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de Filippis R, Aloi M, Liuzza MT, Pugliese V, Carbone EA, Rania M, Segura-Garcia C, De Fazio P. Aberrant salience mediates the interplay between emotional abuse and positive symptoms in schizophrenia. Compr Psychiatry 2024; 133:152496. [PMID: 38718481 DOI: 10.1016/j.comppsych.2024.152496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION Childhood trauma and adversities (CTA) and aberrant salience (AS) have a pivotal role in schizophrenia development, but their interplay with psychotic symptoms remains vague. We explored the mediation performed by AS between CTA and psychotic symptomatology in schizophrenia. METHODS We approached 241 adults suffering from schizophrenia spectrum disorders (SSDs), who have been in the unit for at least 12 consecutive months, excluding the diagnosis of dementia, and recent substance abuse disorder, and cross-sectional evaluated through the Aberrant Salience Inventory (ASI), Childhood Trauma Questionnaire Short-Form (CTQ-SF), and Positive and Negative Symptom Scale (PANSS). We tested a path-diagram where AS mediated the relationship between CTA and psychosis, after verifying each measure one-dimensionality through confirmatory factor analysis. RESULTS The final sample comprised 222 patients (36.9% female), with a mean age of 42.4 (± 13.3) years and an average antipsychotic dose of 453.6 (± 184.2) mg/day (chlorpromazine equivalents). The mean duration of untreated psychosis was 1.8 (± 2.0) years while the mean onset age was 23.9 (± 8.2) years. Significant paths were found from emotional abuse to ASI total score (β = 0.39; p < .001) and from ASI total score to PANSS positive (β = 0.17; p = .019). Finally, a statistically significant indirect association was found from emotional abuse to PANSS positive mediated by ASI total score (β = 0.06; p = .041; CI 95% [0.01, 0.13]). CONCLUSION Emotional abuse has an AS-mediated effect on positive psychotic symptomatology. AS evaluation could allow a better characterization of psychosis as well as explain the presence of positive symptoms in adults with SSDs who experienced CTA.
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Affiliation(s)
- Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Matteo Aloi
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy; Department of Clinical and Experimental Medicine, University of Messina, Italy.
| | | | - Valentina Pugliese
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Elvira Anna Carbone
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Italy.
| | - Marianna Rania
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Italy.
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy.
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Bogudzińska B, Jaworski A, Zajdel A, Skrzypek K, Misiak B. The experience sampling methodology in psychosis risk states: A systematic review. J Psychiatr Res 2024; 175:34-41. [PMID: 38704979 DOI: 10.1016/j.jpsychires.2024.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/03/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
The experience sampling method (ESM) is a structured diary technique, which is used to assess thoughts, mood and appraise subjective experiences in daily life. It has been recognized as a useful tool for understanding the characteristics, dynamics, and underlying mechanisms of prodromal symptoms of psychosis. The present systematic review aimed to provide a qualitative synthesis of findings provided by the ESM studies conducted in people with psychosis risk states. A systematic review of the MEDLINE, ERIC, Academic Search Ultimate, and Health Source: Nursing/Academic Edition databases, utilizing search terms related to the ESM and the risk of psychosis was conducted. Out of 1069 publication records identified, 77 studies met the inclusion criteria for the review. Data were synthesized around the following topics: 1) assessment of symptoms dynamics and social functioning; 2) assessment of the mechanisms contributing to the emergence of psychotic experiences and 3) assessment of stress sensitivity. The studies have shown that negative emotions are associated with subsequent development of paranoia. The tendency to draw hasty conclusions, aberrant salience, self-esteem, and emotion regulation were the most frequently reported mechanisms associated with the emergence of psychotic experiences. Studies using the ESM also provided evidence for the role of stress sensitivity, in the development of psychotic symptoms. The ESM has widely been applied to studies investigating psychosis risk states, using a variety of protocols. Findings from this systematic review might inform future studies and indicate potential targets for interventions.
