is important to consider unique population clinical characteristics when employing self-report data.
Collapse
Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA.
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA.
| | - Richard P Sloan
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Matthew N Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Rehabilitation Medicine, Montefiore Medical Center, New York, NY, USA
| | - Alara Ozsan
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | - Luz H Ospina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- MIRECC, The James J. Peters VA Medical Center, Bronx, NY, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
| |
Collapse
|
10
|
Raballo A, Poletti M, Preti A, Parnas J. The Self in the Spectrum: A Meta-analysis of the Evidence Linking Basic Self-Disorders and Schizophrenia. Schizophr Bull 2021; 47:1007-1017. [PMID: 33479736 PMCID: PMC8266610 DOI: 10.1093/schbul/sbaa201] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Disturbed self-experience has been reported as a characteristic feature of schizophrenia since the first formulation of its diagnostic concept; however, only in the last 2 decades an explicit notion of basic Self-disturbance, or Self-Disorders (SD), has emerged as target for a systematic research program. We conducted systematic searches in bibliographical databases to identify cross-sectional studies that explored SD across different diagnostic groups and explored diagnostic ascription within or outside schizophrenia spectrum disorders (SSD) as main outcome. Data were pooled using fixed- and random-effects meta-analysis models. Heterogeneity was assessed using stratified meta-analyses and meta-regression. Of 218 identified studies, 32 were included in the systematic review and 27 in the meta-analysis. Patients diagnosed with SSD scored higher on measures of SD than healthy controls (HC) (Hedges' g = 1.8; 95% CI = 1.5 to 2.0), individuals diagnosed with other mental illness (OMI) (1.9; 1.6 to 2.2), bipolar or affective disorders (1.8; 1.4 to 2.2), and clinical high risk for psychosis (CHR) (1.6; 0.9 to 2.4). Patients with schizotypy or schizotypal personality disorder scored higher on measures of SD than OMI (1.5; 1.3 to 1.8) and HC (1.4; 1.1 to 1.7). Patients with first-episode psychosis scored higher on measures of SD than HC (2.5; 2.1 to 2.9) and OMI (1.6; 1.2 to 2.1). Subjects at CHR scored higher on measures of SD than HC (2.0; 1.7 to 2.2) and OMI (19; 1.6 to 2.2). Overall, heterogeneity ranged from negligible to high, especially in comparisons of the target group with OMI, probably as a reflection of the immanent diagnostic heterogeneity of this group. The findings suggest that SD selectively aggregate within schizophrenia spectrum disorders as compared to other mental disorders and that they could be a central phenotypic marker of vulnerability to schizophrenia across the different shades of severity of its spectrum of disorders.
Collapse
Affiliation(s)
- Andrea Raballo
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy,Center for Translational, Phenomenological and Developmental Psychopathology (CTPDP), Perugia University Hospital, Perugia, Italy,To whom correspondence should be addressed; Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia Piazzale Lucio Severi 1, 06132, Perugia, Italy; tel: +39 075 5783194, fax: +39 075 5783183, e-mail:
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction, Child and Adolescent Neuropsychiatry Service, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Preti
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Josef Parnas
- Center for Subjectivity Research, University of Copenhagen, 2300, Copenhagen, Denmark,Mental Health Centre Glostrup, University Hospital of Copenhagen, 2605, Brøndby, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| |
Collapse
|
11
|
Collin G, Bauer CCC, Anteraper SA, Gabrieli JDE, Molokotos E, Mesholam-Gately R, Thermenos HW, Seidman LJ, Keshavan MS, Shenton ME, Whitfield-Gabrieli S. Hyperactivation of Posterior Default Mode Network During Self-Referential Processing in Children at Familial High-Risk for Psychosis. Front Psychiatry 2021; 12:613142. [PMID: 33633608 PMCID: PMC7900488 DOI: 10.3389/fpsyt.2021.613142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/04/2021] [Indexed: 11/28/2022] Open
Abstract
Patients with schizophrenia spectrum disorders show disturbances in self-referential processing and associated neural circuits including the default mode network (DMN). These disturbances may precede the onset of psychosis and may underlie early social and emotional problems. In this study, we examined self-referential processing in a group of children (7-12 years) at familial high risk (FHR) for psychosis (N = 17), compared to an age and sex-matched group of healthy control (HC) children (N = 20). The participants were presented with a list of adjectives and asked to indicate whether or not the adjectives described them (self-reference condition) and whether the adjectives described a good or bad trait (semantic condition). Three participants were excluded due to chance-level performance on the semantic task, leaving N = 15 FHR and N = 19 HC for final analysis. Functional MRI (fMRI) was used to measure brain activation during self-referential vs. semantic processing. Internalizing and externalizing problems were assessed with the Child Behavior Checklist (CBCL). Evaluating main effects of task (self > semantic) showed activation of medial prefrontal cortex in HC and precuneus/posterior cingulate cortex (PCC) in FHR. Group-comparison yielded significant results for the FHR > HC contrast, showing two clusters of hyperactivation in precuneus/ PCC (p = 0.004) and anterior cerebellum / temporo-occipital cortex (p = 0.009). Greater precuneus/PCC activation was found to correlate with greater CBCL internalizing (r = 0.60, p = 0.032) and total (r = 0.69, p = 0.009) problems. In all, this study shows hyperactivity of posterior DMN during self-referential processing in pre-adolescent FHR children. This finding posits DMN-related disturbances in self-processing as a developmental brain abnormality associated with familial risk factors that predates not just psychosis, but also the prodromal stage. Moreover, our results suggest that early disturbances in self-referential processing may be related to internalizing problems in at-risk children.
Collapse
Affiliation(s)
- Guusje Collin
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, Netherlands
| | - Clemens C C Bauer
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychology, Northeastern University, Boston, MA, United States
| | - Sheeba Arnold Anteraper
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychology, Northeastern University, Boston, MA, United States
| | - John D E Gabrieli
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Elena Molokotos
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Raquelle Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Heidi W Thermenos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychology, Northeastern University, Boston, MA, United States
| |
Collapse
|
12
|
Lee HS, Griffith T, Park S. Bodily Self-Disturbances in Schizophrenia: A Comparative Study of South Korea and the USA. Psychopathology 2021; 54:262-274. [PMID: 34380136 DOI: 10.1159/000517933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/17/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bodily self-disturbances are highly salient to the phenomenology of schizophrenia (SZ) but difficult to quantify owing to the subjective nature of these experiences that challenge verbal descriptions. The Benson et al. [PsyCh J. 2019 Mar;8(1):110-21] Body Disturbances Inventory (B-BODI) provides visual aids to help participants access the frequency, distressfulness, and vividness of subjective self-experiences with good reliability and validity in North American samples. However, the concept of the self and, accordingly, the conceptualization of self-disorders are influenced by culture. Therefore, we examined self-disturbances in individuals with SZ and control (CO) participants in 2 distinct cultures. METHODS B-BODI was administered to South Korean and North American participants, with and without SZ. Severity of symptoms in diagnosed individuals with SZ and schizotypy in CO was assessed. We also assessed perceived social isolation and mood in all participants. RESULTS Endorsement and frequency of bodily self-disturbances in SZ were similar in both cultures. In contrast, there were significant cultural differences in the degree of distress and vividness of self-disturbances. Bodily self-disturbances were experienced as more vivid and distressing to Americans than Koreans, regardless of diagnosis. For both cultures, B-BODI scores were associated with positive, but not negative, symptoms in SZ. For CO, elevated schizotypy was associated with B-BODI scores. Mood and loneliness were not associated with B-BODI scores. CONCLUSION SZ reported overall increased levels of bodily self-disturbances compared with CO, regardless of culture. However, there were cultural differences in one's emotional reaction to these experiences. Americans were more distressed by self-disturbances and experienced them more vividly than Koreans. These findings suggest that Americans may be less accepting of anomalous bodily self-experiences relative to Koreans. Last, B-BODI appears to be a useful tool for future cross-cultural studies of SZ phenomenology.
Collapse
Affiliation(s)
- Hyeon-Seung Lee
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Taylor Griffith
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| |
Collapse
|
13
|
Grey-matter abnormalities in clinical high-risk participants for psychosis. Schizophr Res 2020; 226:120-128. [PMID: 31740178 PMCID: PMC7774586 DOI: 10.1016/j.schres.2019.08.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 08/28/2019] [Accepted: 08/31/2019] [Indexed: 01/10/2023]
Abstract
The current study examined the presence of abnormalities in cortical grey-matter (GM) in a sample of clinical high-risk (CHR) participants and examined relationships with psychosocial functioning and neurocognition. CHR-participants (n = 114), participants who did not fulfil CHR-criteria (CHR-negative) (n = 39) as well as a group of healthy controls (HC) (n = 49) were recruited. CHR-status was assessed using the Comprehensive Assessment of At-Risk Mental State (CAARMS) and the Schizophrenia Proneness Interview, Adult Version (SPI-A). The Brief Assessment of Cognition in Schizophrenia Battery (BACS) as well as tests for emotion recognition, working memory and attention were administered. In addition, role and social functioning as well as premorbid adjustment were assessed. No significant differences in GM-thickness and intensity were observed in CHR-participants compared to CHR-negative and HC. Circumscribed abnormalities in GM-intensity were found in the visual and frontal cortex of CHR-participants. Moreover, small-to-moderate correlations were observed between GM-intensity and neuropsychological deficits in the CHR-group. The current data suggest that CHR-participants may not show comprehensive abnormalities in GM. We discuss the implications of these findings for the pathophysiological theories of early stage-psychosis as well as methodological issues and the impact of different recruitment strategies.
