Neuroticism and visual memory impairments as predictors of the severity of delusions in schizophrenia

Neurocognitive function and delusion severity in schizophrenia spectrum disorders

The role of basic neurocognitive function in delusions is unclear despite the association to difficulties in reasoning and decision-making. We investigated 812 individuals with schizophrenia spectrum disorders (SSD) using a broad neuropsychological test battery encompassing motor and mental processing speed, working memory, learning and memory, and executive function. Premorbid and current intellectual function was assessed with NART and WASI. Delusion level and other clinical symptoms were measured with the PANSS and GAF. Hierarchical and k-means cluster analysis using standardized scores showed the presence of two separate clusters where the group with the higher delusion level (n = 291) was characterized by more severe neurocognitive deficits (>1.5 standard deviations below the healthy control mean), higher PANSS scores, lower GAF scores, and lower intelligence levels compared to the cluster with mild impairments (n = 521). We conclude that a higher delusion level is related to neurocognitive deficits across domains. Further, the validity of the two separate clusters was indicated by significant differences in clinical symptoms, everyday function, and intellectual ability. Compared to those with mild delusion levels, SSD patients with higher delusion levels seem particularly disadvantaged, with co-occurring general symptoms and lower daily function, underscoring the need for clinical and psychosocial support programs. A limitation of this study is the cross sectional design. Longitudinal studies are needed to determine the causal relationship between delusions and neurocognitive function.

Personality traits in psychotic illness and their clinical correlates: A systematic review

This systematic review focuses on personality traits according to both the Five Factor Model and Cloninger Psychobiological Model in relation to treatment related outcome variables across all stages of clinical psychotic illness. Search of Pubmed and Psychinfo databases led to final inclusion of 65 studies, which were ranked on quality and analyzed according to the associations between personality and outcome. Main findings are that higher levels of Harm Avoidance and Neuroticism are associated with higher symptom levels, tendency towards passive coping, greater self-stigma, lower quality of life, and Harm Avoidance to higher suicidality. Higher levels of Extraversion and higher levels of Self-Directedness are associated with more preference for active coping, more intrinsic motivation and higher self-esteem. Higher Novelty Seeking is related to more substance use and aggression, in men specifically. On outcome of trauma, care consumption and duration of untreated illness no consistent associations with personality traits were found. Combined evidence from both personality models however reveals a consistent pattern of personality traits related to clinical outcome in psychotic disorder, which is discussed in a dimensional manner.

Neuroticism-Withdrawal and Neuroticism-Volatility Differently Influence the Risk of Neuropsychiatric Symptoms in Alzheimer's Disease

BACKGROUND

Neuroticism is recognized as the personality domain that is most strongly associated with behavioral and psychological symptoms (BPS) of Alzheimer's disease (AD). Two sub-components of neuroticism have been recently isolated. Neuroticism-withdrawal (N-withdrawal) refers to the tendency to internalize negative emotion, whereas neuroticism-volatility (N-volatility) reflect the predisposition to externalize negative emotions.

OBJECTIVE

The objective of the current study was to investigate the specific influence of these two sub-components of neuroticism on BPS.

METHODS

One hundred eighty-seven patients with prodromal or mild AD were drawn from the PACO study (Personalité Alzheimer COmportement). Neuroticism and its facets were assessed at baseline using the NEO-PI-R inventory. N-withdrawal and N-volatility were isolated using a principal component analysis led on the six facets composing neuroticism. BPS were measured with the short version of Neuropsychiatric Inventory (NPI-Q) and collected at baseline, then every 6 months over an 18-month follow-up. Linear mixed-effect analyses were conducted to investigate the association between N-withdrawal, N-volatility, and the severity of BPS over the follow-up.