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Affiliation(s)
- Bogna Bogudzińska
- Departament of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
| | | | | | | | - Błażej Misiak
- Departament of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Formica MJC, Fuller-Tyszkiewicz M, Reininghaus U, Kempton M, Delespaul P, de Haan L, Nelson B, Mikocka-Walus A, Olive L, Ruhrmann S, Rutten B, Riecher-Rössler A, Sachs G, Valmaggia L, van der Gaag M, McGuire P, van Os J, Hartmann JA. Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis. Psychol Med 2024:1-10. [PMID: 38450445 DOI: 10.1017/s0033291724000400] [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] [Indexed: 03/08/2024]
Abstract
BACKGROUND Pre-diagnostic stages of psychotic illnesses, including 'clinical high risk' (CHR), are marked by sleep disturbances. These sleep disturbances appear to represent a key aspect in the etiology and maintenance of psychotic disorders. We aimed to examine the relationship between self-reported sleep dysfunction and attenuated psychotic symptoms (APS) on a day-to-day basis. METHODS Seventy-six CHR young people completed the Experience Sampling Methodology (ESM) component of the European Union Gene-Environment Interaction Study, collected through PsyMate® devices, prompting sleep and symptom questionnaires 10 times daily for 6 days. Bayesian multilevel mixed linear regression analyses were performed on time-variant ESM data using the brms package in R. We investigated the day-to-day associations between sleep and psychotic experiences bidirectionally on an item level. Sleep items included sleep onset latency, fragmentation, and quality. Psychosis items assessed a range of perceptual, cognitive, and bizarre thought content common in the CHR population. RESULTS Two of the seven psychosis variables were unidirectionally predicted by previous night's number of awakenings: every unit increase in number of nightly awakenings predicted a 0.27 and 0.28 unit increase in feeling unreal or paranoid the next day, respectively. No other sleep variables credibly predicted next-day psychotic symptoms or vice-versa. CONCLUSION In this study, the relationship between sleep disturbance and APS appears specific to the item in question. However, some APS, including perceptual disturbances, had low levels of endorsement amongst this sample. Nonetheless, these results provide evidence for a unidirectional relationship between sleep and some APS in this population.
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Affiliation(s)
- M J C Formica
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - M Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - U Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - M Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, King's College London, London, UK
| | - P Delespaul
- Facalty of Health, Medicine and Life Sciences, Psychiatrie & Neuropsychologie, Maastricht University, Maastricht, The Netherlands
- Mondriaan Mental Health Centre, Maastricht/Heerlen, The Netherlands
| | - L de Haan
- Department of Psychiatry, Early Psychosis, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - B Nelson
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - A Mikocka-Walus
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - L Olive
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - S Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - B Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), European Graduate School of Neuroscience (EURON), Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - G Sachs
- Medical University of Vienna, Vienna, Austria
| | - L Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M van der Gaag
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - P McGuire
- Department of Psychiatry, University of Oxford, Warneford Hospital OX3 7JX, UK
| | - J van Os
- Department of Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - J A Hartmann
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Grimmer HJ, Laukkonen RE, Freydenzon A, von Hippel W, Tangen JM. Thinking style and psychosis proneness do not predict false insights. Conscious Cogn 2022; 104:103384. [PMID: 35933801 DOI: 10.1016/j.concog.2022.103384] [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: 03/03/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 11/03/2022]
Abstract
The FIAT paradigm (Grimmer et al., 2021) is a novel method of eliciting 'Aha' moments for incorrect solutions to anagrams in the laboratory, i.e. false insights. There exist many documented reports of psychotic symptoms accompanying strong feelings of 'Aha!' (Feyaerts, Henriksen, Vanheule, Myin-Germeys, & Sass, 2021; Mishara, 2010; Tulver, Kaup, Laukkonen, & Aru, 2021), suggesting that the newly developed FIAT could reveal whether people who have more false insights are more prone to psychosis and delusional belief. To test this possibility, we recruited 200 participants to take an adapted version of the FIAT and complete measures of thinking style and psychosis proneness. We found no association between experimentally induced false insights and measures of Schizotypy, Need for Cognition, Jumping to Conclusions, Aberrant Salience, Faith in Intuition, or the Cognitive Reflection Task. We conclude that experiencing false insights might not be constrained to any particular type of person, but rather, may arise for anyone under the right circumstances.