Collapse
|
14
|
Crosta CM, Hernandez K, Bhattiprolu AK, Fu AY, Moore JC, Clarke SG, Dudzinski NR, Brzustowicz LM, Paradiso KG, Firestein BL. Characterization hiPSC-derived neural progenitor cells and neurons to investigate the role of NOS1AP isoforms in human neuron dendritogenesis. Mol Cell Neurosci 2020; 109:103562. [PMID: 32987141 PMCID: PMC7736313 DOI: 10.1016/j.mcn.2020.103562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/02/2020] [Accepted: 09/22/2020] [Indexed: 01/30/2023] Open
Abstract
Abnormal dendritic arbor development has been implicated in a number of neurodevelopmental disorders, such as autism and Rett syndrome, and the neuropsychiatric disorder schizophrenia. Postmortem brain samples from subjects with schizophrenia show elevated levels of NOS1AP in the dorsolateral prefrontal cortex, a region of the brain associated with cognitive function. We previously reported that the long isoform of NOS1AP (NOS1AP-L), but not the short isoform (NOS1AP-S), negatively regulates dendrite branching in rat hippocampal neurons. To investigate the role that NOS1AP isoforms play in human dendritic arbor development, we adapted methods to generate human neural progenitor cells and neurons using induced pluripotent stem cell (iPSC) technology. We found that increased protein levels of either NOS1AP-L or NOS1AP-S decrease dendrite branching in human neurons at the developmental time point when primary and secondary branching actively occurs. Next, we tested whether pharmacological agents can decrease the expression of NOS1AP isoforms. Treatment of human iPSC-derived neurons with d-serine, but not clozapine, haloperidol, fluphenazine, or GLYX-13, results in a reduction in endogenous NOS1AP-L, but not NOS1AP-S, protein expression; however, d-serine treatment does not reverse decreases in dendrite number mediated by overexpression of NOS1AP isoforms. In summary, we demonstrate how an in vitro model of human neuronal development can help in understanding the etiology of schizophrenia and can also be used as a platform to screen drugs for patients.
Collapse
Affiliation(s)
- Christen M Crosta
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; Neurosciences Graduate Program, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Kristina Hernandez
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; Molecular Biosciences Graduate Program, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Atul K Bhattiprolu
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Allen Y Fu
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Jennifer C Moore
- Department of Genetics, Rutgers, The State University of New Jersey, 604 Allison Road, Piscataway, NJ 08854-8082, USA
| | - Stephen G Clarke
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Natasha R Dudzinski
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Linda M Brzustowicz
- Department of Genetics, Rutgers, The State University of New Jersey, 604 Allison Road, Piscataway, NJ 08854-8082, USA
| | - Kenneth G Paradiso
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Bonnie L Firestein
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| |
Collapse
|
15
|
Boldrini T, Pontillo M, Tanzilli A, Giovanardi G, Di Cicilia G, Salcuni S, Vicari S, Lingiardi V. An attachment perspective on the risk for psychosis: Clinical correlates and the predictive value of attachment patterns and mentalization. Schizophr Res 2020; 222:209-217. [PMID: 32513546 DOI: 10.1016/j.schres.2020.05.052] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/07/2020] [Accepted: 05/19/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND In a longitudinal design, the present study examined: (a) the nature of attachment patterns and reflective functioning (RF) in individuals at ultra-high risk for psychosis (UHR); (b) the association between RF and subclinical psychotic symtoms; and (c) the psychosis-predictive value of attachment patterns, RF, and the interaction between these factors. METHOD The sample comprised 57 UHR subjects and 53 clinical controls (non-UHR). UHR subjects were followed over a mean period of 14 months (SD = 2.7; range 11-19), during which time 11.5% developed psychosis. Attachment patterns and RF were measured. Hierarchical logistic regression was used to examine the predictive value of variables in the transition to psychosis. RESULTS At baseline, significant differences were found between groups in secure attachment patterns and RF. RF was negatively associated with the attenuated psychotic symptoms described by the Unusual Thought Content/Delusional Ideas, Suspiciousness/Persecutory Ideas, and Disorganized Communication subscales. Moreover, poor mentalization was related to an increased likelihood of developing a psychotic disorder (OR = 0.427, 95% CI [0.188, 0.970]); conversely, no predictive effects of the attachment variables and their interaction with RF on the transition to psychosis were found. Notably, an optimal threshold value of RF = 1.25 was found to distinguish UHR subjects who made the transition to psychosis from those who did not develop this pathology. CONCLUSION The results suggest that aberrant mentalizing patterns can predict the development of psychosis. Clinical implications of these results for the development of preventive treatments are discussed.
Collapse
Affiliation(s)
- Tommaso Boldrini
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy; Department of Developmental Psychology and Socialization, University of Padua, Via Venezia, 8, 35131 Padua, Italy.
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00100 Rome, Italy.
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy.
| | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100 Caserta, Italy.
| | - Giuseppe Di Cicilia
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy.
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padua, Via Venezia, 8, 35131 Padua, Italy.
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00100 Rome, Italy.
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy.
| |
Collapse
|
16
|
Costantini M, Salone A, Martinotti G, Fiori F, Fotia F, Di Giannantonio M, Ferri F. Body representations and basic symptoms in schizophrenia. Schizophr Res 2020; 222:267-273. [PMID: 32461087 DOI: 10.1016/j.schres.2020.05.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/24/2019] [Accepted: 05/16/2020] [Indexed: 12/25/2022]
Abstract
Patients with schizophrenia report a wide range of anomalous body experiences. According to the basic symptom model of schizophrenia, disturbances of body perception and awareness are among the most powerful predictors of the changes in the subjective experience of the self in schizophrenia. In this study we first investigated the body structural representation (BSR), a specific aspect of body awareness, and its association to basic symptoms in patients with schizophrenia. Using a finger localization task, we found that patients are significantly less accurate than healthy controls when asked to identify pairs of fingers touched by the experimenter, when the hand is hidden from view. Most importantly, patients' performance at the finger localization task was negatively associated to basic symptoms: the worse the individual accuracy, the higher the SPI-A total score. Moreover, the accuracy at the finger localization task was also negatively correlated with the malleability of the sense of body ownership: the less the individual ability to localize fingers, the stronger the rubber hand illusion. These results are in agreement with the idea that self-disorders in schizophrenia reveal a disconnectedness that can be regarded as a problem of disembodiment and traced back to abnormal body experiences.
Collapse
Affiliation(s)
- Marcello Costantini
- Department of Psychological, Health and Territorial Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, ITAB, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Anatolia Salone
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Martinotti
- Institute for Advanced Biomedical Technologies, ITAB, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy
| | | | - Francesca Fotia
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK
| | - Massimo Di Giannantonio
- Institute for Advanced Biomedical Technologies, ITAB, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Francesca Ferri
- Institute for Advanced Biomedical Technologies, ITAB, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy.
| |
Collapse
|
17
|
Cicero DC, Gawęda Ł, Nelson B. The placement of anomalous self-experiences within schizotypal personality in a nonclinical sample. Schizophr Res 2020; 218:219-225. [PMID: 31973995 DOI: 10.1016/j.schres.2019.12.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 12/23/2019] [Accepted: 12/31/2019] [Indexed: 11/17/2022]
Abstract
Anomalous self-experiences are disturbances in the subjective experience of the self and have been shown to be related to the premorbid, prodromal, acute, and chronic phases of schizophrenia-spectrum disorders. Despite having a long history in psychopathology research, anomalous self-experiences are not explicitly represented in any major nosology of mental disorders. Previous research suggests that anomalous self-experiences are correlated, but distinct from other aspects of schizotypal personality, but this has not been examined with confirmatory factor analysis. The current research aimed to examine where anomalous self-experiences fit within the structure of schizotypal personality including cognitive-perceptual, interpersonal, disorganized, and paranoid factors. It also examined the measurement invariance of the factor structure across ethnicity and between sexes. Seven hundred forty-four participants completed multiple measures of anomalous self-experiences and schizotypal personality. The best fitting model was a five-factor model with anomalous self-experiences, cognitive-perceptual, interpersonal, disorganized, and paranoid factors. This model fit better than models with anomalous self-experiences loading on any of the four schizotypal personality factors. The structure had configural, metric, and scalar invariance across race/ethnicities, but lacked scalar invariance between sexes. Anomalous self-experience scores did not differ among race/ethnicity or between sexes. These results suggest that anomalous self-experiences are highly correlated with but distinct from other facets of schizotypal personality. Future research may examine whether anomalous self-experiences should be added to nosologies of psychotic-spectrum disorders.
Collapse
Affiliation(s)
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
18
|
Comparelli A, Corigliano V, Montalbani B, Bargagna P, Forcina F, Cocco G, Erbuto D, De Carolis A, Pompili M. Relationship between aberrant salience and positive emotion misrecognition in acute relapse of schizophrenia. Asian J Psychiatr 2020; 49:101975. [PMID: 32114376 DOI: 10.1016/j.ajp.2020.101975] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/14/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Aberrant salience is the incorrect assignment of salience or significance to innocuous stimuli, and been hypothesized to be a central mechanism in the development of psychosis. In addition to aberrant salience, social-cognitive models of psychosis suggest that the way people process information about the self is important in all stages of psychosis. The aim of the present study is to explore the relationship between aberrant salience and emotion processing in schizophrenia patients with psychotic relapse. METHODS A sample of 42 patients with relapse was recruited. Aberrant salience was measured with the Aberrant Salience Inventory (ASI). Assessment of social cognition was carried out using the Facial Emotion Identification Test (FEIT). Partial correlations were controlled for possible confounding variables. RESULTS The ASI factors "increase in meaning" and "heightened cognition" positively correlated with impaired recognition of positive emotions, and ASI total score inversely correlated to time to response to task. Most of incorrect answers corresponded to misclassification of positive emotions. CONCLUSION Our findings show that there is evidence for a relationship between aberrant salience and emotion processing during a psychotic episode; we propose that aberrant salience and alterations in emotion processing trigger the loss of modulating feedback from the external world to produce a self-referential mental state.