RESULTS

Mean age of the participant was 79.2±6.5; 59% were female; mean MMSE was 24.5±2.5. Both N-volatility and N-withdrawal were related with the NPI-Q (p < 0.001; p = 0,004). N-withdrawal was positively associated with anxiety (p = 0.001) and depression (p = 0.002), while N-volatility was positively related to delusions (p = 0.004), agitation/aggression (p < 0.001), irritability/volatility (p = 0.037), and apathy (p = 0.021).

CONCLUSION

The present study demonstrates that N-volatility and N-withdrawal influence the risk of developing BPS in a different way. These results highlight the relevance of considering sub-components of neuroticism when studying links between personality and BPS.

Aberrant Tendency of Noncurrent Emotional Experiences in Individuals at Ultra-High Risk for Psychosis

OBJECTIVE

This study aimed to investigate whether aberrant tendency of noncurrent emotion was present in individuals at ultra-high risk (UHR) for psychosis and to explore its associations with various clinical profiles.

METHODS

Fifty-seven individuals at UHR and 49 normal controls were enrolled. The tendency of experiencing noncurrent emotion was assessed using various noncurrent emotional self-reported formats, including trait [Neuroticism and Extraversion of the Eysenck Personality Questionnaire], hypothetical (Chapman's Revised Physical and Social Anhedonia Scales), and retrospective [AnhedoniaAsociality Subscale of the Scale for the Assessment of Negative Symptoms (SANS)] measures. Self-related beliefs (Self-Perception Scale), clinical positive and negative symptoms (SA Positive Symptoms and SANS), psychosocial function (Global Functioning Scale: Role Function and Global Functioning Scale: Social Function) were also examined.

RESULTS

Subjects at UHR for psychosis reported more trait unpleasant and less trait pleasant emotions, more hypothetical physical and social anhedonia, and more retrospective anhedonia than normal controls. In UHR, self-perception was correlated to trait unpleasant emotion and hypothetical physical and social anhedonia. Negative symptoms in UHR were associated with hypothetical physical anhedonia and retrospective anhedonia. Global social functioning was related to trait pleasant emotion, hypothetical physical and social anhedonia, and retrospective anhedonia. Neurocognitive function, positive symptoms, and global role functioning were not related with any noncurrent emotional experience measures in UHR.

CONCLUSION

These findings suggest that the aberrant tendency of noncurrent emotional experience may be present at the 'putative' prodromal phase and are grossly associated with self-related beliefs and psychosocial functioning but not neurocognitive functioning.

Relationship between neuroticism, childhood trauma and cognitive-affective responses to auditory verbal hallucinations

Neuroticism has been shown to adversely influence the development and outcome of psychosis. However, how this personality trait associates with the individual’s responses to psychotic symptoms is less well known. Auditory verbal hallucinations (AVHs) have been reported by patients with psychosis and non-clinical individuals. There is evidence that voice-hearers who are more distressed by and resistant against the voices, as well as those who appraise the voices as malevolent and powerful, have poorer outcome. This study aimed to examine the mechanistic association of neuroticism with the cognitive-affective reactions to AVH. We assessed 40 psychotic patients experiencing frequent AVHs, 135 non-clinical participants experiencing frequent AVHs, and 126 healthy individuals. In both clinical and non-clinical voice-hearers alike, a higher level of neuroticism was associated with more distress and behavioral resistance in response to AVHs, as well as a stronger tendency to perceive voices as malevolent and powerful. Neuroticism fully mediated the found associations between childhood trauma and the individuals’ cognitive-affective reactions to voices. Our results supported the role of neurotic personality in shaping maladaptive reactions to voices. Neuroticism may also serve as a putative mechanism linking childhood trauma and psychological reactions to voices. Implications for psychological models of hallucinations are discussed.