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Affiliation(s)
| | | | - Anna Freydenzon
- Institute of Molecular Bioscience, The University of Queensland, Australia
| | | | - Jason M Tangen
- School of Psychology, The University of Queensland, Australia
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Báthori N, Polner B, Simor P. Schizotypy unfolding into the night? Schizotypal traits and daytime psychotic-like experiences predict negative and salient dreams. Schizophr Res 2022; 246:17-25. [PMID: 35696857 DOI: 10.1016/j.schres.2022.05.020] [Citation(s) in RCA: 3] [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: 07/28/2021] [Revised: 03/07/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
Abstract
Symptoms of insomnia and frequent nightmares are prevalent in psychotic disorders, and are associated with psychotic-like experiences (PLEs) in the non-clinical population. Whereas the role of impaired sleep in psychosis was extensively examined by longitudinal and interventional approaches, studies on the association between psychosis and dream quality are scarce, and mainly cross-sectional. We conducted a three-week long prospective study in a group of healthy adults (N = 55), assessed schizotypal traits, daily PLEs, and the emotional quality of dreams recalled in the morning (N = 490). We extracted the latent factors of schizotypal traits and dream emotions, and examined the predictive value of trait-and state-like variables on day-to-day reports of PLEs and dream quality. PLEs reported in the evening predicted emotionally more negative and salient dream reports the following morning. On the other hand, the quality of dreams were not predictive of PLEs reported later during the day. Schizotypal personality traits were differentially associated with dream quality: Introvertive Anhedonia, Cognitive Disorganization, and General-Disorganized schizotypy were linked to more negative dream valence, whereas Unusual Experiences were associated with more salient dreams. Our findings highlight the relevance of the multidimensional nature of schizotypal traits, the role of different facets of schizotypy in daytime and nocturnal mental experiences, and the day-to-day associations between PLEs and dream affect. GENERAL SCIENTIFIC SUMMARIES (GSS): The aim of the study was to examine the temporal associations between psychotic-like experiences and dream emotions, taking into account the trait factors of schizotypy. Psychotic-like experiences during the evening hours predicted reporting more negative and salient dreams the following morning, and schizotypal personality traits were differentially associated with the dimensions of dream emotions.
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Affiliation(s)
- Noémi Báthori
- Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Hungary
| | - Bertalan Polner
- Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Péter Simor
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN-Center for Research in Cognition and Neurosciences and UNI-ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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Pugliese V, de Filippis R, Aloi M, Rotella P, Carbone EA, Gaetano R, De Fazio P. Aberrant salience correlates with psychotic dimensions in outpatients with schizophrenia spectrum disorders. Ann Gen Psychiatry 2022; 21:25. [PMID: 35786401 PMCID: PMC9250738 DOI: 10.1186/s12991-022-00402-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Aberrant salience is a well-known construct associated with the development and maintenance of psychotic symptoms in schizophrenia. However, only a few studies have investigated aberrance salience as a trait, with no study investigating the association between the five aberrant salience domains and psychotic symptoms. We aimed to explore the role of aberrant salience and its domains on psychotic dimensions in both clinically remitted and non-remitted patients. METHODS A sample of 102 patients diagnosed with schizophrenia spectrum disorders was divided according to the Positive and Negative Syndrome Scale (PANSS) remission criteria into two groups: remitted and non-remitted. Differences regarding psychotic symptomatology assessed by the PANSS and aberrant salience measured by the Aberrant Salience Inventory (ASI) were explored. Finally, a correlation analysis between the PANSS and the ASI was run. RESULTS Significantly higher ASI scores were evident among non-remitted patients. Positive symptoms (i.e. delusions, conceptual disorganization, and hallucinatory behaviour) and general psychopathology (i.e. postural mannerisms, unusual thought content) were correlated to the aberrant salience subscales 'sharpening of senses', 'heightened emotionality' and 'heightened cognition' and with the ASI total score. Significant correlations emerged between negative symptoms (blunted affect and social withdrawal) and 'heightened cognition'. Finally, lack of spontaneity of conversation was related to the subscales 'heightened emotionality' and 'heightened cognition', as well as to the ASI total score. CONCLUSIONS These preliminary results support the hypothesis of an association between aberrant salience and psychotic symptoms in schizophrenia. Further research is needed, especially into the mechanisms underlying salience processing, in addition to social and environmental factors and cognitive variables.