Collapse
Affiliation(s)
- Anna Comparelli
- Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
| | | | - Benedetta Montalbani
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Paride Bargagna
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Francesca Forcina
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Gabriele Cocco
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Denise Erbuto
- Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - Antonella De Carolis
- Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - Maurizio Pompili
- Dept. of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sant'Andrea Hospital, Sapienza University of Rome, Italy
| |
Collapse
|
19
|
Jagannath V, Grünblatt E, Theodoridou A, Oneda B, Roth A, Gerstenberg M, Franscini M, Traber-Walker N, Correll CU, Heekeren K, Rössler W, Rauch A, Walitza S. Rare copy number variants in individuals at clinical high risk for psychosis: Enrichment of synaptic/brain-related functional pathways. Am J Med Genet B Neuropsychiatr Genet 2020; 183:140-151. [PMID: 31742845 DOI: 10.1002/ajmg.b.32770] [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: 06/23/2019] [Revised: 10/08/2019] [Accepted: 10/23/2019] [Indexed: 11/07/2022]
Abstract
Schizophrenia is a complex and chronic neuropsychiatric disorder, with a heritability of around 60-80%. Large (>100 kb) rare (<1%) copy number variants (CNVs) occur more frequently in schizophrenia patients compared to controls. Currently, there are no studies reporting genome-wide CNVs in clinical high risk for psychosis (CHR-P) individuals. The aim of this study was to investigate the role of rare genome-wide CNVs in 84 CHR-P individuals and 124 presumably healthy controls. There were no significant differences in all rare CNV frequencies and sizes between CHR-P individuals and controls. However, brain-related CNVs and brain-related deletions were significantly more frequent in CHR-P individuals than controls. In CHR-P individuals, significant associations were found between brain-related CNV carriers and attenuated positive symptoms syndrome or cognitive disturbances (OR = 3.07, p = .0286). Brain-related CNV carriers experienced significantly higher negative symptoms (p = .0047), higher depressive symptoms (p = .0175), and higher disturbances of self and surroundings (p = .0029) than noncarriers. Furthermore, enrichment analysis of genes was performed in the regions of rare CNVs using three independent methods, which confirmed significant clustering of predefined genes involved in synaptic/brain-related functional pathways in CHR-P individuals. These results suggest that rare CNVs might affect synaptic/brain-related functional pathways in CHR-P individuals.
Collapse
Affiliation(s)
- Vinita Jagannath
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Anastasia Theodoridou
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Beatrice Oneda
- Institute of Medical Genetics, University of Zurich, Schlieren, Switzerland
| | - Alexander Roth
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Miriam Gerstenberg
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Maurizia Franscini
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Nina Traber-Walker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York.,Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.,The Feinstein Institute for Medical Research, Manhasset, New York.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Karsten Heekeren
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland.,Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Anita Rauch
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.,Institute of Medical Genetics, University of Zurich, Schlieren, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.,The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland
| |
Collapse
|
20
|
Bauer CCC, Okano K, Gosh SS, Lee YJ, Melero H, de los Angeles C, Nestor PG, del Re EC, Northoff G, Niznikiewicz MA, Whitfield-Gabrieli S. Real-time fMRI neurofeedback reduces auditory hallucinations and modulates resting state connectivity of involved brain regions: Part 2: Default mode network -preliminary evidence. Psychiatry Res 2020; 284:112770. [PMID: 32004893 PMCID: PMC7046150 DOI: 10.1016/j.psychres.2020.112770] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/04/2020] [Accepted: 01/05/2020] [Indexed: 01/02/2023]
Abstract
Auditory hallucinations (AHs) are one of the most distressing symptoms of schizophrenia (SZ) and are often resistant to medication. Imaging studies of individuals with SZ show hyperactivation of the default mode network (DMN) and the superior temporal gyrus (STG). Studies in SZ show DMN hyperconnectivity and reduced anticorrelation between DMN and the central executive network (CEN). DMN hyperconnectivity has been associated with positive symptoms such as AHs while reduced DMN anticorrelations with cognitive impairment. Using real-time fMRI neurofeedback (rt-fMRI-NFB) we trained SZ patients to modulate DMN and CEN networks. Meditation is effective in reducing AHs in SZ and to modulate brain network integration and increase DMN anticorrelations. Consequently, patients were provided with meditation strategies to enhance their abilities to modulate DMN/CEN. Results show a reduction of DMN hyperconnectivity and increase in DMNCEN anticorrelation. Furthermore, the change in individual DMN connectivity significantly correlated with reductions in AHs. This is the first time that meditation enhanced through rt-fMRI-NFB is used to reduce AHs in SZ. Moreover, it provides the first empirical evidence for a direct causal relation between meditation enhanced rt-fMRI-NFB modulation of DMNCEN activity and post-intervention modulation of resting state networks ensuing in reductions in frequency and severity of AHs.
Collapse
Affiliation(s)
- Clemens C. C. Bauer
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA,Northeastern University, Boston, MA 02139, USA,Please address correspondence to Clemens Bauer, Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, 43 Vassar St. 46-4037C Massachusetts Institute of Technology. Cambridge, MA 02139, USA Telephone: +1 (617) 324 5124,
| | - Kana Okano
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA
| | - Satrajit S. Gosh
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA
| | - Yoon Ji Lee
- Northeastern University, Boston, MA 02139, USA
| | - Helena Melero
- Northeastern University, Boston, MA 02139, USA,Medical Image Analysis Laboratory (LAIMBIO), Rey Juan Carlos University, Madrid, Spain
| | - Carlo de los Angeles
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA
| | - Paul G. Nestor
- Harvard Medical School. Boston, MA 02115, USA,Boston VA Healthcare System. Boston, MA 02130, USA,University of Massachusetts, Boston, Boston MA 02215, USA
| | - Elisabetta C. del Re
- Harvard Medical School. Boston, MA 02115, USA,Boston VA Healthcare System. Boston, MA 02130, USA,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA, USA
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Margaret A. Niznikiewicz
- Harvard Medical School. Boston, MA 02115, USA,Boston VA Healthcare System. Boston, MA 02130, USA,Beth Israel Deaconess Medical Center. Boston, MA 02215, USA
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA,Northeastern University, Boston, MA 02139, USA
| |
Collapse
|
21
|
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.
Collapse
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
| |
Collapse
|
22
|
Torregrossa LJ, Snodgress MA, Hong SJ, Nichols HS, Glerean E, Nummenmaa L, Park S. Anomalous Bodily Maps of Emotions in Schizophrenia. Schizophr Bull 2019; 45:1060-1067. [PMID: 30551180 PMCID: PMC6737484 DOI: 10.1093/schbul/sby179] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Embodied emotions arise from interoceptive and somatosensory processes, and are essential to the development of a stable sense of self. Emotional embodiment is therefore inherently interwoven with our sense of bodily self-awareness, and allows us to navigate complex social situations. Given that the core feature of schizophrenia (SZ) is characterized by the presence of bodily self-disturbances and social-emotional deficits, we hypothesized that embodiment of emotion would be disrupted in SZ. METHOD Twenty-six medicated individuals with SZ and 26 demographically matched controls used a computerized topographical mapping tool ("EmBODY") to indicate on a body outline where they felt bodily sensations while experiencing an emotion. There were 13 different emotions plus a neutral state. The resulting bodily maps of emotions were quantitatively compared between groups using linear discriminant analysis and similarity scores. RESULTS Bodily maps of emotions were anomalous in SZ as indicated by indistinguishable maps across different emotions. Relative to the control group, patients reported less discrete and less clear bodily sensations across emotions. In particular, bodily maps for low-arousal emotions were atypical in comparison with healthy controls. CONCLUSIONS Anomalous and undifferentiated mapping of embodied emotions in SZ could lead to deficits in linking bodily sensations to conceptual categories of emotions. Disrupted emotional embodiment could also contribute to poor social functioning. Abnormal bodily sensations of emotions might therefore be a promising target for future psychosocial interventions.
Collapse
Affiliation(s)
| | | | - Seok Jin Hong
- Department of Psychology, Vanderbilt University, Nashville, TN
| | | | - Enrico Glerean
- Human Emotion Systems Laboratory, University of Turku, Turku, Finland
| | - Lauri Nummenmaa
- Human Emotion Systems Laboratory, University of Turku, Turku, Finland
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN,Global Academy for Future Civilizations, Kyung Hee University, Seoul, Korea,To whom correspondence should be addressed; Vanderbilt University, 111 21st Avenue S, Wilson Hall, Nashville, TN 37240, US; tel: 615-322-3435, fax: +1 615 343 8449, e-mail:
| |
Collapse
|
23
|
Rodríguez-Testal JF, Bendala-Rodríguez P, Perona-Garcelán S, Senín-Calderón C. Examining the structure of ideas of reference in clinical and community samples. Compr Psychiatry 2019; 93:48-55. [PMID: 31340191 DOI: 10.1016/j.comppsych.2019.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/13/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022] Open
Abstract
AIMS This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis. METHODS A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses-154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84. RESULTS Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the "causal explanations", "Songs, newspapers, books" and "laughing and commenting" REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders. CONCLUSIONS The results provide satisfactory that the REF scale could be used to study psychosis.