Phase-locking index and power of 40-Hz auditory steady-state response are not related to major personality trait dimensions

Although a number of studies have demonstrated state-related dependence of auditory steady-state responses (ASSRs), the investigations assessing trait-related ASSR changes are limited. Five consistently identified major trait dimensions, also referred to as "big five" (Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness), are considered to account for virtually all personality variances in both healthy people and those with psychiatric disorders. The purpose of the present study was, for the first time, to establish the link between 40-Hz ASSR and "big five" major personality trait dimensions in young healthy adults. Ninety-four young healthy volunteers participated (38 males and 56 females; mean age ± SD 22.180 ± 2.75). The 40-Hz click trains were presented for each subject 30 times with an inter-train interval of 1-1.5 s. The EEG responses were recorded from F3, Fz, F4, C3, Cz, C4, P3, Pz and P4 locations according to 10/20 electrode placement system. Phase-locking index (PLI) and event-related power perturbation (ERSP) were calculated, each providing the following characteristics: peak time, entrainment frequency, peak value and mean value. For assessing "big five" personality traits, NEO Personality Inventory Revised (NEO-PI-R) was used. No significant correlation between 40-Hz ASSR PLI or ERSP and "big five" personality traits was observed. Our results indicate that there is no dependence between 40-Hz ASSR entrainment and personality traits, demonstrating low individual 40-Hz variability in this domain. Our results support further development of 40-Hz ASSR as a neurophysiological marker allowing distinguishing between healthy population and patients with psychiatric disorders.

Dimensions of hallucinations and delusions in affective and nonaffective illnesses

The aim of the study was to examine the dimensions of hallucinations and delusions in affective (manic episode, bipolar affective disorder, and depressive episode) and nonaffective disorders (schizophrenia, acute and transient psychotic disorders, and unspecified psychosis). Sixty outpatients divided equally into two groups comprising affective and nonaffective disorders were taken up for evaluation after screening, as per inclusion and exclusion criteria. Scores of 3 or above on delusion and hallucinatory behavior subscales of positive and negative syndrome scale were sufficient to warrant rating on the psychotic symptom rating scales with which auditory hallucination and delusion were assessed on various dimensions. Insight was assessed using the Beck cognitive insight scale (BCIS). There were no significant differences between the two groups on age, sex, marital status, education, and economic status. There were significant differences in total score and emotional characteristic subscale, cognitive interpretation subscale, and physical characteristic subscale of auditory hallucination scales in between the two groups. Correlation between BCIS-total and total auditory hallucinations score was negative (Spearman Rho −0.319; P < 0.05). Hallucinating patients, more in nonaffective group, described a negative impact of hallucinating voices along with emotional consequences on their lives which lead to distress and disruption.

Increased stress reactivity: a mechanism specifically associated with the positive symptoms of psychotic disorder

BACKGROUND

An increased reactivity to stress in the context of daily life is suggested to be an independent risk factor underlying the positive symptoms of psychotic disorder. The aim of this study was to investigate whether positive symptoms moderate the association between everyday stressful events and negative affect (NA), known as stress reactivity. This hypothesis was put to the test in patients with a diagnosis of psychotic disorder. Method The Comprehensive Assessment of Symptoms and History (CASH) and the Positive and Negative Syndrome Scale (PANSS) were used to assess positive and negative symptoms. The experience sampling method (ESM), a structured diary technique, was used to measure stress reactivity and psychotic symptoms in daily life.

RESULTS

Higher levels of positive symptoms (CASH: B = 0.14, p = 0.005; PANSS: B = 0.05, p = 0.000; ESM: B = 0.03, p = 0.000) and lower levels of negative symptoms (PANSS: B = - 0.05, p = 0.001) significantly moderate the association between unpleasant events and NA. No significant moderating effect was found for CASH negative symptoms. Moreover, the moderating effect of lifetime and current symptoms on the stress-NA association was significantly larger for those patients with predominantly positive symptoms (CASH: B = 0.09, p = 0.000; PANSS: B = 0.08, p = 0.000; ESM: B = 0.13, p = 0.000).