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Affiliation(s)
- Valentina Pugliese
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Matteo Aloi
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Paola Rotella
- Department of Mental Health of Catanzaro, Lamezia Terme, Italy
| | - Elvira Anna Carbone
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Raffaele Gaetano
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
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7
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Dawes C, Quinn D, Bickerdike A, O'Neill C, Granger KT, Pereira SC, Mah SL, Haselgrove M, Waddington JL, O'Tuathaigh C, Moran PM. Latent inhibition, aberrant salience, and schizotypy traits in cannabis users. Schizophr Res Cogn 2022; 28:100235. [PMID: 35028297 PMCID: PMC8738960 DOI: 10.1016/j.scog.2021.100235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Declan Quinn
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Andrea Bickerdike
- Department of Sport, Leisure, and Childhood Studies, Munster Technological University, Bishopstown, Cork, Ireland
| | - Cian O'Neill
- Department of Sport, Leisure, and Childhood Studies, Munster Technological University, Bishopstown, Cork, Ireland
| | - Kiri T Granger
- School of Psychology, University of Nottingham, NG7 2RD, UK
- Monument Therapeutics Ltd, Alderley Park, Congleton Road, Macclesfield SK10 4TG, UK
| | - Sarah Carneiro Pereira
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Sue Lynn Mah
- School of Psychology, University of Nottingham, NG7 2RD, UK
| | | | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland
| | - Colm O'Tuathaigh
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| | - Paula M Moran
- School of Psychology, University of Nottingham, NG7 2RD, UK
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Dawes C, Bickerdike A, O'Neill C, Carneiro Pereira S, Waddington JL, Moran PM, O'Tuathaigh CMP. Cannabis Use, Schizotypy and Kamin Blocking Performance. Front Psychiatry 2021; 12:633476. [PMID: 34887781 PMCID: PMC8649723 DOI: 10.3389/fpsyt.2021.633476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Cannabis use has been associated with increased risk for a first episode of psychosis and inappropriate assignment of salience to extraneous stimuli has been proposed as a mechanism underlying this association. Psychosis-prone (especially schizotypal) personality traits are associated with deficits in associative learning tasks that measure salience allocation. The aim of this study was to examine the relationship between history of cannabis use and Kamin blocking (KB), a form of selective associative learning, in a non-clinical sample. Additionally, KB was examined in relation to self-reported schizotypy and aberrant salience scale profiles. A cross-sectional study was conducted in 307 healthy participants with no previous psychiatric or neurological history. Participants were recruited and tested using the Testable Minds behavioural testing platform. KB was calculated using Oades' "mouse in the house task", performance of which is disrupted in schizophrenia patients. Schizotypy was measured using the Schizotypal Personality Questionnaire (SPQ), and the Aberrant Salience Inventory (ASI) was used to assess self-reported unusual or inappropriate salience. The modified Cannabis Experience Questionnaire (CEQm) was used to collect detailed history of use of cannabis and other recreational drugs. Regression models and Bayesian t-tests or ANOVA (or non-parametric equivalents) examined differences in KB based on lifetime or current cannabis use (frequent use during previous year), as well as frequency of use among those who had previously used cannabis. Neither lifetime nor current cannabis use was associated with any significant change in total or trial-specific KB scores. Current cannabis use was associated with higher Disorganised SPQ dimension scores and higher total and sub-scale values for the ASI. A modest positive association was observed between total KB score and Disorganised SPQ dimension scores, but no relationships were found between KB and other SPQ measures. Higher scores on "Senses Sharpening" ASI sub-scale predicted decreased KB score only in participants who have not engaged in recent cannabis use. These results are discussed in the context of our understanding of the effects of long-term cannabis exposure on salience attribution, as well as inconsistencies in the literature with respect to both the relationship between KB and schizotypy and the measurement of KB associative learning phenomena.
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Affiliation(s)
- Christopher Dawes
- School of Psychology, University Park, University of Nottingham, Nottingham, United Kingdom
| | - Andrea Bickerdike
- Department of Sport, Leisure, and Childhood Studies, Munster Technological University, Cork, Ireland
| | - Cian O'Neill
- Department of Sport, Leisure, and Childhood Studies, Munster Technological University, Cork, Ireland
| | - Sarah Carneiro Pereira
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paula M Moran
- School of Psychology, University Park, University of Nottingham, Nottingham, United Kingdom
| | - Colm M P O'Tuathaigh
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
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