Collapse
Affiliation(s)
- Juan F Rodríguez-Testal
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Seville, Spain. P St. Camilo José Cela s/n, 41018 Seville, Spain
| | - Pedro Bendala-Rodríguez
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Seville, Spain. P St. Camilo José Cela s/n, 41018 Seville, Spain
| | - Salvador Perona-Garcelán
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Seville, Spain. P St. Camilo José Cela s/n, 41018 Seville, Spain; Virgen del Rocío Outpatient Mental Hospital, University Hospital Virgen del Rocío, Seville, Spain St. Manuel Siurot s/n, 41013 Seville, Spain
| | - Cristina Senín-Calderón
- Department of Psychology, University of Cadiz, Ave. República Árabe Saharaui S/N, 11510 Puerto Real, Cádiz, Spain.
| |
Collapse
|
24
|
Increased plasticity of bodily self-experience in individuals who may carry latent liability for schizophrenia. Schizophr Res 2019; 207:58-62. [PMID: 29793817 DOI: 10.1016/j.schres.2018.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/02/2018] [Accepted: 05/06/2018] [Indexed: 11/21/2022]
Abstract
Self-disturbances such as altered perception of one's own body boundary are central to the lived-in experience of schizophrenia. Bodily self-disturbances are also prevalent in healthy individuals who may carry latent liability for schizophrenia. Much of the research on self-disturbances rely on clinical interviews but these experiences are often difficult to verbalize, conceptualize and quantify. Furthermore, experimental evidence for plasticity of bodily self-experience in the schizophrenia-spectrum is scarce. We sought to quantify body boundary experience in healthy young adults who might be at an increased risk for schizophrenia with a multisensory paradigm known as the Pinocchio Illusion (PI) task that engenders the feeling that one's nose is changing, and has previously been used to demonstrate increased plasticity of bodily self-boundary in schizophrenia. 62 college students participated in the PI task that assessed bodily self-disturbances, and a tactile discrimination task. We administered the Prodromal Questionnaire Brief (PQ-B) and the Schizotypal Personality Questionnaire (SPQ) to assess latent liability for schizophrenia. We found that PI was enhanced in individuals with elevated PQ-B scores but their tactile sensitivity was intact. PI was associated with the positive syndrome of schizotypy, but not with negative or disorganized factors. Increased PQ-B and SPQ scores were associated with loneliness. To conclude, these results highlight the importance of bodily self-disturbances in the broader context of the schizophrenia spectrum.
Collapse
|
25
|
Benson TL, Brugger P, Park S. Bodily self-disturbance in schizophrenia-spectrum populations: Introducing the Benson et al. Body Disturbances Inventory (B-BODI). Psych J 2019; 8:110-121. [PMID: 30912624 DOI: 10.1002/pchj.280] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 11/10/2022]
Abstract
Anomalous or weakened sense of self was central to early theories of schizophrenia. Recent studies have also documented disturbances in body ownership and increased susceptibility for dissociative experiences, such as the out-of-body experience in individuals with schizophrenia, but further research is necessary to clarify components of bodily self-disturbances in the schizophrenia spectrum, and the stability of these experiences over time. With respect to methodology, self-disturbances research in schizophrenia tends to rely exclusively on verbal self-report questionnaires and interviews. Given that individuals with schizophrenia suffer from language and communication difficulties, verbal self-report measures may be insufficient. To bridge this gap, we have developed a new picture-based instrument, the Benson et al. Body Disturbances Inventory (B-BODI), designed to quantify bodily self-disturbances with respect to the frequency and vividness of these experiences, as well as the degree of distress associated with them. Drawings that depicted different aspects of aberrant bodily self-experiences were presented with accompanying captions. Participants were asked to indicate the frequency, vividness, and distressfulness of the experience captured by the picture using a 5-point scale. Individuals with schizophrenia, older healthy controls, and college students participated in two alternative versions of the B-BODI. Participants were also asked to complete a battery of established questionnaires that probed psychosis proneness and a range of self, body, and perceptual aberrations. The results suggest that the B-BODI is a useful tool that accurately captures bodily self-disturbances and has the potential to predict psychosis risk in healthy young individuals. Furthermore, anomalous self-disturbances seem to be relatively stable across time in individuals with chronic schizophrenia.
Collapse
Affiliation(s)
- Taylor L Benson
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Peter Brugger
- Neuropsychology Clinic, University Hospital of Zürich, Zürich, Switzerland
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA.,Global Academy for Future Civilizations, Kyung Hee University, Seoul, Korea
| |
Collapse
|
26
|
Damme KSF, Pelletier-Baldelli A, Cowan HR, Orr JM, Mittal VA. Distinct and opposite profiles of connectivity during self-reference task and rest in youth at clinical high risk for psychosis. Hum Brain Mapp 2019; 40:3254-3264. [PMID: 30941844 DOI: 10.1002/hbm.24595] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/24/2019] [Accepted: 03/26/2019] [Indexed: 11/10/2022] Open
Abstract
Self-reference is impaired in psychotic disorders such as schizophrenia, associated with disability, and closely related to characteristic patterns of aberrant brain connectivity. However, at present, it is unclear whether self-reference is impacted in pathogenesis of the disorder. Alterations in connectivity during a self-reference task or resting-state in the psychosis risk (i.e., prodromal) period may yield important clues for biomarker development, as well as for novel treatment targets. This study examined a task-based and resting-state functional magnetic resonance imaging in individuals at clinical high risk (CHR) for psychosis (n = 22) and healthy control unaffected peers (n = 20). The self-reference task comprised three task conditions where subjects were asked if an adjective was relevant to themselves (self), a designated other individual (other), or to evaluate the word's spelling (letter). Connectivity analyses examined medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC), regions commonly found in conjunction analyses of self-reference, during both the self-reference task and rest. In task connectivity analyses, CHR individuals exhibited decreased mPFC-PCC connectivity when compared to controls. In resting-state analyses, CHR participants showed greater mPFC-PCC connectivity. Taken together, results suggest that psychosis-like alterations in mPFC-PCC connectivity is present prior to psychosis onset across both task and rest.
Collapse
Affiliation(s)
| | | | - Henry R Cowan
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Joseph M Orr
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas.,Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, Illinois.,Department of Psychiatry, Northwestern University, Chicago, Illinois.,Medical Social Sciences, Northwestern University, Chicago, Illinois.,Institute for Policy Research (IPR), Northwestern University, Chicago, Illinois.,Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Illinois
| |
Collapse
|
27
|
Pienkos E, Giersch A, Hansen M, Humpston C, McCarthy-Jones S, Mishara A, Nelson B, Park S, Raballo A, Sharma R, Thomas N, Rosen C. Hallucinations Beyond Voices: A Conceptual Review of the Phenomenology of Altered Perception in Psychosis. Schizophr Bull 2019; 45:S67-S77. [PMID: 30715544 PMCID: PMC6357976 DOI: 10.1093/schbul/sby057] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recent psychiatric research and treatment initiatives have tended to move away from traditional diagnostic categories and have focused instead on transdiagnostic phenomena, such as hallucinations. However, this emphasis on isolated experiences may artificially limit the definition of such phenomena and ignore the rich, complex, and dynamic changes occurring simultaneously in other domains of experience. This article reviews the literature on a range of experiential features associated with psychosis, with a focus on their relevance for hallucinations. Phenomenological research on changes in cognition, perception, selfhood and reality, temporality, interpersonal experience, and embodiment are discussed, along with their implications for traditional conceptualizations of hallucinations. We then discuss several phenomenological and neurocognitive theories, as well as the potential impact of trauma on these phenomena. Hallucinations are suggested to be an equifinal outcome of multiple genetic, neurocognitive, subjective, and social processes; by grouping them together under a single, operationalizable definition, meaningful differences in etiology and phenomenology may be ignored. It is suggested that future research efforts strive to incorporate a broader range of experiential alterations, potentially expanding on traditional definitions of hallucinations. Relevance for clinical practice, including emphasizing phenomenologically responsive techniques and developing targeted new therapies, is discussed.
Collapse
Affiliation(s)
- Elizabeth Pienkos
- Graduate Institute of Professional Psychology, University of Hartford, West Hartford, CT,To whom correspondence should be addressed; tel: 315-268-2331, fax: 315-268-7118, e-mail:
| | - Anne Giersch
- INSERM U1114, Pôle de Psychiatrie, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre Hospitalier Régional Universitaire of Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Marie Hansen
- Department of Clinical Psychology, Long Island University Brooklyn, Brooklyn, NY
| | - Clara Humpston
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Aaron Mishara
- Clinical Psychology Department, The Chicago School of Professional Psychology, Los Angeles, CA
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN,Kyung Hee University, Seoul, Korea
| | - Andrea Raballo
- Department of Psychology, Psychopathology and Development Research Unit, Norwegian University of Science and Technology (NTNU), Trondheim, Norway,Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy
| | - Rajiv Sharma
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Jesse Brown Veterans Affairs Medical Center, Chicago, IL
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| |
Collapse
|
28
|
Poletti M, Raballo A. Uncanny Mirroring: A Developmental Perspective on the Neurocognitive Origins of Self-Disorders in Schizophrenia. Psychopathology 2019; 52:316-325. [PMID: 31822008 DOI: 10.1159/000504676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/09/2019] [Indexed: 11/19/2022]
Abstract
Varieties of anomalous subjective experiences, i.e. "basic self-disorders" (SDs), have been empirically demonstrated as core clinical features of schizophrenia spectrum disorders, predating full-blown psychotic symptoms. However, the clinical stage in which SDs emerge and their putative neurocognitive origins remain unsolved issues. Focusing on a prototypical anomalous mirror experience (i.e., a stable, trait-like subjective feeling of nonexisting while looking at oneself in the mirror) reported by an 11-year-old boy at familial high risk for schizophrenia and diagnosed as attenuated psychosis syndrome, we outline some possible developmental pathways leading to SDs. Such pathways are hypothesized in accordance with the documented early impairments in perceptual integration across distinct modalities in children at risk for schizophrenia spectrum disorders and to the specific features of mirror experience as provided by phenomenological and developmental psychology perspectives. We conclude that SDs could presumably have an early developmental origin, although children become progressively more aware of them. Although further hypothesis testing in clinical samples and longitudinal empirical investigation of at-risk children is badly needed, we propose that age-appropriate, phenomenologically oriented assessment of SDs could be useful for the early identification of psychotic risk.