CONCLUSIONS

Patients with a 'psychotic syndrome' with high levels of positive symptoms and low levels of negative symptoms show increased reactivity to stress in daily life, indicating that stress reactivity is a possible risk factor underlying this syndrome.

Do personality traits matter when choosing a group therapy for early psychosis?

OBJECTIVES

This study aimed at determining the predictive value of personality traits, based on the Five Factor Model (FFM) of personality, on therapeutic outcomes according to specific group treatments for first episode psychosis: cognitive-behavioural therapy (CBT) or skills training for symptom management (SM).

METHODS

Individuals experiencing early psychosis were recruited to participate in a randomized- controlled trial (RCT). Participants were randomized to one of two group treatments or to a wait-list control group. Measures included a personality inventory (NEO-FFI) and outcome measures of symptomatology (BPRS-E) and coping strategies (CCS). Pearson correlation analyses were conducted on 78 individuals and linear regression analyses on 66.

RESULTS

Links were found between personality traits, symptoms, and coping outcome measures, according to specific group treatments. Personality traits were particularly linked to therapeutic changes in active coping strategies, with Conscientiousness accounting for 14% of the variance in the CBT group, Extraversion accounting for 41% of the variance in the SM group, and Openness to experience accounting for 22% of the variance in the control group.

CONCLUSIONS

Individual differences in personality traits for people experiencing early psychosis should be considered when offering psychosocial treatments, since it appears that those with specific traits might benefit more than others in specific group interventions, particularly for interventions that do not solely aim at improving symptoms.

Affective Dimensions of the Phenomenon of Double Bookkeeping in Delusions

It has been argued that schizophrenic delusions are “behaviourally inert.” This is evidence for the phenomenon of “double bookkeeping,” according to which people are not consistent in their commitment to the content of their delusions. The traditional explanation for the phenomenon is that people do not genuinely believe the content of their delusions. In the article, we resist the traditional explanation and offer an alternative hypothesis: people with delusions often fail to acquire or to maintain the motivation to act on their delusional beliefs. This may be due to avolition, to emotional disturbances, or to the fact that, given the peculiar content of some delusions, the surrounding environment does not support the agent’s motivation to act.

Personality and psychopathology

Personality and psychopathology are increasingly recognized as tightly linked domains of study, despite historical and theoretical divisions. In this paper, we discuss the history of these divisions, models of inter-relations between personality and psychopathology, and selected examples from the literature demonstrating personality/psychopathology inter-relations in clinical and community populations. We begin by summarizing how personality, temperament, and personality disorders are increasingly conceptualized as overlapping entities. We next address relationships between personality traits and common mental illnesses/symptoms (e.g. internalizing and externalizing problems). Then we discuss the various ways in which personality traits may relate to Axis I conditions causally, with methods for distinguishing between them. We conclude with a more in-depth example, relating personality traits to schizophrenia.

Synergistic pathways to delusions: enduring vulnerabilities, proximal life stressors and maladaptive psychological coping

AIM

We sought to extend findings on the vulnerability to psychosis by investigating multifactorial pathways to delusions. Risk factors assessed spanned across early acquired vulnerabilities (heredity, childhood trauma, early cannabis use), proximal life stressors (life hassles, methamphetamine use) and psychological coping (experiential avoidance).

METHODS

Participants were recruited to a non-clinical sample (n = 133) or a clinical sample of psychosis patients (n = 100).

RESULTS

Path analyses indicated three distinct pathways predicting vulnerability to delusions in the non-clinical sample: (i) childhood emotional trauma combined with subsequent experiences of life hassles; (ii) heredity in combination with experiential avoidance; and (iii) early cannabis use combined with proximal methamphetamine use. The first pathway was partially mediated by experiential avoidance. The model was largely replicated in the clinical sample, with childhood sexual trauma replacing emotional trauma in the model.

CONCLUSION

The study demonstrated that vulnerability to delusions can be usefully predicted by a synergistic model incorporating early-acquired vulnerability factors, proximal day-to-day factors and cognitive styles.