Collapse
Affiliation(s)
- Michele Poletti
- Child and Adolescent Psychiatry Unit, Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale-IRCSS di Reggio Emilia, Reggio Emilia, Italy,
| | - Andrea Raballo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
| |
Collapse
|
29
|
Acosta H, Straube B, Kircher T. Schizotypy and mentalizing: An fMRI study. Neuropsychologia 2018; 124:299-310. [PMID: 30500664 DOI: 10.1016/j.neuropsychologia.2018.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/01/2018] [Accepted: 11/24/2018] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Schizotypy is a personality trait characterized by subclinical schizophrenia symptoms. Individuals with schizophrenia typically display behavioral mentalizing deficits and altered neural correlates during mentalizing. While schizotypy has been inconsistently related to behavioral mentalizing skills, its neural correlates of mentalizing are understudied so far. With this study we tested the association between schizotypy traits in healthy subjects and mentalizing-related neural correlates to provide new insights into neural processes associated with subclinical schizophrenia traits. METHODS Brain activation was measured using fMRI during an interactive mentalizing paradigm (Prisoner's Dilemma Game) in 164 healthy subjects. The Schizotypal Personality Questionnaire (SPQ-B) was administered to assess the three dimensions of schizotypy, i.e., cognitive-perceptual, interpersonal and disorganized. RESULTS We found that interpersonal schizotypy was significantly negatively correlated with brain activation in bilateral precunei and right caudate nucleus (among others) during mentalizing. By contrast, disorganized schizotypy was significantly positively correlated with mentalizing-associated neural activation in right precuneus, left middle cingulate cortex and right cerebellar hemisphere. No significant associations for cognitive-perceptual schizotypy and the SPQ-B total score were found. DISCUSSION Our study showed that interpersonal and disorganized schizotypy are associated with neural correlates of mentalizing in brain regions that are involved in self-processing and mentalizing. These brain regions have also been linked to mentalizing in schizophrenia.
Collapse
Affiliation(s)
- H Acosta
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Germany; The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland.
| | - B Straube
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Germany
| |
Collapse
|
30
|
Moe AM, Breitborde NJ. Psychosis in Emerging Adulthood: Phenomenological, Diagnostic, and Clinical Considerations. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23794925.2018.1509032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Aubrey M. Moe
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Nicholas J.K. Breitborde
- Departments of Psychiatry and Behavioral Health and Psychology, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
31
|
Klaunig MJ, Trask CL, Neis AM, Cohn JR, Chen X, Berglund AM, Cicero DC. Associations among domains of self-disturbance in schizophrenia. Psychiatry Res 2018; 267:187-194. [PMID: 29913377 DOI: 10.1016/j.psychres.2018.05.082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 05/09/2018] [Accepted: 05/29/2018] [Indexed: 11/19/2022]
Abstract
Self-disturbances are increasingly recognized as important, possibly even central, features of schizophrenia. However, little is known about the associations among different manifestations of self-disturbances. The aims of the current study were threefold. We aimed to (1) replicate previous findings of increased self-disturbances in schizophrenia, (2) correlate manifestations of self-disturbances in schizophrenia across three domains, and (3) correlate self-disturbances with five symptoms domains of schizophrenia, including positive, negative, disorganized symptoms, excitement, and emotional distress. We examined three domains of self-experience, including somatosensation, anomalous self-experiences, and self-concept clarity. Participants included 48 individuals with schizophrenia and 36 non-psychiatric controls. The results of this study replicate previous findings of significantly higher levels of self-disturbances in people with schizophrenia. The results also indicate positive correlations between the domains of anomalous self-experiences and self-concept clarity, but not somatosensation, in individuals with schizophrenia. As well, anomalous self-experiences were positively correlated with positive symptoms, disorganized symptoms, and emotional distress and self-concept clarity was negatively correlated with disorganized symptoms and emotional distress.
Collapse
Affiliation(s)
- Mallory J Klaunig
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Christi L Trask
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Aaron M Neis
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Jonathan R Cohn
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Xuefang Chen
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Alysia M Berglund
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - David C Cicero
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA.
| |
Collapse
|
32
|
Rokita KI, Dauvermann MR, Donohoe G. Early life experiences and social cognition in major psychiatric disorders: A systematic review. Eur Psychiatry 2018; 53:123-133. [DOI: 10.1016/j.eurpsy.2018.06.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 11/29/2022] Open
Abstract
AbstractObjective:To present a systematic review of the literature on the associations between early social environment, early life adversity, and social cognition in major psychiatric disorders, including schizophrenia, bipolar disorder, borderline personality disorder, major depressive disorder and posttraumatic stress disorder.Method:Relevant studies were identified via electronic and manual searches of the literature and included articles written in English and published in peer-reviewed journals up to May 2018. Quality assessment was performed using the quality evaluation scale employed in previous systematic reviews.Results:A total of 25 studies were included in the systematic review with the quality assessment scores ranging from 3 to 6 (out of 6). The vast majority of the studies reviewed showed a significant association between early childhood social experience, including both insecure attachment and adversity relating to neglect or abuse, and poorer social cognitive performance.Conclusion:We discuss these findings in the context of an attachment model, suggesting that childhood social adversity may result in poor internal working models, selective attention toward emotional stimuli and greater difficulties with emotional self-regulation. We outline some of the steps required to translate this understanding of social cognitive dysfunction in major psychiatric disorders into a target for interventions that mitigate the adverse effects of childhood maltreatment and poor parental attachment on social cognition.
Collapse
|
33
|
Eddy CM. Social cognition and self-other distinctions in neuropsychiatry: Insights from schizophrenia and Tourette syndrome. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:69-85. [PMID: 29195921 DOI: 10.1016/j.pnpbp.2017.11.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/16/2017] [Accepted: 11/27/2017] [Indexed: 02/08/2023]
Abstract
Impairments in social cognition may reflect dysfunction of disorder specific or disorder general mechanisms. Although cross-disorder comparison may prove insightful, few studies have compared social cognition in different neuropsychiatric disorders. Parallel investigation of schizophrenia and Tourette syndrome (TS) is encouraged by similarities including the presence of problematic social behavior, echophenomena, emotional dysregulation and dopamine dysfunction. Focusing on tests of social cognition administered in both disorders, this review aims to summarize behavioral, neurophysiological and neuroimaging findings, before exploring how these may contribute to clinical symptoms. Studies investigating social cognition (imitation, emotion recognition, and understanding of beliefs or intentions) in patients with schizophrenia or TS were identified through Web of Science and PubMed searches. Although findings indicate that social cognitive deficits are more apparent in schizophrenia, adults with TS can exhibit similar task performance to patients with paranoia. In both disorders, behavioral and neuroimaging findings raise the possibility of increased internal simulation of others' actions and emotions, in combination with a relative under-application of mentalizing. More specifically, dysfunction in neurobiological substrates such as temporo-parietal junction and inferior frontal gyrus may underlie problems with self-other distinctions in both schizophrenia and TS. Difficulties in distinguishing between actions and mental states linked to the self and other may contribute to a range of psychiatric symptoms, including emotional dysregulation, paranoia, social anhedonia and socially disruptive urges. Comparing different patient populations could therefore reveal common neuro-cognitive risk factors for the development of problematic social behaviors, in addition to markers of resilience, coping strategies and potential neuro-compensation mechanisms.
Collapse
Affiliation(s)
- Clare M Eddy
- BSMHFT National Centre for Mental Health, Birmingham, and College of Medical and Dental Sciences, University of Birmingham, UK.
| |
Collapse
|
34
|
Yuen HP, Mackinnon A, Nelson B. A new method for analysing transition to psychosis: Joint modelling of time-to-event outcome with time-dependent predictors. Int J Methods Psychiatr Res 2018; 27:e1588. [PMID: 28944523 PMCID: PMC6877213 DOI: 10.1002/mpr.1588] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/18/2017] [Accepted: 07/31/2017] [Indexed: 11/09/2022] Open
Abstract
An active area in psychosis research is the identification of predictors of transition to a psychotic state among those who are assessed as being at high risk of psychosis. Many of the potential predictors are time dependent in the sense that they may change over time and are measured at a number of assessment time points. Examples are various psychopathological measures such as negative symptoms, positive symptoms, depression, and anxiety. Most research in transition to psychosis has not made use of the dynamic nature of these measures, probably because suitable statistical methods and software have not been easily available. However, a relatively new statistical methodology is well suited to include such time-dependent predictors in transition to psychosis analysis. This methodology is called joint modelling and has recently been incorporated in mainstream statistical software. This paper describes this methodology and demonstrates its usefulness using data from one of the pioneering studies on transition to psychosis.