Personality traits in early psychosis: relationship with symptom and coping treatment outcomes

AIMS

This study aimed to determine personality profiles of individuals with early psychosis based on the Five Factor Model of personality and assess the predictive value of personality traits or profiles on therapeutic outcomes of two group treatments for recent onset psychosis: cognitive behaviour therapy or skills training for symptom management.

METHODS

One hundred and twenty-nine individuals with early psychosis were recruited to participate in a randomized controlled trial. The participants were randomized to one of two group treatments or to a wait-list control group. Measures included a personality inventory (NEO Five Factor Inventory) and outcome measures of symptomatology (Brief Psychiatric Rating Scale-Expanded) and coping strategies (Cybernetic Coping Scale).

RESULTS

Cluster analyses revealed three different personality profiles (based on the Five Factor Model) - none specifically linked to psychotic symptoms. No links were revealed between personality traits and symptom change scores. Personality traits were linked to therapeutic improvements in active coping strategies, with extraversion accounting for 17% of the variance. Neuroticism was linked to increased use of passive coping strategies. Active coping strategies were also predicted by profile 1 (holding the highest openness score) with 26% of the variance explained and by profile 3 (the highest extraversion score), with 14% of the variance explained.

CONCLUSIONS

Individuals with early psychosis can present with distinct personality profiles as would be expected in a non-clinical population. Personality traits do not appear to influence symptomatic treatment outcomes but are linked to behavioural changes, such as the use of coping strategies.

Affective traits in schizophrenia and schizotypy

This article reviews empirical studies of affective traits in individuals with schizophrenia spectrum disorders, population-based investigations of vulnerability to psychosis, and genetic and psychometric high-risk samples. The review focuses on studies that use self-report trait questionnaires to assess Negative Affectivity (NA) and Positive Affectivity (PA), which are conceptualized in contemporary models of personality as broad, temperamentally-based dispositions to experience corresponding emotional states. Individuals with schizophrenia report a pattern of stably elevated NA and low PA throughout the illness course. Among affected individuals, these traits are associated with variability in several clinically important features, including functional outcome, quality of life, and stress reactivity. Furthermore, evidence that elevated NA and low PA (particularly the facet of anhedonia) predict the development of psychosis and are detectable in high-risk samples suggests that these traits play a role in vulnerability to schizophrenia, though they are implicated in other forms of psychopathology as well. Results are discussed in terms of their implications for treatment, etiological models, and future research to advance the study of affective traits in schizophrenia and schizotypy.

Arousability in schizophrenia: relationship to emotional and physiological reactivity and symptom severity

OBJECTIVE

Socioenvironmental stressors have been linked with increased symptom severity and relapse in those with schizophrenia. However, little is known about how individual differences in stress reactivity may contribute to these outcomes.

METHOD

This study examined the association between the temperament characteristic of arousability and changes in negative affect and cardiovascular activity during a challenge task in 58 in-patients with diagnosis of schizophrenia and 21 controls.

RESULTS

In the patient group, levels of arousability were significantly associated with increases in negative affect in response to the task and greater severity of affective symptoms. Levels of arousability were associated with decreased heart rate during the challenge task in our patient group.

CONCLUSION

These findings suggest that greater attention be given to individual differences, such as temperament and personality characteristics, and their role in the experience of stressors, including emotional and physiological response, as well as symptom development.

Normal personality characteristics in schizophrenia: a review of the literature involving the FFM

Schizophrenia is generally viewed as a disruption of normal functioning because of an underlying core illness. A number of theorists have speculated that this core illness may unilaterally disrupt normal personality functioning. However, recent data suggests that the relationship may be more complex and reciprocal than previously conceptualized. Furthermore, basic personality characteristics appear to be associated with numerous clinical phenomena. This article reviews the empirical literature pertaining to normal personality characteristics [structured around the five-factor model (FFM) of personality] in individuals with schizophrenia. Evidence suggests that certain personality characteristics may be uniquely related to the etiology of psychosis, as well as symptom severity, occupational functioning, cigarette smoking, substance use and violent behavior, social isolation, and suicidality in patients with schizophrenia. The implications of these findings and suggestions for future research are discussed.

Stress-reactivity in psychosis: evidence for an affective pathway to psychosis

This paper will review a series of studies using the Experience Sampling Method that suggest that altered sensitivity to stress is an endophenotype for psychosis. The Experience Sampling Method is a structured diary technique allowing the assessment of emotional reactivity to stressors occurring in normal daily life. Elevated emotional reactivity to stress was found in subjects vulnerable to psychosis, suggesting that affective responses to stressors in the flow of daily life are an indicator of genetic and/or environmental liability to psychosis. Indeed, the small stressors in daily life associated with affective responses also predict more intense moment-to-moment variation of subtle positive psychotic experiences. Increased emotional reactivity was found to be independent from cognitive impairments, and argued to constitute evidence of an affective pathway to psychosis that may underlie a more episodic, reactive, good-outcome type of psychosis. Evidence for this hypothesis was found in data suggesting that the experience of stressful life events and early trauma were associated with increased stress-sensitivity, and that women were more likely to display elevated stress-reactivity. These findings are discussed in the light of recent biological and psychological mechanisms.

Neuropsychological correlates of reality distortion in schizophrenic patients

The present study aims at exploring the relationship between content-related aspects of delusions and hallucinations in schizophrenia and the basic domains of cognition, controlling for the other clinical and demographic variables that could produce bias in the interpretation of the results. Seventy stable schizophrenic patients were evaluated through psychiatric assessment and a neuropsychological battery including tests on attention, memory, perceptual-motor speed and executive functions. We found that the severity of negative symptoms was strongly correlated with poor performance in almost all domains of cognitive functions, while only the attentional deficit was correlated with positive symptoms. The relationships between different cognitive domains and specific types of delusions and hallucinations showed that thought insertion, guilt, grandiose, religious and somatic delusions were associated with impairment in different cognitive functions (verbal and visual memory, attention and executive functions). Voices arguing and tactile hallucinations were correlated to delay-recall memory function. Our results suggest that no specific cognitive pattern is associated with typical-content delusions and hallucinations. On the basis of our findings, cognitive impairments associated with delusions and hallucinations, as measured by our battery, seem not to play a central role in the genesis and the maintenance of these symptoms, suggesting a more complex model of pathogenesis.

Associations between delusion proneness and personality structure in non-clinical participants: comparison between young and elderly samples

BACKGROUND

Few studies have explored the prevalence of delusions in the non-clinical, elderly population. In addition, the association between personality structure and delusions remains poorly investigated. The aims of the present study were, first, to explore the relation between age and the prevalence of delusion proneness and, second, to examine the association between personality and delusion proneness in young and elderly participants.

SAMPLING AND METHODS

A sample of young (n = 343; aged 18-30 years) and elderly (n = 183; aged 60-75 years) non-clinical participants completed the 21-item version of the Peters et al. Delusions Inventory (PDI-21), an elaborated and validated version of the Launay-Slade Hallucinations Scale, and the revised version of the NEO Personality Inventory (NEO-PI-R).

RESULTS

Mean scores on the PDI-21 for the young and elderly participants were compared. An independent t test revealed that the total mean scores were significantly higher for young participants compared to elderly participants. PDI-21 items were then re-grouped into previously validated factors. Independent t tests revealed that young participants had significantly higher scores for items related to suspiciousness and persecutory ideas, thought disturbances and jealousy, grandiose ideas, paranormal beliefs and apocalyptic ideas. In contrast, elderly participants scored significantly higher than young participants on the religious ideation factor. Associations between scores on the NEO-PI-R and the PDI-21 were then examined for the two groups. For the young sample, correlational analyses revealed a significant relationship between the total score on the PDI-21 and scores on the openness, neuroticism and agreeability facets of the NEO-PI-R. For the elderly sample, correlational analyses revealed a significant relationship between the total score on the PDI-21 and the openness facet of the NEO-PI-R.