Collapse
Affiliation(s)
- Hok Pan Yuen
- Orygen, The National Centre of Excellence in Youth Mental HealthParkvilleVictoriaAustralia
- Centre for Youth Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
| | - Andrew Mackinnon
- Centre for Mental Health, Melbourne School of Population and Global HealthThe University of MelbourneParkvilleVictoriaAustralia
- Black Dog Institute and University of New South WalesSydneyNew South WalesAustralia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental HealthParkvilleVictoriaAustralia
- Centre for Youth Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
| |
Collapse
|
35
|
Schultze-Lutter F, Theodoridou A. The concept of basic symptoms: its scientific and clinical relevance. World Psychiatry 2017; 16:104-105. [PMID: 28127912 PMCID: PMC5269478 DOI: 10.1002/wps.20404] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zürich, Switzerland
| |
Collapse
|
36
|
Cicero DC, Klaunig MJ, Trask CL, Neis AM. Anomalous Self-Experiences and positive symptoms are independently associated with emotion processing deficits in schizophrenia. Schizophr Res 2016; 176:456-461. [PMID: 27562615 DOI: 10.1016/j.schres.2016.08.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 08/15/2016] [Accepted: 08/18/2016] [Indexed: 11/16/2022]
Abstract
Social-cognitive models posit a role of Anomalous Self-Experiences (ASEs), disturbances in the subjective experience of the self, in the development and maintenance of psychosis. Theorists have suggested that ASEs may underlie the social-cognitive deficits that are common in people with schizophrenia. Positive symptoms, negative symptoms, and ASEs may interfere with the ability to perceive, use, understand, and manage emotions. In the current study, 45 people with schizophrenia and 28 healthy controls completed the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE), the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), and were rated on the Positive and Negative Syndrome Scale (PANSS). Participants with schizophrenia had higher IPASE scores and lower MSCEIT scores than the comparison group. In a series of simultaneous regressions, ASEs, but not positive or negative symptoms, were associated with Total MSCEIT scores and the Using Emotions branch score. In contrast, positive symptoms, but not ASEs or negative symptoms were associated with Perceiving and Managing Emotions branches. Both ASEs and positive symptoms independently contributed to Emotional Experiencing scores. The severity of negative symptoms was not associated with deficits in any MSCEIT scores. These results suggest unique roles for ASEs and positive symptoms in emotion processing deficits in people with schizophrenia.
Collapse
|
37
|
Michael J, Park S. Anomalous bodily experiences and perceived social isolation in schizophrenia: An extension of the Social Deafferentation Hypothesis. Schizophr Res 2016; 176:392-397. [PMID: 27344986 PMCID: PMC8070733 DOI: 10.1016/j.schres.2016.06.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/07/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Disturbances of the bodily self are fundamental to the phenomenological experience of individuals with schizophrenia, a population at risk for social isolation. Both proprioception and exteroception contribute to a sense of consistent body boundary that contains the self across time and space, and this process is influenced by self-other (social) interactions. However, the relationship between social isolation, exteroception, and in-the-moment changes in body representation has not been elucidated. We investigated susceptibility to anomalous bodily experiences with a phantom nose induction procedure that elicits a sensation that one's nose is changing (Pinocchio Illusion: PI) in relation to exteroceptive awareness and social isolation. METHODS 25 individuals with schizophrenia (SZ) and 15 matched controls (CO) participated in a PI induction procedure to quantify susceptibility to bodily aberrations and a tactile discrimination task to assess exteroception. Clinical symptoms in SZ and schizotypy in CO were assessed, in addition to a self-report measure of perceived social isolation. RESULTS Compared to CO, SZ showed increased PI and impaired tactile discriminability. SZ reported greater loneliness than CO. PI scores were correlated with increased loneliness and decreased tactile discriminability. CONCLUSIONS Greater susceptibility to anomalous bodily experiences, together with reduced exteroceptive awareness and increased loneliness, is compatible with the framework of Hoffman's Social Deafferentation Hypothesis, which posits that a functional "amputation" from one's social environment could lead to a reorganization of the social brain network, resulting in hallucinations and delusions. These findings underscore the importance of the relationship between social isolation and self-disturbances in schizophrenia.
Collapse
Affiliation(s)
- Jamie Michael
- Department of Psychology, Vanderbilt University, 111, 21(st) Avenue South, Nashville, TN 37240, United States.
| | - Sohee Park
- Department of Psychology, Vanderbilt University, 111, 21(st) Avenue South, Nashville, TN 37240, United States.
| |
Collapse
|
38
|
Debbané M, Salaminios G, Luyten P, Badoud D, Armando M, Solida Tozzi A, Fonagy P, Brent BK. Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum. Front Hum Neurosci 2016; 10:406. [PMID: 27597820 PMCID: PMC4992687 DOI: 10.3389/fnhum.2016.00406] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 08/02/2016] [Indexed: 11/22/2022] Open
Abstract
In this review article, we outline the evidence linking attachment adversity to psychosis, from the premorbid stages of the disorder to its clinical forms. To better understand the neurobiological mechanisms through which insecure attachment may contribute to psychosis, we identify at least five neurobiological pathways linking attachment to risk for developing psychosis. Besides its well documented influence on the hypothalamic-pituary-adrenal (HPA) axis, insecure attachment may also contribute to neurodevelopmental risk through the dopaminergic and oxytonergic systems, as well as bear influence on neuroinflammation and oxidative stress responses. We further consider the neuroscientific and behavioral studies that underpin mentalization as a suite of processes potentially moderating the risk to transition to psychotic disorders. In particular, mentalization may help the individual compensate for endophenotypical impairments in the integration of sensory and metacognitive information. We propose a model where embodied mentalization would lie at the core of a protective, resilience response mitigating the adverse and potentially pathological influence of the neurodevelopmental cascade of risk for psychosis.
Collapse
Affiliation(s)
- Martin Debbané
- Faculty of Psychology and Educational Sciences, University of GenevaGeneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
- Office Médico-PédagogiqueGeneva, Switzerland
| | - George Salaminios
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
| | - Patrick Luyten
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
- Faculty of Psychology and Educational Sciences, University of LeuvenLeuven, Belgium
| | - Deborah Badoud
- Faculty of Psychology and Educational Sciences, University of GenevaGeneva, Switzerland
| | | | | | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
| | - Benjamin K. Brent
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA
| |
Collapse
|
39
|
Jernigan TL, Brown TT, Bartsch H, Dale AM. Toward an integrative science of the developing human mind and brain: Focus on the developing cortex. Dev Cogn Neurosci 2016; 18:2-11. [PMID: 26347228 PMCID: PMC4762760 DOI: 10.1016/j.dcn.2015.07.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/17/2015] [Accepted: 07/28/2015] [Indexed: 11/24/2022] Open
Abstract
Based on the Huttenlocher lecture, this article describes the need for a more integrative scientific paradigm for addressing important questions raised by key observations made over 2 decades ago. Among these are the early descriptions by Huttenlocher of variability in synaptic density in cortex of postmortem brains of children of different ages and the almost simultaneous reports of cortical volume reductions on MR imaging in children and adolescents. In spite of much progress in developmental neurobiology, developmental cognitive neuroscience, and behavioral and imaging genetics, we still do not know how these early observations relate to each other. It is argued that large scale, collaborative research programs are needed to establish the associations between behavioral differences among children and imaging biomarkers, and to link the latter to cellular changes in the developing brain. Examples of progress and challenges remaining are illustrated with data from the Pediatric Imaging, Neurocognition, and Genetics Project (PING).
Collapse
Affiliation(s)
- Terry L Jernigan
- Center for Human Development, University of California, San Diego, La Jolla, CA, United States; Department of Cognitive Science, University of California, San Diego, La Jolla, CA, United States; Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States; Department of Radiology, University of California, San Diego, La Jolla, CA, United States.
| | - Timothy T Brown
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, United States; Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Hauke Bartsch
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, United States
| | - Anders M Dale
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, United States; Department of Radiology, University of California, San Diego, La Jolla, CA, United States; Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, United States; Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| |
Collapse
|
40
|
Social functioning in patients with a psychotic disorder and first rank symptoms. Psychiatry Res 2016; 237:147-52. [PMID: 26892072 DOI: 10.1016/j.psychres.2016.01.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 11/30/2015] [Accepted: 01/21/2016] [Indexed: 11/20/2022]
Abstract
There have been suggestions that a sense of self emerges through social interaction, which requires an intact capability to distinguish self from others. Here we investigated the contribution of first rank delusions and hallucinations, i.e. symptom expressions of a disturbed sense of self, to social functioning in patients with a psychotic disorder. Life-time and present-state positive symptom clusters (e.g. first rank delusions and hallucinations) and present-state negative symptoms were submitted to hierarchical multiple-regression analyses with (different domains of) social functioning as dependent variable. In addition to negative symptoms (β=-0.48), the life-time presence of first rank delusions is significantly negative associated with level of social functioning, in particular with the quality of interpersonal interactions, with a modest standardized regression coefficient (β=-0.14). We reconfirmed the well-established relationship between negative symptoms and social functioning, but the life-time presence of first rank delusions may also have an subtle ongoing effect on the quality of the interaction with others. We propose that the experience of first rank delusions may be an expression of enduring self-disturbances, leaving patients unsure on how to behave in social interactions.
Collapse
|
41
|
Hernandez K, Swiatkowski P, Patel MV, Liang C, Dudzinski NR, Brzustowicz LM, Firestein BL. Overexpression of Isoforms of Nitric Oxide Synthase 1 Adaptor Protein, Encoded by a Risk Gene for Schizophrenia, Alters Actin Dynamics and Synaptic Function. Front Cell Neurosci 2016; 10:6. [PMID: 26869880 PMCID: PMC4735351 DOI: 10.3389/fncel.2016.00006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/11/2016] [Indexed: 11/13/2022] Open
Abstract
Proper communication between neurons depends upon appropriate patterning of dendrites and correct distribution and structure of spines. Schizophrenia is a neuropsychiatric disorder characterized by alterations in dendrite branching and spine density. Nitric oxide synthase 1 adaptor protein (NOS1AP), a risk gene for schizophrenia, encodes proteins that are upregulated in the dorsolateral prefrontal cortex (DLPFC) of individuals with schizophrenia. To elucidate the effects of NOS1AP overexpression observed in individuals with schizophrenia, we investigated changes in actin dynamics and spine development when a long (NOS1AP-L) or short (NOS1AP-S) isoform of NOS1AP is overexpressed. Increased NOS1AP-L protein promotes the formation of immature spines when overexpressed in rat cortical neurons from day in vitro (DIV) 14 to DIV 17 and reduces the amplitude of miniature excitatory postsynaptic currents (mEPSCs). In contrast, increased NOS1AP-S protein increases the rate of actin polymerization and the number of immature and mature spines, which may be attributed to a decrease in total Rac1 expression and a reduction in the levels of active cofilin. The increase in the number of mature spines by overexpression of NOS1AP-S is accompanied by an increase in the frequency of mEPSCs. Our findings show that overexpression of NOS1AP-L or NOS1AP-S alters the actin cytoskeleton and synaptic function. However, the mechanisms by which these isoforms induce these changes are distinct. These results are important for understanding how increased expression of NOS1AP isoforms can influence spine development and synaptic function.
Collapse
Affiliation(s)
- Kristina Hernandez
- Department of Cell Biology and Neuroscience, Human Genetics Institute of New Jersey, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Przemyslaw Swiatkowski
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Mihir V. Patel
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Chen Liang
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Natasha R. Dudzinski
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Linda M. Brzustowicz
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Bonnie L. Firestein
- Department of Cell Biology and Neuroscience, Human Genetics Institute of New Jersey, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| |
Collapse
|
42
|
Horan WP, Jimenez AM, Lee J, Wynn JK, Eisenberger NI, Green MF. Pain empathy in schizophrenia: an fMRI study. Soc Cogn Affect Neurosci 2016; 11:783-92. [PMID: 26746181 DOI: 10.1093/scan/nsw002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 01/04/2016] [Indexed: 02/06/2023] Open
Abstract
Although it has been proposed that schizophrenia is characterized by impaired empathy, several recent studies found intact neural responses on tasks measuring the affective subdomain of empathy. This study further examined affective empathy in 21 schizophrenia outpatients and 21 healthy controls using a validated pain empathy paradigm with two components: (i) observing videos of people described as medical patients who were receiving a painful sound stimulation treatment; (ii) listening to the painful sounds (to create regions of interest). The observing videos component incorporated experimental manipulations of perspective taking (instructions to imagine 'Self' vs 'Other' experiencing pain) and cognitive appraisal (information about whether treatment was 'Effective' vs 'Not Effective'). When considering activation across experimental conditions, both groups showed similar dorsal anterior cingulate cortex (dACC) and anterior insula (AI) activation while merely observing others in pain. However, there were group differences associated with perspective taking: controls showed relatively greater dACC and AI activation for the Self vs Other contrast whereas patients showed relatively greater activation in these and additional regions for the Other vs Self contrast. Although patients demonstrated grossly intact neural activity while observing others in pain, they showed more subtle abnormalities when required to toggle between imagining themselves vs others experiencing pain.
Collapse
Affiliation(s)
- William P Horan
- VA Greater Los Angeles Healthcare System and University of California, Los Angeles, CA, USA
| | - Amy M Jimenez
- VA Greater Los Angeles Healthcare System and University of California, Los Angeles, CA, USA
| | - Junghee Lee
- VA Greater Los Angeles Healthcare System and University of California, Los Angeles, CA, USA
| | - Jonathan K Wynn
- VA Greater Los Angeles Healthcare System and University of California, Los Angeles, CA, USA
| | | | - Michael F Green
- VA Greater Los Angeles Healthcare System and University of California, Los Angeles, CA, USA
| |
Collapse
|
43
|
Phenomenology and neurobiology of self disorder in schizophrenia: Secondary factors. Schizophr Res 2015; 169:474-482. [PMID: 26603059 DOI: 10.1016/j.schres.2015.09.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 09/16/2015] [Accepted: 09/18/2015] [Indexed: 01/23/2023]
Abstract
Schizophrenia is a diverse and varying syndrome that defies most attempts at classification and pathogenetic explanation. This is the second of two articles offering a comprehensive model meant to integrate an understanding of schizophrenia-related forms of subjectivity, especially anomalous core-self experience (disturbed ipseity), with neurocognitive and neurodevelopmental findings. Previously we discussed the primary or foundational role of disturbed intermodal perceptional integration ("perceptual dys-integration"). Here we discuss phenomenological alterations that can be considered secondary in a pathogenetic sense--whether as consequential products downstream from a more originary disruption, or as defensive reactions involving quasi-intentional or even volitional compensations to the more primary disruptions. These include secondary forms of: 1, hyperreflexivity, 2, diminished self-presence (self-affection), and 3. disturbed "rip" or "hold" on the cognitive/perceptual field of awareness. We consider complementary relations between these secondary abnormal experiences while also considering their temporal relationships and pathogenetic intertwining with the more primary phenomenological alterations discussed previously, all in relation to the neurodevelopmental model. The secondary phenomena can be understood as highly variable factors involving overall orientations or attitudes toward experience; they have some affinities with experiences of meditation, introspectionism, and depersonalization defense. Also, they seem likely to become more pronounced during adolescence as a result of new cognitive capacities related to development of the prefrontal lobes, especially attention allocation, executive functions, abstraction, and meta-awareness. Heterogeneity in these secondary alterations might help explain much of the clinical diversity in schizophrenia, both between patients and within individual patients over time--without however losing sight of key underlying commonalities.
Collapse
|
44
|
Borda JP, Sass LA. Phenomenology and neurobiology of self disorder in schizophrenia: Primary factors. Schizophr Res 2015; 169:464-473. [PMID: 26516103 DOI: 10.1016/j.schres.2015.09.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 09/16/2015] [Accepted: 09/18/2015] [Indexed: 12/13/2022]
Abstract
Schizophrenia is a heterogeneous syndrome, varying between persons and over course of illness. In this and a companion article, we argue that comprehension of this condition or set of conditions may require combining a phenomenological perspective emphasizing disorders of basic-self experience ("ipseity disturbance") with a multidimensional appreciation of possible neurobiological correlates--both primary and secondary. Previous attempts to link phenomenology and neurobiology generally focus on a single neurocognitive factor. We consider diverse aspects of schizophrenia in light of a diverse, albeit interacting, set of neurocognitive abnormalities, examining both synchronic (structural) interdependence and diachronic (temporal) succession. In this article we focus on the primary or foundational role of early perceptual and motoric disturbances that affect perceptual organization and especially intermodal or multisensory perceptual integration (“perceptual dys-integration”). These disturbances are discussed in terms of their implications for three interconnected aspects of selfhood in schizophrenia, primary forms of: disrupted "hold" or "grip" on the world, hyperreflexivity, diminished self-presence (self-affection). Disturbances of organization or integration imply forms of perceptual incoherence or diminished cognitive coordination. The effect is to disrupt one's ability to apprehend the world in holistic, vital, or contextually grounded fashion, or to fully identify with or experience the unity of one's own body or thinking--thereby generating an early and profound (albeit often subtle) disruption or diminishment of basic or core self and of the sense of existing in a coherent world. We discuss interrelationships or possible complementarities between these three aspects, and consider their relevance for a neurodevelopmental account of schizophrenia.
Collapse
Affiliation(s)
- Juan P Borda
- Dept of Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Louis A Sass
- Rutgers University, Piscataway, N.J. 08854, U.S.A.
| |
Collapse
|
45
|
Su TW, Hsu TW, Lin YC, Lin CP. Schizophrenia symptoms and brain network efficiency: A resting-state fMRI study. Psychiatry Res 2015; 234:208-18. [PMID: 26409574 DOI: 10.1016/j.pscychresns.2015.09.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 08/10/2015] [Accepted: 09/02/2015] [Indexed: 12/18/2022]
Abstract
Schizophrenia is a condition marked by a disrupted brain functional network. In schizophrenia, the brain network is characterized by reduced distributed information processing efficiency; however, the correlation between information processing efficiency and the symptomatology of schizophrenia remains unclear. Few studies have examined path length efficiencies in schizophrenia. In this study, we examined small-world network metrics computed from resting state functional magnetic resonance imaging data collected from 49 patients with schizophrenia and 28 healthy people. We calculated brain network efficiency using graph theoretical analysis of the networks of brain areas, as defined by the Automated Anatomical Labeling parcellation scheme, and investigated efficiency correlations by using the 5-factor model of psychopathology, which considers the various domains of schizophrenic symptoms and might also consider discrete pathogenetic processes. The global efficiency of the resting schizophrenic brains was lower than that of the healthy controls, but local efficiency did not differ between the groups. The severity of psychopathology, negative symptoms, and depression and anxiety symptoms were correlated with global efficiency in schizophrenic brains. The severity of psychopathology was correlated with increased network efficiency from short-range connections, but not networks from long-range connections. Our findings indicate that schizophrenic psychopathology is correlated with brain network information processing efficiency.