DISCUSSION

Results from the study reveal that delusional ideation is a relatively common experience for both young and elderly non-clinical participants. In addition, findings are in line with studies suggesting that neuroticism and aspects related to neuroticism increase the risk for the development of psychotic symptoms such as delusions. However, it is important to mention that, because the present study includes non-clinical subjects and is a cross-sectional study, more research is needed.

Reasoning, emotions, and delusional conviction in psychosis

The aim of the study was to elucidate the factors contributing to the severity and persistence of delusional conviction. One hundred participants with current delusions, recruited for a treatment trial of psychological therapy (PRP trial), were assessed at baseline on measures of reasoning, emotions, and dimensions of delusional experience. Reasoning biases (belief inflexibility, jumping to conclusions, and extreme responding) were found to be present in one half of the sample. The hypothesis was confirmed that reasoning biases would be related to delusional conviction. There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction. Emotional states were not associated with the reasoning processes investigated. Anxiety, but not depression, made an independent contribution to delusional conviction.

Agreeableness and neuroticism as predictors of relapse after first-episode psychosis: a prospective follow-up study

Cross-sectional investigations, using the five-factor model of personality have evinced relationships among neuroticism, agreeableness, and psychotic symptoms. The current study examined these relationships via a prospective follow-up study with remitted first-episode psychosis patients. Baseline five-factor model personality profiles, diagnoses, symptom ratings, and premorbid adjustment ratings were followed by nine monthly ratings on Brief Psychiatric Rating Scale psychosis items in 60 first-episode patients. Valid baseline personality profiles were completed by 40 patients. Patients who had a return of symptoms scored higher on baseline neuroticism and agreeableness than those who remained in remission. Premorbid adjustment also predicted return of symptoms. After premorbid adjustment was controlled for, the agreeableness differences remained significant, but the neuroticism scores were no longer significantly different. It is concluded that lower agreeableness acts as a mediating variable in relapse. Further studies should clarify whether agreeableness is associated with specific biases in processing interpersonal information, and interpersonal behaviors.

Social function in schizophrenia and schizoaffective disorder: associations with personality, symptoms and neurocognition

BACKGROUND

Research has indicated that stable individual differences in personality exist among persons with schizophrenia spectrum disorders predating illness onset that are linked to symptoms and self appraised quality of life. Less is known about how closely individual differences in personality are uniquely related to levels of social relationships, a domain of dysfunction in schizophrenia more often linked in the literature with symptoms and neurocognitive deficits. This study tested the hypothesis that trait levels of personality as defined using the five-factor model of personality would be linked to social function in schizophrenia.

METHODS

A self-report measure of the five factor model of personality was gathered along with ratings of social function, symptoms and assessments of neurocognition for 65 participants with schizophrenia or schizoaffective disorder.

RESULTS

Univariate correlations and stepwise multiple regression indicated that frequency of social interaction was predicted by higher levels of the trait of Agreeableness, fewer negative symptoms, better verbal memory and at the trend level, lesser Neuroticism (R2 =.42, p <.0001). In contrast, capacity for intimacy was predicted by fewer negative symptoms, higher levels of Agreeableness, Openness, and Conscientiousness and at the trend level, fewer positive symptoms (R2 =.67, p <.0001).

CONCLUSIONS

Taken together, the findings of this study suggest that person-centered variables such as personality, may account for some of the broad differences seen in outcome in schizophrenia spectrum disorders, including social outcomes. One interpretation of the results of this study is that differences in personality combine with symptoms and neurocognitive deficits to affect how persons with schizophrenia are able to form and sustain social connections with others.