Collapse
Affiliation(s)
- Tsung-Wei Su
- Brain Connectivity Lab., Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan; Department of Psychiatry, Losheng Sanatorium and Hospital, Ministry of Health and Welfare, No. 2, Lane 50, Section 1, Wanshou Rd., Guishan Shiang, Taoyuan County, Taiwan
| | - Tun-Wei Hsu
- Brain Connectivity Lab., Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan
| | - Yi-Ching Lin
- Department of Psychiatry, Losheng Sanatorium and Hospital, Ministry of Health and Welfare, No. 2, Lane 50, Section 1, Wanshou Rd., Guishan Shiang, Taoyuan County, Taiwan
| | - Ching-Po Lin
- Brain Connectivity Lab., Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan.
| |
Collapse
|
46
|
O’Reilly K, Donohoe G, Coyle C, O’Sullivan D, Rowe A, Losty M, McDonagh T, McGuinness L, Ennis Y, Watts E, Brennan L, Owens E, Davoren M, Mullaney R, Abidin Z, Kennedy HG. Prospective cohort study of the relationship between neuro-cognition, social cognition and violence in forensic patients with schizophrenia and schizoaffective disorder. BMC Psychiatry 2015; 15:155. [PMID: 26159728 PMCID: PMC4496853 DOI: 10.1186/s12888-015-0548-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 06/30/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There is a broad literature suggesting that cognitive difficulties are associated with violence across a variety of groups. Although neurocognitive and social cognitive deficits are core features of schizophrenia, evidence of a relationship between cognitive impairments and violence within this patient population has been mixed. METHODS We prospectively examined whether neurocognition and social cognition predicted inpatient violence amongst patients with schizophrenia and schizoaffective disorder (n = 89; 10 violent) over a 12 month period. Neurocognition and social cognition were assessed using the MATRICS Consensus Cognitive Battery (MCCB). RESULTS Using multivariate analysis neurocognition and social cognition variables could account for 34 % of the variance in violent incidents after controlling for age and gender. Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size. Mediation analysis showed that the relationship between neurocognition and violence was completely mediated by each of the following variables independently: social cognition (MSCEIT), symptoms (PANSS Total Score), social functioning (SOFAS) and violence proneness (HCR-20 Total Score). There was no evidence of a serial pathway between neurocognition and multiple mediators and violence, and only social cognition and violence proneness operated in parallel as significant mediators accounting for 46 % of the variance in violent incidents. There was also no evidence that neurocogniton mediated the relationship between any of these variables and violence. CONCLUSIONS Of all the predictors examined, neurocognition was the only variable whose effects on violence consistently showed evidence of mediation. Neurocognition operates as a distal risk factor mediated through more proximal factors. Social cognition in contrast has a direct effect on violence independent of neurocognition, violence proneness and symptom severity. The neurocognitive impairment experienced by patients with schizophrenia spectrum disorders may create the foundation for the emergence of a range of risk factors for violence including deficits in social reasoning, symptoms, social functioning, and HCR-20 risk items, which in turn are causally related to violence.
Collapse
Affiliation(s)
- Ken O’Reilly
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland ,National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland
| | - Gary Donohoe
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.
| | - Ciaran Coyle
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Danny O’Sullivan
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland
| | - Arann Rowe
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Mairead Losty
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Tracey McDonagh
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Lasairiona McGuinness
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Yvette Ennis
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Elizabeth Watts
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Louise Brennan
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Elizabeth Owens
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Mary Davoren
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland. .,National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Ronan Mullaney
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland. .,National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Zareena Abidin
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| | - Harry G Kennedy
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland. .,National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.
| |
Collapse
|
47
|
Abstract
Early formulations of schizophrenia suggested that the disorder involves a loss of ability to form integrated ideas about oneself, others, and the world, resulting in reductions in complex goal-directed behaviors. Exploring this position, the current review describes evidence that persons with schizophrenia experience decrements in their ability to form complex ideas about themselves and to ultimately use that knowledge to respond to psychological and social challenges. Studies are detailed that find greater levels of these impairments, defined as metacognitive deficits, in persons with schizophrenia in both early and later phases of illness as compared with other clinical and community groups. Furthermore, studies linking metacognitive deficits with poorer psychosocial functioning and other variables closely linked to outcomes are summarized. Clinical implications are also discussed.
Collapse
|
48
|
Carrel D, Hernandez K, Kwon M, Mau C, Trivedi MP, Brzustowicz LM, Firestein BL. Nitric oxide synthase 1 adaptor protein, a protein implicated in schizophrenia, controls radial migration of cortical neurons. Biol Psychiatry 2015; 77:969-78. [PMID: 25542305 PMCID: PMC4416077 DOI: 10.1016/j.biopsych.2014.10.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 10/08/2014] [Accepted: 10/22/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Where a neuron is positioned in the brain during development determines neuronal circuitry and information processing needed for normal brain function. When aberrations in this process occur, cognitive disorders may result. Patients diagnosed with schizophrenia have been reported to show altered neuronal connectivity and heterotopias. To elucidate pathways by which this process occurs and become aberrant, we have chosen to study the long isoform of nitric oxide synthase 1 adaptor protein (NOS1AP), a protein encoded by a susceptibility gene for schizophrenia. METHODS To determine whether NOS1AP plays a role in cortical patterning, we knocked down or co-overexpressed NOS1AP and a green fluorescent protein or red fluorescent protein (TagRFP) reporter in neuronal progenitor cells of the embryonic rat neocortex using in utero electroporation. We analyzed sections of cortex (ventricular zone, intermediate zone, and cortical plate [CP]) containing green fluorescent protein or red fluorescent protein TagRFP positive cells and counted the percentage of positive cells that migrated to each region from at least three rats for each condition. RESULTS NOS1AP overexpression disrupts neuronal migration, resulting in increased cells in intermediate zone and less cells in CP, and decreases dendritogenesis. Knockdown results in increased migration, with more cells reaching the CP. The phosphotyrosine binding region, but not the PDZ-binding motif, is necessary for NOS1AP function. Amino acids 181 to 307, which are sufficient for NOS1AP-mediated decreases in dendrite number, have no effect on migration. CONCLUSIONS Our studies show for the first time a critical role for the schizophrenia-associated gene NOS1AP in cortical patterning, which may contribute to underlying pathophysiology seen in schizophrenia.
Collapse
Affiliation(s)
- Damien Carrel
- Department of Cell Biology and Neuroscience, Rutgers, the State University of New Jersey, Piscataway, New Jersey; Neurophotonics Laboratory, Paris Descartes University, Paris, France
| | - Kristina Hernandez
- Department of Cell Biology and Neuroscience, Rutgers, the State University of New Jersey, Piscataway, New Jersey; Molecular Biosciences Graduate Program Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Munjin Kwon
- Department of Cell Biology and Neuroscience, Rutgers, the State University of New Jersey, Piscataway, New Jersey; Molecular Biosciences Graduate Program Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Christine Mau
- Department of Cell Biology and Neuroscience, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Meera P Trivedi
- Department of Cell Biology and Neuroscience, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Linda M Brzustowicz
- Department of Genetics, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Bonnie L Firestein
- Department of Cell Biology and Neuroscience, Rutgers, the State University of New Jersey, Piscataway, New Jersey.
| |
Collapse
|
49
|
Drakesmith M, Caeyenberghs K, Dutt A, Zammit S, Evans CJ, Reichenberg A, Lewis G, David AS, Jones DK. Schizophrenia-like topological changes in the structural connectome of individuals with subclinical psychotic experiences. Hum Brain Mapp 2015; 36:2629-43. [PMID: 25832856 PMCID: PMC4479544 DOI: 10.1002/hbm.22796] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 01/01/2023] Open
Abstract
Schizophrenia is often regarded as a “dysconnectivity” disorder and recent work using graph theory has been used to better characterize dysconnectivity of the structural connectome in schizophrenia. However, there are still little data on the topology of connectomes in less severe forms of the condition. Such analysis will identify topological markers of less severe disease states and provide potential predictors of further disease development. Individuals with psychotic experiences (PEs) were identified from a population‐based cohort without relying on participants presenting to clinical services. Such individuals have an increased risk of developing clinically significant psychosis. 123 individuals with PEs and 125 controls were scanned with diffusion‐weighted MRI. Whole‐brain structural connectomes were derived and a range of global and local GT‐metrics were computed. Global efficiency and density were significantly reduced in individuals with PEs. Local efficiency was reduced in a number of regions, including critical network hubs. Further analysis of functional subnetworks showed differential impairment of the default mode network. An additional analysis of pair‐wise connections showed no evidence of differences in individuals with PEs. These results are consistent with previous findings in schizophrenia. Reduced efficiency in critical core hubs suggests the brains of individuals with PEs may be particularly predisposed to dysfunction. The absence of any detectable effects in pair‐wise connections illustrates that, at less severe stages of psychosis, white‐matter alterations are subtle and only manifest when examining network topology. This study indicates that topology could be a sensitive biomarker for early stages of psychotic illness. Hum Brain Mapp 36:2629–2643, 2015.© 2015 TheAuthors Human Brain Mapping Published by Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Mark Drakesmith
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom.,Neuroscience and Mental Health Research Institute (NMHRI), School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Karen Caeyenberghs
- Department of Physical Therapy and Motor Rehabilitation, Faculty of Medicine and Health Sciences, University of Ghent, Gent, Belgium.,School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Anirban Dutt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, United Kingdom
| | - Stanley Zammit
- Neuroscience and Mental Health Research Institute (NMHRI), School of Medicine, Cardiff University, Cardiff, United Kingdom.,Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - C John Evans
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Abraham Reichenberg
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, United Kingdom.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai Hospital, New York, New York, USA
| | - Glyn Lewis
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.,Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Anthony S David
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, London, United Kingdom
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom.,Neuroscience and Mental Health Research Institute (NMHRI), School of Medicine, Cardiff University, Cardiff, United Kingdom
| |
Collapse
|
50
|
Cicero DC, Docherty AR, Becker TM, Martin EA, Kerns JG. Aberrant salience, self-concept clarity, and interview-rated psychotic-like experiences. J Pers Disord 2015; 29:79-99. [PMID: 25102085 PMCID: PMC4315771 DOI: 10.1521/pedi_2014_28_150] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many social-cognitive models of psychotic-like symptoms posit a role for self-concept and aberrant salience. Previous work has shown that the interaction between aberrant salience and self-concept clarity is associated with self-reported psychotic-like experiences. In the current research with two structured interviews, the interaction between aberrant salience and self-concept clarity was found to be associated with interview-rated psychotic-like experiences. The interaction was associated with psychotic-like experiences composite scores, delusional ideation, grandiosity, and perceptual anomalies. In all cases, self-concept clarity was negatively associated with psychotic-like experiences at high levels of aberrant salience, but unassociated with psychotic-like experiences at low levels of aberrant salience. The interaction was specific to positive psychotic-like experiences and not present for negative or disorganized ratings. The interaction was not mediated by self-esteem levels. These results provide further evidence that aberrant salience and self-concept clarity play an important role in the generation of psychotic-like experiences.
Collapse
|